[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)

----------------------------------------------------------------------------
Identification code 75-9911-0-1-554      2005 actual   2006 est.   2007 est.
----------------------------------------------------------------------------
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..............
---------------------------------------------------------------------------

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9911-0-1-554      2005 actual   2006 est.   2007 est.
----------------------------------------------------------------------------

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

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

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

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

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

                        [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)

----------------------------------------------------------------------------
Identification code 75-9911-0-1-554      2005 actual   2006 est.   2007 est.
----------------------------------------------------------------------------

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

                              Personnel Summary

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

                          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)

----------------------------------------------------------------------------
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)

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

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-4309-0-3-554      2005 actual   2006 est.   2007 est.
----------------------------------------------------------------------------
    Reimbursable:
2001  Civilian full-time equivalent 
        employment......................          35          38          38
---------------------------------------------------------------------------

                                


 
              HEALTH RESOURCES AND SERVICES ADMINISTRATION

                              Federal Funds

General and special funds:

                      Health Resources and Services

    For carrying out titles II, III, IV, VII, VIII, X, XII, [XIX,] and 
XXVI of the Public Health Service Act (``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)

----------------------------------------------------------------------------
Identification code 75-0350-0-1-550      2005 actual   2006 est.   2007 est.
----------------------------------------------------------------------------

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

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

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

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

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.)
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