[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
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Program and Financing (in millions of dollars)
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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
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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
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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
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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
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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
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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
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[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)
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Identification code 75-9911-0-1-554 2006 actual 2007 est. 2008 est.
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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
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Employment Summary
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Identification code 75-9911-0-1-554 2006 actual 2007 est. 2008 est.
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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
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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)
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Identification code 75-9911-2-1-554 2006 actual 2007 est. 2008 est.
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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
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[[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)
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Identification code 75-9911-2-1-554 2006 actual 2007 est. 2008 est.
----------------------------------------------------------------------------
99.0 Reimbursable obligations........ 421
--------- --------- ----------
99.9 Total new obligations........... 421
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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
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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
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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
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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
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Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in
millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0350-0-1-550 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
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[[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
---------------------------------------------------------------------------
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
---------------------------------------------------------------------------
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.