[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 2007
[[Page 421]]
DEPARTMENT OF HEALTH AND HUMAN SERVICES
FOOD AND DRUG ADMINISTRATION
Federal Funds
General and special funds:
Salaries and Expenses
For necessary expenses of the Food and Drug Administration,
including hire and purchase of passenger motor vehicles; for payment of
space rental and related costs pursuant to Public Law 92-313 for
programs and activities of the Food and Drug Administration which are
included in this Act; for rental of special purpose space in the
District of Columbia or elsewhere; for miscellaneous and emergency
expenses of enforcement activities, authorized and approved by the
Secretary and to be accounted for solely on the Secretary's certificate,
not to exceed $25,000; and notwithstanding section 521 of Public Law
107-188; [$1,838,567,000] $1,916,329,000: Provided, That of the amount
provided under this heading, [$305,332,000] $320,600,000 shall be
derived from prescription drug user fees authorized by 21 U.S.C. 379h,
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] 2008 but collected in fiscal year
[2006] 2007; [$40,300,000] $43,726,000 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 [$11,318,000]
$11,604,000 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 [2006] 2007, including any such fees assessed prior to the current
fiscal year but credited during the current year, shall be subject to
the fiscal year [2006] 2007 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) $443,153,000 shall be for the Center for
Food Safety and Applied Nutrition and related field activities in the
Office of Regulatory Affairs; (2) $520,564,000 shall be for the Center
for Drug Evaluation and Research and related field activities in the
Office of Regulatory Affairs; (3) $178,714,000 shall be for the Center
for Biologics Evaluation and Research and for related field activities
in the Office of Regulatory Affairs; (4) $99,787,000 shall be for the
Center for Veterinary Medicine and for related field activities in the
Office of Regulatory Affairs; (5) $245,770,000 shall be for the Center
for Devices and Radiological Health and for related field activities in
the Office of Regulatory Affairs; (6) $41,152,000 shall be for the
National Center for Toxicological Research; (7) $58,515,000 shall be for
Rent and Related activities, of which $21,974,000 is for White Oak
Consolidation, other than the amounts paid to the General Services
Administration for rent; (8) $134,853,000 shall be for payments to the
General Services Administration for rent; and (9) $116,059,000 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, 2006.)
[For an additional amount for ``Food and Drug Administration,
Salaries and Expenses'', to prepare for and respond to an influenza
pandemic, $20,000,000, to remain available until September 30, 2007;
Provided, That of the total amount appropriated $18,000,000 shall be for
the Center for Biologics Evaluation and Research and for related field
activities in the Office of Regulatory Affairs, and $2,000,000 shall be
for other activities including the Office of the Commissioner and the
Office of Management: Provided further, That the amounts provided under
this heading are designated as an emergency requirement pursuant to
section 402 of H. Con. Res. 95 (109th Congress), the concurrent
resolution on the budget for fiscal year 2006.] (Emergency Supplemental
Appropriations Act to Address Hurricanes in the Gulf of Mexico and
Pandemic Influenza, 2006.)
Buildings and Facilities
For plans, construction, repair, improvement, extension, alteration,
and purchase of fixed equipment or facilities of or used by the Food and
Drug Administration, where not otherwise provided, [$8,000,000]
$4,950,000, to remain available until expended. (Agriculture, Rural
Development, Food and Drug Administration, and Related Agencies
Appropriations Act, 2006.)
Special and Trust Fund Receipts (in millions of dollars)
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Identification code 75-9911-0-1-554 2005 actual 2006 est. 2007 est.
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01.00 Balance, start of year............
--------- --------- ----------
01.99 Balance, start of year............
Receipts:
02.00 User fees, FDA--legislative
proposal subject to PAYGO....... 22
02.01 User fees, FDA--legislative
proposal subject to PAYGO....... 4
02.20 Cooperative research and
development agreements, FDA..... 3 3 3
--------- --------- ----------
02.99 Total receipts and collections.. 3 3 29
Appropriations:
05.00 Salaries and expenses............. -3 -3 -3
05.01 Salaries and expenses--legislative
proposal not subject to PAYGO... -22
05.02 Salaries and expenses--legislative
proposal not subject to PAYGO... -4
--------- --------- ----------
05.99 Total appropriations............ -3 -3 -29
--------- --------- ----------
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 2005 actual 2006 est. 2007 est.
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Obligations by program activity:
00.01 Foods............................. 436 439 450
00.02 Drugs............................. 506 526 551
00.03 Devices and radiological products. 215 220 229
00.04 National Center for Toxicological
Research........................ 40 40 34
00.05 Other activities.................. 87 87 88
00.06 Other rent and rent related
activities...................... 54 57 61
00.07 Rental payments................... 113 116 127
00.08 Buildings and facilities.......... 2 8 5
00.09 CRADAs............................ 2 2 2
09.01 Reimbursable program.............. 372 412 432
--------- --------- ----------
10.00 Total new obligations........... 1,827 1,907 1,979
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Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 78 101 104
22.00 New budget authority (gross)...... 1,849 1,910 1,980
22.10 Resources available from
recoveries of prior year
obligations..................... 1
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 1,928 2,011 2,084
23.95 Total new obligations............. -1,827 -1,907 -1,979
--------- --------- ----------
24.40 Unobligated balance carried
forward, end of year.......... 101 104 105
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New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 1,462 1,510 1,545
40.33 Appropriation permanently
reduced (P.L. 109-148)........ -15
40.35 Appropriation permanently
reduced....................... -12
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 1,450 1,495 1,545
[[Page 422]]
Mandatory:
60.20 Appropriation (special fund).... 3 3 3
Spending authority from offsetting
collections:
Discretionary:
68.00 Offsetting collections (cash). 386 412 432
68.10 Change in uncollected customer
payments from Federal
sources (unexpired)......... 33
68.26 Offsetting collections
(previously unavailable).... 163 186 186
68.45 Portion precluded from
obligation (limitation on
obligations)................ -186 -186 -186
--------- --------- ----------
68.90 Spending authority from
offsetting collections
(total discretionary)..... 396 412 432
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 1,849 1,910 1,980
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Change in obligated balances:
72.40 Obligated balance, start of year.. 408 491 529
73.10 Total new obligations............. 1,827 1,907 1,979
73.20 Total outlays (gross)............. -1,721 -1,869 -1,962
73.40 Adjustments in expired accounts
(net)........................... -10
73.45 Recoveries of prior year
obligations..................... -1
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... -33
74.10 Change in uncollected customer
payments from Federal sources
(expired)....................... 21
--------- --------- ----------
74.40 Obligated balance, end of year.. 491 529 546
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Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 1,594 1,539 1,598
86.93 Outlays from discretionary
balances........................ 128 327 361
86.97 Outlays from new mandatory
authority....................... -1 3 3
--------- --------- ----------
87.00 Total outlays (gross)........... 1,721 1,869 1,962
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
Offsetting collections (cash)
from:
88.00 Federal sources............... -36 -36 -36
88.45 Offsetting governmental
collections (from non-
Federal sources)............ -365 -376 -396
--------- --------- ----------
88.90 Total, offsetting
collections (cash)........ -401 -412 -432
Against gross budget authority only:
88.95 Change in uncollected customer
payments from Federal sources
(unexpired)................... -33
88.96 Portion of offsetting
collections (cash) credited to
expired accounts.............. 15
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 1,430 1,498 1,548
90.00 Outlays........................... 1,320 1,457 1,530
----------------------------------------------------------------------------
Memorandum (non-add) entries:
94.01 Unavailable balance, start of
year: Offsetting collections.... 163 186 186
94.02 Unavailable balance, end of year:
Offsetting collections.......... 186 186 186
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[In millions of dollars]
2005 2006 2007
Distribution of budget authority by
account:
Salaries and expenses....... 1,430 1,490 1,543
Buildings and facilities.... 0 8 5
Distribution of outlays by account:
Salaries and expenses....... 1,320 1,454 1,527
Buildings and facilities.... 0 3 3
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 funding for pandemic preparedness,
food defense, drug safety, tissue safety, the critical path to
personalized medicine, medical device and animal drug review, and
headquarters consolidation in White Oak, Maryland.
Object Classification (in millions of dollars)
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Identification code 75-9911-0-1-554 2005 actual 2006 est. 2007 est.
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Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 552 585 606
11.3 Other than full-time permanent 69 73 76
11.5 Other personnel compensation.. 22 23 24
11.7 Military personnel............ 42 45 47
--------- --------- ----------
11.9 Total personnel compensation 685 726 753
12.1 Civilian personnel benefits..... 167 177 184
12.2 Military personnel benefits..... 24 25 26
21.0 Travel and transportation of
persons....................... 23 22 23
22.0 Transportation of things........ 6 6 6
23.1 Rental payments to GSA.......... 113 116 124
23.2 Rental payments to others....... 3 3 3
23.3 Communications, utilities, and
miscellaneous charges......... 27 27 27
24.0 Printing and reproduction....... 3 3 3
25.1 Advisory and assistance services 43 42 42
25.2 Other services.................. 63 60 61
25.3 Other purchases of goods and
services from Government
accounts...................... 89 85 87
25.4 Operation and maintenance of
facilities.................... 46 45 46
25.5 Research and development
contracts..................... 33 33 33
25.7 Operation and maintenance of
equipment..................... 30 30 30
26.0 Supplies and materials.......... 24 22 23
31.0 Equipment....................... 45 44 44
32.0 Land and structures............. 3 2 2
41.0 Grants, subsidies, and
contributions................. 26 25 26
42.0 Insurance claims and indemnities 2 2 2
--------- --------- ----------
99.0 Direct obligations............ 1,455 1,495 1,545
99.0 Reimbursable obligations.......... 372 412 434
--------- --------- ----------
99.9 Total new obligations........... 1,827 1,907 1,979
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Personnel Summary
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Identification code 75-9911-0-1-554 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct:
1001 Civilian full-time equivalent
employment...................... 7,663 7,813 7,717
1101 Military full-time equivalent
employment...................... 589 584 584
Reimbursable:
2001 Civilian full-time equivalent
employment...................... 1,573 1,603 1,732
2101 Military full-time equivalent
employment...................... 120 126 126
Allocation account:
3001 Civilian full-time equivalent
employment...................... 10 10 10
3101 Military full-time equivalent
employment...................... 2 2 2
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Salaries and Expenses
(Legislative proposal, not subject to PAYGO)
In addition, the Secretary may, contingent upon the enactment of
authorizing legislation, charge a fee for conducting re-inspections and
issuing export certificates for food and animal feed: Provided, That
such fees, in an amount not to exceed $25,536,000, shall be credited to
this account, to remain available until expended for the purpose of such
re-inspections and issuance of export certificates for food and animal
feed: Provided further, That the amount appropriated from the General
Fund for fiscal year 2007 shall be reduced by the amount credited to
this account under this paragraph so as to result in a final fiscal year
2007 appropriation from the General Fund estimated at not more than
$1,545,349,000.
[[Page 423]]
Program and Financing (in millions of dollars)
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Identification code 75-9911-2-1-554 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... -26
40.20 Appropriation (special fund).... 22
40.20 Appropriation (special fund).... 4
--------- --------- ----------
43.00 Appropriation (total
discretionary)..............
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays...........................
---------------------------------------------------------------------------
Legislation will be proposed to allow the FDA to collect fees to
support activities related to re-inspections of FDA-regulated facilities
and issue export certificates for food and animal feeds. The FDA will be
able to use the fees to the extent provided in appropriations acts.
Public enterprise funds:
Revolving Fund for Certification and Other Services
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-4309-0-3-554 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
09.01 Reimbursable program.............. 6 6 6
--------- --------- ----------
10.00 Total new obligations........... 6 6 6
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 1 1 1
22.00 New budget authority (gross)...... 7 6 6
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 8 7 7
23.95 Total new obligations............. -6 -6 -6
--------- --------- ----------
24.40 Unobligated balance carried
forward, end of year.......... 1 1 1
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
69.00 Spending authority from
offsetting collections
(gross): Offsetting
collections (cash)............ 7 6 6
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 2 1 1
73.10 Total new obligations............. 6 6 6
73.20 Total outlays (gross)............. -6 -6 -6
--------- --------- ----------
74.40 Obligated balance, end of year.. 1 1 1
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 5 5 5
86.98 Outlays from mandatory balances... 1 1 1
--------- --------- ----------
87.00 Total outlays (gross)........... 6 6 6
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.40 Offsetting collections (cash)
from: Non-Federal sources..... -7 -6 -6
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays...........................
---------------------------------------------------------------------------
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 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
11.1 Personnel compensation: Full-time
permanent....................... 3 3 3
12.1 Civilian personnel benefits....... 1 1 1
23.1 Rental payments to GSA............ 1 1 1
25.2 Other services.................... 1 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 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Reimbursable:
2001 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 (``PHS 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 for expenses
necessary to support activities related to countering potential
biological, disease, nuclear, radiological and chemical threats to
civilian populations, [$6,539,661,000 of which $64,180,000 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 (of which
$25,000,000 is for a Delta health initiative Rural Health, Education,
and Workforce Infrastructure Demonstration Program which shall solicit
and fund proposals from local governments, hospitals, universities, and
rural public health-related entities and organizations for research
development, educational programs, job training, and construction of
public health-related facilities)] $6,308,855,000: Provided, That of the
funds made available under this heading, [$222,000] $220,000 shall be
available until expended for facilities renovations at the Gillis W.
Long Hansen's Disease Center: Provided further, That in addition to fees
authorized by section 427(b) of the Health Care Quality Improvement Act
of 1986, fees shall be collected for the full disclosure of information
under the Act sufficient to recover the full costs of operating the
National Practitioner Data Bank, and shall remain available until
expended to carry out that Act: Provided further, That fees collected
for the full disclosure of information under the ``Health Care Fraud and
Abuse Data Collection Program'', authorized by section 1128E(d)(2) of
the Social Security Act, shall be sufficient to recover the full costs
of operating the program, and shall remain available until expended to
carry out that Act: [Provided further, That no more than $40,000 is
available until expended for carrying out the provisions of 42 U.S.C.
233(o) including associated administrative expenses:] Provided further,
That no more than [$45,000,000] $44,550,000 is available until expended
for carrying out the provisions of Public Law 104-73 and for expenses
incurred by the Department of Health and Human Services pertaining to
administrative claims made under such law: [Provided further, That
$4,000,000 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,
[$285,963,000] $283,103,000 shall be for the program under title X of
the [Public Health Service] PHS 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 [$797,521,000] $789,546,000 shall
be for State AIDS Drug Assistance Programs authorized by section 2616 of
the [Public Health Service] PHS Act: Provided further, That in addition
to grants provided under this heading pursuant to subpart I of part B of
title XXVI of the PHS Act, and notwithstanding sections 2616 through
[[Page 424]]
2620 of the PHS Act, $70,000,000 shall be for awards to States for HIV/
AIDS care and treatment services: Provided further, That in addition to
amounts provided herein, $25,000,000 shall be available from amounts
available under section 241 of the [Public Health Service] PHS 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 $117,108,000 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, $39,680,000 shall be provided to the Denali Commission
as a direct lump payment pursuant to Public Law 106-113]. (Department of
Health and Human Services Appropriations Act, 2006.)
Program and Financing (in millions of dollars)
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Identification code 75-0350-0-1-550 2005 actual 2006 est. 2007 est.
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Obligations by program activity:
00.02 Loan guarantee subsidy............ 1 1
00.10 Health centers.................... 1,690 1,738 1,918
00.11 National Health Service Corps..... 45 40 40
00.12 National Health Service Corps
recruitment..................... 86 85 85
00.13 Hansen's Disease Center........... 17 16 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................ 32 31 31
00.17 Health professions................ 419 264 128
00.18 Maternal and child health block
grant........................... 724 693 693
00.19 Healthy start..................... 103 102 102
00.20 Poison control centers............ 23 23 13
00.21 EMS for children.................. 20 20
00.22 Universal newborn hearing
screening....................... 10 10
00.23 HIV/AIDS.......................... 2,048 2,038 2,133
00.24 Organ transplantation............. 24 23 23
00.25 Bone marrow donor registry........ 25 25 23
00.26 Rural health policy development... 9 9 9
00.27 Rural health outreach grants...... 39 39 10
00.28 Rural health flexibility grants... 39 64
00.29 Denali Commission................. 40 39
00.30 Telehealth........................ 4 7 7
00.31 Program management................ 147 145 141
00.32 Family planning................... 286 283 283
00.36 Health centers tort claim fund.... 23 45 45
00.37 Trauma EMS........................ 3
00.39 Childrens' GME.................... 301 297 99
00.42 State offices of rural health..... 8 8 8
00.43 Healthy communities access program 83
00.44 State planning grant program...... 10
00.45 Rural and community access to
emergency devices............... 9 1
00.46 Radiogenic diseases............... 2 2 2
00.47 Traumatic brain injury............ 9 9
00.49 Health care facilities
construction and miscellaneous
projects........................ 483
00.50 Cord blood stem cell bank......... 14 9
00.51 Bioterrorism activities........... 495 487
00.52 Free clinics medical malpractice.. 1
00.53 Other programs under threshhold... 1
00.54 Sickle cell....................... 2 2
00.55 Drug pricing program.............. 3
00.56 Family to family health
information centers............. 3
--------- --------- ----------
03.00 Total direct programs........... 6,771 6,576 6,322
09.01 Reimbursable program.............. 112 100 100
09.02 Reimbursable program: PHS
evaluation...................... 25 25 25
--------- --------- ----------
10.00 Total new obligations........... 6,908 6,701 6,447
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Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 71 98 85
22.00 New budget authority (gross)...... 6,934 6,688 6,431
22.10 Resources available from
recoveries of prior year
obligations..................... 1
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 7,006 6,786 6,516
23.95 Total new obligations............. -6,908 -6,701 -6,447
--------- --------- ----------
24.40 Unobligated balance carried
forward, end of year.......... 98 85 69
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New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 6,860 6,630 6,309
40.33 Appropriation permanently
reduced (P.L. 109-148)........ -67
40.35 Appropriation permanently
reduced....................... -64
40.36 Unobligated balance permanently
reduced....................... -20 -25 -6
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 6,776 6,538 6,303
Mandatory:
60.00 Appropriation................... 3
Spending authority from offsetting
collections:
Discretionary:
68.00 Offsetting collections (cash). 89 125 125
68.00 Offsetting collections (HPSL/
NSL Recall)................. 100
68.10 Change in uncollected customer
payments from Federal
sources (unexpired)......... 29
68.35 Offsetting collections
permanently reduced (-)..... -100
--------- --------- ----------
68.90 Spending authority from
offsetting collections
(total discretionary)..... 118 125 125
Mandatory:
69.00 Offsetting collections
(cash)(HPSL&NSL)............ 40 25
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 6,934 6,688 6,431
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Change in obligated balances:
72.40 Obligated balance, start of year.. 5,538 5,618 5,742
73.10 Total new obligations............. 6,908 6,701 6,447
73.20 Total outlays (gross)............. -6,795 -6,577 -6,592
73.40 Adjustments in expired accounts
(net)........................... -74
73.45 Recoveries of prior year
obligations..................... -1
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... -29
74.10 Change in uncollected customer
payments from Federal sources
(expired)....................... 71
--------- --------- ----------
74.40 Obligated balance, end of year.. 5,618 5,742 5,597
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 2,910 2,479 2,393
86.93 Outlays from discretionary
balances........................ 3,885 4,082 4,196
86.97 Outlays from new mandatory
authority....................... 3
86.98 Outlays from mandatory balances... 16
--------- --------- ----------
87.00 Total outlays (gross)........... 6,795 6,577 6,592
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
Offsetting collections (cash)
from:
88.00 Federal sources............... -157 -105 -105
88.40 Non-Federal sources........... -42 -45 -120
--------- --------- ----------
88.90 Total, offsetting
collections (cash)........ -199 -150 -225
Against gross budget authority only:
88.95 Change in uncollected customer
payments from Federal sources
(unexpired)................... -29
88.96 Portion of offsetting
collections (cash) credited to
expired accounts.............. 70
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 6,776 6,538 6,206
90.00 Outlays........................... 6,596 6,427 6,367
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Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in
millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0350-0-1-550 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Guaranteed loan levels supportable by subsidy
budget authority:
215001Health centers: Facilities
renovation loan guarantee levels 10 15
215002Health centers: Managed care
network development loan
guarantee levels................ 2
215003Health centers: Managed care plan
loan guarantee levels........... 5
--------- --------- ----------
215901Total loan guarantee levels....... 17 15
Guaranteed loan subsidy (in percent):
232001Health centers: Facilities
renovation loan guarantee levels 3.57 3.50
232002Health centers: Managed care
network development loan
guarantee levels................ 9.28 8.00
232003Health centers: Managed care plan
loan guarantee levels........... 7.33 8.17
--------- --------- ----------
232901Weighted average subsidy rate..... 0.00 0.00
[[Page 425]]
Guaranteed loan subsidy budget authority:
233001Health centers: Facilities
renovation loan guarantee levels 1 1
233002Health centers: Managed care
network development loan
guarantee levels................
233003Health centers: Managed care plan
loan guarantee levels...........
--------- --------- ----------
233901Total subsidy budget authority.... 1 1
Guaranteed loan subsidy outlays:
234001Health centers: Facilities
renovation loan guarantee levels 1 1
234002Health centers: Managed care
network development loan
guarantee levels................
234003Health centers: Managed care plan
loan guarantee levels...........
--------- --------- ----------
234901Total subsidy outlays............. 1 1
Guaranteed loan upward reestimate subsidy
budget authority:
235001Upward reestimate subsidy budget
authority--Facilities Loans.....
235002Upward reestimate subsidy budget
authority--HMP Plan Loans....... 1
--------- --------- ----------
235901Total upward reestimate budget
authority....................... 1
----------------------------------------------------------------------------
Administrative expense data:
351001Administrative expenses........... 1 1
359001Outlays for administrative
expenses........................ 1 1
---------------------------------------------------------------------------
Activities displayed here support categorical health resources and
services grants, treatment and care for those living with HIV/AIDS, and
the medical malpractice claims funds, which pay malpractice claims filed
against employees of federally-supported health centers.
The Budget proposes legislative reform of the Children's Hospitals
Graduate Medical Education payment program. The reform will focus
payments on those hospitals with the greatest financial need that treat
the largest number of uninsured patients and train the greatest number
of physicians.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0350-0-1-550 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 123 99 94
11.3 Other than full-time permanent 3 3 3
11.5 Other personnel compensation.. 4 2 2
11.7 Military personnel............ 1 26 24
--------- --------- ----------
11.9 Total personnel compensation 131 130 123
12.1 Civilian personnel benefits..... 27 25 23
12.2 Military personnel benefits..... 10 14 13
13.0 Benefits for former personnel... 4 1 1
21.0 Travel and transportation of
persons....................... 3 3 3
23.1 Rental payments to GSA.......... 4 3 3
23.2 Rental payments to others....... 10 10 10
23.3 Communications, utilities, and
miscellaneous charges......... 2 4 4
24.0 Printing and reproduction....... 2 1 1
25.1 Advisory and assistance services 53 64 64
25.2 Other services.................. 90 98 93
25.3 Other purchases of goods and
services from Government
accounts...................... 238 208 197
25.4 Operation and maintenance of
facilities.................... 1 2 2
25.6 Medical care.................... 3 3 3
25.7 Operation and maintenance of
equipment..................... 2 3 3
26.0 Supplies and materials.......... 2 2 2
31.0 Equipment....................... 2 1 1
33.0 Investments and loans........... 5 5 5
41.0 Grants, subsidies, and
contributions................. 6,159 5,954 5,725
42.0 Insurance claims and indemnities 23 45 46
--------- --------- ----------
99.0 Direct obligations............ 6,771 6,576 6,322
99.0 Reimbursable obligations.......... 137 125 125
--------- --------- ----------
99.9 Total new obligations........... 6,908 6,701 6,447
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-0350-0-1-550 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct:
1001 Civilian full-time equivalent
employment...................... 1,292 1,281 1,250
1101 Military full-time equivalent
employment...................... 272 264 259
Reimbursable:
2001 Civilian full-time equivalent
employment...................... 94 112 113
2101 Military full-time equivalent
employment...................... 191 216 221
Allocation account:
3001 Civilian full-time equivalent
employment...................... 22 4 4
3101 Military full-time equivalent
employment...................... 14
---------------------------------------------------------------------------
Vaccine Injury Compensation
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0320-0-1-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
09.01 Reimbursable program.............. 1
--------- --------- ----------
09.99 Total reimbursable program...... 1
--------- --------- ----------
10.00 Total new obligations (object
class 42.0)................... 1
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 2 2
22.00 New budget authority (gross)...... 1
23.33 Adjustment for changes in
allocation...................... 1
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 1 3 2
23.95 Total new obligations............. -1
--------- --------- ----------
24.40 Unobligated balance carried
forward, end of year.......... 2 2 2
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
69.00 Spending authority from
offsetting collections
(gross): Offsetting
collections (cash)............ 1
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 2
73.10 Total new obligations............. 1
73.20 Total outlays (gross)............. -1
--------- --------- ----------
74.40 Obligated balance, end of year..
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 1
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.40 Offsetting collections (cash)
from: Non-Federal sources..... -1
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays...........................
---------------------------------------------------------------------------
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
claims yet to be adjudicated, no appropriation is requested in 2007 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 Injury Compensation Program trust fund account.
[[Page 426]]
Credit accounts:
Health Center Guaranteed Loan Financing Account
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-4442-0-3-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 2 4 5
22.00 New financing authority (gross)... 2 1
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 4 5 5
--------- --------- ----------
24.40 Unobligated balance carried
forward, end of year.......... 4 5 5
----------------------------------------------------------------------------
New financing authority (gross), detail:
Mandatory:
69.00 Spending authority from
offsetting collections
(gross): Offsetting
collections (cash)............ 2 1
----------------------------------------------------------------------------
Offsets:
Against gross financing authority and
financing disbursements:
Offsetting collections (cash)
from:
88.00 Federal sources............... -1 -1
88.40 Non-Federal sources........... -1
--------- --------- ----------
88.90 Total, offsetting
collections (cash)........ -2 -1
----------------------------------------------------------------------------
Net financing authority and financing
disbursements:
89.00 Financing authority...............
90.00 Financing disbursements........... -1 -1
---------------------------------------------------------------------------
Status of Guaranteed Loans (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-4442-0-3-551 2005 actual 2006 est. 2007 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......................... 117 100 85
2142 Uncommitted loan guarantee
limitation...................... -85
2143 Uncommitted limitation carried
forward......................... -100 -85
--------- --------- ----------
2150 Total guaranteed loan
commitments................... 17 15
2199 Guaranteed amount of guaranteed
loan commitments................ 14 11
----------------------------------------------------------------------------
Cumulative balance of guaranteed loans
outstanding:
2210 Outstanding, start of year........ 23 40 55
2231 Disbursements of new guaranteed
loans........................... 17 15
2251 Repayments and prepayments........ -1
--------- --------- ----------
2290 Outstanding, end of year........ 40 55 54
----------------------------------------------------------------------------
Memorandum:
2299 Guaranteed amount of guaranteed
loans outstanding, end of year.. 38 40 39
---------------------------------------------------------------------------
P.L. 104-299 and P.L. 104-208 authorize HRSA to guarantee up to $160
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. The Budget proposes to
rescind the unobligated balances of the Health Center Guaranteed Loan
subsidy.
Balance Sheet (in millions of dollars)
-----------------------------------------------------------------------------------------------
Identification code 75-4442-0-3-551
2004 actual
2005 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,
[$2,916,000.] $2,887,000. (Department of Health and Human Services
Appropriations Act, 2006.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0340-0-1-552 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.07 Reestimates of Subsidy............ 7
00.08 Interest on reestimates of loan
guarantee subsidy............... 1
00.09 Administrative expenses........... 3 3 3
--------- --------- ----------
10.00 Total new obligations........... 11 3 3
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 11 3 3
23.95 Total new obligations............. -11 -3 -3
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 3 3 3
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 3 3 3
Mandatory:
60.00 Appropriation................... 8
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 11 3 3
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 2 2 2
73.10 Total new obligations............. 11 3 3
73.20 Total outlays (gross)............. -11 -3 -3
--------- --------- ----------
74.40 Obligated balance, end of year.. 2 2 2
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 3 3 3
86.97 Outlays from new mandatory
authority....................... 8
--------- --------- ----------
87.00 Total outlays (gross)........... 11 3 3
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 11 3 3
90.00 Outlays........................... 11 3 3
---------------------------------------------------------------------------
Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in
millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0340-0-1-552 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Guaranteed loan upward reestimate subsidy
budget authority:
235001HEAL Loan guarantee............... 8
--------- --------- ----------
235901Total upward reestimate budget
authority....................... 8
Guaranteed loan downward reestimate subsidy
budget authority:
237001HEAL Loan guarantee............... -55 -31
--------- --------- ----------
237901Total downward reestimate subsidy
budget authority................ -55 -31
----------------------------------------------------------------------------
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
[[Page 427]]
(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 2005 actual 2006 est. 2007 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................... 8
--------- --------- ----------
99.9 Total new obligations........... 11 3 3
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-0340-0-1-552 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct:
1001 Civilian full-time equivalent
employment...................... 15 16 16
1101 Military full-time equivalent
employment...................... 1 1 1
---------------------------------------------------------------------------
Health Education Assistance Loans Financing Account
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-4304-0-3-552 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Death and disability claims....... 3 3 3
00.02 Default claims.................... 16 22 22
--------- --------- ----------
00.91 Subtotal........................ 19 25 25
08.02 Payment of downward reestimate to
receipt account................. 40 18
08.04 Payment of interest on downward
reestimate to receipt account... 15 13
--------- --------- ----------
08.91 Subtotal (reestimates).......... 55 31
--------- --------- ----------
10.00 Total new obligations........... 74 56 25
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 219 171 126
22.00 New financing authority (gross)... 26 11 11
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 245 182 137
23.95 Total new obligations............. -74 -56 -25
--------- --------- ----------
24.40 Unobligated balance carried
forward, end of year.......... 171 126 112
----------------------------------------------------------------------------
New financing authority (gross), detail:
Mandatory:
69.00 Spending authority from
offsetting collections
(gross): Offsetting
collections (cash)............ 26 11 11
----------------------------------------------------------------------------
Change in obligated balances:
73.10 Total new obligations............. 74 56 25
73.20 Total financing disbursements
(gross)......................... -74 -56 -25
87.00 Total financing disbursements
(gross)......................... 74 56 25
----------------------------------------------------------------------------
Offsets:
Against gross financing authority and
financing disbursements:
Offsetting collections (cash)
from:
88.00 Federal sources............... -8
88.25 Interest on uninvested funds.. -11 -7 -6
88.40 Recoveries of defaulted loans. -6 -4 -5
--------- --------- ----------
88.90 Total, offsetting
collections (cash)........ -25 -11 -11
Against gross financing authority only:
88.96 Portion of offsetting
collections (cash) credited to
expired accounts.............. -1
----------------------------------------------------------------------------
Net financing authority and financing
disbursements:
89.00 Financing authority...............
90.00 Financing disbursements........... 48 45 14
---------------------------------------------------------------------------
Status of Guaranteed Loans (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-4304-0-3-552 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Position with respect to appropriations act
limitation on commitments:
2111 Limitation on guaranteed loans
made by private lenders.........
2142 Uncommitted loan guarantee
limitation......................
--------- --------- ----------
2150 Total guaranteed loan
commitments...................
2199 Guaranteed amount of guaranteed
loan commitments................
----------------------------------------------------------------------------
Cumulative balance of guaranteed loans
outstanding:
2210 Outstanding, start of year........ 1,860 1,440 1,215
2231 Disbursements of new guaranteed
loans...........................
2251 Repayments and prepayments........ -230 -200 -200
Adjustments:
2261 Terminations for default that
result in loans receivable.... -16 -22 -22
2263 Terminations for default that
result in claim payments...... -3 -3 -3
2264 Other adjustments, net.......... -171
--------- --------- ----------
2290 Outstanding, end of year........ 1,440 1,215 990
----------------------------------------------------------------------------
Memorandum:
2299 Guaranteed amount of guaranteed
loans outstanding, end of year.. 1,440 1,215 990
----------------------------------------------------------------------------
Addendum:
Cumulative balance of defaulted guaranteed
loans that result in loans receivable:
2310 Outstanding, start of year...... 458 635 653
2331 Disbursements for guaranteed
loan claims................... 16 22 22
2351 Repayments of loans receivable.. -6 -4 -6
2364 Other adjustments, net.......... 167
--------- --------- ----------
2390 Outstanding, end of year...... 635 653 669
---------------------------------------------------------------------------
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
2004 actual
2005 actual
-----------------------------------------------------------------------------------------------
ASSETS:
1101
Federal assets: Fund balances with Treasury
340
171
1206
Non-Federal assets: Receivables, net
67
Net value of assets related to
post-1991 acquired defaulted
guaranteed loans receivable:
1501
Defaulted guaranteed loans receivable, gross
635
1505
Allowance for subsidy cost (-)
-548
1599
Net present value of assets related to defaulted guaranteed loans
87
1999
Total assets
407
258
LIABILITIES:
Non-Federal liabilities:
2204
Liabilities for loan guarantees
407
227
2207
Other, downward reestimate
31
2999
Total liabilities
407
258
4999
Total liabilities and net position
407
258
-----------------------------------------------------------------------------------------------
Health Education Assistance Loans Liquidating Account
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-4305-0-3-552 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.02 Defaulted loans................... 4 4 1
--------- --------- ----------
10.00 Total new obligations (object
class 42.0)................... 4 4 1
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 4 4 1
[[Page 428]]
23.95 Total new obligations............. -4 -4 -1
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 4 4 1
Spending authority from offsetting
collections:
Mandatory:
69.00 Offsetting collections (cash). 17 10 10
69.27 Capital transfer to general
fund........................ -17 -10 -10
--------- --------- ----------
69.90 Spending authority from
offsetting collections
(total mandatory).........
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 4 4 1
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 5 5 5
73.10 Total new obligations............. 4 4 1
73.20 Total outlays (gross)............. -4 -4 -1
--------- --------- ----------
74.40 Obligated balance, end of year.. 5 5 5
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 4 4 1
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.40 Offsetting collections (cash)
from: Non-Federal sources..... -17 -10 -10
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. -13 -6 -9
90.00 Outlays........................... -12 -6 -9
---------------------------------------------------------------------------
Status of Guaranteed Loans (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-4305-0-3-552 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Cumulative balance of guaranteed loans
outstanding:\1\
2210 Outstanding, start of year........ 556 268 206
2251 Repayments and prepayments........ -67 -58 -58
Adjustments:
2261 Terminations for default that
result in loans receivable.... -4 -4 -1
2264 Other adjustments, net.......... -217
--------- --------- ----------
2290 Outstanding, end of year........ 268 206 147
----------------------------------------------------------------------------
Memorandum:
2299 Guaranteed amount of guaranteed
loans outstanding, end of year.. 268 206 147
----------------------------------------------------------------------------
Addendum:
Cumulative balance of defaulted guaranteed
loans that result in loans receivable:
2310 Outstanding, start of year...... 442 111 105
2331 Disbursements for guaranteed
loan claims................... 4 4 1
2351 Repayments of loans receivable.. -17 -10 -10
2364 Other adjustments, net.......... -318
--------- --------- ----------
2390 Outstanding, end of year...... 111 105 96
---------------------------------------------------------------------------
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
2004 actual
2005 actual
-----------------------------------------------------------------------------------------------
ASSETS:
1101
Federal assets: Fund balances with Treasury
4
4
Net value of assets related to
pre-1992 direct loans
receivable and acquired
defaulted guaranteed loans
receivable:
1701
Defaulted guaranteed loans, gross
376
111
1703
Allowance for estimated uncollectible loans and interest (-)
-4
1704
Defaulted guaranteed loans and interest receivable, net
376
107
1799
Value of assets related to loan guarantees
376
107
1999
Total assets
380
111
LIABILITIES:
2104
Federal liabilities: Resources payable to Treasury
109
2204
Non-Federal liabilities: Liabilities for loan guarantees
380
2
2999
Total liabilities
380
111
4999
Total liabilities and net position
380
111
-----------------------------------------------------------------------------------------------
Medical Facilities Guarantee and Loan Fund
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9931-0-3-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 68
22.40 Capital transfer to general fund.. -68
--------- --------- ----------
23.90 Total budgetary resources
available for obligation......
--------- --------- ----------
24.40 Unobligated balance carried
forward, end of year..........
----------------------------------------------------------------------------
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 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Cumulative balance of direct loans
outstanding:
1210 Outstanding, start of year........ 7 7 7
--------- --------- ----------
1290 Outstanding, end of year........ 7 7 7
---------------------------------------------------------------------------
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
2004 actual
2005 actual
-----------------------------------------------------------------------------------------------
ASSETS:
1206
Non-Federal assets: Receivables, net
13
13
1999
Total assets
13
13
LIABILITIES:
2204
Non-Federal liabilities: Liabilities for loan guarantees
13
13
2999
Total liabilities
13
13
[[Page 429]]
4999
Total liabilities and net position
13
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 [$3,600,000]
$3,564,000 shall be available from the Trust Fund to the Secretary of
Health and Human Services. (Department of Health and Human Services
Appropriations Act, 2006.)
Special and Trust Fund Receipts (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8175-0-7-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
01.00 Balance, start of year............ 2,024 2,162 2,363
--------- --------- ----------
01.99 Balance, start of year............ 2,024 2,162 2,363
Receipts:
02.00 Interest and profits on
investments, Vaccine injury
compensation trust fund......... 90 94 98
02.60 Deposits, Vaccine injury
compensation trust fund......... 123 182 186
--------- --------- ----------
02.99 Total receipts and collections.. 213 276 284
--------- --------- ----------
04.00 Total: Balances and collections... 2,237 2,438 2,647
Appropriations:
05.00 Vaccine injury compensation
program trust fund.............. -13 -14 -14
05.01 Vaccine injury compensation
program trust fund.............. -62 -61 -63
--------- --------- ----------
05.99 Total appropriations............ -75 -75 -77
--------- --------- ----------
07.99 Balance, end of year.............. 2,162 2,363 2,570
---------------------------------------------------------------------------
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8175-0-7-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Compensation: Claims for post--FY
1989 injuries................... 62 61 63
Administrative expenses:
01.03 Claims processing (Claims Court) 4 4 4
01.04 Claims processing (Public Health
Service)...................... 3 4 4
01.05 Claims processing (Dept. of
Justice)...................... 6 6 6
--------- --------- ----------
01.91 Total, administrative expenses 13 14 14
--------- --------- ----------
10.00 Total new obligations........... 75 75 77
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 1 1
22.00 New budget authority (gross)...... 76 75 77
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 76 76 78
23.95 Total new obligations............. -75 -75 -77
--------- --------- ----------
24.40 Unobligated balance carried
forward, end of year.......... 1 1 1
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.26 Appropriation (trust fund)...... 13 14 14
Mandatory:
60.26 Appropriation (trust fund)...... 62 61 63
Mandatory:
69.00 Spending authority from
offsetting collections:
Offsetting collections (cash). 1
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 76 75 77
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 3 3 -1
73.10 Total new obligations............. 75 75 77
73.20 Total outlays (gross)............. -75 -79 -77
--------- --------- ----------
74.40 Obligated balance, end of year.. 3 -1 -1
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 13 14 14
86.97 Outlays from new mandatory
authority....................... 59 61 63
86.98 Outlays from mandatory balances... 3 4
--------- --------- ----------
87.00 Total outlays (gross)........... 75 79 77
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.40 Offsetting collections (cash)
from: Non-Federal sources..... -1
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 75 75 77
90.00 Outlays........................... 74 79 77
----------------------------------------------------------------------------
Memorandum (non-add) entries:
92.01 Total investments, start of year:
Federal securities: Par value... 2,015 2,165 2,362
92.02 Total investments, end of year:
Federal securities: Par value... 2,165 2,362 2,561
---------------------------------------------------------------------------
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 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct obligations:
25.2 Other services.................. 3 4 4
25.3 Other purchases of goods and
services from Government
accounts...................... 10 10 10
42.0 Insurance claims and indemnities 61 61 63
--------- --------- ----------
99.0 Direct obligations............ 74 75 77
99.0 Reimbursable obligations.......... 1
--------- --------- ----------
99.9 Total new obligations........... 75 75 77
---------------------------------------------------------------------------
Ricky Ray Hemophilia Relief Fund
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-8074-0-7-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 3 3 1
23.98 Unobligated balance expiring or
withdrawn....................... -2
--------- --------- ----------
24.40 Unobligated balance carried
forward, end of year.......... 3 1 1
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 3 2 -1
73.20 Total outlays (gross)............. -1 -3
--------- --------- ----------
74.40 Obligated balance, end of year.. 2 -1 -1
----------------------------------------------------------------------------
Outlays (gross), detail:
86.98 Outlays from mandatory balances... 1 3
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays........................... 1 3
---------------------------------------------------------------------------
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 will be
returned to the Treasury.
[[Page 430]]
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-8074-0-7-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct:
1001 Civilian full-time equivalent
employment...................... 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, [$2,732,298,000]
$2,822,500,000, together with payments received during the fiscal year
pursuant to 42 U.S.C. 238(b) for services furnished by the Indian Health
Service: Provided, That funds made available to tribes and tribal
organizations through contracts, grant agreements, or any other
agreements or compacts authorized by the Indian Self-Determination and
Education Assistance Act of 1975 (25 U.S.C. 450), shall be deemed to be
obligated at the time of the grant or contract award and thereafter
shall remain available to the tribe or tribal organization without
fiscal year limitation: Provided further, That up to $18,000,000 shall
remain available until expended, for the Indian Catastrophic Health
Emergency Fund: Provided further, That [$507,021,000] $536,259,000 for
contract medical care shall remain available for obligation until
September 30, [2007] 2008: 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 [$268,683,000] $270,316,000 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 [2006] 2007, of which not to exceed $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 the Bureau of Indian Affairs
may collect from the Indian Health Service and tribes and tribal
organizations operating health facilities pursuant to Public Law 93-638
such individually identifiable health information relating to disabled
children as may be necessary for the purpose of carrying out its
functions under the Individuals with Disabilities Education Act, 20
U.S.C. 1400, et seq.[: Provided further, That of the amounts provided to
the Indian Health Service, $15,000,000 is provided for alcohol control,
enforcement, prevention, treatment, sobriety and wellness, and education
in Alaska, to be distributed in accordance with the instruction provided
in Senate Report 109-80: 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, Environment, and
Related Agencies Appropriations Act, 2006.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0390-0-1-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Clinical services................. 2,084 2,176 2,323
00.02 Preventive health................. 110 117 125
00.03 Urban health...................... 32 33
00.04 Indian health professions......... 27 31 32
00.05 Tribal management................. 2 2 2
00.06 Direct operations................. 62 62 64
00.07 Self-governance................... 6 6 6
00.08 Contract support costs............ 264 265 270
00.09 Diabetes funds.................... 168 150 150
09.01 Reimbursable program.............. 871 879 879
--------- --------- ----------
10.00 Total new obligations........... 3,626 3,721 3,851
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 235 244 244
22.00 New budget authority (gross)...... 3,636 3,721 3,852
22.10 Resources available from
recoveries of prior year
obligations..................... 2
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 3,873 3,965 4,096
23.95 Total new obligations............. -3,626 -3,721 -3,851
23.98 Unobligated balance expiring or
withdrawn....................... -3
--------- --------- ----------
24.40 Unobligated balance carried
forward, end of year.......... 244 244 245
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 2,633 2,732 2,823
40.33 Appropriation permanently
reduced (P.L. 109-148)........ -27
40.35 Appropriation permanently
reduced....................... -37 -13
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 2,596 2,692 2,823
Mandatory:
60.00 Appropriation................... 150 150 150
Spending authority from offsetting
collections:
Discretionary:
68.00 Offsetting collections (cash). 871 879 879
68.10 Change in uncollected customer
payments from Federal
sources (unexpired)......... 19
--------- --------- ----------
68.90 Spending authority from
offsetting collections
(total discretionary)..... 890 879 879
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 3,636 3,721 3,852
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 572 561 560
73.10 Total new obligations............. 3,626 3,721 3,851
73.20 Total outlays (gross)............. -3,616 -3,722 -3,895
73.40 Adjustments in expired accounts
(net)........................... -2
73.45 Recoveries of prior year
obligations..................... -2
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... -19
74.10 Change in uncollected customer
payments from Federal sources
(expired)....................... 2
--------- --------- ----------
74.40 Obligated balance, end of year.. 561 560 516
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 3,268 3,248 3,363
86.93 Outlays from discretionary
balances........................ 199 324 382
86.97 Outlays from new mandatory
authority....................... 149 132 132
86.98 Outlays from mandatory balances... 18 18
--------- --------- ----------
87.00 Total outlays (gross)........... 3,616 3,722 3,895
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
Offsetting collections (cash)
from:
88.00 Federal sources............... -434 -438 -438
88.40 Non-Federal sources........... -439 -441 -441
--------- --------- ----------
88.90 Total, offsetting
collections (cash)........ -873 -879 -879
Against gross budget authority only:
88.95 Change in uncollected customer
payments from Federal sources
(unexpired)................... -19
[[Page 431]]
88.96 Portion of offsetting
collections (cash) credited to
expired accounts.............. 2
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 2,746 2,842 2,973
90.00 Outlays........................... 2,743 2,843 3,016
---------------------------------------------------------------------------
The Indian health services account provides medical care, public
health services, and health professions training opportunities to
American Indians and Alaska Natives. An estimated $1,697 million will be
administered by tribal governments under self-determination contracts
and self-governance compacts in 2007.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0390-0-1-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 324 347 370
11.3 Other than full-time permanent 17 18 19
11.5 Other personnel compensation.. 30 32 33
11.7 Military personnel............ 70 75 80
--------- --------- ----------
11.9 Total personnel compensation 441 472 502
12.1 Civilian personnel benefits..... 99 107 114
12.2 Military personnel benefits..... 31 34 36
13.0 Benefits for former personnel... 6 6 6
21.0 Travel and transportation of
persons....................... 15 14 15
21.0 Patient travel.................. 16 18 18
22.0 Transportation of things........ 9 8 9
23.1 Rental payments to GSA.......... 10 10 10
23.2 Rental payments to others....... 2 2 2
23.3 Communications, utilities, and
miscellaneous charges......... 16 15 16
24.0 Printing and reproduction....... 1 1 1
25.1 Advisory and assistance services 7 7 7
25.2 Other services.................. 80 78 81
25.3 Other purchases of goods and
services from Government
accounts...................... 43 42 55
25.4 Operation and maintenance of
facilities.................... 3 3 3
25.6 Medical care.................... 220 217 250
25.7 Operation and maintenance of
equipment..................... 7 5 5
25.8 Subsistence and support of
persons....................... 2 2
26.0 Supplies and materials.......... 94 93 98
31.0 Equipment....................... 14 13 14
41.0 Grants, subsidies, and
contributions................. 1,639 1,695 1,730
--------- --------- ----------
99.0 Direct obligations............ 2,755 2,842 2,972
99.0 Reimbursable obligations.......... 871 879 879
--------- --------- ----------
99.9 Total new obligations........... 3,626 3,721 3,851
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-0390-0-1-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct:
1001 Civilian full-time equivalent
employment...................... 6,852 7,119 7,350
1101 Military full-time equivalent
employment...................... 1,498 1,499 1,499
Reimbursable:
2001 Civilian full-time equivalent
employment...................... 5,147 5,147 5,147
2101 Military full-time equivalent
employment...................... 435 435 435
---------------------------------------------------------------------------
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, [$358,485,000] $347,287,000, 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, the Indian
Health Service is authorized to construct a replacement health care
facility in Nome, Alaska, on land owned by the Norton Sound Health
Corporation:] Provided further, That not to exceed $500,000 shall be
placed in a Demolition Fund, available until expended, to be used by the
Indian Health Service for demolition of Federal buildings. (Department
of the Interior, Environment, and Related Agencies Appropriations Act,
2006.)
Special and Trust Fund Receipts (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0391-0-1-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
01.00 Balance, start of year............
--------- --------- ----------
01.99 Balance, start of year............
Receipts:
02.20 Rent and charges for quarters,
Indian Health Service........... 5 6 6
Appropriations:
05.00 Indian health facilities.......... -5 -6 -6
--------- --------- ----------
07.99 Balance, end of year..............
---------------------------------------------------------------------------
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0391-0-1-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Sanitation and health facilities.. 194 130 112
00.02 Maintenance....................... 42 51 53
00.03 Facilities and environmental
health.......................... 139 151 161
00.04 Equipment......................... 16 20 21
--------- --------- ----------
01.00 Total direct program............ 391 352 347
09.01 Reimbursable program.............. 10 10 7
--------- --------- ----------
10.00 Total new obligations........... 401 362 354
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 278 285 288
22.00 New budget authority (gross)...... 409 365 360
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 687 650 648
23.95 Total new obligations............. -401 -362 -354
--------- --------- ----------
24.40 Unobligated balance carried
forward, end of year.......... 285 288 294
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 394 358 347
40.33 Appropriation permanently
reduced (P.L. 109-148)........ -4
40.35 Appropriation permanently
reduced....................... -5 -2
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 389 352 347
Mandatory:
60.20 Appropriation (special fund).... 5 6 6
Discretionary:
68.00 Spending authority from
offsetting collections:
Offsetting collections (cash). 15 7 7
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 409 365 360
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 234 246 316
73.10 Total new obligations............. 401 362 354
73.20 Total outlays (gross)............. -389 -292 -400
--------- --------- ----------
74.40 Obligated balance, end of year.. 246 316 270
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 384 113 111
[[Page 432]]
86.93 Outlays from discretionary
balances........................ 173 283
86.97 Outlays from new mandatory
authority....................... 5 6 6
--------- --------- ----------
87.00 Total outlays (gross)........... 389 292 400
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -15 -7 -7
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 394 358 353
90.00 Outlays........................... 374 285 393
---------------------------------------------------------------------------
The Indian health facilities account supports construction, repair
and improvement, equipment, and environmental health and facilities
support for the Indian health services.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0391-0-1-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 36 39 42
11.3 Other than full-time permanent 6 6 6
11.5 Other personnel compensation.. 1 1 2
11.7 Military personnel............ 18 20 21
--------- --------- ----------
11.9 Total personnel compensation 61 66 71
12.1 Civilian personnel benefits..... 11 12 12
12.2 Military personnel benefits..... 7 7 8
13.0 Benefits for former personnel... 1
21.0 Travel and transportation of
persons....................... 3 3 3
22.0 Transportation of things........ 3 3 3
23.1 Rental payments to GSA.......... 1
23.3 Communications, utilities, and
miscellaneous charges......... 13 13 14
25.1 Advisory and assistance services 2 2
25.2 Other services.................. 80 73 74
25.3 Other purchases of goods and
services from Government
accounts...................... 2 2 2
25.4 Operation and maintenance of
facilities.................... 13 11 9
25.7 Operation and maintenance of
equipment..................... 2 3 3
26.0 Supplies and materials.......... 7 7 7
31.0 Equipment....................... 9 10 9
32.0 Land and structures............. 90 35 20
41.0 Grants, subsidies, and
contributions................. 90 103 108
43.0 Interest and dividends.......... 1 1
--------- --------- ----------
99.0 Direct obligations............ 391 352 347
99.0 Reimbursable obligations.......... 10 10 7
--------- --------- ----------
99.9 Total new obligations........... 401 362 354
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-0391-0-1-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct:
1001 Civilian full-time equivalent
employment...................... 1,013 1,045 1,087
1101 Military full-time equivalent
employment...................... 232 232 232
Reimbursable:
2001 Civilian full-time equivalent
employment...................... 37 37 37
---------------------------------------------------------------------------
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 appropriation structure for the Indian Health Service may not be
altered without advance notification to the House and Senate Committees
on Appropriations. (Department of the Interior, Environment, and Related
Agencies Appropriations Act, 2006.)
[[Page 433]]
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, section 501 of the Refugee
Education Assistance Act of 1980, and for expenses necessary to support
activities related to countering potential biological, disease, nuclear,
radiological, and chemical threats to civilian populations; including
purchase and insurance of official motor vehicles in foreign countries;
and purchase, hire, maintenance, and operation of aircraft,
[$5,884,934,000] $5,833,952,000, of which [$160,000,000] $29,700,000
shall remain available until expended for equipment, construction and
renovation of facilities; [of which $30,000,000 of the amounts available
for immunization activities shall remain available until expended;] of
which [$530,000,000] $592,648,000 shall remain available until expended
for the Strategic National Stockpile; and of which [$123,883,000]
$121,952,000 for international HIV/AIDS shall remain available until
September 30, [2007] 2008. 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 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
$31,800,000 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 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
awarded to a State, a State may reallocate up to five percent of such
funds to be used for the purposes designated in section 1904 of the
Public Health Service Act, provided that such reallocations do not
exceed a five percent reduction to any grant: Provided further, that no
State may reallocate grants awarded under section 319C-1 of the Public
Health Service Act: Provided further, That a State must notify the
Director of the Centers for Disease Control and Prevention within 10
days of implementing such a reallocation: 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[: Provided further, That employees of the
Centers for Disease Control and Prevention or the Public Health Service,
both civilian and Commissioned Officers, detailed to States,
municipalities, or other organizations under authority of section 214 of
the Public Health Service Act, 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].
(Department of Health and Human Services Appropriations Act, 2006.)
Special and Trust Fund Receipts (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0943-0-1-550 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
01.00 Balance, start of year............
--------- --------- ----------
01.99 Balance, start of year............
Receipts:
02.20 Cooperative research and
development agreements, Centers
for Disease Control............. 1 1 1
--------- --------- ----------
04.00 Total: Balances and collections... 1 1 1
Appropriations:
05.00 Disease control, research, and
training........................ -1 -1 -1
--------- --------- ----------
07.99 Balance, end of year..............
---------------------------------------------------------------------------
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0943-0-1-550 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Infectious diseases............... 1,679 1,680 1,773
00.02 Health promotion.................. 1,020 963 929
00.03 Health information and service.... 90 89 103
00.04 Environmental health and injury... 283 289 279
00.05 Occupational safety and health.... 196 168 163
00.06 Global health..................... 319 313 381
00.08 Public health improvement and
leadership...................... 263 189 190
00.09 Prev. health and health services
block grant..................... 119 99
00.10 Buildings and facilities.......... 192 158 30
00.11 Business services support......... 279 299 304
00.12 Terrorism......................... 1,577 1,682
00.14 World Trade Center Registry....... 75
Reimbursable program:
09.01 Health statistics............... 109 109 109
09.02 Other reimbursable program...... 405 411 413
09.03 Public health research.......... 31 31 31
--------- --------- ----------
09.09 Subtotal, reimbursable
programs.................... 545 551 553
--------- --------- ----------
10.00 Total new obligations........... 4,985 6,450 6,387
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 219 297 300
22.00 New budget authority (gross)...... 5,053 6,453 6,388
22.10 Resources available from
recoveries of prior year
obligations..................... 13
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 5,285 6,750 6,688
23.95 Total new obligations............. -4,985 -6,450 -6,387
23.98 Unobligated balance expiring or
withdrawn....................... -3
--------- --------- ----------
24.40 Unobligated balance carried
forward, end of year.......... 297 300 301
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 4,534 5,960 5,834
40.33 Appropriation permanently
reduced (P.L. 109-148)........ -59
40.35 Appropriation permanently
reduced....................... -38
42.00 Transferred from other accounts. 73
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 4,569 5,901 5,834
Mandatory:
60.20 Appropriation (special fund).... 1 1 1
Spending authority from offsetting
collections:
Discretionary:
68.00 Offsetting collections (cash). 226 551 553
68.10 Change in uncollected customer
payments from Federal
sources (unexpired)......... 257
--------- --------- ----------
68.90 Spending authority from
offsetting collections
(total discretionary)..... 483 551 553
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 5,053 6,453 6,388
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 3,705 3,635 4,688
73.10 Total new obligations............. 4,985 6,450 6,387
73.20 Total outlays (gross)............. -5,055 -5,667 -6,315
73.40 Adjustments in expired accounts
(net)........................... -22 -22 -22
73.45 Recoveries of prior year
obligations..................... -13
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... -257
74.10 Change in uncollected customer
payments from Federal sources
(expired)....................... 292 292 292
--------- --------- ----------
[[Page 434]]
74.40 Obligated balance, end of year.. 3,635 4,688 5,030
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 2,179 2,852 2,829
86.93 Outlays from discretionary
balances........................ 2,875 2,814 3,485
86.97 Outlays from new mandatory
authority....................... 1 1 1
--------- --------- ----------
87.00 Total outlays (gross)........... 5,055 5,667 6,315
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
Offsetting collections (cash)
from:
88.00 Federal sources............... -37 -512 -514
88.40 Non-Federal sources........... -490 -39 -39
--------- --------- ----------
88.90 Total, offsetting
collections (cash)........ -527 -551 -553
Against gross budget authority only:
88.95 Change in uncollected customer
payments from Federal sources
(unexpired)................... -257
88.96 Portion of offsetting
collections (cash) credited to
expired accounts.............. 301
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 4,570 5,902 5,835
90.00 Outlays........................... 4,528 5,116 5,762
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
2005 actual 2006 est. 2007 est.
Enacted/requested:
Budget Authority............ 4,570 5,902 5,835
Outlays..................... 4,528 5,116 5,762
Legislative proposal, not subject to
PAYGO:
Budget Authority............ -100
Outlays..................... -39
------------------------------------
Total:
Budget Authority............ 4,570 5,902 5,735
Outlays..................... 4,528 5,116 5,723
====================================
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 activities 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, emergency response, and pandemic influenza
preparedness activities. 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 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 344 402 411
11.3 Other than full-time permanent 38 43 43
11.5 Other personnel compensation.. 22 25 26
11.7 Military personnel............ 40 41 42
11.8 Special personal services
payments.................... 1 1 1
--------- --------- ----------
11.9 Total personnel compensation 445 512 523
12.1 Civilian personnel benefits..... 115 134 138
12.2 Military personnel benefits..... 29 30 31
13.0 Benefits for former personnel... 5 5 5
21.0 Travel and transportation of
persons....................... 39 38 35
22.0 Transportation of things........ 9 9 8
23.1 Rental payments to GSA.......... 9 8 7
23.2 Rental payments to others....... 1 1 1
23.3 Communications, utilities, and
miscellaneous charges......... 28 36 33
24.0 Printing and reproduction....... 7 7 6
25.1 Advisory and assistance services 328 328 304
25.2 Other services.................. 133 160 144
25.3 Other purchases of goods and
services from Government
accounts...................... 282 552 497
25.4 Operation and maintenance of
facilities.................... 44 42 38
25.5 Research and development
contracts..................... 130 184 181
25.6 Medical care.................... 14 12 11
25.7 Operation and maintenance of
equipment..................... 17 37 34
26.0 Supplies and materials.......... 37 141 129
31.0 Equipment....................... 50 70 64
32.0 Land and structures............. 163 147 134
41.0 Grants, subsidies, and
contributions................. 2,555 3,446 3,511
--------- --------- ----------
99.0 Direct obligations............ 4,440 5,899 5,834
99.0 Reimbursable obligations.......... 545 551 553
--------- --------- ----------
99.9 Total new obligations........... 4,985 6,450 6,387
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-0943-0-1-550 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct:
1001 Civilian full-time equivalent
employment...................... 5,249 5,530 5,572
1101 Military full-time equivalent
employment...................... 769 770 770
Reimbursable:
2001 Civilian full-time equivalent
employment...................... 1,173 1,226 1,233
2101 Military full-time equivalent
employment...................... 68 68 68
Allocation account:
3001 Civilian full-time equivalent
employment...................... 1,027 1,027 1,027
---------------------------------------------------------------------------
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 2005 actual 2006 est. 2007 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:
73.10 Total new obligations............. -100
73.20 Total outlays (gross)............. 39
--------- --------- ----------
74.40 Obligated balance, end of year.. -61
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... -39
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. -100
90.00 Outlays........................... -39
---------------------------------------------------------------------------
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.
[[Page 435]]
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, [$76,024,000] $75,004,000, 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 [2006] 2007, and existing profiles may be updated as
necessary. (Department of the Interior, Environment, and Related
Agencies Appropriations Act, 2006.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0944-0-1-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Direct program.................... 76 75 75
09.01 Reimbursable program.............. 11 21 24
--------- --------- ----------
10.00 Total new obligations........... 87 96 99
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 88 96 99
23.95 Total new obligations............. -87 -96 -99
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 77 76 75
40.33 Appropriation permanently
reduced (P.L. 109-148)........ -1
40.35 Appropriation permanently
reduced....................... -1
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 76 75 75
Spending authority from offsetting
collections:
Discretionary:
68.00 Offsetting collections (cash). 6 21 24
68.10 Change in uncollected customer
payments from Federal
sources (unexpired)......... 6
--------- --------- ----------
68.90 Spending authority from
offsetting collections
(total discretionary)..... 12 21 24
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 88 96 99
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 10 33 54
73.10 Total new obligations............. 87 96 99
73.20 Total outlays (gross)............. -62 -96 -99
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... -6
74.10 Change in uncollected customer
payments from Federal sources
(expired)....................... 4 21 24
--------- --------- ----------
74.40 Obligated balance, end of year.. 33 54 78
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 57 68 71
86.93 Outlays from discretionary
balances........................ 5 28 28
--------- --------- ----------
87.00 Total outlays (gross)........... 62 96 99
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -10 -21 -24
Against gross budget authority only:
88.95 Change in uncollected customer
payments from Federal sources
(unexpired)................... -6
88.96 Portion of offsetting
collections (cash) credited to
expired accounts.............. 4
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 76 75 75
90.00 Outlays........................... 53 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 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 24 25 25
11.3 Other than full-time permanent 1 1 1
11.5 Other personnel compensation.. 1 1 1
11.7 Military personnel............ 4 5 5
--------- --------- ----------
11.9 Total personnel compensation 30 32 32
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 1
25.1 Advisory and assistance services 6 5 5
25.2 Other services.................. 3 3 3
25.3 Other purchases of goods and
services from Government
accounts...................... 13 12 12
25.5 Research and development
contracts..................... 4 4 4
31.0 Equipment....................... 1 1 1
41.0 Grants, subsidies, and
contributions................. 9 8 8
--------- --------- ----------
99.0 Direct obligations............ 76 75 75
99.0 Reimbursable obligations.......... 11 21 24
--------- --------- ----------
99.9 Total new obligations........... 87 96 99
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-0944-0-1-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct:
1001 Civilian full-time equivalent
employment...................... 298 299 299
1101 Military full-time equivalent
employment...................... 31 30 30
Reimbursable:
2001 Civilian full-time equivalent
employment...................... 30 30 30
2101 Military full-time equivalent
employment...................... 6 6 6
---------------------------------------------------------------------------
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 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 19 10 7
73.20 Total outlays (gross)............. -17 -3 -3
73.40 Adjustments in expired accounts
(net)........................... -1
74.10 Change in uncollected customer
payments from Federal sources
(expired)....................... 9
--------- --------- ----------
74.40 Obligated balance, end of year.. 10 7 4
----------------------------------------------------------------------------
Outlays (gross), detail:
86.93 Outlays from discretionary
balances........................ 17 3 3
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -9
[[Page 436]]
Against gross budget authority only:
88.96 Portion of offsetting
collections (cash) credited to
expired accounts.............. 9
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays........................... 8 3 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 2007, 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, [$4,841,774,000] $4,753,609,000, 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, 2006.)
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, [$2,951,270,000] $2,901,012,000.
(Department of Health and Human Services Appropriations Act, 2006.)
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, [$393,269,000] $386,095,000.
(Department of Health and Human Services Appropriations Act, 2006.)
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,
[$1,722,146,000] $1,694,298,000. (Department of Health and Human
Services Appropriations Act, 2006.)
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,
[$1,550,260,000] $1,524,750,000. (Department of Health and Human
Services Appropriations Act, 2006.)
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,
[$4,459,395,000] $4,395,496,000: 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 [$30,000,000] $25,000,000 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, 2006.)
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, [$1,955,170,000]
$1,923,481,000. (Department of Health and Human Services Appropriations
Act, 2006.)
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,
[$1,277,544,000] $1,257,418,000. (Department of Health and Human
Services Appropriations Act, 2006.)
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,
[$673,491,000] $661,358,000. (Department of Health and Human Services
Appropriations Act, 2006.)
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,
[$647,608,000] $637,323,000. (Department of Health and Human Services
Appropriations Act, 2006.)
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, [$80,289,000] $78,414,000. (Department
of the Interior, Environment, and Related Agencies Appropriations Act,
2006.)
National Institute on Aging
For carrying out section 301 and title IV of the Public Health
Service Act with respect to aging, [$1,057,203,000] $1,039,828,000.
(Department of Health and Human Services Appropriations Act, 2006.)
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, [$513,063,000] $504,533,000. (Department of Health and Human
Services Appropriations Act, 2006.)
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,
[$397,432,000] $391,556,000. (Department of Health and Human Services
Appropriations Act, 2006.)
National Institute of Nursing Research
For carrying out section 301 and title IV of the Public Health
Service Act with respect to nursing research, [$138,729,000]
$136,550,000. (Department of Health and Human Services Appropriations
Act, 2006.)
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, [$440,333,000]
$433,318,000. (Department of Health and Human Services Appropriations
Act, 2006.)
National Institute on Drug Abuse
For carrying out section 301 and title IV of the Public Health
Service Act with respect to drug abuse, [$1,010,130,000] $994,829,000.
(Department of Health and Human Services Appropriations Act, 2006.)
National Institute of Mental Health
For carrying out section 301 and title IV of the Public Health
Service Act with respect to mental health, [$1,417,692,000]
$1,394,806,000. (Department of Health and Human Services Appropriations
Act, 2006.)
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, [$490,959,000]
$482,942,000. (Department of Health and Human Services Appropriations
Act, 2006.)
[[Page 437]]
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, [$299,808,000] $294,850,000. (Department of Health and Human
Services Appropriations Act, 2006.)
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, [$1,110,203,000] $1,098,242,000: 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. (Department of Health and Human Services
Appropriations Act, 2006.)
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,
[$122,692,000] $120,554,000. (Department of Health and Human Services
Appropriations Act, 2006.)
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, [$197,379,000] $194,299,000. (Department of Health and Human
Services Appropriations Act, 2006.)
John E. Fogarty International Center
For carrying out the activities at the John E. Fogarty International
Center, [$67,048,000] $66,681,000. (Department of Health and Human
Services Appropriations Act, 2006.)
National Library of Medicine
For carrying out section 301 and title IV of the Public Health
Service Act with respect to health information communications,
[$318,091,000] $313,269,000, of which $4,000,000 shall be available
until expended for improvement of information systems: Provided, That in
fiscal year [2006] 2007, the Library may enter into personal services
contracts for the provision of services in facilities owned, operated,
or constructed under the jurisdiction of the National Institutes of
Health: Provided further, That in addition to amounts provided herein,
$8,200,000 shall be available from amounts available under section 241
of the Public Health Service Act to carry out National Information
Center on Health Services Research and Health Care Technology and
related health services. (Department of Health and Human Services
Appropriations Act, 2006.)
Office of the Director
(including transfer of funds)
For carrying out the responsibilities of the Office of the Director,
National Institutes of Health, [$482,895,000] $667,825,000, of which up
to [$10,000,000] $14,000,000 shall be used to carry out section 217 of
this Act: 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] such Fund shall remain available for one 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 in addition to the transfer
authority provided above, a uniform percentage of the amounts
appropriated in this Act to each Institute and Center may be transferred
and utilized for the National Institutes of Health [Roadmap for Medical
Research] Common Fund: Provided further, That the amount utilized under
the preceding proviso shall not exceed [$250,000,000] $332,000,000
without prior notification to the Committees on Appropriations of the
House of Representatives and the Senate: Provided further, That amounts
transferred and utilized under the preceding two provisos shall be in
addition to amounts made available for the [Roadmap for Medical
Research] Common Fund from the Director's Discretionary Fund and to any
amounts allocated to activities related to the [Roadmap] Common Fund
through the normal research priority-setting process of individual
Institutes and Centers: 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 the
Office of AIDS Research within the Office of the Director, NIH may spend
up to $4,000,000 to make grants for construction or renovation of
facilities as provided for in section 2354(a)(5)(B) of the Public Health
Service Act: Provided further, That of the funds provided [$97,000,000]
$96,030,000 shall be for expenses necessary to support activities
related to countering potential nuclear, radiological and chemical
threats to civilian populations: Provided further, That of the funds
provided, $159,500,000 shall be for expenses necessary to support
activities related to the advanced development of biodefense
countermeasures. (Department of Health and Human Services Appropriations
Act, 2006.)
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, [$81,900,000]
$81,081,000, to remain available until expended. (Department of Health
and Human Services Appropriations Act, 2006.)
Special and Trust Fund Receipts (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9915-0-1-552 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
01.00 Balance, start of year............
--------- --------- ----------
01.99 Balance, start of year............
Receipts:
02.20 Cooperative research and
development agreements, NIH..... 16 16 16
--------- --------- ----------
04.00 Total: Balances and collections... 16 16 16
Appropriations:
05.00 National Institutes of Health..... -16 -16 -16
--------- --------- ----------
07.99 Balance, end of year..............
---------------------------------------------------------------------------
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9915-0-1-552 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 National Cancer Institute......... 4,798 4,793 4,754
00.02 National Heart, Lung, and Blood
Institute....................... 2,922 2,922 2,901
00.03 National Institute of Dental and
Craniofacial Research........... 389 389 386
00.04 National Institute of Diabetes and
Digestive and Kidney Disease.... 1,852 1,855 1,844
00.05 National Institute of Neurological
Disorders and Stroke............ 1,530 1,535 1,525
00.06 National Institute of Allergy and
Infectious Diseases............. 4,276 4,415 4,395
00.07 National Institute of General
Medical Sciences................ 1,932 1,936 1,923
00.08 National Institute of Child Health
and Human Development........... 1,262 1,265 1,257
00.09 National Eye Institute............ 665 667 661
00.10 National Institute of
Environmental Health Sciences... 720 720 715
00.11 National Institute on Aging....... 1,045 1,047 1,040
00.12 National Institute of Arthritis
and Musculoskeletal and Skin
Disease......................... 508 508 505
00.13 National Institute on Deafness and
Other Communication Disorder.... 392 393 392
00.14 National Institute of Mental
Health.......................... 1,403 1,404 1,395
00.15 National Institute on Drug Abuse.. 1,000 1,000 995
00.16 Natinal Institute on Alcohol Abuse
and Alcoholism.................. 435 436 433
00.17 National Institute of Nursing
Research........................ 137 137 137
00.18 National Human Genome Research
Institute....................... 485 486 483
00.19 National Institute of Biomedical
Imaging and Bioengineering...... 296 297 295
00.20 National Center for Research
Resources....................... 1,108 1,099 1,098
00.21 National Center for Complementary
and Alternative Medicine........ 121 121 121
00.22 National Center on Minority Health
and Health Disparities.......... 195 195 194
00.23 John E. Fogarty International
Center.......................... 66 66 67
00.24 National Library of Medicine...... 313 315 313
00.25 Office of the Director............ 533 478 668
00.26 Buildings and facilities.......... 239 81 81
00.27 Cooperative Research and
Development Agreements.......... 12 16 16
00.28 Royalities........................ 58 58 58
[[Page 438]]
09.00 Reimbursable program.............. 2,489 2,639 2,739
--------- --------- ----------
10.00 Total new obligations........... 31,181 31,273 31,391
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 555 433 283
22.00 New budget authority (gross)...... 31,063 31,123 31,197
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 31,618 31,556 31,480
23.95 Total new obligations............. -31,181 -31,273 -31,391
23.98 Unobligated balance expiring or
withdrawn....................... -4
--------- --------- ----------
24.40 Unobligated balance carried
forward, end of year.......... 433 283 89
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 28,681 28,697 28,428
40.33 Appropriation permanently
reduced (P.L. 109-148)........ -287
40.35 Appropriation permanently
reduced....................... -236
41.00 Transferred to other accounts... -99
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 28,346 28,410 28,428
Mandatory:
60.00 Appropriation................... 150 150 150
60.20 Appropriation (special fund).... 16 16 16
60.20 Appropriation (special fund)....
--------- --------- ----------
62.50 Appropriation (total
mandatory).................. 166 166 166
Spending authority from offsetting
collections:
Discretionary:
68.00 Offsetting collections (cash). 2,032 2,547 2,603
68.10 Change in uncollected customer
payments from Federal
sources (unexpired)......... 519
--------- --------- ----------
68.90 Spending authority from
offsetting collections
(total discretionary)..... 2,551 2,547 2,603
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 31,063 31,123 31,197
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 27,797 29,074 30,134
73.10 Total new obligations............. 31,181 31,273 31,391
73.20 Total outlays (gross)............. -29,623 -30,213 -31,143
73.40 Adjustments in expired accounts
(net)........................... -252
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... -519
74.10 Change in uncollected customer
payments from Federal sources
(expired)....................... 490
--------- --------- ----------
74.40 Obligated balance, end of year.. 29,074 30,134 30,382
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 9,866 9,536 9,596
86.93 Outlays from discretionary
balances........................ 19,614 20,524 21,384
86.97 Outlays from new mandatory
authority....................... 40 40 40
86.98 Outlays from mandatory balances... 103 113 123
--------- --------- ----------
87.00 Total outlays (gross)........... 29,623 30,213 31,143
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
Offsetting collections (cash)
from:
88.00 Federal sources............... -2,398 -2,547 -2,603
88.40 Non-Federal sources........... -102
--------- --------- ----------
88.90 Total, offsetting
collections (cash)........ -2,500 -2,547 -2,603
Against gross budget authority only:
88.95 Change in uncollected customer
payments from Federal sources
(unexpired)................... -519
88.96 Portion of offsetting
collections (cash) credited to
expired accounts.............. 468
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 28,512 28,576 28,594
90.00 Outlays........................... 27,123 27,666 28,540
---------------------------------------------------------------------------
DISTRIBUTION OF BUDGET AUTHORITY AND OUTLAYS BY ACCOUNT
[Dollars in millions]
2005 2006 2007
Distribution of budget authority by
account:
National Cancer Institute... 4,795 4,793 4,754
National Heart, Lung, and
Blood Institute........... 2,923 2,922 2,901
National Institute of Dental
and Craniofacial Research. 389 389 386
National Institute of
Diabetes and Digestive and
Kidney Diseases........... 1,853 1,855 1,844
National Institute of
Neurological Disorder and
Stroke.................... 1,530 1,535 1,525
National Institute of
Allergy and Infectious
Diseases.................. 4,276 4,415 4,395
National Institute of
General Medical Sciences.. 1,932 1,936 1,923
National Institute of Child
Health and Human
Development............... 1,262 1,265 1,257
National Eye Institute...... 665 667 661
National Institute of
Environmental Health
Sciences.................. 720 720 715
National Institute on Aging. 1,045 1,047 1,040
National Institute of
Arthritis and
Musculoskeletal and Skin
Diseases.................. 508 508 505
National Institute on
Deafness and Other
Communication Disorders... 392 393 392
National Institute of
Nursing Research.......... 137 137 137
National Institute on
Alcohol Abuse and
Alcoholism................ 436 436 433
National Institute on Drug
Abuse..................... 1,000 1,000 995
National Institute of Mental
Health.................... 1,403 1,404 1,395
National Center for Research
Resources................. 1,108 1,099 1,098
National Human Genome
Research Institute........ 486 486 483
National Institute of
Biomedical Imaging and
Bioengineering............ 296 297 295
National Center for
Complementary and
Alternative Medicine...... 121 121 121
National Center for Minority
Health and Health
Disparities............... 195 195 194
John E. Fogarty
International Center...... 66 66 67
National Library of Medicine 313 315 313
Office of the Director...... 534 478 668
Buildings and facilities.... 110 81 81
------------------------------------
Subtotal................ 28,495 28,560 28,578
Cooperative Research and
Development Agreements.... 16 16 16
------------------------------------
Total Budget Authority,
NIH................... 28,511 28,576 28,594
====================================
[Dollars in millions]
2005 2006 2007
Distribution of outlays by account:
National Cancer Institute... 4,531 4,644 4,732
National Heart, Lung, and
Blood Institute........... 2,848 2,857 2,916
National Institute of Dental
and Craniofacial Research. 385 370 388
National Institute of
Diabetes and Digestive and
Kidney Diseases........... 1,768 1,805 1,847
National Institute of
Neurological Disorders and
Stroke.................... 1,526 1,472 1,526
National Institute of
Allergy and Infectious
Diseases.................. 3,702 4,062 4,342
National Institute of
General Medical Sciences.. 1,917 1,858 1,920
National Institute of Child
Health and Human
Development............... 1,226 1,237 1,261
National Eye Institute...... 636 655 658
National Institute of
Environmental Health
Sciences.................. 705 703 718
National Institute on Aging. 997 1,027 1,044
National Institute of
Arthritis and
Musculoskeletal and Skin
Diseases.................. 493 500 507
National Institute on
Deafness and Other
Communication Disorders... 385 368 392
National Institute of
Nursing Research.......... 1,412 1,364 1,400
National Institute on
Alcohol Abuse and
Alcoholism................ 1,002 969 988
National Institute on Drug
Abuse..................... 435 424 435
National Institute of Mental
Health.................... 131 137 137
National Center for Research
Resources................. 480 483 481
National Human Genome
Research Institute........ 281 285 296
National Institute of
Biomedical Imaging and
Bioengineering............ 1,180 1,131 1,105
National Center for
Complementary and
Alternative Medicine...... 111 117 121
National Center for Minority
Health and Health
Disparities............... 195 174 191
John E. Fogarty
International Center...... 64 65 66
National Library of Medicine 296 311 312
Office of the Director...... 328 453 546
Buildings and Facilities.... 221 185 201
Service and Supply Fund/
Management Fund........... -140 0 0
------------------------------------
Subtotal Outlays........ 27,115 27,656 28,530
Cooperative Research and
Development Agreements.... 8 10 10
------------------------------------
Total Outlays, NIH...... 27,123 27,666 28,540
====================================
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
[[Page 439]]
available through the Department of Health and Human Services.
NIH will continue to implement strategies and policies in 2007 and
beyond to maximize budgetary and management flexibility in the future.
Such strategies include managing grant average cost and improving trans-
NIH scientific planning.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9915-0-1-552 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 657 693 725
11.3 Other than full-time permanent 350 367 381
11.5 Other personnel compensation.. 39 30 32
11.7 Military personnel............ 22 23 24
11.8 Special personal services
payments.................... 162 165 168
--------- --------- ----------
11.9 Total personnel compensation 1,230 1,278 1,330
12.1 Civilian personnel benefits..... 281 295 306
12.2 Military personnel benefits..... 16 17 17
21.0 Travel and transportation of
persons....................... 54 54 53
22.0 Transportation of things........ 6 6 6
23.2 Rental payments to others....... 9 10 10
23.3 Communications, utilities, and
miscellaneous charges......... 28 29 29
24.0 Printing and reproduction....... 16 15 15
25.1 Advisory and assistance services 120 103 101
25.2 Other services.................. 594 593 568
25.3 Other purchases of goods and
services from Government
accounts...................... 2,566 2,500 2,498
25.4 Operation and maintenance of
facilities.................... 315 245 242
25.5 Research and development
contracts..................... 1,827 2,040 2,033
25.6 Medical care.................... 25 20 20
25.7 Operation and maintenance of
equipment..................... 77 76 75
26.0 Supplies and materials.......... 219 213 210
31.0 Equipment....................... 160 154 150
41.0 Grants, subsidies, and
contributions................. 21,151 20,987 20,987
--------- --------- ----------
99.0 Direct obligations............ 28,694 28,635 28,650
99.0 Reimbursable obligations.......... 2,487 2,638 2,741
--------- --------- ----------
99.9 Total new obligations........... 31,181 31,273 31,391
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-9915-0-1-552 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct:
1001 Civilian full-time equivalent
employment...................... 11,399 11,654 11,738
1101 Military full-time equivalent
employment...................... 296 296 296
Reimbursable:
2001 Civilian full-time equivalent
employment...................... 5,064 5,264 5,300
2101 Military full-time equivalent
employment...................... 111 111 111
---------------------------------------------------------------------------
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 PHS Act with respect to program
management, [$3,237,813,000] $3,133,872,000: 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 under section
241 of the PHS Act: (1) $79,200,000 to carry out subpart II of part B of
title XIX of the 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] $21,629,000 to carry out subpart
I of part B of title XIX of the 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]
$21,000,000 to carry out national surveys on drug abuse; and (4)
$4,300,000 to evaluate substance abuse treatment programs.
Notwithstanding section 1911(b) of the PHS Act, a State that receives an
allotment under section 1911 of the Act for the current fiscal year
shall use any amount it receives in fiscal year 2007 which is in excess
of what it received under such section in 1998 to support mental health
transformation activities such as the expansion of access; advancement
of evidence-based practices; promotion of early assessment and
treatment; and promotion of consumer- and family-driven mental health
care. A State that receives an allotment under section 1911 will report
annually to the Substance Abuse and Mental Health Services
Administration on its use of funds and the outcomes of mental health
transformation activities. (Department of Health and Human Services
Appropriations Act, 2006.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1362-0-1-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
Direct program:
00.01 Mental health and substance
abuse activities.............. 1,085 1,043 972
00.02 Mental health partnership....... 411 407 407
00.03 Substance abuse partnership..... 1,696 1,679 1,679
00.05 Program management.............. 77 76 76
--------- --------- ----------
01.00 Total, direct program........... 3,269 3,205 3,134
09.01 Reimbursable program.............. 236 207 207
--------- --------- ----------
10.00 Total new obligations........... 3,505 3,412 3,341
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 1
22.00 New budget authority (gross)...... 3,504 3,412 3,341
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 3,505 3,412 3,341
23.95 Total new obligations............. -3,505 -3,412 -3,341
--------- --------- ----------
24.40 Unobligated balance carried
forward, end of year..........
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 3,295 3,237 3,134
40.33 Appropriation permanently
reduced (P.L. 109-148)........ -32
40.35 Appropriation permanently
reduced....................... -27
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 3,268 3,205 3,134
Spending authority from offsetting
collections:
Discretionary:
68.00 Offsetting collections (cash). 141 207 207
68.10 Change in uncollected customer
payments from Federal
sources (unexpired)......... 95
--------- --------- ----------
68.90 Spending authority from
offsetting collections
(total discretionary)..... 236 207 207
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 3,504 3,412 3,341
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 2,555 2,600 2,583
73.10 Total new obligations............. 3,505 3,412 3,341
73.20 Total outlays (gross)............. -3,409 -3,429 -3,393
73.40 Adjustments in expired accounts
(net)........................... -21
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... -95
74.10 Change in uncollected customer
payments from Federal sources
(expired)....................... 65
--------- --------- ----------
74.40 Obligated balance, end of year.. 2,600 2,583 2,531
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 1,109 1,489 1,461
86.93 Outlays from discretionary
balances........................ 2,300 1,940 1,932
--------- --------- ----------
87.00 Total outlays (gross)........... 3,409 3,429 3,393
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
Offsetting collections (cash)
from:
88.00 Federal sources............... -65 -207 -207
88.40 Non-Federal sources........... -141
--------- --------- ----------
[[Page 440]]
88.90 Total, offsetting
collections (cash)........ -206 -207 -207
Against gross budget authority only:
88.95 Change in uncollected customer
payments from Federal sources
(unexpired)................... -95
88.96 Portion of offsetting
collections (cash) credited to
expired accounts.............. 65
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 3,268 3,205 3,134
90.00 Outlays........................... 3,204 3,222 3,186
---------------------------------------------------------------------------
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 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 40 44 46
11.3 Other than full-time permanent 2 2 3
11.5 Other personnel compensation.. 1 1 1
11.7 Military personnel............ 2 2
--------- --------- ----------
11.9 Total personnel compensation 43 49 52
12.1 Civilian personnel benefits..... 10 10 11
12.2 Military personnel benefits..... 1 1
21.0 Travel and transportation of
persons....................... 2 1 1
23.1 Rental payments to GSA.......... 6 6 6
23.3 Communications, utilities, and
miscellaneous charges......... 1 3 3
24.0 Printing and reproduction....... 5 4 4
25.1 Advisory and assistance services 25 23 23
25.2 Other services.................. 195 152 152
25.3 Other purchases of goods and
services from Government
accounts...................... 100 91 91
31.0 Equipment....................... 1 2 2
41.0 Grants, subsidies, and
contributions................. 2,878 2,861 2,787
42.0 Insurance claims and indemnities 2 2 1
--------- --------- ----------
99.0 Direct obligations............ 3,268 3,205 3,134
99.0 Reimbursable obligations.......... 237 207 207
--------- --------- ----------
99.9 Total new obligations........... 3,505 3,412 3,341
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-1362-0-1-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct:
1001 Civilian full-time equivalent
employment...................... 456 470 470
1101 Military full-time equivalent
employment...................... 18 16 16
Reimbursable:
2001 Civilian full-time equivalent
employment...................... 33 42 42
2101 Military full-time equivalent
employment...................... 28 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[: Provided further, That not more than
$50,000,000 of these funds shall be for the development of scientific
evidence that supports the implementation and evaluation of health care
information technology systems]. (Department of Health and Human
Services Appropriations Act, 2006.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1700-0-1-552 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
09.00 Reimbursable program.............. 341 341 341
--------- --------- ----------
10.00 Total new obligations........... 341 341 341
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 16 17 17
22.00 New budget authority (gross)...... 342 341 341
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 358 358 358
23.95 Total new obligations............. -341 -341 -341
--------- --------- ----------
24.40 Unobligated balance carried
forward, end of year.......... 17 17 17
----------------------------------------------------------------------------
New budget authority (gross), detail:
Spending authority from offsetting
collections:
Discretionary:
68.00 Offsetting collections (cash). 93 341 341
68.10 Change in uncollected customer
payments from Federal
sources (unexpired)......... 249
--------- --------- ----------
68.90 Spending authority from
offsetting collections
(total discretionary)..... 342 341 341
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 63 44 44
73.10 Total new obligations............. 341 341 341
73.20 Total outlays (gross)............. -324 -341 -341
73.40 Adjustments in expired accounts
(net)........................... -7
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... -249
74.10 Change in uncollected customer
payments from Federal sources
(expired)....................... 220
--------- --------- ----------
74.40 Obligated balance, end of year.. 44 44 44
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 324 341 341
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -312 -341 -341
Against gross budget authority only:
88.95 Change in uncollected customer
payments from Federal sources
(unexpired)................... -249
88.96 Portion of offsetting
collections (cash) credited to
expired accounts.............. 219
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays........................... 12
---------------------------------------------------------------------------
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.
[[Page 441]]
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1700-0-1-552 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
99.0 Reimbursable obligations:
Reimbursable obligations........ 341 341 341
--------- --------- ----------
99.9 Total new obligations........... 341 341 341
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-1700-0-1-552 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Reimbursable:
2001 Civilian full-time equivalent
employment...................... 274 282 286
2101 Military full-time equivalent
employment...................... 12 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, [$156,954,419,000] $138,072,248,000, to remain
available until expended.
For making, after May 31, [2006] 2007, payments to States under
title XIX of the Social Security Act for the last quarter of fiscal year
[2006] 2007, 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 [2007, $62,783,825,000] 2008,
$65,257,617,000, 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, 2006.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0512-0-1-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Medicaid vendor payments.......... 181,658 180,971 188,089
00.02 State and local administration.... 9,722 9,403 9,350
00.03 Vaccine purchases................. 1,503 1,958 2,006
00.04 Incurred by providers but not yet
reported........................ 22,910 2,016
09.01 Medicare Part B premiums.......... 242 300 350
09.02 Medicare Part D eligibility
determinations.................. 73 20 18
--------- --------- ----------
10.00 Total new obligations........... 193,198 215,562 201,829
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 6,077 376 605
22.00 New budget authority (gross)...... 177,855 215,791 201,224
22.10 Resources available from
recoveries of prior year
obligations..................... 9,642
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 193,574 216,167 201,829
23.95 Total new obligations............. -193,198 -215,562 -201,829
--------- --------- ----------
24.40 Unobligated balance carried
forward, end of year.......... 376 605
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 119,124 156,954 138,072
65.00 Advance appropriation........... 58,416 58,517 62,784
Mandatory:
69.00 Spending authority from
offsetting collections:
Offsetting collections (cash). 315 320 368
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 177,855 215,791 201,224
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 9,868 11,389 34,297
73.10 Total new obligations............. 193,198 215,562 201,829
73.20 Total outlays (gross)............. -182,035 -192,654 -199,813
73.45 Recoveries of prior year
obligations..................... -9,642
--------- --------- ----------
74.40 Obligated balance, end of year.. 11,389 34,297 36,313
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 175,958 191,654 198,813
86.98 Outlays from mandatory balances... 6,077 1,000 1,000
--------- --------- ----------
87.00 Total outlays (gross)........... 182,035 192,654 199,813
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -315 -320 -368
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 177,540 215,471 200,856
90.00 Outlays........................... 181,720 192,334 199,445
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
2005 actual 2006 est. 2007 est.
Enacted/requested:
Budget Authority............ 177,540 215,471 200,856
Outlays..................... 181,720 192,334 199,445
Legislative proposal, subject to
PAYGO:
Budget Authority............ -158
Outlays..................... -158
------------------------------------
Total:
Budget Authority............ 177,540 215,471 200,698
Outlays..................... 181,720 192,334 199,287
====================================
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 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
41.0 Direct obligations: Grants,
subsidies, and contributions.... 192,883 215,242 201,461
99.0 Reimbursable obligations:
Reimbursable obligations........ 315 320 368
--------- --------- ----------
99.9 Total new obligations........... 193,198 215,562 201,829
---------------------------------------------------------------------------
Grants to States for Medicaid
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0512-4-1-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Targeted case management.......... -208
00.02 Medicaid pharmacy reform.......... -145
00.03 Third party liability............. -90
00.04 Cost allocation................... -280
00.05 Transitional medical assistance... 180
00.06 Vaccines for Children............. 140
00.07 Cover the Kids.................... 203
00.08 Refugee exemption extension....... 42
--------- --------- ----------
10.00 Total new obligations (object
class 41.0)................... -158
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... -158
23.95 Total new obligations............. 158
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... -158
----------------------------------------------------------------------------
Change in obligated balances:
73.10 Total new obligations............. -158
73.20 Total outlays (gross)............. 158
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... -158
----------------------------------------------------------------------------
[[Page 442]]
Net budget authority and outlays:
89.00 Budget authority.................. -158
90.00 Outlays........................... -158
---------------------------------------------------------------------------
This schedule reflects the Administration's Medicaid proposals.
State Grants and Demonstrations
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0516-0-1-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Ticket to Work--grants............ 41 49 50
00.02 High-risk pools--grants........... 40 80
00.03 Emergency health services for
undocumented aliens............. 250 250 250
00.04 Pilot program--background checks.. 12 11
00.05 State pharmaceutical assistance
programs........................ 63 63
00.06 Health care infrastructure improv
program......................... 140
00.08 Medicaid Integrity Program--
general......................... 5 50
00.09 Site development grants-rural PACE 7
00.10 Funding for PACE outliers......... 10
00.11 Drug surveys & reports............ 5 5
00.12 Partnerships for long term care... 3 3
00.13 Alternate non-emergency network
providers....................... 12 13
00.14 Psychiatric residential treatment
demonstration................... 21
00.15 Money follows the Person (MFP)
demonstration................... 248
00.16 MFP evaluations & technical
support......................... 1
00.17 Medicaid transformation grants.... 75
00.18 Quality of care measures for HCBS
waivers......................... 1
00.19 Katrina relief.................... 2,000
09.11 Reimbursable program-Katrina/Rita
hurricane support............... 70
--------- --------- ----------
10.00 Total new obligations........... 406 2,706 716
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 248 380 271
22.00 New budget authority (gross)...... 536 2,597 709
22.10 Resources available from
recoveries of prior year
obligations..................... 2
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 786 2,977 980
23.95 Total new obligations............. -406 -2,706 -716
23.98 Unobligated balance expiring or
withdrawn....................... -1
--------- --------- ----------
24.40 Unobligated balance carried
forward, end of year.......... 380 271 263
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation--(P.L. 106-170,
Sections 203 & 204)........... 81 81 42
60.00 Appropriation--(P. L. 108-173)--
undocumented aliens........... 250 250 250
60.00 Appropriation-(P.L. 108-173)--
State pharmaceutical
assistance programs........... 63 63
60.00 Appropriation--P.L. (108-173)--
Health care infrastructure
improv program................ 200
60.00 Appropriation-DRA............... 2,133 417
60.35 Appropriation permanently
reduced....................... -58
--------- --------- ----------
62.50 Appropriation (total
mandatory).................. 536 2,527 709
Mandatory:
69.00 Spending authority from
offsetting collections:
Offsetting collections (cash). 70
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 536 2,597 709
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 64 384 548
73.10 Total new obligations............. 406 2,706 716
73.20 Total outlays (gross)............. -84 -2,542 -497
73.45 Recoveries of prior year
obligations..................... -2
--------- --------- ----------
74.40 Obligated balance, end of year.. 384 548 767
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 26 2,330 407
86.98 Outlays from mandatory balances... 58 212 90
--------- --------- ----------
87.00 Total outlays (gross)........... 84 2,542 497
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -70
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 536 2,527 709
90.00 Outlays........................... 84 2,472 497
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
2005 actual 2006 est. 2007 est.
Enacted/requested:
Budget Authority............ 536 2,527 709
Outlays..................... 84 2,472 497
Legislative proposal, subject to
PAYGO:
Budget Authority............ 600
Outlays..................... 350
------------------------------------
Total:
Budget Authority............ 536 2,527 1,309
Outlays..................... 84 2,472 847
====================================
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 to support working individuals with
disabilities.
CMS now administers several programs enacted under the Medicare
Prescription Drug, Improvement, and Modernization Act of 2003 (MMA)
(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 2005 and continuing through 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 2005 and
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.
The Health Care Infrastructure Improvement program provides funding
to qualifying hospitals engaged in cancer-related health care.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0516-0-1-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct obligations:
11.1 Personnel compensation: Full-
time permanent-Medicaid
Integrity Program............. 2 8
12.1 Civilian personnel benefits-
Medicaid Integrity Program.... 1 2
41.0 Grants, subsidies, and
contributions--Ticket to Work. 41 49 50
41.0 Grants, subsidies, and
contributions--High-Risk Pools 40 80
41.0 Grants, subsidies, and
contributions--Fed'l Reimb.--
Emer Svcs, Undoc. Aliens...... 250 250 250
41.0 Grants, subsidies, and
contributions--Background
Checks........................ 12 11
41.0 Grants, subsidies, and
contributions--State
Pharmaceutical Assistance
Programs...................... 63 63
41.0 Grants, subsidies, and
contributions--Health Care
Infrastructure Improvement
Program....................... 140
[[Page 443]]
41.0 Grants, subsidies, and
contributions-Medicaid
Integrity Program............. 2 40
41.0 Grants, subsidies, and
contributions-Site Development
Grants-Rural PACE............. 7
41.0 Grants, subsidies, and
contributions-Funding for PACE
Outliers...................... 10
41.0 Grants, subsidies, and
contributions-Drug Surveys &
Reports....................... 5 5
41.0 Grants, subsidies, and
contributions-Partnership for
Long Term Care................ 3 3
41.0 Grants, subsidies, and
contributions-Alternate Non-
Emergency Network Providers... 12 13
41.0 Grants, subsidies, and
contributions-Psychiatric
Residential Treatment
Demonstration................. 21
41.0 Grants, subsidies, and
contributions-Money follows
the Person (MFP) Demonstration 248
41.0 Grants, subsidies, and
contributions-MFP Evaluations
& Technical Support........... 1
41.0 Grants, subsidies, and
contributions-Medicaid
Transformation Grants......... 75
41.0 Grants, subsidies, and
contributions-Quality of Care
Measures for HCBS Waivers..... 1
41.0 Grants, subsidies, and
contributions-Katrina Relief.. 2,000
--------- --------- ----------
99.0 Direct obligations............ 406 2,636 716
99.0 Reimbursable obligations.......... 70
--------- --------- ----------
99.9 Total new obligations........... 406 2,706 716
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-0516-0-1-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct:
1001 Civilian full-time equivalent
employment...................... 23 100
---------------------------------------------------------------------------
State Grants and Demonstrations
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0516-4-1-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Chronically Ill grants............ 500
00.02 Cover the Kids outreach........... 100
--------- --------- ----------
10.00 Total new obligations........... 600
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 600
23.95 Total new obligations............. -600
--------- --------- ----------
24.40 Unobligated balance carried
forward, end of year..........
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation--Chronically Ill
grants........................ 500
60.00 Appropriation--Cover the Kids... 100
--------- --------- ----------
62.50 Appropriation (total
mandatory).................. 600
----------------------------------------------------------------------------
Change in obligated balances:
73.10 Total new obligations............. 600
73.20 Total outlays (gross)............. -350
--------- --------- ----------
74.40 Obligated balance, end of year.. 250
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 350
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 600
90.00 Outlays........................... 350
---------------------------------------------------------------------------
This schedule reflects the Administration's State Grants and
Demonstrations proposals.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0516-4-1-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
41.0 Grants, subsidies, and
contributions--Chronically Ill
grants.......................... 500
41.0 Grants, subsidies, and
contributions- Cover the Kids... 100
--------- --------- ----------
99.9 Total new obligations........... 600
---------------------------------------------------------------------------
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[,] and 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,
[$177,742,200,000] $197,135,795,000.
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, 2006.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0580-0-1-571 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Supplementary medical insurance
(SMI)........................... 114,002 128,920 139,351
00.02 Hospital insurance for uninsured
(HI)............................ 87 202 239
00.03 Federal uninsured payment (HI).... 199 206 229
00.04 Program management (HI)........... 215 164 153
00.05 Fraud and abuse control, criminal
fines........................... 348 30 30
00.06 Federal payments from taxation of
OASDI benefits (HI)............. 8,765 10,002 11,352
00.07 Fraud and abuse control, FBI...... 114 114 114
00.08 FHI trust fund, Transfers from
general fund (civil monetary
penalties)...................... 10 13 13
00.09 Federal contributions, Drug
account State low-income
determinations.................. 73 20 18
00.10 Federal contributions,
Transitional assistance account. 1,125 134
00.11 General Revenue for Part D
Benefits........................ 36,482 56,574
00.12 General Revenue for Part D Federal
Admin........................... 605 454
00.14 HCFAC reimbursement............... 118
--------- --------- ----------
10.00 Total new obligations........... 124,938 176,892 208,645
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 126,638 194,157 208,645
23.95 Total new obligations............. -124,938 -176,892 -208,645
23.98 Unobligated balance expiring or
withdrawn....................... -1,700 -17,265
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation (Tax on OASDI
Benefits)..................... 8,765 10,002 11,352
60.00 Appropriation (HCFAC penalties,
etc.)......................... 358 43 43
60.00 Appropriation (Subsidy for HI &
SMI benefits, General Fund
federal admin)................ 114,503 129,264 140,426
60.00 Appropriation (HCFAC funding)... 114 114 232
60.00 Appropriation (Transitional
Assistance Benefits).......... 2,792 134
60.00 Appropriation (Part D State
Eligibility Determinations)... 106 99 18
60.00 Appropriation (Part D Drug
Benefits)..................... 53,596 56,574
60.00 Appropriation (Indefinite
general funds for SMI)........ 905
--------- --------- ----------
62.50 Appropriation (total
mandatory).................. 126,638 194,157 208,645
----------------------------------------------------------------------------
Change in obligated balances:
73.10 Total new obligations............. 124,938 176,892 208,645
73.20 Total outlays (gross)............. -124,938 -176,892 -208,645
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 124,938 176,892 208,645
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 126,638 194,157 208,645
90.00 Outlays........................... 124,938 176,892 208,645
---------------------------------------------------------------------------
[[Page 444]]
Summary of Budget Authority and Outlays
(in millions of dollars)
2005 actual 2006 est. 2007 est.
Enacted/requested:
Budget Authority............ 126,638 194,157 208,645
Outlays..................... 124,938 176,892 208,645
Legislative proposal, not subject to
PAYGO:
Budget Authority............ -466
Outlays..................... -466
------------------------------------
Total:
Budget Authority............ 126,638 194,157 208,179
Outlays..................... 124,938 176,892 208,179
====================================
Payments are made to the Federal Hospital Insurance and Federal
Supplementary Medical Insurance trust funds from the general fund of the
Treasury to finance Medicare's medical and drug benefits for
beneficiaries and certain other qualified individuals.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0580-0-1-571 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
41.0 Grants, subsidies, and
contributions................... 124,437 175,715 207,571
42.0 Insurance claims and indemnities.. 286 408 468
94.0 Financial transfers (federal
admin).......................... 215 769 606
--------- --------- ----------
99.0 Direct obligations............ 124,938 176,892 208,645
--------- --------- ----------
99.9 Total new obligations........... 124,938 176,892 208,645
---------------------------------------------------------------------------
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 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Supplementary medical insurance
(SMI)........................... -466
--------- --------- ----------
10.00 Total new obligations (object
class 41.0)................... -466
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... -466
23.95 Total new obligations............. 466
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation (Subsidy for HI &
SMI benefits, General Fund
federal admin)................ -466
----------------------------------------------------------------------------
Change in obligated balances:
73.10 Total new obligations............. -466
73.20 Total outlays (gross)............. 466
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... -466
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. -466
90.00 Outlays........................... -466
---------------------------------------------------------------------------
The budget proposes a package of reforms to encourage competition,
recognize efficiencies and productivity in health care, enhance program
integrity, and strengthen responsibility for health care choices.
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 [$3,170,927,000] $3,148,402,000, 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
[$24,205,000] $22,765,000, to remain available until September 30,
[2007] 2008, is for contract costs for the Centers for Medicare and
Medicaid Services Systems Revitalization Plan: Provided further, That
[$79,934,000] $48,960,000, to remain available until September 30,
[2007] 2008, is for contract costs for the Healthcare Integrated General
Ledger Accounting System: Provided further, That the Centers for
Medicare and Medicaid Services will take all actions necessary to ensure
that before December 15, 2007 no fewer than 7 Medicare Administrative
Contractors will commence the duties of Medicare claims-processing
activities and related responsibilities: Provided further, That
$146,760,000, to remain available until September 30, 2008, is for CMS
Medicare contracting reform activities: 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 the Secretary shall charge a fee for
conducting revisit surveys performed on health care facilities cited for
deficiencies during initial certification, recertification, or
substantiated complaints surveys. Such fees shall be deposited as an
offsetting collection to this appropriation, to remain available until
expended for conducting such surveys. The amount appropriated above from
the HI and SMI trust funds shall be reduced by a corresponding amount of
fees collected: Provided further, That the Secretary of Health and Human
Services is directed to collect fees in fiscal year [2006] 2007 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 volume is projected by the Centers for Medicare and
Medicaid Services (CMS) to exceed 200,000,000 Part A claims and/or
1,022,100,000 Part B claims, an additional $32,500,000 shall be
available for obligation for every 50,000,000 increase in Medicare
claims volume (including a pro rata amount for any increment less than
50,000,000) from the Federal Hospital Insurance and the Federal
Supplementary Medical Insurance Trust Funds]. (Department of Health and
Human Services Appropriations Act, 2006.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0511-0-1-550 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
Direct program:
00.01 Medicare operations............. 2,321 2,161 2,145
00.02 Federal administration.......... 637 653 655
00.03 State survey and certification.. 259 258 284
00.04 Research, demonstrations, and
evaluation projects........... 109 69 42
00.05 Revitalization plan............. 31 26 23
--------- --------- ----------
01.00 Total direct program............ 3,357 3,167 3,149
09.01 CLIA.............................. 44 43 43
09.03 Other reimbursements.............. 15 2 2
09.04 Coordination of benefits.......... 30
09.06 MA/PDP............................ 13 56 69
--------- --------- ----------
09.09 Total reimbursable program...... 72 101 144
--------- --------- ----------
10.00 Total new obligations........... 3,429 3,268 3,293
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 735 102 89
22.00 New budget authority (gross)...... 2,715 3,255 3,293
22.10 Resources available from
recoveries of prior year
obligations..................... 88
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 3,538 3,357 3,382
[[Page 445]]
23.95 Total new obligations............. -3,429 -3,268 -3,293
23.98 Unobligated balance expiring or
withdrawn....................... -7
--------- --------- ----------
24.40 Unobligated balance carried
forward, end of year.......... 102 89 89
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 38
Spending authority from offsetting
collections:
Discretionary:
68.00 Offsetting collections (cash). 2,460 3,080 3,149
68.00 Offsetting collections (cash). 101 144
68.10 Change in uncollected customer
payments from Federal
sources (unexpired)......... 255
--------- --------- ----------
68.90 Spending authority from
offsetting collections
(total discretionary)..... 2,715 3,181 3,293
Mandatory:
69.00 Offsetting collections (cash). 36
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 2,715 3,255 3,293
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. -448 -199 -186
73.10 Total new obligations............. 3,429 3,268 3,293
73.20 Total outlays (gross)............. -3,125 -3,255 -3,293
73.40 Adjustments in expired accounts
(net)........................... -36
73.45 Recoveries of prior year
obligations..................... -88
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... -255
74.10 Change in uncollected customer
payments from Federal sources
(expired)....................... 324
--------- --------- ----------
74.40 Obligated balance, end of year.. -199 -186 -186
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 2,117 3,181 3,293
86.93 Outlays from discretionary
balances........................ 1,008
86.97 Outlays from new mandatory
authority....................... 74
--------- --------- ----------
87.00 Total outlays (gross)........... 3,125 3,255 3,293
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
Offsetting collections (cash)
from:
88.00 Federal sources............... -2,681 -3,080 -3,149
88.00 Federal sources............... -36
88.40 Non-Federal sources........... -60 -101 -144
--------- --------- ----------
88.90 Total, offsetting
collections (cash)........ -2,741 -3,217 -3,293
Against gross budget authority only:
88.95 Change in uncollected customer
payments from Federal sources
(unexpired)................... -255
88.96 Portion of offsetting
collections (cash) credited to
expired accounts.............. 281
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 38
90.00 Outlays........................... 384 38
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
2005 actual 2006 est. 2007 est.
Enacted/requested:
Budget Authority............ 38
Outlays..................... 384 38
Legislative proposal, not subject to
PAYGO:
Budget Authority............
Outlays.....................
------------------------------------
Total:
Budget Authority............ 38
Outlays..................... 384 38
====================================
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 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 359 379 389
11.3 Other than full-time permanent 13 14 14
11.5 Other personnel compensation.. 8 8 6
11.7 Military personnel............ 9 8 9
--------- --------- ----------
11.9 Total personnel compensation 389 409 418
12.1 Civilian personnel benefits..... 89 90 95
12.2 Military personnel benefits..... 3 4 4
21.0 Travel and transportation of
persons....................... 10 11 9
22.0 Transportation of things........ 1
23.1 Rental payments to GSA.......... 20 30 32
23.3 Communications, utilities, and
miscellaneous charges......... 43 3 3
24.0 Printing and reproduction....... 38 3 3
25.1 Advisory and assistance services 43
25.2 Other services.................. 751 179 162
25.3 Other purchases of goods and
services from Government
accounts...................... 94 3 3
25.4 Operation and maintenance of
facilities.................... 7
25.5 Research and development
contracts..................... 57
25.6 Medical care.................... 1,444 2,399 2,409
25.7 Operation and maintenance of
equipment..................... 263
26.0 Supplies and materials.......... 2 1 1
31.0 Equipment....................... 16
32.0 Land and structures............. 10 10 10
41.0 Grants, subsidies, and
contributions................. 77 25
--------- --------- ----------
99.0 Direct obligations............ 3,357 3,167 3,149
99.0 Reimbursable obligations.......... 72 101 144
--------- --------- ----------
99.9 Total new obligations........... 3,429 3,268 3,293
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-0511-0-1-550 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct:
1001 Civilian full-time equivalent
employment...................... 4,496 4,462 4,433
1101 Military full-time equivalent
employment...................... 96 98 98
Reimbursable:
2001 Civilian full-time equivalent
employment...................... 72 72 72
---------------------------------------------------------------------------
Program Management
(Legislative proposal, not subject to PAYGO)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0511-2-1-550 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
Direct program:
00.03 State survey and certification.. -35
--------- --------- ----------
01.00 Total direct program............ -35
09.02 Recertification user fees......... 35
--------- --------- ----------
09.09 Total reimbursable program...... 35
--------- --------- ----------
10.00 Total new obligations...........
----------------------------------------------------------------------------
Change in obligated balances:
73.10 Total new obligations.............
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
Offsetting collections (cash)
from:
88.00 Federal sources............... 35
88.40 Non-Federal sources........... -35
--------- --------- ----------
88.90 Total, offsetting
collections (cash)........
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays...........................
---------------------------------------------------------------------------
The Budget includes $35 million in new user fees to finance CMS
survey and certification activities. CMS would charge revisit survey
fees to health care facilities cited for deficiencies during initial
certification, recertification, or substan
[[Page 446]]
tiated complaint surveys. Proposed appropriations language provides
authority to collect and spend these fees. The amount appropriated from
the HI and SMI Trust Funds would be reduced on a dollar-for-dollar basis
with fees collected.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0511-2-1-550 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
25.6 Direct obligations: Medical care.. -35
99.0 Reimbursable obligations:
Reimbursable obligations........ 35
--------- --------- ----------
99.9 Total new obligations...........
---------------------------------------------------------------------------
State Children's Health Insurance Fund
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0515-0-1-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Grants, subsidies, and
contributions................... 4,725 4,539 5,040
--------- --------- ----------
10.00 Total new obligations (object
class 41.0)................... 4,725 4,539 5,040
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 4,082 4,365 5,040
22.30 Expired unobligated balance
transfer to unexpired account... 643 173
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 4,725 4,538 5,040
23.95 Total new obligations............. -4,725 -4,539 -5,040
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation, BBA.............. 4,050 4,050 5,000
60.00 Appropriation, BBRA for
territories................... 32 32 40
60.00 Appropriation--DRA.............. 283
--------- --------- ----------
62.50 Appropriation (total
mandatory).................. 4,082 4,365 5,040
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 8,322 7,275 5,736
73.10 Total new obligations............. 4,725 4,539 5,040
73.20 Total outlays (gross)............. -5,129 -5,775 -5,244
73.40 Adjustments in expired accounts
(net)........................... -643 -303
--------- --------- ----------
74.40 Obligated balance, end of year.. 7,275 5,736 5,532
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 879 1,378 2,103
86.98 Outlays from mandatory balances... 4,250 4,397 3,141
--------- --------- ----------
87.00 Total outlays (gross)........... 5,129 5,775 5,244
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 4,082 4,365 5,040
90.00 Outlays........................... 5,129 5,775 5,244
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
2005 actual 2006 est. 2007 est.
Enacted/requested:
Budget Authority............ 4,082 4,365 5,040
Outlays..................... 5,129 5,775 5,244
Legislative proposal, subject to
PAYGO:
Budget Authority............
Outlays..................... 704
------------------------------------
Total:
Budget Authority............ 4,082 4,365 5,040
Outlays..................... 5,129 5,775 5,948
====================================
==========
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 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 SCHIP redistribution.............. 635
00.02 Cover the Kids.................... 69
--------- --------- ----------
10.00 Total new obligations (object
class 41.0)................... 704
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.30 Expired unobligated balance
transfer to unexpired account... 704
23.95 Total new obligations............. -704
----------------------------------------------------------------------------
Change in obligated balances:
73.10 Total new obligations............. 704
73.20 Total outlays (gross)............. -704
----------------------------------------------------------------------------
Outlays (gross), detail:
86.98 Outlays from mandatory balances... 704
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays........................... 704
---------------------------------------------------------------------------
-------
This schedule reflects the Administration's SCHIP proposals.
Medicare Advantage Stabilization Fund
Special and Trust Fund Receipts (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-5384-0-2-571 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
01.00 Balance, start of year............
--------- --------- ----------
01.99 Balance, start of year............
Receipts:
02.00 Payments from HI, Stabilization
fund............................ 668
02.01 Payments from SMI, Stabilization
fund............................ 616
--------- --------- ----------
02.99 Total receipts and collections.. 1,284
Appropriations:
05.00 Medicare advantage stabilization
fund............................ -1,284
--------- --------- ----------
07.99 Balance, end of year..............
---------------------------------------------------------------------------
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-5384-0-2-571 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Direct program activity........... 1,284
--------- --------- ----------
10.00 Total new obligations (object
class 25.2)................... 1,284
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 1,284
23.95 Total new obligations............. -1,284
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.20 Appropriation (special fund).... 1,284
----------------------------------------------------------------------------
Change in obligated balances:
73.10 Total new obligations............. 1,284
[[Page 447]]
73.20 Total outlays (gross)............. -1,284
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 1,284
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 1,284
90.00 Outlays........................... 1,284
---------------------------------------------------------------------------
The Medicare Advantage (MA) Regional Stabilization Fund finances
incentives to have MA regional plans offered in each MA region and
retain MA plans in certain regions with below national average MA market
penetration.
Trust Funds
Federal Hospital Insurance Trust Fund
Special and Trust Fund Receipts (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8005-0-7-571 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
01.00 Balance, start of year............ 248,542 259,707 279,591
--------- --------- ----------
01.99 Balance, start of year............ 248,542 259,707 279,591
Receipts:
02.00 FHI trust fund, Federal employer
contributions (FICA)............ 2,630 2,734 2,782
02.01 FHI trust fund, Postal Service
employer contributions (FICA)... 672 682 706
02.02 FHI trust fund, Interest received
by trust funds.................. 15,126 15,035 15,356
02.03 FHI trust fund, Interest received
by trust funds.................. 3 11
02.04 FHI trust fund, Interest received
by trust funds--legislative
proposal not subject to PAYGO... 66
02.05 FHI trust fund, Taxation on OASDI
benefits........................ 8,765 10,002 11,352
02.06 FHI trust fund, Payment from the
general fund for health care
fraud and abuse control account. 114 114 114
02.07 FHI trust fund, Transfers from
general fund (criminal fines)... 348 30 30
02.08 FHI trust fund, Transfers from
general fund (civil monetary
penalties)...................... 13 13 13
02.09 FHI trust fund, Interest payments
by Railroad Retirement Board.... 29 30 32
02.10 FHI trust fund, Payments from the
general fund (uninsured and
program management)............. 502 573 740
02.20 FHI trust fund, Basic premium,
Medicare advantage.............. 58 77
02.21 FHI trust fund, medicare refunds.. 1,551
02.22 FHI trust fund, Premiums collected
for uninsured individuals not
otherwise eligible.............. 2,303 2,523 2,663
02.60 FHI trust fund, Transfers from
general fund (FICA taxes)....... 154,400 165,198 174,722
02.61 FHI trust fund, Receipts from
Railroad Retirement Board....... 416 442 455
02.62 FHI trust fund, Transfers from
general fund (SECA taxes)....... 11,252 11,952 12,763
02.63 FHI trust fund, Civil penalties
and damages..................... 351 238 238
--------- --------- ----------
02.99 Total receipts and collections.. 198,472 209,627 222,120
--------- --------- ----------
04.00 Total: Balances and collections... 447,014 469,334 501,711
Appropriations:
05.00 Federal hospital insurance trust
fund............................ -1,621 -1,807 -1,803
05.01 Federal hospital insurance trust
fund............................ 18
05.02 Federal hospital insurance trust
fund............................ 17
05.03 Federal hospital insurance trust
fund............................ -195,788 -209,627 -222,054
05.04 Federal hospital insurance trust
fund............................ 11,121 22,860 17,225
05.05 Federal hospital insurance trust
fund--legislative proposal not
subject to PAYGO................ 35
05.06 Federal hospital insurance trust
fund--legislative proposal not
subject to PAYGO................ -35
05.07 Federal hospital insurance trust
fund--legislative proposal not
subject to PAYGO................ 35
05.08 Federal hospital insurance trust
fund--legislative proposal
subject to PAYGO................ -66
05.09 Federal hospital insurance trust
fund--legislative proposal
subject to PAYGO................ 2,166
05.10 Health care fraud and abuse
control account................. -118
05.11 Health care fraud and abuse
control account................. -1,075 -1,187 -1,099
05.12 Health care fraud and abuse
control account................. -5
Adjustments:
05.90 Adjustments..................... 20
--------- --------- ----------
05.99 Total appropriations............ -187,331 -189,743 -205,714
06.10 Federal hospital insurance trust
fund............................ 16
06.11 Health care fraud and abuse
control account................. 8
--------- --------- ----------
07.99 Balance, end of year.............. 259,707 279,591 295,997
---------------------------------------------------------------------------
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8005-0-7-571 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Benefit payments, HI.............. 184,309 185,845 204,525
00.02 Administration, HI................ 1,652 1,893 1,911
00.03 Quality improvement organizations,
HI.............................. 244 705 84
00.04 Research, HI...................... 66 55 35
00.05 MA additional premiums............ 58 77
--------- --------- ----------
10.00 Total new obligations........... 186,271 188,556 206,632
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 186,271 188,556 206,632
22.10 Resources available from
recoveries of prior year
obligations..................... 16
22.77 Balance of trust fund authority
withdrawn....................... -16
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 186,271 188,556 206,632
23.95 Total new obligations............. -186,271 -188,556 -206,632
24.41 Special and trust fund receipts
returned to Schedule N.......... 16
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.26 Appropriation (trust fund)...... 1,621 1,807 1,803
40.34 Appropriation temporarily
reduced (P.L. 109-148)........ -18
40.37 Appropriation temporarily
reduced....................... -17
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 1,604 1,789 1,803
Mandatory:
60.26 Appropriation (trust fund)...... 195,788 209,627 222,054
60.45 Portion precluded from balances. -11,121 -22,860 -17,225
--------- --------- ----------
62.50 Appropriation (total
mandatory).................. 184,667 186,767 204,829
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 186,271 188,556 206,632
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 16,091 17,735 18,046
73.10 Total new obligations............. 186,271 188,556 206,632
73.20 Total outlays (gross)............. -184,611 -188,245 -206,900
73.45 Recoveries of prior year
obligations..................... -16
--------- --------- ----------
74.40 Obligated balance, end of year.. 17,735 18,046 17,778
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 1,420 1,481 1,499
86.93 Outlays from discretionary
balances........................ 219 414 319
86.97 Outlays from new mandatory
authority....................... 167,930 171,197 188,762
86.98 Outlays from mandatory balances... 15,042 15,153 16,320
--------- --------- ----------
87.00 Total outlays (gross)........... 184,611 188,245 206,900
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 186,271 188,556 206,632
90.00 Outlays........................... 184,611 188,245 206,900
----------------------------------------------------------------------------
Memorandum (non-add) entries:
92.01 Total investments, start of year:
Federal securities: Par value... 264,375 277,268 295,654
92.02 Total investments, end of year:
Federal securities: Par value... 277,268 295,654 314,032
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
2005 actual 2006 est. 2007 est.
Enacted/requested:
Budget Authority............ 186,271 188,556 206,632
Outlays..................... 184,611 188,245 206,900
Legislative proposal, not subject to
PAYGO:
Budget Authority............ -35
Outlays..................... -35
Legislative proposal, subject to
PAYGO:
Budget Authority............ -2,100
Outlays..................... -2,100
------------------------------------
Total:
Budget Authority............ 186,271 188,556 204,497
Outlays..................... 184,611 188,245 204,765
====================================
The Hospital Insurance (HI) program funds the costs of hospital and
related care for individuals age 65 or older and for eligible disabled
people.
[[Page 448]]
The status of the trust fund is as follows:
Status of Funds (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8005-0-7-571 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Unexpended balance, start of year:
0100 Balance, start of year............ 264,901 277,670 297,865
--------- --------- ----------
0199 Total balance, start of year.... 264,901 277,670 297,865
Cash income during the year:
Current law:
Receipts:
1200 FHI trust fund, Federal
employer contributions
(FICA)...................... 2,630 2,734 2,782
1201 FHI trust fund, Postal Service
employer contributions
(FICA)...................... 672 682 706
1202 FHI trust fund, Interest
received by trust funds..... 15,126 15,035 15,356
1203 FHI trust fund, Interest
received by trust funds..... 3 11
1205 FHI trust fund, Taxation on
OASDI benefits.............. 8,765 10,002 11,352
1206 FHI trust fund, Payment from
the general fund for health
care fraud and abuse control
account..................... 114 114 114
1207 FHI trust fund, Transfers from
general fund (criminal
fines)...................... 348 30 30
1208 FHI trust fund, Transfers from
general fund (civil monetary
penalties).................. 13 13 13
1209 FHI trust fund, Interest
payments by Railroad
Retirement Board............ 29 30 32
1210 FHI trust fund, Payments from
the general fund (uninsured
and program management)..... 502 573 740
Offsetting receipts
(proprietary):
1220 FHI trust fund, Basic premium,
Medicare advantage.......... 58 77
1221 FHI trust fund, medicare
refunds..................... 1,551
1222 FHI trust fund, Premiums
collected for uninsured
individuals not otherwise
eligible.................... 2,303 2,523 2,663
Offsetting governmental
receipts:
1260 FHI trust fund, Transfers from
general fund (FICA taxes)... 154,400 165,198 174,722
1261 FHI trust fund, Receipts from
Railroad Retirement Board... 416 442 455
1262 FHI trust fund, Transfers from
general fund (SECA taxes)... 11,252 11,952 12,763
1263 FHI trust fund, Civil
penalties and damages....... 351 238 238
Offsetting collections:
1280 Health care fraud and abuse
control account............. 8 8 6
1299 Income under present law........ 198,480 209,635 222,060
Proposed legislation:
Receipts:
2204 FHI trust fund, Interest
received by trust funds--
legislative proposal not
subject to PAYGO............ 66
2299 Income under proposed
legislation................... 66
--------- --------- ----------
3299 Total cash income............... 198,480 209,635 222,126
Cash outgo during year:
Current law:
4500 Federal hospital insurance trust
fund.......................... -184,611 -188,245 -206,900
4501 Health care fraud and abuse
control account............... -1,100 -1,195 -1,223
4599 Outgo under current law (-)..... -185,711 -189,440 -208,123
Proposed legislation:
5500 Federal hospital insurance trust
fund--legislative proposal not
subject to PAYGO.............. 35
5501 Federal hospital insurance trust
fund--legislative proposal
subject to PAYGO.............. 2,100
5599 Outgo under proposed legislation
(-)........................... 2,135
--------- --------- ----------
6599 Total cash outgo (-)............ -185,711 -189,440 -205,988
Unexpended balance, end of year:
8700 Uninvested balance (net), end of
year............................ 402 2,211 -2,230
8701 Invested balance, end of year..... 277,268 295,654 314,032
8701 Invested balance, end of year..... 35
8701 Invested balance, end of year..... 2,166
--------- --------- ----------
8799 Appropriation [Benefits]........ 277,670 297,865 314,003
Commitments against unexpended balance, end of
year:
--------- --------- ----------
9900 Uncommitted balance, end of year 277,670 297,865 314,003
---------------------------------------------------------------------------
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8005-0-7-571 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
41.0 Payment for Quality Improvement
Organization (QIO) activities... 244 705 84
42.0 Insurance claims and indemnities
(benefits)...................... 184,288 185,903 204,602
94.0 Financial transfers............... 1,739 1,948 1,946
--------- --------- ----------
99.0 Direct obligations............ 186,271 188,556 206,632
--------- --------- ----------
99.9 Total new obligations........... 186,271 188,556 206,632
---------------------------------------------------------------------------
Federal Hospital Insurance Trust Fund
(Legislative proposal, not subject to PAYGO)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8005-2-7-571 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.02 Administration, HI................ -35
--------- --------- ----------
10.00 Total new obligations (object
class 94.0)................... -35
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... -35
23.95 Total new obligations............. 35
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.26 Appropriation (trust fund)...... -35
Mandatory:
60.26 Appropriation (trust fund)...... 35
60.45 Portion precluded from
obligation.................... -35
--------- --------- ----------
62.50 Appropriation (total
mandatory)..................
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... -35
----------------------------------------------------------------------------
Change in obligated balances:
73.10 Total new obligations............. -35
73.20 Total outlays (gross)............. 35
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... -35
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. -35
90.00 Outlays........................... -35
----------------------------------------------------------------------------
Memorandum (non-add) entries:
92.02 Total investments, end of year:
Federal securities: Par value... 35
---------------------------------------------------------------------------
The Budget proposes a user fee to cover the costs associated with
follow-up visits to health care facilities that are found to be out of
compliance with Medicare standards.
Federal Hospital Insurance Trust Fund
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8005-4-7-571 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Benefit payments, HI.............. -2,100
--------- --------- ----------
10.00 Total new obligations (object
class 42.0)................... -2,100
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... -2,100
23.95 Total new obligations............. 2,100
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.26 Appropriation (trust fund)...... 66
60.45 Portion precluded from
obligation.................... -2,166
--------- --------- ----------
62.50 Appropriation (total
mandatory).................. -2,100
----------------------------------------------------------------------------
Change in obligated balances:
73.10 Total new obligations............. -2,100
73.20 Total outlays (gross)............. 2,100
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... -2,100
----------------------------------------------------------------------------
[[Page 449]]
Net budget authority and outlays:
89.00 Budget authority.................. -2,100
90.00 Outlays........................... -2,100
----------------------------------------------------------------------------
Memorandum (non-add) entries:
92.02 Total investments, end of year:
Federal securities: Par value... 2,166
---------------------------------------------------------------------------
The Budget proposes a package of reforms to encourage competition,
recognize efficiencies and productivity in health care, enhance program
integrity, and strengthen responsibility for health care choices.
Health Care Fraud and Abuse Control Account
In addition to amounts otherwise available for program integrity and
program management, $118,404,000, 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 $85,634,000 is for the Medicare Integrity Program at the Centers
for Medicare and Medicaid Services 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); of
which $11,336,000 is for the Department of Health and Human Services
Office of Inspector General; of which $10,098,000 is for the Medicaid
program integrity activities; and of which $11,336,000 is for the
Department of Justice: Provided, That the report required by 18 U.S.C.
1817(k)(5) for FY 2007 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 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Medicare integrity program........ 720 832 830
00.02 FBI fraud and abuse control....... 114 114 114
00.03 Other fraud and abuse control..... 239 241 273
09.01 Reimbursable (OIG)................ 7 8 6
--------- --------- ----------
10.00 Total new obligations........... 1,080 1,195 1,223
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 1,088 1,195 1,223
23.95 Total new obligations............. -1,080 -1,195 -1,223
23.98 Unobligated balance expiring or
withdrawn....................... -8
24.41 Special and trust fund receipts
returned to Schedule N.......... 8
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.26 Appropriation (trust fund)...... 118
Mandatory:
60.26 Appropriation (trust fund)...... 1,075 1,187 1,099
60.28 Appropriation (previously
unavailable).................. 5
--------- --------- ----------
62.50 Appropriation (total
mandatory).................. 1,080 1,187 1,099
Spending authority from offsetting
collections:
Mandatory:
69.00 Offsetting collections (cash). 8 6 6
69.26 Offsetting collections
(previously unavailable).... 2
--------- --------- ----------
69.90 Spending authority from
offsetting collections
(total mandatory)......... 8 8 6
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 1,088 1,195 1,223
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 268 228 228
73.10 Total new obligations............. 1,080 1,195 1,223
73.20 Total outlays (gross)............. -1,100 -1,195 -1,223
73.40 Adjustments in expired accounts
(net)........................... -20
--------- --------- ----------
74.40 Obligated balance, end of year.. 228 228 228
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 118
86.97 Outlays from new mandatory
authority....................... 937 1,193 1,105
86.98 Outlays from mandatory balances... 163 2
--------- --------- ----------
87.00 Total outlays (gross)........... 1,100 1,195 1,223
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -8 -8 -6
Against gross budget authority only:
88.96 Portion of offsetting
collections (cash) credited to
expired accounts.............. 2
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 1,080 1,189 1,217
90.00 Outlays........................... 1,092 1,187 1,217
---------------------------------------------------------------------------
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
2006 and 2007. As required by statute, actual 2006 and 2007 agency
distributions will be determined by the Secretary of HHS and the
Attorney General consistent with the Administration's priorities.
2005 actual 2006 est. 2007 est.
Department of Justice, DOJ.... 49 49 49
Office of the Inspector
General, HHS.................. 160 160 160
Other specific HHS fraud and
abuse projects................ 31 31 31
------------------------------------
Total................... 240 240 240
====================================
The 2007 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 $118 million for 2007 (see chapter 15 in
Analytical Perspectives).
The HCFAC entities will develop a comprehensive plan for Medicare,
Medicaid and SCHIP program integrity activities. The plan will indicate
how program integrity appropriations from all sources (DRA, HIPAA and
the discretionary cap adjustment) will be allocated to address program
integrity priorities. These priorities include the fraud, waste, and
abuse vulnerabilities of these programs, and efforts to address
responsibilities under the Improper Payments Improvement Act.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-8393-0-7-571 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct obligations:
11.1 Personnel compensation: Full-
time permanent (CMS 100 FTEs). 8 8 8
12.1 Civilian personnel benefits
(CMS)......................... 2 2 2
23.2 Rental payments to others....... 1 1 1
25.1 Advisory and assistance services
(CMS)......................... 4 5 5
25.2 Other services (CMS)............ 3 4 14
25.3 Other purchases of goods and
services from Government
accounts (DoJ)................ 49 49 60
25.3 Other purchases of goods and
services from Government
accounts (HHS/OIG)............ 160 160 171
[[Page 450]]
25.3 Other purchases of goods and
services from Government
accounts (HHS/AoA)............ 2 2 2
25.3 Other purchases of goods and
services from Government
accounts (HHS/OGC)............ 5 5 5
25.6 Medical care (CMS).............. 720 832 830
41.0 Grants, subsidies, and
contributions (CMS)........... 5 5 5
94.0 Financial transfers............. 114 114 114
--------- --------- ----------
99.0 Direct obligations............ 1,073 1,187 1,217
99.0 Reimbursable obligations.......... 7 8 6
--------- --------- ----------
99.9 Total new obligations........... 1,080 1,195 1,223
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-8393-0-7-571 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct:
1001 Civilian full-time equivalent
employment...................... 84 100 100
---------------------------------------------------------------------------
Federal Supplementary Medical Insurance Trust Fund
Special and Trust Fund Receipts (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8004-0-7-571 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
01.00 Balance, start of year............ 400 -1,226 10,544
--------- --------- ----------
01.99 Balance, start of year............ 400 -1,226 10,544
Receipts:
02.00 Federal contributions, FSMI Fund.. 114,002 128,920 136,987
02.01 Federal contributions, FSMI Fund.. 2,364
02.02 Federal contributions, FSMI Fund--
legislative proposal not subject
to PAYGO........................ -466
02.03 Interest received by trust fund,
FSMI Fund....................... 1,364 1,609 2,183
02.04 Interest received by trust fund,
FSMI Fund....................... -25 -35
02.05 Interest received by trust fund,
FSMI Fund--legislative proposal
not subject to PAYGO............ 7
02.06 Federal contribution, State low-
income determinations,
prescription drug account, FSMI. 73 20 18
02.07 Interest, Medicare prescription
drug account, FSMI.............. 138 187
02.08 Federal contributions,
Transitional assistance account,
FSMI............................ 1,125
02.09 Federal contributions,
Transitional assistance account,
FSMI............................ 134
02.10 Federal contribution for admin.
contribution for admin. costs,
prescription drug account, FSMI. 605 453
02.11 Federal contributions for
benefits, prescription drug
account, SMI.................... 36,482 56,574
02.12 Miscellaneous Federal payments,
Federal supplementary medical
insurance trust fund............ 1 2 2
02.20 Other proprietary receipts from
the public, FSMI Fund........... 1
02.21 Premiums collected for Medicare
prescription drug account, FSMI. 3,886 6,558
02.22 Payments from States, Medicare
prescription drug account, FSMI. 5,819 7,588
02.23 Basic premium, Medicare advantage,
FSMI trust fund................. 51 68
02.24 Medicare refunds, SMI............. 993
02.25 Premiums collected for the aged,
FSMI Fund....................... 30,394 35,364 38,357
02.26 Premiums collected for the aged,
FSMI Fund....................... 925
02.27 Premiums collected for the aged,
FSMI Fund--legislative proposal
subject to PAYGO................ -85
02.28 Premiums collected for the
disabled, FSMI Fund............. 5,546 6,237 6,805
02.29 Premiums collected for the
disabled, FSMI Fund............. 132
02.30 Premiums collected for the
disabled, FSMI Fund--legislative
proposal subject to PAYGO....... -22
--------- --------- ----------
02.99 Total receipts and collections.. 153,499 219,242 258,600
--------- --------- ----------
04.00 Total: Balances and collections... 153,899 218,016 269,144
Appropriations:
05.00 Federal supplementary medical
insurance trust fund............ -2,417 -2,441 -2,614
05.01 Federal supplementary medical
insurance trust fund............ 25
05.02 Federal supplementary medical
insurance trust fund............ 22
05.03 Federal supplementary medical
insurance trust fund............ -149,905 -169,742 -185,174
05.04 Federal supplementary medical
insurance trust fund............ -1,666 11,821 9,665
05.05 Federal supplementary medical
insurance trust fund--
legislative proposal subject to
PAYGO........................... 566
05.06 Federal supplementary medical
insurance trust fund--
legislative proposal subject to
PAYGO........................... -106
05.07 Transitional drug assistance,
Federal supplementary medical
insurance trust fund............ -1,111 -83
05.08 Medicare prescription drug
account, Federal supplementary
insurance trust fund............ -1 -714 -468
05.09 Medicare prescription drug
account, Federal supplementary
insurance trust fund............ 7
05.10 Medicare prescription drug
account, Federal supplementary
insurance trust fund............ -73 -47,022 -71,221
05.11 Medicare prescription drug
account, Federal supplementary
insurance trust fund............ 677 296
--------- --------- ----------
05.99 Total appropriations............ -155,151 -207,472 -249,056
06.10 Federal supplementary medical
insurance trust fund............ 26
--------- --------- ----------
07.99 Balance, end of year.............. -1,226 10,544 20,088
---------------------------------------------------------------------------
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8004-0-7-571 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Benefit payments, SMI............. 151,276 157,414 175,132
00.02 Administration, SMI............... 2,390 2,438 2,614
00.03 Quality improvement organizations,
SMI............................. 46 176 21
00.04 Research, SMI..................... 12 9 6
00.06 Transfer to Medicaid for payment
of SMI premiums................. 242 300 350
--------- --------- ----------
10.00 Total new obligations........... 153,966 160,337 178,123
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 153,966 160,337 178,123
22.10 Resources available from
recoveries of prior year
obligations..................... 26
22.77 Balance of trust fund authority
withdrawn (-)................... -26
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 153,966 160,337 178,123
23.95 Total new obligations............. -153,966 -160,337 -178,123
24.41 Special and trust fund receipts
returned to Schedule N.......... 26
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.26 Appropriation (trust fund)...... 2,417 2,441 2,614
40.34 Appropriation temporarily
reduced (P.L. 109-148)........ -25
40.37 Appropriation temporarily
reduced....................... -22
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 2,395 2,416 2,614
Mandatory:
60.26 Appropriation (trust fund)...... 149,905 169,742 185,174
60.28 Appropriation (unavailable
balances)..................... 1,666 -11,821 -9,665
--------- --------- ----------
62.50 Appropriation (total
mandatory).................. 151,571 157,921 175,509
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 153,966 160,337 178,123
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 15,639 17,582 17,680
73.10 Total new obligations............. 153,966 160,337 178,123
73.20 Total outlays (gross)............. -151,963 -160,239 -178,166
73.40 Adjustments in expired accounts
(net)........................... -34
73.45 Recoveries of prior year
obligations..................... -26
--------- --------- ----------
74.40 Obligated balance, end of year.. 17,582 17,680 17,637
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 1,872 2,047 2,208
86.93 Outlays from discretionary
balances........................ 227 383 387
86.97 Outlays from new mandatory
authority....................... 135,060 142,776 159,492
86.98 Outlays from mandatory balances... 14,804 15,033 16,079
--------- --------- ----------
87.00 Total outlays (gross)........... 151,963 160,239 178,166
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 153,966 160,337 178,123
90.00 Outlays........................... 151,963 160,239 178,166
----------------------------------------------------------------------------
Memorandum (non-add) entries:
92.01 Total investments, start of year:
Federal securities: Par value... 17,439 17,204 28,634
92.02 Total investments, end of year:
Federal securities: Par value... 17,204 28,634 38,254
---------------------------------------------------------------------------
[[Page 451]]
Summary of Budget Authority and Outlays
(in millions of dollars)
2005 actual 2006 est. 2007 est.
Enacted/requested:
Budget Authority............ 153,966 160,337 178,123
Outlays..................... 151,963 160,239 178,166
Legislative proposal, subject to
PAYGO:
Budget Authority............ -460
Outlays..................... -460
------------------------------------
Total:
Budget Authority............ 153,966 160,337 177,663
Outlays..................... 151,963 160,239 177,706
====================================
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 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Unexpended balance, start of year:
0100 Treasury balance.................. 17,115 16,887 28,634
--------- --------- ----------
0199 Total balance, start of year.... 17,115 16,887 28,634
Cash income during the year:
Current law:
Receipts:
1200 Federal contributions, FSMI
Fund........................ 114,002 128,920 136,987
1201 Federal contributions, FSMI
Fund........................ 2,364
1203 Interest received by trust
fund, FSMI Fund............. 1,364 1,609 2,183
1204 Interest received by trust
fund, FSMI Fund............. -25 -35
1206 Federal contribution, State
low-income determinations,
prescription drug account,
FSMI........................ 73 20 18
1207 Interest, Medicare
prescription drug account,
FSMI........................ 138 187
1208 Federal contributions,
Transitional assistance
account, FSMI............... 1,125
1209 Federal contributions,
Transitional assistance
account, FSMI............... 134
1210 Federal contribution for
admin. contribution for
admin. costs, prescription
drug account, FSMI.......... 605 453
1211 Federal contributions for
benefits, prescription drug
account, SMI................ 36,482 56,574
1212 Miscellaneous Federal
payments, Federal
supplementary medical
insurance trust fund........ 1 2 2
Offsetting receipts
(proprietary):
1220 Other proprietary receipts
from the public, FSMI Fund.. 1
1221 Premiums collected for
Medicare prescription drug
account, FSMI............... 3,886 6,558
1222 Payments from States, Medicare
prescription drug account,
FSMI........................ 5,819 7,588
1223 Basic premium, Medicare
advantage, FSMI trust fund.. 51 68
1224 Medicare refunds, SMI......... 993
1225 Premiums collected for the
aged, FSMI Fund............. 30,394 35,364 38,357
1226 Premiums collected for the
aged, FSMI Fund............. 925
1228 Premiums collected for the
disabled, FSMI Fund......... 5,546 6,237 6,805
1229 Premiums collected for the
disabled, FSMI Fund......... 132
1299 Income under present law........ 153,499 219,242 259,166
Proposed legislation:
Receipts:
2202 Federal contributions, FSMI
Fund--legislative proposal
not subject to PAYGO........ -466
2205 Interest received by trust
fund, FSMI Fund--legislative
proposal not subject to
PAYGO....................... 7
Offsetting receipts (proprietary
receipts):
2227 Premiums collected for the
aged, FSMI Fund--legislative
proposal subject to PAYGO... -85
2230 Premiums collected for the
disabled, FSMI Fund--
legislative proposal subject
to PAYGO.................... -22
2299 Income under proposed
legislation................... -566
--------- --------- ----------
3299 Total cash income............... 153,499 219,242 258,600
Cash outgo during year:
Current law:
4500 Federal supplementary medical
insurance trust fund.......... -151,963 -160,239 -178,166
4501 Transitional drug assistance,
Federal supplementary medical
insurance trust fund.......... -1,232 -208
4502 Medicare prescription drug
account, Federal supplementary
insurance trust fund.......... -532 -47,048 -71,380
4599 Outgo under current law (-)..... -153,727 -207,495 -249,546
Proposed legislation:
5500 Federal supplementary medical
insurance trust fund--
legislative proposal subject
to PAYGO...................... 460
5599 Outgo under proposed legislation
(-)........................... 460
--------- --------- ----------
6599 Total cash outgo (-)............ -153,727 -207,495 -249,086
Unexpended balance, end of year:
8700 Uninvested balance (net), end of
year............................ -317
8701 Invested balance, end of year..... 17,204 28,634 38,254
8701 Invested balance, end of year..... -106
--------- --------- ----------
8799 Total balance, end of year...... 16,887 28,634 38,148
Commitments against unexpended balance, end of
year:
--------- --------- ----------
9900 Uncommitted balance, end of year -1,226 10,544 20,088
---------------------------------------------------------------------------
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8004-0-7-571 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
41.0 Payment for Quality Improvement
Organization (QIO) activity..... 46 176 21
42.0 Insurance claims and indemnities.. 151,518 157,714 175,482
94.0 Financial transfers............... 2,402 2,447 2,620
--------- --------- ----------
99.0 Direct obligations............ 153,966 160,337 178,123
--------- --------- ----------
99.9 Total new obligations........... 153,966 160,337 178,123
---------------------------------------------------------------------------
Federal Supplementary Medical Insurance Trust Fund
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8004-4-7-571 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Benefit payments, SMI............. -460
--------- --------- ----------
10.00 Total new obligations (object
class 42.0)................... -460
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... -460
23.95 Total new obligations............. 460
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.26 Appropriation (trust fund)...... -566
60.28 Appropriation (unavailable
balances)..................... 106
--------- --------- ----------
62.50 Appropriation (total
mandatory).................. -460
----------------------------------------------------------------------------
Change in obligated balances:
73.10 Total new obligations............. -460
73.20 Total outlays (gross)............. 460
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... -460
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. -460
90.00 Outlays........................... -460
----------------------------------------------------------------------------
Memorandum (non-add) entries:
92.02 Total investments, end of year:
Federal securities: Par value... -106
---------------------------------------------------------------------------
The Budget proposes a package of reforms to encourage competition,
recognize efficiencies and productivity in health care, enhance program
integrity, and strengthen responsibility for health care choices.
[[Page 452]]
Transitional Drug Assistance, Federal Supplementary Medical Insurance
Trust Fund
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-8307-0-7-571 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Benefit payments, transitional
drug assistance................. 1,111 83
--------- --------- ----------
10.00 Total new obligations (object
class 42.0)................... 1,111 83
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 1,111 83
23.95 Total new obligations............. -1,111 -83
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.26 Appropriation (trust fund)...... 1,111 83
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 244 125
73.10 Total new obligations............. 1,111 83
73.20 Total outlays (gross)............. -1,232 -208
73.40 Adjustments in expired accounts
(net)........................... 2
--------- --------- ----------
74.40 Obligated balance, end of year.. 125
----------------------------------------------------------------------------
Outlays (gross), detail:
86.93 Outlays from discretionary
balances........................ 107 74
86.97 Outlays from new mandatory
authority....................... 1,092 83
86.98 Outlays from mandatory balances... 33 51
--------- --------- ----------
87.00 Total outlays (gross)........... 1,232 208
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 1,111 83
90.00 Outlays........................... 1,232 208
---------------------------------------------------------------------------
Authorized under the Medicare Modernization Act as section 1860 D-31
of the Social Security Act, the Medicare Transitional Drug Assistance
program provided low-income beneficiaries with $600 per year in 2004 and
2005 to help them pay for their prescription drugs and covered the cost
of enrollment fees.
Medicare Prescription Drug Account, Federal Supplementary Medical
Insurance Trust Fund
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-8308-0-7-571 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Administrative costs.............. 1 707 468
00.03 Low-income determinations
(Medicaid)...................... 73 20 18
00.04 Prescription Drug Benefits........ 46,325 70,907
--------- --------- ----------
10.00 Total new obligations........... 74 47,052 71,393
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 74 47,052 71,393
23.95 Total new obligations............. -74 -47,052 -71,393
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.26 Appropriation (trust fund)...... 1 714 468
40.26 Appropriation (trust fund)......
40.34 Appropriation temporarily
reduced (P.L. 109-148)........ -7
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 1 707 468
Mandatory:
60.26 Appropriation (trust fund)...... 73 47,022 71,221
60.45 Portion precluded from
obligation.................... -677 -296
--------- --------- ----------
62.50 Appropriation (total
mandatory).................. 73 46,345 70,925
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 74 47,052 71,393
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 832 405 409
73.10 Total new obligations............. 74 47,052 71,393
73.20 Total outlays (gross)............. -532 -47,048 -71,380
73.40 Adjustments in expired accounts
(net)........................... 31
--------- --------- ----------
74.40 Obligated balance, end of year.. 405 409 422
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 1 605 399
86.93 Outlays from discretionary
balances........................ 458 98 56
86.97 Outlays from new mandatory
authority....................... 73 46,345 70,925
--------- --------- ----------
87.00 Total outlays (gross)........... 532 47,048 71,380
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 74 47,052 71,393
90.00 Outlays........................... 532 47,048 71,380
----------------------------------------------------------------------------
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...
---------------------------------------------------------------------------
Beginning in 2006, Medicare beneficiaries have the opportunity to
enroll in a comprehensive voluntary prescription drug benefit.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-8308-0-7-571 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
25.2 Other services.................... 74 727 486
41.0 Grants, subsidies, and
contributions................... 46,325 70,907
--------- --------- ----------
99.9 Total new obligations........... 74 47,052 71,393
---------------------------------------------------------------------------
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 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 State family assistance grant..... 16,478 16,489 16,489
00.02 Territories--family assistance
grants.......................... 77 78 78
00.03 Matching grants to territories.... 6 6
00.04 Supplemental grants for population
increases....................... 319 319 319
00.05 Bonus to reward decrease in
illegitimacy.................... 75
00.06 Tribal work programs.............. 8 8 8
00.07 Bonus to reward high performance
States.......................... 200
00.08 Federal loans (Hurricane Katrina
related)........................ 69
00.09 Healthy marriage and responsible
fatherhood grants............... 150 150
--------- --------- ----------
10.00 Total new obligations........... 17,226 17,050 17,050
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 5,070
22.00 New budget authority (gross)...... 22,348 11,988 17,058
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 22,348 17,058 17,058
23.95 Total new obligations............. -17,226 -17,050 -17,050
23.98 Unobligated balance expiring or
withdrawn....................... -52 -8 -8
--------- --------- ----------
24.40 Unobligated balance carried
forward, end of year.......... 5,070
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 22,348 11,988 17,058
--------- --------- ----------
62.50 Appropriation (total
mandatory).................. 22,348 11,988 17,058
----------------------------------------------------------------------------
[[Page 453]]
Change in obligated balances:
72.40 Obligated balance, start of year.. 6,474 6,335 5,979
73.10 Total new obligations............. 17,226 17,050 17,050
73.20 Total outlays (gross)............. -17,357 -17,406 -17,461
73.40 Adjustments in expired accounts
(net)........................... -8
--------- --------- ----------
74.40 Obligated balance, end of year.. 6,335 5,979 5,568
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 13,113 9,161 13,264
86.98 Outlays from mandatory balances... 4,244 8,245 4,197
--------- --------- ----------
87.00 Total outlays (gross)........... 17,357 17,406 17,461
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 22,348 11,988 17,058
90.00 Outlays........................... 17,357 17,406 17,461
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
2005 actual 2006 est. 2007 est.
Enacted/requested:
Budget Authority............ 22,348 11,988 17,058
Outlays..................... 17,357 17,406 17,461
Legislative proposal, subject to
PAYGO:
Budget Authority............ 100
Outlays..................... 10
------------------------------------
Total:
Budget Authority............ 22,348 11,988 17,158
Outlays..................... 17,357 17,406 17,471
====================================
The Temporary Assistance for Needy Families block grant provides
funding to States for aid to low-income families with children. The
Budget maintains the funding for grants to States, territories, and
Tribes while eliminating the out-of-wedlock bonus and the high
performance bonus. The Budget also strengthens work requirements to
maximize self-sufficiency.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1552-0-1-609 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
11.1 Personnel compensation: Full-time
permanent....................... 2 2
12.1 Civilian personnel benefits....... 1 1
25.1 Advisory and assistance services.. 12 15
25.2 Other services.................... 17 14
41.0 Grants, subsidies, and
contributions................... 17,226 17,018 17,018
--------- --------- ----------
99.9 Total new obligations........... 17,226 17,050 17,050
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-1552-0-1-609 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct:
1001 Civilian full-time equivalent
employment...................... 14 24
---------------------------------------------------------------------------
Temporary Assistance for Needy Families
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1552-4-1-609 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.11 Family formation, healthy marriage
grants.......................... 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
--------- --------- ----------
24.40 Unobligated balance carried
forward, end of year..........
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 100
----------------------------------------------------------------------------
Change in obligated balances:
73.10 Total new obligations............. 100
73.20 Total outlays (gross)............. -10
--------- --------- ----------
74.40 Obligated balance, end of year.. 90
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 10
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 100
90.00 Outlays........................... 10
---------------------------------------------------------------------------
The Budget provides additional funding for the Healthy Marriage/
Family Formation initiative. It also extends the Supplemental Grant for
Population Increases beyond 2008.
Contingency Fund
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1522-0-1-609 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Contingency fund.................. 58 132 92
--------- --------- ----------
10.00 Total new obligations (object
class 41.0)................... 58 132 92
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 1,900 1,768
22.00 New budget authority (gross)...... 1,958
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 1,958 1,900 1,768
23.95 Total new obligations............. -58 -132 -92
--------- --------- ----------
24.40 Unobligated balance carried
forward, end of year.......... 1,900 1,768 1,676
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation...................
--------- --------- ----------
62.50 Appropriation (total
mandatory)..................
63.00 Reappropriation................. 1,958
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 1,958
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 15 16
73.10 Total new obligations............. 58 132 92
73.20 Total outlays (gross)............. -43 -131 -90
--------- --------- ----------
74.40 Obligated balance, end of year.. 15 16 18
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 43
86.98 Outlays from mandatory balances... 131 90
--------- --------- ----------
87.00 Total outlays (gross)........... 43 131 90
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 1,958
90.00 Outlays........................... 43 131 90
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
2005 actual 2006 est. 2007 est.
Enacted/requested:
Budget Authority............ 1,958
Outlays..................... 43 131 90
Legislative proposal, subject to
PAYGO:
Budget Authority............ 232
Outlays..................... 16
------------------------------------
Total:
Budget Authority............ 1,958 232
Outlays..................... 43 131 106
====================================
[[Page 454]]
Contingency Fund
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1522-4-1-609 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Direct program activity........... 20
--------- --------- ----------
10.00 Total new obligations (object
class 41.0)................... 20
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 232
23.95 Total new obligations............. -20
--------- --------- ----------
24.40 Unobligated balance carried
forward, end of year.......... 212
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 232
----------------------------------------------------------------------------
Change in obligated balances:
73.10 Total new obligations............. 20
73.20 Total outlays (gross)............. -16
--------- --------- ----------
74.40 Obligated balance, end of year.. 4
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 16
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 232
90.00 Outlays........................... 16
---------------------------------------------------------------------------
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), $2,121,643,000] $2,752,697,000,
to remain available until expended, of which up to $5,000,000 is for
repatriation of U.S. citizens returned from foreign countries pursuant
to section 1113 of the Act (notwithstanding subsection (d) of such
section); and for such purposes for the first quarter of fiscal year
[2007, $1,200,000,000] 2008, $1,000,000,000, 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, 2006.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1501-0-1-609 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 State child support administrative
costs........................... 3,417 3,387 3,588
00.02 Child support incentive payments.. 446 458 471
00.03 Access and visitation grants...... 10 10 10
--------- --------- ----------
00.91 Subtotal, child support
enforcement................... 3,873 3,855 4,069
01.02 Payments to territories........... 33 38 38
01.03 Repatriation...................... 1 1 1
--------- --------- ----------
01.91 Subtotal, other payments........ 34 39 39
09.01 Offset obligations (CSE grants to
States)......................... 220 224 7
--------- --------- ----------
10.00 Total new obligations........... 4,127 4,118 4,115
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 559 729 157
22.00 New budget authority (gross)...... 4,294 3,546 3,960
22.10 Resources available from
recoveries of prior year
obligations..................... 3
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 4,856 4,275 4,117
23.95 Total new obligations............. -4,127 -4,118 -4,115
--------- --------- ----------
24.40 Unobligated balance carried
forward, end of year.......... 729 157 2
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 2,874 2,122 2,753
--------- --------- ----------
62.50 Appropriation (total
mandatory).................. 2,874 2,122 2,753
65.00 Advance appropriation........... 1,200 1,200 1,200
Mandatory:
69.00 Spending authority from
offsetting collections:
Offsetting collections (cash). 220 224 7
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 4,294 3,546 3,960
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 835 756 747
73.10 Total new obligations............. 4,127 4,118 4,115
73.20 Total outlays (gross)............. -4,203 -4,127 -4,112
73.45 Recoveries of prior year
obligations..................... -3
--------- --------- ----------
74.40 Obligated balance, end of year.. 756 747 750
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 3,621 3,531 3,622
86.98 Outlays from mandatory balances... 582 596 490
--------- --------- ----------
87.00 Total outlays (gross)........... 4,203 4,127 4,112
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.45 Offsetting collections (cash)
from: Offsetting governmental
collections (from non-Federal
sources)...................... -220 -224 -7
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 4,074 3,322 3,953
90.00 Outlays........................... 3,982 3,903 4,105
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
2005 actual 2006 est. 2007 est.
Enacted/requested:
Budget Authority............ 4,074 3,322 3,953
Outlays..................... 3,983 3,903 4,105
Legislative proposal, subject to
PAYGO:
Budget Authority............ 7
Outlays..................... 7
------------------------------------
Total:
Budget Authority............ 4,074 3,322 3,960
Outlays..................... 3,983 3,903 4,112
====================================
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 2007.
Net Federal Costs of Child Support Enforcement
(In millions of dollars)
2005 2006 2007
Gross Federal share of
collections................... -1,188 -1,087 -1,119
Federal incentive payments to
States........................ 446 458 471
State child support
administrative costs.......... 3,637 3,611 3,600
Access and visitation grants.. 10 10 12
------------------------------------
[[Page 455]]
Total..................... 2,905 2,992 2,964
====================================
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1501-0-1-609 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
41.0 Direct obligations: Grants,
subsidies, and contributions.... 3,907 3,894 4,108
99.0 Reimbursable obligations:
Reimbursable obligations........ 220 224 7
--------- --------- ----------
99.9 Total new obligations........... 4,127 4,118 4,115
---------------------------------------------------------------------------
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 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 State child support administrative
costs........................... 5
00.03 Access and visitation grants...... 2
--------- --------- ----------
10.00 Total new obligations (object
class 41.0)................... 7
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 7
23.95 Total new obligations............. -7
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 7
----------------------------------------------------------------------------
Change in obligated balances:
73.10 Total new obligations............. 7
73.20 Total outlays (gross)............. -7
--------- --------- ----------
74.40 Obligated balance, end of year..
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 7
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 7
90.00 Outlays........................... 7
---------------------------------------------------------------------------
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, $2,000,000,000] section 2602(b) of the Low
Income Home Energy Act, $1,782,000,000.
[For making payments under title XXVI of the Omnibus Budget
Reconciliation Act of 1981, $183,000,000 to remain available until
September 30, 2006: Provided, That these funds are for the unanticipated
home energy assistance needs of one or more States, as authorized by
section 2604(e) of such Act, and notwithstanding the designation
requirement of section 2602(e) of such Act.] (Department of Health and
Human Services Appropriations Act, 2006.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1502-0-1-609 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Direct program activity........... 2,162 2,181 2,782
--------- --------- ----------
10.00 Total new obligations (object
class 41.0)................... 2,162 2,181 2,782
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 20
22.00 New budget authority (gross)...... 2,182 2,161 2,782
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 2,182 2,181 2,782
23.95 Total new obligations............. -2,162 -2,181 -2,782
--------- --------- ----------
24.40 Unobligated balance carried
forward, end of year.......... 20
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation--Block............ 1,900 2,000 1,782
40.00 Appropriation--Emergency........ 300 183
40.33 Appropriation permanently
reduced (P.L. 109-148)........ -22
40.35 Appropriation permanently
reduced....................... -18
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 2,182 2,161 1,782
Mandatory:
60.00 Appropriation--Block............ 250
60.00 Appropriation--Emergency........ 750
--------- --------- ----------
62.50 Appropriation (total
mandatory).................. 1,000
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 2,182 2,161 2,782
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 486 548 556
73.10 Total new obligations............. 2,162 2,181 2,782
73.20 Total outlays (gross)............. -2,095 -2,170 -2,638
73.40 Adjustments in expired accounts
(net)........................... -5 -3
--------- --------- ----------
74.40 Obligated balance, end of year.. 548 556 700
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 1,692 1,664 1,372
86.93 Outlays from discretionary
balances........................ 403 506 495
86.97 Outlays from new mandatory
authority....................... 771
--------- --------- ----------
87.00 Total outlays (gross)........... 2,095 2,170 2,638
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 2,182 2,161 2,782
90.00 Outlays........................... 2,095 2,170 2,638
---------------------------------------------------------------------------
This program makes grants to States and Indian Tribes to aid low-
income households with high energy costs through payments to eligible
households, energy suppliers, and weatherization providers. Obligation
estimates for the contingency fund are based on average historical
obligation rates.
Refugee and Entrant Assistance
For 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] section 414 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),
[$575,579,000] $614,935,000, of which up to [$9,915,000] $14,816,000
shall be available to carry out the Trafficking Victims Protection [Act
of 2003 (Public Law 108-193)] Reauthorization Act of 2005: 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 [2006] 2007 shall be available for
the costs of assistance provided and other activities to remain
available through September 30, [2008] 2009. (Department of Health and
Human Services Appropriations Act, 2006.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1503-0-1-609 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Refugee and entrant assistance.... 470 483 500
00.02 Assistance for treatment of
torture victims................. 10 10 10
00.03 Unaccompanied alien children...... 54 77 105
--------- --------- ----------
10.00 Total new obligations........... 534 570 615
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 8
22.00 New budget authority (gross)...... 484 570 615
[[Page 456]]
22.10 Resources available from
recoveries of prior year
obligations..................... 42
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 534 570 615
23.95 Total new obligations............. -534 -570 -615
--------- --------- ----------
24.40 Unobligated balance carried
forward, end of year..........
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 488 576 615
40.33 Appropriation permanently
reduced (P.L. 109-148)........ -6
40.35 Appropriation permanently
reduced....................... -4
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 484 570 615
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 483 471 507
73.10 Total new obligations............. 534 570 615
73.20 Total outlays (gross)............. -504 -534 -582
73.45 Recoveries of prior year
obligations..................... -42
--------- --------- ----------
74.40 Obligated balance, end of year.. 471 507 540
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 175 239 258
86.93 Outlays from discretionary
balances........................ 329 295 324
--------- --------- ----------
87.00 Total outlays (gross)........... 504 534 582
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 484 570 615
90.00 Outlays........................... 504 534 582
---------------------------------------------------------------------------
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 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
11.1 Personnel compensation: Full-time
permanent....................... 2 3 4
23.1 Rental payments to GSA............ 1 1 1
25.1 Advisory and assistance services.. 11 17 17
25.2 Other services.................... 1 1
25.3 Other purchases of goods and
services from Government
accounts........................ 5 5 6
41.0 Grants, subsidies, and
contributions................... 515 543 586
--------- --------- ----------
99.9 Total new obligations........... 534 570 615
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-1503-0-1-609 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct:
1001 Civilian full-time equivalent
employment...................... 16 30 35
---------------------------------------------------------------------------
Promoting Safe and Stable Families
For carrying out section 436 of the Social Security Act,
[$305,000,000] $345,000,000 and for section 437, [$90,000,000]
$89,100,000. (Department of Health and Human Services Appropriations
Act, 2006.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1512-0-1-506 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Grants to States and Tribes....... 382 412 412
00.02 Research, training and technical
assistance...................... 9 9 9
00.03 State court improvement activities 13 33 33
--------- --------- ----------
10.00 Total new obligations........... 404 454 454
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 404 454 454
23.95 Total new obligations............. -404 -454 -454
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 100 90 89
40.33 Appropriation permanently
reduced (P.L. 109-148)........ -1
40.35 Appropriation permanently
reduced....................... -1
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 99 89 89
Mandatory:
60.00 Appropriation................... 305 365 365
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 404 454 454
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 436 430 470
73.10 Total new obligations............. 404 454 454
73.20 Total outlays (gross)............. -409 -414 -442
73.40 Adjustments in expired accounts
(net)........................... -1
--------- --------- ----------
74.40 Obligated balance, end of year.. 430 470 482
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 23 20 20
86.93 Outlays from discretionary
balances........................ 78 75 70
86.97 Outlays from new mandatory
authority....................... 70 84 84
86.98 Outlays from mandatory balances... 238 235 268
--------- --------- ----------
87.00 Total outlays (gross)........... 409 414 442
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 404 454 454
90.00 Outlays........................... 409 414 442
---------------------------------------------------------------------------
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 2005 actual 2006 est. 2007 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................... 400 450 451
--------- --------- ----------
99.9 Total new obligations........... 404 454 454
---------------------------------------------------------------------------
Child Care Entitlement to States
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1550-0-1-609 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Mandatory child care.............. 1,178 1,178 1,178
00.02 Matching child care............... 1,487 1,674 1,674
00.03 Training and technical assistance. 7 7 7
00.04 Child care tribal grants.......... 54 58 58
--------- --------- ----------
10.00 Total new obligations........... 2,726 2,917 2,917
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 991
22.00 New budget authority (gross)...... 3,708 1,926 2,917
22.30 Expired unobligated balance
transfer to unexpired account... 9
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 3,717 2,917 2,917
23.95 Total new obligations............. -2,726 -2,917 -2,917
--------- --------- ----------
24.40 Unobligated balance carried
forward, end of year.......... 991
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 3,708 1,926 2,917
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 956 877 926
[[Page 457]]
73.10 Total new obligations............. 2,726 2,917 2,917
73.20 Total outlays (gross)............. -2,784 -2,868 -2,909
73.40 Adjustments in expired accounts
(net)........................... -21
--------- --------- ----------
74.40 Obligated balance, end of year.. 877 926 934
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 1,957 1,387 2,100
86.98 Outlays from mandatory balances... 827 1,481 809
--------- --------- ----------
87.00 Total outlays (gross)........... 2,784 2,868 2,909
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 3,708 1,926 2,917
90.00 Outlays........................... 2,784 2,868 2,909
---------------------------------------------------------------------------
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 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
25.1 Advisory and assistance services.. 7 7 7
41.0 Grants, subsidies, and
contributions................... 2,719 2,910 2,910
--------- --------- ----------
99.9 Total new obligations........... 2,726 2,917 2,917
---------------------------------------------------------------------------
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] the Child Care and Development Block
Grant Act of 1990[)], [$2,082,910,000] $2,062,081,000 shall be used to
supplement, not supplant State general revenue funds for child care
assistance for low-income families: Provided, That [$18,967,040]
$18,777,370 shall be available for child care resource and referral and
school-aged child care activities, of which [$992,000] $982,080 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, [$270,490,624] $267,785,718 shall be reserved by the
States for activities authorized under section 658G, of which
[$99,200,000] $98,208,000 shall be for activities that improve the
quality of infant and toddler care: Provided further, That [$9,920,000]
$9,821,000 shall be for use by the Secretary for child care research,
demonstration, and evaluation activities. (Department of Health and
Human Services Appropriations Act, 2006.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1515-0-1-609 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Block grant payments to States.... 2,072 2,052 2,052
00.04 Research and evaluation fund...... 10 10 10
09.00 Reimbursable program.............. 1
--------- --------- ----------
10.00 Total new obligations........... 2,083 2,062 2,062
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 2,084 2,062 2,062
23.95 Total new obligations............. -2,083 -2,062 -2,062
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 2,100 2,083 2,062
40.33 Appropriation permanently
reduced (P.L. 109-148)........ -21
40.35 Appropriation permanently
reduced....................... -17
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 2,083 2,062 2,062
Discretionary:
68.00 Spending authority from
offsetting collections:
Offsetting collections (cash). 1
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 2,084 2,062 2,062
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 750 709 730
73.10 Total new obligations............. 2,083 2,062 2,062
73.20 Total outlays (gross)............. -2,121 -2,041 -2,063
73.40 Adjustments in expired accounts
(net)........................... -3
--------- --------- ----------
74.40 Obligated balance, end of year.. 709 730 729
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 1,477 1,464 1,464
86.93 Outlays from discretionary
balances........................ 644 577 599
--------- --------- ----------
87.00 Total outlays (gross)........... 2,121 2,041 2,063
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -4
Against gross budget authority only:
88.96 Portion of offsetting
collections (cash) credited to
expired accounts.............. 3
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 2,083 2,062 2,062
90.00 Outlays........................... 2,117 2,041 2,063
---------------------------------------------------------------------------
This appropriation helps low-income families pay for child care and
related services and supports grants to States for child care quality
activities.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1515-0-1-609 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct obligations:
25.1 Advisory and assistance services 6 5 6
25.3 Other purchases of goods and
services from Government
accounts...................... 1 1 1
41.0 Grants, subsidies, and
contributions................. 2,075 2,056 2,055
--------- --------- ----------
99.0 Direct obligations............ 2,082 2,062 2,062
99.0 Reimbursable obligations.......... 1
--------- --------- ----------
99.9 Total new obligations........... 2,083 2,062 2,062
---------------------------------------------------------------------------
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]
$1,200,000,000: Provided, That notwithstanding section 2003(c) of such
Act, the amount specified for allocation under such section for fiscal
year 2007 shall be $1,200,000,000. (Department of Health and Human
Services Appropriations Act, 2006.)
[For an additional amount for ``Social Services Block Grant'',
$550,000,000, for necessary expenses related to the consequences of
hurricanes in the Gulf of Mexico in calendar year 2005, notwithstanding
section 2003 and paragraphs (1) and (4) of section 2005(a) of the Social
Security Act (42 U.S.C. 1397b and 1397d(a)): Provided, That in addition
to other uses permitted by title XX of the Social Security Act, funds
appropriated under this heading may be used for health services
(including mental health services) and for repair, renovation and
construction of health facilities (including mental health facilities):
Provided further, That the amount provided under this heading is
designated as an emergency requirement pursuant to section 402 of H.
Con. Res. 95 (109th Congress), the concurrent resolution on the budget
for fiscal year 2006.] Emergency Supplemental Appropriations Act to
Address Hurricanes in the Gulf of Mexico and Pandemic Influenza, 2006.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1534-0-1-506 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Direct program activity........... 1,700 2,250 1,200
--------- --------- ----------
10.00 Total new obligations (object
class 41.0)................... 1,700 2,250 1,200
----------------------------------------------------------------------------
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 2,250 1,200
--------- --------- ----------
[[Page 458]]
23.90 Total budgetary resources
available for obligation...... 1,704 2,254 1,204
23.95 Total new obligations............. -1,700 -2,250 -1,200
--------- --------- ----------
24.40 Unobligated balance carried
forward, end of year.......... 4 4 4
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... -500
Mandatory:
60.00 Appropriation................... 1,700 2,250 1,700
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 1,700 2,250 1,200
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 564 442 468
73.10 Total new obligations............. 1,700 2,250 1,200
73.20 Total outlays (gross)............. -1,822 -2,224 -1,402
--------- --------- ----------
74.40 Obligated balance, end of year.. 442 468 266
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... -425
86.97 Outlays from new mandatory
authority....................... 1,445 1,913 1,445
86.98 Outlays from mandatory balances... 377 311 382
--------- --------- ----------
87.00 Total outlays (gross)........... 1,822 2,224 1,402
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 1,700 2,250 1,200
90.00 Outlays........................... 1,822 2,224 1,402
---------------------------------------------------------------------------
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, 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,
[$8,922,213,000] $8,238,603,000, of which [$18,000,000] $29,654,000, to
remain available until September 30, [2007] 2008, 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, [2006] 2007: Provided,
That [$6,843,114,000] $6,785,771,000 shall be for making payments under
the Head Start Act, of which $1,388,800,000 shall become available
October 1, [2006] 2007, and remain available through September 30,
[2007: Provided further, That $701,590,000 shall be for making payments
under the Community Services Block Grant Act: Provided further, That not
less than $7,367,000 shall be for section 680(3)(B) of the Community
Services Block Grant Act] 2008: 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 [$65,000,000]
$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 [$15,879,000] $15,720,000 shall be
for activities authorized by the Help America Vote Act of 2002, of which
[$11,000,000] $10,890,000 shall be for payments to States to promote
access for voters with disabilities, and of which [$4,879,000]
$4,830,000 shall be for payments to States for protection and advocacy
systems for voters with disabilities: Provided further, That
[$110,000,000] $136,665,000 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 Service Act to carry out evaluations
(including longitudinal evaluations) of adolescent pregnancy prevention
approaches: Provided further, That $2,000,000 shall be for improving the
Public Assistance Reporting Information System, including grants to
States to support data collection for a study of the system's
effectiveness.
[Of the funds provided under this heading in Public Law 108-447 to
carry out section 473A of title IV of the Social Security Act (42 U.S.C.
670-679), $22,500,000 are rescinded.] (Department of Health and Human
Services Appropriations Act, 2006.)
[For an additional amount for ``Children and Families Services
Programs'', $90,000,000, for Head Start to serve children displaced by
hurricanes in the Gulf of Mexico in calendar year 2005, notwithstanding
sections 640(a)(1) and 640(g)(1) of the Head Start Act, and to cover the
costs of renovating those Head Start facilities which were affected by
these hurricanes, to the extent reimbursements from FEMA and insurance
companies do not fully cover such costs: Provided, That the amount
provided under this heading is designated as an emergency requirement
pursuant to section 402 of H. Con. Res. 95 (109th Congress), the
concurrent resolution on the budget for fiscal year 2006.] (Emergency
Supplemental Appropriations Act to Address Hurricanes in the Gulf of
Mexico and Pandemic Influenza, 2006.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1536-0-1-506 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
01.01 Head Start........................ 6,842 6,876 6,786
01.02 Early Learning Opportunities...... 36
01.03 Runaway and homeless youth (basic
centers)........................ 49 48 48
01.04 Transitional living............... 40 40 40
01.06 Education grants to reduce sexual
abuse of runaway youth.......... 15 15 15
01.07 Abstinence education (mandatory).. 41 50 13
01.08 Mentoring children of prisoners... 49 49 40
01.09 Child abuse State grants.......... 27 27 27
[[Page 459]]
01.10 Child abuse discretionary
activities...................... 32 26 26
01.11 Community based resource centers.. 43 43 42
01.12 Child welfare services............ 290 287 287
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............... 15 20 30
01.17 Independent training vouchers..... 47 46 46
01.18 Children's health act programs.... 13 13 13
01.19 State grants...................... 72 72 72
01.20 Protection and advocacy........... 38 39 39
01.21 Projects of national significance. 12 11 11
01.22 Centers for excellence............ 32 33 33
01.23 Voting access for individuals with
disabilities.................... 15 16 16
01.24 Native American programs.......... 45 44 44
01.25 Social services and income
maintenance research............ 26 6
01.26 Compassion capital fund........... 55 64 100
01.28 Federal administration............ 185 183 188
01.29 Faith-based center................ 1 1 1
01.30 Abstinence education
(discretionary)................. 99 109 137
--------- --------- ----------
01.91 Subtotal........................ 8,165 8,164 8,100
03.01 Community services block grants... 637 631
03.03 Rural communtiy facilities........ 7 7
03.04 Community services discretionary
(JOLI & CED).................... 33 32
03.05 Community food and nutrition...... 7
03.06 Individual development accounts... 25 24 24
03.07 National youth sports............. 18
03.08 Domestic violence hotline......... 3 3 3
03.09 Grants for battered women's
shelters........................ 125 125 125
--------- --------- ----------
03.91 Subtotal........................ 855 822 152
--------- --------- ----------
04.00 Total, direct program........... 9,020 8,986 8,252
09.01 Reimbursable program.............. 16 17 17
--------- --------- ----------
10.00 Total new obligations........... 9,036 9,003 8,269
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 10 26 2
22.00 New budget authority (gross)...... 9,063 8,979 8,269
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 9,073 9,005 8,271
23.95 Total new obligations............. -9,036 -9,003 -8,269
23.98 Unobligated balance expiring or
withdrawn....................... -11
--------- --------- ----------
24.40 Unobligated balance carried
forward, end of year.......... 26 2 2
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 7,670 7,623 6,850
40.33 Appropriation permanently
reduced (P.L. 109-148)........ -75
40.35 Appropriation permanently
reduced....................... -62
40.36 Unobligated balance permanently
reduced....................... -22
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 7,608 7,526 6,850
55.00 Advance appropriation........... 1,400 1,400 1,389
55.33 Appropriation permanently
reduced (P.L. 109-148)........ -14
55.35 Advance appropriation
permanently reduced........... -11
--------- --------- ----------
55.90 Advance appropriation (total
discretionary).............. 1,389 1,386 1,389
Mandatory:
60.00 Appropriation................... 50 50 13
Spending authority from offsetting
collections:
Discretionary:
68.00 Offsetting collections (cash). 3 17 17
68.10 Change in uncollected customer
payments from Federal
sources (unexpired)......... 13
--------- --------- ----------
68.90 Spending authority from
offsetting collections
(total discretionary)..... 16 17 17
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 9,063 8,979 8,269
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 4,783 4,894 4,996
73.10 Total new obligations............. 9,036 9,003 8,269
73.20 Total outlays (gross)............. -8,864 -8,901 -8,572
73.40 Adjustments in expired accounts
(net)........................... -57
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... -13
74.10 Change in uncollected customer
payments from Federal sources
(expired)....................... 9
--------- --------- ----------
74.40 Obligated balance, end of year.. 4,894 4,996 4,693
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 4,901 4,757 4,358
86.93 Outlays from discretionary
balances........................ 3,944 4,103 4,180
86.97 Outlays from new mandatory
authority....................... 14 19 5
86.98 Outlays from mandatory balances... 5 22 29
--------- --------- ----------
87.00 Total outlays (gross)........... 8,864 8,901 8,572
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -17 -17 -17
Against gross budget authority only:
88.95 Change in uncollected customer
payments from Federal sources
(unexpired)................... -13
88.96 Portion of offsetting
collections (cash) credited to
expired accounts.............. 14
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 9,047 8,962 8,252
90.00 Outlays........................... 8,848 8,884 8,555
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
2005 actual 2006 est. 2007 est.
Enacted/requested:
Budget Authority............ 9,047 8,962 8,252
Outlays..................... 8,847 8,884 8,555
Legislative proposal, subject to
PAYGO:
Budget Authority............ 37
Outlays..................... 14
------------------------------------
Total:
Budget Authority............ 9,047 8,962 8,289
Outlays..................... 8,847 8,884 8,569
====================================
The 2007 Budget eliminates community services programs, including
the Community Services Block Grant, Community Economic Development,
Rural Community Facilities and Job Opportunities for Low-Income
Individuals. This is due to poor program performance and/or duplication
with other Federal programs that can achieve greater results and better
focus on communities most in need of assistance.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1536-0-1-506 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 103 105 108
11.3 Other than full-time permanent 3 3 3
11.5 Other personnel compensation.. 2 2 2
--------- --------- ----------
11.9 Total personnel compensation 108 110 113
12.1 Civilian personnel benefits..... 22 23 23
21.0 Travel and transportation of
persons....................... 4 4 4
23.1 Rental payments to GSA.......... 14 20 21
23.3 Communications, utilities, and
miscellaneous charges......... 2 3 3
24.0 Printing and reproduction....... 3 3 3
25.1 Advisory and assistance services 134 135 128
25.2 Other services.................. 8 8 8
25.3 Other purchases of goods and
services from Government
accounts...................... 104 94 89
25.4 Operation and maintenance of
facilities.................... 1
25.5 Research and development
contracts..................... 1 1
25.7 Operation and maintenance of
equipment..................... 1
26.0 Supplies and materials.......... 1 1 1
41.0 Grants, subsidies, and
contributions................. 8,617 8,584 7,858
--------- --------- ----------
99.0 Direct obligations............ 9,019 8,986 8,252
99.0 Reimbursable obligations.......... 17 17 17
--------- --------- ----------
99.9 Total new obligations........... 9,036 9,003 8,269
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-1536-0-1-506 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct:
1001 Civilian full-time equivalent
employment...................... 1,244 1,215 1,192
---------------------------------------------------------------------------
[[Page 460]]
Children and Family Services Programs
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1536-4-1-506 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
01.07 Abstinence education.............. 37
--------- --------- ----------
10.00 Total new obligations (object
class 41.0)................... 37
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 37
23.95 Total new obligations............. -37
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 37
----------------------------------------------------------------------------
Change in obligated balances:
73.10 Total new obligations............. 37
73.20 Total outlays (gross)............. -14
--------- --------- ----------
74.40 Obligated balance, end of year.. 23
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 14
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 37
90.00 Outlays........................... 14
---------------------------------------------------------------------------
The Budget reauthorizes state-based abstinence education activities.
Violent Crime Reduction Programs
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-8605-0-1-754 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 2
73.20 Total outlays (gross)............. -1
73.40 Adjustments in expired accounts
(net)........................... -1
--------- --------- ----------
74.40 Obligated balance, end of year..
----------------------------------------------------------------------------
Outlays (gross), detail:
86.93 Outlays from discretionary
balances........................ 1
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays........................... 1
---------------------------------------------------------------------------
Children's Research and Technical Assistance
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1553-0-1-609 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Training and technical assistance. 13 12 12
00.02 Federal parent locator service.... 24 25 25
00.03 Child welfare study............... 6 6 6
00.04 Welfare research.................. 15 15 15
09.01 Reimbursable program.............. 15 21 22
--------- --------- ----------
10.00 Total new obligations........... 73 79 80
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 4 1 1
22.00 New budget authority (gross)...... 70 79 80
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 74 80 81
23.95 Total new obligations............. -73 -79 -80
--------- --------- ----------
24.40 Unobligated balance carried
forward, end of year.......... 1 1 1
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 55 58 58
Mandatory:
69.00 Spending authority from
offsetting collections:
Offsetting collections (cash). 15 21 22
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 70 79 80
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 47 67 60
73.10 Total new obligations............. 73 79 80
73.20 Total outlays (gross)............. -54 -86 -82
74.10 Change in uncollected customer
payments from Federal sources
(expired)....................... 1
--------- --------- ----------
74.40 Obligated balance, end of year.. 67 60 58
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 28 44 49
86.98 Outlays from mandatory balances... 26 42 33
--------- --------- ----------
87.00 Total outlays (gross)........... 54 86 82
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
Offsetting collections (cash)
from:
88.00 Federal sources............... -7 -11 -12
88.40 Non-Federal sources........... -9 -10 -10
--------- --------- ----------
88.90 Total, offsetting
collections (cash)........ -16 -21 -22
Against gross budget authority only:
88.96 Portion of offsetting
collections (cash) credited to
expired accounts.............. 1
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 55 58 58
90.00 Outlays........................... 39 65 60
---------------------------------------------------------------------------
This account provides funding for research and technical assistance
activities established in P.L. 104-193.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1553-0-1-609 2005 actual 2006 est. 2007 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....................... 2 1 1
23.1 Rental payments to GSA.......... 3 3 3
25.1 Advisory and assistance services 27 29 30
25.2 Other services.................. 6 6 6
25.3 Other purchases of goods and
services from Government
accounts...................... 7 7 7
41.0 Grants, subsidies, and
contributions................. 5 4 3
--------- --------- ----------
99.0 Direct obligations............ 58 58 58
99.0 Reimbursable obligations.......... 15 21 22
--------- --------- ----------
99.9 Total new obligations........... 73 79 80
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-1553-0-1-609 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct:
1001 Civilian full-time equivalent
employment...................... 68 66 66
---------------------------------------------------------------------------
Disabled Voter Services
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1533-0-1-808 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 12 10 5
73.20 Total outlays (gross)............. -2 -5 -5
--------- --------- ----------
74.40 Obligated balance, end of year.. 10 5
----------------------------------------------------------------------------
Outlays (gross), detail:
86.93 Outlays from discretionary
balances........................ 2 5 5
----------------------------------------------------------------------------
[[Page 461]]
Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays........................... 2 5 5
---------------------------------------------------------------------------
Payments to States for Foster Care and Adoption Assistance
For making payments to States or other non-Federal entities under
title IV-E of the Social Security Act, [$4,852,800,000] $5,211,000,000.
For making payments to States or other non-Federal entities under
title IV-E of the Act, for the first quarter of fiscal year [2007] 2008,
[$1,730,000,000] $1,810,000,000.
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,
2006.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1545-0-1-609 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Foster care....................... 4,371 4,633 4,757
00.02 Independent living................ 140 140 140
00.04 Adoption assistance............... 1,712 1,883 2,044
--------- --------- ----------
10.00 Total new obligations........... 6,223 6,656 6,941
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 6,806 6,708 6,941
23.95 Total new obligations............. -6,223 -6,656 -6,941
23.98 Unobligated balance expiring or
withdrawn....................... -582 -52
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 5,038 4,941 5,211
65.00 Advance appropriation........... 1,768 1,767 1,730
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 6,806 6,708 6,941
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 1,246 1,003 1,056
73.10 Total new obligations............. 6,223 6,656 6,941
73.20 Total outlays (gross)............. -6,427 -6,603 -6,879
73.40 Adjustments in expired accounts
(net)........................... -38
--------- --------- ----------
74.40 Obligated balance, end of year.. 1,003 1,056 1,118
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 5,405 5,786 6,041
86.98 Outlays from mandatory balances... 1,022 817 838
--------- --------- ----------
87.00 Total outlays (gross)........... 6,427 6,603 6,879
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 6,806 6,708 6,941
90.00 Outlays........................... 6,427 6,603 6,879
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
2005 actual 2006 est. 2007 est.
Enacted/requested:
Budget Authority............ 6,806 6,708 6,941
Outlays..................... 6,427 6,603 6,879
Legislative proposal, subject to
PAYGO:
Budget Authority............ 32
Outlays..................... 27
------------------------------------
Total:
Budget Authority............ 6,806 6,708 6,973
Outlays..................... 6,427 6,603 6,906
====================================
Foster care.--The proposed level will support eligible low-income
children who must be placed outside the home. An average of 231,000
children per month will be served in 2007.
Adoption assistance.--The proposed funding level will support
subsidies for families adopting eligible low-income children with
special needs. An average of 420,100 children per month will be served
in 2007.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1545-0-1-609 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
25.1 Advisory and assistance services.. 16 16 14
25.3 Other purchases of goods and
services from Government
accounts........................ 1 1 1
41.0 Grants, subsidies, and
contributions................... 6,206 6,639 6,926
--------- --------- ----------
99.9 Total new obligations........... 6,223 6,656 6,941
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-1545-0-1-609 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct:
1001 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 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Foster care....................... 29
00.04 Adoption assistance............... 3
--------- --------- ----------
10.00 Total new obligations........... 32
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 32
23.95 Total new obligations............. -32
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 32
----------------------------------------------------------------------------
Change in obligated balances:
73.10 Total new obligations............. 32
73.20 Total outlays (gross)............. -27
--------- --------- ----------
74.40 Obligated balance, end of year.. 5
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 27
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 32
90.00 Outlays........................... 27
---------------------------------------------------------------------------
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. The proposal also includes increasing the match rate for the
District of Columbia to match that used in the Medicaid program.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1545-4-1-609 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
25.5 Research and development contracts 1
41.0 Grants, subsidies, and
contributions................... 31
--------- --------- ----------
99.9 Total new obligations........... 32
---------------------------------------------------------------------------
[[Page 462]]
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, $1,376,624,000, of which $5,500,000 shall be available for
activities regarding medication management, screening, and education to
prevent incorrect medication and adverse drug reactions] $1,334,835,000.
(Department of Health and Human Services Appropriations Act, 2006.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0142-0-1-506 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
01.01 Home and community-based
supportive services............. 354 351 351
01.02 Preventive health services........ 22 21
01.03 National family caregiver support
program......................... 156 156 154
01.04 Native American caregiver support
program......................... 6 6 6
01.05 Congregate nutrition services..... 387 385 384
01.06 Home-delivered nutrition services. 183 182 181
01.07 Nutrition services incentive
program......................... 149 148 147
01.08 Native American nutrition and
supportive services............. 26 26 26
01.09 Program innovations............... 43 25 36
01.10 Aging network support activities.. 13 13 13
01.11 Long-term care ombudsmen program.. 14 15 14
01.12 Prevention of elder abuse and
neglect......................... 5 5 5
01.13 Alzheimer's disease demonstration
grants.......................... 12 12
01.14 Program administration............ 18 18 18
01.15 White House Conference on Aging... 3 4
--------- --------- ----------
02.00 Total, direct program........... 1,391 1,367 1,335
09.01 Reimbursable program.............. 9 4 4
--------- --------- ----------
10.00 Total new obligations........... 1,400 1,371 1,339
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 2 4
22.00 New budget authority (gross)...... 1,402 1,367 1,339
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 1,404 1,371 1,339
23.95 Total new obligations............. -1,400 -1,371 -1,339
--------- --------- ----------
24.40 Unobligated balance carried
forward, end of year.......... 4
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 1,405 1,377 1,335
40.33 Appropriation permanently
reduced (P.L. 109-148)........ -14
40.35 Appropriation permanently
reduced....................... -12
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 1,393 1,363 1,335
Spending authority from offsetting
collections:
Discretionary:
68.00 Offsetting collections (cash). 4 4 4
68.10 Change in uncollected customer
payments from Federal
sources (unexpired)......... 5
--------- --------- ----------
68.90 Spending authority from
offsetting collections
(total discretionary)..... 9 4 4
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 1,402 1,367 1,339
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 572 560 569
73.10 Total new obligations............. 1,400 1,371 1,339
73.20 Total outlays (gross)............. -1,405 -1,362 -1,351
73.40 Adjustments in expired accounts
(net)........................... -1
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... -5
--------- --------- ----------
74.40 Obligated balance, end of year.. 560 569 557
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 908 885 866
86.93 Outlays from discretionary
balances........................ 497 477 485
--------- --------- ----------
87.00 Total outlays (gross)........... 1,405 1,362 1,351
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -4 -4 -4
Against gross budget authority only:
88.95 Change in uncollected customer
payments from Federal sources
(unexpired)................... -5
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 1,393 1,363 1,335
90.00 Outlays........................... 1,401 1,358 1,347
---------------------------------------------------------------------------
Note.--The reimbursable program (HCFAC) in the Administration on
Aging (AoA) reflects the estimated distribution of the allocation
account for 2006 and 2007. Actual 2006 and 2007 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 home and
community-based support for older people and their families.
The proposed budget will also provide funding to pilot a new Choices
for Independence initiative, which aims to help older individuals and
their families conserve and extend their personal resources through the
use of low-cost, community-based alternatives in long-term care.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0142-0-1-506 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 9 10 11
11.3 Other than full-time permanent 1 1 1
--------- --------- ----------
11.9 Total personnel compensation 10 11 12
12.1 Civilian personnel benefits..... 2 2 2
21.0 Travel and transportation of
persons....................... 1 1
23.1 Rental payments to GSA.......... 2 2 2
23.3 Communications, utilities, and
miscellaneous charges......... 1
25.1 Advisory and assistance services 9 9 6
25.2 Other services.................. 1 1
25.3 Other purchases of goods and
services from Government
accounts...................... 8 7 7
41.0 Grants, subsidies, and
contributions................. 1,358 1,333 1,306
--------- --------- ----------
99.0 Direct obligations............ 1,391 1,367 1,335
99.0 Reimbursable obligations.......... 9 4 4
--------- --------- ----------
99.9 Total new obligations........... 1,400 1,371 1,339
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-0142-0-1-506 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct:
1001 Civilian full-time equivalent
employment...................... 112 118 120
Reimbursable:
2001 Civilian full-time equivalent
employment...................... 6 9 9
---------------------------------------------------------------------------
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, the
United States-Mexico Border Health Commission Act, and research studies
under section 1110 of the Social Security Act, [$352,703,000]
$362,568,000, together with $5,851,000 to be transferred and expended as
authorized by section 201(g)(1) of the Social Security Act from the
Hospital Insurance Trust Fund and the Supplemental Medical Insurance
Trust Fund, and $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
[[Page 463]]
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, [$52,415,000]
$51,891,000 shall be for minority AIDS prevention and treatment
activities; and [$5,952,000] $6,016,000 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 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,
[$31,682,000] $32,969,000, together with not to exceed $3,314,000 to be
transferred and expended as authorized by section 201(g)(1) of the
Social Security Act from the Hospital Insurance Trust Fund and the
Supplemental Medical Insurance Trust Fund. (Department of Health and
Human Services Appropriations Act, 2006.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9912-0-1-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 General departmental management... 374 351 363
00.02 Office for Civil Rights........... 32 31 33
09.01 Reimbursable program.............. 282 211 219
09.02 Reimbursable program (HCFAC)...... 5 5 5
--------- --------- ----------
10.00 Total new obligations........... 693 598 620
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 2 2
22.00 New budget authority (gross)...... 692 596 620
22.22 Unobligated balance transferred
from other accounts............. 2
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 696 598 620
23.95 Total new obligations............. -693 -598 -620
23.98 Unobligated balance expiring or
withdrawn....................... -1
--------- --------- ----------
24.40 Unobligated balance carried
forward, end of year.......... 2
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 404 384 396
40.33 Appropriation permanently
reduced (P.L. 109-148)........ -4
40.35 Appropriation permanently
reduced....................... -4
42.00 Transferred from other accounts. 4
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 404 380 396
Spending authority from offsetting
collections:
Discretionary:
68.00 Offsetting collections (cash). 193 211 219
68.00 Offsetting collections (cash)
HCFAC....................... 5 5 5
68.10 Change in uncollected customer
payments from Federal
sources (unexpired)......... 90
--------- --------- ----------
68.90 Spending authority from
offsetting collections
(total discretionary)..... 288 216 224
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 692 596 620
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 314 326 321
73.10 Total new obligations............. 693 598 620
73.20 Total outlays (gross)............. -628 -603 -613
73.40 Adjustments in expired accounts
(net)........................... -6
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... -90
74.10 Change in uncollected customer
payments from Federal sources
(expired)....................... 43
--------- --------- ----------
74.40 Obligated balance, end of year.. 326 321 328
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 354 379 394
86.93 Outlays from discretionary
balances........................ 274 224 219
--------- --------- ----------
87.00 Total outlays (gross)........... 628 603 613
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -237 -216 -224
Against gross budget authority only:
88.95 Change in uncollected customer
payments from Federal sources
(unexpired)................... -90
88.96 Portion of offsetting
collections (cash) credited to
expired accounts.............. 39
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 404 380 396
90.00 Outlays........................... 391 387 389
---------------------------------------------------------------------------
Note.--The reimbursable program (HCFAC) in Departmental Management
reflects the estimated distribution from the allocation account for 2006
and 2007. Actual 2006 and 2007 distributions will be determined by the
Secretary of HHS and the Attorney General.
Departmental Management
(Dollars in millions)
2005 actual 2006 est. 2007 est.
Distribution of budget authority by
account:
General Departmental
Management................ 372 349 363
Office for Civil Rights..... 32 31 33
Distribution of outlays by account:
General Departmental
Management................ 360 355 357
Office for Civil Rights..... 31 32 32
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, and women's health.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9912-0-1-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 97 111 116
11.3 Other than full-time permanent 10 4 4
11.5 Other personnel compensation.. 2 2 2
11.7 Military personnel............ 3 3 5
--------- --------- ----------
11.9 Total personnel compensation 112 120 127
12.1 Civilian personnel benefits..... 26 27 28
12.2 Military personnel benefits..... 1 1 2
21.0 Travel and transportation of
persons....................... 3 3 3
23.1 Rental payments to GSA.......... 18 23 25
23.3 Communications, utilities, and
miscellaneous charges......... 4 5 5
24.0 Printing and reproduction....... 2 1 1
25.1 Advisory and assistance services 6 3 3
25.2 Other services.................. 28 37 47
25.3 Other purchases of goods and
services from Government
accounts...................... 80 31 32
25.4 Operation and maintenance of
facilities.................... 8 3 3
25.7 Operation and maintenance of
equipment..................... 4 4 4
26.0 Supplies and materials.......... 3 1 1
31.0 Equipment....................... 2 1 1
41.0 Grants, subsidies, and
contributions................. 109 122 114
--------- --------- ----------
99.0 Direct obligations............ 406 382 396
99.0 Reimbursable obligations.......... 287 216 224
--------- --------- ----------
99.9 Total new obligations........... 693 598 620
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-9912-0-1-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct:
1001 Civilian full-time equivalent
employment...................... 1,205 1,249 1,280
1101 Military full-time equivalent
employment...................... 72 73 76
[[Page 464]]
Reimbursable:
2001 Civilian full-time equivalent
employment...................... 400 340 341
---------------------------------------------------------------------------
Office of the National Coordinator for Health Information Technology
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,
[$42,800,000] $87,872,000: Provided, That in addition to amounts
provided herein, [$18,900,000] $28,000,000 shall be available from
amounts available under section 241 of the Public Health Service Act to
carry out health information technology network development. (Department
of Health and Human Services Appropriations Act, 2006.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0130-0-1-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Health information technology..... 42 88
09.01 Reimbursable program.............. 25 34
--------- --------- ----------
10.00 Total new obligations........... 67 122
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 67 122
23.95 Total new obligations............. -67 -122
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 43 88
40.33 Appropriation permanently
reduced (P.L. 109-148)........ -1
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 42 88
Discretionary:
68.00 Spending authority from
offsetting collections:
Offsetting collections (cash). 25 34
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 67 122
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 25
73.10 Total new obligations............. 67 122
73.20 Total outlays (gross)............. -42 -87
--------- --------- ----------
74.40 Obligated balance, end of year.. 25 60
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 42 69
86.93 Outlays from discretionary
balances........................ 18
--------- --------- ----------
87.00 Total outlays (gross)........... 42 87
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -25 -34
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 42 88
90.00 Outlays........................... 17 53
---------------------------------------------------------------------------
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]
2005 actual 2006 est. 2007 est.
Distribution of funding by account:
National Coordinator for
Health Information
Technology.............. 61 116
General Departmental
Management.............. 24 4
Agency for Healthcare
Research and Quality.... 61 50 50
HIT Initiative Total...... 85 111 169
Federal Health
Architecture............ 5 5 6
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 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct obligations:
11.1 Personnel compensation: Full-
time permanent................ 3 4
12.1 Civilian personnel benefits..... 1 1
25.2 Other services.................. 38 83
--------- --------- ----------
99.0 Direct obligations............ 42 88
99.0 Reimbursable obligations.......... 25 34
--------- --------- ----------
99.9 Total new obligations........... 67 122
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-0130-0-1-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct:
1001 Civilian full-time equivalent
employment...................... 30 38
---------------------------------------------------------------------------
Office of Medicare Hearings and Appeals
For expenses necessary for administrative law judges responsible for
hearing cases under title XVIII of the Social Security Act (and related
provisions of title XI of such Act), [$60,000,000] $74,250,000, to be
transferred in appropriate part from the Federal Hospital Insurance and
the Federal Supplementary Medical Insurance Trust Funds. (Department of
Health and Human Services Appropriations Act, 2006.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0139-0-1-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Direct program activity........... 59 74
--------- --------- ----------
10.00 Total new obligations........... 59 74
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 59 74
23.95 Total new obligations............. -59 -74
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
68.00 Spending authority from
offsetting collections
(gross): Offsetting
collections (cash)............ 59 74
----------------------------------------------------------------------------
Change in obligated balances:
73.10 Total new obligations............. 59 74
73.20 Total outlays (gross)............. -59 -74
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 59 74
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -59 -74
----------------------------------------------------------------------------
[[Page 465]]
Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays...........................
---------------------------------------------------------------------------
This activity funds the Office of Medicare Hearings and 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 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
11.1 Personnel compensation: Full-time
permanent....................... 25 27
12.1 Civilian personnel benefits....... 6 7
21.0 Travel and transportation of
persons......................... 2 3
23.1 Rental payments to GSA............ 6 8
23.3 Communications, utilities, and
miscellaneous charges........... 10 14
25.1 Advisory and assistance services.. 6 8
25.2 Other services.................... 1 4
25.3 Other purchases of goods and
services from Government
accounts........................ 3 3
--------- --------- ----------
99.9 Total new obligations........... 59 74
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-0139-0-1-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct:
1001 Civilian full-time equivalent
employment...................... 325 360
---------------------------------------------------------------------------
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, [and 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, $63,589,000] and other public health emergencies, $160,475,000.
(Department of Health and Human Services Appropriations Act, 2006.)
[For an additional amount for ``Public Health and Social Services
Emergency Fund'' to prepare for and respond to an influenza pandemic,
including the development and purchase of vaccines, antivirals, and
necessary medical supplies, and for planning activities, $3,054,000,000,
to remain available until expended: Provided, That $350,000,000 shall be
for Upgrading State and Local Capacity and $50,000,000 shall be for
laboratory capacity and research at the Centers for Disease Control and
Prevention: Provided further, That products purchased with these funds
may, at the discretion of the Secretary, be deposited in the Strategic
National Stockpile: Provided further, That notwithstanding section
496(b) of the Public Health Service Act, funds may be used for the
construction or renovation of privately owned facilities for the
production of pandemic influenza vaccines and other biologicals, where
the Secretary finds such a contract necessary to secure sufficient
supplies of such vaccines or biologicals: Provided further, That the
Secretary may negotiate a contract with a vendor under which a State may
place an order with the vendor for antivirals; may reimburse a State for
a portion of the price paid by the State pursuant to such an order; and
may use amounts made available herein for such reimbursement: Provided
further, That funds appropriated herein and not specifically designated
under this heading may be transferred to other appropriation accounts of
the Department of Health and Human Services, as determined by the
Secretary to be appropriate, to be used for the purposes specified in
this sentence: Provided further, That the amounts provided under this
heading are designated as an emergency requirement pursuant to section
402 H. Con. Res. 95 (109th Congress), the concurrent resolution on the
budget for fiscal year 2006.
For an additional amount for ``Public Health and Social Services
Emergency Fund'' for activities related to pandemic influenza, including
international activities and activities in foreign countries, related to
preparedness planning, enhancing the pandemic influenza regulatory
science base, accelerating pandemic influenza disease surveillance,
developing registries to monitor influenza vaccine distribution and use,
and supporting pandemic influenza research, clinical trials and clinical
trials infrastructure, $246,000,000 of which $150,000,000, to remain
available until expended, shall be for the Centers for Disease Control
and Prevention to carry out global and domestic disease surveillance,
laboratory diagnostics, rapid response, and quarantine: Provided, That
funds appropriated herein and not specifically designated under this
heading may be transferred to other appropriation accounts of the
Department of Health and Human Services, as determined by the Secretary
to be appropriate, to be used for the purposes specified in this
sentence: Provided further, That the amounts provided under this heading
are designated as an emergency requirement pursuant to section 402 of H.
Con. Res. 95 (109th Congress), the concurrent resolution on the budget
for fiscal year 2006.] (Emergency Supplemental Appropriations Act to
Address Hurricanes in the Gulf of Mexico and Pandemic Influenza, 2006.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0140-0-1-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Public Health and Social Services
Emergency Fund.................. 2,402 3,387 160
09.01 Reimbursable program.............. 1,085 1,392 414
--------- --------- ----------
10.00 Total new obligations........... 3,487 4,779 574
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 112 51 17
22.00 New budget authority (gross)...... 3,413 4,745 574
22.10 Resources available from
recoveries of prior year
obligations..................... 13
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 3,538 4,796 591
23.95 Total new obligations............. -3,487 -4,779 -574
--------- --------- ----------
24.40 Unobligated balance carried
forward, end of year.......... 51 17 17
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 2,426 3,364 160
40.33 Appropriation permanently
reduced (P.L. 109-148)........ -1
40.35 Appropriation permanently
reduced....................... -39
40.36 Unobligated balance permanently
reduced....................... -10
41.00 Transferred to other accounts... -58
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 2,329 3,353 160
Spending authority from offsetting
collections:
Discretionary:
68.00 Offsetting collections (cash). 74 1,392 414
68.10 Change in uncollected customer
payments from Federal
sources (unexpired)......... 1,010
--------- --------- ----------
68.90 Spending authority from
offsetting collections
(total discretionary)..... 1,084 1,392 414
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 3,413 4,745 574
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 3,234 3,342 4,405
73.10 Total new obligations............. 3,487 4,779 574
73.20 Total outlays (gross)............. -2,547 -3,716 -3,023
73.40 Adjustments in expired accounts
(net)........................... -32
73.45 Recoveries of prior year
obligations..................... -13
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... -1,010
74.10 Change in uncollected customer
payments from Federal sources
(expired)....................... 223
--------- --------- ----------
74.40 Obligated balance, end of year.. 3,342 4,405 1,956
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 230 1,694 428
86.93 Outlays from discretionary
balances........................ 2,317 2,022 2,595
--------- --------- ----------
87.00 Total outlays (gross)........... 2,547 3,716 3,023
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -299 -1,392 -414
Against gross budget authority only:
88.95 Change in uncollected customer
payments from Federal sources
(unexpired)................... -1,010
88.96 Portion of offsetting
collections (cash) credited to
expired accounts.............. 225
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 2,329 3,353 160
[[Page 466]]
90.00 Outlays........................... 2,248 2,324 2,609
---------------------------------------------------------------------------
The Public Health and Social Services Emergency Fund provides
resources to support a comprehensive program to prepare for the health
and medical consequences of bioterrorism or other public health
emergencies. The account includes funding for international activities,
rapid tests, and communications to support the detection and control of
pandemic influenza. In addition, the Budget includes an allowance of
$2.3 billion for HHS for 2007 to continue pandemic influenza
preparedness.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0140-0-1-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 5 8 8
11.3 Other than full-time permanent 1
11.7 Military personnel............ 2 3 3
--------- --------- ----------
11.9 Total personnel compensation 8 11 11
12.1 Civilian personnel benefits..... 2 3 3
12.2 Military personnel benefits..... 1 1 1
21.0 Travel and transportation of
persons....................... 1 1 1
23.1 Rental payments to GSA.......... 4 2 2
23.3 Communications, utilities, and
miscellaneous charges......... 1 1 1
25.1 Advisory and assistance services 12 14 14
25.2 Other services.................. 7 11 3
25.3 Other purchases of goods and
services from Government
accounts...................... 24 2,411 110
25.4 Operation and maintenance of
facilities.................... 3
25.5 Research and development
contracts..................... 3
25.7 Operation and maintenance of
equipment..................... 5 1 1
31.0 Equipment....................... 1 5 5
41.0 Grants, subsidies, and
contributions................. 6 178 8
--------- --------- ----------
99.0 Direct obligations............ 78 2,639 160
99.0 Reimbursable obligations.......... 1,085 1,392 414
Allocation Account--direct:
Personnel compensation:
11.1 Full-time permanent........... 55 14
11.3 Other than full-time permanent 2
11.5 Other personnel compensation.. 3
--------- --------- ----------
11.9 Total personnel compensation 60 14
12.1 Civilian personnel benefits..... 17 6
21.0 Travel and transportation of
persons....................... 9 4
22.0 Transportation of things........ 10
23.1 Rental payments to GSA.......... 17
23.3 Communications, utilities, and
miscellaneous charges......... 4
25.1 Advisory and assistance services 150 11
25.2 Other services.................. 81 17
25.3 Other purchases of goods and
services from Government
accounts...................... 95 99
25.4 Operation and maintenance of
facilities.................... 6
25.5 Research and development
contracts..................... 32 15
25.7 Operation and maintenance of
equipment..................... 11
26.0 Supplies and materials.......... 293 162
31.0 Equipment....................... 45 30
41.0 Grants, subsidies, and
contributions................. 1,494 390
--------- --------- ----------
99.0 Allocation account--direct.... 2,324 748
--------- --------- ----------
99.9 Total new obligations........... 3,487 4,779 574
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-0140-0-1-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct:
1001 Civilian full-time equivalent
employment...................... 67 146 171
1101 Military full-time equivalent
employment...................... 35 35 32
---------------------------------------------------------------------------
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. chapter 55), such amounts as may
be required during the current fiscal year. (Department of Health and
Human Services Appropriations Act, 2006.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0379-0-1-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Retirement payments............... 247 256 267
00.02 Survivors' benefits............... 14 16 16
00.03 Medical care...................... 45 57 59
00.04 Medicare eligible accruals........ 32 34 36
--------- --------- ----------
10.00 Total new obligations........... 338 363 378
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 344 363 378
23.95 Total new obligations............. -338 -363 -378
23.98 Unobligated balance expiring or
withdrawn....................... -6
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 34 36
Mandatory:
60.00 Appropriation................... 344 329 342
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 344 363 378
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 25 29 36
73.10 Total new obligations............. 338 363 378
73.20 Total outlays (gross)............. -340 -356 -377
73.40 Adjustments in expired accounts
(net)........................... 6
--------- --------- ----------
74.40 Obligated balance, end of year.. 29 36 37
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 34 36
86.97 Outlays from new mandatory
authority....................... 313 296 308
86.98 Outlays from mandatory balances... 27 26 33
--------- --------- ----------
87.00 Total outlays (gross)........... 340 356 377
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 344 363 378
90.00 Outlays........................... 340 356 377
---------------------------------------------------------------------------
The number of beneficiaries using the Commissioned Corps system is
estimated as follows:
Eligible Beneficiary Category
FY2005 FY2006 FY2007
Active Duty:
Health and Human Services. 4,991 5,005 5,005
Department of Justice,
Bureau of Prisons....... 645 645 645
Department of Homeland
Security................ 186 186 186
Environmental Protection
Agency.................. 86 86 86
All Other................. 69 78 78
Total Active Duty............. 5,977 6,000 6,000
Retirees...................... 4,578 4,807 5,047
Retiree Family Members and
Survivors..................... 645 664 684
Total Beneficiaries........... 11,200 11,471 11,731
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, 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-
[[Page 467]]
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 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
12.2 Military personnel benefits....... 32 34 36
13.0 Benefits for former personnel..... 261 272 283
25.6 Medical care...................... 45 57 59
--------- --------- ----------
99.9 Total new obligations........... 338 363 378
---------------------------------------------------------------------------
Health Activities Funds
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9913-0-1-552 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 7
22.00 New budget authority (gross)...... -7
--------- --------- ----------
23.90 Total budgetary resources
available for obligation......
--------- --------- ----------
24.40 Unobligated balance carried
forward, end of year..........
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.36 Unobligated balance permanently
reduced....................... -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.................. -7
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 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
09.01 Program support center............ 509 611 651
09.02 OS activities..................... 54 59 66
--------- --------- ----------
10.00 Total new obligations........... 563 670 717
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 64 63 44
22.00 New budget authority (gross)...... 562 651 717
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 626 714 761
23.95 Total new obligations............. -563 -670 -717
--------- --------- ----------
24.40 Unobligated balance carried
forward, end of year.......... 63 44 44
----------------------------------------------------------------------------
New budget authority (gross), detail:
Spending authority from offsetting
collections:
Mandatory:
69.00 Offsetting collections (cash). 578 651 717
69.10 Change in uncollected customer
payments from Federal
sources (unexpired)......... -16
--------- --------- ----------
69.90 Spending authority from
offsetting collections
(total mandatory)......... 562 651 717
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. -35 7 26
73.10 Total new obligations............. 563 670 717
73.20 Total outlays (gross)............. -537 -651 -717
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... 16
--------- --------- ----------
74.40 Obligated balance, end of year.. 7 26 26
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 537 651 717
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -578 -651 -717
Against gross budget authority only:
88.95 Change in uncollected customer
payments from Federal sources
(unexpired)................... 16
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays........................... -41
---------------------------------------------------------------------------
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 includes activities
such as personnel and payroll support, 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 include the fund
manager, departmental contracts, audit resolutions, Commissioned Corps
force management, information technology, web management, claims,
acquisition integration and modernization, small business, grants
tracking, and competitive sourcing.
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 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Personnel compensation:
11.1 Full-time permanent............. 86 100 106
11.3 Other than full-time permanent.. 4 5 6
11.5 Other personnel compensation.... 3 3 3
11.7 Military personnel.............. 9 10 11
--------- --------- ----------
11.9 Total personnel compensation.. 102 118 126
12.1 Civilian personnel benefits....... 27 30 33
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 4 4
22.0 Transportation of things.......... 3 3 3
23.1 Rental payments to GSA............ 13 15 16
23.3 Communications, utilities, and
miscellaneous charges........... 46 49 53
24.0 Printing and reproduction......... 1 1 1
25.1 Advisory and assistance services.. 64 54 60
25.2 Other services.................... 135 219 232
25.3 Other purchases of goods and
services from Government
accounts........................ 36 41 45
25.4 Operation and maintenance of
facilities...................... 20 25 27
25.6 Medical care...................... 35 36 37
25.7 Operation and maintenance of
equipment....................... 18 14 15
26.0 Supplies and materials............ 46 50 54
31.0 Equipment......................... 6 5 5
--------- --------- ----------
99.9 Total new obligations........... 563 670 717
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-9941-0-4-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Reimbursable:
2001 Civilian full-time equivalent
employment...................... 1,230 1,380 1,450
[[Page 468]]
2101 Military full-time equivalent
employment...................... 95 100 100
Allocation account:
3101 Military full-time equivalent
employment...................... 645 645 645
3101 Military full-time equivalent
employment...................... 255 255 255
---------------------------------------------------------------------------
Trust Funds
Miscellaneous Trust Funds
Special and Trust Fund Receipts (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9971-0-7-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
01.00 Balance, start of year............ 32 32
--------- --------- ----------
01.99 Balance, start of year............ 32 32
Receipts:
02.20 Contributions, Indian health
facilities...................... 31 31 31
02.60 Contributions to the Indian Health
Service Gift Fund............... 1
02.61 Gifts and contributions,
Miscellaneous trust funds....... 65 34 34
--------- --------- ----------
02.99 Total receipts and collections.. 97 65 65
--------- --------- ----------
04.00 Total: Balances and collections... 97 97 97
Appropriations:
05.00 Miscellaneous trust funds......... -65 -65 -65
--------- --------- ----------
07.99 Balance, end of year.............. 32 32 32
---------------------------------------------------------------------------
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9971-0-7-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.02 Gifts............................. 41 34 34
00.03 Contributions, Indian health
facilities...................... 34 31 31
--------- --------- ----------
10.00 Total new obligations........... 75 65 65
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 128 119 119
22.00 New budget authority (gross)...... 65 65 65
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 193 184 184
23.95 Total new obligations............. -75 -65 -65
--------- --------- ----------
24.40 Unobligated balance carried
forward, end of year.......... 119 119 119
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.26 Appropriation (trust fund)...... 65 65 65
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 94 136 116
73.10 Total new obligations............. 75 65 65
73.20 Total outlays (gross)............. -33 -85 -78
--------- --------- ----------
74.40 Obligated balance, end of year.. 136 116 103
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 33 14 14
86.98 Outlays from mandatory balances... 71 64
--------- --------- ----------
87.00 Total outlays (gross)........... 33 85 78
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 65 65 65
90.00 Outlays........................... 33 85 78
----------------------------------------------------------------------------
Memorandum (non-add) entries:
92.01 Total investments, start of year:
Federal securities: Par value... 22 21 21
92.02 Total investments, end of year:
Federal securities: Par value... 21 21 21
---------------------------------------------------------------------------
[Dollars in millions]
2005 2006 2007
Distribution of budget authority by
account:
Gifts....................... 34 34 34
Contributions, Indian health
facilities................ 31 31 31
Distribution of outlays by account:
Gifts....................... 17 34 34
Contributions, Indian health
facilities................ 16 41 37
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 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Personnel compensation:
11.1 Full-time permanent............. 2 2 2
11.3 Other than full-time permanent.. 2 2 2
--------- --------- ----------
11.9 Total personnel compensation.. 4 4 4
12.1 Civilian personnel benefits....... 1 1 1
21.0 Travel and transportation of
persons......................... 1 1 1
25.1 Advisory and assistance services.. 3 2 2
25.2 Other services.................... 28 25 25
25.3 Other purchases of goods and
services from Government
accounts........................ 1 1 1
25.4 Operation and maintenance of
facilities...................... 1 1 1
25.5 Research and development contracts 9 6 6
25.7 Operation and maintenance of
equipment....................... 1 1 1
26.0 Supplies and materials............ 1 1 1
31.0 Equipment......................... 1 1 1
41.0 Grants, subsidies, and
contributions................... 24 21 21
--------- --------- ----------
99.9 Total new obligations........... 75 65 65
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-9971-0-7-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct:
1001 Civilian full-time equivalent
employment...................... 52 52 52
---------------------------------------------------------------------------
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, [$39,813,000] $43,760,000: Provided, That of such amount,
necessary sums are available for providing protective services to the
Secretary and investigating non-payment of child support cases for which
non-payment is a Federal offense under 18 U.S.C. 228. (Department of
Health and Human Services Appropriations Act, 2006.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0128-0-1-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Direct program.................... 40 64 69
09.01 HCFAC reimbursable program........ 166 170 170
09.02 Reimbursable program.............. 32 34 31
--------- --------- ----------
10.00 Total new obligations........... 237 268 270
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 1
22.00 New budget authority (gross)...... 236 268 270
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 237 268 270
23.95 Total new obligations............. -237 -268 -270
--------- --------- ----------
24.40 Unobligated balance carried
forward, end of year..........
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 40 40 44
[[Page 469]]
40.33 Appropriation permanently
reduced (P.L. 109-148)........ -1
40.36 Unobligated balance permanently
reduced....................... -1
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 39 39 44
Mandatory:
60.00 Appropriation................... 25 25
Spending authority from offsetting
collections:
Discretionary:
68.00 Offsetting collections (cash). 25 34 31
Mandatory:
69.00 Offsetting collections (cash). 162 170 170
69.10 Change in uncollected customer
payments from Federal
sources (unexpired)......... 10
--------- --------- ----------
69.90 Spending authority from
offsetting collections
(total mandatory)......... 172 170 170
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 236 268 270
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 32 33 11
73.10 Total new obligations............. 237 268 270
73.20 Total outlays (gross)............. -237 -290 -269
73.40 Adjustments in expired accounts
(net)........................... 6
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... -10
74.10 Change in uncollected customer
payments from Federal sources
(expired)....................... 5
--------- --------- ----------
74.40 Obligated balance, end of year.. 33 11 12
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 39 67 68
86.93 Outlays from discretionary
balances........................ 26 32 6
86.97 Outlays from new mandatory
authority....................... 172 191 191
86.98 Outlays from mandatory balances... 4
--------- --------- ----------
87.00 Total outlays (gross)........... 237 290 269
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -197 -204 -201
Against gross budget authority only:
88.95 Change in uncollected customer
payments from Federal sources
(unexpired)................... -10
88.96 Portion of offsetting
collections (cash) credited to
expired accounts.............. 10
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 39 64 69
90.00 Outlays........................... 40 86 68
---------------------------------------------------------------------------
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)
2005 actual 2006 est. 2007 est.
Budget Authority:
Discretionary appropriation. 40 39 44
Discretionary caps proposal. 0 0 11
Mandatory (HCFAC account)... 160 160 160
Audit and investigations
reimbursements............ 7 10 10
Medicare Modernization Act.. 11 14 0
Medicaid Integrity program.. 0 25 25
------------------------------------
Total..................... 218 248 250
Note.--The reimbursable program (HCFAC) in Office of the Inspector
General reflects the estimated distribution of the allocation account
for 2006 and 2007. Actual 2006 and 2007 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 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct obligations:
11.1 Personnel compensation: Full-
time permanent................ 22 35 37
12.1 Civilian personnel benefits..... 7 11 11
21.0 Travel and transportation of
persons....................... 2 3 3
23.1 Rental payments to GSA.......... 3 4 4
23.3 Communications, utilities, and
miscellaneous charges......... 1 1 1
25.3 Other purchases of goods and
services from Government
accounts...................... 4 7 11
26.0 Supplies and materials.......... 1
31.0 Equipment....................... 1 2 2
--------- --------- ----------
99.0 Direct obligations............ 40 64 69
99.0 Reimbursable obligations.......... 197 204 201
--------- --------- ----------
99.9 Total new obligations........... 237 268 270
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-0128-0-1-551 2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Direct:
1001 Civilian full-time equivalent
employment...................... 264 432 432
Reimbursable:
2001 Civilian full-time equivalent
employment...................... 1,188 1,191 1,191
---------------------------------------------------------------------------
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)
----------------------------------------------------------------------------
2005 actual 2006 est. 2007 est.
----------------------------------------------------------------------------
Offsetting receipts from the public:
75-274530 Health education assistance
loans, Downward reestimates of
subsidies........................... 55 31
75-310700 Federal share of child
support collections................. 1,188 1,087 1,110
Legislative proposal, subject to
PAYGO............................. 9
--------- --------- ----------
General Fund Offsetting receipts from
the public............................. 1,243 1,118 1,119
---------------------------------------------------------------------------
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 in 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
[[Page 470]]
of Health and Human Services, prior to the Secretary's preparation and
submission of a report to the Committee on Appropriations of the Senate
and of the House detailing the planned uses of such funds.]
Sec. [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 transfer authority granted by this section shall be available
only to meet emergency needs and shall not be used to create any new
program or to fund any project or activity for which no funds are
provided in this Act:] Provided further, That the Appropriations
Committees of both Houses of Congress are notified at least 15 days in
advance of any transfer.
(transfer of funds)
Sec. [209] 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 and centers 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.
(transfer of funds)
Sec. [210] 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. [211] 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. [212] 211. None of the funds appropriated by this Act
(including funds appropriated to any trust fund) may be used to carry
out the 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 Advantage
organization described in this section shall be responsible for
informing enrollees where to obtain information about all Medicare
covered services.
Sec. [213] 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. [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, [2006] 2007, 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
[2006] 2007 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 [2005] 2006, 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 [2005] 2006 State
expenditures and all fiscal year [2006] 2007 obligations for tobacco
prevention and compliance activities by program activity by July 31,
[2006] 2007.
(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, [2006]
2007.
(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 [2006] 2007, the
Secretary of Health and Human Services (HHS)--
(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] HHS 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] HHS. The Department of
State shall cooperate fully with the Secretary of [Health and Human
Services] HHS to ensure that [the Department of Health and Human
Services] HHS 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] HHS 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. The Division of Federal Occupational Health hereafter may
utilize personal services contracting to employ professional management/
administrative and occupational health professionals.]
Sec. [217] 215. (a) Authority.--Notwithstanding any other provision
of law, the Director of the National Institutes of Health may use funds
available under section 402(i) of the Public Health Service Act (42
U.S.C. 282(i)) to enter into transactions (other than contracts,
cooperative agreements, or grants) to carry out research in support of
the NIH Roadmap for Medical Research.
(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. [218] 216. 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
[[Page 471]]
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. 219. Notwithstanding any other provisions of law, funds made
available in this Act may be used to continue operating the Council on
Graduate Medical Education established by section 301 of Public Law 102-
408.]
[(rescission of funds)]
[Sec. 220. The unobligated balance in the amount of $10,000,000
appropriated by Public Law 108-11 under the heading ``Public Health and
Social Services Emergency Fund'' are rescinded.]
[Sec. 221. (a) The Headquarters and Emergency Operations Center
Building (Building 21) at the Centers for Disease Control and Prevention
is hereby renamed as the Arlen Specter Headquarters and Emergency
Operations Center.
(b) The Global Communications Center Building (Building 19) at the
Centers for Disease Control and Prevention is hereby renamed as the
Thomas R. Harkin Global Communications Center.]
[Sec. 222. None of the funds made available under this Act may be
used to implement or enforce the interim final rule published in the
Federal Register by the Centers for Medicare & Medicaid Services on
August 26, 2005 (70 Fed. Reg. 50940) prior to April 1, 2006.]
[Sec. 223. (a) For fiscal year 2006 and subject to subsection (b),
the Secretary of Health and Human Services may waive the requirements of
regulations promulgated under the Head Start Act (42 U.S.C. 9831 et
seq.), for one or more vehicles used by a Head Start agency or an Early
Head Start entity (or the designee of either) in transporting children
enrolled in a Head Start program or an Early Head Start program if--
(1) such requirements pertain to child restraint systems or
vehicle monitors;
(2) the agency or entity demonstrates that compliance with such
requirements will result in a significant disruption to the Head
Start program or the Early Head Start program; and
(3) waiving such requirements is in the best interest of the
children involved.
(b) The Secretary of Health and Human Services may not issue any
waiver under subsection (a) after September 30, 2006, or the date of the
enactment of a statute that authorizes appropriations for fiscal year
2006 to carry out the Head Start Act, whichever date is earlier.]
[Sec. 224. Section 1310.12(a) of title 45 of the Code of Federal
Regulations (October 1, 2004) shall not be effective until June 30, 2006
or 60 days after the date of the enactment of a statute that authorizes
appropriations for fiscal year 2006 to carry out the Head Start Act,
whichever date is earlier.]
[(rescission)]
[Sec. 225. 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.]
[(rescission)]
[Sec. 226. The unobligated balance of the Nursing Student Loan
program authorized by section 835 of the Public Health Services Act is
rescinded.]
Sec. [227] 217. In addition to any other amounts available for such
travel, and notwithstanding any other provision of law, amounts
available [from this or any other appropriation] for the purchase, hire,
maintenance, or operation of aircraft by the Centers for Disease Control
and Prevention [shall be available for] may be used to provide travel on
such aircraft by the Secretary of Health and Human Services, the
Director of the Centers for Disease Control and Prevention, and
employees of the Department of Health and Human Services accompanying
the Secretary or the Director during such travel.
Sec. 218. Not to exceed 5 percent of the funds provided for each of
parts A, B, C, D or F of title XXVI of the Public Health Service Act,
may be reallocated among such parts: Provided, That the Congress is
promptly notified of the reallocation.
Sec. 219. Of the unobligated balances available under the heading;
Health Resources and Service Administration, the amounts made available
to the Health Centers Loan Guarantee Program authorized under section
330(d) of the Public Health Service Act and Title II of P.L. 104-208 are
cancelled.
Notwithstanding section 835 of title VIII and subpart II of title
VII of the Public Health Service Act, an institution of higher education
with a student loan revolving fund established under these authorities
shall, no later than September 30, 2007, pay to the Secretary of Health
and Human Services the Federal portion of all of the liquid assets of
such fund, as determined by the Secretary on June 30, 2007: Provided,
That amounts collected under the proceeding provision are cancelled:
Provided further, That the institution shall not make any new loans
under these authorities until the amount equal to that Federal portion
determined on June 30, 2007 has been paid to the Secretary. (Department
of Health and Human Services Appropriations Act, 2006.)