[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)
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Identification code 75-9911-0-1-554 2004 actual 2005 est. 2006 est.
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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..............
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Program and Financing (in millions of dollars)
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Identification code 75-9911-0-1-554 2004 actual 2005 est. 2006 est.
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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
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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
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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
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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
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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
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[[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
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[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
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Identification code 75-9911-0-1-554 2004 actual 2005 est. 2006 est.
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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%
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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)
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Identification code 75-9911-0-1-554 2004 actual 2005 est. 2006 est.
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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
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Personnel Summary
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Identification code 75-9911-0-1-554 2004 actual 2005 est. 2006 est.
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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
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Public enterprise funds:
Revolving Fund for Certification and Other Services
Program and Financing (in millions of dollars)
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Identification code 75-4309-0-3-554 2004 actual 2005 est. 2006 est.
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Obligations by program activity:
09.01 Reimbursable program.............. 6 6 6
--------- --------- ----------
10.00 Total new obligations........... 6 6 6
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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
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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
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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
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[[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)
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Identification code 75-4309-0-3-554 2004 actual 2005 est. 2006 est.
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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
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Personnel Summary
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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
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HEALTH RESOURCES AND SERVICES ADMINISTRATION
Federal Funds
General and special funds:
Health Resources and Services
For carrying out titles II, III, IV, VII, VIII, X, XII, [XIX,] and
XXVI of the Public Health Service Act, section 427(a) of the Federal
Coal Mine Health and Safety Act, title V 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)
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Identification code 75-0350-0-1-550 2004 actual 2005 est. 2006 est.
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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
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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
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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
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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
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Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in
millions of dollars)
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Identification code 75-0350-0-1-550 2004 actual 2005 est. 2006 est.
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Guaranteed loan levels supportable by subsidy
budget authority:
215001Health centers: Facilities
renovation loan guarantee levels 4 10 10
215002Health centers: Managed care
network development loan
guarantee levels................ 2 2
215003Health centers: Managed care plan
loan guarantee levels........... 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
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Administrative expense data:
351001Administrative expenses........... 1 1 1
359001Outlays for administrative
expenses........................ 1 1 1
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Activities displayed here support categorical health resources and
services grants, treatment and care for those living with HIV/AIDS, and
the medical malpractice claims 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)
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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
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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
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[[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
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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
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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
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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
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Net budget authority and outlays:
89.00 Budget authority.................. 39 40 40
90.00 Outlays........................... 21 40 40
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The Office of Inspector General (OIG) identifies and recommends
actions to correct fraud, waste, and abuse in HHS administered and
assisted programs and operations through audits, 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.
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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
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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
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Allocations Received From Other Accounts
Note.--Obligations incurred under allocations from other accounts
are included in the schedules of the parent appropriations as follows:
Centers for Medicare and Medicaid Services ``Health Care Fraud and Abuse
Control Account.''
GENERAL FUND RECEIPT ACCOUNTS
(in millions of dollars)
----------------------------------------------------------------------------
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
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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.)