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


                     THE BUDGET FOR FISCAL YEAR 2006

[[Page 427]]

 
                 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; [$1,788,478,000] $1,856,676,000, of which $7,000,000 shall 
remain available until expended for plans, construction, extension, 
alteration, and purchase of fixed equipment or facilities: Provided, 
That of the amount provided under this heading, [$284,394,000] 
$305,332,000 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, and shall not include any fees 
pursuant to 21 U.S.C. 379h(a)(2) and (a)(3) assessed for fiscal year 
2007 but collected in fiscal year 2006; [$33,938,000] $40,300,000 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 [$8,354,000] $11,318,000 shall be derived from animal drug 
user fees authorized by 21 U.S.C. 379j, and shall be credited to this 
account and remain available until expended: Provided further, That fees 
derived from prescription drug, medical device, and animal drug 
assessments received during fiscal year [2005] 2006, including any such 
fees assessed prior to the current fiscal year but credited during the 
current year, shall be subject to the fiscal year [2005] 2006 
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) $439,038,000 shall be for the Center for Food Safety and Applied 
Nutrition and related field activities in the Office of Regulatory 
Affairs; (2) $498,647,000 shall be for the Center for Drug Evaluation 
and Research and related field activities in the Office of Regulatory 
Affairs; (3) $172,714,000 shall be for the Center for Biologics 
Evaluation and Research and for related field activities in the Office 
of Regulatory Affairs; (4) $98,964,000 shall be for the Center for 
Veterinary Medicine and for related field activities in the Office of 
Regulatory Affairs; (5) $235,078,000 shall be for the Center for Devices 
and Radiological Health and for related field activities in the Office 
of Regulatory Affairs; (6) $40,530,000 shall be for the National Center 
for Toxicological Research; (7) $57,722,000 shall be for Rent and 
Related activities, other than the amounts paid to the General Services 
Administration for rent; (8) $129,815,000 shall be for payments to the 
General Services Administration for rent; and (9) $115,970,000 shall be 
for other activities, including the Office of the Commissioner; the 
Office of Management; 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. 
(Agriculture, Rural Development, Food and Drug Administration, and 
Related Agencies Appropriations Act, 2005.)

                Unavailable Receipts (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9911-0-1-554      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
    Receipts:
02.20 Cooperative research and 
        development agreements, FDA.....           2           2           2
    Appropriations:
05.00 Salaries and expenses.............          -2          -2          -2
                                           ---------   ---------  ----------
07.99 Balance, end of year..............
---------------------------------------------------------------------------

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9911-0-1-554      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Foods.............................         412         435         461
00.02 Drugs.............................         498         505         507
00.03 Devices and radiological products.         191         215         221
00.04 National Center for Toxicological 
        Research........................          40          40          41
00.05 Other activities..................          91          87          87
00.06 Other rent and rent related 
        activities......................          38          54          58
00.07 Rental payments...................         114         114         117
00.08 Buildings and facilities..........          23                       7
00.09 CRADAs............................           2           2           2
09.01 Reimbursable program..............         306         379         411
                                           ---------   ---------  ----------
10.00   Total new obligations...........       1,715       1,831       1,912
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance carried 
        forward, start of year..........          65          78          61
22.00 New budget authority (gross)......       1,719       1,814       1,900
22.10 Resources available from 
        recoveries of prior year 
        obligations.....................           9
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......       1,793       1,892       1,961
23.95 Total new obligations.............      -1,715      -1,831      -1,912
                                           ---------   ---------  ----------
24.40   Unobligated balance carried 
          forward, end of year..........          78          61          49
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.00   Appropriation...................       1,394       1,462       1,500
40.35   Appropriation permanently 
          reduced.......................          -8         -12
                                           ---------   ---------  ----------
43.00     Appropriation (total 
            discretionary)..............       1,386       1,450       1,500
      Mandatory:

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

        Discretionary:
68.00     Offsetting collections (cash).         354         379         411
68.10     Change in uncollected customer 
            payments from Federal 
            sources (unexpired).........           1
68.26     Offsetting collections 
            (previously unavailable)....         139         163         180
68.45     Portion precluded from 
            obligation (limitation on 
            obligations)................        -163        -180        -193
                                           ---------   ---------  ----------
68.90       Spending authority from 
              offsetting collections 
              (total discretionary).....         331         362         398
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................       1,719       1,814       1,900
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..         460         408         542
73.10 Total new obligations.............       1,715       1,831       1,912
73.20 Total outlays (gross).............      -1,770      -1,697      -1,888
73.40 Adjustments in expired accounts 
        (net)...........................           3
73.45 Recoveries of prior year 
        obligations.....................          -9
74.00 Change in uncollected customer 
        payments from Federal sources 
        (unexpired).....................          -1
74.10 Change in uncollected customer 
        payments from Federal sources 
        (expired).......................          10
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..         408         542         566
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................       1,440       1,450       1,523
86.93 Outlays from discretionary 
        balances........................         329         245         363
86.97 Outlays from new mandatory 
        authority.......................           1           2           2
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       1,770       1,697       1,888
----------------------------------------------------------------------------

[[Page 428]]



    Offsets:
      Against gross budget authority and outlays:

        Offsetting collections (cash) 
            from:
88.00     Federal sources...............         -57         -34         -34
88.40     Non-Federal sources...........        -334        -345        -377
                                           ---------   ---------  ----------
88.90       Total, offsetting 
              collections (cash)........        -391        -379        -411
      Against gross budget authority only:

88.95   Change in uncollected customer 
          payments from Federal sources 
          (unexpired)...................          -1
88.96   Portion of offsetting 
          collections (cash) credited to 
          expired accounts..............          37
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................       1,364       1,435       1,489
90.00 Outlays...........................       1,379       1,318       1,477
94.01 Unavailable balance, start of 
        year: Offsetting collections....                     163         180
94.02 Unavailable balance, end of year: 
        Offsetting collections..........         163         180         193
---------------------------------------------------------------------------

                        [In millions of dollars]

                                        2004         2005        2006
Distribution of budget authority by 
    account:
  Salaries and expenses.............       1,339       1,433       1,480
  Buildings and facilities..........          23           0           7
Distribution of outlays by account:
  Salaries and expenses.............       1,356       1,313       1,472
  Buildings and facilities..........          23           5           5

                             Performance Metrics

----------------------------------------------------------------------------
Identification code 75-9911-0-1-554      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
    Food and Drug Administration:
105701Reduce administrative staff.......       3,086       2,623
105704Percentage of medical device 
        submissions that will receive 
        final decisions within 320 
        review days.....................                     70%         80%
---------------------------------------------------------------------------

    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 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, 
drug safety, medical device reviews, and moving expenses for a new Human 
Drugs facility in White Oak, Maryland.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9911-0-1-554      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

      Direct obligations:

        Personnel compensation:
11.1      Full-time permanent...........         549         639         638
11.3      Other than full-time permanent          64          40          39
11.5      Other personnel compensation..          22          22          22
11.7      Military personnel............          43          36          36
                                           ---------   ---------  ----------
11.9        Total personnel compensation         678         737         735
12.1    Civilian personnel benefits.....         161         156         156
12.2    Military personnel benefits.....          23          17          17
13.0    Benefits for former personnel...           7
21.0    Travel and transportation of 
          persons.......................          23          24          25
22.0    Transportation of things........           4           5           5
23.1    Rental payments to GSA..........         114         114         118
23.2    Rental payments to others.......           4           5           5
23.3    Communications, utilities, and 
          miscellaneous charges.........          23          24          27
24.0    Printing and reproduction.......           2           2           3
25.1    Advisory and assistance services          39          48          43
25.2    Other services..................          83          87          90
25.3    Other purchases of goods and 
          services from Government 
          accounts......................          76          80          83
25.4    Operation and maintenance of 
          facilities....................          49          50          52
25.5    Research and development 
          contracts.....................          19          20          22
25.7    Operation and maintenance of 
          equipment.....................          22          22          25
26.0    Supplies and materials..........          19          19          22
31.0    Equipment.......................          25          25          30
32.0    Land and structures.............          22           1           6
41.0    Grants, subsidies, and 
          contributions.................          22          23          45
44.0    Refunds.........................          -6          -7          -8
                                           ---------   ---------  ----------
99.0      Direct obligations............       1,409       1,452       1,501
99.0  Reimbursable obligations..........         306         379         411
                                           ---------   ---------  ----------
99.9    Total new obligations...........       1,715       1,831       1,912
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-9911-0-1-554      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
    Direct:
      Total compensable workyears:

1001    Civilian full-time equivalent 
          employment....................       7,959       7,957       7,746
1101    Military full-time equivalent 
          employment....................         608         601         588
    Reimbursable:
      Total compensable workyears:

2001    Civilian full-time equivalent 
          employment....................       1,495       1,701       1,738
2101    Military full-time equivalent 
          employment....................         113         125         132
---------------------------------------------------------------------------

                                

Public enterprise funds:

           Revolving Fund for Certification and Other Services

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-4309-0-3-554      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
09.01 Reimbursable program..............           6           6           6
                                           ---------   ---------  ----------
10.00   Total new obligations...........           6           6           6
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance carried 
        forward, start of year..........           2           1
22.00 New budget authority (gross)......           5           5           6
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......           7           6           6
23.95 Total new obligations.............          -6          -6          -6
                                           ---------   ---------  ----------
24.40   Unobligated balance carried 
          forward, end of year..........           1
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

69.00   Offsetting collections (cash)...           5           5           6
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..           2           2           2
73.10 Total new obligations.............           6           6           6
73.20 Total outlays (gross).............          -6          -6          -6
                                           ---------   ---------  ----------
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          -6
----------------------------------------------------------------------------

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



[[Page 429]]



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

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-4309-0-3-554      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
11.1  Personnel compensation: Full-time 
        permanent.......................           2           2           2
12.1  Civilian personnel benefits.......           1           1           1
23.1  Rental payments to GSA............           1           1           1
23.3  Communications, utilities, and 
        miscellaneous charges...........           1
25.2  Other services....................           1           1           1
31.0  Equipment.........................                       1           1
                                           ---------   ---------  ----------
99.9    Total new obligations...........           6           6           6
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-4309-0-3-554      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
    Reimbursable:
2001  Total compensable workyears: 
        Civilian full-time equivalent 
        employment......................          35          38          38
---------------------------------------------------------------------------

                                


 
              HEALTH RESOURCES AND SERVICES ADMINISTRATION

                              Federal Funds

General and special funds:

                      Health Resources and Services

    For carrying out titles II, III, IV, VII, VIII, X, XII, [XIX,] and 
XXVI of the Public Health Service Act, section 427(a) of the Federal 
Coal Mine Health and Safety Act, title V 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, [section 
712 of the American Jobs Creation Act of 2004,] and the Poison Control 
Center Enhancement and Awareness Act, as amended, [$6,856,624,000, of 
which $484,629,000 shall be available for construction and renovation 
(including equipment) of health care and other facilities and other 
health-related activities as specified in the statement of the managers 
on the conference report accompanying this Act, and of which $39,499,000 
from general revenues, notwithstanding section 1820(j) of the Social 
Security Act, shall be available for carrying out the Medicare rural 
hospital flexibility grants program under section 1820 of such Act: 
Provided, That of the funds made available under this heading, $249,000] 
$5,966,144,000, of which $222,000 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 $31,000,000 of the funding provided for 
community health centers shall be used for base grant adjustments for 
existing centers: Provided further, That no more than $100,000 is 
available until expended for carrying out the provisions of 42 U.S.C. 
233(o) including associated administrative expenses:]  Provided further, 
That $26,000,000 of the funding provided for Health Centers shall be 
used for high-need counties, notwithstanding section 330(s)(2)(B) of the 
Public Health Service Act: Provided further, That no more than 
[$45,000,000] $45,000,000 is available until expended for carrying out 
the provisions of Public Law 104-73: [Provided further, That $9,941,000 
is available until expended for the National Cord Blood Stem Cell Bank 
Program as described in House Report 108-401:] Provided further, That of 
the funds made available under this heading, [$288,963,000] $285,963,000 
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 [$793,872,000] $797,521,000 shall be for State AIDS Drug Assistance 
Programs authorized by section 2616 of the Public Health Service Act: 
Provided further, That in addition to amounts provided herein, 
[$25,000,000] $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 $119,158,000 is available for carrying out special 
projects of regional and national significance pursuant to section 
501(a)(2) of such Act: Provided further, That of the funds provided, 
$40,000,000 shall be provided to the Denali Commission as a direct lump 
payment pursuant to Public Law 106-113, of which $10,000,000 shall be 
for a psychiatric treatment facility in Bethel, Alaska, $10,000,000 
shall be for residential and supportive housing for elders, $2,500,000 
shall be for medical and dental equipment for rural clinics, and 
$5,000,000 shall be for upgrade and construction of shelters for victims 
of domestic violence and child abuse]. (Department of Health and Human 
Services Appropriations Act, 2005.)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0350-0-1-550      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.02 Loan guarantee subsidy............           2           1           1
00.07 Reestimates of loan guarantee 
        subsidy.........................                       1
00.10 Health centers....................       1,573       1,690       1,993
00.11 National Health Service Corps.....          45          45          41
00.12 National Health Service Corps 
        recruitment.....................         124          86          86
00.13 Hansen's disease center...........          17          17          16
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 education loan repayment 
        and scholarships................          26          31          31
00.17 Health professions................         410         416         129
00.18 Maternal and child health block 
        grant...........................         730         724         724
00.19 Healthy start.....................          98         102          98
00.20 Poison control centers............          24          23          23
00.21 EMS for children..................          20          20
00.22 Universal newborn hearing 
        screening.......................          10          10
00.23 HIV/AIDS..........................       2,040       2,048       2,058
00.24 Organ transplantation.............          25          24          23
00.25 Bone marrow donor registry........          23          25          23
00.26 Rural health policy development...           9           9           9
00.27 Rural health outreach grants......          40          39          11
00.28 Rural health flexibility grants...          39          39
00.29 Denali Commission.................          35          39
00.30 Telehealth........................           4           4           4
00.31 Program management................         149         147         146
00.32 Family planning...................         278         286         286
00.33 Abstinence education..............          31
00.36 Health centers tort claim fund....          56          45          45
00.37 Trauma EMS........................           3           3
00.39 Childrens' GME....................         303         298         200
00.41 Community based abstinence grants.          70
00.42 State offices of rural health.....           8           8           8
00.43 Healthy communities access program          83          82
00.44 State planning grant program......          15          11
00.45 Rural and community access to 
        emergency devices...............          11           9           2
00.46 Radiogenic diseases...............           2           2           2
00.47 Traumatic brain injury............           9           9
00.49 Health care facilities 
        construction and miscellaneous 
        projects........................         371         478
00.50 Cord blood stem cell bank.........           1           2           8
00.52 Free clinic medical malpractice...                                   1
                                           ---------   ---------  ----------
03.00   Total direct programs...........       6,692       6,781       5,976
09.01 Reimbursable program..............         161         130         130
                                           ---------   ---------  ----------
10.00   Total new obligations...........       6,853       6,911       6,106
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance carried 
        forward, start of year..........          64          71          81
22.00 New budget authority (gross)......       6,868       6,921       6,096
                                           ---------   ---------  ----------

[[Page 430]]


23.90   Total budgetary resources 
          available for obligation......       6,932       6,992       6,177
23.95 Total new obligations.............      -6,853      -6,911      -6,106
23.98 Unobligated balance expiring or 
        withdrawn.......................          -8
                                           ---------   ---------  ----------
24.40   Unobligated balance carried 
          forward, end of year..........          71          81          71
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.00   Appropriation...................       6,705       6,859       5,966
40.35   Appropriation permanently 
          reduced.......................         -42         -56
41.00   Transferred to other accounts...                     -13
                                           ---------   ---------  ----------
43.00     Appropriation (total 
            discretionary)..............       6,663       6,790       5,966
      Mandatory:

60.00   Appropriation...................          38
60.00   Appropriation...................                       1
                                           ---------   ---------  ----------
62.50     Appropriation (total 
            mandatory)..................          38           1
      Spending authority from offsetting 
          collections:

        Discretionary:
68.00     Offsetting collections (cash).          84         130         130
68.10     Change in uncollected customer 
            payments from Federal 
            sources (unexpired).........          48
                                           ---------   ---------  ----------
68.90       Spending authority from 
              offsetting collections 
              (total discretionary).....         132         130         130
      Mandatory:

69.00   Offsetting collections 
          (cash)(HPSL&NSL)..............          35
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................       6,868       6,921       6,096
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..       5,484       5,538       5,750
73.10 Total new obligations.............       6,853       6,911       6,106
73.20 Total outlays (gross).............      -6,702      -6,699      -6,583
73.40 Adjustments in expired accounts 
        (net)...........................         -53
74.00 Change in uncollected customer 
        payments from Federal sources 
        (unexpired).....................         -48
74.10 Change in uncollected customer 
        payments from Federal...........       6,702       6,699       6,583
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

        Offsetting collections (cash) 
            from:
88.00     Federal sources...............         -69        -100        -100
88.40     Non-Federal sources...........         -54         -30         -30
                                           ---------   ---------  ----------
88.90       Total, offsetting 
              collections (cash)........        -123        -130        -130
      Against gross budget authority only:

88.95   Change in uncollected customer 
          payments from Federal sources 
          (unexpired)...................         -48
88.96   Portion of offsetting 
          collections (cash) credited to 
          expired accounts..............           4
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................       6,701       6,791       5,966
90.00 Outlays...........................       6,579       6,569       6,453
---------------------------------------------------------------------------

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

----------------------------------------------------------------------------
Identification code 75-0350-0-1-550      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
    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...........           9           5           5
                                           ---------   ---------  ----------
215901Total loan guarantee levels.......          13          17          17
    Guaranteed loan subsidy (in percent):
232001Health centers: Facilities 
        renovation loan guarantee levels        3.52        3.57        3.50
232002Health centers: Managed care 
        network development loan 
        guarantee levels................        9.28        9.28        8.00
232003Health centers: Managed care plan 
        loan guarantee levels...........       16.61        7.33        8.17
                                           ---------   ---------  ----------
232901Weighted average subsidy rate.....       12.58        5.35        5.40
    Guaranteed loan subsidy budget authority:
233001Health centers: Facilities 
        renovation loan guarantee levels                       1           1
233002Health centers: Managed care 
        network development loan 
        guarantee levels................
233003Health centers: Managed care plan 
        loan guarantee levels...........           2
                                           ---------   ---------  ----------
233901Total subsidy budget authority....           2           1           1
    Guaranteed loan subsidy outlays:
234001Health centers: Facilities 
        renovation loan guarantee levels           2           1           1
234002Health centers: Managed care 
        network development loan 
        guarantee levels................
234003Health centers: Managed care plan 
        loan guarantee levels...........
                                           ---------   ---------  ----------
234901Total subsidy outlays.............           2           1           1
    Guaranteed loan upward reestimate subsidy 
                budget authority:
235007Upward reestimate subsidy budget 
        authority--Facilities Loans.....
235007Upward reestimate subsidy budget 
        authority--HMO Plan Loans.......                       1
                                           ---------   ---------  ----------
235901Total upward reestimate budget 
        authority.......................                       1
----------------------------------------------------------------------------

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

    Activities displayed here support categorical health resources and 
services grants, treatment and care for those living with HIV/AIDS, and 
the medical malpractice claims funds, which pay malpractice claims filed 
against employees of federally-supported health centers and free 
clinics. 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      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

      Direct obligations:

        Personnel compensation:
11.1      Full-time permanent...........         101         114         101
11.3      Other than full-time permanent           3           3           3
11.5      Other personnel compensation..           2           2           2
11.7      Military personnel............          26          26          26
                                           ---------   ---------  ----------
11.9        Total personnel compensation         132         145         132
12.1    Civilian personnel benefits.....          23          25          23
12.2    Military personnel benefits.....          13          14          14
13.0    Benefits for former personnel...           3           1           1
21.0    Travel and transportation of 
          persons.......................           3           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          64          64          64
25.2    Other services..................          95          90          90
25.3    Other purchases of goods and 
          services from Government 
          accounts......................         149         140         140
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           3           3
26.0    Supplies and materials..........           2           2           2
31.0    Equipment.......................           1           1           1
33.0    Investments and loans...........           5
41.0    Grants, subsidies, and 
          contributions.................       6,128       6,217       5,427
42.0    Insurance claims and indemnities          50          55          56
                                           ---------   ---------  ----------
99.0      Direct obligations............       6,692       6,780       5,976
99.0  Reimbursable obligations..........         161         131         130
                                           ---------   ---------  ----------
99.9    Total new obligations...........       6,853       6,911       6,106
---------------------------------------------------------------------------

[[Page 431]]



                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-0350-0-1-550      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
    Direct:
      Total compensable workyears:

1001    Civilian full-time equivalent 
          employment....................       1,315       1,412       1,195
1101    Military full-time equivalent 
          employment....................         270         254         254
    Reimbursable:
      Total compensable workyears:

2001    Civilian full-time equivalent 
          employment....................          73         145         145
2101    Military full-time equivalent 
          employment....................         163         179         179
    Allocation account:
      Total compensable workyears:

3001    Civilian full-time equivalent 
          employment....................          16          16          16
3101    Military full-time equivalent 
          employment....................          20          20          20
---------------------------------------------------------------------------

                                

                       Vaccine Injury Compensation

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0320-0-1-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Direct program activity...........           3
                                           ---------   ---------  ----------
10.00   Total new obligations (object 
          class 42.0)...................           3
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance carried 
        forward, start of year..........           2
22.00 New budget authority (gross)......           2
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......           4
23.95 Total new obligations.............          -3
                                           ---------   ---------  ----------
24.40   Unobligated balance carried 
          forward, end of year..........
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

69.00   Offsetting collections (cash)...           2
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..                       2
73.10 Total new obligations.............           3
73.20 Total outlays (gross).............          -2          -2
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..           2
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.98 Outlays from mandatory balances...           2           2
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.40   Offsetting collections (cash) 
          from: Non-Federal sources.....          -2
----------------------------------------------------------------------------

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

    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 2006 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.

                                

Credit accounts:

             Health Center Guaranteed Loan Financing Account

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-4442-0-3-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance carried 
        forward, start of year..........           1           2           3
22.00 New financing authority (gross)...           2           1           1
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......           3           3           4
23.95 Total new obligations.............
                                           ---------   ---------  ----------
24.40   Unobligated balance carried 
          forward, end of year..........           2           3           4
----------------------------------------------------------------------------

    New financing authority (gross), detail:
      Discretionary:

68.00   Spending authority from 
          offsetting collections: 
          (Federal sources: From program 
          account)......................                       1           1
      Mandatory:

69.00   Offsetting collections (cash)...           2
                                           ---------   ---------  ----------
70.00   Total new financing authority 
          (gross).......................           2           1           1
----------------------------------------------------------------------------

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

    Offsets:
      Against gross financing authority and 
          financing disbursements:

        Offsetting collections (cash) 
            from:
88.00     Federal sources...............          -2          -1          -1
88.40     Non-Federal sources...........
                                           ---------   ---------  ----------
88.90       Total, offsetting 
              collections (cash)........          -2          -1          -1
----------------------------------------------------------------------------

    Net financing authority and financing 
        disbursements:
89.00 Financing authority...............
90.00 Financing disbursements...........          -2          -1          -1
---------------------------------------------------------------------------

             Status of Guaranteed Loans (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-4442-0-3-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
    Position with respect to appropriations act 
                limitation on commitments:
2111  Limitation on guaranteed loans 
        made by private lenders.........
2121  Limitation available from carry-
        forward.........................         134         117         100
2143  Uncommitted limitation carried 
        forward.........................        -121        -100         -83
                                           ---------   ---------  ----------
2150    Total guaranteed loan 
          commitments...................          13          17          17
2199  Guaranteed amount of guaranteed 
        loan commitments................          10          14          14
----------------------------------------------------------------------------

    Cumulative balance of guaranteed loans 
                outstanding:
2210  Outstanding, start of year........          10          23          40
2231  Disbursements of new guaranteed 
        loans...........................          13          17          17
2251  Repayments and prepayments........
2264  Adjustments: Other adjustments, 
        net.............................
                                           ---------   ---------  ----------
2290    Outstanding, end of year........          23          40          57
----------------------------------------------------------------------------

    Memorandum:
2299  Guaranteed amount of guaranteed 
        loans outstanding, end of year..          21          38          55
---------------------------------------------------------------------------

    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.

[[Page 432]]

                             Balance Sheet (in millions of dollars)

-----------------------------------------------------------------------------------------------
Identification code   75-4442-0-3-551

2003 actual

2004 actual

-----------------------------------------------------------------------------------------------
    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





4999

Total liabilities and net position

1

1

-----------------------------------------------------------------------------------------------

                                

            Health Education Assistance Loans Program Account

    Such sums as may be necessary to carry out the purpose of the 
program, as authorized by title VII of the Public Health Service Act, as 
amended. For administrative expenses to carry out the guaranteed loan 
program, including section 709 of the Public Health Service Act, 
[$3,270,000] $2,916,000. (Department of Health and Human Services 
Appropriations Act, 2005.)

        General Fund Credit Receipt Accounts (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0340-0-1-552      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
0101  Negative subsidies/subsidy 
        reestimates.....................          49          55
---------------------------------------------------------------------------

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0340-0-1-552      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.02 Guarantee loan subsidy............          25
00.07 Reestimates of Subsidy............           1           7
00.08 Interest on Reestimates...........           1           1
00.09 Administrative expenses...........           3           3           3
                                           ---------   ---------  ----------
10.00   Total new obligations...........          30          11           3
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......          28          11           3
23.95 Total new obligations.............         -30         -11          -3
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.00   Appropriation...................           3           3           3
      Mandatory:

60.00   Appropriation...................          25           8
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................          28          11           3
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..           2           2           2
73.10 Total new obligations.............          30          11           3
73.20 Total outlays (gross).............         -30         -11          -3
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..           2           2           2
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................           3           3           3
86.93 Outlays from discretionary 
        balances........................           2
86.97 Outlays from new mandatory 
        authority.......................          25           8
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........          30          11           3
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................          28          11           3
90.00 Outlays...........................          29          11           3
---------------------------------------------------------------------------

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

----------------------------------------------------------------------------
Identification code 75-0340-0-1-552      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
    Guaranteed loan levels supportable by subsidy 
                budget authority:
215001HEAL Loan guarantee...............          46
                                           ---------   ---------  ----------
215901Total loan guarantee levels.......          46
    Guaranteed loan subsidy (in percent):
232001HEAL Loan guarantee...............       16.48        0.00        0.00
                                           ---------   ---------  ----------
232901Weighted average subsidy rate.....       16.48        0.00        0.00
    Guaranteed loan subsidy budget authority:
233001HEAL Loan guarantee...............          25
                                           ---------   ---------  ----------
233901Total subsidy budget authority....          25
    Guaranteed loan subsidy outlays:
234001HEAL Loan guarantee...............          25
                                           ---------   ---------  ----------
234901Total subsidy outlays.............          25
    Guaranteed loan upward reestimate subsidy 
                budget authority:
235001HEAL Loan guarantee...............           2           8
                                           ---------   ---------  ----------
235901Total upward reestimate budget 
        authority.......................           2           8
    Guaranteed loan downward reestimate subsidy 
                budget authority:
237001HEAL Loan guarantee...............         -49         -55
                                           ---------   ---------  ----------
237901Total downward reestimate subsidy 
        budget authority................         -49         -55
----------------------------------------------------------------------------

    Administrative expense data:
351001Budget authority..................           3           3           3
359001Outlays from new authority........           3           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      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
11.1  Personnel compensation: Full-time 
        permanent.......................           1           1           1
25.3  Other purchases of goods and 
        services from Government 
        accounts........................           2           2           2
41.0  Grants, subsidies, and 
        contributions...................          27           8
                                           ---------   ---------  ----------
99.9    Total new obligations...........          30          11           3
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-0340-0-1-552      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
    Direct:
      Total compensable workyears:

1001    Civilian full-time equivalent 
          employment....................          15          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      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Death and disability claims.......           3           2           2
00.02 Default claims....................          25          25          25
                                           ---------   ---------  ----------
00.91   Subtotal........................          28          27          27
08.02 Payment of downward reestimate to 
        receipt account.................          38          40
08.04 Payment of interest on downward 
        reestimate to receipt account...          11          15
                                           ---------   ---------  ----------

[[Page 433]]


08.91   Subtotal (reestimates)..........          49          55
                                           ---------   ---------  ----------
10.00   Total new obligations...........          77          82          27
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance carried 
        forward, start of year..........         249         219         152
22.00 New financing authority (gross)...          47          15           7
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......         296         234         159
23.95 Total new obligations.............         -77         -82         -27
                                           ---------   ---------  ----------
24.40   Unobligated balance carried 
          forward, end of year..........         219         152         132
----------------------------------------------------------------------------

    New financing authority (gross), detail:
      Mandatory:

69.00   Offsetting collections (cash)...          47          15           7
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..                                  82
73.10 Total new obligations.............          77          82          27
73.20 Total financing disbursements 
        (gross).........................         -77
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..                      82         109
87.00 Total financing disbursements 
        (gross).........................          77
----------------------------------------------------------------------------

    Offsets:
      Against gross financing authority and 
          financing disbursements:

        Offsetting collections (cash) 
            from:
88.00     Federal sources...............         -27          -8
88.25     Interest on uninvested funds..         -15          -3          -3
88.40     Recoveries of defaulted loans.          -5          -4          -4
                                           ---------   ---------  ----------
88.90       Total, offsetting 
              collections (cash)........         -47         -15          -7
----------------------------------------------------------------------------

    Net financing authority and financing 
        disbursements:
89.00 Financing authority...............
90.00 Financing disbursements...........          30         -15          -7
---------------------------------------------------------------------------

             Status of Guaranteed Loans (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-4304-0-3-552      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
    Position with respect to appropriations act 
                limitation on commitments:
2111  Limitation on guaranteed loans 
        made by private lenders.........         150
2142  Uncommitted loan guarantee 
        limitation......................        -104
                                           ---------   ---------  ----------
2150    Total guaranteed loan 
          commitments...................          46
2199  Guaranteed amount of guaranteed 
        loan commitments................          46
----------------------------------------------------------------------------

    Cumulative balance of guaranteed loans 
                outstanding:
2210  Outstanding, start of year........       1,760       1,860       1,827
2231  Disbursements of new guaranteed 
        loans...........................         150
2251  Repayments and prepayments........          -6          -4          -4
      Adjustments:

2261    Terminations for default that 
          result in loans receivable....         -41         -25         -24
2263    Terminations for default that 
          result in claim payments......          -3          -4          -4
                                           ---------   ---------  ----------
2290    Outstanding, end of year........       1,860       1,827       1,795
----------------------------------------------------------------------------

    Memorandum:
2299  Guaranteed amount of guaranteed 
        loans outstanding, end of year..       1,860       1,827       1,795
----------------------------------------------------------------------------

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

2310    Outstanding, start of year......         423         458         479
2331    Disbursements for guaranteed 
          loan claims...................          41          25          24
2351    Repayments of loans receivable..          -6          -4          -4
                                           ---------   ---------  ----------
2390      Outstanding, end of year......         458         479         499
---------------------------------------------------------------------------

    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

2003 actual

2004 actual

-----------------------------------------------------------------------------------------------
    ASSETS:
1101

Federal assets: Fund balances with Treasury

340

340

1206

Non-Federal assets: Receivables, net

67

67





1999

Total assets

407

407

    LIABILITIES:
2204

Non-Federal liabilities: Liabilities for loan guarantees

407

407





2999

Total liabilities

407

407





4999

Total liabilities and net position

407

407

-----------------------------------------------------------------------------------------------

                                

          Health Education Assistance Loans Liquidating Account

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-4305-0-3-552      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Death and disability claims.......           3           3           3
00.02 Defaulted loans...................           8          15          15
00.03 Debt Collection...................           4
                                           ---------   ---------  ----------
10.00   Total new obligations...........          15          18          18
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......          15          18          18
23.95 Total new obligations.............         -15         -18         -18
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.00   Appropriation...................           4           4           4
69.00 Offsetting collections (cash).....          21          14          14
69.27 Capital transfer to general fund..         -10
                                           ---------   ---------  ----------
69.90   Spending authority from 
          offsetting collections (total 
          mandatory)....................          11          14          14
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................          15          18          18
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..           5           6           6
73.10 Total new obligations.............          15          18          18
73.20 Total outlays (gross).............         -14         -18         -18
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..           6           6           6
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................          14          18          18
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.40   Offsetting collections (cash) 
          from: Non-Federal sources.....         -21         -14         -14
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................          -6           4           4
90.00 Outlays...........................          -7           4           4
---------------------------------------------------------------------------

             Status of Guaranteed Loans (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-4305-0-3-552      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
    Cumulative balance of guaranteed loans 
                outstanding:\1\
2210  Outstanding, start of year........         585         556         529
2251  Repayments and prepayments........         -15         -15         -15
      Adjustments:

2261    Terminations for default that 
          result in loans receivable....         -12         -10         -10
2263    Terminations for default that 
          result in claim payments......          -2          -2          -2
                                           ---------   ---------  ----------
2290    Outstanding, end of year........         556         529         502
----------------------------------------------------------------------------

    Memorandum:
2299  Guaranteed amount of guaranteed 
        loans outstanding, end of year..         556         529         502
----------------------------------------------------------------------------

[[Page 434]]


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

2310    Outstanding, start of year......         468         442         413
2331    Disbursements for guaranteed 
          loan claims...................          12          10          10
2351    Repayments of loans receivable..         -14         -15         -15
2361    Write-offs of loans receivable..         -24         -24         -24
                                           ---------   ---------  ----------
2390      Outstanding, end of year......         442         413         384
---------------------------------------------------------------------------
    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. The debt 
collection contract financed from this account in 2004 will be financed 
from the HEAL program account in 2005 and subsequent fiscal years.

                             Balance Sheet (in millions of dollars)

-----------------------------------------------------------------------------------------------
Identification code   75-4305-0-3-552

2003 actual

2004 actual

-----------------------------------------------------------------------------------------------
    ASSETS:
1101

Federal assets: Fund balances with Treasury

4

4

1206

Non-Federal assets: Receivables, net

376

376





1999

Total assets

380

380

    LIABILITIES:
2204

Non-Federal liabilities: Liabilities for loan guarantees

380

380





2999

Total liabilities

380

380





4999

Total liabilities and net position

380

380

-----------------------------------------------------------------------------------------------

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-4305-0-3-552      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
25.2  Other services....................           4
42.0  Insurance claims and indemnities..          11          18          18
                                           ---------   ---------  ----------
99.9    Total new obligations...........          15          18          18
---------------------------------------------------------------------------

                                

               Medical Facilities Guarantee and Loan Fund

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9931-0-3-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance carried 
        forward, start of year..........          68          68
22.40 Capital transfer to general fund..                     -68
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......          68
                                           ---------   ---------  ----------
24.40   Unobligated balance carried 
          forward, end of year..........          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      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
    Cumulative balance of direct loans 
                outstanding:
1210  Outstanding, start of year........           7           7           7
1251  Repayments: Repayments and 
        prepayments.....................
                                           ---------   ---------  ----------
1290    Outstanding, end of year........           7           7           7
---------------------------------------------------------------------------

             Status of Guaranteed Loans (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9931-0-3-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
    Cumulative balance of guaranteed loans 
                outstanding:
2210  Outstanding, start of year........          13
2251  Repayments and prepayments........         -13
                                           ---------   ---------  ----------
2290    Outstanding, end of year........
----------------------------------------------------------------------------

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

    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. 

                             Balance Sheet (in millions of dollars)

-----------------------------------------------------------------------------------------------
Identification code   75-9931-0-3-551

2003 actual

2004 actual

-----------------------------------------------------------------------------------------------
    ASSETS:
1206

Non-Federal assets: Receivables, net



13





1999

Total assets



13

    LIABILITIES:
2204

Non-Federal liabilities: Liabilities for loan guarantees



13





2999

Total liabilities



13





4999

Total liabilities and net position



13

-----------------------------------------------------------------------------------------------

                                

                               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 [$3,176,000] 
$2,832,000 shall be available from the Trust Fund to the Secretary of 
Health and Human Services. (Department of Health and Human Services 
Appropriations Act, 2005.)

                Unavailable Receipts (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8175-0-7-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
01.99 Balance, start of year............       1,901       2,024       2,172
    Receipts:
02.00 Deposits, Vaccine injury 
        compensation trust fund.........         142         170         188
02.40 Interest and profits on 
        investments, Vaccine injury 
        compensation....................          55          60          62
                                           ---------   ---------  ----------
02.99   Total receipts and collections..         197         230         250
                                           ---------   ---------  ----------
04.00 Total: Balances and collections...       2,098       2,254       2,422
    Appropriations:
05.00 Vaccine injury compensation 
        program trust fund..............         -11         -13         -13
05.01 Vaccine injury compensation 
        program trust fund..............         -63         -69         -71
                                           ---------   ---------  ----------
05.99   Total appropriations............         -74         -82         -84
                                           ---------   ---------  ----------
07.99 Balance, end of year..............       2,024       2,172       2,338
---------------------------------------------------------------------------

[[Page 435]]



               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8175-0-7-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Compensation: Claims for post--FY 
        1989 injuries...................          65          69          71
      Administrative expenses:

01.03   Claims processing (Claims Court)           4           4           4
01.04   Claims processing (Public Health 
          Service)......................           3           3           3
01.05   Claims processing (Dept. of 
          Justice)......................           3           6           6
                                           ---------   ---------  ----------
01.91     Total, administrative expenses          10          13          13
                                           ---------   ---------  ----------
10.00   Total new obligations...........          75          82          84
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance carried 
        forward, start of year..........           1
22.00 New budget authority (gross)......          75          82          84
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......          76          82          84
23.95 Total new obligations.............         -75         -82         -84
                                           ---------   ---------  ----------
24.40   Unobligated balance carried 
          forward, end of year..........
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.26   Appropriation (trust fund)......          11          13          13
      Mandatory:

60.26   Appropriation (trust fund)......          63          69          71
69.00 Offsetting collections (cash).....           1
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................          75          82          84
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..           1           3
73.10 Total new obligations.............          75          82          84
73.20 Total outlays (gross).............         -73         -85         -84
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..           3
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................           9          13          13
86.97 Outlays from new mandatory 
        authority.......................          64          69          71
86.98 Outlays from mandatory balances...                       3
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........          73          85          84
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

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

    Net budget authority and outlays:
89.00 Budget authority..................          74          82          84
90.00 Outlays...........................          72          85          84
----------------------------------------------------------------------------

    Memorandum (non-add) entries:
92.01 Total investments, start of year: 
        Federal securities: Par value...       1,896       2,015       2,163
92.02 Total investments, end of year: 
        Federal securities: Par value...       2,015       2,163       2,329
---------------------------------------------------------------------------

    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      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

      Direct obligations:

25.2    Other services..................           3           3           3
25.3    Other purchases of goods and 
          services from Government 
          accounts......................           6          10          10
42.0    Insurance claims and indemnities          65          69          71
                                           ---------   ---------  ----------
99.0      Direct obligations............          74          82          84
99.0  Reimbursable obligations..........           1
                                           ---------   ---------  ----------
99.9    Total new obligations...........          75          82          84
---------------------------------------------------------------------------

                                

                    Ricky Ray Hemophilia Relief Fund

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-8074-0-7-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Claims............................           1
00.02 Administrative Expenses...........           1
00.03 Funds Returned to Treasury........          86
                                           ---------   ---------  ----------
10.00   Total new obligations...........          88
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance carried 
        forward, start of year..........          91           3
23.95 Total new obligations.............         -88
23.98 Unobligated balance expiring or 
        withdrawn.......................                      -3
                                           ---------   ---------  ----------
24.40   Unobligated balance carried 
          forward, end of year..........           3
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..           1           3
73.10 Total new obligations.............          88
73.20 Total outlays (gross).............         -86          -3
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..           3
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.98 Outlays from mandatory balances...          86           3
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays...........................          86           3
----------------------------------------------------------------------------

    Memorandum (non-add) entries:
92.01 Total investments, start of year: 
        Federal securities: Par value...          89
92.02 Total investments, end of year: 
        Federal securities: Par value...
---------------------------------------------------------------------------

    The Ricky Ray Hemophilia Relief Fund was established pursuant to 
Public Law 105-369 and served 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 have 
been returned to the Treasury.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-8074-0-7-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
25.2  Other services....................           1
42.0  Insurance claims and indemnities..           1
94.0  Financial transfers...............          86
                                           ---------   ---------  ----------
99.0      Direct obligations............          88
                                           ---------   ---------  ----------
99.9    Total new obligations...........          88
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-8074-0-7-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
    Direct:
1001  Total compensable workyears: 
        Civilian full-time equivalent 
        employment......................           4           2
---------------------------------------------------------------------------

                                


 
                          INDIAN HEALTH SERVICE

                              Federal Funds

General and special funds:

                         Indian Health Services

    For expenses necessary to carry out the Act of August 5, 1954 (68 
Stat. 674), the Indian Self-Determination Act, the Indian Health Care 
Improvement Act, and titles II and III of the Public Health Service Act 
with respect to the Indian Health Service, [$2,633,072,000] 
$2,732,298,000, together with payments received

[[Page 436]]

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 
[$487,085,000] $507,021,000 for contract medical care shall remain 
available for obligation until September 30, [2006:] 2007: 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 [$267,398,000] $268,683,000 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 
[2005] 2006, of which not to exceed [$2,500,000] $5,000,000 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: 
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 15 percent may be used by any entity 
receiving funding for administrative overhead including indirect costs]. 
(Department of the Interior and Related Agencies Appropriations Act, 
2005.)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0390-0-1-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
      Direct program:

00.01   Clinical services...............       2,057       2,091       2,209
00.02   Preventive health...............         107         110         119
00.03   Urban health....................          32          32          33
00.04   Indian health professions.......          29          30          32
00.05   Tribal management...............           2           2           2
00.06   Direct operations...............          61          62          63
00.07   Self-governance.................           6           5           6
00.08   Contract support costs..........         267         264         269
00.09   Diabetes funds..................         153         150         150
09.01 Reimbursable program..............         793         821         830
                                           ---------   ---------  ----------
10.00   Total new obligations...........       3,507       3,567       3,713
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance carried 
        forward, start of year..........         300         233         233
22.00 New budget authority (gross)......       3,445       3,567       3,712
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......       3,745       3,800       3,945
23.95 Total new obligations.............      -3,507      -3,567      -3,713
23.98 Unobligated balance expiring or 
        withdrawn.......................          -5
                                           ---------   ---------  ----------
24.40   Unobligated balance carried 
          forward, end of year..........         233         233         232
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.00   Appropriation...................       2,562       2,633       2,732
40.35   Appropriation permanently 
          reduced.......................         -32         -37
                                           ---------   ---------  ----------
43.00     Appropriation (total 
            discretionary)..............       2,530       2,596       2,732
      Mandatory:

60.00   Appropriation...................         150         150         150
      Spending authority from offsetting 
          collections:

        Discretionary:
68.00     Offsetting collections (cash).         814         821         830
68.10     Change in uncollected customer 
            payments from Federal 
            sources (unexpired).........         -49
                                           ---------   ---------  ----------
68.90       Spending authority from 
              offsetting collections 
              (total discretionary).....         765         821         830
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................       3,445       3,567       3,712
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..         506         572         583
73.10 Total new obligations.............       3,507       3,567       3,713
73.20 Total outlays (gross).............      -3,517      -3,556      -3,767
73.40 Adjustments in expired accounts 
        (net)...........................          24
74.00 Change in uncollected customer 
        payments from Federal sources 
        (unexpired).....................          49
74.10 Change in uncollected customer 
        payments from Federal sources 
        (expired).......................           3
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..         572         583         529
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................       3,251       3,106       3,234
86.93 Outlays from discretionary 
        balances........................         266         304         383
86.97 Outlays from new mandatory 
        authority.......................                     132         132
86.98 Outlays from mandatory balances...                      14          18
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       3,517       3,556       3,767
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

        Offsetting collections (cash) 
            from:
88.00     Federal sources...............        -404        -405        -407
88.40     Non-Federal sources...........        -412        -416        -423
                                           ---------   ---------  ----------
88.90       Total, offsetting 
              collections (cash)........        -816        -821        -830
      Against gross budget authority only:

88.95   Change in uncollected customer 
          payments from Federal sources 
          (unexpired)...................          49
88.96   Portion of offsetting 
          collections (cash) credited to 
          expired accounts..............           2
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................       2,680       2,746       2,882
90.00 Outlays...........................       2,700       2,735       2,937
---------------------------------------------------------------------------

    The Indian health services account provides medical care, public 
health services, and health professions training opportunities to 
American Indians and Alaska Natives. An estimated $1,606 million will be 
administered by tribal governments under self-determination contracts 
and self-governance compacts in 2006.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0390-0-1-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

      Direct obligations:

        Personnel compensation:
11.1      Full-time permanent...........         320         378         389
11.3      Other than full-time permanent          16          18          19
11.5      Other personnel compensation..          31          35          36
11.7      Military personnel............          72          85          88
                                           ---------   ---------  ----------
11.9        Total personnel compensation         439         516         532
12.1    Civilian personnel benefits.....          94         109         112
12.2    Military personnel benefits.....          32          37          38

[[Page 437]]

13.0    Benefits for former personnel...          12          13          12
21.0    Travel and transportation of 
          persons.......................          13          13          12
21.0    Patient Travel..................          16          16          16
22.0    Transportation of things........           9           8           8
23.1    Rental payments to GSA..........           5           4           4
23.2    Rental payments to others.......           2           2           2
23.3    Communications, utilities, and 
          miscellaneous charges.........          17          15          15
24.0    Printing and reproduction.......           1           1           1
25.1    Advisory and assistance services           5           4           4
25.2    Other services..................          86          61          59
25.3    Other purchases of goods and 
          services from Government 
          accounts......................          44          47          47
25.4    Operation and maintenance of 
          facilities....................           6           5           5
25.6    Medical care....................         216         215         206
25.7    Operation and maintenance of 
          equipment.....................           5           4           4
25.8    Subsistence and support of 
          persons.......................           2           2           2
26.0    Supplies and materials..........         102          94          91
31.0    Equipment.......................          11           9           9
41.0    Grants, subsidies, and 
          contributions.................       1,597       1,571       1,704
                                           ---------   ---------  ----------
99.0      Direct obligations............       2,714       2,746       2,883
99.0  Reimbursable obligations..........         793         821         830
                                           ---------   ---------  ----------
99.9    Total new obligations...........       3,507       3,567       3,713
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-0390-0-1-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
    Direct:
      Total compensable workyears:

1001    Civilian full-time equivalent 
          employment....................       6,825       7,733       7,733
1101    Military full-time equivalent 
          employment....................       1,458       1,603       1,603
    Reimbursable:
      Total compensable workyears:

2001    Civilian full-time equivalent 
          employment....................       5,041       5,041       5,041
2101    Military full-time equivalent 
          employment....................         423         423         423
---------------------------------------------------------------------------

                                

                        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, [$394,048,000] $315,668,000, to 
remain available until expended: Provided, That notwithstanding any 
other provision of law, funds appropriated for the planning, design, 
construction or renovation of health facilities for the benefit of an 
Indian tribe or tribes may be used to purchase land for sites to 
construct, improve, or enlarge health or related facilities: Provided 
further, That not to exceed $500,000 shall be used by the Indian Health 
Service to purchase TRANSAM equipment from the Department of Defense for 
distribution to the Indian Health Service and tribal facilities: 
Provided further, That 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 notwithstanding any other provision of law, funds 
appropriated for the planning, design, and construction of the 
replacement health care facility in Barrow, Alaska, may be used to 
purchase land up to approximately 8 hectares for a site upon which to 
construct the new health care facility:] Provided further, That not to 
exceed $500,000 shall be placed in a Demolition Fund, available until 
expended, to be used by the Indian Health Service for demolition of 
Federal buildings[: Provided further, That up to $2,700,000 from 
unobligated balances may be used for the purchase of land at two sites 
for the construction of the northern and southern California Youth 
Regional Treatment Centers subject to advance approval from the House 
and Senate Committees on Appropriations]. (Department of the Interior 
and Related Agencies Appropriations Act, 2005.)

                Unavailable Receipts (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0391-0-1-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
    Receipts:
02.20 Rent and charges for quarters, 
        Indian Health Service...........           6           6           6
    Appropriations:
05.00 Indian health facilities..........          -6          -6          -6
                                           ---------   ---------  ----------
07.99 Balance, end of year..............
---------------------------------------------------------------------------

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0391-0-1-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
      Direct program:

00.01   Sanitation and health facilities         138         180          97
00.02   Maintenance.....................          45          55          56
00.03   Facilities and environmental 
          health........................         144         142         151
00.04   Equipment.......................          15          17          18
                                           ---------   ---------  ----------
01.00     Total direct program..........         342         394         322
09.01 Reimbursable program..............           7           7           7
                                           ---------   ---------  ----------
10.00   Total new obligations...........         349         401         329
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance carried 
        forward, start of year..........         227         279         279
22.00 New budget authority (gross)......         401         401         329
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......         628         680         608
23.95 Total new obligations.............        -349        -401        -329
                                           ---------   ---------  ----------
24.40   Unobligated balance carried 
          forward, end of year..........         279         279         279
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.00   Appropriation...................         396         394         316
40.35   Appropriation permanently 
          reduced.......................          -5          -6
                                           ---------   ---------  ----------
43.00     Appropriation (total 
            discretionary)..............         391         388         316
      Mandatory:

60.20   Appropriation (special fund)....           6           6           6
      Discretionary:

68.00   Spending authority from 
          offsetting collections: 
          Offsetting collections (cash).           4           7           7
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................         401         401         329
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..         252         234         348
73.10 Total new obligations.............         349         401         329
73.20 Total outlays (gross).............        -366        -287        -400
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..         234         348         277
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................         360         123         102
86.93 Outlays from discretionary 
        balances........................                     158         292
86.97 Outlays from new mandatory 
        authority.......................           6           6           6
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........         366         287         400
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.00   Offsetting collections (cash) 
          from: Federal sources.........          -4          -7          -7
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................         397         394         322
90.00 Outlays...........................         364         280         393
---------------------------------------------------------------------------

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

[[Page 438]]

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0391-0-1-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

      Direct obligations:

        Personnel compensation:
11.1      Full-time permanent...........          35          40          41
11.3      Other than full-time permanent           6           7           7
11.5      Other personnel compensation..           1           2           2
11.7      Military personnel............          19          22          23
                                           ---------   ---------  ----------
11.9        Total personnel compensation          61          71          73
12.1    Civilian personnel benefits.....          10          12          12
12.2    Military personnel benefits.....           7           9          10
13.0    Benefits for former personnel...           1           1           1
21.0    Travel and transportation of 
          persons.......................           3           3           3
22.0    Transportation of things........           2           2           2
23.3    Communications, utilities, and 
          miscellaneous charges.........          11          11          11
25.1    Advisory and assistance services           2           1           1
25.2    Other services..................         158          77          73
25.3    Other purchases of goods and 
          services from Government 
          accounts......................           2           1           1
25.4    Operation and maintenance of 
          facilities....................          16          15           5
25.7    Operation and maintenance of 
          equipment.....................           1           1           1
26.0    Supplies and materials..........           5           6           6
31.0    Equipment.......................          12          11           7
32.0    Land and structures.............         -48          74          17
41.0    Grants, subsidies, and 
          contributions.................          99          99          99
                                           ---------   ---------  ----------
99.0      Direct obligations............         342         394         322
99.0  Reimbursable obligations..........           7           7           7
                                           ---------   ---------  ----------
99.9    Total new obligations...........         349         401         329
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-0391-0-1-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
    Direct:
      Total compensable workyears:

1001    Civilian full-time equivalent 
          employment....................       1,035       1,176       1,176
1101    Military full-time equivalent 
          employment....................         226         249         249
---------------------------------------------------------------------------

                                

            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 V 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 V 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 Indian Health Service may purchase 8.5 acres of land for 
expansion of parking facilities at the W.W. Hastings hospital in 
Tahlequah, Oklahoma using third party collections subject to advance 
approval from the House and Senate Committees on Appropriations.
    Notwithstanding any other provision of law, the Tulsa and Oklahoma 
City Clinic demonstration projects shall be permanent programs under the 
direct care program of the Indian Health Service; shall be treated as 
service units and operating units in the allocation of resources and 
coordination of care; shall continue to meet the requirements applicable 
to an Urban Indian organization under this title; and shall not be 
subject to the Indian Self-Determination and Education Assistance Act 
(25 U.S.C. 450 et seq.).]
    The appropriation structure for the Indian Health Service may not be 
altered without advance [approval of] notification to the House and 
Senate Committees on Appropriations. (Department of the Interior and 
Related Agencies Appropriations Act, 2005.)

                                


 
               CENTERS FOR DISEASE CONTROL AND PREVENTION

                              Federal Funds

General and special funds:

                 Disease Control, Research, and Training

    To carry out titles II, III, VII, XI, XV, XVII, [XIX,] XXI, and XXVI 
of the Public Health Service Act, sections 101, 102, 103, 201, 202, 203, 
301, and 501 of the Federal Mine Safety and Health Act of 1977, sections 
20, 21, and 22 of the Occupational Safety and Health Act of 1970, title 
IV of the Immigration and Nationality Act, and section 501 of the 
Refugee Education Assistance Act of 1980; including purchase and 
insurance of official motor vehicles in foreign countries; and purchase, 
hire, maintenance, and operation of aircraft, [$4,533,911,000] 
$4,040,963,000, of which [$272,000,000] $30,000,000 shall remain 
available until expended for equipment, and construction and renovation 
of facilities[,] ; of which $30,000,000 of the amounts available for 
immunization activities shall remain

[[Page 439]]

available until expended; and of which [$124,882,000] $123,883,000 for 
international HIV/AIDS shall remain available until September 30, [2006] 
2007. 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, the following amounts shall be 
available from amounts available under section 241 of the Public Health 
Service Act: (1) $12,794,000 to carry out the National Immunization 
Surveys; (2) $109,021,000 to carry out the National Center for Health 
Statistics surveys; (3) $24,751,000 to carry out information systems 
standards development and architecture and applications-based research 
used at local public health levels; (4) $463,000 for Health Marketing 
evaluations; (5) $31,000,000 to carry out Public Health Research; and 
(6) $87,071,000 to carry out [Research Tools and Approaches] research 
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 up to $30,000,000 shall be made available until expended 
for Individual Learning Accounts for full-time equivalent employees of 
the Centers for Disease Control and Prevention: 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:] 
Provided further, That of the funds appropriated, $10,000 is for 
official reception and representation expenses when specifically 
approved by the Director of the Centers for Disease Control and 
Prevention. (Department of Health and Human Services Appropriations Act, 
2005.)

                Unavailable Receipts (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0943-0-1-550      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
    Receipts:
02.20 Cooperative research and 
        development agreements, Centers 
        for Disease Control.............           1           1           1
    Appropriations:
05.01 Disease control, research, and 
        training........................          -1          -1          -1
                                           ---------   ---------  ----------
07.99 Balance, end of year..............
---------------------------------------------------------------------------

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0943-0-1-550      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Infectious Diseases...............                   1,692       1,697
00.02 Health Promotion..................                   1,010         964
00.03 Health Information and Service....                      94          90
00.04 Environmental Hlth and Injury.....                     286         285
00.05 Occupational Safety and Hlth......                     199         199
00.06 Global Health.....................                     294         306
00.08 Public Hlth Improvement and 
        Leadership......................                     267         207
00.09 Prev. Hlth and Hlth Svcs Block 
        Grant...........................                     117
00.10 Buildings and Facilities..........                     270          30
00.11 Business Services Support.........                     279         263
00.19 Birth defects/developmental 
        disabilities/disability and 
        health..........................         113
00.20 Chronic disease prev & health 
        promotion.......................         853
00.21 Environmental health..............         183
00.22 Epidemic services and response....          91
00.24 HIV/AIDS, STD and TB prevention...       1,150
00.25 Immunization......................         630
00.26 Infectious disease control........         369
00.27 Injury prevention and control.....         154
00.28 Occupational safety and health....         235
00.29 Preventive health and heath 
        service block grant.............         133
00.30 Public health improvement.........         142
00.31 Building and facilities...........         212
00.32 Office of the Director............          59
      Reimbursable program:

09.01   Health statistics...............         128         109         109
09.02   Other reimbursable program......         441         485         490
09.03   Public Health Research..........                      31          31
                                           ---------   ---------  ----------
09.09     Subtotal, reimbursable 
            programs....................         569         625         630
                                           ---------   ---------  ----------
10.00   Total new obligations...........       4,893       5,133       4,671
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance carried 
        forward, start of year..........         165         218         219
22.00 New budget authority (gross)......       4,940       5,134       4,672
22.10 Resources available from 
        recoveries of prior year 
        obligations.....................           7
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......       5,112       5,352       4,891
23.95 Total new obligations.............      -4,893      -5,133      -4,671
23.98 Unobligated balance expiring or 
        withdrawn.......................          -1
                                           ---------   ---------  ----------
24.40   Unobligated balance carried 
          forward, end of year..........         218         219         220
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.00   Appropriation...................       4,547       4,534       4,041
40.35   Appropriation permanently 
          reduced.......................         -31         -38
42.00   Transferred from other accounts.                      12
                                           ---------   ---------  ----------
43.00     Appropriation (total 
            discretionary)..............       4,516       4,508       4,041
      Mandatory:

60.20   Appropriation (special fund)....           1           1           1
      Spending authority from offsetting 
          collections:

        Discretionary:
68.00     Offsetting collections (cash).         239         625         630
68.10     Change in uncollected customer 
            payments from Federal 
            sources (unexpired).........         184
                                           ---------   ---------  ----------
68.90       Spending authority from 
              offsetting collections 
              (total discretionary).....         423         625         630
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................       4,940       5,134       4,672
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..       3,582       3,705       3,804
73.10 Total new obligations.............       4,893       5,133       4,671
73.20 Total outlays (gross).............      -4,880      -5,034      -5,023
73.40 Adjustments in expired accounts 
        (net)...........................         -33
73.45 Recoveries of prior year 
        obligations.....................          -7
74.00 Change in uncollected customer 
        payments from Federal sources 
        (unexpired).....................        -184
74.10 Change in uncollected customer 
        payments from Federal sources 
        (expired).......................         334
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..       3,705       3,804       3,452
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................       2,536       2,158       2,004
86.93 Outlays from discretionary 
        balances........................       2,344       2,875       3,018
86.97 Outlays from new mandatory 
        authority.......................                       1           1
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       4,880       5,034       5,023
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

        Offsetting collections (cash) 
            from:
88.00     Federal sources...............         -70        -575        -580
88.40     Non-Federal sources...........        -499         -50         -50
                                           ---------   ---------  ----------
88.90       Total, offsetting 
              collections (cash)........        -569        -625        -630
      Against gross budget authority only:

88.95   Change in uncollected customer 
          payments from Federal sources 
          (unexpired)...................        -184
88.96   Portion of offsetting 
          collections (cash) credited to 
          expired accounts..............         330
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................       4,517       4,509       4,042
90.00 Outlays...........................       4,311       4,409       4,393
---------------------------------------------------------------------------

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

                                     2004 actual  2005 est.   2006 est.
Enacted/requested:
  Budget Authority..................       4,517       4,509       4,042
  Outlays...........................       4,311       4,409       4,393

[[Page 440]]

Legislative proposal, not subject to 
    PAYGO:
  Budget Authority..................                                -100
  Outlays...........................                                 -34
                                    ------------------------------------
Total:
  Budget Authority..................       4,517       4,509       3,942
  Outlays...........................       4,311       4,409       4,359
                                    ====================================

    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 $100 million.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0943-0-1-550      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

      Direct obligations:

        Personnel compensation:
11.1      Full-time permanent...........         347         365         380
11.3      Other than full-time permanent          39          42          43
11.5      Other personnel compensation..          24          25          26
11.7      Military personnel............          56          57          58
11.8      Special personal services 
            payments....................           1           1           1
                                           ---------   ---------  ----------
11.9        Total personnel compensation         467         490         508
12.1    Civilian personnel benefits.....         112         119         123
12.2    Military personnel benefits.....          32          33          34
21.0    Travel and transportation of 
          persons.......................          41          43          40
22.0    Transportation of things........           9           9           9
23.1    Rental payments to GSA..........          30          32          32
23.2    Rental payments to others.......           2           2           2
23.3    Communications, utilities, and 
          miscellaneous charges.........          24          25          23
24.0    Printing and reproduction.......           6           6           6
25.1    Advisory and assistance services         218         229         213
25.2    Other services..................         109         114          62
25.3    Other purchases of goods and 
          services from Government 
          accounts......................         297         311         290
25.4    Operation and maintenance of 
          facilities....................          45          47          24
25.5    Research and development 
          contracts.....................         161         137         137
25.6    Medical care....................           1           1           1
25.7    Operation and maintenance of 
          equipment.....................          21          22          20
26.0    Supplies and materials..........          29          31          29
31.0    Equipment.......................          94          98          52
32.0    Land and structures.............         147         156          20
41.0    Grants, subsidies, and 
          contributions.................       2,479       2,603       2,416
                                           ---------   ---------  ----------
99.0      Direct obligations............       4,324       4,508       4,041
99.0  Reimbursable obligations..........         569         625         630
                                           ---------   ---------  ----------
99.9    Total new obligations...........       4,893       5,133       4,671
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-0943-0-1-550      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
    Direct:
      Total compensable workyears:

1001    Civilian full-time equivalent 
          employment....................       5,819       5,604       5,593
1101    Military full-time equivalent 
          employment....................         558         558         558
    Reimbursable:
      Total compensable workyears:

2001    Civilian full-time equivalent 
          employment....................       1,176       1,176       1,176
2101    Military full-time equivalent 
          employment....................         296         296         296
    Allocation account:
3001  Total compensable workyears: 
        Civilian full-time equivalent 
        employment......................         538         779       1,029
---------------------------------------------------------------------------

                                

                 Disease Control, Research, and Training

              (Legislative proposal, not subject to PAYGO)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0943-2-1-550      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Infectious Diseases...............                                -100
                                           ---------   ---------  ----------
10.00   Total new obligations (object 
          class 41.0)...................                                -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:

40.00   Appropriation...................                                -100
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..
73.10 Total new obligations.............                                -100
73.20 Total outlays (gross).............                                  34
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..                                 -66
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................                                 -34
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                                -100
90.00 Outlays...........................                                 -34
---------------------------------------------------------------------------

    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 price 
caps. These proposals will result in approximately $100 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, [$76,654,000] $76,024,000, of 
which up to $1,500,000, to remain available until expended, is for 
Individual Learning Accounts for full-time equivalent employees of the 
Agency for Toxic Substances and Disease Registry: 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 [2005] 2006, and existing profiles may be updated as 
necessary. (Department of Health and Human Services Appropriations Act, 
2005.)

[[Page 441]]

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0944-0-1-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Direct program....................          73          76          76
09.01 Reimbursable program..............          12          25          25
                                           ---------   ---------  ----------
10.00   Total new obligations...........          85         101         101
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......          86         101         101
23.95 Total new obligations.............         -85        -101        -101
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.00   Appropriation...................          73          77          76
40.35   Appropriation permanently 
          reduced.......................                      -1
                                           ---------   ---------  ----------
43.00     Appropriation (total 
            discretionary)..............          73          76          76
      Spending authority from offsetting 
          collections:

68.00   Offsetting collections (cash)...           7          25          25
68.10   Change in uncollected customer 
          payments from Federal sources 
          (unexpired)...................           6
                                           ---------   ---------  ----------
68.90     Spending authority from 
            offsetting collections 
            (total discretionary).......          13          25          25
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................          86         101         101
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..                      10          11
73.10 Total new obligations.............          85         101         101
73.20 Total outlays (gross).............         -69        -100        -100
74.00 Change in uncollected customer 
        payments from Federal sources 
        (unexpired).....................          -6
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..          10          11          12
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................          69          86          86
86.93 Outlays from discretionary 
        balances........................                      14          14
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........          69         100         100
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.00   Offsetting collections (cash) 
          from: Federal sources.........          -7         -25         -25
      Against gross budget authority only:

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

    Net budget authority and outlays:
89.00 Budget authority..................          73          76          76
90.00 Outlays...........................          63          75          75
---------------------------------------------------------------------------

    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      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

      Direct obligations:

        Personnel compensation:
11.1      Full-time permanent...........          22          23          24
11.3      Other than full-time permanent           1           1           1
11.5      Other personnel compensation..           1           1           1
11.7      Military personnel............           4           4           4
                                           ---------   ---------  ----------
11.9        Total personnel compensation          28          29          30
12.1    Civilian personnel benefits.....           6           6           6
12.2    Military personnel benefits.....           2           2           2
21.0    Travel and transportation of 
          persons.......................           1           1           1
23.3    Communications, utilities, and 
          miscellaneous charges.........                       1           1
25.1    Advisory and assistance services           6           6           6
25.2    Other services..................           3           3           3
25.3    Other purchases of goods and 
          services from Government 
          accounts......................          14          14          13
25.5    Research and development 
          contracts.....................           4           4           4
31.0    Equipment.......................           1           1           1
41.0    Grants, subsidies, and 
          contributions.................           8           9           9
                                           ---------   ---------  ----------
99.0      Direct obligations............          73          76          76
99.0  Reimbursable obligations..........          12          25          25
                                           ---------   ---------  ----------
99.9    Total new obligations...........          85         101         101
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-0944-0-1-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
    Direct:
      Total compensable workyears:

1001    Civilian full-time equivalent 
          employment....................         300         300         300
1101    Military full-time equivalent 
          employment....................          63          63          63
    Reimbursable:
      Total compensable workyears:

2001    Civilian full-time equivalent 
          employment....................          48          58          58
2101    Military full-time equivalent 
          employment....................           8           8           8
---------------------------------------------------------------------------

                                

                               Trust Funds

   Toxic Substances and Environmental Public Health, Agency for Toxic 
                     Substances and Disease Registry

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-8252-0-7-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..          55          19          12
73.20 Total outlays (gross).............         -45          -7          -3
73.40 Adjustments in expired accounts 
        (net)...........................          -1
74.10 Change in uncollected customer 
        payments from Federal sources 
        (expired).......................          10
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..          19          12           9
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.93 Outlays from discretionary 
        balances........................          45           7           3
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.00   Offsetting collections (cash) 
          from: Federal sources.........         -10
      Against gross budget authority only:

88.96   Portion of offsetting 
          collections (cash) credited to 
          expired accounts..............          10
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays...........................          35           7           3
---------------------------------------------------------------------------

    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 2006, without regard to any available balances in the 
trust fund.

                                


 
                      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, [$4,865,525,000] $4,841,774,000, 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. (Department of Health and 
Human Services Appropriations Act, 2005.)

[[Page 442]]

                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, [$2,965,453,000] 2,951,270,000. 
(Department of Health and Human Services Appropriations Act, 2005.)

         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, [$395,080,000] $393,269,000. 
(Department of Health and Human Services Appropriations Act, 2005.)

    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, 
[$1,727,696,000] $1,722,146,000. (Department of Health and Human 
Services Appropriations Act, 2005.)

         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, 
[$1,552,123,000] $1,550,260,000. (Department of Health and Human 
Services Appropriations Act, 2005.)

          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, 
[$4,440,007,000] $4,459,395,000: Provided, That $100,000,000 may be made 
available to International Assistance Programs ``Global Fund to Fight 
HIV/AIDS, Malaria, and Tuberculosis'', to remain available until 
expended: Provided further, That up to [$150,000,000] $30,000,000 shall 
be for extramural facilities construction grants to enhance the Nation's 
capability to do research on biological and other agents. (Department of 
Health and Human Services Appropriations Act, 2005.)

             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, [$1,959,810,000] 
$1,955,170,000. (Department of Health and Human Services Appropriations 
Act, 2005.)

        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, 
[$1,280,915,000] $1,277,544,000. (Department of Health and Human 
Services Appropriations Act, 2005.)

                         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, 
[$674,578,000] $673,491,000. (Department of Health and Human Services 
Appropriations Act, 2005.)

           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, 
[$650,027,000] $647,608,000. (Department of Health and Human Services 
Appropriations Act, 2005.)
    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] $80,289,000. (Departments 
of Veterans Affairs and Housing and Urban Development, and Independent 
Agencies Appropriations Act, 2005).

                       National Institute on Aging

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to aging, [$1,060,666,000] $1,057,203,000. 
(Department of Health and Human Services Appropriations Act, 2005.)

  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, [$515,378,000] $513,063,000. (Department of Health and Human 
Services Appropriations Act, 2005.)

    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, 
[$397,507,000] $397,432,000. (Department of Health and Human Services 
Appropriations Act, 2005.)

                 National Institute of Nursing Research

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to nursing research, [$139,198,000] 
$138,729,000. (Department of Health and Human Services Appropriations 
Act, 2005.)

           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, [$441,911,000] 
$440,333,000. (Department of Health and Human Services Appropriations 
Act, 2005.)

                    National Institute on Drug Abuse

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to drug abuse, [$1,014,760,000] $1,010,130,000. 
(Department of Health and Human Services Appropriations Act, 2005.)

                   National Institute of Mental Health

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to mental health, [$1,423,609,000] 
$1,417,692,000. (Department of Health and Human Services Appropriations 
Act, 2005.)

                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, [$492,670,000] 
$490,959,000. (Department of Health and Human Services Appropriations 
Act, 2005.)

       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, [$300,647,000] $299,808,000. (Department of Health and Human 
Services Appropriations Act, 2005.)

                 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, [$1,124,141,000] $1,100,203,000: 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 $30,000,000 shall be for 
extramural facilities construction grants]. (Department of Health and 
Human Services Appropriations Act, 2005.)

       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, 
[$123,116,000] $122,692,000. (Department of Health and Human Services 
Appropriations Act, 2005.)

        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, [$197,780,000] $197,379,000. (Department of Health and Human 
Services Appropriations Act, 2005.)

                  John E. Fogarty International Center

    For carrying out the activities at the John E. Fogarty International 
Center, [$67,182,000] $67,048,000. (Department of Health and Human 
Services Appropriations Act, 2005.)

[[Page 443]]

                      National Library of Medicine

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to health information communications, 
[$317,947,000] $318,091,000, of which $4,000,000 shall be available 
until expended for improvement of information systems: Provided, That in 
fiscal year [2005] 2006, 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]. 
In addition, $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. (Department of Health and Human 
Services Appropriations Act, 2005.)

                         Office of the Director

                      (including transfer of funds)

    For carrying out the responsibilities of the Office of the Director, 
National Institutes of Health, [$361,145,000, of which up to $10,000,000 
shall be used to carry out section 217 of this Act] $385,195,000: 
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]: Provided further, That of the funds provided 
$10,000 shall be for official reception and representation expenses when 
specifically approved by the Director of NIH[: Provided further, That a 
uniform percentage of the amounts appropriated in this Act to each 
Institute and Center may be utilized for the National Institutes of 
Health Roadmap Initiative: Provided further, That the amount utilized 
under the preceding proviso shall not exceed $176,800,000 without prior 
notification to the Committees on Appropriations of the House of 
Representatives and the Senate: Provided further, That amounts utilized 
under the preceding two provisos shall be in addition to amounts made 
available for the Roadmap Initiative from the Director's Discretionary 
Fund and to any amounts allocated to activities related to the Roadmap 
Initiative through the normal research priority-setting process of 
individual Institutes and Centers]. (Department of Health and Human 
Services Appropriations Act, 2005.)

                        buildings and facilities

    For the study of, construction of, renovation of, and acquisition of 
equipment for, facilities of or used by the National Institutes of 
Health, including the acquisition of real property, [$111,177,000] 
$81,900,000, 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]. (Department of 
Health and Human Services Appropriations Act, 2005.)

                Unavailable Receipts (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9915-0-1-552      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
    Receipts:
02.20 Cooperative research and 
        development agreements, NIH.....          12          16          16
    Appropriations:
05.00 National Institutes of Health.....          -3         -16         -16
05.01 National Institutes of Health.....          -9
                                           ---------   ---------  ----------
05.99   Total appropriations............         -12         -16         -16
                                           ---------   ---------  ----------
07.99 Balance, end of year..............
---------------------------------------------------------------------------

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9915-0-1-552      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
      Direct program:

00.01   National Cancer Institute.......       4,727       4,824       4,842
00.02   National Heart, Lung, and Blood 
          Institute.....................       2,883       2,940       2,951
00.03   National Institute of Dental and 
          Craniofacial Research.........         382         392         393
00.04   National Institute of Diabetes 
          and Digestive and Kidney 
          Disease.......................       1,829       1,863       1,872
00.05   National Institute of 
          Neurological Disorders and 
          Stroke........................       1,498       1,539       1,550
00.06   National Institute of Allergy 
          and Infectious Diseases.......       4,142       4,401       4,460
00.07   National Institute of General 
          Medical Sciences..............       1,915       1,943       1,955
00.08   National Institute of Child 
          Health and Human Development..       1,248       1,270       1,278
00.09   National Eye Institute..........         651         669         674
00.10   National Institute of 
          Environmental Health Sciences.         709         724         728
00.11   National Institute on Aging.....       1,021       1,052       1,057
00.12   National Institute of Arthritis 
          and Musculoskeletal and Skin 
          Disease.......................         499         511         513
00.13   National Institute on Deafness 
          and Other Communication 
          Disorder......................         381         394         398
00.14   National Institute of Mental 
          Health........................       1,379       1,411       1,418
00.15   National Institute on Drug Abuse         991       1,006       1,010
00.16   Natinal Institute on Alcohol 
          Abuse and Alcoholism..........         427         438         440
00.17   National Institute of Nursing 
          Research......................         134         138         139
00.18   National Human Genome Research 
          Institute.....................         491         488         491
00.19   National Institute of Biomedical 
          Imaging and Bioengineering....         287         298         300
00.20   National Center for Research 
          Resources.....................       1,192       1,115       1,100
00.21   National Center for 
          Complementary and Alternative 
          Medicine......................         117         122         122
00.22   National Center on Minority 
          Health and Health Disparities.         191         196         197
00.23   John E. Fogarty International 
          Center........................          65          67          67
00.24   National Library of Medicine....         310         325         318
00.25   Office of the Director..........         327         358         385
00.26   Buildings and facilities........         303         110          82
00.27   Cooperative Research and 
          Development Agreements........          10          16          16
00.28   Royalities......................          42
09.00 Reimbursable program..............       2,250       2,514       2,555
                                           ---------   ---------  ----------
10.00   Total new obligations...........      30,401      31,124      31,311
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance carried 
        forward, start of year..........         649         555         555
22.00 New budget authority (gross)......      30,310      31,124      31,311
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......      30,959      31,679      31,866
23.95 Total new obligations.............     -30,401     -31,124     -31,311
23.98 Unobligated balance expiring or 
        withdrawn.......................          -4
                                           ---------   ---------  ----------
24.40   Unobligated balance carried 
          forward, end of year..........         555         555         555
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.00   Appropriation...................      28,061      28,680      28,590
40.35   Appropriation permanently 
          reduced.......................        -183        -236
41.00   Transferred to other accounts...        -149
42.00   Transferred from other accounts.           4
                                           ---------   ---------  ----------
43.00     Appropriation (total 
            discretionary)..............      27,733      28,444      28,590
      Mandatory:

60.00   Appropriation...................         150         150         150
60.20   Appropriation (special fund)....           3          16          16
60.20   Appropriation (special fund)....           9
                                           ---------   ---------  ----------
62.50     Appropriation (total 
            mandatory)..................         162         166         166
      Spending authority from offsetting 
          collections:

        Discretionary:
68.00     Offsetting collections (cash).       1,790       2,514       2,555
68.10     Change in uncollected customer 
            payments from Federal 
            sources (unexpired).........         625
                                           ---------   ---------  ----------
68.90       Spending authority from 
              offsetting collections 
              (total discretionary).....       2,415       2,514       2,555
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................      30,310      31,124      31,311
----------------------------------------------------------------------------

[[Page 444]]



    Change in obligated balances:
72.40 Obligated balance, start of year..      25,591      27,777      28,904
73.10 Total new obligations.............      30,401      31,124      31,311
73.20 Total outlays (gross).............     -27,742     -29,997     -31,134
73.40 Adjustments in expired accounts 
        (net)...........................        -182
74.00 Change in uncollected customer 
        payments from Federal sources 
        (unexpired).....................        -625
74.10 Change in uncollected customer 
        payments from Federal sources 
        (expired).......................         334
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..      27,777      28,904      29,081
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................       9,191       9,596      10,155
86.93 Outlays from discretionary 
        balances........................      18,431      20,258      20,817
86.97 Outlays from new mandatory 
        authority.......................          35          40          40
86.98 Outlays from mandatory balances...          85         103         122
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........      27,742      29,997      31,134
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

        Offsetting collections (cash) 
            from:
88.00     Federal sources...............      -2,059      -2,514      -2,555
88.40     Non-Federal sources...........         -57
                                           ---------   ---------  ----------
88.90       Total, offsetting 
              collections (cash)........      -2,116      -2,514      -2,555
      Against gross budget authority only:

88.95   Change in uncollected customer 
          payments from Federal sources 
          (unexpired)...................        -625
88.96   Portion of offsetting 
          collections (cash) credited to 
          expired accounts..............         326
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................      27,895      28,610      28,756
90.00 Outlays...........................      25,626      27,483      28,579
---------------------------------------------------------------------------

         DISTRIBUTION OF BUDGET AUTHORITY AND OUTLAYS BY ACCOUNT

                          [Dollars in millions]

                                        2004         2005        2006
Distribution of budget authority by 
    account:
  National Cancer Institute.........       4,724       4,824       4,842
  National Heart, Lung, and Blood 
    Institute.......................       2,883       2,940       2,951
  National Institute of Dental and 
    Craniofacial Research...........         382         392         393
  National Institute of Diabetes and 
    Digestive and Kidney Diseases...       1,830       1,863       1,872
  National Institute of Neurological 
    Disorder and Stroke.............       1,498       1,539       1,550
  National Institute of Allergy and 
    Infectious Diseases.............       4,142       4,401       4,460
  National Institute of General 
    Medical Sciences................       1,915       1,943       1,955
  National Institute of Child Health 
    and Human Development...........       1,248       1,270       1,278
  National Eye Institute............         651         669         674
  National Institute of 
    Environmental Health Sciences...         709         724         728
  National Institute on Aging.......       1,021       1,052       1,057
  National Institute of Arthritis 
    and Musculoskeletal and Skin 
    Diseases........................         499         511         513
  National Institute on Deafness and 
    Other Communication Disorders...         381         394         397
  National Institute of Nursing 
    Research........................         134         138         139
  National Institute on Alcohol 
    Abuse and Alcoholism............         427         438         440
  National Institute on Drug Abuse..         991       1,006       1,010
  National Institute of Mental 
    Health..........................       1,379       1,412       1,418
  National Center for Research 
    Resources.......................       1,192       1,115       1,100
  National Human Genome Research 
    Institute.......................         491         488         491
  National Institute of Biomedical 
    Imaging and Bioengineering......         287         298         300
  National Center for Complementary 
    and Alternative Medicine........         117         122         123
  National Center for Minority 
    Health and Health Disparities...         191         196         197
  John E. Fogarty International 
    Center..........................          65          67          67
  National Library of Medicine......         310         324         318
  Office of the Director............         327         358         385
  Buildings and facilities..........          89         110          82
                                    ------------------------------------
      Subtotal......................      27,883      28,594      28,740
  Cooperative Research and 
    Development Agreements..........          12          16          16
                                    ------------------------------------
      Total Budget Authority, NIH...      27,895      28,610      28,756
                                    ====================================

                          [Dollars in millions]

                                        2004         2005        2006
Distribution of outlays by account:
  National Cancer Institute.........       4,437       4,676       4,806
  National Heart, Lung, and Blood 
    Institute.......................       2,725       2,824       2,925
  National Institute of Dental and 
    Craniofacial Research...........         364         375         389
  National Institute of Diabetes and 
    Digestive and Kidney Diseases...       1,663       1,773       1,845
  National Institute of Neurological 
    Disorders and Stroke............       1,439       1,465       1,531
  National Institute of Allergy and 
    Infectious Diseases.............       3,090       4,068       4,337
  National Institute of General 
    Medical Sciences................       1,873       1,887       1,931
  National Institute of Child Health 
    and Human Development...........       1,191       1,216       1,266
  National Eye Institute............         616         640         666
  National Institute of 
    Environmental Health Sciences...         676         698         722
  National Institute on Aging.......         972       1,003       1,044
  National Institute of Arthritis 
    and Musculoskeletal and Skin 
    Diseases........................         481         495         508
  National Institute on Deafness and 
    Other Communication Disorders...         368         373         392
  National Institute of Nursing 
    Research........................         123         130         137
  National Institute on Alcohol 
    Abuse and Alcoholism............         403         418         436
  National Institute on Drug Abuse..         957         973       1,000
  National Institute of Mental 
    Health..........................       1,351       1,360       1,404
  National Center for Research 
    Resources.......................       1,096       1,165       1,125
  National Human Genome Research 
    Institute.......................         460         489         489
  National Institute of Biomedical 
    Imaging and Bioengineering......         230         273         292
  National Center for Complementary 
    and Alternative Medicine........         110         112         120
  National Center for Minority 
    Health and Health Disparities...         168         179         189
  John E. Fogarty International 
    Center..........................          63          62          66
  National Library of Medicine......         279         310         320
  Office of the Director............         272         300         353
  Buildings and Facilities..........         286         208         275
  Service and Supply Fund/Management 
    Fund............................         -76           0           0
                                    ------------------------------------
      Subtotal Outlays..............      25,617      27,472      28,568
  Cooperative Research and 
    Development Agreements..........           9          10          10
                                    ------------------------------------
      Total Outlays, NIH............      25,626      27,483      29,579
                                    ====================================

    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 2006 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.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9915-0-1-552      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

      Direct obligations:

        Personnel compensation:
11.1      Full-time permanent...........         658         664         690
11.3      Other than full-time permanent         338         345         358
11.5      Other personnel compensation..          37          28          29
11.7      Military personnel............          23          24          24
11.8      Special personal services 
            payments....................         147         152         156
                                           ---------   ---------  ----------
11.9        Total personnel compensation       1,203       1,213       1,257
12.1    Civilian personnel benefits.....         267         271         281
12.2    Military personnel benefits.....          16          16          17
13.0    Benefits for former personnel...           1           1           1
21.0    Travel and transportation of 
          persons.......................          56          57          57
22.0    Transportation of things........           5           6           6
23.1    Rental payments to GSA..........           4           4           4
23.2    Rental payments to others.......          15          15          16
23.3    Communications, utilities, and 
          miscellaneous charges.........          30          31          31
24.0    Printing and reproduction.......          19          19          19
25.1    Advisory and assistance services         116         104         104
25.2    Other services..................         609         580         569
25.3    Other purchases of goods and 
          services from Government 
          accounts......................       2,222       2,311       2,362
25.4    Operation and maintenance of 
          facilities....................         379         269         237
25.5    Research and development 
          contracts.....................       2,164       2,115       2,236

[[Page 445]]

25.6    Medical care....................          24          24          24
25.7    Operation and maintenance of 
          equipment.....................          72          74          74
26.0    Supplies and materials..........         214         223         225
31.0    Equipment.......................         190         197         199
41.0    Grants, subsidies, and 
          contributions.................      20,541      21,080      21,037
42.0    Insurance claims and indemnities           4
                                           ---------   ---------  ----------
99.0      Direct obligations............      28,151      28,610      28,756
99.0  Reimbursable obligations..........       2,250       2,514       2,555
                                           ---------   ---------  ----------
99.9    Total new obligations...........      30,401      31,124      31,311
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-9915-0-1-552      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
    Direct:
      Total compensable workyears:

1001    Civilian full-time equivalent 
          employment....................      12,322      11,875      11,899
1101    Military full-time equivalent 
          employment....................         320         328         328
    Reimbursable:
      Total compensable workyears:

2001    Civilian full-time equivalent 
          employment....................       4,337       5,231       5,211
2101    Military full-time equivalent 
          employment....................         112         104         104
---------------------------------------------------------------------------

                                


 
        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 
(``PHS Act'') with respect to substance abuse and mental health 
services, the Protection and Advocacy for Individuals with Mental 
Illness Act, and section 301 of the [Public Health Service] PHS Act with 
respect to program management, [$3,295,361,000, of which $23,107,000 
shall be available for projects and in the amounts specified in the 
statement of the managers on the conference report accompanying this 
Act] $3,214,720,000: Provided, That notwithstanding section 520A(f)(2) 
of the PHS Act, no funds appropriated for carrying out section 520A are 
available for carrying out section 1971 of the PHS Act: Provided 
further, That in addition to amounts provided herein, the following 
amounts shall be available from amounts available under section 241 of 
the [Public Health Service] PHS Act: (1) $79,200,000 to carry out 
subpart II of part B of title XIX of the [Public Health Service] PHS 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 part B of title 
XIX; (2) $21,803,000 to carry out subpart I of Part B of title XIX of 
the [Public Health Service Act] PHS Act, to fund section 1920(b) 
technical assistance, national data, data collection and 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; (3) $16,000,000 to 
carry out national surveys on drug abuse; (4) [$2,000,000 for mental 
health data collection; and (5)] $4,300,000 [for] to evaluate substance 
abuse treatment programs. (Department of Health and Human Services 
Appropriations Act, 2005.)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1362-0-1-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
      Direct program:

00.01   Mental health and substance 
          abuse activities..............       1,035       1,085       1,032
00.02   Mental health partnership.......         413         411         411
00.03   Substance abuse partnership.....       1,700       1,696       1,696
00.05   Program management..............          76          76          76
09.01 Reimbursable program..............         185         203         202
                                           ---------   ---------  ----------
10.00   Total new obligations...........       3,409       3,471       3,417
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance carried 
        forward, start of year..........           1           1           1
22.00 New budget authority (gross)......       3,419       3,471       3,417
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......       3,420       3,472       3,418
23.95 Total new obligations.............      -3,409      -3,471      -3,417
23.98 Unobligated balance expiring or 
        withdrawn.......................         -10
                                           ---------   ---------  ----------
24.40   Unobligated balance carried 
          forward, end of year..........           1           1           1
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.00   Appropriation...................       3,254       3,295       3,215
40.35   Appropriation permanently 
          reduced.......................         -20         -27
                                           ---------   ---------  ----------
43.00     Appropriation (total 
            discretionary)..............       3,234       3,268       3,215
      Spending authority from offsetting 
          collections:

68.00   Offsetting collections (cash)...          84         203         202
68.10   Change in uncollected customer 
          payments from Federal sources 
          (unexpired)...................         101
                                           ---------   ---------  ----------
68.90     Spending authority from 
            offsetting collections 
            (total discretionary).......         185         203         202
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................       3,419       3,471       3,417
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..       2,465       2,555       2,632
73.10 Total new obligations.............       3,409       3,471       3,417
73.20 Total outlays (gross).............      -3,228      -3,394      -3,441
73.40 Adjustments in expired accounts 
        (net)...........................         -23
74.00 Change in uncollected customer 
        payments from Federal sources 
        (unexpired).....................        -101
74.10 Change in uncollected customer 
        payments from Federal sources 
        (expired).......................          33
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..       2,555       2,632       2,608
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................       1,331       1,445       1,424
86.93 Outlays from discretionary 
        balances........................       1,897       1,949       2,017
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       3,228       3,394       3,441
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.00   Offsetting collections (cash) 
          from: Federal sources.........        -116        -203        -202
      Against gross budget authority only:

88.95   Change in uncollected customer 
          payments from Federal sources 
          (unexpired)...................        -101
88.96   Portion of offsetting 
          collections (cash) credited to 
          expired accounts..............          32
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................       3,234       3,268       3,215
90.00 Outlays...........................       3,112       3,191       3,239
---------------------------------------------------------------------------

    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      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

      Direct obligations:

        Personnel compensation:
11.1      Full-time permanent...........          37          42          44
11.3      Other than full-time permanent           2           2           2
11.5      Other personnel compensation..           1           1           1
11.7      Military personnel............           2           2           2
                                           ---------   ---------  ----------
11.9        Total personnel compensation          42          47          49
12.1    Civilian personnel benefits.....           9          10          10
12.2    Military personnel benefits.....           1           1           1
21.0    Travel and transportation of 
          persons.......................           1           1           1
23.1    Rental payments to GSA..........           6           6           6
23.3    Communications, utilities, and 
          miscellaneous charges.........           3           3           3
24.0    Printing and reproduction.......           5           4           4
25.1    Advisory and assistance services          22          23          23
25.2    Other services..................         172         196         152
25.3    Other purchases of goods and 
          services from Government 
          accounts......................         104         110          91

[[Page 446]]

31.0    Equipment.......................           3           2           2
41.0    Grants, subsidies, and 
          contributions.................       2,854       2,863       2,871
42.0    Insurance claims and indemnities           2           2           2
                                           ---------   ---------  ----------
99.0      Direct obligations............       3,224       3,268       3,215
99.0  Reimbursable obligations..........         185         203         202
                                           ---------   ---------  ----------
99.9    Total new obligations...........       3,409       3,471       3,417
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-1362-0-1-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
    Direct:
      Total compensable workyears:

1001    Civilian full-time equivalent 
          employment....................         450         466         466
1101    Military full-time equivalent 
          employment....................          20          20          20
    Reimbursable:
      Total compensable workyears:

2001    Civilian full-time equivalent 
          employment....................          19          42          42
2101    Military full-time equivalent 
          employment....................          30          30          30
---------------------------------------------------------------------------

                                


 
               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 $318,695,000. (Department of Health and Human 
Services Appropriations Act, 2005.)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1700-0-1-552      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Direct Program Activity...........                       3
09.00 Reimbursable program..............         333         348         348
                                           ---------   ---------  ----------
10.00   Total new obligations...........         333         351         348
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance carried 
        forward, start of year..........          19          16          19
22.00 New budget authority (gross)......         331         354         348
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......         350         370         367
23.95 Total new obligations.............        -333        -351        -348
                                           ---------   ---------  ----------
24.40   Unobligated balance carried 
          forward, end of year..........          16          19          19
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

42.00   Transferred from other accounts.                       3
      Spending authority from offsetting 
          collections:

68.00   Offsetting collections (cash)...         106         351         348
68.10   Change in uncollected customer 
          payments from Federal sources 
          (unexpired)...................         225
                                           ---------   ---------  ----------
68.90     Spending authority from 
            offsetting collections 
            (total discretionary).......         331         351         348
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................         331         354         348
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..         131          63          60
73.10 Total new obligations.............         333         351         348
73.20 Total outlays (gross).............        -321        -354        -348
73.40 Adjustments in expired accounts 
        (net)...........................          -2
74.00 Change in uncollected customer 
        payments from Federal sources 
        (unexpired).....................        -225
74.10 Change in uncollected customer 
        payments from Federal sources 
        (expired).......................         147
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..          63          60          60
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................         331         354         348
86.93 Outlays from discretionary 
        balances........................         -10
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........         321         354         348
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.00   Offsetting collections (cash) 
          from: Federal sources.........        -252        -351        -348
      Against gross budget authority only:

88.95   Change in uncollected customer 
          payments from Federal sources 
          (unexpired)...................        -225
88.96   Portion of offsetting 
          collections (cash) credited to 
          expired accounts..............         146
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                       3
90.00 Outlays...........................          69           3
---------------------------------------------------------------------------

    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      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
25.5  Direct obligations: Research and 
        development contracts...........                       3
99.0  Reimbursable obligations: 
        Reimbursable obligations........         333         348         348
                                           ---------   ---------  ----------
99.9    Total new obligations...........         333         351         348
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-1700-0-1-552      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
    Reimbursable:
      Total compensable workyears:

2001    Civilian full-time equivalent 
          employment....................         277         286         286
2101    Military full-time equivalent 
          employment....................          13          13          13
---------------------------------------------------------------------------

                                


 
               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, [$119,124,488,000] $156,954,419,000, to remain 
available until expended.
    For making, after May 31, [2005] 2006, payments to States under 
title XIX of the Social Security Act for the last quarter of fiscal year 
[2005] 2006 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 [2006, $58,517,290,000] 2007, 
$62,783,825,000, to remain available until expended.
    Payment under title XIX may be made for any quarter with respect to 
a State plan or plan amendment in effect during such quarter, if 
submitted in or prior to such quarter and approved in that or any 
subsequent quarter. (Department of Health and Human Services 
Appropriations Act, 2005.)

[[Page 447]]

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0512-0-1-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Medicaid vendor payments..........     174,003     177,525     181,256
00.02 State and local administration....       9,327       9,112       9,803
00.03 Vaccine purchases.................       1,052       1,635       1,502
00.04 Incurred by providers but not yet 
        reported........................                              22,910
09.01 Medicare Part B premiums..........                     190
09.02 Medicare Part D eligibility 
        determinations..................                      73          99
                                           ---------   ---------  ----------
10.00   Total new obligations...........     184,382     188,535     215,570
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance carried 
        forward, start of year..........          10       6,077
22.00 New budget authority (gross)......     182,921     182,458     215,570
22.10 Resources available from 
        recoveries of prior year 
        obligations.....................       7,527
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......     190,458     188,535     215,570
23.95 Total new obligations.............    -184,382    -188,535    -215,570
                                           ---------   ---------  ----------
24.40   Unobligated balance carried 
          forward, end of year..........       6,077
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.00   Appropriation...................     130,892     119,125     156,954
60.00   Appropriation...................                   4,654
                                           ---------   ---------  ----------
62.50     Appropriation (total 
            mandatory)..................     130,892     123,779     156,954
65.00   Advance appropriation...........      51,861      58,416      58,517
69.00 Offsetting collections (cash).....         168         263          99
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................     182,921     182,458     215,570
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..       9,412       9,868       9,868
73.10 Total new obligations.............     184,382     188,535     215,570
73.20 Total outlays (gross).............    -176,399    -188,535    -192,661
73.45 Recoveries of prior year 
        obligations.....................      -7,527
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..       9,868       9,868      32,777
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................     176,389     182,458     191,661
86.98 Outlays from mandatory balances...          10       6,077       1,000
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........     176,399     188,535     192,661
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.00   Offsetting collections (cash) 
          from: Federal sources.........        -168        -263         -99
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................     182,753     182,195     215,471
90.00 Outlays...........................     176,231     188,272     192,562
---------------------------------------------------------------------------

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

                                     2004 actual  2005 est.   2006 est.
Enacted/requested:
  Budget Authority..................     182,753     182,195     215,471
  Outlays...........................     176,231     188,272     192,562
Legislative proposal, not subject to 
    PAYGO:
  Budget Authority..................                                -230
  Outlays...........................                                -230
Legislative proposal, subject to 
    PAYGO:
  Budget Authority..................                     225         386
  Outlays...........................                     225         386
                                    ------------------------------------
Total:
  Budget Authority..................     182,753     182,420     215,627
  Outlays...........................     176,231     188,497     192,718
                                    ====================================

    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.

    Medicaid estimates assume budget authority for expenses that are 
Incurred But Not Reported (IBNR).

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0512-0-1-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
41.0  Direct obligations: Grants, 
        subsidies, and contributions....     184,382     188,272     215,471
99.0  Reimbursable obligations: 
        Reimbursable obligations........                     263          99
                                           ---------   ---------  ----------
99.9    Total new obligations...........     184,382     188,535     215,570
---------------------------------------------------------------------------

                                

                      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      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.00   Offsetting collections (cash) 
          from: Federal sources.........                                -230
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                                -230
90.00 Outlays...........................                                -230
---------------------------------------------------------------------------

    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      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Asset transfer Reform.............                                 -99
00.02 Provider Tax Reform...............                                -231
00.03 Administrative claiming allotment.
00.04 Payment reform....................
00.05 Appropriate payment for Medicaid 
        services........................                                -129
00.06 Medicaid Pharmacy overpayment.....                                -542
00.07 Medicaid Transitional Assistance..                     225         560
00.08 New Freedom Initiatives...........                                  30
00.09 Vaccines for Children.............                                 140
00.10 Cover the Kids....................                                 389
00.11 Other proposals with Medicaid 
        Impact..........................                                  38
09.00 Reimburseable Program: Medicare 
        Part B premiums.................                                 230
                                           ---------   ---------  ----------
10.00   Total new obligations...........                     225         386
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                     225         386
23.95 Total new obligations.............                    -225        -386
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.00   Appropriation...................                     225         156
69.00 Offsetting collections (cash).....                                 230
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................                     225         386
----------------------------------------------------------------------------

    Change in obligated balances:
73.10 Total new obligations.............                     225         386
73.20 Total outlays (gross).............                    -225        -386
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................                     225         386
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                     225         386
90.00 Outlays...........................                     225         386
---------------------------------------------------------------------------

    This schedule reflects the Administration's Medicaid proposals.

[[Page 448]]

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0512-4-1-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
41.0  Direct obligations: Grants, 
        subsidies, and contributions....                     225         156
99.0  Reimbursable obligations: 
        Reimbursable obligations........                                 230
                                           ---------   ---------  ----------
99.9    Total new obligations...........                     225         386
---------------------------------------------------------------------------

                                

                     State Grants and Demonstrations

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0516-0-1-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 TWWIIA--grants....................          27          62          49
00.02 High-risk pools--grants...........          43          40
00.03 Federal reimbursement of emergency 
        health services--undocumented 
        aliens..........................                     250         250
00.04 Background Checks.................           2          12          11
00.05 SPAP..............................                      62          63
                                           ---------   ---------  ----------
10.00   Total new obligations...........          72         426         373
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance carried 
        forward, start of year..........         194         248         215
22.00 New budget authority (gross)......         142         393         394
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......         336         641         609
23.95 Total new obligations.............         -72        -426        -373
23.98 Unobligated balance expiring or 
        withdrawn.......................         -16
                                           ---------   ---------  ----------
24.40   Unobligated balance carried 
          forward, end of year..........         248         215         236
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.00   Appropriation--(P.L. 106-170, 
          Sections 203 & 204)...........          77          81          81
60.00   Appropriation--(P.L. 107-210)...          40
60.00   Appropriation--(P. L. 108-173)--
          Undocumented Aliens...........                     250         250
60.00   Appropriation- (P.L. 108-173)--
          Background Checks.............          25
60.00   Appropriation-(P.L. 108-173)--
          SPAP..........................                      62          63
                                           ---------   ---------  ----------
62.50     Appropriation (total 
            mandatory)..................         142         393         394
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..          39          63         289
73.10 Total new obligations.............          72         426         373
73.20 Total outlays (gross).............         -48        -200        -399
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..          63         289         263
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................           7         149         333
86.98 Outlays from mandatory balances...          41          51          66
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........          48         200         399
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................         142         393         394
90.00 Outlays...........................          48         200         399
---------------------------------------------------------------------------

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

                                     2004 actual  2005 est.   2006 est.
Enacted/requested:
  Budget Authority..................         142         393         394
  Outlays...........................          48         200         399
Legislative proposal, subject to 
    PAYGO:
  Budget Authority..................                                 900
  Outlays...........................                                 400
                                    ------------------------------------
Total:
  Budget Authority..................         142         393       1,294
  Outlays...........................          48         200         799
                                    ====================================

    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.

    CMS now administers several programs enacted under the Medicare 
Prescription Drug, Improvement, and Modernization Act of 2003 (MNA) 
(Public Law 108-173). The Pilot program for National and State 
Background Checks is authorized to spend a total of $25 million during 
fiscal years 2004 through 2007 to identify efficient, effective, and 
economical procedures for long-term care facilities or providers to 
conduct background checks on prospective employees who would have direct 
access to patients.

    The Federal Reimbursement of Emergency Health Services Furnished to 
Undocumented Aliens has an annual appropriation of $250 million 
beginning in FY 2005 and continuing through FY 2008. The funding is 
available to reimburse eligible providers for furnishing emergency 
health services to undocumented aliens.

    Transitional grants totaling $62.5 million each year in FY 2005 and 
FY 2006 are available to States that operate State Pharmaceutical 
Assistance Programs. These funds will be used to educate Part D eligible 
individuals enrolled in the Program about the prescription drug coverage 
available through Part D of the MMA.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0516-0-1-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
41.0  Grants, subsidies, and 
        contributions--Ticket to Work...          27          62          49
41.0  Grants, subsidies, and 
        contributions--High-Risk Pools..          43          40
41.0  Grants, subsidies, and 
        contributions--Fed'l Reimb.--
        Emer Svcs, Undoc. Aliens........                     250         250
41.0  Grants, subsidies, and 
        contributions--Background Checks           2          12          11
41.0  Grants, subsidies, and 
        contributions--SPAP.............                      62          63
                                           ---------   ---------  ----------
99.9    Total new obligations...........          72         426         373
---------------------------------------------------------------------------

                                

                     State Grants and Demonstrations

                 Legislative proposal, subject to PAYGO

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0516-4-1-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.06 State Purchasing Pools............                                 400
00.07 Cover the Kids Outreach...........                                 500
                                           ---------   ---------  ----------
10.00   Total new obligations...........                                 900
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                                 900
23.95 Total new obligations.............                                -900
----------------------------------------------------------------------------

[[Page 449]]



    New budget authority (gross), detail:
      Mandatory:

60.00   Appropriation-State Purchasing 
          Pools.........................                                 400
60.00   Appropriation-Cover the Kids 
          Outreach......................                                 500
                                           ---------   ---------  ----------
62.50     Appropriation (total 
            mandatory)..................                                 900
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..
73.10 Total new obligations.............                                 900
73.20 Total outlays (gross).............                                -400
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..                                 500
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................                                 400
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                                 900
90.00 Outlays...........................                                 400
---------------------------------------------------------------------------

    This schedule reflects the Administration's State Grants and 
Demonstrations proposals.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0516-4-1-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
41.0  Grants, subsidies, and 
        contributions-State Purchasing 
        Pools...........................                                 400
41.0  Grants, subsidies, and 
        contributions-Cover the Kids 
        Outreach........................                                 500
                                           ---------   ---------  ----------
99.9    Total new obligations...........                                 900
---------------------------------------------------------------------------

                                

 Payment to Health Care Trust Funds for Post-1956 Military Service Wage 
                                 Credits

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0517-0-1-054      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Military Wage Credits (HI)........         173
                                           ---------   ---------  ----------
10.00   Total new obligations (object 
          class 41.0)...................         173
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......         173
23.95 Total new obligations.............        -173
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.00   Appropriation...................         173
----------------------------------------------------------------------------

    Change in obligated balances:
73.10 Total new obligations.............         173
73.20 Total outlays (gross).............        -173
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................         173
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................         173
90.00 Outlays...........................         173
---------------------------------------------------------------------------

    The Hospital Insurance Trust Fund was compensated for the equivalent 
of payroll taxes on deemed wages posted to the Social Security earnings 
of uniformed services personnel in 2000 and 2001.

                                

                   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, [$114,608,900,000] 
$183,039,100,000. [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.]
    In addition, for making matching payments under section 1844, and 
benefit payments under 1860D-16 and 1860D-31, of the Social Security 
Act, not anticipated in budget estimates, such sums as may be necessary. 
(Department of Health and Human Services Appropriations Act, 2005.)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0580-0-1-571      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Supplementary medical insurance 
        (SMI)...........................      94,518     114,002     128,015
00.02 Hospital insurance for uninsured 
        (HI)............................         197          87         202
00.03 Federal uninsured payment (HI)....         168         199         206
00.04 Program management (HI)...........         201         215         164
00.05 FHI trust fund, Transfers from 
        general fund (civil monetary 
        penalties)......................          10          11          11
00.06 Federal payments from taxation of 
        OASDI benefits (HI).............       8,577       8,717       9,726
00.07 Fraud and abuse control, FBI......         114         114         114
00.08 Fraud and abuse control, criminal 
        fines...........................         305           3           3
00.09 Federal contributions, Drug 
        account State low-income 
        determinations..................                      73          99
00.10 Federal contributions, 
        Transitional assistance account.         216       1,155         361
00.11 General Revenue for Part D 
        Benefits........................                              53,596
00.12 General Revenue for Part D Admin 
        (CMS)...........................                                 357
00.13 General Revenue for Part D Admin 
        (SSA)...........................                                 320
00.14 HCFAC reimbursement...............                                  80
                                           ---------   ---------  ----------
10.00   Total new obligations...........     104,306     124,576     193,254
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......     106,411     124,609     193,254
23.95 Total new obligations.............    -104,306    -124,576    -193,254
23.98 Unobligated balance expiring or 
        withdrawn.......................      -2,105         -33
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.00   Appropriation...................       8,577       8,717       9,726
60.00   Appropriation...................         315          14          14
60.00   Appropriation...................      95,084     114,503     128,667
60.00   Appropriation...................         114         114         114
60.00   Appropriation...................       2,321       1,155         361
60.00   Appropriation...................                     106          99
60.00   Appropriation...................                              54,273
                                           ---------   ---------  ----------
62.50     Appropriation (total 
            mandatory)..................     106,411     124,609     193,254
----------------------------------------------------------------------------

    Change in obligated balances:
73.10 Total new obligations.............     104,306     124,576     193,254
73.20 Total outlays (gross).............    -104,306    -124,576    -193,254
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................     104,306     124,576     193,254
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................     106,411     124,609     193,254
90.00 Outlays...........................     104,306     124,576     193,254
---------------------------------------------------------------------------

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

                                     2004 actual  2005 est.   2006 est.
Enacted/requested:
  Budget Authority..................     106,411     124,609     193,254
  Outlays...........................     104,306     124,576     193,254
Legislative proposal, not subject to 
    PAYGO:
  Budget Authority..................                                 108
  Outlays...........................                                 108
                                    ------------------------------------
Total:
  Budget Authority..................     106,411     124,609     193,362
  Outlays...........................     104,306     124,576     193,362
                                    ====================================

    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.


[[Page 450]]



               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0580-0-1-571      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
41.0  Grants, subsidies, and 
        contributions...................     103,740     124,002     191,826
42.0  Insurance claims and indemnities..         365         286         408
94.0  Financial transfers...............         201         288       1,020
                                           ---------   ---------  ----------
99.0      Direct obligations............     104,306     124,576     193,254
                                           ---------   ---------  ----------
99.9    Total new obligations...........     104,306     124,576     193,254
---------------------------------------------------------------------------

                                

                   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      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Supplementary medical insurance 
        (SMI)...........................                                 108
                                           ---------   ---------  ----------
10.00   Total new obligations (object 
          class 41.0)...................                                 108
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                                 108
23.95 Total new obligations.............                                -108
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.00   Appropriation...................
60.00   Appropriation...................
60.00   Appropriation...................                                 108
                                           ---------   ---------  ----------
62.50     Appropriation (total 
            mandatory)..................                                 108
----------------------------------------------------------------------------

    Change in obligated balances:
73.10 Total new obligations.............                                 108
73.20 Total outlays (gross).............                                -108
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................                                 108
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                                 108
90.00 Outlays...........................                                 108
---------------------------------------------------------------------------

    The Budget includes a Medicaid proposal to extend the subsidy of 
Medicare cost sharing for certain qualified individuals that are 
reimbursed by Medicare.

                                

                           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 [$2,696,402,000] $3,177,478,000, 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: 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 
[$24,400,000] $24,205,000, to remain available until September 30, 
[2006] 2007, is for contract costs for CMS's Systems Revitalization 
Plan: Provided further, That [$78,300,000] $79,934,000, to remain 
available until September 30, [2006] 2007, 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 Metro Outreach 
Initiative, Oak Brook, Illinois, to implement an initiative to provide 
comprehensive health education and services to the deaf and hard-of-
hearing community, $150,000 is available for African American 
Interdenominational Ministries, Inc., Philadelphia, Pennsylvania, to 
implement an insurance outreach program, $1,900,000 is available for 
AIDS Healthcare Foundation, Los Angeles, California, for a demonstration 
of residential and outpatient treatment facilities, $450,000 is 
available for Bronx-Lebanon Hospital Center, Bronx, New York, for a 
comprehensive adolescent and young adult health program to demonstrate 
means of improving health care and preventive services for underserved 
inner city teenagers and young adults, $300,000 is available for 
Children's Institute for Palliative Care, Children's Hospitals and 
Clinics, Minneapolis, Minnesota, for a pediatric palliative care 
demonstration program, $600,000 is available for the City of Detroit, 
Michigan, for a project to improve access to primary care and preventive 
health services for low-income and uninsured persons, $100,000 is 
available for Community Catalyst, Inc., Boston, Massachusetts, for the 
expansion of a benefits management program, $150,000 is available for 
Cook County Bureau of Health Services in Chicago, Illinois, for the 
Antibiotic Resistance Program, $340,000 is available for Donald R. 
Watkins Memorial Foundation, Houston, Texas, for a comprehensive HIV/
AIDS treatment and research demonstration program, $100,000 is available 
for Focus on Therapeutic Outcomes, Inc., Knoxville, Tennessee, $250,000 
is available for Hamot Medical Center, Erie, Pennsylvania and the Ohio 
Health System, Columbus, Ohio, to implement a demonstration project on 
the Medicare Advantage program, $25,000 is available for HealthRight, 
Inc., Philadelphia, Pennsylvania, for their Care Access Program, $75,000 
is available for the Inglis Foundation, Philadelphia, Pennsylvania, for 
healthcare and social services for low-income adults with severe 
physical disabilities in an effort to promote independent living, 
$50,000 is available for Medical Care for Children Partnership, Fairfax, 
Virginia, for access to specialty health care for children who have 
serious medical needs, $500,000 is available for Memphis Biotech 
Foundation in Memphis, Tennessee, to develop a biologistics network in 
Mississippi and Tennessee, $225,000 is available for Muskegon Community 
Health Project, Muskegon, Michigan, for the Access Health Program, 
$30,000 is available for Our House of Portland, Portland, Oregon, to 
develop a Care Program for people living with AIDS, $750,000 is 
available for Pace Vermont, Burlington, Vermont, for the Rural Program 
for All-inclusive Care for the Elderly, $150,000 is available for 
Patient Advocate Foundation, Newport News, Virginia, to assist the PAF 
in serving patients experiencing difficulty accessing quality health 
care services, $450,000 is available for Puerto Rico's Governor's Office 
of Elderly Affairs for the Medication Error Prevention Pilot Program, 
$1,500,000 is available for San Francisco Department of Public Health, 
San Francisco, California, for a demonstration project to improve HIV/
AIDS treatment and prevention services, $300,000 is available for Santa 
Clara County, California, for outreach and enrollment assistance 
activities of the Children's Health Initiative, $500,000 is available 
for Susquehanna Health System, Williamsport, Pennsylvania, for 
stabilizing workforce for patient care, $500,000 is available for Swope 
Health Services, Kansas City, Missouri, to supplement recurring 
healthcare costs for underemployed, uninsured, and income-qualified 
patients in Wyandotte and Johnson Counties, Kansas, $100,000 is 
available for Temple University, Crime and Justice Research Center, 
Philadelphia, Pennsylvania, for DNA backlog and utilization, and 
$250,000 is available for University of Maine, Partnership for Early 
Childhood Health & Services:] Provided further, That funds appropriated 
under this heading are available for the Healthy Start, Grow Smart 
program under which the Centers for Medicare and Medicaid Services may, 
directly or through grants, contracts, or cooperative agreements, 
produce and distribute informational materials including, but not 
limited to, pamphlets and brochures on infant and toddler health care to 
expectant parents enrolled in the Medicaid program and to parents and 
guardians enrolled in such program with infants and children: [Provided 
further, That not less than $79,000,000 shall be for processing Medicare 
appeals:] Provided further, That the Secretary of Health and Human 
Services is directed to collect fees in fiscal year [2005 from 
Medicare+Choice] 2006 from Medicare Advantage 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 and Medicaid Services to exceed $0.87 for Part A 
claims and/or $0.63 for Part B claims, up to an additional

[[Page 451]]

$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]. (Department of Health and Human 
Services Appropriations Act, 2005.)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0511-0-1-550      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
      Direct program:

00.01   Medicare operations.............       2,036       2,255       2,190
00.02   Federal administration..........         612         641         657
00.03   State survey and certification..         250         259         261
00.04   Research, demonstrations, and 
          evaluation projects...........          87         110          45
00.05   Revitalization plan.............          23          31          24
                                           ---------   ---------  ----------
01.00   Total direct program............       3,008       3,296       3,177
09.01 CLIA..............................          40          43          43
09.03 Other reimbursements..............           7           2           2
09.06 Medicare+Choice...................          11          13          56
                                           ---------   ---------  ----------
09.09   Total reimbursable program......          58          58         101
                                           ---------   ---------  ----------
10.00   Total new obligations...........       3,066       3,354       3,278
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance carried 
        forward, start of year..........         106         735         112
22.00 New budget authority (gross)......       3,700       2,731       3,278
22.10 Resources available from 
        recoveries of prior year 
        obligations.....................           5
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......       3,811       3,466       3,390
23.95 Total new obligations.............      -3,066      -3,354      -3,278
23.98 Unobligated balance expiring or 
        withdrawn.......................         -10
                                           ---------   ---------  ----------
24.40   Unobligated balance carried 
          forward, end of year..........         735         112         112
----------------------------------------------------------------------------

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

        Discretionary:
68.00     Offsetting collections (cash).       2,473       2,731       3,278
68.00     Offsetting collections (cash).                     623
68.10     Change in uncollected customer 
            payments from Federal 
            sources (unexpired).........       1,227        -623
                                           ---------   ---------  ----------
68.90       Spending authority from 
              offsetting collections 
              (total discretionary).....       3,700       2,731       3,278
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..        -187        -448         175
73.10 Total new obligations.............       3,066       3,354       3,278
73.20 Total outlays (gross).............      -2,794      -3,354      -3,278
73.40 Adjustments in expired accounts 
        (net)...........................         -21
73.45 Recoveries of prior year 
        obligations.....................          -5
74.00 Change in uncollected customer 
        payments from Federal sources 
        (unexpired).....................      -1,227         623
74.10 Change in uncollected customer 
        payments from Federal sources 
        (expired).......................         720
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..        -448         175         175
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................       2,197       2,731       3,278
86.93 Outlays from discretionary 
        balances........................         597         623
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       2,794       3,354       3,278
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

        Offsetting collections (cash) 
            from:
88.00     Federal sources...............      -3,090      -2,673      -3,177
88.00     Federal sources...............                    -623
88.40     Non-Federal sources...........         -60         -58        -101
                                           ---------   ---------  ----------
88.90       Total, offsetting 
              collections (cash)........      -3,150      -3,354      -3,278
      Against gross budget authority only:

88.95   Change in uncollected customer 
          payments from Federal sources 
          (unexpired)...................      -1,227         623
88.96   Portion of offsetting 
          collections (cash) credited to 
          expired accounts..............         677
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays...........................        -356
---------------------------------------------------------------------------

    Program management activities include funding for research, Medicare 
operations, survey and certification, CLIA, Medicare Advantage, 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      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

      Direct obligations:

        Personnel compensation:
11.1      Full-time permanent...........         338         377         397
11.3      Other than full-time permanent           8          11          10
11.5      Other personnel compensation..           6           5           5
11.7      Military personnel............           7           8          10
                                           ---------   ---------  ----------
11.9        Total personnel compensation         359         401         422
12.1    Civilian personnel benefits.....          79          94          94
12.2    Military personnel benefits.....           3           2           3
21.0    Travel and transportation of 
          persons.......................           9           9          11
22.0    Transportation of things........           1
23.1    Rental payments to GSA..........          20          30          26
23.3    Communications, utilities, and 
          miscellaneous charges.........          49           3           2
24.0    Printing and reproduction.......          14           3           3
25.1    Advisory and assistance services          22
25.2    Other services..................         622         198         172
25.3    Other purchases of goods and 
          services from Government 
          accounts......................         137           3           3
25.5    Research and development 
          contracts.....................          35
25.6    Medical care....................       1,437       2,493       2,430
25.7    Operation and maintenance of 
          equipment.....................         120
26.0    Supplies and materials..........           2           1           1
31.0    Equipment.......................          10
32.0    Land and structures.............          10          10          10
41.0    Grants, subsidies, and 
          contributions.................          79          49
                                           ---------   ---------  ----------
99.0      Direct obligations............       3,008       3,296       3,177
99.0  Reimbursable obligations..........          58          58         101
                                           ---------   ---------  ----------
99.9    Total new obligations...........       3,066       3,354       3,278
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-0511-0-1-550      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
    Direct:
      Total compensable workyears:

1001    Civilian full-time equivalent 
          employment....................       4,343       4,680       4,662
1101    Military full-time equivalent 
          employment....................          93          91         109
    Reimbursable:
2001  Total compensable workyears: 
        Civilian full-time equivalent 
        employment......................          78          72          72
---------------------------------------------------------------------------

                                

                 State Children's Health Insurance Fund

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0515-0-1-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Grants, subsidies, and 
        contributions...................       4,924       4,725       4,082
                                           ---------   ---------  ----------
10.00   Total new obligations (object 
          class 41.0)...................       4,924       4,725       4,082
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......       3,175       4,082       4,082
22.30 Expired unobligated balance 
        transfer to unexpired account...       1,749         643
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......       4,924       4,725       4,082
23.95 Total new obligations.............      -4,924      -4,725      -4,082
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.00   Appropriation, BBA..............       3,150       4,050       4,050
60.00   Appropriation, BBRA for 
          territories...................          25          32          32
                                           ---------   ---------  ----------
62.50     Appropriation (total 
            mandatory)..................       3,175       4,082       4,082
----------------------------------------------------------------------------

[[Page 452]]



    Change in obligated balances:
72.40 Obligated balance, start of year..       9,754       8,322       5,780
73.10 Total new obligations.............       4,924       4,725       4,082
73.20 Total outlays (gross).............      -4,607      -5,343      -5,434
73.40 Adjustments in expired accounts 
        (net)...........................      -1,749      -1,924         -37
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..       8,322       5,780       4,391
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................         126         331       1,149
86.98 Outlays from mandatory balances...       4,481       5,012       4,285
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       4,607       5,343       5,434
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................       3,175       4,082       4,082
90.00 Outlays...........................       4,607       5,343       5,434
---------------------------------------------------------------------------

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

                                     2004 actual  2005 est.   2006 est.
Enacted/requested:
  Budget Authority..................       3,175       4,082       4,082
  Outlays...........................       4,607       5,343       5,434
Legislative proposal, subject to 
    PAYGO:
  Budget Authority..................
  Outlays...........................                                 799
                                    ------------------------------------
Total:
  Budget Authority..................       3,175       4,082       4,082
  Outlays...........................       4,607       5,343       6,233
                                    ====================================

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

                                

                 State Children's Health Insurance Fund

                (Legislative proposal, subject to PAYGO)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0515-4-1-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 SCHIP redistribution..............                                 670
00.02 Cover the kids....................                                 129
                                           ---------   ---------  ----------
10.00   Total new obligations (object 
          class 41.0)...................                                 799
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.30 Expired unobligated balance 
        transfer to unexpired account...                                 799
23.95 Total new obligations.............                                -799
----------------------------------------------------------------------------

    Change in obligated balances:
73.10 Total new obligations.............                                 799
73.20 Total outlays (gross).............                                -799
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.98 Outlays from mandatory balances...                                 799
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays...........................                                 799
---------------------------------------------------------------------------

    This schedule reflects the Administration's SCHIP proposals.

      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 [2005] 2006, 
no commitments for direct loans or loan guarantees shall be made. 
(Department of Health and Human Services Appropriations Act, 2005.)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-4420-0-3-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

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

    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      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
01.99 Balance, start of year............     234,616     248,542     257,954
    Receipts:
02.00 FHI trust fund, Transfers from 
        general fund (FICA taxes).......     139,409     149,667     159,814
02.01 FHI trust fund, Transfers from 
        general fund (SECA taxes).......      10,789      11,282      11,904
02.02 FHI trust fund, Receipts from 
        Railroad Retirement Board.......         391         411         417
02.03 FHI trust fund, Civil penalties 
        and damages.....................         355         244         244
02.20 FHI trust fund, Premiums collected 
        for uninsured individuals not...       1,799       2,246       2,376
02.22 Basic premium, Medicare Advantage, 
        HI..............................                                  58
02.40 FHI trust fund, Federal employer 
        contributions (FICA)............       2,540       2,627       2,659
02.41 FHI trust fund, Postal Service 
        employer contributions (FICA)...         710         673         674
02.42 FHI trust fund, Payments from the 
        general fund (uninsured and pr..         568         501         652
02.43 FHI trust fund, Taxation on OASDI 
        benefits........................       8,577       8,717       9,726
02.44 FHI trust fund, Interest payments 
        by Railroad Retirement Board....          28          27          28
02.45 FHI trust fund, Interest received 
        by trust funds..................      15,046      14,941      14,994
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)...         305           3           3
02.48 FHI trust fund, Transfers from 
        general fund (civil monetary 
        pena............................          11          11          11
02.51 Federal hospital insurance trust 
        fund............................         173
                                           ---------   ---------  ----------
02.99   Total receipts and collections..     180,815     191,464     203,674
                                           ---------   ---------  ----------
04.00 Total: Balances and collections...     415,431     440,006     461,628
    Appropriations:
05.00 Federal hospital insurance trust 
        fund............................      -1,889      -1,681      -1,768
05.01 Federal hospital insurance trust 
        fund............................    -177,865    -188,724    -200,752
05.02 Federal hospital insurance trust 
        fund............................      13,920       9,412      17,375
05.03 Health care fraud and abuse 
        control account.................      -1,075      -1,075      -1,075
05.04 Appropriation temporarily reduced.          14          16
05.09 Health care fraud and abuse 
        control account.................                                 -80
                                           ---------   ---------  ----------
05.99   Total appropriations............    -166,895    -182,052    -186,300
06.10 Unobligated balance returned to 
        receipts........................           6
                                           ---------   ---------  ----------
07.99 Balance, end of year..............     248,542     257,954     275,328
---------------------------------------------------------------------------

[[Page 453]]



               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8005-0-7-571      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Benefit payments, HI..............     163,801     178,889     182,566
00.02 Administration, HI................       1,865       1,727       1,862
00.03 Quality improvement organizations, 
        HI..............................          86         293         619
00.04 Research, HI......................          68          68          40
00.05 MA Additional Premiums............                                  58
                                           ---------   ---------  ----------
10.00   Total new obligations...........     165,820     180,977     185,145
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......     165,820     180,977     185,145
23.95 Total new obligations.............    -165,820    -180,977    -185,145
24.41 Unobligated balance returned to 
        receipts........................           6
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.26   Appropriation (trust fund)......       1,889       1,681       1,768
40.37   Appropriation temporarily 
          reduced.......................         -14         -16
                                           ---------   ---------  ----------
43.00     Appropriation (total 
            discretionary)..............       1,875       1,665       1,768
      Mandatory:

60.26   Appropriation (trust fund)......     177,865     188,724     200,752
60.45   Portion precluded from balances.     -13,920      -9,412     -17,375
                                           ---------   ---------  ----------
62.50     Appropriation (total 
            mandatory)..................     163,945     179,312     183,377
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................     165,820     180,977     185,145
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..      16,235      16,091      15,962
73.10 Total new obligations.............     165,820     180,977     185,145
73.20 Total outlays (gross).............    -165,964    -181,106    -184,962
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..      16,091      15,962      16,145
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................       1,411       1,364       1,455
86.93 Outlays from discretionary 
        balances........................         417         435         441
86.97 Outlays from new mandatory 
        authority.......................     148,344     162,934     166,382
86.98 Outlays from mandatory balances...      15,792      16,373      16,684
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........     165,964     181,106     184,962
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................     165,820     180,977     185,145
90.00 Outlays...........................     165,964     181,106     184,962
----------------------------------------------------------------------------

    Memorandum (non-add) entries:
92.01 Total investments, start of year: 
        Federal securities: Par value...     251,307     264,375     274,184
92.02 Total investments, end of year: 
        Federal securities: Par value...     264,375     274,184     291,767
---------------------------------------------------------------------------

    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      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
    Balance, start of year:
0100  Treasury balance..................     251,091     264,901     274,184
      Adjustments:

                                           ---------   ---------  ----------
0199    Total balance, start of year....     251,101     264,901     274,184
    Cash income during the year:
      Current law:

        Receipts:
1200      FHI trust fund, transfers from 
            general fund (FICA taxes)...     139,409     149,667     159,814
1201      FHI trust fund, transfers from 
            general fund (SECA taxes)...      10,789      11,282      11,904
1202      FHI trust fund, receipts from 
            Railroad Retirement Board...         391         411         417
1203      HCFAC: Civil penalties and 
            damages.....................         355         244         244
        Offsetting receipts 
            (proprietary):
1220      FHI trust fund, premiums 
            collected for uninsured 
            individuals not otherwise 
            eligible....................       1,799       2,246       2,376
1222      Offsetting receipts 
            (proprietary)...............                                  58
        Offsetting receipts 
            (intragovernmental):
1240      FHI trust fund, Federal 
            employer contributions 
            (FICA)......................       2,540       2,627       2,659
1241      FHI trust fund, Postal Service 
            employer contributions 
            (FICA)......................         710         673         674
1242      FHI trust fund, Federal 
            payment for transitional 
            coverage for uninsured 
            Federal employees...........         568         501         652
1243      FHI trust fund, Federal 
            payments for OASDI taxes....       8,577       8,717       9,726
1244      FHI trust fund, interest 
            payment from Railroad 
            Retirement Board............          28          27          28
1245      FHI trust fund, interest on 
            investments.................      15,046      14,941      14,994
1246      Offsetting receipts 
            (intragovernmental).........         114         114         114
1247      HCFAC: FBI....................         305           3           3
1248      HCFAC: Criminal fines.........          11          11          11
1251      Offsetting receipts 
            (intragovernmental).........         173
        Offsetting collections:
1280      Offsetting collections........           6           6           6
1299    Income under present law........     180,821     191,470     203,680
                                           ---------   ---------  ----------
3299    Total cash income...............     180,821     191,470     203,680
    Cash outgo during year:
      Current law:

4500    Medicare Part A.................    -165,964    -181,106    -184,962
4501    HCFAC...........................      -1,057      -1,081      -1,161
4599    Outgo under current law (-).....    -167,021    -182,187    -186,123
                                           ---------   ---------  ----------
6599    Total cash outgo (-)............    -167,021    -182,187    -186,123
    Unexpended balance, end of year:
                                           ---------   ---------  ----------
8799    Total balance, end of year......     264,901     274,184     291,741
---------------------------------------------------------------------------

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8005-0-7-571      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
41.0  Payment for Quality Improvement 
        Organization (QIO) activities...          86         293         619
42.0  Insurance claims and indemnities 
        (benefits)......................     163,801     178,889     182,624
94.0  Financial transfers...............       1,933       1,795       1,902
                                           ---------   ---------  ----------
99.0      Direct obligations............     165,820     180,977     185,145
                                           ---------   ---------  ----------
99.9    Total new obligations...........     165,820     180,977     185,145
---------------------------------------------------------------------------

                                

               Health Care Fraud and Abuse Control Account

                [(federal hospital insurance trust fund)]

    In addition to amounts otherwise available for program integrity and 
program management, $80,000,000, 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, of 
which $75,000,000 is for the Medicare Integrity Program at the Centers 
for Medicare and Medicaid Services (``CMS'') to conduct oversight of 
activities authorized in Titles I and II of Public Law 108-173, with 
oversight activities including those activities listed in 18 U.S.C. 
1893(b), and of which $5,000,000 is for the Medicaid program integrity 
activities, together with not less than $20,000,000 made available to 
the Secretary by section 1817(k)(3) of the Social Security Act: 
Provided, That the report required by 18 U.S.C. 1817(k)(5) for FY 2006 
shall include measures of the operational efficiency and impact on 
fraud, waste and abuse in the Medicare and Medicaid programs for the 
funds provided by this appropriation.

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-8393-0-7-571      2004 actual   2005 est.   2006 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.....         241         241         246
00.04 Drug benefit integrity program....                                  75
09.01 Reimbursable (OIG)................           2           6           6
                                           ---------   ---------  ----------
10.00   Total new obligations...........       1,077       1,081       1,161
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......       1,081       1,081       1,161
23.95 Total new obligations.............      -1,077      -1,081      -1,161
23.98 Unobligated balance expiring or 
        withdrawn.......................          -6
----------------------------------------------------------------------------

[[Page 454]]



    New budget authority (gross), detail:
      Discretionary:

40.26   Appropriation (trust fund)......                                  80
      Mandatory:

60.28   Appropriation (unavailable 
          balances).....................       1,075       1,075       1,075
69.00 Offsetting collections (cash).....           6           6           6
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................       1,081       1,081       1,161
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..         250         268         268
73.10 Total new obligations.............       1,077       1,081       1,161
73.20 Total outlays (gross).............      -1,057      -1,081      -1,161
73.40 Adjustments in expired accounts 
        (net)...........................          -2
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..         268         268         268
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................                                  80
86.97 Outlays from new mandatory 
        authority.......................         904       1,081       1,081
86.98 Outlays from mandatory balances...         153
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       1,057       1,081       1,161
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.00   Offsetting collections (cash) 
          from: Federal sources.........          -6          -6          -6
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................       1,075       1,075       1,155
90.00 Outlays...........................       1,051       1,075       1,155
---------------------------------------------------------------------------

    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 
2005 and 2006. As required by statute, actual 2005 and 2006 agency 
distributions will be determined by the Secretary of HHS and the 
Attorney General consistent with the Administration's priorities.

                                     2004 actual  2005 est.   2006 est.
Department of Justice, DOJ..........          49          49          49
Office of the Inspector General, HHS         160         160         160
Centers for Medicare and Medicaid 
Services, Medicaid/SCHIP Program 
Integrity, HHS......................          14          17          20
Centers for Medicare and Medicaid 
Services, Other HHS.................           8           5           5
Office of the General Counsel, HHS..           5           5           5
Other HHS...........................           4           4           1
                                    ------------------------------------
      Total.........................         240         240         240
                                    ====================================

    The 2006 Budget includes a discretionary request for efforts to 
safeguard Medicaid and the Medicare prescription drug benefit, and will 
supplement the mandatory funds made available by P.L. 104-191.

    It is important that these cost increases and new enforcement 
investments be fully funded. The Administration is proposing to fund 
them as contingent appropriations. To ensure full funding of the new 
enforcement investments, the Administration proposes to employ a budget 
enforcement mechanism that allows for an adjustment by the Budget 
Committees to the section 302(a) allocation to the Appropriations 
Committees found in the concurrent resolution on the budget. In 
addition, the Administration will also seek to establish statutory 
spending limits, as defined by section 251 of the Balanced Budget and 
Emergency Deficit Control Act of 1985, and to adjust them for this 
purpose. These adjustments would only be permissible if the use of these 
funds was clearly restricted to the specified purpose. The maximum 
allowable adjustment to the 302(a) allocation and/or the statutory 
spending limit would be $80 million for 2006 (see chapter 15 in 
Analytical Perspectives).

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-8393-0-7-571      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

      Direct obligations:

11.1    Personnel compensation: Full-
          time permanent (CMS 100 FTEs).                       8           8
12.1    Civilian personnel benefits 
          (CMS).........................                       2           2
23.2    Rental payments to others.......           2           1           1
25.1    Advisory and assistance services 
          (CMS).........................           9           5           5
25.2    Other services (CMS)............          12           4          84
25.3    Other purchases of goods and 
          services from Government 
          accounts (DoJ)................          49          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)............           4           2           2
25.3    Other purchases of goods and 
          services from Government 
          accounts (HHS/OGC)............           5           5           5
25.6    Medical care (CMS)..............         720         720         720
41.0    Grants, subsidies, and 
          contributions (CMS)...........                       5           5
94.0    Financial transfers.............         114         114         114
                                           ---------   ---------  ----------
99.0      Direct obligations............       1,075       1,075       1,155
99.0  Reimbursable obligations..........           2           6           6
                                           ---------   ---------  ----------
99.9    Total new obligations...........       1,077       1,081       1,161
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-8393-0-7-571      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
    Direct:
1001  Total compensable workyears: 
        Civilian full-time equivalent 
        employment......................           3         100         100
---------------------------------------------------------------------------

                                

           Federal Supplementary Medical Insurance Trust Fund

                Unavailable Receipts (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8004-0-7-571      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
01.99 Balance, start of year............       8,396         400       2,942
    Receipts:
02.20 Premiums collected for the aged, 
        FSMI Fund.......................      25,873      30,593      34,126
02.21 Premiums collected for the 
        disabled, FSMI Fund.............       4,468       5,171       5,890
02.22 Basic premium, Medicare Advantage, 
        SMI.............................                                  51
02.23 Premiums collected for Medicare 
        prescription drug account, FSMI.                               6,229
02.24 Interest, Medicare prescription 
        drug account, FSMI..............                                 335
02.25 Payments from States, Medicare 
        prescription drug account, FSMI.                               6,778
02.27 Other proprietary receipts from 
        the public, FSMI Fund...........           1
02.28 Proposed legislation..............                                  30
02.29 Proposed legislation..............                                   5
02.40 Federal contributions, FSMI Fund..      94,518     114,002     128,015
02.41 Interest received by trust fund, 
        FSMI Fund.......................       1,727       1,755       2,117
02.43 Legislative proposal: Federal 
        contributions, FSMI.............                                 108
02.44 Federal contributions, Medicare 
        prescription drug account, FSMI.                              53,596
02.45 Proposed legislation: Interest....                                  -4
02.46 Federal contributions, 
        Transitional assistance account, 
        FSMI............................                   1,155         361
02.48 Federal supplementary medical 
        insurance trust fund............                                 357
02.49 Federal supplementary medical 
        insurance trust fund............         216
02.50 Federal supplementary medical 
        insurance trust fund............                                 320
02.51 Federal supplementary medical 
        insurance trust fund............                      73          99
02.52 Miscellaneous Federal payments, 
        Federal supplementary medical in           2
                                           ---------   ---------  ----------
02.99   Total receipts and collections..     126,805     152,749     238,413
                                           ---------   ---------  ----------
04.00 Total: Balances and collections...     135,201     153,149     241,355
    Appropriations:
05.00 Federal supplementary medical 
        insurance trust fund............      -2,333      -2,358      -2,536
05.01 Federal supplementary medical 
        insurance trust fund............    -123,049    -149,219    -167,496

[[Page 455]]

05.02 Federal supplementary medical 
        insurance trust fund............      -7,996
05.03 Federal supplementary medical 
        insurance trust fund............          22          23
05.04 Transitional drug assistance, 
        Federal supplementary medical 
        insu............................        -281      -1,155        -361
05.05 Medicare prescription drug 
        account, Federal supplementary 
        insura..........................                     -73     -67,037
05.06 Transitional drug assistance, 
        Federal supplementary medical 
        insu............................        -229
05.07 Medicare prescription drug 
        account, Federal supplementary 
        insura..........................        -935                    -677
05.08 Federal supplementary medical 
        insurance trust fund............
05.11 Federal supplementary medical 
        insurance trust fund............                   2,575      14,787
05.12 Federal supplementary medical 
        insurance trust fund............                                -230
05.20 Medicare prescription drug account                               8,446
                                           ---------   ---------  ----------
05.99   Total appropriations............    -134,801    -150,207    -215,104
                                           ---------   ---------  ----------
07.99 Balance, end of year..............         400       2,942      26,251
---------------------------------------------------------------------------

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8004-0-7-571      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Benefit payments, SMI.............     130,855     146,375     152,548
00.02 Administration, SMI...............       2,307       2,331       2,537
00.03 Quality improvement organizations, 
        SMI.............................          16          73         155
00.04 Research, SMI.....................          10          10           5
00.06 Transfer to Medicaid for payment 
        of SMI premiums.................         168         190
                                           ---------   ---------  ----------
10.00   Total new obligations...........     133,356     148,979     155,245
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......     133,356     148,979     155,245
23.95 Total new obligations.............    -133,356    -148,979    -155,245
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.26   Appropriation (trust fund)......       2,333       2,358       2,536
40.37   Appropriation temporarily 
          reduced.......................         -22         -23
                                           ---------   ---------  ----------
43.00     Appropriation (total 
            discretionary)..............       2,311       2,335       2,536
      Mandatory:

60.26   Appropriation (trust fund)......     123,049     149,219     167,496
60.28   Appropriation (unavailable 
          balances).....................       7,996
60.45   Portion precluded from 
          obligation....................                  -2,575     -14,787
                                           ---------   ---------  ----------
62.50     Appropriation (total 
            mandatory)..................     131,045     146,644     152,709
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................     133,356     148,979     155,245
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..      16,404      15,639      15,470
73.10 Total new obligations.............     133,356     148,979     155,245
73.20 Total outlays (gross).............    -134,121    -149,148    -155,240
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..      15,639      15,470      15,475
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................       1,946       1,947       2,061
86.93 Outlays from discretionary 
        balances........................         543         556         547
86.97 Outlays from new mandatory 
        authority.......................     116,545     131,575     137,585
86.98 Outlays from mandatory balances...      15,087      15,070      15,047
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........     134,121     149,148     155,240
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................     133,356     148,979     155,245
90.00 Outlays...........................     134,121     149,148     155,240
----------------------------------------------------------------------------

    Memorandum (non-add) entries:
92.01 Total investments, start of year: 
        Federal securities: Par value...      24,849      17,439      18,603
92.02 Total investments, end of year: 
        Federal securities: Par value...      17,439      18,603      33,562
---------------------------------------------------------------------------

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

                                     2004 actual  2005 est.   2006 est.
Enacted/requested:
  Budget Authority..................     133,356     148,979     155,245
  Outlays...........................     134,121     149,148     155,240
Legislative proposal, not subject to 
    PAYGO:
  Budget Authority..................                                 230
  Outlays...........................                                 230
                                    ------------------------------------
Total:
  Budget Authority..................     133,356     148,979     155,475
  Outlays...........................     134,121     149,148     155,470
                                    ====================================

    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      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
    Balance, start of year:
0100  Treasury balance..................      24,801      17,115      18,603
      Adjustments:

                                           ---------   ---------  ----------
0199    Total balance, start of year....      24,800      17,115      18,603
    Cash income during the year:
      Current law:

        Offsetting receipts 
            (proprietary):
1220      Premiums collected for the 
            aged, FSMI fund.............      25,873      30,593      34,126
1221      Premiums collected for the 
            disabled, FSMI fund.........       4,468       5,171       5,890
1222      Other proprietary receipts....                                  51
1223      Premiums collected for 
            Medicare prescription drug 
            account, FSMI (proprietary).                               6,229
1224      Interest, Medicare 
            prescription drug account, 
            FSMI (proprietary)..........                                 335
1225      Payments from States, Medicare 
            prescription drug account, 
            FSMI (proprietary)..........                               6,778
1227      Offsetting receipts 
            (proprietary)...............           1
        Offsetting receipts 
            (intragovernmental):
1240      Federal contributions, FSMI 
            fund........................      94,518     114,002     128,015
1241      Interest received by trust 
            fund, FSMI fund.............       1,727       1,755       2,117
1244      Federal contributions, 
            Medicare prescription drug 
            account (intragovernmental).                              53,596
1246      Federal contributions, 
            Transitional assistance 
            account (intragovernmental).                   1,155         361
1248      Federal contributions, 
            Medicare prescription drug 
            account (intragovernmental).                                 357
1249      Federal contributions, 
            Transitional assistance 
            account (intragovernmental).         216
1250      Federal contributions, 
            Medicare prescription drug 
            account (intragovernmental).                                 320
1251      Federal contributions, 
            Medicare prescription drug 
            account (intragovernmental).                      73          99
1252      Offsetting receipts 
            (intragovernmental).........           2
1299    Income under present law........     126,805     152,749     238,274
      Proposed legislation:

        Offsetting receipts (proprietary 
            receipts):
2228      Offsetting receipts 
            (proprietary receipts)......                                  30
2229      Offsetting receipts 
            (proprietary receipts)......                                   5
        Offsetting receipts 
            (intragovernmental):
2243      Offsetting receipts 
            (intragovernmental).........                                 108
2245      Offsetting receipts 
            (intragovernmental).........                                  -4
2299    Income under proposed 
          legislation...................                                 139
                                           ---------   ---------  ----------
3299    Total cash income...............     126,805     152,749     238,413
    Cash outgo during year:
      Current law:

4500    Medicare Part B.................    -134,121    -149,148    -155,240
4501    Transitional assistance account, 
          FSMI (-)......................        -266      -1,399        -361
4502    Medicare prescription drug 
          account, FSMI.................        -103        -714     -59,341
4599    Outgo under current law (-).....    -134,490    -151,261    -214,942
      Proposed legislation:

5500    Administration, legislative 
          proposal not subject to PAYGO.                                -230
5599    Outgo under proposed legislation 
          (-)...........................                                -230
                                           ---------   ---------  ----------
6599    Total cash outgo (-)............    -134,490    -151,261    -215,172
    Unexpended balance, end of year:
                                           ---------   ---------  ----------
8799    Total balance, end of year......      17,115      18,603      41,844
---------------------------------------------------------------------------

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8004-0-7-571      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
41.0  Payment for Quality Improvement 
        Organization (QIO) activity.....          16          73         155
42.0  Insurance claims and indemnities..     131,023     146,565     152,548
94.0  Financial transfers...............       2,317       2,341       2,542
                                           ---------   ---------  ----------

[[Page 456]]


99.0      Direct obligations............     133,356     148,979     155,245
                                           ---------   ---------  ----------
99.9    Total new obligations...........     133,356     148,979     155,245
---------------------------------------------------------------------------

                                

           Federal Supplementary Medical Insurance Trust Fund

              (Legislative proposal, not subject to PAYGO)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8004-2-7-571      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.06 Transfer to Medicaid for payment 
        of SMI premiums.................                                 230
                                           ---------   ---------  ----------
10.00   Total new obligations (object 
          class 42.0)...................                                 230
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                                 230
23.95 Total new obligations.............                                -230
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

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

60.26   Appropriation (trust fund)......
60.45   Portion precluded from 
          obligation....................                                 230
                                           ---------   ---------  ----------
62.50     Appropriation (total 
            mandatory)..................                                 230
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................                                 230
----------------------------------------------------------------------------

    Change in obligated balances:
73.10 Total new obligations.............                                 230
73.20 Total outlays (gross).............                                -230
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................                                 230
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                                 230
90.00 Outlays...........................                                 230
----------------------------------------------------------------------------

    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...                                 -91
---------------------------------------------------------------------------

    The Budget includes a Medicaid proposal to extend the subsidy of 
Medicare cost sharing for certain qualified individuals that are 
reimbursed by Medicare.

                                

 Transitional Drug Assistance, Federal Supplementary Medical Insurance 
                               Trust Fund

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-8307-0-7-571      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Benefit payments, transitional 
        drug assistance.................         281       1,155         361
00.02 Program management (CMS)..........         229
                                           ---------   ---------  ----------
10.00   Total new obligations...........         510       1,155         361
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......         510       1,155         361
23.95 Total new obligations.............        -510      -1,155        -361
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.26   Appropriation (trust fund)......         229
      Mandatory:

60.26   Appropriation (trust fund)......         281       1,155         361
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................         510       1,155         361
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..                     244
73.10 Total new obligations.............         510       1,155         361
73.20 Total outlays (gross).............        -266      -1,399        -361
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..         244
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................          50
86.93 Outlays from discretionary 
        balances........................                     179
86.97 Outlays from new mandatory 
        authority.......................         216       1,155         361
86.98 Outlays from mandatory balances...                      65
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........         266       1,399         361
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................         510       1,155         361
90.00 Outlays...........................         266       1,399         361
----------------------------------------------------------------------------

    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...
---------------------------------------------------------------------------

    Authorized under the Medicare Modernization Act as section 1860 D-31 
of the Social Security Act, the Medicare Transitional Drug Assistance 
program provides low-income beneficiaries with $600 per year to help 
them pay for their prescription drugs and covers the cost of enrollment 
fees.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-8307-0-7-571      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
25.2  Other services....................         229
42.0  Insurance claims and indemnities..         281       1,155         361
                                           ---------   ---------  ----------
99.9    Total new obligations...........         510       1,155         361
---------------------------------------------------------------------------

                                

   Medicare Prescription Drug Account, Federal Supplementary Medical 
                          Insurance Trust Fund

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-8308-0-7-571      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Program management (CMS)..........         435                     357
00.02 Limitation on administrative 
        expenses (SSA)..................         500                     320
00.03 Low-income determinations 
        (Medicaid)......................                      73          99
00.04 Prescription Drug Benefits........                              58,492
                                           ---------   ---------  ----------
10.00   Total new obligations...........         935          73      59,268
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......         935          73      59,268
23.95 Total new obligations.............        -935         -73     -59,268
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.26   Appropriation (trust fund)......         935                     677
      Mandatory:

60.26   Appropriation (trust fund)......                      73      67,037
60.45   Portion precluded from 
          obligation....................                              -8,446
                                           ---------   ---------  ----------
62.50     Appropriation (total 
            mandatory)..................                      73      58,591
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................         935          73      59,268
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..                     832         191
73.10 Total new obligations.............         935          73      59,268
73.20 Total outlays (gross).............        -103        -714     -59,341
                                           ---------   ---------  ----------

[[Page 457]]


74.40   Obligated balance, end of year..         832         191         118
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................         103                     560
86.93 Outlays from discretionary 
        balances........................                     641         190
86.97 Outlays from new mandatory 
        authority.......................                      73      58,591
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........         103         714      59,341
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................         935          73      59,268
90.00 Outlays...........................         103         714      59,341
----------------------------------------------------------------------------

    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...                               8,373
---------------------------------------------------------------------------

    Beginning in 2006, Medicare beneficiaries will have the opportunity 
to enroll in a comprehensive prescription drug benefit. 2004 and 2005 
include start-up costs associated with implementing the benefit.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-8308-0-7-571      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
25.2  Other services....................         935          73         677
41.0  Grants, subsidies, and 
        contributions...................                              58,591
                                           ---------   ---------  ----------
99.9    Total new obligations...........         935          73      59,268
---------------------------------------------------------------------------

                                

                 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      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 State family assistance grant.....      16,480      16,489      16,489
00.02 Territories--family assistance 
        grants..........................          76          78          78
00.03 Matching grants to territories....                       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..........................         200         200         200
                                           ---------   ---------  ----------
10.00   Total new obligations (object 
          class 41.0)...................      17,183      17,072      16,881
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance carried 
        forward, start of year..........                                 800
22.00 New budget authority (gross)......      17,209      17,881      16,689
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......      17,209      17,881      17,489
23.95 Total new obligations.............     -17,183     -17,072     -16,881
23.98 Unobligated balance expiring or 
        withdrawn.......................         -25          -9          -8
                                           ---------   ---------  ----------
24.40   Unobligated balance carried 
          forward, end of year..........                     800         600
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.00   Appropriation...................      17,209      17,881      16,689
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..       7,016       6,474       5,476
73.10 Total new obligations.............      17,183      17,072      16,881
73.20 Total outlays (gross).............     -17,725     -18,070     -17,918
73.40 Adjustments in expired accounts 
        (net)...........................          -1
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..       6,474       5,476       4,439
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................      12,489      13,489      13,819
86.98 Outlays from mandatory balances...       5,236       4,581       4,099
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........      17,725      18,070      17,918
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................      17,209      17,881      16,689
90.00 Outlays...........................      17,725      18,070      17,918
---------------------------------------------------------------------------

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

                                     2004 actual  2005 est.   2006 est.
Enacted/requested:
  Budget Authority..................      17,209      17,881      16,689
  Outlays...........................      17,725      18,070      17,918
Legislative proposal, subject to 
    PAYGO:
  Budget Authority..................                    -232         459
  Outlays...........................                      29         246
                                    ------------------------------------
Total:
  Budget Authority..................      17,209      17,649      17,148
  Outlays...........................      17,725      18,099      18,164
                                    ====================================

    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      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.04 Supplemental grants for population 
        increases.......................                     128         319
00.05 Bonus to reward decrease in 
        illegitimacy....................                    -100        -100
00.07 Bonus to reward high performance 
        States..........................                    -100        -100
00.08 Responsible Fatherhood Program....                      40          40
00.09 Family Formation Grants...........                     100         100
00.10 Healthy Marriage Research & Tech 
        Asst............................                     100         100
                                           ---------   ---------  ----------
10.00   Total new obligations (object 
          class 41.0)...................                     168         359
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance carried 
        forward, start of year..........                                -400
22.00 New budget authority (gross)......                    -232         459
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......                    -232          59
23.95 Total new obligations.............                    -168        -359
                                           ---------   ---------  ----------
24.40   Unobligated balance carried 
          forward, end of year..........                    -400        -300
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.00   Appropriation...................                    -232         459
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..                                 139
73.10 Total new obligations.............                     168         359
73.20 Total outlays (gross).............                     -29        -246
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..                     139         252
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................                      29         135
86.98 Outlays from mandatory balances...                                 111
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........                      29         246
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                    -232         459
90.00 Outlays...........................                      29         246
---------------------------------------------------------------------------

    This schedule reflects additional proposals to be included in the 
reauthorization of the Temporary Assistance for Needy

[[Page 458]]

Families program. These include funding for Supplemental Grants and 
initiatives to support healthy marriage, family formation, and 
responsible fatherhood activities.

                                

                            Contingency Fund

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1522-0-1-609      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Contingency Fund..................                      38          39
                                           ---------   ---------  ----------
10.00   Total new obligations (object 
          class 41.0)...................                      38          39
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance carried 
        forward, start of year..........                               1,920
22.00 New budget authority (gross)......       1,958       1,958
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......       1,958       1,958       1,920
23.95 Total new obligations.............                     -38         -39
23.98 Unobligated balance expiring or 
        withdrawn.......................      -1,958
                                           ---------   ---------  ----------
24.40   Unobligated balance carried 
          forward, end of year..........                   1,920       1,881
----------------------------------------------------------------------------

    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:
72.40 Obligated balance, start of year..                                   8
73.10 Total new obligations.............                      38          39
73.20 Total outlays (gross).............                     -30         -39
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..                       8           8
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................                      30
86.98 Outlays from mandatory balances...                                  39
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........                      30          39
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................       1,958       1,958
90.00 Outlays...........................                      30          39
---------------------------------------------------------------------------

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

                                     2004 actual  2005 est.   2006 est.
Enacted/requested:
  Budget Authority..................       1,958       1,958
  Outlays...........................                      30          39
Legislative proposal, subject to 
    PAYGO:
  Budget Authority..................                      42
  Outlays...........................                                   6
                                    ------------------------------------
Total:
  Budget Authority..................       1,958       2,000
  Outlays...........................                      30          45
                                    ====================================

                            Contingency Fund

                (Legislative proposal, subject to PAYGO)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1522-4-1-609      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Direct 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).............                                  -6
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.98 Outlays from mandatory balances...                                   6
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                      42
90.00 Outlays...........................                                   6
---------------------------------------------------------------------------

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

                                

  Payments to States for Child Support Enforcement and Family Support 
                                Programs

    For making payments to States or other non-Federal entities under 
titles I, IV-D, X, XI, XIV, and XVI of the Social Security Act and the 
Act of July 5, 1960 (24 U.S.C. ch. 9), [$2,873,802,000] $2,121,643,000, 
to remain available until expended; and for such purposes for the first 
quarter of fiscal year [2006] 2007, $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. (Department of Health and Human Services 
Appropriations Act, 2005.)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1501-0-1-609      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 State child support administrative 
        costs...........................       3,348       3,403       3,560
00.02 Child support incentive payments..         454         446         458
00.03 Access and visitation grants......          10          10          10
                                           ---------   ---------  ----------
00.91   Subtotal, child support 
          enforcement...................       3,812       3,859       4,028
01.02 Payments to territories...........          23          33          33
01.03 Repatriation......................           1           1           1
                                           ---------   ---------  ----------
01.91   Subtotal, other payments........          24          34          34
02.01 AFDC benefit payments.............          20
09.01 Offset obligations (cse grants to 
        states).........................         192         208         208
                                           ---------   ---------  ----------
10.00   Total new obligations...........       4,048       4,101       4,270
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance carried 
        forward, start of year..........                     559         740
22.00 New budget authority (gross)......       4,605       4,282       3,530
22.10 Resources available from 
        recoveries of prior year 
        obligations.....................           2
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......       4,607       4,841       4,270
23.95 Total new obligations.............      -4,048      -4,101      -4,270
                                           ---------   ---------  ----------
24.40   Unobligated balance carried 
          forward, end of year..........         559         740
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.00   Appropriation...................       3,313       2,874       2,122

[[Page 459]]

65.00   Advance appropriation...........       1,100       1,200       1,200
69.00 Offsetting collections (cash).....         192         208         208
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................       4,605       4,282       3,530
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..         797         836         795
73.10 Total new obligations.............       4,048       4,101       4,270
73.20 Total outlays (gross).............      -4,007      -4,142      -4,289
73.45 Recoveries of prior year 
        obligations.....................          -2
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..         836         795         776
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................       3,487       3,015       3,019
86.98 Outlays from mandatory balances...         520       1,127       1,270
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       4,007       4,142       4,289
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

        Offsetting collections (cash) 
            from:
88.00     Federal sources...............        -192
88.45     Offsetting governmental 
            collections (from non-
            Federal sources)............                    -208        -208
                                           ---------   ---------  ----------
88.90       Total, offsetting 
              collections (cash)........        -192        -208        -208
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................       4,413       4,074       3,322
90.00 Outlays...........................       3,815       3,934       4,081
---------------------------------------------------------------------------

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

                                     2004 actual  2005 est.   2006 est.
Enacted/requested:
  Budget Authority..................       4,413       4,074       3,322
  Outlays...........................       3,815       3,934       4,081
Legislative proposal, subject to 
    PAYGO:
  Budget Authority..................                                 -50
  Outlays...........................                                 -50
                                    ------------------------------------
Total:
  Budget Authority..................       4,413       4,074       3,272
  Outlays...........................       3,815       3,934       4,031
                                    ====================================

    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 and 
assumes enactment of legislative proposals effective in FY 2006.

             Net Federal Costs of Child Support Enforcement

                        (In millions of dollars)

                                        2004         2005        2006
Gross Federal share of collections..      -1,096      -1,087      -1,110
Federal incentive payments to States         454         446         458
State child support administrative 
costs...............................       3,540       3,610       3,716
Access and visitation grants........          10          10          12
                                    ------------------------------------
    Total...........................       2,908       2,979       3,076
                                    ====================================

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1501-0-1-609      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
41.0  Direct obligations: Grants, 
        subsidies, and contributions....       3,856       3,893       4,062
99.0  Reimbursable obligations: 
        Reimbursable obligations........         192         208         208
                                           ---------   ---------  ----------
99.9    Total new obligations...........       4,048       4,101       4,270
---------------------------------------------------------------------------

                                

  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      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 State child support administrative 
        costs...........................                                 -52
00.03 Access and visitation grants......                                   2
                                           ---------   ---------  ----------
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).............                                  50
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................                                 -50
----------------------------------------------------------------------------

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

    This legislative proposal increases child support collections and 
directs 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, [$1,900,000,000] $1,800,000,000.
    For making payments under title XXVI of the Omnibus Budget 
Reconciliation Act of 1981, [$300,000,000] $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[: Provided further, That the 
entire amount is designated as an emergency requirement pursuant to 
section 402 of S. Con. Res. 95 (108th Congress) as made applicable to 
the House of Representatives by H. Res. 649 (108th Congress) and 
applicable to the Senate by section 14007 of Public Law 108-287] and 
notwithstanding the designation requirement by section 2602(e). 
(Department of Health and Human Services Appropriations Act, 2005.)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1502-0-1-609      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Direct program activity...........       1,889       2,182       2,000
                                           ---------   ---------  ----------
10.00   Total new obligations...........       1,889       2,182       2,000
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......       1,889       2,182       2,000
23.95 Total new obligations.............      -1,889      -2,182      -2,000
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.00   Appropriation...................       1,900       1,900       1,800
40.00   Appropriation...................                     300         200
40.35   Appropriation permanently 
          reduced.......................         -11         -18
                                           ---------   ---------  ----------
43.00     Appropriation (total 
            discretionary)..............       1,889       2,182       2,000
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..         492         487         549
73.10 Total new obligations.............       1,889       2,182       2,000
73.20 Total outlays (gross).............      -1,891      -2,115      -2,026

[[Page 460]]

73.40 Adjustments in expired accounts 
        (net)...........................          -3          -5
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..         487         549         523
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................       1,404       1,680       1,540
86.93 Outlays from discretionary 
        balances........................         487         435         486
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       1,891       2,115       2,026
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................       1,889       2,182       2,000
90.00 Outlays...........................       1,891       2,115       2,026
---------------------------------------------------------------------------

    This program makes grants to States and Indian Tribes to aid low-
income households with high energy costs through payments to eligible 
households, energy suppliers, and weatherization providers. Obligation 
estimates for the contingency fund are based on average historical 
obligation rates.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1502-0-1-609      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
25.1  Advisory and assistance services..                                   1
41.0  Grants, subsidies, and 
        contributions...................       1,889       2,182       1,999
                                           ---------   ---------  ----------
99.9    Total new obligations...........       1,889       2,182       2,000
---------------------------------------------------------------------------

                                

                     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 the 
Torture Victims Relief Act of 2003 (Public Law 108-179), [$488,336,000] 
$552,040,000, of which up to [$10,000,000] $9,915,000 shall be available 
to carry out the Trafficking Victims Protection Act of 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 [2005] 2006 shall 
be available for the costs of assistance provided and other activities 
to remain available through September 30, [2007] 2008. (Department of 
Health and Human Services Appropriations Act, 2005.)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1503-0-1-609      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Refugee and entrant assistance....         410         458         479
00.02 Assistance for treatment of 
        torture victims.................          10          10          10
00.03 Unaccompanied alien children......          53          54          63
                                           ---------   ---------  ----------
10.00   Total new obligations...........         473         522         552
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance carried 
        forward, start of year..........          28           8
22.00 New budget authority (gross)......         448         484         552
22.10 Resources available from 
        recoveries of prior year 
        obligations.....................           6          30
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......         482         522         552
23.95 Total new obligations.............        -473        -522        -552
                                           ---------   ---------  ----------
24.40   Unobligated balance carried 
          forward, end of year..........           8
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.00   Appropriation...................         450         488         552
40.35   Appropriation permanently 
          reduced.......................          -2          -4
                                           ---------   ---------  ----------
43.00     Appropriation (total 
            discretionary)..............         448         484         552
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..         542         483         491
73.10 Total new obligations.............         473         522         552
73.20 Total outlays (gross).............        -517        -484        -504
73.40 Adjustments in expired accounts 
        (net)...........................          -9
73.45 Recoveries of prior year 
        obligations.....................          -6         -30
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..         483         491         539
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................         151         165         188
86.93 Outlays from discretionary 
        balances........................         366         319         316
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........         517         484         504
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.00   Offsetting collections (cash) 
          from: Federal sources.........          -6
      Against gross budget authority only:

88.96   Portion of offsetting 
          collections (cash) credited to 
          expired accounts..............           6
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................         448         484         552
90.00 Outlays...........................         511         484         504
---------------------------------------------------------------------------

    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      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
11.1  Personnel compensation: Full-time 
        permanent.......................           1           2           3
25.1  Advisory and assistance services..           5          11          12
25.2  Other services....................          10                       1
25.3  Other purchases of goods and 
        services from Government 
        accounts........................           6           5           5
41.0  Grants, subsidies, and 
        contributions...................         451         504         531
                                           ---------   ---------  ----------
99.9    Total new obligations...........         473         522         552
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-1503-0-1-609      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
    Direct:
1001  Total compensable workyears: 
        Civilian full-time equivalent 
        employment......................          13          18          28
---------------------------------------------------------------------------

                                

                   Promoting Safe and Stable Families

    For carrying out section 436 of the Social Security Act, 
$305,000,000 and for section 437, [$99,383,000] $105,000,000. 
(Department of Health and Human Services Appropriations Act, 2005.)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1512-0-1-506      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Grants to States and Tribes.......         382         381         387
00.02 Research, training and technical 
        assistance......................           9           9           9
00.03 State court assessment activities.          13          13          14
                                           ---------   ---------  ----------
10.00   Total new obligations...........         404         403         410
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......         404         403         410
23.95 Total new obligations.............        -404        -403        -410
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.00   Appropriation...................         100          99         105
40.35   Appropriation permanently 
          reduced.......................          -1          -1
                                           ---------   ---------  ----------

[[Page 461]]


43.00     Appropriation (total 
            discretionary)..............          99          98         105
      Mandatory:

60.00   Appropriation...................         305         305         305
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................         404         403         410
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..         463         436         444
73.10 Total new obligations.............         404         403         410
73.20 Total outlays (gross).............        -423        -395        -404
73.40 Adjustments in expired accounts 
        (net)...........................          -8
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..         436         444         450
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................          26          25          27
86.93 Outlays from discretionary 
        balances........................          61          69          72
86.97 Outlays from new mandatory 
        authority.......................          81          79          79
86.98 Outlays from mandatory balances...         255         222         226
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........         423         395         404
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................         404         403         410
90.00 Outlays...........................         424         395         404
---------------------------------------------------------------------------

    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      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
25.1  Advisory and assistance services..           3           4           3
25.3  Other purchases of goods and 
        services from Government 
        accounts........................           1
41.0  Grants, subsidies, and 
        contributions...................         400         399         407
                                           ---------   ---------  ----------
99.9    Total new obligations...........         404         403         410
---------------------------------------------------------------------------

                                

                    Child Care Entitlement to States

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1550-0-1-609      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Mandatory child care..............       1,178       1,178       1,178
00.02 Matching child care...............       1,493       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...........       2,732       2,717       2,717
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......       2,732       2,717       2,717
23.95 Total new obligations.............      -2,732      -2,717      -2,717
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.00   Appropriation...................       2,717       2,717       2,717
63.00   Reappropriation.................          15
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................       2,732       2,717       2,717
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..         965         956         955
73.10 Total new obligations.............       2,732       2,717       2,717
73.20 Total outlays (gross).............      -2,695      -2,718      -2,718
73.40 Adjustments in expired accounts 
        (net)...........................         -46
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..         956         955         954
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................       1,920       1,929       1,929
86.98 Outlays from mandatory balances...         775         789         789
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       2,695       2,718       2,718
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................       2,732       2,717       2,717
90.00 Outlays...........................       2,695       2,718       2,718
---------------------------------------------------------------------------

    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      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
25.1  Advisory and assistance services..           7           7           7
41.0  Grants, subsidies, and 
        contributions...................       2,725       2,710       2,710
                                           ---------   ---------  ----------
99.9    Total new obligations...........       2,732       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] $2,082,910,000 shall be used to 
supplement, not supplant State general revenue funds for child care 
assistance for low-income families: Provided, That [$19,120,000] 
$18,967,040 shall be available for child care resource and referral and 
school-aged child care activities, of which [$1,000,000] $992,000 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] $270,490,624 shall be reserved by the 
States for activities authorized under section 658G, of which 
[$100,000,000] $99,200,000 shall be for activities that improve the 
quality of infant and toddler care: Provided further, That [$10,000,000] 
$9,920,000 shall be for use by the Secretary for child care research, 
demonstration, and evaluation activities. (Department of Health and 
Human Services Appropriations Act, 2005.)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1515-0-1-609      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Block grant payments to States....       2,077       2,073       2,073
00.04 Research and evaluation fund......          10          10          10
09.00 Reimbursable program..............                       1           1
                                           ---------   ---------  ----------
10.00   Total new obligations...........       2,087       2,084       2,084
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......       2,088       2,083       2,083
23.95 Total new obligations.............      -2,087      -2,084      -2,084
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.00   Appropriation...................       2,100       2,100       2,083
40.35   Appropriation permanently 
          reduced.......................         -12         -17
                                           ---------   ---------  ----------
43.00     Appropriation (total 
            discretionary)..............       2,088       2,083       2,083
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..         805         749         734
73.10 Total new obligations.............       2,087       2,084       2,084
73.20 Total outlays (gross).............      -2,138      -2,099      -2,083
73.40 Adjustments in expired accounts 
        (net)...........................          -5
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..         749         734         735
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................       1,476       1,479       1,479
86.93 Outlays from discretionary 
        balances........................         662         620         604
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       2,138       2,099       2,083
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................       2,088       2,083       2,083
90.00 Outlays...........................       2,137       2,099       2,083
---------------------------------------------------------------------------

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

[[Page 462]]

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1515-0-1-609      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

      Direct obligations:

25.1    Advisory and assistance services           6           6           6
25.3    Other purchases of goods and 
          services from Government 
          accounts......................           1           1           1
41.0    Grants, subsidies, and 
          contributions.................       2,080       2,076       2,076
                                           ---------   ---------  ----------
99.0      Direct obligations............       2,087       2,083       2,083
99.0  Reimbursable obligations..........                       1           1
                                           ---------   ---------  ----------
99.9    Total new obligations...........       2,087       2,084       2,084
---------------------------------------------------------------------------

                                

                       Social Services Block Grant

    For making grants to States pursuant to section 2002 of the Social 
Security Act, $1,700,000,000: Provided, That notwithstanding 
subparagraph (B) of section 404(d)(2) of such Act, the applicable 
percent specified under such subparagraph for a State to carry out State 
programs pursuant to title XX of such Act shall be 10 percent. 
(Department of Health and Human Services Appropriations Act, 2005.)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1534-0-1-506      2004 actual   2005 est.   2006 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..........           4           4           4
22.00 New budget authority (gross)......       1,700       1,700       1,700
                                           ---------   ---------  ----------
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..         618         563         499
73.10 Total new obligations.............       1,700       1,700       1,700
73.20 Total outlays (gross).............      -1,752      -1,764      -1,762
73.40 Adjustments in expired accounts 
        (net)...........................          -3
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..         563         499         437
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................       1,397       1,394       1,394
86.98 Outlays from mandatory balances...         355         370         368
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       1,752       1,764       1,762
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................       1,700       1,700       1,700
90.00 Outlays...........................       1,752       1,764       1,762
---------------------------------------------------------------------------

                                

                 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) 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, [sections 40155, 
40211, and 40241 of Public Law 103-322,] and section 126 and titles IV 
and V of Public Law 100-485, [$9,069,853,000] $8,386,293,000, of which 
[$32,103,000] $31,846,000, to remain available until September 30, 
[2006] 2007, 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, [2005] 2006: Provided further, That 
[$6,898,580,000] $6,888,136,000 shall be for making payments under the 
Head Start Act, of which $45,000,000 shall be for grants to States that 
directly administer the Head Start program, notwithstanding section 640 
of such Act; and of which [$1,400,000,000] $1,388,800,000 shall become 
available October 1, [2005] 2006 and remain available through September 
30, [2006] 2007: Provided further, [That $732,385,000 shall be for 
making payments under the Community Services Block Grant Act: Provided 
further, That not less than $7,300,000 shall be for section 680(3)(B) of 
the Community Services Block Grant Act, Provided further, That within 
amounts provided herein for abstinence education for adolescents, up to 
$10,000,000 may be available for a national abstinence education 
campaign: 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 [$55,000,000] $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] $14,879,000 shall be for activities authorized by the 
Help America Vote Act of 2002, of which [$10,000,000] $9,919,000 shall 
be for payments to States to promote access for voters with 
disabilities, and of which [$5,000,000] $4,960,000 shall be for payments 
to States for protection and advocacy systems for voters with 
disabilities: Provided further, That [$100,000,000] $138,045,000 shall 
be 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 abstinence education was provided: Provided further, 
That within amounts provided herein for abstinence education for 
adolescents, up to $10,000,000 may be available for a national 
abstinence education campaign: Provided further, That in addition to 
amounts provided herein for abstinence education for adolescents, 
$4,500,000 shall be available from amounts available under section 241 
of the Public Health Services Act to carry out evaluations (includ

[[Page 463]]

ing 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. (Department of Health and Human Services Appropriations 
Act, 2005.)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1536-0-1-506      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
01.01 Head start........................       6,774       6,843       6,888
01.02 Early Learning Opportunities......          34          35
01.03 Runaway and homeless youth (Basic 
        Centers)........................          49          49          49
01.04 Transitional living...............          40          40          40
01.05 Maternity group homes.............                                  10
01.06 Education grants to reduce sexual 
        abuse of runaway youth..........          15          15          15
01.07 Abstinence education (Mandatory)..          10          25
01.08 Mentoring children of prisoners...          50          50          50
01.09 Child abuse State grants..........          22          27          27
01.10 Child abuse discretionary 
        activities......................          34          31          32
01.11 Community based resource centers..          33          43          43
01.12 Child welfare services............         289         290         290
01.13 Child welfare training............           7           7           7
01.14 Adoption opportunities............          27          27          27
01.15 Abandoned infants.................          12          12          12
01.16 Adoption incentives...............          18          32          32
01.17 Independent training vouchers.....          45          47          60
01.18 Children's health act programs....          13          13          13
01.19 State grants......................          73          72          72
01.20 Protection and advocacy...........          38          38          38
01.21 Projects of national significance.          12          12          11
01.22 Centers for excellence............          27          32          31
01.23 Voting access for individuals with 
        disabilities....................          15          15          15
01.24 Native American programs..........          45          45          45
01.25 Social services and income 
        maintenance research............          13          26
01.26 Compassion capital fund...........          48          54         100
01.28 Federal administration............         177         185         186
01.29 Faith-based center................           2           1           1
01.30 Abstinence Education 
        (Discretionary).................                      99         138
                                           ---------   ---------  ----------
01.91   Subtotal........................       7,922       8,165       8,232
      Community services programs:

03.01   Community services block grants.         642         631
03.03   Rural communtiy facilities......           7           7
03.04   Community services discretionary 
          (JOLI & CED)..................          32          33
03.05   Community food and nutrition....           7           7
03.06 Individual development accounts...          25          25          25
03.07 National youth sports.............          18          18
03.08 Domestic violence hotline.........           3           3           3
03.09 Grants for battered women's 
        shelters........................         126         126         126
                                           ---------   ---------  ----------
03.91   Subtotal........................         860         850         154
                                           ---------   ---------  ----------
04.00   Total, direct program...........       8,782       9,015       8,386
09.01 Reimbursable program..............          14          22          22
                                           ---------   ---------  ----------
10.00   Total new obligations...........       8,796       9,037       8,408
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance carried 
        forward, start of year..........          29          10          10
22.00 New budget authority (gross)......       8,791       9,037       8,409
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......       8,820       9,047       8,419
23.95 Total new obligations.............      -8,796      -9,037      -8,408
23.98 Unobligated balance expiring or 
        withdrawn.......................         -14
                                           ---------   ---------  ----------
24.40   Unobligated balance carried 
          forward, end of year..........          10          10          11
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.00   Appropriation...................       7,417       7,681       6,998
40.35   Appropriation permanently 
          reduced.......................         -53         -73
41.00   Transferred to other accounts...                      -7
                                           ---------   ---------  ----------
43.00     Appropriation (total 
            discretionary)..............       7,364       7,601       6,998
55.00   Advance appropriation...........       1,400       1,389       1,389
      Mandatory:

60.00   Appropriation...................          13          25
      Spending authority from offsetting 
          collections:

        Discretionary:
68.00     Offsetting collections (cash).           5          22          22
68.10     Change in uncollected customer 
            payments from Federal 
            sources (unexpired).........           9
                                           ---------   ---------  ----------
68.90       Spending authority from 
              offsetting collections 
              (total discretionary).....          14          22          22
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................       8,791       9,037       8,409
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..       4,753       4,782       4,918
73.10 Total new obligations.............       8,796       9,037       8,408
73.20 Total outlays (gross).............      -8,689      -8,901      -8,658
73.40 Adjustments in expired accounts 
        (net)...........................         -71
74.00 Change in uncollected customer 
        payments from Federal sources 
        (unexpired).....................          -9
74.10 Change in uncollected customer 
        payments from Federal sources 
        (expired).......................           2
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..       4,782       4,918       4,668
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................       4,763       4,827       4,473
86.93 Outlays from discretionary 
        balances........................       3,916       4,065       4,173
86.97 Outlays from new mandatory 
        authority.......................          10           9
86.98 Outlays from mandatory balances...                                  12
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       8,689       8,901       8,658
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.00   Offsetting collections (cash) 
          from: Federal sources.........         -12         -22         -22
      Against gross budget authority only:

88.95   Change in uncollected customer 
          payments from Federal sources 
          (unexpired)...................          -9
88.96   Portion of offsetting 
          collections (cash) credited to 
          expired accounts..............           7
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................       8,777       9,015       8,387
90.00 Outlays...........................       8,677       8,879       8,636
---------------------------------------------------------------------------

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

                                     2004 actual  2005 est.   2006 est.
Enacted/requested:
  Budget Authority..................       8,777       9,015       8,387
  Outlays...........................       8,677       8,879       8,636
Legislative proposal, subject to 
    PAYGO:
  Budget Authority..................                      25          50
  Outlays...........................                       9          30
                                    ------------------------------------
Total:
  Budget Authority..................       8,777       9,040       8,437
  Outlays...........................       8,677       8,888       8,666
                                    ====================================

    The FY 2006 Budget proposes to consolidate the Community Services 
Block Grant, Community Economic Development, and Rural Community 
Facilities programs into a new economic and community development 
program to be administered by the Department of Commerce. The new 
program would be designed to achieve greater results and focus on 
communities most in need of assistance.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1536-0-1-506      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

      Direct obligations:

        Personnel compensation:
11.1      Full-time permanent...........         104         112         110
11.3      Other than full-time permanent           1           2           1
11.5      Other personnel compensation..           1           1           1
                                           ---------   ---------  ----------
11.9        Total personnel compensation         106         115         112
12.1    Civilian personnel benefits.....          21          23          22
21.0    Travel and transportation of 
          persons.......................           4           4           4
23.1    Rental payments to GSA..........          16          18          19
23.3    Communications, utilities, and 
          miscellaneous charges.........           2           3           3
24.0    Printing and reproduction.......           2           3           3
25.1    Advisory and assistance services         125         131         132
25.2    Other services..................           6          14          19
25.3    Other purchases of goods and 
          services from Government 
          accounts......................          79          75          74
25.4    Operation and maintenance of 
          facilities....................           1           1           1
25.5    Research and development 
          contracts.....................                       5
25.7    Operation and maintenance of 
          equipment.....................           1
26.0    Supplies and materials..........           1           1           1

[[Page 464]]

31.0    Equipment.......................           1
41.0    Grants, subsidies, and 
          contributions.................       8,417       8,622       7,996
                                           ---------   ---------  ----------
99.0      Direct obligations............       8,782       9,015       8,386
99.0  Reimbursable obligations..........          14          22          22
                                           ---------   ---------  ----------
99.9    Total new obligations...........       8,796       9,037       8,408
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-1536-0-1-506      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
    Direct:
1001  Total compensable workyears: 
        Civilian full-time equivalent 
        employment......................       1,250       1,292       1,213
---------------------------------------------------------------------------

                                

                 Children and Families Services Programs

                (Legislative proposal, subject to PAYGO)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1536-4-1-506      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
01.07 Abstinence education..............                      25          50
                                           ---------   ---------  ----------
10.00   Total new obligations (object 
          class 41.0)...................                      25          50
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                      25          50
23.95 Total new obligations.............                     -25         -50
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.00   Appropriation...................                      25          50
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..                                  16
73.10 Total new obligations.............                      25          50
73.20 Total outlays (gross).............                      -9         -30
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..                      16          36
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................                       9          18
86.98 Outlays from mandatory balances...                                  12
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........                       9          30
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                      25          50
90.00 Outlays...........................                       9          30
---------------------------------------------------------------------------

    The budget extends funding for State-based abstinence education 
activities for five years. These activities formerly administered by the 
Health Resources and Services Administration have been transferred 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      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..           6           2
73.20 Total outlays (gross).............          -1          -2
73.40 Adjustments in expired accounts 
        (net)...........................          -3
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..           2
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.93 Outlays from discretionary 
        balances........................           1           2
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays...........................           1           2
---------------------------------------------------------------------------

                                

              Children's Research and Technical Assistance

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1553-0-1-609      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Training and technical assistance.          11          12          11
00.02 Federal parent locator service....          24          25          23
00.03 Child welfare study...............           6           3
00.04 Welfare research..................          15           8
09.01 Reimbursable program..............          11          15          19
                                           ---------   ---------  ----------
10.00   Total new obligations...........          67          63          53
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance carried 
        forward, start of year..........           2           4           1
22.00 New budget authority (gross)......          67          60          53
22.10 Resources available from 
        recoveries of prior year 
        obligations.....................           2
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......          71          64          54
23.95 Total new obligations.............         -67         -63         -53
                                           ---------   ---------  ----------
24.40   Unobligated balance carried 
          forward, end of year..........           4           1           1
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.00   Appropriation...................          56          45          34
69.00 Offsetting collections (cash).....          11          15          19
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................          67          60          53
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..          29          48          47
73.10 Total new obligations.............          67          63          53
73.20 Total outlays (gross).............         -45         -64         -66
73.45 Recoveries of prior year 
        obligations.....................          -2
74.10 Change in uncollected customer 
        payments from Federal sources 
        (expired).......................          -1
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..          48          47          34
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................          19          28          30
86.98 Outlays from mandatory balances...          26          36          36
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........          45          64          66
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

        Offsetting collections (cash) 
            from:
88.00     Federal sources...............         -11          -6          -7
88.40     Non-Federal sources...........                      -9         -12
                                           ---------   ---------  ----------
88.90       Total, offsetting 
              collections (cash)........         -11         -15         -19
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................          56          45          34
90.00 Outlays...........................          35          49          47
---------------------------------------------------------------------------

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

                                     2004 actual  2005 est.   2006 est.
Enacted/requested:
  Budget Authority..................          56          45          34
  Outlays...........................          34          49          47
Legislative proposal, subject to 
    PAYGO:
  Budget Authority..................                       7          15
  Outlays...........................                                   4
                                    ------------------------------------
Total:
  Budget Authority..................          56          52          49
  Outlays...........................          34          49          51
                                    ====================================

                                                            

[[Page 465]]



    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 for Needy Families account 
under Healthy Marriage and Family Formation activities.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1553-0-1-609      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

      Direct obligations:

11.1    Personnel compensation: Full-
          time permanent................           7           7           7
12.1    Civilian personnel benefits.....           1           1           1
21.0    Travel and transportation of 
          persons.......................           1           1           1
23.1    Rental payments to GSA..........           3           3           3
25.1    Advisory and assistance services          36          29          17
25.2    Other services..................           1           1           1
25.3    Other purchases of goods and 
          services from Government 
          accounts......................           4           4           2
41.0    Grants, subsidies, and 
          contributions.................           3           2           2
                                           ---------   ---------  ----------
99.0      Direct obligations............          56          48          34
99.0  Reimbursable obligations..........          11          15          19
                                           ---------   ---------  ----------
99.9    Total new obligations...........          67          63          53
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-1553-0-1-609      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
    Direct:
1001  Total compensable workyears: 
        Civilian full-time equivalent 
        employment......................          73          70          70
---------------------------------------------------------------------------

              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      2004 actual   2005 est.   2006 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..                                   7
73.10 Total new obligations.............                       7          15
73.20 Total outlays (gross).............                                  -4
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..                       7          18
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................                                   2
86.98 Outlays from mandatory balances...                                   2
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........                                   4
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                       7          15
90.00 Outlays...........................                                   4
---------------------------------------------------------------------------

    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      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
25.1  Advisory and assistance services..                       7          13
25.2  Other services....................                                   1
41.0  Grants, subsidies, and 
        contributions...................                                   1
                                           ---------   ---------  ----------
99.9    Total new obligations...........                       7          15
---------------------------------------------------------------------------

                                

                         Disabled Voter Services

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1533-0-1-808      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..          15          12           4
73.20 Total outlays (gross).............          -3          -8          -4
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..          12           4
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.93 Outlays from discretionary 
        balances........................           3           8           4
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays...........................           3           8           4
---------------------------------------------------------------------------

                                

       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, [$5,037,900,000] $4,852,800,000.
    For making payments to States or other non-Federal entities under 
title IV-E of the Act, for the first quarter of fiscal year [2006] 2007, 
[$1,767,200,000] $1,730,000,000.
    For making, after May 31 of the current fiscal year, payments to 
States or other non-Federal entities under section 474 of title IV-E, 
for the last 3 months of the current fiscal year for unanticipated 
costs, incurred for the current fiscal year, such sums as may be 
necessary. (Department of Health and Human Services Appropriations Act, 
2005.)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1545-0-1-609      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Foster care.......................       4,742       4,627       4,685
00.02 Independent living................         140         140         140
00.04 Adoption assistance...............       1,544       1,703       1,795
                                           ---------   ---------  ----------
10.00   Total new obligations...........       6,426       6,470       6,620
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......       6,814       6,806       6,620
23.95 Total new obligations.............      -6,426      -6,470      -6,620
23.98 Unobligated balance expiring or 
        withdrawn.......................        -388        -336
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.00   Appropriation...................       5,068       5,038       4,853
65.00   Advance appropriation...........       1,746       1,768       1,767
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................       6,814       6,806       6,620
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..       1,167       1,245       1,241
73.10 Total new obligations.............       6,426       6,470       6,620
73.20 Total outlays (gross).............      -6,341      -6,474      -6,619
73.40 Adjustments in expired accounts 
        (net)...........................          -7
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..       1,245       1,241       1,242
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................       5,495       5,534       5,691
86.98 Outlays from mandatory balances...         846         940         928
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       6,341       6,474       6,619
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

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

88.96   Portion of offsetting 
          collections (cash) credited to 
          expired accounts..............           1
----------------------------------------------------------------------------

[[Page 466]]



    Net budget authority and outlays:
89.00 Budget authority..................       6,814       6,806       6,620
90.00 Outlays...........................       6,340       6,474       6,619
---------------------------------------------------------------------------

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

                                     2004 actual  2005 est.   2006 est.
Enacted/requested:
  Budget Authority..................       6,814       6,806       6,620
  Outlays...........................       6,340       6,474       6,619
Legislative proposal, subject to 
    PAYGO:
  Budget Authority..................                                 -40
  Outlays...........................                                 -58
                                    ------------------------------------
Total:
  Budget Authority..................       6,814       6,806       6,580
  Outlays...........................       6,340       6,474       6,561
                                    ====================================

    Foster care.--The proposed level will support eligible low-income 
children who must be placed outside the home. An average of 230,300 
children per month will be served in 2006.

    Adoption assistance.--The proposed funding level will support 
subsidies for families adopting eligible low-income children with 
special needs. An average of 369,500 children per month will be served 
in 2006.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1545-0-1-609      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
25.1  Advisory and assistance services..           6          13          14
41.0  Grants, subsidies, and 
        contributions...................       6,420       6,457       6,606
                                           ---------   ---------  ----------
99.9    Total new obligations...........       6,426       6,470       6,620
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-1545-0-1-609      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
    Direct:
1001  Total compensable workyears: 
        Civilian full-time equivalent 
        employment......................           2           2           2
---------------------------------------------------------------------------

       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      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Foster care.......................                                 -40
                                           ---------   ---------  ----------
10.00   Total new obligations...........                                 -40
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                                 -40
23.95 Total new obligations.............                                  40
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.00   Appropriation...................                                 -40
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..
73.10 Total new obligations.............                                 -40
73.20 Total outlays (gross).............                                  58
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..                                  18
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................                                 -58
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                                 -40
90.00 Outlays...........................                                 -58
---------------------------------------------------------------------------

    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 face far 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      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
25.5  Research and development contracts                                   1
41.0  Grants, subsidies, and 
        contributions...................                                 -41
                                           ---------   ---------  ----------
99.9    Total new obligations...........                                 -40
---------------------------------------------------------------------------

                                


 
                         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, [$1,404,634,000] $1,369,028,000, 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 $4,558,000 shall remain available until 
September 30, 2007, for the White House Conference on Aging]. 
(Department of Health and Human Services Appropriations Act, 2005.)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0142-0-1-506      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
01.01 Home and community-based 
        supportive services.............         354         354         354
01.02 Preventive health services........          22          22          22
01.03 National family caregiver support 
        program.........................         153         156         156
01.04 Native American caregiver support 
        program.........................           6           6           6
01.05 Congregate nutrition services.....         386         387         387
01.06 Home-delivered nutrition services.         180         183         183
01.07 Nutrition services incentive 
        program.........................         148         149         149
01.08 Native American nutrition and 
        supportive services.............          27          26          26
01.09 Program innovations...............          34          43          24
01.10 Aging network support activities..          13          13          13
01.11 Long-term care ombudsmen program..          14          14          14
01.12 Prevention of elder abuse and 
        neglect.........................           5           5           5
01.13 Alzheimer's disease demonstration 
        grants..........................          12          12          12
01.14 Program administration............          17          18          18
01.15 White House Conference on Aging...           1           3           4
                                           ---------   ---------  ----------
02.00   Total, direct program...........       1,372       1,391       1,373
09.01 Reimbursable program..............           4           4           4
                                           ---------   ---------  ----------
10.00   Total new obligations...........       1,376       1,395       1,377
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance carried 
        forward, start of year..........                       2           4
22.00 New budget authority (gross)......       1,378       1,397       1,373
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......       1,378       1,399       1,377
23.95 Total new obligations.............      -1,376      -1,395      -1,377
                                           ---------   ---------  ----------
24.40   Unobligated balance carried 
          forward, end of year..........           2           4
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.00   Appropriation...................       1,382       1,404       1,369
40.35   Appropriation permanently 
          reduced.......................          -8         -11
                                           ---------   ---------  ----------
43.00     Appropriation (total 
            discretionary)..............       1,374       1,393       1,369
68.00 Spending authority from offsetting 
        collections: Offsetting 
        collections (cash)..............           4           4           4
                                           ---------   ---------  ----------

[[Page 467]]


70.00   Total new budget authority 
          (gross).......................       1,378       1,397       1,373
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..         542         572         596
73.10 Total new obligations.............       1,376       1,395       1,377
73.20 Total outlays (gross).............      -1,350      -1,371      -1,383
73.40 Adjustments in expired accounts 
        (net)...........................           1
74.10 Change in uncollected customer 
        payments from Federal sources 
        (expired).......................           3
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..         572         596         590
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................         876         882         876
86.93 Outlays from discretionary 
        balances........................         474         489         507
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       1,350       1,371       1,383
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.00   Offsetting collections (cash) 
          from: Federal sources.........          -8          -4          -4
      Against gross budget authority only:

88.96   Portion of offsetting 
          collections (cash) credited to 
          expired accounts..............           4
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................       1,374       1,393       1,369
90.00 Outlays...........................       1,342       1,367       1,379
---------------------------------------------------------------------------
    Note.--The reimbursable program (HCFAC) in the Administration on 
Aging (AoA) reflects the estimated distribution of the allocation 
account for 2006. Actual 2006 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 continued 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. Re-balancing the long-
term care system will provide older Americans more choices and 
opportunities for independence.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0142-0-1-506      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

      Direct obligations:

11.1    Personnel compensation: Full-
          time permanent................          10          11          11
12.1    Civilian personnel benefits.....           2           2           2
21.0    Travel and transportation of 
          persons.......................                       1           2
23.1    Rental payments to GSA..........           2           2           2
23.3    Communications, utilities, and 
          miscellaneous charges.........                                   1
24.0    Printing and reproduction.......                                   1
25.1    Advisory and assistance services           7           7           6
25.2    Other services..................           1           1           1
25.3    Other purchases of goods and 
          services from Government 
          accounts......................           7           8           7
41.0    Grants, subsidies, and 
          contributions.................       1,343       1,359       1,340
                                           ---------   ---------  ----------
99.0      Direct obligations............       1,372       1,391       1,373
99.0  Reimbursable obligations..........           4           4           4
                                           ---------   ---------  ----------
99.9    Total new obligations...........       1,376       1,395       1,377
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-0142-0-1-506      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
    Direct:
1001  Total compensable workyears: 
        Civilian full-time equivalent 
        employment......................         110         119         116
    Reimbursable:
2001  Total compensable workyears: 
        Civilian full-time equivalent 
        employment......................           7           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, and 
research studies under section 1110 of the Social Security Act, 
[$371,975,000] $353,595,000, together with [$55,851,000] $5,581,000 to 
be transferred and expended as authorized by section 201(g)(1) of the 
Social Security Act from the Hospital Insurance Trust Fund and the 
Supplemental Medical Insurance Trust Fund, and $39,552,000 from the 
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 of the funds made available under this 
heading for carrying out title XX of the Public Health Service Act, 
$13,120,000 shall be for activities specified under section 2003(b)(2), 
all of which 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, [$52,838,000] $52,415,000 
shall be for minority AIDS prevention and treatment activities; 
[$14,847,000] $14,630,000 shall be for an Information Technology 
Security and Innovation Fund for Department-wide activities involving 
cybersecurity, information technology security, and related innovation 
projects; and [$6,000,000] $5,952,000 shall be 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: 
[Provided further, That no more than $2,754,000 shall be available for 
the Office of the Assistant Secretary for Legislation: Provided further, 
That $50,000,000 shall be transferred to the Social Security 
Administration for processing Medicare appeals: Provided further, That 
specific information requests from the chairmen and ranking members of 
the Subcommittees on Labor, Health and Human Services, and Education, 
and Related Agencies, on scientific research or any other matter, shall 
be transmitted to the Committees on Appropriations in a prompt 
professional manner and within the time frame specified in the request: 
Provided further, That scientific information requested by the 
Committees on Appropriations and prepared by government researchers and 
scientists shall be transmitted to the Committees on Appropriations, 
uncensored and without delay.]

                         Office for Civil Rights

    For expenses necessary for the Office for Civil Rights, 
[$32,043,000] $31,682,000, 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, 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 206 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, [$2,208,287,000] $2,427,833,000: 
Provided, That this amount is distributed as follows: Centers for 
Disease Control and Prevention, [$1,173,300,000] $1,016,723,000; Office 
of the Secretary, [$64,438,000] $83,589,000; Strategic National 
Stockpile, [$400,000,000] $600,000,000, to remain available until 
expended; National Institutes of Health, [$47,400,000] $97,021,000; and 
Health Resources and Services Administration, [$523,149,000: 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

[[Page 468]]

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] $510,500,000: Provided further, That at the discretion of 
the Secretary, these amounts may be transferred between categories 
subject to normal reprogramming procedures: Provided further, That from 
amounts provided in this paragraph, up to $1,800,000, to remain 
available until expended, is for Individual Learning Accounts for full-
time equivalent employees of the Centers for Disease Control and 
Prevention.
    In addition, for activities to ensure a year-round influenza vaccine 
production capacity; the development and implementation of rapidly 
expandable influenza vaccine production technologies; and if determined 
necessary by the Secretary, the purchase of influenza vaccine, 
[$100,000,000] $120,000,000, to remain available until expended. 
(Department of Health and Human Services Appropriations Act, 2005.)
    [For an additional amount for ``Public Health and Social Services 
Emergency Fund'' to support aging services, social services and health 
services associated with natural disaster recovery and response efforts, 
$50,000,000, to remain available until expended: Provided, That such 
amount is designated as an emergency requirement pursuant to section 402 
of S. Con. Res. 95 (108th Congress), as made applicable to the House of 
Representatives by H. Res. 649 (108th Congress) and applicable to the 
Senate by section 14007 of Public Law 108-287.] (Emergency Supplemental 
Appropriations for Hurricane Disasters Assistance Act, 2005.)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9912-0-1-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 General departmental management...         361         375         353
00.02 Office for Civil Rights...........          31          32          32
00.04 Public health and social services 
        emergency fund..................       2,433       2,604       2,428
09.01 Reimbursable program..............         199         275         159
09.02 Reimbursable program (HCFAC)......           5           5           5
                                           ---------   ---------  ----------
10.00   Total new obligations...........       3,029       3,291       2,977
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance carried 
        forward, start of year..........         187         313          26
22.00 New budget authority (gross)......       3,147       3,004       2,977
22.10 Resources available from 
        recoveries of prior year 
        obligations.....................          10
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......       3,344       3,317       3,003
23.95 Total new obligations.............      -3,029      -3,291      -2,977
23.98 Unobligated balance expiring or 
        withdrawn.......................          -2
                                           ---------   ---------  ----------
24.40   Unobligated balance carried 
          forward, end of year..........         313          26          26
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.00   Appropriation...................       2,563       2,762       2,813
40.35   Appropriation permanently 
          reduced.......................         -14         -23
40.36   Unobligated balance permanently 
          reduced.......................                     -20
42.00   Transferred from other accounts.           8           5
                                           ---------   ---------  ----------
43.00     Appropriation (total 
            discretionary)..............       2,557       2,724       2,813
      Mandatory:

60.00   Appropriation...................         200
      Spending authority from offsetting 
          collections:

        Discretionary:
68.00     Offsetting collections (cash).         165         275         159
68.00     Offsetting collections (cash) 
            HCFAC.......................           5           5           5
68.10     Change in uncollected customer 
            payments from Federal 
            sources (unexpired).........         220
                                           ---------   ---------  ----------
68.90       Spending authority from 
              offsetting collections 
              (total discretionary).....         390         280         164
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................       3,147       3,004       2,977
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..       3,281       3,548       4,113
73.10 Total new obligations.............       3,029       3,291       2,977
73.20 Total outlays (gross).............      -2,616      -2,726      -3,202
73.40 Adjustments in expired accounts 
        (net)...........................          -9
73.45 Recoveries of prior year 
        obligations.....................         -10
74.00 Change in uncollected customer 
        payments from Federal sources 
        (unexpired).....................        -220
74.10 Change in uncollected customer 
        payments from Federal sources 
        (expired).......................          93
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..       3,548       4,113       3,888
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................         585         793         680
86.93 Outlays from discretionary 
        balances........................       2,031       1,933       2,522
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       2,616       2,726       3,202
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.00   Offsetting collections (cash) 
          from: Federal sources.........        -256        -280        -164
      Against gross budget authority only:

88.95   Change in uncollected customer 
          payments from Federal sources 
          (unexpired)...................        -220
88.96   Portion of offsetting 
          collections (cash) credited to 
          expired accounts..............          86
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................       2,757       2,724       2,813
90.00 Outlays...........................       2,360       2,446       3,038
---------------------------------------------------------------------------
    Note.--The reimbursable program (HCFAC) in Departmental Management 
reflects the estimated distribution from the allocation account for 2005 
and 2006. Actual 2005 and 2006 distributions will be determined by the 
Secretary of HHS and the Attorney General.

                          (Dollars in millions)

                                     2004 actual  2005 est.   2006 est.
Distribution of budget authority by 
    account:
  General Departmental Management 
    \1\.............................         362         373         353
  Office for Civil Rights...........          31          32          32
  Public Health and Social Services 
    Emergency Fund..................       2,364       2,319       2,428
Distribution of outlays by account:
  General Departmental Management...         326         379         325
  Office for Civil Rights...........          30          33          32
  Public Health and Social Services 
    Emergency Fund..................       2,004       2,034       2,681
    \1\ Includes $10 million for the Health Information Technology 
Initiative in 2005.

    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 nondiscrimination and health information privacy compliance 
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 2006 Budget displays the transfer of 
the Strategic National Stockpile from DHS into HHS as enacted in P.L. 
108-276 on a three-year comparable basis. All budget authority, balances 
and outlays are shown in HHS in all years.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9912-0-1-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

      Direct obligations:

        Personnel compensation:
11.1      Full-time permanent...........         107         122         127
11.3      Other than full-time permanent           5           4           4
11.5      Other personnel compensation..           2           2           2
11.7      Military personnel............           5           5           5
                                           ---------   ---------  ----------
11.9        Total personnel compensation         119         133         138
12.1    Civilian personnel benefits.....          27          29          30
12.2    Military personnel benefits.....           1           1           1
13.0    Benefits for former personnel...           1
21.0    Travel and transportation of 
          persons.......................           5           4           4
23.1    Rental payments to GSA..........          21          24          25
23.3    Communications, utilities, and 
          miscellaneous charges.........           5           5           5
24.0    Printing and reproduction.......           3           2           2
25.1    Advisory and assistance services          17           4           4
25.2    Other services..................          48          85          75

[[Page 469]]

25.3    Other purchases of goods and 
          services from Government 
          accounts......................         236          32          32
25.4    Operation and maintenance of 
          facilities....................          10           3           3
25.7    Operation and maintenance of 
          equipment.....................           3          22          22
26.0    Supplies and materials..........           3           2           2
31.0    Equipment.......................           6           3           3
41.0    Grants, subsidies, and 
          contributions.................         109         137         122
                                           ---------   ---------  ----------
99.0      Direct obligations............         614         486         468
99.0  Reimbursable obligations..........         204         280         164
      Allocation Account:

        Personnel compensation:
11.1      Full-time permanent...........          42          44          45
11.3      Other than full-time permanent           3           3           3
11.5      Other personnel compensation..           2           2           3
                                           ---------   ---------  ----------
11.9        Total personnel compensation          47          49          51
12.1    Civilian personnel benefits.....          16          16          17
21.0    Travel and transportation of 
          persons.......................           9           9           9
22.0    Transportation of things........          11           9          11
23.1    Rental payments to GSA..........          13          11          12
23.3    Communications, utilities, and 
          miscellaneous charges.........           9           9           9
24.0    Printing and reproduction.......                       1           1
25.1    Advisory and assistance services          67          64          64
25.2    Other services..................         132         197         180
25.3    Other purchases of goods and 
          services from Government 
          accounts......................          37          42          39
25.4    Operation and maintenance of 
          facilities....................           2           6           6
25.5    Research and development 
          contracts.....................          89         123         158
25.7    Operation and maintenance of 
          equipment.....................           4          27          23
26.0    Supplies and materials..........          15         258         452
31.0    Equipment.......................         332           3           3
32.0    Land and structures.............           5
41.0    Grants, subsidies, and 
          contributions.................       1,423       1,701       1,310
                                           ---------   ---------  ----------
99.0      Allocation account............       2,211       2,525       2,345
                                           ---------   ---------  ----------
99.9    Total new obligations...........       3,029       3,291       2,977
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-9912-0-1-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
    Direct:
      Total compensable workyears:

1001    Civilian full-time equivalent 
          employment....................       1,311       1,400       1,401
1101    Military full-time equivalent 
          employment....................          97          71          70
    Reimbursable:
2001  Total compensable workyears: 
        Civilian full-time equivalent 
        employment......................         319         496         358
---------------------------------------------------------------------------

                                

                Health Information Technology Initiative

    For expenses necessary for the Office of the National Coordinator 
for Health Information Technology, including grants, contracts and 
cooperative agreements for the development and advancement of an 
interoperable national health information technology infrastructure, 
$75,000,000.

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0130-0-1-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Health Information Technology.....                                  75
09.01 Reimbursable program..............                                   6
                                           ---------   ---------  ----------
10.00   Total new obligations...........                                  81
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                                  81
23.95 Total new obligations.............                                 -81
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.00   Appropriation...................                                  75
68.00 Spending authority from offsetting 
        collections: Offsetting 
        collections (cash)..............                                   6
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................                                  81
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..
73.10 Total new obligations.............                                  81
73.20 Total outlays (gross).............                                 -45
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..                                  36
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................                                  45
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.00   Offsetting collections (cash) 
          from: Federal sources.........                                  -6
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                                  75
90.00 Outlays...........................                                  39
---------------------------------------------------------------------------

    This program supports coordination of Federal health information 
technology activities, and of Federal initiatives for the development 
and advancement of an interoperable national health information 
technology infrastructure, in cooperation with participants in the 
health sector. The Office of the National Coordinator for Health 
Information Technology was created by Executive Order 13335, for the 
purpose of addressing strategic planning, coordination, and the analysis 
of key technical, economic and other issues related to the public and 
private adoption of health information technology.

    Through this program, activities related to health information 
technology are coordinated across several HHS organizations, as shown in 
the following consolidated table.

                  Health Information Technology Funding

                  [Program level--Dollars in millions]

                                     2004 actual  2005 est.   2006 est.
Distribution of funding by account:
    Health Information Technology 
      Initiative....................           0           0          75
    General Departmental Management.           0          27           0
    Agency for Healthcare Research 
      and Quality...................          50          64          50
    National Library of Medicine....           0           9           0
    HIT Initiative Total............          50         100         125
    Federal Health Architecture and 
      Other Activities..............           2           8           8

    Note.--Includes budget authority, Public Health Service evaluation funds 
and other resources.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0130-0-1-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

      Direct obligations:

11.1    Personnel compensation: Full-
          time permanent................                                   4
12.1    Civilian personnel benefits.....                                   1
25.2    Other services..................                                  70
                                           ---------   ---------  ----------
99.0      Direct obligations............                                  75
99.0  Reimbursable obligations..........                                   6
                                           ---------   ---------  ----------
99.9    Total new obligations...........                                  81
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-0130-0-1-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
    Direct:
1001  Total compensable workyears: 
        Civilian full-time equivalent 
        employment......................                                  36
    Reimbursable:
2001  Total compensable workyears: 
        Civilian full-time equivalent 
        employment......................                                  21
---------------------------------------------------------------------------

                                

                            Medicare Appeals

    For expenses necessary for administrative law judges responsible for 
hearing cases under title XVIII of the Social Security Act (and related 
provisiosn of title XI of such Act), $80,000,000, to be transferred in 
appropriate part from the Federal Hospital Insurance and the Federal 
Supplementary Medical Insurance Trust Funds.

[[Page 470]]

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0139-0-1-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Direct Program Activity...........                                  80
                                           ---------   ---------  ----------
10.00   Total new obligations...........                                  80
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                                  80
23.95 Total new obligations.............                                 -80
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

68.00   Spending authority from 
          offsetting collections 
          (gross): Offsetting 
          collections (cash)............                                  80
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..
73.10 Total new obligations.............                                  80
73.20 Total outlays (gross).............                                 -68
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..                                  12
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................                                  68
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.00   Offsetting collections (cash) 
          from: Federal sources.........                                 -80
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays...........................                                 -12
---------------------------------------------------------------------------

    This activity funds the Office of Medicare Appeals, as directed by 
Medicare Prescription Drug, Improvement, and Modernization Act of 2003.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0139-0-1-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
11.1  Personnel compensation: Full-time 
        permanent.......................                                  21
12.1  Civilian personnel benefits.......                                   5
21.0  Travel and transportation of 
        persons.........................                                   3
23.1  Rental payments to GSA............                                   6
23.3  Communications, utilities, and 
        miscellaneous charges...........                                  17
25.1  Advisory and assistance services..                                   6
25.2  Other services....................                                   2
25.7  Operation and maintenance of 
        equipment.......................                                  20
                                           ---------   ---------  ----------
99.9    Total new obligations...........                                  80
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-0139-0-1-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
    Direct:
1001  Total compensable workyears: 
        Civilian full-time equivalent 
        employment......................                                 261
---------------------------------------------------------------------------

                                

                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. [chapters] chapter 55 [and 56]), 
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; all of which payments are provided for by the 
Retirement Pay and Medical Benefits for Commissioned Officers account.] 
(Department of Health and Human Services Appropriations Act, 2005.)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0379-0-1-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Retirement payments...............         227         241         256
00.02 Survivors' benefits...............          14          15          16
00.03 Medical care......................          53          55          57
00.04 Medicare Eligible Accruals........          27          33          34
                                           ---------   ---------  ----------
10.00   Total new obligations...........         321         344         363
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......         322         344         363
23.95 Total new obligations.............        -321        -344        -363
23.98 Unobligated balance expiring or 
        withdrawn.......................          -1
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.00   Appropriation...................          27          33          34
      Mandatory:

60.00   Appropriation...................         295         311         329
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................         322         344         363
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..          30          25          34
73.10 Total new obligations.............         321         344         363
73.20 Total outlays (gross).............        -320        -335        -361
73.40 Adjustments in expired accounts 
        (net)...........................          -5
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..          25          34          36
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................          24          30          31
86.93 Outlays from discretionary 
        balances........................           2           2           3
86.97 Outlays from new mandatory 
        authority.......................         266         280         296
86.98 Outlays from mandatory balances...          28          23          31
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........         320         335         361
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................         322         344         363
90.00 Outlays...........................         321         335         361
---------------------------------------------------------------------------

    The number of beneficiaries using the Commissioned Corps system is 
estimated as follows:

                      Eligible Beneficiary Category

                                       FY2004       FY2005      FY2006
Active Duty:
    Health and Human Services.......       4,989       5,138       5,150
    Department of Justice, Bureau of 
      Prisons.......................         667         667         667
    Department of Homeland Security.         181         181         181
    Environmental Protection Agency.          88          88          88
    All Other.......................          69          69          69
Total Active Duty...................       5,994       6,143       6,155
Retirees............................       4,364       4,472       4,582
Retiree Family Members and Survivors         636         648         660
Total Beneficiaries.................      10,994      11,263      11,397

    This activity funds annuities of retired Public Health Service (PHS) 
commissioned officers and survivors of retirees, and medical benefits 
for active duty PHS commissioned officers,

[[Page 471]]

retirees, and dependents of member and retirees of the PHS Commissioned 
Corps.

    The cost of medical benefits for Medicare-eligible beneficiaries is 
paid from the Department of Defense Medicare-Eligible Retiree Health 
Care Fund (10 U.S.C., ch. 56). Beginning in 2006, permanent indefinite 
authority is provided for a discretionary appropriation of the annual 
accrual payment into this fund (P.L. No. 108-375, section 725).

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0379-0-1-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
13.0  Benefits for former personnel.....         243         256         272
25.6  Medical care......................          78          88          91
                                           ---------   ---------  ----------
99.9    Total new obligations...........         321         344         363
---------------------------------------------------------------------------

                                

                         Health Activities Funds

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9913-0-1-552      2004 actual   2005 est.   2006 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      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
09.01 Program support center............         506         536         542
09.02 OS activities.....................          42          70          71
                                           ---------   ---------  ----------
10.00   Total new obligations...........         548         606         613
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance carried 
        forward, start of year..........          67          64          64
22.00 New budget authority (gross)......         545         606         613
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......         612         670         677
23.95 Total new obligations.............        -548        -606        -613
                                           ---------   ---------  ----------
24.40   Unobligated balance carried 
          forward, end of year..........          64          64          64
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

69.00   Offsetting collections (cash)...         499         606         613
69.10   Change in uncollected customer 
          payments from Federal sources 
          (unexpired)...................          46
                                           ---------   ---------  ----------
69.90     Spending authority from 
            offsetting collections 
            (total mandatory)...........         545         606         613
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..         -34         -35         -35
73.10 Total new obligations.............         548         606         613
73.20 Total outlays (gross).............        -503        -606        -613
74.00 Change in uncollected customer 
        payments from Federal sources 
        (unexpired).....................         -46
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..         -35         -35         -35
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................          90         606         613
86.98 Outlays from mandatory balances...         413
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........         503         606         613
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.00   Offsetting collections (cash) 
          from: Federal sources.........        -499        -606        -613
      Against gross budget authority only:

88.95   Change in uncollected customer 
          payments from Federal sources 
          (unexpired)...................         -46
----------------------------------------------------------------------------

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

    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, information technology, web management, claims, and 
acquisition integration and modernization.

    Most Commissioned Corps officers work for agencies in the Department 
of Health and Human Services and are reflected in the agencies' 
personnel summaries. However, some officers are assigned to other 
Federal agencies. The allocation account section in the following 
personnel summary shows officers assigned to other agencies which are 
paid directly by that agency, either through an allocation account or by 
directly citing that agency's appropriation.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9941-0-4-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

      Personnel compensation:

11.1    Full-time permanent.............          77         101         103
11.3    Other than full-time permanent..           4           5           5
11.5    Other personnel compensation....           2           2           2
11.7    Military personnel..............           8          11          11
                                           ---------   ---------  ----------
11.9      Total personnel compensation..          91         119         121
12.1  Civilian personnel benefits.......          23          29          30
12.2  Military personnel benefits.......           4           5           5
13.0  Benefits for former personnel.....           1           1           1
21.0  Travel and transportation of 
        persons.........................           6           6           6
22.0  Transportation of things..........           3           3           3
23.1  Rental payments to GSA............          12          15          16
23.3  Communications, utilities, and 
        miscellaneous charges...........          45          49          50
24.0  Printing and reproduction.........           1           1           1
25.1  Advisory and assistance services..          24          25          25
25.2  Other services....................         127         130         132
25.3  Other purchases of goods and 
        services from Government 
        accounts........................          37          39          39
25.4  Operation and maintenance of 
        facilities......................          19          19          19
25.6  Medical care......................          37          38          38
25.7  Operation and maintenance of 
        equipment.......................          22          22          22
26.0  Supplies and materials............          88          95          95
31.0  Equipment.........................           8          10          10
                                           ---------   ---------  ----------
99.9    Total new obligations...........         548         606         613
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-9941-0-4-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
    Reimbursable:
      Total compensable workyears:

2001    Civilian full-time equivalent 
          employment....................       1,111       1,454       1,453
2101    Military full-time equivalent 
          employment....................          95          99         100

[[Page 472]]

    Allocation account:
      Total compensable workyears:

3101    Military full-time equivalent 
          employment....................         667         667         667
3101    Military full-time equivalent 
          employment....................         250         250         250
---------------------------------------------------------------------------

                                

  

                               Trust Funds

                        Miscellaneous Trust Funds

                Unavailable Receipts (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9971-0-7-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
    Receipts:
02.00 Gifts and contributions, 
        Miscellaneous trust funds.......          11          43          43
02.20 Contributions, Indian health 
        facilities......................          38          38          38
                                           ---------   ---------  ----------
02.99   Total receipts and collections..          49          81          81
    Appropriations:
05.00 Miscellaneous trust funds.........         -49         -81         -81
                                           ---------   ---------  ----------
07.99 Balance, end of year..............
---------------------------------------------------------------------------

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9971-0-7-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.02 Gifts.............................          33          43          43
00.03 Contributions, Indian health 
        facilities......................          34          38          38
                                           ---------   ---------  ----------
10.00   Total new obligations...........          67          81          81
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance carried 
        forward, start of year..........         114         128         128
22.00 New budget authority (gross)......          81          81          81
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......         195         209         209
23.95 Total new obligations.............         -67         -81         -81
                                           ---------   ---------  ----------
24.40   Unobligated balance carried 
          forward, end of year..........         128         128         128
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.26   Appropriation (trust fund)......          49          81          81
60.26   Appropriation (trust fund)......          32
                                           ---------   ---------  ----------
62.50     Appropriation (total 
            mandatory)..................          81          81          81
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..          58          64          63
73.10 Total new obligations.............          67          81          81
73.20 Total outlays (gross).............         -61         -82         -93
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..          64          63          51
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................          12          17          17
86.98 Outlays from mandatory balances...          49          65          76
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........          61          82          93
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................          81          81          81
90.00 Outlays...........................          61          82          93
----------------------------------------------------------------------------

    Memorandum (non-add) entries:
92.01 Total investments, start of year: 
        Federal securities: Par value...          25          22          25
92.02 Total investments, end of year: 
        Federal securities: Par value...          22          25          25
---------------------------------------------------------------------------

                          [Dollars in millions]

                                        2004         2005        2006
Distribution of budget authority by 
    account:
  Gifts.............................          43          43          43
  Contributions, Indian health 
    facilities......................          38          38          38
Distribution of outlays by account:
  Gifts.............................          32          45          50
  Contributions, Indian health 
    facilities......................          29          37          43

    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      2004 actual   2005 est.   2006 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           2           2
25.1  Advisory and assistance services..           2           3           3
25.2  Other services....................          23          27          27
25.3  Other purchases of goods and 
        services from Government 
        accounts........................                       1           1
25.4  Operation and maintenance of 
        facilities......................           4           5           5
25.5  Research and development contracts           5           6           6
25.7  Operation and maintenance of 
        equipment.......................           1           1           1
26.0  Supplies and materials............           1           3           3
31.0  Equipment.........................           1           1           1
41.0  Grants, subsidies, and 
        contributions...................          26          29          29
                                           ---------   ---------  ----------
99.9    Total new obligations...........          67          81          81
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-9971-0-7-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
    Direct:
1001  Total compensable workyears: 
        Civilian full-time equivalent 
        employment......................          37          37          37
---------------------------------------------------------------------------

                                


 
                     OFFICE OF THE INSPECTOR GENERAL

General and special funds:

                       Office of Inspector General

    For expenses necessary for the Office of Inspector General, 
including the hire of passenger motor vehicles for investigations, in 
carrying out the provisions of the Inspector General Act of 1978, as 
amended, [$40,323,000] $39,813,000: 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: Provided further, 
That funds transferred to this heading pursuant to section 220 of the 
Department of Health and Human Services Appropriations Act, 2005, shall 
remain available until September 30, 2006. (Department of Health and 
Human Services Appropriations Act, 2005.)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0128-0-1-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Direct program....................          39          40          40
09.01 HCFAC reimbursable program........         164         167         165
09.02 Reimbursable program..............          20          44          19
                                           ---------   ---------  ----------
10.00   Total new obligations...........         223         251         224
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance carried 
        forward, start of year..........           1           1           1
22.00 New budget authority (gross)......         223         251         224
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......         224         252         225
23.95 Total new obligations.............        -223        -251        -224
                                           ---------   ---------  ----------
24.40   Unobligated balance carried 
          forward, end of year..........           1           1           1
----------------------------------------------------------------------------

[[Page 473]]



    New budget authority (gross), detail:
      Discretionary:

40.00   Appropriation...................          39          40          40
      Spending authority from offsetting 
          collections:

68.00   Offsetting collections (cash)...          15          44          19
68.10   Change in uncollected customer 
          payments from Federal sources 
          (unexpired)...................           5
                                           ---------   ---------  ----------
68.90     Spending authority from 
            offsetting collections 
            (total discretionary).......          20          44          19
      Mandatory:

69.00   Offsetting collections (cash)...         164         167         165
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................         223         251         224
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..          14          32          32
73.10 Total new obligations.............         223         251         224
73.20 Total outlays (gross).............        -221        -251        -224
73.40 Adjustments in expired accounts 
        (net)...........................          -1
74.00 Change in uncollected customer 
        payments from Federal sources 
        (unexpired).....................          -5
74.10 Change in uncollected customer 
        payments from Federal sources 
        (expired).......................          21
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..          32          32          32
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................          39          78          53
86.93 Outlays from discretionary 
        balances........................           2           6           6
86.97 Outlays from new mandatory 
        authority.......................         164         167         165
86.98 Outlays from mandatory balances...          16
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........         221         251         224
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.00   Offsetting collections (cash) 
          from: Federal sources.........        -200        -211        -184
      Against gross budget authority only:

88.95   Change in uncollected customer 
          payments from Federal sources 
          (unexpired)...................          -5
88.96   Portion of offsetting 
          collections (cash) credited to 
          expired accounts..............          21
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................          39          40          40
90.00 Outlays...........................          21          40          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, evaluations, 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, waste, 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)

                                         2004 actual   2005 est.   2006 est.
Budget Authority:
  Discretionary appropriations..........          39          40          40
  Mandatory (HCFAC Account).............         160         160         160
                                           ---------   ---------  ----------
      Total.............................         199         200         200
    Note.--The reimbursable program (HCFAC) in Office of the Inspector 
General reflects the estimated distribution of the allocation account 
for 2006. Actual 2006 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      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------

      Direct obligations:

        Personnel compensation:
11.1      Full-time permanent...........          21          22          22
11.5      Other personnel compensation..           1           1           1
                                           ---------   ---------  ----------
11.9        Total personnel compensation          22          23          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............          39          40          40
99.0  Reimbursable obligations..........         184         211         184
                                           ---------   ---------  ----------
99.9    Total new obligations...........         223         251         224
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-0128-0-1-551      2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
    Direct:
      Total compensable workyears:

1001    Civilian full-time equivalent 
          employment....................         284         278         268
1101    Military full-time equivalent 
          employment....................           1           1           1
    Reimbursable:
2001  Total compensable workyears: 
        Civilian full-time equivalent 
        employment......................       1,215       1,228       1,126
---------------------------------------------------------------------------

                                

                Allocations Received From Other Accounts

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

                                


 
                      GENERAL FUND RECEIPT ACCOUNTS

                           (in millions of dollars)

----------------------------------------------------------------------------
                                         2004 actual   2005 est.   2006 est.
----------------------------------------------------------------------------
Offsetting receipts from the public:
  75-274530  Health education assistance 
    loans, Downward reestimates of 
    subsidies...........................          49          55
  75-310700  Federal share of child 
    support collections.................       1,096       1,087       1,097
    Legislative proposal, subject to 
      PAYGO.............................                                  13
                                           ---------   ---------  ----------
General Fund Offsetting receipts from 
 the public.............................       1,145       1,142       1,110
---------------------------------------------------------------------------

                                


 
                           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 title for Head 
Start shall be used to pay the compensation of an individual, either as 
direct costs or any proration as an indirect cost, at a rate in excess 
of Executive Level II.
    [Sec. 206. 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.]

[[Page 474]]

    Sec. [207] 206. Notwithstanding section 241(a) of the Public Health 
Service Act, such portion as the Secretary shall determine, but not more 
than 2.4 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. [208] 207. 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 [a program, project, or activity] appropriations, 
but no such [program, project, or activity] appropriation shall be 
increased by more than 3 percent by any such transfer: Provided, That [a 
program, project, or activity] 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. 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. 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. 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. None of the funds appropriated by this Act (including 
funds appropriated to any trust fund) may be used to carry out the 
[Medicare+Choice] Medicare Advantage 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] Medicare 
Advantage organization described in this section shall be responsible 
for informing enrollees where to obtain information about all Medicare 
covered services.
    Sec. 212. 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, 2003, 2004, and 2005'' and inserting 
            ``1997, 1998, 1999, 2000, 2001, 2002, 2003, 2004, 2005, and 
            2006'';
                (B) in subsection (e), by striking ``October 1, 2004'' 
            each place it appears and inserting ``October 1, 2005''; and
                (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, 2004'' and inserting ``September 30, 
    2005''.]
    Sec. [214] 213. (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, [2005] 2006 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 
[2005] 2006 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 [2004] 2005, 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 [2004] 2005 State 
expenditures and all fiscal year [2005] 2006 obligations for tobacco 
prevention and compliance activities by program activity by July 31, 
[2005] 2006.
    (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, [2005] 
2006.
    (e) None of the funds appropriated by this Act may be used to 
withhold substance abuse funding pursuant to section 1926 from a 
territory that receives less than $1,000,000.
    Sec. [215] 214. 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 [2005] 2006, 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] 215. The Division of Federal Occupational Health 
hereafter may utilize personal services contracting to employ 
professional management/administrative and occupational health 
professionals.
    Sec. [217] 216. (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] for Medical Research.

[[Page 475]]

    (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. 217. Funds which are available for Individual Learning Accounts 
for employees of the Centers for Disease Control and Prevention and the 
Agency for Toxic Substances and Disease Registry may be transferred to 
``Disease Control, Research, and Training,'' to be available only for 
Individual Learning Accounts: Provided, That such funds may be used for 
any individual full-time equivalent employee while such employee is 
employed either by CDC or ATSDR.
    [Sec. 218. 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. 219. (a) Notwithstanding section 412.23(b)(2) of title 42 of 
the Code of Federal Regulations, none of the funds appropriated by this 
Act may be expended by the Secretary of Health and Human Services to 
treat a hospital or unit of a hospital that was certified by the 
Secretary as an inpatient rehabilitation facility on or before June 30, 
2004, as a subsection (d) hospital (as defined in section 1886(d)(1)(B) 
of the Social Security Act (42 U.S.C. 1395ww(d)(1)(B))) until, not later 
than 60 days after the date on which the report under subsection (b) is 
issued, the Secretary, taking into account the recommendations in such 
report--
        (1) determines that the classification criteria of hospitals and 
    units of hospitals as inpatient rehabilitation facilities under such 
    section 412.23(b)(2) are not inconsistent with such recommendations; 
    or
        (2) promulgates a regulation providing for revised criteria 
    under such section 412.23(b)(2), which regulation shall be effective 
    and final immediately on an interim basis as of the date of 
    publication of the regulation.
    (b) The study referred to in subsection (a) is a study by the 
Comptroller General of the United States directed in the statement of 
managers accompanying the conference report on the bill H.R. 1 of the 
108th Congress regarding clinically appropriate standards for defining 
inpatient rehabilitation services under such section 412.23(b)(2).]
    [Sec. 220. In addition to funds appropriated to the Office of 
Inspector General of the Department of Health and Human Services under 
Public Law 104-191 and this Act, $25,000,000 shall be transferred from 
amounts appropriated under section 1015(a)(1) of Public Law 108-173 for 
activities by the Office of Inspector General of the Department of 
Health and Human Services relating to oversight of programs established 
or revised by Public Law 108-173.]
    [Sec. 221. The unobligated balance of the Health Professions Student 
Loan program authorized in Subpart II, Federally-Supported Student Loan 
Funds, of title VII of the Public Health Services Act is rescinded.]
    [Sec. 222. The unobligated balance of the Nursing Student Loan 
program authorized by section 835 of the Public Health Services Act is 
rescinded.]
    [Sec. 223. The unobligated balance, excluding amounts necessary for 
the costs of potential defaults, in the Medical Facilities Guarantee and 
Loan Fund is rescinded.]
    [Sec. 224. The unobligated balance in the amount of $20,000,000 
appropriated by Public Law 108-11 under the heading ``Public Health and 
Social Services Emergency Fund'' is rescinded.]
    [Sec. 225. The Center for Biodefense and Emerging Infectious 
Diseases (Building 33) at the National Institutes of Health is hereby 
named the C.W. Bill Young Center for Biodefense and Emerging Infectious 
Diseases.] (Department of Health and Human Services Appropriations Act, 
2005.)
    [Sec. 119. Notwithstanding any other provision of law, in addition 
to amounts otherwise provided in this or any other Act for fiscal year 
2005, the following amounts are appropriated: $2,000,000 for the Helen 
Keller National Center for Deaf-Blind Youths and Adults for activities 
authorized under the Helen Keller National Center Act; and for the 
Department of Health and Human Services, Health Resources and Services 
Administration, $1,000,000 for the Hospital for Special Surgery to 
establish a National Center for Musculoskeletal Research, New York, New 
York, for facilities and equipment; and for the Department of Health and 
Human Services, Health Resources and Services Administration, $1,000,000 
for the Jesse Helms Nursing Center at Union Regional Medical Center, 
Union County, North Carolina for facilities and equipment.] 
(Miscellaneous Appropriations and Offsets Act, 2005.)
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