    [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 2008

    [[Page 393]]

                     DEPARTMENT OF HEALTH AND HUMAN SERVICES

                          FOOD AND DRUG ADMINISTRATION

                                  Federal 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; $1,649,405,000: Provided, That of the amount provided under
    this heading, $13,696,000 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 animal drug assessments received during fiscal year 2008, including
    any such fees assessed prior to the current fiscal year but credited
    during the current year, shall be subject to the fiscal year 2008
    limitation.
        In addition, export certification user fees authorized by 21 U.S.C.
    381 may be credited to this account, to remain available until expended.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

                            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, $4,950,000, to remain
    available until expended.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

              Special and Trust Fund Receipts (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9911-0-1-554      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
    01.00 Balance, start of year............
                                               ---------   ---------  ----------
    01.99 Balance, start of year............
        Receipts:
    02.00 User fees, FDA--legislative
            proposal subject to PAYGO.......                                  23
    02.01 User fees, FDA--legislative
            proposal subject to PAYGO.......                                   4
    02.20 Cooperative research and
            development agreements, FDA.....           1           1           1
                                               ---------   ---------  ----------
    02.99   Total receipts and collections..           1           1          28
                                               ---------   ---------  ----------
    04.00 Total: Balances and collections...           1           1          28
        Appropriations:
    05.00 Salaries and expenses.............          -1          -1          -1
                                               ---------   ---------  ----------
    05.99   Total appropriations............          -1          -1          -1
                                               ---------   ---------  ----------
    07.99 Balance, end of year..............                                  27
    ---------------------------------------------------------------------------

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9911-0-1-554      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 Foods.............................         439         439         467
    00.02 Drugs.............................         526         526         574
    00.03 Devices and radiological products.         220         220         240
    00.04 National Center for Toxicological
            Research........................          41          41          36
    00.05 Other activities..................          86          86          88
    00.06 Other rent and rent related
            activities......................          57          57          98
    00.07 Rental payments...................         116         116         132
    00.08 Buildings and facilities..........           8           5           5
    00.09 CRADAs............................           1           1           1
    09.01 Reimbursable program..............         411         370          62
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       1,905       1,861       1,703
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........          99         116         116
    22.00 New budget authority (gross)......       1,922       1,861       1,704
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......       2,021       1,977       1,820
    23.95 Total new obligations.............      -1,905      -1,861      -1,703
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........         116         116         117
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................       1,510       1,490       1,641
    40.35   Appropriation permanently
              reduced.......................         -15
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............       1,495       1,490       1,641
            Spending authority from
                offsetting collections:
    58.00     Offsetting collections (cash).         433         370          62
    58.10     Change in uncollected customer
                payments from Federal
                sources (unexpired).........          19
    58.26     Offsetting collections
                (previously unavailable)....         186         212         212
    58.45     Portion precluded from
                obligation (limitation on
                obligations)................        -212        -212        -212
                                               ---------   ---------  ----------
    58.90     Spending authority from
                offsetting collections
                (total discretionary).......         426         370          62
          Mandatory:

    60.20   Appropriation (special fund)....           1           1           1
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................       1,922       1,861       1,704
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         491         414         518
    73.10 Total new obligations.............       1,905       1,861       1,703
    73.20 Total outlays (gross).............      -1,900      -1,757      -1,652
    73.40 Adjustments in expired accounts
            (net)...........................          -1
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................         -19
    74.10 Change in uncollected customer
            payments from Federal sources
            (expired).......................         -62
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..         414         518         569
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................       1,520       1,484       1,292
    86.93 Outlays from discretionary
            balances........................         377         272         359
    86.97 Outlays from new mandatory
            authority.......................                       1           1
    86.98 Outlays from mandatory balances...           3
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       1,900       1,757       1,652
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

            Offsetting collections (cash)
                from:
    88.00     Federal sources...............         -49         -45         -45
    88.45     Offsetting governmental
                collections (from non-
                Federal sources)............        -402        -325         -17
                                               ---------   ---------  ----------
    88.90     Total, offsetting collections
                (cash)......................        -451        -370         -62
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................         -19
    88.96   Portion of offsetting
              collections (cash) credited to
              expired accounts..............          18
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       1,470       1,491       1,642
    90.00 Outlays...........................       1,449       1,387       1,590
    ----------------------------------------------------------------------------

        Memorandum (non-add) entries:
    94.01 Unavailable balance, start of
            year: Offsetting collections....         186         212         212

    [[Page 394]]

    94.02 Unavailable balance, end of year:
            Offsetting collections..........         212         212         212
    ---------------------------------------------------------------------------

                            [In millions of dollars]

                                            2006         2007        2008
    Distribution of budget authority by
        account:
      Salaries and expenses.......          1,486          1,485           1,636
      Buildings and facilities....              9              5               5
    Distribution of outlays by account:
      Salaries and expenses.......          1,465          1,384           1,585
      Buildings and facilities....              9              5               5

                     Summary of Budget Authority and Outlays

                            (in millions of dollars)

                                         2006 actual  2007 est.   2008 est.
    Enacted/requested:
      Budget Authority............          1,470          1,491           1,642
      Outlays.....................          1,449          1,387           1,590
    Legislative proposal, not subject to
        PAYGO:
      Budget Authority............
      Outlays.....................

    Total:
      Budget Authority............          1,470          1,491           1,642
      Outlays.....................          1,449          1,387           1,590

        The Food and Drug Administration (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 and helping to
    provide the public accurate, science-based information about medicines
    and foods to improve their health. FDA decisions affect Americans on a
    daily basis. 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
    generic and other drug review, drug safety, food safety, medical device
    review and safety, and headquarters consolidation in White Oak,
    Maryland.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9911-0-1-554      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
          Direct obligations:

            Personnel compensation:
    11.1      Full-time permanent...........         547         533         609
    11.3      Other than full-time permanent          73          71          81
    11.5      Other personnel compensation..          24          23          27
    11.7      Military personnel............          44          42          48
                                               ---------   ---------  ----------
    11.9      Total personnel compensation..         688         669         765
    12.1    Civilian personnel benefits.....         172         167         191
    12.2    Military personnel benefits.....          23          22          26
    13.0    Benefits for former personnel...           5           5           6
    21.0    Travel and transportation of
              persons.......................          22          21          23
    22.0    Transportation of things........           4           3           4
    23.1    Rental payments to GSA..........         116         127         132
    23.2    Rental payments to others.......           4          21           4
    23.3    Communications, utilities, and
              miscellaneous charges.........          30          31          33
    24.0    Printing and reproduction.......           3           3           3
    25.1    Advisory and assistance services          52          52          56
    25.2    Other services..................          97          96         104
    25.3    Other purchases of goods and
              services from Government
              accounts......................          92          95          99
    25.4    Operation and maintenance of
              facilities....................          50          48          52
    25.5    Research and development
              contracts.....................          26          26          28
    25.7    Operation and maintenance of
              equipment.....................          21          21          23
    26.0    Supplies and materials..........          26          24          28
    31.0    Equipment.......................          26          26          28
    32.0    Land and structures.............           6           4           4
    41.0    Grants, subsidies, and
              contributions.................          28          28          30
    42.0    Insurance claims and indemnities           2           2           2
                                               ---------   ---------  ----------
    99.0      Direct obligations............       1,493       1,491       1,641
    99.0  Reimbursable obligations..........         412         370          62
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       1,905       1,861       1,703
    ---------------------------------------------------------------------------

                                 Employment Summary

    ----------------------------------------------------------------------------
    Identification code 75-9911-0-1-554      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Civilian full-time equivalent
            employment......................       7,319       6,965       7,407
    1101  Military full-time equivalent
            employment......................         573         545         580
        Reimbursable:
    2001  Civilian full-time equivalent
            employment......................       1,717       1,462         146
    2101  Military full-time equivalent
            employment......................         135         114          11
        Allocation account:
    3001  Civilian full-time equivalent
            employment......................          28          28          28
    3101  Military full-time equivalent
            employment......................           1           1           1
    ---------------------------------------------------------------------------

                              Salaries and Expenses

                  (Legislative proposal, not subject to PAYGO)

        Contingent upon the enactment of authorizing legislation, the
    Secretary shall charge a fee for generic drug review activities:
    Provided, That such fees, in an amount not to exceed $15,701,000, shall
    be credited as an offsetting collection to this account, to remain
    available until expended for the purpose of such generic drug review
    activities.
        In addition, contingent upon the enactment of authorizing
    legislation, the Secretary shall charge a fee for prescription drug
    review activities and medical device review activities: Provided, That
    such fees, in an amount not to exceed $339,195,000, for prescription
    drug reviews, shall be credited to this account and remain available
    until expended for the purpose of such prescription drug reviews, and
    shall not include any prescription drug review fees assessed for fiscal
    year 2009 but collected in fiscal year 2008; and $47,500,000 for medical
    device reviews, shall be credited to this account, to remain available
    until expended for the purpose of such medical device review activities:
    Provided further, That fees derived from prescription drug and medical
    device review assessments received during fiscal year 2008, including
    any such fees assessed prior to the current fiscal year but credited
    during the current year, shall be subject to the fiscal year 2008
    limitation.
        In addition, contingent upon the enactment of authorizing
    legislation, the Secretary shall charge a fee for mammography-related
    activities: Provided, That such fees shall be credited as an offsetting
    collection to this account, to remain available until expended for the
    purpose of ensuring mammography quality.

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9911-2-1-554      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    09.01 Reimbursable program--PDUFA.......                                 339
    09.02 Reimbursable program--MDUFMA......                                  48
    09.03 Reimbursable program--MQSA........                                  18
    09.04 Reimbursable program- Generic
            Drugs...........................                                  16
                                               ---------   ---------  ----------
    10.00   Total new obligations...........                                 421
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......                                 421
    23.95 Total new obligations.............                                -421
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    58.00   Spending authority from
              offsetting collections:
              Offsetting collections (cash).                                 421
    ----------------------------------------------------------------------------

        Change in obligated balances:
    73.10 Total new obligations.............                                 421
    73.20 Total outlays (gross).............                                -421
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................                                 421
    ----------------------------------------------------------------------------

    [[Page 395]]

        Offsets:
          Against gross budget authority and outlays:

    88.45   Offsetting collections (cash)
              from: Offsetting governmental
              collections (from non-Federal
              sources)......................                                -421
    ----------------------------------------------------------------------------

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

        The 2008 Budget includes a number of new and current user fees.
    Legislation will be proposed to allow FDA to collect fees to support
    generic drug review activities. The additional resources, estimated at
    $16 million in 2008, would enable FDA to reduce review times and respond
    to the growing number of generic drug applications. The budget also
    reproposes user fees to support activities related to re-inspections of
    FDA-regulated facilities and issue export certificates for food and
    animal feeds.

        Lastly, the budget includes a total of $339 million in prescription
    drug user fees, $48 million in medical device user fees, and $18 million
    in mammography user fees. Authorizing language for these fees will be
    proposed to reauthorize the collection and spending of the fees subject
    to appropriations language.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9911-2-1-554      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
    99.0    Reimbursable obligations........                                 421
                                               ---------   ---------  ----------
    99.9    Total new obligations...........                                 421
    ---------------------------------------------------------------------------

                                 Employment Summary

    ----------------------------------------------------------------------------
    Identification code 75-9911-2-1-554      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Civilian full-time equivalent
            employment......................
        Reimbursable:
    2001  Civilian full-time equivalent
            employment......................                               1,703
    2101  Military full-time equivalent
            employment......................                                  87
        Allocation account:
    3001  Civilian full-time equivalent
            employment......................
    3101  Military full-time equivalent
            employment......................
    ---------------------------------------------------------------------------

               Revolving Fund for Certification and Other Services

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-4309-0-3-554      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    09.01 Reimbursable program..............           6           7           7
                                               ---------   ---------  ----------
    10.00   Total new obligations...........           6           7           7
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........           1           2           2
    22.00 New budget authority (gross)......           7           7           7
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......           8           9           9
    23.95 Total new obligations.............          -6          -7          -7
                                               ---------   ---------  ----------
    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:
              Offsetting collections (cash).           7           7           7
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..           1           2           2
    73.10 Total new obligations.............           6           7           7
    73.20 Total outlays (gross).............          -5          -7          -7
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..           2           2           2
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................           5           5           5
    86.98 Outlays from mandatory balances...                       2           2
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........           5           7           7
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.40   Offsetting collections (cash)
              from: Non-Federal sources.....          -7          -7          -7
    ----------------------------------------------------------------------------

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

        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      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Reimbursable obligations:
    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
    26.0  Supplies and materials............           1           1           1
    31.0  Equipment.........................                       1
                                               ---------   ---------  ----------
    99.9    Total new obligations...........           6           7           7
    ---------------------------------------------------------------------------

                                 Employment Summary

    ----------------------------------------------------------------------------
    Identification code 75-4309-0-3-554      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Reimbursable:
    2001  Civilian full-time equivalent
            employment......................          33          31          34
    ---------------------------------------------------------------------------

                  HEALTH RESOURCES AND SERVICES ADMINISTRATION

                                     Federal

                          Health Resources and Services

        For carrying out titles II, III, IV, VII, VIII, X, XII, 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 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, and section 712 of the American Jobs Creation Act of 2004,
    $5,795,805,000: Provided, That of the funds made available under this
    heading, $100,000 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 no more than $100,000 is available until expended for
    carrying out 42 U.S.C. 233(o) including administrative expenses:
    Provided further, That $1,966,000 is available until expended for the
    National Cord Blood Stem Cell Program: 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 $44,055,000 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 $26,000,000 of
    funding provided for health centers shall be used for high-need
    counties, notwithstanding section 330(r)(2)(B) of the PHS Act: Provided
    further, That of the funds made available under this heading,
    $283,103,000 shall be for the program

    [[Page 396]]

    under title X of the 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 of the funds available under this heading,
    $1,819,511,000 shall remain available to the Secretary until September
    30, 2010, for parts A and B of title XXVI of the PHS Act; Provided
    further, That $814,546,000 shall be for State AIDS Drug Assistance
    Programs authorized by section 2616 of the PHS Act: Provided further,
    That in addition to amounts provided herein, $25,000,000 shall be
    available from amounts available under section 241 of the PHS Act to
    carry out parts A, B, C, and D of title XXVI of the PHS Act to fund
    section 2691 Special Projects of National Significance.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0350-0-1-550      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.07 Loan Guarantee Downward Reestimate           1
    00.10 Health centers....................       1,740       1,738       1,944
    00.11 National Health Service Corps.....          40          40          31
    00.12 National Health Service Corps
            recruitment.....................          85          85          85
    00.13 Hansen's Disease Center...........          16          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................          31          31          44
    00.17 Health professions................         264         264          71
    00.18 Maternal and child health block
            grant...........................         693         693         693
    00.19 Healthy start.....................         101         102         101
    00.20 Poison control centers............          23          23          10
    00.21 EMS for children..................          20          20
    00.22 Universal newborn hearing
            screening.......................          10          10
    00.23 HIV/AIDS..........................       2,036       2,038       2,133
    00.24 Organ transplantation.............          23          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
    00.28 Rural health flexibility grants...          63          64
    00.29 Denali Commission.................          39          39
    00.30 Telehealth........................           7           7           7
    00.31 Program management................         144         145         144
    00.32 Family planning...................         283         283         283
    00.36 Health centers tort claim fund....          27          54          44
    00.39 Childrens' GME....................         297         297         110
    00.42 State offices of rural health.....           8           8           8
    00.45 Rural and community access to
            emergency devices...............           1           1
    00.46 Radiogenic diseases...............           2           2           2
    00.47 Traumatic brain injury............           9           9
    00.50 Cord blood stem cell bank.........                      23           2
    00.51 Bioterrorism activities...........         495         495
    00.52 Free clinics medical malpractice..           1           1
    00.54 Sickle cell.......................           2           2           2
    00.55 Drug pricing program..............                                   3
    00.56 Family to family health
            information centers.............                       3           4
                                               ---------   ---------  ----------
    03.00   Total direct programs...........       6,542       6,597       5,800
    09.01 Reimbursable program..............         112         124         123
    09.02 Reimbursable program: PHS
            evaluation......................          25          25          25
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       6,679       6,746       5,948
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........          98         109          41
    22.00 New budget authority (gross)......       6,690       6,678       5,914
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......       6,788       6,787       5,955
    23.95 Total new obligations.............      -6,679      -6,746      -5,948
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........         109          41           7
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................       6,634       6,542       5,796
    40.35   Appropriation permanently
              reduced.......................         -66
    40.36   Unobligated balance permanently
              reduced.......................                     -16          -5
    41.00   Transferred to other accounts...          -5
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............       6,563       6,526       5,791
            Spending authority from
                offsetting collections:
    58.00     Offsetting collections (cash).          92         120         119
    58.00     Offsetting collections (HPSL/
                NSL Recall).................                                 100
    58.00     Offsetting collections (cash)
                HPSL/NSL M-SAVER............                                 -29
    58.10     Change in uncollected customer
                payments from Federal
                sources (unexpired).........          30
    58.35     Offsetting collections
                permanently reduced (-).....                                -100
                                               ---------   ---------  ----------
    58.90     Spending authority from
                offsetting collections
                (total discretionary).......         122         120          90
          Mandatory:

    60.00   Appropriation...................                       3           4
    60.35   Appropriation permanently
              reduced.......................         -25
                                               ---------   ---------  ----------
    62.50     Appropriation (total
                mandatory)..................         -25           3           4
    69.00   Spending authority from
              offsetting collections:
              Offsetting collections
              (cash)(HPSL&NSL)..............          30          29          29
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................       6,690       6,678       5,914
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..       5,617       5,349       5,590
    73.10 Total new obligations.............       6,679       6,746       5,948
    73.20 Total outlays (gross).............      -6,800      -6,505      -6,323
    73.40 Adjustments in expired accounts
            (net)...........................        -126
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................         -30
    74.10 Change in uncollected customer
            payments from Federal sources
            (expired).......................           9
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..       5,349       5,590       5,215
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................       2,647       2,590       2,292
    86.93 Outlays from discretionary
            balances........................       4,141       3,883       3,998
    86.97 Outlays from new mandatory
            authority.......................           1          32          33
    86.98 Outlays from mandatory balances...          11
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       6,800       6,505       6,323
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

            Offsetting collections (cash)
                from:
    88.00     Federal sources...............         -80        -100        -100
    88.40     Non-Federal sources...........         -51         -49        -119
                                               ---------   ---------  ----------
    88.90     Total, offsetting collections
                (cash)......................        -131        -149        -219
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................         -30
    88.96   Portion of offsetting
              collections (cash) credited to
              expired accounts..............           9
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       6,538       6,529       5,695
    90.00 Outlays...........................       6,669       6,356       6,104
    ---------------------------------------------------------------------------

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

    ----------------------------------------------------------------------------
    Identification code 75-0350-0-1-550      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Guaranteed loan levels supportable by subsidy
                    budget authority:
    215001Health centers: Facilities
            renovation loan guarantee levels           2           8
                                               ---------   ---------  ----------
    215999Total loan guarantee levels.......           2           8
        Guaranteed loan subsidy (in percent):
    232001Health centers: Facilities
            renovation loan guarantee levels        3.50        4.08        0.00
    232002Health centers: Managed care
            network development loan
            guarantee.......................        8.00        8.88        0.00
    232003Health centers: Managed care plan
            loan guarantee levels...........        8.17        8.43        0.00
                                               ---------   ---------  ----------
    232999Weighted average subsidy rate.....        3.50        4.08        0.00
        Guaranteed loan downward reestimates:
    237001Health centers: Facilities
            renovation loan guarantee levels          -1
                                               ---------   ---------  ----------
    237999Total downward reestimate subsidy
            budget authority................          -1
    ----------------------------------------------------------------------------

    [[Page 397]]

        Administrative expense data:
    3510  Budget authority..................           1
    3590  Outlays from new authority........           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.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0350-0-1-550      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
          Direct obligations:

            Personnel compensation:
    11.1      Full-time permanent...........         100         104         108
    11.3      Other than full-time permanent           4           3           3
    11.5      Other personnel compensation..           3           4           4
    11.7      Military personnel............          21          24          24
                                               ---------   ---------  ----------
    11.9      Total personnel compensation..         128         135         139
    12.1    Civilian personnel benefits.....          26          26          26
    12.2    Military personnel benefits.....          12          13          13
    13.0    Benefits for former personnel...           3           4           4
    21.0    Travel and transportation of
              persons.......................           3           3           2
    23.1    Rental payments to GSA..........          10          11           7
    23.2    Rental payments to others.......           2           2           2
    23.3    Communications, utilities, and
              miscellaneous charges.........           3           3           1
    24.0    Printing and reproduction.......           4           4           4
    25.1    Advisory and assistance services          57          70          54
    25.2    Other services..................          77          91          65
    25.3    Other purchases of goods and
              services from Government
              accounts......................         203         225         161
    25.4    Operation and maintenance of
              facilities....................           1           1           1
    25.6    Medical care....................           3           2           2
    25.7    Operation and maintenance of
              equipment.....................           2           2           2
    26.0    Supplies and materials..........           1           1           1
    31.0    Equipment.......................           1           1           1
    33.0    Investments and loans...........           5           5           5
    41.0    Grants, subsidies, and
              contributions.................       5,979       5,962       5,282
    42.0    Insurance claims and indemnities          22          37          28
                                               ---------   ---------  ----------
    99.0      Direct obligations............       6,542       6,598       5,800
    99.0  Reimbursable obligations..........         137         148         148
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       6,679       6,746       5,948
    ---------------------------------------------------------------------------

                                 Employment Summary

    ----------------------------------------------------------------------------
    Identification code 75-0350-0-1-550      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Civilian full-time equivalent
            employment......................       1,226       1,255       1,222
    1101  Military full-time equivalent
            employment......................         259         270         259
        Reimbursable:
    2001  Civilian full-time equivalent
            employment......................          90          99         141
    2101  Military full-time equivalent
            employment......................         221         301         339
        Allocation account:
    3001  Civilian full-time equivalent
            employment......................
    3101  Military full-time equivalent
            employment......................
    ---------------------------------------------------------------------------

                           Vaccine Injury Compensation

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0320-0-1-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........           2           5           5
    22.00 New budget authority (gross)......           3
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......           5           5           5
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........           5           5           5
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    69.00   Spending authority from
              offsetting collections:
              Offsetting collections (cash).           3
    ----------------------------------------------------------------------------

        Change in obligated balances:
    73.20 Total outlays (gross).............
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................          -3
    86.98 Outlays from mandatory balances...           3
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.40   Offsetting collections (cash)
              from: Non-Federal sources.....          -3
    ----------------------------------------------------------------------------

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

        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 2008 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.

                 Health Center Guaranteed Loan Financing Account

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-4442-0-3-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 Default claims....................                       1
    08.02 Downward reestimates paid to
            receipt accounts................           1
                                               ---------   ---------  ----------
    10.00   Total new obligations...........           1           1
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........           4           3           2
    23.95 Total new obligations.............          -1          -1
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........           3           2           2
    ----------------------------------------------------------------------------

        Change in obligated balances:
    73.10 Total new obligations.............           1           1
    73.20 Total financing disbursements
            (gross).........................          -1          -1
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    87.00 Total financing disbursements
            (gross).........................           1           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      2006 actual   2007 est.   2008 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.........................         100          98          90
    2142  Uncommitted loan guarantee
            limitation......................                                 -90
    2143  Uncommitted limitation carried
            forward.........................         -98         -90
                                               ---------   ---------  ----------
    2150    Total guaranteed loan
              commitments...................           2           8
    2199  Guaranteed amount of guaranteed
            loan commitments................           2           8
    ----------------------------------------------------------------------------

        Cumulative balance of guaranteed loans
                    outstanding:
    2210  Outstanding, start of year........          40          38          42
    2231  Disbursements of new guaranteed
            loans...........................           2           8

    [[Page 398]]

    2251  Repayments and prepayments........          -4          -3          -3
    2263  Adjustments: Terminations for
            default that result in claim
            payments........................                      -1
                                               ---------   ---------  ----------
    2290    Outstanding, end of year........          38          42          39
    ----------------------------------------------------------------------------

        Memorandum:
    2299  Guaranteed amount of guaranteed
            loans outstanding, end of year..          32          30          34
    ---------------------------------------------------------------------------

        P.L. 104-299 and P.L. 104-208 authorize Health Resources and
    Services Administration (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

    2005 actual

    2006 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

    Negative subsidy BA total [75-0350]

    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,
    $2,906,000.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0340-0-1-552      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.09 Administrative expenses...........           3           3           3
                                               ---------   ---------  ----------
    10.00   Total new obligations...........           3           3           3
    ----------------------------------------------------------------------------

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

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................           3           3           3
    ----------------------------------------------------------------------------

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

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

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

    ----------------------------------------------------------------------------
    Identification code 75-0340-0-1-552      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Guaranteed loan downward reestimates:
    237001HEAL Loan guarantee...............         -31         -34
                                               ---------   ---------  ----------
    237999Total downward reestimate subsidy
            budget authority................         -31         -34
    ----------------------------------------------------------------------------

        Administrative expense data:
    3510  Budget authority..................           3           3           3
    3590  Outlays from new authority........           3           3           3
    ---------------------------------------------------------------------------

        The Health Education Assistance Loan (HEAL) program guarantees loans
    from private lenders to health professions students to help pay for the
    costs of their training. As required by the Federal Credit Reform Act of
    1990, this account records, for the HEAL program, the subsidy costs
    associated with HEAL loan guarantees committed in 1992 and beyond
    (including modifications of HEAL loan guarantees that resulted from
    obligations or commitments in any year), as well as administrative
    expenses of the program. The administrative expenses are estimated on a
    cash basis.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0340-0-1-552      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Direct obligations:
    11.1  Personnel compensation: Full-time
            permanent.......................           1           1           1
    25.3  Other purchases of goods and
            services from Government
            accounts........................           2           2           2
                                               ---------   ---------  ----------
    99.9    Total new obligations...........           3           3           3
    ---------------------------------------------------------------------------

                                 Employment Summary

    ----------------------------------------------------------------------------
    Identification code 75-0340-0-1-552      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Civilian full-time equivalent
            employment......................          12          12          12
    1101  Military full-time equivalent
            employment......................
    ---------------------------------------------------------------------------

               Health Education Assistance Loans Financing Account

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-4304-0-3-552      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 Default Claims....................          13          20          20
    08.02 Payment of downward reestimate to
            receipt account.................          18          20
    08.04 Payment of interest on downward
            reestimate to receipt account...          13          14
                                               ---------   ---------  ----------
    08.91   Subtotal (reestimates)..........          31          34
                                               ---------   ---------  ----------
    10.00   Total new obligations...........          44          54          20
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........         171         144         100
    22.00 New financing authority (gross)...          17          10          11
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......         188         154         111
    23.95 Total new obligations.............         -44         -54         -20
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........         144         100          91
    ----------------------------------------------------------------------------

        New financing authority (gross), detail:
          Mandatory:

    [[Page 399]]

    69.00   Spending authority from
              offsetting collections:
              Offsetting collections (cash).          17          10          11
    ----------------------------------------------------------------------------

        Change in obligated balances:
    73.10 Total new obligations.............          44          54          20
    73.20 Total financing disbursements
            (gross).........................         -44         -54         -20
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    87.00 Total financing disbursements
            (gross).........................          44          54          20
    ----------------------------------------------------------------------------

        Offsets:
          Against gross financing authority and
              financing disbursements:

            Offsetting collections (cash)
                from:
    88.25     Interest on uninvested funds..          -9          -6          -6
    88.40     Recoveries of defaulted loans.          -8          -4          -5
                                               ---------   ---------  ----------
    88.90     Total, offsetting collections
                (cash)......................         -17         -10         -11
    ----------------------------------------------------------------------------

        Net financing authority and financing
            disbursements:
    89.00 Financing authority...............
    90.00 Financing disbursements...........          28          44           9
    ---------------------------------------------------------------------------

                 Status of Guaranteed Loans (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-4304-0-3-552      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Position with respect to appropriations act
                    limitation on commitments:
    2111  Limitation on guaranteed loans
            made by private lenders.........
                                               ---------   ---------  ----------
    2150    Total guaranteed loan
              commitments...................
    ----------------------------------------------------------------------------

        Cumulative balance of guaranteed loans
                    outstanding:
    2210  Outstanding, start of year........       1,440       1,156         936
    2251  Repayments and prepayments........        -271        -200        -200
          Adjustments:

    2261    Terminations for default that
              result in loans receivable....         -10         -17         -17
    2263    Terminations for default that
              result in claim payments......          -3          -3          -3
    2264    Other adjustments, net..........
                                               ---------   ---------  ----------
    2290    Outstanding, end of year........       1,156         936         716
    ----------------------------------------------------------------------------

        Memorandum:
    2299  Guaranteed amount of guaranteed
            loans outstanding, end of year..       1,156         936         716
    ----------------------------------------------------------------------------

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

    2310    Outstanding, start of year......         635         640         656
    2331    Disbursements for guaranteed
              loan claims...................          13          20          20
    2351    Repayments of loans receivable..          -8          -4          -5
    2364    Other adjustments, net..........
                                               ---------   ---------  ----------
    2390      Outstanding, end of year......         640         656         671
    ---------------------------------------------------------------------------

        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

    2005 actual

    2006 actual

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

    Federal assets: Fund balances with Treasury

    171

    144

          Net value of assets related to
              post-1991 acquired defaulted
              guaranteed loans receivable:

    1501

    Defaulted guaranteed loans receivable, gross

    635

    640

    1505

    Allowance for subsidy cost (-)

    -548

    -568

    1599

    Net present value of assets related to defaulted guaranteed loans

    87

    72

    1999

    Total assets

    258

    216

        LIABILITIES:
          Non-Federal liabilities:

    2204

    Liabilities for loan guarantees

    227

    182

    2207

    Other, downward reestimate

    31

    34

    2999

    Total liabilities

    258

    216

    4999

    Total liabilities and net position

    258

    216

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

              Health Education Assistance Loans Liquidating Account

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-4305-0-3-552      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.02 Defaulted loans...................           3           4           1
                                               ---------   ---------  ----------
    10.00   Total new obligations (object
              class 42.0)...................           3           4           1
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......           4           4           1
    23.95 Total new obligations.............          -3          -4          -1
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................           4           4           1
            Spending authority from
                offsetting collections:
    69.00     Offsetting collections (cash).          15          15          10
    69.27     Capital transfer to general
                fund........................         -15         -15         -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..           4           4           4
    73.10 Total new obligations.............           3           4           1
    73.20 Total outlays (gross).............          -3          -4          -1
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..           4           4           4
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................           3           4           1
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.40   Offsetting collections (cash)
              from: Non-Federal sources.....         -15         -15         -10
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................         -11         -11          -9
    90.00 Outlays...........................         -12         -11          -9
    ---------------------------------------------------------------------------

                 Status of Guaranteed Loans (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-4305-0-3-552      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Cumulative balance of guaranteed loans
                    outstanding:
    2210  Outstanding, start of year........         268         216         154
    2251  Repayments and prepayments........         -49         -58         -58
          Adjustments:

    2261    Terminations for default that
              result in loans receivable....          -3          -4          -1
    2264    Other adjustments, net..........
                                               ---------   ---------  ----------
    2290    Outstanding, end of year........         216         154          95
    ----------------------------------------------------------------------------

        Memorandum:
    2299  Guaranteed amount of guaranteed
            loans outstanding, end of year..         216         154          95
    ----------------------------------------------------------------------------

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

    2310    Outstanding, start of year......         111          99          88
    2331    Disbursements for guaranteed
              loan claims...................           3           4           1
    2351    Repayments of loans receivable..         -15         -15         -10
    2364    Other adjustments, net..........
                                               ---------   ---------  ----------
    2390      Outstanding, end of year......          99          88          79
    ---------------------------------------------------------------------------
        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.

    [[Page 400]]

                                 Balance Sheet (in millions of dollars)

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

    2005 actual

    2006 actual

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

    Federal assets: Fund balances with Treasury

    4

    4

    1701

    Defaulted guaranteed loans, gross

    111

    99

    1703

    Allowance for estimated uncollectible loans and interest (-)

    -4

    -4

    1704

    Defaulted guaranteed loans and interest receivable, net

    107

    95

    1799

    Value of assets related to loan guarantees

    107

    95

    1999

    Total assets

    111

    99

        LIABILITIES:
    2104

    Federal liabilities: Resources payable to Treasury

    109

    99

    2204

    Non-Federal liabilities: Liabilities for loan guarantees

    2

    2999

    Total liabilities

    111

    99

    4999

    Total liabilities and net position

    111

    99

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

                   Medical Facilities Guarantee and Loan Fund

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9931-0-3-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        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      2006 actual   2007 est.   2008 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

    2005 actual

    2006 actual

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

    Non-Federal assets: Receivables, net

    13

    12

    1601

    Direct loans, gross

    7

    1999

    Total assets

    13

    19

        LIABILITIES:
    2204

    Non-Federal liabilities: Liabilities for loan guarantees

    13

    19

    2999

    Total liabilities

    13

    19

    4999

    Total liabilities and net position

    13

    19

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

                                   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 $3,528,000 shall be
    available from the Trust Fund to the Secretary of Health and Human
    Services.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

              Special and Trust Fund Receipts (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 20-8175-0-7-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
    01.00 Balance, start of year............       2,162       2,371       2,587
                                               ---------   ---------  ----------
    01.99 Balance, start of year............       2,162       2,371       2,587
        Receipts:
    02.00 Interest and profits on
            investments, Vaccine injury
            compensation trust fund.........          93          98         103
    02.60 Deposits, Vaccine injury
            compensation trust fund.........         184         195         196
                                               ---------   ---------  ----------
    02.99   Total receipts and collections..         277         293         299
                                               ---------   ---------  ----------
    04.00 Total: Balances and collections...       2,439       2,664       2,886
        Appropriations:
    05.00 Vaccine injury compensation
            program trust fund..............         -14         -14         -14
    05.01 Vaccine injury compensation
            program trust fund..............         -54         -63         -73
                                               ---------   ---------  ----------
    05.99   Total appropriations............         -68         -77         -87
                                               ---------   ---------  ----------
    07.99 Balance, end of year..............       2,371       2,587       2,799
    ---------------------------------------------------------------------------

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 20-8175-0-7-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 Compensation: Claims for post--FY
            1989 injuries...................          54          56          58
          Administrative expenses:

    01.03   Claims processing (Claims Court)           4           4           4
    01.04   Claims processing (HRSA)........           4           4           4
    01.05   Claims processing (Dept. of
              Justice)......................           6           6           7
                                               ---------   ---------  ----------
    01.91     Total, administrative expenses          14          14          15
                                               ---------   ---------  ----------
    10.00   Total new obligations...........          68          70          73
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........           1           1           8
    22.00 New budget authority (gross)......          68          77          87
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......          69          78          95
    23.95 Total new obligations.............         -68         -70         -73
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........           1           8          22
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.26   Appropriation (trust fund)......          14          14          14
          Mandatory:

    60.26   Appropriation (trust fund)......          54          63          73
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................          68          77          87
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..           4           8           1
    73.10 Total new obligations.............          68          70          73
    73.20 Total outlays (gross).............         -64         -77         -87
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..           8           1         -13
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................          10          14          14
    86.97 Outlays from new mandatory
            authority.......................          53          63          73
    86.98 Outlays from mandatory balances...           1
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........          64          77          87
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................          68          77          87
    90.00 Outlays...........................          64          77          87
    ----------------------------------------------------------------------------

        Memorandum (non-add) entries:
    92.01 Total investments, start of year:
            Federal securities: Par value...       2,165       2,380       2,303

    [[Page 401]]

    92.02 Total investments, end of year:
            Federal securities: Par value...       2,380       2,303       2,216
    ---------------------------------------------------------------------------

        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      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Direct obligations:
    25.2  Other services....................           4           4           5
    25.3  Other purchases of goods and
            services from Government
            accounts........................          10          10          10
    42.0  Insurance claims and indemnities..          54          56          58
                                               ---------   ---------  ----------
    99.9    Total new obligations...........          68          70          73
    ---------------------------------------------------------------------------

                        Ricky Ray Hemophilia Relief Fund

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-8074-0-7-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 Funds Returned to Treasury from
            Original Obligations............           2
    00.02 New Collections Returned to
            Treasury........................           3
                                               ---------   ---------  ----------
    10.00   Total new obligations (object
              class 94.0)...................           5
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........           2
    22.10 Resources available from
            recoveries of prior year
            obligations.....................           3
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......           5
    23.95 Total new obligations.............          -5
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..           3
    73.10 Total new obligations.............           5
    73.20 Total outlays (gross).............          -5
    73.45 Recoveries of prior year
            obligations.....................          -3
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.98 Outlays from mandatory balances...           5
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................
    90.00 Outlays...........................           5
    ---------------------------------------------------------------------------

        The Ricky Ray Hemophilia Relief Fund was established pursuant to
    Public Law 105-369 and served as a source of funds to pay claims to
    eligible individuals on behalf of persons with HIV and a blood clotting
    disorder, who were treated with an anti-hemophiliac factor between July
    1982 and December 1987. By law the fund terminated November 12, 2003,
    five years after the date of enactment. All unobligated balances have
    been returned to the Treasury.

                              INDIAN HEALTH SERVICE

                                     Federal

                             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, $2,931,530,000, 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 $551,515,000 for contract medical care shall remain available for
    obligation until September 30, 2009: 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 $271,636,000 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 2008, 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.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0390-0-1-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 Clinical services.................       2,175       2,179       2,425
    00.02 Preventive health.................         117         117         130
    00.03 Urban health......................          33          33
    00.04 Indian health professions.........          32          31          32
    00.05 Tribal management.................           2           2           2
    00.06 Direct operations.................          63          62          65
    00.07 Self-governance...................           6           6           6
    00.08 Contract support costs............         265         265         272
    00.09 Diabetes funds....................         163         150         150
    09.01 Reimbursable program..............         909         909         909
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       3,765       3,754       3,991
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........         244         183         162
    22.00 New budget authority (gross)......       3,710       3,733       3,970
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......       3,954       3,916       4,132
    23.95 Total new obligations.............      -3,765      -3,754      -3,991
    23.98 Unobligated balance expiring or
            withdrawn.......................          -6
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........         183         162         141
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    [[Page 402]]

    40.00   Appropriation...................       2,732       2,695       2,932
    40.35   Appropriation permanently
              reduced.......................         -40
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............       2,692       2,695       2,932
            Spending authority from
                offsetting collections:
    58.00     Offsetting collections (cash).         885         888         888
    58.10     Change in uncollected customer
                payments from Federal
                sources (unexpired).........         -17
                                               ---------   ---------  ----------
    58.90     Spending authority from
                offsetting collections
                (total discretionary).......         868         888         888
          Mandatory:

    60.00   Appropriation...................         150         150         150
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................       3,710       3,733       3,970
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         562         610         581
    73.10 Total new obligations.............       3,765       3,754       3,991
    73.20 Total outlays (gross).............      -3,744      -3,783      -3,986
    73.40 Adjustments in expired accounts
            (net)...........................           8
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................          17
    74.10 Change in uncollected customer
            payments from Federal sources
            (expired).......................           2
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..         610         581         586
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................       3,272       3,260       3,468
    86.93 Outlays from discretionary
            balances........................         322         373         367
    86.97 Outlays from new mandatory
            authority.......................         132         132         132
    86.98 Outlays from mandatory balances...          18          18          19
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       3,744       3,783       3,986
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

            Offsetting collections (cash)
                from:
    88.00     Federal sources...............        -444        -444        -444
    88.40     Non-Federal sources...........        -444        -444        -444
                                               ---------   ---------  ----------
    88.90     Total, offsetting collections
                (cash)......................        -888        -888        -888
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................          17
    88.96   Portion of offsetting
              collections (cash) credited to
              expired accounts..............           3
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       2,842       2,845       3,082
    90.00 Outlays...........................       2,856       2,895       3,098
    ---------------------------------------------------------------------------

        The Indian health services account provides medical care, public
    health services, and health professions training opportunities to
    American Indians and Alaska Natives. An estimated $1,766 million,
    primarily through self determination contracts and compacts, will be
    administered by tribal governments in 2008.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0390-0-1-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
          Direct obligations:

            Personnel compensation:
    11.1      Full-time permanent...........         332         345         364
    11.3      Other than full-time permanent          22          23          24
    11.5      Other personnel compensation..          31          32          33
    11.7      Military personnel............          72          73          81
                                               ---------   ---------  ----------
    11.9      Total personnel compensation..         457         473         502
    12.1    Civilian personnel benefits.....         104         108         114
    12.2    Military personnel benefits.....          33          34          36
    13.0    Benefits for former personnel...           6           6           6
    21.0    Travel and transportation of
              persons.......................          14          13          14
    21.0    Patient travel..................          19          19          19
    22.0    Transportation of things........           9           8           9
    23.1    Rental payments to GSA..........           6           6           7
    23.2    Rental payments to others.......           2           1           1
    23.3    Communications, utilities, and
              miscellaneous charges.........          14          14          15
    24.0    Printing and reproduction.......           1           1           1
    25.1    Advisory and assistance services          10          10          10
    25.2    Other services..................          83          81          89
    25.3    Other purchases of goods and
              services from Government
              accounts......................          50          48          54
    25.4    Operation and maintenance of
              facilities....................           4           4           5
    25.6    Medical care....................         246         248         274
    25.7    Operation and maintenance of
              equipment.....................           6           6           6
    25.8    Subsistence and support of
              persons.......................           2           2           1
    26.0    Supplies and materials..........          95          91         101
    31.0    Equipment.......................          18          17          19
    41.0    Grants, subsidies, and
              contributions.................       1,676       1,654       1,798
    42.0    Insurance claims and indemnities           1           1           1
                                               ---------   ---------  ----------
    99.0      Direct obligations............       2,856       2,845       3,082
    99.0  Reimbursable obligations..........         909         909         909
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       3,765       3,754       3,991
    ---------------------------------------------------------------------------

                                 Employment Summary

    ----------------------------------------------------------------------------
    Identification code 75-0390-0-1-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Civilian full-time equivalent
            employment......................       7,189       7,220       7,326
    1101  Military full-time equivalent
            employment......................       1,147       1,135       1,153
        Reimbursable:
    2001  Civilian full-time equivalent
            employment......................       4,893       4,904       4,904
    2101  Military full-time equivalent
            employment......................         782         771         771
    ---------------------------------------------------------------------------

                            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, $339,196,000, 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 a
    federally-recognized 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 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.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

              Special and Trust Fund Receipts (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0391-0-1-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
    01.00 Balance, start of year............
                                               ---------   ---------  ----------
    01.99 Balance, start of year............
        Receipts:
    02.20 Rent and charges for quarters,
            Indian Health Service...........          -1           6           6
          Adjustments:

    02.90   Adjustments.....................           1
                                               ---------   ---------  ----------

    [[Page 403]]

    02.99   Total receipts and collections..                       6           6
                                               ---------   ---------  ----------
    04.00 Total: Balances and collections...                       6           6
        Appropriations:
    05.00 Indian health facilities..........                      -6          -6
                                               ---------   ---------  ----------
    07.99 Balance, end of year..............
    ---------------------------------------------------------------------------

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0391-0-1-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 Sanitation and health facilities..         156         130         101
    00.02 Maintenance.......................          63          52          52
    00.03 Facilities and environmental
            health..........................         149         161         165
    00.04 Equipment.........................          22          21          21
                                               ---------   ---------  ----------
    01.00   Total direct program............         390         364         339
    09.01 Reimbursable program..............           4           7           7
                                               ---------   ---------  ----------
    10.00   Total new obligations...........         394         371         346
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........         285         251         257
    22.00 New budget authority (gross)......         360         377         352
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......         645         628         609
    23.95 Total new obligations.............        -394        -371        -346
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........         251         257         263
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................         358         364         339
    40.35   Appropriation permanently
              reduced.......................          -5
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............         353         364         339
    58.00   Spending authority from
              offsetting collections:
              Offsetting collections (cash).           2           7           7
          Mandatory:

    60.20   Appropriation (special fund)....                       6           6
    69.00   Spending authority from
              offsetting collections:
              Offsetting collections (cash).           5
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................         360         377         352
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         246         236         234
    73.10 Total new obligations.............         394         371         346
    73.20 Total outlays (gross).............        -404        -373        -389
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..         236         234         191
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................         336         116         109
    86.93 Outlays from discretionary
            balances........................          63         251         274
    86.97 Outlays from new mandatory
            authority.......................           5           6           6
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........         404         373         389
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

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

        Net budget authority and outlays:
    89.00 Budget authority..................         353         370         345
    90.00 Outlays...........................         397         366         382
    ---------------------------------------------------------------------------

        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      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
          Direct obligations:

            Personnel compensation:
    11.1      Full-time permanent...........          42          43          45
    11.3      Other than full-time permanent           4           5           5
    11.5      Other personnel compensation..           1           1           1
    11.7      Military personnel............          19          19          20
                                               ---------   ---------  ----------
    11.9      Total personnel compensation..          66          68          71
    12.1    Civilian personnel benefits.....          12          13          13
    12.2    Military personnel benefits.....           7           8           8
    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           1           1
    23.3    Communications, utilities, and
              miscellaneous charges.........          14          15          15
    25.1    Advisory and assistance services           5           5           4
    25.2    Other services..................          95          88          76
    25.3    Other purchases of goods and
              services from Government
              accounts......................           1           1           1
    25.4    Operation and maintenance of
              facilities....................           7           6           7
    25.7    Operation and maintenance of
              equipment.....................           2           2           2
    26.0    Supplies and materials..........           8           7           7
    31.0    Equipment.......................          11          10           9
    32.0    Land and structures.............          43          29          15
    41.0    Grants, subsidies, and
              contributions.................         112         105         104
                                               ---------   ---------  ----------
    99.0      Direct obligations............         390         364         339
    99.0  Reimbursable obligations..........           4           7           7
                                               ---------   ---------  ----------
    99.9    Total new obligations...........         394         371         346
    ---------------------------------------------------------------------------

                                 Employment Summary

    ----------------------------------------------------------------------------
    Identification code 75-0391-0-1-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Civilian full-time equivalent
            employment......................         981         989       1,008
    1101  Military full-time equivalent
            employment......................         238         236         238
        Reimbursable:
    2001  Civilian full-time equivalent
            employment......................          46          46          46
    ---------------------------------------------------------------------------

                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.
        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 author

    [[Page 404]]

    ized 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.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

                   CENTERS FOR DISEASE CONTROL AND PREVENTION

                                     Federal

                     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,
    $5,716,651,000, of which $20,000,000 shall remain available until
    expended for equipment, construction and renovation of facilities; of
    which $581,335,000 shall remain available until expended for the
    Strategic National Stockpile; and of which $121,224,000 for
    international HIV/AIDS shall remain available until September 30, 2009;
    and of which $30,000,000 shall remain available until expended for
    section 2625 of the PHS act. 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) $109,921,000 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 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.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

              Special and Trust Fund Receipts (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0943-0-1-550      2006 actual   2007 est.   2008 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      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 Infectious diseases...............       1,649       1,646       1,752
    00.02 Health promotion..................         962         959         959
    00.03 Health information and service....          87          85         108
    00.04 Environmental health and injury...         286         287         288
    00.05 Occupational safety and health....         164         166         166
    00.06 Global health.....................         311         310         380
    00.08 Public health improvement and
            leadership......................         200         189         190
    00.09 Prev. health and health services
            block grant.....................          99          99
    00.10 Buildings and facilities..........         136         134          20
    00.11 Business services support.........         316         318         320
    00.12 Terrorism.........................       1,534       1,544       1,504
    00.14 World Trade Center Registry.......           6
          Reimbursable program:

    09.01   Health statistics...............         109         109         110
    09.02   Other reimbursable program......         387         403         418
    09.03   Public health research..........          31          31          31
                                               ---------   ---------  ----------
    09.09     Subtotal, reimbursable
                programs....................         527         543         559
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       6,277       6,280       6,246
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........         300         466         477
    22.00 New budget authority (gross)......       6,444       6,291       6,230
    22.10 Resources available from
            recoveries of prior year
            obligations.....................           3
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......       6,747       6,757       6,707
    23.95 Total new obligations.............      -6,277      -6,280      -6,246
    23.98 Unobligated balance expiring or
            withdrawn.......................          -4
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........         466         477         461
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................       5,978       5,737       5,717
    40.35   Appropriation permanently
              reduced.......................         -59
    40.36   Unobligated balance permanently
              reduced.......................                                 -30
    41.00 Transferred to other accounts.....          -4
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............       5,915       5,737       5,687
            Spending authority from
                offsetting collections:
    58.00     Offsetting collections (cash).         234         553         542
    58.10     Change in uncollected customer
                payments from Federal
                sources (unexpired).........         294
                                               ---------   ---------  ----------
    58.90     Spending authority from
                offsetting collections
                (total discretionary).......         528         553         542
          Mandatory:

    60.20   Appropriation (special fund)....           1           1           1
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................       6,444       6,291       6,230
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..       3,633       4,694       4,817
    73.10 Total new obligations.............       6,277       6,280       6,246
    73.20 Total outlays (gross).............      -5,057      -6,157      -6,283
    73.40 Adjustments in expired accounts
            (net)...........................         -71
    73.45 Recoveries of prior year
            obligations.....................          -3
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................        -294
    74.10 Change in uncollected customer
            payments from Federal sources
            (expired).......................         209
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..       4,694       4,817       4,780
    ----------------------------------------------------------------------------

    [[Page 405]]

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................       1,986       2,561       2,531
    86.93 Outlays from discretionary
            balances........................       3,070       3,595       3,751
    86.97 Outlays from new mandatory
            authority.......................           1           1           1
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       5,057       6,157       6,283
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

            Offsetting collections (cash)
                from:
    88.00     Federal sources...............        -186        -514        -503
    88.40     Non-Federal sources...........        -256         -39         -39
                                               ---------   ---------  ----------
    88.90     Total, offsetting collections
                (cash)......................        -442        -553        -542
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................        -294
    88.96   Portion of offsetting
              collections (cash) credited to
              expired accounts..............         208
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       5,916       5,738       5,688
    90.00 Outlays...........................       4,615       5,604       5,741
    ---------------------------------------------------------------------------

        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.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0943-0-1-550      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
          Direct obligations:

            Personnel compensation:
    11.1      Full-time permanent...........         469         488         515
    11.3      Other than full-time permanent          53          55          58
    11.5      Other personnel compensation..          22          23          25
    11.7      Military personnel............          57          59          62
    11.8      Special personal services
                payments....................           1           1           1
                                               ---------   ---------  ----------
    11.9      Total personnel compensation..         602         626         661
    12.1    Civilian personnel benefits.....         145         152         160
    12.2    Military personnel benefits.....          36          38          40
    21.0    Travel and transportation of
              persons.......................          43          42          39
    22.0    Transportation of things........          21          21          19
    23.1    Rental payments to GSA..........          69          68          63
    23.2    Rental payments to others.......           1           1           1
    23.3    Communications, utilities, and
              miscellaneous charges.........          22          21          20
    24.0    Printing and reproduction.......           9           9           8
    25.1    Advisory and assistance services         381         377         350
    25.2    Other services..................         215         212         197
    25.3    Other purchases of goods and
              services from Government
              accounts......................         347         342         319
    25.4    Operation and maintenance of
              facilities....................          77          76          71
    25.5    Research and development
              contracts.....................         123         124         129
    25.6    Medical care....................          19          19          17
    25.7    Operation and maintenance of
              equipment.....................          24          24          22
    26.0    Supplies and materials..........         529         523         486
    31.0    Equipment.......................          70          69          65
    32.0    Land and structures.............         105         102          92
    41.0    Grants, subsidies, and
              contributions.................       2,912       2,891       2,928
                                               ---------   ---------  ----------
    99.0      Direct obligations............       5,750       5,737       5,687
    99.0  Reimbursable obligations..........         527         543         559
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       6,277       6,280       6,246
    ---------------------------------------------------------------------------

                                 Employment Summary

    ----------------------------------------------------------------------------
    Identification code 75-0943-0-1-550      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Civilian full-time equivalent
            employment......................       6,453       6,761       7,173
    1101  Military full-time equivalent
            employment......................         773         778         783
        Reimbursable:
    2001  Civilian full-time equivalent
            employment......................         895         895         950
    2101  Military full-time equivalent
            employment......................          57          57          57
        Allocation account:
    3001  Civilian full-time equivalent
            employment......................
    ---------------------------------------------------------------------------

                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, $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 2008,
    and existing profiles may be updated as necessary.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0944-0-1-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 Direct program....................          74          75          75
    09.01 Reimbursable program..............           6           6           6
                                               ---------   ---------  ----------
    10.00   Total new obligations...........          80          81          81
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........                       1           1
    22.00 New budget authority (gross)......          81          81          81
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......          81          82          82
    23.95 Total new obligations.............         -80         -81         -81
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........           1           1           1
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................          76          75          75
    40.35   Appropriation permanently
              reduced.......................          -1
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............          75          75          75
            Spending authority from
                offsetting collections:
    58.00     Offsetting collections (cash).           4           6           6
    58.10     Change in uncollected customer
                payments from Federal
                sources (unexpired).........           2
                                               ---------   ---------  ----------
    58.90     Spending authority from
                offsetting collections
                (total discretionary).......           6           6           6
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................          81          81          81
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..          33          38          45
    73.10 Total new obligations.............          80          81          81
    73.20 Total outlays (gross).............         -77         -80         -81
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................          -2
    74.10 Change in uncollected customer
            payments from Federal sources
            (expired).......................           4           6           6
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..          38          45          51
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................          54          52          52

    [[Page 406]]

    86.93 Outlays from discretionary
            balances........................          23          28          29
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........          77          80          81
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.00   Offsetting collections (cash)
              from: Federal sources.........          -8          -6          -6
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................          -2
    88.96   Portion of offsetting
              collections (cash) credited to
              expired accounts..............           4
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................          75          75          75
    90.00 Outlays...........................          69          74          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      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
          Direct obligations:

            Personnel compensation:
    11.1      Full-time permanent...........          21          21          22
    11.3      Other than full-time permanent           1           1           1
    11.5      Other personnel compensation..           1           1           1
    11.7      Military personnel............           4           4           5
                                               ---------   ---------  ----------
    11.9      Total personnel compensation..          27          27          29
    12.1    Civilian personnel benefits.....           6           6           6
    12.2    Military personnel benefits.....           1           2           2
    21.0    Travel and transportation of
              persons.......................           1           1           1
    23.3    Communications, utilities, and
              miscellaneous charges.........          12          12          11
    25.1    Advisory and assistance services           2           2           2
    25.2    Other services..................           6           6           5
    25.3    Other purchases of goods and
              services from Government
              accounts......................           1           1           1
    25.5    Research and development
              contracts.....................           1           1           1
    31.0    Equipment.......................           2           2           2
    41.0    Grants, subsidies, and
              contributions.................          15          15          15
                                               ---------   ---------  ----------
    99.0      Direct obligations............          74          75          75
    99.0  Reimbursable obligations..........           6           6           6
                                               ---------   ---------  ----------
    99.9    Total new obligations...........          80          81          81
    ---------------------------------------------------------------------------

                                 Employment Summary

    ----------------------------------------------------------------------------
    Identification code 75-0944-0-1-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Civilian full-time equivalent
            employment......................         300         300         300
    1101  Military full-time equivalent
            employment......................          14          14          14
        Reimbursable:
    2001  Civilian full-time equivalent
            employment......................          16          16          16
    2101  Military full-time equivalent
            employment......................
    ---------------------------------------------------------------------------

                                   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      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Budgetary resources available for obligation:
    24.41 Special and trust fund receipts
            returned to Schedule N..........           1
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..          10           2
    73.20 Total outlays (gross).............          -8          -2
    73.40 Adjustments in expired accounts
            (net)...........................          -1
    74.10 Change in uncollected customer
            payments from Federal sources
            (expired).......................           1
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..           2
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.93 Outlays from discretionary
            balances........................           8           2
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

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

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

        Net budget authority and outlays:
    89.00 Budget authority..................
    90.00 Outlays...........................           7           2
    ---------------------------------------------------------------------------

        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 proposes that ATSDR's appropriation come only from the
    general fund in 2008, without regard to any available balances in the
    trust fund.

                          NATIONAL INSTITUTES OF HEALTH

                                     Federal

                            National Cancer Institute

        For carrying out section 301 and title IV of the Public Health
    Service Act with respect to cancer, $4,782,114,000, 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.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

                    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, $2,925,413,000.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

             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, $389,722,000.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

        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,
    $1,708,045,000.

    [[Page 407]]

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

             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,
    $1,537,019,000.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

              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,
    $4,592,482,000: Provided, That $300,000,000 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 such sums obligated in fiscal years 2003 through
    2007 for extramural facilities construction projects are to remain
    available until expended for disbursement, with prior notification of
    such projects to the House of Representatives and Senate Committees on
    Appropriations.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

                 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, $1,941,462,000.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

            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,
    $1,264,946,000.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

                             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,
    $667,820,000.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

               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,
    $637,406,000.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

        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, $78,434,000.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

                           National Institute on Aging

        For carrying out section 301 and title IV of the Public Health
    Service Act with respect to aging, $1,047,148,000.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

      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, $508,082,000.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

        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,
    $393,682,000.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

                     National Institute of Nursing Research

        For carrying out section 301 and title IV of the Public Health
    Service Act with respect to nursing research, $137,800,000.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

               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, $436,505,000.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

                        National Institute on Drug Abuse

        For carrying out section 301 and title IV of the Public Health
    Service Act with respect to drug abuse, $1,000,365,000.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

                       National Institute of Mental Health

        For carrying out section 301 and title IV of the Public Health
    Service Act with respect to mental health, $1,405,421,000.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

                    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, $484,436,000.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

           National Institute of Biomedical Imaging and Bioengineering

        For carrying out section 301 and title IV of the Public Health
    Service Act with respect to biomedical imaging and bioengineering
    research, $300,463,000.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

                     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, $1,112,498,000: 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.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

    [[Page 408]]

           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,
    $121,699,000.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

            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, $194,495,000.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

                      John E. Fogarty International Center

        For carrying out the activities at the John E. Fogarty International
    Center, $66,594,000.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

                          National Library of Medicine

        For carrying out section 301 and title IV of the Public Health
    Service Act with respect to health information communications,
    $312,562,000, of which $4,000,000 shall be available until expended for
    improvement of information systems: Provided, That in fiscal year 2008,
    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.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

                             Office of the Director

                          (including transfer of funds)

        For carrying out the responsibilities of the Office of the Director,
    National Institutes of Health, $517,062,000, of which up to $25,000,000
    shall be used to carry out section 215 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 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 such Fund shall remain available for
    one fiscal year after the fiscal year in which they are deposited:
    Provided further, That the amounts appropriated in this Act to each
    Institute and Center may be transferred and utilized for the National
    Institutes of Health Common Fund: Provided further, That the amount
    utilized under the preceding proviso shall not exceed $365,000,000
    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 Common Fund from the
    Director's Discretionary Fund and to any amounts allocated to activities
    related to the 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.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

                            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, $136,000,000, to
    remain available until expended.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

              Special and Trust Fund Receipts (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9915-0-1-552      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
    01.00 Balance, start of year............
                                               ---------   ---------  ----------
    01.99 Balance, start of year............
        Receipts:
    02.20 Cooperative research and
            development agreements, NIH.....          15          16          16
                                               ---------   ---------  ----------
    04.00 Total: Balances and collections...          15          16          16
        Appropriations:
    05.00 National Institutes of Health.....         -15         -16         -16
                                               ---------   ---------  ----------
    07.99 Balance, end of year..............
    ---------------------------------------------------------------------------

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9915-0-1-552      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 National Cancer Institute.........       4,747       4,793       4,782
    00.02 National Heart, Lung, and Blood
            Institute.......................       2,894       2,922       2,925
    00.03 National Institute of Dental and
            Craniofacial Research...........         386         389         390
    00.04 National Institute of Diabetes and
            Digestive and Kidney Disease....       1,839       1,855       1,858
    00.05 National Institute of Neurological
            Disorders and Stroke............       1,520       1,535       1,537
    00.06 National Institute of Allergy and
            Infectious Diseases.............       4,224       4,365       4,592
    00.07 National Institute of General
            Medical Sciences................       1,917       1,936       1,941
    00.08 National Institute of Child Health
            and Human Development...........       1,253       1,265       1,265
    00.09 National Eye Institute............         660         667         668
    00.10 National Institute of
            Environmental Health Sciences...         710         720         716
    00.11 National Institute on Aging.......       1,037       1,047       1,047
    00.12 National Institute of Arthritis
            and Musculoskeletal and Skin
            Disease.........................         503         508         508
    00.13 National Institute on Deafness and
            Other Communication Disorder....         390         393         394
    00.14 National Institute of Mental
            Health..........................       1,390       1,404       1,405
    00.15 National Institute on Drug Abuse..         990       1,000       1,000
    00.16 Natinal Institute on Alcohol Abuse
            and Alcoholism..................         432         436         437
    00.17 National Institute of Nursing
            Research........................         136         137         138
    00.18 National Human Genome Research
            Institute.......................         481         486         484
    00.19 National Institute of Biomedical
            Imaging and Bioengineering......         294         297         300
    00.20 National Center for Research
            Resources.......................       1,088       1,099       1,113
    00.21 National Center for Complementary
            and Alternative Medicine........         120         121         122
    00.22 National Center on Minority Health
            and Health Disparities..........         193         195         195
    00.23 John E. Fogarty International
            Center..........................          66          66          67
    00.24 National Library of Medicine......         312         315         313
    00.25 Office of the Director............         725         478         517
    00.26 Buildings and facilities..........         175         171         136
    00.27 Cooperative Research and
            Development Agreements..........          20          20          16
    00.28 Royalities........................          76          76          76
    09.00 Reimbursable program..............       2,637       2,758       2,883
                                               ---------   ---------  ----------
    10.00   Total new obligations...........      31,224      31,454      31,823
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........         434         381          88
    22.00 New budget authority (gross)......      31,180      31,161      31,825
    22.10 Resources available from
            recoveries of prior year
            obligations.....................           2
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......      31,616      31,542      31,913
    23.95 Total new obligations.............     -31,224     -31,454     -31,823
    23.98 Unobligated balance expiring or
            withdrawn.......................         -11
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........         381          88          90
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................      28,648      28,450      28,700

    [[Page 409]]

    40.35   Appropriation permanently
              reduced.......................        -287
    41.00 Transferred to other accounts.....        -119
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............      28,242      28,450      28,700
            Spending authority from
                offsetting collections:
    58.00     Offsetting collections (cash).       2,124       2,545       2,959
    58.10     Change in uncollected customer
                payments from Federal
                sources (unexpired).........         649
                                               ---------   ---------  ----------
    58.90     Spending authority from
                offsetting collections
                (total discretionary).......       2,773       2,545       2,959
          Mandatory:

    60.00   Appropriation...................         150         150         150
    60.20   Appropriation (special fund)....          15          16          16
                                               ---------   ---------  ----------
    62.50     Appropriation (total
                mandatory)..................         165         166         166
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................      31,180      31,161      31,825
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..      29,063      29,560      30,351
    73.10 Total new obligations.............      31,224      31,454      31,823
    73.20 Total outlays (gross).............     -30,362     -30,663     -31,551
    73.40 Adjustments in expired accounts
            (net)...........................        -192
    73.45 Recoveries of prior year
            obligations.....................          -2
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................        -649
    74.10 Change in uncollected customer
            payments from Federal sources
            (expired).......................         478
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..      29,560      30,351      30,623
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................       9,862       9,658      10,162
    86.93 Outlays from discretionary
            balances........................      20,338      20,842      21,223
    86.97 Outlays from new mandatory
            authority.......................          49          40          40
    86.98 Outlays from mandatory balances...         113         123         126
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........      30,362      30,663      31,551
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

            Offsetting collections (cash)
                from:
    88.00     Federal sources...............      -2,502      -2,545      -2,959
    88.40     Non-Federal sources...........         -89
                                               ---------   ---------  ----------
    88.90     Total, offsetting collections
                (cash)......................      -2,591      -2,545      -2,959
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................        -649
    88.96   Portion of offsetting
              collections (cash) credited to
              expired accounts..............         467
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................      28,407      28,616      28,866
    90.00 Outlays...........................      27,771      28,118      28,592
    ---------------------------------------------------------------------------

        Note.--Excludes $50 million in budget authority and associated
    outlays in 2006 and 2007 for advanced development of bioterrorism
    countermeasures activities that are proposed to be financed in the
    Public Health and Social Services Emergency Fund in 2008.

             DISTRIBUTION OF BUDGET AUTHORITY AND OUTLAYS BY ACCOUNT

                              [Dollars in millions]

                                            2006         2007        2008
    Distribution of budget authority by
        account:
      National Cancer Institute...          4,747          4,793           4,782
      National Heart, Lung, and
        Blood Institute...........          2,894          2,922           2,925
      National Institute of Dental
        and Craniofacial Research.            386            389             390
      National Institute of
        Diabetes and Digestive and
        Kidney Diseases...........          1,839          1,855           1,858
      National Institute of
        Neurological Disorder and
        Stroke....................          1,520          1,535           1,537
      National Institute of
        Allergy and Infectious
        Diseases..................          4,224          4,365           4,592
      National Institute of
        General Medical Sciences..          1,917          1,936           1,941
      National Institute of Child
        Health and Human
        Development...............          1,253          1,265           1,265
      National Eye Institute......            660            667             668
      National Institute of
        Environmental Health
        Sciences..................            710            720             716
      National Institute on Aging.          1,037          1,047           1,047
      National Institute of
        Arthritis and
        Musculoskeletal and Skin
        Diseases..................            503            508             508
      National Institute on
        Deafness and Other
        Communication Disorders...            390            393             394
      National Institute of
        Nursing Research..........            136            137             138
      National Institute on
        Alcohol Abuse and
        Alcoholism................            432            436             437
      National Institute on Drug
        Abuse.....................            990          1,000           1,000
      National Institute of Mental
        Health....................          1,390          1,404           1,405
      National Center for Research
        Resources.................          1,088          1,099           1,113
      National Human Genome
        Research Institute........            481            486             484
      National Institute of
        Biomedical Imaging and
        Bioengineering............            294            297             300
      National Center for
        Complementary and
        Alternative Medicine......            120            121             122
      National Center for Minority
        Health and Health
        Disparities...............            193            195             195
      John E. Fogarty
        International Center......             66             66              67
      National Library of Medicine            312            315             313
      Office of the Director......            725            478             517
      Buildings and facilities....            175            171             136
                                        ------------------------------------
          Subtotal................         28,392         28,600          28,850
      Cooperative Research and
        Development Agreements....             15             16              16
                                        ------------------------------------
          Total Budget Authority,
            NIH...................         28,407         28,616          28,866
                                        ====================================

                              [Dollars in millions]

                                            2006         2007        2008
    Distribution of outlays by account:
      National Cancer Institute...          4,713          4,660           4,694
      National Heart, Lung, and
        Blood Institute...........          2,854          2,817           2,894
      National Institute of Dental
        and Craniofacial Research.            379            371             385
      National Institute of
        Diabetes and Digestive and
        Kidney Diseases...........          1,808          1,721           1,837
      National Institute of
        Neurological Disorders and
        Stroke....................          1,536          1,506           1,504
      National Institute of
        Allergy and Infectious
        Diseases..................          4,007          4,314           4,362
      National Institute of
        General Medical Sciences..          1,907          1,855           1,906
      National Institute of Child
        Health and Human
        Development...............          1,235          1,252           1,252
      National Eye Institute......            649            662             654
      National Institute of
        Environmental Health
        Sciences..................            728            693             712
      National Institute on Aging.          1,029          1,033           1,036
      National Institute of
        Arthritis and
        Musculoskeletal and Skin
        Diseases..................            498            496             503
      National Institute on
        Deafness and Other
        Communication Disorders...            387            372             390
      National Institute of
        Nursing Research..........            135            135             136
      National Institute on
        Alcohol Abuse and
        Alcoholism................            424            430             432
      National Institute on Drug
        Abuse.....................            979            976             981
      National Institute of Mental
        Health....................          1,412          1,331           1,390
      National Center for Research
        Resources.................          1,119          1,080           1,093
      National Human Genome
        Research Institute........            463            497             477
      National Institute of
        Biomedical Imaging and
        Bioengineering............            292            286             294
      National Center for
        Complementary and
        Alternative Medicine......            114            118             120
      National Center for Minority
        Health and Health
        Disparities...............            194            174             188
      John E, Fogarty
        International Center......             64             66              66
      National Library of Medicine            314            310             308
      Office of the Director......            479            706             756
      Buildings and Facilities....            158            247             212
      Service and Supply Fund/
        Management Fund...........          (118)              0               0
                                        ------------------------------------
          Subtotal Outlays........         27,759         28,108          28,582
      Cooperative Research and
        Development Agreements....             12             10              10
                                        ------------------------------------
          Total Outlays, NIH......         27,771         28,118          28,592
                                        ====================================

        This program funds biomedical research and research training. These
    accounts will continue to be appropriated separately, and are displayed
    in a consolidated format to improve the readability of the presentation.
    Detailed information is available through the Department of Health and
    Human Services.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9915-0-1-552      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
          Direct obligations:

            Personnel compensation:
    11.1      Full-time permanent...........         800         847         891
    11.3      Other than full-time permanent         250         264         277
    11.5      Other personnel compensation..          33          35          36
    11.7      Military personnel............          25          26          28
    11.8      Special personal services
                payments....................         169         174         178
                                               ---------   ---------  ----------
    11.9      Total personnel compensation..       1,277       1,346       1,410
    12.1    Civilian personnel benefits.....         295         312         327
    12.2    Military personnel benefits.....          17          17          18
    21.0    Travel and transportation of
              persons.......................          55          55          53
    22.0    Transportation of things........           5           5           5
    23.2    Rental payments to others.......           1           1           1
    23.3    Communications, utilities, and
              miscellaneous charges.........          29          30          30
    24.0    Printing and reproduction.......          15          14          14

    [[Page 410]]

    25.1    Advisory and assistance services         131         132         129
    25.2    Other services..................         553         522         520
    25.3    Other purchases of goods and
              services from Government
              accounts......................       2,555       2,594       2,558
    25.4    Operation and maintenance of
              facilities....................         292         298         258
    25.5    Research and development
              contracts.....................       1,976       2,090       2,243
    25.6    Medical care....................          18          17          17
    25.7    Operation and maintenance of
              equipment.....................          78          77          73
    26.0    Supplies and materials..........         223         218         208
    31.0    Equipment.......................         136         135         130
    41.0    Grants, subsidies, and
              contributions.................      20,931      20,833      20,946
                                               ---------   ---------  ----------
    99.0      Direct obligations............      28,587      28,696      28,940
    99.0  Reimbursable obligations..........       2,637       2,758       2,883
                                               ---------   ---------  ----------
    99.9    Total new obligations...........      31,224      31,454      31,823
    ---------------------------------------------------------------------------

                                 Employment Summary

    ----------------------------------------------------------------------------
    Identification code 75-9915-0-1-552      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Civilian full-time equivalent
            employment......................      11,454      11,642      11,776
    1101  Military full-time equivalent
            employment......................         285         321         358
        Reimbursable:
    2001  Civilian full-time equivalent
            employment......................       5,020       5,118       5,177
    2101  Military full-time equivalent
            employment......................         107         121         134
    ---------------------------------------------------------------------------

            SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION

                                     Federal

                   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, $3,046,426,000: 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) $21,413,000 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) $16,250,000 to carry out national surveys on drug abuse; and
    (4) $4,300,000 to evaluate substance abuse treatment programs. Pursuant
    to section 1942 of the PHS Act, a State that receives an allotment under
    section 1911 or 1921 of such Act for the current fiscal year shall
    submit data from the previous year on all developed National Outcome
    Measures. A State shall not receive more than 95 percent of the State's
    allotment as determined under section 1933 for such year if that State
    does not report on National Outcome Measures under section 1921.
    Undistributed amounts under section 1921 shall be reallocated to States
    that report on such measures under section 1921 in accordance with
    section 1944 of the PHS Act.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1362-0-1-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
          Direct program:

    00.02   Mental health block grant.......         407         407         407
    00.03   Substance abuse block grant.....       1,678       1,679       1,679
    00.05   Program management..............          75          76          77
    00.10 Children's mental health..........         104         104         104
    00.11 PATH homeless State grants........          54          54          54
    00.12 Protection and advocacy...........          34          34          34
    00.13 Mental health programs of regional
            and national significance.......         263         263         187
    00.18 Prevention programs of regional
            and national significance.......         192         193         156
    00.19 Treatment programs of regional and
            national significance...........         394         395         348
                                               ---------   ---------  ----------
    01.00   Total, direct program...........       3,201       3,205       3,046
    09.01 Reimbursable program..............         281         272         272
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       3,482       3,477       3,318
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......       3,485       3,477       3,318
    23.95 Total new obligations.............      -3,482      -3,477      -3,318
    23.98 Unobligated balance expiring or
            withdrawn.......................          -2
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................       3,238       3,205       3,046
    40.35   Appropriation permanently
              reduced.......................         -32
    41.00   Transferred to other accounts...          -2
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............       3,204       3,205       3,046
            Spending authority from
                offsetting collections:
    58.00     Offsetting collections (cash).         157         272         272
    58.10     Change in uncollected customer
                payments from Federal
                sources (unexpired).........         124
                                               ---------   ---------  ----------
    58.90     Spending authority from
                offsetting collections
                (total discretionary).......         281         272         272
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................       3,485       3,477       3,318
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..       2,600       2,589       2,590
    73.10 Total new obligations.............       3,482       3,477       3,318
    73.20 Total outlays (gross).............      -3,425      -3,476      -3,416
    73.40 Adjustments in expired accounts
            (net)...........................         -36
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................        -124
    74.10 Change in uncollected customer
            payments from Federal sources
            (expired).......................          92
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..       2,589       2,590       2,492
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................       1,431       1,554       1,491
    86.93 Outlays from discretionary
            balances........................       1,994       1,922       1,925
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       3,425       3,476       3,416
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

            Offsetting collections (cash)
                from:
    88.00     Federal sources...............        -189        -272        -272
    88.40     Non-Federal sources...........         -53
                                               ---------   ---------  ----------
    88.90     Total, offsetting collections
                (cash)......................        -242        -272        -272
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................        -124
    88.96   Portion of offsetting
              collections (cash) credited to
              expired accounts..............          85
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       3,204       3,205       3,046
    90.00 Outlays...........................       3,183       3,204       3,144
    ---------------------------------------------------------------------------

        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

    [[Page 411]]

    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      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
          Direct obligations:

            Personnel compensation:
    11.1      Full-time permanent...........          39          41          42
    11.3      Other than full-time permanent           2           3           3
    11.5      Other personnel compensation..           1           1           2
    11.7      Military personnel............           1           2           2
                                               ---------   ---------  ----------
    11.9      Total personnel compensation..          43          47          49
    12.1    Civilian personnel benefits.....           9          10          10
    12.2    Military personnel benefits.....           1           2           2
    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           1           1
    24.0    Printing and reproduction.......           5           4           3
    25.1    Advisory and assistance services          23          22          12
    25.2    Other services..................         176         169          98
    25.3    Other purchases of goods and
              services from Government
              accounts......................         100         102          75
    26.0    Supplies and materials..........           1           1           1
    41.0    Grants, subsidies, and
              contributions.................       2,832       2,839       2,787
    42.0    Insurance claims and indemnities           2           1           1
                                               ---------   ---------  ----------
    99.0      Direct obligations............       3,201       3,205       3,046
    99.0  Reimbursable obligations..........         281         272         272
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       3,482       3,477       3,318
    ---------------------------------------------------------------------------

                                 Employment Summary

    ----------------------------------------------------------------------------
    Identification code 75-1362-0-1-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Civilian full-time equivalent
            employment......................         448         452         452
    1101  Military full-time equivalent
            employment......................          17          28          28
        Reimbursable:
    2001  Civilian full-time equivalent
            employment......................          36          37          37
    2101  Military full-time equivalent
            employment......................          23          23          23
    ---------------------------------------------------------------------------

                   AGENCY FOR HEALTHCARE RESEARCH AND QUALITY

                                     Federal

                         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 $329,564,000.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1700-0-1-552      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    09.00 Reimbursable program..............         346         346         357
                                               ---------   ---------  ----------
    10.00   Total new obligations...........         346         346         357
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........          17          17          17
    22.00 New budget authority (gross)......         346         346         357
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......         363         363         374
    23.95 Total new obligations.............        -346        -346        -357
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........          17          17          17
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

            Spending authority from
                offsetting collections:
    58.00     Offsetting collections (cash).         106         346         357
    58.10     Change in uncollected customer
                payments from Federal
                sources (unexpired).........         239
                                               ---------   ---------  ----------
    58.90     Spending authority from
                offsetting collections
                (total discretionary).......         345         346         357
          Mandatory:

    60.00   Appropriation...................           1
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................         346         346         357
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..          44          45          45
    73.10 Total new obligations.............         346         346         357
    73.20 Total outlays (gross).............        -326        -346        -357
    73.40 Adjustments in expired accounts
            (net)...........................          -1
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................        -239
    74.10 Change in uncollected customer
            payments from Federal sources
            (expired).......................         221
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..          45          45          45
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................         325         346         357
    86.97 Outlays from new mandatory
            authority.......................           1
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........         326         346         357
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.00   Offsetting collections (cash)
              from: Federal sources.........        -327        -346        -357
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................        -239
    88.96   Portion of offsetting
              collections (cash) credited to
              expired accounts..............         221
    ----------------------------------------------------------------------------

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

        This activity supports the development of scientific evidence and
    tools to improve the quality, safety, and effectiveness of all aspects
    of the health care system, and initiatives to disseminate and translate
    scientific findings into health care practice.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1700-0-1-552      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
    99.0    Reimbursable obligations........         346         346         357
                                               ---------   ---------  ----------
    99.9    Total new obligations...........         346         346         357
    ---------------------------------------------------------------------------

                                 Employment Summary

    ----------------------------------------------------------------------------
    Identification code 75-1700-0-1-552      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Reimbursable:
    2001  Civilian full-time equivalent
            employment......................         279         279         286
    2101  Military full-time equivalent
            employment......................          13          13          13
    ---------------------------------------------------------------------------

                   CENTERS FOR MEDICARE AND MEDICAID SERVICES

                                     Federal

                          Grants to States for Medicaid

        For carrying out, except as otherwise provided, titles XI and XIX of
    the Social Security Act, $141,628,056,000, to remain available until
    expended.
        For making, after May 31, 2008, payments to States under title XIX
    of the Social Security Act for the last quarter of fiscal year

    [[Page 412]]

     2008, 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 2009, $67,292,669,000, 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.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0512-0-1-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 Medicaid vendor payments..........     182,284     179,054     191,109
    00.02 State and local administration....      10,490       9,882      10,015
    00.03 Vaccine purchases.................       1,974       2,905       2,762
    00.04 Incurred by providers but not yet
            reported........................       6,830       3,000       3,000
    09.01 Medicare Part B premiums..........         264         350
                                               ---------   ---------  ----------
    10.00   Total new obligations...........     201,842     195,191     206,886
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........         378      26,586
    22.00 New budget authority (gross)......     215,737     168,605     206,886
    22.10 Resources available from
            recoveries of prior year
            obligations.....................      12,313
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......     228,428     195,191     206,886
    23.95 Total new obligations.............    -201,842    -195,191    -206,886
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........      26,586
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................     156,954     105,471     141,628
    65.00   Advance appropriation...........      58,517      62,784      65,258
    69.00   Spending authority from
              offsetting collections:
              Offsetting collections (cash).         266         350
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................     215,737     168,605     206,886
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..      11,388      20,026      23,026
    73.10 Total new obligations.............     201,842     195,191     206,886
    73.20 Total outlays (gross).............    -180,891    -192,191    -203,886
    73.45 Recoveries of prior year
            obligations.....................     -12,313
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..      20,026      23,026      26,026
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................     180,513     165,605     203,886
    86.98 Outlays from mandatory balances...         378      26,586
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........     180,891     192,191     203,886
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

            Offsetting collections (cash)
                from:
    88.00     Federal sources...............        -264        -350
    88.40     Non-Federal sources...........          -2
                                               ---------   ---------  ----------
    88.90     Total, offsetting collections
                (cash)......................        -266        -350
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................     215,471     168,255     206,886
    90.00 Outlays...........................     180,625     191,841     203,886
    ---------------------------------------------------------------------------

                     Summary of Budget Authority and Outlays

                            (in millions of dollars)

                                         2006 actual  2007 est.   2008 est.
    Enacted/requested:
      Budget Authority............        215,471        168,255         206,886
      Outlays.....................        180,625        191,841         203,886
    Legislative proposal, not subject to
        PAYGO:
      Budget Authority............                                          -425
      Outlays.....................                                          -425
    Legislative proposal, subject to
        PAYGO:
      Budget Authority............                            35          -1,517
      Outlays.....................                            35          -1,517

    Total:
      Budget Authority............        215,471        168,290         204,944
      Outlays.....................        180,625        191,876         201,944

        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      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
    41.0  Direct obligations: Grants,
            subsidies, and contributions....     201,578     194,841     206,886
    99.0    Reimbursable obligations:
              reimbursable obligations......         264         350
                                               ---------   ---------  ----------
    99.9    Total new obligations...........     201,842     195,191     206,886
    ---------------------------------------------------------------------------

                          Grants to States for Medicaid

                  (Legislative proposal, not subject to PAYGO)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0512-2-1-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Offsets:
          Against gross budget authority and outlays:

    88.00   Offsetting collections (cash)
              from: Federal sources.........                                -425
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................                                -425
    90.00 Outlays...........................                                -425
    ---------------------------------------------------------------------------

        This schedule reflects the Administration's Medicaid proposal.

                          Grants to States for Medicaid

                    (Legislative proposal, subject to PAYGO)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0512-4-1-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 Administrative Services Reforms...                              -1,225
    00.02 Reimbursement Reforms.............                                -200
    00.03 Pharmacy Reforms..................                                -355
    00.04 Program Integrity Reforms.........                                 -75
    00.05 Long Term Care Reform.............                                 -70
    00.06 Authorization Extensions and
            Modifications...................                      35         460
    00.07 Other proposals...................                                -477
    09.01 Medicare Part B premiums..........                                 425
                                               ---------   ---------  ----------
    10.00   Total new obligations...........                      35      -1,517
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......                      35      -1,517
    23.95 Total new obligations.............                     -35       1,517
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................                      35      -1,942
    69.00   Spending authority from
              offsetting collections:
              Offsetting collections (cash).                                 425
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................                      35      -1,517
    ----------------------------------------------------------------------------

        Change in obligated balances:
    73.10 Total new obligations.............                      35      -1,517
    73.20 Total outlays (gross).............                     -35       1,517
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................                      35      -1,517
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................                      35      -1,517

    [[Page 413]]

    90.00 Outlays...........................                      35      -1,517
    ---------------------------------------------------------------------------

        This schedule reflects the Administration's Medicaid proposal.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0512-4-1-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
    41.0  Direct obligations: Grants,
            subsidies, and contributions....                      35      -1,942
    99.0    Reimbursable obligations:
              reimbursable obligations......                                 425
                                               ---------   ---------  ----------
    99.9    Total new obligations...........                      35      -1,517
    ---------------------------------------------------------------------------

                         State Grants and Demonstrations

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0516-0-1-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 Ticket to Work--grants............         104          50          51
    00.02 High-risk pools--grants...........          77
    00.03 Emergency health services for
            undocumented aliens.............         170         200         250
    00.04 Pilot program--background checks..          10
    00.05 State pharmaceutical assistance
            programs........................          63
    00.06 Health care infrastructure improv
            program.........................         140           2
    00.08 Medicaid Integrity Program--
            general.........................           3          52          50
    00.09 Site development grants-rural PACE           7
    00.10 Funding for PACE outliers.........                       2           3
    00.11 Drug surveys & reports............           5           5           5
    00.12 Partnerships for long term care...           3           3           3
    00.13 Alternate non-emergency network
            providers.......................                      25          12
    00.14 Psychiatric residential treatment
            demonstration...................                      21          37
    00.15 Money follows the Person (MFP)
            demonstration...................                     248         298
    00.16 MFP evaluations & technical
            support.........................                       1           2
    00.17 Medicaid transformation grants....                      75          75
    00.19 Katrina relief....................       1,864         136
    09.11 Reimbursable program-Katrina/Rita
            hurricane support...............          69           1
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       2,515         821         786
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........         381         634         520
    22.00 New budget authority (gross)......       2,636         707         764
    22.10 Resources available from
            recoveries of prior year
            obligations.....................         155
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......       3,172       1,341       1,284
    23.95 Total new obligations.............      -2,515        -821        -786
    23.98 Unobligated balance expiring or
            withdrawn.......................         -23
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........         634         520         498
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation--(P.L. 106-170,
              Sections 203 & 204)...........          82          43          44
    60.00   Appropriation--(P. L. 108-173)--
              Undocumented aliens...........         250         250         250
    60.00   Appropriation-(P.L. 108-173)--
              State pharmaceutical
              assistance programs...........          63
    60.00   Appropriation-High Risk Pools...          90
    60.00   Appropriation-Katrina Relief....       2,000
    60.00   Appropriation-Site Development
              for Rural PACE grants.........           8
    60.00   Appropriation-Rural PACE outlier
              grants........................          10
    60.00   Appropriation-Federal upper
              payment limit for multiple
              source drugs..................           5           5           5
    60.00   Appropriation-Expansion of Long-
              term Care Partnerships........           3           3           3
    60.00   Appropriation-Grants to
              establish alternate non-
              emergency services............          50
    60.00   Appropriation-Psychiatric
              Residential Treatment
              Demonstration.................                      21          37
    60.00   Appropriation-Money follows the
              Person demonstration..........                     249         298
    60.00   Appropriation-Money follows the
              Person--evaluation............                       1           2
    60.00   Appropriation-Medicaid
              Transformation grants.........                      75          75
    60.00   AppropriationMedicaid Integrity
              Program.......................           5          50          50
                                               ---------   ---------  ----------
    62.50     Appropriation (total
                mandatory)..................       2,566         697         764
    63.00   Reappropriation--Tax Relief and
              Health Care Act of 2006.......                      10
    69.00   Spending authority from
              offsetting collections:
              Offsetting collections (cash).          70
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................       2,636         707         764
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         383       1,404         545
    73.10 Total new obligations.............       2,515         821         786
    73.20 Total outlays (gross).............      -1,339      -1,680        -496
    73.45 Recoveries of prior year
            obligations.....................        -155
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..       1,404         545         835
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................       1,124         378         433
    86.98 Outlays from mandatory balances...         215       1,302          63
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       1,339       1,680         496
    ----------------------------------------------------------------------------

        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..................       2,566         707         764
    90.00 Outlays...........................       1,269       1,680         496
    ---------------------------------------------------------------------------

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

    ----------------------------------------------------------------------------
    Identification code 75-0516-0-1-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Direct loan levels supportable by subsidy
                    budget authority:
    115001Health care infrastructure
            improvement.....................         140           1
                                               ---------   ---------  ----------
    115999Total direct loan levels..........         140           1
        Direct loan subsidy (in percent):
    132001Health care infrastructure
            improvement.....................      100.00      100.00        0.00
                                               ---------   ---------  ----------
    132999Weighted average subsidy rate.....      100.00      100.00        0.00
        Direct loan subsidy budget authority:
    133001Health care infrastructure
            improvement.....................         140           1
                                               ---------   ---------  ----------
    133999Total subsidy budget authority....         140           1
        Direct loan subsidy outlays:
    134001Health care infrastructure
            improvement.....................         140           1
                                               ---------   ---------  ----------
    134999Total subsidy outlays.............         140           1
    ---------------------------------------------------------------------------

        State Grants and Demonstrations provides funding for grant programs
    established under several legislative authorities, including the Ticket
    to Work and Work Incentives Improvement Act of 1999 (P.L. 106-170), the
    Medicare Prescription Drug, Improvement, and Modernization Act of 2003
    (P.L. 108-173), and the Deficit Reduction Act of 2005 (P.L. 109-171).

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0516-0-1-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
          Direct obligations:

    11.1    Personnel compensation: Full-
              time permanent-Medicaid
              Integrity Program.............                       3           6
    12.1    Civilian personnel benefits-
              Medicaid Integrity Program....                       2           2
    41.0    Grants, subsidies, and
              contributions--Ticket to Work.         103          50          51
    41.0    Grants, subsidies, and
              contributions--High-Risk Pools          77
    41.0    Grants, subsidies, and
              contributions--Fed'l Reimb.--
              Emer Svcs, Undoc. Aliens......         170         200         250
    41.0    Grants, subsidies, and
              contributions--Background
              Checks........................          10
    41.0    Grants, subsidies, and
              contributions--State
              Pharmaceutical Assistance
              Programs......................          63
    41.0    Grants, subsidies, and
              contributions--Health Care
              Infrastructure Improvement
              Program.......................         140           2
    41.0    Grants, subsidies, and
              contributions-Medicaid
              Integrity Program.............           3          47          42
    41.0    Grants, subsidies, and
              contributions-Site Development
              Grants-Rural PACE.............           7

    [[Page 414]]

    41.0    Grants, subsidies, and
              contributions-Funding for PACE
              Outliers......................                       2           3
    41.0    Grants, subsidies, and
              contributions-Drug Surveys &
              Reports.......................           5           5           5
    41.0    Grants, subsidies, and
              contributions-Partnership for
              Long Term Care................           3           3           3
    41.0    Grants, subsidies, and
              contributions-Alternate Non-
              Emergency Network Providers...                      25          12
    41.0    Grants, subsidies, and
              contributions-Psychiatric
              Residential Treatment
              Demonstration.................                      21          37
    41.0    Grants, subsidies, and
              contributions-Money follows
              the Person (MFP) Demonstration                     248         298
    41.0    Grants, subsidies, and
              contributions-MFP Evaluations
              & Technical Support...........                       1           2
    41.0    Grants, subsidies, and
              contributions-Medicaid
              Transformation Grants.........                      75          75
    41.0    Grants, subsidies, and
              contributions-Katrina/Rita
              Hurricane Support.............                       1
    41.0    Grants, subsidies, and
              contributions-Katrina Relief..       1,864         136
                                               ---------   ---------  ----------
    99.0      Direct obligations............       2,445         821         786
    99.0  Reimbursable obligations..........          70
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       2,515         821         786
    ---------------------------------------------------------------------------

                                 Employment Summary

    ----------------------------------------------------------------------------
    Identification code 75-0516-0-1-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Civilian full-time equivalent
            employment......................                      26          53
    ---------------------------------------------------------------------------

     Health Care Infrastructure Improvement Program, Direct Loan Financing
                                     Account

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-4438-0-3-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 Health care infrastructure
            improvement program.............         140           1
                                               ---------   ---------  ----------
    10.00   Total new obligations...........         140           1
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New financing authority (gross)...         140           1
    23.95 Total new obligations.............        -140          -1
    ----------------------------------------------------------------------------

        New financing authority (gross), detail:
          Mandatory:

    69.00   Spending authority from
              offsetting collections:
              Offsetting collections (cash).         140           1
    ----------------------------------------------------------------------------

        Change in obligated balances:
    73.10 Total new obligations.............         140           1
    73.20 Financing disbursements (gross)...        -140          -1
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    87.00 Total financing disbursements
            (gross).........................         140           1
    ----------------------------------------------------------------------------

        Offsets:
          Against gross financing authority and
              financing disbursements:

    88.00   Offsetting collections (cash)
              from: Federal sources.........        -140          -1
    ----------------------------------------------------------------------------

        Net financing authority and financing
            disbursements:
    89.00 Financing authority...............
    90.00 Negative subsidy BA total [75-
            0516]...........................
    ---------------------------------------------------------------------------

                   Status of Direct Loans (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-4438-0-3-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Position with respect to appropriations act
                    limitation on obligations:
    1111  Limitation on direct loans........
    1131  Direct loan obligations exempt
            from limitation.................         140           1
                                               ---------   ---------  ----------
    1150    Total direct loan obligations...         140           1
    ----------------------------------------------------------------------------

        Cumulative balance of direct loans
                    outstanding:
    1210  Outstanding, start of year........                     140         141
    1231  Disbursements: Direct loan
            disbursements...................         140           1
    1264  Write-offs for default: Loan
            forgiveness.....................
                                               ---------   ---------  ----------
    1290    Outstanding, end of year........         140         141         141
    ---------------------------------------------------------------------------

                                 Balance Sheet (in millions of dollars)

    -----------------------------------------------------------------------------------------------
    Identification code 75-4438-0-
    3-551

    2005 actual

    2006 actual

    -----------------------------------------------------------------------------------------------
        ASSETS:
          Net value of assets related to
              post-1991 direct loans
              receivable:

    1401

    Direct loans receivable, gross

    140

    1402

    Interest receivable

    7

    1405

    Allowance for subsidy cost (-)

    -147

    1499

    Net present value of assets related to direct loans

    1999

    Total assets

        LIABILITIES:
    2999

    Total liabilities

        NET POSITION:
    3999

    Total net position

    4999

    Total liabilities and net position

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

                       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 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, $188,628,000,000.
        In addition, for making matching payments under section 1844, and
    benefit payments under 1860D-16 of the Social Security Act, not
    anticipated in budget estimates, such sums as may be necessary.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0580-0-1-571      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 Supplementary medical insurance
            (SMI)...........................     134,255     137,623     140,704
    00.02 Hospital insurance for uninsured
            (HI)............................         202         239         269
    00.03 Federal uninsured payment (HI)....         206         229         237
    00.04 Program management (HI)...........         131         175         192
    00.05 Fraud and abuse control, criminal
            fines...........................         144         200         200
    00.06 Federal payments from taxation of
            OASDI benefits (HI).............      10,319      10,810      12,245
    00.07 Fraud and abuse control, FBI......         114         118         121
    00.08 FHI trust fund, Transfers from
            general fund (civil monetary
            penalties)......................          11          22          22
    00.10 Federal contributions,
            Transitional assistance account.         229
    00.11 General Revenue for Part D
            Benefits........................      27,943      37,329      46,299
    00.12 General Revenue for Part D Federal
            Admin...........................         174         704         744
    00.14 HCFAC reimbursement...............                                 183
                                               ---------   ---------  ----------
    10.00   Total new obligations...........     173,728     187,449     201,216
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......     201,386     187,449     201,216
    23.95 Total new obligations.............    -173,728    -187,449    -201,216
    23.98 Unobligated balance expiring or
            withdrawn.......................     -27,658
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation (Tax on OASDI
              Benefits).....................      10,319      10,810      12,245
    60.00   Appropriation (HCFAC penalties,
              etc.).........................         155         222         222
    60.00   Appropriation (Subsidy for HI &
              SMI benefits, General Fund
              federal admin)................     136,087     138,970     142,146
    60.00   Appropriation (HCFAC funding)...         114         118         304

    [[Page 415]]

    60.00   Appropriation (Transitional
              Assistance Benefits)..........         339
    60.00   Appropriation (Part D State
              Eligibility Determinations)...          99
    60.00   Appropriation (Part D Drug
              Benefits).....................      54,273      37,329      46,299
                                               ---------   ---------  ----------
    62.50     Appropriation (total
                mandatory)..................     201,386     187,449     201,216
    ----------------------------------------------------------------------------

        Change in obligated balances:
    73.10 Total new obligations.............     173,728     187,449     201,216
    73.20 Total outlays (gross).............    -173,728    -187,449    -201,216
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................     173,728     187,449     201,216
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................     201,386     187,449     201,216
    90.00 Outlays...........................     173,728     187,449     201,216
    ---------------------------------------------------------------------------

                     Summary of Budget Authority and Outlays

                            (in millions of dollars)

                                         2006 actual  2007 est.   2008 est.
    Enacted/requested:
      Budget Authority............        201,386        187,449         201,216
      Outlays.....................        173,728        187,449         201,216
    Legislative proposal, not subject to
        PAYGO:
      Budget Authority............                                        -1,649
      Outlays.....................                                        -1,649

    Total:
      Budget Authority............        201,386        187,449         199,567
      Outlays.....................        173,728        187,449         199,567

        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      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Direct obligations:
    41.0  Grants, subsidies, and
            contributions...................     173,015     186,102     199,774
    42.0  Insurance claims and indemnities..         408         468         506
    94.0  Financial transfers (federal
            admin)..........................         305         879         936
                                               ---------   ---------  ----------
    99.0    Direct obligations..............     173,728     187,449     201,216
                                               ---------   ---------  ----------
    99.9    Total new obligations...........     173,728     187,449     201,216
    ---------------------------------------------------------------------------

                       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      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 Supplementary medical insurance
            (SMI)...........................                              -1,203
    00.11 General Revenue for Part D
            Benefits........................                                -446
                                               ---------   ---------  ----------
    10.00   Total new obligations (object
              class 41.0)...................                              -1,649
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......                              -1,649
    23.95 Total new obligations.............                               1,649
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation (Subsidy for HI &
              SMI benefits, General Fund
              federal admin)................                              -1,203
    60.00   Appropriation (Part D Drug
              Benefits).....................                                -446
                                               ---------   ---------  ----------
    62.50     Appropriation (total
                mandatory)..................                              -1,649
    ----------------------------------------------------------------------------

        Change in obligated balances:
    73.10 Total new obligations.............                              -1,649
    73.20 Total outlays (gross).............                               1,649
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................                              -1,649
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................                              -1,649
    90.00 Outlays...........................                              -1,649
    ---------------------------------------------------------------------------

        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 (SSA), titles XIII and XXVII of
    the Public Health Service Act, and the Clinical Laboratory Improvement
    Amendments of 1988, not to exceed $3,274,026,000, to be transferred from
    the Federal Hospital Insurance and the Federal Supplementary Medical
    Insurance Trust Funds, as authorized by section 201(g) of the SSA;
    together with all funds collected in accordance with section 353 of the
    Public Health Service Act and section 1857(e)(2) of the SSA, funds
    retained by the Secretary pursuant to section 302 of the Tax Relief and
    Health Care Act of 2006; 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
    $49,869,000, to remain available until September 30, 2009, 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 reasonable actions necessary to ensure that
    before December 15, 2008 no fewer than 15 Medicare Administrative
    Contractors will commence the duties of Medicare claims-processing
    activities and related responsibilities: Provided further, That
    $253,775,000, to remain available until September 30, 2009, 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 of Health and Human
    Services is directed to collect fees in fiscal year 2008 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.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0511-0-1-550      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
          Direct program:

    00.01   Medicare operations.............       2,208       2,225       2,304
    00.02   Federal administration..........         639         648         643
    00.03   State survey and certification..         258         258         293
    00.04   Research, demonstrations, and
              evaluation projects...........          62          48          34
    00.05   Revitalization plan.............          23          25
                                               ---------   ---------  ----------
    01.00   Total direct program............       3,190       3,204       3,274
    09.01 CLIA..............................          43          43          43
    09.03 Other reimbursements..............          34           2           2
    09.04 Coordination of benefits..........          18          30          32
    09.06 MA/PDP............................          58          69          70
                                               ---------   ---------  ----------
    09.09   Total reimbursable program......         153         144         147
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       3,343       3,348       3,421
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........         103         116          93
    22.00 New budget authority (gross)......       3,354       3,325       3,421

    [[Page 416]]

    22.10 Resources available from
            recoveries of prior year
            obligations.....................          12
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......       3,469       3,441       3,514
    23.95 Total new obligations.............      -3,343      -3,348      -3,421
    23.98 Unobligated balance expiring or
            withdrawn.......................         -10
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........         116          93          93
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    42.00   Transferred from other accounts.          40
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............          40
            Spending authority from
                offsetting collections:
    58.00     Offsetting collections (cash).       2,222       3,076       3,274
    58.00     Offsetting collections (cash).         136         144         147
    58.10     Change in uncollected customer
                payments from Federal
                sources (unexpired).........         882
                                               ---------   ---------  ----------
    58.90     Spending authority from
                offsetting collections
                (total discretionary).......       3,240       3,220       3,421
          Mandatory:

    60.00   Appropriation...................          38
    69.00   Spending authority from
              offsetting collections:
              Offsetting collections (cash).          36         105
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................       3,354       3,325       3,421
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..        -199         -94         -71
    73.10 Total new obligations.............       3,343       3,348       3,421
    73.20 Total outlays (gross).............      -3,407      -3,325      -3,421
    73.40 Adjustments in expired accounts
            (net)...........................         -18
    73.45 Recoveries of prior year
            obligations.....................         -12
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................        -882
    74.10 Change in uncollected customer
            payments from Federal sources
            (expired).......................       1,081
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..         -94         -71         -71
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................       2,349       3,220       3,421
    86.93 Outlays from discretionary
            balances........................         990
    86.97 Outlays from new mandatory
            authority.......................          68         105
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       3,407       3,325       3,421
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

            Offsetting collections (cash)
                from:
    88.00     Federal sources...............      -3,308      -3,181      -3,274
    88.00     Federal sources...............
    88.40     Non-Federal sources...........        -124        -144        -147
                                               ---------   ---------  ----------
    88.90     Total, offsetting collections
                (cash)......................      -3,432      -3,325      -3,421
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................        -882
    88.96   Portion of offsetting
              collections (cash) credited to
              expired accounts..............       1,038
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................          78
    90.00 Outlays...........................         -25
    ---------------------------------------------------------------------------

                     Summary of Budget Authority and Outlays

                            (in millions of dollars)

                                         2006 actual  2007 est.   2008 est.
    Enacted/requested:
      Budget Authority............             78
      Outlays.....................            -25
    Legislative proposal, not subject to
        PAYGO:
      Budget Authority............
      Outlays.....................

    Total:
      Budget Authority............             78
      Outlays.....................            -25

        Program management activities include funding for research, Medicare
    operations, survey and certification, Clinical Laboratory Improvement
    Amendments (CLIA), Medicare Advantage, and administrative costs. Program
    management activities also include funding for the implementation of the
    Medicare Prescription Drug, Improvement, and Modernization Act of 2003
    and the Tax Relief and Health Care Act of 2006.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0511-0-1-550      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
          Direct obligations:

            Personnel compensation:
    11.1      Full-time permanent...........         369         371         391
    11.3      Other than full-time permanent          16          13          14
    11.5      Other personnel compensation..           9           8           6
    11.7      Military personnel............           8           7           7
                                               ---------   ---------  ----------
    11.9      Total personnel compensation..         402         399         418
    12.1    Civilian personnel benefits.....          95          96          96
    12.2    Military personnel benefits.....           3           3           3
    21.0    Travel and transportation of
              persons.......................           8           9           9
    22.0    Transportation of things........           1
    23.1    Rental payments to GSA..........          23          27          28
    23.3    Communications, utilities, and
              miscellaneous charges.........          39           2           2
    24.0    Printing and reproduction.......          17           3           3
    25.1    Advisory and assistance services          38
    25.2    Other services..................         660         146          90
    25.3    Other purchases of goods and
              services from Government
              accounts......................          72           3           3
    25.4    Operation and maintenance of
              facilities....................           8
    25.5    Research and development
              contracts.....................          36          42          24
    25.6    Medical care....................       1,357       2,463       2,577
    25.7    Operation and maintenance of
              equipment.....................         359
    26.0    Supplies and materials..........           1           1           1
    31.0    Equipment.......................           7
    32.0    Land and structures.............          10          10          10
    41.0    Grants, subsidies, and
              contributions.................          54                      10
                                               ---------   ---------  ----------
    99.0      Direct obligations............       3,190       3,204       3,274
    99.0  Reimbursable obligations..........         153         144         147
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       3,343       3,348       3,421
    ---------------------------------------------------------------------------

                                 Employment Summary

    ----------------------------------------------------------------------------
    Identification code 75-0511-0-1-550      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Civilian full-time equivalent
            employment......................       4,461       4,255       4,255
    1101  Military full-time equivalent
            employment......................          93          89          89
        Reimbursable:
    2001  Civilian full-time equivalent
            employment......................          72          75          84
    ---------------------------------------------------------------------------

                               Program Management

                  (Legislative proposal, not subject to PAYGO)

        In addition, the Secretary may, contingent upon the enactment of
    authorizing legislation, charge a fee for conducting revisit surveys on
    health care facilities cited for deficiencies during initial
    certification, recertification, or substantiated complaints surveys:
    Provided, That such fees, in an amount not to exceed $35,000,000, shall
    be credited to this account as offsetting collections, to remain
    available until expended for the purpose of conducting such revisit
    surveys: Provided further, That amounts transferred to this account from
    the Federal Health Insurance and Federal Supplementary Medical Insurance
    Trust Funds for fiscal year 2008 shall be reduced by the amount credited
    to this account under this paragraph.

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0511-2-1-550      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
          Direct program:

    00.03   State survey and certification..                                 -35
                                               ---------   ---------  ----------
    01.00   Total direct program............                                 -35
    09.02 Revisit Fees......................                                  35
                                               ---------   ---------  ----------

    [[Page 417]]

    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 survey
    and certification activities. Centers for Medicare and Medicaid Services
    (CMS) would charge revisit survey fees to health care facilities cited
    for deficiencies during initial certification, recertification, or
    substantiated complaint surveys. Proposed appropriations language
    provides authority to collect and spend these fees. The amount
    appropriated from the Federal Hospital Insurance (HI) and Federal
    Supplementary Medical Insurance (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      2006 actual   2007 est.   2008 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      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 Grants to States and U.S.
            territories.....................       4,539       5,187       5,040
                                               ---------   ---------  ----------
    10.00   Total new obligations (object
              class 41.0)...................       4,539       5,187       5,040
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......       4,365       5,040       5,040
    22.30 Expired unobligated balance
            transfer to unexpired account...         174         147
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......       4,539       5,187       5,040
    23.95 Total new obligations.............      -4,539      -5,187      -5,040
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation, BBA..............       4,050       5,000       5,000
    60.00   Appropriation, BBRA for
              territories...................          32          40          40
    60.00   Appropriation, DRA 2006.........         283
                                               ---------   ---------  ----------
    62.50     Appropriation (total
                mandatory)..................       4,365       5,040       5,040
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..       7,275       4,908       4,301
    73.10 Total new obligations.............       4,539       5,187       5,040
    73.20 Total outlays (gross).............      -5,451      -5,647      -5,424
    73.40 Adjustments in expired accounts
            (net)...........................      -1,455        -147
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..       4,908       4,301       3,917
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................       1,202       2,225       2,671
    86.98 Outlays from mandatory balances...       4,249       3,422       2,753
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       5,451       5,647       5,424
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       4,365       5,040       5,040
    90.00 Outlays...........................       5,451       5,647       5,424
    ---------------------------------------------------------------------------

                     Summary of Budget Authority and Outlays

                            (in millions of dollars)

                                         2006 actual  2007 est.   2008 est.
    Enacted/requested:
      Budget Authority............          4,365          5,040           5,040
      Outlays.....................          5,451          5,647           5,424
    Legislative proposal, subject to
        PAYGO:
      Budget Authority............
      Outlays.....................                                         1,220

    Total:
      Budget Authority............          4,365          5,040           5,040
      Outlays.....................          5,451          5,647           6,644

        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      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 SCHIP Reauthorization.............                               1,220
                                               ---------   ---------  ----------
    10.00   Total new obligations (object
              class 41.0)...................                               1,220
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.30 Expired unobligated balance
            transfer to unexpired account...                               1,220
    23.95 Total new obligations.............                              -1,220
    ----------------------------------------------------------------------------

        Change in obligated balances:
    73.10 Total new obligations.............                               1,220
    73.20 Total outlays (gross).............                              -1,220
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................                               1,220
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................
    90.00 Outlays...........................                               1,220
    ---------------------------------------------------------------------------

        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      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
    01.00 Balance, start of year............                                  13
                                               ---------   ---------  ----------
    01.99 Balance, start of year............                                  13
        Receipts:
    02.00 Payments from HI, Stabilization
            fund............................                       7          10
    02.01 Payments from SMI, Stabilization
            fund............................                       6           8
                                               ---------   ---------  ----------
    02.99   Total receipts and collections..                      13          18
                                               ---------   ---------  ----------
    04.00 Total: Balances and collections...                      13          31
                                               ---------   ---------  ----------
    07.99 Balance, end of year..............                      13          31
    ---------------------------------------------------------------------------

        The Medicare Advantage (MA) Regional Stabilization Fund finances
    incentives to have MA regional plans offered in each

    [[Page 418]]

    MA region and to retain MA plans in certain regions with below national
    average MA market penetration. The Tax Relief and Health Care Act of
    2006 amended this fund.

                                   Trust Funds

                      Federal Hospital Insurance Trust Fund

              Special and Trust Fund Receipts (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 20-8005-0-7-571      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
    01.00 Balance, start of year............     259,707     281,754     294,939
                                               ---------   ---------  ----------
    01.99 Balance, start of year............     259,707     281,754     294,939
        Receipts:
    02.00 FHI trust fund, Federal employer
            contributions (FICA)............       2,722       2,839       2,965
    02.01 FHI trust fund, Postal Service
            employer contributions (FICA)...         682         694         720
    02.02 FHI trust fund, Interest received
            by trust funds..................      15,356      15,216      15,883
    02.03 FHI trust fund, Interest received
            by trust funds--legislative
            proposal not subject to PAYGO...                                 109
    02.04 FHI trust fund, Taxation on OASDI
            benefits........................      10,319      10,810      12,245
    02.05 FHI trust fund, Payment from the
            general fund for health care
            fraud and abuse control account.         114         118         121
    02.06 FHI trust fund, Transfers from
            general fund (criminal fines)...         144         200         200
    02.07 FHI trust fund, Transfers from
            general fund (civil monetary
            penalties)......................          19          22          22
    02.08 FHI trust fund, Interest payments
            by Railroad Retirement Board....          32          30          29
    02.09 FHI trust fund, Payments from the
            general fund (uninsured and
            program management).............         540         644         882
    02.20 FHI trust fund, Other proprietary
            receipts from the public........           3           1           1
    02.21 FHI trust fund, Basic premium,
            Medicare advantage..............          20          77          85
    02.22 FHI trust fund, medicare refunds..       2,088       2,100       2,200
    02.23 FHI trust fund, Premiums collected
            for uninsured individuals not
            otherwise eligible..............       2,632       2,782       2,889
    02.60 FHI trust fund, Transfers from
            general fund (FICA taxes).......     165,160     171,199     184,499
    02.61 FHI trust fund, Receipts from
            Railroad Retirement Board.......         440         459         483
    02.62 FHI trust fund, Transfers from
            general fund (SECA taxes).......      11,829      13,505      13,744
    02.63 FHI trust fund, Civil penalties
            and damages.....................         297         297         297
                                               ---------   ---------  ----------
    02.99   Total receipts and collections..     212,397     220,993     237,374
                                               ---------   ---------  ----------
    04.00 Total: Balances and collections...     472,104     502,747     532,313
        Appropriations:
    05.00 Federal hospital insurance trust
            fund............................         -29
    05.01 Federal hospital insurance trust
            fund............................      -1,832      -1,660      -1,731
    05.02 Federal hospital insurance trust
            fund............................          43
    05.03 Federal hospital insurance trust
            fund............................    -209,421    -218,221    -234,329
    05.04 Federal hospital insurance trust
            fund............................      22,059      13,185      19,642
    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................                                -109
    05.09 Federal hospital insurance trust
            fund--legislative proposal
            subject to PAYGO................                               3,309
    05.10 Health care fraud and abuse
            control account.................                                -183
    05.11 Health care fraud and abuse
            control account.................      -1,187      -1,112      -1,131
                                               ---------   ---------  ----------
    05.99   Total appropriations............    -190,367    -207,808    -214,497
    06.10 Health care fraud and abuse
            control account.................          17
                                               ---------   ---------  ----------
    07.99 Balance, end of year..............     281,754     294,939     317,816
    ---------------------------------------------------------------------------

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 20-8005-0-7-571      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 Benefit payments, HI..............     186,541     204,729     214,288
    00.02 Administration, HI................       1,950       1,783       1,849
    00.03 Quality improvement organizations,
            HI..............................         678         149         246
    00.04 Research, HI......................          11          35          35
                                               ---------   ---------  ----------
    10.00   Total new obligations...........     189,180     206,696     216,418
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......     189,151     206,696     216,418
    22.10 Resources available from
            recoveries of prior year
            obligations.....................          14
    23.33 Adjustment for changes in
            allocation......................          29
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......     189,194     206,696     216,418
    23.95 Total new obligations.............    -189,180    -206,696    -216,418
    23.98 Unobligated balance expiring or
            withdrawn.......................         -14
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.26   Appropriation (trust fund)......       1,832       1,660       1,731
    40.37   Appropriation temporarily
              reduced.......................         -43
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............       1,789       1,660       1,731
          Mandatory:

    60.26   Appropriation (trust fund)......     209,421     218,221     234,329
    60.45   Portion precluded from balances.     -22,059     -13,185     -19,642
                                               ---------   ---------  ----------
    62.50     Appropriation (total
                mandatory)..................     187,362     205,036     214,687
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................     189,151     206,696     216,418
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..      17,735      21,028      20,798
    73.10 Total new obligations.............     189,180     206,696     216,418
    73.20 Total outlays (gross).............    -185,873    -206,926    -216,512
    73.45 Recoveries of prior year
            obligations.....................         -14
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..      21,028      20,798      20,704
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................       1,429       1,370       1,430
    86.93 Outlays from discretionary
            balances........................         383         313         301
    86.97 Outlays from new mandatory
            authority.......................     167,231     188,923     197,453
    86.98 Outlays from mandatory balances...      16,830      16,320      17,328
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........     185,873     206,926     216,512
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................     189,151     206,696     216,418
    90.00 Outlays...........................     185,873     206,926     216,512
    ----------------------------------------------------------------------------

        Memorandum (non-add) entries:
    92.01 Total investments, start of year:
            Federal securities: Par value...     277,268     302,186     314,044
    92.02 Total investments, end of year:
            Federal securities: Par value...     302,186     314,044     314,041
    ---------------------------------------------------------------------------

                     Summary of Budget Authority and Outlays

                            (in millions of dollars)

                                         2006 actual  2007 est.   2008 est.
    Enacted/requested:
      Budget Authority............        189,151        206,696         216,418
      Outlays.....................        185,873        206,926         216,512
    Legislative proposal, not subject to
        PAYGO:
      Budget Authority............                                           -35
      Outlays.....................                                           -35
    Legislative proposal, subject to
        PAYGO:
      Budget Authority............                                        -3,200
      Outlays.....................                                        -3,200

    Total:
      Budget Authority............        189,151        206,696         213,183
      Outlays.....................        185,873        206,926         213,277

        The Hospital Insurance (HI) program funds the costs of hospital and
    related care for individuals age 65 or older and for eligible disabled
    people.

        The status of the trust fund is as follows:

                      Status of Funds (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 20-8005-0-7-571      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Unexpended balance, start of year:
    0100  Balance, start of year............     277,670     303,131     315,978
                                               ---------   ---------  ----------
    0199    Total balance, start of year....     277,670     303,131     315,978
        Cash income during the year:
          Current law:

            Receipts:
    1200      FHI trust fund, Federal
                employer contributions
                (FICA)......................       2,722       2,839       2,965

    [[Page 419]]

    1201      FHI trust fund, Postal Service
                employer contributions
                (FICA)......................         682         694         720
    1202      FHI trust fund, Interest
                received by trust funds.....      15,356      15,216      15,883
    1204      FHI trust fund, Taxation on
                OASDI benefits..............      10,319      10,810      12,245
    1205      FHI trust fund, Payment from
                the general fund for health
                care fraud and abuse control
                account.....................         114         118         121
    1206      FHI trust fund, Transfers from
                general fund (criminal
                fines)......................         144         200         200
    1207      FHI trust fund, Transfers from
                general fund (civil monetary
                penalties)..................          19          22          22
    1208      FHI trust fund, Interest
                payments by Railroad
                Retirement Board............          32          30          29
    1209      FHI trust fund, Payments from
                the general fund (uninsured
                and program management).....         540         644         882
            Offsetting receipts
                (proprietary):
    1220      FHI trust fund, Other
                proprietary receipts from
                the public..................           3           1           1
    1221      FHI trust fund, Basic premium,
                Medicare advantage..........          20          77          85
    1222      FHI trust fund, medicare
                refunds.....................       2,088       2,100       2,200
    1223      FHI trust fund, Premiums
                collected for uninsured
                individuals not otherwise
                eligible....................       2,632       2,782       2,889
            Offsetting governmental
                receipts:
    1260      FHI trust fund, Transfers from
                general fund (FICA taxes)...     165,160     171,199     184,499
    1261      FHI trust fund, Receipts from
                Railroad Retirement Board...         440         459         483
    1262      FHI trust fund, Transfers from
                general fund (SECA taxes)...      11,829      13,505      13,744
    1263      FHI trust fund, Civil
                penalties and damages.......         297         297         297
            Offsetting collections:
    1280      Health care fraud and abuse
                control account.............           6          10          10
    1299    Income under present law........     212,403     221,003     237,275
          Proposed legislation:

            Receipts:
    2203      FHI trust fund, Interest
                received by trust funds.....                                 109
    2299    Income under proposed
              legislation...................                                 109
                                               ---------   ---------  ----------
    3299    Total cash income...............     212,403     221,003     237,384
        Cash outgo during year:
          Current law:

    4500    Federal hospital insurance trust
              fund..........................    -185,873    -206,926    -216,512
    4501    Health care fraud and abuse
              control account...............      -1,069      -1,230      -1,324
    4599    Outgo under current law (-).....    -186,942    -208,156    -217,836
          Proposed legislation:

    5500    Federal hospital insurance trust
              fund..........................                                  35
    5501    Federal hospital insurance trust
              fund..........................                               3,200
    5599    Outgo under proposed legislation
              (-)...........................                               3,235
                                               ---------   ---------  ----------
    6599    Total cash outgo (-)............    -186,942    -208,156    -214,601
        Unexpended balance, end of year:
    8700  Uninvested balance (net), end of
            year............................         945       1,934      21,376
    8701  Invested balance, end of year.....     302,186     314,044     314,041
    8701  Invested balance, end of year.....                                  35
    8701  Invested balance, end of year.....                               3,309
                                               ---------   ---------  ----------
    8799    Total balance, end of year......     303,131     315,978     338,761
    ---------------------------------------------------------------------------

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 20-8005-0-7-571      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Direct obligations:
    41.0  Payment for Quality Improvement
            Organization (QIO) activities...         705         149         246
    42.0  Insurance claims and indemnities
            (benefits)......................     186,515     204,729     214,288
    94.0  Financial transfers...............       1,960       1,818       1,884
                                               ---------   ---------  ----------
    99.0    Direct obligations..............     189,180     206,696     216,418
                                               ---------   ---------  ----------
    99.9    Total new obligations...........     189,180     206,696     216,418
    ---------------------------------------------------------------------------

                      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      2006 actual   2007 est.   2008 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 balances.                                 -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 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      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 Benefit payments, HI..............                              -3,200
                                               ---------   ---------  ----------
    10.00   Total new obligations (object
              class 42.0)...................                              -3,200
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......                              -3,200
    23.95 Total new obligations.............                               3,200
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.26   Appropriation (trust fund)......                                 109
    60.45   Portion precluded from balances.                              -3,309
                                               ---------   ---------  ----------
    62.50     Appropriation (total
                mandatory)..................                              -3,200
    ----------------------------------------------------------------------------

        Change in obligated balances:
    73.10 Total new obligations.............                              -3,200
    73.20 Total outlays (gross).............                               3,200
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................                              -3,200
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................                              -3,200
    90.00 Outlays...........................                              -3,200
    ----------------------------------------------------------------------------

        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...                               3,309
    ---------------------------------------------------------------------------

        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, $183,000,000, to be transferred from the

    [[Page 420]]

    Federal Hospital Insurance and the Federal Supplementary Medical
    Insurance Trust Funds, as authorized by section 201(g) of the Social
    Security Act, of which $137,840,000 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 $17,530,000 is for the Department of Health and
    Human Services Office of Inspector General; of which $10,100,000 is for
    the Medicaid program integrity activities; and of which $17,530,000 is
    for the Department of Justice: Provided, That the report required by 18
    U.S.C. 1817(k)(5) for FY 2008 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      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 Medicare integrity program........         832         744         756
    00.02 FBI fraud and abuse control.......         114         118         121
    00.03 Other fraud and abuse control.....         240         250         254
                                               ---------   ---------  ----------
    00.91   Subtotal, mandatory.............       1,186       1,112       1,131
    01.01 MIP--discretionary................                                 138
    01.02 FBI--discretionary................                                   9
    01.03 Other discretionary...............                                  36
                                               ---------   ---------  ----------
    01.91   Subtotal, discretionary.........                                 183
    09.01 Reimbursable (OIG)................           8           6          10
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       1,194       1,118       1,324
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........           7           6          10
    22.00 New budget authority (gross)......       1,193       1,122       1,324
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......       1,200       1,128       1,334
    23.95 Total new obligations.............      -1,194      -1,118      -1,324
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........           6          10          10
    24.41 Special and trust fund receipts
            returned to Schedule N..........          17
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.26   Appropriation (trust fund)......                                 183
          Mandatory:

    60.26   Appropriation (trust fund)......       1,187       1,112       1,131
    69.00   Spending authority from
              offsetting collections:
              Offsetting collections (cash).           6          10          10
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................       1,193       1,122       1,324
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         228         343         231
    73.10 Total new obligations.............       1,194       1,118       1,324
    73.20 Total outlays (gross).............      -1,069      -1,230      -1,324
    73.40 Adjustments in expired accounts
            (net)...........................         -10
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..         343         231         231
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................                                 183
    86.97 Outlays from new mandatory
            authority.......................         940       1,118       1,141
    86.98 Outlays from mandatory balances...         129         112
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       1,069       1,230       1,324
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.00   Offsetting collections (cash)
              from: Federal sources.........          -6         -10         -10
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       1,187       1,112       1,314
    90.00 Outlays...........................       1,063       1,220       1,314
    ---------------------------------------------------------------------------

        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
    2007 and 2008. As required by statute, actual 2007 and 2008 agency
    distributions will be determined by the Secretary of HHS and the
    Attorney General consistent with the Administration's priorities.

                                         2006 actual  2007 est.   2008 est.
    Department of Justice, DOJ....             49             51              52
    Office of the Inspector
    General, HHS..................            160            166             169
    Other specific HHS fraud and
    abuse projects................             31             32              33
                                        ------------------------------------
          Total...................            240            249             254
                                        ====================================

        The 2008 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 $183 million for 2008 (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      2006 actual   2007 est.   2008 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
    23.3    Communications, utilities, and
              miscellaneous charges.........           1           1           1
    25.2    Other services (CMS)............          10          10          20
    25.3    Other purchases of goods and
              services from Government
              accounts (HHS)................           1           3           3
    25.3    Other purchases of goods and
              services from Government
              accounts (DoJ)................          49          51          61
    25.3    Other purchases of goods and
              services from Government
              accounts (HHS/OIG)............         160         166         187
    25.3    Other purchases of goods and
              services from Government
              accounts (HHS/AoA)............           3           3           3
    25.3    Other purchases of goods and
              services from Government
              accounts (HHS/OGC)............           5           5           5
    25.6    Medical care (CMS)..............         832         744         894
    94.0    Financial transfers.............         114         118         129
                                               ---------   ---------  ----------
    99.0      Direct obligations............       1,186       1,112       1,314
    99.0  Reimbursable obligations..........           8           6          10
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       1,194       1,118       1,324
    ---------------------------------------------------------------------------

    [[Page 421]]

                                 Employment Summary

    ----------------------------------------------------------------------------
    Identification code 75-8393-0-7-571      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Civilian full-time equivalent
            employment......................          90          93         100
    ---------------------------------------------------------------------------

               Federal Supplementary Medical Insurance Trust Fund

              Special and Trust Fund Receipts (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 20-8004-0-7-571      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
    01.00 Balance, start of year............      -1,226      10,660      19,259
                                               ---------   ---------  ----------
    01.99 Balance, start of year............      -1,226      10,660      19,259
        Receipts:
    02.00 Federal contributions, FSMI Fund..     134,255     137,623     140,704
    02.01 Federal contributions, FSMI Fund--
            legislative proposal not subject
            to PAYGO........................                              -1,203
    02.02 Interest received by trust fund,
            FSMI Fund.......................       1,452       1,998       2,451
    02.03 Interest received by trust fund,
            FSMI Fund--legislative proposal
            not subject to PAYGO............                                   8
    02.04 Interest, Medicare prescription
            drug account, FSMI..............           7          14          16
    02.05 Federal contributions,
            Transitional assistance account,
            FSMI............................         229
    02.06 Federal contribution for admin.
            contribution for admin. costs,
            prescription drug account, FSMI.         174         703         744
    02.07 Federal contributions for
            benefits, prescription drug
            account, SMI....................      27,943      37,329      46,299
    02.08 Federal contributions for
            benefits, prescription drug
            account, SMI--legislative
            proposal not subject to PAYGO...                                -446
    02.09 Miscellaneous Federal payments,
            Federal supplementary medical
            insurance trust fund............           1           2           2
    02.20 Premiums collected for Medicare
            prescription drug account, FSMI.         809       3,840       5,926
    02.21 Premiums collected for Medicare
            prescription drug account,
            FSMI--legislative proposal
            subject to PAYGO................                                 280
    02.22 Payments from States, Medicare
            prescription drug account, FSMI.       3,630       8,030       7,918
    02.23 Payments from States, Medicare
            prescription drug account,
            FSMI--legislative proposal
            subject to PAYGO................                                  91
    02.24 Basic premium, Medicare advantage,
            FSMI trust fund.................          18          68          75
    02.25 Medicare refunds, SMI.............       1,114       1,200       1,300
    02.26 Premiums collected for the aged,
            FSMI Fund.......................      35,606      39,090      41,050
    02.27 Premiums collected for the aged,
            FSMI Fund--legislative proposal
            subject to PAYGO................                                -179
    02.28 Premiums collected for the
            disabled, FSMI Fund.............       6,023       6,928       7,177
    02.29 Premiums collected for the
            disabled, FSMI Fund--legislative
            proposal subject to PAYGO.......                                 -23
                                               ---------   ---------  ----------
    02.99   Total receipts and collections..     211,261     236,825     252,190
                                               ---------   ---------  ----------
    04.00 Total: Balances and collections...     210,035     247,485     271,449
        Appropriations:
    05.00 Federal supplementary medical
            insurance trust fund............        -531
    05.01 Federal supplementary medical
            insurance trust fund............      -2,488      -2,371      -2,553
    05.02 Federal supplementary medical
            insurance trust fund............          72
    05.03 Federal supplementary medical
            insurance trust fund............    -173,234    -184,545    -190,230
    05.04 Federal supplementary medical
            insurance trust fund............      11,853       8,599       6,879
    05.05 Federal supplementary medical
            insurance trust fund--
            legislative proposal not subject
            to PAYGO........................                                -319
    05.06 Federal supplementary medical
            insurance trust fund--
            legislative proposal not subject
            to PAYGO........................                                -106
    05.07 Federal supplementary medical
            insurance trust fund--
            legislative proposal subject to
            PAYGO...........................                               1,714
    05.08 Federal supplementary medical
            insurance trust fund--
            legislative proposal subject to
            PAYGO...........................                                -464
    05.09 Transitional drug assistance,
            Federal supplementary medical
            insurance trust fund............        -194
    05.10 Medicare prescription drug
            account, Federal supplementary
            insurance trust fund............         457
    05.11 Medicare prescription drug
            account, Federal supplementary
            insurance trust fund............        -707        -726        -760
    05.12 Medicare prescription drug
            account, Federal supplementary
            insurance trust fund............     -34,626     -49,183     -60,119
    05.13 Medicare prescription drug
            account, Federal supplementary
            insurance trust fund--
            legislative proposal subject to
            PAYGO...........................                                  77
                                               ---------   ---------  ----------
    05.99   Total appropriations............    -199,398    -228,226    -245,881
    06.10 Federal supplementary medical
            insurance trust fund............          20
    06.11 Transitional drug assistance,
            Federal supplementary medical
            insurance trust fund............           3
                                               ---------   ---------  ----------
    07.99 Balance, end of year..............      10,660      19,259      25,568
    ---------------------------------------------------------------------------

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 20-8004-0-7-571      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 Benefit payments, SMI.............     160,980     175,463     183,282
    00.02 Administration, SMI...............       2,967       2,459       2,553
    00.03 Quality improvement organizations,
            SMI.............................         106          38          62
    00.04 Research, SMI.....................          11           7           7
    00.06 Transfer to Medicaid for payment
            of SMI premiums.................         264         350
                                               ---------   ---------  ----------
    10.00   Total new obligations...........     164,328     178,317     185,904
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......     163,797     178,317     185,904
    22.10 Resources available from
            recoveries of prior year
            obligations.....................          20
    23.33 Adjustment for changes in
            allocation......................         531
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......     164,348     178,317     185,904
    23.95 Total new obligations.............    -164,328    -178,317    -185,904
    23.98 Unobligated balance expiring or
            withdrawn.......................         -20
    24.41 Special and trust fund receipts
            returned to Schedule N..........          20
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.26   Appropriation (trust fund)......       2,488       2,371       2,553
    40.37   Appropriation temporarily
              reduced.......................         -72
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............       2,416       2,371       2,553
          Mandatory:

    60.26   Appropriation (trust fund)......     173,234     184,545     190,230
    60.45   Portion precluded from
              obligation....................     -11,853      -8,599      -6,879
                                               ---------   ---------  ----------
    62.50     Appropriation (total
                mandatory)..................     161,381     175,946     183,351
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................     163,797     178,317     185,904
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..      17,582      19,495      19,454
    73.10 Total new obligations.............     164,328     178,317     185,904
    73.20 Total outlays (gross).............    -162,395    -178,358    -185,906
    73.45 Recoveries of prior year
            obligations.....................         -20
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..      19,495      19,454      19,452
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................       2,037       1,916       2,063
    86.93 Outlays from discretionary
            balances........................         600         484         471
    86.97 Outlays from new mandatory
            authority.......................     143,188     158,905     166,299
    86.98 Outlays from mandatory balances...      16,570      17,053      17,073
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........     162,395     178,358     185,906
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................     163,797     178,317     185,904
    90.00 Outlays...........................     162,395     178,358     185,906
    ----------------------------------------------------------------------------

        Memorandum (non-add) entries:
    92.01 Total investments, start of year:
            Federal securities: Par value...      17,204      33,061      41,855
    92.02 Total investments, end of year:
            Federal securities: Par value...      33,061      41,855      48,750
    ---------------------------------------------------------------------------

                     Summary of Budget Authority and Outlays

                            (in millions of dollars)

                                         2006 actual  2007 est.   2008 est.
    Enacted/requested:
      Budget Authority............        163,797        178,317         185,904
      Outlays.....................        162,395        178,358         185,906
    Legislative proposal, not subject to
        PAYGO:
      Budget Authority............                                           425
      Outlays.....................                                           425
    Legislative proposal, subject to
        PAYGO:
      Budget Authority............                                        -1,250
      Outlays.....................                                        -1,250

    Total:
      Budget Authority............        163,797        178,317         185,079
      Outlays.....................        162,395        178,358         185,081

    [[Page 422]]

        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      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Unexpended balance, start of year:
    0100  Balance, start of year............      16,887      33,264      41,855
          Adjustments:

    0190    Adjustments.....................          -2
                                               ---------   ---------  ----------
    0199    Total balance, start of year....      16,885      33,264      41,855
        Cash income during the year:
          Current law:

            Receipts:
    1200      Federal contributions, FSMI
                Fund........................     134,255     137,623     140,704
    1202      Interest received by trust
                fund, FSMI Fund.............       1,452       1,998       2,451
    1204      Interest, Medicare
                prescription drug account,
                FSMI........................           7          14          16
    1205      Federal contributions,
                Transitional assistance
                account, FSMI...............         229
    1206      Federal contribution for
                admin. contribution for
                admin. costs, prescription
                drug account, FSMI..........         174         703         744
    1207      Federal contributions for
                benefits, prescription drug
                account, SMI................      27,943      37,329      46,299
    1209      Miscellaneous Federal
                payments, Federal
                supplementary medical
                insurance trust fund........           1           2           2
            Offsetting receipts
                (proprietary):
    1220      Premiums collected for
                Medicare prescription drug
                account, FSMI...............         809       3,840       5,926
    1222      Payments from States, Medicare
                prescription drug account,
                FSMI........................       3,630       8,030       7,918
    1224      Basic premium, Medicare
                advantage, FSMI trust fund..          18          68          75
    1225      Medicare refunds, SMI.........       1,114       1,200       1,300
    1226      Premiums collected for the
                aged, FSMI Fund.............      35,606      39,090      41,050
    1228      Premiums collected for the
                disabled, FSMI Fund.........       6,023       6,928       7,177
    1299    Income under present law........     211,261     236,825     253,662
          Proposed legislation:

            Receipts:
    2201      Federal contributions, FSMI
                Fund........................                              -1,203
    2203      Interest received by trust
                fund, FSMI Fund.............                                   8
    2208      Federal contributions for
                benefits, prescription drug
                account, SMI................                                -446
            Offsetting receipts (proprietary
                receipts):
    2221      Premiums collected for
                Medicare prescription drug
                account, FSMI...............                                 280
    2223      Payments from States, Medicare
                prescription drug account,
                FSMI........................                                  91
    2227      Premiums collected for the
                aged, FSMI Fund.............                                -179
    2229      Premiums collected for the
                disabled, FSMI Fund.........                                 -23
    2299    Income under proposed
              legislation...................                              -1,472
                                               ---------   ---------  ----------
    3299    Total cash income...............     211,261     236,825     252,190
        Cash outgo during year:
          Current law:

    4500    Federal supplementary medical
              insurance trust fund..........    -162,395    -178,358    -185,906
    4501    Transitional drug assistance,
              Federal supplementary medical
              insurance trust fund..........        -258
    4502    Medicare prescription drug
              account, Federal supplementary
              insurance trust fund..........     -32,229     -49,876     -60,861
    4599    Outgo under current law (-).....    -194,882    -228,234    -246,767
          Proposed legislation:

    5500    Federal supplementary medical
              insurance trust fund..........                                -425
    5501    Federal supplementary medical
              insurance trust fund..........                               1,250
    5502    Medicare prescription drug
              account, Federal supplementary
              insurance trust fund..........                                  77
    5599    Outgo under proposed legislation
              (-)...........................                                 902
                                               ---------   ---------  ----------
    6599    Total cash outgo (-)............    -194,882    -228,234    -245,865
        Unexpended balance, end of year:
    8700  Uninvested balance (net), end of
            year............................         203
    8701  Invested balance, end of year.....      33,061      41,855      48,750
    8701  Invested balance, end of year.....                                -106
    8701  Invested balance, end of year.....                                -464
                                               ---------   ---------  ----------
    8799    Total balance, end of year......      33,264      41,855      48,180
    ---------------------------------------------------------------------------

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 20-8004-0-7-571      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Direct obligations:
    41.0  Payment for Quality Improvement
            Organization (QIO) activity.....         106          38          62
    42.0  Insurance claims and indemnities..     161,244     175,813     183,282
    94.0  Financial transfers...............       2,978       2,466       2,560
                                               ---------   ---------  ----------
    99.0    Direct obligations..............     164,328     178,317     185,904
                                               ---------   ---------  ----------
    99.9    Total new obligations...........     164,328     178,317     185,904
    ---------------------------------------------------------------------------

               Federal Supplementary Medical Insurance Trust Fund

                  (Legislative proposal, not subject to PAYGO)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 20-8004-2-7-571      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.06 Transfer to Medicaid for payment
            of SMI premiums.................                                 425
                                               ---------   ---------  ----------
    10.00   Total new obligations (object
              class 42.0)...................                                 425
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......                                 425
    23.95 Total new obligations.............                                -425
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.26   Appropriation (trust fund)......                                 319
    60.28   Appropriation (previously
              unavailable)..................                                 106
                                               ---------   ---------  ----------
    62.50     Appropriation (total
                mandatory)..................                                 425
    ----------------------------------------------------------------------------

        Change in obligated balances:
    73.10 Total new obligations.............                                 425
    73.20 Total outlays (gross).............                                -425
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................                                 425
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................                                 425
    90.00 Outlays...........................                                 425
    ----------------------------------------------------------------------------

        Memorandum (non-add) entries:
    92.02 Total investments, end of year:
            Federal securities: Par value...                                -106
    ---------------------------------------------------------------------------

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

               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      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 Benefit payments, SMI.............                              -1,250
                                               ---------   ---------  ----------
    10.00   Total new obligations (object
              class 42.0)...................                              -1,250
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......                              -1,250
    23.95 Total new obligations.............                               1,250
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.26   Appropriation (trust fund)......                              -1,714
    60.28   Appropriation (unavailable
              balances).....................                                 464
                                               ---------   ---------  ----------
    62.50     Appropriation (total
                mandatory)..................                              -1,250
    ----------------------------------------------------------------------------

    [[Page 423]]

        Change in obligated balances:
    73.10 Total new obligations.............                              -1,250
    73.20 Total outlays (gross).............                               1,250
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................                              -1,250
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................                              -1,250
    90.00 Outlays...........................                              -1,250
    ----------------------------------------------------------------------------

        Memorandum (non-add) entries:
    92.02 Total investments, end of year:
            Federal securities: Par value...                                -464
    ---------------------------------------------------------------------------

        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.

     Transitional Drug Assistance, Federal Supplementary Medical Insurance
                                   Trust Fund

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-8307-0-7-571      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 Benefit payments, transitional
            drug assistance.................         194
                                               ---------   ---------  ----------
    10.00   Total new obligations (object
              class 42.0)...................         194
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......         194
    23.95 Total new obligations.............        -194
    24.41 Special and trust fund receipts
            returned to Schedule N..........           3
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.26   Appropriation (trust fund)......         194
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         125          58          58
    73.10 Total new obligations.............         194
    73.20 Total outlays (gross).............        -258
    73.40 Adjustments in expired accounts
            (net)...........................          -3
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..          58          58          58
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.93 Outlays from discretionary
            balances........................          29
    86.97 Outlays from new mandatory
            authority.......................         183
    86.98 Outlays from mandatory balances...          46
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........         258
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................         194
    90.00 Outlays...........................         258
    ---------------------------------------------------------------------------

        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. Some benefits remained available in early 2006,
    until beneficiaries had the opportunity to enroll in the voluntary
    Medicare prescription drug benefits.

       Medicare Prescription Drug Account, Federal Supplementary Medical
                              Insurance Trust Fund

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-8308-0-7-571      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 Administrative costs..............         250         736         761
    00.04 Prescription Drug Benefits........      34,626      49,173      60,118
                                               ---------   ---------  ----------
    10.00   Total new obligations...........      34,876      49,909      60,879
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......      35,333      49,909      60,879
    23.33 Adjustment for changes in
            allocation......................        -457
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......      34,876      49,909      60,879
    23.95 Total new obligations.............     -34,876     -49,909     -60,879
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.26   Appropriation (trust fund)......         707         726         760
          Mandatory:

    60.26   Appropriation (trust fund)......      34,626      49,183      60,119
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................      35,333      49,909      60,879
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         405       3,065       3,098
    73.10 Total new obligations.............      34,876      49,909      60,879
    73.20 Total outlays (gross).............     -32,229     -49,876     -60,861
    73.40 Adjustments in expired accounts
            (net)...........................          13
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..       3,065       3,098       3,116
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................         174         589         613
    86.93 Outlays from discretionary
            balances........................         337         106         127
    86.97 Outlays from new mandatory
            authority.......................      31,718      49,181      60,119
    86.98 Outlays from mandatory balances...                                   2
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........      32,229      49,876      60,861
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................      35,333      49,909      60,879
    90.00 Outlays...........................      32,229      49,876      60,861
    ---------------------------------------------------------------------------

                     Summary of Budget Authority and Outlays

                            (in millions of dollars)

                                         2006 actual  2007 est.   2008 est.
    Enacted/requested:
      Budget Authority............         35,333         49,909          60,879
      Outlays.....................         32,229         49,876          60,861
    Legislative proposal, subject to
        PAYGO:
      Budget Authority............                                           -77
      Outlays.....................                                           -77

    Total:
      Budget Authority............         35,333         49,909          60,802
      Outlays.....................         32,229         49,876          60,784

        Since January 2006, Medicare beneficiaries have had the opportunity
    to enroll in a comprehensive voluntary prescription drug benefit.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-8308-0-7-571      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Direct obligations:
    25.2  Other services....................         250         736         761
    41.0  Grants, subsidies, and
            contributions...................      34,626      49,173      60,118
                                               ---------   ---------  ----------
    99.9    Total new obligations...........      34,876      49,909      60,879
    ---------------------------------------------------------------------------

       Medicare Prescription Drug Account, Federal Supplementary Medical
                              Insurance Trust Fund

                    (Legislative proposal, subject to PAYGO)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-8308-4-7-571      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.04 Prescription Drug Benefits........                                 -77
                                               ---------   ---------  ----------
    10.00   Total new obligations (object
              class 41.0)...................                                 -77
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......                                 -77
    23.95 Total new obligations.............                                  77
    ----------------------------------------------------------------------------

    [[Page 424]]

        New budget authority (gross), detail:
          Mandatory:

    60.26   Appropriation (trust fund)......                                 -77
    ----------------------------------------------------------------------------

        Change in obligated balances:
    73.10 Total new obligations.............                                 -77
    73.20 Total outlays (gross).............                                  77
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................                                 -77
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................                                 -77
    90.00 Outlays...........................                                 -77
    ---------------------------------------------------------------------------

        The Budget proposes changes to strengthen the financing of the
    Medicare prescription drug benefit.

                     Allocation Received From Other Accounts

        Note.--Obligations incurred under allocations from other accounts
    are included in the schedule of the parent appropriation as follows:
    Centers for Medicare and Medicaid Services ``Health Care Fraud and Abuse
    Control Account.''

                    ADMINISTRATION FOR CHILDREN AND FAMILIES

                                     Federal

                     Temporary Assistance for Needy Families

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1552-0-1-609      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 State family assistance grant.....      16,479      16,489      16,489
    00.02 Territories--family assistance
            grants..........................          77          78          78
    00.04 Supplemental grants for population
            increases.......................         319         319         319
    00.06 Tribal work programs..............           8           8           8
    00.09 Healthy marriage and responsible
            fatherhood grants...............         150         150         150
                                               ---------   ---------  ----------
    10.00   Total new obligations...........      17,033      17,044      17,044
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........       5,070
    22.00 New budget authority (gross)......      11,988      17,059      17,059
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......      17,058      17,059      17,059
    23.95 Total new obligations.............     -17,033     -17,044     -17,044
    23.98 Unobligated balance expiring or
            withdrawn.......................         -25         -15         -15
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................      11,988      17,059      17,059
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..       6,334       6,414       6,140
    73.10 Total new obligations.............      17,033      17,044      17,044
    73.20 Total outlays (gross).............     -16,897     -17,318     -17,296
    73.40 Adjustments in expired accounts
            (net)...........................         -56
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..       6,414       6,140       5,888
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................      11,988      12,826      12,992
    86.98 Outlays from mandatory balances...       4,909       4,492       4,304
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........      16,897      17,318      17,296
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................      11,988      17,059      17,059
    90.00 Outlays...........................      16,897      17,318      17,296
    ---------------------------------------------------------------------------

        The Temporary Assistance for Needy Families block grant provides
    funding to States for aid to low-income families with children. The
    Budget provides funding for activities reauthorized by the Deficit
    Reduction Act of 2005 (P.L. 109-171). This includes funding for a
    healthy marriage and fatherhood grant program.

        The Budget proposes to extend supplemental grants for population
    increases. It also proposes to eliminate the separate two-parent family
    work participation rate and to require two-parent families to meet the
    50 percent work rate that single parent families adhere to.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1552-0-1-609      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Direct obligations:
    11.1  Personnel compensation: Full-time
            permanent.......................           1           2           2
    12.1  Civilian personnel benefits.......           1           1           1
    21.0  Travel and transportation of
            persons.........................           1           1           1
    23.1  Rental payments to GSA............                       1           1
    25.1  Advisory and assistance services..          19          22          22
    25.2  Other services....................           5
    25.3  Other purchases of goods and
            services from Government
            accounts........................           2           2           2
    41.0  Grants, subsidies, and
            contributions...................      17,004      17,015      17,015
                                               ---------   ---------  ----------
    99.9    Total new obligations...........      17,033      17,044      17,044
    ---------------------------------------------------------------------------

                                 Employment Summary

    ----------------------------------------------------------------------------
    Identification code 75-1552-0-1-609      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Civilian full-time equivalent
            employment......................          11          24          24
    ---------------------------------------------------------------------------

                                Contingency Fund

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1522-0-1-609      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 Contingency fund..................         107          90          91
                                               ---------   ---------  ----------
    10.00   Total new obligations (object
              class 41.0)...................         107          90          91
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........       1,900       1,793       1,703
    23.95 Total new obligations.............        -107         -90         -91
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........       1,793       1,703       1,612
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.36   Unobligated balance permanently
              reduced.......................      -1,855
    63.00   Reappropriation.................       1,855
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..          15          45          32
    73.10 Total new obligations.............         107          90          91
    73.20 Total outlays (gross).............         -77        -103         -91
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..          45          32          32
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.98 Outlays from mandatory balances...          77         103          91
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................
    90.00 Outlays...........................          77         103          91
    ---------------------------------------------------------------------------

        The Budget proposes to allow States participating in the child
    welfare program the option to access the TANF contingency fund if they
    experience increases in their foster care caseload.

    [[Page 425]]

      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), $2,949,713,000, 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 2009,
    $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.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1501-0-1-609      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 State child support administrative
            costs...........................       3,517       3,936       3,468
    00.02 Child support incentive payments..         458         471         483
    00.03 Access and visitation grants......          10          10          10
                                               ---------   ---------  ----------
    00.91   Subtotal, child support
              enforcement...................       3,985       4,417       3,961
    01.02 Payments to territories...........          59          38          38
    01.03 Repatriation......................           3           1           1
                                               ---------   ---------  ----------
    01.91   Subtotal, other payments........          62          39          39
    09.01 Offset obligations (CSE grants to
            States).........................         221           7           7
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       4,268       4,463       4,007
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........         728           7
    22.00 New budget authority (gross)......       3,543       4,406       3,957
    22.10 Resources available from
            recoveries of prior year
            obligations.....................           4          50          50
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......       4,275       4,463       4,007
    23.95 Total new obligations.............      -4,268      -4,463      -4,007
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........           7
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................       2,122       3,199       2,950
    65.00   Advance appropriation...........       1,200       1,200       1,000
    69.00   Spending authority from
              offsetting collections:
              Offsetting collections (cash).         221           7           7
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................       3,543       4,406       3,957
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         757         799         686
    73.10 Total new obligations.............       4,268       4,463       4,007
    73.20 Total outlays (gross).............      -4,222      -4,526      -4,085
    73.45 Recoveries of prior year
            obligations.....................          -4         -50         -50
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..         799         686         558
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................       3,465       3,933       3,537
    86.98 Outlays from mandatory balances...         757         593         548
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       4,222       4,526       4,085
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.40   Offsetting collections (cash)
              from: Non-Federal sources.....        -221          -7          -7
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       3,322       4,399       3,950
    90.00 Outlays...........................       4,001       4,519       4,078
    ---------------------------------------------------------------------------

                     Summary of Budget Authority and Outlays

                            (in millions of dollars)

                                         2006 actual  2007 est.   2008 est.
    Enacted/requested:
      Budget Authority............          3,322          4,399           3,950
      Outlays.....................          4,001          4,519           4,078
    Legislative proposal, subject to
        PAYGO:
      Budget Authority............                                             7
      Outlays.....................                                             7

    Total:
      Budget Authority............          3,322          4,399           3,957
      Outlays.....................          4,001          4,519           4,085

        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 2008.

                 Net Federal Costs of Child Support Enforcement

                            (In millions of dollars)

                                            2006         2007        2008
    Gross Federal share of
    collections...................         -1,055         -1,065          -1,049
    Federal incentive payments to
    States........................            458            471             483
    State child support
    administrative costs..........          3,739          3,944           3,480
    Access and visitation grants..             10             10              12
                                        ------------------------------------
        Total.....................          3,152          3,360           2,926
                                        ====================================

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1501-0-1-609      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
    41.0  Direct obligations: Grants,
            subsidies, and contributions....       4,047       4,456       4,000
    99.0    Reimbursable obligations:
              reimbursable obligations......         221           7           7
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       4,268       4,463       4,007
    ---------------------------------------------------------------------------

      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      2006 actual   2007 est.   2008 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
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................                                   7
    ----------------------------------------------------------------------------

    [[Page 426]]

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

        The legislative proposals include tools to increase child support
    collections such as intercept of gaming proceeds and data match of
    multi-state financial institutions. It also provides an increase in
    resources for the Access and Visitation Program which aims to increase
    the non-custodial parents' involvement in their children's lives.
    Additionally, new legislative proposals will provide Tribal child
    support programs with access to waivers and new enforcement and
    collections tools.

                        Low Income Home Energy Assistance

        For making payments under section 2602(b) of the Low Income Home
    Energy Act (42 U.S.C. 8621(b)), $1,500,000,000.
        For making payments under section 2604(e) of the Low Income Home
    Energy Assistance Act of 1981 (42 U.S.C. 8623(e)), $282,000,000,
    notwithstanding the emergency designation requirement of section 2602(e)
    of such Act.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1502-0-1-609      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 Direct program activity...........       3,160       2,180       1,782
                                               ---------   ---------  ----------
    10.00   Total new obligations (object
              class 41.0)...................       3,160       2,180       1,782
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........          20          19
    22.00 New budget authority (gross)......       3,159       2,161       1,782
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......       3,179       2,180       1,782
    23.95 Total new obligations.............      -3,160      -2,180      -1,782
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........          19
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation--Block............       2,000       1,980       1,500
    40.00   Appropriation--Emergency........         183         181         282
    40.35   Appropriation permanently
              reduced.......................         -22
    41.00   Transferred to other accounts...          -2
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............       2,159       2,161       1,782
          Mandatory:

    60.00   Appropriation--Block............         500
    60.00   Appropriation--Emergency........         500
                                               ---------   ---------  ----------
    62.50     Appropriation (total
                mandatory)..................       1,000
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................       3,159       2,161       1,782
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         549       1,069         606
    73.10 Total new obligations.............       3,160       2,180       1,782
    73.20 Total outlays (gross).............      -2,637      -2,635      -1,874
    73.40 Adjustments in expired accounts
            (net)...........................          -3          -8
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..       1,069         606         514
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................       1,471       1,624       1,342
    86.93 Outlays from discretionary
            balances........................         476         701         532
    86.97 Outlays from new mandatory
            authority.......................         690
    86.98 Outlays from mandatory balances...                     310
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       2,637       2,635       1,874
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       3,159       2,161       1,782
    90.00 Outlays...........................       2,637       2,635       1,874
    ---------------------------------------------------------------------------

        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 section 414 of the Immigration and
    Nationality Act and section 501 of the Refugee Education Assistance Act
    of 1980, for carrying out section 462 of the Homeland Security Act of
    2002, and for carrying out the Torture Victims Relief Act of 2003,
    $655,630,000, of which up to $14,816,000 shall be available to carry out
    the Trafficking Victims Protection 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 2008 shall be available
    for the costs of assistance provided and other activities to remain
    available through September 30, 2010 (6 U.S.C. 279; 8 U.S.C. 1522 note,
    1524; 22 U.S.C. 2152 note, 7101 et seq.).

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1503-0-1-609      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 Refugee and entrant assistance....         466         484         511
    00.02 Assistance for treatment of
            torture victims.................          10          10          10
    00.03 Unaccompanied alien children......          77          77         135
                                               ---------   ---------  ----------
    10.00   Total new obligations...........         553         571         656
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........                      18
    22.00 New budget authority (gross)......         570         553         656
    22.10 Resources available from
            recoveries of prior year
            obligations.....................           1
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......         571         571         656
    23.95 Total new obligations.............        -553        -571        -656
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........          18
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................         576         553         656
    40.35   Appropriation permanently
              reduced.......................          -6
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............         570         553         656
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         471         506         536
    73.10 Total new obligations.............         553         571         656
    73.20 Total outlays (gross).............        -510        -541        -598
    73.40 Adjustments in expired accounts
            (net)...........................          -7
    73.45 Recoveries of prior year
            obligations.....................          -1
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..         506         536         594
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................         235         232         276
    86.93 Outlays from discretionary
            balances........................         275         309         322
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........         510         541         598
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................         570         553         656
    90.00 Outlays...........................         510         541         598
    ---------------------------------------------------------------------------

        States are subsidized for administering the refugee assistance
    program. Funds are also provided to assist in the reha

    [[Page 427]]

    bilitation 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      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Direct obligations:
    11.1  Personnel compensation: Full-time
            permanent.......................           3           3           3
    23.1  Rental payments to GSA............           1           1           1
    25.1  Advisory and assistance services..          14          15          15
    25.2  Other services....................           2           3           3
    25.3  Other purchases of goods and
            services from Government
            accounts........................          10          10          14
    41.0  Grants, subsidies, and
            contributions...................         523         539         620
                                               ---------   ---------  ----------
    99.9    Total new obligations...........         553         571         656
    ---------------------------------------------------------------------------

                                 Employment Summary

    ----------------------------------------------------------------------------
    Identification code 75-1503-0-1-609      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Civilian full-time equivalent
            employment......................          26          33          33
    ---------------------------------------------------------------------------

                       Promoting Safe and Stable Families

        For carrying out section 436 of the Social Security Act,
    $345,000,000 and section 437, $89,100,000.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1512-0-1-506      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 Grants to States and Tribes.......         412         412         412
    00.02 Research, training and technical
            assistance......................           9           9           9
    00.03 State court improvement activities          33          33          33
                                               ---------   ---------  ----------
    10.00   Total new obligations...........         454         454         454
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......         454         454         454
    23.95 Total new obligations.............        -454        -454        -454
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................          90          89          89
    40.35   Appropriation permanently
              reduced.......................          -1
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............          89          89          89
          Mandatory:

    60.00   Appropriation...................         365         365         365
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................         454         454         454
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         429         451         454
    73.10 Total new obligations.............         454         454         454
    73.20 Total outlays (gross).............        -424        -451        -447
    73.40 Adjustments in expired accounts
            (net)...........................          -8
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..         451         454         461
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................          23          20          20
    86.93 Outlays from discretionary
            balances........................          73          71          66
    86.97 Outlays from new mandatory
            authority.......................          82          84          84
    86.98 Outlays from mandatory balances...         246         276         277
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........         424         451         447
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................         454         454         454
    90.00 Outlays...........................         424         451         447
    ---------------------------------------------------------------------------

        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      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Direct obligations:
    25.1  Advisory and assistance services..           4           3           3
    25.3  Other purchases of goods and
            services from Government
            accounts........................           1
    41.0  Grants, subsidies, and
            contributions...................         449         451         451
                                               ---------   ---------  ----------
    99.9    Total new obligations...........         454         454         454
    ---------------------------------------------------------------------------

                        Child Care Entitlement to States

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1550-0-1-609      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 Mandatory child care..............       1,178       1,178       1,178
    00.02 Matching child care...............       1,677       1,674       1,674
    00.03 Training and technical assistance.           7           7           7
    00.04 Child care tribal grants..........          58          58          58
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       2,920       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)......       1,926       2,917       2,917
    22.30 Expired unobligated balance
            transfer to unexpired account...           3
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......       2,920       2,917       2,917
    23.95 Total new obligations.............      -2,920      -2,917      -2,917
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................       1,926       2,917       2,917
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         877         729         818
    73.10 Total new obligations.............       2,920       2,917       2,917
    73.20 Total outlays (gross).............      -3,060      -2,828      -2,800
    73.40 Adjustments in expired accounts
            (net)...........................          -8
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..         729         818         935
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................       1,926       2,100       2,100
    86.98 Outlays from mandatory balances...       1,134         728         700
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       3,060       2,828       2,800
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       1,926       2,917       2,917
    90.00 Outlays...........................       3,060       2,828       2,800
    ---------------------------------------------------------------------------

        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      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Direct obligations:
    25.1  Advisory and assistance services..           7           7           7
    41.0  Grants, subsidies, and
            contributions...................       2,913       2,910       2,910
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       2,920       2,917       2,917
    ---------------------------------------------------------------------------

        Payments to States for the Child Care and Development Block Grant

        For carrying out the Child Care and Development Block Grant Act of
    1990 (42 U.S.C. 9858 et seq.), $2,062,081,000 shall be used to
    supplement, not supplant State general revenue funds for child

    [[Page 428]]

    care assistance for low-income families: Provided, That $18,777,370
    shall be available for child care resource and referral and school-aged
    child care activities, of which $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,
    $267,785,718 shall be reserved by the States for activities authorized
    under section 658G, of which $98,208,000 shall be for activities that
    improve the quality of infant and toddler care: Provided further, That
    $9,821,000 shall be for use by the Secretary for child care research,
    demonstration, and evaluation activities.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1515-0-1-609      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 Block grant payments to States....       2,051       2,052       2,052
    00.04 Research and evaluation fund......          10          10          10
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       2,061       2,062       2,062
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......       2,061       2,062       2,062
    23.95 Total new obligations.............      -2,061      -2,062      -2,062
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................       2,083       2,062       2,062
    40.35   Appropriation permanently
              reduced.......................         -21
    41.00   Transferred to other accounts...          -1
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............       2,061       2,062       2,062
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         710         575         610
    73.10 Total new obligations.............       2,061       2,062       2,062
    73.20 Total outlays (gross).............      -2,192      -2,024      -2,053
    73.40 Adjustments in expired accounts
            (net)...........................          -4          -3
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..         575         610         619
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................       1,553       1,526       1,526
    86.93 Outlays from discretionary
            balances........................         639         498         527
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       2,192       2,024       2,053
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       2,061       2,062       2,062
    90.00 Outlays...........................       2,192       2,024       2,053
    ---------------------------------------------------------------------------

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

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1515-0-1-609      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Direct obligations:
    25.1  Advisory and assistance services..           5           6           6
    25.3  Other purchases of goods and
            services from Government
            accounts........................           1           1           1
    41.0  Grants, subsidies, and
            contributions...................       2,055       2,055       2,055
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       2,061       2,062       2,062
    ---------------------------------------------------------------------------

                           Social Services Block Grant

        For making grants to States pursuant to section 2002 of the Social
    Security Act (42 U.S.C. 1397a), $1,200,000,000: Provided, That
    notwithstanding section 2003(c) of such Act, the amount specified for
    allocation under such section for fiscal year 2008 shall be
    $1,200,000,000.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1534-0-1-506      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 Direct program activity...........       2,250       1,700       1,200
                                               ---------   ---------  ----------
    10.00   Total new obligations (object
              class 41.0)...................       2,250       1,700       1,200
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........           4          17          17
    22.00 New budget authority (gross)......       2,250       1,700       1,200
    22.10 Resources available from
            recoveries of prior year
            obligations.....................          13
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......       2,267       1,717       1,217
    23.95 Total new obligations.............      -2,250      -1,700      -1,200
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........          17          17          17
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................                                -500
          Mandatory:

    60.00   Appropriation...................       2,250       1,700       1,700
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................       2,250       1,700       1,200
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         442         831         376
    73.10 Total new obligations.............       2,250       1,700       1,200
    73.20 Total outlays (gross).............      -1,848      -2,155      -1,306
    73.45 Recoveries of prior year
            obligations.....................         -13
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..         831         376         270
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................                                -425
    86.97 Outlays from new mandatory
            authority.......................       1,550       1,445       1,445
    86.98 Outlays from mandatory balances...         298         710         286
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       1,848       2,155       1,306
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       2,250       1,700       1,200
    90.00 Outlays...........................       1,848       2,155       1,306
    ---------------------------------------------------------------------------

                     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 of 2000, the Head Start Act, the Child Abuse Prevention
    and Treatment Act, sections 310 and 316 of the Family Violence
    Prevention and Services Act, the Native American Programs Act of 1974,
    title II of the Child Abuse Prevention and Treatment and Adoption Reform
    Act of 1978 (adoption opportunities), sections 330F and 330G of the
    Public Health Services Act, 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, 1110, and 1115 of the Social Security
    Act, sections 439(i), 473(B), and 477(i) of the Social Security Act, and
    the Assets for Independence Act, 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, the Low
    Income Home Energy Assistance Act of 1981, title IV of the Immigration
    and Nationality Act, section 501 of the Refugee Education Assistance Act
    of 1980, $8,239,709,000, of which $13,500,000, to remain available until
    September 30, 2009, shall be for grants to States for adoption incentive
    payments, as authorized by section 473A of the Social Security Act and
    may be made for adoptions completed before September 30, 2008: Provided,
    That $6,788,571,000 shall be for making payments under the Head Start
    Act, of which $1,388,800,000 shall become available October 1, 2008, and
    remain available through September 30, 2009: Provided further, That in
    addition to amounts provided herein, $5,880,000 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 $75,000,000 is for

    [[Page 429]]

    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 $15,720,000 shall be for activities authorized by the Help America
    Vote Act of 2002, of which $10,890,000 shall be for payments to States
    to promote access for voters with disabilities, and of which $4,830,000
    shall be for payments to States for protection and advocacy systems for
    voters with disabilities: Provided further, That $136,664,000 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 up to $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. (42 U.S.C. 254C-6, 254C-7, 604 note, 670 note, 673b,
    2991a et seq., 5101 et seq., 5111 et seq., 5751 et seq., 9834 et seq.,
    10409, 10416, 15001 et seq., 15424, 15462; 24 U.S.C. ch. 9.)

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1536-0-1-506      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    01.01 Head start........................       6,851       6,789       6,789
    01.03 Runaway and homeless youth (basic
            centers)........................          48          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)..          42          37
    01.08 Mentoring children of prisoners...          49          50          50
    01.09 Child abuse state grants..........          27          27          27
    01.10 Child abuse discretionary
            activities......................          26          26          36
    01.11 Community based resource centers..          42          42          42
    01.12 Child welfare services............         287         287         287
    01.13 Child welfare training............           7           7           7
    01.14 Adoption opportunities............          27          27          27
    01.15 Abandoned infants assistance......          12          12          12
    01.16 Adoption incentives...............          12          12          14
    01.17 Independent living training
            vouchers........................          46          46          46
    01.18 Children's health act programs....          13          13          13
    01.19 State councils on developmental
            disabilities....................          72          72          72
    01.20 Protection and advocacy...........          39          39          39
    01.21 Projects of national significance.          11          11          11
    01.22 University centers for excellence.          33          33          33
    01.23 Voting access for individuals with
            disabilities....................          16          16          16
    01.24 Native american programs..........          43          44          44
    01.25 Social services and income
            maintenance research............           6           6
    01.26 Compassion capital fund...........          64          64          75
    01.28 Federal administration............         183         184         197
    01.29 Center for faith-based and
            community initiatives...........           1           1           1
    01.30 Abstinence education
            (discretionary).................         109         109         137
    01.31 Interstate home study incentives..                                  10
                                               ---------   ---------  ----------
    01.91   Subtotal........................       8,121       8,057       8,088
    03.01 Community services block grant....         630         630
    03.03 Rural communtiy facilities........           7           7
    03.04 Community services discretionary
            (JOLI & CED)....................          32          32
    03.06 Assets for independence...........          25          24          24
    03.08 Domestic violence hotline.........         125           3           3
    03.09 Family violence prevention and
            services........................           3         125         125
                                               ---------   ---------  ----------
    03.91   Subtotal........................         822         821         152
                                               ---------   ---------  ----------
    04.00   Total, direct program...........       8,943       8,878       8,240
    09.01 Reimbursable program..............          14          22          17
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       8,957       8,900       8,257
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........          26           9           4
    22.00 New budget authority (gross)......       8,971       8,895       8,257
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......       8,997       8,904       8,261
    23.95 Total new obligations.............      -8,957      -8,900      -8,257
    23.98 Unobligated balance expiring or
            withdrawn.......................         -31
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........           9           4           4
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................       7,623       7,452       6,851
    40.35   Appropriation permanently
              reduced.......................         -75
    40.36   Unobligated balance permanently
              reduced.......................         -23
    41.00   Transferred to other accounts...          -5
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............       7,520       7,452       6,851
    55.00   Advance appropriation...........       1,400       1,389       1,389
    55.35   Advance appropriation
              permanently reduced...........         -14
                                               ---------   ---------  ----------
    55.90     Advance appropriation (total
                discretionary)..............       1,386       1,389       1,389
            Spending authority from
                offsetting collections:
    58.00     Offsetting collections (cash).           4          17          17
    58.10     Change in uncollected customer
                payments from Federal
                sources (unexpired).........          11
                                               ---------   ---------  ----------
    58.90     Spending authority from
                offsetting collections
                (total discretionary).......          15          17          17
          Mandatory:

    60.00   Appropriation...................          50          37
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................       8,971       8,895       8,257
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..       4,892       4,850       4,892
    73.10 Total new obligations.............       8,957       8,900       8,257
    73.20 Total outlays (gross).............      -8,882      -8,858      -8,501
    73.40 Adjustments in expired accounts
            (net)...........................        -118
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................         -11
    74.10 Change in uncollected customer
            payments from Federal sources
            (expired).......................          12
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..       4,850       4,892       4,648
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................       4,768       4,719       4,374
    86.93 Outlays from discretionary
            balances........................       4,064       4,101       4,107
    86.97 Outlays from new mandatory
            authority.......................          18          14
    86.98 Outlays from mandatory balances...          32          24          20
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       8,882       8,858       8,501
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.00   Offsetting collections (cash)
              from: Federal sources.........         -22         -17         -17
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................         -11
    88.96   Portion of offsetting
              collections (cash) credited to
              expired accounts..............          18
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       8,956       8,878       8,240
    90.00 Outlays...........................       8,860       8,841       8,484
    ---------------------------------------------------------------------------

                     Summary of Budget Authority and Outlays

                            (in millions of dollars)

                                         2006 actual  2007 est.   2008 est.
    Enacted/requested:
      Budget Authority............          8,956          8,878           8,240
      Outlays.....................          8,860          8,841           8,484
    Legislative proposal, subject to
        PAYGO:
      Budget Authority............                            13              50
      Outlays.....................                             5              25

    Total:
      Budget Authority............          8,956          8,891           8,290
      Outlays.....................          8,860          8,846           8,509

    [[Page 430]]

        The 2008 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      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
          Direct obligations:

            Personnel compensation:
    11.1      Full-time permanent...........          98         103         110
    11.3      Other than full-time permanent           5           5           6
    11.5      Other personnel compensation..           2           1           1
                                               ---------   ---------  ----------
    11.9      Total personnel compensation..         105         109         117
    12.1    Civilian personnel benefits.....          22          24          25
    21.0    Travel and transportation of
              persons.......................           4           4           4
    23.1    Rental payments to GSA..........          13          16          16
    23.3    Communications, utilities, and
              miscellaneous charges.........           2           3           5
    24.0    Printing and reproduction.......           2           2           2
    25.1    Advisory and assistance services         154         142         148
    25.2    Other services..................          11           6           6
    25.3    Other purchases of goods and
              services from Government
              accounts......................          99          70          72
    25.4    Operation and maintenance of
              facilities....................           2           2           3
    25.5    Research and development
              contracts.....................                       1           1
    26.0    Supplies and materials..........           1           1           1
    41.0    Grants, subsidies, and
              contributions.................       8,528       8,498       7,840
                                               ---------   ---------  ----------
    99.0      Direct obligations............       8,943       8,878       8,240
    99.0  Reimbursable obligations..........          14          22          17
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       8,957       8,900       8,257
    ---------------------------------------------------------------------------

                                 Employment Summary

    ----------------------------------------------------------------------------
    Identification code 75-1536-0-1-506      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Civilian full-time equivalent
            employment......................       1,156       1,157       1,196
    ---------------------------------------------------------------------------

                     Children and Families Services Programs

                    (Legislative proposal, subject to PAYGO)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1536-4-1-506      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    01.07 Abstinence education..............                      13          50
                                               ---------   ---------  ----------
    04.00   Total, direct program...........                      13          50
                                               ---------   ---------  ----------
    10.00   Total new obligations (object
              class 41.0)...................                      13          50
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......                      13          50
    23.95 Total new obligations.............                     -13         -50
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................                      13          50
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..                                   8
    73.10 Total new obligations.............                      13          50
    73.20 Total outlays (gross).............                      -5         -25
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..                       8          33
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................                       5          19
    86.98 Outlays from mandatory balances...                                   6
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........                       5          25
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................                      13          50
    90.00 Outlays...........................                       5          25
    ---------------------------------------------------------------------------

        This legislative proposal provides for an extension of the Title V
    abstinence education program.

                  Children's Research and Technical Assistance

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1553-0-1-609      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 Training and technical assistance.          12          14          12
    00.02 Federal parent locator service....          25          25          25
    00.03 Child welfare study...............           6           6           6
    00.04 Welfare research..................          15          15          15
    09.01 Reimbursable program..............          18          23          24
                                               ---------   ---------  ----------
    10.00   Total new obligations...........          76          83          82
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........           1           2
    22.00 New budget authority (gross)......          77          81          82
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......          78          83          82
    23.95 Total new obligations.............         -76         -83         -82
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........           2
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................          58          58          58
            Spending authority from
                offsetting collections:
    69.00     Offsetting collections (cash).          15          23          24
    69.10     Change in uncollected customer
                payments from Federal
                sources (unexpired).........           4
                                               ---------   ---------  ----------
    69.90     Spending authority from
                offsetting collections
                (total mandatory)...........          19          23          24
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................          77          81          82
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..          66          64          60
    73.10 Total new obligations.............          76          83          82
    73.20 Total outlays (gross).............         -72         -87         -82
    73.40 Adjustments in expired accounts
            (net)...........................          -2
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................          -4
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..          64          60          60
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................          40          44          45
    86.98 Outlays from mandatory balances...          32          43          37
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........          72          87          82
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

            Offsetting collections (cash)
                from:
    88.00     Federal sources...............         -15         -13         -14
    88.40     Non-Federal sources...........                     -10         -10
                                               ---------   ---------  ----------
    88.90     Total, offsetting collections
                (cash)......................         -15         -23         -24
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................          -4
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................          58          58          58
    90.00 Outlays...........................          57          64          58
    ---------------------------------------------------------------------------

        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      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
          Direct obligations:

    11.1    Personnel compensation: Full-
              time permanent................           7           7           7
    12.1    Civilian personnel benefits.....           1           1           1
    21.0    Travel and transportation of
              persons.......................           1           1           1

    [[Page 431]]

    23.1    Rental payments to GSA..........           3           3           3
    25.1    Advisory and assistance services          28          32          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.................           4           3           3
                                               ---------   ---------  ----------
    99.0      Direct obligations............          57          60          58
    99.0  Reimbursable obligations..........          19          23          24
                                               ---------   ---------  ----------
    99.9    Total new obligations...........          76          83          82
    ---------------------------------------------------------------------------

                                 Employment Summary

    ----------------------------------------------------------------------------
    Identification code 75-1553-0-1-609      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Civilian full-time equivalent
            employment......................          65          64          64
    ---------------------------------------------------------------------------

                             Disabled Voter Services

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1533-0-1-808      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Change in obligated balances:
    72.40 Obligated balance, start of year..          10           7           2
    73.20 Total outlays (gross).............          -3          -5          -2
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..           7           2
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.93 Outlays from discretionary
            balances........................           3           5           2
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................
    90.00 Outlays...........................           3           5           2
    ---------------------------------------------------------------------------

           Payments to States for Foster Care and Adoption Assistance

        For making payments to States or other non-Federal entities under
    title IV-E of the Social Security Act, $5,067,000,000.
        For making payments to States or other non-Federal entities under
    title IV-E of the Act, for the first quarter of fiscal year 2009,
    $1,776,000,000.
        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.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1545-0-1-609      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 Foster care.......................       4,325       4,475       4,581
    00.02 Independent living................         140         140         140
    00.04 Adoption assistance...............       1,792       2,027       2,156
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       6,257       6,642       6,877
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......       6,620       6,941       6,877
    23.95 Total new obligations.............      -6,257      -6,642      -6,877
    23.98 Unobligated balance expiring or
            withdrawn.......................        -363        -299
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................       4,853       5,211       5,067
    65.00   Advance appropriation...........       1,767       1,730       1,810
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................       6,620       6,941       6,877
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..       1,003         917       1,026
    73.10 Total new obligations.............       6,257       6,642       6,877
    73.20 Total outlays (gross).............      -6,353      -6,533      -6,821
    73.40 Adjustments in expired accounts
            (net)...........................          10
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..         917       1,026       1,082
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................       5,537       5,795       6,005
    86.98 Outlays from mandatory balances...         816         738         816
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       6,353       6,533       6,821
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

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

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

        Net budget authority and outlays:
    89.00 Budget authority..................       6,620       6,941       6,877
    90.00 Outlays...........................       6,352       6,533       6,821
    ---------------------------------------------------------------------------

                     Summary of Budget Authority and Outlays

                            (in millions of dollars)

                                         2006 actual  2007 est.   2008 est.
    Enacted/requested:
      Budget Authority............          6,620          6,941           6,877
      Outlays.....................          6,352          6,533           6,821
    Legislative proposal, subject to
        PAYGO:
      Budget Authority............                                            15
      Outlays.....................                                            13

    Total:
      Budget Authority............          6,620          6,941           6,892
      Outlays.....................          6,352          6,533           6,834

        Foster care.--The proposed level will support eligible low-income
    children who must be placed outside the home. An average of 211,000
    children per month will be served in 2008.

        Adoption assistance.--The proposed funding level will support
    subsidies for families adopting eligible low-income children with
    special needs. An average of 426,900 children per month will be served
    in 2008.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1545-0-1-609      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Direct obligations:
    25.1  Advisory and assistance services..           9          11          11
    25.3  Other purchases of goods and
            services from Government
            accounts........................           1           1           1
    41.0  Grants, subsidies, and
            contributions...................       6,247       6,630       6,865
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       6,257       6,642       6,877
    ---------------------------------------------------------------------------

                                 Employment Summary

    ----------------------------------------------------------------------------
    Identification code 75-1545-0-1-609      2006 actual   2007 est.   2008 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      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 Foster care.......................                                  12
    00.04 Adoption assistance...............                                   3
                                               ---------   ---------  ----------
    10.00   Total new obligations...........                                  15
    ----------------------------------------------------------------------------

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

        New budget authority (gross), detail:
          Mandatory:

    [[Page 432]]

    60.00   Appropriation...................                                  15
    ----------------------------------------------------------------------------

        Change in obligated balances:
    73.10 Total new obligations.............                                  15
    73.20 Total outlays (gross).............                                 -13
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..                                   2
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................                                  13
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................                                  15
    90.00 Outlays...........................                                  13
    ---------------------------------------------------------------------------

        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      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Direct obligations:
    21.0  Travel and transportation of
            persons.........................                                   1
    25.1  Advisory and assistance services..                                   3
    25.5  Research and development contracts                                   1
    41.0  Grants, subsidies, and
            contributions...................                                  10
                                               ---------   ---------  ----------
    99.9    Total new obligations...........                                  15
    ---------------------------------------------------------------------------

                             ADMINISTRATION ON AGING

                                     Federal

                             Aging Services Programs

        For carrying out, to the extent not otherwise provided, the Older
    Americans Act of 1965, as amended, $1,335,146,000.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0142-0-1-506      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    01.01 Home and community-based
            supportive services.............         350         351         351
    01.02 Preventive health services........          21          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.....         385         385         383
    01.06 Home-delivered nutrition services.         182         182         181
    01.07 Nutrition services incentive
            program.........................         148         148         147
    01.08 Native American nutrition and
            supportive services.............          26          26          26
    01.09 Program innovations...............          25          25          36
    01.10 Aging network support activities..          13          13          13
    01.11 Long-term care ombudsmen program..          15          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          19
    01.15 White House Conference on Aging...           3
                                               ---------   ---------  ----------
    02.00   Total, direct program...........       1,365       1,363       1,335
    09.01 Reimbursable program..............           4           4           4
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       1,369       1,367       1,339
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........           4                       4
    22.00 New budget authority (gross)......       1,366       1,371       1,339
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......       1,370       1,371       1,343
    23.95 Total new obligations.............      -1,369      -1,367      -1,339
    23.98 Unobligated balance expiring or
            withdrawn.......................          -1
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........                       4           4
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................       1,377       1,367       1,335
    40.35   Appropriation permanently
              reduced.......................         -14
    41.00   Transferred to other accounts...          -1
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............       1,362       1,367       1,335
            Spending authority from
                offsetting collections:
    58.00     Offsetting collections (cash).           1           4           4
    58.10     Change in uncollected customer
                payments from Federal
                sources (unexpired).........           3
                                               ---------   ---------  ----------
    58.90     Spending authority from
                offsetting collections
                (total discretionary).......           4           4           4
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................       1,366       1,371       1,339
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         560         541         556
    73.10 Total new obligations.............       1,369       1,367       1,339
    73.20 Total outlays (gross).............      -1,385      -1,352      -1,346
    73.40 Adjustments in expired accounts
            (net)...........................           4
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................          -3
    74.10 Change in uncollected customer
            payments from Federal sources
            (expired).......................          -4
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..         541         556         549
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................         902         888         867
    86.93 Outlays from discretionary
            balances........................         483         464         479
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       1,385       1,352       1,346
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.00   Offsetting collections (cash)
              from: Federal sources.........          -6          -4          -4
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................          -3
    88.96   Portion of offsetting
              collections (cash) credited to
              expired accounts..............           5
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       1,362       1,367       1,335
    90.00 Outlays...........................       1,379       1,348       1,342
    ---------------------------------------------------------------------------
        Note.--The reimbursable program (HCFAC) in the Administration on
    Aging (AoA) reflects the estimated distribution of the allocation
    account for 2007 and 2008. Actual 2007 and 2008 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 Budget will fund the Choices for Independence demonstration
    first proposed in the 2007 Budget 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      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
          Direct obligations:

            Personnel compensation:
    11.1      Full-time permanent...........          10          11          12
    11.3      Other than full-time permanent           1
                                               ---------   ---------  ----------
    11.9      Total personnel compensation..          11          11          12
    12.1    Civilian personnel benefits.....           2           2           2

    [[Page 433]]

    21.0    Travel and transportation of
              persons.......................           1
    23.1    Rental payments to GSA..........           2           2           2
    25.1    Advisory and assistance services          10           8           7
    25.3    Other purchases of goods and
              services from Government
              accounts......................           7           7           7
    41.0    Grants, subsidies, and
              contributions.................       1,332       1,333       1,305
                                               ---------   ---------  ----------
    99.0      Direct obligations............       1,365       1,363       1,335
    99.0  Reimbursable obligations..........           4           4           4
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       1,369       1,367       1,339
    ---------------------------------------------------------------------------

                                 Employment Summary

    ----------------------------------------------------------------------------
    Identification code 75-0142-0-1-506      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Civilian full-time equivalent
            employment......................         113         104         109
        Reimbursable:
    2001  Civilian full-time equivalent
            employment......................          10          11          11
    ---------------------------------------------------------------------------

                             DEPARTMENTAL MANAGEMENT

                                     Federal

                             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, $386,705,000, 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 $46,756,000
    from the amounts available under section 241 of the Public Health
    Service Act to carry out national health or human services research and
    evaluation activities: Provided, That of the funds made available under
    this heading for carrying out title XX of the Public Health Service Act,
    $13,120,000 shall be for activities specified under section 2003(b)(2),
    all of which shall be for prevention service demonstration grants under
    section 510(b)(2) of title V of the Social Security Act, as amended,
    without application of the limitation of section 2010(c) of said title
    XX: Provided further, That of this amount, $51,891,000 shall be for
    minority AIDS prevention and treatment activities; $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; and up to $4,000,000 may be used by the Secretary
    of Health and Human Services to meet unanticipated needs of Departmental
    programs.

                             Office for Civil Rights

        For expenses necessary for the Office for Civil Rights, $33,748,000,
    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.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9912-0-1-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 General departmental management...         356         351         386
    00.02 Office for Civil Rights...........          31          31          34
    09.01 Reimbursable program..............         220         234         244
    09.02 Reimbursable program (HCFAC)......           5           5           5
                                               ---------   ---------  ----------
    10.00   Total new obligations...........         612         621         669
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........           2           2
    22.00 New budget authority (gross)......         612         619         669
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......         614         621         669
    23.95 Total new obligations.............        -612        -621        -669
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........           2
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................         384         380         420
    40.35   Appropriation permanently
              reduced.......................          -4
    42.00   Transferred from other accounts.           7
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............         387         380         420
            Spending authority from
                offsetting collections:
    58.00     Offsetting collections (cash).         111         234         244
    58.00     Offsetting collections (cash).           5           5           5
    58.10     Change in uncollected customer
                payments from Federal
                sources (unexpired).........         109
                                               ---------   ---------  ----------
    58.90     Spending authority from
                offsetting collections
                (total discretionary).......         225         239         249
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................         612         619         669
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         326         294         314
    73.10 Total new obligations.............         612         621         669
    73.20 Total outlays (gross).............        -622        -601        -645
    73.40 Adjustments in expired accounts
            (net)...........................         -18
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................        -109
    74.10 Change in uncollected customer
            payments from Federal sources
            (expired).......................         105
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..         294         314         338
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................         328         440         471
    86.93 Outlays from discretionary
            balances........................         294         161         174
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........         622         601         645
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.00   Offsetting collections (cash)
              from: Federal sources.........        -207        -239        -249
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................        -109
    88.96   Portion of offsetting
              collections (cash) credited to
              expired accounts..............          91
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................         387         380         420
    90.00 Outlays...........................         415         362         396
    ---------------------------------------------------------------------------
        Note.--The reimbursable program (HCFAC) in Departmental Management
    reflects the estimated distribution from the allocation account for 2007
    and 2008. Actual 2007 and 2008 distributions will be determined by the
    Secretary of HHS and the Attorney General.

                             Departmental Management

                              (Dollars in millions)

                                         2006 actual  2007 est.   2008 est.
    Distribution of budget authority by
        account:
      General Departmental
        Management................            356            349             386
      Office for Civil Rights.....             31             31              34
    Distribution of outlays by account:
      General Departmental
        Management................            459            330             362
      Office for Civil Rights.....             36             32              34

        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      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
          Direct obligations:

    [[Page 434]]

            Personnel compensation:
    11.1      Full-time permanent...........          99         106         111
    11.3      Other than full-time permanent          10           4           4
    11.5      Other personnel compensation..           2           2           2
    11.7      Military personnel............           4           4          20
                                               ---------   ---------  ----------
    11.9      Total personnel compensation..         115         116         137
    12.1    Civilian personnel benefits.....          29          31          32
    12.2    Military personnel benefits.....           1           1           6
    21.0    Travel and transportation of
              persons.......................           3           3           3
    23.1    Rental payments to GSA..........          20          24          26
    23.3    Communications, utilities, and
              miscellaneous charges.........           4           4           4
    24.0    Printing and reproduction.......           2           1           1
    25.1    Advisory and assistance services          19          18          20
    25.2    Other services..................          32          26          32
    25.3    Other purchases of goods and
              services from Government
              accounts......................          45          35          42
    25.4    Operation and maintenance of
              facilities....................           5           4           4
    25.7    Operation and maintenance of
              equipment.....................           5           4           4
    26.0    Supplies and materials..........           3           3           2
    31.0    Equipment.......................           2           2           1
    41.0    Grants, subsidies, and
              contributions.................         102         110         106
                                               ---------   ---------  ----------
    99.0      Direct obligations............         387         382         420
    99.0  Reimbursable obligations..........         225         239         249
                                               ---------   ---------  ----------
    99.9    Total new obligations...........         612         621         669
    ---------------------------------------------------------------------------

                                 Employment Summary

    ----------------------------------------------------------------------------
    Identification code 75-9912-0-1-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Civilian full-time equivalent
            employment......................       1,228       1,174       1,182
    1101  Military full-time equivalent
            employment......................          71          77         171
        Reimbursable:
    2001  Civilian full-time equivalent
            employment......................         340         345         404
    ---------------------------------------------------------------------------

      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,
    $89,872,000: Provided, That in addition to amounts provided herein,
    $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.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0130-0-1-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 Health information technology.....          42          42          90
    09.01 Reimbursable program..............          24          24          33
                                               ---------   ---------  ----------
    10.00   Total new obligations...........          66          66         123
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......          67          66         123
    23.95 Total new obligations.............         -66         -66        -123
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................          43          42          90
            Spending authority from
                offsetting collections:
    58.00     Offsetting collections (cash).           2          24          33
    58.10     Change in uncollected customer
                payments from Federal
                sources (unexpired).........          22
                                               ---------   ---------  ----------
    58.90     Spending authority from
                offsetting collections
                (total discretionary).......          24          24          33
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................          67          66         123
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..                      27          34
    73.10 Total new obligations.............          66          66         123
    73.20 Total outlays (gross).............         -17         -59         -90
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................         -22
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..          27          34          67
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................          17          39          65
    86.93 Outlays from discretionary
            balances........................                      20          25
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........          17          59          90
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.00   Offsetting collections (cash)
              from: Federal sources.........          -2         -24         -33
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................         -22
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................          43          42          90
    90.00 Outlays...........................          15          35          57
    ---------------------------------------------------------------------------

        This program supports coordination of Federal health information
    technology activities, and Federal initiatives for the 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]

                                         2006 actual  2007 est.   2008 est.
    Distribution of funding by account:
        National Coordinator for
          Health Information
          Technology..............             61             61             118
        General Departmental
          Management..............              1              4               2
        Agency for Healthcare
          Research and Quality....             50             50              45
        HIT Initiative Total......            112            115             165
        Federal Health
          Architecture............              5              5               5

        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      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
          Direct obligations:

    11.1    Personnel compensation: Full-
              time permanent................           1           3           4
    12.1    Civilian personnel benefits.....                       1           1
    25.1    Advisory and assistance services          23          22          36
    25.2    Other services..................          18          16          49
                                               ---------   ---------  ----------
    99.0      Direct obligations............          42          42          90
    99.0  Reimbursable obligations..........          24          24          33
                                               ---------   ---------  ----------
    99.9    Total new obligations...........          66          66         123
    ---------------------------------------------------------------------------

                                 Employment Summary

    ----------------------------------------------------------------------------
    Identification code 75-0130-0-1-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Civilian full-time equivalent
            employment......................           5          27          37
    1101  Military full-time equivalent
            employment......................           1           1           1
    ---------------------------------------------------------------------------

    [[Page 435]]

                     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), $70,000,000, to be transferred in
    appropriate part from the Federal Hospital Insurance and the Federal
    Supplementary Medical Insurance Trust Funds.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0139-0-1-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 Direct program activity...........          59          59          70
                                               ---------   ---------  ----------
    10.00   Total new obligations...........          59          59          70
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......          59          59          70
    23.95 Total new obligations.............         -59         -59         -70
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    58.00   Spending authority from
              offsetting collections:
              Offsetting collections (cash).          59          59          70
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..                      30          31
    73.10 Total new obligations.............          59          59          70
    73.20 Total outlays (gross).............         -29         -58         -83
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..          30          31          18
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................          29          44          53
    86.93 Outlays from discretionary
            balances........................                      14          30
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........          29          58          83
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.00   Offsetting collections (cash)
              from: Federal sources.........         -59         -59         -70
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................
    90.00 Outlays...........................         -30          -1          13
    ---------------------------------------------------------------------------

        This activity funds the Office of Medicare Hearings and Appeals
    (OMHA), as directed by Medicare Prescription Drug, Improvement, and
    Modernization Act of 2003. OMHA provides the basic mechanisms through
    which individuals and organizations who are dissatisfied with Medicare
    determinations affecting their rights to, or their participation in, the
    Medicare program may administratively appeal these determinations, in
    accordance with the requirements of the Administrative Procedures Act
    and the Social Security Act.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0139-0-1-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Direct obligations:
    11.1  Personnel compensation: Full-time
            permanent.......................          20          28          30
    12.1  Civilian personnel benefits.......           6           7           9
    23.1  Rental payments to GSA............           7           7           7
    23.3  Communications, utilities, and
            miscellaneous charges...........           1           1           1
    25.1  Advisory and assistance services..           1           1           1
    25.2  Other services....................          15           6          13
    25.3  Other purchases of goods and
            services from Government
            accounts........................           6           6           6
    25.4  Operation and maintenance of
            facilities......................           1           1           1
    26.0  Supplies and materials............           1           1           1
    31.0  Equipment.........................           1           1           1
                                               ---------   ---------  ----------
    99.9    Total new obligations...........          59          59          70
    ---------------------------------------------------------------------------

                                 Employment Summary

    ----------------------------------------------------------------------------
    Identification code 75-0139-0-1-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Civilian full-time equivalent
            employment......................         274         360         382
    ---------------------------------------------------------------------------

                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 for other public health
    emergencies, $780,646,000, of which not to exceed $22,338,000, to remain
    available until September 30, 2009, is to pay the costs described in
    section 319F-2(c)(7)(B) of the Public Health Service Act.
        For expenses necessary to prepare for and respond to an influenza
    pandemic, $948,091,000, of which $870,000,000 shall be available until
    expended, for activities including the development and purchase of
    vaccine, antivirals, necessary medical supplies, diagnostics, and other
    surveillance tools: Provided, 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 funds
    appropriated herein 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.
        For expenses to provide screening and treatment for first response
    emergency services personnel related to the September 11, 2001,
    terrorist attacks on the World Trade Center, $25,000,000 shall be
    available until expended.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0140-0-1-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 Public Health and Social Services
            Emergency Fund..................       2,466       3,548       1,754
    09.01 Reimbursable program..............         980          54          54
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       3,446       3,602       1,808
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........          52       3,278          10
    22.00 New budget authority (gross)......       6,658         304       1,808
    22.10 Resources available from
            recoveries of prior year
            obligations.....................          15
    22.22 Unobligated balance transferred
            from other accounts.............                      30
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......       6,725       3,612       1,818
    23.95 Total new obligations.............      -3,446      -3,602      -1,808
    23.98 Unobligated balance expiring or
            withdrawn.......................          -1
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........       3,278          10          10
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................       5,713         208       1,754
    40.35   Appropriation permanently
              reduced.......................         -11
    40.36   Unobligated balance permanently
              reduced.......................                      -5
    41.00   Transferred to other accounts...         -30
    42.00   Transferred from other accounts.                      47
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............       5,672         250       1,754
            Spending authority from
                offsetting collections:
    58.00     Offsetting collections (cash).           6          54          54
    58.10     Change in uncollected customer
                payments from Federal
                sources (unexpired).........         980
                                               ---------   ---------  ----------
    58.90     Spending authority from
                offsetting collections
                (total discretionary).......         986          54          54
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................       6,658         304       1,808
    ----------------------------------------------------------------------------

    [[Page 436]]

        Change in obligated balances:
    72.40 Obligated balance, start of year..       3,342       3,386       4,192
    73.10 Total new obligations.............       3,446       3,602       1,808
    73.20 Total outlays (gross).............      -2,406      -2,796      -2,717
    73.40 Adjustments in expired accounts
            (net)...........................          -7
    73.45 Recoveries of prior year
            obligations.....................         -15
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................        -980
    74.10 Change in uncollected customer
            payments from Federal sources
            (expired).......................           6
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..       3,386       4,192       3,283
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................         663          77         211
    86.93 Outlays from discretionary
            balances........................       1,743       2,719       2,506
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       2,406       2,796       2,717
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.00   Offsetting collections (cash)
              from: Federal sources.........         -12         -54         -54
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................        -980
    88.96   Portion of offsetting
              collections (cash) credited to
              expired accounts..............           6
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       5,672         250       1,754
    90.00 Outlays...........................       2,394       2,742       2,663
    ---------------------------------------------------------------------------
        Note.--Activities financed under the Office of the Director at NIH
    for the advanced development of medical countermeasures in 2006 and 2007
    are proposed to be financed in this account in 2008 and are presented in
    these schedules on a three year comparable basis.

        The Public Health and Social Services Emergency Fund (PHSSEF)
    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, PHSSEF includes funding for the Office
    of the Assistant Secretary for Preparedness and Response (ASPR), as
    authorized by the Pandemic and All-Hazards Preparedness Act. Funds will
    be used for the advanced development of pandemic and biodefense
    countermeasures, hospital preparedness and other emergency preparedness
    activities including the National Disaster Medical System that was
    transferred to HHS from the Department of Homeland Security in January
    2007.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0140-0-1-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
          Direct obligations:

            Personnel compensation:
    11.1      Full-time permanent...........           7          15          31
    11.3      Other than full-time permanent           1          10          10
    11.5      Other personnel compensation..                       2           1
    11.7      Military personnel............           3           3           4
                                               ---------   ---------  ----------
    11.9      Total personnel compensation..          11          30          46
    12.1    Civilian personnel benefits.....           2           6          13
    12.2    Military personnel benefits.....           1           1           1
    21.0    Travel and transportation of
              persons.......................           2           8           6
    23.1    Rental payments to GSA..........           3           8           8
    23.2    Rental payments to others.......                       2           3
    23.3    Communications, utilities, and
              miscellaneous charges.........           1           2           3
    25.1    Advisory and assistance services          11          13          20
    25.2    Other services..................       1,024       2,536         810
    25.3    Other purchases of goods and
              services from Government
              accounts......................         135         228         291
    25.4    Operation and maintenance of
              facilities....................           2           2           2
    25.7    Operation and maintenance of
              equipment.....................           3           4           4
    26.0    Supplies and materials..........                       2           2
    31.0    Equipment.......................           3           5          19
    41.0    Grants, subsidies, and
              contributions.................          27          26         426
                                               ---------   ---------  ----------
    99.0      Direct obligations............       1,225       2,873       1,654
    99.0  Reimbursable obligations..........         980          54          54
          Allocation Account--direct:

            Personnel compensation:
    11.1      Full-time permanent...........           5           4
    11.3      Other than full-time permanent           3           1
    11.7      Military personnel............           2           1
                                               ---------   ---------  ----------
    11.9      Total personnel compensation..          10           6
    12.1    Civilian personnel benefits.....           2           1
    12.2    Military personnel benefits.....           1           1
    21.0    Travel and transportation of
              persons.......................           1           1
    22.0    Transportation of things........           2           1
    23.1    Rental payments to GSA..........          24          13
    23.3    Communications, utilities, and
              miscellaneous charges.........           1           1           1
    25.1    Advisory and assistance services          33          21          32
    25.2    Other services..................           9           8          17
    25.3    Other purchases of goods and
              services from Government
              accounts......................          44          24          29
    25.4    Operation and maintenance of
              facilities....................           1           1
    25.5    Research and development
              contracts.....................          14          13
    26.0    Supplies and materials..........         688         363          11
    31.0    Equipment.......................          16           9
    41.0    Grants, subsidies, and
              contributions.................         395         212          10
                                               ---------   ---------  ----------
    99.0      Allocation account--direct....       1,241         675         100
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       3,446       3,602       1,808
    ---------------------------------------------------------------------------

                                 Employment Summary

    ----------------------------------------------------------------------------
    Identification code 75-0140-0-1-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Civilian full-time equivalent
            employment......................          66         222         343
    1101  Military full-time equivalent
            employment......................          38          48          99
    ---------------------------------------------------------------------------

                           Nonrecurring Expenses Fund

        There is hereby established in the Treasury of the United States a
    fund to be known as the ``Nonrecurring expenses fund'' (the Fund):
    Provided, That unobligated balances of expired discretionary funds
    appropriated for this or any succeeding fiscal year from the General
    Fund of the Treasury to the Department of Health and Human Services by
    this or any other Act may be transferred (not later than the end of the
    fifth fiscal year after the last fiscal year for which such funds are
    available for the purposes for which appropriated) into the Fund:
    Provided further, That amounts deposited in the Fund shall be available
    until expended, and in addition to such other funds as may be available
    for such purposes, for capital acquisition necessary for the operation
    of the Department, including facilities infrastructure and information
    technology infrastructure; and other Department-wide higher priorities,
    as the Secretary of Health and Human Services considers appropriate,
    subject to approval by the Office of Management and Budget: Provided
    further, That amounts in the Fund may be obligated only after
    notification of the Committees on Appropriations of the House of
    Representatives and the Senate of the planned use of funds.

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0125-0-1-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Budgetary resources available for obligation:
    22.30 Expired unobligated balance
            transfer to unexpired account...
    ----------------------------------------------------------------------------

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

        The Nonrecurring expenses fund is a no-year account that captures
    expired unobligated balances from discretionary accounts prior to
    cancellation. This fund will be used for nonrecurring expenses that are
    difficult to accommodate or arise outside of the normal budget process.
    Beginning with 2008

    [[Page 437]]

    appropriations, transfers will occur up to five years after expiration
    when it is certain that original obligations have been fully paid and
    closed out. Advance notification of the proposed use of the Nonrecurring
    expenses fund is submitted to the relevant Committees on Appropriations
    of the House of Representatives and the Senate with justification for
    the areas/projects proposed.

                             PROGRAM SUPPORT CENTER

          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.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0379-0-1-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 Retirement payments...............         269         292         318
    00.02 Survivors' benefits...............          16          17          18
    00.03 Medical care......................          57          61          67
                                               ---------   ---------  ----------
    10.00   Total new obligations...........         342         370         403
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......         342         370         403
    23.95 Total new obligations.............        -342        -370        -403
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................         342         370         403
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..          29          31          37
    73.10 Total new obligations.............         342         370         403
    73.20 Total outlays (gross).............        -343        -364        -400
    73.40 Adjustments in expired accounts
            (net)...........................           3
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..          31          37          40
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................         314         333         363
    86.98 Outlays from mandatory balances...          29          31          37
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........         343         364         400
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................         342         370         403
    90.00 Outlays...........................         343         364         400
    ---------------------------------------------------------------------------

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

                      Retirement Pay Eligible Beneficiaries

                                           FY2006       FY2007      FY2008
    Active Duty:
      HHS.........................          4,948          5,031           5,247
      DOJ, BOP....................            635            630             630
      Homeland Security...........            210            213             213
      EPA.........................             82             82              82
      All Other...................             73             74              74
    Total Active Duty.............          5,948          6,030           6,246
    Retirees & Survivors:
    Retirees......................          4,647          4,896           5,149
    Retiree family members and
    survivors.....................            633            639             645
    Total Retirement Pay..........          5,280          5,535           5,794
    Total Beneficiaries (active
    duty, retirees, survivors)....         11,228         11,565          12,040

        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.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0379-0-1-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Direct obligations:
    13.0  Benefits for former personnel.....         285         309         336
    25.6  Medical care......................          57          61          67
                                               ---------   ---------  ----------
    99.9    Total new obligations...........         342         370         403
    ---------------------------------------------------------------------------

     HHS Accrual Contribution to the Uniformed Services Retiree Health Care
                                      Fund

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0170-0-1-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 Medicare eligible accruals........          34          36          37
                                               ---------   ---------  ----------
    10.00   Total new obligations (object
              class 12.2)...................          34          36          37
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......          34          36          37
    23.95 Total new obligations.............         -34         -36         -37
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................          34          36          37
    ----------------------------------------------------------------------------

        Change in obligated balances:
    73.10 Total new obligations.............          34          36          37
    73.20 Total outlays (gross).............         -34         -36         -37
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................          34          36          37
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................          34          36          37
    90.00 Outlays...........................          34          36          37
    ---------------------------------------------------------------------------

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

                             Health Activities Funds

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9913-0-1-552      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Change in obligated balances:
    72.40 Obligated balance, start of year..           2           2           2
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..           2           2           2
    ----------------------------------------------------------------------------

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

        This display shows activities in support of St. Elizabeths Hospital
    and scientific activities overseas that were supported by foreign
    currencies by the United States abroad.

                           HHS Service and Supply Fund

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9941-0-4-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:

    [[Page 438]]

    09.01 Program support center............         633         617         647
    09.02 OS activities.....................          64          74          73
                                               ---------   ---------  ----------
    10.00   Total new obligations...........         697         691         720
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........          63          98          98
    22.00 New budget authority (gross)......         711         691         720
    22.10 Resources available from
            recoveries of prior year
            obligations.....................          20
    22.22 Unobligated balance transferred
            from other accounts.............           1
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......         795         789         818
    23.95 Total new obligations.............        -697        -691        -720
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........          98          98          98
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

            Spending authority from
                offsetting collections:
    69.00     Offsetting collections (cash).         689         691         720
    69.10     Change in uncollected customer
                payments from Federal
                sources (unexpired).........          22
                                               ---------   ---------  ----------
    69.90     Spending authority from
                offsetting collections
                (total mandatory)...........         711         691         720
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..           6          23          23
    73.10 Total new obligations.............         697         691         720
    73.20 Total outlays (gross).............        -638        -691        -720
    73.45 Recoveries of prior year
            obligations.....................         -20
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................         -22
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..          23          23          23
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................         128         691         720
    86.98 Outlays from mandatory balances...         510
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........         638         691         720
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.00   Offsetting collections (cash)
              from: Federal sources.........        -689        -691        -720
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................         -22
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................
    90.00 Outlays...........................         -51
    ---------------------------------------------------------------------------

        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      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Reimbursable obligations:
          Personnel compensation:

    11.1    Full-time permanent.............          92         100         106
    11.3    Other than full-time permanent..           4           4           5
    11.5    Other personnel compensation....           2           2           3
    11.7    Military personnel..............           9           9           9
                                               ---------   ---------  ----------
    11.9      Total personnel compensation..         107         115         123
    12.1  Civilian personnel benefits.......          28          30          31
    12.2  Military personnel benefits.......           4           5           5
    21.0  Travel and transportation of
            persons.........................           2           3           3
    22.0  Transportation of things..........           3           3           4
    23.1  Rental payments to GSA............          14          17          17
    23.3  Communications, utilities, and
            miscellaneous charges...........          46          43          45
    24.0  Printing and reproduction.........           1           1           1
    25.1  Advisory and assistance services..          39          38          39
    25.2  Other services....................         275         255         261
    25.3  Other purchases of goods and
            services from Government
            accounts........................          48          45          47
    25.4  Operation and maintenance of
            facilities......................          18          24          26
    25.6  Medical care......................          45          35          37
    25.7  Operation and maintenance of
            equipment.......................          18          12          12
    26.0  Supplies and materials............          42          62          66
    31.0  Equipment.........................           7           3           3
                                               ---------   ---------  ----------
    99.9    Total new obligations...........         697         691         720
    ---------------------------------------------------------------------------

                                 Employment Summary

    ----------------------------------------------------------------------------
    Identification code 75-9941-0-4-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Reimbursable:
    2001  Civilian full-time equivalent
            employment......................       1,260       1,317       1,348
    2101  Military full-time equivalent
            employment......................         100          99          99
        Allocation account:
    3101  Military full-time equivalent
            employment......................         635         630         630
    3101  Military full-time equivalent
            employment......................         283         287         287
    ---------------------------------------------------------------------------

                                   Trust Funds

                            Miscellaneous Trust Funds

              Special and Trust Fund Receipts (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9971-0-7-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
    01.00 Balance, start of year............          32          32          32
                                               ---------   ---------  ----------
    01.99 Balance, start of year............          32          32          32
        Receipts:
    02.00 Interest, Miscellaneous trust
            funds...........................           1           1           1
    02.20 Contributions, Indian health
            facilities......................           9           9           9
    02.60 Gifts and contributions,
            Miscellaneous trust funds.......          41          41          41
                                               ---------   ---------  ----------
    02.99   Total receipts and collections..          51          51          51
                                               ---------   ---------  ----------
    04.00 Total: Balances and collections...          83          83          83
        Appropriations:
    05.00 Miscellaneous trust funds.........         -51         -51         -51
                                               ---------   ---------  ----------
    07.99 Balance, end of year..............          32          32          32
    ---------------------------------------------------------------------------

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9971-0-7-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.02 Gifts.............................          35          42          42
    00.03 Contributions, Indian health
            facilities......................          27           9           9
                                               ---------   ---------  ----------
    10.00   Total new obligations...........          62          51          51
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........         119         109         109
    22.00 New budget authority (gross)......          51          51          51
    22.10 Resources available from
            recoveries of prior year
            obligations.....................           1
                                               ---------   ---------  ----------

    [[Page 439]]

    23.90   Total budgetary resources
              available for obligation......         171         160         160
    23.95 Total new obligations.............         -62         -51         -51
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........         109         109         109
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.26   Appropriation (trust fund)......          51          51          51
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         135         148         122
    73.10 Total new obligations.............          62          51          51
    73.20 Total outlays (gross).............         -48         -77         -67
    73.45 Recoveries of prior year
            obligations.....................          -1
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..         148         122         106
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................           8          11          11
    86.98 Outlays from mandatory balances...          40          66          56
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........          48          77          67
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................          51          51          51
    90.00 Outlays...........................          48          77          67
    ----------------------------------------------------------------------------

        Memorandum (non-add) entries:
    92.01 Total investments, start of year:
            Federal securities: Par value...          21          32          32
    92.02 Total investments, end of year:
            Federal securities: Par value...          32          32          32
    ---------------------------------------------------------------------------

                              [Dollars in millions]

                                            2006         2007        2008
    Distribution of budget authority by
        account:
      Gifts.......................             42             42              42
      Contributions, Indian health
        facilities................              9              9               9
    Distribution of outlays by account:
      Gifts.......................             41             63              55
      Contributions, Indian health
        facilities................              7             14              12

        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      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Direct obligations:
          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..           2           2           2
    25.2  Other services....................          26          23          23
    25.5  Research and development contracts          10           7           7
    25.7  Operation and maintenance of
            equipment.......................           2           2           2
    26.0  Supplies and materials............           2           1           1
    31.0  Equipment.........................           1
    41.0  Grants, subsidies, and
            contributions...................          13          10          10
                                               ---------   ---------  ----------
    99.9    Total new obligations...........          62          51          51
    ---------------------------------------------------------------------------

                                 Employment Summary

    ----------------------------------------------------------------------------
    Identification code 75-9971-0-7-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Civilian full-time equivalent
            employment......................          71          71          71
    ---------------------------------------------------------------------------

                         OFFICE OF THE INSPECTOR GENERAL

                           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, $44,687,000: 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.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0128-0-1-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Obligations by program activity:
    00.01 Direct program....................          39          75          81
    09.01 HCFAC reimbursable program........         170         176         197
    09.02 Reimbursable program..............          30          16          16
                                               ---------   ---------  ----------
    10.00   Total new obligations...........         239         267         294
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........                      24          16
    22.00 New budget authority (gross)......         264         259         283
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......         264         283         299
    23.95 Total new obligations.............        -239        -267        -294
    23.98 Unobligated balance expiring or
            withdrawn.......................          -1
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........          24          16           5
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................          40          39          45
    40.35   Appropriation permanently
              reduced.......................          -1
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............          39          39          45
    58.00   Spending authority from
              offsetting collections:
              Offsetting collections (cash).          14          16          34
          Mandatory:

    60.00   Appropriation...................          25          28          25
            Spending authority from
                offsetting collections:
    69.00     Offsetting collections (cash).         178         176         179
    69.10     Change in uncollected customer
                payments from Federal
                sources (unexpired).........           8
                                               ---------   ---------  ----------
    69.90     Spending authority from
                offsetting collections
                (total mandatory)...........         186         176         179
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................         264         259         283
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..          32          37          48
    73.10 Total new obligations.............         239         267         294
    73.20 Total outlays (gross).............        -232        -256        -288
    73.40 Adjustments in expired accounts
            (net)...........................          -2
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................          -8
    74.10 Change in uncollected customer
            payments from Federal sources
            (expired).......................           8
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..          37          48          54
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................          30          32          52
    86.93 Outlays from discretionary
            balances........................          17          33          21
    86.97 Outlays from new mandatory
            authority.......................         172         187         189
    86.98 Outlays from mandatory balances...          13           4          26
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........         232         256         288
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.00   Offsetting collections (cash)
              from: Federal sources.........        -200        -192        -213
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................          -8
    88.96   Portion of offsetting
              collections (cash) credited to
              expired accounts..............           8
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................          64          67          70
    90.00 Outlays...........................          32          64          75
    ---------------------------------------------------------------------------

        The Office of Inspector General (OIG) identifies and recommends
    actions to correct fraud, waste, and abuse in HHS

    [[Page 440]]

    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 and the
    Deficit Reduction Act of 2005 (DRA) make 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 and to establish a Medicaid
    Integrity Program under DRA. The following table shows total funding
    resources for the OIG:

                            (In millions of dollars)

    Budget Authority:                    2006 actual  2007 est.   2008 est.
      Discretionary appropriation.             39             39              45
      Discretionary caps proposal.              0              0              18
      Mandatory (HCFAC Account)...            160            166             169
      Medicaid Integrity Program..             25             25              25
      Audit and investigations
        reimburements.............             10             10              10
      Medicare Modernization Act..             14              0               0
      Never Events Study..........              0              3               0
                                        ------------------------------------
        Total.....................            248            243             267
        Note.--The reimbursable program (HCFAC) in Office of the Inspector
    General reflects the estimated distribution of the allocation account
    for 2007 and 2008. Actual 2007 and 2008 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      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
          Direct obligations:

    11.1    Personnel compensation: Full-
              time permanent................          23          42          45
    12.1    Civilian personnel benefits.....           7          13          14
    21.0    Travel and transportation of
              persons.......................           2           3           3
    23.1    Rental payments to GSA..........           3           5           5
    23.3    Communications, utilities, and
              miscellaneous charges.........           1           1           1
    25.2    Other services..................                       1           1
    25.3    Other purchases of goods and
              services from Government
              accounts......................           3           8           9
    26.0    Supplies and materials..........                       1           1
    31.0    Equipment.......................                       1           2
                                               ---------   ---------  ----------
    99.0      Direct obligations............          39          75          81
    99.0  Reimbursable obligations..........         200         192         213
                                               ---------   ---------  ----------
    99.9    Total new obligations...........         239         267         294
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                                 Employment Summary

    ----------------------------------------------------------------------------
    Identification code 75-0128-0-1-551      2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Civilian full-time equivalent
            employment......................         266         472         489
        Reimbursable:
    2001  Civilian full-time equivalent
            employment......................       1,181       1,113       1,212
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                          GENERAL FUND RECEIPT ACCOUNTS

                               (in millions of dollars)

    ----------------------------------------------------------------------------
                                             2006 actual   2007 est.   2008 est.
    ----------------------------------------------------------------------------
    Offsetting receipts from the public:
      75-143500  General fund proprietary
        interest receipts, not otherwise
        classified..........................          77          77          77
      75-274530  Health education assistance
        loans, Downward reestimates of
        subsidies...........................          31          34
      75-275830  Downward reestimates of
        subsidies, Health Centers...........           1
      75-310700  Federal share of child
        support collections.................       1,055       1,065       1,047
    Legislative proposal, subject to PAYGO..                                   2
      75-322000  All other general fund
        proprietary receipts including
        budget clearing accounts............         362         107         107
    General Fund Offsetting receipts from
     the public.............................       1,526       1,283       1,233
    ----------------------------------------------------------------------------

    Intragovernmental payments:.............
      75-330500  Transfer of excess receipts
        to the general fund, trust fund
        payments............................           5           5           5
      75-388500  Undistributed
        intragovernmental payments and
        receivables from cancelled accounts.        -120
                                               ---------   ---------  ----------
    General Fund Intragovernmental payments.        -115           5           5
    ---------------------------------------------------------------------------

                    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 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 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 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. 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. 207. Not to exceed 3 percent of any discretionary funds
    (pursuant to the Balanced Budget and Emergency Deficit Control Act of
    1985, as amended) which are appropriated for the current fiscal year for
    the Department of Health and Human Services in this Act may be
    transferred between appropriations, but no such appropriation shall be
    increased by more than 3 percent by any such transfer: Provided, That an
    appropriation may be increased by up to an additional 2 percent after
    notification of the House and Senate Committees on Appropriations:
    Provided further, That the Appropriations Committees of both Houses of
    Congress are notified at least 15 days in advance of any transfer.

                               (transfer of funds)

        Sec. 208. The Director of the National Institutes of Health, jointly
    with the Director of the Office of AIDS Research, may transfer up to 3
    percent among institutes 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. 209. Of the amounts made available in this Act for the National
    Institutes of Health, the amount for research related to the human
    immunodeficiency virus, as jointly determined by the Director of the
    National Institutes of Health and the Director of the Office of AIDS
    Research, shall be made available to the ``Office of AIDS Research''
    account. The Director of the Office of AIDS Research shall transfer from
    such account amounts necessary to carry out section 2353(d)(3) of the
    Public Health Service Act.
        Sec. 210. None of the funds appropriated in this Act may be made
    available to any entity under title X of the Public Health Service Act
    unless the applicant for the award certifies to the Secretary that

    [[Page 441]]

    it encourages family participation in the decision of minors to seek
    family planning services and that it provides counseling to minors on
    how to resist attempts to coerce minors into engaging in sexual
    activities.
        Sec. 211. None of the funds appropriated by this Act (including
    funds appropriated to any trust fund) may be used to carry out the
    Medicare 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. 212. Notwithstanding any other provision of law, no provider of
    services under title X of the Public Health Service Act shall be exempt
    from any State law requiring notification or the reporting of child
    abuse, child molestation, sexual abuse, rape, or incest.
        Sec. 213. (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, 2008, 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 2008
    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 2007, 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 2007
    State expenditures and all fiscal year 2008 obligations for tobacco
    prevention and compliance activities by program activity by July 31,
    2008.
        (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, 2008.
        (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. 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 2008, 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 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
        HHS. The Department of State shall cooperate fully with the
        Secretary of HHS to ensure that 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 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. 215. (a) Authority.--Notwithstanding any other provision of
    law, the Director of the National Institutes of Health may use funds
    available under section 402(b)(7) and 402(b)(12) of the Public Health
    Service Act to enter into transactions (other than contracts,
    cooperative agreements, or grants) to carry out research in support of
    the NIH Common Fund.
        (b) Peer Review.--In entering into transactions under subsection
    (a), the Director of the National Institutes of Health may utilize such
    peer review procedures (including consultation with appropriate
    scientific experts) as the Director determines to be appropriate to
    obtain assessments of scientific and technical merit. Such procedures
    shall apply to such transactions in lieu of the peer review and advisory
    council review procedures that would otherwise be required under
    sections 301(a)(3), 405(b)(1)(B), 405(b)(2), 406(a)(3)(A), 492, and 494
    of the Public Health Service Act (42 U.S.C. 241, 284(b)(1)(B),
    284(b)(2), 284a(a)(3)(A), 289a, and 289c).
        Sec. 216. Funds which are available for Individual Learning Accounts
    for employees of the Centers for Disease Control and Prevention and the
    Agency for Toxic Substances and Disease Registry may be transferred to
    ``Disease Control, Research, and Training,'' to be available only for
    Individual Learning Accounts: Provided, That such funds may be used for
    any individual full-time equivalent employee while such employee is
    employed either by CDC or ATSDR.
        Sec. 217. 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.
        Sec. 218. 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, 2008, 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,
    2008: 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, 2008 has been paid to the Secretary.
        Sec. 219. Of the unobligated balances available under the heading,
    ``Centers for Disease Control and Prevention,'' in Public Law 109-149,
    $29,680,000 are cancelled.
        Sec. 220. The Director of the Centers for Disease Control and
    Prevention may reallocate up to one percent of any discretionary funds
    appropriated for the current fiscal year for the Centers for Disease
    Control and Prevention between the agency's programs, projects, and
    activities: Provided, That the transfer should not decrease any program,
    project, or activity by more than three percent: Provided further, That
    the reallocation authority granted by this section shall be available
    only to meet CDC's public health mission: Provided further, That the
    appropriations committees of both Houses of Congress are notified within
    15 days of any reallocation.
        Sec. 221. Not to exceed $35,000,000 of funds appropriated by this
    Act to the Institutes and Centers of the National Institutes of Health
    may be used for alteration, repair, or improvement of facilities, as
    necessary for the proper and efficient conduct of the activities
    authorized herein, at not to exceed $2,500,000 per project.

        Note.--A regular 2007 appropriation for this account had not been
    enacted at the time the budget was prepared; therefore, this account is
    operating under a continuing resolution (P.L. 109-289, Division B, as
    amended). The amounts included for 2007 in this budget reflect the
    levels provided by the continuing resolution.