[Appendix]
[Detailed Budget Estimates by Agency]
[Department of Health and Human Services]
[From the U.S. Government Printing Office, www.gpo.gov]
<h1>DEPARTMENT OF HEALTH AND HUMAN SERVICES
</h1>
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; [$4,346,670,000] $4,430,203,000: Provided, That of the amount provided under this heading, [$760,000,000] $798,000,000 shall be derived from prescription drug user fees authorized by 21 U.S.C. 379h, and shall be credited to this account and
remain available until expended; [$114,833,000] $128,282,000 shall be derived from medical device user fees authorized by 21 U.S.C. 379j, and shall be credited to this account and remain
available until expended; [$305,996,000] $312,116,000 shall be derived from human generic drug user fees authorized by 21 U.S.C. 379j-42, and shall be credited to this account
and remain available until expended; [$20,716,000] $21,014,000 shall be derived from biosimilar biological product user fees authorized by 21 U.S.C. 379j-52, and shall be credited to this
account and remain available until expended; [$23,600,000] $22,464,000 shall be derived from animal drug user fees authorized by 21 U.S.C. 379j-12, and shall be credited to this account and remain
available until expended; [$7,328,000] $6,944,000 shall be derived from animal generic drug user fees authorized by 21 U.S.C. 379j-21, and shall be credited to this account
and remain available until expended; [$534,000,000] $566,000,000 shall be derived from tobacco product user fees authorized by 21 U.S.C. 387s, and shall be credited to this account and remain
available until expended[; $12,925,000 shall be derived from food and feed recall fees authorized by 21 U.S.C. 379j-31, and shall be credited to this
account and remain available until expended; $15,367,000 shall be derived from food reinspection fees authorized by 21 U.S.C.
379j-31, and shall be credited to this account and remain available until expended; and amounts derived from voluntary qualified
importer program fees authorized by 21 U.S.C. 379j-31 shall be credited to this account and remain available until expended]: Provided further, That in addition and notwithstanding any other provision under this heading, amounts collected for prescription drug user
fees, medical device user fees, human generic drug user fees, biosimilar biological product user fees, animal drug user fees,
and animal generic drug user fees that exceed the respective fiscal year [2014] 2015 limitations are appropriated and shall be credited to this account and remain available until expended: Provided further, That fees derived from prescription drug, medical device, human generic drug, biosimilar biological product, animal drug,
and animal generic drug assessments for fiscal year [2014] 2015, including any such fees collected prior to fiscal year [2014] 2015 but credited for fiscal year [2014] 2015, shall be subject to the fiscal year [2014] 2015 limitations: Provided further, That the Secretary may accept payment during fiscal year [2014] 2015 of user fees specified under this heading and authorized for fiscal year [2015] 2016, prior to the due date for such fees, and that amounts of such fees assessed for fiscal year [2015] 2016 for which the Secretary accepts payment in fiscal year [2014] 2015 shall not be included in amounts under this heading: Provided further, That none of these funds shall be used to develop, establish, or operate any program of user fees authorized by 31 U.S.C.
9701: [Provided further, That of the total amount appropriated: (1) $900,259,000 shall be for the Center for Food Safety and Applied Nutrition and
related field activities in the Office of Regulatory Affairs; (2) $1,289,304,000 shall be for the Center for Drug Evaluation
and Research and related field activities in the Office of Regulatory Affairs; (3) $337,543,000 shall be for the Center for
Biologics Evaluation and Research and for related field activities in the Office of Regulatory Affairs; (4) $173,207,000 shall
be for the Center for Veterinary Medicine and for related field activities in the Office of Regulatory Affairs; (5) $408,918,000
shall be for the Center for Devices and Radiological Health and for related field activities in the Office of Regulatory Affairs;
(6) $62,494,000 shall be for the National Center for Toxicological Research; (7) $501,476,000 shall be for the Center for
Tobacco Products and for related field activities in the Office of Regulatory Affairs; (8) not to exceed $178,361,000 shall
be for Rent and Related activities, of which $61,922,000 is for White Oak Consolidation, other than the amounts paid to the
General Services Administration for rent; (9) not to exceed $219,907,000 shall be for payments to the General Services Administration
for rent; and (10) $275,201,000 shall be for other activities, including the Office of the Commissioner of Food and Drugs,
the Office of Foods and Veterinary Medicine, the Office of Medical and Tobacco Products, the Office of Global and Regulatory
Policy, the Office of Operations, the Office of the Chief Scientist, and central services for these offices:] Provided further, That not to exceed $25,000 of this amount shall be for official reception and representation expenses, not otherwise provided for, as determined by
the Commissioner: [Provided further, That any transfer of funds pursuant to section 770(n) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379dd(n)) shall
only be from amounts made available under this heading for other activities:] Provided further, That funds may be transferred from one specified activity to another with the prior [approval] notification of the Committees on Appropriations of both Houses of Congress.
In addition, mammography user fees authorized by 42 U.S.C. 263b, export certification user fees authorized by 21 U.S.C. 381,
[and] priority review user fees authorized by 21 U.S.C. 360n, food and feed recall fees, food reinspection fees, and voluntary qualified importer program fees authorized by 21 U.S.C.
379j-31, outsourcing facility fees authorized by 21 U.S.C.379j-62, prescription drug wholesale distributer licensing and inspection
fees authorized by 21 U.S.C. 353(e)(3), and third-party logistics provider licensing and inspection fees authorized by 21
U.S.C. 360eee-3(c)(1), [may] shall be credited to this account, to remain available until expended.
Buildings and Facilities
For plans, construction, repair, improvement, extension, alteration, and purchase of fixed equipment or facilities of or used
by the Food and Drug Administration, where not otherwise provided, $8,788,000, to remain available until expended. (Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2014.)
Special and Trust Fund Receipts (in millions of dollars)
Identification code 75–9911–0–1–554
2013 actual
2014 est.
2015 est.
0100
Balance, start of year
1
1
Receipts:
0220
Cooperative Research and Development Agreements, FDA
3
2
3
0400
Total: Balances and collections
3
3
4
Appropriations:
0500
Salaries and Expenses
–2
–2
–2
0799
Balance, end of year
1
1
2
Program and Financing (in millions of dollars)
Identification code 75–9911–0–1–554
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Foods
797
883
903
0002
Drugs
438
466
480
0003
Devices and Radiological Products
296
321
318
0004
National Center for Toxicological Research
55
62
59
0005
Other Activities
160
172
175
0006
Other Rent and Rent Related Activities
118
132
116
0007
Rental Payments
150
162
169
0008
Buildings and Facilities
6
9
9
0009
CRADAs
2
2
2
0010
Animal Drugs and Feed
126
141
145
0011
Biologics
195
211
210
0012
Food and Drug Safety (no-year)
9
0799
Total direct obligations
2,352
2,561
2,586
0801
Reimbursable program (User fees)
1,795
2,456
1,900
0802
Reimbursable program (Federal sources)
40
0899
Total reimbursable obligations
1,835
2,456
1,900
0900
Total new obligations
4,187
5,017
4,486
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
852
670
122
1001
Discretionary unobligated balance brought fwd, Oct 1
1
1021
Recoveries of prior year unpaid obligations
1
1050
Unobligated balance (total)
853
670
122
Budget authority:
Appropriations, discretionary:
1100
Appropriation
2,580
2,561
2,584
1130
Appropriations permanently reduced
–194
1160
Appropriation, discretionary (total)
2,386
2,561
2,584
Appropriations, mandatory:
1201
Appropriation (special or trust fund)
2
2
2
1260
Appropriations, mandatory (total)
2
2
2
Spending authority from offsetting collections, discretionary:
1700
Collected
1,676
1,827
1,900
1701
Change in uncollected payments, Federal sources
23
1702
Offsetting collections (previously unavailable)
327
333
333
1702
Offsetting collections (previously unavailable) — previously reported as precluded from obligation that will be available
for obligation
79
1723
New and/or unobligated balance of spending authority from offsetting collections temporarily reduced
–67
1725
Spending authority from offsetting collections precluded from obligation (limitation on obligations)
–564
–333
–333
1750
Spending auth from offsetting collections, disc (total)
1,395
1,906
1,900
Spending authority from offsetting collections, mandatory:
1800
Collected
232
1823
New and/or unobligated balance of spending authority from offsetting collections temporarily reduced
–11
1850
Spending auth from offsetting collections, mand (total)
221
1900
Budget authority (total)
4,004
4,469
4,486
1930
Total budgetary resources available
4,857
5,139
4,608
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
670
122
122
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
1,663
2,319
2,841
3010
Obligations incurred, unexpired accounts
4,187
5,017
4,486
3011
Obligations incurred, expired accounts
1
3020
Outlays (gross)
–3,460
–4,495
–4,776
3040
Recoveries of prior year unpaid obligations, unexpired
–1
3041
Recoveries of prior year unpaid obligations, expired
–71
3050
Unpaid obligations, end of year
2,319
2,841
2,551
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–44
–51
–51
3070
Change in uncollected pymts, Fed sources, unexpired
–23
3071
Change in uncollected pymts, Fed sources, expired
16
3090
Uncollected pymts, Fed sources, end of year
–51
–51
–51
Memorandum (non-add) entries:
3100
Obligated balance, start of year
1,619
2,268
2,790
3200
Obligated balance, end of year
2,268
2,790
2,500
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
3,781
4,467
4,484
Outlays, gross:
4010
Outlays from new discretionary authority
2,516
3,401
3,409
4011
Outlays from discretionary balances
906
1,092
1,365
4020
Outlays, gross (total)
3,422
4,493
4,774
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–33
–1
4033
Non-Federal sources
–1,657
–1,826
–1,900
4040
Offsets against gross budget authority and outlays (total)
–1,690
–1,827
–1,900
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–23
4052
Offsetting collections credited to expired accounts
14
4060
Additional offsets against budget authority only (total)
–9
4070
Budget authority, net (discretionary)
2,082
2,640
2,584
4080
Outlays, net (discretionary)
1,732
2,666
2,874
Mandatory:
4090
Budget authority, gross
223
2
2
Outlays, gross:
4100
Outlays from new mandatory authority
38
2
2
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123
Non-Federal sources
–232
4180
Budget authority, net (total)
2,073
2,642
2,586
4190
Outlays, net (total)
1,538
2,668
2,876
Memorandum (non-add) entries:
5090
Unavailable balance, SOY: Offsetting collections
349
664
585
5091
Unavailable balance, EOY: Offsetting collections
664
585
585
[In millions of dollars]
2013
2014
2015
Distribution of discretionary budget authority by account:
Salaries and expenses
2,380
2,552
2,575
Buildings and facilities
6
9
9
Distribution of discretionary outlays by account:
Salaries and expenses
1,726
2,657
2,865
Buildings and facilities
6
9
9
The Food and Drug Administration (FDA) promotes and protects public health by overseeing the safety, efficacy, quality, and
security of human and veterinary drugs, biological products, medical devices, foods, cosmetics, and products that emit radiation.
FDA also has responsbility for regulating the manufacturing, marketing, and distribution of tobacco products to protect public
health and to reduce tobacco use by minors. FDA advances public health by helping to speed innovations that make medicines
more effective, safer, and more affordable and by helping the public get the accurate, science-based information they need
to use medicines and foods to maintain and improve their health. FDA supports the Nation's counterterrorism capability by
ensuring the security of the food supply and by fostering the development of medical products and countermeasures to respond
to deliberate and naturally emerging public health threats. The FY 2015 Budget provides funding to support food and medical
product safety, including implementation of the Food Safety Modernization Act and increased oversight of the pharmacy compounding
industry, promote development of medical countermeasures, and maintain the integrity of operations and infrastructure.
Object Classification (in millions of dollars)
Identification code 75–9911–0–1–554
2013 actual
2014 est.
2015 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
789
790
793
11.3
Other than full-time permanent
97
106
106
11.5
Other personnel compensation
46
56
56
11.7
Military personnel
62
61
61
11.8
Special personal services payments
1
1
1
11.9
Total personnel compensation
995
1,014
1,017
12.1
Civilian personnel benefits
276
280
282
12.2
Military personnel benefits
32
32
32
21.0
Travel and transportation of persons
38
38
49
22.0
Transportation of things
3
5
5
23.1
Rental payments to GSA
150
162
169
23.2
Rental payments to others
5
3
3
23.3
Communications, utilities, and miscellaneous charges
38
38
40
24.0
Printing and reproduction
1
3
3
25.1
Advisory and assistance services
49
48
48
25.2
Other services from non-Federal sources
279
340
340
25.3
Other goods and services from Federal sources
143
233
233
25.4
Operation and maintenance of facilities
66
66
66
25.5
Research and development contracts
30
34
34
25.7
Operation and maintenance of equipment
63
50
50
26.0
Supplies and materials
33
44
44
31.0
Equipment
57
56
56
32.0
Land and structures
1
5
5
41.0
Grants, subsidies, and contributions
91
109
109
42.0
Insurance claims and indemnities
1
1
1
99.0
Direct obligations
2,351
2,561
2,586
99.0
Reimbursable obligations
1,836
2,456
1,900
99.9
Total new obligations
4,187
5,017
4,486
Employment Summary
Identification code 75–9911–0–1–554
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
9,113
9,677
9,886
1101
Direct military average strength employment
684
648
648
2001
Reimbursable civilian full-time equivalent employment
3,960
5,117
5,441
2101
Reimbursable military average strength employment
297
343
343
3001
Allocation account civilian full-time equivalent employment
48
48
48
3101
Allocation account military average strength employment
1
1
1
Salaries and Expenses
(Legislative proposal, not subject to PAYGO)
In addition, contingent upon the enactment of authorizing legislation, the Secretary shall assess user fees with respect to
food facility registrations and inspections, food imports, food contact notification activities, cosmetic activities, and
international express courier import activities, and such fees shall be credited to this account and remain available until
expended.
Program and Financing (in millions of dollars)
Identification code 75–9911–2–1–554
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0801
Food Facility Registration and Inspection
60
0802
Food Import
169
0803
International Courier
6
0804
Cosmetics
19
0805
Food Contact Substance Notification
5
0900
Total new obligations
259
Budgetary Resources:
Budget authority:
Spending authority from offsetting collections, discretionary:
1700
Collected
259
1750
Spending auth from offsetting collections, disc (total)
259
1900
Budget authority (total)
259
1930
Total budgetary resources available
259
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
259
3020
Outlays (gross)
–259
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
259
Outlays, gross:
4010
Outlays from new discretionary authority
259
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4033
Non-Federal sources
–259
The 2015 Budget includes a number of new user fees. Legislation will be proposed to allow FDA to collect fees for food import
and food facility registration and inspection to implement the requirements of the FDA Food Safety Modernization Act (FSMA).
The additional resources, estimated at $169 million for the food import program, would support FDA's food safety efforts to
modernize the import system. The fees collected for the food facility registration and inspection program, estimated at $60
million, would enable FDA to target new and improved activities required by FSMA to modernize the food safety system and support
improvements in safety science and risk analysis to prevent food safety outbreaks. The Budget also reproposes user fees to
support activities related to cosmetics and food contact notification activities, and fees to support inspection-related activities
at domestic courier facilities.
Object Classification (in millions of dollars)
Identification code 75–9911–2–1–554
2013 actual
2014 est.
2015 est.
99.9
Total new obligations
259
Employment Summary
Identification code 75–9911–2–1–554
2013 actual
2014 est.
2015 est.
2001
Reimbursable civilian full-time equivalent employment
500
Revolving Fund for Certification and Other Services
Program and Financing (in millions of dollars)
Identification code 75–4309–0–3–554
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0801
Reimbursable program
8
8
8
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
3
4
4
Budget authority:
Spending authority from offsetting collections, mandatory:
1800
Collected
9
8
8
1850
Spending auth from offsetting collections, mand (total)
9
8
8
1930
Total budgetary resources available
12
12
12
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
4
4
4
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
3
3
3
3010
Obligations incurred, unexpired accounts
8
8
8
3020
Outlays (gross)
–8
–8
–9
3050
Unpaid obligations, end of year
3
3
2
Memorandum (non-add) entries:
3100
Obligated balance, start of year
3
3
3
3200
Obligated balance, end of year
3
3
2
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
9
8
8
Outlays, gross:
4100
Outlays from new mandatory authority
2
7
8
4101
Outlays from mandatory balances
6
1
1
4110
Outlays, gross (total)
8
8
9
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123
Non-Federal sources
–9
–8
–8
4190
Outlays, net (total)
–1
1
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
2013 actual
2014 est.
2015 est.
Reimbursable obligations:
11.1
Personnel compensation: Full-time permanent
4
4
4
12.1
Civilian personnel benefits
1
1
1
23.1
Rental payments to GSA
1
1
1
25.2
Other services from non-Federal sources
1
1
1
26.0
Supplies and materials
1
1
1
99.9
Total new obligations
8
8
8
Employment Summary
Identification code 75–4309–0–3–554
2013 actual
2014 est.
2015 est.
2001
Reimbursable civilian full-time equivalent employment
38
38
38
Health Resources and Services Administration
Federal Funds
Health Resources and Services
Primary Health Care
For carrying out titles II and III of the Public Health Service Act (referred to in this Act as the "PHS Act'') with respect
to primary health care and the Native Hawaiian Health Care Act of 1988, [$1,495,276,000] $1,000,040,000: Provided, That no more than [$40,000] $40,000 shall be available until expended for carrying out the provisions of section 224(o) of the PHS[Act, including associated administrative expenses and relevant evaluations]: Provided further, That no more than [$94,893,000] $88,983,000 shall be 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 (referred to in this Act as "HHS'') pertaining to administrative claims made under such law:
Provided further, That [of funds provided for the Health Centers program, as defined by section 330 of the PHS Act, by this Act or any other Act for
fiscal year 2014, not less than $110,000,000 shall be obligated in fiscal year 2014 as base grant adjustments and not less
than $350,000,000 shall be obligated in fiscal year 2014 to support new access points including approved and unfunded applications
from fiscal year 2013, grants to expand medical services, behavioral health, oral health, pharmacy, and vision services, and
costs associated with the HHS administration of these grants] funds made available for carrying out section 330 of the PHS Act in this or any prior Act, including section 10503 of Public
Law 111–148, may also be used for the construction and improvement of community health centers.
Health Workforce
For carrying out titles III, VII, and VIII of the PHS Act with respect to the health workforce, section 1128E and 1921(b) of the Social Security Act, and the Health Care Quality Improvement Act of 1986, [$734,236,000] $477,140,000: Provided, That $100,000,000, to remain available until expended, shall be for the National Health Service Corps Program: Provided further, That sections 747(c)(2)[, 751(j)(2),] and 762(k), and the proportional funding amounts in paragraphs (1) through (4) of section 756(e) of the PHS Act shall not apply
to funds made available under this heading: Provided further, That [for any program operating under section 751 of the PHS Act on or before January 1, 2009, the Secretary may hereafter waive
any of the requirements contained in sections 751(d)(2)(A) and 751(d)(2)(B) of such Act for the full project period of a grant
under such section: Provided further, That no funds shall be available for section 340G-1 of the PHS Act: 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 such Act sufficient to recover the full costs of operating the National
Practitioner Data Bank and shall remain available until expended to carry out that Act: Provided further, That fees collected for the full disclosure of information under the "Health Care Fraud and Abuse Data Collection Program'',
authorized by section 1128E(d)(2) of the Social Security Act, shall be sufficient to recover the full costs of operating the
program, and shall remain available until expended to carry out that Act: Provided further, That fees collected for the disclosure of information under the information reporting requirement program authorized by
section 1921 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:] fees collected for the disclosure of information under section 427(b) of the Health Care Quality Improvement Act of 1986 and
sections 1128E(d)(2) and 1921 of the Social Security Act shall be sufficient to recover the full costs of operating the programs
authorized by such sections and shall remain available until expended for the National Practitioner Data Bank: Provided further, That funds transferred to this account to carry out section 846 and subpart 3 of part D of title III of the PHS Act may
be used to make prior year adjustments to awards made under such sections: Provided further, That, on April 1, 2015, available amounts appropriated under section 340H(g) of the PHS Act are hereby
permanently cancelled, and an equal amount of funding is hereby appropriated to be available until expended to carry out such
section: Provided further, That in addition to amounts provided herein, $61,581,000 shall be available from amounts available
under section 241 of the PHS Act to carry out section 811 of the PHS Act.
Maternal and Child Health
For carrying out titles III, XI, XII, and XIX of the PHS Act with respect to maternal and child health, title V of the Social
Security Act, and section 712 of the American Jobs Creation Act of 2004, [$846,017,000] $846,017,000: Provided, That notwithstanding sections 502(a)(1) and 502(b)(1) of the Social Security Act, not more than $77,093,000 shall be available
for carrying out special projects of regional and national significance pursuant to section 501(a)(2) of such Act and $10,276,000
shall be available for projects described in paragraphs (A) through (F) of section 501(a)(3) of such Act.
Ryan White Hiv/Aids Program
For carrying out title XXVI of the PHS Act with respect to the Ryan White HIV/AIDS program, [$2,293,781,000],$2,297,781,000: of which [$1,970,881,000] $1,970,881,000 shall remain available to the Secretary through September 30, [2016] 2017, for parts A and B of title XXVI of the PHS Act, and of which not less than [$900,313,000] $900,313,000 shall be for State AIDS Drug Assistance Programs under the authority of section 2616 or 311(c) of such Act: Provided, That in addition to amounts provided herein, [$25,000,000] $25,000,000 shall be available from amounts available under section 241 of the PHS Act to carry out parts A, B, and C[, and D] of title XXVI of [the PHS] such Act to fund Special Projects of National Significance under section 2691.
Health Care Systems
For carrying out titles III and XII of the PHS Act with respect to health care systems, and the Stem Cell Therapeutic and
Research Act of 2005, [$103,193,000] $103,659,000, of which [$122,000] $122,000 shall be available until expended for facilities renovations at the Gillis W. Long Hansen's Disease Center: Provided, That the Secretary may collect a fee of 0.1 percent of each purchase of 340B drugs from entities participating
in the Drug Pricing Program pursuant to section 340B of the PHS Act to pay for the operating costs of such program: Provided
further, That fees pursuant to the 340B Drug Pricing Program shall be collected by the Secretary based on sales data that
shall be submitted by drug manufacturers and shall be credited to this account, to remain available until expended.
Rural Health
For carrying out titles III and IV of the PHS Act with respect to rural health, section 427(a) of the Federal Coal Mine Health
and Safety Act of 1969, [the Cardiac Arrest Survival Act of 2000,] and sections 711 and 1820 of the Social Security Act, [$142,335,000] $124,562,000, of which [$40,609,000] $26,200,000 from general revenues, notwithstanding section 1820(j) of the Social Security Act, shall be available for carrying out the
Medicare rural hospital flexibility grants program: Provided, That of the funds made available under this heading for Medicare rural hospital flexibility grants, [$14,942,000 shall be available for the Small Rural Hospital Improvement Grant Program for quality improvement and adoption
of health information technology and] up to [$1,000,000] $1,000,000 shall be to carry out section 1820(g)(6) of the Social Security Act, with funds provided for grants under section 1820(g)(6)
available for the purchase and implementation of telehealth services, including pilots and demonstrations on the use of electronic
health records to coordinate rural veterans care between rural providers and the Department of Veterans Affairs electronic
health record system: Provided further, That notwithstanding section 338J(k) of the PHS Act, [$9,511,000] $9,511,000 shall be available for State Offices of Rural Health.
Family Planning
For carrying out the program under title X of the PHS Act to provide for voluntary family planning projects, [$286,479,000] $286,479,000: Provided, 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.
Program Management
For program support in the Health Resources and Services Administration, [$153,061,000] $157,061,000: Provided, That funds made available under this heading may be used to supplement program support funding provided under the headings
"Primary Health Care'', "Health Workforce'', "Maternal and Child Health'', "Ryan White HIV/AIDS Program'', "Health Care Systems'',
and "Rural Health'': Provided further, That the Administrator may transfer funds between any of the accounts of HRSA with notification to the
Committees on Appropriations of both Houses of Congress at least 15 days in advance of any transfer, but no such account shall
be decreased by more than 3 percent by any such transfer. (Department of Health and Human Services Appropriations Act, 2014.)
Program and Financing (in millions of dollars)
Identification code 75–0350–0–1–550
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0009
Free Clinics Medical Malpractice
1
0010
Health Centers
1,390
1,400
911
0012
National Health Service Corps
100
0013
Hansen's Disease Center
15
15
15
0014
Payment to Hawaii for the Treatment of Hansen's Disease
2
2
2
0015
Black Lung Clinics
7
7
7
0016
Nursing Education Loan Repayment and Scholarships
78
80
80
0017
Health Professions
357
389
297
0018
Maternal and Child Health Block Grant
605
634
634
0019
Healthy Start
98
101
101
0020
Poison Control Centers
18
19
19
0021
EMS for Children
20
20
20
0022
Universal Newborn Hearing Screening
18
18
18
0023
HIV/AIDS
2,220
2,297
2,298
0024
Organ Transplantation
23
24
24
0025
Bone Marrow Donor Registry
22
22
22
0026
Rural Health Policy Development
9
9
9
0027
Rural Health Outreach Grants
52
57
57
0028
Rural Health Flexibility Grants
38
41
26
0030
Telehealth
11
14
14
0031
Program Management
151
153
157
0032
Family Planning
278
286
286
0033
Loan Repayment/Faculty Fellowship
1
1
1
0035
Health Centers Tort Claim Fund
58
95
89
0036
Heritable Disorders
9
12
12
0038
Childrens' GME
251
265
0041
State Offices of Rural Health
9
10
10
0043
Radiogenic Diseases
2
2
2
0044
Traumatic Brain Injury
9
9
9
0045
Autism and Other Developmental Disorders
45
47
47
0046
Cord Blood Stem Cell Bank
11
11
11
0048
Sickle Cell
4
4
4
0049
Drug Pricing Program
4
10
10
0050
Family to Family Health Information Centers ACA
5
3
0067
Prevention Fund
2
0073
Health Centers ACA
1,491
2,145
3,600
0074
Health Centers Construction ACA
1
28
0075
National Health Service Corps ACA
286
283
310
0076
School Based Health Centers ACA
82
2
2
0077
GME Payments THC ACA
31
73
105
0079
Rural Health AED
2
3
0300
Total direct programs
7,716
8,591
9,309
0799
Total direct obligations
7,716
8,591
9,309
0801
Reimbursable program
48
48
54
0802
Reimbursable program: PHS evaluation
22
25
87
0899
Total reimbursable obligations
70
73
141
0900
Total new obligations
7,786
8,664
9,450
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
382
362
261
1001
Discretionary unobligated balance brought fwd, Oct 1
68
1021
Recoveries of prior year unpaid obligations
32
1050
Unobligated balance (total)
414
362
261
Budget authority:
Appropriations, discretionary:
1100
Appropriation
6,194
6,054
5,293
1100
Appropriation
135
1120
Appropriations transferred to other accts [75–0943]
–16
1120
Appropriations transferred to other accts [75–1362]
–15
1121
Appropriations transferred from other accts [75–0943]
8
1121
Appropriations transferred from other accts [75–1362]
1
1121
Appropriations transferred from other accts [75–1502]
6
1121
Appropriations transferred from other accts [75–0142]
1
1130
Appropriations permanently reduced
–324
1131
Unobligated balance of appropriations permanently reduced
–135
1160
Appropriation, discretionary (total)
5,855
6,054
5,293
Appropriations, mandatory:
1200
Appropriation
1,855
2,508
3,910
1221
Appropriations transferred from other accts [75–0116]
2
1230
Appropriations and/or unobligated balance of appropriations permanently reduced
–53
–77
1260
Appropriations, mandatory (total)
1,804
2,431
3,910
Spending authority from offsetting collections, discretionary:
1700
Collected
31
62
122
1701
Change in uncollected payments, Federal sources
31
1723
New and/or unobligated balance of spending authority from offsetting collections temporarily reduced
–1
1750
Spending auth from offsetting collections, disc (total)
61
62
122
Spending authority from offsetting collections, mandatory:
1800
Offsetting collections (cash)(HPSL&NSL)
16
16
16
1850
Spending auth from offsetting collections, mand (total)
16
16
16
1900
Budget authority (total)
7,736
8,563
9,341
1930
Total budgetary resources available
8,150
8,925
9,602
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–2
1941
Unexpired unobligated balance, end of year
362
261
152
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
6,681
6,238
6,334
3010
Obligations incurred, unexpired accounts
7,786
8,664
9,450
3011
Obligations incurred, expired accounts
3
3020
Outlays (gross)
–8,136
–8,568
–8,770
3040
Recoveries of prior year unpaid obligations, unexpired
–32
3041
Recoveries of prior year unpaid obligations, expired
–64
3050
Unpaid obligations, end of year
6,238
6,334
7,014
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–80
–74
–74
3070
Change in uncollected pymts, Fed sources, unexpired
–31
3071
Change in uncollected pymts, Fed sources, expired
37
3090
Uncollected pymts, Fed sources, end of year
–74
–74
–74
Memorandum (non-add) entries:
3100
Obligated balance, start of year
6,601
6,164
6,260
3200
Obligated balance, end of year
6,164
6,260
6,940
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
5,916
6,116
5,415
Outlays, gross:
4010
Outlays from new discretionary authority
2,201
2,407
2,075
4011
Outlays from discretionary balances
3,820
3,615
3,511
4020
Outlays, gross (total)
6,021
6,022
5,586
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–34
–35
–96
4033
Non-Federal sources
–30
–27
–19
4033
Non-Federal sources
–7
4040
Offsets against gross budget authority and outlays (total)
–64
–62
–122
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–31
4052
Offsetting collections credited to expired accounts
33
4060
Additional offsets against budget authority only (total)
2
4070
Budget authority, net (discretionary)
5,854
6,054
5,293
4080
Outlays, net (discretionary)
5,957
5,960
5,464
Mandatory:
4090
Budget authority, gross
1,820
2,447
3,926
Outlays, gross:
4100
Outlays from new mandatory authority
907
1,166
1,467
4101
Outlays from mandatory balances
1,208
1,380
1,717
4110
Outlays, gross (total)
2,115
2,546
3,184
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123
Non-Federal sources
–16
–16
–16
4180
Budget authority, net (total)
7,658
8,485
9,203
4190
Outlays, net (total)
8,056
8,490
8,632
Memorandum (non-add) entries:
5090
Unavailable balance, SOY: Offsetting collections
1
1
5091
Unavailable balance, EOY: Offsetting collections
1
1
1
Summary of Budget Authority and Outlays (in millions of dollars)
2013 actual
2014 est.
2015 est.
Enacted/requested:
Budget Authority
7,658
8,485
9,203
Outlays
8,056
8,490
8,632
Legislative proposal, subject to PAYGO:
Budget Authority
400
Outlays
200
Total:
Budget Authority
7,658
8,485
9,603
Outlays
8,056
8,490
8,832
Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in millions of dollars)
Identification code 75–0350–0–1–550
2013 actual
2014 est.
2015 est.
Guaranteed loan levels supportable by subsidy budget authority:
215001
Health centers: Facilities renovation loan guarantee levels
8
4
215002
Health centers: Managed care network development loan guarantee
1
1
215003
Health centers: Managed care plan loan guarantee levels
3
1
215999
Total loan guarantee levels
12
6
Guaranteed loan subsidy (in percent):
232001
Health centers: Facilities renovation loan guarantee levels
0.00
2.81
2.67
232002
Health centers: Managed care network development loan guarantee
0.00
10.10
9.68
232003
Health centers: Managed care plan loan guarantee levels
0.00
5.86
5.83
232999
Weighted average subsidy rate
0.00
4.18
4.37
Resources displayed here support categorical grants and contracts managed by Health Resources and Services Administration
(HRSA). These activities include support for Federally Qualified Health Centers, treatment and care for those living with
HIV/AIDS, health professions training, maternal and child health care services, promotion of organ and bone marrow donation,
and the medical malpractice claims funds, which pay malpractice claims filed against employees of federally-supported health
centers and free clinics. HRSA is also responsible for oversight of the 340B Drug Discount Program. The 2015 Budget proposes
a new user fee for this program to improve administration and oversight of this activity.
HRSA administers the following revolving loan programs: Health Professions Student Loans (HPSL), Nursing Student Loans (NSL),
Primary Care Loans (PCL) and Loans for Disadvantaged Students (LDS). These programs are financed through revolving accounts
(Federal Capital Contribution) and do not receive annual appropriations. Through these revolving fund accounts, funds are
awarded to institutions that in turn provide loans to individual students. As borrowers pay back loans the programs revolving
account gets replenished, and the collected funds are then used to give out new loans in the following academic years. If
the program's revolving account has excess funds that will not be used to provide new loans, these excess funds are returned
to HRSA. Funds returned to HRSA are then awarded to programs that are in need of additional funds. The information below reflects
Academic Year 2012–2013 data reported in the Annual Operating Report.
Health Professions Revolving Loan Programs Federal Capital Contribution
Program
Account Balance
HPSL
389,796,286
NSL
174,462,796
PCL
258,568,607
LDS
132,944,663
Total
955,772,352
Object Classification (in millions of dollars)
Identification code 75–0350–0–1–550
2013 actual
2014 est.
2015 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
157
166
160
11.3
Other than full-time permanent
6
6
6
11.5
Other personnel compensation
2
2
2
11.7
Military personnel
19
19
19
11.9
Total personnel compensation
184
193
187
12.1
Civilian personnel benefits
47
50
49
12.2
Military personnel benefits
10
10
10
21.0
Travel and transportation of persons
2
2
2
23.1
Rental payments to GSA
21
22
26
23.2
Rental payments to others
1
1
1
23.3
Communications, utilities, and miscellaneous charges
6
6
6
25.1
Advisory and assistance services
13
13
13
25.2
Other services from non-Federal sources
137
133
127
25.3
Other goods and services from Federal sources
200
196
183
25.4
Operation and maintenance of facilities
1
1
1
25.6
Medical care
3
3
2
25.7
Operation and maintenance of equipment
25
25
23
26.0
Supplies and materials
2
2
2
31.0
Equipment
3
3
3
41.0
Grants, subsidies, and contributions
7,010
7,880
8,623
42.0
Insurance claims and indemnities
51
51
51
99.0
Direct obligations
7,716
8,591
9,309
99.0
Reimbursable obligations
70
73
141
99.9
Total new obligations
7,786
8,664
9,450
Employment Summary
Identification code 75–0350–0–1–550
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
1,578
1,613
1,596
1101
Direct military average strength employment
195
195
195
2001
Reimbursable civilian full-time equivalent employment
62
62
72
2101
Reimbursable military average strength employment
4
4
4
Health Resources and Services
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 75–0350–4–1–550
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0075
National Health Service Corps ACA
400
0300
Total direct programs
400
0803
Reimbursable program: Targeted Support for GME
530
0900
Total new obligations
930
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
400
1260
Appropriations, mandatory (total)
400
Spending authority from offsetting collections, mandatory:
1800
Collected
530
1850
Spending auth from offsetting collections, mand (total)
530
1900
Budget authority (total)
930
1930
Total budgetary resources available
930
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
930
3020
Outlays (gross)
–730
3050
Unpaid obligations, end of year
200
Memorandum (non-add) entries:
3200
Obligated balance, end of year
200
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
930
Outlays, gross:
4100
Outlays from new mandatory authority
730
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120
Federal sources
–530
4180
Budget authority, net (total)
400
4190
Outlays, net (total)
200
Object Classification (in millions of dollars)
Identification code 75–0350–4–1–550
2013 actual
2014 est.
2015 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
3
11.7
Military personnel
1
11.9
Total personnel compensation
4
12.1
Civilian personnel benefits
1
23.3
Communications, utilities, and miscellaneous charges
2
25.2
Other services from non-Federal sources
5
25.3
Other goods and services from Federal sources
23
25.7
Operation and maintenance of equipment
2
41.0
Grants, subsidies, and contributions
362
99.0
Direct obligations
399
99.0
Reimbursable obligations
531
99.9
Total new obligations
930
Employment Summary
Identification code 75–0350–4–1–550
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
56
1101
Direct military average strength employment
5
2001
Reimbursable civilian full-time equivalent employment
2101
Reimbursable military average strength employment
Vaccine Injury Compensation
Program and Financing (in millions of dollars)
Identification code 75–0320–0–1–551
2013 actual
2014 est.
2015 est.
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
15
19
19
Budget authority:
Spending authority from offsetting collections, mandatory:
1800
Collected
4
1850
Spending auth from offsetting collections, mand (total)
4
1900
Budget authority (total)
4
1930
Total budgetary resources available
19
19
19
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
19
19
19
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
4
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120
Federal sources
–4
4190
Outlays, net (total)
–4
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 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.
Covered Countermeasure Process Fund
Program and Financing (in millions of dollars)
Identification code 75–0343–0–1–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Claims
3
1
1
0103
Admin Expense
3
3
0900
Total new obligations
3
4
4
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
2
2
1
1011
Unobligated balance transfer from other accts [75–0140]
3
3
3
1050
Unobligated balance (total)
5
5
4
1930
Total budgetary resources available
5
5
4
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
2
1
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
2
2
6
3010
Obligations incurred, unexpired accounts
3
4
4
3020
Outlays (gross)
–3
3050
Unpaid obligations, end of year
2
6
10
Memorandum (non-add) entries:
3100
Obligated balance, start of year
2
2
6
3200
Obligated balance, end of year
2
6
10
Budget authority and outlays, net:
Discretionary:
Outlays, gross:
4011
Outlays from discretionary balances
3
4190
Outlays, net (total)
3
The Covered Countermeasure Process Fund is established pursuant to the PHS Act, as amended by Division C of Public Law 109–148,
to serve as a source of funds to pay for compensation for injuries, illnesses or death, or losses resulting from the administration
to or use by an individual of a covered countermeasure for which a Secretarial Declaration has been issued, pursuant to section
319F-3(b) of the Public Health Service Act. Additionally, authority is provided to address any unexpected claims that may
arise under the Smallpox Emergency Personal Protection Act of 2003.
Object Classification (in millions of dollars)
Identification code 75–0343–0–1–551
2013 actual
2014 est.
2015 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent
1
25.2
Other services from non-Federal sources
2
2
2
42.0
Insurance claims and indemnities
1
1
99.0
Direct obligations
3
3
3
99.5
Below reporting threshold
1
1
99.9
Total new obligations
3
4
4
Employment Summary
Identification code 75–0343–0–1–551
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
5
5
5
1101
Direct military average strength employment
3
3
3
Maternal, Infant, and Early Childhood Home Visiting Programs
Program and Financing (in millions of dollars)
Identification code 75–0321–0–1–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0010
Maternal, Infant, and Early Childhood Home Visiting Programs
378
396
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
14
25
1012
Unobligated balance transfers between expired and unexpired accounts
9
1050
Unobligated balance (total)
23
25
Budget authority:
Appropriations, mandatory:
1200
Appropriation
400
400
1230
Appropriations and/or unobligated balance of appropriations permanently reduced
–20
–29
1260
Appropriations, mandatory (total)
380
371
1930
Total budgetary resources available
403
396
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
25
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
528
654
734
3010
Obligations incurred, unexpired accounts
378
396
3020
Outlays (gross)
–242
–316
–348
3041
Recoveries of prior year unpaid obligations, expired
–10
3050
Unpaid obligations, end of year
654
734
386
Memorandum (non-add) entries:
3100
Obligated balance, start of year
528
654
734
3200
Obligated balance, end of year
654
734
386
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
380
371
Outlays, gross:
4100
Outlays from new mandatory authority
12
15
4101
Outlays from mandatory balances
230
301
348
4110
Outlays, gross (total)
242
316
348
4180
Budget authority, net (total)
380
371
4190
Outlays, net (total)
242
316
348
Summary of Budget Authority and Outlays (in millions of dollars)
2013 actual
2014 est.
2015 est.
Enacted/requested:
Budget Authority
380
371
Outlays
242
316
348
Legislative proposal, subject to PAYGO:
Budget Authority
500
Outlays
20
Total:
Budget Authority
380
371
500
Outlays
242
316
368
P.L. 111–148 provides resources to Maternal, Infant and Early Childhood Home Visiting Program through 2014 to provide comprehensive
services for at risk communities. The 2015 Budget includes $500 million for the Maternal, Infant and Early Childhood Home
Visiting Program to extend and expand evidenced-based home visiting services for at risk communities. These activities are
administered by HRSA.
Object Classification (in millions of dollars)
Identification code 75–0321–0–1–551
2013 actual
2014 est.
2015 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
2
2
11.7
Military personnel
1
11.9
Total personnel compensation
2
3
12.1
Civilian personnel benefits
1
1
25.1
Advisory and assistance services
19
19
41.0
Grants, subsidies, and contributions
356
373
99.9
Total new obligations
378
396
Employment Summary
Identification code 75–0321–0–1–551
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
19
19
1101
Direct military average strength employment
3
3
Maternal, Infant, and Early Childhood Home Visiting Programs
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 75–0321–4–1–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0010
Maternal, Infant, and Early Childhood Home Visiting Programs
497
Budgetary Resources:
Unobligated balance:
1012
Unobligated balance transfers between expired and unexpired accounts
25
1050
Unobligated balance (total)
25
Budget authority:
Appropriations, mandatory:
1200
Appropriation
500
1260
Appropriations, mandatory (total)
500
1930
Total budgetary resources available
525
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
28
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
497
3020
Outlays (gross)
–20
3050
Unpaid obligations, end of year
477
Memorandum (non-add) entries:
3200
Obligated balance, end of year
477
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
500
Outlays, gross:
4100
Outlays from new mandatory authority
20
4180
Budget authority, net (total)
500
4190
Outlays, net (total)
20
Object Classification (in millions of dollars)
Identification code 75–0321–4–1–551
2013 actual
2014 est.
2015 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
3
11.7
Military personnel
1
11.9
Total personnel compensation
4
12.1
Civilian personnel benefits
1
25.1
Advisory and assistance services
23
41.0
Grants, subsidies, and contributions
469
99.9
Total new obligations
497
Employment Summary
Identification code 75–0321–4–1–551
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
19
1101
Direct military average strength employment
3
Health Center Guaranteed Loan Financing Account
Program and Financing (in millions of dollars)
Identification code 75–4442–0–3–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
Credit program obligations:
0711
Default claim payments on principal
1
1
0900
Total new obligations
1
1
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
3
3
2
1930
Total budgetary resources available
3
3
2
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
3
2
1
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
1
3010
Obligations incurred, unexpired accounts
1
1
3050
Unpaid obligations, end of year
1
2
Memorandum (non-add) entries:
3100
Obligated balance, start of year
1
3200
Obligated balance, end of year
1
2
Status of Guaranteed Loans (in millions of dollars)
Identification code 75–4442–0–3–551
2013 actual
2014 est.
2015 est.
Position with respect to appropriations act limitation on commitments:
2121
Limitation available from carry-forward
18
18
6
2143
Uncommitted limitation carried forward
–18
–6
2150
Total guaranteed loan commitments
12
6
2199
Guaranteed amount of guaranteed loan commitments
12
6
Cumulative balance of guaranteed loans outstanding:
2210
Outstanding, start of year
77
77
78
2231
Disbursements of new guaranteed loans
12
6
2251
Repayments and prepayments
–10
–10
2263
Adjustments: Terminations for default that result in claim payments
–1
–1
2290
Outstanding, end of year
77
78
73
Memorandum:
2299
Guaranteed amount of guaranteed loans outstanding, end of year
77
60
60
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.
Balance Sheet (in millions of dollars)
Identification code 75–4442–0–3–551
2012 actual
2013 actual
ASSETS:
1101
Federal assets: Fund balances with Treasury
3
3
1999
Total assets
3
3
LIABILITIES:
2204
Non-Federal liabilities: Liabilities for loan guarantees
3
3
4999
Total liabilities and net position
3
3
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 PHS Act. For administrative
expenses to carry out the guaranteed loan program, including section 709 of the PHS Act, $2,687,000.] (Department of Health and Human Services Appropriations Act, 2014.)
Program and Financing (in millions of dollars)
Identification code 75–0340–0–1–552
2013 actual
2014 est.
2015 est.
Obligations by program activity:
Credit program obligations:
0707
Reestimates of loan guarantee subsidy
25
0708
Interest on reestimates of loan guarantee subsidy
31
0709
Administrative expenses
3
2
0900
Total new obligations
59
2
Budgetary Resources:
Budget authority:
Appropriations, discretionary:
1100
Appropriation
3
3
1120
Appropriations transferred to other accts [91–0202]
–1
1160
Appropriation, discretionary (total)
3
2
Appropriations, mandatory:
1200
Appropriation
56
1260
Appropriations, mandatory (total)
56
1900
Budget authority (total)
59
2
1930
Total budgetary resources available
59
2
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
1
1
1
3010
Obligations incurred, unexpired accounts
59
2
3020
Outlays (gross)
–59
–2
3050
Unpaid obligations, end of year
1
1
1
Memorandum (non-add) entries:
3100
Obligated balance, start of year
1
1
1
3200
Obligated balance, end of year
1
1
1
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
3
2
Outlays, gross:
4010
Outlays from new discretionary authority
3
2
Mandatory:
4090
Budget authority, gross
56
Outlays, gross:
4100
Outlays from new mandatory authority
56
4180
Budget authority, net (total)
59
2
4190
Outlays, net (total)
59
2
Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in millions of dollars)
Identification code 75–0340–0–1–552
2013 actual
2014 est.
2015 est.
Guaranteed loan upward reestimates:
235001
HEAL Loan guarantee
56
235999
Total upward reestimate budget authority
56
Guaranteed loan downward reestimates:
237001
HEAL Loan guarantee
–43
237999
Total downward reestimate subsidy budget authority
–43
Administrative expense data:
3510
Budget authority
3
3590
Outlays from new authority
2
Pursuant to P.L. 113–76, the Consolidated Appropriations Act, 2014 the authority to administer, service, collect, and enforce
the program as well as the functions, assets, and liabilities of the Secretary of Health and Human Services are permanently
transferred to the Secretary of Education.
Object Classification (in millions of dollars)
Identification code 75–0340–0–1–552
2013 actual
2014 est.
2015 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent
2
1
25.3
Other goods and services from Federal sources
1
1
41.0
Grants, subsidies, and contributions
56
99.9
Total new obligations
59
2
Employment Summary
Identification code 75–0340–0–1–552
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
14
14
Health Education Assistance Loans Financing Account
Program and Financing (in millions of dollars)
Identification code 75–4304–0–3–552
2013 actual
2014 est.
2015 est.
Obligations by program activity:
Credit program obligations:
0711
Default claim payments on principal
10
12
0742
Downward reestimate paid to receipt account
18
0743
Interest on downward reestimates
26
0900
Total new obligations
10
56
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
49
107
1010
Unobligated balance transfer to other accts [91–4300]
–54
1023
Unobligated balances applied to repay debt
–1
1050
Unobligated balance (total)
48
53
Financing authority:
Spending authority from offsetting collections, mandatory:
1800
Collected
69
3
1850
Spending auth from offsetting collections, mand (total)
69
3
1930
Total budgetary resources available
117
56
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
107
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
10
56
3020
Financing disbursements (gross)
–10
–56
Financing authority and disbursements, net:
Mandatory:
4090
Financing authority, gross
69
3
Financing disbursements:
4110
Financing disbursements, gross
10
56
Offsets against gross financing authority and disbursements:
Offsetting collections (collected) from:
4120
Federal sources-upward estimate and interest
–56
4122
Interest on uninvested funds
–6
4123
Recoveries of defaulted loans
–7
–3
4130
Offsets against gross financing auth and disbursements (total)
–69
–3
4170
Financing disbursements, net (mandatory)
–59
53
4190
Financing disbursements, net (total)
–59
53
Status of Guaranteed Loans (in millions of dollars)
Identification code 75–4304–0–3–552
2013 actual
2014 est.
2015 est.
Cumulative balance of guaranteed loans outstanding:
2210
Outstanding, start of year
430
350
2251
Repayments and prepayments
–70
–5
Adjustments:
2261
Terminations for default that result in loans receivable
–8
–13
2263
Terminations for default that result in claim payments
–2
–3
2264
Other adjustments, net
–329
2290
Outstanding, end of year
350
Memorandum:
2299
Guaranteed amount of guaranteed loans outstanding, end of year
350
Addendum:
Cumulative balance of defaulted guaranteed loans that result in loans receivable:
2310
Outstanding, start of year
184
192
2331
Disbursements for guaranteed loan claims
10
12
2361
Write-offs of loans receivable
–2
–3
2364
Other adjustments, net
–201
2390
Outstanding, end of year
192
Pursuant to P.L. 113–76, the Consolidated Appropriations Act, 2014 this activity is transferred to the Department of Education.
Balance Sheet (in millions of dollars)
Identification code 75–4304–0–3–552
2012 actual
2013 actual
ASSETS:
1101
Federal assets: Fund balances with Treasury
50
108
Net value of assets related to post-1991 acquired defaulted guaranteed loans receivable:
1501
Defaulted guaranteed loans receivable, gross
184
192
1505
Allowance for subsidy cost (-)
–126
–144
1599
Net present value of assets related to defaulted guaranteed loans
58
48
1999
Total assets
108
156
LIABILITIES:
2204
Non-Federal liabilities: Liabilities for loan guarantees
108
156
4999
Total liabilities and net position
108
156
Health Education Assistance Loans Liquidating Account
Program and Financing (in millions of dollars)
Identification code 75–4305–0–3–552
2013 actual
2014 est.
2015 est.
Obligations by program activity:
Credit program obligations:
0711
Default claim payments on principal
2
2
0900
Total new obligations (object class 33.0)
2
2
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
1
1
1260
Appropriations, mandatory (total)
1
1
Spending authority from offsetting collections, mandatory:
1800
Collected
9
9
1820
Capital transfer of spending authority from offsetting collections to general fund
–8
–8
1850
Spending auth from offsetting collections, mand (total)
1
1
1900
Budget authority (total)
2
2
1930
Total budgetary resources available
2
2
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
2
2
3020
Outlays (gross)
–2
–2
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
2
2
Outlays, gross:
4100
Outlays from new mandatory authority
2
2
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123
Non-Federal sources
–9
–9
4180
Budget authority, net (total)
–7
–7
4190
Outlays, net (total)
–7
–7
Status of Guaranteed Loans (in millions of dollars)
Identification code 75–4305–0–3–552
2013 actual
2014 est.
2015 est.
Cumulative balance of guaranteed loans outstanding:
2210
Outstanding, start of year
64
49
2251
Repayments and prepayments
–13
–7
Adjustments:
2261
Terminations for default that result in loans receivable
–2
–2
2264
Other adjustments, net
–40
2290
Outstanding, end of year
49
Memorandum:
2299
Guaranteed amount of guaranteed loans outstanding, end of year
49
Addendum:
Cumulative balance of defaulted guaranteed loans that result in loans receivable:
2310
Outstanding, start of year
346
331
2331
Disbursements for guaranteed loan claims
2
2
2351
Repayments of loans receivable
–8
–9
2361
Write-offs of loans receivable
–20
2364
Other adjustments, net
11
–324
2390
Outstanding, end of year
331
Pursuant to P.L. 113–76, the Consolidated Appropriations Act, 2014 this activity is transferred to the Department of Education.
Balance Sheet (in millions of dollars)
Identification code 75–4305–0–3–552
2012 actual
2013 actual
ASSETS:
1101
Federal assets: Fund balances with Treasury
1
1
1701
Defaulted guaranteed loans, gross
346
331
1703
Allowance for estimated uncollectible loans and interest (-)
–238
–248
1799
Value of assets related to loan guarantees
108
83
1999
Total assets
109
84
LIABILITIES:
2104
Federal liabilities: Resources payable to Treasury
109
82
2204
Non-Federal liabilities: Liabilities for loan guarantees
2
2999
Total liabilities
109
84
4999
Total liabilities and net position
109
84
Medical Facilities Guarantee and Loan Fund
Status of Direct Loans (in millions of dollars)
Identification code 75–9931–0–3–551
2013 actual
2014 est.
2015 est.
Cumulative balance of direct loans outstanding:
1210
Outstanding, start of year
7
7
7
1251
Repayments: Repayments and prepayments
1290
Outstanding, end of year
7
7
7
Titles VI and 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
2012 actual
2013 actual
ASSETS:
1601
Direct loans, gross
7
7
1999
Total assets
7
7
LIABILITIES:
2201
Non-Federal liabilities: Accounts payable
7
7
4999
Total liabilities and net position
7
7
Trust Funds
Vaccine Injury Compensation Program Trust Fund
For payments from the Vaccine Injury Compensation Program Trust Fund (the "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 PHS Act, to remain available until expended: Provided, That for necessary administrative expenses, not to exceed [$6,464,000] $7,500,000 shall be available from the Trust Fund to the Secretary. (Department of Health and Human Services Appropriations Act, 2014.)
Special and Trust Fund Receipts (in millions of dollars)
Identification code 75–8175–0–7–551
2013 actual
2014 est.
2015 est.
0100
Balance, start of year
3,214
3,244
3,304
Receipts:
0200
Deposits, Vaccine Injury Compensation Trust Fund
204
249
256
0240
Interest and Profits on Investments, Vaccine Injury Compensation Trust Fund
119
115
128
0299
Total receipts and collections
323
364
384
0400
Total: Balances and collections
3,537
3,608
3,688
Appropriations:
0500
Vaccine Injury Compensation Program Trust Fund
–18
–19
–21
0501
Vaccine Injury Compensation Program Trust Fund
–275
–285
–293
0599
Total appropriations
–293
–304
–314
0799
Balance, end of year
3,244
3,304
3,374
Program and Financing (in millions of dollars)
Identification code 75–8175–0–7–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Compensation: Claims for post - FY 1989 injuries
275
285
293
0103
Claims processing (Claims Court)
5
5
5
0104
Claims processing (HRSA)
6
6
8
0105
Claims processing (Dept. of Justice)
8
8
8
0191
Total, administrative expenses
19
19
21
0799
Total direct obligations
294
304
314
0801
Reimbursable program activity (claims)
2
0900
Total new obligations
296
304
314
Budgetary Resources:
Unobligated balance:
1021
Recoveries of prior year unpaid obligations
1
1050
Unobligated balance (total)
1
Budget authority:
Appropriations, discretionary:
1101
Appropriation (special or trust fund)
18
19
21
1160
Appropriation, discretionary (total)
18
19
21
Appropriations, mandatory:
1201
Appropriation (special or trust fund)
275
285
293
1260
Appropriations, mandatory (total)
275
285
293
Spending authority from offsetting collections, mandatory:
1800
Collected
2
1850
Spending auth from offsetting collections, mand (total)
2
1900
Budget authority (total)
295
304
314
1930
Total budgetary resources available
296
304
314
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
19
16
3010
Obligations incurred, unexpired accounts
296
304
314
3020
Outlays (gross)
–298
–320
–314
3040
Recoveries of prior year unpaid obligations, unexpired
–1
3050
Unpaid obligations, end of year
16
Memorandum (non-add) entries:
3100
Obligated balance, start of year
19
16
3200
Obligated balance, end of year
16
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
18
19
21
Outlays, gross:
4010
Outlays from new discretionary authority
13
19
21
4011
Outlays from discretionary balances
8
16
4020
Outlays, gross (total)
21
35
21
Mandatory:
4090
Budget authority, gross
277
285
293
Outlays, gross:
4100
Outlays from new mandatory authority
277
285
293
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123
Non-Federal sources
–2
4180
Budget authority, net (total)
293
304
314
4190
Outlays, net (total)
296
320
314
Memorandum (non-add) entries:
5000
Total investments, SOY: Federal securities: Par value
3,194
3,244
3,324
5001
Total investments, EOY: Federal securities: Par value
3,244
3,324
3,415
The Vaccine Injury Compensation Program was established pursuant to P.L. 99–660 and P.L. 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 75–8175–0–7–551
2013 actual
2014 est.
2015 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent
2
2
2
12.1
Civilian personnel benefits
1
1
1
25.3
Other goods and services from Federal sources
3
16
18
42.0
Insurance claims and indemnities
290
285
293
99.9
Total new obligations
296
304
314
Employment Summary
Identification code 75–8175–0–7–551
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
17
20
23
1101
Direct military average strength employment
2
2
2
Indian Health Service
Federal Funds
Indian Health Services
For expenses necessary to carry out the Act of August 5, 1954 (68 Stat. 674), the Indian Self-Determination and Education Assistance 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, [$3,982,842,000] $4,172,182,000, together with payments received during the fiscal year pursuant to 42 U.S.C. 238(b) and 238b, 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,[$878,575,000] $929,041,000 for Purchased/Referred Care, including [$51,500,000] $51,500,000 for the Indian Catastrophic Health Emergency Fund, shall remain available until expended: Provided further, That, of the funds provided, up to $36,000,000 shall remain available until expended for implementation of the loan repayment program
under section 108 of the Indian Health Care Improvement Act: Provided further, That the amounts collected by the Federal Government as authorized by sections 104 and 108 of the Indian Health Care Improvement
Act (25 U.S.C. 1613a and 1616a) during the preceding fiscal year for breach of contracts shall be deposited to the Fund authorized
by section 108A of the Act (25 U.S.C. 1616a-1) and shall remain available until expended and, notwithstanding section 108A(c)
of the Act (25 U.S.C. 1616a-1(c)), funds shall be available to make new awards under the loan repayment and scholarship programs
under sections 104 and 108 of the Act (25 U.S.C. 1613a and 1616a): Provided further, That notwithstanding any other provision of law, the amounts made available within this account for the methamphetamine
and suicide prevention and treatment initiative and for the domestic violence prevention initiative shall be allocated at
the discretion of the Director of the Indian Health Service and shall remain available until expended: Provided further, That funds provided in this Act may be used for annual contracts and grants that fall within 2 fiscal years, provided the
total obligation is recorded in the year 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, except for those related to the planning, design, or
construction of new facilities: Provided further, That funding contained herein 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 the Bureau of Indian Affairs may collect from the Indian Health Service, tribes and tribal organizations operating
health facilities pursuant to Public Law 93–638, such individually identifiable health information relating to disabled children
as may be necessary for the purpose of carrying out its functions under the Individuals with Disabilities Education Act (20
U.S.C. 1400, et seq.): Provided further, That the Indian Health Care Improvement Fund may be used, as needed, to carry out activities typically funded under the
Indian Health Facilities account. (Department of the Interior, Environment, and Related Agencies Appropriations Act, 2014.)
Program and Financing (in millions of dollars)
Identification code 75–0390–0–1–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Clinical services
3,051
3,099
3,243
0002
Preventive health
143
148
156
0003
Urban health
41
41
41
0004
Indian health professions
32
34
39
0005
Tribal management
2
1
2
0006
Direct operations
68
68
68
0007
Self-governance
6
5
6
0008
Contract support costs
448
587
617
0009
Diabetes funds
147
147
0799
Total direct obligations
3,938
4,130
4,172
0801
Reimbursable program
1,219
1,334
1,364
0900
Total new obligations
5,157
5,464
5,536
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
560
577
408
1001
Discretionary unobligated balance brought fwd, Oct 1
560
1021
Recoveries of prior year unpaid obligations
124
1050
Unobligated balance (total)
684
577
408
Budget authority:
Appropriations, discretionary:
1100
Appropriation
3,915
3,983
4,172
1120
Appropriations transferred to other accts [75–0390]
–65
1121
Appropriations transferred from other accts [75–0390]
65
1130
Appropriations permanently reduced
–202
1160
Appropriation, discretionary (total)
3,713
3,983
4,172
Appropriations, mandatory:
1200
Appropriation
150
150
1230
Appropriations and/or unobligated balance of appropriations permanently reduced
–3
–3
1260
Appropriations, mandatory (total)
147
147
Spending authority from offsetting collections, discretionary:
1700
Collected
1,203
1,165
1,165
1701
Change in uncollected payments, Federal sources
–10
1750
Spending auth from offsetting collections, disc (total)
1,193
1,165
1,165
1900
Budget authority (total)
5,053
5,295
5,337
1930
Total budgetary resources available
5,737
5,872
5,745
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–3
1941
Unexpired unobligated balance, end of year
577
408
209
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
844
833
1,016
3010
Obligations incurred, unexpired accounts
5,157
5,464
5,536
3011
Obligations incurred, expired accounts
24
3020
Outlays (gross)
–5,037
–5,281
–5,416
3040
Recoveries of prior year unpaid obligations, unexpired
–124
3041
Recoveries of prior year unpaid obligations, expired
–31
3050
Unpaid obligations, end of year
833
1,016
1,136
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–82
–68
–68
3070
Change in uncollected pymts, Fed sources, unexpired
10
3071
Change in uncollected pymts, Fed sources, expired
4
3090
Uncollected pymts, Fed sources, end of year
–68
–68
–68
Memorandum (non-add) entries:
3100
Obligated balance, start of year
762
765
948
3200
Obligated balance, end of year
765
948
1,068
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
4,906
5,148
5,337
Outlays, gross:
4010
Outlays from new discretionary authority
4,178
4,431
4,586
4011
Outlays from discretionary balances
734
838
830
4020
Outlays, gross (total)
4,912
5,269
5,416
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–263
–368
–368
4033
Non-Federal sources
–942
–797
–797
4040
Offsets against gross budget authority and outlays (total)
–1,205
–1,165
–1,165
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
10
4052
Offsetting collections credited to expired accounts
2
4060
Additional offsets against budget authority only (total)
12
4070
Budget authority, net (discretionary)
3,713
3,983
4,172
4080
Outlays, net (discretionary)
3,707
4,104
4,251
Mandatory:
4090
Budget authority, gross
147
147
Outlays, gross:
4100
Outlays from new mandatory authority
48
4101
Outlays from mandatory balances
77
12
4110
Outlays, gross (total)
125
12
4180
Budget authority, net (total)
3,860
4,130
4,172
4190
Outlays, net (total)
3,832
4,116
4,251
Summary of Budget Authority and Outlays (in millions of dollars)
2013 actual
2014 est.
2015 est.
Enacted/requested:
Budget Authority
3,860
4,130
4,172
Outlays
3,832
4,116
4,251
Legislative proposal, subject to PAYGO:
Budget Authority
150
Outlays
144
Total:
Budget Authority
3,860
4,130
4,322
Outlays
3,832
4,116
4,395
The Indian Health Services account provides medical care, public health services, and health professions training opportunities
to American Indians and Alaska Natives. An estimated $2.248 billion primarily through self-determination contracts and compacts,
will be administered by tribal governments in 2015.
Object Classification (in millions of dollars)
Identification code 75–0390–0–1–551
2013 actual
2014 est.
2015 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
397
404
413
11.3
Other than full-time permanent
20
20
21
11.5
Other personnel compensation
50
51
52
11.7
Military personnel
72
74
75
11.9
Total personnel compensation
539
549
561
12.1
Civilian personnel benefits
143
146
149
12.2
Military personnel benefits
32
32
33
13.0
Benefits for former personnel
13
13
13
21.0
Travel and transportation of persons
8
8
8
21.0
Patient travel
32
33
35
22.0
Transportation of things
6
6
6
23.1
Rental payments to GSA
8
8
8
23.2
Rental payments to others
1
1
1
23.3
Communications, utilities, and miscellaneous charges
11
11
11
25.1
Advisory and assistance services
8
8
8
25.2
Other services from non-Federal sources
90
95
101
25.3
Other goods and services from Federal sources
50
51
52
25.4
Operation and maintenance of facilities
8
9
9
25.6
Medical care
308
452
504
25.7
Operation and maintenance of equipment
13
13
13
25.8
Subsistence and support of persons
3
3
3
26.0
Supplies and materials
98
103
109
31.0
Equipment
7
8
8
41.0
Grants, subsidies, and contributions
2,559
2,580
2,539
42.0
Insurance claims and indemnities
1
1
1
99.0
Direct obligations
3,938
4,130
4,172
99.0
Reimbursable obligations
1,219
1,334
1,364
99.9
Total new obligations
5,157
5,464
5,536
Employment Summary
Identification code 75–0390–0–1–551
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
7,082
7,358
7,474
1101
Direct military average strength employment
1,105
1,138
1,147
2001
Reimbursable civilian full-time equivalent employment
5,173
5,059
5,065
2101
Reimbursable military average strength employment
807
783
777
Indian Health Services
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 75–0390–4–1–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0003
Urban health
150
0900
Total new obligations (object class 41.0)
150
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
150
1260
Appropriations, mandatory (total)
150
1900
Budget authority (total)
150
1930
Total budgetary resources available
150
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
150
3020
Outlays (gross)
–144
3050
Unpaid obligations, end of year
6
Memorandum (non-add) entries:
3200
Obligated balance, end of year
6
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
150
Outlays, gross:
4100
Outlays from new mandatory authority
144
4180
Budget authority, net (total)
150
4190
Outlays, net (total)
144
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, $461,995,000 [$451,673,000], to remain available until expended: Provided, That notwithstanding any other provision of law, funds appropriated for the planning, design, construction, renovation or
expansion of health facilities for the benefit of an Indian tribe or tribes may be used to purchase land on which such facilities
will be located: Provided further, That not to exceed $500,000 may 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 $2,700,000 from this account and the "Indian Health Services'' account may 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 may be placed in a Demolition Fund, to remain available until expended, and be used by the Indian
Health Service for the demolition of Federal buildings. (Department of the Interior, Environment, and Related Agencies Appropriations Act, 2014.)
Special and Trust Fund Receipts (in millions of dollars)
Identification code 75–0391–0–1–551
2013 actual
2014 est.
2015 est.
0100
Balance, start of year
Receipts:
0220
Rent and Charges for Quarters, Indian Health Service
8
8
8
0400
Total: Balances and collections
8
8
8
Appropriations:
0500
Indian Health Facilities
–8
–8
–8
0799
Balance, end of year
Program and Financing (in millions of dollars)
Identification code 75–0391–0–1–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Sanitation and health facilities
164
164
164
0002
Maintenance
54
54
54
0003
Facilities and environmental health
201
211
221
0004
Equipment
20
23
23
0100
Total direct program
439
452
462
0799
Total direct obligations
439
452
462
0801
Reimbursable program
65
65
65
0900
Total new obligations
504
517
527
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
169
156
105
1001
Discretionary unobligated balance brought fwd, Oct 1
169
1021
Recoveries of prior year unpaid obligations
8
1050
Unobligated balance (total)
177
156
105
Budget authority:
Appropriations, discretionary:
1100
Appropriation
442
452
462
1130
Appropriations permanently reduced
–23
1160
Appropriation, discretionary (total)
419
452
462
Appropriations, mandatory:
1201
Appropriation (special or trust fund)
8
8
8
1260
Appropriations, mandatory (total)
8
8
8
Spending authority from offsetting collections, discretionary:
1700
Collected
56
6
6
1750
Spending auth from offsetting collections, disc (total)
56
6
6
1900
Budget authority (total)
483
466
476
1930
Total budgetary resources available
660
622
581
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
156
105
54
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
525
522
542
3010
Obligations incurred, unexpired accounts
504
517
527
3020
Outlays (gross)
–498
–497
–494
3040
Recoveries of prior year unpaid obligations, unexpired
–8
3041
Recoveries of prior year unpaid obligations, expired
–1
3050
Unpaid obligations, end of year
522
542
575
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–6
–5
–5
3071
Change in uncollected pymts, Fed sources, expired
1
3090
Uncollected pymts, Fed sources, end of year
–5
–5
–5
Memorandum (non-add) entries:
3100
Obligated balance, start of year
519
517
537
3200
Obligated balance, end of year
517
537
570
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
475
458
468
Outlays, gross:
4010
Outlays from new discretionary authority
259
142
145
4011
Outlays from discretionary balances
230
347
341
4020
Outlays, gross (total)
489
489
486
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–42
–6
–6
4033
Non-Federal sources
–14
4040
Offsets against gross budget authority and outlays (total)
–56
–6
–6
4070
Budget authority, net (discretionary)
419
452
462
4080
Outlays, net (discretionary)
433
483
480
Mandatory:
4090
Budget authority, gross
8
8
8
Outlays, gross:
4100
Outlays from new mandatory authority
3
8
8
4101
Outlays from mandatory balances
6
4110
Outlays, gross (total)
9
8
8
4180
Budget authority, net (total)
427
460
470
4190
Outlays, net (total)
442
491
488
The Indian Health Facilities account supports construction, repair and improvement, equipment, and environmental health and
facilities support for the Indian Health Service. An estimated $208.7 million primarily through self-determination contracts
and compacts, will be administered by tribal governments in 2015.
Object Classification (in millions of dollars)
Identification code 75–0391–0–1–551
2013 actual
2014 est.
2015 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
46
48
51
11.3
Other than full-time permanent
2
2
2
11.5
Other personnel compensation
2
2
2
11.7
Military personnel
24
24
25
11.9
Total personnel compensation
74
76
80
12.1
Civilian personnel benefits
14
15
16
12.2
Military personnel benefits
9
9
9
21.0
Travel and transportation of persons
2
2
2
22.0
Transportation of things
4
4
4
23.1
Rental payments to GSA
1
1
1
23.3
Communications, utilities, and miscellaneous charges
14
16
16
25.1
Advisory and assistance services
3
2
2
25.2
Other services from non-Federal sources
69
71
71
25.3
Other goods and services from Federal sources
2
2
2
25.4
Operation and maintenance of facilities
9
10
10
25.7
Operation and maintenance of equipment
5
6
6
26.0
Supplies and materials
6
7
7
31.0
Equipment
8
9
10
32.0
Land and structures
83
82
82
41.0
Grants, subsidies, and contributions
136
140
144
99.0
Direct obligations
439
452
462
99.0
Reimbursable obligations
65
65
65
99.9
Total new obligations
504
517
527
Employment Summary
Identification code 75–0391–0–1–551
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
1,003
1,049
1,082
1101
Direct military average strength employment
171
171
163
2001
Reimbursable civilian full-time equivalent employment
29
29
29
ADMINISTRATIVE PROVISIONS
Indian Health Service Administrative Provisions
Appropriations provided in this Act to the Indian Health Service shall be available for services as authorized by 5 U.S.C.
3109 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; uniforms or allowances therefor as authorized by
5 U.S.C. 5901–5902; and for expenses of attendance at meetings that relate to the functions or activities of the Indian Health
Service: Provided, That 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: Provided further, That 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: Provided
further, That 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: Provided
further, That none of the funds made available to the Indian Health Service in this Act shall be used for any assessments
or charges by the Department of Health and Human Services unless identified in the budget justification and provided in this
Act, or notified to the House and Senate Committees on Appropriations through the reprogramming process: Provided further,
That 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: Provided further, That 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: Provided further, That with respect to functions transferred
by the Indian Health Service to tribes or tribal organizations, the Indian Health Service is authorized to provide goods and
services to those entities on a reimbursable basis, including payments in advance with subsequent adjustment, and 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 from which the funds were originally derived, with such amounts to
remain available until expended: Provided further, That 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: Provided further, That the appropriation structure for the Indian Health
Service may not be altered without advance notification to the House and Senate Committees on Appropriations.
Centers for Disease Control and Prevention
Federal Funds
CDC-Wide Activities and Program Support
Immunization and Respiratory Diseases
For carrying out titles II, III, XVII, and XXI, and section 2821 of the PHS Act, titles II and IV of the Immigration and Nationality
Act, and section 501 of the Refugee Education Assistance Act, with respect to immunization and respiratory diseases, [$571,536,000] $607,942,000: Provided, That in addition to amounts provided herein, $12,864,000 shall be available from amounts available under section 241 of
the PHS Act to carry out the National Immunization Surveys.
Hiv/Aids, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis Prevention
For carrying out titles II, III, XVII, and XXIII[, and XXVI] of the PHS Act with respect to HIV/AIDS, viral hepatitis, sexually transmitted diseases, and tuberculosis prevention, [$1,072,834,000] $1,124,942,000: Provided, That, in addition to the amounts provided herein, $3,000,000 shall be available from amounts available
under section 241 of the PHS Act to carry out the evaluation of HIV school health activities.
Emerging and Zoonotic Infectious Diseases
For carrying out titles II, III, and XVII, and section 2821 of the PHS Act, titles II and IV of the Immigration and Nationality
Act, and section 501 of the Refugee Education Assistance Act, with respect to emerging and zoonotic infectious diseases, [$287,300,000] $393,549,000: Provided, That of the [funds provided for the Advanced Molecular Detection initiative, the CDC Director shall establish and publish a five-year program
implementation plan within 90 days of enactment] amounts available to pay for the transportation, medical care, treatment, and other related costs of persons quarantined
or isolated under federal or state quarantine law, up to $1,000,000 shall remain available until expended.
Chronic Disease Prevention and Health Promotion
For carrying out titles II, III, XI, XV, XVII, and XIX of the PHS Act with respect to chronic disease prevention and health
promotion, [$711,650,000] $608,253,000: Provided, That funds appropriated under this account may be available for making grants under section 1509 of the PHS Act for [not less than] up to 21 States, tribes, or tribal organizations: Provided further, That [of the funds available under this heading, $5,000,000 shall be available to conduct an extension and outreach program to combat
obesity in counties with the highest levels of obesity: Provided further, That of the funds provided under this heading, $80,000,000 shall be available for a program consisting of three-year grants
of no less than $100,000 per year to non-governmental entities, local public health offices, school districts, local housing
authorities, local transportation authorities or Indian tribes to implement evidence-based chronic disease prevention strategies:
Provided further, That applicants for grants described in the previous proviso shall determine the population to be served and shall agree
to work in collaboration with multi-sector partners] the proportional funding requirements under section 1503(a) of the PHS Act shall not apply to funds made available under
this heading.
Birth Defects, Developmental Disabilities, Disabilities and Health
For carrying out titles II, III, XI, and XVII of the PHS Act with respect to birth defects, developmental disabilities, disabilities
and health, [$122,435,000] $61,541,000.
Public Health Scientific Services
For carrying out titles II, III, and XVII of the PHS Act with respect to health statistics, surveillance, health informatics, and workforce development, [$347,179,000] $377,723,000: Provided, That, in addition to amounts provided herein, [$85,691,000] $95,086,000 shall be available from amounts available under section 241 of the PHS Act to carry out public health scientific services.
Environmental Health
For carrying out titles II, III, and XVII of the PHS Act with respect to environmental health, [$147,555,000] $131,811,000.
Injury Prevention and Control
For carrying out titles II, III, and XVII of the PHS Act with respect to injury prevention and control, [$142,311,000] $188,699,000: Provided, That, in addition to the amounts provided herein, $5,605,000 shall be available from amounts under
section 241 of the PHS Act to carry out the evaluation of Rape Prevention and Education programs.
National Institute for Occupational Safety and Health
For carrying out titles II, III, and XVII of the PHS Act, sections 101, 102, 103, 201, 202, 203, 301, and 501[, and 514] of the Federal Mine Safety and Health Act, section 13 of the Mine Improvement and New Emergency Response Act, and sections
20, 21, and 22 of the Occupational Safety and Health Act, with respect to occupational safety and health, [$180,300,000: Provided, That in addition to amounts provided herein, $112,000,000] $280,590,000 shall be available from amounts available under section 241 of the PHS Act.
Energy Employees Occupational Illness Compensation Program
For necessary expenses to administer the Energy Employees Occupational Illness Compensation Program Act, $55,358,000, to remain
available until expended: Provided, That this amount shall be available consistent with the provision regarding administrative expenses in section 151(b) of
division B, title I of Public Law 106–554.
Global Health
For carrying out titles II, III, and XVII of the PHS Act with respect to global health, [$383,000,000] $464,301,000, of which [$114,250,000] $128,735,000 for international HIV/AIDS shall remain available through September 30, [2015, and of which $7,500,000 shall remain available through September 30, 2015, to support national public health institutes] 2016: Provided, That funds may be used for purchase and insurance of official motor vehicles in foreign countries.
Public Health Preparedness and Response
For carrying out titles II, III, and XVII of the PHS Act with respect to public health preparedness and response, and for
expenses necessary to support activities related to countering potential biological, nuclear, radiological, and chemical threats
to civilian populations, [$1,323,450,000, of which $535,000,000 shall remain available until expended for the Strategic National Stockpile: Provided, That in the event the Director of the CDC activates the Emergency Operations Center, the Director of the CDC may detail
CDC staff without reimbursement for up to 30 days to support the work of the CDC Emergency Operations Center, so long as the
Director provides a notice to the Committees on Appropriations of the House of Representatives and the Senate within 15 days
of the use of this authority and a full report within 30 days after use of this authority which includes the number of staff
and funding level broken down by the originating center and number of days detailed: Provided further, That in the previous proviso the annual reimbursement cannot exceed $3,000,000 across CDC: Provided further, That of the funds provided for the Strategic National Stockpile, up to $2,000,000 shall be used to support a comprehensive
IOM evaluation of the distribution system] $1,317,375,000: Provided, That, of the amounts available to the Strategic National Stockpile, $542,817,000 shall remain available
until expended: Provided further, That the Director of the CDC, or the Administrator of the Agency for Toxic Substances and
Disease Registry, may detail staff without reimbursement for up to 180 days, to support an activation of the Emergency Operations
Center at the CDC.
Cdc-Wide Activities and Program Support
(including transfer of funds)
For carrying out titles II, III, XVII, and XIX, and section 2821 of the PHS Act and for cross-cutting activities and program support that supplement activities
funded under the headings "Immunization and Respiratory Diseases'', "HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases,
and Tuberculosis Prevention'', "Emerging and Zoonotic Infectious Diseases'', "Chronic Disease Prevention and Health Promotion'',
"Birth Defects, Developmental Disabilities, Disabilities and Health'', "Environmental Health'', "Injury Prevention and Control'',
"National Institute for Occupational Safety and Health'', "Energy Employees Occupational Illness Compensation Program'', "Global
Health'', "Public Health Preparedness and Response'', and "Public Health Scientific Services'', [$517,570,000, of which $380,000,000 shall be available until September 30, 2015, for business services and transfer to the
Working Capital Fund ,] and for carrying out section 4001 of Public Law 111–148, $123,570,000,of which [$24,000,000] $10,000,000 shall be available until September 30, 2018, for [acquisition of real property,] equipment, construction and renovation of facilities: Provided, That paragraphs (1) through (3) of subsection (b) of section 2821 of the PHS Act shall not apply to funds appropriated under
this heading and in all other accounts of the CDC: Provided further, That funds appropriated under this heading and in all other accounts of CDC may be used to support the purchase,
hire, maintenance, and operation of aircraft for use and support of the activities of CDC: Provided further, That employees of CDC or the Public Health Service, both civilian and commissioned officers, detailed to States, municipalities,
or other organizations under authority of section 214 of the PHS Act, or in overseas assignments, shall be treated as non-Federal
employees for reporting purposes only and shall not be included within any personnel ceiling applicable to the Agency, Service,
or HHS during the period of detail or assignment: Provided further, That CDC may use up to $10,000 from amounts appropriated to CDC in this Act for official reception and representation expenses
when specifically approved by the Director of CDC: Provided further, That in addition, such sums as may be derived from authorized user fees, which shall be credited to the appropriation charged
with the cost thereof: Provided further, That with respect to the previous proviso, authorized user fees from the Vessel Sanitation Program shall be available through
September 30, [2015] 2016: Provided further, That, of the funds made available under this heading and in all other accounts of CDC, up to $1,000 per eligible employee of CDC
shall be made available until expended for Individual Learning Accounts: Provided further, That [to facilitate the implementation of the permanent Working Capital Fund ("WCF'') authorized under this heading in division
F of Public Law 112–74, on or after enactment of this Act, unobligated balances of amounts appropriated for business services
for fiscal year 2013 shall be transferred to the WCF: Provided further, That on or after enactment of this Act, CDC shall transfer amounts available for business services to other CDC appropriations
consistent with the benefit each appropriation received from the business services appropriation in fiscal year 2013: Provided further, That once the WCF is implemented in fiscal year 2014, assets purchased in any prior fiscal year with funds appropriated
for or reimbursed to business services may be transferred to the WCF and customers billed for depreciation of those assets:
Provided further, That CDC shall, consistent with the authorities provided in 42 U.S.C. 231, ensure that the WCF is used only for administrative
support services and not for programmatic activities: Provided further, That CDC shall notify the Committees on Appropriations of the House of Representatives and the Senate not later than 15
days prior to any transfers made with funds provided under this heading] the Director may transfer funds between any of the accounts of CDC with notification to the Comittees on Appropriations of
both Houses of Congress at least 15 days in advance of any transfer, but no such account shall be decreased by more than 3
percent by any such transfer. (Department of Health and Human Services Appropriations Act, 2014.)
Special and Trust Fund Receipts (in millions of dollars)
Identification code 75–0943–0–1–999
2013 actual
2014 est.
2015 est.
0100
Balance, start of year
Receipts:
0220
Cooperative Research and Development Agreements, Centers for Disease Control
1
2
2
0400
Total: Balances and collections
1
2
2
Appropriations:
0500
CDC-Wide Activities and Program Support
–1
–2
–2
0799
Balance, end of year
Program and Financing (in millions of dollars)
Identification code 75–0943–0–1–999
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Birth Defects, Developmental Disabilities, Disability and Health (0958)
130
132
132
0002
CDC Wide Activities and Program Support (0943)
1,099
299
124
0004
Chronic Disease Prevention and Health Promotion (0948)
739
1,188
1,078
0005
Emerging and Zoonotics Infectious Diseases (0949)
246
393
445
0006
Energy Employee Illness Occupational Compensation Program Act (EEOICPA) (0954)
50
50
55
0007
Environmental Health (0947)
102
180
169
0008
Global Health (0955)
332
414
465
0012
HIV/AIDS, Viral Hepatitis, STD and TB Prevention (0950)
1,045
1,121
1,128
0013
Immunization and Respiratory Diseases (0951)
563
772
735
0015
Injury Prevention and Control (0952)
130
151
189
0016
Occupational Safety and Health (0953)
172
221
0019
Public Health Preparedness and Response (0956)
1,255
1,371
1,317
0020
Public Health Scientific Services (0959)
144
397
431
0021
Cooperative Research and Development Agreements (CRADA) (5146)
1
2
2
0799
Total direct obligations
6,008
6,691
6,270
0802
Reimbursable program activity
588
541
738
0809
Reimbursable program activities, subtotal
588
541
738
0900
Total new obligations
6,596
7,232
7,008
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
182
165
166
1001
Discretionary unobligated balance brought fwd, Oct 1
182
1021
Recoveries of prior year unpaid obligations
46
1050
Unobligated balance (total)
228
165
166
Budget authority:
Appropriations, discretionary:
1100
Appropriation
5,657
5,807
5,400
1120
Appropriations transferred to other accts [75–0350]
–8
1121
Appropriations transferred from other accts [75–9915]
59
1121
Appropriations transferred from other accts [75–9912]
2
1121
Appropriations transferred from other accts [75–0140]
2
1121
Appropriations transferred from other accts [75–0142]
5
1121
Appropriations transferred from other accts [75–0350]
16
1130
Appropriations permanently reduced
–296
1160
Appropriation, discretionary (total)
5,437
5,807
5,400
Appropriations, mandatory:
1200
Appropriation
55
55
55
1201
Appropriation (special or trust fund)
1
2
2
1221
Appropriations transferred from other accts [75–0116]
463
831
809
1230
Appropriations and/or unobligated balance of appropriations permanently reduced
–5
–5
1260
Appropriations, mandatory (total)
514
883
866
Spending authority from offsetting collections, discretionary:
1700
Collected
329
541
736
1701
Change in uncollected payments, Federal sources
260
1750
Spending auth from offsetting collections, disc (total)
589
541
736
Spending authority from offsetting collections, mandatory:
1800
Collected
2
2
1850
Spending auth from offsetting collections, mand (total)
2
2
1900
Budget authority (total)
6,540
7,233
7,004
1930
Total budgetary resources available
6,768
7,398
7,170
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–7
1941
Unexpired unobligated balance, end of year
165
166
162
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
6,312
5,779
6,052
3010
Obligations incurred, unexpired accounts
6,596
7,232
7,008
3011
Obligations incurred, expired accounts
32
3020
Outlays (gross)
–6,979
–6,959
–6,909
3040
Recoveries of prior year unpaid obligations, unexpired
–46
3041
Recoveries of prior year unpaid obligations, expired
–136
3050
Unpaid obligations, end of year
5,779
6,052
6,151
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–461
–429
–429
3070
Change in uncollected pymts, Fed sources, unexpired
–260
3071
Change in uncollected pymts, Fed sources, expired
292
3090
Uncollected pymts, Fed sources, end of year
–429
–429
–429
Memorandum (non-add) entries:
3100
Obligated balance, start of year
5,851
5,350
5,623
3200
Obligated balance, end of year
5,350
5,623
5,722
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
6,026
6,348
6,136
Outlays, gross:
4010
Outlays from new discretionary authority
2,373
2,539
2,470
4011
Outlays from discretionary balances
3,898
3,328
3,531
4020
Outlays, gross (total)
6,271
5,867
6,001
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–603
–532
–727
4033
Non-Federal sources
–7
–9
–9
4040
Offsets against gross budget authority and outlays (total)
–610
–541
–736
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–260
4052
Offsetting collections credited to expired accounts
281
4060
Additional offsets against budget authority only (total)
21
4070
Budget authority, net (discretionary)
5,437
5,807
5,400
4080
Outlays, net (discretionary)
5,661
5,326
5,265
Mandatory:
4090
Budget authority, gross
514
885
868
Outlays, gross:
4100
Outlays from new mandatory authority
128
329
321
4101
Outlays from mandatory balances
580
763
587
4110
Outlays, gross (total)
708
1,092
908
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123
Non-Federal sources
–2
–2
4180
Budget authority, net (total)
5,951
6,690
6,266
4190
Outlays, net (total)
6,369
6,416
6,171
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 and respiratory diseases, HIV/AIDS, Hepatitis,
STDs, and Tuberculosis prevention, emerging and zoonotic infectious diseases, chronic disease prevention and health promotion,
occupational safety and health, public health and scientific services, injury prevention and control, environmental health,
global health, programs that reduce the occurrence of birth defects and developmental disabilities, public health preparedness
and emergency response, and CDC-Wide Activities and Program Support. The 2013 levels in MAX are not comparable with 2014
and the 2015 Budget levels. In 2014, CDC implemented a Working Capital Fund, which realigned business support services from
the prior fiscal year to the program budget lines based on 2013 consumption data.
Object Classification (in millions of dollars)
Identification code 75–0943–0–1–999
2013 actual
2014 est.
2015 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
700
706
713
11.3
Other than full-time permanent
98
102
102
11.5
Other personnel compensation
25
24
24
11.7
Military personnel
70
65
65
11.8
Special personal services payments
1
1
1
11.9
Total personnel compensation
894
898
905
12.1
Civilian personnel benefits
251
252
254
12.2
Military personnel benefits
48
44
44
13.0
Benefits for former personnel
2
2
2
21.0
Travel and transportation of persons
37
33
40
22.0
Transportation of things
12
10
9
23.1
Rental payments to GSA
35
59
60
23.2
Rental payments to others
1
1
1
23.3
Communications, utilities, and miscellaneous charges
32
34
35
24.0
Printing and reproduction
3
3
3
25.1
Advisory and assistance services
541
796
681
25.2
Other services from non-Federal sources
207
198
135
25.3
Other goods and services from Federal sources
253
293
240
25.4
Operation and maintenance of facilities
67
48
37
25.5
Research and development contracts
37
41
31
25.6
Medical care
5
7
6
25.7
Operation and maintenance of equipment
39
32
25
25.8
Subsistence and support of persons
1
30
26.0
Supplies and materials
561
299
297
31.0
Equipment
53
54
52
32.0
Land and structures
19
11
11
41.0
Grants, subsidies, and contributions
2,911
3,575
3,372
99.0
Direct obligations
6,008
6,691
6,270
99.0
Reimbursable obligations
588
541
738
99.9
Total new obligations
6,596
7,232
7,008
Employment Summary
Identification code 75–0943–0–1–999
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
8,764
8,764
8,764
1101
Direct military average strength employment
800
800
800
2001
Reimbursable civilian full-time equivalent employment
1,159
1,159
1,159
2101
Reimbursable military average strength employment
101
101
101
CDC Working Capital Fund
Program and Financing (in millions of dollars)
Identification code 75–4553–0–4–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0801
Reimbursable program activity
520
517
0900
Total new obligations (object class 25.3)
520
517
Budgetary Resources:
Budget authority:
Spending authority from offsetting collections, discretionary:
1700
Collected
520
517
1750
Spending auth from offsetting collections, disc (total)
520
517
1900
Budget authority (total)
520
517
1930
Total budgetary resources available
520
517
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
520
517
3020
Outlays (gross)
–520
–517
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
520
517
Outlays, gross:
4010
Outlays from new discretionary authority
520
517
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–520
–517
Implemented in 2014, CDC's new Working Capital Fund has extended availability and serves as the funding mechanism to finance
centralized business services support across CDC. Services rendered under the fund are performed at pre-established rates
that are used to cover the full cost of operations and future investments. Contributions are collected for services, thereby
creating market-like incentives to maximize efficiency and quality.
Object Classification (in millions of dollars)
Identification code 75–4553–0–4–551
2013 actual
2014 est.
2015 est.
Reimbursable obligations:
25.3
Other goods and services from Federal sources
520
517
99.0
Reimbursable obligations
520
517
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) and 111(c)(4) of the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA)[; section 118(f) of the Superfund Amendments and Reauthorization Act of 1986 (SARA);] and section 3019 of the Solid Waste Disposal Act, $74,691,000, of which up to $1,000 per eligible employee of the Agency
for Toxic Substances and Disease Registry shall remain available until expended for Individual Learning Accounts: 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 healthcare 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)] 104(i) of CERCLA during fiscal year [2014] 2015, and existing profiles may be updated as necessary. (Department of the Interior, Environment, and Related Agencies Appropriations Act, 2014.)
Program and Financing (in millions of dollars)
Identification code 75–0944–0–1–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Direct program
75
75
75
0801
Reimbursable program
4
10
10
0900
Total new obligations
79
85
85
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
17
14
14
Budget authority:
Appropriations, discretionary:
1100
Appropriation
76
75
75
1130
Appropriations permanently reduced
–4
1160
Appropriation, discretionary (total)
72
75
75
Appropriations, mandatory:
1200
Appropriation
20
1260
Appropriations, mandatory (total)
20
Spending authority from offsetting collections, discretionary:
1700
Collected
2
10
10
1701
Change in uncollected payments, Federal sources
2
1750
Spending auth from offsetting collections, disc (total)
4
10
10
1900
Budget authority (total)
76
85
105
1930
Total budgetary resources available
93
99
119
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
14
14
34
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
52
42
33
3010
Obligations incurred, unexpired accounts
79
85
85
3020
Outlays (gross)
–87
–94
–98
3041
Recoveries of prior year unpaid obligations, expired
–2
3050
Unpaid obligations, end of year
42
33
20
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–14
–10
–10
3070
Change in uncollected pymts, Fed sources, unexpired
–2
3071
Change in uncollected pymts, Fed sources, expired
6
3090
Uncollected pymts, Fed sources, end of year
–10
–10
–10
Memorandum (non-add) entries:
3100
Obligated balance, start of year
38
32
23
3200
Obligated balance, end of year
32
23
10
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
76
85
85
Outlays, gross:
4010
Outlays from new discretionary authority
51
63
63
4011
Outlays from discretionary balances
32
31
21
4020
Outlays, gross (total)
83
94
84
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–9
–10
–10
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–2
4052
Offsetting collections credited to expired accounts
7
4060
Additional offsets against budget authority only (total)
5
4070
Budget authority, net (discretionary)
72
75
75
4080
Outlays, net (discretionary)
74
84
74
Mandatory:
4090
Budget authority, gross
20
Outlays, gross:
4100
Outlays from new mandatory authority
14
4101
Outlays from mandatory balances
4
4110
Outlays, gross (total)
4
14
4180
Budget authority, net (total)
72
75
95
4190
Outlays, net (total)
78
84
88
The Agency for Toxic Substances and Disease Registry (ATSDR) is authorized under the Comprehensive Environmental Response,
Compensation, and Liability Act of 1980 (CERCLA). ATSDR's mission is to use the best science, take responsive action, and
provide trustworthy health information to prevent and mitigate harmful exposures to toxic substances and related disease.
Object Classification (in millions of dollars)
Identification code 75–0944–0–1–551
2013 actual
2014 est.
2015 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
22
23
24
11.3
Other than full-time permanent
1
1
1
11.5
Other personnel compensation
1
1
1
11.7
Military personnel
4
4
4
11.9
Total personnel compensation
28
29
30
12.1
Civilian personnel benefits
8
8
8
12.2
Military personnel benefits
1
1
2
23.3
Communications, utilities, and miscellaneous charges
5
5
3
25.1
Advisory and assistance services
3
4
4
25.2
Other services from non-Federal sources
5
5
5
25.3
Other goods and services from Federal sources
7
7
7
25.7
Operation and maintenance of equipment
1
1
1
31.0
Equipment
1
1
1
41.0
Grants, subsidies, and contributions
16
14
14
99.0
Direct obligations
75
75
75
99.0
Reimbursable obligations
4
10
10
99.9
Total new obligations
79
85
85
Employment Summary
Identification code 75–0944–0–1–551
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
240
240
240
1101
Direct military average strength employment
38
38
38
2001
Reimbursable civilian full-time equivalent employment
9
9
9
2101
Reimbursable military average strength employment
1
1
1
World Trade Center Health Program Fund
Program and Financing (in millions of dollars)
Identification code 75–0946–0–1–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Federal Share
230
268
282
0002
NYC
26
30
31
0900
Total new obligations
256
298
313
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
107
Budget authority:
Appropriations, mandatory:
1200
Appropriation (WTC (CDC Direct))
234
382
282
1200
Appropriation (WTC—NYC DHSS—CDC)
26
42
31
1230
Appropriations and/or unobligated balance of appropriations permanently reduced
–10
–19
1260
Appropriations, mandatory (total)
250
405
313
Spending authority from offsetting collections, mandatory:
1800
Collected
6
1850
Spending auth from offsetting collections, mand (total)
6
1900
Budget authority (total)
256
405
313
1930
Total budgetary resources available
256
405
420
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
107
107
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
114
162
177
3010
Obligations incurred, unexpired accounts
256
298
313
3020
Outlays (gross)
–191
–283
–365
3041
Recoveries of prior year unpaid obligations, expired
–17
3050
Unpaid obligations, end of year
162
177
125
Memorandum (non-add) entries:
3100
Obligated balance, start of year
114
162
177
3200
Obligated balance, end of year
162
177
125
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
256
405
313
Outlays, gross:
4100
Outlays from new mandatory authority
125
203
157
4101
Outlays from mandatory balances
66
80
208
4110
Outlays, gross (total)
191
283
365
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123
Non-Federal sources
–21
Additional offsets against gross budget authority only:
4142
Offsetting collections credited to expired accounts
15
4160
Budget authority, net (mandatory)
250
405
313
4170
Outlays, net (mandatory)
170
283
365
4180
Budget authority, net (total)
250
405
313
4190
Outlays, net (total)
170
283
365
HHS along with CDC began implementing provisions of The James Zadroga 9/11 Health and Compensation Act of 2010 (P.L. 111–347)
on July 1, 2011, to provide monitoring and treatment benefits to eligible responders and survivors. CDC/NIOSH serves as the
Program Administrator for the WTC Health Program. The WTC Health Program provides quality care for WTC-related health conditions,
conducts WTC research, and maintains a health registry to collect data on victims of the September 11, 2001, terrorist attacks.
The amounts included for 2014 and 2015 Budget reflect estimated Federal obligations for the WTC Health Program.
Object Classification (in millions of dollars)
Identification code 75–0946–0–1–551
2013 actual
2014 est.
2015 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
2
2
2
11.7
Military personnel
1
1
1
11.9
Total personnel compensation
3
3
3
25.1
Advisory and assistance services
18
18
20
25.2
Other services from non-Federal sources
71
82
33
25.3
Other goods and services from Federal sources
10
5
4
25.6
Medical care
134
170
233
41.0
Grants, subsidies, and contributions
20
20
20
99.9
Total new obligations
256
298
313
Employment Summary
Identification code 75–0946–0–1–551
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
18
18
18
1101
Direct military average strength employment
4
4
4
National Institutes of Health
Federal Funds
National Cancer Institute
For carrying out section 301 and title IV of the PHS Act with respect to cancer, [$4,923,238,000] $4,930,715,000, of which up to $8,000,000 may be used for facilities repairs and improvements at the National Cancer Institute—Frederick
Federally Funded Research and Development Center in Frederick, Maryland. (Department of Health and Human Services Appropriations Act, 2014.)
National Heart, Lung, and Blood Institute
For carrying out section 301 and title IV of the PHS Act with respect to cardiovascular, lung, and blood diseases, and blood
and blood products, [$2,988,605,000] $2,987,685,000. (Department of Health and Human Services Appropriations Act, 2014.)
National Institute of Dental and Craniofacial Research
For carrying out section 301 and title IV of the PHS Act with respect to dental and craniofacial diseases, [$398,650,000] $397,131,000. (Department of Health and Human Services Appropriations Act, 2014.)
National Institute of Diabetes and Digestive and Kidney Diseases
For carrying out section 301 and title IV of the PHS Act with respect to diabetes and digestive and kidney disease, [$1,744,274,000] $1,743,336,000. (Department of Health and Human Services Appropriations Act, 2014.)
National Institute of Neurological Disorders and Stroke
For carrying out section 301 and title IV of the PHS Act with respect to neurological disorders and stroke, [$1,587,982,000] $1,608,461,000. (Department of Health and Human Services Appropriations Act, 2014.)
National Institute of Allergy and Infectious Diseases
For carrying out section 301 and title IV of the PHS Act with respect to allergy and infectious diseases, [$4,358,841,000] $4,423,357,000. (Department of Health and Human Services Appropriations Act, 2014.)
National Institute of General Medical Sciences
For carrying out section 301 and title IV of the PHS Act with respect to general medical sciences, [$2,364,147,000: Provided, That not less than $273,325,000 is provided for the Institutional Development Awards program] $2,368,877,000. (Department of Health and Human Services Appropriations Act, 2014.)
Eunice Kennedy Shriver National Institute of Child Health and Human Development
For carrying out section 301 and title IV of the PHS Act with respect to child health and human development, [$1,282,595,000] $1,283,487,000. (Department of Health and Human Services Appropriations Act, 2014.)
National Eye Institute
For carrying out section 301 and title IV of the PHS Act with respect to eye diseases and visual disorders, [$682,077,000] $675,168,000. (Department of Health and Human Services Appropriations Act, 2014.)
National Institute of Environmental Health Sciences
For carrying out section 301 and title IV of the PHS Act with respect to environmental health sciences, [$665,439,000] $665,080,000. (Department of Health and Human Services Appropriations Act, 2014.)
For necessary expenses [for] of 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 (42 U.S.C. 9660(a)) and section 126(g) of the Superfund Amendments
and Reauthorization Act of 1986, $77,349,000. (Department of the Interior, Environment, and Related Agencies Appropriations Act, 2014.)
National Institute on Aging
For carrying out section 301 and title IV of the PHS Act with respect to aging, [$1,171,038,000] $1,170,880,000. (Department of Health and Human Services Appropriations Act, 2014.)
National Institute of Arthritis and Musculoskeletal and Skin Diseases
For carrying out section 301 and title IV of the PHS Act with respect to arthritis and musculoskeletal and skin diseases,
[$520,053,000] $520,189,000. (Department of Health and Human Services Appropriations Act, 2014.)
National Institute on Deafness and Other Communication Disorders
For carrying out section 301 and title IV of the PHS Act with respect to deafness and other communication disorders, [$404,049,000] $403,933,000. (Department of Health and Human Services Appropriations Act, 2014.)
National Institute of Nursing Research
For carrying out section 301 and title IV of the PHS Act with respect to nursing research, [$140,517,000] $140,452,000. (Department of Health and Human Services Appropriations Act, 2014.)
National Institute on Alcohol Abuse and Alcoholism
For carrying out section 301 and title IV of the PHS Act with respect to alcohol abuse and alcoholism, [$446,025,000] $446,017,000. (Department of Health and Human Services Appropriations Act, 2014.)
National Institute on Drug Abuse
For carrying out section 301 and title IV of the PHS Act with respect to drug abuse, [$1,025,435,000] $1,023,268,000. (Department of Health and Human Services Appropriations Act, 2014.)
National Institute of Mental Health
For carrying out section 301 and title IV of the PHS Act with respect to mental health, [$1,446,172,000] $1,440,076,000. (Department of Health and Human Services Appropriations Act, 2014.)
National Human Genome Research Institute
For carrying out section 301 and title IV of the PHS Act with respect to human genome research, [$497,813,000] $498,451,000. (Department of Health and Human Services Appropriations Act, 2014.)
National Institute of Biomedical Imaging and Bioengineering
For carrying out section 301 and title IV of the PHS Act with respect to biomedical imaging and bioengineering research, [$329,172,000] $328,532,000. (Department of Health and Human Services Appropriations Act, 2014.)
National Center for Complementary and Alternative Medicine
For carrying out section 301 and title IV of the PHS Act with respect to complementary and alternative medicine, [$124,296,000] $124,509,000. (Department of Health and Human Services Appropriations Act, 2014.)
National Institute on Minority Health and Health Disparities
For carrying out section 301 and title IV of the PHS Act with respect to minority health and health disparities research,
[$268,322,000] $267,953,000. (Department of Health and Human Services Appropriations Act, 2014.)
John E. Fogarty International Center
For carrying out the activities of the John E. Fogarty International Center (described in subpart 2 of part E of title IV
of the PHS Act), [$67,577,000] $67,776,000. (Department of Health and Human Services Appropriations Act, 2014.)
National Library of Medicine
For carrying out section 301 and title IV of the PHS Act with respect to health information communications, [$327,723,000, of which] $372,851,000: Provided, That, of the amounts available for improvement of information systems, $4,000,000 shall be available until September 30, [2015 , for improvement of information systems] 2016: Provided further, That, in fiscal year [2014] 2015, the National Library of Medicine 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 (referred to in this title as
"NIH''): Provided further, That, in addition to amounts provided herein, $8,200,000 shall be available from amounts available under section 241 of the PHS
Act to carry out the purposes of the National Information Center on Health Services Research and Health Care Technology established
under section 478A of the PHS Act and related health information services. (Department of Health and Human Services Appropriations Act, 2014.)
National Center for Advancing Translational Sciences
For carrying out section 301 and title IV of the PHS Act with respect to translational sciences, [$633,267,000] $657,471,000: Provided, That up to [$9,835,000] $29,810,000 shall be available to implement section 480 of the PHS Act, relating to the Cures Acceleration Network[: Provided further, That at least $474,746,000 is provided to the Clinical and Translational Sciences Awards program]. (Department of Health and Human Services Appropriations Act, 2014.)
Office of the Director
For carrying out the responsibilities of the Office of the Director, NIH, [$1,400,134,000] $1,451,786,000, of which up to [$25,000,000] $30,000,000 shall be used to carry out section [213] 212 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 NIH is authorized to collect third-party payments for the cost of clinical services that are incurred in NIH research
facilities and that such payments shall be credited to the NIH Management Fund: Provided further, That all funds credited to the NIH Management Fund shall remain available for one fiscal year after the fiscal year in which
they are deposited: Provided further, That $165,000,000 shall be for the National Children's Study ("NCS''), except that not later than July 15, [2014] 2015, the Director shall estimate the amount needed for the NCS during fiscal year [2014] 2015, and any funds in excess of the estimated need shall be transferred to and merged with the accounts for the various Institutes
and Centers in proportion to their shares of total NIH appropriations made by this Act: Provided further, That [$533,039,000] $583,039,000 shall be available for the Common Fund established under section 402A(c)(1) of the PHS Act: Provided further, That of the funds provided $10,000 shall be for official reception and representation expenses when specifically approved
by the Director of the NIH: Provided further, That the Office of AIDS Research within the Office of the Director of the NIH may spend up to $8,000,000 to make grants
for construction or renovation of facilities as provided for in section 2354(a)(5)(B) of the PHS Act: Provided further, That the Director may direct up to 1 percent of the total made available in this or any other Act to all
National Institutes of Health appropriations to activities that the Director may so designate: Provided further, That no such
appropriation shall be decreased by more than 1 percent by any such transfers and that the Congress is promptly notified of
the transfer. (Department of Health and Human Services Appropriations Act, 2014.)
Buildings and Facilities
For the study of, construction or demolition of, renovation of, and acquisition of equipment for, facilities of or used by
NIH, including the acquisition of real property, [$128,663,000] $128,663,000, to remain available until [September 30, 2018, of which up to $7,000,000 may be used for demolition] expended. (Department of Health and Human Services Appropriations Act, 2014.)
Special and Trust Fund Receipts (in millions of dollars)
Identification code 75–9915–0–1–552
2013 actual
2014 est.
2015 est.
0100
Balance, start of year
Receipts:
0220
Cooperative Research and Development Agreements, NIH
18
17
17
0400
Total: Balances and collections
18
17
17
Appropriations:
0500
National Institutes of Health
–18
–17
–17
0799
Balance, end of year
Program and Financing (in millions of dollars)
Identification code 75–9915–0–1–552
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
National Cancer Institute (0849)
4,789
4,929
4,931
0002
National Heart, Lung, and Blood Institute (0872)
2,904
2,987
2,988
0003
National Institute of Dental and Craniofacial Research (0873)
387
398
397
0004
National Institute of Diabetes and Digestive and Kidney Disease (0884)
1,695
1,744
1,743
0005
National Institute of Neurological Disorders and Stroke (0886)
1,534
1,588
1,608
0006
National Institute of Allergy and Infectious Diseases (0885)
4,235
4,399
4,423
0007
National Institute of General Medical Sciences (0851)
2,293
2,365
2,369
0008
National Institute of Child Health and Human Development (0844)
1,246
1,283
1,283
0009
National Eye Institute (0887)
657
675
675
0010
National Institute of Environmental Health Sciences (0862)
721
742
742
0011
National Institute on Aging (0843)
1,041
1,171
1,171
0012
National Institute of Arthritis and Musculoskeletal and Skin Disease (0888)
505
520
520
0013
National Institute on Deafness and Other Communication Disorder (0890)
393
404
404
0014
National Institute of Mental Health (0892)
1,396
1,419
1,440
0015
National Institute on Drug Abuse (0893)
993
1,017
1,023
0016
National Institute on Alcohol Abuse and Alcoholism (0894)
433
446
446
0017
National Institute of Nursing Research (0889)
137
141
141
0018
National Human Genome Research Institute (0891)
484
498
498
0019
National Institute of Biomedical Imaging and Bioengineering (0898)
319
327
329
0021
National Center for Complementary and Alternative Medicine (0896)
121
124
125
0022
National Institute on Minority Health and Health Disparities (0897)
261
268
268
0023
John E. Fogarty International Center (0819)
66
68
68
0024
National Library of Medicine (0807)
317
328
373
0025
Office of the Director (0846)
1,412
1,400
1,452
0026
Buildings and facilities (0838)
167
129
129
0027
Cooperative Research and Development Agreements
21
17
17
0028
National Center for Advancing Translational Sciences (0875)
543
633
657
0031
Type 1 Diabetes
142
139
0799
Total direct obligations
29,212
30,159
30,220
0801
Reimbursable - Other
3,151
3,192
3,201
0802
Royalties
92
179
179
0809
Reimbursable program activities, subtotal
3,243
3,371
3,380
0899
Total reimbursable obligations
3,243
3,371
3,380
0900
Total new obligations
32,455
33,530
33,600
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
458
739
564
1001
Discretionary unobligated balance brought fwd, Oct 1
253
702
1021
Recoveries of prior year unpaid obligations
59
4
1050
Unobligated balance (total)
517
743
564
Budget authority:
Appropriations, discretionary:
1100
Appropriation
30,780
30,003
30,203
1120
Appropriations transferred to other accts [75–0943]
–59
1120
Appropriations transferred to other accts [75–0511]
–114
1121
Appropriations transferred from other accts [75–0140]
149
1130
Appropriations permanently reduced
–1,607
1160
Appropriation, discretionary (total)
29,149
30,003
30,203
Appropriations, mandatory:
1200
Appropriation
150
150
1201
Appropriation (special or trust fund)
18
17
17
1230
Appropriations and/or unobligated balance of appropriations permanently reduced
–8
–11
1260
Appropriations, mandatory (total)
160
156
17
Spending authority from offsetting collections, discretionary:
1700
Collected
2,609
3,192
3,201
1701
Change in uncollected payments, Federal sources
762
1750
Spending auth from offsetting collections, disc (total)
3,371
3,192
3,201
1900
Budget authority (total)
32,680
33,351
33,421
1930
Total budgetary resources available
33,197
34,094
33,985
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–3
1941
Unexpired unobligated balance, end of year
739
564
385
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
33,050
31,107
30,317
3010
Obligations incurred, unexpired accounts
32,455
33,530
33,600
3011
Obligations incurred, expired accounts
203
3020
Outlays (gross)
–34,173
–34,316
–32,870
3040
Recoveries of prior year unpaid obligations, unexpired
–59
–4
3041
Recoveries of prior year unpaid obligations, expired
–369
3050
Unpaid obligations, end of year
31,107
30,317
31,047
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–938
–1,253
–1,253
3070
Change in uncollected pymts, Fed sources, unexpired
–762
3071
Change in uncollected pymts, Fed sources, expired
447
3090
Uncollected pymts, Fed sources, end of year
–1,253
–1,253
–1,253
Memorandum (non-add) entries:
3100
Obligated balance, start of year
32,112
29,854
29,064
3200
Obligated balance, end of year
29,854
29,064
29,794
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
32,520
33,195
33,404
Outlays, gross:
4010
Outlays from new discretionary authority
10,579
11,293
11,356
4011
Outlays from discretionary balances
23,438
22,905
21,384
4020
Outlays, gross (total)
34,017
34,198
32,740
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–3,080
–3,192
–3,201
4033
Non-Federal sources
–117
4040
Offsets against gross budget authority and outlays (total)
–3,197
–3,192
–3,201
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–762
4052
Offsetting collections credited to expired accounts
588
4060
Additional offsets against budget authority only (total)
–174
4070
Budget authority, net (discretionary)
29,149
30,003
30,203
4080
Outlays, net (discretionary)
30,820
31,006
29,539
Mandatory:
4090
Budget authority, gross
160
156
17
Outlays, gross:
4100
Outlays from new mandatory authority
7
49
17
4101
Outlays from mandatory balances
149
69
113
4110
Outlays, gross (total)
156
118
130
4180
Budget authority, net (total)
29,309
30,159
30,220
4190
Outlays, net (total)
30,976
31,124
29,669
Summary of Budget Authority and Outlays (in millions of dollars)
2013 actual
2014 est.
2015 est.
Enacted/requested:
Budget Authority
29,309
30,159
30,220
Outlays
30,976
31,124
29,669
Legislative proposal, subject to PAYGO:
Budget Authority
150
Outlays
36
Total:
Budget Authority
29,309
30,159
30,370
Outlays
30,976
31,124
29,705
DISTRIBUTION OF BUDGET AUTHORITY AND OUTLAYS BY ACCOUNT (in millions of dollars)
2013
2014
2015
Distribution of budget authority by account:
National Cancer Institute
4,789
4,929
4,931
National Heart, Lung, and Blood Institute
2,904
2,987
2,988
National Institute of Dental and Craniofacial Research
387
398
397
National Institute of Diabetes and Digestive and Kidney Diseases
1,695
1,744
1,743
National Institute of Neurological Disorder and Stroke
1,534
1,588
1,608
National Institute of Allergy and Infectious Diseases
4,235
4,399
4,423
National Institute of General Medical Sciences
2,293
2,365
2,369
Eunice Kennedy Shriver National Institute of Child Health and Human Development
1,246
1,283
1,283
National Eye Institute
657
675
675
National Institute of Environmental Health Sciences
721
742
742
National Institute on Aging
1,041
1,171
1,171
National Institute of Arthritis and Musculoskeletal and Skin Diseases
505
520
520
National Institute on Deafness and Other Communication Disorders
393
404
404
National Institute of Mental Health
1,396
1,419
1,440
National Institute on Drug Abuse
993
1,017
1,023
National Institute on Alcohol Abuse and Alcoholism
433
446
446
National Institute of Nursing Research
137
141
141
National Center for Research Resources
0
0
0
National Human Genome Research Institute
484
498
498
National Institute of Biomedical Imaging and Bioengineering
319
327
329
National Institute on Minority Health and Health Disparities
261
268
268
National Center for Complementary and Alternative Medicine
121
124
125
National Center for Advancing Translational Sciences
543
633
657
John E. Fogarty International Center
66
68
68
National Library of Medicine
317
328
373
Office of the Director
1,412
1,400
1,452
Buildings and Facilities
167
129
129
Subtotal
29,049
30,003
30,203
Cooperative Research and Development Agreements
21
17
17
Total Budget Authority, NIH
29,070
30,020
30,220
2013
2014
2015
Distribution of outlays by account:
National Cancer Institute
4,867
5,075
4,832
National Heart, Lung, and Blood Institute
3,021
2,945
2,926
National Institute of Dental and Craniofacial Research
401
430
390
National Institute of Diabetes and Digestive and Kidney Diseases
1,908
2,067
1,710
National Institute of Neurological Disorders and Stroke
1,593
1,735
1,560
National Institute of Allergy and Infectious Diseases
4,514
4,250
4,314
National Institute of General Medical Sciences
2,574
2,583
2,315
Eunice Kennedy Shriver National Institute of Child Health and Human Development
1,298
1,388
1,257
National Eye Institute
707
693
661
National Institute of Environmental Health Sciences
507
718
728
National Institute on Aging
1,074
1,115
1,127
National Institute of Arthritis and Musculoskeletal and Skin Diseases
517
540
509
National Institute on Deafness and Other Communication Disorders
407
421
396
National Institute of Mental Health
1,476
1,419
1,399
National Institute on Drug Abuse
1,071
936
999
National Institute on Alcohol Abuse and Alcoholism
469
448
437
National Institute of Nursing Research
143
138
138
National Center for Research Resources
125
83
28
National Human Genome Research Institute
470
567
488
National Institute of Biomedical Imaging and Bioengineering
330
338
320
National Institute on Minority Health and Health Disparities
248
262
260
National Center for Complementary and Alternative Medicine
125
128
122
National Center for Advancing Translational Sciences
476
564
578
John E. Fogarty International Center
67
73
66
National Library of Medicine
318
336
345
Office of the Director
1,324
1,504
1,387
Buildings and Facilities
95
83
91
ARRA Funds
935
273
273
Management Fund/Service and Supply Fund
–103
Subtotal Outlays
Cooperative Research and Development Agreements
18
16
16
Total Outlays, NIH
30,975
31,125
29,670
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
2013 actual
2014 est.
2015 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
905
921
931
11.3
Other than full-time permanent
463
468
473
11.5
Other personnel compensation
18
19
19
11.7
Military personnel
21
21
22
11.8
Special personal services payments
160
160
162
11.9
Total personnel compensation
1,567
1,589
1,607
12.1
Civilian personnel benefits
422
430
445
12.2
Military personnel benefits
15
15
15
21.0
Travel and transportation of persons
43
45
45
22.0
Transportation of things
5
5
5
23.1
Rental payments to GSA
2
2
2
23.2
Rental payments to others
1
1
23.3
Communications, utilities, and miscellaneous charges
28
29
29
24.0
Printing and reproduction
1
1
1
25.1
Advisory and assistance services
112
114
115
25.2
Other services from non-Federal sources
732
791
760
25.3
Other goods and services from Federal sources
2,872
2,985
3,032
25.4
Operation and maintenance of facilities
210
174
174
25.5
Research and development contracts
2,072
2,201
2,180
25.6
Medical care
21
22
22
25.7
Operation and maintenance of equipment
106
108
109
26.0
Supplies and materials
178
185
184
31.0
Equipment
131
136
135
41.0
Grants, subsidies, and contributions
20,695
21,326
21,359
99.0
Direct obligations
29,212
30,159
30,220
99.0
Reimbursable obligations
3,243
3,371
3,380
99.9
Total new obligations
32,455
33,530
33,600
Employment Summary
Identification code 75–9915–0–1–552
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
13,255
13,240
13,240
1101
Direct military average strength employment
200
200
200
2001
Reimbursable civilian full-time equivalent employment
4,675
4,690
4,690
2101
Reimbursable military average strength employment
100
100
100
National Institutes of Health
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 75–9915–4–1–552
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Direct program activity
150
0900
Total new obligations (object class 41.0)
150
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
150
1260
Appropriations, mandatory (total)
150
1900
Budget authority (total)
150
1930
Total budgetary resources available
150
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
150
3020
Outlays (gross)
–36
3050
Unpaid obligations, end of year
114
Memorandum (non-add) entries:
3200
Obligated balance, end of year
114
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
150
Outlays, gross:
4100
Outlays from new mandatory authority
36
4180
Budget authority, net (total)
150
4190
Outlays, net (total)
36
Substance Abuse and Mental Health Services Administration
Federal Funds
Mental Health
For carrying out titles III, V, and XIX of the PHS Act with respect to mental health, and the Protection and Advocacy for
Individuals with Mental Illness Act, [$1,055,347,000] $992,792,000: Provided, That notwithstanding section 520A(f)(2) of the PHS Act, no funds appropriated for carrying out section 520A shall be available
for carrying out section 1971 of the PHS Act: Provided further, That in addition to amounts provided herein, [$21,039,000] $26,039,000 shall be available under section 241 of the PHS Act to supplement funds otherwise available for mental health activities and 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: Provided further, That section 520E(b)(2) of the PHS Act shall not apply to funds appropriated under this Act for fiscal year [2014] 2015: Provided further, That [of the amount appropriated under this heading, $46,000,000 shall be for the National Child Traumatic Stress Initiative as
described in section 582 of the PHS Act] notwithstanding section 565(b)(1) of the PHS Act, technical assistance may be provided to a public entity to establish or
operate a system of comprehensive community mental health services to children with a serious emotional disturbance, without
regard to whether the public entity receives a grant under section 561(a) of such Act: Provided further, That States shall expend at least 5 percent of the amount each receives for carrying out section 1911 of the PHS Act to
support evidence-based [programs that] mental health prevention and treatment practices to address the needs of individuals with early serious mental illness, including psychotic disorders, regardless of the age
of the individual at onset: Provided further, That none of the funds provided for section 1911 of the PHS Act shall be subject to section 241 of such Act.
Substance Abuse Treatment
For carrying out titles III[,] and V[, and XIX] of the PHS Act with respect to substance abuse treatment and [section 1922(a) of the PHS Act] title XIX of such Act with respect to substance abuse treatment and prevention, [$2,052,661,000] $2,008,056,000: Provided, That in addition to amounts provided herein, [the following amounts] $109,200,000 shall be available under section 241 of the PHS Act[: (1) $79,200,000] to supplement funds otherwise available for substance abuse treatment activities and 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[; and (2) $2,000,000 to evaluate substance abuse treatment programs]: Provided further, That none of the funds provided for section 1921 of the PHS Act shall be subject to section 241 of such Act.
Substance Abuse Prevention
For carrying out titles III and V of the PHS Act with respect to substance abuse prevention, [$175,631,000] $169,092,000: Provided, That in addition to amounts provided herein, $16,468,000 shall be available under section 241 of
the PHS Act to supplement funds otherwise available for substance abuse prevention activities.
Health Surveillance and Program Support
For program support and cross-cutting activities that supplement activities funded under the headings "Mental Health'', "Substance
Abuse Treatment'', and "Substance Abuse Prevention'' in carrying out titles III, V, and XIX of the PHS Act and the Protection
and Advocacy for Individuals with Mental Illness Act in the Substance Abuse and Mental Health Services Administration, [$151,296,000] $127,729,000: Provided, That in addition to amounts provided herein, [$30,428,000] $58,995,000 shall be available under section 241 of the PHS Act to supplement funds available to carry out national surveys on drug abuse
and mental health, to collect and analyze program data, and to conduct public awareness and technical assistance activities:
Provided further, That, in addition, fees may be collected for the costs of publications, data, data tabulations, and data analysis completed
under title V of the PHS Act and provided to a public or private entity upon request, which shall be credited to this appropriation
and shall remain available until expended for such purposes: Provided further, That amounts made available in this Act for carrying out section 501(m) of the PHS Act shall remain available
through September 30, 2016: Provided further, That funds made available under this heading may be used to supplement program support funding provided under the headings
"Mental Health'', "Substance Abuse Treatment'', and "Substance Abuse Prevention'': Provided further, That the Administrator may transfer funds between any of the accounts of SAMHSA with notification to the
Committees on Appropriations of both Houses of Congress at least 15 days in advance of any transfer, but no such account shall
be decreased by more than 3 percent by any such transfer. (Department of Health and Human Services Appropriations Act, 2014.)
Program and Financing (in millions of dollars)
Identification code 75–1362–0–1–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0006
Mental Health
894
1,055
999
0007
Substance Abuse Treatment
2,033
2,052
2,002
0008
Substance Abuse Prevention
176
176
169
0009
Health Surveillance and Program Support
121
152
128
0100
Total, direct program
3,224
3,435
3,298
0799
Total direct obligations
3,224
3,435
3,298
0802
Reimbursables
280
249
328
0900
Total new obligations
3,504
3,684
3,626
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
1
63
1001
Discretionary unobligated balance brought fwd, Oct 1
1
Budget authority:
Appropriations, discretionary:
1100
Appropriation
3,349
3,435
3,298
1120
Appropriations transferred to other accts [75–0350]
–1
1121
Appropriations transferred from other accts [75–0350]
15
1121
Appropriations transferred from other accts [75–1536]
21
1121
Appropriations transferred from other accts [75–1515]
2
1130
Appropriations permanently reduced
–175
1160
Appropriation, discretionary (total)
3,211
3,435
3,298
Appropriations, mandatory:
1221
Appropriations transferred from the Prevention and Public Health Fund [75–0116]
15
62
58
1260
Appropriations, mandatory (total)
15
62
58
Spending authority from offsetting collections, discretionary:
1700
Collected
145
249
330
1701
Change in uncollected payments, Federal sources
135
1750
Spending auth from offsetting collections, disc (total)
280
249
330
1900
Budget authority (total)
3,506
3,746
3,686
1930
Total budgetary resources available
3,506
3,747
3,749
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–1
1941
Unexpired unobligated balance, end of year
1
63
123
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
3,125
3,219
2,953
3010
Obligations incurred, unexpired accounts
3,504
3,684
3,626
3011
Obligations incurred, expired accounts
10
3020
Outlays (gross)
–3,378
–3,950
–3,739
3041
Recoveries of prior year unpaid obligations, expired
–42
3050
Unpaid obligations, end of year
3,219
2,953
2,840
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–22
–143
–143
3070
Change in uncollected pymts, Fed sources, unexpired
–135
3071
Change in uncollected pymts, Fed sources, expired
14
3090
Uncollected pymts, Fed sources, end of year
–143
–143
–143
Memorandum (non-add) entries:
3100
Obligated balance, start of year
3,103
3,076
2,810
3200
Obligated balance, end of year
3,076
2,810
2,697
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
3,491
3,684
3,628
Outlays, gross:
4010
Outlays from new discretionary authority
1,176
1,554
1,583
4011
Outlays from discretionary balances
2,167
2,289
2,100
4020
Outlays, gross (total)
3,343
3,843
3,683
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–153
–249
–328
4033
Non-Federal sources
–2
4040
Offsets against gross budget authority and outlays (total)
–153
–249
–330
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–135
4052
Offsetting collections credited to expired accounts
8
4060
Additional offsets against budget authority only (total)
–127
4070
Budget authority, net (discretionary)
3,211
3,435
3,298
4080
Outlays, net (discretionary)
3,190
3,594
3,353
Mandatory:
4090
Budget authority, gross
15
62
58
Outlays, gross:
4100
Outlays from new mandatory authority
4
24
22
4101
Outlays from mandatory balances
31
83
34
4110
Outlays, gross (total)
35
107
56
4180
Budget authority, net (total)
3,226
3,497
3,356
4190
Outlays, net (total)
3,225
3,701
3,409
This program provides Federal support to strengthen the capacity of the Nation's health care delivery system to provide effective
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, tribal and private not-for-profit organizations
to enhance health and reduce the adverse impact of substance abuse and mental illness on America's communities.
Object Classification (in millions of dollars)
Identification code 75–1362–0–1–551
2013 actual
2014 est.
2015 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
48
51
51
11.3
Other than full-time permanent
4
4
4
11.5
Other personnel compensation
1
1
11.7
Military personnel
3
3
3
11.9
Total personnel compensation
55
59
59
12.1
Civilian personnel benefits
15
16
16
12.2
Military personnel benefits
2
2
2
21.0
Travel and transportation of persons
1
1
1
23.1
Rental payments to GSA
6
6
10
23.3
Communications, utilities, and miscellaneous charges
1
1
24.0
Printing and reproduction
1
1
1
25.1
Advisory and assistance services
54
48
50
25.2
Other services from non-Federal sources
163
204
192
25.3
Other goods and services from Federal sources
33
63
70
25.4
Operation and maintenance of facilities
2
1
1
25.5
Research and development contracts
4
4
41.0
Grants, subsidies, and contributions
2,892
3,029
2,891
99.0
Direct obligations
3,224
3,435
3,298
99.0
Reimbursable obligations
280
249
328
99.9
Total new obligations
3,504
3,684
3,626
Employment Summary
Identification code 75–1362–0–1–551
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
492
520
509
1101
Direct military average strength employment
34
35
37
2001
Reimbursable civilian full-time equivalent employment
66
85
93
2101
Reimbursable military average strength employment
16
15
16
Agency for Healthcare Research and Quality
Federal Funds
Healthcare Research and Quality
For carrying out titles III and IX of the PHS Act, part A of title XI of the Social Security Act, and section 1013 of the
Medicare Prescription Drug, Improvement, and Modernization Act of 2003, [$364,008,000] $334,099,000 shall be available from amounts available under section 241 of the PHS Act, notwithstanding subsection 947(c) of such Act:
Provided, That in addition, 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 [September 30, 2015] expended. (Department of Health and Human Services Appropriations Act, 2014.)
Program and Financing (in millions of dollars)
Identification code 75–1700–0–1–552
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0003
Prevention and Public Health Fund
6
7
0801
Reimbursable program
15
15
15
0802
Reimbursable program: PHS evaluation
366
364
334
0899
Total reimbursable obligations
381
379
349
0900
Total new obligations
387
386
349
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
4
21
21
1001
Discretionary unobligated balance brought fwd, Oct 1
4
21
Budget authority:
Appropriations, mandatory:
1221
Appropriations transferred from other accts [75–0116]
6
7
1260
Appropriations, mandatory (total)
6
7
Spending authority from offsetting collections, discretionary:
1700
Collected
121
379
349
1701
Change in uncollected payments, Federal sources
256
1750
Spending auth from offsetting collections, disc (total)
377
379
349
Spending authority from offsetting collections, mandatory:
1800
Collected
21
1850
Spending auth from offsetting collections, mand (total)
21
1900
Budget authority (total)
404
386
349
1930
Total budgetary resources available
408
407
370
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
21
21
21
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
725
487
151
3010
Obligations incurred, unexpired accounts
387
386
349
3011
Obligations incurred, expired accounts
4
3020
Outlays (gross)
–613
–722
–462
3041
Recoveries of prior year unpaid obligations, expired
–16
3050
Unpaid obligations, end of year
487
151
38
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–293
–387
–387
3070
Change in uncollected pymts, Fed sources, unexpired
–256
3071
Change in uncollected pymts, Fed sources, expired
162
3090
Uncollected pymts, Fed sources, end of year
–387
–387
–387
Memorandum (non-add) entries:
3100
Obligated balance, start of year
432
100
–236
3200
Obligated balance, end of year
100
–236
–349
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
377
379
349
Outlays, gross:
4010
Outlays from new discretionary authority
126
379
349
4011
Outlays from discretionary balances
477
331
100
4020
Outlays, gross (total)
603
710
449
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–273
–379
–349
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–256
4052
Offsetting collections credited to expired accounts
152
4060
Additional offsets against budget authority only (total)
–104
4080
Outlays, net (discretionary)
330
331
100
Mandatory:
4090
Budget authority, gross
27
7
Outlays, gross:
4101
Outlays from mandatory balances
10
12
13
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123
Non-Federal sources
–21
4180
Budget authority, net (total)
6
7
4190
Outlays, net (total)
319
343
113
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
2013 actual
2014 est.
2015 est.
Direct obligations:
25.5
Research and development contracts
2
7
41.0
Grants, subsidies, and contributions
4
99.0
Direct obligations
6
7
99.0
Reimbursable obligations
381
379
349
99.9
Total new obligations
387
386
349
Employment Summary
Identification code 75–1700–0–1–552
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
2001
Reimbursable civilian full-time equivalent employment
296
297
297
2101
Reimbursable military average strength employment
9
9
9
3001
Allocation account civilian full-time equivalent employment
6
20
20
Centers for Medicare and Medicaid Services
Federal Funds
Grants to States for Medicaid
For carrying out, except as otherwise provided, titles XI and XIX of the Social Security Act, [$177,872,985,000] $234,608,916,000, to remain available until expended.
For making, after May 31, [2014] 2015, payments to States under title XIX or in the case of section 1928 on behalf of States under title XIX of the Social Security
Act for the last quarter of fiscal year [2014] 2015 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 [2015] 2016, [$103,472,323,000] $113,272,140,000, to remain available until expended.
Payment under such title XIX may be made for any quarter with respect to a State plan or plan amendment in effect during such
quarter, if submitted in or prior to such quarter and approved in that or any subsequent quarter. (Department of Health and Human Services Appropriations Act, 2014.)
Program and Financing (in millions of dollars)
Identification code 75–0512–0–1–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Medicaid vendor payments
265,069
290,533
315,239
0002
State and local administration
17,767
18,556
18,766
0003
Vaccines for Children
3,607
3,562
4,077
0799
Total direct obligations
286,443
312,651
338,082
0801
Medicare Part B premiums
477
390
0802
Medicare Part D
6
0899
Total reimbursable obligations
477
390
6
0900
Total new obligations
286,920
313,041
338,088
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
21,091
2,283
1
1021
Recoveries of prior year unpaid obligations
18,143
1050
Unobligated balance (total)
39,234
2,283
1
Budget authority:
Appropriations, mandatory:
1200
Appropriation Medicaid
158,827
204,033
234,609
1260
Appropriations, mandatory (total)
158,827
204,033
234,609
Advance appropriations, mandatory:
1270
Advance appropriation
90,614
106,336
103,472
1280
Advanced appropriation, mandatory (total)
90,614
106,336
103,472
Spending authority from offsetting collections, mandatory:
1800
Collected
528
390
6
1850
Spending auth from offsetting collections, mand (total)
528
390
6
1900
Budget authority (total)
249,969
310,759
338,087
1930
Total budgetary resources available
289,203
313,042
338,088
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
2,283
1
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
27,899
30,756
34,967
3010
Obligations incurred, unexpired accounts
286,920
313,041
338,088
3020
Outlays (gross)
–265,920
–308,830
–331,446
3040
Recoveries of prior year unpaid obligations, unexpired
–18,143
3050
Unpaid obligations, end of year
30,756
34,967
41,609
Memorandum (non-add) entries:
3100
Obligated balance, start of year
27,899
30,756
34,967
3200
Obligated balance, end of year
30,756
34,967
41,609
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
249,969
310,759
338,087
Outlays, gross:
4100
Outlays from new mandatory authority
230,914
279,612
331,446
4101
Outlays from mandatory balances
35,006
29,218
4110
Outlays, gross (total)
265,920
308,830
331,446
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120
Federal sources
–477
–390
–6
4123
Non-Federal sources
–51
4130
Offsets against gross budget authority and outlays (total)
–528
–390
–6
4160
Budget authority, net (mandatory)
249,441
310,369
338,081
4170
Outlays, net (mandatory)
265,392
308,440
331,440
4180
Budget authority, net (total)
249,441
310,369
338,081
4190
Outlays, net (total)
265,392
308,440
331,440
Summary of Budget Authority and Outlays (in millions of dollars)
2013 actual
2014 est.
2015 est.
Enacted/requested:
Budget Authority
249,441
310,369
338,081
Outlays
265,392
308,440
331,440
Amounts included in the adjusted baseline:
Budget Authority
7
Outlays
7
Legislative proposal, not subject to PAYGO:
Budget Authority
–365
–636
Outlays
–365
–636
Legislative proposal, subject to PAYGO:
Budget Authority
540
5,151
Outlays
540
5,151
Total:
Budget Authority
249,441
310,544
342,603
Outlays
265,392
308,615
335,962
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).
Authorized as part of Title XIX, Vaccines for Children (VFC) finances the purchase of vaccines for low-income, eligible children.
VFC is administered by the Centers for Disease Control and Prevention and is funded entirely by the Federal Government.
Vaccines for Children (in millions of dollars)
Obligations
2013
2014
2015
Vaccine Purchase
3,335
3,273
3,776
Vaccine Stockpile
137
135
138
Ordering, Distribution, and Operations
94
111
119
Vaccine Management Contract Support
1
0
0
Evaluation Activities
42
43
44
Total Obligations
3,609
3,562
4,077
Object Classification (in millions of dollars)
Identification code 75–0512–0–1–551
2013 actual
2014 est.
2015 est.
41.0
Direct obligations: Grants, subsidies, and contributions
286,443
312,651
338,082
99.0
Reimbursable obligations
477
390
6
99.9
Total new obligations
286,920
313,041
338,088
Grants to States for Medicaid
(Amounts included in the adjusted baseline)
Program and Financing (in millions of dollars)
Identification code 75–0512–7–1–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Medicaid vendor payments
7
0900
Total new obligations (object class 41.0)
7
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
7
1260
Appropriations, mandatory (total)
7
1930
Total budgetary resources available
7
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
7
3020
Outlays (gross)
–7
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
7
Outlays, gross:
4100
Outlays from new mandatory authority
7
4180
Budget authority, net (total)
7
4190
Outlays, net (total)
7
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
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Medicaid vendor payments
124
0900
Total new obligations (object class 41.0)
124
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
124
1260
Appropriations, mandatory (total)
124
1930
Total budgetary resources available
124
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
124
3020
Outlays (gross)
–124
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
124
Outlays, gross:
4100
Outlays from new mandatory authority
124
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120
Federal sources
–365
–760
4180
Budget authority, net (total)
–365
–636
4190
Outlays, net (total)
–365
–636
Please see the narratives in the Program Integrity Administrative Expenses (Social Security Administration) and Health Care Fraud and Abuse Control accounts for a description of certain program integrity estimates reflected here. This schedule also reflects the offsetting
collections from Medicare Part B for the extension of the Qualified Individuals (QI) program, and other impacts of the Administration's
Medicaid proposals.
Grants to States for Medicaid
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 75–0512–4–1–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Medicaid vendor payments
175
4,391
0801
Medicare Part B Premiums
365
760
0900
Total new obligations
540
5,151
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation Medicaid
175
4,391
1260
Appropriations, mandatory (total)
175
4,391
Spending authority from offsetting collections, mandatory:
1800
Collected
365
760
1850
Spending auth from offsetting collections, mand (total)
365
760
1900
Budget authority (total)
540
5,151
1930
Total budgetary resources available
540
5,151
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
540
5,151
3020
Outlays (gross)
–540
–5,151
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
540
5,151
Outlays, gross:
4100
Outlays from new mandatory authority
540
5,151
4180
Budget authority, net (total)
540
5,151
4190
Outlays, net (total)
540
5,151
This schedule reflects the Administration's Medicaid proposals.
Object Classification (in millions of dollars)
Identification code 75–0512–4–1–551
2013 actual
2014 est.
2015 est.
41.0
Direct obligations: Grants, subsidies, and contributions
175
4,391
99.0
Reimbursable obligations
365
760
99.9
Total new obligations
540
5,151
State Grants and Demonstrations
Program and Financing (in millions of dollars)
Identification code 75–0516–0–1–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0011
Emergency health services for undocumented aliens
16
7
2
0012
Medicaid integrity program
102
132
78
0018
Money follows the person (MFP) demonstration
344
434
434
0019
MFP evaluations and technical support
1
1
1
0023
Grants to improve outreach and enrollment
34
6
1
0025
Medicaid emergency psychiatric demonstration
14
30
19
0026
Incentives for prevention of chronic diseases in Medicaid
23
22
8
0900
Total new obligations
534
632
543
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
1,459
1,489
1,346
1012
Unobligated balance transfers between expired and unexpired accounts
1
1021
Recoveries of prior year unpaid obligations
61
1050
Unobligated balance (total)
1,521
1,489
1,346
Budget authority:
Appropriations, mandatory:
1200
Appropriation
530
527
528
1230
Appropriations and/or unobligated balance of appropriations permanently reduced
–27
–38
1260
Appropriations, mandatory (total)
503
489
528
1900
Budget authority (total)
503
489
528
1930
Total budgetary resources available
2,024
1,978
1,874
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–1
1941
Unexpired unobligated balance, end of year
1,489
1,346
1,331
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
765
715
598
3010
Obligations incurred, unexpired accounts
534
632
543
3011
Obligations incurred, expired accounts
9
3020
Outlays (gross)
–517
–749
–673
3040
Recoveries of prior year unpaid obligations, unexpired
–61
3041
Recoveries of prior year unpaid obligations, expired
–15
3050
Unpaid obligations, end of year
715
598
468
Memorandum (non-add) entries:
3100
Obligated balance, start of year
765
715
598
3200
Obligated balance, end of year
715
598
468
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
503
489
528
Outlays, gross:
4100
Outlays from new mandatory authority
134
117
4101
Outlays from mandatory balances
517
615
556
4110
Outlays, gross (total)
517
749
673
4180
Budget authority, net (total)
503
489
528
4190
Outlays, net (total)
517
749
673
Summary of Budget Authority and Outlays (in millions of dollars)
2013 actual
2014 est.
2015 est.
Enacted/requested:
Budget Authority
503
489
528
Outlays
517
749
673
Legislative proposal, subject to PAYGO:
Budget Authority
525
Outlays
25
Total:
Budget Authority
503
489
1,053
Outlays
517
749
698
State Grants and Demonstrations includes funding for grant programs enacted in 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), the Deficit Reduction Act of 2005 (P.L. 109–171), the Children's Health Insurance
Program Reauthorization Act of 2009 (P.L. 111–3), the Patient Protection and Affordable Care Act (P.L. 111–148), and the Health
Care and Education Reconciliation Act of 2010 (P.L. 111–152).
The Budget includes an unobligated balance of approximately $9 million for activities authorized by Section 203 and $130 million
for activities authorized by Section 204 of the Ticket to Work and Work Incentives Improvement Act. Thus, pursuant to 31 U.S.C.
1555, any remaining balance (whether obligated or unobligated) will be withdrawn and returned to the Treasury two years after
there has been no disbursement made against the appropriation.
Object Classification (in millions of dollars)
Identification code 75–0516–0–1–551
2013 actual
2014 est.
2015 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent - Medicaid Integrity Program
9
9
9
12.1
Civilian personnel benefits - Medicaid Integrity Program
6
6
6
41.0
Grants, subsidies, and contributions - Emergency services for undocumented aliens
7
2
41.0
Grants, subsidies, and contributions - Medicaid Integrity Program
16
117
63
41.0
Grants, subsidies, and contributions - Money follows the person (MFP) demonstrations
87
434
434
41.0
Grants, subsidies, and contributions - MFP evaluations and technical support
344
1
1
41.0
Grants, subsidies, and contributions - Grants to improve outreach and enrollment
1
6
1
41.0
Grants, subsidies, and contributions - Medicaid emergency psychiatric demonstration
34
30
19
41.0
Grants, subsidies, and contributions - Incentives for prevention of chronic diseases in Medicaid
41.0
Grants, subsidies, and contributions - Medicaid emergency psychiatric demonstration
14
41.0
Grants, subsidies, and contributions - Incentives for prevention of chronic diseases in Medicaid
23
22
8
99.9
Total new obligations
534
632
543
Employment Summary
Identification code 75–0516–0–1–551
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
79
90
102
State Grants and Demonstrations
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 75–0516–4–1–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0012
Medicaid integrity program
25
0900
Total new obligations (object class 41.0)
25
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
525
1260
Appropriations, mandatory (total)
525
1900
Budget authority (total)
525
1930
Total budgetary resources available
525
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
500
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
25
3020
Outlays (gross)
–25
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
525
Outlays, gross:
4100
Outlays from new mandatory authority
25
4180
Budget authority, net (total)
525
4190
Outlays, net (total)
25
Payments to Health Care Trust Funds
For payment to the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund, as provided
under sections 217(g), 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)(3) of Public Law 97–248, and for administrative expenses incurred pursuant to section 201(g) of the
Social Security Act, [$255,185,000,000] $259,212,000,000.
In addition, for making matching payments under section 1844 and benefit payments under section 1860D-16 of the Social Security
Act that were not anticipated in budget estimates, such sums as may be necessary. (Department of Health and Human Services Appropriations Act, 2014.)
Program and Financing (in millions of dollars)
Identification code 75–0580–0–1–571
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Federal contribution to match premiums (SMI)
181,194
192,491
194,343
0002
Part D benefits (Rx Drug)
49,900
54,599
63,342
0003
Part D Federal administration (Rx Drug)
368
373
418
0004
General Fund Transfers to HI
816
1,070
1,103
0006
Federal Bureau of Investigation (HCFAC)
128
127
140
0007
Federal payments from taxation of OASDI benefits (HI)
14,310
18,114
20,956
0008
Criminal fines (HCFAC)
708
1,141
1,156
0009
Civil monetary penalties and damages (HCFAC - DOJ and CMS administration)
41
32
33
0010
Asset Forfeiture
30
27
28
0011
State Low Income Determinations
6
0900
Total new obligations
247,495
267,974
281,525
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
6,652
Budget authority:
Appropriations, mandatory:
1200
Appropriation (definite, annual)
234,082
255,185
259,212
1200
Appropriation (indefinite, permanent)
14,310
18,114
20,956
1200
Appropriation (HCFAC for FBI)
128
127
140
1200
Appropriation (indefinite for HCFAC)
780
1,200
1,217
1260
Appropriations, mandatory (total)
249,300
274,626
281,525
1930
Total budgetary resources available
249,300
274,626
288,177
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–1,805
1941
Unexpired unobligated balance, end of year
6,652
6,652
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
5,277
5,049
3010
Obligations incurred, unexpired accounts
247,495
267,974
281,525
3011
Obligations incurred, expired accounts
206
3020
Outlays (gross)
–242,424
–268,202
–281,525
3050
Unpaid obligations, end of year
5,277
5,049
5,049
Memorandum (non-add) entries:
3100
Obligated balance, start of year
5,277
5,049
3200
Obligated balance, end of year
5,277
5,049
5,049
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
249,300
274,626
281,525
Outlays, gross:
4100
Outlays from new mandatory authority
242,318
263,017
281,525
4101
Outlays from mandatory balances
106
5,185
4110
Outlays, gross (total)
242,424
268,202
281,525
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120
Federal sources
–18
Additional offsets against gross budget authority only:
4142
Offsetting collections credited to expired accounts
18
4160
Budget authority, net (mandatory)
249,300
274,626
281,525
4170
Outlays, net (mandatory)
242,406
268,202
281,525
4180
Budget authority, net (total)
249,300
274,626
281,525
4190
Outlays, net (total)
242,406
268,202
281,525
Summary of Budget Authority and Outlays (in millions of dollars)
2013 actual
2014 est.
2015 est.
Enacted/requested:
Budget Authority
249,300
274,626
281,525
Outlays
242,406
268,202
281,525
Amounts included in the adjusted baseline:
Budget Authority
–60
Outlays
–60
Legislative proposal, not subject to PAYGO:
Budget Authority
–1,181
Outlays
–1,181
Total:
Budget Authority
249,300
274,626
280,284
Outlays
242,406
268,202
280,284
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
2013 actual
2014 est.
2015 est.
Direct obligations:
41.0
Grants, subsidies, and contributions
246,184
266,404
279,864
42.0
Insurance claims and indemnities
228
204
187
94.0
Financial transfers (Federal admin)
1,083
1,366
1,474
99.9
Total new obligations
247,495
267,974
281,525
Payments to Health Care Trust Funds
(Amounts included in the adjusted baseline)
Program and Financing (in millions of dollars)
Identification code 75–0580–7–1–571
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Federal contribution to match premiums (SMI)
–60
0900
Total new obligations (object class 41.0)
–60
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation (definite annual)
–60
1260
Appropriations, mandatory (total)
–60
1930
Total budgetary resources available
–60
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
–60
3020
Outlays (gross)
60
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
–60
Outlays, gross:
4100
Outlays from new mandatory authority
–60
4180
Budget authority, net (total)
–60
4190
Outlays, net (total)
–60
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
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Federal contribution to match premiums (SMI)
–700
0002
Part D benefits (Rx Drug)
–481
0900
Total new obligations (object class 41.0)
–1,181
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation (definite, annual)
–1,181
1260
Appropriations, mandatory (total)
–1,181
1930
Total budgetary resources available
–1,181
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
–1,181
3020
Outlays (gross)
1,181
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
–1,181
Outlays, gross:
4100
Outlays from new mandatory authority
–1,181
4180
Budget authority, net (total)
–1,181
4190
Outlays, net (total)
–1,181
Quality Improvement Organizations
Program and Financing (in millions of dollars)
Identification code 75–0519–0–1–571
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
QIO contracts
372
1,272
334
0002
QIO support contracts
377
391
0900
Total new obligations
372
1,649
725
Budgetary Resources:
Budget authority:
Spending authority from offsetting collections, mandatory:
1800
Collected
55
1,649
725
1801
Change in uncollected payments, Federal sources
404
1850
Spending auth from offsetting collections, mand (total)
459
1,649
725
1930
Total budgetary resources available
459
1,649
725
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–87
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
765
626
626
3010
Obligations incurred, unexpired accounts
372
1,649
725
3011
Obligations incurred, expired accounts
17
3020
Outlays (gross)
–512
–1,649
–725
3041
Recoveries of prior year unpaid obligations, expired
–16
3050
Unpaid obligations, end of year
626
626
626
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–1,100
–1,060
–1,060
3070
Change in uncollected pymts, Fed sources, unexpired
–404
3071
Change in uncollected pymts, Fed sources, expired
444
3090
Uncollected pymts, Fed sources, end of year
–1,060
–1,060
–1,060
Memorandum (non-add) entries:
3100
Obligated balance, start of year
–335
–434
–434
3200
Obligated balance, end of year
–434
–434
–434
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
459
1,649
725
Outlays, gross:
4100
Outlays from new mandatory authority
74
1,069
254
4101
Outlays from mandatory balances
438
580
471
4110
Outlays, gross (total)
512
1,649
725
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120
Baseline Program [Text]
–499
–1,649
–725
Additional offsets against gross budget authority only:
4140
Change in uncollected pymts, Fed sources, unexpired
–404
4142
Offsetting collections credited to expired accounts
444
4150
Additional offsets against budget authority only (total)
40
4170
Outlays, net (mandatory)
13
4190
Outlays, net (total)
13
Part B of Title XI of the Social Security Act, as amended by the Peer Review Improvement Act of 1982, provides the statutory
authority for the Medicare Quality Improvement Organization (QIO) Program. The mission of the program is to promote the effectiveness,
efficiency, economy, and quality of services delivered to Medicare beneficiaries and to ensure that those services are reasonable
and necessary. The program is funded through transfers from the Medicare Hospital Insurance Trust Fund and the Medicare Supplementary
Medical Insurance Trust Fund. In FY 2012, a Treasury account specific to the QIO program was established to improve budgetary
operations.
Object Classification (in millions of dollars)
Identification code 75–0519–0–1–571
2013 actual
2014 est.
2015 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent
28
22
24
12.1
Civilian personnel benefits
26
26
25.2
Other services from non-Federal sources
342
1,224
284
25.3
Other goods and services from Federal sources
2
377
391
99.9
Total new obligations
372
1,649
725
Employment Summary
Identification code 75–0519–0–1–571
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
153
182
205
Program Management
For carrying out, except as otherwise provided, titles XI, XVIII, XIX, and XXI of the Social Security Act, titles XIII and
XXVII of the PHS Act, the Clinical Laboratory Improvement Amendments of 1988, and other responsibilities of the Centers for
Medicare and Medicaid Services, not to exceed [$3,669,744,000] $4,199,744,000, to be transferred from the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund,
as authorized by section 201(g) of the Social Security Act; together with all funds collected in accordance with section 353
of the PHS Act and section 1857(e)(2) of the Social Security Act, 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 be credited to this account and remain available until [September 30, 2019] expended: Provided, That all funds derived in accordance with 31 U.S.C. 9701 from organizations established under title XIII of the PHS Act
shall be credited to and available for carrying out the purposes of this appropriation: Provided further, That the Secretary is directed to collect fees in fiscal year [2014] 2015 from Medicare Advantage organizations pursuant to section 1857(e)(2) of the Social Security Act and from eligible organizations
with risk-sharing contracts under section 1876 of that Act pursuant to section 1876(k)(4)(D) of that Act[: Provided further, That $22,004,000 shall be available for the State high-risk health insurance pool program as authorized by the State High
Risk Pool Funding Extension Act of 2006]. (Department of Health and Human Services Appropriations Act, 2014.)
Program and Financing (in millions of dollars)
Identification code 75–0511–0–1–550
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Program operations
3,127
2,888
3,003
0002
Federal administration
788
840
860
0003
State survey and certification
372
399
448
0004
Research, demonstrations, and evaluation projects
331
99
60
0006
High-risk pool grants
42
20
0007
ARRA Medicare/Medicaid HIT
131
130
138
0100
Total direct program
4,791
4,376
4,509
0799
Total direct obligations
4,791
4,376
4,509
0801
Clinical laboratory improvement amendments
56
46
50
0802
Sale of data
16
7
7
0803
Coordination of benefits
15
1
30
0804
Medicare advantage/Prescription drug plan
85
70
71
0805
Provider enrollment
16
27
28
0806
Recovery audit contractors
455
763
750
0807
Other reimbursable program activity
37
0808
Marketplace User Fees
200
1,159
0810
Risk Adjustment Administrative Expenses
20
0811
Risk Corridors
5,450
0899
Total reimbursable obligations
680
1,114
7,565
0900
Total new obligations
5,471
5,490
12,074
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
1,297
837
686
1001
Discretionary unobligated balance brought fwd, Oct 1
190
1020
Adjustment of unobligated bal brought forward, Oct 1
–10
1021
Recoveries of prior year unpaid obligations
17
1050
Unobligated balance (total)
1,314
827
686
Budget authority:
Appropriations, discretionary:
1121
Appropriations transferred from other accts [75–9915]
114
1160
Appropriation, discretionary (total)
114
Appropriations, mandatory:
1200
Appropriation
253
253
193
1221
Appropriations transferred from other accts [75–0116]
454
1230
Appropriations and/or unobligated balance of appropriations permanently reduced
–213
–18
1260
Appropriations, mandatory (total)
494
235
193
Spending authority from offsetting collections, discretionary:
1700
Collected
2,066
3,960
9,657
1701
Change in uncollected payments, Federal sources
2,257
1702
Offsetting collections (previously unavailable)
4
1750
Spending auth from offsetting collections, disc (total)
4,323
3,964
9,657
Spending authority from offsetting collections, mandatory:
1800
Collected
149
1,234
2,115
1801
Change in uncollected payments, Federal sources
–42
1802
Offsetting collections (previously unavailable)
1
1823
New and/or unobligated balance of spending authority from offsetting collections temporarily reduced
–85
1850
Spending auth from offsetting collections, mand (total)
107
1,150
2,115
1900
Budget authority (total)
5,038
5,349
11,965
1930
Total budgetary resources available
6,352
6,176
12,651
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–44
1941
Unexpired unobligated balance, end of year
837
686
577
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
3,436
4,197
3,525
3010
Obligations incurred, unexpired accounts
5,471
5,490
12,074
3011
Obligations incurred, expired accounts
63
3020
Outlays (gross)
–4,578
–6,162
–12,279
3040
Recoveries of prior year unpaid obligations, unexpired
–17
3041
Recoveries of prior year unpaid obligations, expired
–178
3050
Unpaid obligations, end of year
4,197
3,525
3,320
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–4,252
–4,097
–4,097
3070
Change in uncollected pymts, Fed sources, unexpired
–2,215
3071
Change in uncollected pymts, Fed sources, expired
2,370
3090
Uncollected pymts, Fed sources, end of year
–4,097
–4,097
–4,097
Memorandum (non-add) entries:
3100
Obligated balance, start of year
–816
100
–572
3200
Obligated balance, end of year
100
–572
–777
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
4,437
3,964
9,657
Outlays, gross:
4010
Outlays from new discretionary authority
2,109
3,964
9,657
4011
Outlays from discretionary balances
2,035
4020
Outlays, gross (total)
4,144
3,964
9,657
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–3,598
–3,953
–4,200
4033
Non-Federal sources
–617
–11
–5,457
4040
Offsets against gross budget authority and outlays (total)
–4,215
–3,964
–9,657
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–2,257
4052
Offsetting collections credited to expired accounts
2,149
4060
Additional offsets against budget authority only (total)
–108
4070
Budget authority, net (discretionary)
114
4080
Outlays, net (discretionary)
–71
Mandatory:
4090
Budget authority, gross
601
1,385
2,308
Outlays, gross:
4100
Outlays from new mandatory authority
7
1,153
2,118
4101
Outlays from mandatory balances
427
1,045
504
4110
Outlays, gross (total)
434
2,198
2,622
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120
Federal sources
–184
–48
–6
4123
Non-Federal sources
–25
–1,102
–2,109
4130
Offsets against gross budget authority and outlays (total)
–209
–1,150
–2,115
Additional offsets against gross budget authority only:
4140
Change in uncollected pymts, Fed sources, unexpired
42
4142
Offsetting collections credited to expired accounts
60
4150
Additional offsets against budget authority only (total)
102
4160
Budget authority, net (mandatory)
494
235
193
4170
Outlays, net (mandatory)
225
1,048
507
4180
Budget authority, net (total)
608
235
193
4190
Outlays, net (total)
154
1,048
507
Memorandum (non-add) entries:
5090
Unavailable balance, SOY: Offsetting collections
80
5091
Unavailable balance, EOY: Offsetting collections
80
80
Summary of Budget Authority and Outlays (in millions of dollars)
2013 actual
2014 est.
2015 est.
Enacted/requested:
Budget Authority
608
235
193
Outlays
154
1,048
507
Legislative proposal, subject to PAYGO:
Budget Authority
401
Outlays
6
Total:
Budget Authority
608
235
594
Outlays
154
1,048
513
Program management activities include funding for program operations, survey and certification, the Clinical Laboratory Improvement
Amendments (CLIA), Medicare Advantage, Medicare Part D coordination of benefits, recovery audit contracts and other administrative
costs.
Object Classification (in millions of dollars)
Identification code 75–0511–0–1–550
2013 actual
2014 est.
2015 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
465
473
507
11.3
Other than full-time permanent
14
10
11
11.5
Other personnel compensation
2
8
8
11.7
Military personnel
11
15
15
11.9
Total personnel compensation
492
506
541
12.1
Civilian personnel benefits
147
136
152
12.2
Military personnel benefits
6
8
8
21.0
Travel and transportation of persons
5
7
7
22.0
Transportation of things
1
23.1
Rental payments to GSA
8
8
8
23.3
Communications, utilities, and miscellaneous charges
47
24.0
Printing and reproduction
39
4
4
25.1
Advisory and assistance services
49
25.2
Other services from non-Federal sources
2,703
2,399
2,271
25.3
Other goods and services from Federal sources
70
11
10
25.4
Operation and maintenance of facilities
6
25.5
Research and development contracts
13
20
16
25.6
Medical care
704
1,162
1,425
25.7
Operation and maintenance of equipment
8
26.0
Supplies and materials
2
1
1
31.0
Equipment
3
41.0
Grants, subsidies, and contributions
201
67
19
42.0
Insurance claims and indemnities
287
47
47
99.0
Direct obligations
4,791
4,376
4,509
99.0
Reimbursable obligations
680
1,114
7,565
99.9
Total new obligations
5,471
5,490
12,074
Employment Summary
Identification code 75–0511–0–1–550
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
4,551
4,379
4,574
1001
Direct civilian full-time equivalent employment
150
159
190
1101
Direct military average strength employment
138
163
164
2001
Reimbursable civilian full-time equivalent employment
105
112
125
Program Management
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 75–0511–4–1–550
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Program operations
430
0100
Total direct program
430
0801
Federal Payment Levy Program
2
0802
Survey and Certification CMP Investment
1
0809
Reimbursable program activities, subtotal
3
0899
Total reimbursable obligations
3
0900
Total new obligations
433
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
400
1260
Appropriations, mandatory (total)
400
Spending authority from offsetting collections, mandatory:
1800
Collected
33
1850
Spending auth from offsetting collections, mand (total)
33
1900
Budget authority (total)
433
1930
Total budgetary resources available
433
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
433
3020
Outlays (gross)
–38
3050
Unpaid obligations, end of year
395
Memorandum (non-add) entries:
3200
Obligated balance, end of year
395
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
433
Outlays, gross:
4100
Outlays from new mandatory authority
38
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120
Federal sources
–30
4124
Offsetting governmental collections
–2
4130
Offsets against gross budget authority and outlays (total)
–32
4160
Budget authority, net (mandatory)
401
4170
Outlays, net (mandatory)
6
4180
Budget authority, net (total)
401
4190
Outlays, net (total)
6
Object Classification (in millions of dollars)
Identification code 75–0511–4–1–550
2013 actual
2014 est.
2015 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent
2
12.1
Civilian personnel benefits
1
25.2
Other services from non-Federal sources
427
99.0
Direct obligations
430
99.0
Reimbursable obligations
3
99.9
Total new obligations
433
Employment Summary
Identification code 75–0511–4–1–550
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
20
1101
Direct military average strength employment
2001
Reimbursable civilian full-time equivalent employment
Children's Health Insurance Fund
Program and Financing (in millions of dollars)
Identification code 75–0515–0–1–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Grants to States and U.S. territories
8,972
9,514
10,388
0002
Performance bonus payments
345
339
0003
Child health quality improvement
40
52
11
0900
Total new obligations (object class 41.0)
9,357
9,905
10,399
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
860
282
3,207
1012
Unobligated balance transfers between expired and unexpired accounts
6,094
1021
Recoveries of prior year unpaid obligations
36
1050
Unobligated balance (total)
6,990
282
3,207
Budget authority:
Appropriations, discretionary:
1100
Appropriation (CHIPRA Performance Bonus Extension)
350
1130
Appropriations permanently reduced
–3,485
1160
Appropriation, discretionary (total)
–3,135
Appropriations, mandatory:
1200
Appropriation
17,451
19,147
21,061
1230
Appropriations and/or unobligated balance of appropriations permanently reduced
–6,368
–6,317
1260
Appropriations, mandatory (total)
11,083
12,830
21,061
1900
Budget authority (total)
11,083
12,830
17,926
1930
Total budgetary resources available
18,073
13,112
21,133
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–8,434
1941
Unexpired unobligated balance, end of year
282
3,207
10,734
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
6,474
6,115
5,831
3010
Obligations incurred, unexpired accounts
9,357
9,905
10,399
3011
Obligations incurred, expired accounts
17
3020
Outlays (gross)
–9,469
–10,189
–10,861
3040
Recoveries of prior year unpaid obligations, unexpired
–36
3041
Recoveries of prior year unpaid obligations, expired
–228
3050
Unpaid obligations, end of year
6,115
5,831
5,369
Memorandum (non-add) entries:
3100
Obligated balance, start of year
6,474
6,115
5,831
3200
Obligated balance, end of year
6,115
5,831
5,369
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
–3,135
Outlays, gross:
4010
Outlays from new discretionary authority
350
Mandatory:
4090
Budget authority, gross
11,083
12,830
21,061
Outlays, gross:
4100
Outlays from new mandatory authority
3,466
6,300
1,100
4101
Outlays from mandatory balances
6,003
3,889
9,411
4110
Outlays, gross (total)
9,469
10,189
10,511
4180
Budget authority, net (total)
11,083
12,830
17,926
4190
Outlays, net (total)
9,469
10,189
10,861
Summary of Budget Authority and Outlays (in millions of dollars)
2013 actual
2014 est.
2015 est.
Enacted/requested:
Budget Authority
11,083
12,830
17,926
Outlays
9,469
10,189
10,861
Legislative proposal, subject to PAYGO:
Budget Authority
10
Outlays
10
Total:
Budget Authority
11,083
12,830
17,936
Outlays
9,469
10,189
10,871
The Balanced Budget Act of 1997 established the Children's Health Insurance Program (CHIP) 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 separate
CHIP program, a CHIP Medicaid expansion program, or a combination of both. The Children's Health Insurance Program Reauthorization
Act of 2009 (P.L. 111–3, CHIPRA) reauthorized the CHIP program and appropriated funding for CHIP through 2013. CHIPRA made
some modifications to the program including increased funding for States and territories, bonus payments for States that exceed
Medicaid child enrollment targets, and support for child health quality and outreach activities. A contingency fund to assist
States who project spending above their available allocated CHIP funds was also created by CHIPRA and funding is included
in a separate account. The Patient Protection and Affordable Care Act of 2010 (P.L. 111–148) extended funding for CHIP, providing
appropriations through 2015.
Children's Health Insurance Fund
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 75–0515–4–1–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0004
Express Lane Eligibility
10
0900
Total new obligations (object class 41.0)
10
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
10
1260
Appropriations, mandatory (total)
10
1900
Budget authority (total)
10
1930
Total budgetary resources available
10
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
10
3020
Outlays (gross)
–10
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
10
Outlays, gross:
4100
Outlays from new mandatory authority
10
4180
Budget authority, net (total)
10
4190
Outlays, net (total)
10
Center for Medicare and Medicaid Innovation
Program and Financing (in millions of dollars)
Identification code 75–0522–0–1–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Administration
97
213
216
0002
Innovation Activities
856
1,424
1,306
0900
Total new obligations
953
1,637
1,522
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
9,130
8,180
6,543
1021
Recoveries of prior year unpaid obligations
3
1050
Unobligated balance (total)
9,133
8,180
6,543
1930
Total budgetary resources available
9,133
8,180
6,543
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
8,180
6,543
5,021
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
647
941
1,524
3010
Obligations incurred, unexpired accounts
953
1,637
1,522
3020
Outlays (gross)
–656
–1,054
–1,444
3040
Recoveries of prior year unpaid obligations, unexpired
–3
3050
Unpaid obligations, end of year
941
1,524
1,602
Memorandum (non-add) entries:
3100
Obligated balance, start of year
647
941
1,524
3200
Obligated balance, end of year
941
1,524
1,602
Budget authority and outlays, net:
Mandatory:
Outlays, gross:
4101
Outlays from mandatory balances
656
1,054
1,444
4190
Outlays, net (total)
656
1,054
1,444
The Center for Medicare and Medicaid Innovation ("Innovation Center") was established by section 1115A of the Social Security
Act (as added by section 3021 of the Affordable Care Act). The Innovation Center is tasked with testing innovative payment
and service delivery models to reduce program expenditures while preserving or enhancing the quality of care provided to individuals
under Medicare, Medicaid, or Children's Health Insurance Program (CHIP). The statute provides $10 billion in mandatory funding
for these purposes in fiscal years 2011 through 2019.
Object Classification (in millions of dollars)
Identification code 75–0522–0–1–551
2013 actual
2014 est.
2015 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent
26
45
48
12.1
Civilian personnel benefits
8
14
15
25.2
Other services from non-Federal sources
282
485
450
25.3
Other goods and services from Federal sources
2
2
3
41.0
Grants, subsidies, and contributions
635
1,091
1,006
99.9
Total new obligations
953
1,637
1,522
Employment Summary
Identification code 75–0522–0–1–551
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
258
412
443
Child Enrollment Contingency Fund
Special and Trust Fund Receipts (in millions of dollars)
Identification code 75–5551–0–2–551
2013 actual
2014 est.
2015 est.
0100
Balance, start of year
3
Receipts:
0240
Interest, Child Enrollment Contingency Fund
3
3
0400
Total: Balances and collections
3
3
3
Appropriations:
0500
Child Enrollment Contingency Fund
2,099
0501
Child Enrollment Contingency Fund
–3
0599
Total appropriations
–3
2,099
0799
Balance, end of year
3
2,102
Program and Financing (in millions of dollars)
Identification code 75–5551–0–2–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Grants to States and US Territories
100
100
0900
Total new obligations (object class 41.0)
100
100
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
2,093
2,096
2,099
Budget authority:
Appropriations, discretionary:
1134
Unobligated balance precluded from obligation
–2,099
1160
Appropriation, discretionary (total)
–2,099
Appropriations, mandatory:
1200
Appropriation
103
100
1201
Appropriation (special or trust fund)
3
1260
Appropriations, mandatory (total)
3
103
100
1900
Budget authority (total)
3
103
–1,999
1930
Total budgetary resources available
2,096
2,199
100
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
2,096
2,099
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
26
12
12
3010
Obligations incurred, unexpired accounts
100
100
3020
Outlays (gross)
–14
–100
–100
3050
Unpaid obligations, end of year
12
12
12
Memorandum (non-add) entries:
3100
Obligated balance, start of year
26
12
12
3200
Obligated balance, end of year
12
12
12
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
–2,099
Mandatory:
4090
Budget authority, gross
3
103
100
Outlays, gross:
4101
Outlays from mandatory balances
14
100
100
4180
Budget authority, net (total)
3
103
–1,999
4190
Outlays, net (total)
14
100
100
Memorandum (non-add) entries:
5000
Total investments, SOY: Federal securities: Par value
2,096
2,098
5001
Total investments, EOY: Federal securities: Par value
2,098
The Children's Health Insurance Program Reauthorization Act of 2009 (P.L. 111–3, CHIPRA) established the Child Enrollment
Contingency Fund under Title XXI of the Social Security Act. Beginning in 2009, a State may qualify for a contingency fund
payment if it projects a funding shortfall for the fiscal year and if its average monthly child enrollment exceeds its target
average number of enrollees for the fiscal year. The Patient Protection and Affordable Care Act of 2010 (P.L. 111–148) extended
the contingency fund through 2015.
The fund received an initial appropriation equal to 20 percent of the FY 2009 national allotment ($2.1 billion). In fiscal
years 2010 through 2015, the statute appropriates the amount necessary to make payments to eligible States, but not to exceed
20 percent of the total annual appropriation for CHIP allotments to States. Any amounts in excess of this aggregate cap will
be made available for CHIP performance bonus payments. The contingency fund is invested in interest bearing securities of
the United States, and the income derived from these investments constitutes a part of the fund.
Medicare Health Information Technology Incentive Payments, Recovery Act
Program and Financing (in millions of dollars)
Identification code 75–0508–0–1–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0801
Incentive payments to hospitals
3,385
6,213
1,436
0802
Incentive payments to eligible professionals
2,674
3,450
710
0900
Total new obligations (object class 42.0)
6,059
9,663
2,146
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
1,070
1,871
1,871
Budget authority:
Spending authority from offsetting collections, mandatory:
1800
Collected from the HI Trust Fund
3,519
6,213
1,436
1800
Collected from the SMI Trust Fund
2,797
3,450
710
1801
Change in uncollected payments, Federal sources
544
1850
Spending auth from offsetting collections, mand (total)
6,860
9,663
2,146
1930
Total budgetary resources available
7,930
11,534
4,017
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
1,871
1,871
1,871
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
448
305
305
3010
Obligations incurred, unexpired accounts
6,059
9,663
2,146
3020
Outlays (gross)
–6,202
–9,663
–2,146
3050
Unpaid obligations, end of year
305
305
305
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–1,898
–2,442
–2,442
3070
Change in uncollected pymts, Fed sources, unexpired
–544
3090
Uncollected pymts, Fed sources, end of year
–2,442
–2,442
–2,442
Memorandum (non-add) entries:
3100
Obligated balance, start of year
–1,450
–2,137
–2,137
3200
Obligated balance, end of year
–2,137
–2,137
–2,137
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
6,860
9,663
2,146
Outlays, gross:
4100
Outlays from new mandatory authority
4,685
8,363
1,696
4101
Outlays from mandatory balances
1,517
1,300
450
4110
Outlays, gross (total)
6,202
9,663
2,146
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120
Federal sources
–6,316
–9,663
–2,146
Additional offsets against gross budget authority only:
4140
Change in uncollected pymts, Fed sources, unexpired
–544
4170
Outlays, net (mandatory)
–114
4190
Outlays, net (total)
–114
Rate Review Grants
Program and Financing (in millions of dollars)
Identification code 75–0112–0–1–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Premium rate review grants
70
31
0900
Total new obligations (object class 41.0)
70
31
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
90
29
1021
Recoveries of prior year unpaid obligations
9
2
1050
Unobligated balance (total)
99
31
1930
Total budgetary resources available
99
31
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
29
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
127
162
111
3010
Obligations incurred, unexpired accounts
70
31
3020
Outlays (gross)
–26
–80
–50
3040
Recoveries of prior year unpaid obligations, unexpired
–9
–2
3050
Unpaid obligations, end of year
162
111
61
Memorandum (non-add) entries:
3100
Obligated balance, start of year
127
162
111
3200
Obligated balance, end of year
162
111
61
Budget authority and outlays, net:
Mandatory:
Outlays, gross:
4101
Outlays from mandatory balances
26
80
50
4190
Outlays, net (total)
26
80
50
The Affordable Care Act (P.L. 111–148) amends Section 2794 of the Public Health Service Act and provides that the Secretary
shall carry out a program to award grants to States for a five-year period beginning in fiscal year 2010. The Grants to States
for Health Insurance Premium Review program provides funding to help States develop or enhance their current rate review activities.
The program provides $250,000,000 over the five-year period beginning with fiscal year 2010. States may receive no less than
$1,000,000 and no more than $5,000,000 in any one grant year. Grant recipients are required to submit data to the Secretary
on health insurance rate trends.
Pre-Existing Condition Insurance Plan Program
Program and Financing (in millions of dollars)
Identification code 75–0113–0–1–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Direct program activity
1,587
367
0801
Premiums from Fallback States
183
75
0900
Total new obligations
1,770
442
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
1,832
367
1021
Recoveries of prior year unpaid obligations
93
1050
Unobligated balance (total)
1,925
367
Budget authority:
Spending authority from offsetting collections, mandatory:
1800
Collected
212
75
1850
Spending auth from offsetting collections, mand (total)
212
75
1900
Budget authority (total)
212
75
1930
Total budgetary resources available
2,137
442
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
367
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
1,261
585
3010
Obligations incurred, unexpired accounts
1,770
442
3020
Outlays (gross)
–2,353
–1,027
3040
Recoveries of prior year unpaid obligations, unexpired
–93
3050
Unpaid obligations, end of year
585
Memorandum (non-add) entries:
3100
Obligated balance, start of year
1,261
585
3200
Obligated balance, end of year
585
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
212
75
Outlays, gross:
4100
Outlays from new mandatory authority
183
75
4101
Outlays from mandatory balances
2,170
952
4110
Outlays, gross (total)
2,353
1,027
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123
Non-Federal sources
–212
–75
4190
Outlays, net (total)
2,141
952
This account funds the Pre-Existing Condition Insurance Plan Program (PCIP), which makes health insurance available to people
who have been unable to get insurance due to a pre-existing condition. Enrollees pay monthly premiums similar to those charged
in the commercial individual market, and the Federal government pays for remaining costs that exceed enrollee contributions.
The funding for this program, including operating costs, was provided in the FY 2010 appropriation by the Affordable Care
Act (P.L. 111–148). The FY 2015 President's Budget obligation and outlays projections are based on policy assumptions to manage
costs in the program to the $5 billion appropriation.
Object Classification (in millions of dollars)
Identification code 75–0113–0–1–551
2013 actual
2014 est.
2015 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent
4
3
25.2
Other services from non-Federal sources
20
16
41.0
Grants, subsidies, and contributions
1,563
348
99.0
Direct obligations
1,587
367
99.0
Reimbursable obligations
183
75
99.9
Total new obligations
1,770
442
Employment Summary
Identification code 75–0113–0–1–551
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
12
14
Early Retiree Reinsurance Program
Program and Financing (in millions of dollars)
Identification code 75–0114–0–1–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Subsidies for early retirees
39
7
0002
Administration
21
12
1
0799
Total direct obligations
60
19
1
0801
Reimbursable program activity
21
33
0900
Total new obligations
81
52
1
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
75
20
1
1021
Recoveries of prior year unpaid obligations
5
1050
Unobligated balance (total)
80
20
1
Budget authority:
Spending authority from offsetting collections, mandatory:
1800
Collected
21
33
1850
Spending auth from offsetting collections, mand (total)
21
33
1900
Budget authority (total)
21
33
1930
Total budgetary resources available
101
53
1
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
20
1
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
23
19
3010
Obligations incurred, unexpired accounts
81
52
1
3020
Outlays (gross)
–80
–71
–1
3040
Recoveries of prior year unpaid obligations, unexpired
–5
3050
Unpaid obligations, end of year
19
Memorandum (non-add) entries:
3100
Obligated balance, start of year
23
19
3200
Obligated balance, end of year
19
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
21
33
Outlays, gross:
4100
Outlays from new mandatory authority
21
33
4101
Outlays from mandatory balances
59
38
1
4110
Outlays, gross (total)
80
71
1
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120
Federal sources
–10
–17
4123
Non-Federal sources
–11
–16
4130
Offsets against gross budget authority and outlays (total)
–21
–33
4170
Outlays, net (mandatory)
59
38
1
4190
Outlays, net (total)
59
38
1
The Affordable Care Act (P.L. 111–148) authorized and appropriated $5 billion for the Early Retiree Reinsurance Program (ERRP).
ERRP provides reimbursement to participating sponsors of certified plans that provide health benefits to early retirees (age
55 and older and not eligible for Medicare), their spouses, and surviving spouses and dependents. Reimbursement is equal to
80 percent of the actual cost of health expenses paid for an individual (net of price concessions) between a cost threshold
of $15,000 and cost limit of $90,000 beginning in 2010. The cost threshold and cost limit are adjusted for inflation each
year based on the Medical Care Component of the consumer price index for all urban consumers. Reimbursements to sponsors shall
be used to reduce the sponsor's health benefit or premium costs, provide premium and cost sharing relief to plan participants,
or both. By statute, ERRP sunsets on January 1, 2014 and is no longer providing reimbursements to plan sponsors.
Object Classification (in millions of dollars)
Identification code 75–0114–0–1–551
2013 actual
2014 est.
2015 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent
2
12
25.2
Other services from non-Federal sources
19
1
42.0
Insurance claims and indemnities
39
7
99.0
Direct obligations
60
19
1
99.0
Reimbursable obligations
21
33
99.9
Total new obligations
81
52
1
Employment Summary
Identification code 75–0114–0–1–551
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
11
8
Affordable Insurance Exchange Grants
Program and Financing (in millions of dollars)
Identification code 75–0115–0–1–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Planning and establishment grants
2,107
1,268
785
0002
Administration
41
51
51
0900
Total new obligations
2,148
1,319
836
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
2,194
1,414
836
1230
Appropriations and/or unobligated balance of appropriations permanently reduced
–46
–95
1260
Appropriations, mandatory (total)
2,148
1,319
836
1930
Total budgetary resources available
2,148
1,319
836
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
1,899
3,016
1,888
3010
Obligations incurred, unexpired accounts
2,148
1,319
836
3011
Obligations incurred, expired accounts
159
3020
Outlays (gross)
–963
–2,447
–1,899
3041
Recoveries of prior year unpaid obligations, expired
–227
3050
Unpaid obligations, end of year
3,016
1,888
825
Memorandum (non-add) entries:
3100
Obligated balance, start of year
1,899
3,016
1,888
3200
Obligated balance, end of year
3,016
1,888
825
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
2,148
1,319
836
Outlays, gross:
4100
Outlays from new mandatory authority
100
659
418
4101
Outlays from mandatory balances
863
1,788
1,481
4110
Outlays, gross (total)
963
2,447
1,899
4180
Budget authority, net (total)
2,148
1,319
836
4190
Outlays, net (total)
963
2,447
1,899
This program provides funding for Planning and Establishment Grants to States for their activities to implement Affordable
Insurance Exchanges, which are also referred to as Marketplaces. The Exchanges will facilitate the purchase of qualified health
plans in the individual market and provide for the establishment of a Small Business Health Options Program to allow small
businesses to offer qualified health plans to their employees. Section 1311 of the Patient Protection and Affordable Care
Act (P.L. 111–148) provides amounts necessary to enable the Secretary to award grants to States beginning no later than March
23, 2011, and allows for renewal grants through January 1, 2015.
Object Classification (in millions of dollars)
Identification code 75–0115–0–1–551
2013 actual
2014 est.
2015 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent
10
10
10
25.2
Other services from non-Federal sources
31
41
41
41.0
Grants, subsidies, and contributions
2,107
1,268
785
99.9
Total new obligations
2,148
1,319
836
Employment Summary
Identification code 75–0115–0–1–551
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
56
65
76
Risk Adjustment Program Payments
Special and Trust Fund Receipts (in millions of dollars)
Identification code 75–5733–0–2–551
2013 actual
2014 est.
2015 est.
0100
Balance, start of year
Receipts:
0200
Receipts, Risk Adjustment Program
3,378
0400
Total: Balances and collections
3,378
Appropriations:
0500
Risk Adjustment Program Payments
–3,378
0799
Balance, end of year
Program and Financing (in millions of dollars)
Identification code 75–5733–0–2–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Direct program activity
3,378
0900
Total new obligations (object class 41.0)
3,378
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1201
Appropriation (special or trust fund)
3,378
1260
Appropriations, mandatory (total)
3,378
1930
Total budgetary resources available
3,378
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
3,378
3020
Outlays (gross)
–3,378
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
3,378
Outlays, gross:
4100
Outlays from new mandatory authority
3,378
4180
Budget authority, net (total)
3,378
4190
Outlays, net (total)
3,378
Section 1343 of the Affordable Care Act (P.L. 111–148) established a permanent risk adjustment program for non-grandfathered
plans in the individual and small group markets. Charges are collected from health insurance issuers that enroll healthier
than average enrollees and payments are made to issuers that enroll sicker than average enrollees. Risk adjustment may be
operated by a State, or by the Federal government in the event a State chooses not to operate risk adjustment. Payments and
charges are made in the year following the plan year for which they are calculated.
Transitional Reinsurance Program
Special and Trust Fund Receipts (in millions of dollars)
Identification code 75–5735–0–2–551
2013 actual
2014 est.
2015 est.
0100
Balance, start of year
Receipts:
0200
Contributions, Transitional Reinsurance Program
10,020
0400
Total: Balances and collections
10,020
Appropriations:
0500
Transitional Reinsurance Program
–10,020
0799
Balance, end of year
Program and Financing (in millions of dollars)
Identification code 75–5735–0–2–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Transitional reinsurance payments
10,000
0002
Administrative expenses
20
0900
Total new obligations
10,020
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1201
Appropriation (special or trust fund)
10,020
1260
Appropriations, mandatory (total)
10,020
1930
Total budgetary resources available
10,020
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
10,020
3020
Outlays (gross)
–10,020
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
10,020
Outlays, gross:
4100
Outlays from new mandatory authority
10,020
4180
Budget authority, net (total)
10,020
4190
Outlays, net (total)
10,020
Section 1341 of the Affordable Care Act (P.L. 111–148) established a transitional, temporary, three-year reinsurance program
to minimize the impact of high-cost enrollees in plans in the individual market for plan years 2014, 2015, and 2016. The Centers
for Medicare & Medicaid Services assesses health insurance issuers and group health plans a per enrollee fee to fund the reinsurance
contributions, and makes payments to issuers in the individual market for enrollees whose medical costs exceed a certain threshold,
up to a reinsurance cap. Reinsurance collections and payments are made in the year following the plan year for which they
are applicable.
Object Classification (in millions of dollars)
Identification code 75–5735–0–2–551
2013 actual
2014 est.
2015 est.
Direct obligations:
41.0
Grants, subsidies, and contributions - Transitional Reinsurance
10,000
41.0
Grants, subsidies, and contributions - Administration
20
99.9
Total new obligations
10,020
Consumer Operated and Oriented Plan Program Contingency Fund
Program and Financing (in millions of dollars)
Identification code 75–0524–0–1–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
Credit program obligations:
0701
Direct loan subsidy
2
210
0709
Administrative expenses
8
11
8
0900
Total new obligations
10
221
8
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
230
9
Budget authority:
Appropriations, mandatory:
1221
Appropriations transferred from other accts [75–0118]
253
1230
Appropriations and/or unobligated balance of appropriations permanently reduced
–13
1260
Appropriations, mandatory (total)
240
1930
Total budgetary resources available
240
230
9
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
230
9
1
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
7
173
3010
Obligations incurred, unexpired accounts
10
221
8
3020
Outlays (gross)
–3
–55
–10
3050
Unpaid obligations, end of year
7
173
171
Memorandum (non-add) entries:
3100
Obligated balance, start of year
7
173
3200
Obligated balance, end of year
7
173
171
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
240
Outlays, gross:
4100
Outlays from new mandatory authority
3
4101
Outlays from mandatory balances
55
10
4110
Outlays, gross (total)
3
55
10
4180
Budget authority, net (total)
240
4190
Outlays, net (total)
3
55
10
Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in millions of dollars)
Identification code 75–0524–0–1–551
2013 actual
2014 est.
2015 est.
Direct loan levels supportable by subsidy budget authority:
115001
Startup Loans
7
116
115002
Solvency Loans
402
115999
Total direct loan levels
7
518
Direct loan subsidy (in percent):
132001
Startup Loans
37.66
35.66
0.00
132002
Solvency Loans
0.00
42.08
0.00
132999
Weighted average subsidy rate
37.66
40.64
0.00
Direct loan subsidy budget authority:
133001
Startup Loans
2
41
133002
Solvency Loans
169
133999
Total subsidy budget authority
2
210
Direct loan subsidy outlays:
134001
Startup Loans
1
43
134999
Total subsidy outlays
1
43
Direct loan downward reestimates:
Administrative expense data:
3580
Outlays from balances
2
12
The Consumer Operated and Oriented Plan Contingency Fund was established by the American Taxpayer Relief Act of 2012 (P.L.
112–240). This fund provides assistance and oversight to qualified nonprofit health insurance issuers that have been awarded
loans or grants under section 1322 of the Affordable Care Act (P.L. 111–148).
Object Classification (in millions of dollars)
Identification code 75–0524–0–1–551
2013 actual
2014 est.
2015 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent
1
5
4
23.1
Rental payments to GSA
1
1
1
25.2
Other services from non-Federal sources
6
5
3
41.0
Grants, subsidies, and contributions
2
210
99.9
Total new obligations
10
221
8
Employment Summary
Identification code 75–0524–0–1–551
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
18
18
16
Consumer Operated and Oriented Plan Program Account
Program and Financing (in millions of dollars)
Identification code 75–0118–0–1–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
Credit program obligations:
0701
Direct loan subsidy
122
0703
Subsidy for modifications of direct loans
5
0705
Reestimates of direct loan subsidy
3
18
0706
Interest on reestimates of direct loan subsidy
1
0709
Administrative expenses
1
0900
Total new obligations
130
19
1
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
2,659
8
8
1021
Recoveries of prior year unpaid obligations
8
1050
Unobligated balance (total)
2,667
8
8
Budget authority:
Appropriations, mandatory:
1200
Appropriation
3
19
1220
Appropriations transferred to other accts [75–0524]
–253
1230
Appropriations and/or unobligated balance of appropriations permanently reduced
–2,279
1260
Appropriations, mandatory (total)
–2,529
19
1930
Total budgetary resources available
138
27
8
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
8
8
7
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
703
548
326
3010
Obligations incurred, unexpired accounts
130
19
1
3020
Outlays (gross)
–277
–241
–147
3040
Recoveries of prior year unpaid obligations, unexpired
–8
3050
Unpaid obligations, end of year
548
326
180
Memorandum (non-add) entries:
3100
Obligated balance, start of year
703
548
326
3200
Obligated balance, end of year
548
326
180
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
–2,529
19
Outlays, gross:
4100
Outlays from new mandatory authority
3
19
4101
Outlays from mandatory balances
274
222
147
4110
Outlays, gross (total)
277
241
147
4180
Budget authority, net (total)
–2,529
19
4190
Outlays, net (total)
277
241
147
Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in millions of dollars)
Identification code 75–0118–0–1–551
2013 actual
2014 est.
2015 est.
Direct loan levels supportable by subsidy budget authority:
115002
Startup Loans
37
115003
Solvency
257
115999
Total direct loan levels
294
Direct loan subsidy (in percent):
132002
Startup Loans
37.66
0.00
0.00
132003
Solvency
41.90
0.00
0.00
132999
Weighted average subsidy rate
41.37
0.00
0.00
Direct loan subsidy budget authority:
133002
Startup Loans
14
133003
Solvency
108
133999
Total subsidy budget authority
122
Direct loan subsidy outlays:
134002
Startup Loans
71
14
134003
Solvency
195
205
147
134999
Total subsidy outlays
266
219
147
Direct loan upward reestimates:
135002
Startup Loans
3
135003
Solvency
19
135999
Total upward reestimate budget authority
3
19
Direct loan downward reestimates:
137002
Startup Loans
–6
137999
Total downward reestimate budget authority
–6
Administrative expense data:
3580
Outlays from balances
4
3
Section 1322 of the Affordable Care Act (P.L. 111–148) authorized and appropriated funding for the Consumer Operated and Oriented
Plan (CO-OP) Program. The CO-OP Program fosters the creation of qualified nonprofit health insurance issuers that operate
with a strong consumer focus to offer qualified health plans in the individual and small group markets in the States. The
Secretary shall award loans to qualified nonprofit issuers to fund start-up costs and reserves which enable qualified issuers
to meet state solvency requirements. The Secretary may also award loans for the purposes of encouraging the establishment
of CO-OPs in states where no issuer applies to be a qualified nonprofit issuer under Section 1322.
As required by the Federal Credit Reform Act of 1990, this account records, for this program, the subsidy costs associated
with CO-OP Program grants and loans, as well as administrative expenses of this program. The subsidy amounts are estimated
on a present value basis; the administrative expenses are estimated on a cash basis.
Object Classification (in millions of dollars)
Identification code 75–0118–0–1–551
2013 actual
2014 est.
2015 est.
Direct obligations:
25.2
Other services from non-Federal sources
1
41.0
Grants, subsidies, and contributions
130
19
99.9
Total new obligations
130
19
1
Consumer Operated and Oriented Plan Financing Account
Program and Financing (in millions of dollars)
Identification code 75–4418–0–3–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
Credit program obligations:
0710
Direct loan obligations
295
0713
Payment of interest to Treasury
22
35
45
0742
Downward reestimate paid to receipt account
6
0900
Total new obligations
317
41
45
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
2,228
1
1
1020
Adjustment of unobligated bal brought forward, Oct 1
–2,228
1021
Recoveries of prior year unpaid obligations
19
1050
Unobligated balance (total)
19
1
1
Financing authority:
Borrowing authority, mandatory:
1400
Borrowing authority
386
24
27
1422
Borrowing authority applied to repay debt
–236
1440
Borrowing authority, mandatory (total)
150
24
27
Spending authority from offsetting collections, mandatory:
1800
Collected
296
255
165
1801
Change in uncollected payments, Federal sources
–147
–219
–147
1825
Spending authority from offsetting collections applied to repay debt
–19
1850
Spending auth from offsetting collections, mand (total)
149
17
18
1900
Financing authority (total)
299
41
45
1930
Total budgetary resources available
318
42
46
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
1
1
1
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
1,601
1,243
739
3010
Obligations incurred, unexpired accounts
317
41
45
3020
Financing disbursements (gross)
–656
–545
–379
3040
Recoveries of prior year unpaid obligations, unexpired
–19
3050
Unpaid obligations, end of year
1,243
739
405
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–692
–545
–326
3070
Change in uncollected pymts, Fed sources, unexpired
147
219
147
3090
Uncollected pymts, Fed sources, end of year
–545
–326
–179
Memorandum (non-add) entries:
3100
Obligated balance, start of year
909
698
413
3200
Obligated balance, end of year
698
413
226
Financing authority and disbursements, net:
Mandatory:
4090
Financing authority, gross
299
41
45
Financing disbursements:
4110
Financing disbursements, gross
656
545
379
Offsets against gross financing authority and disbursements:
Offsetting collections (collected) from:
4120
Federal sources
–269
–238
–147
4122
Interest on uninvested funds
–17
–17
–18
4123
Non-Federal sources
–10
4130
Offsets against gross financing auth and disbursements (total)
–296
–255
–165
Additional offsets against financing authority only (total):
4140
Change in uncollected pymts, Fed sources, unexpired
147
219
147
4160
Financing authority, net (mandatory)
150
5
27
4170
Financing disbursements, net (mandatory)
360
290
214
4180
Financing authority, net (total)
150
5
27
4190
Financing disbursements, net (total)
360
290
214
Status of Direct Loans (in millions of dollars)
Identification code 75–4418–0–3–551
2013 actual
2014 est.
2015 est.
Position with respect to appropriations act limitation on obligations:
1131
Direct loan obligations exempt from limitation
295
1150
Total direct loan obligations
295
Cumulative balance of direct loans outstanding:
1210
Outstanding, start of year
90
714
1,218
1231
Disbursements: Direct loan disbursements
634
504
333
1251
Repayments: Repayments and prepayments
–10
1263
Write-offs for default: Direct loans
1290
Outstanding, end of year
714
1,218
1,551
As required by the Federal Credit Reform Act of 1990, this non-budgetary account records all cash flows to and from the Government
resulting from direct loans obligated in 1992 and beyond (including modifications of direct loans that resulted from obligations
in any year). The amounts in this account are a means of financing and are not included in the budget totals.
Balance Sheet (in millions of dollars)
Identification code 75–4418–0–3–551
2012 actual
2013 actual
Group heading
ASSETS:
Federal assets:
1101
Fund balances with Treasury
118
Investments in US securities:
1106
Receivables, net
25
Net value of assets related to post-1991 direct loans receivable:
1401
Direct loans receivable, gross
90
714
1405
Allowance for subsidy cost (-)
–34
–309
1499
Net present value of assets related to direct loans
56
405
1999
Total assets
56
548
LIABILITIES:
2103
Federal liabilities: Debt
56
548
4999
Total liabilities and net position
56
548
Consumer Operated and Oriented Plan Program Contingency Fund Financing Account
Program and Financing (in millions of dollars)
Identification code 75–4482–0–3–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
Credit program obligations:
0710
Direct loan obligations
7
518
0713
Payment of interest to Treasury
1
3
0900
Total new obligations
7
519
3
Budgetary Resources:
Financing authority:
Borrowing authority, mandatory:
1400
Borrowing authority
5
309
3
1422
Borrowing authority applied to repay debt
–1
1440
Borrowing authority, mandatory (total)
4
309
3
Spending authority from offsetting collections, mandatory:
1800
Collected
1
43
1801
Change in uncollected payments, Federal sources
2
167
1850
Spending auth from offsetting collections, mand (total)
3
210
1900
Financing authority (total)
7
519
3
1930
Total budgetary resources available
7
519
3
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
5
402
3010
Obligations incurred, unexpired accounts
7
519
3
3020
Financing disbursements (gross)
–2
–122
–3
3050
Unpaid obligations, end of year
5
402
402
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–2
–169
3070
Change in uncollected pymts, Fed sources, unexpired
–2
–167
3090
Uncollected pymts, Fed sources, end of year
–2
–169
–169
Memorandum (non-add) entries:
3100
Obligated balance, start of year
3
233
3200
Obligated balance, end of year
3
233
233
Financing authority and disbursements, net:
Mandatory:
4090
Financing authority, gross
7
519
3
Financing disbursements:
4110
Financing disbursements, gross
2
122
3
Offsets against gross financing authority and disbursements:
Offsetting collections (collected) from:
4120
Federal sources
–1
–43
Additional offsets against financing authority only (total):
4140
Change in uncollected pymts, Fed sources, unexpired
–2
–167
4160
Financing authority, net (mandatory)
4
309
3
4170
Financing disbursements, net (mandatory)
1
79
3
4180
Financing authority, net (total)
4
309
3
4190
Financing disbursements, net (total)
1
79
3
Status of Direct Loans (in millions of dollars)
Identification code 75–4482–0–3–551
2013 actual
2014 est.
2015 est.
Position with respect to appropriations act limitation on obligations:
1131
Direct loan obligations exempt from limitation
7
518
1150
Total direct loan obligations
7
518
Cumulative balance of direct loans outstanding:
1210
Outstanding, start of year
2
123
1231
Disbursements: Direct loan disbursements
2
121
1251
Repayments: Repayments and prepayments
1263
Write-offs for default: Direct loans
1290
Outstanding, end of year
2
123
123
As required by the Federal Credit Reform Act of 1990, this non-budgetary account records all cash flows to and from the federal
treasury resulting from direct loans obligated in 1992 and beyond (including modifications of direct loans that resulted from
obligations in any year). The amounts in this account are a means of financing only and are not included in the budget totals.
Balance Sheet (in millions of dollars)
Identification code 75–4482–0–3–551
2012 actual
2013 actual
ASSETS:
1401
Net value of assets related to post-1991 direct loans receivable: Direct loans receivable, gross
2
1999
Total assets
2
Trust Funds
Federal Hospital Insurance Trust Fund
Special and Trust Fund Receipts (in millions of dollars)
Identification code 75–8005–0–7–571
2013 actual
2014 est.
2015 est.
0100
Balance, start of year
203,744
179,985
163,016
Adjustments:
0190
Rounding adjustment
1
0199
Balance, start of year
203,745
179,985
163,016
Receipts:
0200
FHI Trust Fund, Transfers from General Fund (FICA Taxes)
192,707
200,501
211,795
0201
FHI Trust Fund, Transfers from General Fund (FICA Taxes)- legislative proposal subject to PAYGO
7
679
0202
FHI Trust Fund, Receipts from Railroad Retirement Board
547
556
568
0203
FHI Trust Fund, Transfers from General Fund (SECA Taxes)
16,016
18,406
18,683
0204
FHI Trust Fund, Civil Penalties and Damages
1,364
1,134
1,172
0220
FHI Trust Fund, Other Proprietary Interest from the Public
1
2
2
0221
FHI Trust Fund, Basic Premium, Medicare Advantage
260
246
232
0222
FHI Trust Fund, Basic Premium, Medicare Advantage- legislative proposal subject to PAYGO
–2
0223
FHI Trust Fund, Medicare Refunds
10,603
9,500
9,850
0224
FHI Trust Fund, Premiums Collected for Uninsured Individuals not Otherwise Eligible
3,397
3,520
3,499
0225
FHI Trust Fund, Premiums Collected for Uninsured Individuals not Otherwise Eligible- legislative proposal subject to PAYGO
–38
0240
FHI Trust Fund, Federal Employer Contributions (FICA)
3,582
3,440
3,446
0241
FHI Trust Fund, Postal Service Employer Contributions (FICA)
596
600
610
0242
FHI Trust Fund, Interest Received by Trust Funds
9,888
8,855
8,275
0243
FHI Trust Fund, Interest Received by Trust Funds- legislative proposal not subject to PAYGO
72
0244
FHI Trust Fund, Taxation on OASDI Benefits
14,310
18,114
20,956
0245
FHI Trust Fund, Payment from the General Fund for Health Care Fraud and Abuse Control Account
127
140
0246
FHI Trust Fund, Transfers from General Fund (criminal Fines)
708
1,141
1,156
0247
FHI Trust Fund, Transfers from General Fund (civil Monetary Penalties)
14
23
23
0248
FHI Trust Fund, Transfers from General Fund (asset Forfeitures)
30
27
28
0249
FHI Trust Fund, Interest Payments by Railroad Retirement Board
29
26
31
0250
FHI Trust Fund, Payments from the General Fund (uninsured and Program Management)
110
1,299
1,104
0299
Total receipts and collections
254,162
267,524
282,281
0400
Total: Balances and collections
457,907
447,509
445,297
Appropriations:
0500
Federal Hospital Insurance Trust Fund
–2,505
–2,565
–2,711
0501
Federal Hospital Insurance Trust Fund
132
0502
Federal Hospital Insurance Trust Fund
–250,116
–263,358
–278,237
0503
Federal Hospital Insurance Trust Fund
–23,960
–17,016
–3,174
0504
Federal Hospital Insurance Trust Fund
27
2
0505
Federal Hospital Insurance Trust Fund- legislative proposal not subject to PAYGO
480
0506
Federal Hospital Insurance Trust Fund- legislative proposal not subject to PAYGO
–480
0507
Federal Hospital Insurance Trust Fund- legislative proposal subject to PAYGO
–340
0508
Federal Hospital Insurance Trust Fund- legislative proposal subject to PAYGO
2,717
0509
Federal Hospital Insurance Trust Fund
6
0510
Federal Hospital Insurance Trust Fund
–6
0511
Health Care Fraud and Abuse Control Account
–310
–294
–319
0512
Health Care Fraud and Abuse Control Account
16
0513
Health Care Fraud and Abuse Control Account
–1,294
–1,313
–1,214
0514
Health Care Fraud and Abuse Control Account
34
51
0515
Health Care Fraud and Abuse Control Account- legislative proposal not subject to PAYGO
552
0516
Health Care Fraud and Abuse Control Account- legislative proposal subject to PAYGO
–378
0517
Health Care Fraud and Abuse Control Account
43
0599
Total appropriations
–277,976
–284,493
–283,061
0610
Federal Hospital Insurance Trust Fund
2
0620
Federal Hospital Insurance Trust Fund
52
0799
Balance, end of year
179,985
163,016
162,236
Program and Financing (in millions of dollars)
Identification code 75–8005–0–7–571
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Benefit payments, HI
269,780
272,604
279,185
0002
HIT Incentive Payments
3,366
6,213
1,436
0003
Administration, HI
2,904
2,730
2,860
0004
Quality improvement organizations, HI
459
1,319
580
0799
Total direct obligations
276,509
282,866
284,061
0801
Reimbursable program activity
439
0900
Total new obligations
276,948
282,866
284,061
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
71
1021
Recoveries of prior year unpaid obligations
141
1026
Adjustment for change in allocation of trust fund limitation or foreign exchange valuation
–52
1029
Other balances withdrawn
–2
1050
Unobligated balance (total)
87
71
Budget authority:
Appropriations, discretionary:
1101
Appropriation (special or trust fund)
2,505
2,565
2,711
1132
Appropriations temporarily reduced
–132
1160
Appropriation, discretionary (total)
2,373
2,565
2,711
Appropriations, mandatory:
1201
Appropriation (special or trust fund)
250,116
263,358
278,237
1203
Appropriation (previously unavailable)
23,960
17,016
3,174
1232
Appropriations and/or unobligated balance of appropriations temporarily reduced
–27
–2
1260
Appropriations, mandatory (total)
274,049
280,372
281,411
Spending authority from offsetting collections, mandatory:
1800
Collected
440
1801
Change in uncollected payments, Federal sources
–1
1850
Spending auth from offsetting collections, mand (total)
439
1900
Budget authority (total)
276,861
282,937
284,122
1930
Total budgetary resources available
276,948
282,937
284,193
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
71
132
Special and non-revolving trust funds:
1950
Other balances withdrawn and returned to unappropriated receipts
2
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
24,209
24,941
24,922
3010
Obligations incurred, unexpired accounts
276,948
282,866
284,061
3020
Outlays (gross)
–276,075
–282,885
–284,064
3040
Recoveries of prior year unpaid obligations, unexpired
–141
3050
Unpaid obligations, end of year
24,941
24,922
24,919
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–1
3070
Change in uncollected pymts, Fed sources, unexpired
1
Memorandum (non-add) entries:
3100
Obligated balance, start of year
24,208
24,941
24,922
3200
Obligated balance, end of year
24,941
24,922
24,919
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
2,373
2,565
2,711
Outlays, gross:
4010
Outlays from new discretionary authority
1,599
1,699
1,793
4011
Outlays from discretionary balances
857
747
831
4020
Outlays, gross (total)
2,456
2,446
2,624
Mandatory:
4090
Budget authority, gross
274,488
280,372
281,411
Outlays, gross:
4100
Outlays from new mandatory authority
273,031
253,958
254,032
4101
Outlays from mandatory balances
588
26,481
27,408
4110
Outlays, gross (total)
273,619
280,439
281,440
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123
Non-Federal sources
–440
Additional offsets against gross budget authority only:
4140
Change in uncollected pymts, Fed sources, unexpired
1
4160
Budget authority, net (mandatory)
274,049
280,372
281,411
4170
Outlays, net (mandatory)
273,179
280,439
281,440
4180
Budget authority, net (total)
276,422
282,937
284,122
4190
Outlays, net (total)
275,635
282,885
284,064
Memorandum (non-add) entries:
5000
Total investments, SOY: Federal securities: Par value
228,292
206,010
188,994
5001
Total investments, EOY: Federal securities: Par value
206,010
188,994
185,820
Summary of Budget Authority and Outlays (in millions of dollars)
2013 actual
2014 est.
2015 est.
Enacted/requested:
Budget Authority
276,422
282,937
284,122
Outlays
275,635
282,885
284,064
Legislative proposal, subject to PAYGO:
Budget Authority
–2,377
Outlays
–2,377
Total:
Budget Authority
276,422
282,937
281,745
Outlays
275,635
282,885
281,687
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. In addition, the Budget includes a package of proposals that improve Medicare's
sustainability by promoting high-quality, efficient care; aligning payments with the costs of providing care; encouraging
beneficiaries to seek high-value services; and reducing the Federal subsidy of Medicare costs for those beneficiaries who
can most afford them.
Status of Funds (in millions of dollars)
Identification code 75–8005–0–7–571
2013 actual
2014 est.
2015 est.
Unexpended balance, start of year:
0100
Balance, start of year
229,337
206,314
189,256
Adjustments:
0190
Rounding adjustment
2
0199
Total balance, start of year
229,340
206,314
189,256
Cash income during the year:
Current law:
Receipts:
1200
FHI Trust Fund, Transfers from General Fund (FICA Taxes)
192,707
200,501
211,795
1202
FHI Trust Fund, Receipts from Railroad Retirement Board
547
556
568
1203
FHI Trust Fund, Transfers from General Fund (SECA Taxes)
16,016
18,406
18,683
1204
FHI Trust Fund, Civil Penalties and Damages
1,364
1,134
1,172
Offsetting receipts (proprietary):
1220
FHI Trust Fund, Other Proprietary Interest from the Public
1
2
2
1221
FHI Trust Fund, Basic Premium, Medicare Advantage
260
246
232
1223
FHI Trust Fund, Medicare Refunds
10,603
9,500
9,850
1224
FHI Trust Fund, Premiums Collected for Uninsured Individuals not Otherwise Eligible
3,397
3,520
3,499
Offsetting receipts (intragovernmental):
1240
FHI Trust Fund, Federal Employer Contributions (FICA)
3,582
3,440
3,446
1241
FHI Trust Fund, Postal Service Employer Contributions (FICA)
596
600
610
1242
FHI Trust Fund, Interest Received by Trust Funds
9,888
8,855
8,275
1244
FHI Trust Fund, Taxation on OASDI Benefits
14,310
18,114
20,956
1245
FHI Trust Fund, Payment from the General Fund for Health Care Fraud and Abuse Control Account
127
140
1246
FHI Trust Fund, Transfers from General Fund (criminal Fines)
708
1,141
1,156
1247
FHI Trust Fund, Transfers from General Fund (civil Monetary Penalties)
14
23
23
1248
FHI Trust Fund, Transfers from General Fund (asset Forfeitures)
30
27
28
1249
FHI Trust Fund, Interest Payments by Railroad Retirement Board
29
26
31
1250
FHI Trust Fund, Payments from the General Fund (uninsured and Program Management)
110
1,299
1,104
Offsetting collections:
1280
Federal Hospital Insurance Trust Fund
440
1299
Income under present law
254,602
267,517
281,570
Proposed legislation:
Receipts:
2201
FHI Trust Fund, Transfers from General Fund (FICA Taxes)
7
679
Offsetting receipts (proprietary receipts):
2222
FHI Trust Fund, Basic Premium, Medicare Advantage
–2
2225
FHI Trust Fund, Premiums Collected for Uninsured Individuals not Otherwise Eligible
–38
Offsetting receipts (intragovernmental):
2243
FHI Trust Fund, Interest Received by Trust Funds
72
2299
Income under proposed legislation
7
711
3299
Total cash income
254,602
267,524
282,281
Cash outgo during year:
Current law:
4500
Federal Hospital Insurance Trust Fund
–276,075
–282,885
–284,064
4500
Health Care Fraud and Abuse Control Account
43
4500
Health Care Fraud and Abuse Control Account
–1,555
–1,697
–1,576
4599
Outgo under current law (-)
–277,630
–284,582
–285,597
Proposed legislation:
5500
Federal Hospital Insurance Trust Fund
2,377
5500
Health Care Fraud and Abuse Control Account
–378
5500
Health Care Fraud and Abuse Control Account
552
5599
Outgo under proposed legislation (-)
2,551
6599
Total cash outgo (-)
–277,630
–284,582
–283,046
Manual Adjustments:
7690
Rounding adjustment
2
7699
Total adjustments
2
Unexpended balance, end of year:
8700
Uninvested balance (net), end of year
304
262
2,671
8701
Federal Hospital Insurance Trust Fund
206,010
188,994
185,820
8799
Total balance, end of year
206,314
189,256
188,491
Object Classification (in millions of dollars)
Identification code 75–8005–0–7–571
2013 actual
2014 est.
2015 est.
Direct obligations:
41.0
Payment for Quality Improvement Organization (QIO) activities
459
1,319
580
42.0
Insurance claims and indemnities (benefits)
273,146
272,604
279,185
94.0
Financial transfers
2,904
8,943
4,296
99.0
Direct obligations
276,509
282,866
284,061
42.0
Allocation Account - reimbursable: Insurance claims and indemnities
439
99.9
Total new obligations
276,948
282,866
284,061
Federal Hospital Insurance Trust Fund
(Amounts included in the adjusted baseline)
Program and Financing (in millions of dollars)
Identification code 75–8005–7–7–571
2013 actual
2014 est.
2015 est.
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1201
Appropriation (special or trust fund)
–6
1203
Appropriation (previously unavailable)
6
Federal Hospital Insurance Trust Fund
(Legislative proposal, not subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 75–8005–2–7–571
2013 actual
2014 est.
2015 est.
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1201
Appropriation (special or trust fund)
–480
1203
Appropriation (previously unavailable)
480
Federal Hospital Insurance Trust Fund
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 75–8005–4–7–571
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Benefit payments, HI
–2,392
0003
Administration, HI
15
0900
Total new obligations
–2,377
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1201
Appropriation (special or trust fund)
340
1232
Appropriations and/or unobligated balance of appropriations temporarily reduced
–2,717
1260
Appropriations, mandatory (total)
–2,377
1900
Budget authority (total)
–2,377
1930
Total budgetary resources available
–2,377
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
–2,377
3020
Outlays (gross)
2,377
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
–2,377
Outlays, gross:
4100
Outlays from new mandatory authority
–2,377
4180
Budget authority, net (total)
–2,377
4190
Outlays, net (total)
–2,377
Object Classification (in millions of dollars)
Identification code 75–8005–4–7–571
2013 actual
2014 est.
2015 est.
Direct obligations:
42.0
Insurance claims and indemnities (benefits)
–2,392
94.0
Financial transfers
15
99.9
Total new obligations
–2,377
Health Care Fraud and Abuse Control Account
In addition to amounts otherwise available for program integrity and program management, [$293,588,000] $318,588,000, to remain available through September 30, [2015] 2016, to be transferred from the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund,
as authorized by section 201(g) of the Social Security Act, of which [$207,636,000] $262,344,000 shall be for [the Medicare Integrity Program at the Centers for Medicare and Medicaid Services, including administrative costs, to conduct
oversight activities for Medicare Advantage under Part C and the Medicare Prescription Drug Program under Part D of the Social
Security Act and for activities described in section 1893(b) of such Act,] Centers for Medicare and Medicaid Services program integrity activities; of which [$28,122,000] $28,122,000 shall be for the Department of Health and Human Services Office of Inspector General to carry out fraud and abuse activities
authorized by section 1817(k)(3) of such Act[, of which $29,708,000 shall be for the Medicaid and Children's Health Insurance Program ("CHIP'') program integrity activities,]; and of which [$28,122,000] $28,122,000 shall be for the Department of Justice to carry out fraud and abuse activities authorized by section 1817(k)(3) of such Act:
Provided, That the report required by section 1817(k)(5) of the Social Security Act for fiscal year [2014] 2015 shall include measures of the operational efficiency and impact on fraud, waste, and abuse in the Medicare, Medicaid, and
CHIP programs for the funds provided by this appropriation. (Department of Health and Human Services Appropriations Act, 2014.)
Program and Financing (in millions of dollars)
Identification code 75–8393–0–7–571
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Medicare integrity program
815
858
882
0002
FBI fraud and abuse control
132
127
139
0003
Other fraud and abuse control
296
278
301
0004
Predictive Modeling
22
11
0005
Undistributed SSA savings
–19
–108
0091
Total Mandatory
1,265
1,255
1,214
0101
CMS discretionary
284
238
262
0102
Other discretionary
84
56
56
0191
Total Discretionary
368
294
318
0900
Total new obligations
1,633
1,549
1,532
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
186
166
173
1001
Discretionary unobligated balance brought fwd, Oct 1
55
1021
Recoveries of prior year unpaid obligations
64
1050
Unobligated balance (total)
250
166
173
Budget authority:
Appropriations, discretionary:
1101
Appropriation (special or trust fund)
310
294
319
1132
Appropriations temporarily reduced
–16
1160
Appropriation, discretionary (total)
294
294
319
Appropriations, mandatory:
1201
Appropriation (special or trust fund)
1,294
1,313
1,214
1232
Appropriations and/or unobligated balance of appropriations temporarily reduced
–34
–51
1260
Appropriations, mandatory (total)
1,260
1,262
1,214
1900
Budget authority (total)
1,554
1,556
1,533
1930
Total budgetary resources available
1,804
1,722
1,706
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–5
1941
Unexpired unobligated balance, end of year
166
173
174
Special and non-revolving trust funds:
1951
Unobligated balance expiring
5
1952
Expired unobligated balance, start of year
44
36
44
1953
Expired unobligated balance, end of year
31
44
44
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
1,157
1,155
1,007
3010
Obligations incurred, unexpired accounts
1,633
1,549
1,532
3020
Outlays (gross)
–1,555
–1,697
–1,576
3040
Recoveries of prior year unpaid obligations, unexpired
–64
3041
Recoveries of prior year unpaid obligations, expired
–16
3050
Unpaid obligations, end of year
1,155
1,007
963
Memorandum (non-add) entries:
3100
Obligated balance, start of year
1,157
1,155
1,007
3200
Obligated balance, end of year
1,155
1,007
963
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
294
294
319
Outlays, gross:
4010
Outlays from new discretionary authority
106
294
319
4011
Outlays from discretionary balances
247
4020
Outlays, gross (total)
353
294
319
Mandatory:
4090
Budget authority, gross
1,260
1,262
1,214
Outlays, gross:
4100
Outlays from new mandatory authority
402
899
800
4101
Outlays from mandatory balances
800
504
457
4110
Outlays, gross (total)
1,202
1,403
1,257
4180
Budget authority, net (total)
1,554
1,556
1,533
4190
Outlays, net (total)
1,555
1,697
1,576
Summary of Budget Authority and Outlays (in millions of dollars)
2013 actual
2014 est.
2015 est.
Enacted/requested:
Budget Authority
1,554
1,556
1,533
Outlays
1,555
1,697
1,576
Amounts included in the adjusted baseline:
Budget Authority
–43
Outlays
–43
Legislative proposal, not subject to PAYGO:
Budget Authority
–552
Outlays
–552
Legislative proposal, subject to PAYGO:
Budget Authority
378
Outlays
378
Total:
Budget Authority
1,554
1,556
1,316
Outlays
1,555
1,697
1,359
The Health Insurance Portability and Accountability Act of 1996 (P.L. 104–191) established the Health Care Fraud and Abuse
Control (HCFAC) account within the Federal Hospital Insurance Trust Fund and appropriated funds 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.
The Budget includes a discretionary request for efforts to safeguard Centers for Medicare and Medicaid Services (CMS) program
integrity that will supplement other CMS program integrity funds. See additional discussion in the Budget Process chapter
in the Analytical Perspectives volume.
Object Classification (in millions of dollars)
Identification code 75–8393–0–7–571
2013 actual
2014 est.
2015 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent (CMS)
37
45
51
12.1
Civilian personnel benefits (CMS)
10
13
13
23.3
Communications, utilities, and miscellaneous charges
9
12
13
25.1
Advisory and assistance services (predictive modeling)
22
11
25.2
Other services (CMS/Medicaid)
40
28
28
25.3
Other purchases of goods and services from Government accounts (HHS/DOJ)
107
86
90
25.3
Other purchases of goods and services from Government accounts (HHS/OIG)
234
213
228
25.3
Other purchases of goods and services from Government accounts (HHS/AoA)
11
10
11
25.3
Other purchases of goods and services from Government accounts (HHS/OGC)
9
9
9
25.3
Other goods and services from Federal sources (HHS/CMS)
15
13
15
25.3
Other goods and services from Government accounts (HHS/FDA)
5
3
3
25.6
Medical care (CMS)
1,001
998
1,040
92.0
Undistributed
–19
–108
94.0
Financial transfers (FBI)
133
127
139
99.9
Total new obligations
1,633
1,549
1,532
Employment Summary
Identification code 75–8393–0–7–571
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
358
442
465
Health Care Fraud and Abuse Control Account
(Amounts included in the adjusted baseline)
Program and Financing (in millions of dollars)
Identification code 75–8393–7–7–571
2013 actual
2014 est.
2015 est.
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1201
Appropriation (special or trust fund)
–43
1260
Appropriations, mandatory (total)
–43
1900
Budget authority (total)
–43
1930
Total budgetary resources available
–43
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
–43
Change in obligated balance:
Unpaid obligations:
3020
Outlays (gross)
43
3050
Unpaid obligations, end of year
43
Memorandum (non-add) entries:
3200
Obligated balance, end of year
43
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
–43
Outlays, gross:
4100
Outlays from new mandatory authority
–43
4180
Budget authority, net (total)
–43
4190
Outlays, net (total)
–43
Health Care Fraud and Abuse Control Account
(Legislative proposal, not subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 75–8393–2–7–571
2013 actual
2014 est.
2015 est.
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1201
Appropriation (special or trust fund)
–552
1260
Appropriations, mandatory (total)
–552
1930
Total budgetary resources available
–552
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
–552
Change in obligated balance:
Unpaid obligations:
3020
Outlays (gross)
552
3050
Unpaid obligations, end of year
552
Memorandum (non-add) entries:
3200
Obligated balance, end of year
552
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
–552
Outlays, gross:
4100
Outlays from new mandatory authority
–552
4180
Budget authority, net (total)
–552
4190
Outlays, net (total)
–552
The mandatory proposal included in the Budget is estimated to achieve additional savings.
Health Care Fraud and Abuse Control Account
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 75–8393–4–7–571
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
CMS program integrity
214
0002
Other program integrity
164
0900
Total new obligations
378
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1201
Appropriation (special or trust fund)
378
1260
Appropriations, mandatory (total)
378
1930
Total budgetary resources available
378
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
378
3020
Outlays (gross)
–378
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
378
Outlays, gross:
4100
Outlays from new mandatory authority
378
4180
Budget authority, net (total)
378
4190
Outlays, net (total)
378
For FY 2015, the Budget proposes $378 million in mandatory funds for the Health Care Fraud and Abuse Control program and proposes
$319 million through discretionary appropriations. After 2015, no discretionary funding is being proposed for this purpose.
In addition, an annual reduction to the discretionary spending limits in section 251(c) of the BBEDCA, as amended, is proposed
beginning in 2016 to offset the cost of shifting the FY 2014 enacted portion of the base funding from discretionary to mandatory.
The more stable mandatory program integrity funding will produce new net deficit savings of over $2 billion over 10 years.
Object Classification (in millions of dollars)
Identification code 75–8393–4–7–571
2013 actual
2014 est.
2015 est.
Direct obligations:
25.2
Other services (CMS/Medicaid)
15
25.3
Other purchases of goods and services from Government accounts (HHS/DOJ)
80
25.3
Other purchases of goods and services from Government accounts (HHS/OIG)
85
25.6
Medical care (CMS)
198
99.9
Total new obligations
378
Federal Supplementary Medical Insurance Trust Fund
Special and Trust Fund Receipts (in millions of dollars)
Identification code 75–8004–0–7–571
2013 actual
2014 est.
2015 est.
0100
Balance, start of year
41,270
37,018
42,384
Receipts:
0200
Fee on Branded Prescription Pharmaceutical Manufacturers and Importers, SMI
3,216
2,960
3,000
0220
Other Proprietary Interest from the Public, FSMI Fund
4
3
3
0221
Premiums Collected for Medicare Prescription Drug Account, FSMI
3,224
3,633
4,270
0222
Premiums Collected for Medicare Prescription Drug Account, FSMI- legislative proposal subject to PAYGO
–110
0223
Payments from States, Medicare Prescription Drug Account, FSMI
8,666
8,748
8,795
0224
Payments from States, Medicare Prescription Drug Account, FSMI- legislative proposal subject to PAYGO
–80
0225
Basic Premium, Medicare Advantage, FSMI Trust Fund
246
259
265
0226
Medicare Refunds, SMI
5,248
4,400
4,500
0227
Premiums Collected for the Aged, FSMI Fund
51,679
55,123
57,302
0228
Premiums Collected for the Aged, FSMI Fund- legislative proposal subject to PAYGO
–203
0229
Premiums Collected for the Disabled, FSMI Fund
10,091
10,094
10,285
0230
Premiums Collected for the Disabled, FSMI Fund- legislative proposal subject to PAYGO
–37
0240
Federal Contributions, FSMI Fund
176,940
192,491
194,343
0241
Federal Contributions, FSMI Fund- legislative proposal not subject to PAYGO
–700
0242
Federal Contributions, FSMI Fund
–60
0243
Interest Received by Trust Fund, FSMI Fund
2,511
2,786
3,274
0244
Interest Received by Trust Fund, FSMI Fund- legislative proposal not subject to PAYGO
–2
0245
Interest Received by Trust Fund, FSMI Fund
–34
–319
0246
Federal Contribution, State Low-income Determinations, Prescription Drug Account, FSMI
6
0247
Interest, Medicare Prescription Drug Account, FSMI
7
8
10
0248
Federal Contribution for Admin. Contribution for Admin. Costs, Prescription Drug Account, FSMI
367
373
418
0249
Federal Contributions for Benefits, Prescription Drug Account, SMI
49,900
54,599
63,342
0250
Federal Contributions for Benefits, Prescription Drug Account, SMI- legislative proposal not subject to PAYGO
–481
0251
Miscellaneous Federal Payments, Federal Supplementary Medical Insurance Trust Fund
1
1
1
0299
Total receipts and collections
312,100
335,442
347,824
0400
Total: Balances and collections
353,370
372,460
390,208
Appropriations:
0500
Federal Supplementary Medical Insurance Trust Fund
–3,150
–3,007
–3,147
0501
Federal Supplementary Medical Insurance Trust Fund
162
0502
Federal Supplementary Medical Insurance Trust Fund
–242,531
–264,896
–269,917
0503
Federal Supplementary Medical Insurance Trust Fund
–6,793
0504
Federal Supplementary Medical Insurance Trust Fund
7
1
0505
Federal Supplementary Medical Insurance Trust Fund
11,949
14,722
0506
Federal Supplementary Medical Insurance Trust Fund- legislative proposal not subject to PAYGO
1,181
0507
Federal Supplementary Medical Insurance Trust Fund- legislative proposal not subject to PAYGO
–365
–1,941
0508
Federal Supplementary Medical Insurance Trust Fund- legislative proposal subject to PAYGO
1,101
0509
Federal Supplementary Medical Insurance Trust Fund- legislative proposal subject to PAYGO
–176
0510
Federal Supplementary Medical Insurance Trust Fund
34
379
0511
Federal Supplementary Medical Insurance Trust Fund
–6,214
–14,036
0512
Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund
–348
–334
–344
0513
Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund
20
0514
Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund
–63,698
–67,244
–76,406
0515
Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund- legislative proposal subject to PAYGO
671
0599
Total appropriations
–316,331
–330,076
–347,913
0610
Federal Supplementary Medical Insurance Trust Fund
1
0620
Federal Supplementary Medical Insurance Trust Fund
–22
0799
Balance, end of year
37,018
42,384
42,295
Program and Financing (in millions of dollars)
Identification code 75–8004–0–7–571
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Benefit payments, SMI
245,396
248,693
254,328
0002
Transfer to Medicaid for payment of SMI premiums
477
390
0003
HIT Incentive Payments
3,656
3,450
640
0004
Administration, SMI
2,880
3,090
3,229
0005
Quality Improvement Organizations, SMI
14
330
145
0799
Total direct obligations
252,423
255,953
258,342
0801
Reimbursable program activity
11
0900
Total new obligations
252,434
255,953
258,342
Budgetary Resources:
Unobligated balance:
1021
Recoveries of prior year unpaid obligations
97
1026
Adjustment for change in allocation of trust fund limitation or foreign exchange valuation
22
1029
Other balances withdrawn
–1
1050
Unobligated balance (total)
118
Budget authority:
Appropriations, discretionary:
1101
Appropriation (special or trust fund)
3,150
3,007
3,147
1132
Appropriations temporarily reduced
–162
1160
Appropriation, discretionary (total)
2,988
3,007
3,147
Appropriations, mandatory:
1201
Appropriation (special or trust fund)
242,531
264,896
269,917
1203
Appropriation (previously unavailable)
6,793
1232
Appropriations and/or unobligated balance of appropriations temporarily reduced
–7
–1
1234
Appropriations precluded from obligation
–11,949
–14,722
1260
Appropriations, mandatory (total)
249,317
252,946
255,195
Spending authority from offsetting collections, mandatory:
1800
Collected
11
1850
Spending auth from offsetting collections, mand (total)
11
1900
Budget authority (total)
252,316
255,953
258,342
1930
Total budgetary resources available
252,434
255,953
258,342
Memorandum (non-add) entries:
Special and non-revolving trust funds:
1950
Other balances withdrawn and returned to unappropriated receipts
1
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
24,404
24,692
24,835
3010
Obligations incurred, unexpired accounts
252,434
255,953
258,342
3020
Outlays (gross)
–252,049
–255,810
–258,223
3040
Recoveries of prior year unpaid obligations, unexpired
–97
3050
Unpaid obligations, end of year
24,692
24,835
24,954
Memorandum (non-add) entries:
3100
Obligated balance, start of year
24,404
24,692
24,835
3200
Obligated balance, end of year
24,692
24,835
24,954
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
2,988
3,007
3,147
Outlays, gross:
4010
Outlays from new discretionary authority
1,666
1,643
1,710
4011
Outlays from discretionary balances
1,177
1,158
1,299
4020
Outlays, gross (total)
2,843
2,801
3,009
Mandatory:
4090
Budget authority, gross
249,328
252,946
255,195
Outlays, gross:
4100
Outlays from new mandatory authority
248,293
231,056
230,102
4101
Outlays from mandatory balances
913
21,953
25,112
4110
Outlays, gross (total)
249,206
253,009
255,214
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123
Non-Federal sources
–11
4180
Budget authority, net (total)
252,305
255,953
258,342
4190
Outlays, net (total)
252,038
255,810
258,223
Memorandum (non-add) entries:
5000
Total investments, SOY: Federal securities: Par value
69,324
67,385
72,639
5001
Total investments, EOY: Federal securities: Par value
67,385
72,639
72,738
Summary of Budget Authority and Outlays (in millions of dollars)
2013 actual
2014 est.
2015 est.
Enacted/requested:
Budget Authority
252,305
255,953
258,342
Outlays
252,038
255,810
258,223
Amounts included in the adjusted baseline:
Budget Authority
6,180
13,657
Outlays
6,180
13,657
Legislative proposal, not subject to PAYGO:
Budget Authority
365
760
Outlays
365
760
Legislative proposal, subject to PAYGO:
Budget Authority
–925
Outlays
–925
Total:
Budget Authority
252,305
262,498
271,834
Outlays
252,038
262,355
271,715
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 generally financed by premium payments from enrollees and contributions from the general revenues.
The status of the trust fund is as follows. In addition, the Budget includes a package of proposals that improve Medicare's
sustainability by promoting high-quality, efficient care; aligning payments with the costs of providing care; encouraging
beneficiaries to seek high-value services; and reducing the Federal subsidy of Medicare costs for those who need the subsidy
the least.
Status of Funds (in millions of dollars)
Identification code 75–8004–0–7–571
2013 actual
2014 est.
2015 est.
Unexpended balance, start of year:
0100
Balance, start of year
71,728
69,818
75,309
Adjustments:
0191
Rounding adjustment
2
0199
Total balance, start of year
71,730
69,818
75,309
Cash income during the year:
Current law:
Receipts:
1200
Fee on Branded Prescription Pharmaceutical Manufacturers and Importers, SMI
3,216
2,960
3,000
Offsetting receipts (proprietary):
1220
Other Proprietary Interest from the Public, FSMI Fund
4
3
3
1221
Premiums Collected for Medicare Prescription Drug Account, FSMI
3,224
3,633
4,270
1223
Payments from States, Medicare Prescription Drug Account, FSMI
8,666
8,748
8,795
1225
Basic Premium, Medicare Advantage, FSMI Trust Fund
246
259
265
1226
Medicare Refunds, SMI
5,248
4,400
4,500
1227
Premiums Collected for the Aged, FSMI Fund
51,679
55,123
57,302
1229
Premiums Collected for the Disabled, FSMI Fund
10,091
10,094
10,285
Offsetting receipts (intragovernmental):
1240
Federal Contributions, FSMI Fund
176,940
192,491
194,343
1242
Federal Contributions, FSMI Fund
–60
1243
Interest Received by Trust Fund, FSMI Fund
2,511
2,786
3,274
1245
Interest Received by Trust Fund, FSMI Fund
–34
–319
1246
Federal Contribution, State Low-income Determinations, Prescription Drug Account, FSMI
6
1247
Interest, Medicare Prescription Drug Account, FSMI
7
8
10
1248
Federal Contribution for Admin. Contribution for Admin. Costs, Prescription Drug Account, FSMI
367
373
418
1249
Federal Contributions for Benefits, Prescription Drug Account, SMI
49,900
54,599
63,342
1251
Miscellaneous Federal Payments, Federal Supplementary Medical Insurance Trust Fund
1
1
1
Offsetting collections:
1280
Federal Supplementary Medical Insurance Trust Fund
11
1281
Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund
3,160
1299
Income under present law
315,271
335,444
349,435
Proposed legislation:
Offsetting receipts (proprietary receipts):
2222
Premiums Collected for Medicare Prescription Drug Account, FSMI
–110
2224
Payments from States, Medicare Prescription Drug Account, FSMI
–80
2228
Premiums Collected for the Aged, FSMI Fund
–203
2230
Premiums Collected for the Disabled, FSMI Fund
–37
Offsetting receipts (intragovernmental):
2241
Federal Contributions, FSMI Fund
–700
2244
Interest Received by Trust Fund, FSMI Fund
–2
2250
Federal Contributions for Benefits, Prescription Drug Account, SMI
–481
2299
Income under proposed legislation
–2
–1,611
3299
Total cash income
315,271
335,442
347,824
Cash outgo during year:
Current law:
4500
Federal Supplementary Medical Insurance Trust Fund
–252,049
–255,810
–258,223
4500
Federal Supplementary Medical Insurance Trust Fund
–6,180
–13,657
4500
Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund
–65,133
–67,596
–76,748
4599
Outgo under current law (-)
–317,182
–329,586
–348,628
Proposed legislation:
5500
Federal Supplementary Medical Insurance Trust Fund
925
5500
Federal Supplementary Medical Insurance Trust Fund
–365
–760
5500
Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund
671
5599
Outgo under proposed legislation (-)
–365
836
6599
Total cash outgo (-)
–317,182
–329,951
–347,792
Manual Adjustments:
7690
Cash reconciliation adjustment
–1
7699
Total adjustments
–1
Unexpended balance, end of year:
8700
Uninvested balance (net), end of year
2,433
2,670
2,603
8701
Federal Supplementary Medical Insurance Trust Fund
67,385
72,639
72,738
8799
Total balance, end of year
69,818
75,309
75,341
Object Classification (in millions of dollars)
Identification code 75–8004–0–7–571
2013 actual
2014 est.
2015 est.
Direct obligations:
41.0
Payment for Quality Improvement Organization (QIO) activity
14
330
145
42.0
Insurance claims and indemnities
249,529
252,533
254,968
94.0
Financial transfers
2,880
3,090
3,229
99.0
Direct obligations
252,423
255,953
258,342
42.0
Allocation Account - reimbursable: Insurance claims and indemnities
11
99.9
Total new obligations
252,434
255,953
258,342
Federal Supplementary Medical Insurance Trust Fund
(Amounts included in the adjusted baseline)
Program and Financing (in millions of dollars)
Identification code 75–8004–7–7–571
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Benefits
6,180
13,657
0900
Total new obligations (object class 42.0)
6,180
13,657
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1201
Appropriation (special or trust fund)
–34
–379
1234
Appropriations precluded from obligation
6,214
14,036
1260
Appropriations, mandatory (total)
6,180
13,657
1900
Budget authority (total)
6,180
13,657
1930
Total budgetary resources available
6,180
13,657
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
6,180
13,657
3020
Outlays (gross)
–6,180
–13,657
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
6,180
13,657
Outlays, gross:
4100
Outlays from new mandatory authority
6,180
13,657
4180
Budget authority, net (total)
6,180
13,657
4190
Outlays, net (total)
6,180
13,657
Federal Supplementary Medical Insurance Trust Fund
(Legislative proposal, not subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 75–8004–2–7–571
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0002
Transfer to Medicaid for payment of SMI premiums
365
760
0900
Total new obligations (object class 42.0)
365
760
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1201
Appropriation (special or trust fund)
–1,181
1234
Appropriations precluded from obligation
365
1,941
1260
Appropriations, mandatory (total)
365
760
1900
Budget authority (total)
365
760
1930
Total budgetary resources available
365
760
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
365
760
3020
Outlays (gross)
–365
–760
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
365
760
Outlays, gross:
4100
Outlays from new mandatory authority
365
760
4180
Budget authority, net (total)
365
760
4190
Outlays, net (total)
365
760
Federal Supplementary Medical Insurance Trust Fund
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 75–8004–4–7–571
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Benefit payments, SMI
–940
0004
Administration, SMI
15
0900
Total new obligations
–925
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1201
Appropriation (special or trust fund)
–1,101
1234
Appropriations precluded from obligation
176
1260
Appropriations, mandatory (total)
–925
1900
Budget authority (total)
–925
1930
Total budgetary resources available
–925
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
–925
3020
Outlays (gross)
925
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
–925
Outlays, gross:
4100
Outlays from new mandatory authority
–925
4180
Budget authority, net (total)
–925
4190
Outlays, net (total)
–925
Object Classification (in millions of dollars)
Identification code 75–8004–4–7–571
2013 actual
2014 est.
2015 est.
Direct obligations:
42.0
Insurance claims and indemnities
–940
94.0
Financial transfers
15
99.9
Total new obligations
–925
Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund
Program and Financing (in millions of dollars)
Identification code 75–8308–0–7–571
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Prescription Drug Benefits
69,358
67,239
76,396
0002
Administrative Costs
312
339
354
0900
Total new obligations
69,670
67,578
76,750
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
1
1021
Recoveries of prior year unpaid obligations
2,555
1050
Unobligated balance (total)
2,555
1
Budget authority:
Appropriations, discretionary:
1101
Appropriation (special or trust fund)
348
334
344
1132
Appropriations temporarily reduced
–20
1160
Appropriation, discretionary (total)
328
334
344
Appropriations, mandatory:
1201
Appropriation (special or trust fund)
63,698
67,244
76,406
1260
Appropriations, mandatory (total)
63,698
67,244
76,406
Spending authority from offsetting collections, mandatory:
1800
Collected
3,160
1850
Spending auth from offsetting collections, mand (total)
3,160
1900
Budget authority (total)
67,186
67,578
76,750
1930
Total budgetary resources available
69,741
67,579
76,750
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–70
–1
1941
Unexpired unobligated balance, end of year
1
Special and non-revolving trust funds:
1951
Unobligated balance expiring
70
1
1952
Expired unobligated balance, start of year
599
439
450
1953
Expired unobligated balance, end of year
369
449
449
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
5,607
7,397
7,379
3010
Obligations incurred, unexpired accounts
69,670
67,578
76,750
3011
Obligations incurred, expired accounts
77
3020
Outlays (gross)
–65,133
–67,596
–76,748
3040
Recoveries of prior year unpaid obligations, unexpired
–2,555
3041
Recoveries of prior year unpaid obligations, expired
–269
3050
Unpaid obligations, end of year
7,397
7,379
7,381
Memorandum (non-add) entries:
3100
Obligated balance, start of year
5,607
7,397
7,379
3200
Obligated balance, end of year
7,397
7,379
7,381
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
328
334
344
Outlays, gross:
4010
Outlays from new discretionary authority
210
232
241
4011
Outlays from discretionary balances
155
88
98
4020
Outlays, gross (total)
365
320
339
Mandatory:
4090
Budget authority, gross
66,858
67,244
76,406
Outlays, gross:
4100
Outlays from new mandatory authority
59,477
60,503
72,005
4101
Outlays from mandatory balances
5,291
6,773
4,404
4110
Outlays, gross (total)
64,768
67,276
76,409
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120
Federal sources
–3,160
4180
Budget authority, net (total)
64,026
67,578
76,750
4190
Outlays, net (total)
61,973
67,596
76,748
Summary of Budget Authority and Outlays (in millions of dollars)
2013 actual
2014 est.
2015 est.
Enacted/requested:
Budget Authority
64,026
67,578
76,750
Outlays
61,973
67,596
76,748
Legislative proposal, subject to PAYGO:
Budget Authority
–671
Outlays
–671
Total:
Budget Authority
64,026
67,578
76,079
Outlays
61,973
67,596
76,077
Since January 2006, Medicare beneficiaries have had the opportunity to enroll in a comprehensive voluntary prescription drug
benefit. The Budget includes a package of proposals that slow the growth of Part D net expenditures.
Object Classification (in millions of dollars)
Identification code 75–8308–0–7–571
2013 actual
2014 est.
2015 est.
Direct obligations:
25.2
Other services from non-Federal sources
312
339
354
42.0
Insurance claims and indemnities
69,358
67,239
76,396
99.9
Total new obligations
69,670
67,578
76,750
Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 75–8308–4–7–571
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Prescription Drug Benefits
–671
0900
Total new obligations (object class 42.0)
–671
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1201
Appropriation (special or trust fund)
–671
1260
Appropriations, mandatory (total)
–671
1900
Budget authority (total)
–671
1930
Total budgetary resources available
–671
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
–671
3020
Outlays (gross)
671
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
–671
Outlays, gross:
4100
Outlays from new mandatory authority
–671
4180
Budget authority, net (total)
–671
4190
Outlays, net (total)
–671
Allocations Received from Other Accounts
Note.—Obligations incurred under allocations from other accounts are included in the schedule of the parent appropriation
as in the following example: Centers for Medicare and Medicaid Services "Health Care Fraud and Abuse Control Account."
Administration for Children and Families
Federal Funds
Temporary Assistance for Needy Families
Program and Financing (in millions of dollars)
Identification code 75–1552–0–1–609
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
State family assistance grant
16,488
16,486
16,486
0002
Territories - family assistance grants
78
78
78
0006
Tribal work programs
8
8
8
0009
Healthy marriage and responsible fatherhood grants
148
148
150
0900
Total new obligations
16,722
16,720
16,722
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
1
3
Budget authority:
Appropriations, mandatory:
1200
Appropriation
16,739
16,737
16,739
1220
Appropriations transferred to other accts [75–1552]
–36
1221
Appropriations transferred from other accts [75–1552]
36
1230
Appropriations and/or unobligated balance of appropriations permanently reduced
–1
1260
Appropriations, mandatory (total)
16,738
16,737
16,739
1930
Total budgetary resources available
16,738
16,738
16,742
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–15
–15
–15
1941
Unexpired unobligated balance, end of year
1
3
5
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
5,180
4,795
4,690
3010
Obligations incurred, unexpired accounts
16,722
16,720
16,722
3020
Outlays (gross)
–17,107
–16,825
–16,805
3050
Unpaid obligations, end of year
4,795
4,690
4,607
Memorandum (non-add) entries:
3100
Obligated balance, start of year
5,180
4,795
4,690
3200
Obligated balance, end of year
4,795
4,690
4,607
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
16,738
16,737
16,739
Outlays, gross:
4100
Outlays from new mandatory authority
13,557
13,376
13,378
4101
Outlays from mandatory balances
3,550
3,449
3,427
4110
Outlays, gross (total)
17,107
16,825
16,805
4180
Budget authority, net (total)
16,738
16,737
16,739
4190
Outlays, net (total)
17,107
16,825
16,805
Summary of Budget Authority and Outlays (in millions of dollars)
2013 actual
2014 est.
2015 est.
Enacted/requested:
Budget Authority
16,738
16,737
16,739
Outlays
17,107
16,825
16,805
Legislative proposal, subject to PAYGO:
Budget Authority
10
Outlays
8
Total:
Budget Authority
16,738
16,737
16,749
Outlays
17,107
16,825
16,813
This account provides funding for the Temporary Assistance for Needy Families block grant and related activities authorized
by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (P.L. 104–193), as amended by the Deficit Reduction
Act of 2005 (P.L. 109–171). Since 2010, this account has been temporarily reauthorized by a series of Acts, most recently
in the Consolidated Appropriations Act, 2014 (P.L. 113–76).
Object Classification (in millions of dollars)
Identification code 75–1552–0–1–609
2013 actual
2014 est.
2015 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent
1
1
1
12.1
Civilian personnel benefits
1
1
1
25.1
Advisory and assistance services
20
20
22
25.3
Other goods and services from Federal sources
2
2
2
41.0
Grants, subsidies, and contributions
16,698
16,696
16,696
99.9
Total new obligations
16,722
16,720
16,722
Employment Summary
Identification code 75–1552–0–1–609
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
15
15
15
Temporary Assistance for Needy Families
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 75–1552–4–1–609
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Monitoring and Oversight
10
0900
Total new obligations (object class 25.1)
10
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
10
1260
Appropriations, mandatory (total)
10
1930
Total budgetary resources available
10
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
10
3020
Outlays (gross)
–8
3050
Unpaid obligations, end of year
2
Memorandum (non-add) entries:
3200
Obligated balance, end of year
2
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
10
Outlays, gross:
4100
Outlays from new mandatory authority
8
4180
Budget authority, net (total)
10
4190
Outlays, net (total)
8
Contingency Fund
Program and Financing (in millions of dollars)
Identification code 75–1522–0–1–609
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Contingency fund
610
608
612
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
6
1012
Unobligated balance transfers between expired and unexpired accounts
2
1050
Unobligated balance (total)
2
6
Budget authority:
Appropriations, mandatory:
1200
Appropriation
612
612
612
1260
Appropriations, mandatory (total)
612
612
612
1930
Total budgetary resources available
612
614
618
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–2
1941
Unexpired unobligated balance, end of year
6
6
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
596
274
129
3010
Obligations incurred, unexpired accounts
610
608
612
3020
Outlays (gross)
–699
–753
–683
3041
Recoveries of prior year unpaid obligations, expired
–233
3050
Unpaid obligations, end of year
274
129
58
Memorandum (non-add) entries:
3100
Obligated balance, start of year
596
274
129
3200
Obligated balance, end of year
274
129
58
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
612
612
612
Outlays, gross:
4100
Outlays from new mandatory authority
487
553
555
4101
Outlays from mandatory balances
212
200
128
4110
Outlays, gross (total)
699
753
683
4180
Budget authority, net (total)
612
612
612
4190
Outlays, net (total)
699
753
683
Summary of Budget Authority and Outlays (in millions of dollars)
2013 actual
2014 est.
2015 est.
Enacted/requested:
Budget Authority
612
612
612
Outlays
699
753
683
Legislative proposal, subject to PAYGO:
Budget Authority
–10
Outlays
–8
Total:
Budget Authority
612
612
602
Outlays
699
753
675
Object Classification (in millions of dollars)
Identification code 75–1522–0–1–609
2013 actual
2014 est.
2015 est.
Direct obligations:
41.0
Grants, subsidies, and contributions
610
604
612
94.0
Financial transfers
4
99.9
Total new obligations
610
608
612
Contingency Fund
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 75–1522–4–1–609
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Contingency fund
–10
0900
Total new obligations (object class 41.0)
–10
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
–10
1260
Appropriations, mandatory (total)
–10
1930
Total budgetary resources available
–10
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
–10
3020
Outlays (gross)
8
3050
Unpaid obligations, end of year
–2
Memorandum (non-add) entries:
3200
Obligated balance, end of year
–2
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
–10
Outlays, gross:
4100
Outlays from new mandatory authority
–8
4180
Budget authority, net (total)
–10
4190
Outlays, net (total)
–8
Payments to States for Child Support Enforcement and Family Support Programs
For carrying out, except as otherwise provided, [under] titles I, IV-D, X, XI, XIV, and XVI of the Social Security Act and the Act of July 5, 1960[, $2,965,245,000] (24 U.S.C. 321–329), $2,438,523,000, to remain available until expended; and for such purposes for the first quarter of fiscal year [2015, $1,250,000,000] 2016, $1,160,000,000, to remain available until expended.
For [making] carrying out, after May 31 of the current fiscal year, [payments to States or other non-Federal entities under] except as otherwise provided, 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. 321–329), for the last 3 months of the current fiscal year for unanticipated costs, incurred for the current fiscal year, such sums
as may be necessary. (Department of Health and Human Services Appropriations Act, 2014.)
Program and Financing (in millions of dollars)
Identification code 75–1501–0–1–609
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
State child support administrative costs
3,716
3,633
3,386
0002
Child support incentive payments
510
520
527
0003
Access and visitation grants
10
10
10
0091
Subtotal, child support enforcement
4,236
4,163
3,923
0102
Payments to territories
33
33
33
0103
Repatriation
1
1
1
0191
Subtotal, other payments
34
34
34
0799
Total direct obligations
4,270
4,197
3,957
0801
Offset obligations (CSE grants to States)
8
22
6
0900
Total new obligations
4,278
4,219
3,963
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
3
68
1021
Recoveries of prior year unpaid obligations
269
200
200
1050
Unobligated balance (total)
272
200
268
Budget authority:
Appropriations, mandatory:
1200
Appropriation
2,901
2,965
2,439
1260
Appropriations, mandatory (total)
2,901
2,965
2,439
Advance appropriations, mandatory:
1270
Advance appropriation
1,100
1,100
1,250
1280
Advanced appropriation, mandatory (total)
1,100
1,100
1,250
Spending authority from offsetting collections, mandatory:
1800
Collected
7
22
6
1801
Change in uncollected payments, Federal sources
–2
1850
Spending auth from offsetting collections, mand (total)
5
22
6
1900
Budget authority (total)
4,006
4,087
3,695
1930
Total budgetary resources available
4,278
4,287
3,963
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
68
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
986
922
1,032
3010
Obligations incurred, unexpired accounts
4,278
4,219
3,963
3020
Outlays (gross)
–4,073
–3,909
–4,088
3040
Recoveries of prior year unpaid obligations, unexpired
–269
–200
–200
3050
Unpaid obligations, end of year
922
1,032
707
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–2
3070
Change in uncollected pymts, Fed sources, unexpired
2
Memorandum (non-add) entries:
3100
Obligated balance, start of year
984
922
1,032
3200
Obligated balance, end of year
922
1,032
707
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
4,006
4,087
3,695
Outlays, gross:
4100
Outlays from new mandatory authority
3,497
3,669
3,552
4101
Outlays from mandatory balances
576
240
536
4110
Outlays, gross (total)
4,073
3,909
4,088
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123
Non-Federal sources
–7
–22
–6
Additional offsets against gross budget authority only:
4140
Change in uncollected pymts, Fed sources, unexpired
2
4160
Budget authority, net (mandatory)
4,001
4,065
3,689
4170
Outlays, net (mandatory)
4,066
3,887
4,082
4180
Budget authority, net (total)
4,001
4,065
3,689
4190
Outlays, net (total)
4,066
3,887
4,082
Summary of Budget Authority and Outlays (in millions of dollars)
2013 actual
2014 est.
2015 est.
Enacted/requested:
Budget Authority
4,001
4,065
3,689
Outlays
4,066
3,887
4,082
Legislative proposal, subject to PAYGO:
Budget Authority
10
Outlays
10
Total:
Budget Authority
4,001
4,065
3,699
Outlays
4,066
3,887
4,092
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 Budget proposes a Child Support and Fatherhood Initiative, a comprehensive set of proposals which promotes using
child support payments in the best interest of the child, supports noncustodial parents becoming and staying involved in their
children's lives, and improves establishment and enforcement procedures by closing loopholes and improving Federal processes.
Object Classification (in millions of dollars)
Identification code 75–1501–0–1–609
2013 actual
2014 est.
2015 est.
41.0
Direct obligations: Grants, subsidies, and contributions
4,270
4,197
3,957
99.0
Reimbursable obligations
8
22
6
99.9
Total new obligations
4,278
4,219
3,963
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
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
State child support administrative costs
10
0900
Total new obligations (object class 41.0)
10
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
10
1260
Appropriations, mandatory (total)
10
1930
Total budgetary resources available
10
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
10
3020
Outlays (gross)
–10
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
10
Outlays, gross:
4100
Outlays from new mandatory authority
10
4180
Budget authority, net (total)
10
4190
Outlays, net (total)
10
Low Income Home Energy Assistance
For making payments under subsections (b), [and] (d), and (e) of section 2602 of the Low Income Home Energy Assistance Act of 1981, [$3,424,549,000] $2,750,000,000, of which $2,550,000,000 shall be for making payments under subsections (b) and (d) of such section; and of
which $200,000,000 shall be for making payments under subsection (e) of such section, to be made notwithstanding the designation
requirements of such subsection: Provided, That all but [$491,000,000] $366,000,000 of [this] the amount provided in this section for subsections (b) and (d) shall be allocated as though the total appropriation for such payments for fiscal year [2014] 2015 was less than $1,975,000,000: Provided further, That, notwithstanding section 2609A(a), of the amounts appropriated under section 2602(b), not more than [$2,988,000] $3,000,000 of such amounts may be reserved by the Secretary for technical assistance, training, and monitoring of program activities
for compliance with internal controls, policies and procedures and may, in addition to the authorities provided in section
2609A(a)(1), use such funds through contracts with private entities that do not qualify as nonprofit organizations.
For making competitive grants to current grantees to assist low-income households in reducing home energy burden and for
conducting a national evaluation of such grants, $50,000,000. (Department of Health and Human Services Appropriations Act, 2014.)
Program and Financing (in millions of dollars)
Identification code 75–1502–0–1–609
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
LIHEAP Block Grant
3,255
3,425
2,550
0002
Contingency Fund
200
0003
Energy Burden Reduction Grants
50
0900
Total new obligations
3,255
3,425
2,800
Budgetary Resources:
Budget authority:
Appropriations, discretionary:
1100
Appropriation
3,472
3,425
2,800
1120
Appropriations transferred to other accts [75–1503]
–29
1120
Appropriations transferred to other accts [75–0350]
–6
1130
Appropriations permanently reduced
–182
1160
Appropriation, discretionary (total)
3,255
3,425
2,800
1930
Total budgetary resources available
3,255
3,425
2,800
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
1,642
1,361
1,703
3010
Obligations incurred, unexpired accounts
3,255
3,425
2,800
3020
Outlays (gross)
–3,532
–3,083
–2,892
3041
Recoveries of prior year unpaid obligations, expired
–4
3050
Unpaid obligations, end of year
1,361
1,703
1,611
Memorandum (non-add) entries:
3100
Obligated balance, start of year
1,642
1,361
1,703
3200
Obligated balance, end of year
1,361
1,703
1,611
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
3,255
3,425
2,800
Outlays, gross:
4010
Outlays from new discretionary authority
2,180
2,158
1,767
4011
Outlays from discretionary balances
1,352
925
1,125
4020
Outlays, gross (total)
3,532
3,083
2,892
4180
Budget authority, net (total)
3,255
3,425
2,800
4190
Outlays, net (total)
3,532
3,083
2,892
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. The Budget proposes new competitive grants to reduce
household energy burdens for low-income households.
Object Classification (in millions of dollars)
Identification code 75–1502–0–1–609
2013 actual
2014 est.
2015 est.
Direct obligations:
25.1
Advisory and assistance services
2
2
2
25.3
Other goods and services from Federal sources
1
1
1
41.0
Grants, subsidies, and contributions
3,252
3,422
2,797
99.9
Total new obligations
3,255
3,425
2,800
Refugee and Entrant Assistance
For necessary expenses for refugee and entrant assistance activities authorized by section 414 of the Immigration and Nationality
Act and section 501 of the Refugee Education Assistance Act of 1980, and for carrying out section 462 of the Homeland Security
Act of 2002, section 235 of the William Wilberforce Trafficking Victims Protection Reauthorization Act of 2008, the Trafficking
Victims Protection Act of 2000 ("TVPA''), section 203 of the Trafficking Victims Protection Reauthorization Act of 2005, and
the Torture Victims Relief Act of 1998, [$1,486,095,000] $1,486,129,000, of which [$1,461,605,000] $1,453,394,000 shall remain available through September 30, [2016] 2017, for carrying out such sections 414, 501, 462, and 235: Provided, That amounts available under this heading to carry out such section 203 and the TVPA shall also be available for research
and evaluation with respect to activities under those authorities: Provided further, That a contingency fund, to be available until expended, shall be established for the unaccompanied alien
children program authorized by section 462 of the Homeland Security Act of 2002 and section 235 of the William Wilberforce
Trafficking Victims Protection Reauthorization Act of 2008: Provided further, That all available balances from this appropriation
available for such activities may be deposited in such fund prior to expiration. (Department of Health and Human Services Appropriations Act, 2014.)
Program and Financing (in millions of dollars)
Identification code 75–1503–0–1–609
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Refugee and entrant assistance
603
593
585
0002
Assistance for treatment of torture victims
11
11
11
0003
Unaccompanied alien children
376
868
868
0005
Trafficking Victims program
9
14
22
0900
Total new obligations
999
1,486
1,486
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
1
2
2
1021
Recoveries of prior year unpaid obligations
1
1050
Unobligated balance (total)
2
2
2
Budget authority:
Appropriations, discretionary:
1100
Appropriation
1,016
1,486
1,486
1120
Appropriations transferred to other accts [75–1503]
–1,003
1121
Appropriations transferred from other accts [75–1503]
1,003
1121
Appropriations transferred from other accts [75–1515]
1
1121
Appropriations transferred from other accts [75–1502]
29
1130
Appropriations permanently reduced
–47
1160
Appropriation, discretionary (total)
999
1,486
1,486
1930
Total budgetary resources available
1,001
1,488
1,488
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
2
2
2
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
544
537
902
3010
Obligations incurred, unexpired accounts
999
1,486
1,486
3020
Outlays (gross)
–997
–1,121
–1,398
3040
Recoveries of prior year unpaid obligations, unexpired
–1
3041
Recoveries of prior year unpaid obligations, expired
–8
3050
Unpaid obligations, end of year
537
902
990
Memorandum (non-add) entries:
3100
Obligated balance, start of year
544
537
902
3200
Obligated balance, end of year
537
902
990
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
999
1,486
1,486
Outlays, gross:
4010
Outlays from new discretionary authority
612
743
743
4011
Outlays from discretionary balances
385
378
655
4020
Outlays, gross (total)
997
1,121
1,398
4180
Budget authority, net (total)
999
1,486
1,486
4190
Outlays, net (total)
997
1,121
1,398
This program provides funds to States and non-governmental organizations for administering the refugee and entrant assistance
program. Funds also are provided to assist in the rehabilitation of victims of torture, trafficking victims, and the care
and placement of unaccompanied alien children. Additional funding is included for a new initiative aimed at preventing human
trafficking and providing direct services to domestic victims.
Object Classification (in millions of dollars)
Identification code 75–1503–0–1–609
2013 actual
2014 est.
2015 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent
4
6
6
12.1
Civilian personnel benefits
1
2
2
23.1
Rental payments to GSA
2
3
3
25.1
Advisory and assistance services
35
62
63
25.2
Other services from non-Federal sources
11
7
7
25.3
Other goods and services from Federal sources
7
49
49
41.0
Grants, subsidies, and contributions
939
1,357
1,356
99.9
Total new obligations
999
1,486
1,486
Employment Summary
Identification code 75–1503–0–1–609
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
53
73
81
Promoting Safe and Stable Families
For carrying out, except as otherwise provided, section 436 of the Social Security Act, $345,000,000 and [in addition,] for carrying out, except as otherwise provided, section 437 of such Act, $59,765,000. (Department of Health and Human Services Appropriations Act, 2014.)
Program and Financing (in millions of dollars)
Identification code 75–1512–0–1–506
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Grants to States and Tribes
349
343
365
0002
Research, training and technical assistance
8
8
8
0003
State court improvement activities
30
30
32
0004
Family Connection Grants
14
0005
PREP
79
78
0006
Abstinence Education
37
35
0900
Total new obligations
517
494
405
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
16
9
11
1021
Recoveries of prior year unpaid obligations
1
1050
Unobligated balance (total)
17
9
11
Budget authority:
Appropriations, discretionary:
1100
Appropriation
63
60
60
1130
Appropriations permanently reduced
–3
1160
Appropriation, discretionary (total)
60
60
60
Appropriations, mandatory:
1200
Appropriation
485
470
345
1230
Appropriations and/or unobligated balance of appropriations permanently reduced
–25
–34
1260
Appropriations, mandatory (total)
460
436
345
1900
Budget authority (total)
520
496
405
1930
Total budgetary resources available
537
505
416
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–11
1941
Unexpired unobligated balance, end of year
9
11
11
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
677
622
562
3010
Obligations incurred, unexpired accounts
517
494
405
3020
Outlays (gross)
–565
–554
–497
3040
Recoveries of prior year unpaid obligations, unexpired
–1
3041
Recoveries of prior year unpaid obligations, expired
–6
3050
Unpaid obligations, end of year
622
562
470
Memorandum (non-add) entries:
3100
Obligated balance, start of year
677
622
562
3200
Obligated balance, end of year
622
562
470
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
60
60
60
Outlays, gross:
4010
Outlays from new discretionary authority
20
19
19
4011
Outlays from discretionary balances
48
44
40
4020
Outlays, gross (total)
68
63
59
Mandatory:
4090
Budget authority, gross
460
436
345
Outlays, gross:
4100
Outlays from new mandatory authority
97
91
95
4101
Outlays from mandatory balances
400
400
343
4110
Outlays, gross (total)
497
491
438
4180
Budget authority, net (total)
520
496
405
4190
Outlays, net (total)
565
554
497
Summary of Budget Authority and Outlays (in millions of dollars)
2013 actual
2014 est.
2015 est.
Enacted/requested:
Budget Authority
520
496
405
Outlays
565
554
497
Legislative proposal, subject to PAYGO:
Budget Authority
90
Outlays
2
Total:
Budget Authority
520
496
495
Outlays
565
554
499
This account provides funds for a broad range of child welfare services, including family preservation and family support
services. Additionally, this account includes funding for the Personal Responsibility Education Program (PREP) which was made
available by the Patient Protection and Affordable Care Act (P.L. 111–148). The Budget includes a five-year reauthorization
of PREP as well as continuation of Family Connection Grants through 2016.
Object Classification (in millions of dollars)
Identification code 75–1512–0–1–506
2013 actual
2014 est.
2015 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent
1
1
25.1
Advisory and assistance services
9
11
11
25.3
Other goods and services from Federal sources
4
2
2
41.0
Grants, subsidies, and contributions
503
480
392
99.9
Total new obligations
517
494
405
Employment Summary
Identification code 75–1512–0–1–506
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
10
10
2
Promoting Safe and Stable Families
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 75–1512–4–1–506
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0004
Family Connection Grants
15
0005
PREP
75
0900
Total new obligations
90
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
90
1260
Appropriations, mandatory (total)
90
1900
Budget authority (total)
90
1930
Total budgetary resources available
90
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
90
3020
Outlays (gross)
–2
3050
Unpaid obligations, end of year
88
Memorandum (non-add) entries:
3200
Obligated balance, end of year
88
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
90
Outlays, gross:
4100
Outlays from new mandatory authority
2
4180
Budget authority, net (total)
90
4190
Outlays, net (total)
2
Object Classification (in millions of dollars)
Identification code 75–1512–4–1–506
2013 actual
2014 est.
2015 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent
1
25.1
Advisory and assistance services
6
25.3
Other goods and services from Federal sources
1
41.0
Grants, subsidies, and contributions
82
99.9
Total new obligations
90
Employment Summary
Identification code 75–1512–4–1–506
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
8
Child Care Entitlement to States
Program and Financing (in millions of dollars)
Identification code 75–1550–0–1–609
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Mandatory child care
1,178
1,178
1,178
0002
Matching child care
1,691
1,674
1,674
0003
Training and technical assistance
7
7
7
0004
Child care tribal grants
58
58
58
0900
Total new obligations
2,934
2,917
2,917
Budgetary Resources:
Unobligated balance:
1012
Unobligated balance transfers between expired and unexpired accounts
17
1050
Unobligated balance (total)
17
Budget authority:
Appropriations, mandatory:
1200
Appropriation
2,917
2,917
2,917
1260
Appropriations, mandatory (total)
2,917
2,917
2,917
1900
Budget authority (total)
2,917
2,917
2,917
1930
Total budgetary resources available
2,934
2,917
2,917
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
711
755
771
3010
Obligations incurred, unexpired accounts
2,934
2,917
2,917
3020
Outlays (gross)
–2,872
–2,901
–2,912
3041
Recoveries of prior year unpaid obligations, expired
–18
3050
Unpaid obligations, end of year
755
771
776
Memorandum (non-add) entries:
3100
Obligated balance, start of year
711
755
771
3200
Obligated balance, end of year
755
771
776
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
2,917
2,917
2,917
Outlays, gross:
4100
Outlays from new mandatory authority
2,264
2,363
2,363
4101
Outlays from mandatory balances
608
538
549
4110
Outlays, gross (total)
2,872
2,901
2,912
4180
Budget authority, net (total)
2,917
2,917
2,917
4190
Outlays, net (total)
2,872
2,901
2,912
Summary of Budget Authority and Outlays (in millions of dollars)
2013 actual
2014 est.
2015 est.
Enacted/requested:
Budget Authority
2,917
2,917
2,917
Outlays
2,872
2,901
2,912
Legislative proposal, subject to PAYGO:
Budget Authority
750
Outlays
600
Total:
Budget Authority
2,917
2,917
3,667
Outlays
2,872
2,901
3,512
This account provides child care subsidies for low-income working families and was established by the Personal Responsibility
and Work Opportunity Reconciliation Act of 1996 (P.L. 104–193), as amended by the Deficit Reduction Act of 2005 (P.L. 109–171).
Since 2010, this account has been temporarily reauthorized by a series of Acts, most recently in the Consolidated Appropriations
Act, 2014 (P.L. 113–76).
Object Classification (in millions of dollars)
Identification code 75–1550–0–1–609
2013 actual
2014 est.
2015 est.
Direct obligations:
25.1
Advisory and assistance services
6
6
6
25.3
Other goods and services from Federal sources
1
1
1
41.0
Grants, subsidies, and contributions
2,927
2,910
2,910
99.9
Total new obligations
2,934
2,917
2,917
Child Care Entitlement to States
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 75–1550–4–1–609
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0002
Matching child care
706
0003
Training and technical assistance
11
0004
Child care tribal grants
33
0900
Total new obligations
750
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
750
1260
Appropriations, mandatory (total)
750
1900
Budget authority (total)
750
1930
Total budgetary resources available
750
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
750
3020
Outlays (gross)
–600
3050
Unpaid obligations, end of year
150
Memorandum (non-add) entries:
3200
Obligated balance, end of year
150
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
750
Outlays, gross:
4100
Outlays from new mandatory authority
600
4180
Budget authority, net (total)
750
4190
Outlays, net (total)
600
Object Classification (in millions of dollars)
Identification code 75–1550–4–1–609
2013 actual
2014 est.
2015 est.
Direct obligations:
25.1
Advisory and assistance services
11
41.0
Grants, subsidies, and contributions
739
99.9
Total new obligations
750
Payments to States for the Child Care and Development Block Grant
For carrying out the Child Care and Development Block Grant Act of 1990 ("CCDBG Act''), [$2,360,000,000] $2,417,000,000 shall be used to supplement, not supplant State general revenue funds for child care assistance for low-income families:
Provided, That [$19,357,000] $19,824,500 shall be available for child care resource and referral and school-aged child care activities, of which [$996,000] $1,000,000 shall be available to the Secretary for a competitive grant for the operation of a national toll free referral line and Web
site to develop and disseminate child care consumer education information for parents and help parents access child care in
their local community: Provided further, That, in addition to the amounts required to be reserved by the States under section 658G of the CCDBG Act, [$296,484,000] $303,645,000 shall be reserved by the States for activities authorized under section 658G, of which [$108,732,000] $111,358,000 shall be for activities that improve the quality of infant and toddler care: Provided further, That [$9,851,000] $9,871,000 shall be for use by the Secretary for child care research, demonstration, and evaluation activities: Provided further, That technical assistance under section 658I(a)(3) of such Act may be provided directly, or through the use of contracts,
grants, cooperative agreements, or interagency agreements:Provided further, That $200,000,000 shall be made available, using the allocation formula in section 658O of the CCDBG Act,
for grants to each State, territory, and Indian tribe and tribal organization that submits a plan to be approved by the Secretary
demonstrating how it will use these funds to improve the quality of child care, including the quality of the child care workforce,
and health and safety measures. (Department of Health and Human Services Appropriations Act, 2014.)
Program and Financing (in millions of dollars)
Identification code 75–1515–0–1–609
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Block grant payments to States
2,197
2,350
2,407
0004
Research and evaluation fund
9
10
10
0900
Total new obligations
2,206
2,360
2,417
Budgetary Resources:
Budget authority:
Appropriations, discretionary:
1100
Appropriation
2,328
2,360
2,417
1120
Appropriations transferred to other accts [75–1515]
–12
1120
Appropriations transferred to other accts [75–1503]
–1
1120
Appropriations transferred to other accts [75–1362]
–2
1121
Appropriations transferred from other accts [75–1515]
12
1130
Appropriations permanently reduced
–119
1160
Appropriation, discretionary (total)
2,206
2,360
2,417
1930
Total budgetary resources available
2,206
2,360
2,417
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
555
583
605
3010
Obligations incurred, unexpired accounts
2,206
2,360
2,417
3020
Outlays (gross)
–2,177
–2,338
–2,413
3041
Recoveries of prior year unpaid obligations, expired
–1
3050
Unpaid obligations, end of year
583
605
609
Memorandum (non-add) entries:
3100
Obligated balance, start of year
555
583
605
3200
Obligated balance, end of year
583
605
609
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
2,206
2,360
2,417
Outlays, gross:
4010
Outlays from new discretionary authority
1,706
1,912
1,958
4011
Outlays from discretionary balances
471
426
455
4020
Outlays, gross (total)
2,177
2,338
2,413
4180
Budget authority, net (total)
2,206
2,360
2,417
4190
Outlays, net (total)
2,177
2,338
2,413
This program provides grants to States for child care subsidies for low-income working families and activities to improve
child care quality. In FY 2015, it includes a new initiative to improve the quality of child care, including health and safety
measures.
Object Classification (in millions of dollars)
Identification code 75–1515–0–1–609
2013 actual
2014 est.
2015 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent
2
25.1
Advisory and assistance services
11
11
15
25.3
Other goods and services from Federal sources
1
1
1
41.0
Grants, subsidies, and contributions
2,194
2,348
2,399
99.9
Total new obligations
2,206
2,360
2,417
Employment Summary
Identification code 75–1515–0–1–609
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
13
Social Services Block Grant
For making grants to States pursuant to section 2002 of the Social Security Act, $1,700,000,000: Provided, That notwithstanding subparagraph (B) of section 404(d)(2) of such Act, the applicable percent specified under such subparagraph
for a State to carry out State programs pursuant to title XX-A of such Act shall be 10 percent. (Department of Health and Human Services Appropriations Act, 2014.)
Program and Financing (in millions of dollars)
Identification code 75–1534–0–1–506
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Social Services Block Grant
1,613
1,577
1,700
0002
Health Profession Opportunity Grants
81
79
0003
Hurricane Sandy Funding
474
0900
Total new obligations
2,168
1,656
1,700
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
29
30
30
1021
Recoveries of prior year unpaid obligations
1
1050
Unobligated balance (total)
30
30
30
Budget authority:
Appropriations, mandatory:
1200
Appropriation
1,785
1,785
1,700
1221
Appropriations transferred from other accts [75–0140]
500
1230
Appropriations and/or unobligated balance of appropriations permanently reduced
–117
–129
1260
Appropriations, mandatory (total)
2,168
1,656
1,700
1900
Budget authority (total)
2,168
1,656
1,700
1930
Total budgetary resources available
2,198
1,686
1,730
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
30
30
30
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
572
862
653
3010
Obligations incurred, unexpired accounts
2,168
1,656
1,700
3020
Outlays (gross)
–1,877
–1,865
–1,996
3040
Recoveries of prior year unpaid obligations, unexpired
–1
3050
Unpaid obligations, end of year
862
653
357
Memorandum (non-add) entries:
3100
Obligated balance, start of year
572
862
653
3200
Obligated balance, end of year
862
653
357
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
2,168
1,656
1,700
Outlays, gross:
4100
Outlays from new mandatory authority
1,395
1,328
1,428
4101
Outlays from mandatory balances
482
537
568
4110
Outlays, gross (total)
1,877
1,865
1,996
4180
Budget authority, net (total)
2,168
1,656
1,700
4190
Outlays, net (total)
1,877
1,865
1,996
Summary of Budget Authority and Outlays (in millions of dollars)
2013 actual
2014 est.
2015 est.
Enacted/requested:
Budget Authority
2,168
1,656
1,700
Outlays
1,877
1,865
1,996
Legislative proposal, subject to PAYGO:
Budget Authority
85
Outlays
2
Total:
Budget Authority
2,168
1,656
1,785
Outlays
1,877
1,865
1,998
Object Classification (in millions of dollars)
Identification code 75–1534–0–1–506
2013 actual
2014 est.
2015 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent
1
1
25.1
Advisory and assistance services
9
16
25.3
Other goods and services from Federal sources
2
41.0
Grants, subsidies, and contributions
2,156
1,639
1,700
99.9
Total new obligations
2,168
1,656
1,700
Employment Summary
Identification code 75–1534–0–1–506
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
10
10
Social Services Block Grant
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 75–1534–4–1–506
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0002
Health Profession Opportunity Grants
85
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
85
1260
Appropriations, mandatory (total)
85
1900
Budget authority (total)
85
1930
Total budgetary resources available
85
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
85
3020
Outlays (gross)
–2
3050
Unpaid obligations, end of year
83
Memorandum (non-add) entries:
3200
Obligated balance, end of year
83
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
85
Outlays, gross:
4100
Outlays from new mandatory authority
2
4180
Budget authority, net (total)
85
4190
Outlays, net (total)
2
Object Classification (in millions of dollars)
Identification code 75–1534–4–1–506
2013 actual
2014 est.
2015 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent
1
25.1
Advisory and assistance services
3
25.3
Other goods and services from Federal sources
10
41.0
Grants, subsidies, and contributions
71
99.9
Total new obligations
85
Employment Summary
Identification code 75–1534–4–1–506
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
10
Children and Families Services Programs
For carrying out, except as otherwise provided, the Runaway and Homeless Youth Act, the Head Start Act, the Child Abuse Prevention
and Treatment Act, sections 303 and 313 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), the
Abandoned Infants Assistance Act of 1988, part B-1 of title IV and sections 413, 1110, and 1115 of the Social Security Act;
for making payments under the Community Services Block Grant Act ("CSBG Act''), sections 473B and 477(i) of the Social Security
Act, and the Assets for Independence Act; for necessary administrative expenses to carry out such 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, and section 501 of the Refugee Education Assistance Act of 1980; and
for the administration of prior year obligations made by the Administration for Children and Families under the Developmental
Disabilities Assistance and Bill of Rights Act and the Help America Vote Act of 2002, [$10,346,943,000] $10,277,062,000, of which $37,943,000, to remain available through September 30, [2015] 2016, 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, [2014] 2015: Provided, That subsection (b)(5) of such section 473A shall apply to funds appropriated under this heading by substituting ["2013''] "2014" for "2012'': Provided further, That [$8,598,095,000] $8,868,389,000 shall be for making payments under the Head Start Act: Provided further, That of the amount in the previous proviso, [$8,073,095,000] $8,193,389,000 shall be available for payments under section 640 of the Head Start Act[, of which $100,000,000 shall be available for a cost of living adjustment notwithstanding section 640(a)(3)(A) of such Act:
Provided further, That for purposes of allocating funds under section 640 of the Head Start Act, subsection (a)(2) of such section shall be
applied by substituting "fiscal year 2012'' for "the prior fiscal year'' each place it appears in such subsection]: Provided further, That of the amount provided for making payments under the Head Start Act, $25,000,000 shall be available for allocation
by the Secretary to supplement activities described in paragraphs (7)(B) and (9) of section 641(c) of such Act under the Designation
Renewal System, established under the authority of sections 641(c)(7), 645A(b)(12) and 645A(d) of such Act: Provided further, That amounts allocated to Head Start grantees at the discretion of the Secretary to supplement activities pursuant to the
previous proviso shall not be included in the calculation of the "base grant'' in subsequent fiscal years, as such term is
used in section 640(a)(7)(A) of the Head Start Act: Provided further, That notwithstanding section 640 of the Head Start Act, of the amount provided for making payments under the Head Start
Act, [$500,000,000] $650,000,000 shall be available through March 31, [2015] 2016 for [expansion of] Early Head Start programs as described in section 645A of such Act, for conversion of Head Start services to Early Head Start
services as described in section 645(a)(5)(A) of such Act, and for [new] discretionary grants for high quality infant and toddler care through Early Head Start-Child Care Partnerships, to entities
defined as eligible under section 645A(d) of such Act, and, notwithstanding section 645A(c)(2) of such Act, these funds are
available to serve children under age 4: Provided further, That of the amount made available in the immediately preceding proviso, up to [$10,000,000] $15,000,000 shall be available for the Federal costs of administration and evaluation activities of the program described in such proviso:
Provided further, That an Early Head Start agency awarded funds for an Early Head Start-Child Care Partnership after October 1, [2014] 2015, shall not be subject to the requirements of the system for designation renewal as defined by section 641 of the Head Start
Act, for this award only, prior to 18 months after the date of such award: Provided further, That amounts provided under the seventh proviso under this heading in Public Law 113–76 shall not be included
in the calculation of the "base grant'' in fiscal year 2015, as such term is used in section 640(a)(7)(A) of the Head Start
Act: Provided further, That [$709,854,000] $350,000,000 shall be for making payments under the CSBG Act: Provided further, That [$36,204,000 shall be for sections 680 and 678E(b)(2) of the CSBG Act, of which not less than $29,883,000 shall be for section
680(a)(2) and not less than $5,971,000 shall be for section 680(a)(3)(B) of such Act] no more than $350,000 shall be reserved under section 674(b)(3) of the CSBG Act, all of which shall be available solely for
carrying out section 678E(b)(2) of such Act: Provided further, That to the extent Community Services Block Grant funds are distributed as grant funds by a State to an eligible entity
as provided under the CSBG Act, and have not been expended by such entity, they shall remain with such entity for carryover
into the next fiscal year for expenditure by such entity consistent with program purposes: Provided further, That [the Secretary shall establish procedures regarding the disposition of intangible assets and program income that permit such
assets acquired with, and program income derived from, grant funds authorized under section 680 of the CSBG Act to become
the sole property of such grantees after a period of not more than 12 years after the end of the grant period for any activity
consistent with section 680(a)(2)(A) of the CSBG Act: Provided further, That intangible assets in the form of loans, equity investments and other debt instruments, and program income may be used
by grantees for any eligible purpose consistent with section 680(a)(2)(A) of the CSBG Act: Provided further, That these procedures shall apply to such grant funds made available after November 29, 1999: Provided further, That funds appropriated for section 680(a)(2) of the CSBG Act shall be available for financing construction and rehabilitation
and loans or investments in private business enterprises owned by community development corporations:], to the extent funds for the Assets for Independence Act are distributed as grant funds to a qualified entity and have not
been expended by such entity within three years after the date of award, such funds may be recaptured and, during the fiscal
year of such recapture, reallocated among other qualified entities, to remain available to such entities for five years: Provided
further, That notwithstanding section 414(e) of such Act, the Secretary may award up to $1,000,000 to support evidence-based
evaluation: Provided further, That in addition to amounts provided herein, $5,762,000 shall be available from amounts available under section 241 of the
PHS Act to carry out the provisions of section 1110 of the Social Security Act: Provided further, That amounts provided under this heading to carry out section 1110 of the Social Security Act, other than
amounts made available for that purpose under the previous proviso, shall remain available until expended: Provided further, That section 303(a)(2)(A)(i) of the Family Violence Prevention and Services Act shall not apply to amounts provided herein:
Provided further, That $1,864,000 shall be for a human services case management system for federally declared disasters, to include a comprehensive
national case management contract and Federal costs of administering the system: 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. (Department of Health and Human Services Appropriations Act, 2014.)
Program and Financing (in millions of dollars)
Identification code 75–1536–0–1–506
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0101
Head Start
7,573
8,598
8,868
0102
Head Start Emergency Hurricane Sandy funding
8
0103
Runaway and homeless youth (basic centers)
50
53
53
0104
Transitional living
41
44
44
0105
Prevalence, Needs and Characteristics of Homeless Youth
2
0106
Education grants to reduce sexual abuse of runaway youth
17
17
17
0109
Child abuse State grants
25
25
25
0110
Child abuse discretionary activities
24
29
29
0111
Community-based child abuse prevention
39
40
40
0112
Child welfare services
263
269
269
0113
Child welfare training, research, or demonstration projects
24
25
25
0114
Adoption opportunities
36
40
40
0115
Abandoned infants assistance
11
11
11
0116
Adoption incentives
37
38
38
0117
Independent living training vouchers
42
43
43
0119
State councils on developmental disabilities
70
0120
Protection and advocacy
39
0121
Projects of national significance
8
0122
University centers for excellence
37
0123
Voting access for individuals with disabilities
5
0124
Native American programs
45
47
47
0125
Social services and income maintenance research
9
0128
Federal administration
201
198
205
0129
Center for faith-based and community initiatives
1
1
1
0131
Disaster human services case management
2
2
2
0191
Direct program activities, subtotal
8,598
9,480
9,768
0301
Community services block grant
635
674
350
0303
Rural community facilities
5
6
0304
Community services discretionary (JOLI & CED)
28
30
0306
Assets for independence
19
19
19
0308
Domestic violence hotline
3
4
5
0309
Family violence prevention and services
121
134
135
0391
Direct program activities, subtotal
811
867
509
0400
Total, direct program
9,409
10,347
10,277
0799
Total direct obligations
9,409
10,347
10,277
0801
Reimbursable program
35
30
30
0809
Reimbursable program activities, subtotal
35
30
30
0900
Total new obligations
9,444
10,377
10,307
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
2
89
84
1001
Discretionary unobligated balance brought fwd, Oct 1
2
89
Budget authority:
Appropriations, discretionary:
1100
Appropriation
9,941
10,347
10,277
1120
Appropriations transferred to other accts [75–1362]
–21
1121
Appropriations transferred from other accounts [75–0140]
100
1130
Appropriations permanently reduced
–523
1160
Appropriation, discretionary (total)
9,497
10,347
10,277
Spending authority from offsetting collections, discretionary:
1700
Collected
21
24
24
1701
Change in uncollected payments, Federal sources
12
1750
Spending auth from offsetting collections, disc (total)
33
24
24
Spending authority from offsetting collections, mandatory:
1800
Collected
1
1
1
1801
Change in uncollected payments, Federal sources
1
1850
Spending auth from offsetting collections, mand (total)
2
1
1
1900
Budget authority (total)
9,532
10,372
10,302
1930
Total budgetary resources available
9,534
10,461
10,386
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–1
1941
Unexpired unobligated balance, end of year
89
84
79
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
6,628
6,218
6,676
3010
Obligations incurred, unexpired accounts
9,444
10,377
10,307
3011
Obligations incurred, expired accounts
2
3020
Outlays (gross)
–9,751
–9,919
–10,217
3041
Recoveries of prior year unpaid obligations, expired
–105
3050
Unpaid obligations, end of year
6,218
6,676
6,766
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–10
–16
–16
3070
Change in uncollected pymts, Fed sources, unexpired
–13
3071
Change in uncollected pymts, Fed sources, expired
7
3090
Uncollected pymts, Fed sources, end of year
–16
–16
–16
Memorandum (non-add) entries:
3100
Obligated balance, start of year
6,618
6,202
6,660
3200
Obligated balance, end of year
6,202
6,660
6,750
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
9,530
10,371
10,301
Outlays, gross:
4010
Outlays from new discretionary authority
3,942
4,371
4,343
4011
Outlays from discretionary balances
5,808
5,546
5,874
4020
Outlays, gross (total)
9,750
9,917
10,217
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–27
–18
–18
4033
Non-Federal sources
–6
–6
4040
Offsets against gross budget authority and outlays (total)
–27
–24
–24
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–12
4052
Offsetting collections credited to expired accounts
6
4060
Additional offsets against budget authority only (total)
–6
4070
Budget authority, net (discretionary)
9,497
10,347
10,277
4080
Outlays, net (discretionary)
9,723
9,893
10,193
Mandatory:
4090
Budget authority, gross
2
1
1
Outlays, gross:
4100
Outlays from new mandatory authority
1
1
4101
Outlays from mandatory balances
1
4110
Outlays, gross (total)
1
2
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120
Federal sources
–2
–1
–1
Additional offsets against gross budget authority only:
4140
Change in uncollected pymts, Fed sources, unexpired
–1
4142
Offsetting collections credited to expired accounts
1
4170
Outlays, net (mandatory)
–1
1
–1
4180
Budget authority, net (total)
9,497
10,347
10,277
4190
Outlays, net (total)
9,722
9,894
10,192
The request prioritizes investments in early learning to improve outcomes for children. A total of $8.9 billion is requested
to support an early learning initiative to expand access to high quality infant and toddler care, Head Start services, and
support the transition between new and incumbent Head Start grantees in the Designation Renewal System. This Budget also requests
an additional $1 million for family violence prevention, $9 million for research to improve effectiveness of programs serving
children and adolescents, and $2 million to study the prevalence, needs and characteristics of homeless youth. This request
discontinues funding for the Rural Communities Facilities and the Community Economic Development programs.
Object Classification (in millions of dollars)
Identification code 75–1536–0–1–506
2013 actual
2014 est.
2015 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
109
111
115
11.3
Other than full-time permanent
5
5
5
11.7
Military personnel
1
1
1
11.9
Total personnel compensation
115
117
121
12.1
Civilian personnel benefits
31
32
33
21.0
Travel and transportation of persons
3
4
4
23.1
Rental payments to GSA
15
14
14
23.2
Rental payments to others
1
1
1
23.3
Communications, utilities, and miscellaneous charges
2
4
4
24.0
Printing and reproduction
1
1
1
25.1
Advisory and assistance services
190
202
208
25.2
Other services from non-Federal sources
3
4
4
25.3
Other goods and services from Federal sources
47
49
49
25.4
Operation and maintenance of facilities
2
2
2
25.5
Research and development contracts
1
1
1
26.0
Supplies and materials
1
1
1
41.0
Grants, subsidies, and contributions
8,997
9,915
9,834
99.0
Direct obligations
9,409
10,347
10,277
99.0
Reimbursable obligations
35
30
30
99.9
Total new obligations
9,444
10,377
10,307
Employment Summary
Identification code 75–1536–0–1–506
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
1,126
1,139
1,174
1101
Direct military average strength employment
7
7
7
2001
Reimbursable civilian full-time equivalent employment
11
19
19
Children's Research and Technical Assistance
Program and Financing (in millions of dollars)
Identification code 75–1553–0–1–609
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Training and technical assistance
12
15
12
0002
Federal parent locator service
24
24
25
0004
Welfare research
14
14
15
0799
Total direct obligations
50
53
52
0801
Reimbursable program FPLS REIMB
23
30
30
0900
Total new obligations
73
83
82
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
7
5
Budget authority:
Appropriations, mandatory:
1200
Appropriation
52
52
52
1230
Appropriations and/or unobligated balance of appropriations permanently reduced
–3
–4
1260
Appropriations, mandatory (total)
49
48
52
Spending authority from offsetting collections, mandatory:
1800
Collected
23
30
30
1802
Offsetting collections (previously unavailable)
1
1823
New and/or unobligated balance of spending authority from offsetting collections temporarily reduced
–1
–1
1850
Spending auth from offsetting collections, mand (total)
22
30
30
1900
Budget authority (total)
71
78
82
1930
Total budgetary resources available
78
83
82
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
5
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
60
64
69
3010
Obligations incurred, unexpired accounts
73
83
82
3020
Outlays (gross)
–69
–78
–81
3050
Unpaid obligations, end of year
64
69
70
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–5
–5
–5
3090
Uncollected pymts, Fed sources, end of year
–5
–5
–5
Memorandum (non-add) entries:
3100
Obligated balance, start of year
55
59
64
3200
Obligated balance, end of year
59
64
65
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
71
78
82
Outlays, gross:
4100
Outlays from new mandatory authority
21
28
28
4101
Outlays from mandatory balances
48
50
53
4110
Outlays, gross (total)
69
78
81
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120
Federal sources
–11
–13
–13
4123
Non-Federal sources
–12
–17
–17
4130
Offsets against gross budget authority and outlays (total)
–23
–30
–30
4160
Budget authority, net (mandatory)
48
48
52
4170
Outlays, net (mandatory)
46
48
51
4180
Budget authority, net (total)
48
48
52
4190
Outlays, net (total)
46
48
51
Memorandum (non-add) entries:
5090
Unavailable balance, SOY: Offsetting collections
1
1
5091
Unavailable balance, EOY: Offsetting collections
1
1
1
This account provides funding for research and technical assistance activities established by the Personal Responsibility
and Work Opportunity Reconciliation Act of 1996 (P.L. 104–193), as amended by the Deficit Reduction Act of 2005 (P.L. 109–171).
Since 2010, Welfare Research has been temporarily reauthorized by a series of Acts and is currently authorized through September
30, 2014, in the Consolidated Appropriations Act, 2014 (P.L. 113–76).
Object Classification (in millions of dollars)
Identification code 75–1553–0–1–609
2013 actual
2014 est.
2015 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent
7
7
7
12.1
Civilian personnel benefits
2
2
2
21.0
Travel and transportation of persons
1
1
1
23.1
Rental payments to GSA
3
3
3
25.1
Advisory and assistance services
12
11
12
25.2
Other services from non-Federal sources
13
17
14
25.3
Other goods and services from Federal sources
9
9
10
25.7
Operation and maintenance of equipment
2
1
41.0
Grants, subsidies, and contributions
1
3
2
99.0
Direct obligations
50
53
52
99.0
Reimbursable obligations
23
30
30
99.9
Total new obligations
73
83
82
Employment Summary
Identification code 75–1553–0–1–609
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
67
67
67
Payments for Foster Care and Permanency
For carrying out, except as otherwise provided, title IV-E of the Social Security Act, [$4,806,000,000] $4,832,000,000.
For carrying out, except as otherwise provided, title IV-E of the Social Security Act, for the first quarter of fiscal year
[2015, $2,200,000,000] 2016, $2,300,000,000.
For [making] carrying out, after May 31 of the current fiscal year, [payments to States or other non-Federal entities under] except as otherwise provided, section 474 of title IV-E of the Social Security Act, for the last 3 months of the current fiscal year for unanticipated costs,
incurred for the current fiscal year, such sums as may be necessary. (Department of Health and Human Services Appropriations Act, 2014.)
Program and Financing (in millions of dollars)
Identification code 75–1545–0–1–609
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Foster care
4,133
4,269
4,289
0002
Independent living
140
140
140
0004
Adoption assistance
2,278
2,384
2,504
0005
Guardianship
77
85
99
0006
Tribal T&TA
3
3
3
0900
Total new obligations
6,631
6,881
7,035
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
4,531
4,809
4,835
1260
Appropriations, mandatory (total)
4,531
4,809
4,835
Advance appropriations, mandatory:
1270
Advance appropriation
2,100
2,200
2,200
1280
Advanced appropriation, mandatory (total)
2,100
2,200
2,200
1900
Budget authority (total)
6,631
7,009
7,035
1930
Total budgetary resources available
6,631
7,009
7,035
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–128
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
979
716
782
3010
Obligations incurred, unexpired accounts
6,631
6,881
7,035
3011
Obligations incurred, expired accounts
4
3020
Outlays (gross)
–6,770
–6,803
–6,952
3041
Recoveries of prior year unpaid obligations, expired
–128
–12
3050
Unpaid obligations, end of year
716
782
865
Memorandum (non-add) entries:
3100
Obligated balance, start of year
979
716
782
3200
Obligated balance, end of year
716
782
865
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
6,631
7,009
7,035
Outlays, gross:
4100
Outlays from new mandatory authority
6,066
6,246
6,387
4101
Outlays from mandatory balances
704
557
565
4110
Outlays, gross (total)
6,770
6,803
6,952
4180
Budget authority, net (total)
6,631
7,009
7,035
4190
Outlays, net (total)
6,770
6,803
6,952
Summary of Budget Authority and Outlays (in millions of dollars)
2013 actual
2014 est.
2015 est.
Enacted/requested:
Budget Authority
6,631
7,009
7,035
Outlays
6,770
6,803
6,952
Legislative proposal, subject to PAYGO:
Budget Authority
252
Outlays
3
Total:
Budget Authority
6,631
7,009
7,287
Outlays
6,770
6,803
6,955
This account provides formula grants for Foster Care, Adoption Assistance, Guardianship Assistance, and the Chafee Foster
Care Independence Program as well as technical assistance and implementation services for Tribal programs.
Foster Care—The proposed level will support eligible low-income children who must be placed outside the home. An average of 150,800 children
per month are estimated to be served in FY 2015.
Adoption Assistance—The proposed funding level will support subsidies for families adopting eligible low-income children with special needs.
An average of 452,000 children per month are estimated to be served in FY 2015.
Guardianship Assistance—The proposed funding level will provide payments for relatives taking legal guardianship of eligible children who have been
in foster care. An average of 21,100 children per month are estimated to be served in FY 2015.
This account includes a new initiative to address over-prescription of psychotropic medications for children in foster care
and a new requirement to use child support collected on behalf of children in foster care in the best interest of the child.
Object Classification (in millions of dollars)
Identification code 75–1545–0–1–609
2013 actual
2014 est.
2015 est.
Direct obligations:
25.1
Advisory and assistance services
16
21
21
41.0
Grants, subsidies, and contributions
6,615
6,860
7,014
99.9
Total new obligations
6,631
6,881
7,035
Employment Summary
Identification code 75–1545–0–1–609
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
4
4
4
Payments for Foster Care and Permanency
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 75–1545–4–1–609
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Foster care
2
0007
Address over-prescription of psychotropic medications for children in foster care
50
0900
Total new obligations
52
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
252
1260
Appropriations, mandatory (total)
252
1900
Budget authority (total)
252
1930
Total budgetary resources available
252
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
200
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
52
3020
Outlays (gross)
–3
3050
Unpaid obligations, end of year
49
Memorandum (non-add) entries:
3200
Obligated balance, end of year
49
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
252
Outlays, gross:
4100
Outlays from new mandatory authority
3
4180
Budget authority, net (total)
252
4190
Outlays, net (total)
3
Object Classification (in millions of dollars)
Identification code 75–1545–4–1–609
2013 actual
2014 est.
2015 est.
Direct obligations:
25.1
Advisory and assistance services
23
41.0
Grants, subsidies, and contributions
29
99.9
Total new obligations
52
Employment Summary
Identification code 75–1545–4–1–609
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
2
Administration for Community Living
Federal Funds
Aging and Disability Services Programs
(including transfer of funds)
For carrying out, to the extent not otherwise provided, the Older Americans Act of 1965 ("OAA"), titles III and XXIX of the PHS Act, section 119 of the Medicare Improvements for Patients and Providers Act of 2008, section 6021(d) of the Deficit Reduction Act of 2005, title XX-B of the Social Security Act, the Developmental Disabilities Assistance and Bill of Rights Act, parts 2 and 5 of
subtitle D of title II of the Help America Vote Act of 2002, and for Department-wide coordination of policy and program activities
that assist individuals with disabilities, [$1,610,143,000] $2,010,164,000, together with $52,115,000 to be transferred from the Federal Hospital Insurance Trust Fund and the Federal Supplementary
Medical Insurance Trust Fund to carry out section 4360 of the Omnibus Budget Reconciliation Act of 1990: Provided, That, in addition to amounts provided herein, $12,860,000 shall be available from amounts available under section
241 of the PHS Act to supplement funds otherwise available for carrying out titles III and XXIX of such Act: Provided further, That amounts appropriated under this heading may be used for grants to States under section 361 of the OAA only for disease
prevention and health promotion programs and activities which have been demonstrated through rigorous evaluation to be evidence-based
and effective: Provided further, That, notwithstanding section 206(g) of the OAA, up to one percent of amounts appropriated to carry out
programs authorized under title III of such Act shall be available for conducting evaluations, training, and technical assistance:
Provided further, That none of the funds provided shall be used to carry out sections 1701 and 1703 of the PHS Act (with respect to chronic
disease self-management activity grants), except that such funds may be used for necessary expenses associated with administering
any such grants awarded prior to the date of the enactment of this Act: Provided further, That notwithstanding any other provision of this Act, funds made available under this heading to carry out section 311 of
the OAA may be transferred to the Secretary of Agriculture in accordance with such section: Provided further, That, of the amounts provided under this heading, $380,000,000 shall be available for carrying out title
V of the OAA: Provided further, That with respect to the previous proviso, such funds shall be available through June 30,
2016, and may be recaptured and reobligated in accordance with section 517(c) of the OAA: Provided further, That $3,000,000
shall be available until September 30, 2016, for the White House Conference on Aging. (Department of Health and Human Services Appropriations Act, 2014.)
Program and Financing (in millions of dollars)
Identification code 75–0142–0–1–506
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0101
Home and community-based supportive services
348
348
347
0102
Preventive health services
20
20
20
0103
National family caregiver support program
146
146
146
0104
Native American caregiver support program
6
6
6
0105
Congregate nutrition services
416
438
437
0106
Home-delivered nutrition services
205
216
216
0107
Nutrition services incentive program
144
158
160
0108
Native American nutrition and supportive services
26
26
26
0110
Aging network support activities
7
7
7
0111
Long-term care ombudsmen program
16
16
16
0112
Prevention of elder abuse and neglect
5
5
5
0113
Alzheimer's Disease Demo Grants ADSSP
4
4
0114
Program administration
22
30
30
0115
Lifespan respite care program
2
2
0116
Paralysis Resource Center
7
0117
Aging and Disability Resource Centers (ADRC)
6
6
0118
Chronic Disease Self-Management Education Program PPHF
7
8
8
0121
Senior Medicare Patrol program
9
9
9
0122
Elder Rights Support Activities
4
4
4
0123
Falls Prevention - PPHF
5
5
0124
Elder Justice Initiative
25
0126
National Clearinghouse Long-Term Care Information
1
0127
Alzheimer's Disease Communications Campaign PPHF
4
4
0128
Adult Protective Services - ACA
2
0129
Senior Community Service Employment Program
380
0132
State Aging & Disability Resource Centers - HCR
9
10
0133
Alzheimer's Disease Initiative - Services PPHF
11
11
0136
Voting Access for People With Disabilities (HAVA)
5
5
0138
State Councils on Developmental Disabilities
71
71
0139
Protection and Advocacy
39
39
0141
University Centers for Excellence in Developmental Disabilities
37
37
0142
Projects of National Significance
9
9
0145
Youth Transitions Initiative
5
0146
White House Conference on Aging
3
0147
Holocaust Survivor Assistance Fund
5
0300
Total, direct program
1,404
1,647
2,037
0799
Total direct obligations
1,404
1,647
2,037
0801
Reimbursable program - HCFAC and Other
11
11
12
0802
ADRC's MIPPA (TRA)
5
2
0803
Area Agencies on Aging - MIPPA (TRA)
7
4
0804
MIPPA - Natl Center Benefits Outreach Enrollment
5
3
0805
SHIP - (DISC and ATRA BBA)
55
52
0806
Alzheimers Disease Supportive Services Program - PHS
4
0807
Paralysis Resource Center PHS
7
0808
Lifespan Respite - PHS
2
0899
Total reimbursable obligations
28
75
77
0900
Total new obligations
1,432
1,722
2,114
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
2
1
Budget authority:
Appropriations, discretionary:
1100
Appropriation
1,471
1,610
2,010
1120
Appropriations transferred to other accts [12–3507]
–3
–2
1120
Appropriations transferred to other accts [75–0943]
–5
1120
Appropriations transferred to other accts [75–0350]
–1
1130
Appropriations permanently reduced
–77
1160
Appropriation, discretionary (total)
1,385
1,608
2,010
Appropriations, mandatory:
1200
Appropriation
14
10
1221
PPHF Appropriations transferred from other accounts [75–0116]
9
28
28
1230
Appropriations and/or unobligated balance of appropriations permanently reduced
–4
–1
1260
Appropriations, mandatory (total)
19
37
28
Spending authority from offsetting collections, discretionary:
1700
Collected
52
65
1750
Spending auth from offsetting collections, disc (total)
52
65
Spending authority from offsetting collections, mandatory:
1800
Collected
1
24
11
1801
Change in uncollected payments, Federal sources
26
1850
Spending auth from offsetting collections, mand (total)
27
24
11
1900
Budget authority (total)
1,431
1,721
2,114
1930
Total budgetary resources available
1,433
1,722
2,114
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
1
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
691
667
750
3010
Obligations incurred, unexpired accounts
1,432
1,722
2,114
3011
Obligations incurred, expired accounts
1
3020
Outlays (gross)
–1,448
–1,639
–1,959
3041
Recoveries of prior year unpaid obligations, expired
–9
3050
Unpaid obligations, end of year
667
750
905
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–18
–36
–36
3070
Change in uncollected pymts, Fed sources, unexpired
–26
3071
Change in uncollected pymts, Fed sources, expired
8
3090
Uncollected pymts, Fed sources, end of year
–36
–36
–36
Memorandum (non-add) entries:
3100
Obligated balance, start of year
673
631
714
3200
Obligated balance, end of year
631
714
869
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
1,385
1,660
2,075
Outlays, gross:
4010
Outlays from new discretionary authority
885
1,033
1,291
4011
Outlays from discretionary balances
530
563
622
4020
Outlays, gross (total)
1,415
1,596
1,913
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–52
–65
Mandatory:
4090
Budget authority, gross
46
61
39
Outlays, gross:
4100
Outlays from new mandatory authority
3
42
28
4101
Outlays from mandatory balances
30
1
18
4110
Outlays, gross (total)
33
43
46
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120
Federal sources
–8
–24
–11
Additional offsets against gross budget authority only:
4140
Change in uncollected pymts, Fed sources, unexpired
–26
4142
Offsetting collections credited to expired accounts
7
4150
Additional offsets against budget authority only (total)
–19
4160
Budget authority, net (mandatory)
19
37
28
4170
Outlays, net (mandatory)
25
19
35
4180
Budget authority, net (total)
1,404
1,645
2,038
4190
Outlays, net (total)
1,440
1,563
1,883
Summary of Budget Authority and Outlays (in millions of dollars)
2013 actual
2014 est.
2015 est.
Enacted/requested:
Budget Authority
1,404
1,645
2,038
Outlays
1,440
1,563
1,883
Legislative proposal, subject to PAYGO:
Budget Authority
20
Outlays
20
Total:
Budget Authority
1,404
1,645
2,058
Outlays
1,440
1,563
1,903
Note.—The reimbursable program (HCFAC) in the Administration for Community Living (ACL) reflects the actual distribution of
the allocation account for 2013. Future allocations will be determined annually.
This account provides funding for formula grant programs that provide nutrition, supportive services and caregiver support
services, and protection and advocacy services through a network of aging- and disability-related organizations to help older
Americans and people with disabilities, with the assistance of their families and caregivers, maintain their independence
in their homes and communities. The Budget proposes to transfer the Senior Community Services Employment Program (SCSEP),
authorized under title V of the Older Americans Act, from the Department of Labor to the Department of Health and Human Services
(HHS), which administers the remainder of the Older Americans Act. SCSEP offers participants work-based community service
training so that they can gain on-the-job experience and prepare to enter or to re-enter the workforce. As a part of the proposed
transfer to HHS, the Department will make improving program performance a priority.
Object Classification (in millions of dollars)
Identification code 75–0142–0–1–506
2013 actual
2014 est.
2015 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent
12
15
17
12.1
Civilian personnel benefits
3
4
5
23.1
Rental payments to GSA
2
2
3
25.1
Advisory and assistance services
11
26
44
25.3
Other goods and services from Federal sources
6
8
9
41.0
Grants, subsidies, and contributions
1,370
1,590
1,959
99.0
Direct obligations
1,404
1,645
2,037
99.0
Reimbursable obligations
28
77
77
99.9
Total new obligations
1,432
1,722
2,114
Employment Summary
Identification code 75–0142–0–1–506
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
138
156
162
2001
Reimbursable civilian full-time equivalent employment
8
15
16
Aging and Disability Services Programs
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 75–0142–4–1–506
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0117
Aging and Disability Resource Centers (ADRC)
20
0900
Total new obligations (object class 41.0)
20
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
20
1260
Appropriations, mandatory (total)
20
1900
Budget authority (total)
20
1930
Total budgetary resources available
20
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
20
3020
Outlays (gross)
–20
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
20
Outlays, gross:
4100
Outlays from new mandatory authority
20
4180
Budget authority, net (total)
20
4190
Outlays, net (total)
20
Departmental Management
Federal Funds
General Departmental Management
For necessary expenses, not otherwise provided, for general departmental management, including hire of [six] passenger motor vehicles, and for carrying out titles III, XVII, XXI, and section 229 of the PHS Act, the United States-Mexico
Border Health Commission Act, and research studies under section 1110 of the Social Security Act, [$458,056,000] $286,204,000, together with [$69,211,000] $118,728,000 from the amounts available under section 241 of the PHS Act to carry out national health or human services research and evaluation
activities: Provided, That, of [this amount, $52,224,000 shall be for minority AIDS prevention and treatment activities: Provided further, That of the funds made available under this heading, $101,000,000 shall be for making competitive contracts and grants to
public and private entities to fund medically accurate and age appropriate programs that reduce teen pregnancy and for the
Federal costs associated with administering and evaluating such contracts and grants, of which not less than $72,200,000 shall
be for replicating programs that have been proven effective through rigorous evaluation to reduce teenage pregnancy, behavioral
risk factors underlying teenage pregnancy, or other associated risk factors, of which not less than $24,000,000 shall be available
for research and demonstration grants to develop, replicate, refine, and test additional models and innovative strategies
for preventing teenage pregnancy, and of which any remaining amounts shall be available for training and technical assistance,
evaluation, outreach, and additional program support activities: Provided further, That of] the amounts provided under this heading from amounts available under section 241 of the PHS Act, [$8,455,000] $6,800,000 shall be available to carry out evaluations (including longitudinal evaluations) of teenage pregnancy prevention approaches, and $53,900,000 shall be for minority AIDS prevention and treatment activities: Provided further, That of the funds made available under this heading, $1,750,000 is for strengthening the Department's acquisition workforce
capacity and capabilities, including[: Provided further, That with respect to the previous proviso, such funds shall be available] for training, [recruitment] recruiting, [retention] retaining, and hiring members of the acquisition workforce as defined by 41 U.S.C. 1703, [and] for information technology in support of acquisition workforce effectiveness, [or] and for management solutions to improve acquisition management[: Provided further, That of the funds made available under this heading, $5,000,000 shall be for making competitive grants to provide abstinence
education (as defined by section 510(b)(2)(A)-(H) of the Social Security Act) to adolescents, and for Federal costs of administering
the grant: Provided further, That grants made under the authority of section 510(b)(2)(A)-(H) of the Social Security Act shall be made only to public
and private entities that 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 funds provided in this Act for embryo adoption activities may be used to provide to individuals adopting embryos, through
grants and other mechanisms, medical and administrative services deemed necessary for such adoptions: Provided further, That such services shall be provided consistent with 42 CFR 59.5(a)(4)]. (Department of Health and Human Services Appropriations Act, 2014.)
Program and Financing (in millions of dollars)
Identification code 75–9912–0–1–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
General Departmental Management
447
458
286
0004
Prevention & Public Health Fund (75–0116 MAND)
105
0799
Total direct obligations
447
458
391
0801
GDM (Collected)
173
158
158
0802
HCFAC (Mandatory)
9
9
15
0803
PHS Evaluation
69
69
119
0899
Total reimbursable obligations
251
236
292
0900
Total new obligations
698
694
683
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
2
9
1001
Discretionary unobligated balance brought fwd, Oct 1
2
Budget authority:
Appropriations, discretionary:
1100
Appropriation
474
458
286
1120
Appropriations transferred to other accts [75–0943]
–2
1120
Appropriations transferred to other accts [75–0139]
–1
1130
Appropriations permanently reduced (SEQ)
–25
1160
Appropriation, discretionary (total)
446
458
286
Appropriations, mandatory:
1221
Appropriations transferred from other accts [75–0116]
105
1260
Appropriations, mandatory (total)
105
Spending authority from offsetting collections, discretionary:
1700
Collected [PHS Evaluation & Collected]
113
236
277
1701
Change in uncollected payments, Federal sources
129
1750
Spending auth from offsetting collections, disc (total)
242
236
277
Spending authority from offsetting collections, mandatory:
1800
Collected HCFAC (Mandatory)
9
9
1801
Change in uncollected payments, Federal sources
9
1850
Spending auth from offsetting collections, mand (total)
9
9
9
1900
Budget authority (total)
697
703
677
1930
Total budgetary resources available
699
703
686
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–1
1941
Unexpired unobligated balance, end of year
9
3
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
624
536
559
3010
Obligations incurred, unexpired accounts
698
694
683
3011
Obligations incurred, expired accounts
11
3020
Outlays (gross)
–776
–671
–736
3041
Recoveries of prior year unpaid obligations, expired
–21
3050
Unpaid obligations, end of year
536
559
506
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–232
–257
–257
3070
Change in uncollected pymts, Fed sources, unexpired
–138
3071
Change in uncollected pymts, Fed sources, expired
113
3090
Uncollected pymts, Fed sources, end of year
–257
–257
–257
Memorandum (non-add) entries:
3100
Obligated balance, start of year
392
279
302
3200
Obligated balance, end of year
279
302
249
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
688
694
563
Outlays, gross:
4010
Outlays from new discretionary authority
351
332
278
4011
Outlays from discretionary balances
386
317
430
4020
Outlays, gross (total)
737
649
708
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources (PHS Evaluation & Collected)
–224
–236
–277
4033
Non-Federal sources
–2
4040
Offsets against gross budget authority and outlays (total)
–226
–236
–277
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–129
4052
Offsetting collections credited to expired accounts
113
4060
Additional offsets against budget authority only (total)
–16
4070
Budget authority, net (discretionary)
446
458
286
4080
Outlays, net (discretionary)
511
413
431
Mandatory:
4090
Budget authority, gross
9
9
114
Outlays, gross:
4100
Outlays from new mandatory authority
9
9
23
4101
Outlays from mandatory balances
30
13
5
4110
Outlays, gross (total)
39
22
28
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120
Federal sources (HCFAC Mandatory)
–9
–9
–9
Additional offsets against gross budget authority only:
4140
Change in uncollected pymts, Fed sources, unexpired
–9
4142
Offsetting collections credited to expired accounts
9
4160
Budget authority, net (mandatory)
105
4170
Outlays, net (mandatory)
30
13
19
4180
Budget authority, net (total)
446
458
391
4190
Outlays, net (total)
541
426
450
Note.—The reimbursable program (HCFAC) in the General Department Management (GDM) account reflects estimates of the allocation
account for 2015. Actual allocation will be determined annually.
General Departmental Management (GDM) funds activities that provide leadership, policy, legal, and administrative guidance
to HHS components, and support research to develop policy initiatives and improve existing HHS programs. GDM also funds the
activities of the Office of the Assistant Secretary for Health, including adolescent health, disease prevention and health
promotion, physical fitness and sports, minority health, research integrity, women's health, and programs funded through the
Prevention and Public Health Fund. This includes funding the continuation of grants for medically accurate and age appropriate
programs to reduce teen pregnancy, including funds for research, demonstration grants, and replication of programs that have
been proven effective through rigorous evaluation to reduce teen pregnancy.
Object Classification (in millions of dollars)
Identification code 75–9912–0–1–551
2013 actual
2014 est.
2015 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
90
92
94
11.3
Other than full-time permanent
14
13
12
11.5
Other personnel compensation
2
3
3
11.7
Military personnel
3
3
6
11.9
Total personnel compensation
109
111
115
12.1
Civilian personnel benefits
28
28
28
12.2
Military personnel benefits
2
2
2
21.0
Travel and transportation of persons
5
5
4
23.1
Rental payments to GSA
19
18
18
23.3
Communications, utilities, and miscellaneous charges
4
4
4
24.0
Printing and reproduction
1
1
1
25.1
Advisory and assistance services
27
28
18
25.2
Other services from non-Federal sources
43
38
28
25.3
Other goods and services from Federal sources
78
70
43
25.4
Operation and maintenance of facilities
2
2
4
25.7
Operation and maintenance of equipment
5
4
4
26.0
Supplies and materials
2
1
1
31.0
Equipment
2
1
1
41.0
Grants, subsidies, and contributions
120
145
120
99.0
Direct obligations
447
458
391
99.0
Reimbursable obligations
251
236
292
99.9
Total new obligations
698
694
683
Employment Summary
Identification code 75–9912–0–1–551
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
1,032
1,051
1,076
1101
Direct military average strength employment
39
37
43
2001
Reimbursable civilian full-time equivalent employment
483
469
462
2101
Reimbursable military average strength employment
23
17
9
Office for Civil Rights
For expenses necessary for the Office for Civil Rights, [$38,798,000] 41,205,000. (Department of Health and Human Services Appropriations Act, 2014.)
Program and Financing (in millions of dollars)
Identification code 75–0135–0–1–751
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Direct program activity
39
39
41
0801
Reimbursable program activity
3
7
7
0900
Total new obligations
42
46
48
Budgetary Resources:
Budget authority:
Appropriations, discretionary:
1100
Appropriation
41
39
41
1130
Appropriations permanently reduced
–2
1160
Appropriation, discretionary (total)
39
39
41
Spending authority from offsetting collections, mandatory:
1800
Collected
5
7
7
1850
Spending auth from offsetting collections, mand (total)
5
7
7
1900
Budget authority (total)
44
46
48
1930
Total budgetary resources available
44
46
48
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–2
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
13
10
10
3010
Obligations incurred, unexpired accounts
42
46
48
3011
Obligations incurred, expired accounts
1
3020
Outlays (gross)
–45
–46
–48
3041
Recoveries of prior year unpaid obligations, expired
–1
3050
Unpaid obligations, end of year
10
10
10
Memorandum (non-add) entries:
3100
Obligated balance, start of year
13
10
10
3200
Obligated balance, end of year
10
10
10
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
39
39
41
Outlays, gross:
4010
Outlays from new discretionary authority
34
31
33
4011
Outlays from discretionary balances
10
8
8
4020
Outlays, gross (total)
44
39
41
Mandatory:
4090
Budget authority, gross
5
7
7
Outlays, gross:
4100
Outlays from new mandatory authority
1
7
7
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123
Non-Federal sources
–5
–7
–7
4180
Budget authority, net (total)
39
39
41
4190
Outlays, net (total)
40
39
41
The Office for Civil Rights funds activities that carry out the Department's civil rights nondiscrimination and health information
privacy and security compliance programs.
Object Classification (in millions of dollars)
Identification code 75–0135–0–1–751
2013 actual
2014 est.
2015 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
20
21
20
11.3
Other than full-time permanent
1
1
1
11.9
Total personnel compensation
21
22
21
12.1
Civilian personnel benefits
6
6
6
23.1
Rental payments to GSA
3
3
3
25.2
Other services from non-Federal sources
2
1
2
25.3
Other goods and services from Federal sources
5
6
8
25.4
Operation and maintenance of facilities
1
1
1
25.7
Operation and maintenance of equipment
1
99.0
Direct obligations
39
39
41
99.0
Reimbursable obligations
3
7
7
99.9
Total new obligations
42
46
48
Employment Summary
Identification code 75–0135–0–1–751
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
207
203
196
1101
Direct military average strength employment
2
2
2
2001
Reimbursable civilian full-time equivalent employment
3
2
20
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 interoperable health information technology, [$15,556,000: Provided, That in addition to amounts provided herein, $44,811,000] $74,688,000 shall be available from amounts available under section 241 of the PHS Act. (Department of Health and Human Services Appropriations Act, 2014.)
Program and Financing (in millions of dollars)
Identification code 75–0130–0–1–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Health information technology
16
16
0002
Recovery Act activities
4
0799
Total direct obligations
20
16
0801
Reimbursable program
15
24
17
0802
Reimbursable program: PHS evaluation
45
45
75
0899
Total reimbursable obligations
60
69
92
0900
Total new obligations
80
85
92
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
2
1021
Recoveries of prior year unpaid obligations
4
1050
Unobligated balance (total)
6
Budget authority:
Appropriations, discretionary:
1100
Appropriation
16
16
1130
Appropriations permanently reduced
–1
1131
Unobligated balance of appropriations permanently reduced
–1
1160
Appropriation, discretionary (total)
14
16
Spending authority from offsetting collections, discretionary:
1700
PHS and Other
26
69
92
1701
Change in uncollected payments, Federal sources
34
1750
Spending auth from offsetting collections, disc (total)
60
69
92
1900
Budget authority (total)
74
85
92
1930
Total budgetary resources available
80
85
92
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
976
451
53
3010
Obligations incurred, unexpired accounts
80
85
92
3020
Outlays (gross)
–598
–483
–145
3040
Recoveries of prior year unpaid obligations, unexpired
–4
3041
Recoveries of prior year unpaid obligations, expired
–3
3050
Unpaid obligations, end of year
451
53
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–22
–34
–34
3070
Change in uncollected pymts, Fed sources, unexpired
–34
3071
Change in uncollected pymts, Fed sources, expired
22
3090
Uncollected pymts, Fed sources, end of year
–34
–34
–34
Memorandum (non-add) entries:
3100
Obligated balance, start of year
954
417
19
3200
Obligated balance, end of year
417
19
–34
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
74
85
92
Outlays, gross:
4010
Outlays from new discretionary authority
48
83
92
4011
Outlays from discretionary balances
548
400
53
4020
Outlays, gross (total)
596
483
145
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–47
–69
–92
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–34
4052
Offsetting collections credited to expired accounts
21
4060
Additional offsets against budget authority only (total)
–13
4070
Budget authority, net (discretionary)
14
16
4080
Outlays, net (discretionary)
549
414
53
Mandatory:
Outlays, gross:
4101
Outlays from mandatory balances
2
4180
Budget authority, net (total)
14
16
4190
Outlays, net (total)
551
414
53
This program supports coordination, leadership, and development of Federal health information technology activities and Federal
initiatives for the nationwide advancement of private and secure interoperable health information technology, in cooperation
with participants in the health sector. The Office of the National Coordinator for Health Information Technology was established
in the Health Information Technology for Economic and Clinical Health Act (P.L. 111–5, Title XIII), 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.
Object Classification (in millions of dollars)
Identification code 75–0130–0–1–551
2013 actual
2014 est.
2015 est.
Direct obligations:
23.1
Rental payments to GSA
3
3
25.1
Advisory and assistance services
1
25.2
Other services from non-Federal sources
10
6
25.3
Other goods and services from Federal sources
5
5
25.4
Operation and maintenance of facilities
2
1
99.0
Direct obligations
20
16
99.0
Reimbursable obligations
60
69
92
99.9
Total new obligations
80
85
92
Employment Summary
Identification code 75–0130–0–1–551
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
170
184
190
1101
Direct military average strength employment
1
1
1
Office of Medicare Hearings and Appeals
For expenses necessary for the Office of Medicare Hearings and Appeals, [$82,381,000] $100,000,000, to be transferred in appropriate part from the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical
Insurance Trust Fund. (Department of Health and Human Services Appropriations Act, 2014.)
Program and Financing (in millions of dollars)
Identification code 75–0139–0–1–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Direct program activity
69
82
100
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
1
1
Budget authority:
Appropriations, discretionary:
1121
Appropriations transferred from other accts [75–9912]
1
1121
Appropriations transferred from other accts [75–0140]
1
1160
Appropriation, discretionary (total)
2
Spending authority from offsetting collections, discretionary:
1700
Collected
45
82
100
1701
Change in uncollected payments, Federal sources
23
1750
Spending auth from offsetting collections, disc (total)
68
82
100
1900
Budget authority (total)
70
82
100
1930
Total budgetary resources available
70
83
101
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
1
1
1
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
14
9
3010
Obligations incurred, unexpired accounts
69
82
100
3011
Obligations incurred, expired accounts
1
3020
Outlays (gross)
–73
–91
–100
3041
Recoveries of prior year unpaid obligations, expired
–2
3050
Unpaid obligations, end of year
9
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–23
–23
3070
Change in uncollected pymts, Fed sources, unexpired
–23
3090
Uncollected pymts, Fed sources, end of year
–23
–23
–23
Memorandum (non-add) entries:
3100
Obligated balance, start of year
14
–14
–23
3200
Obligated balance, end of year
–14
–23
–23
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
70
82
100
Outlays, gross:
4010
Outlays from new discretionary authority
65
82
100
4011
Outlays from discretionary balances
8
9
4020
Outlays, gross (total)
73
91
100
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–45
–82
–100
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–23
4070
Budget authority, net (discretionary)
2
4080
Outlays, net (discretionary)
28
9
4180
Budget authority, net (total)
2
4190
Outlays, net (total)
28
9
This appropriation funds the operations of the Office of Medicare Hearings and Appeals (OMHA), as authorized by the Medicare
Prescription Drug, Improvement, and Modernization Act of 2003. OMHA provides an independent and impartial forum for the adjudication
of claims brought by or on behalf of Medicare beneficiaries related to their benefits and care.
Object Classification (in millions of dollars)
Identification code 75–0139–0–1–551
2013 actual
2014 est.
2015 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent
40
45
55
12.1
Civilian personnel benefits
12
14
17
22.0
Transportation of things
1
1
23.1
Rental payments to GSA
6
7
7
23.3
Communications, utilities, and miscellaneous charges
3
4
4
25.1
Advisory and assistance services
1
25.2
Other services from non-Federal sources
1
1
2
25.3
Other goods and services from Federal sources
5
5
7
25.4
Operation and maintenance of facilities
1
1
3
25.7
Operation and maintenance of equipment
1
1
26.0
Supplies and materials
1
1
31.0
Equipment
2
2
99.9
Total new obligations
69
82
100
Employment Summary
Identification code 75–0139–0–1–551
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
492
514
629
Public Health and Social Services Emergency Fund
For expenses necessary to support activities related to countering potential biological, nuclear, radiological, chemical,
and cybersecurity threats to civilian populations, and for other public health emergencies, [$857,290,000] $837,927,000, of which [$415,000,000] $415,000,000 shall remain available through September 30, [2015] 2016, for expenses necessary to support advanced research and development pursuant to section 319L of the PHS Act, and other administrative
expenses of the Biomedical Advanced Research and Development Authority[, and of which up to $5,000,000 shall remain available through September 30, 2016, to support the delivery of medical countermeasures
and shall be in addition to any other amounts available for such purpose]: Provided, That funds provided under this heading for the purpose of acquisition of security countermeasures shall be in addition to
any other funds available for such purpose: Provided further, That products purchased with funds provided under this heading may, at the discretion of the Secretary, be deposited in
the Strategic National Stockpile pursuant to section 319F-2 of the PHS Act: Provided further, That $5,000,000 of the amounts made available to support emergency operations shall remain available [through September 30, 2016.] until expended: Provided further, That, of the amounts made available to support advanced research and development, up to
$20,000,000 shall be available for the purposes of establishing and funding, using for either such purpose contracts, grants,
cooperative agreements, or other transactions as described in section 319L of the PHS Act (42 U.S.C. 247d-7e), a strategic
investment corporation, which shall not be deemed to be a Federal agency for any purpose, to further the purposes of such
section 319L to foster innovation in the development of medical countermeasures: Provided further, That, in addition to amounts
provided herein, $14,877,000 shall be available from amounts available under section 241 of the PHS Act to supplement funds
otherwise available for carrying out activities of the Office of the Assistant Secretary for Preparedness and Response.
For [necessary] expenses necessary for procuring security countermeasures (as defined in section 319F-2(c)(1)(B) of the PHS Act), [$255,000,000] $415,000,000, to remain available until expended.
For an additional amount for expenses necessary to prepare for [and] or respond to an influenza pandemic[, $115,009,000] or emerging infectious disease, including the development and purchase of vaccine, antivirals, necessary medical supplies,
diagnostics, and other surveillance tools, $170,009,000; of which [$83,000,000] $140,000,000 shall be available until expended[, for activities including the development and purchase of vaccine, antivirals, necessary medical supplies, diagnostics, and
other surveillance tools]: Provided [further], That, notwithstanding section 496(b) of the PHS Act, funds may be used for the construction or renovation of privately owned facilities
for the production of pandemic influenza vaccines and other biologics, if the Secretary finds such construction or renovation
necessary to secure sufficient supplies of such vaccines or biologics: Provided further, That funds appropriated in this paragraph 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
paragraph.
[In addition, for expenses necessary for replacement of building leases and associated renovation costs for Public Health Service
agencies and other components of HHS, including relocation and fit-out costs, $16,131,000, to remain available until expended.] (Department of Health and Human Services Appropriations Act, 2014.)
Program and Financing (in millions of dollars)
Identification code 75–0140–0–1–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Public Health and Social Services Emergency Fund
2,326
1,319
1,541
0801
Reimbursable program (FEMA)
44
80
80
0802
Reimbursable program activity (OPP)
15
0899
Total reimbursable obligations
44
80
95
0900
Total new obligations
2,370
1,399
1,636
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
2,349
850
771
1010
Unobligated balance transfer to other accts [75–0343]
–3
–3
–3
1021
Recoveries of prior year unpaid obligations
238
1050
Unobligated balance (total)
2,584
847
768
Budget authority:
Appropriations, discretionary:
1100
Appropriation
1,385
1,243
1,423
1120
Appropriations transferred to other accts [75–1534]
–500
1120
Appropriations transferred to other accts [75–1536]
–100
1120
Appropriations transferred to other accts [75–0128]
–5
1120
Appropriations transferred to other accts [75–9915]
–149
1120
Appropriations transferred to other accts [75–0943]
–2
1120
Appropriations transferred to other accts [75–0139]
–1
1130
Appropriations permanently reduced
–40
1160
Appropriation, discretionary (total)
588
1,243
1,423
Spending authority from offsetting collections, discretionary:
1700
Collected
27
80
95
1701
Change in uncollected payments, Federal sources
30
1750
Spending auth from offsetting collections, disc (total)
57
80
95
1900
Budget authority (total)
645
1,323
1,518
1930
Total budgetary resources available
3,229
2,170
2,286
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–9
1941
Unexpired unobligated balance, end of year
850
771
650
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
4,456
4,655
4,190
3010
Obligations incurred, unexpired accounts
2,370
1,399
1,636
3011
Obligations incurred, expired accounts
2
3020
Outlays (gross)
–1,880
–1,864
–2,000
3040
Recoveries of prior year unpaid obligations, unexpired
–238
3041
Recoveries of prior year unpaid obligations, expired
–55
3050
Unpaid obligations, end of year
4,655
4,190
3,826
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–241
–153
–153
3070
Change in uncollected pymts, Fed sources, unexpired
–30
3071
Change in uncollected pymts, Fed sources, expired
118
3090
Uncollected pymts, Fed sources, end of year
–153
–153
–153
Memorandum (non-add) entries:
3100
Obligated balance, start of year
4,215
4,502
4,037
3200
Obligated balance, end of year
4,502
4,037
3,673
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
645
1,323
1,518
Outlays, gross:
4010
Outlays from new discretionary authority
177
439
445
4011
Outlays from discretionary balances
1,703
1,425
1,555
4020
Outlays, gross (total)
1,880
1,864
2,000
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–111
–80
–95
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–30
4052
Offsetting collections credited to expired accounts
84
4060
Additional offsets against budget authority only (total)
54
4070
Budget authority, net (discretionary)
588
1,243
1,423
4080
Outlays, net (discretionary)
1,769
1,784
1,905
4180
Budget authority, net (total)
588
1,243
1,423
4190
Outlays, net (total)
1,769
1,784
1,905
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. This account includes funding
for the Office of the Assistant Secretary for Preparedness and Response, as authorized by the Pandemic and All-Hazards Preparedness
Reauthorization Act. Funds will be used for hospital preparedness and other emergency preparedness activities including the
National Disaster Medical System. The PHSSEF also supports the HHS Cybersecurity and Security and Strategic Information programs,
and the Medical Reserve Corps.
The PHSSEF also continues to support the advanced development and procurement of biodefense and pandemic influenza countermeasures.
A Strategic Investor corporation will be estabished to invest in the private sector, specifically focusing on disruptive technologies
including novel antimicrobials and multi-use platform technologies for diagnostics and medical countermeasures.
Object Classification (in millions of dollars)
Identification code 75–0140–0–1–551
2013 actual
2014 est.
2015 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
67
69
73
11.3
Other than full-time permanent
8
8
8
11.7
Military personnel
7
7
7
11.9
Total personnel compensation
82
84
88
12.1
Civilian personnel benefits
21
22
23
12.2
Military personnel benefits
3
3
3
21.0
Travel and transportation of persons
8
7
7
22.0
Transportation of things
1
1
1
23.1
Rental payments to GSA
18
18
18
23.3
Communications, utilities, and miscellaneous charges
4
8
10
25.1
Advisory and assistance services
414
210
297
25.2
Other services from non-Federal sources
249
138
131
25.3
Other goods and services from Federal sources
72
54
58
25.4
Operation and maintenance of facilities
22
23
25
25.5
Research and development contracts
241
104
146
25.7
Operation and maintenance of equipment
30
26
28
26.0
Supplies and materials
685
340
377
31.0
Equipment
20
16
17
41.0
Grants, subsidies, and contributions
456
265
312
99.0
Direct obligations
2,326
1,319
1,541
99.0
Reimbursable obligations
44
80
95
99.9
Total new obligations
2,370
1,399
1,636
Employment Summary
Identification code 75–0140–0–1–551
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
600
665
689
1101
Direct military average strength employment
63
76
76
Transfers from the Patient-Centered Outcomes Research Trust Fund
Program and Financing (in millions of dollars)
Identification code 75–0145–0–1–552
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0801
AHRQ
44
68
120
0802
Office of the Secretary
7
25
25
0809
Reimbursable program activities, subtotal
51
93
145
0900
Total new obligations
51
93
145
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
28
49
92
Budget authority:
Spending authority from offsetting collections, mandatory:
1800
Collected
72
136
132
1850
Spending auth from offsetting collections, mand (total)
72
136
132
1900
Budget authority (total)
72
136
132
1930
Total budgetary resources available
100
185
224
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
49
92
79
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
9
49
108
3010
Obligations incurred, unexpired accounts
51
93
145
3020
Outlays (gross)
–11
–34
–70
3050
Unpaid obligations, end of year
49
108
183
Memorandum (non-add) entries:
3100
Obligated balance, start of year
9
49
108
3200
Obligated balance, end of year
49
108
183
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
72
136
132
Outlays, gross:
4100
Outlays from new mandatory authority
1
4
4
4101
Outlays from mandatory balances
10
30
66
4110
Outlays, gross (total)
11
34
70
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120
Federal sources
–72
–136
–132
4190
Outlays, net (total)
–61
–102
–62
Public Law 111–148 established the Patient-Centered Outcomes Research Trust Fund (PCORTF). Beginning in FY 2011, a total of
20 percent of the funds appropriated or credited to the PCORTF will be transferred each year to the Department of Health and
Human Services (HHS). As authorized in section 937 of the Public Health Service Act, HHS will disseminate research findings
from the Patient-Centered Outcomes Research Institute and other government-funded comparative clinical effectiveness research
and build research and data capacity for comparative clinical effectiveness research. Transferred funds will be distributed
to the Secretary of HHS and the Agency for Healthcare Research and Quality to carry out these activities.
Object Classification (in millions of dollars)
Identification code 75–0145–0–1–552
2013 actual
2014 est.
2015 est.
99.0
Reimbursable obligations
7
25
25
Allocation Account - reimbursable:
11.1
Personnel compensation: Full-time permanent
2
3
25.5
Research and development contracts
44
25
28
41.0
Grants, subsidies, and contributions
41
89
99.0
Allocation account - reimbursable
44
68
120
99.9
Total new obligations
51
93
145
Employment Summary
Identification code 75–0145–0–1–552
2013 actual
2014 est.
2015 est.
2001
Reimbursable civilian full-time equivalent employment
2
3
3
Prevention and Wellness Fund, Recovery Act
Program and Financing (in millions of dollars)
Identification code 75–0144–0–1–551
2013 actual
2014 est.
2015 est.
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
2
3041
Recoveries of prior year unpaid obligations, expired
–2
Memorandum (non-add) entries:
3100
Obligated balance, start of year
2
The Prevention and Wellness Fund is authorized under the American Recovery and Reinvestment Act (ARRA), (P.L. 111–5). The
Prevention and Wellness Fund administered evidence-based clinical and community-based prevention and wellness strategies.
Nonrecurring Expenses Fund
Program and Financing (in millions of dollars)
Identification code 75–0125–0–1–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Nonrecurring Expenses Fund Projects
578
550
50
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
285
50
1012
Unobligated balance transfers between expired and unexpired accounts
863
315
1050
Unobligated balance (total)
863
600
50
1930
Total budgetary resources available
863
600
50
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
285
50
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
505
539
3010
Obligations incurred, unexpired accounts
578
550
50
3020
Outlays (gross)
–73
–516
–178
3050
Unpaid obligations, end of year
505
539
411
Memorandum (non-add) entries:
3100
Obligated balance, start of year
505
539
3200
Obligated balance, end of year
505
539
411
Budget authority and outlays, net:
Discretionary:
Outlays, gross:
4011
Outlays from discretionary balances
73
516
178
4190
Outlays, net (total)
73
516
178
The Nonrecurring Expenses Fund is a no-year account that captures expired unobligated balances from discretionary accounts
prior to cancellation. The Fund will be used for capital acquisition, including facilities infrastructure and information
technology infrastructure.
Object Classification (in millions of dollars)
Identification code 75–0125–0–1–551
2013 actual
2014 est.
2015 est.
Direct obligations:
25.2
Other services from non-Federal sources
45
25.3
Other goods and services from Federal sources
88
25.7
Operation and maintenance of equipment
9
99.0
Direct obligations
97
45
25.2
Allocation Account - direct: Other services from non-Federal sources
481
505
50
99.9
Total new obligations
578
550
50
Health Insurance Reform Implementation Fund
Program and Financing (in millions of dollars)
Identification code 75–0119–0–1–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Direct program activity
160
87
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
240
87
1021
Recoveries of prior year unpaid obligations
7
1050
Unobligated balance (total)
247
87
1930
Total budgetary resources available
247
87
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
87
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
265
197
121
3010
Obligations incurred, unexpired accounts
160
87
3020
Outlays (gross)
–221
–163
–100
3040
Recoveries of prior year unpaid obligations, unexpired
–7
3050
Unpaid obligations, end of year
197
121
21
Memorandum (non-add) entries:
3100
Obligated balance, start of year
265
197
121
3200
Obligated balance, end of year
197
121
21
Budget authority and outlays, net:
Mandatory:
Outlays, gross:
4101
Outlays from mandatory balances
221
163
100
4190
Outlays, net (total)
221
163
100
Section 1005 of the Health Care and Education Reconciliation Act of 2010 (P.L. 111–152) appropriated $1,000,000,000 to the
Health Insurance Reform Implementation Fund within the Department of Health and Human Services. The Fund shall be used for
Federal administrative expenses necessary to carry out the requirements of the Patient Protection and Affordable Care Act
of 2010 (P.L. 111–148) and the Health Care and Education Reconciliation Act of 2010.
Object Classification (in millions of dollars)
Identification code 75–0119–0–1–551
2013 actual
2014 est.
2015 est.
25.2
Direct obligations: Other services from non-Federal sources
158
25
Allocation Account - direct:
11.1
Personnel compensation: Full-time permanent
12.1
Civilian personnel benefits
25.2
Other services from non-Federal sources
62
99.0
Allocation account - direct
62
99.5
Below reporting threshold
2
99.9
Total new obligations
160
87
Prevention and Public Health Fund
Program and Financing (in millions of dollars)
Identification code 75–0116–0–1–551
2013 actual
2014 est.
2015 est.
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
1,000
1,000
1,000
1220
Appropriations transferred to other accts [75–0142]
–9
–28
–28
1220
Appropriations transferred to other accts [75–1700]
–6
–7
1220
Appropriations transferred to other accts [75–0943]
–463
–831
–809
1220
Appropriations transferred to other accts [75–0511]
–454
1220
Appropriations transferred to other accts [75–0350]
–2
1220
Appropriations transferred to other accts [75–1362]
–15
–62
–58
1220
Appropriations transferred to other accts [75–9912]
–105
1230
Appropriations and/or unobligated balance of appropriations permanently reduced [SEQ]
–51
–72
The Affordable Care Act, (P.L. 111–148) established the Prevention and Public Health Fund to support prevention and public
health activities. In FY 2015, $1.00 billion is available to support a range of public health efforts intended to prevent
disease and reduce health care costs. The Secretary has authority to transfer to accounts within HHS.
Pregnancy Assistance Fund
Program and Financing (in millions of dollars)
Identification code 75–0117–0–1–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Direct program activity
24
23
25
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
25
25
25
1230
Appropriations and/or unobligated balance of appropriations permanently reduced
–1
–2
1260
Appropriations, mandatory (total)
24
23
25
1930
Total budgetary resources available
24
23
25
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
39
34
42
3010
Obligations incurred, unexpired accounts
24
23
25
3020
Outlays (gross)
–29
–15
–24
3050
Unpaid obligations, end of year
34
42
43
Memorandum (non-add) entries:
3100
Obligated balance, start of year
39
34
42
3200
Obligated balance, end of year
34
42
43
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
24
23
25
Outlays, gross:
4100
Outlays from new mandatory authority
1
2
2
4101
Outlays from mandatory balances
28
13
22
4110
Outlays, gross (total)
29
15
24
4180
Budget authority, net (total)
24
23
25
4190
Outlays, net (total)
29
15
24
For awarding competitive grants to States to assist pregnant and parenting teens and women.
Object Classification (in millions of dollars)
Identification code 75–0117–0–1–551
2013 actual
2014 est.
2015 est.
Direct obligations:
25.3
Other goods and services from Federal sources
1
1
1
41.0
Grants, subsidies, and contributions
23
22
24
99.9
Total new obligations
24
23
25
Employment Summary
Identification code 75–0117–0–1–551
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
2
Section 241 Evaluation Transactions Account
Program and Financing (in millions of dollars)
Identification code 75–3902–0–1–552
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0801
Reimbursable program activity
1,060
1,264
0809
Reimbursable program activities, subtotal
1,060
1,264
0900
Total new obligations (object class 25.3)
1,060
1,264
Budgetary Resources:
Budget authority:
Spending authority from offsetting collections, discretionary:
1700
Collected
1,060
1,264
1750
Spending auth from offsetting collections, disc (total)
1,060
1,264
1930
Total budgetary resources available
1,060
1,264
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
1,060
1,264
3020
Outlays (gross)
–1,060
–1,264
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
1,060
1,264
Outlays, gross:
4010
Outlays from new discretionary authority
1,060
1,264
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–1,060
–1,264
The Public Health Service Act (PHS) Evaluation Transactions account supports the execution of section 241 of the PHS Act.
Object Classification (in millions of dollars)
Identification code 75–3902–0–1–552
2013 actual
2014 est.
2015 est.
99.0
Reimbursable obligations
1,060
1,264
Program Support Center
Federal Funds
Retirement Pay and Medical Benefits for Commissioned Officers
For retirement pay and medical benefits of Public Health Service Commissioned Officers as authorized by law, for payments
under the Retired Serviceman's Family Protection Plan and Survivor Benefit Plan, and for medical care of dependents and retired
personnel under the Dependents' Medical Care Act, such amounts as may be required during the current fiscal year. (Department of Health and Human Services Appropriations Act, 2014.)
Program and Financing (in millions of dollars)
Identification code 75–0379–0–1–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Retirement payments
393
414
432
0002
Survivors' benefits
26
27
28
0003
Medical care
95
99
102
0900
Total new obligations
514
540
562
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
514
540
562
1260
Appropriations, mandatory (total)
514
540
562
1930
Total budgetary resources available
514
540
562
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
101
67
30
3001
Adjustments to unpaid obligations, brought forward, Oct 1
–31
3010
Obligations incurred, unexpired accounts
514
540
562
3020
Outlays (gross)
–497
–577
–561
3041
Recoveries of prior year unpaid obligations, expired
–20
3050
Unpaid obligations, end of year
67
30
31
Memorandum (non-add) entries:
3100
Obligated balance, start of year
70
67
30
3200
Obligated balance, end of year
67
30
31
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
514
540
562
Outlays, gross:
4100
Outlays from new mandatory authority
453
513
534
4101
Outlays from mandatory balances
44
64
27
4110
Outlays, gross (total)
497
577
561
4180
Budget authority, net (total)
514
540
562
4190
Outlays, net (total)
497
577
561
The number of beneficiaries using the Commissioned Corps system is estimated as follows:
Retirement Pay, Survivor Benefits, and Medical Benefits
2013
2014
2015
Active Duty:
HHS
4964
4985
4985
DOJ, BOP
866
870
870
Homeland Security
494
494
494
EPA
65
65
65
All Other
376
384
384
Total Active Duty
6765
6798
6798
Retirees & Survivors:
Retirees
5714
5860
6010
Retiree family members and survivors
1029
1058
1088
Total Retirement Pay
6743
6918
7098
Total Beneficiaries (active duty, retirees, survivors)
13508
13716
13896
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 members and retirees of the PHS Commissioned
Corps.
Object Classification (in millions of dollars)
Identification code 75–0379–0–1–551
2013 actual
2014 est.
2015 est.
Direct obligations:
13.0
Benefits for former personnel
419
441
460
25.6
Medical care
95
99
102
99.9
Total new obligations
514
540
562
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
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Medicare eligible accruals
28
27
28
0900
Total new obligations (object class 12.2)
28
27
28
Budgetary Resources:
Budget authority:
Appropriations, discretionary:
1100
Appropriation
29
27
28
1130
Appropriations permanently reduced
–1
1160
Appropriation, discretionary (total)
28
27
28
1930
Total budgetary resources available
28
27
28
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
28
27
28
3020
Outlays (gross)
–28
–27
–28
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
28
27
28
Outlays, gross:
4010
Outlays from new discretionary authority
28
27
28
4180
Budget authority, net (total)
28
27
28
4190
Outlays, net (total)
28
27
28
Summary of Budget Authority and Outlays (in millions of dollars)
2013 actual
2014 est.
2015 est.
Enacted/requested:
Budget Authority
28
27
28
Outlays
28
27
28
Legislative proposal, not subject to PAYGO:
Budget Authority
–3
Outlays
–3
Total:
Budget Authority
28
27
25
Outlays
28
27
25
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).
HHS Accrual Contribution to the Uniformed Services Retiree Health Care Fund
(Legislative proposal, not subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 75–0170–2–1–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Medicare eligible accruals
–3
0900
Total new obligations (object class 12.2)
–3
Budgetary Resources:
Budget authority:
Appropriations, discretionary:
1100
Appropriation
–3
1160
Appropriation, discretionary (total)
–3
1930
Total budgetary resources available
–3
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
–3
3020
Outlays (gross)
3
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
–3
Outlays, gross:
4010
Outlays from new discretionary authority
–3
4180
Budget authority, net (total)
–3
4190
Outlays, net (total)
–3
Health Activities Funds
Program and Financing (in millions of dollars)
Identification code 75–9913–0–1–552
2013 actual
2014 est.
2015 est.
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
1
1
1021
Recoveries of prior year unpaid obligations
1
1050
Unobligated balance (total)
1
1
1
1930
Total budgetary resources available
1
1
1
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
1
1
1
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
1
3040
Recoveries of prior year unpaid obligations, unexpired
–1
Memorandum (non-add) entries:
3100
Obligated balance, start of year
1
This display shows activities in support of 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
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0801
Program Support Center
654
796
785
0802
OS activities
300
351
359
0900
Total new obligations
954
1,147
1,144
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
102
117
73
1021
Recoveries of prior year unpaid obligations
97
1050
Unobligated balance (total)
199
117
73
Budget authority:
Spending authority from offsetting collections, discretionary:
1700
Collected
916
1,103
1,103
1701
Change in uncollected payments, Federal sources
–44
1750
Spending auth from offsetting collections, disc (total)
872
1,103
1,103
1930
Total budgetary resources available
1,071
1,220
1,176
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
117
73
32
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
510
515
70
3010
Obligations incurred, unexpired accounts
954
1,147
1,144
3020
Outlays (gross)
–852
–1,592
–1,103
3040
Recoveries of prior year unpaid obligations, unexpired
–97
3050
Unpaid obligations, end of year
515
70
111
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–285
–241
–241
3070
Change in uncollected pymts, Fed sources, unexpired
44
3090
Uncollected pymts, Fed sources, end of year
–241
–241
–241
Memorandum (non-add) entries:
3100
Obligated balance, start of year
225
274
–171
3200
Obligated balance, end of year
274
–171
–130
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
872
1,103
1,103
Outlays, gross:
4010
Outlays from new discretionary authority
568
1,103
1,103
4011
Outlays from discretionary balances
284
489
4020
Outlays, gross (total)
852
1,592
1,103
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–911
–1,103
–1,103
4033
Non-Federal sources
–5
4040
Offsets against gross budget authority and outlays (total)
–916
–1,103
–1,103
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
44
4080
Outlays, net (discretionary)
–64
489
4190
Outlays, net (total)
–64
489
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, information
technology, 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, web management, claims, acquisition integration and modernization, small business, grants tracking,
the physical access aspects of the Department's implementation of Homeland Security Presidential Directive 12, and commercial
services management.
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
2013 actual
2014 est.
2015 est.
Reimbursable obligations:
Personnel compensation:
11.1
Full-time permanent
92
103
103
11.3
Other than full-time permanent
4
2
2
11.5
Other personnel compensation
2
3
3
11.7
Military personnel
7
8
8
11.9
Total personnel compensation
105
116
116
12.1
Civilian personnel benefits
28
29
29
12.2
Military personnel benefits
4
2
2
21.0
Travel and transportation of persons
2
2
2
22.0
Transportation of things
3
4
4
23.1
Rental payments to GSA
22
22
22
23.3
Communications, utilities, and miscellaneous charges
34
6
6
24.0
Printing and reproduction
3
3
3
25.1
Advisory and assistance services
29
32
31
25.2
Other services from non-Federal sources
554
706
707
25.3
Other goods and services from Federal sources
52
71
70
25.4
Operation and maintenance of facilities
13
16
16
25.6
Medical care
20
29
29
25.7
Operation and maintenance of equipment
60
74
73
26.0
Supplies and materials
24
32
32
31.0
Equipment
1
3
2
99.9
Total new obligations
954
1,147
1,144
Employment Summary
Identification code 75–9941–0–4–551
2013 actual
2014 est.
2015 est.
2001
Reimbursable civilian full-time equivalent employment
1,071
1,238
1,238
2101
Reimbursable military average strength employment
83
88
86
3101
Allocation account military average strength employment
1,736
1,748
1,748
Trust Funds
Miscellaneous Trust Funds
Special and Trust Fund Receipts (in millions of dollars)
Identification code 75–9971–0–7–551
2013 actual
2014 est.
2015 est.
0100
Balance, start of year
32
Receipts:
0220
Contributions, Indian Health Facilities
12
48
48
0221
Contributions, N.I.H., Unconditional Gift Fund
3
3
3
0222
Centers for Disease Control, Gifts and Donations
15
15
15
0223
Contributions, N.I.H., Conditional Gift Fund
31
27
27
0224
Contributions to the Indian Health Service Gift Fund
1
1
1
0299
Total receipts and collections
62
94
94
0400
Total: Balances and collections
62
94
126
Appropriations:
0500
Miscellaneous Trust Funds
–62
–62
–63
0799
Balance, end of year
32
63
Program and Financing (in millions of dollars)
Identification code 75–9971–0–7–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0002
Gifts
39
39
39
0003
Contributions, Indian Health Facilities
12
12
12
0900
Total new obligations
51
51
51
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
133
149
160
1021
Recoveries of prior year unpaid obligations
5
1050
Unobligated balance (total)
138
149
160
Budget authority:
Appropriations, mandatory:
1201
Appropriation (special or trust fund)
62
62
63
1260
Appropriations, mandatory (total)
62
62
63
1930
Total budgetary resources available
200
211
223
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
149
160
172
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
75
67
66
3010
Obligations incurred, unexpired accounts
51
51
51
3020
Outlays (gross)
–54
–52
–57
3040
Recoveries of prior year unpaid obligations, unexpired
–5
3050
Unpaid obligations, end of year
67
66
60
Memorandum (non-add) entries:
3100
Obligated balance, start of year
75
67
66
3200
Obligated balance, end of year
67
66
60
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
62
62
63
Outlays, gross:
4100
Outlays from new mandatory authority
22
5
6
4101
Outlays from mandatory balances
32
47
51
4110
Outlays, gross (total)
54
52
57
4180
Budget authority, net (total)
62
62
63
4190
Outlays, net (total)
54
52
57
Memorandum (non-add) entries:
5000
Total investments, SOY: Federal securities: Par value
25
28
28
5001
Total investments, EOY: Federal securities: Par value
28
28
28
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
2013 actual
2014 est.
2015 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
2
2
2
11.3
Other than full-time permanent
1
1
1
11.9
Total personnel compensation
3
3
3
12.1
Civilian personnel benefits
1
1
1
21.0
Travel and transportation of persons
1
1
1
25.1
Advisory and assistance services
3
3
3
25.2
Other services from non-Federal sources
6
6
6
25.3
Other goods and services from Federal sources
7
7
7
25.5
Research and development contracts
7
7
7
25.6
Medical care
1
1
1
26.0
Supplies and materials
5
4
4
31.0
Equipment
5
6
6
41.0
Grants, subsidies, and contributions
12
12
12
99.9
Total new obligations
51
51
51
Employment Summary
Identification code 75–9971–0–7–551
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
27
27
27
Office of the Inspector General
Federal Funds
Office of Inspector General
For expenses necessary for the Office of Inspector General, including the hire of passenger motor vehicles for investigations,
in carrying out the provisions of the Inspector General Act of 1978, [$71,000,000] $75,000,000: Provided, That of such amount, necessary sums shall be available for providing protective services to the Secretary and investigating
non-payment of child support cases for which non-payment is a Federal offense under 18 U.S.C. 228. (Department of Health and Human Services Appropriations Act, 2014.)
Program and Financing (in millions of dollars)
Identification code 75–0128–0–1–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0001
Direct program
49
74
78
0801
HCFAC Reimbursable program
213
197
197
0802
Direct Reimbursable program
18
21
21
0803
HCFAC Discretionary allocation adjustment
39
30
23
0899
Total reimbursable obligations
270
248
241
0900
Total new obligations
319
322
319
Budgetary Resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
10
21
16
1001
Discretionary unobligated balance brought fwd, Oct 1
7
1012
Unobligated balance transfers between expired and unexpired accounts
10
1021
Recoveries of prior year unpaid obligations
4
1050
Unobligated balance (total)
24
21
16
Budget authority:
Appropriations, discretionary:
1100
Appropriation
50
71
75
1121
Appropriations transferred from other accts [75–0140]
5
1130
Appropriations permanently reduced
–3
1160
Appropriation, discretionary (total)
52
71
75
Spending authority from offsetting collections, discretionary:
1700
Collected
51
49
49
1701
Change in uncollected payments, Federal sources
9
1750
Spending auth from offsetting collections, disc (total)
60
49
49
Spending authority from offsetting collections, mandatory:
1800
Collected
224
197
212
1801
Change in uncollected payments, Federal sources
–20
1802
Offsetting collections (previously unavailable)
1
1823
New and/or unobligated balance of spending authority from offsetting collections temporarily reduced
–1
1850
Spending auth from offsetting collections, mand (total)
204
197
212
1900
Budget authority (total)
316
317
336
1930
Total budgetary resources available
340
338
352
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
21
16
33
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
57
35
45
3010
Obligations incurred, unexpired accounts
319
322
319
3011
Obligations incurred, expired accounts
4
3020
Outlays (gross)
–333
–312
–342
3040
Recoveries of prior year unpaid obligations, unexpired
–4
3041
Recoveries of prior year unpaid obligations, expired
–8
3050
Unpaid obligations, end of year
35
45
22
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–61
–35
–35
3070
Change in uncollected pymts, Fed sources, unexpired
11
3071
Change in uncollected pymts, Fed sources, expired
15
3090
Uncollected pymts, Fed sources, end of year
–35
–35
–35
Memorandum (non-add) entries:
3100
Obligated balance, start of year
–4
10
3200
Obligated balance, end of year
10
–13
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
112
120
124
Outlays, gross:
4010
Outlays from new discretionary authority
82
114
117
4011
Outlays from discretionary balances
29
6
8
4020
Outlays, gross (total)
111
120
125
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–68
–49
–49
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–9
4052
Offsetting collections credited to expired accounts
17
4060
Additional offsets against budget authority only (total)
8
4070
Budget authority, net (discretionary)
52
71
75
4080
Outlays, net (discretionary)
43
71
76
Mandatory:
4090
Budget authority, gross
204
197
212
Outlays, gross:
4100
Outlays from new mandatory authority
184
179
193
4101
Outlays from mandatory balances
38
13
24
4110
Outlays, gross (total)
222
192
217
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120
Federal sources
–214
–185
–200
4123
Non-Federal sources
–10
–12
–12
4130
Offsets against gross budget authority and outlays (total)
–224
–197
–212
Additional offsets against gross budget authority only:
4140
Change in uncollected pymts, Fed sources, unexpired
20
4170
Outlays, net (mandatory)
–2
–5
5
4180
Budget authority, net (total)
52
71
75
4190
Outlays, net (total)
41
66
81
The mission of the Office of Inspector General (OIG) is to protect the integrity of the U.S. Department of Health and Human
Services (HHS) programs and the health and welfare of the people they serve. As established by the Inspector General Act of
1978, OIG is an independent and objective organization that fights fraud, waste, and abuse and promotes efficiency, economy,
and effectiveness in HHS programs and operations. OIG works to ensure that Federal dollars are used appropriately and that
HHS programs well serve the people that use them. OIG fulfills its mission through a broad range of audits, evaluations, investigations,
and enforcement and compliance activities. In addition to discretionary appropriations, OIG receives funds through the Health
Care Fraud and Abuse Control (HCFAC) account created by the Health Insurance Portability and Accountability Act of 1996.
Object Classification (in millions of dollars)
Identification code 75–0128–0–1–551
2013 actual
2014 est.
2015 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
26
40
42
11.3
Other than full-time permanent
1
1
1
11.9
Total personnel compensation
27
41
43
12.1
Civilian personnel benefits
9
14
15
21.0
Travel and transportation of persons
1
2
2
22.0
Transportation of things
1
1
23.3
Communications, utilities, and miscellaneous charges
1
1
1
25.2
Other services from non-Federal sources
1
1
25.3
Other goods and services from Federal sources
9
10
11
25.4
Operation and maintenance of facilities
1
1
1
26.0
Supplies and materials
1
1
31.0
Equipment
1
2
2
99.0
Direct obligations
49
74
78
99.0
Reimbursable obligations
270
248
241
99.9
Total new obligations
319
322
319
Employment Summary
Identification code 75–0128–0–1–551
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
245
379
397
2001
Reimbursable civilian full-time equivalent employment
1,415
1,198
1,048
Office of Inspector General
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 75–0128–4–1–551
2013 actual
2014 est.
2015 est.
Obligations by program activity:
0801
Reimbursable program activity
85
Budgetary Resources:
Budget authority:
Spending authority from offsetting collections, mandatory:
1800
Collected
85
1850
Spending auth from offsetting collections, mand (total)
85
1900
Budget authority (total)
85
1930
Total budgetary resources available
85
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
85
3020
Outlays (gross)
–85
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
85
Outlays, gross:
4100
Outlays from new mandatory authority
85
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120
Federal sources
–85
Object Classification (in millions of dollars)
Identification code 75–0128–4–1–551
2013 actual
2014 est.
2015 est.
99.9
Total new obligations
85
Employment Summary
Identification code 75–0128–4–1–551
2013 actual
2014 est.
2015 est.
1001
Direct civilian full-time equivalent employment
2001
Reimbursable civilian full-time equivalent employment
416
General and Administrative Provisions
GENERAL FUND RECEIPT ACCOUNTS
(in millions of dollars)
2013 actual
2014 est.
2015 est.
Offsetting receipts from the public:
75–143500
General Fund Proprietary Interest Receipts, not Otherwise Classified: Enacted/requested
173
90
90
75–267403
Consumer Operated and Oriented Plan Direct Loan Program, Downward Reestimate of Subsidies: Enacted/requested
6
75–274530
Health Education Assistance Loans, Downward Reestimates of Subsidies: Enacted/requested
43
75–310700
Federal Share of Child Support Collections: Enacted/requested
841
759
700
Legislative proposal, subject to PAYGO
5
75–322000
All Other General Fund Proprietary Receipts Including Budget Clearing Accounts: Enacted/requested
41
34
34
General Fund Offsetting receipts from the public
1,055
932
829
Intragovernmental payments:
75–388500
Undistributed Intragovernmental Payments and Receivables from Cancelled Accounts: Enacted/requested
1,147
General Fund Intragovernmental payments
1,147
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]202. None of the discretionary funds appropriated in this title 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. [204]203. None of the funds appropriated in this Act may be expended pursuant to section 241 of the PHS Act, except for funds specifically
provided for in this Act, or for other taps and assessments made by any office located in HHS, prior to the preparation and
submission of a report by the Secretary to the Committees on Appropriations of the House of Representatives and the Senate
detailing the planned uses of such funds.SEC. [205]204. Notwithstanding section 241(a) of the PHS Act, such portion as the Secretary shall determine, but not more than [2.5] 3.0 percent, of any amounts appropriated for programs authorized under such Act shall be made available for the evaluation (directly,
or by grants or contracts) and the implementation and effectiveness of programs funded in this title.'
(transfer of funds)
SEC. [206]205. Not to exceed 1 percent of any discretionary funds (pursuant to the Balanced Budget and Emergency Deficit Control Act of 1985)
which are appropriated for the current fiscal year for HHS 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 the transfer authority granted by this section shall not be used to create any new program or to fund any project or
activity for which no funds are provided in this Act: Provided further, That the Committees on Appropriations of the House of Representatives and the Senate are notified at least 15 days in advance
of any transfer.'
(transfer of funds)
SEC. [207]206. The Director of the NIH, 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 Committees on Appropriations of the House of Representatives and the Senate are notified at least 15 days in advance
of any transfer.'
(transfer of funds)
SEC. [208]207. Of the amounts made available in this Act for NIH, the amount for research related to the human immunodeficiency virus, as
jointly determined by the Director of NIH 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 PHS Act.SEC. [209]208. None of the funds appropriated in this Act may be made available to any entity under title X of the PHS Act unless the applicant
for the award certifies to the Secretary that it encourages family participation in the decision of minors to seek family
planning services and that it provides counseling to minors on how to resist attempts to coerce minors into engaging in sexual
activities.SEC. [210]209. Notwithstanding any other provision of law, no provider of services under title X of the PHS Act shall be exempt from any
State law requiring notification or the reporting of child abuse, child molestation, sexual abuse, rape, or incest.SEC. [211]210. 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]211. In order for HHS 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 [2014] 2015:
(1) The Secretary 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. The Secretary 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 and other applicable statutes administered by the Department of State.
(2) The Secretary 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 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 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.
(3) The Secretary is authorized to provide to personnel appointed or assigned by the Secretary to serve abroad, allowances and
benefits similar to those provided under chapter 9 of title I of the Foreign Service Act of 1980, and 22 U.S.C. 4081 through
4086 and subject to such regulations prescribed by the Secretary. The Secretary is further authorized to provide locality-based
comparability payments (stated as a percentage) up to the amount of the locality-based comparability payment (stated as a
percentage) that would be payable to such personnel under section 5304 of title 5, United States Code if such personnel's
official duty station were in the District of Columbia. Leaves of absence for personnel under this subsection shall be on
the same basis as that provided under subchapter I of chapter 63 of title 5, United States Code, or section 903 of the Foreign
Service Act of 1980, to individuals serving in the Foreign Service.
SEC. [213]212. (a) Authority.—Notwithstanding any other provision of law, the Director of NIH ("Director'') may use funds available under section 402(b)(7)
or 402(b)(12) of the PHS Act to enter into transactions (other than contracts, cooperative agreements, or grants) to carry
out research identified pursuant to such section 402(b)(7) (pertaining to the Common Fund) or research and activities described
in such section 402(b)(12).
(b) Peer Review.—In entering into transactions under subsection (a), the Director 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 PHS
Act.
SEC. [214]213. Funds which are available for Individual Learning Accounts for employees of CDC and the Agency for Toxic Substances and Disease
Registry ("ATSDR'') may be transferred [to] between appropriate accounts of CDC, 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. [215]214. Not to exceed $45,000,000 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 $3,500,000 per project.'
(transfer of funds)
SEC. [216]215. Of the amounts made available for NIH, 1 percent of the amount made available for National Research Service Awards ("NRSA'')
shall be made available to the Administrator of the Health Resources and Services Administration to make NRSA awards for research
in primary medical care to individuals affiliated with entities who have received grants or contracts under section 747 of
the PHS Act, and 1 percent of the amount made available for NRSA shall be made available to the Director of the Agency for
Healthcare Research and Quality to make NRSA awards for health service research.[SEC. 217. None of the funds made available in this title may be used, in whole or in part, to advocate or promote gun control.][SEC. 218. (a) The Secretary shall establish a publicly accessible Web site to provide information regarding the uses of funds made available
under section 4002 of the Patient Protection and Affordable Care Act of 2010 ("ACA'').
(b) With respect to funds provided under section 4002 of the ACA, the Secretary shall include on the Web site established under
subsection (a) at a minimum the following information:
(1) In the case of each transfer of funds under section 4002(c), a statement indicating the program or activity receiving funds,
the operating division or office that will administer the funds, and the planned uses of the funds, to be posted not later
than the day after the transfer is made.
(2) Identification (along with a link to the full text) of each funding opportunity announcement, request for proposals, or other
announcement or solicitation of proposals for grants, cooperative agreements, or contracts intended to be awarded using such
funds, to be posted not later than the day after the announcement or solicitation is issued.
(3) Identification of each grant, cooperative agreement, or contract with a value of $25,000 or more awarded using such funds,
including the purpose of the award and the identity of the recipient, to be posted not later than 5 days after the award is
made.
(4) A report detailing the uses of all funds transferred under section 4002(c) during the fiscal year, to be posted not later
than 90 days after the end of the fiscal year.
(c) With respect to awards made in fiscal years 2013 and 2014, the Secretary shall also include on the Web site established under
subsection (a), semi-annual reports from each entity awarded a grant, cooperative agreement, or contract from such funds with
a value of $25,000 or more, summarizing the activities undertaken and identifying any sub-grants or sub-contracts awarded
(including the purpose of the award and the identity of the recipient), to be posted not later than 30 days after the end
of each 6-month period.
(d) In carrying out this section, the Secretary shall:
(1) present the information required in subsection (b)(1) on a single webpage or on a single database;
(2) ensure that all information required in this section is directly accessible from the single webpage or database; and
(3) ensure that all information required in this section is able to be organized by program or State.]
'
(transfer of funds)
[SEC. 219. (a) Within 45 days of enactment of this Act, the Secretary shall transfer funds appropriated under section 4002 of the Patient
Protection and Affordable Care Act of 2010 ("ACA'') to the accounts specified, in the amounts specified, and for the activities
specified under the heading "Prevention and Public Health Fund'' in the explanatory statement described in section 4 (in the
matter preceding division A of this Consolidated Act) accompanying this Act.
(b) Notwithstanding section 4002(c) of the ACA, the Secretary may not further transfer these amounts.
(c) Funds transferred for activities authorized under section 2821 of the PHS Act shall be made available without reference to
section 2821(b) of such Act.]
SEC. [220]216. (a) The Biomedical Advanced Research and Development Authority ("BARDA'') may enter into a contract, for more than one but no
more than 10 program years, for purchase of research services or of security countermeasures, as that term is defined in section
319F-2(c)(1)(B) of the PHS Act (42 U.S.C. 247d-6b(c)(1)(B)), if—
(1) funds are available and obligated—
(A) for the full period of the contract or for the first fiscal year in which the contract is in effect; and
(B) for the estimated costs associated with a necessary termination of the contract; and
(2) the Secretary determines that a multi-year contract will serve the best interests of the Federal Government by encouraging
full and open competition or promoting economy in administration, performance, and operation of BARDA's programs.
(b) A contract entered into under this section:
(1) shall include a termination clause as described by subsection (c) of section 3903 of title 41, United States Code; and
(2) shall be subject to the congressional notice requirement stated in subsection (d) of such section.
[SEC. 221. (a) The Secretary shall publish in the fiscal year 2015 budget justification and on Departmental Web sites information concerning
the employment of full-time equivalent Federal employees or contractors for the purposes of implementing, administering, enforcing,
or otherwise carrying out the provisions of the Patient Protection and Affordable Care Act of 2010 ("ACA''), and the amendments
made by that Act, in the proposed fiscal year and the 4 prior fiscal years.
(b) With respect to employees or contractors supported by all funds appropriated for purposes of carrying out the ACA (and the
amendments made by that Act), the Secretary shall include, at a minimum, the following information:
(1) For each such fiscal year, the section of such Act under which such funds were appropriated, a statement indicating the program,
project, or activity receiving such funds, the Federal operating division or office that administers such program, and the
amount of funding received in discretionary or mandatory appropriations.
(2) For each such fiscal year, the number of full-time equivalent employees or contracted employees assigned to each authorized
and funded provision detailed in accordance with paragraph (1).
(c) In carrying out this section, the Secretary may exclude from the report employees or contractors who:
(1) Are supported through appropriations enacted in laws other than the ACA and work on programs that existed prior to the passage
of the ACA;
(2) spend less than 50 percent of their time on activities funded by or newly authorized in the ACA;
(3) or who work on contracts for which FTE reporting is not a requirement of their contract, such as fixed-price contracts.]
[SEC. 222. In addition to the amounts otherwise available for "Centers for Medicare and Medicaid Services, Program Management'', the
Secretary of Health and Human Services may transfer up to $305,000,000 to such account from the Federal Hospital Insurance
Trust Fund and the Federal Supplementary Medical Insurance Trust Fund to support program management activity related to the
Medicare Program: Provided, That except for the foregoing purpose, such funds may not be used to support any provision of Public Law 111–148 or Public
Law 111–152 (or any amendment made by either such Public Law) or to supplant any other amounts within such account.]SEC. [223]217. In lieu of the timeframe specified in section 338E(c)(2) of the PHS Act, terminations described in such section may occur
up to 60 days after the execution of a contract awarded in fiscal year [2014] 2015 under section 338B of such Act.[SEC. 224. The Secretary shall publish, as part of the fiscal year 2015 budget of the President submitted under section 1105(a) of title
31, United States Code, information that details the uses of all funds used by the Centers for Medicare and Medicaid Services
specifically for Health Insurance Marketplaces for each fiscal year since the enactment of the Patient Protection and Affordable
Care Act (Public Law 111–148) and the proposed uses for such funds for fiscal year 2015. Such information shall include, for
each such fiscal year—
(1) the section(s) of such Act under which such funds were appropriated or used;
(2) the program, project, or activity for which such funds were used;
(3) the amount of funds that were used for the Health Insurance Marketplaces within each such program, project, or activity; and
(4) the milestones completed for data hub functionality and implementation readiness.]
[SEC. 225. Activities authorized under part A of title IV and section 1108(b) of the Social Security Act (except for activities authorized
in section 403(b)) shall continue through September 30, 2014, in the manner authorized for fiscal year 2013, and out of any
money in the Treasury of the United States not otherwise appropriated, there are hereby appropriated such sums as may be necessary
for such purpose.][SEC. 226. The Secretary shall include in the fiscal year 2016 budget justification an analysis of how section 2713 of the PHS Act will
impact eligibility for discretionary HHS programs.]SEC. 218. In the event of a public health emergency declared under section 319 of the PHS Act, the Secretary of HHS may, during the
duration of the emergency, transfer discretionary funds (pursuant to the Balanced Budget and Emergency Deficit Control Act
of 1985) which are appropriated in this Act for the current fiscal year for HHS between appropriations for costs of responding
to and aiding in recovery from such public health emergency: Provided, That no appropriation may be reduced by more than 10
percent under this section: Provided further, That the Committees on Appropriations of the House of Representatives and the
Senate shall be promptly notified of such transfers: Provided further, That this transfer authority is in addition to any
other transfer authority (Department of Health and Human Services Appropriations Act, 2014.)