[Appendix]
[Detailed Budget Estimates by Agency]
[Department of Health and Human Services]
[From the U.S. Government Printing Office, www.gpo.gov]


                     THE BUDGET FOR FISCAL YEAR 2008

[[Page 393]]

 
                 DEPARTMENT OF HEALTH AND HUMAN SERVICES

                      FOOD AND DRUG ADMINISTRATION

                              Federal Funds

                          Salaries and Expenses

    For necessary expenses of the Food and Drug Administration, 
including hire and purchase of passenger motor vehicles; for payment of 
space rental and related costs pursuant to Public Law 92-313 for 
programs and activities of the Food and Drug Administration which are 
included in this Act; for rental of special purpose space in the 
District of Columbia or elsewhere; for miscellaneous and emergency 
expenses of enforcement activities, authorized and approved by the 
Secretary and to be accounted for solely on the Secretary's certificate, 
not to exceed $25,000; and notwithstanding section 521 of Public Law 
107-188; $1,649,405,000: Provided, That of the amount provided under 
this heading, $13,696,000 shall be derived from animal drug user fees 
authorized by 21 U.S.C. 379j, and shall be credited to this account and 
remain available until expended: Provided further, That fees derived 
from animal drug assessments received during fiscal year 2008, including 
any such fees assessed prior to the current fiscal year but credited 
during the current year, shall be subject to the fiscal year 2008 
limitation.
    In addition, export certification user fees authorized by 21 U.S.C. 
381 may be credited to this account, to remain available until expended.

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

                        Buildings and Facilities

    For plans, construction, repair, improvement, extension, alteration, 
and purchase of fixed equipment or facilities of or used by the Food and 
Drug Administration, where not otherwise provided, $4,950,000, to remain 
available until expended.

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

          Special and Trust Fund Receipts (in millions of dollars)

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

               Program and Financing (in millions of dollars)

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

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

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

[[Page 394]]

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

                        [In millions of dollars]

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

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

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

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

    The Food and Drug Administration (FDA) is responsible for protecting 
the public health by assuring the safety, efficacy, and security of 
human and veterinary drugs, biological products, medical devices, our 
Nation's food supply, cosmetics, and products that emit radiation. The 
FDA is also responsible for advancing the public health by helping to 
speed innovations that make medicines more effective and helping to 
provide the public accurate, science-based information about medicines 
and foods to improve their health. FDA decisions affect Americans on a 
daily basis. The Budget includes funding for counterterrorism activities 
that specifically relate to the protection of products or therapies 
regulated by the FDA (such as drugs, vaccines, foods, and animal feed), 
and the availability of medical products for public health preparedness 
in the event of an attack. Specifically, the Budget requests funding for 
generic and other drug review, drug safety, food safety, medical device 
review and safety, and headquarters consolidation in White Oak, 
Maryland.

               Object Classification (in millions of dollars)

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

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

                             Employment Summary

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

                          Salaries and Expenses

              (Legislative proposal, not subject to PAYGO)

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

               Program and Financing (in millions of dollars)

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

[[Page 395]]



    Offsets:
      Against gross budget authority and outlays:

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

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

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

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

               Object Classification (in millions of dollars)

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

                             Employment Summary

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

                                

           Revolving Fund for Certification and Other Services

               Program and Financing (in millions of dollars)

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

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

    New budget authority (gross), detail:
      Mandatory:

69.00   Spending authority from 
          offsetting collections: 
          Offsetting collections (cash).           7           7           7
----------------------------------------------------------------------------

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

    FDA certifies color additives for use in foods, drugs, and 
cosmetics. It also lists color additives for use in foods, drugs, 
medical devices, and cosmetics (21 U.S.C. 346a, 356, 357, 376). These 
services are financed wholly by fees paid by the industries affected.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-4309-0-3-554      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
    Reimbursable obligations:
11.1  Personnel compensation: Full-time 
        permanent.......................           3           3           3
12.1  Civilian personnel benefits.......           1           1           1
23.1  Rental payments to GSA............           1           1           1
25.2  Other services....................                                   1
26.0  Supplies and materials............           1           1           1
31.0  Equipment.........................                       1
                                           ---------   ---------  ----------
99.9    Total new obligations...........           6           7           7
---------------------------------------------------------------------------

                             Employment Summary

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

                                


 
              HEALTH RESOURCES AND SERVICES ADMINISTRATION

                                 Federal

                      Health Resources and Services

    For carrying out titles II, III, IV, VII, VIII, X, XII, and XXVI of 
the Public Health Service Act (``PHS Act''), section 427(a) of the 
Federal Coal Mine Health and Safety Act, title V and sections 1128E, and 
711 of the Social Security Act, the Health Care Quality Improvement Act 
of 1986, as amended, the Native Hawaiian Health Care Act of 1988, as 
amended, and section 712 of the American Jobs Creation Act of 2004, 
$5,795,805,000: Provided, That of the funds made available under this 
heading, $100,000 shall be available until expended for facilities 
renovations at the Gillis W. Long Hansen's Disease Center: Provided 
further, That in addition to fees authorized by section 427(b) of the 
Health Care Quality Improvement Act of 1986, fees shall be collected for 
the full disclosure of information under the Act sufficient to recover 
the full costs of operating the National Practitioner Data Bank, and 
shall remain available until expended to carry out that Act: Provided 
further, That no more than $100,000 is available until expended for 
carrying out 42 U.S.C. 233(o) including administrative expenses: 
Provided further, That $1,966,000 is available until expended for the 
National Cord Blood Stem Cell Program: Provided further, That fees 
collected for the full disclosure of information under the ``Health Care 
Fraud and Abuse Data Collection Program'', authorized by section 
1128E(d)(2) of the Social Security Act, shall be sufficient to recover 
the full costs of operating the program, and shall remain available 
until expended to carry out that Act: Provided further, That no more 
than $44,055,000 is available until expended for carrying out the 
provisions of Public Law 104-73 and for expenses incurred by the 
Department of Health and Human Services pertaining to administrative 
claims made under such law: Provided further, That $26,000,000 of 
funding provided for health centers shall be used for high-need 
counties, notwithstanding section 330(r)(2)(B) of the PHS Act: Provided 
further, That of the funds made available under this heading, 
$283,103,000 shall be for the program

[[Page 396]]

under title X of the PHS Act to provide for voluntary family planning 
projects: Provided further, That amounts provided to said projects under 
such title shall not be expended for abortions, that all pregnancy 
counseling shall be nondirective, and that such amounts shall not be 
expended for any activity (including the publication or distribution of 
literature) that in any way tends to promote public support or 
opposition to any legislative proposal or candidate for public office: 
Provided further, That of the funds available under this heading, 
$1,819,511,000 shall remain available to the Secretary until September 
30, 2010, for parts A and B of title XXVI of the PHS Act; Provided 
further, That $814,546,000 shall be for State AIDS Drug Assistance 
Programs authorized by section 2616 of the PHS Act: Provided further, 
That in addition to amounts provided herein, $25,000,000 shall be 
available from amounts available under section 241 of the PHS Act to 
carry out parts A, B, C, and D of title XXVI of the PHS Act to fund 
section 2691 Special Projects of National Significance.

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

               Program and Financing (in millions of dollars)

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

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

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

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

[[Page 397]]


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

    Activities displayed here support categorical health resources and 
services grants, treatment and care for those living with HIV/AIDS, and 
the medical malpractice claims funds, which pay malpractice claims filed 
against employees of federally-supported health centers. 

               Object Classification (in millions of dollars)

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

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

                             Employment Summary

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

                                

                       Vaccine Injury Compensation

               Program and Financing (in millions of dollars)

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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

    The Vaccine Injury Compensation Program was established pursuant to 
Public Law 99-660 and Public Law 100-203, and serves as a source of 
funds to pay claims for compensation for vaccine related injury or 
death. Payment of claims associated with vaccine related injury or death 
occurring before October 1, 1988 are financed from the General Fund and 
are reflected in this account. Given sufficient carry-over funds from 
prior years' appropriations to pay for the balance of the pre-1988 
claims yet to be adjudicated, no appropriation is requested in 2008 to 
cover payment of pre-1988 claims. By statute, no new claims are accepted 
for this account. Payment of claims associated with vaccine related 
injury or death occurring after October 1, 1988 are reflected in the 
Vaccine Injury Compensation Program trust fund account.

                                

             Health Center Guaranteed Loan Financing Account

               Program and Financing (in millions of dollars)

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

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

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

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

    Net financing authority and financing 
        disbursements:
89.00 Financing authority...............
90.00 Financing disbursements...........           1           1
---------------------------------------------------------------------------

             Status of Guaranteed Loans (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-4442-0-3-551      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
    Position with respect to appropriations act 
                limitation on commitments:
2111  Limitation on guaranteed loans 
        made by private lenders.........
2121  Limitation available from carry-
        forward.........................         100          98          90
2142  Uncommitted loan guarantee 
        limitation......................                                 -90
2143  Uncommitted limitation carried 
        forward.........................         -98         -90
                                           ---------   ---------  ----------
2150    Total guaranteed loan 
          commitments...................           2           8
2199  Guaranteed amount of guaranteed 
        loan commitments................           2           8
----------------------------------------------------------------------------

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

[[Page 398]]

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

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

    P.L. 104-299 and P.L. 104-208 authorize Health Resources and 
Services Administration (HRSA) to guarantee up to $160 million in 
private loans to health centers for the costs of developing and 
operating managed care networks or plans and for the construction, 
renovation and modernization of medical facilities. As required by the 
Federal Credit Reform Act of 1990, this financing account records all 
cash flows to and from the Government resulting from the Health center 
loan guarantee program. The program account for this activity is 
displayed in the Health resources and services account (75-0350) as a 
line in the program and financing schedule. The Budget proposes to 
rescind the unobligated balances of the Health Center Guaranteed Loan 
subsidy.

                             Balance Sheet (in millions of dollars)

-----------------------------------------------------------------------------------------------
Identification code 75-4442-0-
3-551

2005 actual

2006 actual

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

Federal assets: Fund balances with Treasury

1

1





1999

Total assets

1

1

    LIABILITIES:
2204

Non-Federal liabilities: Liabilities for loan guarantees

1

1





2999

Total liabilities

1

1





4999

Negative subsidy BA total [75-0350]

1

1

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

                                

            Health Education Assistance Loans Program Account

    Such sums as may be necessary to carry out the purpose of the 
program, as authorized by title VII of the Public Health Service Act, as 
amended. For administrative expenses to carry out the guaranteed loan 
program, including section 709 of the Public Health Service Act, 
$2,906,000.

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

               Program and Financing (in millions of dollars)

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................           3           3           3
----------------------------------------------------------------------------

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

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

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

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

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

               Object Classification (in millions of dollars)

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

                             Employment Summary

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

                                

           Health Education Assistance Loans Financing Account

               Program and Financing (in millions of dollars)

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

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

    New financing authority (gross), detail:
      Mandatory:

[[Page 399]]

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

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

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

    Offsets:
      Against gross financing authority and 
          financing disbursements:

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

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

             Status of Guaranteed Loans (in millions of dollars)

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

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

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

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

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

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

    This account records all cash flows to and from the Government 
resulting from HEAL loan guarantees committed between 1992 and 2004. No 
new loan guarantees will be issued after 2004.

                             Balance Sheet (in millions of dollars)

-----------------------------------------------------------------------------------------------
Identification code 75-4304-0-
3-552

2005 actual

2006 actual

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

Federal assets: Fund balances with Treasury

171

144

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

1501

Defaulted guaranteed loans receivable, gross

635

640

1505

Allowance for subsidy cost (-)

-548

-568





1599

Net present value of assets related to defaulted guaranteed loans

87

72





1999

Total assets

258

216

    LIABILITIES:
      Non-Federal liabilities:

2204

Liabilities for loan guarantees

227

182

2207

Other, downward reestimate

31

34





2999

Total liabilities

258

216





4999

Total liabilities and net position

258

216

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

                                

          Health Education Assistance Loans Liquidating Account

               Program and Financing (in millions of dollars)

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

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

    New budget authority (gross), detail:
      Mandatory:

60.00   Appropriation...................           4           4           1
        Spending authority from 
            offsetting collections:
69.00     Offsetting collections (cash).          15          15          10
69.27     Capital transfer to general 
            fund........................         -15         -15         -10
                                           ---------   ---------  ----------
69.90     Spending authority from 
            offsetting collections 
            (total mandatory)...........
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................           4           4           1
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..           4           4           4
73.10 Total new obligations.............           3           4           1
73.20 Total outlays (gross).............          -3          -4          -1
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..           4           4           4
----------------------------------------------------------------------------

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

    Offsets:
      Against gross budget authority and outlays:

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

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

             Status of Guaranteed Loans (in millions of dollars)

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

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

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

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

2310    Outstanding, start of year......         111          99          88
2331    Disbursements for guaranteed 
          loan claims...................           3           4           1
2351    Repayments of loans receivable..         -15         -15         -10
2364    Other adjustments, net..........
                                           ---------   ---------  ----------
2390      Outstanding, end of year......          99          88          79
---------------------------------------------------------------------------
    Note.--Includes carryover commitments from prior years.
    Note.--The adjustment to loans receivable represents interest, which 
had not previously been reflected in cumulative outstanding balances.

    This account records all cash flows to and from the Government 
resulting from HEAL loan guarantees committed prior to 1992. 

[[Page 400]]

                             Balance Sheet (in millions of dollars)

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

2005 actual

2006 actual

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

Federal assets: Fund balances with Treasury

4

4

1701

Defaulted guaranteed loans, gross

111

99

1703

Allowance for estimated uncollectible loans and interest (-)

-4

-4





1704

Defaulted guaranteed loans and interest receivable, net

107

95





1799

Value of assets related to loan guarantees

107

95





1999

Total assets

111

99

    LIABILITIES:
2104

Federal liabilities: Resources payable to Treasury

109

99

2204

Non-Federal liabilities: Liabilities for loan guarantees

2







2999

Total liabilities

111

99





4999

Total liabilities and net position

111

99

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

                                

               Medical Facilities Guarantee and Loan Fund

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9931-0-3-551      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
    Change in obligated balances:
72.40 Obligated balance, start of year..           1           1           1
                                           ---------   ---------  ----------
74.40   Obligated balance, end of year..           1           1           1
----------------------------------------------------------------------------

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

               Status of Direct Loans (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9931-0-3-551      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
    Cumulative balance of direct loans 
                outstanding:
1210  Outstanding, start of year........           7           7           7
                                           ---------   ---------  ----------
1290    Outstanding, end of year........           7           7           7
---------------------------------------------------------------------------

    Title VI and subsequently title XVI of the Public Health Service Act 
established a loan and loan guarantee fund for medical facilities with a 
maximum amount allowable for the Government's liability. Direct loans 
were made available for public facilities and guaranteed loans for 
private, nonprofit facilities. Funds under this authority were 
established in the amount of $50 million for use in fulfilling 
guarantees in event of default, $30 million as a revolving fund for 
direct loans and an amount for interest subsidy payments on guaranteed 
loans. 

                             Balance Sheet (in millions of dollars)

-----------------------------------------------------------------------------------------------
Identification code 75-9931-0-
3-551

2005 actual

2006 actual

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

Non-Federal assets: Receivables, net

13

12

1601

Direct loans, gross



7





1999

Total assets

13

19

    LIABILITIES:
2204

Non-Federal liabilities: Liabilities for loan guarantees

13

19





2999

Total liabilities

13

19





4999

Total liabilities and net position

13

19

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

                                

  

                               Trust Funds

             Vaccine Injury Compensation Program Trust Fund

    For payments from the Vaccine Injury Compensation Program Trust 
Fund, such sums as may be necessary for claims associated with vaccine-
related injury or death with respect to vaccines administered after 
September 30, 1988, pursuant to subtitle 2 of title XXI of the Public 
Health Service Act, to remain available until expended: Provided, That 
for necessary administrative expenses, not to exceed $3,528,000 shall be 
available from the Trust Fund to the Secretary of Health and Human 
Services.

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

          Special and Trust Fund Receipts (in millions of dollars)

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

               Program and Financing (in millions of dollars)

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

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

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

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

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

[[Page 401]]

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

    The Vaccine Injury Compensation Program was established pursuant to 
Public Law 99-660 and Public Law 100-203, and serves as a source of 
funds to pay claims for compensation for vaccine related injury or 
death. This account reflects payments for claims for vaccine related 
injury or death occurring after October 1, 1988.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8175-0-7-551      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
    Direct obligations:
25.2  Other services....................           4           4           5
25.3  Other purchases of goods and 
        services from Government 
        accounts........................          10          10          10
42.0  Insurance claims and indemnities..          54          56          58
                                           ---------   ---------  ----------
99.9    Total new obligations...........          68          70          73
---------------------------------------------------------------------------

                                

                    Ricky Ray Hemophilia Relief Fund

               Program and Financing (in millions of dollars)

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

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

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

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

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

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

                                


 
                          INDIAN HEALTH SERVICE

                                 Federal

                         Indian Health Services

    For expenses necessary to carry out the Act of August 5, 1954 (68 
Stat. 674), the Indian Self-Determination Act, the Indian Health Care 
Improvement Act, and titles II and III of the Public Health Service Act 
with respect to the Indian Health Service, $2,931,530,000, together with 
payments received during the fiscal year pursuant to 42 U.S.C. 238(b) 
for services furnished by the Indian Health Service: Provided, That 
funds made available to tribes and tribal organizations through 
contracts, grant agreements, or any other agreements or compacts 
authorized by the Indian Self-Determination and Education Assistance Act 
of 1975 (25 U.S.C. 450), shall be deemed to be obligated at the time of 
the grant or contract award and thereafter shall remain available to the 
tribe or tribal organization without fiscal year limitation: Provided 
further, That up to $18,000,000 shall remain available until expended, 
for the Indian Catastrophic Health Emergency Fund: Provided further, 
That $551,515,000 for contract medical care shall remain available for 
obligation until September 30, 2009: Provided further, That of the funds 
provided, up to $27,000,000, to remain available until expended, shall 
be used to carry out the loan repayment program under section 108 of the 
Indian Health Care Improvement Act: Provided further, That funds 
provided in this Act may be used for one-year contracts and grants which 
are to be performed in two fiscal years, so long as the total obligation 
is recorded in the year for which the funds are appropriated: Provided 
further, That the amounts collected by the Secretary of Health and Human 
Services under the authority of title IV of the Indian Health Care 
Improvement Act shall remain available until expended for the purpose of 
achieving compliance with the applicable conditions and requirements of 
titles XVIII and XIX of the Social Security Act (exclusive of planning, 
design, or construction of new facilities): Provided further, That 
funding contained herein, and in any earlier appropriations Acts for 
scholarship programs under the Indian Health Care Improvement Act (25 
U.S.C. 1613), shall remain available until expended: Provided further, 
That amounts received by tribes and tribal organizations under title IV 
of the Indian Health Care Improvement Act shall be reported and 
accounted for and available to the receiving tribes and tribal 
organizations until expended: Provided further, That, notwithstanding 
any other provision of law, of the amounts provided herein, not to 
exceed $271,636,000 shall be for payments to tribes and tribal 
organizations for contract or grant support costs associated with 
contracts, grants, self-governance compacts or annual funding agreements 
between the Indian Health Service and a tribe or tribal organization 
pursuant to the Indian Self-Determination Act of 1975, as amended, prior 
to or during fiscal year 2008, of which not to exceed $5,000,000 may be 
used for contract support costs associated with new or expanded self-
determination contracts, grants, self-governance compacts or annual 
funding agreements: Provided further, That the Bureau of Indian Affairs 
may collect from the Indian Health Service and tribes and tribal 
organizations operating health facilities pursuant to Public Law 93-638 
such individually identifiable health information relating to disabled 
children as may be necessary for the purpose of carrying out its 
functions under the Individuals with Disabilities Education Act, 20 
U.S.C. 1400, et seq.

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

               Program and Financing (in millions of dollars)

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

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

    New budget authority (gross), detail:
      Discretionary:

[[Page 402]]

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

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

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

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

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

               Object Classification (in millions of dollars)

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

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

                             Employment Summary

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

                                

                        Indian Health Facilities

    For construction, repair, maintenance, improvement, and equipment of 
health and related auxiliary facilities, including quarters for 
personnel; preparation of plans, specifications, and drawings; 
acquisition of sites, purchase and erection of modular buildings, and 
purchases of trailers; and for provision of domestic and community 
sanitation facilities for Indians, as authorized by section 7 of the Act 
of August 5, 1954 (42 U.S.C. 2004a), the Indian Self-Determination Act, 
and the Indian Health Care Improvement Act, and for expenses necessary 
to carry out such Acts and titles II and III of the Public Health 
Service Act with respect to environmental health and facilities support 
activities of the Indian Health Service, $339,196,000, to remain 
available until expended: Provided, That notwithstanding any other 
provision of law, funds appropriated for the planning, design, 
construction or renovation of health facilities for the benefit of a 
federally-recognized Indian tribe or tribes may be used to purchase land 
for sites to construct, improve, or enlarge health or related 
facilities: Provided further, That not to exceed $500,000 shall be used 
by the Indian Health Service to purchase TRANSAM equipment from the 
Department of Defense for distribution to the Indian Health Service and 
tribal facilities: Provided further, That none of the funds appropriated 
to the Indian Health Service may be used for sanitation facilities 
construction for new homes funded with grants by the housing programs of 
the United States Department of Housing and Urban Development: Provided 
further, That not to exceed $1,000,000 from this account and the 
``Indian Health Services'' account shall be used by the Indian Health 
Service to obtain ambulances for the Indian Health Service and tribal 
facilities in conjunction with an existing interagency agreement between 
the Indian Health Service and the General Services Administration: 
Provided further, That not to exceed $500,000 shall be placed in a 
Demolition Fund, available until expended, to be used by the Indian 
Health Service for demolition of Federal buildings.

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

          Special and Trust Fund Receipts (in millions of dollars)

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

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

[[Page 403]]


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

               Program and Financing (in millions of dollars)

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

    The Indian health facilities account supports construction, repair 
and improvement, equipment, and environmental health and facilities 
support for the Indian health services.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0391-0-1-551      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
      Direct obligations:

        Personnel compensation:
11.1      Full-time permanent...........          42          43          45
11.3      Other than full-time permanent           4           5           5
11.5      Other personnel compensation..           1           1           1
11.7      Military personnel............          19          19          20
                                           ---------   ---------  ----------
11.9      Total personnel compensation..          66          68          71
12.1    Civilian personnel benefits.....          12          13          13
12.2    Military personnel benefits.....           7           8           8
21.0    Travel and transportation of 
          persons.......................           3           3           3
22.0    Transportation of things........           3           3           3
23.1    Rental payments to GSA..........           1           1           1
23.3    Communications, utilities, and 
          miscellaneous charges.........          14          15          15
25.1    Advisory and assistance services           5           5           4
25.2    Other services..................          95          88          76
25.3    Other purchases of goods and 
          services from Government 
          accounts......................           1           1           1
25.4    Operation and maintenance of 
          facilities....................           7           6           7
25.7    Operation and maintenance of 
          equipment.....................           2           2           2
26.0    Supplies and materials..........           8           7           7
31.0    Equipment.......................          11          10           9
32.0    Land and structures.............          43          29          15
41.0    Grants, subsidies, and 
          contributions.................         112         105         104
                                           ---------   ---------  ----------
99.0      Direct obligations............         390         364         339
99.0  Reimbursable obligations..........           4           7           7
                                           ---------   ---------  ----------
99.9    Total new obligations...........         394         371         346
---------------------------------------------------------------------------

                             Employment Summary

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

                                

            Administrative Provisions, Indian Health Service

    Appropriations in this Act to the Indian Health Service shall be 
available for services as authorized by 5 U.S.C. 3109 but at rates not 
to exceed the per diem rate equivalent to the maximum rate payable for 
senior-level positions under 5 U.S.C. 5376; hire of passenger motor 
vehicles and aircraft; purchase of medical equipment; purchase of 
reprints; purchase, renovation and erection of modular buildings and 
renovation of existing facilities; payments for telephone service in 
private residences in the field, when authorized under regulations 
approved by the Secretary; and for uniforms or allowances therefor as 
authorized by 5 U.S.C. 5901-5902; and for expenses of attendance at 
meetings which are concerned with the functions or activities for which 
the appropriation is made or which will contribute to improved conduct, 
supervision, or management of those functions or activities.
    In accordance with the provisions of the Indian Health Care 
Improvement Act, non-Indian patients may be extended health care at all 
tribally administered or Indian Health Service facilities, subject to 
charges, and the proceeds along with funds recovered under the Federal 
Medical Care Recovery Act (42 U.S.C. 2651-2653) shall be credited to the 
account of the facility providing the service and shall be available 
without fiscal year limitation. Notwithstanding any other law or 
regulation, funds transferred from the Department of Housing and Urban 
Development to the Indian Health Service shall be administered under 
Public Law 86-121 (the Indian Sanitation Facilities Act) and Public Law 
93-638, as amended.
    Funds appropriated to the Indian Health Service in this Act, except 
those used for administrative and program direction purposes, shall not 
be subject to limitations directed at curtailing Federal travel and 
transportation.
    Notwithstanding any other provision of law, funds previously or 
herein made available to a tribe or tribal organization through a 
contract, grant, or agreement authorized by title I or title V of the 
Indian Self-Determination and Education Assistance Act of 1975 (25 
U.S.C. 450), may be deobligated and reobligated to a self-determination 
contract under title I, or a self-governance agreement under title V of 
such Act and thereafter shall remain available to the tribe or tribal 
organization without fiscal year limitation.
    None of the funds made available to the Indian Health Service in 
this Act shall be used to implement the final rule published in the 
Federal Register on September 16, 1987, by the Department of Health and 
Human Services, relating to the eligibility for the health care services 
of the Indian Health Service until the Indian Health Service has 
submitted a budget request reflecting the increased costs associated 
with the proposed final rule, and such request has been included in an 
appropriations Act and enacted into law.
    With respect to functions transferred by the Indian Health Service 
to tribes or tribal organizations, the Indian Health Service is author

[[Page 404]]

ized to provide goods and services to those entities, on a reimbursable 
basis, including payment in advance with subsequent adjustment. The 
reimbursements received therefrom, along with the funds received from 
those entities pursuant to the Indian Self-Determination Act, may be 
credited to the same or subsequent appropriation account which provided 
the funding. Such amounts shall remain available until expended.
    Reimbursements for training, technical assistance, or services 
provided by the Indian Health Service will contain total costs, 
including direct, administrative, and overhead associated with the 
provision of goods, services, or technical assistance.
    The appropriation structure for the Indian Health Service may not be 
altered without advance notification to the House and Senate Committees 
on Appropriations.

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

                                


 
               CENTERS FOR DISEASE CONTROL AND PREVENTION

                                 Federal

                 Disease Control, Research, and Training

    To carry out titles II, III, VII, XI, XV, XVII, XIX, XXI, and XXVI 
of the Public Health Service Act, sections 101, 102, 103, 201, 202, 203, 
301, and 501 of the Federal Mine Safety and Health Act of 1977, sections 
20, 21, and 22 of the Occupational Safety and Health Act of 1970, title 
IV of the Immigration and Nationality Act, section 501 of the Refugee 
Education Assistance Act of 1980, and for expenses necessary to support 
activities related to countering potential biological, disease, nuclear, 
radiological, and chemical threats to civilian populations; including 
purchase and insurance of official motor vehicles in foreign countries; 
and purchase, hire, maintenance, and operation of aircraft, 
$5,716,651,000, of which $20,000,000 shall remain available until 
expended for equipment, construction and renovation of facilities; of 
which $581,335,000 shall remain available until expended for the 
Strategic National Stockpile; and of which $121,224,000 for 
international HIV/AIDS shall remain available until September 30, 2009; 
and of which $30,000,000 shall remain available until expended for 
section 2625 of the PHS act. In addition, such sums as may be derived 
from authorized user fees, which shall be credited to this account: 
Provided, That in addition to amounts provided herein, the following 
amounts shall be available from amounts available under section 241 of 
the Public Health Service Act: (1) $12,794,000 to carry out the National 
Immunization Surveys; (2) $109,921,000 to carry out the National Center 
for Health Statistics surveys; (3) $24,751,000 to carry out information 
systems standards development and architecture and applications-based 
research used at local public health levels; (4) $463,000 for Health 
Marketing evaluations; (5) $31,000,000 to carry out Public Health 
Research; and (6) $87,071,000 to carry out research activities within 
the National Occupational Research Agenda: Provided further, That none 
of the funds made available for injury prevention and control at the 
Centers for Disease Control and Prevention may be used, in whole or in 
part, to advocate or promote gun control: Provided further, That up to 
$31,800,000 shall be made available until expended for Individual 
Learning Accounts for full-time equivalent employees of the Centers for 
Disease Control and Prevention: Provided further, That the Director may 
redirect the total amount made available under authority of Public Law 
101-502, section 3, dated November 3, 1990, to activities the Director 
may so designate: Provided further, That the Congress is to be notified 
promptly of any such transfer: Provided further, That not to exceed 
$12,500,000 may be available for making grants under section 1509 of the 
Public Health Service Act to not more than 15 States, tribes, or tribal 
organizations: Provided further, That of the funds appropriated, $10,000 
is for official reception and representation expenses when specifically 
approved by the Director of the Centers for Disease Control and 
Prevention.

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

          Special and Trust Fund Receipts (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0943-0-1-550      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
01.00 Balance, start of year............
                                           ---------   ---------  ----------
01.99 Balance, start of year............
    Receipts:
02.20 Cooperative research and 
        development agreements, Centers 
        for Disease Control.............           1           1           1
                                           ---------   ---------  ----------
04.00 Total: Balances and collections...           1           1           1
    Appropriations:
05.00 Disease control, research, and 
        training........................          -1          -1          -1
                                           ---------   ---------  ----------
07.99 Balance, end of year..............
---------------------------------------------------------------------------

               Program and Financing (in millions of dollars)

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

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

[[Page 405]]



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

    Offsets:
      Against gross budget authority and outlays:

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

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

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

    The Centers for Disease Control and Prevention (CDC) supports a 
number of categorical programs designed to improve the health, safety, 
and protection of all Americans. These activities include immunization, 
HIV prevention, chronic disease prevention and health promotion, 
infectious disease control, occupational safety and health, injury 
prevention and control, environmental health, and programs that reduce 
the occurrence of birth defects and developmental disabilities. CDC also 
supports bioterrorism, emergency response, and pandemic influenza 
preparedness activities.

               Object Classification (in millions of dollars)

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

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

                             Employment Summary

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

                                

            Agency for Toxic Substances and Disease Registry

            toxic substances and environmental public health

    For necessary expenses for the Agency for Toxic Substances and 
Disease Registry (ATSDR) in carrying out activities set forth in 
sections 104(i), 111(c)(4), and 111(c)(14) of the Comprehensive 
Environmental Response, Compensation, and Liability Act of 1980 
(CERCLA), as amended; section 118(f) of the Superfund Amendments and 
Reauthorization Act of 1986 (SARA), as amended; and section 3019 of the 
Solid Waste Disposal Act, as amended, $75,004,000, of which up to 
$1,500,000, to remain available until expended, is for Individual 
Learning Accounts for full-time equivalent employees of the Agency for 
Toxic Substances and Disease Registry: Provided, That notwithstanding 
any other provision of law, in lieu of performing a health assessment 
under section 104(i)(6) of CERCLA, the Administrator of ATSDR may 
conduct other appropriate health studies, evaluations, or activities, 
including, without limitation, biomedical testing, clinical evaluations, 
medical monitoring, and referral to accredited health care providers: 
Provided further, That in performing any such health assessment or 
health study, evaluation, or activity, the Administrator of ATSDR shall 
not be bound by the deadlines in section 104(i)(6)(A) of CERCLA: 
Provided further, That none of the funds appropriated under this heading 
shall be available for ATSDR to issue in excess of 40 toxicological 
profiles pursuant to section 104(i) of CERCLA during fiscal year 2008, 
and existing profiles may be updated as necessary.

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

               Program and Financing (in millions of dollars)

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

[[Page 406]]

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

    Offsets:
      Against gross budget authority and outlays:

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

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

    Net budget authority and outlays:
89.00 Budget authority..................          75          75          75
90.00 Outlays...........................          69          74          75
---------------------------------------------------------------------------

    The Agency for Toxic Substances and Disease Registry (ATSDR) is 
authorized under the Comprehensive Environmental Response, Compensation, 
and Liability Act of 1980 (CERCLA). ATSDR assesses health hazards at 
specific hazardous waste sites helping to prevent or reduce exposure and 
illnesses that result, and increasing knowledge and understanding of the 
health effects that may result from exposure to hazardous substances.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0944-0-1-551      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
      Direct obligations:

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

                             Employment Summary

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

                                

                               Trust Funds

   Toxic Substances and Environmental Public Health, Agency for Toxic 
                     Substances and Disease Registry

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-8252-0-7-551      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
    Budgetary resources available for obligation:
24.41 Special and trust fund receipts 
        returned to Schedule N..........           1
----------------------------------------------------------------------------

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

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

    The Agency for Toxic Substances and Disease Registry (ATSDR) 
received appropriations solely from the Hazardous Substance Superfund 
trust fund until 2004, when ATSDR received an appropriation from the 
general fund, depending on any available balances from the trust fund. 
The Budget proposes that ATSDR's appropriation come only from the 
general fund in 2008, without regard to any available balances in the 
trust fund.

                                


 
                      NATIONAL INSTITUTES OF HEALTH

                                 Federal

                        National Cancer Institute

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to cancer, $4,782,114,000, of which up to 
$8,000,000 may be used for facilities repairs and improvements at the 
NCI-Frederick Federally Funded Research and Development Center in 
Frederick, Maryland.

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

                National Heart, Lung, and Blood Institute

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to cardiovascular, lung, and blood diseases, 
and blood and blood products, $2,925,413,000.

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

         National Institute of Dental and Craniofacial Research

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to dental disease, $389,722,000.

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

    National Institute of Diabetes and Digestive and Kidney Diseases

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to diabetes and digestive and kidney disease, 
$1,708,045,000.


[[Page 407]]


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

         National Institute of Neurological Disorders and Stroke

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to neurological disorders and stroke, 
$1,537,019,000.

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

          National Institute of Allergy and Infectious Diseases

                      (including transfer of funds)

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to allergy and infectious diseases, 
$4,592,482,000: Provided, That $300,000,000 may be made available to 
International Assistance Programs ``Global Fund to Fight HIV/AIDS, 
Malaria, and Tuberculosis'', to remain available until expended: 
Provided further, That such sums obligated in fiscal years 2003 through 
2007 for extramural facilities construction projects are to remain 
available until expended for disbursement, with prior notification of 
such projects to the House of Representatives and Senate Committees on 
Appropriations.

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

             National Institute of General Medical Sciences

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to general medical sciences, $1,941,462,000.

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

        National Institute of Child Health and Human Development

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to child health and human development, 
$1,264,946,000.

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

                         National Eye Institute

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to eye diseases and visual disorders, 
$667,820,000.

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

           National Institute of Environmental Health Sciences

    For carrying out sections 301 and 311 and title IV of the Public 
Health Service Act with respect to environmental health sciences, 
$637,406,000.

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

    For necessary expenses for the National Institute of Environmental 
Health Sciences in carrying out activities set forth in section 311(a) 
of the Comprehensive Environmental Response, Compensation, and Liability 
Act of 1980, as amended, and section 126(g) of the Superfund Amendments 
and Reauthorization Act of 1986, $78,434,000.

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

                       National Institute on Aging

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

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

  National Institute of Arthritis and Musculoskeletal and Skin Diseases

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to arthritis and musculoskeletal and skin 
diseases, $508,082,000.

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

    National Institute on Deafness and Other Communication Disorders

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to deafness and other communication disorders, 
$393,682,000.

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

                 National Institute of Nursing Research

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

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

           National Institute on Alcohol Abuse and Alcoholism

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to alcohol abuse and alcoholism, $436,505,000.

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

                    National Institute on Drug Abuse

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

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

                   National Institute of Mental Health

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

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

                National Human Genome Research Institute

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to human genome research, $484,436,000.

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

       National Institute of Biomedical Imaging and Bioengineering

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

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

                 National Center for Research Resources

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to research resources and general research 
support grants, $1,112,498,000: Provided, That none of these funds shall 
be used to pay recipients of the general research support grants program 
any amount for indirect expenses in connection with such grants.

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

[[Page 408]]

       National Center for Complementary and Alternative Medicine

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to complementary and alternative medicine, 
$121,699,000.

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

        National Center on Minority Health and Health Disparities

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to minority health and health disparities 
research, $194,495,000.

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

                  John E. Fogarty International Center

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

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

                      National Library of Medicine

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to health information communications, 
$312,562,000, of which $4,000,000 shall be available until expended for 
improvement of information systems: Provided, That in fiscal year 2008, 
the Library may enter into personal services contracts for the provision 
of services in facilities owned, operated, or constructed under the 
jurisdiction of the National Institutes of Health: Provided further, 
That in addition to amounts provided herein, $8,200,000 shall be 
available from amounts available under section 241 of the Public Health 
Service Act to carry out National Information Center on Health Services 
Research and Health Care Technology and related health services.

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

                         Office of the Director

                      (including transfer of funds)

    For carrying out the responsibilities of the Office of the Director, 
National Institutes of Health, $517,062,000, of which up to $25,000,000 
shall be used to carry out section 215 of this Act: Provided, That 
funding shall be available for the purchase of not to exceed 29 
passenger motor vehicles for replacement only: Provided further, That 
the National Institutes of Health is authorized to collect third party 
payments for the cost of clinical services that are incurred in National 
Institutes of Health research facilities and that such payments shall be 
credited to the National Institutes of Health Management Fund: Provided 
further, That all funds credited to such Fund shall remain available for 
one fiscal year after the fiscal year in which they are deposited: 
Provided further, That the amounts appropriated in this Act to each 
Institute and Center may be transferred and utilized for the National 
Institutes of Health Common Fund: Provided further, That the amount 
utilized under the preceding proviso shall not exceed $365,000,000 
without prior notification to the Committees on Appropriations of the 
House of Representatives and the Senate: Provided further, That amounts 
transferred and utilized under the preceding two provisos shall be in 
addition to amounts made available for the Common Fund from the 
Director's Discretionary Fund and to any amounts allocated to activities 
related to the Common Fund through the normal research priority-setting 
process of individual Institutes and Centers: Provided further, That of 
the funds provided $10,000 shall be for official reception and 
representation expenses when specifically approved by the Director of 
NIH: Provided further, That the Office of AIDS Research within the 
Office of the Director, NIH may spend up to $4,000,000 to make grants 
for construction or renovation of facilities as provided for in section 
2354(a)(5)(B) of the Public Health Service Act.

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

                        Buildings and Facilities

    For the study of, construction of, renovation of, and acquisition of 
equipment for, facilities of or used by the National Institutes of 
Health, including the acquisition of real property, $136,000,000, to 
remain available until expended.

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

          Special and Trust Fund Receipts (in millions of dollars)

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

               Program and Financing (in millions of dollars)

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

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

    New budget authority (gross), detail:
      Discretionary:

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

[[Page 409]]

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

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

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

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

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

         DISTRIBUTION OF BUDGET AUTHORITY AND OUTLAYS BY ACCOUNT

                          [Dollars in millions]

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

                          [Dollars in millions]

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

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

               Object Classification (in millions of dollars)

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

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

[[Page 410]]

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

                             Employment Summary

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

                                


 
        SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION

                                 Federal

               Substance Abuse and Mental Health Services

    For carrying out titles V and XIX of the Public Health Service Act 
(``PHS Act'') with respect to substance abuse and mental health 
services, the Protection and Advocacy for Individuals with Mental 
Illness Act, and section 301 of the PHS Act with respect to program 
management, $3,046,426,000: Provided, That notwithstanding section 
520A(f)(2) of the PHS Act, no funds appropriated for carrying out 
section 520A are available for carrying out section 1971 of the PHS Act: 
Provided further, That in addition to amounts provided herein, the 
following amounts shall be available under section 241 of the PHS Act: 
(1) $79,200,000 to carry out subpart II of part B of title XIX of the 
PHS Act to fund section 1935(b) technical assistance, national data, 
data collection and evaluation activities, and further that the total 
available under this Act for section 1935(b) activities shall not exceed 
5 percent of the amounts appropriated for subpart II of part B of title 
XIX; (2) $21,413,000 to carry out subpart I of part B of title XIX of 
the PHS Act to fund section 1920(b) technical assistance, national data, 
data collection and evaluation activities, and further that the total 
available under this Act for section 1920(b) activities shall not exceed 
5 percent of the amounts appropriated for subpart I of part B of title 
XIX; (3) $16,250,000 to carry out national surveys on drug abuse; and 
(4) $4,300,000 to evaluate substance abuse treatment programs. Pursuant 
to section 1942 of the PHS Act, a State that receives an allotment under 
section 1911 or 1921 of such Act for the current fiscal year shall 
submit data from the previous year on all developed National Outcome 
Measures. A State shall not receive more than 95 percent of the State's 
allotment as determined under section 1933 for such year if that State 
does not report on National Outcome Measures under section 1921. 
Undistributed amounts under section 1921 shall be reallocated to States 
that report on such measures under section 1921 in accordance with 
section 1944 of the PHS Act.

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

               Program and Financing (in millions of dollars)

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

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

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

    This program provides Federal support to strengthen the capacity of 
the Nation's health care delivery system to provide substance abuse 
prevention, addiction treatment, and mental health services, for people 
at risk for or experiencing substance abuse or mental illness. SAMHSA 
builds partnerships with states, communities, and private organizations 
to address the needs of individuals with substance abuse disorders

[[Page 411]]

and/or mental illness and to identify and respond to the community risk 
factors that contribute to these illnesses.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1362-0-1-551      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
      Direct obligations:

        Personnel compensation:
11.1      Full-time permanent...........          39          41          42
11.3      Other than full-time permanent           2           3           3
11.5      Other personnel compensation..           1           1           2
11.7      Military personnel............           1           2           2
                                           ---------   ---------  ----------
11.9      Total personnel compensation..          43          47          49
12.1    Civilian personnel benefits.....           9          10          10
12.2    Military personnel benefits.....           1           2           2
21.0    Travel and transportation of 
          persons.......................           2           1           1
23.1    Rental payments to GSA..........           6           6           6
23.3    Communications, utilities, and 
          miscellaneous charges.........           1           1           1
24.0    Printing and reproduction.......           5           4           3
25.1    Advisory and assistance services          23          22          12
25.2    Other services..................         176         169          98
25.3    Other purchases of goods and 
          services from Government 
          accounts......................         100         102          75
26.0    Supplies and materials..........           1           1           1
41.0    Grants, subsidies, and 
          contributions.................       2,832       2,839       2,787
42.0    Insurance claims and indemnities           2           1           1
                                           ---------   ---------  ----------
99.0      Direct obligations............       3,201       3,205       3,046
99.0  Reimbursable obligations..........         281         272         272
                                           ---------   ---------  ----------
99.9    Total new obligations...........       3,482       3,477       3,318
---------------------------------------------------------------------------

                             Employment Summary

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

                                


 
               AGENCY FOR HEALTHCARE RESEARCH AND QUALITY

                                 Federal

                     Healthcare Research and Quality

    For carrying out titles III and IX of the Public Health Service Act, 
and part A of title XI of the Social Security Act, amounts received from 
Freedom of Information Act fees, reimbursable and interagency 
agreements, and the sale of data shall be credited to this appropriation 
and shall remain available until expended: Provided, That the amount 
made available pursuant to section 927(c) of the Public Health Service 
Act shall not exceed $329,564,000.

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

               Program and Financing (in millions of dollars)

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

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

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

               Object Classification (in millions of dollars)

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

                             Employment Summary

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

                                


 
               CENTERS FOR MEDICARE AND MEDICAID SERVICES

                                 Federal

                      Grants to States for Medicaid

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

[[Page 412]]

 2008, for unanticipated costs, incurred for the current fiscal year, 
such sums as may be necessary.
    For making payments to States or in the case of section 1928 on 
behalf of States under title XIX of the Social Security Act for the 
first quarter of fiscal year 2009, $67,292,669,000, to remain available 
until expended.
    Payment under title XIX may be made for any quarter with respect to 
a State plan or plan amendment in effect during such quarter, if 
submitted in or prior to such quarter and approved in that or any 
subsequent quarter.

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

               Program and Financing (in millions of dollars)

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

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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

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

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

    Medicaid assists States in providing medical care to their low-
income populations by granting Federal matching payments under title XIX 
of the Social Security Act to States with approved plans.

    Medicaid estimates assume budget authority for expenses that are 
incurred but not reported (IBNR).

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0512-0-1-551      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
41.0  Direct obligations: Grants, 
        subsidies, and contributions....     201,578     194,841     206,886
99.0    Reimbursable obligations: 
          reimbursable obligations......         264         350
                                           ---------   ---------  ----------
99.9    Total new obligations...........     201,842     195,191     206,886
---------------------------------------------------------------------------

                      Grants to States for Medicaid

              (Legislative proposal, not subject to PAYGO)

               Program and Financing (in millions of dollars)

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

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

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

    This schedule reflects the Administration's Medicaid proposal.

                      Grants to States for Medicaid

                (Legislative proposal, subject to PAYGO)

               Program and Financing (in millions of dollars)

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

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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

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

[[Page 413]]

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

    This schedule reflects the Administration's Medicaid proposal.

               Object Classification (in millions of dollars)

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

                                

                     State Grants and Demonstrations

               Program and Financing (in millions of dollars)

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

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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

    Offsets:
      Against gross budget authority and outlays:

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

    Net budget authority and outlays:
89.00 Budget authority..................       2,566         707         764
90.00 Outlays...........................       1,269       1,680         496
---------------------------------------------------------------------------

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

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

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

               Object Classification (in millions of dollars)

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

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

[[Page 414]]

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

                             Employment Summary

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

                                

 Health Care Infrastructure Improvement Program, Direct Loan Financing 
                                 Account

               Program and Financing (in millions of dollars)

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

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

    New financing authority (gross), detail:
      Mandatory:

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

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

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

    Offsets:
      Against gross financing authority and 
          financing disbursements:

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

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

               Status of Direct Loans (in millions of dollars)

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

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

                             Balance Sheet (in millions of dollars)

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

2005 actual

2006 actual

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

1401

Direct loans receivable, gross



140

1402

Interest receivable



7

1405

Allowance for subsidy cost (-)



-147





1499

Net present value of assets related to direct loans









1999

Total assets





    LIABILITIES:
2999

Total liabilities





    NET POSITION:
3999

Total net position









4999

Total liabilities and net position





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

                                

                   Payments to Health Care Trust Funds

    For payment to the Federal Hospital Insurance and the Federal 
Supplementary Medical Insurance Trust Funds, as provided under section 
1844 and 1860D-16 of the Social Security Act, sections 103(c) and 111(d) 
of the Social Security Amendments of 1965, section 278(d) of Public Law 
97-248, and for administrative expenses incurred pursuant to section 
201(g) of the Social Security Act, $188,628,000,000.
    In addition, for making matching payments under section 1844, and 
benefit payments under 1860D-16 of the Social Security Act, not 
anticipated in budget estimates, such sums as may be necessary.

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

               Program and Financing (in millions of dollars)

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

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

    New budget authority (gross), detail:
      Mandatory:

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

[[Page 415]]

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

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

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

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

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

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

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

    Payments are made to the Federal Hospital Insurance and Federal 
Supplementary Medical Insurance trust funds from the general fund of the 
Treasury to finance Medicare's medical and drug benefits for 
beneficiaries and certain other qualified individuals.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0580-0-1-571      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
    Direct obligations:
41.0  Grants, subsidies, and 
        contributions...................     173,015     186,102     199,774
42.0  Insurance claims and indemnities..         408         468         506
94.0  Financial transfers (federal 
        admin)..........................         305         879         936
                                           ---------   ---------  ----------
99.0    Direct obligations..............     173,728     187,449     201,216
                                           ---------   ---------  ----------
99.9    Total new obligations...........     173,728     187,449     201,216
---------------------------------------------------------------------------

                   Payments to Health Care Trust Funds

              (Legislative proposal, not subject to PAYGO)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0580-2-1-571      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
    Obligations by program activity:
00.01 Supplementary medical insurance 
        (SMI)...........................                              -1,203
00.11 General Revenue for Part D 
        Benefits........................                                -446
                                           ---------   ---------  ----------
10.00   Total new obligations (object 
          class 41.0)...................                              -1,649
----------------------------------------------------------------------------

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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

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

    The Budget proposes a package of reforms to encourage competition, 
recognize efficiencies and productivity in health care, enhance program 
integrity, and strengthen responsibility for health care choices.

                                

                           Program Management

    For carrying out, except as otherwise provided, titles XI, XVIII, 
XIX, and XXI of the Social Security Act (SSA), titles XIII and XXVII of 
the Public Health Service Act, and the Clinical Laboratory Improvement 
Amendments of 1988, not to exceed $3,274,026,000, to be transferred from 
the Federal Hospital Insurance and the Federal Supplementary Medical 
Insurance Trust Funds, as authorized by section 201(g) of the SSA; 
together with all funds collected in accordance with section 353 of the 
Public Health Service Act and section 1857(e)(2) of the SSA, funds 
retained by the Secretary pursuant to section 302 of the Tax Relief and 
Health Care Act of 2006; and such sums as may be collected from 
authorized user fees and the sale of data, which shall remain available 
until expended: Provided, That all funds derived in accordance with 31 
U.S.C. 9701 from organizations established under title XIII of the 
Public Health Service Act shall be credited to and available for 
carrying out the purposes of this appropriation: Provided further, That 
$49,869,000, to remain available until September 30, 2009, is for 
contract costs for the Healthcare Integrated General Ledger Accounting 
System: Provided further, That the Centers for Medicare and Medicaid 
Services will take all reasonable actions necessary to ensure that 
before December 15, 2008 no fewer than 15 Medicare Administrative 
Contractors will commence the duties of Medicare claims-processing 
activities and related responsibilities: Provided further, That 
$253,775,000, to remain available until September 30, 2009, is for CMS 
Medicare contracting reform activities: Provided further, That funds 
appropriated under this heading are available for the Healthy Start, 
Grow Smart program under which the Centers for Medicare and Medicaid 
Services may, directly or through grants, contracts, or cooperative 
agreements, produce and distribute informational materials including, 
but not limited to, pamphlets and brochures on infant and toddler health 
care to expectant parents enrolled in the Medicaid program and to 
parents and guardians enrolled in such program with infants and 
children: Provided further, That the Secretary of Health and Human 
Services is directed to collect fees in fiscal year 2008 from Medicare 
Advantage organizations pursuant to section 1857(e)(2) of the Social 
Security Act and from eligible organizations with risk-sharing contracts 
under section 1876 of that Act pursuant to section 1876(k)(4)(D) of that 
Act.

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

               Program and Financing (in millions of dollars)

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

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

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

[[Page 416]]

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

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

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

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

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

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

               Object Classification (in millions of dollars)

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

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

                             Employment Summary

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

                           Program Management

              (Legislative proposal, not subject to PAYGO)

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

               Program and Financing (in millions of dollars)

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

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

[[Page 417]]


09.09   Total reimbursable program......                                  35
                                           ---------   ---------  ----------
10.00   Total new obligations...........
----------------------------------------------------------------------------

    Change in obligated balances:
73.10 Total new obligations.............
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

        Offsetting collections (cash) 
            from:
88.00     Federal sources...............                                  35
88.40     Non-Federal sources...........                                 -35
                                           ---------   ---------  ----------
88.90     Total, offsetting collections 
            (cash)......................
----------------------------------------------------------------------------

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

    The Budget includes $35 million in new user fees to finance survey 
and certification activities. Centers for Medicare and Medicaid Services 
(CMS) would charge revisit survey fees to health care facilities cited 
for deficiencies during initial certification, recertification, or 
substantiated complaint surveys. Proposed appropriations language 
provides authority to collect and spend these fees. The amount 
appropriated from the Federal Hospital Insurance (HI) and Federal 
Supplementary Medical Insurance (SMI) trust funds would be reduced on a 
dollar-for-dollar basis with fees collected.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0511-2-1-550      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
25.6  Direct obligations: Medical care..                                 -35
99.0    Reimbursable obligations: 
          reimbursable obligations......                                  35
                                           ---------   ---------  ----------
99.9    Total new obligations...........
---------------------------------------------------------------------------

                                

                 State Children's Health Insurance Fund

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0515-0-1-551      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
    Obligations by program activity:
00.01 Grants to States and U.S. 
        territories.....................       4,539       5,187       5,040
                                           ---------   ---------  ----------
10.00   Total new obligations (object 
          class 41.0)...................       4,539       5,187       5,040
----------------------------------------------------------------------------

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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

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

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

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

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

    The Balanced Budget Act of 1997 established the State Children's 
Health Insurance Program (SCHIP) under Title XXI of the Social Security 
Act. Title XXI provides Federal matching funds to States to enable them 
to extend coverage to uninsured children from low-income families. 
States are able to use Title XXI funds for obtaining health benefit 
coverage for uninsured children through a SCHIP program, a SCHIP 
Medicaid expansion program, or a combination of both.

                 State Children's Health Insurance Fund

                (Legislative proposal, subject to PAYGO)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0515-4-1-551      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
    Obligations by program activity:
00.01 SCHIP Reauthorization.............                               1,220
                                           ---------   ---------  ----------
10.00   Total new obligations (object 
          class 41.0)...................                               1,220
----------------------------------------------------------------------------

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

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

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

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

    This schedule reflects the Administration's SCHIP proposals.

                                

                  Medicare Advantage Stabilization Fund

          Special and Trust Fund Receipts (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-5384-0-2-571      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
01.00 Balance, start of year............                                  13
                                           ---------   ---------  ----------
01.99 Balance, start of year............                                  13
    Receipts:
02.00 Payments from HI, Stabilization 
        fund............................                       7          10
02.01 Payments from SMI, Stabilization 
        fund............................                       6           8
                                           ---------   ---------  ----------
02.99   Total receipts and collections..                      13          18
                                           ---------   ---------  ----------
04.00 Total: Balances and collections...                      13          31
                                           ---------   ---------  ----------
07.99 Balance, end of year..............                      13          31
---------------------------------------------------------------------------

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

[[Page 418]]

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

                                

  

                               Trust Funds

                  Federal Hospital Insurance Trust Fund

          Special and Trust Fund Receipts (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8005-0-7-571      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
01.00 Balance, start of year............     259,707     281,754     294,939
                                           ---------   ---------  ----------
01.99 Balance, start of year............     259,707     281,754     294,939
    Receipts:
02.00 FHI trust fund, Federal employer 
        contributions (FICA)............       2,722       2,839       2,965
02.01 FHI trust fund, Postal Service 
        employer contributions (FICA)...         682         694         720
02.02 FHI trust fund, Interest received 
        by trust funds..................      15,356      15,216      15,883
02.03 FHI trust fund, Interest received 
        by trust funds--legislative 
        proposal not subject to PAYGO...                                 109
02.04 FHI trust fund, Taxation on OASDI 
        benefits........................      10,319      10,810      12,245
02.05 FHI trust fund, Payment from the 
        general fund for health care 
        fraud and abuse control account.         114         118         121
02.06 FHI trust fund, Transfers from 
        general fund (criminal fines)...         144         200         200
02.07 FHI trust fund, Transfers from 
        general fund (civil monetary 
        penalties)......................          19          22          22
02.08 FHI trust fund, Interest payments 
        by Railroad Retirement Board....          32          30          29
02.09 FHI trust fund, Payments from the 
        general fund (uninsured and 
        program management).............         540         644         882
02.20 FHI trust fund, Other proprietary 
        receipts from the public........           3           1           1
02.21 FHI trust fund, Basic premium, 
        Medicare advantage..............          20          77          85
02.22 FHI trust fund, medicare refunds..       2,088       2,100       2,200
02.23 FHI trust fund, Premiums collected 
        for uninsured individuals not 
        otherwise eligible..............       2,632       2,782       2,889
02.60 FHI trust fund, Transfers from 
        general fund (FICA taxes).......     165,160     171,199     184,499
02.61 FHI trust fund, Receipts from 
        Railroad Retirement Board.......         440         459         483
02.62 FHI trust fund, Transfers from 
        general fund (SECA taxes).......      11,829      13,505      13,744
02.63 FHI trust fund, Civil penalties 
        and damages.....................         297         297         297
                                           ---------   ---------  ----------
02.99   Total receipts and collections..     212,397     220,993     237,374
                                           ---------   ---------  ----------
04.00 Total: Balances and collections...     472,104     502,747     532,313
    Appropriations:
05.00 Federal hospital insurance trust 
        fund............................         -29
05.01 Federal hospital insurance trust 
        fund............................      -1,832      -1,660      -1,731
05.02 Federal hospital insurance trust 
        fund............................          43
05.03 Federal hospital insurance trust 
        fund............................    -209,421    -218,221    -234,329
05.04 Federal hospital insurance trust 
        fund............................      22,059      13,185      19,642
05.05 Federal hospital insurance trust 
        fund--legislative proposal not 
        subject to PAYGO................                                  35
05.06 Federal hospital insurance trust 
        fund--legislative proposal not 
        subject to PAYGO................                                 -35
05.07 Federal hospital insurance trust 
        fund--legislative proposal not 
        subject to PAYGO................                                  35
05.08 Federal hospital insurance trust 
        fund--legislative proposal 
        subject to PAYGO................                                -109
05.09 Federal hospital insurance trust 
        fund--legislative proposal 
        subject to PAYGO................                               3,309
05.10 Health care fraud and abuse 
        control account.................                                -183
05.11 Health care fraud and abuse 
        control account.................      -1,187      -1,112      -1,131
                                           ---------   ---------  ----------
05.99   Total appropriations............    -190,367    -207,808    -214,497
06.10 Health care fraud and abuse 
        control account.................          17
                                           ---------   ---------  ----------
07.99 Balance, end of year..............     281,754     294,939     317,816
---------------------------------------------------------------------------

               Program and Financing (in millions of dollars)

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

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

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

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

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

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

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

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

    The status of the trust fund is as follows:

                  Status of Funds (in millions of dollars)

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

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

[[Page 419]]

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

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

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

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

               Object Classification (in millions of dollars)

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

                  Federal Hospital Insurance Trust Fund

              (Legislative proposal, not subject to PAYGO)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8005-2-7-571      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
    Obligations by program activity:
00.02 Administration, HI................                                 -35
                                           ---------   ---------  ----------
10.00   Total new obligations (object 
          class 94.0)...................                                 -35
----------------------------------------------------------------------------

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

    New budget authority (gross), detail:
      Discretionary:

40.26   Appropriation (trust fund)......                                 -35
      Mandatory:

60.26   Appropriation (trust fund)......                                  35
60.45   Portion precluded from balances.                                 -35
                                           ---------   ---------  ----------
62.50     Appropriation (total 
            mandatory)..................
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................                                 -35
----------------------------------------------------------------------------

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

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................                                 -35
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                                 -35
90.00 Outlays...........................                                 -35
----------------------------------------------------------------------------

    Memorandum (non-add) entries:
92.02 Total investments, end of year: 
        Federal securities: Par value...                                  35
---------------------------------------------------------------------------

    The Budget proposes a user fee to cover the costs associated with 
follow-up visits to health care facilities found to be out of compliance 
with Medicare standards.

                  Federal Hospital Insurance Trust Fund

                (Legislative proposal, subject to PAYGO)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8005-4-7-571      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
    Obligations by program activity:
00.01 Benefit payments, HI..............                              -3,200
                                           ---------   ---------  ----------
10.00   Total new obligations (object 
          class 42.0)...................                              -3,200
----------------------------------------------------------------------------

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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

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

    Memorandum (non-add) entries:
92.01 Total investments, start of year: 
        Federal securities: Par value...
92.02 Total investments, end of year: 
        Federal securities: Par value...                               3,309
---------------------------------------------------------------------------

    The Budget proposes a package of reforms to encourage competition, 
recognize efficiencies and productivity in health care, enhance program 
integrity, and strengthen responsibility for health care choices.

                                

               Health Care Fraud and Abuse Control Account

    In addition to amounts otherwise available for program integrity and 
program management, $183,000,000, to be transferred from the

[[Page 420]]

Federal Hospital Insurance and the Federal Supplementary Medical 
Insurance Trust Funds, as authorized by section 201(g) of the Social 
Security Act, of which $137,840,000 is for the Medicare Integrity 
Program at the Centers for Medicare and Medicaid Services to conduct 
oversight of activities authorized in titles I and II of Public Law 108-
173, with oversight activities including those activities listed in 18 
U.S.C. 1893(b); of which $17,530,000 is for the Department of Health and 
Human Services Office of Inspector General; of which $10,100,000 is for 
the Medicaid program integrity activities; and of which $17,530,000 is 
for the Department of Justice: Provided, That the report required by 18 
U.S.C. 1817(k)(5) for FY 2008 shall include measures of the operational 
efficiency and impact on fraud, waste and abuse in the Medicare and 
Medicaid programs for the funds provided by this appropriation.

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-8393-0-7-571      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
    Obligations by program activity:
00.01 Medicare integrity program........         832         744         756
00.02 FBI fraud and abuse control.......         114         118         121
00.03 Other fraud and abuse control.....         240         250         254
                                           ---------   ---------  ----------
00.91   Subtotal, mandatory.............       1,186       1,112       1,131
01.01 MIP--discretionary................                                 138
01.02 FBI--discretionary................                                   9
01.03 Other discretionary...............                                  36
                                           ---------   ---------  ----------
01.91   Subtotal, discretionary.........                                 183
09.01 Reimbursable (OIG)................           8           6          10
                                           ---------   ---------  ----------
10.00   Total new obligations...........       1,194       1,118       1,324
----------------------------------------------------------------------------

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

    P.L. 104-191 established the Health Care Fraud and Abuse Control 
(HCFAC) account within the Federal hospital insurance trust fund and 
appropriated funds, to be available without further appropriation, from 
the trust fund to the HCFAC account for specified health care fraud and 
abuse control activities of the Department of Health and Human Services 
(HHS), the Department of Justice, and other agencies.

    This schedule reflects the estimated distribution of the account for 
2007 and 2008. As required by statute, actual 2007 and 2008 agency 
distributions will be determined by the Secretary of HHS and the 
Attorney General consistent with the Administration's priorities.

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

    The 2008 Budget includes a discretionary request for efforts to 
safeguard Medicaid and the Medicare prescription drug benefit, and will 
supplement the mandatory funds made available by P.L. 104-191.

    It is important that these cost increases and new enforcement 
investments be fully funded. The Administration is proposing to fund 
them as contingent appropriations. To ensure full funding of the new 
enforcement investments, the Administration proposes to employ a budget 
enforcement mechanism that allows for an adjustment by the Budget 
Committees to the section 302(a) allocation to the Appropriations 
Committees found in the concurrent resolution on the budget. In 
addition, the Administration will also seek to establish statutory 
spending limits, as defined by section 251 of the Balanced Budget and 
Emergency Deficit Control Act of 1985, and to adjust them for this 
purpose. These adjustments would only be permissible if the use of these 
funds was clearly restricted to the specified purpose. The maximum 
allowable adjustment to the 302(a) allocation and/or the statutory 
spending limit would be $183 million for 2008 (see chapter 15 in 
Analytical Perspectives).

    The HCFAC entities will develop a comprehensive plan for Medicare, 
Medicaid and SCHIP program integrity activities. The plan will indicate 
how program integrity appropriations from all sources (DRA, HIPAA and 
the discretionary cap adjustment) will be allocated to address program 
integrity priorities. These priorities include the fraud, waste, and 
abuse vulnerabilities of these programs, and efforts to address 
responsibilities under the Improper Payments Improvement Act. 

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-8393-0-7-571      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
      Direct obligations:

11.1    Personnel compensation: Full-
          time permanent (CMS 100 FTEs).           8           8           8
12.1    Civilian personnel benefits 
          (CMS).........................           2           2           2
23.2    Rental payments to others.......           1           1           1
23.3    Communications, utilities, and 
          miscellaneous charges.........           1           1           1
25.2    Other services (CMS)............          10          10          20
25.3    Other purchases of goods and 
          services from Government 
          accounts (HHS)................           1           3           3
25.3    Other purchases of goods and 
          services from Government 
          accounts (DoJ)................          49          51          61
25.3    Other purchases of goods and 
          services from Government 
          accounts (HHS/OIG)............         160         166         187
25.3    Other purchases of goods and 
          services from Government 
          accounts (HHS/AoA)............           3           3           3
25.3    Other purchases of goods and 
          services from Government 
          accounts (HHS/OGC)............           5           5           5
25.6    Medical care (CMS)..............         832         744         894
94.0    Financial transfers.............         114         118         129
                                           ---------   ---------  ----------
99.0      Direct obligations............       1,186       1,112       1,314
99.0  Reimbursable obligations..........           8           6          10
                                           ---------   ---------  ----------
99.9    Total new obligations...........       1,194       1,118       1,324
---------------------------------------------------------------------------

[[Page 421]]



                             Employment Summary

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

                                

           Federal Supplementary Medical Insurance Trust Fund

          Special and Trust Fund Receipts (in millions of dollars)

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

               Program and Financing (in millions of dollars)

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

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

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

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

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

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

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


[[Page 422]]



    The Supplementary Medical Insurance (SMI) program is a voluntary 
program that affords protection against the costs of physician and 
certain other medical services. The program also covers treatment of 
end-stage renal disease for eligible enrollees. SMI costs are financed 
by premium payments from enrollees and contributions from the general 
revenues.

    The status of the trust fund is as follows:

                  Status of Funds (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8004-0-7-571      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
    Unexpended balance, start of year:
0100  Balance, start of year............      16,887      33,264      41,855
      Adjustments:

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

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

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

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

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

               Object Classification (in millions of dollars)

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

           Federal Supplementary Medical Insurance Trust Fund

              (Legislative proposal, not subject to PAYGO)

               Program and Financing (in millions of dollars)

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

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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

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

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

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

           Federal Supplementary Medical Insurance Trust Fund

                (Legislative proposal, subject to PAYGO)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8004-4-7-571      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
    Obligations by program activity:
00.01 Benefit payments, SMI.............                              -1,250
                                           ---------   ---------  ----------
10.00   Total new obligations (object 
          class 42.0)...................                              -1,250
----------------------------------------------------------------------------

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

    New budget authority (gross), detail:
      Mandatory:

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

[[Page 423]]



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

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

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

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

    The Budget proposes a package of reforms to encourage competition, 
recognize efficiencies and productivity in health care, enhance program 
integrity, and strengthen responsibility for health care choices.

                                

  

 Transitional Drug Assistance, Federal Supplementary Medical Insurance 
                               Trust Fund

               Program and Financing (in millions of dollars)

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

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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

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

    Authorized under the Medicare Modernization Act as section 1860 D-31 
of the Social Security Act, the Medicare Transitional Drug Assistance 
program provided low-income beneficiaries with $600 per year in 2004 and 
2005 to help them pay for their prescription drugs and covered the cost 
of enrollment fees. Some benefits remained available in early 2006, 
until beneficiaries had the opportunity to enroll in the voluntary 
Medicare prescription drug benefits.

                                

   Medicare Prescription Drug Account, Federal Supplementary Medical 
                          Insurance Trust Fund

               Program and Financing (in millions of dollars)

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

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

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

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

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

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

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

               Object Classification (in millions of dollars)

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

   Medicare Prescription Drug Account, Federal Supplementary Medical 
                          Insurance Trust Fund

                (Legislative proposal, subject to PAYGO)

               Program and Financing (in millions of dollars)

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

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

[[Page 424]]



    New budget authority (gross), detail:
      Mandatory:

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

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

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

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

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

                                

                 Allocation Received From Other Accounts

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

                                


 
                ADMINISTRATION FOR CHILDREN AND FAMILIES

                                 Federal

                 Temporary Assistance for Needy Families

               Program and Financing (in millions of dollars)

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

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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

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

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

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

               Object Classification (in millions of dollars)

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

                             Employment Summary

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

                                

                            Contingency Fund

               Program and Financing (in millions of dollars)

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

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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

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

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

[[Page 425]]

                                

  Payments to States for Child Support Enforcement and Family Support 
                                Programs

    For making payments to States or other non-Federal entities under 
titles I, IV-D, X, XI, XIV, and XVI of the Social Security Act and the 
Act of July 5, 1960 (24 U.S.C. Ch. 9), $2,949,713,000, to remain 
available until expended, of which up to $5,000,000 is for repatriation 
of U.S. citizens returned from foreign countries pursuant to section 
1113 of the Act (notwithstanding subsection (d) of such section); and 
for such purposes for the first quarter of fiscal year 2009, 
$1,000,000,000, to remain available until expended.
    For making payments to each State for carrying out the program of 
Aid to Families with Dependent Children under title IV-A of the Social 
Security Act before the effective date of the program of Temporary 
Assistance for Needy Families (TANF) with respect to such State, such 
sums as may be necessary: Provided, That the sum of the amounts 
available to a State with respect to expenditures under such title IV-A 
in fiscal year 1997 under this appropriation and under such title IV-A 
as amended by the Personal Responsibility and Work Opportunity 
Reconciliation Act of 1996 shall not exceed the limitations under 
section 116(b) of such Act.
    For making, after May 31 of the current fiscal year, payments to 
States or other non-Federal entities under titles I, IV-D, X, XI, XIV, 
and XVI of the Social Security Act and the Act of July 5, 1960 (24 
U.S.C. Ch. 9), for the last 3 months of the current fiscal year for 
unanticipated costs, incurred for the current fiscal year, such sums as 
may be necessary.

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

               Program and Financing (in millions of dollars)

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

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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

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

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

    This account provides for payments to States for child support 
enforcement and other family support programs, including access and 
visitation programs for families. The Federal share of child support 
collections is returned to the Treasury in a receipt account. The text 
table below shows the net Federal costs of child support enforcement and 
assumes enactment of legislative proposals effective in 2008.

             Net Federal Costs of Child Support Enforcement

                        (In millions of dollars)

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

               Object Classification (in millions of dollars)

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

  Payments to States for Child Support Enforcement and Family Support 
                                Programs

                (Legislative proposal, subject to PAYGO)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1501-4-1-609      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
    Obligations by program activity:
00.01 State child support administrative 
        costs...........................                                   5
00.03 Access and visitation grants......                                   2
                                           ---------   ---------  ----------
10.00   Total new obligations (object 
          class 41.0)...................                                   7
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                                   7
23.95 Total new obligations.............                                  -7
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.00   Appropriation...................                                   7
----------------------------------------------------------------------------

    Change in obligated balances:
73.10 Total new obligations.............                                   7
73.20 Total outlays (gross).............                                  -7
----------------------------------------------------------------------------

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

[[Page 426]]



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

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

                                

                    Low Income Home Energy Assistance

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

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

               Program and Financing (in millions of dollars)

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

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

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

    This program makes grants to States and Indian Tribes to aid low-
income households with high energy costs through payments to eligible 
households, energy suppliers, and weatherization providers. Obligation 
estimates for the contingency fund are based on average historical 
obligation rates.

                                

                     Refugee and Entrant Assistance

    For necessary expenses for refugee and entrant assistance activities 
and for costs associated with the care and placement of unaccompanied 
alien children authorized by section 414 of the Immigration and 
Nationality Act and section 501 of the Refugee Education Assistance Act 
of 1980, for carrying out section 462 of the Homeland Security Act of 
2002, and for carrying out the Torture Victims Relief Act of 2003, 
$655,630,000, of which up to $14,816,000 shall be available to carry out 
the Trafficking Victims Protection Reauthorization Act of 2005: 
Provided, That funds appropriated under this heading pursuant to section 
414(a) of the Immigration and Nationality Act and section 462 of the 
Homeland Security Act of 2002 for fiscal year 2008 shall be available 
for the costs of assistance provided and other activities to remain 
available through September 30, 2010 (6 U.S.C. 279; 8 U.S.C. 1522 note, 
1524; 22 U.S.C. 2152 note, 7101 et seq.).

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

               Program and Financing (in millions of dollars)

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

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

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

[[Page 427]]

bilitation of victims of torture, trafficking victims, and the care and 
placement of unaccompanied alien children.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1503-0-1-609      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
    Direct obligations:
11.1  Personnel compensation: Full-time 
        permanent.......................           3           3           3
23.1  Rental payments to GSA............           1           1           1
25.1  Advisory and assistance services..          14          15          15
25.2  Other services....................           2           3           3
25.3  Other purchases of goods and 
        services from Government 
        accounts........................          10          10          14
41.0  Grants, subsidies, and 
        contributions...................         523         539         620
                                           ---------   ---------  ----------
99.9    Total new obligations...........         553         571         656
---------------------------------------------------------------------------

                             Employment Summary

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

                                

                   Promoting Safe and Stable Families

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

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

               Program and Financing (in millions of dollars)

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

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

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

    This program provides funds for a broad range of child welfare 
services, including family preservation and family support services.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1512-0-1-506      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
    Direct obligations:
25.1  Advisory and assistance services..           4           3           3
25.3  Other purchases of goods and 
        services from Government 
        accounts........................           1
41.0  Grants, subsidies, and 
        contributions...................         449         451         451
                                           ---------   ---------  ----------
99.9    Total new obligations...........         454         454         454
---------------------------------------------------------------------------

                                

                    Child Care Entitlement to States

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1550-0-1-609      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
    Obligations by program activity:
00.01 Mandatory child care..............       1,178       1,178       1,178
00.02 Matching child care...............       1,677       1,674       1,674
00.03 Training and technical assistance.           7           7           7
00.04 Child care tribal grants..........          58          58          58
                                           ---------   ---------  ----------
10.00   Total new obligations...........       2,920       2,917       2,917
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance carried 
        forward, start of year..........         991
22.00 New budget authority (gross)......       1,926       2,917       2,917
22.30 Expired unobligated balance 
        transfer to unexpired account...           3
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......       2,920       2,917       2,917
23.95 Total new obligations.............      -2,920      -2,917      -2,917
                                           ---------   ---------  ----------
24.40   Unobligated balance carried 
          forward, end of year..........
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

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

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

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

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

    This account provides child care funding for welfare recipients and 
low-income working families and was established by the Personal 
Responsibility and Work Opportunity Reconciliation Act of 1996 (P.L. 
104-193).

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1550-0-1-609      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
    Direct obligations:
25.1  Advisory and assistance services..           7           7           7
41.0  Grants, subsidies, and 
        contributions...................       2,913       2,910       2,910
                                           ---------   ---------  ----------
99.9    Total new obligations...........       2,920       2,917       2,917
---------------------------------------------------------------------------

                                

    Payments to States for the Child Care and Development Block Grant

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

[[Page 428]]

care assistance for low-income families: Provided, That $18,777,370 
shall be available for child care resource and referral and school-aged 
child care activities, of which $982,080 shall be for the Child Care 
Aware toll-free hotline: Provided further, That, in addition to the 
amounts required to be reserved by the States under section 658G, 
$267,785,718 shall be reserved by the States for activities authorized 
under section 658G, of which $98,208,000 shall be for activities that 
improve the quality of infant and toddler care: Provided further, That 
$9,821,000 shall be for use by the Secretary for child care research, 
demonstration, and evaluation activities.

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

               Program and Financing (in millions of dollars)

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

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

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

               Object Classification (in millions of dollars)

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

                                

                       Social Services Block Grant

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

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

               Program and Financing (in millions of dollars)

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

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

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

                                

                 Children and Families Services Programs

    For carrying out, except as otherwise provided, the Runaway and 
Homeless Youth Act, the Developmental Disabilities Assistance and Bill 
of Rights Act of 2000, the Head Start Act, the Child Abuse Prevention 
and Treatment Act, sections 310 and 316 of the Family Violence 
Prevention and Services Act, the Native American Programs Act of 1974, 
title II of the Child Abuse Prevention and Treatment and Adoption Reform 
Act of 1978 (adoption opportunities), sections 330F and 330G of the 
Public Health Services Act, the Abandoned Infants Assistance Act of 
1988, sections 261 and 291 of the Help America Vote Act of 2002, part 
B(1) of title IV and sections 413, 1110, and 1115 of the Social Security 
Act, sections 439(i), 473(B), and 477(i) of the Social Security Act, and 
the Assets for Independence Act, and for necessary administrative 
expenses to carry out said Acts and titles I, IV, V, X, XI, XIV, XVI, 
and XX of the Social Security Act, the Act of July 5, 1960, the Low 
Income Home Energy Assistance Act of 1981, title IV of the Immigration 
and Nationality Act, section 501 of the Refugee Education Assistance Act 
of 1980, $8,239,709,000, of which $13,500,000, to remain available until 
September 30, 2009, shall be for grants to States for adoption incentive 
payments, as authorized by section 473A of the Social Security Act and 
may be made for adoptions completed before September 30, 2008: Provided, 
That $6,788,571,000 shall be for making payments under the Head Start 
Act, of which $1,388,800,000 shall become available October 1, 2008, and 
remain available through September 30, 2009: Provided further, That in 
addition to amounts provided herein, $5,880,000 shall be available from 
amounts available under section 241 of the Public Health Service Act to 
carry out the provisions of section 1110 of the Social Security Act: 
Provided further, That $75,000,000 is for

[[Page 429]]

a compassion capital fund to provide grants to charitable organizations 
to emulate model social service programs and to encourage research on 
the best practices of social service organizations: Provided further, 
That $15,720,000 shall be for activities authorized by the Help America 
Vote Act of 2002, of which $10,890,000 shall be for payments to States 
to promote access for voters with disabilities, and of which $4,830,000 
shall be for payments to States for protection and advocacy systems for 
voters with disabilities: Provided further, That $136,664,000 shall be 
for making competitive grants to provide abstinence education (as 
defined by section 510(b)(2) of the Social Security Act) to adolescents, 
and for Federal costs of administering the grant: Provided further, That 
grants under the immediately preceding proviso shall be made only to 
public and private entities which agree that, with respect to an 
adolescent to whom the entities provide abstinence education under such 
grant, the entities will not provide to that adolescent any other 
education regarding sexual conduct, except that, in the case of an 
entity expressly required by law to provide health information or 
services the adolescent shall not be precluded from seeking health 
information or services from the entity in a different setting than the 
setting in which abstinence education was provided: Provided further, 
That within amounts provided herein for abstinence education for 
adolescents, up to $10,000,000 may be available for a national 
abstinence education campaign: Provided further, That in addition to 
amounts provided herein for abstinence education for adolescents, 
$4,500,000 shall be available from amounts available under section 241 
of the Public Health Service Act to carry out evaluations (including 
longitudinal evaluations) of adolescent pregnancy prevention approaches: 
Provided further, That up to $2,000,000 shall be for improving the 
Public Assistance Reporting Information System, including grants to 
States to support data collection for a study of the system's 
effectiveness. (42 U.S.C. 254C-6, 254C-7, 604 note, 670 note, 673b, 
2991a et seq., 5101 et seq., 5111 et seq., 5751 et seq., 9834 et seq., 
10409, 10416, 15001 et seq., 15424, 15462; 24 U.S.C. ch. 9.)

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

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1536-0-1-506      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
    Obligations by program activity:
01.01 Head start........................       6,851       6,789       6,789
01.03 Runaway and homeless youth (basic 
        centers)........................          48          48          48
01.04 Transitional living...............          40          40          40
01.06 Education grants to reduce sexual 
        abuse of runaway youth..........          15          15          15
01.07 Abstinence education (mandatory)..          42          37
01.08 Mentoring children of prisoners...          49          50          50
01.09 Child abuse state grants..........          27          27          27
01.10 Child abuse discretionary 
        activities......................          26          26          36
01.11 Community based resource centers..          42          42          42
01.12 Child welfare services............         287         287         287
01.13 Child welfare training............           7           7           7
01.14 Adoption opportunities............          27          27          27
01.15 Abandoned infants assistance......          12          12          12
01.16 Adoption incentives...............          12          12          14
01.17 Independent living training 
        vouchers........................          46          46          46
01.18 Children's health act programs....          13          13          13
01.19 State councils on developmental 
        disabilities....................          72          72          72
01.20 Protection and advocacy...........          39          39          39
01.21 Projects of national significance.          11          11          11
01.22 University centers for excellence.          33          33          33
01.23 Voting access for individuals with 
        disabilities....................          16          16          16
01.24 Native american programs..........          43          44          44
01.25 Social services and income 
        maintenance research............           6           6
01.26 Compassion capital fund...........          64          64          75
01.28 Federal administration............         183         184         197
01.29 Center for faith-based and 
        community initiatives...........           1           1           1
01.30 Abstinence education 
        (discretionary).................         109         109         137
01.31 Interstate home study incentives..                                  10
                                           ---------   ---------  ----------
01.91   Subtotal........................       8,121       8,057       8,088
03.01 Community services block grant....         630         630
03.03 Rural communtiy facilities........           7           7
03.04 Community services discretionary 
        (JOLI & CED)....................          32          32
03.06 Assets for independence...........          25          24          24
03.08 Domestic violence hotline.........         125           3           3
03.09 Family violence prevention and 
        services........................           3         125         125
                                           ---------   ---------  ----------
03.91   Subtotal........................         822         821         152
                                           ---------   ---------  ----------
04.00   Total, direct program...........       8,943       8,878       8,240
09.01 Reimbursable program..............          14          22          17
                                           ---------   ---------  ----------
10.00   Total new obligations...........       8,957       8,900       8,257
----------------------------------------------------------------------------

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

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

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

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

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


[[Page 430]]



    The 2008 Budget eliminates community services programs, including 
the Community Services Block Grant, Community Economic Development, 
Rural Community Facilities and Job Opportunities for Low-Income 
Individuals. This is due to poor program performance and/or duplication 
with other Federal programs that can achieve greater results and better 
focus on communities most in need of assistance.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1536-0-1-506      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
      Direct obligations:

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

                             Employment Summary

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

                 Children and Families Services Programs

                (Legislative proposal, subject to PAYGO)

               Program and Financing (in millions of dollars)

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

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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

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

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

                                

              Children's Research and Technical Assistance

               Program and Financing (in millions of dollars)

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

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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

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

    This account provides funding for research and technical assistance 
activities established in P.L. 104-193. 

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1553-0-1-609      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
      Direct obligations:

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

[[Page 431]]

23.1    Rental payments to GSA..........           3           3           3
25.1    Advisory and assistance services          28          32          30
25.2    Other services..................           6           6           6
25.3    Other purchases of goods and 
          services from Government 
          accounts......................           7           7           7
41.0    Grants, subsidies, and 
          contributions.................           4           3           3
                                           ---------   ---------  ----------
99.0      Direct obligations............          57          60          58
99.0  Reimbursable obligations..........          19          23          24
                                           ---------   ---------  ----------
99.9    Total new obligations...........          76          83          82
---------------------------------------------------------------------------

                             Employment Summary

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

                                

                         Disabled Voter Services

               Program and Financing (in millions of dollars)

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

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

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

                                

       Payments to States for Foster Care and Adoption Assistance

    For making payments to States or other non-Federal entities under 
title IV-E of the Social Security Act, $5,067,000,000.
    For making payments to States or other non-Federal entities under 
title IV-E of the Act, for the first quarter of fiscal year 2009, 
$1,776,000,000.
    For making, after May 31 of the current fiscal year, payments to 
States or other non-Federal entities under section 474 of title IV-E, 
for the last 3 months of the current fiscal year for unanticipated 
costs, incurred for the current fiscal year, such sums as may be 
necessary.

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

               Program and Financing (in millions of dollars)

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

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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

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

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

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

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

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

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

               Object Classification (in millions of dollars)

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

                             Employment Summary

----------------------------------------------------------------------------
Identification code 75-1545-0-1-609      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
    Direct:
1001  Civilian full-time equivalent 
        employment......................           2           2           2
---------------------------------------------------------------------------

       Payments to States for Foster Care and Adoption Assistance

                (Legislative proposal, subject to PAYGO)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1545-4-1-609      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
    Obligations by program activity:
00.01 Foster care.......................                                  12
00.04 Adoption assistance...............                                   3
                                           ---------   ---------  ----------
10.00   Total new obligations...........                                  15
----------------------------------------------------------------------------

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

    New budget authority (gross), detail:
      Mandatory:

[[Page 432]]

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

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

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

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

    This legislative proposal includes provisions to introduce an option 
available to all States to participate in an alternative financing 
system for child welfare that will better meet the needs of each state's 
foster care population. States choosing to participate face far fewer 
administrative burdens and will receive funds in the form of flexible 
grants. The proposal also includes increasing the match rate for the 
District of Columbia to match that used in the Medicaid program.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1545-4-1-609      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
    Direct obligations:
21.0  Travel and transportation of 
        persons.........................                                   1
25.1  Advisory and assistance services..                                   3
25.5  Research and development contracts                                   1
41.0  Grants, subsidies, and 
        contributions...................                                  10
                                           ---------   ---------  ----------
99.9    Total new obligations...........                                  15
---------------------------------------------------------------------------

                                


 
                         ADMINISTRATION ON AGING

                                 Federal

                         Aging Services Programs

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

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

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0142-0-1-506      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
    Obligations by program activity:
01.01 Home and community-based 
        supportive services.............         350         351         351
01.02 Preventive health services........          21          21
01.03 National family caregiver support 
        program.........................         156         156         154
01.04 Native American caregiver support 
        program.........................           6           6           6
01.05 Congregate nutrition services.....         385         385         383
01.06 Home-delivered nutrition services.         182         182         181
01.07 Nutrition services incentive 
        program.........................         148         148         147
01.08 Native American nutrition and 
        supportive services.............          26          26          26
01.09 Program innovations...............          25          25          36
01.10 Aging network support activities..          13          13          13
01.11 Long-term care ombudsmen program..          15          15          14
01.12 Prevention of elder abuse and 
        neglect.........................           5           5           5
01.13 Alzheimer's disease demonstration 
        grants..........................          12          12
01.14 Program administration............          18          18          19
01.15 White House Conference on Aging...           3
                                           ---------   ---------  ----------
02.00   Total, direct program...........       1,365       1,363       1,335
09.01 Reimbursable program..............           4           4           4
                                           ---------   ---------  ----------
10.00   Total new obligations...........       1,369       1,367       1,339
----------------------------------------------------------------------------

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

    Net budget authority and outlays:
89.00 Budget authority..................       1,362       1,367       1,335
90.00 Outlays...........................       1,379       1,348       1,342
---------------------------------------------------------------------------
    Note.--The reimbursable program (HCFAC) in the Administration on 
Aging (AoA) reflects the estimated distribution of the allocation 
account for 2007 and 2008. Actual 2007 and 2008 distributions will be 
determined by the Secretary of HHS and the Attorney General.

    Administration on Aging.--The proposed level will provide continued 
funding for core formula grant programs that provide nutrition, 
supportive services and caregiver support services through the aging 
network. These programs are part of a comprehensive system of home and 
community-based support for older people and their families.

    The Budget will fund the Choices for Independence demonstration 
first proposed in the 2007 Budget which aims to help older individuals 
and their families conserve and extend their personal resources through 
the use of low-cost, community-based alternatives in long-term care.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0142-0-1-506      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
      Direct obligations:

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

[[Page 433]]

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

                             Employment Summary

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

                                


 
                         DEPARTMENTAL MANAGEMENT

                                 Federal

                         Office of the Secretary

                     General Departmental Management

    For necessary expenses, not otherwise provided, for general 
departmental management, including hire of six sedans, and for carrying 
out titles III, XVII, XX, and XXI of the Public Health Service Act, the 
United States-Mexico Border Health Commission Act, and research studies 
under section 1110 of the Social Security Act, $386,705,000, together 
with $5,851,000 to be transferred and expended as authorized by section 
201(g)(1) of the Social Security Act from the Hospital Insurance Trust 
Fund and the Supplemental Medical Insurance Trust Fund, and $46,756,000 
from the amounts available under section 241 of the Public Health 
Service Act to carry out national health or human services research and 
evaluation activities: Provided, That of the funds made available under 
this heading for carrying out title XX of the Public Health Service Act, 
$13,120,000 shall be for activities specified under section 2003(b)(2), 
all of which shall be for prevention service demonstration grants under 
section 510(b)(2) of title V of the Social Security Act, as amended, 
without application of the limitation of section 2010(c) of said title 
XX: Provided further, That of this amount, $51,891,000 shall be for 
minority AIDS prevention and treatment activities; $6,016,000 shall be 
to assist Afghanistan in the development of maternal and child health 
clinics, consistent with section 103(a)(4)(H) of the Afghanistan Freedom 
Support Act of 2002; and up to $4,000,000 may be used by the Secretary 
of Health and Human Services to meet unanticipated needs of Departmental 
programs.

                         Office for Civil Rights

    For expenses necessary for the Office for Civil Rights, $33,748,000, 
together with not to exceed $3,314,000 to be transferred and expended as 
authorized by section 201(g)(1) of the Social Security Act from the 
Hospital Insurance Trust Fund and the Supplemental Medical Insurance 
Trust Fund.

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

               Program and Financing (in millions of dollars)

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

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

                         Departmental Management

                          (Dollars in millions)

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

    Departmental management (DM) is a consolidated display of accounts 
that fund activities which provide leadership, policy, legal, and 
administrative guidance to HHS components; carry out the Department's 
civil rights nondiscrimination and health information privacy compliance 
programs; and support research to develop policy initiatives and improve 
existing HHS programs. DM also includes the activities of the Office of 
Public Health and Science, including adolescent family life, disease 
prevention and health promotion, physical fitness and sports, minority 
health, research integrity, and women's health.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9912-0-1-551      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
      Direct obligations:

[[Page 434]]

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

                             Employment Summary

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

                                

  Office of the National Coordinator for Health Information Technology

    For expenses necessary for the Office of the National Coordinator 
for Health Information Technology, including grants, contracts and 
cooperative agreements for the development and advancement of an 
interoperable national health information technology infrastructure, 
$89,872,000: Provided, That in addition to amounts provided herein, 
$28,000,000 shall be available from amounts available under section 241 
of the Public Health Service Act to carry out health information 
technology network development.

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

               Program and Financing (in millions of dollars)

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

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

    This program supports coordination of Federal health information 
technology activities, and Federal initiatives for the advancement of an 
interoperable national health information technology infrastructure, in 
cooperation with participants in the health sector. The Office of the 
National Coordinator for Health Information Technology was created by 
Executive Order 13335, for the purpose of addressing strategic planning, 
coordination, and the analysis of key technical, economic and other 
issues related to the public and private adoption of health information 
technology.

    Through this program, activities related to health information 
technology are coordinated across several HHS organizations, as shown in 
the following consolidated table.

                  Health Information Technology Funding

                  [Program level--Dollars in millions]

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

    Note.--Includes budget authority, Public Health Service evaluation funds 
and other resources.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0130-0-1-551      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
      Direct obligations:

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

                             Employment Summary

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

[[Page 435]]



                                

                 Office of Medicare Hearings and Appeals

    For expenses necessary for administrative law judges responsible for 
hearing cases under title XVIII of the Social Security Act (and related 
provisions of title XI of such Act), $70,000,000, to be transferred in 
appropriate part from the Federal Hospital Insurance and the Federal 
Supplementary Medical Insurance Trust Funds.

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

               Program and Financing (in millions of dollars)

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

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

               Object Classification (in millions of dollars)

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

                             Employment Summary

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

                                

            Public Health and Social Services Emergency Fund

    For expenses necessary to support activities related to countering 
potential biological, disease, nuclear, radiological and chemical 
threats to civilian populations, and for other public health 
emergencies, $780,646,000, of which not to exceed $22,338,000, to remain 
available until September 30, 2009, is to pay the costs described in 
section 319F-2(c)(7)(B) of the Public Health Service Act.
    For expenses necessary to prepare for and respond to an influenza 
pandemic, $948,091,000, of which $870,000,000 shall be available until 
expended, for activities including the development and purchase of 
vaccine, antivirals, necessary medical supplies, diagnostics, and other 
surveillance tools: Provided, That products purchased with these funds 
may, at the discretion of the Secretary, be deposited in the Strategic 
National Stockpile: Provided further, That notwithstanding section 
496(b) of the Public Health Service Act, funds may be used for the 
construction or renovation of privately owned facilities for the 
production of pandemic influenza vaccines and other biologicals, where 
the Secretary finds such a contract necessary to secure sufficient 
supplies of such vaccines or biologicals: Provided further, That funds 
appropriated herein may be transferred to other appropriation accounts 
of the Department of Health and Human Services, as determined by the 
Secretary to be appropriate, to be used for the purposes specified in 
this sentence.
    For expenses to provide screening and treatment for first response 
emergency services personnel related to the September 11, 2001, 
terrorist attacks on the World Trade Center, $25,000,000 shall be 
available until expended.

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

               Program and Financing (in millions of dollars)

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

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

    New budget authority (gross), detail:
      Discretionary:

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

[[Page 436]]



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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

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

    The Public Health and Social Services Emergency Fund (PHSSEF) 
provides resources to support a comprehensive program to prepare for the 
health and medical consequences of bioterrorism or other public health 
emergencies. The account includes funding for international activities, 
rapid tests, and communications to support the detection and control of 
pandemic influenza. In addition, PHSSEF includes funding for the Office 
of the Assistant Secretary for Preparedness and Response (ASPR), as 
authorized by the Pandemic and All-Hazards Preparedness Act. Funds will 
be used for the advanced development of pandemic and biodefense 
countermeasures, hospital preparedness and other emergency preparedness 
activities including the National Disaster Medical System that was 
transferred to HHS from the Department of Homeland Security in January 
2007.

               Object Classification (in millions of dollars)

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

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

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

                             Employment Summary

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

                       Nonrecurring Expenses Fund

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

               Program and Financing (in millions of dollars)

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

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

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

[[Page 437]]

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

                                


 
                         PROGRAM SUPPORT CENTER

      Retirement Pay and Medical Benefits for Commissioned Officers

    For retirement pay and medical benefits of Public Health Service 
Commissioned Officers as authorized by law, for payments under the 
Retired Serviceman's Family Protection Plan and Survivor Benefit Plan, 
for medical care of dependents and retired personnel under the 
Dependents' Medical Care Act (10 U.S.C. chapter 55), such amounts as may 
be required during the current fiscal year.

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

               Program and Financing (in millions of dollars)

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

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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

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

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

                  Retirement Pay Eligible Beneficiaries

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

    This activity funds annuities of retired Public Health Service (PHS) 
commissioned officers and survivors of retirees, and medical benefits 
for active duty PHS commissioned officers, retirees, and dependents of 
member and retirees of the PHS Commissioned Corps.

               Object Classification (in millions of dollars)

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

                                

 HHS Accrual Contribution to the Uniformed Services Retiree Health Care 
                                  Fund

               Program and Financing (in millions of dollars)

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

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

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

                                

                         Health Activities Funds

               Program and Financing (in millions of dollars)

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

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

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

                                

                       HHS Service and Supply Fund

               Program and Financing (in millions of dollars)

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

[[Page 438]]

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

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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

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

    HHS Service and Supply Fund (SSF) provides a wide range of 
logistical and support services to components of the Department and 
other Federal agencies. The Program Support Center includes activities 
such as personnel and payroll support, financial management operations, 
and administrative services, including acquisitions management, building 
and property management, telecommunication services, medical supplies 
repackaging and distribution services, and the Federal Occupational 
Health Service. The Office of Secretary activities include the fund 
manager, departmental contracts, audit resolutions, Commissioned Corps 
force management, information technology, web management, claims, 
acquisition integration and modernization, small business, grants 
tracking, and competitive sourcing.

    Most Commissioned Corps officers work for agencies in the Department 
of Health and Human Services and are reflected in the agencies' 
personnel summaries. However, some officers are assigned to other 
Federal agencies. The allocation account section in the following 
personnel summary shows officers assigned to other agencies which are 
paid directly by that agency, either through an allocation account or by 
directly citing that agency's appropriation.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9941-0-4-551      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
    Reimbursable obligations:
      Personnel compensation:

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

                             Employment Summary

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

                                

  

                               Trust Funds

                        Miscellaneous Trust Funds

          Special and Trust Fund Receipts (in millions of dollars)

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

               Program and Financing (in millions of dollars)

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

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

[[Page 439]]


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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

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

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

                          [Dollars in millions]

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

    Gifts to the Public Health Service are for the benefit of patients 
and for research. Contributions are made for the construction, 
improvement, extension, and provision of sanitation facilities.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9971-0-7-551      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
    Direct obligations:
      Personnel compensation:

11.1    Full-time permanent.............           2           2           2
11.3    Other than full-time permanent..           2           2           2
                                           ---------   ---------  ----------
11.9      Total personnel compensation..           4           4           4
12.1  Civilian personnel benefits.......           1           1           1
21.0  Travel and transportation of 
        persons.........................           1           1           1
25.1  Advisory and assistance services..           2           2           2
25.2  Other services....................          26          23          23
25.5  Research and development contracts          10           7           7
25.7  Operation and maintenance of 
        equipment.......................           2           2           2
26.0  Supplies and materials............           2           1           1
31.0  Equipment.........................           1
41.0  Grants, subsidies, and 
        contributions...................          13          10          10
                                           ---------   ---------  ----------
99.9    Total new obligations...........          62          51          51
---------------------------------------------------------------------------

                             Employment Summary

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

                                


 
                     OFFICE OF THE INSPECTOR GENERAL

                       Office of Inspector General

    For expenses necessary for the Office of Inspector General, 
including the hire of passenger motor vehicles for investigations, in 
carrying out the provisions of the Inspector General Act of 1978, as 
amended, $44,687,000: Provided, That of such amount, necessary sums are 
available for providing protective services to the Secretary and 
investigating non-payment of child support cases for which non-payment 
is a Federal offense under 18 U.S.C. 228.

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

               Program and Financing (in millions of dollars)

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

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

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

[[Page 440]]

administered and assisted programs and operations through audits, 
evaluations, and investigations.

    In addition to the discretionary resources appropriated to the OIG, 
the Health Insurance Portability and Accountability Act of 1996 and the 
Deficit Reduction Act of 2005 (DRA) make available mandatory funding for 
use by the OIG. These funds are used to combat Medicare, Medicaid, and 
State Children's Health Insurance Program (SCHIP) fraud, waste, and 
abuse through a coordinated Health care fraud and abuse control (HCFAC) 
program with the Department of Justice and to establish a Medicaid 
Integrity Program under DRA. The following table shows total funding 
resources for the OIG:

                        (In millions of dollars)

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

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0128-0-1-551      2006 actual   2007 est.   2008 est.
----------------------------------------------------------------------------
      Direct obligations:

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

                             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.
