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



   
      
      
         DEPARTMENT OF HEALTH AND HUMAN SERVICES                                                                                  
            
         
      
      
   
   
      DEPARTMENT OF HEALTH AND HUMAN SERVICES                                                                                  
         
      
         Food and Drug Administration                                                                                             
            
         Federal Funds
         Salaries and ExpensesFor 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 92â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 107â188; [$4,443,356,000] $4,665,400,000: Provided, That of the amount provided under this heading, [$798,000,000] $826,072,000 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; [$128,282,000] $134,475,000 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; [$312,116,000] $320,029,000 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; [$21,014,000] $21,540,000 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; [$22,464,000] $22,140,000 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; [$6,944,000] $7,429,000 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; [$566,000,000] $599,000,000 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: Provided further, That in addition to 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 [2015] 2016 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 [2015] 2016, including any such fees collected prior to fiscal year [2015] 2016 but credited for fiscal year [2015] 2016, shall be subject to the fiscal year [2015] 2016 limitations: Provided further, That the Secretary may accept payment during fiscal year [2015] 2016 of user fees specified under this heading and authorized for fiscal year [2016] 2017, prior to the due date for such fees, and that amounts of such fees assessed for fiscal year [2016] 2017 for which the Secretary accepts payment in fiscal year [2015] 2016 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) $903,403,000 shall be for the Center for Food Safety and Applied Nutrition and
         related field activities in the Office of Regulatory Affairs; (2) $1,337,948,000 shall be for the Center for Drug Evaluation
         and Research and related field activities in the Office of Regulatory Affairs; (3) $344,267,000 shall be for the Center for
         Biologics Evaluation and Research and for related field activities in the Office of Regulatory Affairs; (4) $173,976,000 shall
         be for the Center for Veterinary Medicine and for related field activities in the Office of Regulatory Affairs; (5) $420,548,000
         shall be for the Center for Devices and Radiological Health and for related field activities in the Office of Regulatory Affairs;
         (6) $63,331,000 shall be for the National Center for Toxicological Research; (7) $531,527,000 shall be for the Center for
         Tobacco Products and for related field activities in the Office of Regulatory Affairs; (8) not to exceed $163,079,000 shall
         be for Rent and Related activities, of which $47,116,000 is for White Oak Consolidation, other than the amounts paid to the
         General Services Administration for rent; (9) not to exceed $227,674,000 shall be for payments to the General Services Administration
         for rent; and (10) $277,603,000 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 of the amounts that are made available under this heading for "other activities", and that are not derived from user
         fees, $1,500,000 shall be transferred to and merged with the appropriation for "Department of Health and Human ServicesâOffice
         of Inspector General" for oversight of the programs and operations of the Food and Drug Administration and shall be in addition
         to funds otherwise made available for oversight of the Food and Drug Administration:] 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,
         priority review user fees authorized by 21 U.S.C. 360n and 360ff, 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 distributor 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), and third-party auditor fees authorized by 21 U.S.C. 384d(C)(8) shall be credited to this account, to remain available until expended.  
      [For an additional amount for "Salaries and Expenses", to prevent, prepare for, and respond to the Ebola virus domestically
         and internationally, and to develop necessary medical countermeasures and vaccines, including the review, regulations, post
         market surveillance of vaccines and therapies, and administrative activities, $25,000,000, to remain available until expended:
         Provided, That such amount is designated by the Congress as an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced
         Budget and Emergency Deficit Control Act of 1985: Provided further, That of the amounts provided, $4,800,000 is for the Center for Biologics Evaluation and Research; $2,400,000 is for the
         Center for Devices and Radiological Health; $400,000 is for the Office of the Commissioner; $1,900,000 is for the Center for
         Drug Evaluation and Research; $500,000 is for the Office of Regulatory Affairs; and $15,000,000 is for the Medical Countermeasures
         Initiative.]  
         Buildings and facilitiesFor 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, 2015.)
      Special and Trust Fund Receipts (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â9911â0â1â554
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  0100
                  Balance, start of year
                  1
                  1
                  2
               
               
                  
                  Receipts:
               
               
                  0220
                  Cooperative Research and Development Agreements, FDA
                  2
                  3
                  3
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0400
                  Total: Balances and collections
                  3
                  4
                  5
               
               
                  
                  Appropriations:
               
               
                  0500
                  Salaries and Expenses
                  â2
                  â2
                  â2
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0799
                  Balance, end of year
                  1
                  2
                  3
               
               
                  
                     
                  
               
            
         
      
      Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â9911â0â1â554
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Foods
                  883
                  903
                  987
               
               
                  0002
                  Drugs
                  466
                  482
                  485
               
               
                  0003
                  Devices and Radiological Products
                  321
                  321
                  328
               
               
                  0004
                  National Center for Toxicological Research
                  62
                  63
                  59
               
               
                  0005
                  Other Activities
                  172
                  175
                  181
               
               
                  0006
                  Other Rent and Rent Related Activities
                  133
                  116
                  137
               
               
                  0007
                  Rental Payments
                  162
                  169
                  177
               
               
                  0008
                  Buildings and Facilities
                  8
                  9
                  9
               
               
                  0009
                  CRADAs
                  2
                  2
                  2
               
               
                  0010
                  Animal Drugs and Feed
                  142
                  148
                  166
               
               
                  0011
                  Biologics
                  211
                  211
                  215
               
               
                  0012
                  Food and Drug Safety (no-year)
                  24
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0799
                  Total direct obligations
                  2,586
                  2,599
                  2,746
               
               
                  0801
                  Reimbursable program (User fees)
                  1,707
                  1,901
                  2,177
               
               
                  0802
                  Reimbursable program (Federal sources)
                  38
                  
                  
               
               
                  0803
                  Reimbursable program (Refund Sequester collections - User fee)
                  8
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0899
                  Total reimbursable obligations
                  1,753
                  1,901
                  2,177
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  4,339
                  4,500
                  4,923
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  670
                  974
                  997
               
               
                  1001
                  Discretionary unobligated balance brought fwd, Oct 1
                  4
                  
                  
               
               
                  1021
                  Recoveries of prior year unpaid obligations
                  4
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1050
                  Unobligated balance (total)
                  674
                  974
                  997
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, discretionary:
               
               
                  1100
                  Appropriation
                  2,561
                  2,597
                  2,744
               
               
                  1100
                  Appropriation- Emergency pursuant to  2011 BCA [EBOLA]
                  
                  25
                  
               
               
                  1120
                  Appropriations transferred to other accts [075â0128]
                  
                  â2
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1160
                  Appropriation, discretionary (total)
                  2,561
                  2,620
                  2,744
               
               
                  
                  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
                  1,931
                  1,901
                  1,978
               
               
                  1701
                  Change in uncollected payments, Federal sources
                  22
                  
                  
               
               
                  1702
                  Offsetting collections (previously unavailable)
                  605
                  333
                  333
               
               
                  1725
                  Spending authority from offsetting collections precluded from obligation (limitation on obligations)
                  â494
                  â333
                  â333
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1750
                  Spending auth from offsetting collections, disc (total)
                  2,064
                  1,901
                  1,978
               
               
                  
                  Spending authority from offsetting collections, mandatory:
               
               
                  1802
                  Offsetting collections (previously unavailable)
                  12
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1850
                  Spending auth from offsetting collections, mand (total)
                  12
                  
                  
               
               
                  1900
                  Budget authority (total)
                  4,639
                  4,523
                  4,724
               
               
                  1930
                  Total budgetary resources available
                  5,313
                  5,497
                  5,721
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  974
                  997
                  798
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  2,319
                  2,676
                  2,334
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  4,339
                  4,500
                  4,923
               
               
                  3011
                  Obligations incurred, expired accounts
                  6
                  
                  
               
               
                  3020
                  Outlays (gross)
                  â3,915
                  â4,842
                  â4,752
               
               
                  3040
                  Recoveries of prior year unpaid obligations, unexpired
                  â4
                  
                  
               
               
                  3041
                  Recoveries of prior year unpaid obligations, expired
                  â69
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  2,676
                  2,334
                  2,505
               
               
                  
                  Uncollected payments:
               
               
                  3060
                  Uncollected pymts, Fed sources, brought forward, Oct 1
                  â51
                  â51
                  â51
               
               
                  3070
                  Change in uncollected pymts, Fed sources, unexpired
                  â22
                  
                  
               
               
                  3071
                  Change in uncollected pymts, Fed sources, expired
                  22
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3090
                  Uncollected pymts, Fed sources, end of year
                  â51
                  â51
                  â51
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  2,268
                  2,625
                  2,283
               
               
                  3200
                  Obligated balance, end of year
                  2,625
                  2,283
                  2,454
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Discretionary:
               
               
                  4000
                  Budget authority, gross
                  4,625
                  4,521
                  4,722
               
               
                  
                  Outlays, gross:
               
               
                  4010
                  Outlays from new discretionary authority
                  2,513
                  3,430
                  3,579
               
               
                  4011
                  Outlays from discretionary balances
                  1,401
                  1,410
                  1,171
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4020
                  Outlays, gross (total)
                  3,914
                  4,840
                  4,750
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4030
                  Federal sources
                  â33
                  â1
                  â1
               
               
                  4033
                  Non-Federal sources
                  â1,915
                  â1,900
                  â1,977
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4040
                  Offsets against gross budget authority  and outlays (total)
                  â1,948
                  â1,901
                  â1,978
               
               
                  
                  Additional offsets against gross budget authority only:
               
               
                  4050
                  Change in uncollected pymts, Fed sources, unexpired
                  â22
                  
                  
               
               
                  4052
                  Offsetting collections credited to expired accounts
                  17
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4060
                  Additional offsets against budget authority only (total)
                  â5
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4070
                  Budget authority, net (discretionary)
                  2,672
                  2,620
                  2,744
               
               
                  4080
                  Outlays, net (discretionary)
                  1,966
                  2,939
                  2,772
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  14
                  2
                  2
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  1
                  2
                  2
               
               
                  4180
                  Budget authority, net (total)
                  2,686
                  2,622
                  2,746
               
               
                  4190
                  Outlays, net (total)
                  1,967
                  2,941
                  2,774
               
               
                  
                     
                  
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  5090
                  Unexpired unavailable balance, SOY: Offsetting collections
                  664
                  541
                  541
               
               
                  5092
                  Unexpired unavailable balance, EOY: Offsetting collections
                  541
                  541
                  541
               
               
                  
                     
                  
               
            
         
      
      
         [In millions of dollars]
         
            
               
                  
                     
                        
                     
                  
                  
                      
                     2014
                     2015
                     2016
                  
                  
                     
                        
                     
                  
                  
                     Distribution of discretionary budget authority by account:
                     
                     
                     
                  
                  
                     Salaries and expenses
                     2,575
                     2,611
                     2,734
                  
                  
                     Buildings and facilities
                     8
                     9
                     9
                  
                  
                     Distribution of discretionary outlays by account:
                     
                     
                     
                  
                  
                     Salaries and expenses
                     1,726
                     2,930
                     2,763
                  
                  
                     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 responsibility 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 2016 Budget provides funding to support food and medical
            product safety, including implementation of the Food Safety Modernization Act and the Food and Drug Administration Safety
            and Innovation Act, encourage development of innovative diagnostics and theraputics, promote development of medical countermeasures,
            and maintain the integrity of operations and infrastructure. In addition, the FY 2015 funding level for FDA includes $25 million
            in one-time emergency funding for the U.S. Government response to contain, treat, and prevent the spread of Ebola.
         
          The President is again asking Congress to revive an authority enabling him to submit fast-track proposals to reorganize or
            consolidate Federal programs and agencies in order to reduce the size of Government or cut costs. The Budget includes a variety
            of proposed reforms across government designed to drive efficiency and accountability, prevent duplication, and make government
            work better and smarter for the American people. One of these reorganizations the President would propose with this authority
            is to consolidate the USDA's Food Safety Inspection Service and the food safety components of the Food and Drug Administration
            at HHS to create a new agency at HHS. This consolidation could deliver a "one-stop" shop for most of the issues that mean
            the most for consumers and industry and provide centralized leadership to allocate resources strategically across all food
            products. The Budget schedules for these agencies and programs continue to reflect them in their current alignment.
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â9911â0â1â554
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  
                  Personnel compensation:
               
               
                  11.1
                  Full-time permanent
                  819
                  842
                  883
               
               
                  11.3
                  Other than full-time permanent
                  95
                  98
                  102
               
               
                  11.5
                  Other personnel compensation
                  55
                  56
                  59
               
               
                  11.7
                  Military personnel
                  64
                  66
                  67
               
               
                  11.8
                  Special personal services payments
                  1
                  1
                  1
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  11.9
                  Total personnel compensation
                  1,034
                  1,063
                  1,112
               
               
                  12.1
                  Civilian personnel benefits
                  290
                  298
                  312
               
               
                  12.2
                  Military personnel benefits
                  34
                  35
                  35
               
               
                  21.0
                  Travel and transportation of persons
                  44
                  43
                  46
               
               
                  22.0
                  Transportation of things
                  3
                  3
                  3
               
               
                  23.1
                  Rental payments to GSA
                  162
                  169
                  177
               
               
                  23.2
                  Rental payments to others
                  2
                  2
                  2
               
               
                  23.3
                  Communications, utilities, and miscellaneous charges
                  49
                  47
                  51
               
               
                  24.0
                  Printing and reproduction
                  1
                  1
                  2
               
               
                  25.1
                  Advisory and assistance services
                  51
                  49
                  53
               
               
                  25.2
                  Other services from non-Federal sources
                  399
                  388
                  417
               
               
                  25.3
                  Other goods and services from Federal sources
                  140
                  135
                  145
               
               
                  25.4
                  Operation and maintenance of facilities
                  110
                  107
                  115
               
               
                  25.5
                  Research and development contracts
                  21
                  20
                  21
               
               
                  25.7
                  Operation and maintenance of equipment
                  32
                  31
                  33
               
               
                  26.0
                  Supplies and materials
                  41
                  40
                  43
               
               
                  31.0
                  Equipment
                  66
                  63
                  68
               
               
                  32.0
                  Land and structures
                  1
                  1
                  1
               
               
                  41.0
                  Grants, subsidies, and contributions
                  105
                  101
                  109
               
               
                  42.0
                  Insurance claims and indemnities
                  1
                  1
                  1
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.0
                  Direct obligations
                  2,586
                  2,597
                  2,746
               
               
                  99.0
                  Reimbursable obligations
                  1,753
                  1,903
                  2,177
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  4,339
                  4,500
                  4,923
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â9911â0â1â554
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  9,246
                  9,420
                  9,537
               
               
                  1101
                  Direct military average strength employment
                  696
                  712
                  712
               
               
                  2001
                  Reimbursable civilian full-time equivalent employment
                  4,338
                  5,392
                  5,855
               
               
                  2101
                  Reimbursable military average strength employment
                  327
                  335
                  335
               
               
                  3001
                  Allocation account civilian full-time equivalent employment
                  38
                  38
                  38
               
               
                  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 shall assess an increase in export certification user fees otherwise
            appropriated under this heading, and such fees shall be credited to this account and remain available until expended.   
      Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â9911â2â1â554
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0801
                  Food Facility Registration and Inspection
                  
                  
                  60
               
               
                  0802
                  Food Import
                  
                  
                  103
               
               
                  0803
                  International Courier
                  
                  
                  6
               
               
                  0804
                  Food Contact Substance Notification
                  
                  
                  5
               
               
                  0805
                  Cosmetics
                  
                  
                  20
               
               
                  0806
                  Export Certification fee increase
                  
                  
                  4
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  
                  
                  198
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Spending authority from offsetting collections, discretionary:
               
               
                  1700
                  Collected
                  
                  
                  198
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1750
                  Spending auth from offsetting collections, disc (total)
                  
                  
                  198
               
               
                  1930
                  Total budgetary resources available
                  
                  
                  198
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  
                  
                  198
               
               
                  3020
                  Outlays (gross)
                  
                  
                  â198
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Discretionary:
               
               
                  4000
                  Budget authority, gross
                  
                  
                  198
               
               
                  
                  Outlays, gross:
               
               
                  4010
                  Outlays from new discretionary authority
                  
                  
                  198
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4033
                  Non-Federal sources
                  
                  
                  â198
               
               
                  
                     
                  
               
            
         
      
      
         The FY 2016 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 $103 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 proposes user fees
            to support activities related to cosmetics and food contact notification activities, and fees to support inspection-related
            activities at domestic courier facilities. The Budget also includes a proposal to allow FDA to increase the funding cap for
            the export certification fee from $175 to $600 per certification to ensure that FDA can efficiently implement the export certification
            program.
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â9911â2â1â554
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Reimbursable obligations:
               
               
                  
                  Personnel compensation:
               
               
                  11.1
                  Full-time permanent
                  
                  
                  152
               
               
                  11.3
                  Other than full-time permanent
                  
                  
                  30
               
               
                  11.5
                  Other personnel compensation
                  
                  
                  8
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  11.9
                  Total personnel compensation
                  
                  
                  190
               
               
                  25.1
                  Advisory and assistance services
                  
                  
                  8
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  
                  
                  198
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â9911â2â1â554
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  2001
                  Reimbursable civilian full-time equivalent employment
                  
                  
                  242
               
               
                  
                     
                  
               
            
         
      
         Revolving Fund for Certification and Other Services                                                                      
            
         Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â4309â0â3â554
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0801
                  Revolving Fund for Certification and Other Services (Reimbursable)
                  8
                  9
                  10
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  5
                  4
                  3
               
               
                  
                  Budget authority:
               
               
                  
                  Spending authority from offsetting collections, mandatory:
               
               
                  1800
                  Collected
                  8
                  8
                  9
               
               
                  1802
                  Offsetting collections (previously unavailable)
                  
                  1
                  1
               
               
                  1823
                  New and/or unobligated balance of spending authority from offsetting collections temporarily reduced
                  â1
                  â1
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1850
                  Spending auth from offsetting collections, mand (total)
                  7
                  8
                  10
               
               
                  1900
                  Budget authority (total)
                  7
                  8
                  10
               
               
                  1930
                  Total budgetary resources available
                  12
                  12
                  13
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  4
                  3
                  3
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  2
                  2
                  1
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  8
                  9
                  10
               
               
                  3020
                  Outlays (gross)
                  â8
                  â10
                  â10
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  2
                  1
                  1
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  2
                  2
                  1
               
               
                  3200
                  Obligated balance, end of year
                  2
                  1
                  1
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  7
                  8
                  10
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  
                  8
                  10
               
               
                  4101
                  Outlays from mandatory balances
                  8
                  2
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4110
                  Outlays, gross (total)
                  8
                  10
                  10
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4123
                  Non-Federal sources
                  â8
                  â8
                  â9
               
               
                  4180
                  Budget authority, net (total)
                  â1
                  
                  1
               
               
                  4190
                  Outlays, net (total)
                  
                  2
                  1
               
               
                  
                     
                  
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  5090
                  Unexpired unavailable balance, SOY: Offsetting collections
                  
                  1
                  1
               
               
                  5092
                  Unexpired unavailable balance, EOY: Offsetting collections
                  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 075â4309â0â3â554
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Reimbursable obligations:
               
               
                  11.1
                  Personnel compensation: Full-time permanent
                  4
                  5
                  6
               
               
                  12.1
                  Civilian personnel benefits
                  1
                  1
                  1
               
               
                  23.1
                  Rental payments to GSA
                  1
                  1
                  1
               
               
                  25.7
                  Operation and maintenance of equipment
                  1
                  1
                  1
               
               
                  31.0
                  Equipment
                  1
                  1
                  1
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  8
                  9
                  10
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â4309â0â3â554
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  2001
                  Reimbursable civilian full-time equivalent employment
                  36
                  37
                  37
               
               
                  
                     
                  
               
            
         
      
         Health Resources and Services Administration                                                                             
            
         Federal Funds
         Primary health careFor 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, [$1,491,522,000] $1,491,522,000: Provided, That no more than [$100,000] $100,000 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 [$99,893,000] $99,893,000 shall be available until expended for carrying out the provisions of Public Law 104â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 2015, not less than $165,000,000 shall be obligated in fiscal year 2015 as base grant adjustments, not
         less than $350,000,000 shall be obligated in fiscal year 2015 to support new access points including approved and unfunded
         applications from fiscal year 2014, grants to expand medical services, behavioral health, oral health, pharmacy, and vision
         services, and up to $150,000,000 shall be obligated in fiscal year 2015 for construction and capital improvement costs].  
         Health workforceFor carrying out titles III, VII, and VIII of the PHS Act with respect to the health workforce, sections 1128E and 1921(b) of the Social Security Act, and the Health Care Quality Improvement Act of 1986, [$751,600,000] $856,820,000: Provided, That $287,370,000, 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 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, of the amount appropriated under this heading, $100,000,000 shall be for payments to children's hospitals
            pursuant to section 340E of the PHS Act, all of which shall be for payments for direct graduate medical education as described
            in section 340E(c).  
         Maternal and child healthFor 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, [$851,738,000] $851,738,000: Provided, That notwithstanding sections 502(a)(1) and 502(b)(1) of the Social Security Act, not more than [$77,093,000] $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] $10,276,000 shall be available for projects described in subparagraphs (A) through (F) of section 501(a)(3) of such Act.  
         Ryan white HIV/AIDS programFor carrying out title XXVI of the PHS Act with respect to the Ryan White HIV/AIDS program, [$2,318,781,000] $2,322,781,000, of which [$1,970,881,000] $1,970,881,000 shall remain available to the Secretary through September 30, [2017] 2018, 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.  
         Health care systemsFor 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] $110,193,000, 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 healthFor 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, [$147,471,000] $127,562,000, of which [$41,609,000] $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 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 PlanningFor carrying out the program under title X of the PHS Act to provide for voluntary family planning projects, [$286,479,000] $300,000,000: 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 managementFor program support in the Health Resources and Services Administration, [$154,000,000] $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, 2015.)
      Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0350â0â1â550
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0009
                  Free Clinics Medical Malpractice
                  1
                  
                  
               
               
                  0010
                  Health Centers
                  1,397
                  1,392
                  1,392
               
               
                  0012
                  National Health Service Corps
                  
                  
                  287
               
               
                  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
                  80
                  82
                  82
               
               
                  0017
                  Health Professions
                  387
                  403
                  386
               
               
                  0018
                  Maternal and Child Health Block Grant
                  632
                  637
                  637
               
               
                  0019
                  Healthy Start
                  101
                  102
                  102
               
               
                  0020
                  Poison Control Centers
                  19
                  19
                  19
               
               
                  0021
                  EMS for Children
                  20
                  20
                  20
               
               
                  0022
                  Universal Newborn Hearing Screening
                  18
                  18
                  18
               
               
                  0023
                  HIV/AIDS
                  2,290
                  2,319
                  2,323
               
               
                  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
                  57
                  59
                  59
               
               
                  0028
                  Rural Health Flexibility Grants
                  40
                  42
                  26
               
               
                  0030
                  Telehealth
                  14
                  15
                  15
               
               
                  0031
                  Program Management
                  153
                  154
                  157
               
               
                  0032
                  Family Planning
                  286
                  286
                  300
               
               
                  0033
                  Loan Repayment/Faculty Fellowship
                  1
                  1
                  1
               
               
                  0035
                  Health Centers Tort Claim Fund
                  81
                  100
                  100
               
               
                  0036
                  Heritable Disorders
                  12
                  14
                  14
               
               
                  0038
                  Childrens' GME
                  264
                  265
                  100
               
               
                  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
                  47
                  47
                  47
               
               
                  0046
                  Cord Blood Stem Cell Bank
                  11
                  11
                  11
               
               
                  0048
                  Sickle Cell
                  4
                  4
                  4
               
               
                  0049
                  Drug Pricing Program
                  10
                  10
                  17
               
               
                  0050
                  Family to Family Health Information Centers ACA
                  5
                  3
                  
               
               
                  0073
                  Health Centers ACA
                  2,152
                  2,968
                  178
               
               
                  0074
                  Health Centers Construction ACA
                  38
                  
                  
               
               
                  0075
                  National Health Service Corps ACA
                  281
                  287
                  
               
               
                  0076
                  School Based Health Centers ACA
                  1
                  3
                  
               
               
                  0077
                  GME Payments THC ACA
                  60
                  105
                  
               
               
                  0079
                  Rural Health AED
                  3
                  5
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0300
                  Total direct programs
                  8,563
                  9,471
                  6,395
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0799
                  Total direct obligations
                  8,563
                  9,471
                  6,395
               
               
                  0801
                  Health Resources and Services (Reimbursable)
                  56
                  57
                  64
               
               
                  0802
                  Reimbursable program: PHS evaluation
                  25
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0899
                  Total reimbursable obligations
                  81
                  57
                  64
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  8,644
                  9,528
                  6,459
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  361
                  298
                  726
               
               
                  1001
                  Discretionary unobligated balance brought fwd, Oct 1
                  123
                  
                  
               
               
                  1021
                  Recoveries of prior year unpaid obligations
                  26
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1050
                  Unobligated balance (total)
                  387
                  298
                  726
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, discretionary:
               
               
                  1100
                  Appropriation
                  6,054
                  6,105
                  6,218
               
               
                  1120
                  Appropriations transferred to other accts [075â0511]
                  â10
                  
                  
               
               
                  1120
                  Appropriations transferred to other accts [075â1503]
                  â5
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1160
                  Appropriation, discretionary (total)
                  6,039
                  6,105
                  6,218
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriation
                  2,510
                  3,799
                  
               
               
                  1230
                  Appropriations and/or unobligated balance of appropriations permanently reduced
                  â77
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  2,433
                  3,799
                  
               
               
                  
                  Spending authority from offsetting collections, discretionary:
               
               
                  1700
                  Collected
                  30
                  35
                  43
               
               
                  1701
                  Change in uncollected payments, Federal sources
                  38
                  
                  
               
               
                  1702
                  Offsetting collections (previously unavailable)
                  1
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1750
                  Spending auth from offsetting collections, disc (total)
                  69
                  35
                  43
               
               
                  
                  Spending authority from offsetting collections, mandatory:
               
               
                  1800
                  Offsetting collections (cash)(HPSL&NSL)
                  17
                  17
                  17
               
               
                  1802
                  Offsetting collections (previously unavailable)
                  
                  1
                  1
               
               
                  1823
                  New and/or unobligated balance of spending authority from offsetting collections temporarily reduced
                  â1
                  â1
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1850
                  Spending auth from offsetting collections, mand (total)
                  16
                  17
                  18
               
               
                  1900
                  Budget authority (total)
                  8,557
                  9,956
                  6,279
               
               
                  1930
                  Total budgetary resources available
                  8,944
                  10,254
                  7,005
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1940
                  Unobligated balance expiring
                  â2
                  
                  
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  298
                  726
                  546
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  6,239
                  6,233
                  6,952
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  8,644
                  9,528
                  6,459
               
               
                  3011
                  Obligations incurred, expired accounts
                  1
                  
                  
               
               
                  3020
                  Outlays (gross)
                  â8,530
                  â8,809
                  â8,215
               
               
                  3040
                  Recoveries of prior year unpaid obligations, unexpired
                  â26
                  
                  
               
               
                  3041
                  Recoveries of prior year unpaid obligations, expired
                  â95
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  6,233
                  6,952
                  5,196
               
               
                  
                  Uncollected payments:
               
               
                  3060
                  Uncollected pymts, Fed sources, brought forward, Oct 1
                  â74
                  â67
                  â67
               
               
                  3070
                  Change in uncollected pymts, Fed sources, unexpired
                  â38
                  
                  
               
               
                  3071
                  Change in uncollected pymts, Fed sources, expired
                  45
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3090
                  Uncollected pymts, Fed sources, end of year
                  â67
                  â67
                  â67
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  6,165
                  6,166
                  6,885
               
               
                  3200
                  Obligated balance, end of year
                  6,166
                  6,885
                  5,129
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Discretionary:
               
               
                  4000
                  Budget authority, gross
                  6,108
                  6,140
                  6,261
               
               
                  
                  Outlays, gross:
               
               
                  4010
                  Outlays from new discretionary authority
                  2,259
                  2,310
                  2,367
               
               
                  4011
                  Outlays from discretionary balances
                  3,642
                  3,492
                  3,816
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4020
                  Outlays, gross (total)
                  5,901
                  5,802
                  6,183
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4030
                  Federal sources
                  â43
                  â15
                  â15
               
               
                  4033
                  Non-Federal sources
                  â28
                  â20
                  â20
               
               
                  4033
                  Non-Federal sources
                  
                  
                  â8
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4040
                  Offsets against gross budget authority  and outlays (total)
                  â71
                  â35
                  â43
               
               
                  
                  Additional offsets against gross budget authority only:
               
               
                  4050
                  Change in uncollected pymts, Fed sources, unexpired
                  â38
                  
                  
               
               
                  4052
                  Offsetting collections credited to expired accounts
                  41
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4060
                  Additional offsets against budget authority only (total)
                  3
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4070
                  Budget authority, net (discretionary)
                  6,040
                  6,105
                  6,218
               
               
                  4080
                  Outlays, net (discretionary)
                  5,830
                  5,767
                  6,140
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  2,449
                  3,816
                  18
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  1,241
                  1,486
                  18
               
               
                  4101
                  Outlays from mandatory balances
                  1,388
                  1,521
                  2,014
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4110
                  Outlays, gross (total)
                  2,629
                  3,007
                  2,032
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4123
                  Non-Federal sources
                  â17
                  â17
                  â17
               
               
                  4180
                  Budget authority, net (total)
                  8,472
                  9,904
                  6,219
               
               
                  4190
                  Outlays, net (total)
                  8,442
                  8,757
                  8,155
               
               
                  
                     
                  
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  5090
                  Unexpired unavailable balance, SOY: Offsetting collections
                  1
                  1
                  1
               
               
                  5092
                  Unexpired unavailable balance, EOY: Offsetting collections
                  1
                  1
                  
               
               
                  
                     
                  
               
            
         
      
      Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0350â0â1â550
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Guaranteed loan levels supportable by subsidy budget authority:
               
               
                  215001
                  Health centers: Facilities renovation loan guarantee levels
                  3
                  6
                  4
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  215999
                  Total loan guarantee levels
                  3
                  6
                  4
               
               
                  
                  Guaranteed loan subsidy (in percent):
               
               
                  232001
                  Health centers: Facilities renovation loan guarantee levels
                  2.81
                  2.67
                  2.67
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  232999
                  Weighted average subsidy rate
                  2.81
                  2.67
                  2.67
               
               
                  
                     
                  
               
            
         
      
      
         Resources displayed here support categorical grants and contracts managed by Health Resources and Services Administration
            (HRSA). These activities include support for 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 2016 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 2012â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 075â0350â0â1â550
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  
                  Personnel compensation:
               
               
                  11.1
                  Full-time permanent
                  158
                  175
                  159
               
               
                  11.3
                  Other than full-time permanent
                  6
                  6
                  6
               
               
                  11.5
                  Other personnel compensation
                  3
                  3
                  3
               
               
                  11.7
                  Military personnel
                  18
                  18
                  13
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  11.9
                  Total personnel compensation
                  185
                  202
                  181
               
               
                  12.1
                  Civilian personnel benefits
                  48
                  53
                  48
               
               
                  12.2
                  Military personnel benefits
                  10
                  10
                  7
               
               
                  21.0
                  Travel and transportation of persons
                  2
                  2
                  2
               
               
                  23.1
                  Rental payments to GSA
                  22
                  26
                  22
               
               
                  23.2
                  Rental payments to others
                  1
                  1
                  1
               
               
                  23.3
                  Communications, utilities, and miscellaneous charges
                  7
                  6
                  5
               
               
                  25.1
                  Advisory and assistance services
                  14
                  13
                  13
               
               
                  25.2
                  Other services from non-Federal sources
                  136
                  134
                  125
               
               
                  25.3
                  Other goods and services from Federal sources
                  254
                  250
                  170
               
               
                  25.4
                  Operation and maintenance of facilities
                  1
                  1
                  1
               
               
                  25.6
                  Medical care
                  3
                  3
                  3
               
               
                  25.7
                  Operation and maintenance of equipment
                  42
                  42
                  41
               
               
                  26.0
                  Supplies and materials
                  1
                  1
                  1
               
               
                  31.0
                  Equipment
                  3
                  3
                  3
               
               
                  41.0
                  Grants, subsidies, and contributions
                  7,762
                  8,632
                  5,680
               
               
                  42.0
                  Insurance claims and indemnities
                  72
                  92
                  92
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.0
                  Direct obligations
                  8,563
                  9,471
                  6,395
               
               
                  99.0
                  Reimbursable obligations
                  81
                  57
                  64
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  8,644
                  9,528
                  6,459
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0350â0â1â550
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  1,555
                  1,688
                  1,500
               
               
                  1101
                  Direct military average strength employment
                  182
                  182
                  131
               
               
                  2001
                  Reimbursable civilian full-time equivalent employment
                  58
                  62
                  68
               
               
                  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 075â0350â4â1â550
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Targeted Support GME
                  
                  
                  400
               
               
                  0073
                  Health Centers
                  
                  
                  2,700
               
               
                  0075
                  National Health Service Corps
                  
                  
                  523
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0300
                  Total direct programs
                  
                  
                  3,623
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  
                  
                  3,623
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriation
                  
                  
                  3,623
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  
                  
                  3,623
               
               
                  1900
                  Budget authority (total)
                  
                  
                  3,623
               
               
                  1930
                  Total budgetary resources available
                  
                  
                  3,623
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  
                  
                  3,623
               
               
                  3020
                  Outlays (gross)
                  
                  
                  â1,652
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  
                  
                  1,971
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3200
                  Obligated balance, end of year
                  
                  
                  1,971
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  
                  
                  3,623
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  
                  
                  1,652
               
               
                  4180
                  Budget authority, net (total)
                  
                  
                  3,623
               
               
                  4190
                  Outlays, net (total)
                  
                  
                  1,652
               
               
                  
                     
                  
               
            
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0350â4â1â550
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  
                  Personnel compensation:
               
               
                  11.1
                  Full-time permanent
                  
                  
                  28
               
               
                  11.3
                  Other than full-time permanent
                  
                  
                  1
               
               
                  11.7
                  Military personnel
                  
                  
                  5
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  11.9
                  Total personnel compensation
                  
                  
                  34
               
               
                  12.1
                  Civilian personnel benefits
                  
                  
                  9
               
               
                  12.2
                  Military personnel benefits
                  
                  
                  3
               
               
                  23.1
                  Rental payments to GSA
                  
                  
                  4
               
               
                  23.3
                  Communications, utilities, and miscellaneous charges
                  
                  
                  1
               
               
                  25.2
                  Other services from non-Federal sources
                  
                  
                  14
               
               
                  25.3
                  Other goods and services from Federal sources
                  
                  
                  77
               
               
                  41.0
                  Grants, subsidies, and contributions
                  
                  
                  3,481
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  
                  
                  3,623
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0350â4â1â550
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  
                  
                  264
               
               
                  1101
                  Direct military average strength employment
                  
                  
                  50
               
               
                  
                     
                  
               
            
         
      
         Vaccine Injury Compensation                                                                                              
            
         Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0320â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  19
                  23
                  23
               
               
                  
                  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
                  23
                  23
                  23
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  23
                  23
                  23
               
               
                  
                     
                  
               
               
                  
                  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
                  â4
                  
                  
               
               
                  4190
                  Outlays, net (total)
                  â4
                  
                  
               
               
                  
                     
                  
               
            
         
      
      
         The Vaccine Injury Compensation Program was established pursuant to Public Law 99â660 and Public Law 100â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 075â0343â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Claims
                  5
                  3
                  2
               
               
                  0103
                  Admin Expense
                  
                  2
                  1
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  5
                  5
                  3
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  2
                  2
                  
               
               
                  1011
                  Unobligated balance transfer from other acct [075â0140]
                  5
                  3
                  3
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1050
                  Unobligated balance (total)
                  7
                  5
                  3
               
               
                  1930
                  Total budgetary resources available
                  7
                  5
                  3
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  2
                  
                  
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  2
                  2
                  3
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  5
                  5
                  3
               
               
                  3020
                  Outlays (gross)
                  â5
                  â4
                  â4
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  2
                  3
                  2
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  2
                  2
                  3
               
               
                  3200
                  Obligated balance, end of year
                  2
                  3
                  2
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Discretionary:
               
               
                  
                  Outlays, gross:
               
               
                  4011
                  Outlays from discretionary balances
                  5
                  4
                  4
               
               
                  4190
                  Outlays, net (total)
                  5
                  4
                  4
               
               
                  
                     
                  
               
            
         
      
      
         The Covered Countermeasure Process Fund is established pursuant to the PHS Act, as amended by Division C of Public Law 109â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 075â0343â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  11.1
                  Personnel compensation: Full-time permanent
                  1
                  
                  
               
               
                  25.2
                  Other services from non-Federal sources
                  1
                  1
                  1
               
               
                  42.0
                  Insurance claims and indemnities
                  2
                  3
                  1
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.0
                  Direct obligations
                  4
                  4
                  2
               
               
                  99.5
                  Below reporting threshold
                  1
                  1
                  1
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  5
                  5
                  3
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0343â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  4
                  6
                  6
               
               
                  1101
                  Direct military average strength employment
                  2
                  2
                  2
               
               
                  
                     
                  
               
            
         
      
         Maternal, Infant, and Early Childhood Home Visiting Programs  
      Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0321â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0010
                  Maternal, Infant, and Early Childhood Home Visiting Programs
                  394
                  422
                  
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  25
                  27
                  5
               
               
                  1012
                  Unobligated balance transfers between expired and unexpired accounts
                  25
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1050
                  Unobligated balance (total)
                  50
                  27
                  5
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriation
                  400
                  400
                  
               
               
                  1230
                  Appropriations and/or unobligated balance of appropriations permanently reduced
                  â29
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  371
                  400
                  
               
               
                  1930
                  Total budgetary resources available
                  421
                  427
                  5
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  27
                  5
                  5
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  654
                  703
                  803
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  394
                  422
                  
               
               
                  3020
                  Outlays (gross)
                  â320
                  â322
                  â367
               
               
                  3041
                  Recoveries of prior year unpaid obligations, expired
                  â25
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  703
                  803
                  436
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  654
                  703
                  803
               
               
                  3200
                  Obligated balance, end of year
                  703
                  803
                  436
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  371
                  400
                  
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  6
                  16
                  
               
               
                  4101
                  Outlays from mandatory balances
                  314
                  306
                  367
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4110
                  Outlays, gross (total)
                  320
                  322
                  367
               
               
                  4180
                  Budget authority, net (total)
                  371
                  400
                  
               
               
                  4190
                  Outlays, net (total)
                  320
                  322
                  367
               
               
                  
                     
                  
               
            
         
      
      
         P.L. 113â93 provides resources to Maternal, Infant and Early Childhood Home Visiting Program through 2015 to provide comprehensive
            services for at risk communities. The 2016 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 075â0321â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  
                  Personnel compensation:
               
               
                  11.1
                  Full-time permanent
                  2
                  2
                  
               
               
                  11.7
                  Military personnel
                  1
                  1
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  11.9
                  Total personnel compensation
                  3
                  3
                  
               
               
                  12.1
                  Civilian personnel benefits
                  1
                  1
                  
               
               
                  25.1
                  Advisory and assistance services
                  19
                  19
                  
               
               
                  41.0
                  Grants, subsidies, and contributions
                  371
                  399
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  394
                  422
                  
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0321â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  18
                  18
                  
               
               
                  1101
                  Direct military average strength employment
                  4
                  4
                  
               
               
                  
                     
                  
               
            
         
      
         Maternal, Infant, and Early Childhood Home Visiting Programs                                                             
            
         
         (Legislative proposal, subject to PAYGO)Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0321â4â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0010
                  Maternal, Infant, and Early Childhood Home Visiting Programs
                  
                  
                  500
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriation
                  
                  
                  500
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  
                  
                  500
               
               
                  1930
                  Total budgetary resources available
                  
                  
                  500
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  
                  
                  500
               
               
                  3020
                  Outlays (gross)
                  
                  
                  â20
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  
                  
                  480
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3200
                  Obligated balance, end of year
                  
                  
                  480
               
               
                  
                     
                  
               
               
                  
                  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
               
               
                  
                     
                  
               
            
         
      
      
          P.L. 113â93 provides resources to Maternal, Infant and Early Childhood Home Visiting Program through 2015 to provide comprehensive
            services for at risk communities. The 2016 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 075â0321â4â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  
                  Personnel compensation:
               
               
                  11.1
                  Full-time permanent
                  
                  
                  2
               
               
                  11.7
                  Military personnel
                  
                  
                  1
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  11.9
                  Total personnel compensation
                  
                  
                  3
               
               
                  12.1
                  Civilian personnel benefits
                  
                  
                  1
               
               
                  25.1
                  Advisory and assistance services
                  
                  
                  19
               
               
                  41.0
                  Grants, subsidies, and contributions
                  
                  
                  477
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  
                  
                  500
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0321â4â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  
                  
                  18
               
               
                  1101
                  Direct military average strength employment
                  
                  
                  4
               
               
                  
                     
                  
               
            
         
      
         Health Center Guaranteed Loan Financing Account                                                                          
            
         Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â4442â0â3â551
                  2014 actual
                  2015 est.
                  2016 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 075â4442â0â3â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Position with respect to appropriations act limitation on commitments:
               
               
                  2121
                  Limitation available from carry-forward
                  18
                  15
                  9
               
               
                  2143
                  Uncommitted limitation carried forward
                  â15
                  â9
                  â5
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  2150
                  Total guaranteed loan commitments
                  3
                  6
                  4
               
               
                  2199
                  Guaranteed amount of guaranteed loan commitments
                  3
                  5
                  3
               
               
                  
                     
                  
               
               
                  
                  Cumulative balance of guaranteed loans outstanding:
               
               
                  2210
                  Outstanding, start of year
                  77
                  80
                  75
               
               
                  2231
                  Disbursements of new guaranteed loans
                  3
                  6
                  4
               
               
                  2251
                  Repayments and prepayments
                  
                  â10
                  â10
               
               
                  2263
                  Adjustments: Terminations for default that result in claim payments
                  
                  â1
                  â1
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  2290
                  Outstanding, end of year
                  80
                  75
                  68
               
               
                  
                     
                  
               
               
                  
                  Memorandum:
               
               
                  2299
                  Guaranteed amount of guaranteed loans outstanding, end of year
                  80
                  75
                  68
               
               
                  
                     
                  
               
            
         
      
      
         P.L. 104â299 and P.L. 104â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. The program account for this activity is displayed in the Health Resources
            and Services account (75â0350) as a line in the program and financing schedule.
         
      
      Balance Sheet (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â4442â0â3â551
                  2013 actual
                  2014 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                                                                        
            
         Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0340â0â1â552
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  
                  Credit program obligations:
               
               
                  0709
                  Administrative expenses
                  2
                  
                  
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, discretionary:
               
               
                  1100
                  Appropriation
                  3
                  
                  
               
               
                  1120
                  Appropriations transferred to other accts [091â0202]
                  â1
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1160
                  Appropriation, discretionary (total)
                  2
                  
                  
               
               
                  1900
                  Budget authority (total)
                  2
                  
                  
               
               
                  1930
                  Total budgetary resources available
                  2
                  
                  
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  1
                  
                  
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  2
                  
                  
               
               
                  3020
                  Outlays (gross)
                  â3
                  
                  
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  1
                  
                  
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Discretionary:
               
               
                  4000
                  Budget authority, gross
                  2
                  
                  
               
               
                  
                  Outlays, gross:
               
               
                  4010
                  Outlays from new discretionary authority
                  2
                  
                  
               
               
                  4011
                  Outlays from discretionary balances
                  1
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4020
                  Outlays, gross (total)
                  3
                  
                  
               
               
                  4180
                  Budget authority, net (total)
                  2
                  
                  
               
               
                  4190
                  Outlays, net (total)
                  3
                  
                  
               
               
                  
                     
                  
               
            
         
      
      Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0340â0â1â552
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Guaranteed loan reestimates:
               
               
                  235001
                  HEAL Loan guarantee
                  â43
                  
                  
               
               
                  
                     
                  
               
            
         
      
      
         Pursuant to P.L. 113â76, the Consolidated Appropriations Act, in 2014 the authority to administer, service, collect, and enforce
            the program as wel as the functions, assets, and liabilities of the Secretary of Health and Human Services was permanently
            transferred to the Secretary of Education.
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0340â0â1â552
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  11.1
                  Personnel compensation: Full-time permanent
                  1
                  
                  
               
               
                  25.3
                  Other goods and services from Federal sources
                  1
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  2
                  
                  
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0340â0â1â552
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  10
                  
                  
               
               
                  
                     
                  
               
            
         
      
         Health Education Assistance Loans Financing Account                                                                      
            
         Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â4304â0â3â552
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  
                  Credit program obligations:
               
               
                  0711
                  Default claim payments on principal
                  2
                  
                  
               
               
                  0742
                  Downward reestimate paid to receipt account
                  18
                  
                  
               
               
                  0743
                  Interest on downward reestimates
                  26
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  46
                  
                  
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  108
                  
                  
               
               
                  1010
                  Unobligated balance transfer to other accts [091â4300]
                  â62
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1050
                  Unobligated balance (total)
                  46
                  
                  
               
               
                  
                  Financing authority:
               
               
                  
                  Spending authority from offsetting collections, mandatory:
               
               
                  1800
                  Collected
                  5
                  
                  
               
               
                  1810
                  Spending authority from offsetting collections transferred to other accounts [091â4300]
                  â5
                  
                  
               
               
                  1930
                  Total budgetary resources available
                  46
                  
                  
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  46
                  
                  
               
               
                  3020
                  Financing disbursements (gross)
                  â46
                  
                  
               
               
                  
                     
                  
               
               
                  
                  Financing authority and disbursements, net:
               
               
                  
                  Mandatory:
               
               
                  
                  Financing disbursements:
               
               
                  4110
                  Financing disbursements, gross
                  46
                  
                  
               
               
                  
                  Offsets against gross financing authority and disbursements:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4123
                  Recoveries of defaulted loans
                  â5
                  
                  
               
               
                  4180
                  Financing authority, net (total)
                  â5
                  
                  
               
               
                  4190
                  Financing disbursements, net (total)
                  41
                  
                  
               
               
                  
                     
                  
               
            
         
      
      Status of Guaranteed Loans (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â4304â0â3â552
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Cumulative balance of guaranteed loans outstanding:
               
               
                  2210
                  Outstanding, start of year
                  350
                  
                  
               
               
                  
                  Adjustments:
               
               
                  2261
                  Terminations for default that result in loans receivable
                  â2
                  
                  
               
               
                  2264
                  Other adjustments, net
                  â348
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  2290
                  Outstanding, end of year
                  
                  
                  
               
               
                  
                     
                  
               
               
                  
                  Addendum:
               
               
                  
                  Cumulative balance of defaulted guaranteed loans that result in loans receivable:
               
               
                  2310
                  Outstanding, start of year
                  192
                  
                  
               
               
                  2364
                  Other adjustments, net
                  â192
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  2390
                  Outstanding, end of year
                  
                  
                  
               
               
                  
                     
                  
               
            
         
      
      
         Pursuant to P.L. 113â76, the Consolidated Appropriations Act, in 2014 this activity was transferred to the Department of Education.
      
      Balance Sheet (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â4304â0â3â552
                  2013 actual
                  2014 actual
               
               
                  
                     
                  
               
               
                  
                  ASSETS:
               
               
                  1101
                  Federal assets: Fund balances with Treasury
                  108
                  
               
               
                  
                  Net value of assets related to post-1991 acquired defaulted guaranteed loans receivable:
               
               
                  1501
                  Defaulted guaranteed loans receivable, gross
                  192
                  
               
               
                  1505
                  Allowance for subsidy cost (-)
                  â144
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
               
               
                  1599
                  Net present value of assets related to defaulted guaranteed loans
                  48
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
               
               
                  1999
                  Total assets
                  156
                  
               
               
                  
                  LIABILITIES:
               
               
                  2204
                  Non-Federal liabilities: Liabilities for loan guarantees
                  156
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
               
               
                  4999
                  Total liabilities and net position
                  156
                  
               
               
                  
                     
                  
               
            
         
      
         Health Education Assistance Loans Liquidating Account                                                                    
            
         Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â4305â0â3â552
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriation
                  1
                  
                  
               
               
                  1220
                  Appropriations transferred to other accts [091â4299]
                  â1
                  
                  
               
               
                  
                  Spending authority from offsetting collections, mandatory:
               
               
                  1800
                  Collected
                  6
                  
                  
               
               
                  1810
                  Spending authority from offsetting collections transferred to other accounts [091â4299]
                  â6
                  
                  
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4123
                  Non-Federal sources
                  â6
                  
                  
               
               
                  4180
                  Budget authority, net (total)
                  â6
                  
                  
               
               
                  4190
                  Outlays, net (total)
                  â6
                  
                  
               
               
                  
                     
                  
               
            
         
      
      Status of Guaranteed Loans (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â4305â0â3â552
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Cumulative balance of guaranteed loans outstanding:
               
               
                  2210
                  Outstanding, start of year
                  49
                  
                  
               
               
                  2264
                  Adjustments: Other adjustments, net
                  â49
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  2290
                  Outstanding, end of year
                  
                  
                  
               
               
                  
                     
                  
               
               
                  
                  Addendum:
               
               
                  
                  Cumulative balance of defaulted guaranteed loans that result in loans receivable:
               
               
                  2310
                  Outstanding, start of year
                  331
                  
                  
               
               
                  2364
                  Other adjustments, net
                  â331
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  2390
                  Outstanding, end of year
                  
                  
                  
               
               
                  
                     
                  
               
            
         
      
      
         Pursuant to P.L. 113â76, the Consolidated Appropriations Act, in 2014 this activity was transferred to the Department of Education.
      
      Balance Sheet (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â4305â0â3â552
                  2013 actual
                  2014 actual
               
               
                  
                     
                  
               
               
                  
                  ASSETS:
               
               
                  1101
                  Federal assets: Fund balances with Treasury
                  1
                  
               
               
                  1701
                  Defaulted guaranteed loans, gross
                  331
                  
               
               
                  1703
                  Allowance for estimated uncollectible loans and interest (-)
                  â248
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
               
               
                  1799
                  Value of assets related to loan guarantees
                  83
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
               
               
                  1999
                  Total assets
                  84
                  
               
               
                  
                  LIABILITIES:
               
               
                  2104
                  Federal liabilities: Resources payable to Treasury
                  82
                  
               
               
                  2204
                  Non-Federal liabilities: Liabilities for loan guarantees
                  2
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
               
               
                  2999
                  Total liabilities
                  84
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
               
               
                  4999
                  Total liabilities and net position
                  84
                  
               
               
                  
                     
                  
               
            
         
      
         Medical Facilities Guarantee and Loan Fund                                                                               
            
         Status of Direct Loans (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â9931â0â3â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Cumulative balance of direct loans outstanding:
               
               
                  1210
                  Outstanding, start of year
                  7
                  6
                  6
               
               
                  1251
                  Repayments: Repayments and prepayments
                  â1
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1290
                  Outstanding, end of year
                  6
                  6
                  6
               
               
                  
                     
                  
               
            
         
      
      
         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 075â9931â0â3â551
                  2013 actual
                  2014 actual
               
               
                  
                     
                  
               
               
                  
                  ASSETS:
               
               
                  1601
                  Direct loans, gross
                  7
                  6
               
               
                  
                  
                  
                     
                  
                  
                     
                  
               
               
                  1999
                  Total assets
                  7
                  6
               
               
                  
                  LIABILITIES:
               
               
                  2201
                  Non-Federal liabilities: Accounts payable
                  7
                  6
               
               
                  
                  
                  
                     
                  
                  
                     
                  
               
               
                  4999
                  Total liabilities and net position
                  7
                  6
               
               
                  
                     
                  
               
            
         
      
      Trust Funds
         Vaccine injury compensation program trust fundFor 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 [$7,500,000] $7,500,000 shall be available from the Trust Fund to the Secretary. (Department of Health and Human Services Appropriations Act, 2015.)
      Special and Trust Fund Receipts (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â8175â0â7â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  0100
                  Balance, start of year
                  3,244
                  3,356
                  3,403
               
               
                  
                  Receipts:
               
               
                  0200
                  Deposits, Vaccine Injury Compensation Trust Fund
                  243
                  242
                  250
               
               
                  0240
                  Interest and Profits on Investments, Vaccine Injury Compensation Trust Fund
                  108
                  56
                  90
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0299
                  Total receipts and collections
                  351
                  298
                  340
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0400
                  Total: Balances and collections
                  3,595
                  3,654
                  3,743
               
               
                  
                  Appropriations:
               
               
                  0500
                  Vaccine Injury Compensation Program Trust Fund
                  â18
                  â21
                  â23
               
               
                  0501
                  Vaccine Injury Compensation Program Trust Fund
                  â221
                  â230
                  â237
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0599
                  Total appropriations
                  â239
                  â251
                  â260
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0799
                  Balance, end of year
                  3,356
                  3,403
                  3,483
               
               
                  
                     
                  
               
            
         
      
      Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â8175â0â7â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Compensation: Claims for post - FY 1989 injuries
                  224
                  230
                  237
               
               
                  0103
                  Claims processing (Claims Court)
                  4
                  5
                  6
               
               
                  0104
                  Claims processing (HRSA)
                  6
                  8
                  8
               
               
                  0105
                  Claims processing (Dept. of Justice)
                  8
                  8
                  9
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0191
                  Total, administrative expenses
                  18
                  21
                  23
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  242
                  251
                  260
               
               
                  
                     
                  
               
               
                  
                  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
                  21
                  23
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1160
                  Appropriation, discretionary (total)
                  18
                  21
                  23
               
               
                  
                  Appropriations, mandatory:
               
               
                  1201
                  Appropriation (special or trust fund)
                  221
                  230
                  237
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  221
                  230
                  237
               
               
                  
                  Spending authority from offsetting collections, mandatory:
               
               
                  1800
                  Collected
                  2
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1850
                  Spending auth from offsetting collections, mand (total)
                  2
                  
                  
               
               
                  1900
                  Budget authority (total)
                  241
                  251
                  260
               
               
                  1930
                  Total budgetary resources available
                  242
                  251
                  260
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  16
                  12
                  1
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  242
                  251
                  260
               
               
                  3020
                  Outlays (gross)
                  â245
                  â262
                  â260
               
               
                  3040
                  Recoveries of prior year unpaid obligations, unexpired
                  â1
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  12
                  1
                  1
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  16
                  12
                  1
               
               
                  3200
                  Obligated balance, end of year
                  12
                  1
                  1
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Discretionary:
               
               
                  4000
                  Budget authority, gross
                  18
                  21
                  23
               
               
                  
                  Outlays, gross:
               
               
                  4010
                  Outlays from new discretionary authority
                  18
                  21
                  23
               
               
                  4011
                  Outlays from discretionary balances
                  4
                  11
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4020
                  Outlays, gross (total)
                  22
                  32
                  23
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  223
                  230
                  237
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  223
                  230
                  237
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4120
                  Federal sources
                  â2
                  
                  
               
               
                  4180
                  Budget authority, net (total)
                  239
                  251
                  260
               
               
                  4190
                  Outlays, net (total)
                  243
                  262
                  260
               
               
                  
                     
                  
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  5000
                  Total investments, SOY: Federal securities: Par value
                  3,244
                  3,360
                  3,428
               
               
                  5001
                  Total investments, EOY: Federal securities: Par value
                  3,360
                  3,428
                  3,530
               
               
                  
                     
                  
               
            
         
      
      
         The Vaccine Injury Compensation Program was established pursuant to P.L. 99â660 and P.L. 100â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 075â8175â0â7â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  11.1
                  Personnel compensation: Full-time permanent
                  2
                  2
                  3
               
               
                  12.1
                  Civilian personnel benefits
                  1
                  1
                  1
               
               
                  25.3
                  Other goods and services from Federal sources
                  4
                  3
                  4
               
               
                  42.0
                  Insurance claims and indemnities
                  235
                  245
                  252
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  242
                  251
                  260
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â8175â0â7â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  18
                  18
                  24
               
               
                  1101
                  Direct military average strength employment
                  1
                  1
                  1
               
               
                  
                     
                  
               
            
         
      
         Indian Health Service                                                                                                    
            
         Federal Funds
         Indian health servicesFor 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, [$4,182,147,000] $4,463,260,000,  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, [$914,139,000] $984,475,000 for Purchased/Referred Care, including $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, and to improve collections from public and private insurance at IHS and tribally operated facilities 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 93â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, 2015.)
      Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0390â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Clinical services
                  3,131
                  3,197
                  3,414
               
               
                  0002
                  Preventive health
                  148
                  154
                  163
               
               
                  0003
                  Urban health
                  41
                  44
                  44
               
               
                  0004
                  Indian health professions
                  32
                  48
                  48
               
               
                  0005
                  Tribal management
                  1
                  2
                  2
               
               
                  0006
                  Direct operations
                  61
                  68
                  68
               
               
                  0007
                  Self-governance
                  4
                  6
                  6
               
               
                  0008
                  Contract support costs
                  605
                  663
                  718
               
               
                  0009
                  Diabetes funds
                  147
                  150
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0799
                  Total direct obligations
                  4,170
                  4,332
                  4,463
               
               
                  0801
                  Indian Health Services (Reimbursable)
                  1,239
                  1,106
                  1,131
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  5,409
                  5,438
                  5,594
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  576
                  670
                  735
               
               
                  1001
                  Discretionary unobligated balance brought fwd, Oct 1
                  576
                  
                  
               
               
                  1021
                  Recoveries of prior year unpaid obligations
                  130
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1050
                  Unobligated balance (total)
                  706
                  670
                  735
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, discretionary:
               
               
                  1100
                  Appropriation
                  3,983
                  4,182
                  4,463
               
               
                  1120
                  Appropriations transferred to other accts [075â0390]
                  â55
                  
                  
               
               
                  1121
                  Appropriations transferred from other acct [075â0390]
                  55
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1160
                  Appropriation, discretionary (total)
                  3,983
                  4,182
                  4,463
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriation
                  150
                  150
                  
               
               
                  1230
                  Appropriations and/or unobligated balance of appropriations permanently reduced
                  â3
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  147
                  150
                  
               
               
                  
                  Spending authority from offsetting collections, discretionary:
               
               
                  1700
                  Collected
                  1,255
                  1,171
                  1,172
               
               
                  1701
                  Change in uncollected payments, Federal sources
                  1
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1750
                  Spending auth from offsetting collections, disc (total)
                  1,256
                  1,171
                  1,172
               
               
                  1900
                  Budget authority (total)
                  5,386
                  5,503
                  5,635
               
               
                  1930
                  Total budgetary resources available
                  6,092
                  6,173
                  6,370
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1940
                  Unobligated balance expiring
                  â13
                  
                  
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  670
                  735
                  776
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  834
                  805
                  549
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  5,409
                  5,438
                  5,594
               
               
                  3011
                  Obligations incurred, expired accounts
                  17
                  
                  
               
               
                  3020
                  Outlays (gross)
                  â5,305
                  â5,694
                  â5,721
               
               
                  3040
                  Recoveries of prior year unpaid obligations, unexpired
                  â130
                  
                  
               
               
                  3041
                  Recoveries of prior year unpaid obligations, expired
                  â20
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  805
                  549
                  422
               
               
                  
                  Uncollected payments:
               
               
                  3060
                  Uncollected pymts, Fed sources, brought forward, Oct 1
                  â67
                  â68
                  â68
               
               
                  3070
                  Change in uncollected pymts, Fed sources, unexpired
                  â1
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3090
                  Uncollected pymts, Fed sources, end of year
                  â68
                  â68
                  â68
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  767
                  737
                  481
               
               
                  3200
                  Obligated balance, end of year
                  737
                  481
                  354
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Discretionary:
               
               
                  4000
                  Budget authority, gross
                  5,239
                  5,353
                  5,635
               
               
                  
                  Outlays, gross:
               
               
                  4010
                  Outlays from new discretionary authority
                  4,462
                  4,720
                  4,961
               
               
                  4011
                  Outlays from discretionary balances
                  702
                  830
                  754
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4020
                  Outlays, gross (total)
                  5,164
                  5,550
                  5,715
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4030
                  Federal sources
                  â354
                  â374
                  â375
               
               
                  4033
                  Non-Federal sources
                  â903
                  â797
                  â797
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4040
                  Offsets against gross budget authority  and outlays (total)
                  â1,257
                  â1,171
                  â1,172
               
               
                  
                  Additional offsets against gross budget authority only:
               
               
                  4050
                  Change in uncollected pymts, Fed sources, unexpired
                  â1
                  
                  
               
               
                  4052
                  Offsetting collections credited to expired accounts
                  2
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4060
                  Additional offsets against budget authority only (total)
                  1
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4070
                  Budget authority, net (discretionary)
                  3,983
                  4,182
                  4,463
               
               
                  4080
                  Outlays, net (discretionary)
                  3,907
                  4,379
                  4,543
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  147
                  150
                  
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  50
                  144
                  
               
               
                  4101
                  Outlays from mandatory balances
                  91
                  
                  6
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4110
                  Outlays, gross (total)
                  141
                  144
                  6
               
               
                  4180
                  Budget authority, net (total)
                  4,130
                  4,332
                  4,463
               
               
                  4190
                  Outlays, net (total)
                  4,048
                  4,523
                  4,549
               
               
                  
                     
                  
               
            
         
      
      
         The Indian Health Services account provides medical care, public health services, and health professions training opportunities
            to American Indians and Alaska Natives. An estimated $3.066 billion primarily through self-determination contracts and compacts,
            will be administered by tribal governments in 2016.
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0390â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  
                  Personnel compensation:
               
               
                  11.1
                  Full-time permanent
                  396
                  386
                  393
               
               
                  11.3
                  Other than full-time permanent
                  17
                  18
                  18
               
               
                  11.5
                  Other personnel compensation
                  55
                  56
                  56
               
               
                  11.7
                  Military personnel
                  71
                  72
                  73
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  11.9
                  Total personnel compensation
                  539
                  532
                  540
               
               
                  12.1
                  Civilian personnel benefits
                  143
                  141
                  143
               
               
                  12.2
                  Military personnel benefits
                  31
                  31
                  32
               
               
                  13.0
                  Benefits for former personnel
                  2
                  2
                  2
               
               
                  21.0
                  Travel and transportation of persons
                  4
                  
                  
               
               
                  21.0
                  Patient travel
                  34
                  40
                  42
               
               
                  22.0
                  Transportation of things
                  5
                  6
                  6
               
               
                  23.1
                  Rental payments to GSA
                  14
                  14
                  15
               
               
                  23.2
                  Rental payments to others
                  2
                  2
                  2
               
               
                  23.3
                  Communications, utilities, and miscellaneous charges
                  10
                  10
                  11
               
               
                  25.1
                  Advisory and assistance services
                  8
                  4
                  4
               
               
                  25.2
                  Other services from non-Federal sources
                  92
                  95
                  121
               
               
                  25.3
                  Other goods and services from Federal sources
                  49
                  52
                  55
               
               
                  25.4
                  Operation and maintenance of facilities
                  2
                  2
                  3
               
               
                  25.6
                  Medical care
                  316
                  328
                  344
               
               
                  25.7
                  Operation and maintenance of equipment
                  12
                  12
                  13
               
               
                  25.8
                  Subsistence and support of persons
                  3
                  4
                  4
               
               
                  26.0
                  Supplies and materials
                  91
                  98
                  105
               
               
                  31.0
                  Equipment
                  10
                  10
                  11
               
               
                  41.0
                  Grants, subsidies, and contributions
                  2,802
                  2,948
                  3,009
               
               
                  42.0
                  Insurance claims and indemnities
                  1
                  1
                  1
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.0
                  Direct obligations
                  4,170
                  4,332
                  4,463
               
               
                  99.0
                  Reimbursable obligations
                  1,239
                  1,106
                  1,131
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  5,409
                  5,438
                  5,594
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0390â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  6,833
                  7,314
                  7,367
               
               
                  1101
                  Direct military average strength employment
                  1,085
                  1,112
                  1,111
               
               
                  2001
                  Reimbursable civilian full-time equivalent employment
                  5,270
                  5,300
                  5,306
               
               
                  2101
                  Reimbursable military average strength employment
                  836
                  806
                  800
               
               
                  
                     
                  
               
            
         
      
         Indian Health Services                                                                                                   
            
         
         (Legislative proposal, subject to PAYGO)Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0390â4â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0009
                  Diabetes funds
                  
                  
                  150
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations (object class 41.0)
                  
                  
                  150
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriation
                  
                  
                  150
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  
                  
                  150
               
               
                  1930
                  Total budgetary resources available
                  
                  
                  150
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  
                  
                  150
               
               
                  3020
                  Outlays (gross)
                  
                  
                  â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 facilitiesFor 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, [$460,234,000] $639,725,000, 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, 2015.)
      Special and Trust Fund Receipts (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0391â0â1â551
                  2014 actual
                  2015 est.
                  2016 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
                  â8
                  â8
                  â8
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0799
                  Balance, end of year
                  
                  
                  
               
               
                  
                     
                  
               
            
         
      
      Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0391â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Sanitation and health facilities
                  164
                  164
                  300
               
               
                  0002
                  Maintenance
                  54
                  54
                  89
               
               
                  0003
                  Facilities and environmental health
                  211
                  220
                  227
               
               
                  0004
                  Equipment
                  23
                  23
                  24
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0100
                  Total direct program
                  452
                  461
                  640
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0799
                  Total direct obligations
                  452
                  461
                  640
               
               
                  0801
                  Indian Health Facilities (Reimbursable)
                  49
                  55
                  55
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  501
                  516
                  695
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  155
                  170
                  177
               
               
                  1001
                  Discretionary unobligated balance brought fwd, Oct 1
                  7
                  
                  
               
               
                  1021
                  Recoveries of prior year unpaid obligations
                  7
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1050
                  Unobligated balance (total)
                  162
                  170
                  177
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, discretionary:
               
               
                  1100
                  Appropriation
                  452
                  460
                  640
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1160
                  Appropriation, discretionary (total)
                  452
                  460
                  640
               
               
                  
                  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
                  49
                  55
                  55
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1750
                  Spending auth from offsetting collections, disc (total)
                  49
                  55
                  55
               
               
                  1900
                  Budget authority (total)
                  509
                  523
                  703
               
               
                  1930
                  Total budgetary resources available
                  671
                  693
                  880
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  170
                  177
                  185
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  522
                  504
                  478
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  501
                  516
                  695
               
               
                  3020
                  Outlays (gross)
                  â511
                  â542
                  â599
               
               
                  3040
                  Recoveries of prior year unpaid obligations, unexpired
                  â7
                  
                  
               
               
                  3041
                  Recoveries of prior year unpaid obligations, expired
                  â1
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  504
                  478
                  574
               
               
                  
                  Uncollected payments:
               
               
                  3060
                  Uncollected pymts, Fed sources, brought forward, Oct 1
                  â5
                  â5
                  â5
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3090
                  Uncollected pymts, Fed sources, end of year
                  â5
                  â5
                  â5
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  517
                  499
                  473
               
               
                  3200
                  Obligated balance, end of year
                  499
                  473
                  569
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Discretionary:
               
               
                  4000
                  Budget authority, gross
                  501
                  515
                  695
               
               
                  
                  Outlays, gross:
               
               
                  4010
                  Outlays from new discretionary authority
                  254
                  193
                  247
               
               
                  4011
                  Outlays from discretionary balances
                  249
                  341
                  344
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4020
                  Outlays, gross (total)
                  503
                  534
                  591
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4030
                  Federal sources
                  â49
                  â55
                  â55
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  8
                  8
                  8
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  3
                  8
                  8
               
               
                  4101
                  Outlays from mandatory balances
                  5
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4110
                  Outlays, gross (total)
                  8
                  8
                  8
               
               
                  4180
                  Budget authority, net (total)
                  460
                  468
                  648
               
               
                  4190
                  Outlays, net (total)
                  462
                  487
                  544
               
               
                  
                     
                  
               
            
         
      
      
         The Indian Health Facilities account supports construction, repair and improvement, equipment, and environmental health and
            facilities support for the Indian Health Service. An estimated $333.2 million primarily through self-determination contracts
            and compacts, will be administered by tribal governments in 2016.
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0391â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  
                  Personnel compensation:
               
               
                  11.1
                  Full-time permanent
                  48
                  51
                  52
               
               
                  11.3
                  Other than full-time permanent
                  2
                  2
                  2
               
               
                  11.5
                  Other personnel compensation
                  2
                  2
                  2
               
               
                  11.7
                  Military personnel
                  24
                  25
                  25
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  11.9
                  Total personnel compensation
                  76
                  80
                  81
               
               
                  12.1
                  Civilian personnel benefits
                  15
                  16
                  16
               
               
                  12.2
                  Military personnel benefits
                  9
                  9
                  9
               
               
                  21.0
                  Travel and transportation of persons
                  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
                  15
                  16
                  17
               
               
                  25.1
                  Advisory and assistance services
                  2
                  2
                  2
               
               
                  25.2
                  Other services from non-Federal sources
                  70
                  70
                  106
               
               
                  25.3
                  Other goods and services from Federal sources
                  2
                  2
                  2
               
               
                  25.4
                  Operation and maintenance of facilities
                  9
                  8
                  26
               
               
                  25.7
                  Operation and maintenance of equipment
                  4
                  3
                  21
               
               
                  26.0
                  Supplies and materials
                  6
                  7
                  7
               
               
                  31.0
                  Equipment
                  9
                  9
                  9
               
               
                  32.0
                  Land and structures
                  89
                  87
                  191
               
               
                  41.0
                  Grants, subsidies, and contributions
                  141
                  145
                  148
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.0
                  Direct obligations
                  454
                  461
                  640
               
               
                  99.0
                  Reimbursable obligations
                  47
                  55
                  55
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  501
                  516
                  695
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0391â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  1,008
                  1,056
                  1,054
               
               
                  1101
                  Direct military average strength employment
                  160
                  163
                  170
               
               
                  2001
                  Reimbursable civilian full-time equivalent employment
                  29
                  29
                  29
               
               
                  
                     
                  
               
            
         
      
         ADMINISTRATIVE PROVISIONSâINDIAN HEALTH SERVICE                                                                          
            
         
         administrative provisionsâIndian health serviceAppropriations 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. 5901â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. 2651â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 86â121, the Indian Sanitation Facilities Act and Public
         Law 93â638: 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
         [approved by] 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. (Department of the Interior, Environment, and Related Agencies Appropriations Act, 2015.)
         Centers for Disease Control and Prevention                                                                               
            
         Federal Funds
         Immunization and respiratory diseasesFor 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, [$573,105,000] $537,766,000. (Department of Health and Human Services Appropriations Act, 2015.)
         HIV/AIDS, viral hepatitis, sexually transmitted diseases, and tuberculosis preventionFor carrying out titles II, III, XVII, and XXIII of the PHS Act with respect to HIV/AIDS, viral hepatitis, sexually transmitted
         diseases, and tuberculosis prevention, [$1,117,609,000] $1,161,747,000. (Department of Health and Human Services Appropriations Act, 2015.)
         Emerging and zoonotic infectious diseasesFor 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, [$352,990,000] $644,687,000: Provided, That of the [funds available under this heading, $30,000,000 shall be for the Advanced Molecular Detection initiative] 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. (Department of Health and Human Services Appropriations Act, 2015.)
         Chronic disease prevention and health promotionFor carrying out titles II, III, XI, XV, XVII, and XIX of the PHS Act with respect to chronic disease prevention and health
         promotion, [$747,220,000] $577,854,000: Provided, That funds appropriated under this account may be available for making grants under section 1509 of the PHS Act for not
         less than 21 States, tribes, or tribal organizations: [Provided further, That of the funds available under this heading, $7,500,000 shall be available to continue and expand community specific
         extension and outreach programs 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:] Provided further, That the proportional funding requirements under section 1503(a) of the PHS Act shall not apply to funds made available
         under this heading. (Department of Health and Human Services Appropriations Act, 2015.)
         Birth defects, developmental disabilities, disabilities and healthFor carrying out titles II, III, XI, and XVII of the PHS Act with respect to birth defects, developmental disabilities, disabilities
         and health, [$131,781,000] $63,815,000. (Department of Health and Human Services Appropriations Act, 2015.)
         Public Health Scientific ServicesFor carrying out titles II, III, and XVII of the PHS Act with respect to health statistics, surveillance, health informatics,
         and workforce development, [$481,061,000] $474,559,000. (Department of Health and Human Services Appropriations Act, 2015.)
         Environmental healthFor carrying out titles II, III, and XVII of the PHS Act with respect to environmental health, [$166,404,000] $141,500,000. (Department of Health and Human Services Appropriations Act, 2015.)
         Injury prevention and controlFor carrying out titles II, III, and XVII of the PHS Act with respect to injury prevention and control, [$170,447,000: Provided, That of the funds provided under this heading, $20,000,000 shall be available for an evidence-based prescription drug overdose
         prevention program] $256,977,000. (Department of Health and Human Services Appropriations Act, 2015.)
         National Institute for Occupational Safety and HealthFor carrying out titles II, III, and XVII of the PHS Act, sections 101, 102, 103, 201, 202, 203, 301, and 501 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, [$334,863,000] $283,418,000. (Department of Health and Human Services Appropriations Act, 2015.)
         Energy employees occupational illness compensation programFor 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 106â554. (Department of Health and Human Services Appropriations Act, 2015.)
         Global healthFor carrying out titles II, III, and XVII of the PHS Act with respect to global health, [$416,517,000] $448,092,000, of which [$128,421,000] $128,421,000 for international HIV/AIDS shall remain available through September 30, [2016] 2017: Provided, That funds may be used for purchase and insurance of official motor vehicles in foreign countries [: Provided further, That these funds are in addition to amounts provided in section 137 of Public Law 113â164]. (Department of Health and Human Services Appropriations Act, 2015.)
         Public health preparedness and responseFor 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, [$1,352,551,000] $1,381,818,000, of which [$534,343,000] $571,043,000 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 Centers for Disease Control and Prevention (CDC) or the Administrator of the Agency for Toxic Substances and Disease Registry may detail [CDC] staff without reimbursement for up to [45] 180 days to support [the work] an activation 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 funds appropriated under this heading may be used to support a contract for the operation and maintenance of an aircraft
         in direct support of activities throughout CDC to ensure the agency is prepared to address public health preparedness emergencies]. (Department of Health and Human Services Appropriations Act, 2015.)
         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 for activities funded in other appropriations included in this Act for the Centers for Disease Control and Prevention,
         [$113,570,000] $113,570,000: 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 and the Respirator Certification Program shall be available through September 30, [2016] 2017: 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 the Director may transfer funds between any of the accounts of CDC 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, 2015.)
         [(including transfer of funds)][For an additional amount for "CDC-Wide Activities and Program Support", $1,771,000,000, to remain available until September
         30, 2019, to prevent, prepare for, and respond to Ebola domestically and internationally; for the transportation, medical
         care, treatment, and other related costs of persons quarantined or isolated under Federal or State quarantine law; and to
         carry out titles II, III, and XVII of the Public Health Service ("PHS") Act with respect to domestic preparedness and global
         health: Provided, That no less than $10,000,000 shall be for worker-based training to prevent and reduce exposure of hospital employees, emergency
         first responders and other workers who are at risk of exposure to Ebola through their work duties: Provided further, That $597,000,000 shall be used to support national public health institutes and global health security: Provided further, That $155,000,000 shall be to support the Public Health Emergency Preparedness program: Provided further, That products purchased with these funds may, at the discretion of the Secretary of Health and Human Services, be deposited
         in the Strategic National Stockpile under section 319F-2 of the PHS Act: Provided further, That funds may be used for purchase and insurance of official motor vehicles in foreign countries: Provided further, That such funds may be transferred by the Director of the Centers for Disease Control and Prevention ("CDC") to other accounts
         of the CDC for the purposes provided in this paragraph: Provided further, That the Director of the CDC shall notify the Committees on Appropriations of the House of Representatives and the Senate
         promptly after any transfer under the preceding proviso: Provided further, That the transfer authority provided in this paragraph is in addition to any other transfer authority provided by law: Provided further, That such amount is designated by the Congress as an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced
         Budget and Emergency Deficit Control Act of 1985.] (Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2015.)
         Buildings and facilitiesFor [acquisition of real property,] equipment, construction, and renovation of facilities, $10,000,000, [which shall] to remain available until September 30, [2019] 2020: Provided, That funds [previously set-aside by CDC for repair and upgrade of the Lake Lynn Experimental Mine and Laboratory shall be used to acquire
         a replacement mine safety research facility] made available by prior appropriations Acts for CDC for construction and renovation of facilities may also be used, in fiscal
            year 2016, for the construction of a replacement freezer building in the Fort Collins, Colorado area. (Department of Health and Human Services Appropriations Act, 2015.)
      Special and Trust Fund Receipts (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0943â0â1â999
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  0100
                  Balance, start of year
                  
                  
                  
               
               
                  
                  Receipts:
               
               
                  0220
                  Cooperative Research and Development Agreements, Centers for Disease Control
                  2
                  2
                  2
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0400
                  Total: Balances and collections
                  2
                  2
                  2
               
               
                  
                  Appropriations:
               
               
                  0500
                  CDC-Wide Activities and Program Support
                  â2
                  â2
                  â2
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0799
                  Balance, end of year
                  
                  
                  
               
               
                  
                     
                  
               
            
         
      
      Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0943â0â1â999
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Birth Defects, Developmental Disabilities, Disability and Health (0958)
                  132
                  132
                  132
               
               
                  0002
                  CDC Wide Activities and Program Support (0943)
                  299
                  274
                  114
               
               
                  0004
                  Chronic Disease Prevention and Health Promotion (0948)
                  1,183
                  1,198
                  1,058
               
               
                  0005
                  Emerging and Zoonotics Infectious Diseases (0949)
                  391
                  405
                  699
               
               
                  0006
                  Energy Employee Illness Occupational Compensation Program Act (EEOICPA) (0954)
                  53
                  50
                  55
               
               
                  0007
                  Environmental Health (0947)
                  179
                  179
                  179
               
               
                  0008
                  Global Health (0955)
                  403
                  447
                  448
               
               
                  0012
                  HIV/AIDS, Viral Hepatitis, STD and TB Prevention (0950)
                  1,116
                  1,118
                  1,162
               
               
                  0013
                  Immunization and Respiratory Diseases (0951)
                  769
                  798
                  748
               
               
                  0015
                  Injury Prevention and Control (0952)
                  150
                  170
                  257
               
               
                  0016
                  Occupational Safety and Health (0953)
                  220
                  335
                  283
               
               
                  0019
                  Public Health Preparedness and Response (0956)
                  1,401
                  1,353
                  1,382
               
               
                  0020
                  Public Health Scientific Services (0959)
                  394
                  481
                  539
               
               
                  0021
                  Cooperative Research and Development Agreements (CRADA) (5146)
                  2
                  2
                  2
               
               
                  0022
                  Ebola (Emergency pursuant to 2011 BCA)
                  
                  1,771
                  
               
               
                  0023
                  Buidling and Facilities (0960)
                  
                  10
                  10
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0799
                  Total direct obligations
                  6,692
                  8,723
                  7,068
               
               
                  0801
                  PHS Evalauation
                  211
                  
                  
               
               
                  0802
                  CDC-Wide Activities and Program Support (Reimbursable)
                  211
                  635
                  635
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0809
                  Reimbursable program activities, subtotal
                  422
                  635
                  635
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0899
                  Total reimbursable obligations
                  422
                  635
                  635
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  7,114
                  9,358
                  7,703
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  166
                  124
                  108
               
               
                  1001
                  Discretionary unobligated balance brought fwd, Oct 1
                  166
                  
                  
               
               
                  1010
                  Unobligated balance transfer to other accts [075â4553]
                  â23
                  
                  
               
               
                  1021
                  Recoveries of prior year unpaid obligations
                  12
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1050
                  Unobligated balance (total)
                  155
                  124
                  108
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, discretionary:
               
               
                  1100
                  Appropriation
                  5,807
                  7,769
                  6,096
               
               
                  1120
                  Appropriations transferred to other accts [075â0511]
                  â13
                  
                  
               
               
                  1120
                  Appropriations transferred to other accts [075â1503]
                  â2
                  
                  
               
               
                  1120
                  Appropriations transferred to other accts [075â0140]
                  â1
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1160
                  Appropriation, discretionary (total)
                  5,791
                  7,769
                  6,096
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriation (075â0954 - EEOICPA)
                  55
                  55
                  55
               
               
                  1201
                  Appropriation (075â5146 CRADA)
                  2
                  2
                  2
               
               
                  1221
                  Appropriations transferred from other acct [075â0116]
                  831
                  886
                  914
               
               
                  1230
                  Appropriations and/or unobligated balance of appropriations permanently reduced
                  â6
                  â5
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  882
                  938
                  971
               
               
                  
                  Spending authority from offsetting collections, discretionary:
               
               
                  1700
                  Collected
                  340
                  633
                  633
               
               
                  1701
                  Change in uncollected payments, Federal sources
                  76
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1750
                  Spending auth from offsetting collections, disc (total)
                  416
                  633
                  633
               
               
                  
                  Spending authority from offsetting collections, mandatory:
               
               
                  1800
                  Collected
                  4
                  2
                  2
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1850
                  Spending auth from offsetting collections, mand (total)
                  4
                  2
                  2
               
               
                  1900
                  Budget authority (total)
                  7,093
                  9,342
                  7,702
               
               
                  1930
                  Total budgetary resources available
                  7,248
                  9,466
                  7,810
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1940
                  Unobligated balance expiring
                  â10
                  
                  
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  124
                  108
                  107
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  5,779
                  5,822
                  7,284
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  7,114
                  9,358
                  7,703
               
               
                  3011
                  Obligations incurred, expired accounts
                  21
                  
                  
               
               
                  3020
                  Outlays (gross)
                  â6,843
                  â7,896
                  â8,380
               
               
                  3040
                  Recoveries of prior year unpaid obligations, unexpired
                  â12
                  
                  
               
               
                  3041
                  Recoveries of prior year unpaid obligations, expired
                  â237
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  5,822
                  7,284
                  6,607
               
               
                  
                  Uncollected payments:
               
               
                  3060
                  Uncollected pymts, Fed sources, brought forward, Oct 1
                  â429
                  â215
                  â215
               
               
                  3070
                  Change in uncollected pymts, Fed sources, unexpired
                  â76
                  
                  
               
               
                  3071
                  Change in uncollected pymts, Fed sources, expired
                  290
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3090
                  Uncollected pymts, Fed sources, end of year
                  â215
                  â215
                  â215
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  5,350
                  5,607
                  7,069
               
               
                  3200
                  Obligated balance, end of year
                  5,607
                  7,069
                  6,392
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Discretionary:
               
               
                  4000
                  Budget authority, gross
                  6,207
                  8,402
                  6,729
               
               
                  
                  Outlays, gross:
               
               
                  4010
                  Outlays from new discretionary authority
                  2,706
                  3,744
                  3,078
               
               
                  4011
                  Outlays from discretionary balances
                  3,457
                  3,442
                  4,521
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4020
                  Outlays, gross (total)
                  6,163
                  7,186
                  7,599
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4030
                  Federal sources
                  â615
                  â633
                  â633
               
               
                  4033
                  Non-Federal sources
                  â4
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4040
                  Offsets against gross budget authority  and outlays (total)
                  â619
                  â633
                  â633
               
               
                  
                  Additional offsets against gross budget authority only:
               
               
                  4050
                  Change in uncollected pymts, Fed sources, unexpired
                  â76
                  
                  
               
               
                  4052
                  Offsetting collections credited to expired accounts
                  279
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4060
                  Additional offsets against budget authority only (total)
                  203
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4070
                  Budget authority, net (discretionary)
                  5,791
                  7,769
                  6,096
               
               
                  4080
                  Outlays, net (discretionary)
                  5,544
                  6,553
                  6,966
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  886
                  940
                  973
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  153
                  224
                  230
               
               
                  4101
                  Outlays from mandatory balances
                  527
                  486
                  551
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4110
                  Outlays, gross (total)
                  680
                  710
                  781
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4123
                  Non-Federal sources
                  â4
                  â2
                  â2
               
               
                  4180
                  Budget authority, net (total)
                  6,673
                  8,707
                  7,067
               
               
                  4190
                  Outlays, net (total)
                  6,220
                  7,261
                  7,745
               
               
                  
                     
                  
               
            
         
      
      
         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 FY 2015 funding level for CDC includes $1,771 million
            in one-time emergency funding for the U.S. Government response to contain, treat, and prevent the spread of Ebola.  
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0943â0â1â999
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  
                  Personnel compensation:
               
               
                  11.1
                  Full-time permanent
                  629
                  914
                  740
               
               
                  11.3
                  Other than full-time permanent
                  104
                  100
                  101
               
               
                  11.5
                  Other personnel compensation
                  28
                  29
                  30
               
               
                  11.7
                  Military personnel
                  72
                  67
                  68
               
               
                  11.8
                  Special personal services payments
                  4
                  1
                  1
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  11.9
                  Total personnel compensation
                  837
                  1,111
                  940
               
               
                  12.1
                  Civilian personnel benefits
                  234
                  302
                  256
               
               
                  12.2
                  Military personnel benefits
                  50
                  46
                  46
               
               
                  21.0
                  Travel and transportation of persons
                  39
                  64
                  58
               
               
                  22.0
                  Transportation of things
                  15
                  20
                  18
               
               
                  23.1
                  Rental payments to GSA
                  5
                  37
                  38
               
               
                  23.2
                  Rental payments to others
                  1
                  14
                  1
               
               
                  23.3
                  Communications, utilities, and miscellaneous charges
                  23
                  40
                  40
               
               
                  24.0
                  Printing and reproduction
                  3
                  7
                  4
               
               
                  25.1
                  Advisory and assistance services
                  656
                  843
                  959
               
               
                  25.2
                  Other services from non-Federal sources
                  203
                  341
                  384
               
               
                  25.3
                  Other goods and services from Federal sources
                  705
                  542
                  608
               
               
                  25.4
                  Operation and maintenance of facilities
                  16
                  106
                  119
               
               
                  25.5
                  Research and development contracts
                  45
                  541
                  112
               
               
                  25.6
                  Medical care
                  2
                  44
                  49
               
               
                  25.7
                  Operation and maintenance of equipment
                  37
                  45
                  51
               
               
                  25.8
                  Subsistence and support of persons
                  
                  1
                  1
               
               
                  26.0
                  Supplies and materials
                  506
                  624
                  584
               
               
                  31.0
                  Equipment
                  59
                  72
                  63
               
               
                  32.0
                  Land and structures
                  5
                  14
                  14
               
               
                  41.0
                  Grants, subsidies, and contributions
                  3,251
                  3,909
                  2,723
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.0
                  Direct obligations
                  6,692
                  8,723
                  7,068
               
               
                  99.0
                  Reimbursable obligations
                  422
                  635
                  635
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  7,114
                  9,358
                  7,703
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0943â0â1â999
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  7,714
                  7,722
                  7,765
               
               
                  1101
                  Direct military average strength employment
                  803
                  803
                  803
               
               
                  2001
                  Reimbursable civilian full-time equivalent employment
                  716
                  716
                  716
               
               
                  2101
                  Reimbursable military average strength employment
                  87
                  87
                  87
               
               
                  
                     
                  
               
            
         
      
         CDC Working Capital Fund                                                                                                 
            
         Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â4553â0â4â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Direct program activity
                  21
                  
                  
               
               
                  0801
                  CDC Working Capital Fund (Reimbursable)
                  474
                  530
                  530
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  495
                  530
                  530
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  
                  27
                  27
               
               
                  1011
                  Unobligated balance transfer from other acct [075â0943]
                  23
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1050
                  Unobligated balance (total)
                  23
                  27
                  27
               
               
                  
                  Budget authority:
               
               
                  
                  Spending authority from offsetting collections, discretionary:
               
               
                  1700
                  Collected
                  499
                  530
                  530
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1750
                  Spending auth from offsetting collections, disc (total)
                  499
                  530
                  530
               
               
                  1900
                  Budget authority (total)
                  499
                  530
                  530
               
               
                  1930
                  Total budgetary resources available
                  522
                  557
                  557
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  27
                  27
                  27
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  
                  150
                  
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  495
                  530
                  530
               
               
                  3020
                  Outlays (gross)
                  â345
                  â680
                  â530
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  150
                  
                  
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  
                  150
                  
               
               
                  3200
                  Obligated balance, end of year
                  150
                  
                  
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Discretionary:
               
               
                  4000
                  Budget authority, gross
                  499
                  530
                  530
               
               
                  
                  Outlays, gross:
               
               
                  4010
                  Outlays from new discretionary authority
                  345
                  530
                  530
               
               
                  4011
                  Outlays from discretionary balances
                  
                  150
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4020
                  Outlays, gross (total)
                  345
                  680
                  530
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4030
                  Federal sources
                  â499
                  â530
                  â530
               
               
                  4190
                  Outlays, net (total)
                  â154
                  150
                  
               
               
                  
                     
                  
               
            
         
      
      
         Implemented in fiscal year 2014, CDC's 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 075â4553â0â4â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  25.1
                  Advisory and assistance services
                  1
                  
                  
               
               
                  25.2
                  Other services from non-Federal sources
                  1
                  
                  
               
               
                  25.4
                  Operation and maintenance of facilities
                  17
                  
                  
               
               
                  25.7
                  Operation and maintenance of equipment
                  1
                  
                  
               
               
                  31.0
                  Equipment
                  1
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.0
                  Direct obligations
                  21
                  
                  
               
               
                  
                  Reimbursable obligations:
               
               
                  
                  Personnel compensation:
               
               
                  11.1
                  Full-time permanent
                  135
                  155
                  155
               
               
                  11.3
                  Other than full-time permanent
                  2
                  2
                  2
               
               
                  11.5
                  Other personnel compensation
                  2
                  2
                  2
               
               
                  11.7
                  Military personnel
                  3
                  3
                  3
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  11.9
                  Total personnel compensation
                  142
                  162
                  162
               
               
                  12.1
                  Civilian personnel benefits
                  42
                  42
                  42
               
               
                  12.2
                  Military personnel benefits
                  1
                  1
                  1
               
               
                  21.0
                  Travel and transportation of persons
                  1
                  2
                  2
               
               
                  22.0
                  Transportation of things
                  1
                  1
                  1
               
               
                  23.1
                  Rental payments to GSA
                  35
                  50
                  50
               
               
                  23.3
                  Communications, utilities, and miscellaneous charges
                  26
                  26
                  26
               
               
                  25.1
                  Advisory and assistance services
                  20
                  41
                  41
               
               
                  25.2
                  Other services from non-Federal sources
                  81
                  81
                  81
               
               
                  25.3
                  Other goods and services from Federal sources
                  46
                  46
                  46
               
               
                  25.4
                  Operation and maintenance of facilities
                  21
                  21
                  21
               
               
                  25.6
                  Medical care
                  1
                  1
                  1
               
               
                  25.7
                  Operation and maintenance of equipment
                  38
                  46
                  46
               
               
                  26.0
                  Supplies and materials
                  1
                  2
                  2
               
               
                  31.0
                  Equipment
                  10
                  7
                  7
               
               
                  32.0
                  Land and structures
                  8
                  1
                  1
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.0
                  Reimbursable obligations
                  474
                  530
                  530
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  495
                  530
                  530
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â4553â0â4â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  15
                  
                  
               
               
                  2001
                  Reimbursable civilian full-time equivalent employment
                  1,458
                  1,458
                  1,458
               
               
                  2101
                  Reimbursable military average strength employment
                  31
                  31
                  31
               
               
                  
                     
                  
               
            
         
      
         Agency for toxic substances and disease registry
         Toxic substances and environmental public healthFor 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)
         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) of CERCLA during fiscal year [2015] 2016, and existing profiles may be updated as necessary. (Department of the Interior, Environment, and Related Agencies Appropriations Act, 2015.)
      Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0944â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Agency for Toxic Substances and Disease Registry, Toxic Substanc (Direct)
                  74
                  75
                  75
               
               
                  0002
                  Health Reform Prog. Grants Environ. Hazzards
                  3
                  
                  
               
               
                  0003
                  Affordable Care Act
                  
                  19
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0799
                  Total direct obligations
                  77
                  94
                  75
               
               
                  0801
                  Agency for Toxic Substances and Disease Registry, Toxic Substanc (Reimbursable)
                  3
                  3
                  3
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  80
                  97
                  78
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  14
                  12
                  12
               
               
                  1001
                  Discretionary unobligated balance brought fwd, Oct 1
                  
                  12
                  
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, discretionary:
               
               
                  1100
                  Appropriation
                  75
                  75
                  75
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1160
                  Appropriation, discretionary (total)
                  75
                  75
                  75
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriation
                  
                  19
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  
                  19
                  
               
               
                  
                  Spending authority from offsetting collections, discretionary:
               
               
                  1700
                  Collected
                  1
                  3
                  3
               
               
                  1701
                  Change in uncollected payments, Federal sources
                  2
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1750
                  Spending auth from offsetting collections, disc (total)
                  3
                  3
                  3
               
               
                  1900
                  Budget authority (total)
                  78
                  97
                  78
               
               
                  1930
                  Total budgetary resources available
                  92
                  109
                  90
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  12
                  12
                  12
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  43
                  46
                  52
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  80
                  97
                  78
               
               
                  3020
                  Outlays (gross)
                  â76
                  â91
                  â90
               
               
                  3041
                  Recoveries of prior year unpaid obligations, expired
                  â1
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  46
                  52
                  40
               
               
                  
                  Uncollected payments:
               
               
                  3060
                  Uncollected pymts, Fed sources, brought forward, Oct 1
                  â10
                  â7
                  â7
               
               
                  3070
                  Change in uncollected pymts, Fed sources, unexpired
                  â2
                  
                  
               
               
                  3071
                  Change in uncollected pymts, Fed sources, expired
                  5
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3090
                  Uncollected pymts, Fed sources, end of year
                  â7
                  â7
                  â7
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  33
                  39
                  45
               
               
                  3200
                  Obligated balance, end of year
                  39
                  45
                  33
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Discretionary:
               
               
                  4000
                  Budget authority, gross
                  78
                  78
                  78
               
               
                  
                  Outlays, gross:
               
               
                  4010
                  Outlays from new discretionary authority
                  51
                  55
                  55
               
               
                  4011
                  Outlays from discretionary balances
                  23
                  23
                  22
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4020
                  Outlays, gross (total)
                  74
                  78
                  77
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4030
                  Federal sources
                  â6
                  â3
                  â3
               
               
                  
                  Additional offsets against gross budget authority only:
               
               
                  4050
                  Change in uncollected pymts, Fed sources, unexpired
                  â2
                  
                  
               
               
                  4052
                  Offsetting collections credited to expired accounts
                  5
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4060
                  Additional offsets against budget authority only (total)
                  3
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4070
                  Budget authority, net (discretionary)
                  75
                  75
                  75
               
               
                  4080
                  Outlays, net (discretionary)
                  68
                  75
                  74
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  
                  19
                  
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  
                  13
                  
               
               
                  4101
                  Outlays from mandatory balances
                  2
                  
                  13
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4110
                  Outlays, gross (total)
                  2
                  13
                  13
               
               
                  4180
                  Budget authority, net (total)
                  75
                  94
                  75
               
               
                  4190
                  Outlays, net (total)
                  70
                  88
                  87
               
               
                  
                     
                  
               
            
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0944â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  
                  Personnel compensation:
               
               
                  11.1
                  Full-time permanent
                  22
                  22
                  22
               
               
                  11.3
                  Other than full-time permanent
                  2
                  2
                  2
               
               
                  11.5
                  Other personnel compensation
                  1
                  1
                  1
               
               
                  11.7
                  Military personnel
                  3
                  3
                  3
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  11.9
                  Total personnel compensation
                  28
                  28
                  28
               
               
                  12.1
                  Civilian personnel benefits
                  8
                  8
                  8
               
               
                  12.2
                  Military personnel benefits
                  1
                  1
                  1
               
               
                  25.1
                  Advisory and assistance services
                  6
                  6
                  6
               
               
                  25.2
                  Other services from non-Federal sources
                  5
                  5
                  5
               
               
                  25.3
                  Other goods and services from Federal sources
                  11
                  9
                  9
               
               
                  25.7
                  Operation and maintenance of equipment
                  1
                  1
                  1
               
               
                  41.0
                  Grants, subsidies, and contributions
                  17
                  36
                  17
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.0
                  Direct obligations
                  77
                  94
                  75
               
               
                  99.0
                  Reimbursable obligations
                  3
                  3
                  3
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  80
                  97
                  78
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0944â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  235
                  235
                  235
               
               
                  1101
                  Direct military average strength employment
                  35
                  35
                  35
               
               
                  2001
                  Reimbursable civilian full-time equivalent employment
                  7
                  7
                  
               
               
                  2101
                  Reimbursable military average strength employment
                  2
                  
                  
               
               
                  
                     
                  
               
            
         
      
         World Trade Center Health Program Fund                                                                                   
            
         Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0946â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Federal Share
                  236
                  261
                  285
               
               
                  0002
                  NYC
                  26
                  27
                  32
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  262
                  288
                  317
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  
                  
                  168
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriation (WTC (CDC Direct))
                  247
                  431
                  285
               
               
                  1200
                  Appropriation (WTCâNYC DHSSâCDC)
                  28
                  48
                  32
               
               
                  1230
                  Appropriations and/or unobligated balance of appropriations permanently reduced
                  â21
                  â23
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  254
                  456
                  317
               
               
                  
                  Spending authority from offsetting collections, mandatory:
               
               
                  1800
                  Collected
                  8
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1850
                  Spending auth from offsetting collections, mand (total)
                  8
                  
                  
               
               
                  1900
                  Budget authority (total)
                  262
                  456
                  317
               
               
                  1930
                  Total budgetary resources available
                  262
                  456
                  485
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  
                  168
                  168
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  163
                  154
                  149
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  262
                  288
                  317
               
               
                  3011
                  Obligations incurred, expired accounts
                  3
                  
                  
               
               
                  3020
                  Outlays (gross)
                  â196
                  â293
                  â261
               
               
                  3041
                  Recoveries of prior year unpaid obligations, expired
                  â78
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  154
                  149
                  205
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  163
                  154
                  149
               
               
                  3200
                  Obligated balance, end of year
                  154
                  149
                  205
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  262
                  456
                  317
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  131
                  210
                  146
               
               
                  4101
                  Outlays from mandatory balances
                  65
                  83
                  115
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4110
                  Outlays, gross (total)
                  196
                  293
                  261
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4123
                  Non-Federal sources
                  â19
                  
                  
               
               
                  
                  Additional offsets against gross budget authority only:
               
               
                  4142
                  Offsetting collections credited to expired accounts
                  11
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4160
                  Budget authority, net (mandatory)
                  254
                  456
                  317
               
               
                  4170
                  Outlays, net (mandatory)
                  177
                  293
                  261
               
               
                  4180
                  Budget authority, net (total)
                  254
                  456
                  317
               
               
                  4190
                  Outlays, net (total)
                  177
                  293
                  261
               
               
                  
                     
                  
               
            
         
      
      
         HHS along with CDC began implementing provisions of The James Zadroga 9/11 Health and Compensation Act of 2010 (P.L. 111â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 2015 and 2016 Budget reflect estimated Federal obligations for the WTC Health Program.
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0946â0â1â551
                  2014 actual
                  2015 est.
                  2016 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
                  24
                  24
                  24
               
               
                  25.2
                  Other services from non-Federal sources
                  71
                  71
                  71
               
               
                  25.3
                  Other goods and services from Federal sources
                  5
                  5
                  5
               
               
                  25.6
                  Medical care
                  2
                  2
                  2
               
               
                  41.0
                  Grants, subsidies, and contributions
                  23
                  23
                  23
               
               
                  42.0
                  Insurance claims and indemnities
                  134
                  160
                  189
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  262
                  288
                  317
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0946â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  18
                  18
                  18
               
               
                  1101
                  Direct military average strength employment
                  5
                  5
                  5
               
               
                  
                     
                  
               
            
         
      
         National Institutes of Health                                                                                            
            
         Federal Funds
         National cancer instituteFor carrying out section 301 and title IV of the PHS Act with respect to cancer, [$4,950,396,000] $5,098,479,000, of which up to [$8,000,000] $16,000,000 may be used for facilities repairs and improvements at the National Cancer InstituteâFrederick Federally Funded Research and
         Development Center in Frederick, Maryland. (Department of Health and Human Services Appropriations Act, 2015.)
         National heart, lung, and blood instituteFor carrying out section 301 and title IV of the PHS Act with respect to cardiovascular, lung, and blood diseases, and blood
         and blood products, [$2,997,870,000] $3,071,906,000. (Department of Health and Human Services Appropriations Act, 2015.)
         National institute of dental and craniofacial researchFor carrying out section 301 and title IV of the PHS Act with respect to dental and craniofacial diseases, [$399,886,000] $406,746,000. (Department of Health and Human Services Appropriations Act, 2015.)
         National institute of diabetes and digestive and kidney diseasesFor carrying out section 301 and title IV of the PHS Act with respect to diabetes and digestive and kidney disease, [$1,749,681,000] $1,788,133,000. (Department of Health and Human Services Appropriations Act, 2015.)
         National institute of neurological disorders and strokeFor carrying out section 301 and title IV of the PHS Act with respect to neurological disorders and stroke, [$1,605,205,000] $1,660,375,000. (Department of Health and Human Services Appropriations Act, 2015.)
         National institute of allergy and infectious diseasesFor carrying out section 301 and title IV of the PHS Act with respect to allergy and infectious diseases, [$4,358,841,000] $4,614,779,000. (Department of Health and Human Services Appropriations Act, 2015.)
      [For an additional amount for National Institute of Allergy and Infectious Diseases to prevent, prepare for, and respond to
         Ebola domestically and internationally, including expenses related to carrying out section 301 and title IV of the PHS Act,
         $238,000,000, to remain available until September 30, 2016: Provided, That such amount is designated by the Congress as an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced
         Budget and Emergency Deficit Control Act of 1985.] (Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2015.)
         National institute of general medical sciencesFor carrying out section 301 and title IV of the PHS Act with respect to general medical sciences, [$2,371,476,000] $2,433,780,000, of which [$715,000,000] $847,489,000 shall be from funds available under section 241 of the PHS Act [: Provided, That not less than $273,325,000 is provided for the Institutional Development Awards program]. (Department of Health and Human Services Appropriations Act, 2015.)
         Eunice kennedy shriver national institute of child health and human developmentFor carrying out section 301 and title IV of the PHS Act with respect to child health and human development, [$1,286,571,000] $1,318,061,000. (Department of Health and Human Services Appropriations Act, 2015.)
         National eye instituteFor carrying out section 301 and title IV of the PHS Act with respect to eye diseases and visual disorders, [$684,191,000] $695,154,000. (Department of Health and Human Services Appropriations Act, 2015.)
         National institute of environmental health sciencesFor carrying out section 301 and title IV of the PHS Act with respect to environmental health sciences, [$667,502,000] $681,782,000. (Department of Health and Human Services Appropriations Act, 2015.)
         National institute of environmental health sciencesFor necessary expenses for the National Institute of Environmental Health Sciences in carrying out activities set forth in
         section 311(a) of the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (42 U.S.C. 9660(a)) and
         section 126(g) of the Superfund Amendments and Reauthorization Act of 1986, [$77,349,000] $77,349,000. (Department of the Interior, Environment, and Related Agencies Appropriations Act, 2015.)
         National institute on agingFor carrying out section 301 and title IV of the PHS Act with respect to aging, [$1,199,468,000] $1,267,078,000. (Department of Health and Human Services Appropriations Act, 2015.)
         National institute of arthritis and musculoskeletal and skin diseasesFor carrying out section 301 and title IV of the PHS Act with respect to arthritis and musculoskeletal and skin diseases,
         [$521,665,000] $533,232,000. (Department of Health and Human Services Appropriations Act, 2015.)
         National institute on deafness and other communication disordersFor carrying out section 301 and title IV of the PHS Act with respect to deafness and other communication disorders, [$405,302,000] $416,241,000. (Department of Health and Human Services Appropriations Act, 2015.)
         National institute of nursing researchFor carrying out section 301 and title IV of the PHS Act with respect to nursing research, [$140,953,000] $144,515,000. (Department of Health and Human Services Appropriations Act, 2015.)
         National institute on alcohol abuse and alcoholismFor carrying out section 301 and title IV of the PHS Act with respect to alcohol abuse and alcoholism, [$447,408,000] $459,833,000. (Department of Health and Human Services Appropriations Act, 2015.)
         National institute on drug abuseFor carrying out section 301 and title IV of the PHS Act with respect to drug abuse, [$1,028,614,000] $1,047,397,000. (Department of Health and Human Services Appropriations Act, 2015.)
         National institute of mental healthFor carrying out section 301 and title IV of the PHS Act with respect to mental health, [$1,463,036,000] $1,489,417,000. (Department of Health and Human Services Appropriations Act, 2015.)
         National human genome research instituteFor carrying out section 301 and title IV of the PHS Act with respect to human genome research, [$499,356,000] $515,491,000. (Department of Health and Human Services Appropriations Act, 2015.)
         National institute of biomedical imaging and bioengineeringFor carrying out section 301 and title IV of the PHS Act with respect to biomedical imaging and bioengineering research, [$330,192,000] $337,314,000. (Department of Health and Human Services Appropriations Act, 2015.)
         National center for complementary and integrative healthFor carrying out section 301 and title IV of the PHS Act with respect to complementary and integrative health, [$124,681,000: Provided, That these funds may be used to support the transition enacted in section 224 of this Act] $127,521,000. (Department of Health and Human Services Appropriations Act, 2015.)
         National institute on minority health and health disparitiesFor carrying out section 301 and title IV of the PHS Act with respect to minority health and health disparities research,
         [$269,154,000] $281,549,000. (Department of Health and Human Services Appropriations Act, 2015.)
         John e. fogarty international centerFor 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), [$67,786,000] $69,505,000. (Department of Health and Human Services Appropriations Act, 2015.)
         National library of medicineFor carrying out section 301 and title IV of the PHS Act with respect to health information communications, [$336,939,000] $394,090,000: Provided, That of the amounts available for improvement of information systems, $4,000,000 shall be available until September 30,
         [2016] 2017: Provided further, That in fiscal year [2015] 2016, 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"). (Department of Health and Human Services Appropriations Act, 2015.)
         NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCESFor carrying out section 301 and title IV of the PHS Act with respect to translational sciences, [$635,230,000] $660,131,000: Provided, That up to [$9,835,000] $25,835,000 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, 2015.)
         Office of the director
         (including transfer of funds)For carrying out the responsibilities of the Office of the Director, NIH, [$1,401,134,000] $1,430,028,000, of which up to [$25,000,000] $30,000,000 may 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 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") or research related to the Study's goals and mission,
         and any funds in excess of the estimated need shall be transferred to and merged with the accounts for the various Institutes
         and Centers to support activity related to the goals and objectives of the NCS: Provided further, That NIH shall submit a spend plan on the NCS's next phase to the Committees on Appropriations of the House of Representatives
         and the Senate not later than 90 days after the date of enactment of this Act]: Provided further, That [$533,039,000] $553,039,000 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 NIH shall contract with the National Academy of Sciences for a Blue Ribbon Commission on Scientific Literacy and Standing:
         Provided further, That NIH shall submit to Congress an NIH-wide 5-year scientific strategic plan as outlined in sections 402(b)(3) and 402(b)(4)
         of the PHS Act no later than 1 year after enactment of this 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.
      
      In addition to other funds appropriated for the Common Fund established under section 402A(c) of the PHS Act, $12,600,000
         is appropriated to the Common Fund from the 10-year Pediatric Research Initiative Fund described in section 9008 of title
         26, United States Code, for the purpose of carrying out section 402(b)(7)(B)(ii) of the PHS Act (relating to pediatric research),
         as authorized in the Gabriella Miller Kids First Research Act. (Department of Health and Human Services Appropriations Act, 2015.)
         Buildings and facilitiesFor 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,
         [$128,863,000] $128,863,000, to remain available [through September 30, 2019] until expended. (Department of Health and Human Services Appropriations Act, 2015.)
      Special and Trust Fund Receipts (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â9915â0â1â552
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  0100
                  Balance, start of year
                  
                  
                  
               
               
                  
                  Receipts:
               
               
                  0220
                  Cooperative Research and Development Agreements, NIH
                  16
                  17
                  17
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0400
                  Total: Balances and collections
                  16
                  17
                  17
               
               
                  
                  Appropriations:
               
               
                  0500
                  National Institutes of Health
                  â16
                  â17
                  â16
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0799
                  Balance, end of year
                  
                  
                  1
               
               
                  
                     
                  
               
            
         
      
      Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â9915â0â1â552
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  National Cancer Institute (0849)
                  4,933
                  4,887
                  5,099
               
               
                  0002
                  National Heart, Lung, and Blood Institute (0872)
                  2,989
                  2,988
                  3,072
               
               
                  0003
                  National Institute of Dental and Craniofacial Research (0873)
                  398
                  400
                  407
               
               
                  0004
                  National Institute of Diabetes and Digestive and Kidney Disease (0884)
                  1,745
                  1,750
                  1,638
               
               
                  0005
                  National Institute of Neurological Disorders and Stroke (0886)
                  1,589
                  1,605
                  1,660
               
               
                  0006
                  National Institute of Allergy and Infectious Diseases (0885)
                  4,401
                  4,359
                  4,616
               
               
                  0007
                  National Institute of General Medical Sciences (0851)
                  2,366
                  2,371
                  1,586
               
               
                  0008
                  National Institute of Child Health and Human Development (0844)
                  1,283
                  1,287
                  1,318
               
               
                  0009
                  National Eye Institute (0887)
                  676
                  684
                  695
               
               
                  0010
                  National Institute of Environmental Health Sciences (0862)
                  743
                  745
                  759
               
               
                  0011
                  National Institute on Aging (0843)
                  1,172
                  1,199
                  1,267
               
               
                  0012
                  National Institute of Arthritis and Musculoskeletal and Skin Disease (0888)
                  520
                  522
                  533
               
               
                  0013
                  National Institute on Deafness and Other Communication Disorder (0890)
                  404
                  405
                  416
               
               
                  0014
                  National Institute of Mental Health (0892)
                  1,420
                  1,463
                  1,489
               
               
                  0015
                  National Institute on Drug Abuse (0893)
                  1,018
                  1,029
                  1,047
               
               
                  0016
                  National Institute on Alcohol Abuse and Alcoholism (0894)
                  446
                  447
                  460
               
               
                  0017
                  National Institute of Nursing Research (0889)
                  141
                  141
                  145
               
               
                  0018
                  National Human Genome Research Institute (0891)
                  498
                  499
                  515
               
               
                  0019
                  National Institute of Biomedical Imaging and Bioengineering (0898)
                  327
                  330
                  337
               
               
                  0021
                  National Center for Complementary and Integrative Health (0896)
                  124
                  125
                  128
               
               
                  0022
                  National Institute on Minority Health and Health Disparities (0897)
                  268
                  269
                  282
               
               
                  0023
                  John E. Fogarty International Center (0819)
                  68
                  68
                  70
               
               
                  0024
                  National Library of Medicine (0807)
                  328
                  337
                  394
               
               
                  0025
                  Office of the Director (0846)
                  1,417
                  1,414
                  1,431
               
               
                  0026
                  Buildings and facilities (0838)
                  98
                  129
                  129
               
               
                  0027
                  Cooperative Research and Development Agreements
                  11
                  11
                  11
               
               
                  0028
                  National Center for Advancing Translational Sciences (0875)
                  634
                  635
                  660
               
               
                  0031
                  Type 1 Diabetes
                  139
                  150
                  150
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0799
                  Total direct obligations
                  30,156
                  30,249
                  30,314
               
               
                  0801
                  Reimbursable - Other
                  3,313
                  3,423
                  3,400
               
               
                  0802
                  Royalties
                  104
                  102
                  105
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0809
                  Reimbursable program activities, subtotal
                  3,417
                  3,525
                  3,505
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0899
                  Total reimbursable obligations
                  3,417
                  3,525
                  3,505
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  33,573
                  33,774
                  33,819
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  740
                  723
                  
               
               
                  1001
                  Discretionary unobligated balance brought fwd, Oct 1
                  740
                  
                  
               
               
                  1021
                  Recoveries of prior year unpaid obligations
                  10
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1050
                  Unobligated balance (total)
                  750
                  723
                  
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, discretionary:
               
               
                  1100
                  Appropriation
                  30,003
                  29,432
                  30,301
               
               
                  1100
                  Appropriation - Emergency pursuant to 2011 BCA
                  
                  238
                  
               
               
                  1120
                  Appropriations transferred to other accts [075â0511]
                  â75
                  
                  
               
               
                  1120
                  Appropriations transferred to other accts [075â0140]
                  â6
                  
                  
               
               
                  1121
                  Appropriations transferred from other acct [075â5736]
                  
                  13
                  13
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1160
                  Appropriation, discretionary (total)
                  29,922
                  29,683
                  30,314
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriation
                  150
                  150
                  
               
               
                  1201
                  Appropriation (special or trust fund)
                  16
                  17
                  16
               
               
                  1230
                  Appropriations and/or unobligated balance of appropriations permanently reduced
                  â11
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  155
                  167
                  16
               
               
                  
                  Spending authority from offsetting collections, discretionary:
               
               
                  1700
                  Collected
                  2,562
                  3,201
                  3,489
               
               
                  1701
                  Change in uncollected payments, Federal sources
                  971
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1750
                  Spending auth from offsetting collections, disc (total)
                  3,533
                  3,201
                  3,489
               
               
                  1900
                  Budget authority (total)
                  33,610
                  33,051
                  33,819
               
               
                  1930
                  Total budgetary resources available
                  34,360
                  33,774
                  33,819
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1940
                  Unobligated balance expiring
                  â64
                  
                  
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  723
                  
                  
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  31,109
                  31,701
                  32,709
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  33,573
                  33,774
                  33,819
               
               
                  3011
                  Obligations incurred, expired accounts
                  952
                  
                  
               
               
                  3020
                  Outlays (gross)
                  â33,441
                  â32,766
                  â33,386
               
               
                  3040
                  Recoveries of prior year unpaid obligations, unexpired
                  â10
                  
                  
               
               
                  3041
                  Recoveries of prior year unpaid obligations, expired
                  â482
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  31,701
                  32,709
                  33,142
               
               
                  
                  Uncollected payments:
               
               
                  3060
                  Uncollected pymts, Fed sources, brought forward, Oct 1
                  â1,254
                  â1,559
                  â1,559
               
               
                  3070
                  Change in uncollected pymts, Fed sources, unexpired
                  â971
                  
                  
               
               
                  3071
                  Change in uncollected pymts, Fed sources, expired
                  666
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3090
                  Uncollected pymts, Fed sources, end of year
                  â1,559
                  â1,559
                  â1,559
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  29,855
                  30,142
                  31,150
               
               
                  3200
                  Obligated balance, end of year
                  30,142
                  31,150
                  31,583
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Discretionary:
               
               
                  4000
                  Budget authority, gross
                  33,455
                  32,884
                  33,803
               
               
                  
                  Outlays, gross:
               
               
                  4010
                  Outlays from new discretionary authority
                  10,229
                  11,215
                  11,674
               
               
                  4011
                  Outlays from discretionary balances
                  23,164
                  21,384
                  21,582
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4020
                  Outlays, gross (total)
                  33,393
                  32,599
                  33,256
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4030
                  Federal sources
                  â3,955
                  â3,201
                  â3,489
               
               
                  4033
                  Non-Federal sources
                  â138
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4040
                  Offsets against gross budget authority  and outlays (total)
                  â4,093
                  â3,201
                  â3,489
               
               
                  
                  Additional offsets against gross budget authority only:
               
               
                  4050
                  Change in uncollected pymts, Fed sources, unexpired
                  â971
                  
                  
               
               
                  4052
                  Offsetting collections credited to expired accounts
                  1,531
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4060
                  Additional offsets against budget authority only (total)
                  560
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4070
                  Budget authority, net (discretionary)
                  29,922
                  29,683
                  30,314
               
               
                  4080
                  Outlays, net (discretionary)
                  29,300
                  29,398
                  29,767
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  155
                  167
                  16
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  
                  53
                  16
               
               
                  4101
                  Outlays from mandatory balances
                  48
                  114
                  114
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4110
                  Outlays, gross (total)
                  48
                  167
                  130
               
               
                  4180
                  Budget authority, net (total)
                  30,077
                  29,850
                  30,330
               
               
                  4190
                  Outlays, net (total)
                  29,348
                  29,565
                  29,897
               
               
                  
                     
                  
               
            
         
      
      
         DISTRIBUTION OF BUDGET AUTHORITY AND OUTLAYS BY ACCOUNT (in millions of dollars)
         
            
               
                  
                     
                        
                     
                  
                  
                      
                     2014
                     2015*
                     2016
                  
                  
                     
                        
                     
                  
                  
                     Distribution of Discretionary Budget Authority by account:
                     
                     
                     
                  
                  
                     National Cancer Institute
                     4,933
                     4,950
                     5,098
                  
                  
                     National Heart, Lung, and Blood Institute
                     2,989
                     2,998
                     3,072
                  
                  
                     National Institute of Dental and Craniofacial Research
                     398
                     400
                     407
                  
                  
                     National Institute of Diabetes and Digestive and Kidney Diseases
                     1,745
                     1,750
                     1,788
                  
                  
                     National Institute of Neurological Disorder and Stroke
                     1,589
                     1,605
                     1,660
                  
                  
                     National Institute of Allergy and Infectious Diseases
                     4,401
                     4,597
                     4,615
                  
                  
                     National Institute of General Medical Sciences
                     2,366
                     1,656
                     1,586
                  
                  
                     Eunice Kennedy Shriver National Institute of Child Health and Human Development
                     1,283
                     1,287
                     1,318
                  
                  
                     National Eye Institute
                     676
                     684
                     695
                  
                  
                     National Institute of Environmental Health Sciences
                     743
                     745
                     759
                  
                  
                     National Institute on Aging
                     1,172
                     1,199
                     1,267
                  
                  
                     National Institute of Arthritis and Musculoskeletal and Skin Diseases
                     520
                     522
                     533
                  
                  
                     National Institute on Deafness and Other Communication Disorders
                     404
                     405
                     416
                  
                  
                     National Institute of Nursing Research
                     141
                     141
                     145
                  
                  
                     National Institute on Alcohol Abuse and Alcoholism
                     446
                     447
                     460
                  
                  
                     National Institute on Drug Abuse
                     1,018
                     1,029
                     1,047
                  
                  
                     National Institute of Mental Health
                     1,420
                     1,463
                     1,489
                  
                  
                     National Human Genome Research Institute
                     498
                     499
                     515
                  
                  
                     National Institute of Biomedical Imaging and Bioengineering
                     327
                     330
                     337
                  
                  
                     National Center for Complementary and Integrative Health
                     124
                     125
                     128
                  
                  
                     National Institute on Minority Health and Health Disparities
                     268
                     269
                     282
                  
                  
                     John E. Fogarty International Center
                     68
                     68
                     70
                  
                  
                     National Library of Medicine
                     328
                     337
                     394
                  
                  
                     National Center for Advancing Translational Sciences
                     634
                     635
                     660
                  
                  
                     Office of the Director
                     1,417
                     1,414
                     1,443
                  
                  
                     Buildings and Facilities
                     98
                     129
                     129
                  
                  
                     
                     
                        
                     
                     
                        
                     
                     
                        
                     
                  
                  
                     Total Budget Authority, NIH
                     30,006
                     29,684
                     30,313
                  
                  
                     
                     
                        
                     
                     
                        
                     
                     
                        
                     
                  
                  
                     
                        
                     
                  
               
            
         
         
            
               
                  
                     
                        
                     
                  
                  
                      
                     2014
                     2015
                     2016
                  
                  
                     
                        
                     
                  
                  
                     Distribution of Discretionary Outlays by account:
                     
                     
                     
                  
                  
                     National Cancer Institute
                     4,659
                     5,005
                     4,995
                  
                  
                     National Heart, Lung, and Blood Institute
                     2,874
                     2,824
                     3,010
                  
                  
                     National Institute of Dental and Craniofacial Research
                     374
                     424
                     400
                  
                  
                     National Institute of Diabetes and Digestive and Kidney Diseases
                     1,789
                     2,010
                     1,757
                  
                  
                     National Institute of Neurological Disorders and Stroke
                     1,515
                     1,676
                     1,617
                  
                  
                     National Institute of Allergy and Infectious Diseases
                     4,415
                     3,961
                     4,465
                  
                  
                     National Institute of General Medical Sciences
                     2,338
                     2,413
                     2,381
                  
                  
                     Eunice Kennedy Shriver National Institute of Child Health and Human Development
                     1,213
                     1,348
                     1,295
                  
                  
                     National Eye Institute
                     671
                     652
                     682
                  
                  
                     National Institute of Environmental Health Sciences
                     710
                     718
                     750
                  
                  
                     National Institute on Aging
                     1,088
                     1,125
                     1,205
                  
                  
                     National Institute of Arthritis and Musculoskeletal and Skin Diseases
                     509
                     515
                     524
                  
                  
                     National Institute on Deafness and Other Communication Disorders
                     398
                     399
                     408
                  
                  
                     National Institute of Nursing Research
                     130
                     138
                     141
                  
                  
                     National Institute on Alcohol Abuse and Alcoholism
                     419
                     442
                     450
                  
                  
                     National Institute on Drug Abuse
                     959
                     927
                     1,023
                  
                  
                     National Institute of Mental Health
                     1,330
                     1,419
                     1,447
                  
                  
                     National Human Genome Research Institute
                     483
                     541
                     506
                  
                  
                     National Institute of Biomedical Imaging and Bioengineering
                     320
                     321
                     329
                  
                  
                     National Center for Complementary and Integrative Health
                     119
                     122
                     125
                  
                  
                     National Institute on Minority Health and Health Disparities
                     255
                     255
                     271
                  
                  
                     John E. Fogarty International Center
                     63
                     72
                     68
                  
                  
                     National Library of Medicine
                     326
                     316
                     367
                  
                  
                     National Center for Advancing Translational Sciences
                     569
                     556
                     597
                  
                  
                     Office of the Director
                     1,364
                     1,383
                     1,399
                  
                  
                     Buildings and Facilities
                     111
                     107
                     97
                  
                  
                     National Center for Research Resources
                     108
                     78
                     28
                  
                  
                     
                     
                        
                     
                     
                        
                     
                     
                        
                     
                  
                  
                     Total Outlays, NIH
                     29,109
                     29,748
                     30,337
                  
                  
                     
                     
                        
                     
                     
                        
                     
                     
                        
                     
                  
                  
                     
                        
                     
                  
               
            
         *The FY 2015 funding level includes $238 million in one-time emergency funding for the U.S. Government response to contain,
         treat, and prevent the spread of Ebola.
         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 075â9915â0â1â552
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  
                  Personnel compensation:
               
               
                  11.1
                  Full-time permanent
                  907
                  923
                  923
               
               
                  11.3
                  Other than full-time permanent
                  457
                  461
                  465
               
               
                  11.5
                  Other personnel compensation
                  33
                  34
                  34
               
               
                  11.7
                  Military personnel
                  20
                  20
                  20
               
               
                  11.8
                  Special personal services payments
                  158
                  158
                  161
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  11.9
                  Total personnel compensation
                  1,575
                  1,596
                  1,603
               
               
                  12.1
                  Civilian personnel benefits
                  428
                  442
                  449
               
               
                  12.2
                  Military personnel benefits
                  14
                  14
                  15
               
               
                  21.0
                  Travel and transportation of persons
                  45
                  45
                  45
               
               
                  22.0
                  Transportation of things
                  5
                  5
                  5
               
               
                  23.1
                  Rental payments to GSA
                  14
                  14
                  15
               
               
                  23.3
                  Communications, utilities, and miscellaneous charges
                  24
                  24
                  25
               
               
                  24.0
                  Printing and reproduction
                  1
                  1
                  1
               
               
                  25.1
                  Advisory and assistance services
                  158
                  168
                  160
               
               
                  25.2
                  Other services from non-Federal sources
                  902
                  896
                  874
               
               
                  25.3
                  Other goods and services from Federal sources
                  2,981
                  3,009
                  3,020
               
               
                  25.4
                  Operation and maintenance of facilities
                  142
                  173
                  173
               
               
                  25.5
                  Research and development contracts
                  1,774
                  1,691
                  1,626
               
               
                  25.6
                  Medical care
                  28
                  28
                  28
               
               
                  25.7
                  Operation and maintenance of equipment
                  103
                  104
                  105
               
               
                  26.0
                  Supplies and materials
                  182
                  178
                  170
               
               
                  31.0
                  Equipment
                  152
                  154
                  150
               
               
                  41.0
                  Grants, subsidies, and contributions
                  21,628
                  21,706
                  21,850
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.0
                  Direct obligations
                  30,156
                  30,248
                  30,314
               
               
                  99.0
                  Reimbursable obligations
                  3,417
                  3,526
                  3,505
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  33,573
                  33,774
                  33,819
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â9915â0â1â552
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  13,086
                  13,160
                  13,160
               
               
                  1101
                  Direct military average strength employment
                  189
                  190
                  190
               
               
                  2001
                  Reimbursable civilian full-time equivalent employment
                  4,666
                  4,692
                  4,692
               
               
                  2101
                  Reimbursable military average strength employment
                  107
                  108
                  108
               
               
                  
                     
                  
               
            
         
      
         National Institutes of Health                                                                                            
            
         
         (Legislative proposal, subject to PAYGO)Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â9915â4â1â552
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Type 1 Diabetes
                  
                  
                  150
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations (object class 41.0)
                  
                  
                  150
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriation
                  
                  
                  150
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  
                  
                  150
               
               
                  1930
                  Total budgetary resources available
                  
                  
                  150
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  
                  
                  150
               
               
                  3020
                  Outlays (gross)
                  
                  
                  â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
               
               
                  
                     
                  
               
            
         
      
         10-Year Pediatric Research Initiative Fund                                                                               
            
         Special and Trust Fund Receipts (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â5736â0â2â552
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  0100
                  Balance, start of year
                  
                  38
                  25
               
               
                  
                  Receipts:
               
               
                  0240
                  Transfers from Presidential Election Campaign Fund
                  38
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0400
                  Total: Balances and collections
                  38
                  38
                  25
               
               
                  
                  Appropriations:
               
               
                  0500
                  10-Year Pediatric Research Initiative Fund
                  
                  â13
                  â13
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0799
                  Balance, end of year
                  38
                  25
                  12
               
               
                  
                     
                  
               
            
         
      
      Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â5736â0â2â552
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, discretionary:
               
               
                  1101
                  Appropriation (special or trust fund)
                  
                  13
                  13
               
               
                  1120
                  Appropriations transferred to other accts [075â9915]
                  
                  â13
                  â13
               
               
                  
                     
                  
               
            
         
      
         Substance Abuse and Mental Health Services Administration                                                                
            
         Federal Funds
         MENTAL HEALTHFor 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, [$1,045,936,000] $1,013,628,000: 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 in this Act for fiscal year [2015 : Provided further, That of the amount appropriated under this heading, $45,887,000 shall be for the National Child Traumatic Stress Initiative
         as described in section 582 of the PHS Act] 2016: Provided further, That 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 TREATMENTFor 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, [$2,102,658,000] $2,031,357,000: 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 PREVENTIONFor carrying out titles III and V of the PHS Act with respect to substance abuse prevention, [$175,219,000] $194,450,000: 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 SUPPORTFor 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, [$150,232,000] $156,228,000: Provided, That in addition to amounts provided herein, [$31,428,000] $58,917,000 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] 2017: 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, 2015.)
      Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1362â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0006
                  Mental Health
                  1,052
                  1,046
                  1,014
               
               
                  0007
                  Substance Abuse Treatment
                  2,047
                  2,103
                  2,031
               
               
                  0008
                  Substance Abuse Prevention
                  175
                  175
                  195
               
               
                  0009
                  Health Surveillance and Program Support
                  150
                  150
                  156
               
               
                  0011
                  Prevention Fund
                  62
                  12
                  58
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0100
                  Total, direct program
                  3,486
                  3,486
                  3,454
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0799
                  Total direct obligations
                  3,486
                  3,486
                  3,454
               
               
                  0802
                  Reimbursables
                  105
                  111
                  111
               
               
                  0810
                  Reimbursable:  PHS Evaluation
                  133
                  134
                  211
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0899
                  Total reimbursable obligations
                  238
                  245
                  322
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  3,724
                  3,731
                  3,776
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, discretionary:
               
               
                  1100
                  Appropriation
                  3,435
                  3,474
                  3,396
               
               
                  1120
                  Appropriations transferred to other accts [075â0140]
                  â1
                  
                  
               
               
                  1120
                  Appropriations transferred to other accts [075â0511]
                  â9
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1160
                  Appropriation, discretionary (total)
                  3,425
                  3,474
                  3,396
               
               
                  
                  Appropriations, mandatory:
               
               
                  1221
                  Appropriations transferred from the Prevention and Public Health Fund [075â0116]
                  62
                  12
                  58
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  62
                  12
                  58
               
               
                  
                  Spending authority from offsetting collections, discretionary:
               
               
                  1700
                  Collected
                  125
                  245
                  322
               
               
                  1701
                  Change in uncollected payments, Federal sources
                  112
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1750
                  Spending auth from offsetting collections, disc (total)
                  237
                  245
                  322
               
               
                  1900
                  Budget authority (total)
                  3,724
                  3,731
                  3,776
               
               
                  1930
                  Total budgetary resources available
                  3,724
                  3,731
                  3,776
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  3,219
                  3,493
                  3,059
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  3,724
                  3,731
                  3,776
               
               
                  3011
                  Obligations incurred, expired accounts
                  1
                  
                  
               
               
                  3020
                  Outlays (gross)
                  â3,416
                  â4,165
                  â3,787
               
               
                  3041
                  Recoveries of prior year unpaid obligations, expired
                  â35
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  3,493
                  3,059
                  3,048
               
               
                  
                  Uncollected payments:
               
               
                  3060
                  Uncollected pymts, Fed sources, brought forward, Oct 1
                  â143
                  â155
                  â155
               
               
                  3070
                  Change in uncollected pymts, Fed sources, unexpired
                  â112
                  
                  
               
               
                  3071
                  Change in uncollected pymts, Fed sources, expired
                  100
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3090
                  Uncollected pymts, Fed sources, end of year
                  â155
                  â155
                  â155
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  3,076
                  3,338
                  2,904
               
               
                  3200
                  Obligated balance, end of year
                  3,338
                  2,904
                  2,893
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Discretionary:
               
               
                  4000
                  Budget authority, gross
                  3,662
                  3,719
                  3,718
               
               
                  
                  Outlays, gross:
               
               
                  4010
                  Outlays from new discretionary authority
                  1,213
                  1,565
                  1,612
               
               
                  4011
                  Outlays from discretionary balances
                  2,163
                  2,480
                  2,139
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4020
                  Outlays, gross (total)
                  3,376
                  4,045
                  3,751
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4030
                  Federal sources
                  â223
                  â243
                  â320
               
               
                  4033
                  Non-Federal sources
                  
                  â2
                  â2
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4040
                  Offsets against gross budget authority  and outlays (total)
                  â223
                  â245
                  â322
               
               
                  
                  Additional offsets against gross budget authority only:
               
               
                  4050
                  Change in uncollected pymts, Fed sources, unexpired
                  â112
                  
                  
               
               
                  4052
                  Offsetting collections credited to expired accounts
                  98
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4060
                  Additional offsets against budget authority only (total)
                  â14
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4070
                  Budget authority, net (discretionary)
                  3,425
                  3,474
                  3,396
               
               
                  4080
                  Outlays, net (discretionary)
                  3,153
                  3,800
                  3,429
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  62
                  12
                  58
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  3
                  4
                  22
               
               
                  4101
                  Outlays from mandatory balances
                  37
                  116
                  14
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4110
                  Outlays, gross (total)
                  40
                  120
                  36
               
               
                  4180
                  Budget authority, net (total)
                  3,487
                  3,486
                  3,454
               
               
                  4190
                  Outlays, net (total)
                  3,193
                  3,920
                  3,465
               
               
                  
                     
                  
               
            
         
      
      
         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 075â1362â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  
                  Personnel compensation:
               
               
                  11.1
                  Full-time permanent
                  48
                  50
                  50
               
               
                  11.3
                  Other than full-time permanent
                  3
                  3
                  3
               
               
                  11.5
                  Other personnel compensation
                  1
                  1
                  1
               
               
                  11.7
                  Military personnel
                  3
                  4
                  3
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  11.9
                  Total personnel compensation
                  55
                  58
                  57
               
               
                  12.1
                  Civilian personnel benefits
                  15
                  15
                  15
               
               
                  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
                  10
                  12
               
               
                  23.3
                  Communications, utilities, and miscellaneous charges
                  
                  1
                  2
               
               
                  24.0
                  Printing and reproduction
                  2
                  1
                  1
               
               
                  25.1
                  Advisory and assistance services
                  29
                  26
                  26
               
               
                  25.2
                  Other services from non-Federal sources
                  170
                  156
                  153
               
               
                  25.3
                  Other goods and services from Federal sources
                  40
                  33
                  33
               
               
                  25.4
                  Operation and maintenance of facilities
                  2
                  1
                  1
               
               
                  25.5
                  Research and development contracts
                  
                  1
                  1
               
               
                  31.0
                  Equipment
                  1
                  1
                  1
               
               
                  41.0
                  Grants, subsidies, and contributions
                  3,163
                  3,180
                  3,149
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.0
                  Direct obligations
                  3,486
                  3,486
                  3,454
               
               
                  99.0
                  Reimbursable obligations
                  238
                  245
                  322
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  3,724
                  3,731
                  3,776
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1362â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  484
                  499
                  492
               
               
                  1101
                  Direct military average strength employment
                  35
                  36
                  33
               
               
                  2001
                  Reimbursable civilian full-time equivalent employment
                  80
                  110
                  117
               
               
                  2101
                  Reimbursable military average strength employment
                  16
                  20
                  23
               
               
                  
                     
                  
               
            
         
      
         Agency for Healthcare Research and Quality                                                                               
            
         Federal Funds
         Healthcare research and qualityFor 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, $363,698,000, of which $87,888,000 shall be from funds available under section 241 of the PHS Act: Provided, That section 947(c) of the PHS Act shall not apply in fiscal year [2015] 2016: Provided further, 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, 2016] expended. (Department of Health and Human Services Appropriations Act, 2015.)
      Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1700â0â1â552
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Research on Health Costs, Quality and Outcomes
                  7
                  229
                  135
               
               
                  0002
                  Medical Expenditure Panel Survey
                  
                  65
                  69
               
               
                  0003
                  Program Support
                  
                  70
                  72
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0799
                  Total direct obligations
                  7
                  364
                  276
               
               
                  0803
                  Research on Health Costs, Quality and Outcomes
                  252
                  21
                  109
               
               
                  0804
                  Medical Expenditure Panel Survey
                  64
                  
                  
               
               
                  0805
                  Program Support
                  69
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0899
                  Total reimbursable obligations
                  385
                  21
                  109
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  392
                  385
                  385
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  22
                  19
                  19
               
               
                  1001
                  Discretionary unobligated balance brought fwd, Oct 1
                  22
                  19
                  
               
               
                  1021
                  Recoveries of prior year unpaid obligations
                  1
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1050
                  Unobligated balance (total)
                  23
                  19
                  19
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, discretionary:
               
               
                  1100
                  Appropriation
                  
                  364
                  276
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1160
                  Appropriation, discretionary (total)
                  
                  364
                  276
               
               
                  
                  Appropriations, mandatory:
               
               
                  1221
                  Appropriations transferred from other acct [075â0116]
                  7
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  7
                  
                  
               
               
                  
                  Spending authority from offsetting collections, discretionary:
               
               
                  1700
                  Collected
                  154
                  21
                  109
               
               
                  1700
                  Collected
                  
                  361
                  
               
               
                  1701
                  Change in uncollected payments, Federal sources
                  227
                  â361
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1750
                  Spending auth from offsetting collections, disc (total)
                  381
                  21
                  109
               
               
                  1900
                  Budget authority (total)
                  388
                  385
                  385
               
               
                  1930
                  Total budgetary resources available
                  411
                  404
                  404
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  19
                  19
                  19
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  487
                  416
                  313
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  392
                  385
                  385
               
               
                  3020
                  Outlays (gross)
                  â436
                  â488
                  â237
               
               
                  3040
                  Recoveries of prior year unpaid obligations, unexpired
                  â1
                  
                  
               
               
                  3041
                  Recoveries of prior year unpaid obligations, expired
                  â26
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  416
                  313
                  461
               
               
                  
                  Uncollected payments:
               
               
                  3060
                  Uncollected pymts, Fed sources, brought forward, Oct 1
                  â388
                  â361
                  
               
               
                  3070
                  Change in uncollected pymts, Fed sources, unexpired
                  â227
                  361
                  
               
               
                  3071
                  Change in uncollected pymts, Fed sources, expired
                  254
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3090
                  Uncollected pymts, Fed sources, end of year
                  â361
                  
                  
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  99
                  55
                  313
               
               
                  3200
                  Obligated balance, end of year
                  55
                  313
                  461
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Discretionary:
               
               
                  4000
                  Budget authority, gross
                  381
                  385
                  385
               
               
                  
                  Outlays, gross:
               
               
                  4010
                  Outlays from new discretionary authority
                  135
                  87
                  159
               
               
                  4011
                  Outlays from discretionary balances
                  293
                  395
                  76
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4020
                  Outlays, gross (total)
                  428
                  482
                  235
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4030
                  Federal sources
                  â394
                  â21
                  â109
               
               
                  4030
                  Federal sources
                  
                  â361
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4040
                  Offsets against gross budget authority  and outlays (total)
                  â394
                  â382
                  â109
               
               
                  
                  Additional offsets against gross budget authority only:
               
               
                  4050
                  Change in uncollected pymts, Fed sources, unexpired
                  â227
                  361
                  
               
               
                  4052
                  Offsetting collections credited to expired accounts
                  240
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4060
                  Additional offsets against budget authority only (total)
                  13
                  361
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4070
                  Budget authority, net (discretionary)
                  
                  364
                  276
               
               
                  4080
                  Outlays, net (discretionary)
                  34
                  100
                  126
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  7
                  
                  
               
               
                  
                  Outlays, gross:
               
               
                  4101
                  Outlays from mandatory balances
                  8
                  6
                  2
               
               
                  4180
                  Budget authority, net (total)
                  7
                  364
                  276
               
               
                  4190
                  Outlays, net (total)
                  42
                  106
                  128
               
               
                  
                     
                  
               
            
         
      
      
         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 075â1700â0â1â552
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  
                  Personnel compensation:
               
               
                  11.1
                  Full-time permanent
                  
                  32
                  32
               
               
                  11.3
                  Other than full-time permanent
                  
                  3
                  3
               
               
                  11.5
                  Other personnel compensation
                  
                  1
                  1
               
               
                  11.7
                  Military personnel
                  
                  1
                  1
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  11.9
                  Total personnel compensation
                  
                  37
                  37
               
               
                  12.1
                  Civilian personnel benefits
                  
                  10
                  10
               
               
                  12.2
                  Military personnel benefits
                  
                  1
                  1
               
               
                  23.1
                  Rental payments to GSA
                  
                  5
                  5
               
               
                  23.3
                  Communications, utilities, and miscellaneous charges
                  
                  1
                  1
               
               
                  24.0
                  Printing and reproduction
                  
                  1
                  1
               
               
                  25.2
                  Other services from non-Federal sources
                  
                  13
                  15
               
               
                  25.3
                  Other goods and services from Federal sources
                  
                  19
                  20
               
               
                  25.5
                  Research and development contracts
                  7
                  162
                  98
               
               
                  31.0
                  Equipment
                  
                  2
                  2
               
               
                  41.0
                  Grants, subsidies, and contributions
                  
                  113
                  86
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.0
                  Direct obligations
                  7
                  364
                  276
               
               
                  99.0
                  Reimbursable obligations
                  385
                  21
                  109
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  392
                  385
                  385
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1700â0â1â552
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  
                  294
                  294
               
               
                  1101
                  Direct military average strength employment
                  
                  6
                  6
               
               
                  2001
                  Reimbursable civilian full-time equivalent employment
                  293
                  6
                  6
               
               
                  2101
                  Reimbursable military average strength employment
                  8
                  
                  
               
               
                  
                     
                  
               
            
         
      
         Centers for Medicare and Medicaid Services                                                                               
            
         Federal Funds
         Grants to states for medicaidFor carrying out, except as otherwise provided, titles XI and XIX of the Social Security Act, [$234,608,916,000] $243,545,410,000, to remain available until expended.
      
      [For making,] In addition, for carrying out such titles after May 31,  [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] 2016 for the last quarter of fiscal year [2015] 2016 for unanticipated costs incurred for the current fiscal year, such sums as may be necessary, to remain available until expended.
      
      [For making payments to States or in the case of section 1928 on behalf of States under title XIX of the Social Security Act] In addition, for carrying out such titles for the first quarter of fiscal year [2016, $113,272,140,000] 2017, $115,582,502,000, 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, 2015.)
      Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0512â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Medicaid vendor payments
                  306,134
                  316,151
                  335,076
               
               
                  0002
                  State and local administration
                  18,640
                  19,222
                  17,767
               
               
                  0003
                  Vaccines for Children
                  3,557
                  3,981
                  4,109
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0799
                  Total direct obligations
                  328,331
                  339,354
                  356,952
               
               
                  0801
                  Medicare Part B premiums
                  688
                  360
                  
               
               
                  0802
                  Medicare Part D
                  
                  
                  5
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0899
                  Total reimbursable obligations
                  688
                  360
                  5
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  329,019
                  339,714
                  356,957
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  2,283
                  1,408
                  135
               
               
                  1021
                  Recoveries of prior year unpaid obligations
                  21,597
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1050
                  Unobligated balance (total)
                  23,880
                  1,408
                  135
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, discretionary:
               
               
                  1100
                  Appropriation
                  
                  
                  12
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1160
                  Appropriation, discretionary (total)
                  
                  
                  12
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriation Medicaid
                  199,508
                  234,609
                  243,545
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  199,508
                  234,609
                  243,545
               
               
                  
                  Advance appropriations, mandatory:
               
               
                  1270
                  Advance appropriation
                  106,336
                  103,472
                  113,272
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1280
                  Advanced appropriation, mandatory (total)
                  106,336
                  103,472
                  113,272
               
               
                  
                  Spending authority from offsetting collections, mandatory:
               
               
                  1800
                  Collected
                  703
                  360
                  5
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1850
                  Spending auth from offsetting collections, mand (total)
                  703
                  360
                  5
               
               
                  1900
                  Budget authority (total)
                  306,547
                  338,441
                  356,834
               
               
                  1930
                  Total budgetary resources available
                  330,427
                  339,849
                  356,969
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  1,408
                  135
                  12
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  30,756
                  36,003
                  46,762
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  329,019
                  339,714
                  356,957
               
               
                  3020
                  Outlays (gross)
                  â302,175
                  â328,955
                  â344,464
               
               
                  3040
                  Recoveries of prior year unpaid obligations, unexpired
                  â21,597
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  36,003
                  46,762
                  59,255
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  30,756
                  36,003
                  46,762
               
               
                  3200
                  Obligated balance, end of year
                  36,003
                  46,762
                  59,255
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Discretionary:
               
               
                  4000
                  Budget authority, gross
                  
                  
                  12
               
               
                  
                  Outlays, gross:
               
               
                  4010
                  Outlays from new discretionary authority
                  
                  
                  12
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  306,547
                  338,441
                  356,822
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  270,817
                  294,752
                  344,452
               
               
                  4101
                  Outlays from mandatory balances
                  31,358
                  34,203
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4110
                  Outlays, gross (total)
                  302,175
                  328,955
                  344,452
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4120
                  Federal sources
                  â688
                  â360
                  â5
               
               
                  4123
                  Non-Federal sources
                  â15
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4130
                  Offsets against gross budget authority and outlays (total)
                  â703
                  â360
                  â5
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4160
                  Budget authority, net (mandatory)
                  305,844
                  338,081
                  356,817
               
               
                  4170
                  Outlays, net (mandatory)
                  301,472
                  328,595
                  344,447
               
               
                  4180
                  Budget authority, net (total)
                  305,844
                  338,081
                  356,829
               
               
                  4190
                  Outlays, net (total)
                  301,472
                  328,595
                  344,459
               
               
                  
                     
                  
               
            
         
      
      
         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
                     2014
                     2015
                     2016
                  
                  
                     
                        
                     
                  
                  
                     Vaccine Purchase
                     3,262
                     3,688
                     3,797
                  
                  
                     Vaccine Stockpile
                     136
                     122
                     132
                  
                  
                     Ordering, Distribution, and Operations
                     116
                     127
                     133
                  
                  
                     Vaccine Management Contract Support
                     0
                     0
                     0
                  
                  
                     Evaluation Activities
                     43
                     44
                     48
                  
                  
                     
                     
                        
                     
                     
                        
                     
                     
                        
                     
                  
                  
                     Total Obligations
                     3,557
                     3,981
                     4,109
                  
                  
                     
                        
                     
                  
               
            
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0512â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  41.0
                  Direct obligations: Grants, subsidies, and contributions
                  328,331
                  339,354
                  356,952
               
               
                  99.0
                  Reimbursable obligations
                  688
                  360
                  5
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  329,019
                  339,714
                  356,957
               
               
                  
                     
                  
               
            
         
      
         Grants to States for Medicaid                                                                                            
            
         
         (Amounts included in the adjusted baseline)Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0512â7â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Medicaid vendor payments
                  
                  
                  1
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations (object class 41.0)
                  
                  
                  1
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriation
                  
                  
                  1
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  
                  
                  1
               
               
                  1930
                  Total budgetary resources available
                  
                  
                  1
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  
                  
                  1
               
               
                  3020
                  Outlays (gross)
                  
                  
                  â1
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  
                  
                  1
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  
                  
                  1
               
               
                  4180
                  Budget authority, net (total)
                  
                  
                  1
               
               
                  4190
                  Outlays, net (total)
                  
                  
                  1
               
               
                  
                     
                  
               
            
         
      
         Grants to States for Medicaid                                                                                            
            
         
         (Legislative proposal, not subject to PAYGO)Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0512â2â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Medicaid Vendor Payments
                  
                  
                  54
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations (object class 41.0)
                  
                  
                  54
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriation
                  
                  
                  54
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  
                  
                  54
               
               
                  1930
                  Total budgetary resources available
                  
                  
                  54
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  
                  
                  54
               
               
                  3020
                  Outlays (gross)
                  
                  
                  â54
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  
                  
                  54
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  
                  
                  54
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4120
                  Federal sources
                  
                  â370
                  â775
               
               
                  4180
                  Budget authority, net (total)
                  
                  â370
                  â721
               
               
                  4190
                  Outlays, net (total)
                  
                  â370
                  â721
               
               
                  
                     
                  
               
            
         
      
      
         Please see the narrative in the Program Integrity Administrative Expenses (Social Security Administration) account 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 075â0512â4â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Medicaid Vendor Payments
                  
                  4,485
                  6,491
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0100
                  Direct program activities, subtotal
                  
                  4,485
                  6,491
               
               
                  0801
                  Part B Premiums
                  
                  370
                  775
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0809
                  Reimbursable program activities, subtotal
                  
                  370
                  775
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  
                  4,855
                  7,266
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriation
                  
                  4,485
                  6,491
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  
                  4,485
                  6,491
               
               
                  
                  Spending authority from offsetting collections, mandatory:
               
               
                  1800
                  Collected
                  
                  370
                  775
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1850
                  Spending auth from offsetting collections, mand (total)
                  
                  370
                  775
               
               
                  1900
                  Budget authority (total)
                  
                  4,855
                  7,266
               
               
                  1930
                  Total budgetary resources available
                  
                  4,855
                  7,266
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  
                  4,855
                  7,266
               
               
                  3020
                  Outlays (gross)
                  
                  â4,855
                  â7,266
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  
                  4,855
                  7,266
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  
                  4,855
                  7,266
               
               
                  4180
                  Budget authority, net (total)
                  
                  4,855
                  7,266
               
               
                  4190
                  Outlays, net (total)
                  
                  4,855
                  7,266
               
               
                  
                     
                  
               
            
         
      
      
         This schedule reflects the Administration's Medicaid proposals.
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0512â4â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  41.0
                  Direct obligations: Grants, subsidies, and contributions
                  
                  4,485
                  6,491
               
               
                  99.0
                  Reimbursable obligations
                  
                  370
                  775
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  
                  4,855
                  7,266
               
               
                  
                     
                  
               
            
         
      
         State Grants and Demonstrations                                                                                          
            
         Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0516â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0011
                  Emergency health services for undocumented aliens
                  6
                  2
                  2
               
               
                  0012
                  Medicaid integrity program
                  101
                  112
                  84
               
               
                  0018
                  Money follows the person (MFP) demonstration
                  367
                  428
                  1,649
               
               
                  0019
                  MFP evaluations and technical support
                  1
                  1
                  1
               
               
                  0023
                  Grants to improve outreach and enrollment
                  3
                  4
                  
               
               
                  0025
                  Medicaid emergency psychiatric demonstration
                  25
                  34
                  
               
               
                  0026
                  Incentives for prevention of chronic diseases in Medicaid
                  21
                  8
                  
               
               
                  0027
                  Demonstration Programs to Improve Mental Health Services
                  
                  1
                  25
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  524
                  590
                  1,761
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  1,489
                  2,415
                  2,319
               
               
                  1012
                  Unobligated balance transfers between expired and unexpired accounts
                  1
                  
                  
               
               
                  1021
                  Recoveries of prior year unpaid obligations
                  26
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1050
                  Unobligated balance (total)
                  1,516
                  2,415
                  2,319
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriation
                  1,533
                  494
                  559
               
               
                  1230
                  Appropriations and/or unobligated balance of appropriations permanently reduced
                  â110
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  1,423
                  494
                  559
               
               
                  1900
                  Budget authority (total)
                  1,423
                  494
                  559
               
               
                  1930
                  Total budgetary resources available
                  2,939
                  2,909
                  2,878
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  2,415
                  2,319
                  1,117
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  715
                  696
                  714
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  524
                  590
                  1,761
               
               
                  3011
                  Obligations incurred, expired accounts
                  3
                  
                  
               
               
                  3020
                  Outlays (gross)
                  â510
                  â572
                  â593
               
               
                  3040
                  Recoveries of prior year unpaid obligations, unexpired
                  â26
                  
                  
               
               
                  3041
                  Recoveries of prior year unpaid obligations, expired
                  â10
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  696
                  714
                  1,882
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  715
                  696
                  714
               
               
                  3200
                  Obligated balance, end of year
                  696
                  714
                  1,882
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  1,423
                  494
                  559
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  
                  129
                  47
               
               
                  4101
                  Outlays from mandatory balances
                  510
                  443
                  546
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4110
                  Outlays, gross (total)
                  510
                  572
                  593
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4123
                  Non-Federal sources
                  â2
                  
                  
               
               
                  
                  Additional offsets against gross budget authority only:
               
               
                  4142
                  Offsetting collections credited to expired accounts
                  2
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4160
                  Budget authority, net (mandatory)
                  1,423
                  494
                  559
               
               
                  4170
                  Outlays, net (mandatory)
                  508
                  572
                  593
               
               
                  4180
                  Budget authority, net (total)
                  1,423
                  494
                  559
               
               
                  4190
                  Outlays, net (total)
                  508
                  572
                  593
               
               
                  
                     
                  
               
            
         
      
      
         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. 106â170), the Medicare Prescription Drug, Improvement,
            and Modernization Act of 2003 (P.L. 108â173), the Deficit Reduction Act of 2005 (P.L. 109â171), the Children's Health Insurance
            Program Reauthorization Act of 2009 (P.L. 111â3), the Patient Protection and Affordable Care Act (P.L. 111â148), the Health
            Care and Education Reconciliation Act of 2010 (P.L. 111â152), and the Protecting Access to Medicare Act of 2014 (P.L. 113â93).
         
         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 075â0516â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  11.1
                  Personnel compensation: Full-time permanent - Medicaid Integrity Program
                  7
                  10
                  13
               
               
                  12.1
                  Civilian personnel benefits - Medicaid Integrity Program
                  3
                  4
                  5
               
               
                  41.0
                  Grants, subsidies, and contributions - Emergency services for undocumented aliens
                  6
                  2
                  2
               
               
                  41.0
                  Grants, subsidies, and contributions - Medicaid Integrity Program
                  91
                  98
                  66
               
               
                  41.0
                  Grants, subsidies, and contributions - Money follows the person (MFP) demonstrations
                  367
                  428
                  1,649
               
               
                  41.0
                  Grants, subsidies, and contributions - MFP evaluations and technical support
                  1
                  1
                  1
               
               
                  41.0
                  Grants, subsidies, and contributions - Grants to improve outreach and enrollment
                  3
                  4
                  
               
               
                  41.0
                  Grants, subsidies, and contributions - Medicaid emergency psychiatric demonstration
                  25
                  34
                  
               
               
                  41.0
                  Grants, subsidies, and contributions - Incentives for prevention of chronic diseases in Medicaid
                  
                  8
                  
               
               
                  41.0
                  Grants, subsidies, and contributions - Demos to Improve Mental Health
                  
                  1
                  25
               
               
                  41.0
                  Grants, subsidies, and contributions - Incentives for prevention of chronic diseases in Medicaid
                  21
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  524
                  590
                  1,761
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0516â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  80
                  91
                  97
               
               
                  
                     
                  
               
            
         
      
         State Grants and Demonstrations                                                                                          
            
         
         (Legislative proposal, subject to PAYGO)Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0516â4â1â551
                  2014 actual
                  2015 est.
                  2016 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
               
               
                  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)
                  
                  
                  â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 fundsFor 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 97â248, and for administrative expenses incurred pursuant to section 201(g) of the
         Social Security Act, [$259,212,000,000] $283,171,800,000.
      
      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, 2015.)
      Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0580â0â1â571
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Federal contribution to match premiums (SMI)
                  194,565
                  194,775
                  198,530
               
               
                  0002
                  Part D benefits (Rx Drug)
                  58,596
                  63,342
                  82,453
               
               
                  0003
                  Part D Federal administration (Rx Drug)
                  373
                  418
                  691
               
               
                  0004
                  General Fund Transfers to HI
                  1,651
                  1,103
                  1,493
               
               
                  0006
                  Federal Bureau of Investigation (HCFAC)
                  127
                  129
                  141
               
               
                  0007
                  Federal payments from taxation of OASDI benefits (HI)
                  18,066
                  20,225
                  23,480
               
               
                  0008
                  Criminal fines (HCFAC)
                  345
                  950
                  990
               
               
                  0009
                  Civil monetary penalties and damages (HCFAC - DOJ and CMS administration)
                  24
                  31
                  32
               
               
                  0010
                  Asset Forfeiture
                  25
                  28
                  29
               
               
                  0011
                  State Low Income Determinations
                  
                  6
                  5
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  273,772
                  281,007
                  307,844
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriation (definite, annual)
                  255,185
                  259,212
                  283,172
               
               
                  1200
                  Appropriation (indefinite, permanent)
                  18,066
                  20,225
                  23,480
               
               
                  1200
                  Appropriation (HCFAC for FBI)
                  127
                  129
                  141
               
               
                  1200
                  Appropriation (indefinite for HCFAC)
                  394
                  1,009
                  1,051
               
               
                  1200
                  Appropriation (indefinite, annual)
                  
                  432
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  273,772
                  281,007
                  307,844
               
               
                  1930
                  Total budgetary resources available
                  273,772
                  281,007
                  307,844
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  5,277
                  16,313
                  17,600
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  273,772
                  281,007
                  307,844
               
               
                  3011
                  Obligations incurred, expired accounts
                  2,920
                  
                  
               
               
                  3020
                  Outlays (gross)
                  â265,656
                  â279,720
                  â307,844
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  16,313
                  17,600
                  17,600
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  5,277
                  16,313
                  17,600
               
               
                  3200
                  Obligated balance, end of year
                  16,313
                  17,600
                  17,600
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  273,772
                  281,007
                  307,844
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  260,113
                  264,220
                  307,844
               
               
                  4101
                  Outlays from mandatory balances
                  5,543
                  15,500
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4110
                  Outlays, gross (total)
                  265,656
                  279,720
                  307,844
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4120
                  Federal sources
                  â19
                  
                  
               
               
                  
                  Additional offsets against gross budget authority only:
               
               
                  4142
                  Offsetting collections credited to expired accounts
                  19
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4160
                  Budget authority, net (mandatory)
                  273,772
                  281,007
                  307,844
               
               
                  4170
                  Outlays, net (mandatory)
                  265,637
                  279,720
                  307,844
               
               
                  4180
                  Budget authority, net (total)
                  273,772
                  281,007
                  307,844
               
               
                  4190
                  Outlays, net (total)
                  265,637
                  279,720
                  307,844
               
               
                  
                     
                  
               
            
         
      
      
         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 administrative expenses that are
            properly chargeable to the general fund.
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0580â0â1â571
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  41.0
                  Grants, subsidies, and contributions
                  271,621
                  279,351
                  305,514
               
               
                  42.0
                  Insurance claims and indemnities
                  204
                  187
                  158
               
               
                  94.0
                  Financial transfers (Federal admin)
                  1,947
                  1,469
                  2,172
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  273,772
                  281,007
                  307,844
               
               
                  
                     
                  
               
            
         
      
         Payments to Health Care Trust Funds                                                                                      
            
         
         (Amounts included in the adjusted baseline)Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0580â7â1â571
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Federal contribution to match premiums (SMI)
                  
                  â11
                  7,970
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations (object class 41.0)
                  
                  â11
                  7,970
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriation (definite annual)
                  
                  â11
                  7,970
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  
                  â11
                  7,970
               
               
                  1930
                  Total budgetary resources available
                  
                  â11
                  7,970
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  
                  â11
                  7,970
               
               
                  3020
                  Outlays (gross)
                  
                  11
                  â7,970
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  
                  â11
                  7,970
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  
                  â11
                  7,970
               
               
                  4180
                  Budget authority, net (total)
                  
                  â11
                  7,970
               
               
                  4190
                  Outlays, net (total)
                  
                  â11
                  7,970
               
               
                  
                     
                  
               
            
         
      
         Payments to Health Care Trust Funds                                                                                      
            
         
         (Legislative proposal, not subject to PAYGO)Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0580â2â1â571
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Federal contribution to match premiums (SMI)
                  
                  370
                  1,264
               
               
                  0002
                  Part D benefits (Rx drug)
                  
                  
                  â560
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations (object class 41.0)
                  
                  370
                  704
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriation (definite, annual)
                  
                  370
                  704
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  
                  370
                  704
               
               
                  1930
                  Total budgetary resources available
                  
                  370
                  704
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  
                  370
                  704
               
               
                  3020
                  Outlays (gross)
                  
                  â370
                  â704
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  
                  370
                  704
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  
                  370
                  704
               
               
                  4180
                  Budget authority, net (total)
                  
                  370
                  704
               
               
                  4190
                  Outlays, net (total)
                  
                  370
                  704
               
               
                  
                     
                  
               
            
         
      
         Quality Improvement Organizations                                                                                        
            
         Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0519â0â1â571
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  QIO contracts
                  1,282
                  559
                  329
               
               
                  0002
                  QIO support contracts
                  130
                  211
                  230
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  1,412
                  770
                  559
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Spending authority from offsetting collections, mandatory:
               
               
                  1800
                  Collected
                  64
                  770
                  559
               
               
                  1801
                  Change in uncollected payments, Federal sources
                  1,635
                  
                  
               
               
                  1823
                  New and/or unobligated balance of spending authority from offsetting collections temporarily reduced
                  â50
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1850
                  Spending auth from offsetting collections, mand (total)
                  1,649
                  770
                  559
               
               
                  1930
                  Total budgetary resources available
                  1,649
                  770
                  559
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1940
                  Unobligated balance expiring
                  â237
                  
                  
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  627
                  1,461
                  1,461
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  1,412
                  770
                  559
               
               
                  3011
                  Obligations incurred, expired accounts
                  1
                  
                  
               
               
                  3020
                  Outlays (gross)
                  â579
                  â770
                  â559
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  1,461
                  1,461
                  1,461
               
               
                  
                  Uncollected payments:
               
               
                  3060
                  Uncollected pymts, Fed sources, brought forward, Oct 1
                  â1,059
                  â2,189
                  â2,189
               
               
                  3070
                  Change in uncollected pymts, Fed sources, unexpired
                  â1,635
                  
                  
               
               
                  3071
                  Change in uncollected pymts, Fed sources, expired
                  505
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3090
                  Uncollected pymts, Fed sources, end of year
                  â2,189
                  â2,189
                  â2,189
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  â432
                  â728
                  â728
               
               
                  3200
                  Obligated balance, end of year
                  â728
                  â728
                  â728
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  1,649
                  770
                  559
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  88
                  299
                  139
               
               
                  4101
                  Outlays from mandatory balances
                  491
                  471
                  420
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4110
                  Outlays, gross (total)
                  579
                  770
                  559
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4120
                  Baseline Program [Text]
                  â570
                  â770
                  â559
               
               
                  
                  Additional offsets against gross budget authority only:
               
               
                  4140
                  Change in uncollected pymts, Fed sources, unexpired
                  â1,635
                  
                  
               
               
                  4142
                  Offsetting collections credited to expired accounts
                  506
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4150
                  Additional offsets against budget authority only (total)
                  â1,129
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4160
                  Budget authority, net (mandatory)
                  â50
                  
                  
               
               
                  4170
                  Outlays, net (mandatory)
                  9
                  
                  
               
               
                  4180
                  Budget authority, net (total)
                  â50
                  
                  
               
               
                  4190
                  Outlays, net (total)
                  9
                  
                  
               
               
                  
                     
                  
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  5091
                  Expiring unavailable balance: Offsetting collections
                  â50
                  
                  
               
               
                  5093
                  Expired unavailable balance, SOY: Offsetting collections
                  
                  50
                  50
               
               
                  5095
                  Expired unavailable balance, EOY: Offsetting collections
                  
                  50
                  50
               
               
                  
                     
                  
               
            
         
      
      
         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 075â0519â0â1â571
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  11.1
                  Personnel compensation: Full-time permanent
                  24
                  47
                  52
               
               
                  23.3
                  Communications, utilities, and miscellaneous charges
                  7
                  2
                  2
               
               
                  25.2
                  Other services from non-Federal sources
                  1,362
                  715
                  500
               
               
                  25.3
                  Other goods and services from Federal sources
                  11
                  4
                  3
               
               
                  25.4
                  Operation and maintenance of facilities
                  8
                  2
                  2
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  1,412
                  770
                  559
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0519â0â1â571
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  196
                  224
                  225
               
               
                  
                     
                  
               
            
         
      
         Program managementFor 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] $4,245,186,000, 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;] 1893(h) of the Social Security Act, 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, 2020] 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 [2015] 2016 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. (Department of Health and Human Services Appropriations Act, 2015.)
      Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0511â0â1â550
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Program operations
                  2,970
                  3,005
                  3,046
               
               
                  0002
                  Federal administration
                  789
                  804
                  838
               
               
                  0003
                  State survey and certification
                  381
                  440
                  469
               
               
                  0004
                  Research, demonstrations, and evaluation projects
                  88
                  95
                  64
               
               
                  0006
                  High-risk pool grants
                  20
                  
                  
               
               
                  0007
                  ARRA Medicare/Medicaid HIT
                  108
                  139
                  100
               
               
                  0008
                  Consumer Assistance Grants
                  5
                  1
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0100
                  Total direct program
                  4,361
                  4,484
                  4,517
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0799
                  Total direct obligations
                  4,361
                  4,484
                  4,517
               
               
                  0801
                  Clinical laboratory improvement amendments
                  58
                  46
                  50
               
               
                  0802
                  Sale of data
                  7
                  7
                  7
               
               
                  0803
                  Coordination of benefits
                  32
                  28
                  30
               
               
                  0804
                  Medicare advantage/Prescription drug plan
                  70
                  71
                  82
               
               
                  0805
                  Provider enrollment
                  38
                  28
                  32
               
               
                  0806
                  Recovery audit contractors
                  469
                  437
                  750
               
               
                  0808
                  Marketplace User Fees
                  252
                  850
                  1,514
               
               
                  0810
                  Risk Adjustment Administrative Expenses
                  
                  19
                  21
               
               
                  0811
                  Risk Corridors
                  
                  5,450
                  6,390
               
               
                  0812
                  Reimbursable program activity
                  200
                  
                  
               
               
                  0813
                  Other reimbursable program activity
                  20
                  4
                  4
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0899
                  Total reimbursable obligations
                  1,146
                  6,940
                  8,880
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  5,507
                  11,424
                  13,397
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  836
                  916
                  724
               
               
                  1001
                  Discretionary unobligated balance brought fwd, Oct 1
                  196
                  
                  
               
               
                  1020
                  Adjustment of unobligated bal brought forward, Oct 1
                  â10
                  
                  
               
               
                  1021
                  Recoveries of prior year unpaid obligations
                  25
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1050
                  Unobligated balance (total)
                  851
                  916
                  724
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, discretionary:
               
               
                  1121
                  Appropriations transferred from other acct [075â9915]
                  75
                  
                  
               
               
                  1121
                  Appropriations transferred from other acct [075â1362]
                  9
                  
                  
               
               
                  1121
                  Appropriations transferred from other acct [075â0350]
                  10
                  
                  
               
               
                  1121
                  Appropriations transferred from other acct [075â0943]
                  13
                  
                  
               
               
                  1121
                  Appropriations transferred from other acct [075â1536]
                  5
                  
                  
               
               
                  1121
                  Appropriations transferred from other acct [075â0142]
                  4
                  
                  
               
               
                  1121
                  Appropriations transferred from other acct [075â9912]
                  1
                  
                  
               
               
                  1121
                  Appropriations transferred from other acct [075â0140]
                  2
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1160
                  Appropriation, discretionary (total)
                  119
                  
                  
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriation
                  253
                  193
                  68
               
               
                  1230
                  Appropriations and/or unobligated balance of appropriations permanently reduced
                  â18
                  â14
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  235
                  179
                  68
               
               
                  
                  Spending authority from offsetting collections, discretionary:
               
               
                  1700
                  Collected
                  1,935
                  9,433
                  10,643
               
               
                  1701
                  Change in uncollected payments, Federal sources
                  2,251
                  
                  
               
               
                  1702
                  Offsetting collections (previously unavailable)
                  4
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1750
                  Spending auth from offsetting collections, disc (total)
                  4,190
                  9,433
                  10,643
               
               
                  
                  Spending authority from offsetting collections, mandatory:
               
               
                  1800
                  Collected
                  870
                  1,700
                  2,437
               
               
                  1801
                  Change in uncollected payments, Federal sources
                  579
                  
                  
               
               
                  1802
                  Offsetting collections (previously unavailable)
                  1
                  34
                  73
               
               
                  1823
                  New and/or unobligated balance of spending authority from offsetting collections temporarily reduced
                  â97
                  â114
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1850
                  Spending auth from offsetting collections, mand (total)
                  1,353
                  1,620
                  2,510
               
               
                  1900
                  Budget authority (total)
                  5,897
                  11,232
                  13,221
               
               
                  1930
                  Total budgetary resources available
                  6,748
                  12,148
                  13,945
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1940
                  Unobligated balance expiring
                  â325
                  
                  
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  916
                  724
                  548
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  4,198
                  4,117
                  3,741
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  5,507
                  11,424
                  13,397
               
               
                  3011
                  Obligations incurred, expired accounts
                  27
                  
                  
               
               
                  3020
                  Outlays (gross)
                  â5,462
                  â11,800
                  â13,442
               
               
                  3040
                  Recoveries of prior year unpaid obligations, unexpired
                  â25
                  
                  
               
               
                  3041
                  Recoveries of prior year unpaid obligations, expired
                  â128
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  4,117
                  3,741
                  3,696
               
               
                  
                  Uncollected payments:
               
               
                  3060
                  Uncollected pymts, Fed sources, brought forward, Oct 1
                  â4,097
                  â4,465
                  â4,465
               
               
                  3070
                  Change in uncollected pymts, Fed sources, unexpired
                  â2,830
                  
                  
               
               
                  3071
                  Change in uncollected pymts, Fed sources, expired
                  2,462
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3090
                  Uncollected pymts, Fed sources, end of year
                  â4,465
                  â4,465
                  â4,465
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  101
                  â348
                  â724
               
               
                  3200
                  Obligated balance, end of year
                  â348
                  â724
                  â769
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Discretionary:
               
               
                  4000
                  Budget authority, gross
                  4,309
                  9,433
                  10,643
               
               
                  
                  Outlays, gross:
               
               
                  4010
                  Outlays from new discretionary authority
                  2,037
                  9,433
                  10,643
               
               
                  4011
                  Outlays from discretionary balances
                  2,223
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4020
                  Outlays, gross (total)
                  4,260
                  9,433
                  10,643
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4030
                  Federal sources
                  â4,260
                  â3,976
                  â4,246
               
               
                  4033
                  Non-Federal sources
                  â12
                  â5,457
                  â6,397
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4040
                  Offsets against gross budget authority  and outlays (total)
                  â4,272
                  â9,433
                  â10,643
               
               
                  
                  Additional offsets against gross budget authority only:
               
               
                  4050
                  Change in uncollected pymts, Fed sources, unexpired
                  â2,251
                  
                  
               
               
                  4052
                  Offsetting collections credited to expired accounts
                  2,337
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4060
                  Additional offsets against budget authority only (total)
                  86
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4070
                  Budget authority, net (discretionary)
                  123
                  
                  
               
               
                  4080
                  Outlays, net (discretionary)
                  â12
                  
                  
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  1,588
                  1,799
                  2,578
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  394
                  1,737
                  2,513
               
               
                  4101
                  Outlays from mandatory balances
                  808
                  630
                  286
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4110
                  Outlays, gross (total)
                  1,202
                  2,367
                  2,799
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4120
                  Federal sources
                  â414
                  â137
                  â28
               
               
                  4123
                  Non-Federal sources
                  â501
                  â1,563
                  â2,409
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4130
                  Offsets against gross budget authority and outlays (total)
                  â915
                  â1,700
                  â2,437
               
               
                  
                  Additional offsets against gross budget authority only:
               
               
                  4140
                  Change in uncollected pymts, Fed sources, unexpired
                  â579
                  
                  
               
               
                  4142
                  Offsetting collections credited to expired accounts
                  45
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4150
                  Additional offsets against budget authority only (total)
                  â534
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4160
                  Budget authority, net (mandatory)
                  139
                  99
                  141
               
               
                  4170
                  Outlays, net (mandatory)
                  287
                  667
                  362
               
               
                  4180
                  Budget authority, net (total)
                  262
                  99
                  141
               
               
                  4190
                  Outlays, net (total)
                  275
                  667
                  362
               
               
                  
                     
                  
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  5090
                  Unexpired unavailable balance, SOY: Offsetting collections
                  10
                  43
                  123
               
               
                  5091
                  Expiring unavailable balance: Offsetting collections
                  â59
                  
                  
               
               
                  5092
                  Unexpired unavailable balance, EOY: Offsetting collections
                  43
                  123
                  50
               
               
                  5093
                  Expired unavailable balance, SOY: Offsetting collections
                  
                  59
                  59
               
               
                  5095
                  Expired unavailable balance, EOY: Offsetting collections
                  
                  59
                  59
               
               
                  
                     
                  
               
            
         
      
      
         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 075â0511â0â1â550
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  
                  Personnel compensation:
               
               
                  11.1
                  Full-time permanent
                  453
                  471
                  491
               
               
                  11.3
                  Other than full-time permanent
                  13
                  12
                  12
               
               
                  11.5
                  Other personnel compensation
                  8
                  8
                  8
               
               
                  11.7
                  Military personnel
                  12
                  16
                  16
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  11.9
                  Total personnel compensation
                  486
                  507
                  527
               
               
                  12.1
                  Civilian personnel benefits
                  147
                  140
                  152
               
               
                  12.2
                  Military personnel benefits
                  6
                  8
                  8
               
               
                  21.0
                  Travel and transportation of persons
                  5
                  6
                  7
               
               
                  22.0
                  Transportation of things
                  1
                  
                  
               
               
                  23.1
                  Rental payments to GSA
                  12
                  8
                  8
               
               
                  23.3
                  Communications, utilities, and miscellaneous charges
                  70
                  
                  
               
               
                  24.0
                  Printing and reproduction
                  41
                  2
                  4
               
               
                  25.2
                  Other services from non-Federal sources
                  2,768
                  2,391
                  2,392
               
               
                  25.3
                  Other goods and services from Federal sources
                  63
                  9
                  9
               
               
                  25.4
                  Operation and maintenance of facilities
                  3
                  
                  
               
               
                  25.5
                  Research and development contracts
                  2
                  20
                  19
               
               
                  25.6
                  Medical care
                  571
                  1,265
                  1,302
               
               
                  26.0
                  Supplies and materials
                  1
                  1
                  1
               
               
                  31.0
                  Equipment
                  2
                  
                  
               
               
                  41.0
                  Grants, subsidies, and contributions
                  126
                  77
                  38
               
               
                  42.0
                  Insurance claims and indemnities
                  57
                  50
                  50
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.0
                  Direct obligations
                  4,361
                  4,484
                  4,517
               
               
                  99.0
                  Reimbursable obligations
                  1,146
                  6,940
                  8,880
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  5,507
                  11,424
                  13,397
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0511â0â1â550
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  4,327
                  4,302
                  4,503
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  127
                  97
                  8
               
               
                  1101
                  Direct military average strength employment
                  168
                  168
                  168
               
               
                  2001
                  Reimbursable civilian full-time equivalent employment
                  103
                  122
                  125
               
               
                  
                     
                  
               
            
         
      
         Program Management                                                                                                       
            
         
         (Legislative proposal, subject to PAYGO)Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0511â4â1â550
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Program operations
                  
                  
                  1,025
               
               
                  0002
                  Federal administration
                  
                  
                  5
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0100
                  Total direct program
                  
                  
                  1,030
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0799
                  Total direct obligations
                  
                  
                  1,030
               
               
                  0801
                  Federal Payment Levy Program
                  
                  
                  2
               
               
                  0802
                  Home Health Civil Monetary Penalties
                  
                  
                  1
               
               
                  0803
                  Appeals Filing Fees
                  
                  
                  4
               
               
                  0804
                  Provider Application Fees
                  
                  
                  9
               
               
                  0805
                  Registration Fees
                  
                  
                  14
               
               
                  0806
                  RAC Recoveries for Preventative Action
                  
                  
                  177
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0899
                  Total reimbursable obligations
                  
                  
                  207
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  
                  
                  1,237
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriation
                  
                  
                  401
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  
                  
                  401
               
               
                  
                  Spending authority from offsetting collections, mandatory:
               
               
                  1800
                  Collected
                  
                  
                  836
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1850
                  Spending auth from offsetting collections, mand (total)
                  
                  
                  836
               
               
                  1900
                  Budget authority (total)
                  
                  
                  1,237
               
               
                  1930
                  Total budgetary resources available
                  
                  
                  1,237
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  
                  
                  1,237
               
               
                  3020
                  Outlays (gross)
                  
                  
                  â322
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  
                  
                  915
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3200
                  Obligated balance, end of year
                  
                  
                  915
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  
                  
                  1,237
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  
                  
                  322
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4120
                  Federal sources
                  
                  
                  â811
               
               
                  4123
                  Non-Federal sources
                  
                  
                  â25
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4130
                  Offsets against gross budget authority and outlays (total)
                  
                  
                  â836
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4160
                  Budget authority, net (mandatory)
                  
                  
                  401
               
               
                  4170
                  Outlays, net (mandatory)
                  
                  
                  â514
               
               
                  4180
                  Budget authority, net (total)
                  
                  
                  401
               
               
                  4190
                  Outlays, net (total)
                  
                  
                  â514
               
               
                  
                     
                  
               
            
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0511â4â1â550
                  2014 actual
                  2015 est.
                  2016 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
                  
                  
                  1,027
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.0
                  Direct obligations
                  
                  
                  1,030
               
               
                  99.0
                  Reimbursable obligations
                  
                  
                  207
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  
                  
                  1,237
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0511â4â1â550
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  
                  
                  20
               
               
                  
                     
                  
               
            
         
      
         Children's Health Insurance Fund                                                                                         
            
         Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0515â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Grants to States and U.S. Territories
                  9,760
                  9,756
                  8,800
               
               
                  0002
                  Performance bonus payments
                  312
                  
                  
               
               
                  0003
                  Child health quality improvement
                  39
                  8
                  10
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations (object class 41.0)
                  10,111
                  9,764
                  8,810
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  281
                  3,159
                  8,162
               
               
                  1012
                  Unobligated balance transfers between expired and unexpired accounts
                  9,534
                  
                  
               
               
                  1021
                  Recoveries of prior year unpaid obligations
                  16
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1050
                  Unobligated balance (total)
                  9,831
                  3,159
                  8,162
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, discretionary:
               
               
                  1130
                  Appropriations permanently reduced
                  
                  
                  â3,330
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1160
                  Appropriation, discretionary (total)
                  
                  
                  â3,330
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriation
                  19,147
                  21,061
                  5,700
               
               
                  1230
                  Appropriations and/or unobligated balance of appropriations permanently reduced
                  â6,317
                  â6,294
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  12,830
                  14,767
                  5,700
               
               
                  1900
                  Budget authority (total)
                  12,830
                  14,767
                  2,370
               
               
                  1930
                  Total budgetary resources available
                  22,661
                  17,926
                  10,532
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1940
                  Unobligated balance expiring
                  â9,391
                  
                  
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  3,159
                  8,162
                  1,722
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  6,117
                  6,707
                  5,913
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  10,111
                  9,764
                  8,810
               
               
                  3020
                  Outlays (gross)
                  â9,319
                  â10,558
                  â14,010
               
               
                  3040
                  Recoveries of prior year unpaid obligations, unexpired
                  â16
                  
                  
               
               
                  3041
                  Recoveries of prior year unpaid obligations, expired
                  â186
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  6,707
                  5,913
                  713
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  6,117
                  6,707
                  5,913
               
               
                  3200
                  Obligated balance, end of year
                  6,707
                  5,913
                  713
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Discretionary:
               
               
                  4000
                  Budget authority, gross
                  
                  
                  â3,330
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  12,830
                  14,767
                  5,700
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  3,626
                  4,100
                  5,700
               
               
                  4101
                  Outlays from mandatory balances
                  5,693
                  6,458
                  8,310
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4110
                  Outlays, gross (total)
                  9,319
                  10,558
                  14,010
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4123
                  Non-Federal sources
                  â5
                  
                  
               
               
                  
                  Additional offsets against gross budget authority only:
               
               
                  4142
                  Offsetting collections credited to expired accounts
                  5
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4160
                  Budget authority, net (mandatory)
                  12,830
                  14,767
                  5,700
               
               
                  4170
                  Outlays, net (mandatory)
                  9,314
                  10,558
                  14,010
               
               
                  4180
                  Budget authority, net (total)
                  12,830
                  14,767
                  2,370
               
               
                  4190
                  Outlays, net (total)
                  9,314
                  10,558
                  14,010
               
               
                  
                     
                  
               
            
         
      
      
         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. 111â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. 111â148) extended funding for CHIP, providing
            appropriations through 2015. The Budget proposes a four-year extension of CHIP funding through 2019.
         
      
         Children's Health Insurance Fund                                                                                         
            
         
         (Legislative proposal, subject to PAYGO)Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0515â4â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Grants to State and U.S. Territories
                  
                  
                  510
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations (object class 41.0)
                  
                  
                  510
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriation
                  
                  
                  510
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  
                  
                  510
               
               
                  1930
                  Total budgetary resources available
                  
                  
                  510
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  
                  
                  510
               
               
                  3020
                  Outlays (gross)
                  
                  
                  â510
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  
                  
                  510
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  
                  
                  510
               
               
                  4180
                  Budget authority, net (total)
                  
                  
                  510
               
               
                  4190
                  Outlays, net (total)
                  
                  
                  510
               
               
                  
                     
                  
               
            
         
      
      
          This schedule reflects the Administration's Children's Health Insurance Program (CHIP) proposals.
      
         Center for Medicare and Medicaid Innovation                                                                              
            
         Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0522â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Administration
                  190
                  340
                  348
               
               
                  0002
                  Innovation Activities
                  990
                  1,501
                  1,298
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  1,180
                  1,841
                  1,646
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  8,180
                  7,010
                  5,169
               
               
                  1021
                  Recoveries of prior year unpaid obligations
                  10
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1050
                  Unobligated balance (total)
                  8,190
                  7,010
                  5,169
               
               
                  1930
                  Total budgetary resources available
                  8,190
                  7,010
                  5,169
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  7,010
                  5,169
                  3,523
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  941
                  1,114
                  1,664
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  1,180
                  1,841
                  1,646
               
               
                  3020
                  Outlays (gross)
                  â997
                  â1,291
                  â1,590
               
               
                  3040
                  Recoveries of prior year unpaid obligations, unexpired
                  â10
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  1,114
                  1,664
                  1,720
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  941
                  1,114
                  1,664
               
               
                  3200
                  Obligated balance, end of year
                  1,114
                  1,664
                  1,720
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  
                  Outlays, gross:
               
               
                  4101
                  Outlays from mandatory balances
                  997
                  1,291
                  1,590
               
               
                  4190
                  Outlays, net (total)
                  997
                  1,291
                  1,590
               
               
                  
                     
                  
               
            
         
      
      
         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 075â0522â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  11.1
                  Personnel compensation: Full-time permanent
                  35
                  55
                  49
               
               
                  12.1
                  Civilian personnel benefits
                  10
                  16
                  14
               
               
                  23.3
                  Communications, utilities, and miscellaneous charges
                  3
                  5
                  4
               
               
                  25.2
                  Other services from non-Federal sources
                  452
                  705
                  631
               
               
                  41.0
                  Grants, subsidies, and contributions
                  564
                  879
                  786
               
               
                  42.0
                  Insurance claims and indemnities
                  116
                  181
                  162
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  1,180
                  1,841
                  1,646
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0522â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  355
                  518
                  625
               
               
                  
                     
                  
               
            
         
      
         Child Enrollment Contingency Fund                                                                                        
            
         Special and Trust Fund Receipts (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â5551â0â2â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  0100
                  Balance, start of year
                  
                  
                  6
               
               
                  
                  Receipts:
               
               
                  0240
                  Interest, Child Enrollment Contingency Fund
                  3
                  6
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0400
                  Total: Balances and collections
                  3
                  6
                  6
               
               
                  
                  Appropriations:
               
               
                  0500
                  Child Enrollment Contingency Fund
                  
                  
                  2,105
               
               
                  0501
                  Child Enrollment Contingency Fund
                  â3
                  
                  
               
               
                  0502
                  Child Enrollment Contingency Fund
                  
                  
                  â50
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0599
                  Total appropriations
                  â3
                  
                  2,055
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0799
                  Balance, end of year
                  
                  6
                  2,061
               
               
                  
                     
                  
               
            
         
      
      Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â5551â0â2â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Grants to States and US Territories
                  
                  50
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations (object class 41.0)
                  
                  50
                  
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  2,096
                  2,099
                  2,105
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, discretionary:
               
               
                  1134
                  Appropriations precluded from obligation
                  
                  
                  â2,105
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1160
                  Appropriation, discretionary (total)
                  
                  
                  â2,105
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriation
                  
                  56
                  
               
               
                  1201
                  Appropriation (special or trust fund)
                  3
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  3
                  56
                  
               
               
                  1900
                  Budget authority (total)
                  3
                  56
                  â2,105
               
               
                  1930
                  Total budgetary resources available
                  2,099
                  2,155
                  
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  2,099
                  2,105
                  
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  12
                  9
                  9
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  
                  50
                  
               
               
                  3020
                  Outlays (gross)
                  â3
                  â50
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  9
                  9
                  9
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  12
                  9
                  9
               
               
                  3200
                  Obligated balance, end of year
                  9
                  9
                  9
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Discretionary:
               
               
                  4000
                  Budget authority, gross
                  
                  
                  â2,105
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  3
                  56
                  
               
               
                  
                  Outlays, gross:
               
               
                  4101
                  Outlays from mandatory balances
                  3
                  50
                  
               
               
                  4180
                  Budget authority, net (total)
                  3
                  56
                  â2,105
               
               
                  4190
                  Outlays, net (total)
                  3
                  50
                  
               
               
                  
                     
                  
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  5000
                  Total investments, SOY: Federal securities: Par value
                  2,098
                  2,101
                  2,105
               
               
                  5001
                  Total investments, EOY: Federal securities: Par value
                  2,101
                  2,105
                  2,105
               
               
                  
                     
                  
               
            
         
      
      
         The Children's Health Insurance Program Reauthorization Act of 2009 (P.L. 111â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. 111â148) extended
            the contingency fund through 2015. The Budget proposes a four-year extension of CHIP funding, including an extension of the
            contingency fund through 2019.
         
         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.
         
      
         Child Enrollment Contingency Fund                                                                                        
            
         
         (Legislative proposal, subject to PAYGO)Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â5551â4â2â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1201
                  Appropriation (special or trust fund)
                  
                  
                  50
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  
                  
                  50
               
               
                  1930
                  Total budgetary resources available
                  
                  
                  50
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  
                  
                  50
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3020
                  Outlays (gross)
                  
                  
                  â50
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  
                  
                  â50
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3200
                  Obligated balance, end of year
                  
                  
                  â50
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  
                  
                  50
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  
                  
                  50
               
               
                  4180
                  Budget authority, net (total)
                  
                  
                  50
               
               
                  4190
                  Outlays, net (total)
                  
                  
                  50
               
               
                  
                     
                  
               
            
         
      
      
          This schedule reflects the Administration's Children's Health Insurance Program (CHIP) proposals.
      
         Medicare Health Information Technology Incentive Payments, Recovery Act                                                  
            
         Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0508â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0801
                  Incentive payments to hospitals
                  4,075
                  2,100
                  2,656
               
               
                  0802
                  Incentive payments to eligible professionals
                  2,734
                  870
                  940
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations (object class 42.0)
                  6,809
                  2,970
                  3,596
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  1,871
                  161
                  161
               
               
                  
                  Budget authority:
               
               
                  
                  Spending authority from offsetting collections, mandatory:
               
               
                  1800
                  Collected from the HI Trust Fund
                  3,849
                  2,100
                  2,656
               
               
                  1800
                  Collected from the SMI Trust Fund
                  2,660
                  870
                  940
               
               
                  1801
                  Change in uncollected payments, Federal sources
                  â1,277
                  
                  
               
               
                  1823
                  New and/or unobligated balance of spending authority from offsetting collections temporarily reduced
                  â133
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1850
                  Spending auth from offsetting collections, mand (total)
                  5,099
                  2,970
                  3,596
               
               
                  1930
                  Total budgetary resources available
                  6,970
                  3,131
                  3,757
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  161
                  161
                  161
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  305
                  729
                  729
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  6,809
                  2,970
                  3,596
               
               
                  3020
                  Outlays (gross)
                  â6,385
                  â2,970
                  â3,596
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  729
                  729
                  729
               
               
                  
                  Uncollected payments:
               
               
                  3060
                  Uncollected pymts, Fed sources, brought forward, Oct 1
                  â2,442
                  â1,165
                  â1,165
               
               
                  3070
                  Change in uncollected pymts, Fed sources, unexpired
                  1,277
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3090
                  Uncollected pymts, Fed sources, end of year
                  â1,165
                  â1,165
                  â1,165
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  â2,137
                  â436
                  â436
               
               
                  3200
                  Obligated balance, end of year
                  â436
                  â436
                  â436
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  5,099
                  2,970
                  3,596
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  4,209
                  2,520
                  3,356
               
               
                  4101
                  Outlays from mandatory balances
                  2,176
                  450
                  240
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4110
                  Outlays, gross (total)
                  6,385
                  2,970
                  3,596
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4120
                  Federal sources
                  â6,509
                  â2,970
                  â3,596
               
               
                  
                  Additional offsets against gross budget authority only:
               
               
                  4140
                  Change in uncollected pymts, Fed sources, unexpired
                  1,277
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4160
                  Budget authority, net (mandatory)
                  â133
                  
                  
               
               
                  4170
                  Outlays, net (mandatory)
                  â124
                  
                  
               
               
                  4180
                  Budget authority, net (total)
                  â133
                  
                  
               
               
                  4190
                  Outlays, net (total)
                  â124
                  
                  
               
               
                  
                     
                  
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  5090
                  Unexpired unavailable balance, SOY: Offsetting collections
                  
                  133
                  133
               
               
                  5092
                  Unexpired unavailable balance, EOY: Offsetting collections
                  133
                  133
                  133
               
               
                  
                     
                  
               
            
         
      
         Rate Review Grants                                                                                                       
            
         Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0112â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Premium rate review grants
                  25
                  7
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations (object class 41.0)
                  25
                  7
                  
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  29
                  
                  15
               
               
                  1021
                  Recoveries of prior year unpaid obligations
                  3
                  22
                  25
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1050
                  Unobligated balance (total)
                  32
                  22
                  40
               
               
                  1930
                  Total budgetary resources available
                  32
                  22
                  40
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1940
                  Unobligated balance expiring
                  â7
                  
                  
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  
                  15
                  40
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  161
                  156
                  87
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  25
                  7
                  
               
               
                  3020
                  Outlays (gross)
                  â27
                  â54
                  â40
               
               
                  3040
                  Recoveries of prior year unpaid obligations, unexpired
                  â3
                  â22
                  â25
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  156
                  87
                  22
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  161
                  156
                  87
               
               
                  3200
                  Obligated balance, end of year
                  156
                  87
                  22
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  
                  Outlays, gross:
               
               
                  4101
                  Outlays from mandatory balances
                  27
                  54
                  40
               
               
                  4190
                  Outlays, net (total)
                  27
                  54
                  40
               
               
                  
                     
                  
               
            
         
      
      
         The Affordable Care Act (P.L. 111â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
            or other insurance reform activities consistent with Section 2794 (c)(2)(B). The program provides $250,000,000 over the five-year
            period beginning with fiscal year 2010. 
         
      
         Pre-Existing Condition Insurance Plan Program                                                                            
            
         Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0113â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Pre-Existing Condition Insurance Plan Program (Direct)
                  286
                  
                  
               
               
                  0002
                  Administration
                  25
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0799
                  Total direct obligations
                  311
                  
                  
               
               
                  0801
                  Premiums from Fallback States
                  114
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  425
                  
                  
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  367
                  166
                  383
               
               
                  1021
                  Recoveries of prior year unpaid obligations
                  140
                  217
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1050
                  Unobligated balance (total)
                  507
                  383
                  383
               
               
                  
                  Budget authority:
               
               
                  
                  Spending authority from offsetting collections, mandatory:
               
               
                  1800
                  Collected
                  84
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1850
                  Spending auth from offsetting collections, mand (total)
                  84
                  
                  
               
               
                  1900
                  Budget authority (total)
                  84
                  
                  
               
               
                  1930
                  Total budgetary resources available
                  591
                  383
                  383
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  166
                  383
                  383
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  585
                  251
                  1
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  425
                  
                  
               
               
                  3020
                  Outlays (gross)
                  â619
                  â33
                  
               
               
                  3040
                  Recoveries of prior year unpaid obligations, unexpired
                  â140
                  â217
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  251
                  1
                  1
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  585
                  251
                  1
               
               
                  3200
                  Obligated balance, end of year
                  251
                  1
                  1
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  84
                  
                  
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  84
                  
                  
               
               
                  4101
                  Outlays from mandatory balances
                  535
                  33
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4110
                  Outlays, gross (total)
                  619
                  33
                  
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4123
                  Non-Federal sources
                  â84
                  
                  
               
               
                  4190
                  Outlays, net (total)
                  535
                  33
                  
               
               
                  
                     
                  
               
            
         
      
      
         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 Affordable Care Act (P.L. 111â148).  The PCIP
            program ended in FY 2014 as new insurance options became available to the enrolled population, and outlays reflected in subsequent
            fiscal years reflect program close out and claims run out costs.
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0113â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  11.1
                  Personnel compensation: Full-time permanent
                  2
                  
                  
               
               
                  25.2
                  Other services from non-Federal sources
                  23
                  
                  
               
               
                  41.0
                  Grants, subsidies, and contributions
                  286
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.0
                  Direct obligations
                  311
                  
                  
               
               
                  99.0
                  Reimbursable obligations
                  114
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  425
                  
                  
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0113â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  7
                  
                  
               
               
                  
                     
                  
               
            
         
      
         Early Retiree Reinsurance Program                                                                                        
            
         Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0114â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0002
                  Administration
                  8
                  1
                  
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  20
                  13
                  24
               
               
                  
                  Budget authority:
               
               
                  
                  Spending authority from offsetting collections, mandatory:
               
               
                  1800
                  Collected
                  1
                  12
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1850
                  Spending auth from offsetting collections, mand (total)
                  1
                  12
                  
               
               
                  1900
                  Budget authority (total)
                  1
                  12
                  
               
               
                  1930
                  Total budgetary resources available
                  21
                  25
                  24
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  13
                  24
                  24
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  19
                  13
                  12
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  8
                  1
                  
               
               
                  3020
                  Outlays (gross)
                  â14
                  â2
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  13
                  12
                  12
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  19
                  13
                  12
               
               
                  3200
                  Obligated balance, end of year
                  13
                  12
                  12
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  1
                  12
                  
               
               
                  
                  Outlays, gross:
               
               
                  4101
                  Outlays from mandatory balances
                  14
                  2
                  
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4123
                  Non-Federal sources
                  â1
                  â12
                  
               
               
                  4190
                  Outlays, net (total)
                  13
                  â10
                  
               
               
                  
                     
                  
               
            
         
      
      
         The Affordable Care Act (P.L. 111â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 075â0114â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  11.1
                  Personnel compensation: Full-time permanent
                  2
                  1
                  
               
               
                  25.2
                  Other services from non-Federal sources
                  6
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  8
                  1
                  
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0114â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  4
                  5
                  
               
               
                  
                     
                  
               
            
         
      
         Affordable Insurance Exchange Grants                                                                                     
            
         Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0115â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Planning and establishment grants
                  743
                  449
                  
               
               
                  0002
                  Administration
                  41
                  47
                  52
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  784
                  496
                  52
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  
                  1
                  1
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriation
                  846
                  535
                  51
               
               
                  1230
                  Appropriations and/or unobligated balance of appropriations permanently reduced
                  â61
                  â39
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  785
                  496
                  51
               
               
                  1930
                  Total budgetary resources available
                  785
                  497
                  52
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  1
                  1
                  
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  3,016
                  1,976
                  328
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  784
                  496
                  52
               
               
                  3020
                  Outlays (gross)
                  â1,803
                  â2,144
                  â380
               
               
                  3041
                  Recoveries of prior year unpaid obligations, expired
                  â21
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  1,976
                  328
                  
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  3,016
                  1,976
                  328
               
               
                  3200
                  Obligated balance, end of year
                  1,976
                  328
                  
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  785
                  496
                  51
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  92
                  
                  51
               
               
                  4101
                  Outlays from mandatory balances
                  1,711
                  2,144
                  329
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4110
                  Outlays, gross (total)
                  1,803
                  2,144
                  380
               
               
                  4180
                  Budget authority, net (total)
                  785
                  496
                  51
               
               
                  4190
                  Outlays, net (total)
                  1,803
                  2,144
                  380
               
               
                  
                     
                  
               
            
         
      
      
         This program provides funding for Planning and Establishment Grants to States for their activities to implement Health Insurance
            Marketplaces. The Marketplaces facilitate the purchase of qualified health plans in the individual market and allow small
            businesses to offer qualified health plans to their employees through the Small Business Health Options Program (SHOP). Section
            1311 of the Patient Protection and Affordable Care Act (P.L. 111â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. The
            final round of grants was awarded to States in December 2014.
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0115â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  11.1
                  Personnel compensation: Full-time permanent
                  11
                  13
                  13
               
               
                  25.2
                  Other services from non-Federal sources
                  30
                  34
                  39
               
               
                  41.0
                  Grants, subsidies, and contributions
                  743
                  449
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  784
                  496
                  52
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0115â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  51
                  65
                  66
               
               
                  
                     
                  
               
            
         
      
         Risk Adjustment Program Payments                                                                                         
            
         Special and Trust Fund Receipts (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â5733â0â2â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  0100
                  Balance, start of year
                  
                  
                  269
               
               
                  
                  Receipts:
               
               
                  0200
                  Receipts, Risk Adjustment Program
                  
                  3,679
                  5,641
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0400
                  Total: Balances and collections
                  
                  3,679
                  5,910
               
               
                  
                  Appropriations:
               
               
                  0500
                  Risk Adjustment Program Payments
                  
                  â3,679
                  â5,641
               
               
                  0501
                  Risk Adjustment Program Payments
                  
                  
                  â269
               
               
                  0502
                  Risk Adjustment Program Payments
                  
                  269
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0599
                  Total appropriations
                  
                  â3,410
                  â5,910
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0799
                  Balance, end of year
                  
                  269
                  
               
               
                  
                     
                  
               
            
         
      
      Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â5733â0â2â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Risk Adjustment Program Payments (Direct)
                  
                  3,410
                  5,910
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations (object class 41.0)
                  
                  3,410
                  5,910
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1201
                  Appropriation (special or trust fund)
                  
                  3,679
                  5,641
               
               
                  1203
                  Appropriation (previously unavailable)
                  
                  
                  269
               
               
                  1232
                  Appropriations and/or unobligated balance of appropriations temporarily reduced
                  
                  â269
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  
                  3,410
                  5,910
               
               
                  1930
                  Total budgetary resources available
                  
                  3,410
                  5,910
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  
                  3,410
                  5,910
               
               
                  3020
                  Outlays (gross)
                  
                  â3,410
                  â5,910
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  
                  3,410
                  5,910
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  
                  3,410
                  5,910
               
               
                  4180
                  Budget authority, net (total)
                  
                  3,410
                  5,910
               
               
                  4190
                  Outlays, net (total)
                  
                  3,410
                  5,910
               
               
                  
                     
                  
               
            
         
      
      
         Section 1343 of the Affordable Care Act (P.L. 111â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 075â5735â0â2â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  0100
                  Balance, start of year
                  
                  
                  731
               
               
                  
                  Receipts:
               
               
                  0200
                  Contributions, Transitional Reinsurance Program
                  
                  10,020
                  6,025
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0400
                  Total: Balances and collections
                  
                  10,020
                  6,756
               
               
                  
                  Appropriations:
               
               
                  0500
                  Transitional Reinsurance Program
                  
                  â10,020
                  â6,025
               
               
                  0501
                  Transitional Reinsurance Program
                  
                  
                  â731
               
               
                  0502
                  Transitional Reinsurance Program
                  
                  731
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0599
                  Total appropriations
                  
                  â9,289
                  â6,756
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0799
                  Balance, end of year
                  
                  731
                  
               
               
                  
                     
                  
               
            
         
      
      Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â5735â0â2â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Transitional reinsurance payments
                  
                  9,269
                  6,731
               
               
                  0002
                  Administrative expenses
                  
                  20
                  25
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  
                  9,289
                  6,756
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1201
                  Appropriation (special or trust fund)
                  
                  10,020
                  6,025
               
               
                  1203
                  Appropriation (previously unavailable)
                  
                  
                  731
               
               
                  1232
                  Appropriations and/or unobligated balance of appropriations temporarily reduced
                  
                  â731
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  
                  9,289
                  6,756
               
               
                  1930
                  Total budgetary resources available
                  
                  9,289
                  6,756
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  
                  9,289
                  6,756
               
               
                  3020
                  Outlays (gross)
                  
                  â9,289
                  â6,756
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  
                  9,289
                  6,756
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  
                  9,289
                  6,756
               
               
                  4180
                  Budget authority, net (total)
                  
                  9,289
                  6,756
               
               
                  4190
                  Outlays, net (total)
                  
                  9,289
                  6,756
               
               
                  
                     
                  
               
            
         
      
      
         Section 1341 of the Affordable Care Act (P.L. 111â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 contributing entities a per enrollee fee to fund the reinsurance program, 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 075â5735â0â2â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  41.0
                  Grants, subsidies, and contributions - Transitional Reinsurance
                  
                  9,269
                  6,731
               
               
                  41.0
                  Grants, subsidies, and contributions - Administration
                  
                  20
                  25
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  
                  9,289
                  6,756
               
               
                  
                     
                  
               
            
         
      
         Consumer Operated and Oriented Plan Program Contingency Fund                                                             
            
         Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0524â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  
                  Credit program obligations:
               
               
                  0701
                  Direct loan subsidy
                  165
                  42
                  
               
               
                  0709
                  Administrative expenses
                  9
                  11
                  3
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  174
                  53
                  3
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  230
                  56
                  3
               
               
                  1930
                  Total budgetary resources available
                  230
                  56
                  3
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  56
                  3
                  
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  7
                  154
                  75
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  174
                  53
                  3
               
               
                  3020
                  Outlays (gross)
                  â27
                  â132
                  â52
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  154
                  75
                  26
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  7
                  154
                  75
               
               
                  3200
                  Obligated balance, end of year
                  154
                  75
                  26
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  
                  Outlays, gross:
               
               
                  4101
                  Outlays from mandatory balances
                  27
                  132
                  52
               
               
                  4190
                  Outlays, net (total)
                  27
                  132
                  52
               
               
                  
                     
                  
               
            
         
      
      Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0524â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct loan levels supportable by subsidy budget authority:
               
               
                  115001
                  Startup Loans
                  39
                  
                  
               
               
                  115002
                  Solvency Loans
                  358
                  88
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  115999
                  Total direct loan levels
                  397
                  88
                  
               
               
                  
                  Direct loan subsidy (in percent):
               
               
                  132001
                  Startup Loans
                  35.66
                  0.00
                  0.00
               
               
                  132002
                  Solvency Loans
                  42.08
                  48.22
                  0.00
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  132999
                  Weighted average subsidy rate
                  41.45
                  48.22
                  0.00
               
               
                  
                  Direct loan subsidy budget authority:
               
               
                  133001
                  Startup Loans
                  14
                  
                  
               
               
                  133002
                  Solvency Loans
                  151
                  42
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  133999
                  Total subsidy budget authority
                  165
                  42
                  
               
               
                  
                  Direct loan subsidy outlays:
               
               
                  134001
                  Startup Loans
                  12
                  3
                  
               
               
                  134002
                  Solvency Loans
                  5
                  118
                  47
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  134999
                  Total subsidy outlays
                  17
                  121
                  47
               
               
                  
                  Direct loan reestimates:
               
               
                  135001
                  Startup Loans
                  
                  â1
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  135999
                  Total direct loan reestimates
                  
                  â1
                  
               
               
                  
                     
                  
               
               
                  
                  Administrative expense data:
               
               
                  3580
                  Outlays from balances
                  10
                  11
                  5
               
               
                  
                     
                  
               
            
         
      
      
         The Consumer Operated and Oriented Plan Contingency Fund was established by the American Taxpayer Relief Act of 2012 (P.L.
            112â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. 111â148).
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0524â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  11.1
                  Personnel compensation: Full-time permanent
                  4
                  3
                  
               
               
                  23.1
                  Rental payments to GSA
                  1
                  1
                  
               
               
                  25.2
                  Other services from non-Federal sources
                  4
                  7
                  3
               
               
                  41.0
                  Grants, subsidies, and contributions
                  165
                  42
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  174
                  53
                  3
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0524â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  15
                  18
                  
               
               
                  
                     
                  
               
            
         
      
         Consumer Operated and Oriented Plan Program Account                                                                      
            
         Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0118â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  
                  Credit program obligations:
               
               
                  0705
                  Reestimates of direct loan subsidy
                  18
                  23
                  
               
               
                  0706
                  Interest on reestimates of direct loan subsidy
                  1
                  2
                  
               
               
                  0709
                  Administrative expenses
                  
                  
                  9
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  19
                  25
                  9
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  9
                  9
                  9
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriation
                  19
                  25
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  19
                  25
                  
               
               
                  1930
                  Total budgetary resources available
                  28
                  34
                  9
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  9
                  9
                  
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  547
                  282
                  119
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  19
                  25
                  9
               
               
                  3020
                  Outlays (gross)
                  â284
                  â188
                  â116
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  282
                  119
                  12
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  547
                  282
                  119
               
               
                  3200
                  Obligated balance, end of year
                  282
                  119
                  12
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  19
                  25
                  
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  19
                  25
                  
               
               
                  4101
                  Outlays from mandatory balances
                  265
                  163
                  116
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4110
                  Outlays, gross (total)
                  284
                  188
                  116
               
               
                  4180
                  Budget authority, net (total)
                  19
                  25
                  
               
               
                  4190
                  Outlays, net (total)
                  284
                  188
                  116
               
               
                  
                     
                  
               
            
         
      
      Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0118â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct loan subsidy outlays:
               
               
                  134002
                  Startup Loans
                  13
                  
                  
               
               
                  134003
                  Solvency
                  251
                  162
                  111
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  134999
                  Total subsidy outlays
                  264
                  162
                  111
               
               
                  
                  Direct loan reestimates:
               
               
                  135002
                  Startup Loans
                  â6
                  â5
                  
               
               
                  135003
                  Solvency
                  19
                  26
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  135999
                  Total direct loan reestimates
                  13
                  21
                  
               
               
                  
                     
                  
               
               
                  
                  Administrative expense data:
               
               
                  3580
                  Outlays from balances
                  1
                  
                  4
               
               
                  
                     
                  
               
            
         
      
      
         Section 1322 of the Affordable Care Act (P.L. 111â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.
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0118â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  11.1
                  Personnel compensation: Full-time permanent
                  
                  
                  5
               
               
                  25.2
                  Other services from non-Federal sources
                  
                  
                  4
               
               
                  41.0
                  Grants, subsidies, and contributions
                  19
                  25
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  19
                  25
                  9
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0118â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  
                  
                  18
               
               
                  
                     
                  
               
            
         
      
         Consumer Operated and Oriented Plan Financing Account                                                                    
            
         Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â4418â0â3â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  
                  Credit program obligations:
               
               
                  0713
                  Payment of interest to Treasury
                  25
                  46
                  53
               
               
                  0742
                  Downward reestimate paid to receipt account
                  6
                  5
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  31
                  51
                  53
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Financing authority:
               
               
                  
                  Borrowing authority, mandatory:
               
               
                  1400
                  Borrowing authority
                  3
                  41
                  43
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1440
                  Borrowing authority, mandatory (total)
                  3
                  41
                  43
               
               
                  
                  Spending authority from offsetting collections, mandatory:
               
               
                  1800
                  Collected
                  292
                  199
                  121
               
               
                  1801
                  Change in uncollected payments, Federal sources
                  â264
                  â163
                  â111
               
               
                  1825
                  Spending authority from offsetting collections applied to repay debt
                  
                  â26
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1850
                  Spending auth from offsetting collections, mand (total)
                  28
                  10
                  10
               
               
                  1900
                  Financing authority (total)
                  31
                  51
                  53
               
               
                  1930
                  Total budgetary resources available
                  31
                  51
                  53
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  1,243
                  641
                  267
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  31
                  51
                  53
               
               
                  3020
                  Financing disbursements (gross)
                  â633
                  â425
                  â307
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  641
                  267
                  13
               
               
                  
                  Uncollected payments:
               
               
                  3060
                  Uncollected pymts, Fed sources, brought forward, Oct 1
                  â545
                  â281
                  â118
               
               
                  3070
                  Change in uncollected pymts, Fed sources, unexpired
                  264
                  163
                  111
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3090
                  Uncollected pymts, Fed sources, end of year
                  â281
                  â118
                  â7
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  698
                  360
                  149
               
               
                  3200
                  Obligated balance, end of year
                  360
                  149
                  6
               
               
                  
                     
                  
               
               
                  
                  Financing authority and disbursements, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Financing authority, gross
                  31
                  51
                  53
               
               
                  
                  Financing disbursements:
               
               
                  4110
                  Financing disbursements, gross
                  633
                  425
                  307
               
               
                  
                  Offsets against gross financing authority and disbursements:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4120
                  Federal sources
                  â282
                  â189
                  â111
               
               
                  4122
                  Interest on uninvested funds
                  â10
                  â10
                  â10
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4130
                  Offsets against gross financing auth and disbursements (total)
                  â292
                  â199
                  â121
               
               
                  
                  Additional offsets against financing authority only (total):
               
               
                  4140
                  Change in uncollected pymts, Fed sources, unexpired
                  264
                  163
                  111
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4160
                  Financing authority, net (mandatory)
                  3
                  15
                  43
               
               
                  4170
                  Financing disbursements, net (mandatory)
                  341
                  226
                  186
               
               
                  4180
                  Financing authority, net (total)
                  3
                  15
                  43
               
               
                  4190
                  Financing disbursements, net (total)
                  341
                  226
                  186
               
               
                  
                     
                  
               
            
         
      
      Status of Direct Loans (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â4418â0â3â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Cumulative balance of direct loans outstanding:
               
               
                  1210
                  Outstanding, start of year
                  714
                  1,315
                  1,689
               
               
                  1231
                  Disbursements: Direct loan disbursements
                  601
                  374
                  254
               
               
                  1251
                  Repayments: Repayments and prepayments
                  
                  
                  
               
               
                  1263
                  Write-offs for default: Direct loans
                  
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1290
                  Outstanding, end of year
                  1,315
                  1,689
                  1,943
               
               
                  
                     
                  
               
            
         
      
      Balance Sheet (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â4418â0â3â551
                  2013 actual
                  2014 actual
               
               
                  
                     
                  
               
               
                  
                  Group heading
               
               
                  0000
                  Group heading
                  
                  
               
               
                  
                     
                  
               
               
                  
                  ASSETS:
               
               
                  
                  Federal assets:
               
               
                  1101
                  Fund balances with Treasury
                  118
                  99
               
               
                  
                  Investments in US securities:
               
               
                  1106
                  Receivables, net
                  25
                  6
               
               
                  
                  Net value of assets related to post-1991 direct loans receivable:
               
               
                  1401
                  Direct loans receivable, gross
                  714
                  1,315
               
               
                  1405
                  Allowance for subsidy cost (-)
                  â309
                  â570
               
               
                  
                  
                  
                     
                  
                  
                     
                  
               
               
                  1499
                  Net present value of assets related to direct loans
                  405
                  745
               
               
                  
                  
                  
                     
                  
                  
                     
                  
               
               
                  1999
                  Total assets
                  548
                  850
               
               
                  
                  LIABILITIES:
               
               
                  2103
                  Federal liabilities: Debt
                  548
                  850
               
               
                  
                  
                  
                     
                  
                  
                     
                  
               
               
                  4999
                  Total liabilities and net position
                  548
                  850
               
               
                  
                     
                  
               
            
         
      
         Consumer Operated and Oriented Plan Program Contingency Fund Financing Account                                           
            
         Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â4482â0â3â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  
                  Credit program obligations:
               
               
                  0710
                  Direct loan obligations
                  398
                  88
                  
               
               
                  0713
                  Payment of interest to Treasury
                  1
                  7
                  8
               
               
                  0742
                  Downward reestimate paid to receipt account
                  
                  1
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  399
                  96
                  8
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Financing authority:
               
               
                  
                  Borrowing authority, mandatory:
               
               
                  1400
                  Borrowing authority
                  255
                  52
                  7
               
               
                  1422
                  Borrowing authority applied to repay debt
                  â22
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1440
                  Borrowing authority, mandatory (total)
                  233
                  52
                  7
               
               
                  
                  Spending authority from offsetting collections, mandatory:
               
               
                  1800
                  Collected
                  19
                  122
                  48
               
               
                  1801
                  Change in uncollected payments, Federal sources
                  147
                  â78
                  â47
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1850
                  Spending auth from offsetting collections, mand (total)
                  166
                  44
                  1
               
               
                  1900
                  Financing authority (total)
                  399
                  96
                  8
               
               
                  1930
                  Total budgetary resources available
                  399
                  96
                  8
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  4
                  355
                  155
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  399
                  96
                  8
               
               
                  3020
                  Financing disbursements (gross)
                  â48
                  â296
                  â110
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  355
                  155
                  53
               
               
                  
                  Uncollected payments:
               
               
                  3060
                  Uncollected pymts, Fed sources, brought forward, Oct 1
                  â2
                  â149
                  â71
               
               
                  3070
                  Change in uncollected pymts, Fed sources, unexpired
                  â147
                  78
                  47
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3090
                  Uncollected pymts, Fed sources, end of year
                  â149
                  â71
                  â24
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  2
                  206
                  84
               
               
                  3200
                  Obligated balance, end of year
                  206
                  84
                  29
               
               
                  
                     
                  
               
               
                  
                  Financing authority and disbursements, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Financing authority, gross
                  399
                  96
                  8
               
               
                  
                  Financing disbursements:
               
               
                  4110
                  Financing disbursements, gross
                  48
                  296
                  110
               
               
                  
                  Offsets against gross financing authority and disbursements:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4120
                  Federal sources
                  â18
                  â121
                  â47
               
               
                  4122
                  Interest on uninvested funds
                  â1
                  â1
                  â1
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4130
                  Offsets against gross financing auth and disbursements (total)
                  â19
                  â122
                  â48
               
               
                  
                  Additional offsets against financing authority only (total):
               
               
                  4140
                  Change in uncollected pymts, Fed sources, unexpired
                  â147
                  78
                  47
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4160
                  Financing authority, net (mandatory)
                  233
                  52
                  7
               
               
                  4170
                  Financing disbursements, net (mandatory)
                  29
                  174
                  62
               
               
                  4180
                  Financing authority, net (total)
                  233
                  52
                  7
               
               
                  4190
                  Financing disbursements, net (total)
                  29
                  174
                  62
               
               
                  
                     
                  
               
            
         
      
      Status of Direct Loans (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â4482â0â3â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Position with respect to appropriations act limitation on obligations:
               
               
                  1121
                  Limitation available from carry-forward
                  398
                  88
                  
               
               
                  1143
                  Unobligated limitation carried forward (P.L. xx) (-)
                  
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1150
                  Total direct loan obligations
                  398
                  88
                  
               
               
                  
                     
                  
               
               
                  
                  Cumulative balance of direct loans outstanding:
               
               
                  1210
                  Outstanding, start of year
                  2
                  49
                  337
               
               
                  1231
                  Disbursements: Direct loan disbursements
                  47
                  288
                  102
               
               
                  1251
                  Repayments: Repayments and prepayments
                  
                  
                  
               
               
                  1263
                  Write-offs for default: Direct loans
                  
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1290
                  Outstanding, end of year
                  49
                  337
                  439
               
               
                  
                     
                  
               
            
         
      
      Balance Sheet (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â4482â0â3â551
                  2013 actual
                  2014 actual
               
               
                  
                     
                  
               
               
                  
                  ASSETS:
               
               
                  1101
                  Federal assets: Fund balances with Treasury
                  3
                  6
               
               
                  
                  Net value of assets related to post-1991 direct loans receivable:
               
               
                  1401
                  Direct loans receivable, gross
                  2
                  49
               
               
                  1402
                  Interest receivable
                  
                  1
               
               
                  1405
                  Allowance for subsidy cost (-)
                  â1
                  â19
               
               
                  
                  
                  
                     
                  
                  
                     
                  
               
               
                  1499
                  Net present value of assets related to direct loans
                  1
                  31
               
               
                  
                  
                  
                     
                  
                  
                     
                  
               
               
                  1999
                  Total assets
                  4
                  37
               
               
                  
                  LIABILITIES:
               
               
                  2104
                  Federal liabilities: Resources payable to Treasury
                  4
                  37
               
               
                  
                  
                  
                     
                  
                  
                     
                  
               
               
                  4999
                  Total liabilities and net position
                  4
                  37
               
               
                  
                     
                  
               
            
         
      
      Trust Funds
         Federal Hospital Insurance Trust Fund                                                                                    
            
         Special and Trust Fund Receipts (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â8005â0â7â571
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  0100
                  Balance, start of year
                  179,985
                  171,674
                  150,555
               
               
                  
                  Receipts:
               
               
                  0200
                  FHI Trust Fund, Transfers from General Fund (FICA Taxes)
                  205,296
                  214,828
                  224,562
               
               
                  0201
                  FHI Trust Fund, Transfers from General Fund (FICA Taxes)
                  
                  
                  1,103
               
               
                  0202
                  FHI Trust Fund, Receipts from Railroad Retirement Board
                  581
                  594
                  608
               
               
                  0203
                  FHI Trust Fund, Transfers from General Fund (SECA Taxes)
                  18,230
                  18,436
                  18,975
               
               
                  0204
                  FHI Trust Fund, Civil Penalties and Damages
                  807
                  1,033
                  1,134
               
               
                  0220
                  FHI Trust Fund, Other Proprietary Interest from the Public
                  2
                  2
                  2
               
               
                  0221
                  FHI Trust Fund, Basic Premium, Medicare Advantage
                  278
                  277
                  297
               
               
                  0222
                  FHI Trust Fund, Medicare Refunds
                  8,445
                  8,900
                  8,950
               
               
                  0223
                  Affordable Care Act Medicare Shared Savings Models (HI)
                  2
                  2
                  2
               
               
                  0224
                  FHI Trust Fund, Premiums Collected for Uninsured Individuals not Otherwise Eligible
                  3,259
                  3,444
                  3,508
               
               
                  0225
                  FHI Trust Fund, Premiums Collected for Uninsured Individuals not Otherwise Eligible
                  
                  
                  â45
               
               
                  0240
                  FHI Trust Fund, Federal Employer Contributions (FICA)
                  3,451
                  3,452
                  3,517
               
               
                  0241
                  FHI Trust Fund, Postal Service Employer Contributions (FICA)
                  601
                  622
                  635
               
               
                  0242
                  FHI Trust Fund, Interest Received by Trust Funds
                  8,929
                  8,795
                  8,885
               
               
                  0243
                  FHI Trust Fund, Interest Received by Trust Funds
                  
                  7
                  69
               
               
                  0244
                  FHI Trust Fund, Taxation on OASDI Benefits
                  18,066
                  20,225
                  23,480
               
               
                  0245
                  FHI Trust Fund, Payment from the General Fund for Health Care Fraud and Abuse Control Account
                  255
                  129
                  141
               
               
                  0246
                  FHI Trust Fund, Transfers from General Fund (criminal Fines)
                  344
                  950
                  990
               
               
                  0247
                  FHI Trust Fund, Transfers from General Fund (civil Monetary Penalties)
                  24
                  23
                  24
               
               
                  0248
                  FHI Trust Fund, Transfers from General Fund (civil Monetary Penalties)
                  
                  
                  1
               
               
                  0249
                  FHI Trust Fund, Transfers from General Fund (asset Forfeitures)
                  25
                  28
                  29
               
               
                  0250
                  FHI Trust Fund, Interest Payments by Railroad Retirement Board
                  31
                  30
                  32
               
               
                  0251
                  FHI Trust Fund, Payments from the General Fund (uninsured and Program Management)
                  2,572
                  1,104
                  1,494
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0299
                  Total receipts and collections
                  271,198
                  282,881
                  298,393
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0400
                  Total: Balances and collections
                  451,183
                  454,555
                  448,948
               
               
                  
                  Appropriations:
               
               
                  0500
                  Federal Hospital Insurance Trust Fund
                  â2,547
                  â2,508
                  â2,740
               
               
                  0501
                  Federal Hospital Insurance Trust Fund
                  â266,983
                  â278,986
                  â292,623
               
               
                  0502
                  Federal Hospital Insurance Trust Fund
                  â14,127
                  â21,126
                  â2,581
               
               
                  0503
                  Federal Hospital Insurance Trust Fund
                  5,442
                  
                  
               
               
                  0504
                  Federal Hospital Insurance Trust Fund
                  263
                  
                  
               
               
                  0505
                  Federal Hospital Insurance Trust Fund
                  
                  â7
                  â69
               
               
                  0506
                  Federal Hospital Insurance Trust Fund
                  
                  7
                  79
               
               
                  0507
                  Federal Hospital Insurance Trust Fund
                  
                  
                  â1,059
               
               
                  0508
                  Federal Hospital Insurance Trust Fund
                  
                  
                  3,600
               
               
                  0509
                  Federal Hospital Insurance Trust Fund
                  
                  6
                  â32
               
               
                  0510
                  Federal Hospital Insurance Trust Fund
                  
                  â6
                  32
               
               
                  0511
                  Health Care Fraud and Abuse Control Account
                  â294
                  â672
                  â706
               
               
                  0512
                  Health Care Fraud and Abuse Control Account
                  â1,314
                  â760
                  â1,196
               
               
                  0513
                  Health Care Fraud and Abuse Control Account
                  51
                  52
                  
               
               
                  0514
                  Health Care Fraud and Abuse Control Account
                  
                  
                  781
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0599
                  Total appropriations
                  â279,509
                  â304,000
                  â296,514
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0799
                  Balance, end of year
                  171,674
                  150,555
                  152,434
               
               
                  
                     
                  
               
            
         
      
      Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â8005â0â7â571
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Benefit payments, HI
                  271,406
                  297,100
                  291,975
               
               
                  0002
                  HIT Incentive Payments
                  3,849
                  2,100
                  2,656
               
               
                  0003
                  Administration, HI
                  2,343
                  2,766
                  2,946
               
               
                  0004
                  Quality improvement organizations, HI
                  1,131
                  580
                  430
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0799
                  Total direct obligations
                  278,729
                  302,546
                  298,007
               
               
                  0801
                  Federal Hospital Insurance Trust Fund (Reimbursable)
                  5
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  278,734
                  302,546
                  298,007
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  
                  
                  74
               
               
                  1021
                  Recoveries of prior year unpaid obligations
                  777
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1050
                  Unobligated balance (total)
                  777
                  
                  74
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, discretionary:
               
               
                  1101
                  Appropriation (special or trust fund)
                  2,547
                  2,508
                  2,740
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1160
                  Appropriation, discretionary (total)
                  2,547
                  2,508
                  2,740
               
               
                  
                  Appropriations, mandatory:
               
               
                  1201
                  Appropriation (special or trust fund)
                  266,983
                  278,986
                  292,623
               
               
                  1203
                  Appropriation (previously unavailable)
                  14,127
                  21,126
                  2,581
               
               
                  1232
                  Appropriations and/or unobligated balance of appropriations temporarily reduced
                  â5,442
                  
                  
               
               
                  1234
                  Appropriations precluded from obligation
                  â263
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  275,405
                  300,112
                  295,204
               
               
                  
                  Spending authority from offsetting collections, mandatory:
               
               
                  1800
                  Collected
                  5
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1850
                  Spending auth from offsetting collections, mand (total)
                  5
                  
                  
               
               
                  1900
                  Budget authority (total)
                  277,957
                  302,620
                  297,944
               
               
                  1930
                  Total budgetary resources available
                  278,734
                  302,620
                  298,018
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  
                  74
                  11
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  24,942
                  29,103
                  52,046
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  278,734
                  302,546
                  298,007
               
               
                  3020
                  Outlays (gross)
                  â273,796
                  â279,603
                  â297,850
               
               
                  3040
                  Recoveries of prior year unpaid obligations, unexpired
                  â777
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  29,103
                  52,046
                  52,203
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  24,942
                  29,103
                  52,046
               
               
                  3200
                  Obligated balance, end of year
                  29,103
                  52,046
                  52,203
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Discretionary:
               
               
                  4000
                  Budget authority, gross
                  2,547
                  2,508
                  2,740
               
               
                  
                  Outlays, gross:
               
               
                  4010
                  Outlays from new discretionary authority
                  1,732
                  1,854
                  2,007
               
               
                  4011
                  Outlays from discretionary balances
                  898
                  602
                  600
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4020
                  Outlays, gross (total)
                  2,630
                  2,456
                  2,607
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  275,410
                  300,112
                  295,204
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  249,544
                  249,716
                  266,863
               
               
                  4101
                  Outlays from mandatory balances
                  21,622
                  27,431
                  28,380
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4110
                  Outlays, gross (total)
                  271,166
                  277,147
                  295,243
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4123
                  Non-Federal sources
                  â5
                  
                  
               
               
                  4180
                  Budget authority, net (total)
                  277,952
                  302,620
                  297,944
               
               
                  4190
                  Outlays, net (total)
                  273,791
                  279,603
                  297,850
               
               
                  
                     
                  
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  5000
                  Total investments, SOY: Federal securities: Par value
                  206,010
                  202,207
                  203,805
               
               
                  5001
                  Total investments, EOY: Federal securities: Par value
                  202,207
                  203,805
                  201,218
               
               
                  
                     
                  
               
            
         
      
      
         The Hospital Insurance (HI) program funds the costs of hospital and related care for individuals age 65 or older and for eligible
            disabled people.
         
          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; and encouraging beneficiaries to seek high-value services.
            The status of the trust fund is as follows.
         
      
      Status of Funds (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â8005â0â7â571
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Unexpended balance, start of year:
               
               
                  0100
                  Balance, start of year
                  206,314
                  202,362
                  203,869
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0199
                  Total balance, start of year
                  206,314
                  202,362
                  203,869
               
               
                  
                  Cash income during the year:
               
               
                  
                  Current law:
               
               
                  
                  Receipts:
               
               
                  1200
                  FHI Trust Fund, Transfers from General Fund (FICA Taxes)
                  205,296
                  214,828
                  224,562
               
               
                  1200
                  FHI Trust Fund, Receipts from Railroad Retirement Board
                  581
                  594
                  608
               
               
                  1200
                  FHI Trust Fund, Transfers from General Fund (SECA Taxes)
                  18,230
                  18,436
                  18,975
               
               
                  1200
                  FHI Trust Fund, Civil Penalties and Damages
                  807
                  1,033
                  1,134
               
               
                  
                  Offsetting receipts (proprietary):
               
               
                  1220
                  FHI Trust Fund, Other Proprietary Interest from the Public
                  2
                  2
                  2
               
               
                  1220
                  FHI Trust Fund, Basic Premium, Medicare Advantage
                  278
                  277
                  297
               
               
                  1220
                  FHI Trust Fund, Medicare Refunds
                  8,445
                  8,900
                  8,950
               
               
                  1220
                  Affordable Care Act Medicare Shared Savings Models (HI)
                  2
                  2
                  2
               
               
                  1220
                  FHI Trust Fund, Premiums Collected for Uninsured Individuals not Otherwise Eligible
                  3,259
                  3,444
                  3,508
               
               
                  
                  Offsetting receipts (intragovernmental):
               
               
                  1240
                  FHI Trust Fund, Federal Employer Contributions (FICA)
                  3,451
                  3,452
                  3,517
               
               
                  1240
                  FHI Trust Fund, Postal Service Employer Contributions (FICA)
                  601
                  622
                  635
               
               
                  1240
                  FHI Trust Fund, Interest Received by Trust Funds
                  8,929
                  8,795
                  8,885
               
               
                  1240
                  FHI Trust Fund, Taxation on OASDI Benefits
                  18,066
                  20,225
                  23,480
               
               
                  1240
                  FHI Trust Fund, Payment from the General Fund for Health Care Fraud and Abuse Control Account
                  255
                  129
                  141
               
               
                  1240
                  FHI Trust Fund, Transfers from General Fund (criminal Fines)
                  344
                  950
                  990
               
               
                  1240
                  FHI Trust Fund, Transfers from General Fund (civil Monetary Penalties)
                  24
                  23
                  24
               
               
                  1240
                  FHI Trust Fund, Transfers from General Fund (asset Forfeitures)
                  25
                  28
                  29
               
               
                  1240
                  FHI Trust Fund, Interest Payments by Railroad Retirement Board
                  31
                  30
                  32
               
               
                  1240
                  FHI Trust Fund, Payments from the General Fund (uninsured and Program Management)
                  2,572
                  1,104
                  1,494
               
               
                  
                  Offsetting collections:
               
               
                  1280
                  Federal Hospital Insurance Trust Fund
                  5
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1299
                  Income under present law
                  271,203
                  282,874
                  297,265
               
               
                  
                  Proposed legislation:
               
               
                  
                  Receipts:
               
               
                  2200
                  FHI Trust Fund, Transfers from General Fund (FICA Taxes)
                  
                  
                  1,103
               
               
                  
                  Offsetting receipts (proprietary receipts):
               
               
                  2220
                  FHI Trust Fund, Premiums Collected for Uninsured Individuals not Otherwise Eligible
                  
                  
                  â45
               
               
                  
                  Offsetting receipts (intragovernmental):
               
               
                  2240
                  FHI Trust Fund, Interest Received by Trust Funds
                  
                  7
                  69
               
               
                  2240
                  FHI Trust Fund, Transfers from General Fund (civil Monetary Penalties)
                  
                  
                  1
               
               
                  
                  Offsetting collections:
               
               
                  2280
                  Federal Hospital Insurance Trust Fund
                  
                  
                  5
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  2299
                  Income under proposed legislation
                  
                  7
                  1,133
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3299
                  Total cash income
                  271,203
                  282,881
                  298,398
               
               
                  
                  Cash outgo during year:
               
               
                  
                  Current law:
               
               
                  4500
                  Federal Hospital Insurance Trust Fund
                  â273,796
                  â279,603
                  â297,850
               
               
                  4500
                  Health Care Fraud and Abuse Control Account
                  â1,358
                  â1,771
                  â1,829
               
               
                  4500
                  Health Care Fraud and Abuse Control Account
                  
                  
                  781
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4599
                  Outgo under current law (-)
                  â275,154
                  â281,374
                  â298,898
               
               
                  
                  Proposed legislation:
               
               
                  5500
                  Federal Hospital Insurance Trust Fund
                  
                  
                  10
               
               
                  5500
                  Federal Hospital Insurance Trust Fund
                  
                  
                  2,536
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  5599
                  Outgo under proposed legislation (-)
                  
                  
                  2,546
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  6599
                  Total cash outgo (-)
                  â275,154
                  â281,374
                  â296,352
               
               
                  
                  Manual Adjustments:
               
               
                  7695
                  Rounding adjustment
                  â1
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  7699
                  Total adjustments
                  â1
                  
                  
               
               
                  
                  Unexpended balance, end of year:
               
               
                  8700
                  Uninvested balance (net), end of year
                  155
                  64
                  4,697
               
               
                  8701
                  Federal Hospital Insurance Trust Fund
                  202,207
                  203,805
                  201,218
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  8799
                  Total balance, end of year
                  202,362
                  203,869
                  205,915
               
               
                  
                     
                  
               
            
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â8005â0â7â571
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  41.0
                  Payment for Quality Improvement Organization (QIO) activities
                  1,131
                  580
                  430
               
               
                  42.0
                  Insurance claims and indemnities (benefits)
                  271,406
                  297,100
                  291,975
               
               
                  94.0
                  Financial transfers
                  6,192
                  4,866
                  5,602
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.0
                  Direct obligations
                  278,729
                  302,546
                  298,007
               
               
                  42.0
                  Allocation Account - reimbursable: Insurance claims and indemnities
                  5
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  278,734
                  302,546
                  298,007
               
               
                  
                     
                  
               
            
         
      
         Federal Hospital Insurance Trust Fund                                                                                    
            
         
         (Amounts included in the adjusted baseline)Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â8005â7â7â571
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1201
                  Appropriation (special or trust fund)
                  
                  â6
                  32
               
               
                  1203
                  Appropriation (previously unavailable)
                  
                  6
                  â32
               
               
                  
                     
                  
               
            
         
      
         Federal Hospital Insurance Trust Fund                                                                                    
            
         
         (Legislative proposal, not subject to PAYGO)Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â8005â2â7â571
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Benefit payments, HI
                  
                  
                  â10
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations (object class 94.0)
                  
                  
                  â10
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1201
                  Appropriation (special or trust fund)
                  
                  7
                  69
               
               
                  1234
                  Appropriations precluded from obligation
                  
                  â7
                  â79
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  
                  
                  â10
               
               
                  1900
                  Budget authority (total)
                  
                  
                  â10
               
               
                  1930
                  Total budgetary resources available
                  
                  
                  â10
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  
                  
                  â10
               
               
                  3020
                  Outlays (gross)
                  
                  
                  10
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  
                  
                  â10
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  
                  
                  â10
               
               
                  4180
                  Budget authority, net (total)
                  
                  
                  â10
               
               
                  4190
                  Outlays, net (total)
                  
                  
                  â10
               
               
                  
                     
                  
               
            
         
      
         Federal Hospital Insurance Trust Fund                                                                                    
            
         
         (Legislative proposal, subject to PAYGO)Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â8005â4â7â571
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Benefit payments, HI
                  
                  
                  â2,650
               
               
                  0003
                  Administration, HI
                  
                  
                  104
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0799
                  Total direct obligations
                  
                  
                  â2,546
               
               
                  0801
                  Appeals Fees
                  
                  
                  5
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  
                  
                  â2,541
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1201
                  Appropriation (special or trust fund)
                  
                  
                  1,059
               
               
                  1203
                  Appropriation (previously unavailable)
                  
                  
                  â3,600
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  
                  
                  â2,541
               
               
                  
                  Spending authority from offsetting collections, mandatory:
               
               
                  1800
                  Collected
                  
                  
                  5
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1850
                  Spending auth from offsetting collections, mand (total)
                  
                  
                  5
               
               
                  1900
                  Budget authority (total)
                  
                  
                  â2,536
               
               
                  1930
                  Total budgetary resources available
                  
                  
                  â2,536
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  
                  
                  5
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  
                  
                  â2,541
               
               
                  3020
                  Outlays (gross)
                  
                  
                  2,536
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  
                  
                  â5
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3200
                  Obligated balance, end of year
                  
                  
                  â5
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  
                  
                  â2,536
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  
                  
                  â2,536
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4123
                  Non-Federal sources
                  
                  
                  â5
               
               
                  4180
                  Budget authority, net (total)
                  
                  
                  â2,541
               
               
                  4190
                  Outlays, net (total)
                  
                  
                  â2,541
               
               
                  
                     
                  
               
            
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â8005â4â7â571
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  42.0
                  Insurance claims and indemnities (benefits)
                  
                  
                  â2,650
               
               
                  94.0
                  Financial transfers
                  
                  
                  104
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.0
                  Direct obligations
                  
                  
                  â2,546
               
               
                  99.0
                  Reimbursable obligations
                  
                  
                  5
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  
                  
                  â2,541
               
               
                  
                     
                  
               
            
         
      
         Health care fraud and abuse control accountIn addition to amounts otherwise available for program integrity and program management, [$672,000,000] $706,000,000,  to remain available through September 30, [2016] 2017, 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 [$477,120,000] $474,175,000 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 of Services program integrity activities; of which [$67,200,000] $118,631,000 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 $67,200,000 shall be for the Medicaid and Children's Health Insurance Program ("CHIP") program integrity activities,] and of which [$60,480,000] $113,194,000 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 [2015] 2016 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: Provided further, That of the amount provided under this heading, $311,000,000 is provided to meet the terms of section 251(b)(2)(C)(ii) of
         the Balanced Budget and Emergency Deficit Control Act of 1985, as amended, and [$361,000,000] $395,000,000 is additional new budget authority specified for purposes of section 251(b)(2)(C) of such Act. (Department of Health and Human Services Appropriations Act, 2015.)
      Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â8393â0â7â571
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Medicare integrity program
                  895
                  864
                  895
               
               
                  0002
                  FBI fraud and abuse control
                  135
                  129
                  141
               
               
                  0003
                  Other fraud and abuse control
                  276
                  279
                  306
               
               
                  0004
                  Predictive Modeling
                  12
                  
                  
               
               
                  0005
                  Undistributed Savings, HCFAC and SSA
                  
                  â565
                  â146
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0091
                  Total Mandatory
                  1,318
                  707
                  1,196
               
               
                  0101
                  CMS discretionary
                  216
                  451
                  474
               
               
                  0102
                  Other discretionary
                  66
                  221
                  232
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0191
                  Total Discretionary
                  282
                  672
                  706
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  1,600
                  1,379
                  1,902
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  166
                  165
                  166
               
               
                  1001
                  Discretionary unobligated balance brought fwd, Oct 1
                  10
                  
                  
               
               
                  1021
                  Recoveries of prior year unpaid obligations
                  43
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1050
                  Unobligated balance (total)
                  209
                  165
                  166
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, discretionary:
               
               
                  1101
                  Appropriation (special or trust fund)
                  294
                  672
                  706
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1160
                  Appropriation, discretionary (total)
                  294
                  672
                  706
               
               
                  
                  Appropriations, mandatory:
               
               
                  1201
                  Appropriation (special or trust fund)
                  1,314
                  760
                  1,196
               
               
                  1232
                  Appropriations and/or unobligated balance of appropriations temporarily reduced
                  â51
                  â52
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  1,263
                  708
                  1,196
               
               
                  1900
                  Budget authority (total)
                  1,557
                  1,380
                  1,902
               
               
                  1930
                  Total budgetary resources available
                  1,766
                  1,545
                  2,068
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1940
                  Unobligated balance expiring
                  â1
                  
                  
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  165
                  166
                  166
               
               
                  
                  Special and non-revolving trust funds:
               
               
                  1951
                  Unobligated balance expiring
                  1
                  
                  
               
               
                  1952
                  Expired unobligated balance, start of year
                  36
                  20
                  44
               
               
                  1953
                  Expired unobligated balance, end of year
                  19
                  44
                  44
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  1,153
                  1,312
                  920
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  1,600
                  1,379
                  1,902
               
               
                  3020
                  Outlays (gross)
                  â1,358
                  â1,771
                  â1,829
               
               
                  3040
                  Recoveries of prior year unpaid obligations, unexpired
                  â43
                  
                  
               
               
                  3041
                  Recoveries of prior year unpaid obligations, expired
                  â40
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  1,312
                  920
                  993
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  1,153
                  1,312
                  920
               
               
                  3200
                  Obligated balance, end of year
                  1,312
                  920
                  993
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Discretionary:
               
               
                  4000
                  Budget authority, gross
                  294
                  672
                  706
               
               
                  
                  Outlays, gross:
               
               
                  4010
                  Outlays from new discretionary authority
                  71
                  672
                  706
               
               
                  4011
                  Outlays from discretionary balances
                  218
                  5
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4020
                  Outlays, gross (total)
                  289
                  677
                  706
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  1,263
                  708
                  1,196
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  174
                  345
                  775
               
               
                  4101
                  Outlays from mandatory balances
                  895
                  749
                  348
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4110
                  Outlays, gross (total)
                  1,069
                  1,094
                  1,123
               
               
                  4180
                  Budget authority, net (total)
                  1,557
                  1,380
                  1,902
               
               
                  4190
                  Outlays, net (total)
                  1,358
                  1,771
                  1,829
               
               
                  
                     
                  
               
            
         
      
      
         The Health Insurance Portability and Accountability Act of 1996 (P.L. 104â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 075â8393â0â7â571
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  11.1
                  Personnel compensation: Full-time permanent (CMS)
                  34
                  51
                  51
               
               
                  12.1
                  Civilian personnel benefits (CMS)
                  9
                  14
                  14
               
               
                  23.3
                  Communications, utilities, and miscellaneous charges
                  9
                  13
                  13
               
               
                  25.1
                  Advisory and assistance services (predictive modeling)
                  12
                  
                  
               
               
                  25.2
                  Other services (CMS/Medicaid)
                  22
                  52
                  54
               
               
                  25.3
                  Other purchases of goods and services from Government accounts (HHS/DOJ)
                  88
                  166
                  177
               
               
                  25.3
                  Other purchases of goods and services from Government accounts (HHS/OIG)
                  217
                  299
                  322
               
               
                  25.3
                  Other purchases of goods and services from Government accounts (HHS/AoA)
                  7
                  9
                  11
               
               
                  25.3
                  Other purchases of goods and services from Government accounts (HHS/OGC)
                  13
                  10
                  11
               
               
                  25.3
                  Other goods and services from Federal sources (HHS/CMS)
                  13
                  13
                  14
               
               
                  25.3
                  Other goods and services from Government accounts (HHS/FDA)
                  3
                  3
                  3
               
               
                  25.6
                  Medical care  (CMS)
                  1,038
                  1,185
                  1,237
               
               
                  92.0
                  Undistributed
                  
                  â565
                  â146
               
               
                  94.0
                  Financial transfers (FBI)
                  135
                  129
                  141
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  1,600
                  1,379
                  1,902
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â8393â0â7â571
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  387
                  470
                  472
               
               
                  
                     
                  
               
            
         
      
         Health Care Fraud and Abuse Control Account                                                                              
            
         
         (Amounts included in the adjusted baseline)Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â8393â7â7â571
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1201
                  Appropriation (special or trust fund)
                  
                  
                  â781
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  
                  
                  â781
               
               
                  1900
                  Budget authority (total)
                  
                  
                  â781
               
               
                  1930
                  Total budgetary resources available
                  
                  
                  â781
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  
                  
                  â781
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3020
                  Outlays (gross)
                  
                  
                  781
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  
                  
                  781
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3200
                  Obligated balance, end of year
                  
                  
                  781
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  
                  
                  â781
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  
                  
                  â781
               
               
                  4180
                  Budget authority, net (total)
                  
                  
                  â781
               
               
                  4190
                  Outlays, net (total)
                  
                  
                  â781
               
               
                  
                     
                  
               
            
         
      
         Federal Supplementary Medical Insurance Trust Fund                                                                       
            
         Special and Trust Fund Receipts (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â8004â0â7â571
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  0100
                  Balance, start of year
                  37,018
                  35,073
                  30,392
               
               
                  
                  Receipts:
               
               
                  0200
                  Fee on Branded Prescription Pharmaceutical Manufacturers and Importers, SMI
                  3,209
                  2,940
                  3,000
               
               
                  0220
                  Other Proprietary Interest from the Public, FSMI Fund
                  5
                  3
                  3
               
               
                  0221
                  Premiums Collected for Medicare Prescription Drug Account, FSMI
                  3,564
                  4,064
                  5,000
               
               
                  0222
                  Premiums Collected for Medicare Prescription Drug Account, FSMI
                  
                  
                  â40
               
               
                  0223
                  Payments from States, Medicare Prescription Drug Account, FSMI
                  8,727
                  8,851
                  9,546
               
               
                  0224
                  Payments from States, Medicare Prescription Drug Account, FSMI
                  
                  
                  â80
               
               
                  0225
                  Basic Premium, Medicare Advantage, FSMI Trust Fund
                  301
                  327
                  355
               
               
                  0226
                  Medicare Refunds, SMI
                  5,030
                  4,400
                  4,500
               
               
                  0227
                  Affordable Care Act Medicare Shared Savings Models, SMI
                  1
                  1
                  1
               
               
                  0228
                  Premiums Collected for the Aged, FSMI Fund
                  54,415
                  57,042
                  59,263
               
               
                  0229
                  Premiums Collected for the Aged, FSMI Fund
                  
                  
                  â10
               
               
                  0230
                  Premiums Collected for the Aged, FSMI Fund
                  
                  
                  29
               
               
                  0231
                  Premiums Collected for the Aged, FSMI Fund
                  
                  
                  2,095
               
               
                  0232
                  Premiums Collected for the Disabled, FSMI Fund
                  10,458
                  10,298
                  10,386
               
               
                  0233
                  Premiums Collected for the Disabled, FSMI Fund
                  
                  
                  â3
               
               
                  0234
                  Premiums Collected for the Disabled, FSMI Fund
                  
                  
                  364
               
               
                  0240
                  Federal Contributions, FSMI Fund
                  191,431
                  194,775
                  198,530
               
               
                  0241
                  Federal Contributions, FSMI Fund
                  
                  370
                  1,264
               
               
                  0242
                  Federal Contributions, FSMI Fund
                  
                  â11
                  7,970
               
               
                  0243
                  Interest Received by Trust Fund, FSMI Fund
                  2,450
                  2,654
                  2,813
               
               
                  0244
                  Interest Received by Trust Fund, FSMI Fund
                  
                  â142
                  â352
               
               
                  0245
                  Federal Contribution, State Low-income Determinations, Prescription Drug Account, FSMI
                  
                  
                  5
               
               
                  0246
                  Interest, Medicare Prescription Drug Account, FSMI
                  10
                  10
                  12
               
               
                  0247
                  Federal Contribution for Admin. Contribution for Admin. Costs, Prescription Drug Account, FSMI
                  400
                  418
                  691
               
               
                  0248
                  Federal Contributions for Benefits, Prescription Drug Account, SMI
                  52,520
                  62,061
                  82,453
               
               
                  0249
                  Federal Contributions for Benefits, Prescription Drug Account, SMI
                  
                  
                  â560
               
               
                  0250
                  Miscellaneous Federal Payments, Federal Supplementary Medical Insurance Trust Fund
                  1
                  1
                  1
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0299
                  Total receipts and collections
                  332,522
                  348,062
                  387,236
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0400
                  Total: Balances and collections
                  369,540
                  383,135
                  417,628
               
               
                  
                  Appropriations:
               
               
                  0500
                  Federal Supplementary Medical Insurance Trust Fund
                  â2,989
                  â2,826
                  â2,995
               
               
                  0501
                  Federal Supplementary Medical Insurance Trust Fund
                  â258,781
                  â269,138
                  â275,219
               
               
                  0502
                  Federal Supplementary Medical Insurance Trust Fund
                  â7,365
                  
                  â9,188
               
               
                  0503
                  Federal Supplementary Medical Insurance Trust Fund
                  5,288
                  
                  
               
               
                  0504
                  Federal Supplementary Medical Insurance Trust Fund
                  
                  1,069
                  
               
               
                  0505
                  Federal Supplementary Medical Insurance Trust Fund
                  
                  â370
                  â694
               
               
                  0506
                  Federal Supplementary Medical Insurance Trust Fund
                  
                  
                  â51
               
               
                  0507
                  Federal Supplementary Medical Insurance Trust Fund
                  
                  
                  â576
               
               
                  0508
                  Federal Supplementary Medical Insurance Trust Fund
                  
                  â260
                  
               
               
                  0509
                  Federal Supplementary Medical Insurance Trust Fund
                  
                  
                  51
               
               
                  0510
                  Federal Supplementary Medical Insurance Trust Fund
                  
                  153
                  â10,077
               
               
                  0511
                  Federal Supplementary Medical Insurance Trust Fund
                  
                  â5,490
                  â1,168
               
               
                  0512
                  Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund
                  â370
                  â548
                  â573
               
               
                  0513
                  Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund
                  â70,674
                  â75,333
                  â97,773
               
               
                  0514
                  Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund
                  424
                  
                  
               
               
                  0515
                  Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund
                  
                  
                  680
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0599
                  Total appropriations
                  â334,467
                  â352,743
                  â397,583
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0799
                  Balance, end of year
                  35,073
                  30,392
                  20,045
               
               
                  
                     
                  
               
            
         
      
      Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â8004â0â7â571
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Benefit payments, SMI
                  257,694
                  266,544
                  283,235
               
               
                  0002
                  Transfer to Medicaid for payment of SMI premiums
                  688
                  360
                  
               
               
                  0003
                  HIT Incentive Payments
                  2,660
                  870
                  940
               
               
                  0004
                  Administration, SMI
                  2,525
                  2,967
                  3,115
               
               
                  0005
                  Quality Improvement Organizations, SMI
                  282
                  154
                  112
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0799
                  Total direct obligations
                  263,849
                  270,895
                  287,402
               
               
                  0801
                  Federal Supplementary Medical Insurance Trust Fund (Reimbursable)
                  18
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  263,867
                  270,895
                  287,402
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1021
                  Recoveries of prior year unpaid obligations
                  2
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1050
                  Unobligated balance (total)
                  2
                  
                  
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, discretionary:
               
               
                  1101
                  Appropriation (special or trust fund)
                  2,989
                  2,826
                  2,995
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1160
                  Appropriation, discretionary (total)
                  2,989
                  2,826
                  2,995
               
               
                  
                  Appropriations, mandatory:
               
               
                  1201
                  Appropriation (special or trust fund)
                  258,781
                  269,138
                  275,219
               
               
                  1203
                  Appropriation (previously unavailable)
                  7,365
                  
                  9,188
               
               
                  1232
                  Appropriations and/or unobligated balance of appropriations temporarily reduced
                  â5,288
                  
                  
               
               
                  1234
                  Appropriations precluded from obligation
                  
                  â1,069
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  260,858
                  268,069
                  284,407
               
               
                  
                  Spending authority from offsetting collections, mandatory:
               
               
                  1800
                  Collected
                  18
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1850
                  Spending auth from offsetting collections, mand (total)
                  18
                  
                  
               
               
                  1900
                  Budget authority (total)
                  263,865
                  270,895
                  287,402
               
               
                  1930
                  Total budgetary resources available
                  263,867
                  270,895
                  287,402
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  24,692
                  22,625
                  22,691
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  263,867
                  270,895
                  287,402
               
               
                  3020
                  Outlays (gross)
                  â265,932
                  â270,829
                  â287,308
               
               
                  3040
                  Recoveries of prior year unpaid obligations, unexpired
                  â2
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  22,625
                  22,691
                  22,785
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  24,692
                  22,625
                  22,691
               
               
                  3200
                  Obligated balance, end of year
                  22,625
                  22,691
                  22,785
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Discretionary:
               
               
                  4000
                  Budget authority, gross
                  2,989
                  2,826
                  2,995
               
               
                  
                  Outlays, gross:
               
               
                  4010
                  Outlays from new discretionary authority
                  1,714
                  1,920
                  2,050
               
               
                  4011
                  Outlays from discretionary balances
                  1,355
                  844
                  826
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4020
                  Outlays, gross (total)
                  3,069
                  2,764
                  2,876
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  260,876
                  268,069
                  284,407
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  241,825
                  248,409
                  258,319
               
               
                  4101
                  Outlays from mandatory balances
                  21,038
                  19,656
                  26,113
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4110
                  Outlays, gross (total)
                  262,863
                  268,065
                  284,432
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4123
                  Non-Federal sources
                  â18
                  
                  
               
               
                  4180
                  Budget authority, net (total)
                  263,847
                  270,895
                  287,402
               
               
                  4190
                  Outlays, net (total)
                  265,914
                  270,829
                  287,308
               
               
                  
                     
                  
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  5000
                  Total investments, SOY: Federal securities: Par value
                  67,385
                  68,391
                  64,722
               
               
                  5001
                  Total investments, EOY: Federal securities: Par value
                  68,391
                  64,722
                  53,886
               
               
                  
                     
                  
               
            
         
      
      
         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 Budget includes a package of proposals that strengthen Medicare by more closely aligning payments with the costs of providing
            care, encouraging health care providers to deliver better care and better outcomes for their patients, and improving access
            to care for beneficiaries. This includes investments to reform Medicare physician payments and accelerate physician participation
            in high-quality and efficient healthcare delivery systems.  The Budget also makes structural changes that will reduce Federal
            subsidies to high income beneficiaries and create incentives for beneficiaries to seek high value services.The status of the
            trust fund is as follows.
         
      
      Status of Funds (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â8004â0â7â571
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Unexpended balance, start of year:
               
               
                  0100
                  Balance, start of year
                  69,818
                  71,328
                  66,743
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0199
                  Total balance, start of year
                  69,818
                  71,328
                  66,743
               
               
                  
                  Cash income during the year:
               
               
                  
                  Current law:
               
               
                  
                  Receipts:
               
               
                  1200
                  Fee on Branded Prescription Pharmaceutical Manufacturers and Importers, SMI
                  3,209
                  2,940
                  3,000
               
               
                  
                  Offsetting receipts (proprietary):
               
               
                  1220
                  Other Proprietary Interest from the Public, FSMI Fund
                  5
                  3
                  3
               
               
                  1220
                  Premiums Collected for Medicare Prescription Drug Account, FSMI
                  3,564
                  4,064
                  5,000
               
               
                  1220
                  Payments from States, Medicare Prescription Drug Account, FSMI
                  8,727
                  8,851
                  9,546
               
               
                  1220
                  Basic Premium, Medicare Advantage, FSMI Trust Fund
                  301
                  327
                  355
               
               
                  1220
                  Medicare Refunds, SMI
                  5,030
                  4,400
                  4,500
               
               
                  1220
                  Affordable Care Act Medicare Shared Savings Models, SMI
                  1
                  1
                  1
               
               
                  1220
                  Premiums Collected for the Aged, FSMI Fund
                  
                  
                  2,095
               
               
                  1220
                  Premiums Collected for the Aged, FSMI Fund
                  54,415
                  57,042
                  59,263
               
               
                  1220
                  Premiums Collected for the Disabled, FSMI Fund
                  
                  
                  364
               
               
                  1220
                  Premiums Collected for the Disabled, FSMI Fund
                  10,458
                  10,298
                  10,386
               
               
                  
                  Offsetting receipts (intragovernmental):
               
               
                  1240
                  Federal Contributions, FSMI Fund
                  
                  â11
                  7,970
               
               
                  1240
                  Federal Contributions, FSMI Fund
                  191,431
                  194,775
                  198,530
               
               
                  1240
                  Interest Received by Trust Fund, FSMI Fund
                  
                  â142
                  â352
               
               
                  1240
                  Interest Received by Trust Fund, FSMI Fund
                  2,450
                  2,654
                  2,813
               
               
                  1240
                  Federal Contribution, State Low-income Determinations, Prescription Drug Account, FSMI
                  
                  
                  5
               
               
                  1240
                  Interest, Medicare Prescription Drug Account, FSMI
                  10
                  10
                  12
               
               
                  1240
                  Federal Contribution for Admin. Contribution for Admin. Costs, Prescription Drug Account, FSMI
                  400
                  418
                  691
               
               
                  1240
                  Federal Contributions for Benefits, Prescription Drug Account, SMI
                  52,520
                  62,061
                  82,453
               
               
                  1240
                  Miscellaneous Federal Payments, Federal Supplementary Medical Insurance Trust Fund
                  1
                  1
                  1
               
               
                  
                  Offsetting collections:
               
               
                  1280
                  Federal Supplementary Medical Insurance Trust Fund
                  18
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1299
                  Income under present law
                  332,540
                  347,692
                  386,636
               
               
                  
                  Proposed legislation:
               
               
                  
                  Offsetting receipts (proprietary receipts):
               
               
                  2220
                  Premiums Collected for Medicare Prescription Drug Account, FSMI
                  
                  
                  â40
               
               
                  2220
                  Payments from States, Medicare Prescription Drug Account, FSMI
                  
                  
                  â80
               
               
                  2220
                  Premiums Collected for the Aged, FSMI Fund
                  
                  
                  â10
               
               
                  2220
                  Premiums Collected for the Aged, FSMI Fund
                  
                  
                  29
               
               
                  2220
                  Premiums Collected for the Disabled, FSMI Fund
                  
                  
                  â3
               
               
                  
                  Offsetting receipts (intragovernmental):
               
               
                  2240
                  Federal Contributions, FSMI Fund
                  
                  370
                  1,264
               
               
                  2240
                  Federal Contributions for Benefits, Prescription Drug Account, SMI
                  
                  
                  â560
               
               
                  
                  Offsetting collections:
               
               
                  2280
                  Federal Supplementary Medical Insurance Trust Fund
                  
                  
                  4
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  2299
                  Income under proposed legislation
                  
                  370
                  604
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3299
                  Total cash income
                  332,540
                  348,062
                  387,240
               
               
                  
                  Cash outgo during year:
               
               
                  
                  Current law:
               
               
                  4500
                  Federal Supplementary Medical Insurance Trust Fund
                  â265,932
                  â270,829
                  â287,308
               
               
                  4500
                  Federal Supplementary Medical Insurance Trust Fund
                  
                  â5,337
                  â11,245
               
               
                  4500
                  Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund
                  â65,098
                  â75,851
                  â98,337
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4599
                  Outgo under current law (-)
                  â331,030
                  â352,017
                  â396,890
               
               
                  
                  Proposed legislation:
               
               
                  5500
                  Federal Supplementary Medical Insurance Trust Fund
                  
                  â370
                  â745
               
               
                  5500
                  Federal Supplementary Medical Insurance Trust Fund
                  
                  â260
                  â529
               
               
                  5500
                  Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund
                  
                  
                  680
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  5599
                  Outgo under proposed legislation (-)
                  
                  â630
                  â594
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  6599
                  Total cash outgo (-)
                  â331,030
                  â352,647
                  â397,484
               
               
                  
                  Unexpended balance, end of year:
               
               
                  8700
                  Uninvested balance (net), end of year
                  2,937
                  7,510
                  9,270
               
               
                  8701
                  Federal Supplementary Medical Insurance Trust Fund
                  
                  â5,489
                  â6,657
               
               
                  8701
                  Federal Supplementary Medical Insurance Trust Fund
                  68,391
                  64,722
                  53,886
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  8799
                  Total balance, end of year
                  71,328
                  66,743
                  56,499
               
               
                  
                     
                  
               
            
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â8004â0â7â571
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  41.0
                  Payment for Quality Improvement Organization (QIO) activity
                  282
                  154
                  112
               
               
                  42.0
                  Insurance claims and indemnities
                  261,042
                  267,774
                  284,175
               
               
                  94.0
                  Financial transfers
                  2,525
                  2,967
                  3,115
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.0
                  Direct obligations
                  263,849
                  270,895
                  287,402
               
               
                  42.0
                  Allocation Account - reimbursable: Insurance claims and indemnities
                  18
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  263,867
                  270,895
                  287,402
               
               
                  
                     
                  
               
            
         
      
         Federal Supplementary Medical Insurance Trust Fund                                                                       
            
         
         (Amounts included in the adjusted baseline)Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â8004â7â7â571
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Benefits
                  
                  5,337
                  11,245
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations (object class 42.0)
                  
                  5,337
                  11,245
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1201
                  Appropriation (special or trust fund)
                  
                  â153
                  10,077
               
               
                  1234
                  Appropriations precluded from obligation
                  
                  5,490
                  1,168
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  
                  5,337
                  11,245
               
               
                  1900
                  Budget authority (total)
                  
                  5,337
                  11,245
               
               
                  1930
                  Total budgetary resources available
                  
                  5,337
                  11,245
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  
                  5,337
                  11,245
               
               
                  3020
                  Outlays (gross)
                  
                  â5,337
                  â11,245
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  
                  5,337
                  11,245
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  
                  5,337
                  11,245
               
               
                  4180
                  Budget authority, net (total)
                  
                  5,337
                  11,245
               
               
                  4190
                  Outlays, net (total)
                  
                  5,337
                  11,245
               
               
                  
                     
                  
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  5000
                  Total investments, SOY: Federal securities: Par value
                  
                  
                  â5,489
               
               
                  5001
                  Total investments, EOY: Federal securities: Par value
                  
                  â5,489
                  â6,657
               
               
                  
                     
                  
               
            
         
      
         Federal Supplementary Medical Insurance Trust Fund                                                                       
            
         
         (Legislative proposal, not subject to PAYGO)Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â8004â2â7â571
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Benefit payments, SMI
                  
                  
                  â30
               
               
                  0002
                  Transfer to Medicaid for payment of SMI premiums
                  
                  370
                  775
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations (object class 42.0)
                  
                  370
                  745
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1201
                  Appropriation (special or trust fund)
                  
                  370
                  694
               
               
                  1203
                  Appropriation (previously unavailable)
                  
                  
                  51
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  
                  370
                  745
               
               
                  1900
                  Budget authority (total)
                  
                  370
                  745
               
               
                  1930
                  Total budgetary resources available
                  
                  370
                  745
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  
                  370
                  745
               
               
                  3020
                  Outlays (gross)
                  
                  â370
                  â745
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  
                  370
                  745
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  
                  370
                  745
               
               
                  4180
                  Budget authority, net (total)
                  
                  370
                  745
               
               
                  4190
                  Outlays, net (total)
                  
                  370
                  745
               
               
                  
                     
                  
               
            
         
      
         Federal Supplementary Medical Insurance Trust Fund                                                                       
            
         
         (Legislative proposal, subject to PAYGO)Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â8004â4â7â571
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Benefit payments, SMI
                  
                  260
                  â300
               
               
                  0004
                  Administration, SMI
                  
                  
                  821
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0799
                  Total direct obligations
                  
                  260
                  521
               
               
                  0801
                  Federal Supplementary Medical Insurance Trust Fund (Reimbursable)
                  
                  
                  4
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  
                  260
                  525
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1201
                  Appropriation (special or trust fund)
                  
                  
                  576
               
               
                  1203
                  Appropriation (previously unavailable)
                  
                  260
                  
               
               
                  1234
                  Appropriations precluded from obligation
                  
                  
                  â51
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  
                  260
                  525
               
               
                  
                  Spending authority from offsetting collections, mandatory:
               
               
                  1800
                  Collected
                  
                  
                  4
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1850
                  Spending auth from offsetting collections, mand (total)
                  
                  
                  4
               
               
                  1900
                  Budget authority (total)
                  
                  260
                  529
               
               
                  1930
                  Total budgetary resources available
                  
                  260
                  529
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  
                  
                  4
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  
                  260
                  525
               
               
                  3020
                  Outlays (gross)
                  
                  â260
                  â529
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  
                  
                  â4
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3200
                  Obligated balance, end of year
                  
                  
                  â4
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  
                  260
                  529
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  
                  260
                  529
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4123
                  Non-Federal sources
                  
                  
                  â4
               
               
                  4180
                  Budget authority, net (total)
                  
                  260
                  525
               
               
                  4190
                  Outlays, net (total)
                  
                  260
                  525
               
               
                  
                     
                  
               
            
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â8004â4â7â571
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  42.0
                  Insurance claims and indemnities
                  
                  260
                  â300
               
               
                  94.0
                  Financial transfers
                  
                  
                  821
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.0
                  Direct obligations
                  
                  260
                  521
               
               
                  42.0
                  Allocation Account - reimbursable: Insurance claims and indemnities
                  
                  
                  4
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  
                  260
                  525
               
               
                  
                     
                  
               
            
         
      
         Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund                                           
            
         Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â8308â0â7â571
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Prescription Drug Benefits
                  71,153
                  75,321
                  97,764
               
               
                  0002
                  Administrative Costs
                  373
                  560
                  581
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  71,526
                  75,881
                  98,345
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1021
                  Recoveries of prior year unpaid obligations
                  906
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1050
                  Unobligated balance (total)
                  906
                  
                  
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, discretionary:
               
               
                  1101
                  Appropriation (special or trust fund)
                  370
                  548
                  573
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1160
                  Appropriation, discretionary (total)
                  370
                  548
                  573
               
               
                  
                  Appropriations, mandatory:
               
               
                  1201
                  Appropriation (special or trust fund)
                  70,674
                  75,333
                  97,773
               
               
                  1232
                  Appropriations and/or unobligated balance of appropriations temporarily reduced
                  â424
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  70,250
                  75,333
                  97,773
               
               
                  1900
                  Budget authority (total)
                  70,620
                  75,881
                  98,346
               
               
                  1930
                  Total budgetary resources available
                  71,526
                  75,881
                  98,346
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  
                  
                  1
               
               
                  
                  Special and non-revolving trust funds:
               
               
                  1952
                  Expired unobligated balance, start of year
                  440
                  179
                  664
               
               
                  1953
                  Expired unobligated balance, end of year
                  179
                  664
                  664
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  7,397
                  12,966
                  12,996
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  71,526
                  75,881
                  98,345
               
               
                  3011
                  Obligations incurred, expired accounts
                  53
                  
                  
               
               
                  3020
                  Outlays (gross)
                  â65,098
                  â75,851
                  â98,337
               
               
                  3040
                  Recoveries of prior year unpaid obligations, unexpired
                  â906
                  
                  
               
               
                  3041
                  Recoveries of prior year unpaid obligations, expired
                  â6
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  12,966
                  12,996
                  13,004
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  7,397
                  12,966
                  12,996
               
               
                  3200
                  Obligated balance, end of year
                  12,966
                  12,996
                  13,004
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Discretionary:
               
               
                  4000
                  Budget authority, gross
                  370
                  548
                  573
               
               
                  
                  Outlays, gross:
               
               
                  4010
                  Outlays from new discretionary authority
                  228
                  376
                  396
               
               
                  4011
                  Outlays from discretionary balances
                  170
                  154
                  154
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4020
                  Outlays, gross (total)
                  398
                  530
                  550
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  70,250
                  75,333
                  97,773
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  57,371
                  63,231
                  90,273
               
               
                  4101
                  Outlays from mandatory balances
                  7,329
                  12,090
                  7,514
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4110
                  Outlays, gross (total)
                  64,700
                  75,321
                  97,787
               
               
                  4180
                  Budget authority, net (total)
                  70,620
                  75,881
                  98,346
               
               
                  4190
                  Outlays, net (total)
                  65,098
                  75,851
                  98,337
               
               
                  
                     
                  
               
            
         
      
      
         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 075â8308â0â7â571
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  25.2
                  Other services from non-Federal sources
                  373
                  560
                  581
               
               
                  42.0
                  Insurance claims and indemnities
                  71,153
                  75,321
                  97,764
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  71,526
                  75,881
                  98,345
               
               
                  
                     
                  
               
            
         
      
         Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund                                           
            
         
         (Legislative proposal, subject to PAYGO)Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â8308â4â7â571
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Prescription Drug Benefits
                  
                  
                  â680
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations (object class 42.0)
                  
                  
                  â680
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1201
                  Appropriation (special or trust fund)
                  
                  
                  â680
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  
                  
                  â680
               
               
                  1900
                  Budget authority (total)
                  
                  
                  â680
               
               
                  1930
                  Total budgetary resources available
                  
                  
                  â680
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  
                  
                  â680
               
               
                  3020
                  Outlays (gross)
                  
                  
                  680
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  
                  
                  â680
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  
                  
                  â680
               
               
                  4180
                  Budget authority, net (total)
                  
                  
                  â680
               
               
                  4190
                  Outlays, net (total)
                  
                  
                  â680
               
               
                  
                     
                  
               
            
         
      
         Administration for Children and Families                                                                                 
            
         Federal Funds
         Temporary Assistance for Needy Families                                                                                  
            
         Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1552â0â1â609
                  2014 actual
                  2015 est.
                  2016 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
                  147
                  148
                  150
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  16,721
                  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
                  16,739
                  16,739
               
               
                  1220
                  Appropriations transferred to other accts [075â1552]
                  â36
                  
                  
               
               
                  1221
                  Appropriations transferred from other acct [075â1552]
                  36
                  
                  
               
               
                  1230
                  Appropriations and/or unobligated balance of appropriations permanently reduced
                  â2
                  â2
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  16,737
                  16,737
                  16,739
               
               
                  1930
                  Total budgetary resources available
                  16,737
                  16,738
                  16,742
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1940
                  Unobligated balance expiring
                  â15
                  â15
                  â15
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  1
                  3
                  5
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  4,795
                  5,250
                  5,355
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  16,721
                  16,720
                  16,722
               
               
                  3011
                  Obligations incurred, expired accounts
                  39
                  
                  
               
               
                  3020
                  Outlays (gross)
                  â16,305
                  â16,615
                  â16,860
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  5,250
                  5,355
                  5,217
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  4,795
                  5,250
                  5,355
               
               
                  3200
                  Obligated balance, end of year
                  5,250
                  5,355
                  5,217
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  16,737
                  16,737
                  16,739
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  12,998
                  13,376
                  13,378
               
               
                  4101
                  Outlays from mandatory balances
                  3,307
                  3,239
                  3,482
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4110
                  Outlays, gross (total)
                  16,305
                  16,615
                  16,860
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4120
                  Federal sources
                  â39
                  
                  
               
               
                  
                  Additional offsets against gross budget authority only:
               
               
                  4142
                  Offsetting collections credited to expired accounts
                  39
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4160
                  Budget authority, net (mandatory)
                  16,737
                  16,737
                  16,739
               
               
                  4170
                  Outlays, net (mandatory)
                  16,266
                  16,615
                  16,860
               
               
                  4180
                  Budget authority, net (total)
                  16,737
                  16,737
                  16,739
               
               
                  4190
                  Outlays, net (total)
                  16,266
                  16,615
                  16,860
               
               
                  
                     
                  
               
            
         
      
      
         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. 104â193), as amended by the Deficit Reduction
            Act of 2005 (P.L. 109â171). Since 2010, this account has been temporarily reauthorized by a series of Acts, most recently
            in the Consolidated and Further Continuing Appropriations Act, 2015 (P.L. 113â235). 
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1552â0â1â609
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  11.1
                  Personnel compensation: Full-time permanent
                  1
                  2
                  2
               
               
                  23.1
                  Rental payments to GSA
                  1
                  1
                  1
               
               
                  25.1
                  Advisory and assistance services
                  27
                  27
                  27
               
               
                  25.2
                  Other services from non-Federal sources
                  15
                  13
                  15
               
               
                  25.3
                  Other goods and services from Federal sources
                  1
                  1
                  1
               
               
                  41.0
                  Grants, subsidies, and contributions
                  16,676
                  16,676
                  16,676
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  16,721
                  16,720
                  16,722
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1552â0â1â609
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  15
                  18
                  19
               
               
                  
                     
                  
               
            
         
      
         Temporary Assistance for Needy Families                                                                                  
            
         
         (Legislative proposal, subject to PAYGO)Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1552â4â1â609
                  2014 actual
                  2015 est.
                  2016 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:
               
               
                  1221
                  Appropriations transferred from other acct [075â1522]
                  
                  
                  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)
                  
                  
                  â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 075â1522â0â1â609
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Contingency fund
                  610
                  583
                  583
               
               
                  0002
                  Commission
                  4
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  614
                  583
                  583
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1012
                  Unobligated balance transfers between expired and unexpired accounts
                  2
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1050
                  Unobligated balance (total)
                  2
                  
                  
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, discretionary:
               
               
                  1120
                  Appropriations transferred to other accts [075â1553]
                  
                  
                  â15
               
               
                  1120
                  Appropriations transferred to other accts [013â0401]
                  
                  
                  â10
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1160
                  Appropriation, discretionary (total)
                  
                  
                  â25
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriation
                  612
                  608
                  608
               
               
                  1220
                  Appropriations transferred to other accts [075â1553]
                  
                  â15
                  
               
               
                  1220
                  Appropriations transferred to other accts [013â0401]
                  
                  â10
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  612
                  583
                  608
               
               
                  1900
                  Budget authority (total)
                  612
                  583
                  583
               
               
                  1930
                  Total budgetary resources available
                  614
                  583
                  583
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  275
                  132
                  85
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  614
                  583
                  583
               
               
                  3011
                  Obligations incurred, expired accounts
                  2
                  
                  
               
               
                  3020
                  Outlays (gross)
                  â624
                  â630
                  â610
               
               
                  3041
                  Recoveries of prior year unpaid obligations, expired
                  â135
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  132
                  85
                  58
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  275
                  132
                  85
               
               
                  3200
                  Obligated balance, end of year
                  132
                  85
                  58
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Discretionary:
               
               
                  4000
                  Budget authority, gross
                  
                  
                  â25
               
               
                  
                  Outlays, gross:
               
               
                  4010
                  Outlays from new discretionary authority
                  
                  
                  â22
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  612
                  583
                  608
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  546
                  525
                  547
               
               
                  4101
                  Outlays from mandatory balances
                  78
                  105
                  85
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4110
                  Outlays, gross (total)
                  624
                  630
                  632
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4120
                  Federal sources
                  â3
                  
                  
               
               
                  
                  Additional offsets against gross budget authority only:
               
               
                  4142
                  Offsetting collections credited to expired accounts
                  3
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4160
                  Budget authority, net (mandatory)
                  612
                  583
                  608
               
               
                  4170
                  Outlays, net (mandatory)
                  621
                  630
                  632
               
               
                  4180
                  Budget authority, net (total)
                  612
                  583
                  583
               
               
                  4190
                  Outlays, net (total)
                  621
                  630
                  610
               
               
                  
                     
                  
               
            
         
      
      
         This account provides a funding reserve to assist states that meet certain criteria intended to reflect economic distress
            and was established by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (P.L. 104â193), as amended
            by the Deficit Reduction Act of 2005 (P.L. 109â171). The Consolidated and Further Continuing Appropriations Act, 2015 (P.L.
            113â235) most recently temporarily reauthorized this account. In FY 2016, the Budget includes a general provision to transfer
            $15 million from the Contingency Fund to Welfare Research, and to transfer $10 to support the Census Survey of Income and
            Program Participation, consistent with the FY 2015 appropriations funding. The Budget also includes a proposal to redirect
            $10 million for TANF program improvements, including technical assistance for state programs, research, and evaluation. The
            Budget also re-purposes $573 million for the Pathways to Jobs initiative.
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1522â0â1â609
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  41.0
                  Grants, subsidies, and contributions
                  610
                  583
                  583
               
               
                  94.0
                  Financial transfers
                  4
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  614
                  583
                  583
               
               
                  
                     
                  
               
            
         
      
         Contingency Fund                                                                                                         
            
         
         (Legislative proposal, subject to PAYGO)Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1522â4â1â609
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Contingency fund
                  
                  
                  â10
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations (object class 41.0)
                  
                  
                  â10
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1220
                  Appropriations transferred to other accts [075â1552]
                  
                  
                  â10
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  
                  
                  â10
               
               
                  1930
                  Total budgetary resources available
                  
                  
                  â10
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  
                  
                  â10
               
               
                  3020
                  Outlays (gross)
                  
                  
                  8
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  
                  
                  â2
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3200
                  Obligated balance, end of year
                  
                  
                  â2
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  
                  
                  â10
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  
                  
                  â8
               
               
                  4180
                  Budget authority, net (total)
                  
                  
                  â10
               
               
                  4190
                  Outlays, net (total)
                  
                  
                  â8
               
               
                  
                     
                  
               
            
         
      
         Payments to states for child support enforcement and family support programsFor carrying out, 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. 321â329), [$2,438,523,000] $2,944,905,898, to remain available until expended; and for such purposes for the first quarter of fiscal year [2016, $1,160,000,000] 2017, $1,300,000,000, to remain available until expended.
      
      For carrying out, after May 31 of the current fiscal year, 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. 321â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, 2015.)
      Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1501â0â1â609
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  State child support administrative costs
                  3,655
                  3,611
                  3,741
               
               
                  0002
                  Child support incentive payments
                  606
                  583
                  520
               
               
                  0003
                  Access and visitation grants
                  10
                  10
                  10
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0091
                  Subtotal, child support enforcement
                  4,271
                  4,204
                  4,271
               
               
                  0102
                  Payments to territories
                  32
                  33
                  33
               
               
                  0103
                  Repatriation
                  1
                  1
                  1
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0191
                  Subtotal, other payments
                  33
                  34
                  34
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0799
                  Total direct obligations
                  4,304
                  4,238
                  4,305
               
               
                  0801
                  Offset obligations (CSE grants to States)
                  20
                  16
                  2
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  4,324
                  4,254
                  4,307
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1021
                  Recoveries of prior year unpaid obligations
                  173
                  200
                  200
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1050
                  Unobligated balance (total)
                  173
                  200
                  200
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriation
                  3,031
                  2,788
                  2,945
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  3,031
                  2,788
                  2,945
               
               
                  
                  Advance appropriations, mandatory:
               
               
                  1270
                  Advance appropriation
                  1,100
                  1,250
                  1,160
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1280
                  Advanced appropriation, mandatory (total)
                  1,100
                  1,250
                  1,160
               
               
                  
                  Spending authority from offsetting collections, mandatory:
               
               
                  1800
                  Collected
                  20
                  16
                  2
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1850
                  Spending auth from offsetting collections, mand (total)
                  20
                  16
                  2
               
               
                  1900
                  Budget authority (total)
                  4,151
                  4,054
                  4,107
               
               
                  1930
                  Total budgetary resources available
                  4,324
                  4,254
                  4,307
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  922
                  941
                  685
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  4,324
                  4,254
                  4,307
               
               
                  3020
                  Outlays (gross)
                  â4,132
                  â4,310
                  â4,220
               
               
                  3040
                  Recoveries of prior year unpaid obligations, unexpired
                  â173
                  â200
                  â200
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  941
                  685
                  572
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  922
                  941
                  685
               
               
                  3200
                  Obligated balance, end of year
                  941
                  685
                  572
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  4,151
                  4,054
                  4,107
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  3,529
                  3,616
                  3,435
               
               
                  4101
                  Outlays from mandatory balances
                  603
                  694
                  785
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4110
                  Outlays, gross (total)
                  4,132
                  4,310
                  4,220
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4123
                  Non-Federal sources
                  â20
                  â16
                  â2
               
               
                  4180
                  Budget authority, net (total)
                  4,131
                  4,038
                  4,105
               
               
                  4190
                  Outlays, net (total)
                  4,112
                  4,294
                  4,218
               
               
                  
                     
                  
               
            
         
      
      
         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 075â1501â0â1â609
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  41.0
                  Direct obligations: Grants, subsidies, and contributions
                  4,304
                  4,238
                  4,305
               
               
                  99.0
                  Reimbursable obligations
                  20
                  16
                  2
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  4,324
                  4,254
                  4,307
               
               
                  
                     
                  
               
            
         
      
         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 075â1501â4â1â609
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  State child support administrative costs
                  
                  
                  110
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations (object class 41.0)
                  
                  
                  110
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriation
                  
                  
                  110
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  
                  
                  110
               
               
                  1930
                  Total budgetary resources available
                  
                  
                  110
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  
                  
                  110
               
               
                  3020
                  Outlays (gross)
                  
                  
                  â110
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  
                  
                  110
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  
                  
                  110
               
               
                  4180
                  Budget authority, net (total)
                  
                  
                  110
               
               
                  4190
                  Outlays, net (total)
                  
                  
                  110
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1501â4â1â609
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  
                  
                  2
               
               
                  
                     
                  
               
            
         
      
         Low income home energy assistanceFor making payments under subsections (b) and (d) of section 2602 of the Low Income Home Energy Assistance Act of 1981, [$3,390,304,000] $3,190,304,000: Provided, That all but [$491,000,000] $462,000,000 of this amount shall be allocated as though the total appropriation for such payments for fiscal year [2015] 2016 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: Provided further, That notwithstanding section 2605(k) of the Low-Income Home Energy Assistance Act of 1981, a state receiving
            an allotment for fiscal year 2016 shall use not less than 10 percent of such allotment for residential weatherization or other
            energy-related home repair activities, and may use up to 40 percent of such allotment for such purpose without regard to the
            waiver process specified in such section: Provided further, That section 2607B(b)(1) of such Act shall be applied by substituting
            "up to 100 percent" for "not more than 25 percent". 
      For competitive grants to states that partner with other entities as determined appropriate by the Secretary, to further the
            purposes of section 2602 of the Low Income Home Energy Assistance Act of 1981 and to foster innovation in the provision of
            energy assistance to low-income households and for conducting a national evaluation of such grants, $200,000,000, to remain
            available until expended.  (Department of Health and Human Services Appropriations Act, 2015.)
      Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1502â0â1â609
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  LIHEAP Block Grant
                  3,401
                  3,390
                  3,190
               
               
                  0003
                  Utility Innovation Fund
                  
                  
                  200
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  3,401
                  3,390
                  3,390
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1012
                  Unobligated balance transfers between expired and unexpired accounts
                  11
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1050
                  Unobligated balance (total)
                  11
                  
                  
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, discretionary:
               
               
                  1100
                  Appropriation
                  3,425
                  3,390
                  3,390
               
               
                  1120
                  Appropriations transferred to other accts [075â1503]
                  â34
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1160
                  Appropriation, discretionary (total)
                  3,391
                  3,390
                  3,390
               
               
                  1930
                  Total budgetary resources available
                  3,402
                  3,390
                  3,390
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1940
                  Unobligated balance expiring
                  â1
                  
                  
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  1,361
                  1,202
                  1,637
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  3,401
                  3,390
                  3,390
               
               
                  3020
                  Outlays (gross)
                  â3,537
                  â2,955
                  â3,400
               
               
                  3041
                  Recoveries of prior year unpaid obligations, expired
                  â23
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  1,202
                  1,637
                  1,627
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  1,361
                  1,202
                  1,637
               
               
                  3200
                  Obligated balance, end of year
                  1,202
                  1,637
                  1,627
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Discretionary:
               
               
                  4000
                  Budget authority, gross
                  3,391
                  3,390
                  3,390
               
               
                  
                  Outlays, gross:
               
               
                  4010
                  Outlays from new discretionary authority
                  2,397
                  2,136
                  2,136
               
               
                  4011
                  Outlays from discretionary balances
                  1,140
                  819
                  1,264
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4020
                  Outlays, gross (total)
                  3,537
                  2,955
                  3,400
               
               
                  4180
                  Budget authority, net (total)
                  3,391
                  3,390
                  3,390
               
               
                  4190
                  Outlays, net (total)
                  3,537
                  2,955
                  3,400
               
               
                  
                     
                  
               
            
         
      
      
         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 a new Energy Assistance Innovation
            Fund to provide competitive grants to foster innovation in energy assistance to low-income households. The Budget also proposes to establish a contingency fund providing additional mandatory funds to respond to increases in
            the number of low-income households, spikes in the price of natural gas, electricity, or oil, and extreme cold at the beginning
            of winter.
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1502â0â1â609
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  25.1
                  Advisory and assistance services
                  2
                  2
                  2
               
               
                  25.3
                  Other goods and services from Federal sources
                  1
                  
                  1
               
               
                  41.0
                  Grants, subsidies, and contributions
                  3,398
                  3,388
                  3,387
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  3,401
                  3,390
                  3,390
               
               
                  
                     
                  
               
            
         
      
         Low Income Home Energy Assistance                                                                                        
            
         
         (Legislative proposal, subject to PAYGO)Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1502â4â1â609
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Mandatory LIHEAP Contingency Fund
                  
                  
                  1,130
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations (object class 41.0)
                  
                  
                  1,130
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriations, mandatory
                  
                  
                  1,130
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  
                  
                  1,130
               
               
                  1930
                  Total budgetary resources available
                  
                  
                  1,130
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  
                  
                  1,130
               
               
                  3020
                  Outlays (gross)
                  
                  
                  â825
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  
                  
                  305
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3200
                  Obligated balance, end of year
                  
                  
                  305
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  
                  
                  1,130
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  
                  
                  825
               
               
                  4180
                  Budget authority, net (total)
                  
                  
                  1,130
               
               
                  4190
                  Outlays, net (total)
                  
                  
                  825
               
               
                  
                     
                  
               
            
         
      
         Refugee and entrant assistanceFor 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, [$1,559,884,000] $1,609,612,000, of which [$1,533,394,000] $1,576,877,000 shall remain available through September 30, [2017] 2018 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, at any point after January 1, 2016, and before October 1, 2016, if the Secretary of Health and Human
            Services has transferred at least 3 percent under this heading to the Office of Refugee Resettlement to support higher than
            expected caseloads, and if the Secretary of Health and Human Services, in consultation with the Secretary of Homeland Security,
            determines that the percentage increase in the cumulative number of unaccompanied children transferred to the custody of the
            Secretary of Health and Human Services pursuant to such section 235 for the current fiscal year over the number transferred
            through the comparable date in the previous fiscal year (the caseload ratio) exceeds the trigger percentage specified in the
            next proviso, an additional $100,000,000 shall be available under this heading to carry out such sections 462 and 235: Provided
            further, That the trigger percentage referenced in the previous proviso is calculated by taking the unobligated balances for
            the Unaccompanied Children program at the end of the previous fiscal year, adding the difference between the amounts appropriated
            under this heading for the Unaccompanied Children program for the current fiscal year and obligations for such program for
            the previous fiscal year, dividing the result by the obligations for such program for the previous fiscal year, and adding
            five percentage points to the resulting amount (expressed as a percentage): Provided further, That for every 25 percentage
            point increment in the caseload ratio above the trigger percentage, an additional $100,000,000 shall be available under this
            heading to carry out such sections 462 and 235: Provided further, That the total additional amount available pursuant to the
            three preceding provisos shall not exceed $400,000,000: Provided further, That the limitation in section 206 of this Act regarding transfers increasing any appropriation shall apply to transfers
         to appropriations under this heading by substituting "10 percent" for "3 percent".  (Department of Health and Human Services Appropriations Act, 2015.)
      Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1503â0â1â609
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Refugee and entrant assistance
                  592
                  585
                  629
               
               
                  0002
                  Assistance for treatment of torture victims
                  11
                  11
                  11
               
               
                  0003
                  Unaccompanied alien children
                  910
                  948
                  967
               
               
                  0005
                  Trafficking Victims program
                  14
                  16
                  22
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  1,527
                  1,560
                  1,629
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  1
                  4
                  4
               
               
                  1021
                  Recoveries of prior year unpaid obligations
                  1
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1050
                  Unobligated balance (total)
                  2
                  4
                  4
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, discretionary:
               
               
                  1100
                  Base Appropriation
                  1,486
                  1,560
                  1,610
               
               
                  1100
                  UC Contingency Fund
                  
                  
                  19
               
               
                  1121
                  Appropriations transferred from other acct [075â1536]
                  2
                  
                  
               
               
                  1121
                  Appropriations transferred from other acct [075â0350]
                  5
                  
                  
               
               
                  1121
                  Appropriations transferred from other acct [075â1502]
                  34
                  
                  
               
               
                  1121
                  Appropriations transferred from other acct [075â0140]
                  1
                  
                  
               
               
                  1121
                  Appropriations transferred from other acct [075â0943]
                  2
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1160
                  Appropriation, discretionary (total)
                  1,530
                  1,560
                  1,629
               
               
                  1930
                  Total budgetary resources available
                  1,532
                  1,564
                  1,633
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1940
                  Unobligated balance expiring
                  â1
                  
                  
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  4
                  4
                  4
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  537
                  775
                  1,161
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  1,527
                  1,560
                  1,629
               
               
                  3020
                  Outlays (gross)
                  â1,278
                  â1,174
                  â1,592
               
               
                  3040
                  Recoveries of prior year unpaid obligations, unexpired
                  â1
                  
                  
               
               
                  3041
                  Recoveries of prior year unpaid obligations, expired
                  â10
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  775
                  1,161
                  1,198
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  537
                  775
                  1,161
               
               
                  3200
                  Obligated balance, end of year
                  775
                  1,161
                  1,198
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Discretionary:
               
               
                  4000
                  Budget authority, gross
                  1,530
                  1,560
                  1,629
               
               
                  
                  Outlays, gross:
               
               
                  4010
                  Outlays from new discretionary authority
                  925
                  780
                  814
               
               
                  4011
                  Outlays from discretionary balances
                  353
                  394
                  778
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4020
                  Outlays, gross (total)
                  1,278
                  1,174
                  1,592
               
               
                  4180
                  Budget authority, net (total)
                  1,530
                  1,560
                  1,629
               
               
                  4190
                  Outlays, net (total)
                  1,278
                  1,174
                  1,592
               
               
                  
                     
                  
               
            
         
      
      
         This account provides funds to States and non-governmental organizations to administer the refugee and entrant assistance
            programs. Funds support cash and medical assistance and social services for refugees, asylees, and other arrivals eligible
            for refugee benefits. The account also includes funding for the rehabilitation of victims of torture and human trafficking
            , and for the care and placement of unaccompanied children. The President's 2016 Budget includes funding to expand efforts
            to prevent human trafficking and provide direct services to domestic victims.
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1503â0â1â609
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  11.1
                  Personnel compensation: Full-time permanent
                  5
                  7
                  8
               
               
                  12.1
                  Civilian personnel benefits
                  1
                  2
                  2
               
               
                  23.1
                  Rental payments to GSA
                  2
                  4
                  5
               
               
                  25.1
                  Advisory and assistance services
                  88
                  44
                  47
               
               
                  25.2
                  Other services from non-Federal sources
                  4
                  17
                  18
               
               
                  25.3
                  Other goods and services from Federal sources
                  7
                  57
                  57
               
               
                  41.0
                  Grants, subsidies, and contributions
                  1,420
                  1,429
                  1,492
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  1,527
                  1,560
                  1,629
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1503â0â1â609
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  60
                  96
                  112
               
               
                  
                     
                  
               
            
         
      
         Promoting Safe and Stable FamiliesFor carrying out, except as otherwise provided, section 436 of the Social Security Act, $345,000,000 and, for carrying out,
         except as otherwise provided, section 437 of such Act, [$59,765,000] $89,765,000: Provided, That of funds available to carry out such section 437, $59,765,000 shall be allocated consistent with subsection
            (b) of such section: Provided further, That $20,000,000 shall be used to increase the amount available for activities described
            in paragraph (c)(1) of such section, with paragraph (d)(1) of such section not applying to such funds: Provided further, That
            $7,000,000 shall be used to increase the amount available for activities described in paragraph (c)(3) of such section with
            respect to rural areas, with funds allocated on the basis described in such paragraph adjusted by the percentage of the population
            that were defined as rural in the 2010 Decennial Census, and with paragraph (d)(1) of such section not applying to such funds:
            Provided further, That $3,000,000 shall be used to increase the amount available for activities described in (b)(1) of such
            section: Provided further, That for purposes of funds provided under this heading, an Indian Tribe or Tribal Consortium may
            apply the term "adoption" in a manner that includes customary adoptions. (Department of Health and Human Services Appropriations Act, 2015.)
      Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1512â0â1â506
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Grants to States and Tribes
                  342
                  339
                  394
               
               
                  0002
                  Research, training and technical assistance
                  8
                  8
                  11
               
               
                  0003
                  State court improvement activities
                  30
                  30
                  30
               
               
                  0004
                  Family Connection Grants
                  9
                  7
                  
               
               
                  0005
                  PREP
                  77
                  92
                  
               
               
                  0006
                  Abstinence Education
                  36
                  50
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  502
                  526
                  435
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  8
                  1
                  12
               
               
                  1012
                  Unobligated balance transfers between expired and unexpired accounts
                  
                  6
                  
               
               
                  1021
                  Recoveries of prior year unpaid obligations
                  
                  1
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1050
                  Unobligated balance (total)
                  8
                  8
                  12
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, discretionary:
               
               
                  1100
                  Appropriation
                  60
                  60
                  90
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1160
                  Appropriation, discretionary (total)
                  60
                  60
                  90
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriation
                  485
                  470
                  345
               
               
                  1230
                  Appropriations and/or unobligated balance of appropriations permanently reduced
                  â34
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  451
                  470
                  345
               
               
                  1900
                  Budget authority (total)
                  511
                  530
                  435
               
               
                  1930
                  Total budgetary resources available
                  519
                  538
                  447
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1940
                  Unobligated balance expiring
                  â16
                  
                  
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  1
                  12
                  12
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  624
                  609
                  616
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  502
                  526
                  435
               
               
                  3020
                  Outlays (gross)
                  â507
                  â518
                  â522
               
               
                  3040
                  Recoveries of prior year unpaid obligations, unexpired
                  
                  â1
                  
               
               
                  3041
                  Recoveries of prior year unpaid obligations, expired
                  â10
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  609
                  616
                  529
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  624
                  609
                  616
               
               
                  3200
                  Obligated balance, end of year
                  609
                  616
                  529
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Discretionary:
               
               
                  4000
                  Budget authority, gross
                  60
                  60
                  90
               
               
                  
                  Outlays, gross:
               
               
                  4010
                  Outlays from new discretionary authority
                  18
                  19
                  28
               
               
                  4011
                  Outlays from discretionary balances
                  41
                  42
                  42
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4020
                  Outlays, gross (total)
                  59
                  61
                  70
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  451
                  470
                  345
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  89
                  99
                  97
               
               
                  4101
                  Outlays from mandatory balances
                  359
                  358
                  355
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4110
                  Outlays, gross (total)
                  448
                  457
                  452
               
               
                  4180
                  Budget authority, net (total)
                  511
                  530
                  435
               
               
                  4190
                  Outlays, net (total)
                  507
                  518
                  522
               
               
                  
                     
                  
               
            
         
      
      
         This account provides funds for a broad range of child welfare services, including family preservation and family support
            services, through Promoting Safe and Stable Families. The Budget includes a five-year reauthorization of the Personal Responsibility
            Education Program (PREP), a continuation of Family Connection Grants through FY 2016, and a $30 million increase in discretionary
            appropriations for Promoting Safe and Stable Families to increase capacity for tribal child welfare systems and child welfare
            services in rural communities.
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1512â0â1â506
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  11.1
                  Personnel compensation: Full-time permanent
                  1
                  1
                  
               
               
                  25.1
                  Advisory and assistance services
                  12
                  13
                  9
               
               
                  25.3
                  Other goods and services from Federal sources
                  4
                  4
                  3
               
               
                  41.0
                  Grants, subsidies, and contributions
                  485
                  508
                  423
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  502
                  526
                  435
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1512â0â1â506
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  10
                  12
                  2
               
               
                  
                     
                  
               
            
         
      
         Promoting Safe and Stable Families                                                                                       
            
         
         (Legislative proposal, subject to PAYGO)Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1512â4â1â506
                  2014 actual
                  2015 est.
                  2016 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
               
               
                  1930
                  Total budgetary resources available
                  
                  
                  90
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  
                  
                  90
               
               
                  3020
                  Outlays (gross)
                  
                  
                  â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 075â1512â4â1â506
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  11.1
                  Personnel compensation: Full-time permanent
                  
                  
                  1
               
               
                  25.1
                  Advisory and assistance services
                  
                  
                  5
               
               
                  25.3
                  Other goods and services from Federal sources
                  
                  
                  1
               
               
                  41.0
                  Grants, subsidies, and contributions
                  
                  
                  83
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  
                  
                  90
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1512â4â1â506
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  
                  
                  11
               
               
                  
                     
                  
               
            
         
      
         Child Care Entitlement to States                                                                                         
            
         Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1550â0â1â609
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Mandatory child care
                  1,178
                  1,178
                  1,178
               
               
                  0002
                  Matching child care
                  1,689
                  1,674
                  1,666
               
               
                  0003
                  Training and technical assistance
                  7
                  7
                  15
               
               
                  0004
                  Child care tribal grants
                  56
                  58
                  58
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  2,930
                  2,917
                  2,917
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1012
                  Unobligated balance transfers between expired and unexpired accounts
                  15
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1050
                  Unobligated balance (total)
                  15
                  
                  
               
               
                  
                  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
                  2,932
                  2,917
                  2,917
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1940
                  Unobligated balance expiring
                  â2
                  
                  
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  755
                  831
                  791
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  2,930
                  2,917
                  2,917
               
               
                  3011
                  Obligations incurred, expired accounts
                  16
                  
                  
               
               
                  3020
                  Outlays (gross)
                  â2,854
                  â2,957
                  â2,950
               
               
                  3041
                  Recoveries of prior year unpaid obligations, expired
                  â16
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  831
                  791
                  758
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  755
                  831
                  791
               
               
                  3200
                  Obligated balance, end of year
                  831
                  791
                  758
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  2,917
                  2,917
                  2,917
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  2,161
                  2,363
                  2,363
               
               
                  4101
                  Outlays from mandatory balances
                  693
                  594
                  587
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4110
                  Outlays, gross (total)
                  2,854
                  2,957
                  2,950
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4120
                  Federal sources
                  â16
                  
                  
               
               
                  
                  Additional offsets against gross budget authority only:
               
               
                  4142
                  Offsetting collections credited to expired accounts
                  16
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4160
                  Budget authority, net (mandatory)
                  2,917
                  2,917
                  2,917
               
               
                  4170
                  Outlays, net (mandatory)
                  2,838
                  2,957
                  2,950
               
               
                  4180
                  Budget authority, net (total)
                  2,917
                  2,917
                  2,917
               
               
                  4190
                  Outlays, net (total)
                  2,838
                  2,957
                  2,950
               
               
                  
                     
                  
               
            
         
      
      
         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. 104â193), as amended by the Deficit Reduction Act of 2005 (P.L. 109â171).
            Since 2010, this account has been temporarily reauthorized by a series of Acts, most recently in the Consolidated and Further
            Continuing Appropriations Act, 2015 (P.L. 113â235). The Budget includes an $82 billion investment over ten years above current
            law to expand access to high-quality child care. 
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1550â0â1â609
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  25.1
                  Advisory and assistance services
                  6
                  6
                  6
               
               
                  25.2
                  Other services from non-Federal sources
                  10
                  10
                  10
               
               
                  25.3
                  Other goods and services from Federal sources
                  1
                  1
                  1
               
               
                  41.0
                  Grants, subsidies, and contributions
                  2,913
                  2,900
                  2,900
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  2,930
                  2,917
                  2,917
               
               
                  
                     
                  
               
            
         
      
         Child Care Entitlement to States                                                                                         
            
         
         (Legislative proposal, subject to PAYGO)Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1550â4â1â609
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0002
                  Matching child care
                  
                  
                  3,574
               
               
                  0003
                  Training and technical assistance
                  
                  
                  18
               
               
                  0004
                  Child care tribal grants
                  
                  
                  73
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  
                  
                  3,665
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriation
                  
                  
                  3,665
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  
                  
                  3,665
               
               
                  1930
                  Total budgetary resources available
                  
                  
                  3,665
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  
                  
                  3,665
               
               
                  3020
                  Outlays (gross)
                  
                  
                  â2,969
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  
                  
                  696
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3200
                  Obligated balance, end of year
                  
                  
                  696
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  
                  
                  3,665
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  
                  
                  2,969
               
               
                  4180
                  Budget authority, net (total)
                  
                  
                  3,665
               
               
                  4190
                  Outlays, net (total)
                  
                  
                  2,969
               
               
                  
                     
                  
               
            
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1550â4â1â609
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  25.1
                  Advisory and assistance services
                  
                  
                  18
               
               
                  41.0
                  Grants, subsidies, and contributions
                  
                  
                  3,647
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  
                  
                  3,665
               
               
                  
                     
                  
               
            
         
      
         Payments to states for the child care and development block grantFor carrying out the Child Care and Development Block Grant Act of [1990] 2014 ("CCDBG Act"), [$2,435,000,000] $2,805,149,000 shall be used to supplement, not supplant State general revenue funds for child care assistance for low-income families:
         Provided, That [$19,357,000 shall be available for child care resource and referral and school-aged child care activities, of which $996,000
         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] in addition to amounts reserved by section 658O(5) of such Act, $100,000,000 shall be available for allocation by the Secretary
            for grants to States, territories, tribes, and local governments to develop, implement, and evaluate models of child care
            provision for specific populations of working families and to address unique challenges to securing stable and high quality
            child care as identified by the Secretary: Provided further, That, in addition to the amounts required to be reserved by the States under section 658G of the CCDBG Act, [$305,906,000 shall be reserved by the States for activities authorized under section 658G, of which$112,187,000] $125,562,000 shall be for activities that improve the quality of infant and toddler care: Provided further, That [$9,851,000] $14,000,000 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 the reservation of funds specified in paragraphs (4) and (5) of section 658O(a) of such Act shall
            also be applied to funds appropriated in this or any other Act, including section 418 of the Social Security Act (42 U.S.C.
            618), to carry out such section 418. (Department of Health and Human Services Appropriations Act, 2015.)
      Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1515â0â1â609
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Block grant payments to States
                  2,348
                  2,425
                  2,691
               
               
                  0002
                  Child care pilots for working families
                  
                  
                  100
               
               
                  0004
                  Research and evaluation fund
                  10
                  10
                  14
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  2,358
                  2,435
                  2,805
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, discretionary:
               
               
                  1100
                  Appropriation
                  2,360
                  2,435
                  2,805
               
               
                  1120
                  Appropriations transferred to other accts [075â0140]
                  â2
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1160
                  Appropriation, discretionary (total)
                  2,358
                  2,435
                  2,805
               
               
                  1930
                  Total budgetary resources available
                  2,358
                  2,435
                  2,805
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  581
                  713
                  676
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  2,358
                  2,435
                  2,805
               
               
                  3011
                  Obligations incurred, expired accounts
                  12
                  
                  
               
               
                  3020
                  Outlays (gross)
                  â2,238
                  â2,472
                  â2,777
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  713
                  676
                  704
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  581
                  713
                  676
               
               
                  3200
                  Obligated balance, end of year
                  713
                  676
                  704
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Discretionary:
               
               
                  4000
                  Budget authority, gross
                  2,358
                  2,435
                  2,805
               
               
                  
                  Outlays, gross:
               
               
                  4010
                  Outlays from new discretionary authority
                  1,714
                  1,972
                  2,272
               
               
                  4011
                  Outlays from discretionary balances
                  524
                  500
                  505
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4020
                  Outlays, gross (total)
                  2,238
                  2,472
                  2,777
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4030
                  Federal sources
                  â12
                  
                  
               
               
                  
                  Additional offsets against gross budget authority only:
               
               
                  4052
                  Offsetting collections credited to expired accounts
                  12
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4070
                  Budget authority, net (discretionary)
                  2,358
                  2,435
                  2,805
               
               
                  4080
                  Outlays, net (discretionary)
                  2,226
                  2,472
                  2,777
               
               
                  4180
                  Budget authority, net (total)
                  2,358
                  2,435
                  2,805
               
               
                  4190
                  Outlays, net (total)
                  2,226
                  2,472
                  2,777
               
               
                  
                     
                  
               
            
         
      
      
         This program provides grants to States for child care subsidies for low-income working families and activities to improve
            child care quality. In FY 2016, it includes a new competitive pilot program to develop and evaluate effective strategies for
            meeting the child care needs of working families.
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1515â0â1â609
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  11.1
                  Personnel compensation: Full-time permanent
                  
                  
                  1
               
               
                  25.1
                  Advisory and assistance services
                  11
                  11
                  15
               
               
                  25.2
                  Other services from non-Federal sources
                  10
                  10
                  10
               
               
                  41.0
                  Grants, subsidies, and contributions
                  2,337
                  2,414
                  2,779
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  2,358
                  2,435
                  2,805
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1515â0â1â609
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  
                  
                  3
               
               
                  
                     
                  
               
            
         
      
         Social services block grantFor making grants to States pursuant to section 2002 of the Social Security Act and supplementing research and evaluation related to activities funded by such grants, $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: Provided further, That notwithstanding section 2003(c) of such Act, the amount specified for allocation under such section
            for fiscal year 2016 shall be $1,691,500,000. (Department of Health and Human Services Appropriations Act, 2015.)
      Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1534â0â1â506
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Social Services Block Grant
                  1,577
                  1,576
                  1,700
               
               
                  0002
                  Health Profession Opportunity Grants
                  79
                  85
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  1,656
                  1,661
                  1,700
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  30
                  30
                  30
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriation
                  1,785
                  1,785
                  1,700
               
               
                  1230
                  Appropriations and/or unobligated balance of appropriations permanently reduced
                  â129
                  â124
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  1,656
                  1,661
                  1,700
               
               
                  1900
                  Budget authority (total)
                  1,656
                  1,661
                  1,700
               
               
                  1930
                  Total budgetary resources available
                  1,686
                  1,691
                  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
                  862
                  769
                  476
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  1,656
                  1,661
                  1,700
               
               
                  3020
                  Outlays (gross)
                  â1,748
                  â1,954
                  â1,761
               
               
                  3041
                  Recoveries of prior year unpaid obligations, expired
                  â1
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  769
                  476
                  415
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  862
                  769
                  476
               
               
                  3200
                  Obligated balance, end of year
                  769
                  476
                  415
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  1,656
                  1,661
                  1,700
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  1,311
                  1,312
                  1,411
               
               
                  4101
                  Outlays from mandatory balances
                  437
                  642
                  350
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4110
                  Outlays, gross (total)
                  1,748
                  1,954
                  1,761
               
               
                  4180
                  Budget authority, net (total)
                  1,656
                  1,661
                  1,700
               
               
                  4190
                  Outlays, net (total)
                  1,748
                  1,954
                  1,761
               
               
                  
                     
                  
               
            
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1534â0â1â506
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  11.1
                  Personnel compensation: Full-time permanent
                  1
                  1
                  
               
               
                  25.1
                  Advisory and assistance services
                  4
                  4
                  
               
               
                  25.5
                  Research and development contracts
                  
                  
                  9
               
               
                  41.0
                  Grants, subsidies, and contributions
                  1,651
                  1,656
                  1,691
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  1,656
                  1,661
                  1,700
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1534â0â1â506
                  2014 actual
                  2015 est.
                  2016 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 075â1534â4â1â506
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0002
                  Health Profession Opportunity Grants
                  
                  
                  85
               
               
                  0003
                  Upward Mobility Project
                  
                  
                  300
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  
                  
                  385
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriation
                  
                  
                  385
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  
                  
                  385
               
               
                  1900
                  Budget authority (total)
                  
                  
                  385
               
               
                  1930
                  Total budgetary resources available
                  
                  
                  385
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  
                  
                  385
               
               
                  3020
                  Outlays (gross)
                  
                  
                  â304
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  
                  
                  81
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3200
                  Obligated balance, end of year
                  
                  
                  81
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  
                  
                  385
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  
                  
                  304
               
               
                  4180
                  Budget authority, net (total)
                  
                  
                  385
               
               
                  4190
                  Outlays, net (total)
                  
                  
                  304
               
               
                  
                     
                  
               
            
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1534â4â1â506
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  11.1
                  Personnel compensation: Full-time permanent
                  
                  
                  1
               
               
                  25.1
                  Advisory and assistance services
                  
                  
                  4
               
               
                  41.0
                  Grants, subsidies, and contributions
                  
                  
                  380
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  
                  
                  385
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1534â4â1â506
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  
                  
                  10
               
               
                  
                     
                  
               
            
         
      
         Children and families services programsFor 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] 429, 473A, 477(i), 1110, 1114A 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-A 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, [$10,346,115,000] $11,911,242,000,  of which $37,943,000, to remain available through September 30, [2016] 2017, shall be for grants to States for adoption and legal guardianship incentive payments, as [authorized] defined by section 473A of the Social Security Act and may be made for adoptions completed before September 30, 2015: Provided, That [$8,598,095,000] $10,117,706,000 shall be for making payments under the Head Start Act: Provided further, That of the amount in the previous proviso, [$8,073,095,000] $8,364,706,000 shall be available for payments under section 640 of the Head Start Act, of which $284,482,375 shall be available for a cost of living adjustment notwithstanding section 640(a)(3)(A): Provided further, That notwithstanding such section 640, of the amount in the second preceding proviso, $1,078,000,000 (of
            which up to one percent may be reserved for research and evaluation) shall be allocated by the Secretary to supplement funding
            available to increase the hours of program operations to no less than 6 hours per day and to no less than 170 days per year
            and for training and technical assistance for such activities: 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 such section 640 [of the Head Start Act] , of the amount provided for making payments under the Head Start Act, and in addition to funds otherwise available under
         such section 640 [for such purposes, $500,000,000] , $650,000,000 shall be available [through March 31, 2016] for 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 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,  [with such funds in this Act and Public Law 113â76 not included in the calculation of the "base grant" for the current or any
         subsequent fiscal year as such term is used in section 640(a)(7)(A) of the Head Start Act] for training and technical assistance for such activities, and for up to $15,000,000 in Federal costs of administration and
            evaluation, 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 shall be available for the Federal
         costs of administration and evaluation activities of the program described in such proviso:] Provided further, That funds described in the preceding two provisos shall not be included in the calculation of "base grant" in subsequent fiscal
            years, as such term is used in section 640(a)(7)(A) of such Act: Provided further, That [$710,383,000] $674,000,000 shall be for making payments under the CSBG Act: Provided further, That [$36,733,000 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 $6,500,000 shall be for section 680(a)(3)(B) 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: Provided further, That section 303(a)(2)(A)(i) of the Family Violence Prevention and Services Act shall not apply to amounts provided herein:] 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, in addition to the reservation set forth in section 674(b)
            of the CSBG Act, the Secretary may reserve up to 1 percent of the amount for making payments under such Act for research and
            evaluation activities funded under such Act: Provided further, That the Secretary shall issue performance standards for nonprofit
            organizations receiving funds from state and territorial grantees under the CSBG Act, and such states and territories shall
            assure the implementation of such standards prior to September 30, 2016, and include information on such implementation in
            the report required by section 678E(2) of such Act: Provided further, That, to the extent funds for the Assets for Independence (AFI) 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 the 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, up to $3,000,000 of the
            funds provided for such Act shall be available for research and evaluation: Provided further, That up to 30 percent of funds
            appropriated for the AFI Act under this heading shall be for grants under sections 402 and 403 of such Act, notwithstanding
            sections 404(8), 410(a), and 410(d) of such Act: Provided further, That, notwithstanding section 404(5)(A)(i) of such Act,
            contributions to an individual development account shall be allowable through any mechanism allowed by the financial institution
            at which the account is held: Provided further, That, of the amounts available for carrying out the Runaway and Homeless Youth
            Act, up to $2,330,000 may be reserved for activities under section 386(a) of such Act notwithstanding section 388 of such
            Act: 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, 2015.)
      Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1536â0â1â506
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0101
                  Head Start
                  8,105
                  8,598
                  10,118
               
               
                  0102
                  Head Start Emergency Hurricane Sandy funding
                  20
                  
                  
               
               
                  0103
                  Runaway and homeless youth (basic centers)
                  53
                  53
                  54
               
               
                  0104
                  Transitional living
                  44
                  44
                  50
               
               
                  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
                  28
                  29
                  49
               
               
                  0111
                  Community-based child abuse prevention
                  40
                  40
                  40
               
               
                  0112
                  Child welfare services
                  269
                  269
                  269
               
               
                  0113
                  Child welfare training, research, or demonstration projects
                  25
                  16
                  16
               
               
                  0114
                  Adoption opportunities
                  40
                  39
                  42
               
               
                  0115
                  Abandoned infants assistance
                  11
                  11
                  11
               
               
                  0116
                  Adoption incentives
                  38
                  38
                  38
               
               
                  0117
                  Independent living training vouchers
                  43
                  43
                  43
               
               
                  0124
                  Native American programs
                  47
                  47
                  50
               
               
                  0125
                  Social services and income maintenance research
                  2
                  5
                  18
               
               
                  0128
                  Federal administration
                  196
                  200
                  212
               
               
                  0129
                  Center for faith-based and community initiatives
                  1
                  1
                  
               
               
                  0131
                  Disaster human services case management
                  2
                  2
                  2
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0191
                  Direct program activities, subtotal
                  9,006
                  9,477
                  11,056
               
               
                  0301
                  Community services block grant
                  667
                  674
                  674
               
               
                  0303
                  Rural community facilities
                  6
                  7
                  
               
               
                  0304
                  Community services discretionary (JOLI & CED)
                  30
                  30
                  
               
               
                  0306
                  Assets for independence
                  19
                  19
                  19
               
               
                  0308
                  Domestic violence hotline
                  5
                  5
                  12
               
               
                  0309
                  Family violence prevention and services
                  133
                  134
                  150
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0391
                  Direct program activities, subtotal
                  860
                  869
                  855
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0400
                  Total, direct program
                  9,866
                  10,346
                  11,911
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0799
                  Total direct obligations
                  9,866
                  10,346
                  11,911
               
               
                  0801
                  Children and Families Services Programs (Reimbursable)
                  26
                  26
                  26
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0809
                  Reimbursable program activities, subtotal
                  26
                  26
                  26
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  9,892
                  10,372
                  11,937
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  89
                  562
                  561
               
               
                  1001
                  Discretionary unobligated balance brought fwd, Oct 1
                  89
                  562
                  
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, discretionary:
               
               
                  1100
                  Appropriation
                  10,347
                  10,346
                  11,911
               
               
                  1120
                  Appropriations transferred to other accts [075â0511]
                  â5
                  
                  
               
               
                  1120
                  Appropriations transferred to other accts [075â1503]
                  â2
                  
                  
               
               
                  1120
                  Appropriations transferred to other accts [075â0140]
                  â1
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1160
                  Appropriation, discretionary (total)
                  10,339
                  10,346
                  11,911
               
               
                  
                  Spending authority from offsetting collections, discretionary:
               
               
                  1700
                  Collected
                  22
                  24
                  24
               
               
                  1701
                  Change in uncollected payments, Federal sources
                  5
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1750
                  Spending auth from offsetting collections, disc (total)
                  27
                  24
                  24
               
               
                  
                  Spending authority from offsetting collections, mandatory:
               
               
                  1800
                  Collected
                  
                  1
                  1
               
               
                  1801
                  Change in uncollected payments, Federal sources
                  2
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1850
                  Spending auth from offsetting collections, mand (total)
                  2
                  1
                  1
               
               
                  1900
                  Budget authority (total)
                  10,368
                  10,371
                  11,936
               
               
                  1930
                  Total budgetary resources available
                  10,457
                  10,933
                  12,497
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1940
                  Unobligated balance expiring
                  â3
                  
                  
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  562
                  561
                  560
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  6,218
                  6,646
                  6,703
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  9,892
                  10,372
                  11,937
               
               
                  3011
                  Obligations incurred, expired accounts
                  2
                  
                  
               
               
                  3020
                  Outlays (gross)
                  â9,407
                  â10,315
                  â10,753
               
               
                  3041
                  Recoveries of prior year unpaid obligations, expired
                  â59
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  6,646
                  6,703
                  7,887
               
               
                  
                  Uncollected payments:
               
               
                  3060
                  Uncollected pymts, Fed sources, brought forward, Oct 1
                  â16
                  â10
                  â10
               
               
                  3070
                  Change in uncollected pymts, Fed sources, unexpired
                  â7
                  
                  
               
               
                  3071
                  Change in uncollected pymts, Fed sources, expired
                  13
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3090
                  Uncollected pymts, Fed sources, end of year
                  â10
                  â10
                  â10
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  6,202
                  6,636
                  6,693
               
               
                  3200
                  Obligated balance, end of year
                  6,636
                  6,693
                  7,877
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Discretionary:
               
               
                  4000
                  Budget authority, gross
                  10,366
                  10,370
                  11,935
               
               
                  
                  Outlays, gross:
               
               
                  4010
                  Outlays from new discretionary authority
                  3,960
                  4,371
                  5,029
               
               
                  4011
                  Outlays from discretionary balances
                  5,446
                  5,944
                  5,724
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4020
                  Outlays, gross (total)
                  9,406
                  10,315
                  10,753
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4030
                  Federal sources
                  â34
                  â18
                  â18
               
               
                  4033
                  Non-Federal sources
                  
                  â6
                  â6
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4040
                  Offsets against gross budget authority  and outlays (total)
                  â34
                  â24
                  â24
               
               
                  
                  Additional offsets against gross budget authority only:
               
               
                  4050
                  Change in uncollected pymts, Fed sources, unexpired
                  â5
                  
                  
               
               
                  4052
                  Offsetting collections credited to expired accounts
                  12
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4060
                  Additional offsets against budget authority only (total)
                  7
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4070
                  Budget authority, net (discretionary)
                  10,339
                  10,346
                  11,911
               
               
                  4080
                  Outlays, net (discretionary)
                  9,372
                  10,291
                  10,729
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  2
                  1
                  1
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  1
                  
                  
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4120
                  Federal sources
                  â1
                  â1
                  â1
               
               
                  
                  Additional offsets against gross budget authority only:
               
               
                  4140
                  Change in uncollected pymts, Fed sources, unexpired
                  â2
                  
                  
               
               
                  4142
                  Offsetting collections credited to expired accounts
                  1
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4150
                  Additional offsets against budget authority only (total)
                  â1
                  
                  
               
               
                  4170
                  Outlays, net (mandatory)
                  
                  â1
                  â1
               
               
                  4180
                  Budget authority, net (total)
                  10,339
                  10,346
                  11,911
               
               
                  4190
                  Outlays, net (total)
                  9,372
                  10,290
                  10,728
               
               
                  
                     
                  
               
            
         
      
      
         The request totals $11.9 billion, including $10.1 billion for priority investments in early learning to improve outcomes for
            children. This funding will expand access to high quality early care and education for young children. The Budget also requests
            an additional $23 million for family violence prevention and services, $15 million to provide comprehensive services to youth
            in the child welfare system who are victims of or at-risk of human trafficking, including an evaluation component to help
            build a research base of effective interventions for this population, $9 million to improve services for homeless youth, $5
            million for child protection investigations, $3 million to support energy assistance evaluations, and $3 million for Native
            American language acquisition. This request discontinues funding for the Rural Communities Facilities and the Community Economic
            Development programs.
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1536â0â1â506
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  
                  Personnel compensation:
               
               
                  11.1
                  Full-time permanent
                  104
                  119
                  122
               
               
                  11.3
                  Other than full-time permanent
                  5
                  5
                  5
               
               
                  11.7
                  Military personnel
                  1
                  1
                  1
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  11.9
                  Total personnel compensation
                  110
                  125
                  128
               
               
                  12.1
                  Civilian personnel benefits
                  30
                  35
                  36
               
               
                  21.0
                  Travel and transportation of persons
                  3
                  4
                  4
               
               
                  23.1
                  Rental payments to GSA
                  14
                  16
                  17
               
               
                  23.2
                  Rental payments to others
                  1
                  1
                  1
               
               
                  23.3
                  Communications, utilities, and miscellaneous charges
                  3
                  2
                  2
               
               
                  24.0
                  Printing and reproduction
                  1
                  1
                  1
               
               
                  25.1
                  Advisory and assistance services
                  204
                  225
                  230
               
               
                  25.2
                  Other services from non-Federal sources
                  4
                  3
                  4
               
               
                  25.3
                  Other goods and services from Federal sources
                  55
                  48
                  46
               
               
                  25.4
                  Operation and maintenance of facilities
                  1
                  2
                  2
               
               
                  26.0
                  Supplies and materials
                  1
                  1
                  1
               
               
                  41.0
                  Grants, subsidies, and contributions
                  9,439
                  9,883
                  11,439
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.0
                  Direct obligations
                  9,866
                  10,346
                  11,911
               
               
                  99.0
                  Reimbursable obligations
                  26
                  26
                  26
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  9,892
                  10,372
                  11,937
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1536â0â1â506
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  1,038
                  1,167
                  1,186
               
               
                  1101
                  Direct military average strength employment
                  7
                  8
                  8
               
               
                  2001
                  Reimbursable civilian full-time equivalent employment
                  19
                  19
                  10
               
               
                  
                     
                  
               
            
         
      
         Children's Research and Technical Assistance                                                                             
            
         Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1553â0â1â609
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Training and technical assistance
                  13
                  15
                  12
               
               
                  0002
                  Federal parent locator service
                  22
                  27
                  26
               
               
                  0004
                  Welfare research
                  14
                  15
                  15
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0799
                  Total direct obligations
                  49
                  57
                  53
               
               
                  0801
                  Reimbursable program FPLS REIMB
                  23
                  30
                  31
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  72
                  87
                  84
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  5
                  6
                  1
               
               
                  1021
                  Recoveries of prior year unpaid obligations
                  2
                  2
                  2
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1050
                  Unobligated balance (total)
                  7
                  8
                  3
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, discretionary:
               
               
                  1121
                  Appropriations transferred from other acct [075â1522]
                  
                  
                  15
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1160
                  Appropriation, discretionary (total)
                  
                  
                  15
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriation
                  52
                  37
                  37
               
               
                  1200
                  Appropriation [Pop-up]
                  
                  1
                  1
               
               
                  1221
                  Appropriations transferred from other acct [075â1522]
                  
                  15
                  
               
               
                  1230
                  Appropriations and/or unobligated balance of appropriations permanently reduced
                  â4
                  â3
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  48
                  50
                  38
               
               
                  
                  Spending authority from offsetting collections, mandatory:
               
               
                  1800
                  Collected
                  23
                  30
                  30
               
               
                  1802
                  Offsetting collections (previously unavailable)
                  1
                  1
                  1
               
               
                  1823
                  New and/or unobligated balance of spending authority from offsetting collections temporarily reduced
                  â1
                  â1
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1850
                  Spending auth from offsetting collections, mand (total)
                  23
                  30
                  31
               
               
                  1900
                  Budget authority (total)
                  71
                  80
                  84
               
               
                  1930
                  Total budgetary resources available
                  78
                  88
                  87
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  6
                  1
                  3
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  64
                  63
                  69
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  72
                  87
                  84
               
               
                  3020
                  Outlays (gross)
                  â71
                  â79
                  â82
               
               
                  3040
                  Recoveries of prior year unpaid obligations, unexpired
                  â2
                  â2
                  â2
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  63
                  69
                  69
               
               
                  
                  Uncollected payments:
               
               
                  3060
                  Uncollected pymts, Fed sources, brought forward, Oct 1
                  â5
                  â5
                  â5
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3090
                  Uncollected pymts, Fed sources, end of year
                  â5
                  â5
                  â5
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  59
                  58
                  64
               
               
                  3200
                  Obligated balance, end of year
                  58
                  64
                  64
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Discretionary:
               
               
                  4000
                  Budget authority, gross
                  
                  
                  15
               
               
                  
                  Outlays, gross:
               
               
                  4010
                  Outlays from new discretionary authority
                  
                  
                  2
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  71
                  80
                  69
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  22
                  26
                  26
               
               
                  4101
                  Outlays from mandatory balances
                  49
                  53
                  54
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4110
                  Outlays, gross (total)
                  71
                  79
                  80
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4120
                  Federal sources
                  â12
                  â13
                  â13
               
               
                  4123
                  Non-Federal sources
                  â11
                  â17
                  â17
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4130
                  Offsets against gross budget authority and outlays (total)
                  â23
                  â30
                  â30
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4160
                  Budget authority, net (mandatory)
                  48
                  50
                  39
               
               
                  4170
                  Outlays, net (mandatory)
                  48
                  49
                  50
               
               
                  4180
                  Budget authority, net (total)
                  48
                  50
                  54
               
               
                  4190
                  Outlays, net (total)
                  48
                  49
                  52
               
               
                  
                     
                  
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  5090
                  Unexpired unavailable balance, SOY: Offsetting collections
                  1
                  1
                  1
               
               
                  5092
                  Unexpired unavailable balance, EOY: Offsetting collections
                  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. 104â193), as amended by the Deficit Reduction Act of 2005 (P.L. 109â171).
            For fiscal years 2010â2014, Welfare Research had been temporarily reauthorized ; for FY 2015, the Consolidated and Further
            Continuing Appropriations Act, 2015 (P.L. 113â235) provided funds for Welfare Research via a transfer from the TANF Contingency
            Fund. The Budget includes a general provision to transfer $15 million from the TANF Contingency Fund in FY 2016 to Welfare
            Research. 
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1553â0â1â609
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  11.1
                  Personnel compensation: Full-time permanent
                  6
                  7
                  7
               
               
                  12.1
                  Civilian personnel benefits
                  2
                  2
                  2
               
               
                  21.0
                  Travel and transportation of persons
                  
                  
                  1
               
               
                  23.1
                  Rental payments to GSA
                  3
                  3
                  3
               
               
                  25.1
                  Advisory and assistance services
                  11
                  12
                  12
               
               
                  25.2
                  Other services from non-Federal sources
                  14
                  19
                  13
               
               
                  25.3
                  Other goods and services from Federal sources
                  7
                  8
                  9
               
               
                  25.7
                  Operation and maintenance of equipment
                  3
                  4
                  4
               
               
                  41.0
                  Grants, subsidies, and contributions
                  3
                  2
                  2
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.0
                  Direct obligations
                  49
                  57
                  53
               
               
                  99.0
                  Reimbursable obligations
                  23
                  30
                  31
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  72
                  87
                  84
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1553â0â1â609
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  63
                  67
                  72
               
               
                  
                     
                  
               
            
         
      
         Children's Research and Technical Assistance                                                                             
            
         
         (Legislative proposal, subject to PAYGO)Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1553â4â1â609
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0801
                  Reimbursable program FPLS REIMB
                  
                  
                  2
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  
                  
                  2
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Spending authority from offsetting collections, mandatory:
               
               
                  1800
                  Collected
                  
                  
                  2
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1850
                  Spending auth from offsetting collections, mand (total)
                  
                  
                  2
               
               
                  1900
                  Budget authority (total)
                  
                  
                  2
               
               
                  1930
                  Total budgetary resources available
                  
                  
                  2
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  
                  
                  2
               
               
                  3020
                  Outlays (gross)
                  
                  
                  â2
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  
                  
                  2
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  
                  
                  2
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4120
                  Federal sources
                  
                  
                  â2
               
               
                  
                     
                  
               
            
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1553â4â1â609
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  25.1
                  Reimbursable obligations: Advisory and assistance services
                  
                  
                  2
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.0
                  Reimbursable obligations
                  
                  
                  2
               
               
                  
                     
                  
               
            
         
      
         Payments for foster care and permanencyFor carrying out, except as otherwise provided, title IV-E of the Social Security Act, [$4,832,000,000] $5,298,000,000.
      
      For carrying out, except as otherwise provided, title IV-E of the Social Security Act, for the first quarter of fiscal year
         [2016] 2017, $2,300,000,000.
      
      For carrying out, after May 31 of the current fiscal year, 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, 2015.)
      Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1545â0â1â609
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Foster care
                  4,746
                  4,581
                  4,772
               
               
                  0002
                  Independent living
                  140
                  140
                  140
               
               
                  0004
                  Adoption assistance
                  2,450
                  2,510
                  2,563
               
               
                  0005
                  Guardianship
                  90
                  109
                  123
               
               
                  0006
                  Tribal T&TA
                  3
                  3
                  3
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  7,429
                  7,343
                  7,601
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriation
                  5,229
                  5,143
                  5,301
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  5,229
                  5,143
                  5,301
               
               
                  
                  Advance appropriations, mandatory:
               
               
                  1270
                  Advance appropriation
                  2,200
                  2,200
                  2,300
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1280
                  Advanced appropriation, mandatory (total)
                  2,200
                  2,200
                  2,300
               
               
                  1900
                  Budget authority (total)
                  7,429
                  7,343
                  7,601
               
               
                  1930
                  Total budgetary resources available
                  7,429
                  7,343
                  7,601
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  716
                  1,231
                  1,495
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  7,429
                  7,343
                  7,601
               
               
                  3011
                  Obligations incurred, expired accounts
                  1
                  
                  
               
               
                  3020
                  Outlays (gross)
                  â6,868
                  â7,079
                  â7,412
               
               
                  3041
                  Recoveries of prior year unpaid obligations, expired
                  â47
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  1,231
                  1,495
                  1,684
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  716
                  1,231
                  1,495
               
               
                  3200
                  Obligated balance, end of year
                  1,231
                  1,495
                  1,684
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  7,429
                  7,343
                  7,601
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  6,277
                  6,210
                  6,433
               
               
                  4101
                  Outlays from mandatory balances
                  591
                  869
                  979
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4110
                  Outlays, gross (total)
                  6,868
                  7,079
                  7,412
               
               
                  4180
                  Budget authority, net (total)
                  7,429
                  7,343
                  7,601
               
               
                  4190
                  Outlays, net (total)
                  6,868
                  7,079
                  7,412
               
               
                  
                     
                  
               
            
         
      
      
         This account provides formula grants for Foster Care, Adoption Assistance, Guardianship Assistance Program, and the Chafee
            Foster Care Independence Program as well as technical assistance and implementation services for Tribal programs.
         
         Foster CareâThe proposed level will support eligible low-income children who must be placed outside the home. An average of 168,900 children
            per month are estimated to be served in FY 2016.
         
         Adoption AssistanceâThe proposed funding level will support subsidies for families adopting eligible low-income children with special needs.
            An average of 444,200 children per month are estimated to be served in FY 2016.
         
         Guardianship Assistance ProgramâThe proposed funding level will provide payments for relatives taking legal guardianship of eligible children who have been
            in foster care. An average of 25,100 children per month are estimated to be served in FY 2016.
         
         This account includes new investments to promote family-based care and increase oversight on the use of congregate care, to
            provide federal reimbursement for prevention and permanency interventions, and to provide additional support for new direct
            Tribal IV-E programs. Additionally, this account incldues a re-proposal from the FY 2015 President's Budget to address the
            over-prescription of psychotropic medications for children in foster care, and a re-proposal of a requirement to use child
            support collected on behalf of children in foster care in the best interest of the child. In addition, the Budget proposes
            to allow the title IV-E agencies that have extended foster care to age 21 to use existing Chafee Foster Care Independence
            Program funds to serve young people formerly in foster care through age 23.
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1545â0â1â609
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  25.1
                  Advisory and assistance services
                  25
                  27
                  39
               
               
                  41.0
                  Grants, subsidies, and contributions
                  7,404
                  7,316
                  7,562
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  7,429
                  7,343
                  7,601
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1545â0â1â609
                  2014 actual
                  2015 est.
                  2016 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 075â1545â4â1â609
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Foster care
                  
                  
                  181
               
               
                  0002
                  Demonstration to Address the Over-Prescription of Psychotropic Drugs for Children in Foster Care
                  
                  
                  50
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  
                  
                  231
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriation
                  
                  
                  430
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  
                  
                  430
               
               
                  1900
                  Budget authority (total)
                  
                  
                  430
               
               
                  1930
                  Total budgetary resources available
                  
                  
                  430
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  
                  
                  199
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  
                  
                  231
               
               
                  3020
                  Outlays (gross)
                  
                  
                  â181
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  
                  
                  50
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3200
                  Obligated balance, end of year
                  
                  
                  50
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  
                  
                  430
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  
                  
                  181
               
               
                  4180
                  Budget authority, net (total)
                  
                  
                  430
               
               
                  4190
                  Outlays, net (total)
                  
                  
                  181
               
               
                  
                     
                  
               
            
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1545â4â1â609
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  25.1
                  Advisory and assistance services
                  
                  
                  23
               
               
                  41.0
                  Grants, subsidies, and contributions
                  
                  
                  208
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  
                  
                  231
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â1545â4â1â609
                  2014 actual
                  2015 est.
                  2016 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, the Assistive Technology Act of 1998, titles II and VII (and section 14 with respect to such titles) of the Rehabilitation
            Act of 1973, and for Department-wide coordination of policy and program activities that assist individuals with disabilities, [$1,621,141,000] $2,043,540,000, 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 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 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:] 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 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. (Department of Health and Human Services Appropriations Act, 2015.)
      Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0142â0â1â506
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0101
                  Home and community-based supportive services
                  348
                  348
                  386
               
               
                  0102
                  Preventive health services
                  20
                  20
                  20
               
               
                  0103
                  National family caregiver support program
                  145
                  145
                  150
               
               
                  0104
                  Native American caregiver support program
                  6
                  6
                  7
               
               
                  0105
                  Congregate nutrition services
                  438
                  438
                  458
               
               
                  0106
                  Home-delivered nutrition services
                  216
                  216
                  236
               
               
                  0107
                  Nutrition services incentive program
                  153
                  160
                  160
               
               
                  0108
                  Native American nutrition and supportive services
                  26
                  26
                  29
               
               
                  0109
                  Nutrition Innovation Demonstrations
                  
                  
                  20
               
               
                  0110
                  Aging network support activities
                  7
                  10
                  10
               
               
                  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
                  4
               
               
                  0114
                  Program administration
                  29
                  30
                  40
               
               
                  0115
                  Lifespan respite care program
                  2
                  2
                  5
               
               
                  0116
                  Paralysis Resource Center
                  7
                  7
                  7
               
               
                  0117
                  Aging and Disability Resource Centers (ADRC)
                  6
                  6
                  20
               
               
                  0118
                  Chronic Disease Self-Management Education Program PPHF
                  8
                  8
                  8
               
               
                  0119
                  Family Support
                  
                  
                  15
               
               
                  0121
                  Senior Medicare Patrol program
                  9
                  9
                  9
               
               
                  0122
                  Elder Rights Support Activities
                  4
                  8
                  29
               
               
                  0123
                  Falls Prevention - PPHF
                  5
                  5
                  5
               
               
                  0126
                  National Clearinghouse Long-Term Care Information
                  
                  
                  1
               
               
                  0127
                  Alzheimer's Disease Communications Campaign PPHF
                  4
                  4
                  4
               
               
                  0132
                  State Aging & Disability Resource Centers - HCR
                  9
                  
                  
               
               
                  0133
                  Alzheimer's Disease Initiative - Services PPHF
                  11
                  11
                  11
               
               
                  0136
                  Voting Access for People With Disabilities (HAVA)
                  5
                  5
                  5
               
               
                  0138
                  State Councils on Developmental Disabilities
                  71
                  71
                  71
               
               
                  0139
                  Protection and Advocacy
                  39
                  39
                  39
               
               
                  0141
                  University Centers for Excellence in Developmental Disabilities
                  37
                  37
                  38
               
               
                  0142
                  Projects of National Significance
                  9
                  9
                  15
               
               
                  0144
                  Limb Loss Resource Center
                  
                  3
                  3
               
               
                  0145
                  National Institute on Disability, Independent Living & Rehab Research
                  
                  
                  108
               
               
                  0146
                  Independent Living - State Grants
                  
                  
                  23
               
               
                  0147
                  Independent Living - Centers (CILs)
                  
                  
                  83
               
               
                  0148
                  Assistive Technology
                  
                  
                  31
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0300
                  Total, direct program
                  1,639
                  1,648
                  2,071
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0799
                  Total direct obligations
                  1,639
                  1,648
                  2,071
               
               
                  0801
                  Reimbursable program - HCFAC and Other
                  10
                  9
                  9
               
               
                  0802
                  ADRC's MIPPA (TRA)
                  5
                  3
                  
               
               
                  0803
                  Area Agencies on Aging - MIPPA (TRA)
                  8
                  4
                  
               
               
                  0804
                  MIPPA - Natl Center Benefits Outreach Enrollment
                  5
                  2
                  
               
               
                  0805
                  SHIP - (DISC and ATRA BBA)
                  52
                  52
                  52
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0899
                  Total reimbursable obligations
                  80
                  70
                  61
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  1,719
                  1,718
                  2,132
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  2
                  1
                  
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, discretionary:
               
               
                  1100
                  Appropriation
                  1,610
                  1,621
                  2,043
               
               
                  1120
                  Appropriations transferred to other accts [012â3507]
                  â3
                  â3
                  
               
               
                  1120
                  Appropriations transferred to other accts [075â0511]
                  â4
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1160
                  Appropriation, discretionary (total)
                  1,603
                  1,618
                  2,043
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriation
                  10
                  
                  
               
               
                  1221
                  PPHF Appropriations transferred from other accounts [075â0116]
                  28
                  28
                  28
               
               
                  1230
                  Appropriations and/or unobligated balance of appropriations permanently reduced
                  â1
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  37
                  28
                  28
               
               
                  
                  Spending authority from offsetting collections, discretionary:
               
               
                  1700
                  Collected
                  1
                  52
                  52
               
               
                  1701
                  Change in uncollected payments, Federal sources
                  53
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1750
                  Spending auth from offsetting collections, disc (total)
                  54
                  52
                  52
               
               
                  
                  Spending authority from offsetting collections, mandatory:
               
               
                  1800
                  Collected
                  12
                  19
                  9
               
               
                  1801
                  Change in uncollected payments, Federal sources
                  13
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1850
                  Spending auth from offsetting collections, mand (total)
                  25
                  19
                  9
               
               
                  1900
                  Budget authority (total)
                  1,719
                  1,717
                  2,132
               
               
                  1930
                  Total budgetary resources available
                  1,721
                  1,718
                  2,132
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1940
                  Unobligated balance expiring
                  â1
                  
                  
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  1
                  
                  
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  665
                  895
                  871
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  1,719
                  1,718
                  2,132
               
               
                  3020
                  Outlays (gross)
                  â1,484
                  â1,742
                  â1,940
               
               
                  3041
                  Recoveries of prior year unpaid obligations, expired
                  â5
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  895
                  871
                  1,063
               
               
                  
                  Uncollected payments:
               
               
                  3060
                  Uncollected pymts, Fed sources, brought forward, Oct 1
                  â37
                  â94
                  â94
               
               
                  3070
                  Change in uncollected pymts, Fed sources, unexpired
                  â66
                  
                  
               
               
                  3071
                  Change in uncollected pymts, Fed sources, expired
                  9
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3090
                  Uncollected pymts, Fed sources, end of year
                  â94
                  â94
                  â94
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  628
                  801
                  777
               
               
                  3200
                  Obligated balance, end of year
                  801
                  777
                  969
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Discretionary:
               
               
                  4000
                  Budget authority, gross
                  1,657
                  1,670
                  2,095
               
               
                  
                  Outlays, gross:
               
               
                  4010
                  Outlays from new discretionary authority
                  952
                  997
                  1,256
               
               
                  4011
                  Outlays from discretionary balances
                  493
                  732
                  657
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4020
                  Outlays, gross (total)
                  1,445
                  1,729
                  1,913
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4030
                  Federal sources
                  â2
                  â52
                  â52
               
               
                  
                  Additional offsets against gross budget authority only:
               
               
                  4050
                  Change in uncollected pymts, Fed sources, unexpired
                  â53
                  
                  
               
               
                  4052
                  Offsetting collections credited to expired accounts
                  1
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4060
                  Additional offsets against budget authority only (total)
                  â52
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4070
                  Budget authority, net (discretionary)
                  1,603
                  1,618
                  2,043
               
               
                  4080
                  Outlays, net (discretionary)
                  1,443
                  1,677
                  1,861
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  62
                  47
                  37
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  3
                  5
                  3
               
               
                  4101
                  Outlays from mandatory balances
                  36
                  8
                  24
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4110
                  Outlays, gross (total)
                  39
                  13
                  27
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4120
                  Federal sources
                  â20
                  â19
                  â9
               
               
                  
                  Additional offsets against gross budget authority only:
               
               
                  4140
                  Change in uncollected pymts, Fed sources, unexpired
                  â13
                  
                  
               
               
                  4142
                  Offsetting collections credited to expired accounts
                  8
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4150
                  Additional offsets against budget authority only (total)
                  â5
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4160
                  Budget authority, net (mandatory)
                  37
                  28
                  28
               
               
                  4170
                  Outlays, net (mandatory)
                  19
                  â6
                  18
               
               
                  4180
                  Budget authority, net (total)
                  1,640
                  1,646
                  2,071
               
               
                  4190
                  Outlays, net (total)
                  1,462
                  1,671
                  1,879
               
               
                  
                     
                  
               
            
         
      
      
         Note.âThe reimbursable program (HCFAC) in the Administration for Community Living (ACL) reflects the actual distribution of
            the allocation account for 2014 and 2015. 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.  Beginning in 2016, this account also provides funding for three additional programs transferred
            from the Department of Education by the Workforce Innovation and Opportunity Act that further ACL's mission. These include
            Assistive Technology, Independent Living and the National Institute for Disability, Independent Living and Rehabilition Research.
            
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0142â0â1â506
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  11.1
                  Personnel compensation: Full-time permanent
                  16
                  16
                  22
               
               
                  12.1
                  Civilian personnel benefits
                  5
                  5
                  6
               
               
                  23.1
                  Rental payments to GSA
                  2
                  2
                  4
               
               
                  25.1
                  Advisory and assistance services
                  20
                  16
                  30
               
               
                  25.3
                  Other goods and services from Federal sources
                  7
                  5
                  9
               
               
                  41.0
                  Grants, subsidies, and contributions
                  1,590
                  1,604
                  2,000
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.0
                  Direct obligations
                  1,640
                  1,648
                  2,071
               
               
                  99.0
                  Reimbursable obligations
                  79
                  70
                  61
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  1,719
                  1,718
                  2,132
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0142â0â1â506
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  138
                  147
                  202
               
               
                  2001
                  Reimbursable civilian full-time equivalent employment
                  11
                  19
                  19
               
               
                  
                     
                  
               
            
         
      
         Departmental Management                                                                                                  
            
         Federal Funds
         General departmental managementFor 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, [$448,034,000] $472,196,000, together with [$64,828,000] $66,078,000 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] of the funds made available under this heading, $53,900,000 shall be for minority AIDS prevention and treatment activities: Provided further, That of the funds made available under this heading, [$101,000,000] $104,790,000 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 more than 10 percent of the available funds shall be for training and technical assistance, evaluation,
         outreach, and additional program support activities, and of the remaining amount 75 percent 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, and 25 percent shall be available for research and demonstration grants
         to develop, replicate, refine, and test additional models and innovative strategies for preventing teenage pregnancy: Provided further, That of the amounts provided under this heading from amounts available under section 241 of the PHS Act, $6,800,000 shall
         be available to carry out evaluations (including longitudinal evaluations) of teenage pregnancy prevention approaches:  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 [: Provided further, That with respect to the previous proviso, such funds shall be available for], including training, recruiting, retaining, and hiring members of the acquisition workforce as defined by 41 U.S.C. 1703, for information
         technology in support of acquisition workforce effectiveness 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)] Provided further, That funds made available under this heading may also be used for activities to encourage innovative approaches
            to increase efficiency and effectiveness in the Department's programs.
      In addition, to supplement the Department's activities related to implementation of the Digital Accountability and Transparency
            Act (DATA Act; Public Law 113â101; 31 U.S.C. 6101 note), $10,320,000, of which $500,000 shall be available to support the
            Department's implementation of a uniform procurement instrument identifier, as described in 48 C.F.R. subpart 4.16.
      In addition, for a Digital Service team for HHS, $10,000,000. (Department of Health and Human Services Appropriations Act, 2015.)
      Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â9912â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  General Departmental Management
                  458
                  448
                  493
               
               
                  0801
                  GDM (Collected)
                  149
                  158
                  158
               
               
                  0802
                  HCFAC (Mandatory)
                  13
                  10
                  13
               
               
                  0803
                  PHS Evaluation
                  62
                  65
                  66
               
               
                  0804
                  CMS Trust Funds (Mandatory)
                  
                  6
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0899
                  Total reimbursable obligations
                  224
                  239
                  237
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  682
                  687
                  730
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  2
                  2
                  23
               
               
                  1001
                  Discretionary unobligated balance brought fwd, Oct 1
                  2
                  2
                  
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, discretionary:
               
               
                  1100
                  Appropriation
                  458
                  448
                  493
               
               
                  1120
                  Appropriations transferred to other accts [075â0511]
                  â1
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1160
                  Appropriation, discretionary (total)
                  457
                  448
                  493
               
               
                  
                  Spending authority from offsetting collections, discretionary:
               
               
                  1700
                  Collected
                  119
                  244
                  239
               
               
                  1701
                  Change in uncollected payments, Federal sources
                  96
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1750
                  Spending auth from offsetting collections, disc (total)
                  215
                  244
                  239
               
               
                  
                  Spending authority from offsetting collections, mandatory:
               
               
                  1800
                  Collected
                  
                  16
                  13
               
               
                  1801
                  Change in uncollected payments, Federal sources
                  13
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1850
                  Spending auth from offsetting collections, mand (total)
                  13
                  16
                  13
               
               
                  1900
                  Budget authority (total)
                  685
                  708
                  745
               
               
                  1930
                  Total budgetary resources available
                  687
                  710
                  768
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1940
                  Unobligated balance expiring
                  â3
                  
                  
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  2
                  23
                  38
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  534
                  533
                  472
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  682
                  687
                  730
               
               
                  3011
                  Obligations incurred, expired accounts
                  11
                  
                  
               
               
                  3020
                  Outlays (gross)
                  â672
                  â748
                  â734
               
               
                  3041
                  Recoveries of prior year unpaid obligations, expired
                  â22
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  533
                  472
                  468
               
               
                  
                  Uncollected payments:
               
               
                  3060
                  Uncollected pymts, Fed sources, brought forward, Oct 1
                  â257
                  â243
                  â243
               
               
                  3070
                  Change in uncollected pymts, Fed sources, unexpired
                  â109
                  
                  
               
               
                  3071
                  Change in uncollected pymts, Fed sources, expired
                  123
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3090
                  Uncollected pymts, Fed sources, end of year
                  â243
                  â243
                  â243
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  277
                  290
                  229
               
               
                  3200
                  Obligated balance, end of year
                  290
                  229
                  225
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Discretionary:
               
               
                  4000
                  Budget authority, gross
                  672
                  692
                  732
               
               
                  
                  Outlays, gross:
               
               
                  4010
                  Outlays from new discretionary authority
                  321
                  331
                  348
               
               
                  4011
                  Outlays from discretionary balances
                  333
                  396
                  372
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4020
                  Outlays, gross (total)
                  654
                  727
                  720
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4030
                  Federal sources
                  â244
                  â244
                  â239
               
               
                  
                  Additional offsets against gross budget authority only:
               
               
                  4050
                  Change in uncollected pymts, Fed sources, unexpired
                  â96
                  
                  
               
               
                  4052
                  Offsetting collections credited to expired accounts
                  125
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4060
                  Additional offsets against budget authority only (total)
                  29
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4070
                  Budget authority, net (discretionary)
                  457
                  448
                  493
               
               
                  4080
                  Outlays, net (discretionary)
                  410
                  483
                  481
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  13
                  16
                  13
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  12
                  16
                  13
               
               
                  4101
                  Outlays from mandatory balances
                  6
                  5
                  1
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4110
                  Outlays, gross (total)
                  18
                  21
                  14
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4120
                  Federal sources
                  
                  â16
                  â13
               
               
                  
                  Additional offsets against gross budget authority only:
               
               
                  4140
                  Change in uncollected pymts, Fed sources, unexpired
                  â13
                  
                  
               
               
                  4170
                  Outlays, net (mandatory)
                  18
                  5
                  1
               
               
                  4180
                  Budget authority, net (total)
                  457
                  448
                  493
               
               
                  4190
                  Outlays, net (total)
                  428
                  488
                  482
               
               
                  
                     
                  
               
            
         
      
      
         Note.âThe reimbursable program (HCFAC) in the General Department Management (GDM) account reflects estimates of the allocation
            account for 2016. 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. FY 2016 Budget includes funding for staffing costs
            to build a Digital Service team that will focus on transforming the agency's digital services with the greatest impact to
            citizens and businesses so they are easier to use and maintain. The Budget also includes funding to implement the Digital
            Accountability and Transparency Act of 2014 to improve transparency of Federal spending and Government-wide financial data
            standards. The Department of Health and Human Services plays a crucial role in the implementation of the Act and has been
            designated as the leader for the grants standardization.
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â9912â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  
                  Personnel compensation:
               
               
                  11.1
                  Full-time permanent
                  92
                  94
                  101
               
               
                  11.3
                  Other than full-time permanent
                  13
                  12
                  13
               
               
                  11.5
                  Other personnel compensation
                  3
                  3
                  3
               
               
                  11.7
                  Military personnel
                  3
                  5
                  4
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  11.9
                  Total personnel compensation
                  111
                  114
                  121
               
               
                  12.1
                  Civilian personnel benefits
                  28
                  29
                  33
               
               
                  12.2
                  Military personnel benefits
                  2
                  2
                  2
               
               
                  21.0
                  Travel and transportation of persons
                  5
                  4
                  4
               
               
                  23.1
                  Rental payments to GSA
                  17
                  17
                  17
               
               
                  23.3
                  Communications, utilities, and miscellaneous charges
                  2
                  2
                  2
               
               
                  24.0
                  Printing and reproduction
                  1
                  1
                  1
               
               
                  25.1
                  Advisory and assistance services
                  22
                  18
                  27
               
               
                  25.2
                  Other services from non-Federal sources
                  43
                  34
                  24
               
               
                  25.3
                  Other goods and services from Federal sources
                  65
                  63
                  98
               
               
                  25.4
                  Operation and maintenance of facilities
                  6
                  6
                  6
               
               
                  25.7
                  Operation and maintenance of equipment
                  5
                  5
                  5
               
               
                  26.0
                  Supplies and materials
                  1
                  1
                  1
               
               
                  31.0
                  Equipment
                  1
                  1
                  1
               
               
                  41.0
                  Grants, subsidies, and contributions
                  149
                  151
                  151
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.0
                  Direct obligations
                  458
                  448
                  493
               
               
                  99.0
                  Reimbursable obligations
                  224
                  239
                  237
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  682
                  687
                  730
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â9912â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  974
                  1,002
                  1,100
               
               
                  1101
                  Direct military average strength employment
                  31
                  43
                  36
               
               
                  2001
                  Reimbursable civilian full-time equivalent employment
                  469
                  527
                  511
               
               
                  2101
                  Reimbursable military average strength employment
                  19
                  9
                  9
               
               
                  
                     
                  
               
            
         
      
         General Departmental Management                                                                                          
            
         
         (Legislative proposal, subject to PAYGO)Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â9912â4â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0805
                  RAC Collected (Mandatory)
                  
                  
                  2
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  
                  
                  2
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Spending authority from offsetting collections, mandatory:
               
               
                  1800
                  Collected
                  
                  
                  2
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1850
                  Spending auth from offsetting collections, mand (total)
                  
                  
                  2
               
               
                  1900
                  Budget authority (total)
                  
                  
                  2
               
               
                  1930
                  Total budgetary resources available
                  
                  
                  2
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  
                  
                  2
               
               
                  3020
                  Outlays (gross)
                  
                  
                  â2
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  
                  
                  2
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  
                  
                  2
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4120
                  Federal sources
                  
                  
                  â2
               
               
                  
                     
                  
               
            
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â9912â4â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  25.3
                  Reimbursable obligations: Other goods and services from Federal sources
                  
                  
                  2
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.0
                  Reimbursable obligations
                  
                  
                  2
               
               
                  
                     
                  
               
            
         
      
         Office for civil rightsFor expenses necessary for the Office for Civil Rights, [$38,798,000] $42,705,000. (Department of Health and Human Services Appropriations Act, 2015.)
      Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0135â0â1â751
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Office for Civil Rights (Direct)
                  39
                  39
                  43
               
               
                  0801
                  Office for Civil Rights (Reimbursable)
                  4
                  8
                  6
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  43
                  47
                  49
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  
                  6
                  3
               
               
                  1012
                  Unobligated balance transfers between expired and unexpired accounts
                  2
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1050
                  Unobligated balance (total)
                  2
                  6
                  3
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, discretionary:
               
               
                  1100
                  Appropriation
                  39
                  39
                  43
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1160
                  Appropriation, discretionary (total)
                  39
                  39
                  43
               
               
                  
                  Spending authority from offsetting collections, mandatory:
               
               
                  1800
                  Collected
                  8
                  5
                  6
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1850
                  Spending auth from offsetting collections, mand (total)
                  8
                  5
                  6
               
               
                  1900
                  Budget authority (total)
                  47
                  44
                  49
               
               
                  1930
                  Total budgetary resources available
                  49
                  50
                  52
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  6
                  3
                  3
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  9
                  9
                  11
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  43
                  47
                  49
               
               
                  3011
                  Obligations incurred, expired accounts
                  1
                  
                  
               
               
                  3020
                  Outlays (gross)
                  â43
                  â45
                  â51
               
               
                  3041
                  Recoveries of prior year unpaid obligations, expired
                  â1
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  9
                  11
                  9
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  9
                  9
                  11
               
               
                  3200
                  Obligated balance, end of year
                  9
                  11
                  9
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Discretionary:
               
               
                  4000
                  Budget authority, gross
                  39
                  39
                  43
               
               
                  
                  Outlays, gross:
               
               
                  4010
                  Outlays from new discretionary authority
                  35
                  31
                  34
               
               
                  4011
                  Outlays from discretionary balances
                  6
                  6
                  9
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4020
                  Outlays, gross (total)
                  41
                  37
                  43
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  8
                  5
                  6
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  
                  5
                  6
               
               
                  4101
                  Outlays from mandatory balances
                  2
                  3
                  2
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4110
                  Outlays, gross (total)
                  2
                  8
                  8
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4123
                  Non-Federal sources
                  â8
                  â5
                  â6
               
               
                  4180
                  Budget authority, net (total)
                  39
                  39
                  43
               
               
                  4190
                  Outlays, net (total)
                  35
                  40
                  45
               
               
                  
                     
                  
               
            
         
      
      
         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 075â0135â0â1â751
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  
                  Personnel compensation:
               
               
                  11.1
                  Full-time permanent
                  21
                  18
                  19
               
               
                  11.3
                  Other than full-time permanent
                  1
                  2
                  2
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  11.9
                  Total personnel compensation
                  22
                  20
                  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
                  1
                  
                  
               
               
                  25.3
                  Other goods and services from Federal sources
                  6
                  9
                  12
               
               
                  25.4
                  Operation and maintenance of facilities
                  1
                  1
                  1
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.0
                  Direct obligations
                  39
                  39
                  43
               
               
                  99.0
                  Reimbursable obligations
                  4
                  8
                  6
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  43
                  47
                  49
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0135â0â1â751
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  200
                  193
                  197
               
               
                  1101
                  Direct military average strength employment
                  2
                  2
                  2
               
               
                  2001
                  Reimbursable civilian full-time equivalent employment
                  1
                  1
                  1
               
               
                  
                     
                  
               
            
         
      
         Office of the national coordinator for health information technologyFor 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, [$60,367,000] $91,800,000 shall be available from amounts available under section 241 of the PHS Act. (Department of Health and Human Services Appropriations Act, 2015.)
      Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0130â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Health information technology
                  15
                  60
                  
               
               
                  0002
                  Recovery Act activities
                  9
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0799
                  Total direct obligations
                  24
                  60
                  
               
               
                  0801
                  Office of the National Coordinator for Health Information Techno (Reimbursable)
                  19
                  22
                  22
               
               
                  0802
                  Reimbursable program: PHS evaluation
                  45
                  
                  92
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0899
                  Total reimbursable obligations
                  64
                  22
                  114
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  88
                  82
                  114
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  1
                  2
                  2
               
               
                  1021
                  Recoveries of prior year unpaid obligations
                  10
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1050
                  Unobligated balance (total)
                  11
                  2
                  2
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, discretionary:
               
               
                  1100
                  Appropriation
                  16
                  60
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1160
                  Appropriation, discretionary (total)
                  16
                  60
                  
               
               
                  
                  Spending authority from offsetting collections, discretionary:
               
               
                  1700
                  PHS and Other
                  28
                  22
                  125
               
               
                  1700
                  Collected
                  
                  49
                  
               
               
                  1701
                  Change in uncollected payments, Federal sources
                  35
                  â49
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1750
                  Spending auth from offsetting collections, disc (total)
                  63
                  22
                  125
               
               
                  1900
                  Budget authority (total)
                  79
                  82
                  125
               
               
                  1930
                  Total budgetary resources available
                  90
                  84
                  127
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  2
                  2
                  13
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  452
                  189
                  101
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  88
                  82
                  114
               
               
                  3011
                  Obligations incurred, expired accounts
                  2
                  
                  
               
               
                  3020
                  Outlays (gross)
                  â342
                  â170
                  â174
               
               
                  3040
                  Recoveries of prior year unpaid obligations, unexpired
                  â10
                  
                  
               
               
                  3041
                  Recoveries of prior year unpaid obligations, expired
                  â1
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  189
                  101
                  41
               
               
                  
                  Uncollected payments:
               
               
                  3060
                  Uncollected pymts, Fed sources, brought forward, Oct 1
                  â34
                  â49
                  
               
               
                  3070
                  Change in uncollected pymts, Fed sources, unexpired
                  â35
                  49
                  
               
               
                  3071
                  Change in uncollected pymts, Fed sources, expired
                  20
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3090
                  Uncollected pymts, Fed sources, end of year
                  â49
                  
                  
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  418
                  140
                  101
               
               
                  3200
                  Obligated balance, end of year
                  140
                  101
                  41
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Discretionary:
               
               
                  4000
                  Budget authority, gross
                  79
                  82
                  125
               
               
                  
                  Outlays, gross:
               
               
                  4010
                  Outlays from new discretionary authority
                  39
                  70
                  106
               
               
                  4011
                  Outlays from discretionary balances
                  301
                  100
                  68
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4020
                  Outlays, gross (total)
                  340
                  170
                  174
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4030
                  Federal sources
                  â48
                  â22
                  â125
               
               
                  4030
                  Federal sources
                  
                  â49
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4040
                  Offsets against gross budget authority  and outlays (total)
                  â48
                  â71
                  â125
               
               
                  
                  Additional offsets against gross budget authority only:
               
               
                  4050
                  Change in uncollected pymts, Fed sources, unexpired
                  â35
                  49
                  
               
               
                  4052
                  Offsetting collections credited to expired accounts
                  20
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4060
                  Additional offsets against budget authority only (total)
                  â15
                  49
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4070
                  Budget authority, net (discretionary)
                  16
                  60
                  
               
               
                  4080
                  Outlays, net (discretionary)
                  292
                  99
                  49
               
               
                  
                  Mandatory:
               
               
                  
                  Outlays, gross:
               
               
                  4101
                  Outlays from mandatory balances
                  2
                  
                  
               
               
                  4180
                  Budget authority, net (total)
                  16
                  60
                  
               
               
                  4190
                  Outlays, net (total)
                  294
                  99
                  49
               
               
                  
                     
                  
               
            
         
      
      
         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. 111â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 075â0130â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  
                  Personnel compensation:
               
               
                  11.1
                  Full-time permanent
                  
                  15
                  
               
               
                  11.3
                  Other than full-time permanent
                  
                  5
                  
               
               
                  11.5
                  Other personnel compensation
                  
                  1
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  11.9
                  Total personnel compensation
                  
                  21
                  
               
               
                  12.1
                  Civilian personnel benefits
                  
                  6
                  
               
               
                  21.0
                  Travel and transportation of persons
                  
                  1
                  
               
               
                  23.1
                  Rental payments to GSA
                  3
                  4
                  
               
               
                  23.3
                  Communications, utilities, and miscellaneous charges
                  
                  1
                  
               
               
                  25.1
                  Advisory and assistance services
                  1
                  1
                  
               
               
                  25.2
                  Other services from non-Federal sources
                  6
                  14
                  
               
               
                  25.3
                  Other goods and services from Federal sources
                  5
                  12
                  
               
               
                  25.4
                  Operation and maintenance of facilities
                  1
                  
                  
               
               
                  41.0
                  Grants, subsidies, and contributions
                  8
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.0
                  Direct obligations
                  24
                  60
                  
               
               
                  99.0
                  Reimbursable obligations
                  64
                  22
                  114
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  88
                  82
                  114
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0130â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  
                  185
                  
               
               
                  1101
                  Direct military average strength employment
                  1
                  
                  
               
               
                  2001
                  Reimbursable civilian full-time equivalent employment
                  170
                  
                  200
               
               
                  
                     
                  
               
            
         
      
         Office of Medicare Hearings and Appeals                                                                                  
            
         Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0139â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Office of Medicare Hearings and Appeals (Direct)
                  82
                  87
                  140
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Spending authority from offsetting collections, discretionary:
               
               
                  1700
                  Collected
                  65
                  87
                  140
               
               
                  1701
                  Change in uncollected payments, Federal sources
                  17
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1750
                  Spending auth from offsetting collections, disc (total)
                  82
                  87
                  140
               
               
                  1900
                  Budget authority (total)
                  82
                  87
                  140
               
               
                  1930
                  Total budgetary resources available
                  82
                  87
                  140
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  9
                  16
                  
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  82
                  87
                  140
               
               
                  3020
                  Outlays (gross)
                  â73
                  â103
                  â140
               
               
                  3041
                  Recoveries of prior year unpaid obligations, expired
                  â2
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  16
                  
                  
               
               
                  
                  Uncollected payments:
               
               
                  3060
                  Uncollected pymts, Fed sources, brought forward, Oct 1
                  â23
                  â18
                  â18
               
               
                  3070
                  Change in uncollected pymts, Fed sources, unexpired
                  â17
                  
                  
               
               
                  3071
                  Change in uncollected pymts, Fed sources, expired
                  22
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3090
                  Uncollected pymts, Fed sources, end of year
                  â18
                  â18
                  â18
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  â14
                  â2
                  â18
               
               
                  3200
                  Obligated balance, end of year
                  â2
                  â18
                  â18
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Discretionary:
               
               
                  4000
                  Budget authority, gross
                  82
                  87
                  140
               
               
                  
                  Outlays, gross:
               
               
                  4010
                  Outlays from new discretionary authority
                  68
                  87
                  140
               
               
                  4011
                  Outlays from discretionary balances
                  5
                  16
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4020
                  Outlays, gross (total)
                  73
                  103
                  140
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4030
                  Federal sources
                  â87
                  â87
                  â140
               
               
                  
                  Additional offsets against gross budget authority only:
               
               
                  4050
                  Change in uncollected pymts, Fed sources, unexpired
                  â17
                  
                  
               
               
                  4052
                  Offsetting collections credited to expired accounts
                  22
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4060
                  Additional offsets against budget authority only (total)
                  5
                  
                  
               
               
                  4080
                  Outlays, net (discretionary)
                  â14
                  16
                  
               
               
                  4190
                  Outlays, net (total)
                  â14
                  16
                  
               
               
                  
                     
                  
               
            
         
      
      
         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 075â0139â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  11.1
                  Personnel compensation: Full-time permanent
                  40
                  51
                  75
               
               
                  12.1
                  Civilian personnel benefits
                  12
                  16
                  24
               
               
                  22.0
                  Transportation of things
                  
                  
                  2
               
               
                  23.1
                  Rental payments to GSA
                  7
                  7
                  10
               
               
                  23.3
                  Communications, utilities, and miscellaneous charges
                  3
                  3
                  4
               
               
                  25.1
                  Advisory and assistance services
                  5
                  
                  
               
               
                  25.2
                  Other services from non-Federal sources
                  1
                  1
                  1
               
               
                  25.3
                  Other goods and services from Federal sources
                  5
                  6
                  15
               
               
                  25.4
                  Operation and maintenance of facilities
                  6
                  1
                  4
               
               
                  25.7
                  Operation and maintenance of equipment
                  1
                  1
                  1
               
               
                  26.0
                  Supplies and materials
                  1
                  1
                  1
               
               
                  31.0
                  Equipment
                  1
                  
                  3
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  82
                  87
                  140
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0139â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  468
                  564
                  903
               
               
                  
                     
                  
               
            
         
      
         Office of Medicare Hearings and Appeals                                                                                  
            
         
         (Legislative proposal, subject to PAYGO)Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0139â4â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0801
                  Reimbursable program activity
                  
                  
                  130
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Spending authority from offsetting collections, mandatory:
               
               
                  1800
                  Collected
                  
                  
                  130
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1850
                  Spending auth from offsetting collections, mand (total)
                  
                  
                  130
               
               
                  1930
                  Total budgetary resources available
                  
                  
                  130
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  
                  
                  130
               
               
                  3020
                  Outlays (gross)
                  
                  
                  â130
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  
                  
                  130
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  
                  
                  130
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4120
                  Federal sources
                  
                  
                  â130
               
               
                  
                     
                  
               
            
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0139â4â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Reimbursable obligations:
               
               
                  11.1
                  Personnel compensation: Full-time permanent
                  
                  
                  50
               
               
                  12.1
                  Civilian personnel benefits
                  
                  
                  18
               
               
                  22.0
                  Transportation of things
                  
                  
                  9
               
               
                  23.1
                  Rental payments to GSA
                  
                  
                  11
               
               
                  23.3
                  Communications, utilities, and miscellaneous charges
                  
                  
                  2
               
               
                  25.3
                  Other goods and services from Federal sources
                  
                  
                  14
               
               
                  25.4
                  Operation and maintenance of facilities
                  
                  
                  6
               
               
                  25.7
                  Operation and maintenance of equipment
                  
                  
                  4
               
               
                  26.0
                  Supplies and materials
                  
                  
                  1
               
               
                  31.0
                  Equipment
                  
                  
                  15
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  
                  
                  130
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0139â4â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  
                  
                  572
               
               
                  
                     
                  
               
            
         
      
         Public health and social services emergency fundFor 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, [$848,154,000] $983,546,760, of which [$415,000,000] $521,732,000 shall remain available through September 30, [2016] 2017, 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: 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, 2017] until expended: Provided further, That [these funds are] in addition to amounts provided [in section 136 of Public Law 113â164] herein, $30,000,000 shall be made available under section 241 of the PHS Act for necessary expenses to initiate a longitudinal
            health insurance study, with such reimbursable amounts advanced and available until September 30, 2020.
      
      For expenses necessary for procuring security countermeasures (as defined in section 319F-2(c)(1)(B) of the PHS Act), [$255,000,000] $646,425,000, to remain available until expended.
      
      For an additional amount for expenses necessary to prepare for or respond to an influenza pandemic [, $71,915,000] 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 [$39,906,000] $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, 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.
      
      For an additional amount for expenses necessary to provide immediate response to an urgent need, including a disease outbreak,
            a disaster, and an urgent or emergency public health care need, $90,000,000, to be available until expended: Provided, That
            funds may be used for state and local emergency response: Provided further, That, in addition to amounts provided herein,
            $20,000,000 shall be made available for preparedness or response activities, including for equipment and training, and shall
            be available until expended: Provided further, That the funds in this paragraph may be transferred at the discretion of the
            Secretary for the purposes provided in this paragraph to other accounts within the Department of Health and Human Services. (Department of Health and Human Services Appropriations Act, 2015.)
         [(INCLUDING TRANSFER OF FUNDS)][For an additional amount for "Public Health and Social Services Emergency Fund" to prevent, prepare for, and respond to Ebola
         domestically or internationally, and to develop necessary medical countermeasures and vaccines including the development and
         purchase of vaccines, therapeutics, diagnostics, necessary medical supplies, and administrative activities, $733,000,000,
         to remain available until September 30, 2019: Provided, That products purchased with these funds may, at the discretion of the Secretary of Health and Human Services, be deposited
         in the Strategic National Stockpile under section 319F-2 of the PHS Act: Provided further, That, notwithstanding section 496(b) of the PHS Act, funds may be used for the renovation and alteration of privately owned
         facilities to improve preparedness and response capability at the State and local level: Provided further, That sections 319C-1(h)(3) and 319C-2(h) of the PHS Act shall not apply to funds appropriated under this heading: Provided further, That reimbursement of domestic transportation and treatment costs (other than costs paid or reimbursed by the individual's
         health coverage) for an individual treated in the United States for Ebola, before or after the date of enactment of this Act,
         shall be deemed to be a use of resources of the Secretary in implementation of a plan under section 311(c)(1) of the PHS Act
         (42 U.S.C. 243(c)(1)), and funds made available by this title shall be available for that purpose, at the discretion of the
         Secretary: Provided further, That funds appropriated in this paragraph may be used for the purposes specified in this paragraph and to the fund authorized
         by section 319F-4 of the PHS Act: Provided further, That such amount is designated by the Congress as an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced
         Budget and Emergency Deficit Control Act of 1985.] (Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2015.)
      Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0140â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Public Health and Social Services Emergency Fund
                  1,529
                  1,392
                  1,507
               
               
                  0801
                  Reimbursable program (FEMA)
                  24
                  80
                  80
               
               
                  0802
                  Reimbursable program activity (OPP)
                  2
                  2
                  32
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0899
                  Total reimbursable obligations
                  26
                  82
                  112
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  1,555
                  1,474
                  1,619
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  851
                  627
                  1,168
               
               
                  1010
                  Unobligated balance transfer to other accts [075â0343]
                  â5
                  â3
                  â3
               
               
                  1021
                  Recoveries of prior year unpaid obligations
                  60
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1050
                  Unobligated balance (total)
                  906
                  624
                  1,165
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, discretionary:
               
               
                  1100
                  Appropriation
                  1,243
                  1,233
                  1,910
               
               
                  1100
                  Appropriation - Emergency Pursuant to 2011 BCA
                  
                  733
                  
               
               
                  1120
                  Appropriations transferred to other accts [075â1503]
                  â1
                  
                  
               
               
                  1120
                  Appropriations transferred to other accts [075â0511]
                  â2
                  
                  
               
               
                  1121
                  Appropriations transferred from other acct [075â9915]
                  6
                  
                  
               
               
                  1121
                  Appropriations transferred from other acct [075â0943]
                  1
                  
                  
               
               
                  1121
                  Appropriations transferred from other acct [075â1362]
                  1
                  
                  
               
               
                  1121
                  Appropriations transferred from other acct [075â1515]
                  2
                  
                  
               
               
                  1121
                  Appropriations transferred from other acct [075â1536]
                  1
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1160
                  Appropriation, discretionary (total)
                  1,251
                  1,966
                  1,910
               
               
                  
                  Spending authority from offsetting collections, discretionary:
               
               
                  1700
                  Collected
                  1
                  81
                  95
               
               
                  1701
                  Change in uncollected payments, Federal sources
                  25
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1750
                  Spending auth from offsetting collections, disc (total)
                  26
                  81
                  95
               
               
                  1900
                  Budget authority (total)
                  1,277
                  2,047
                  2,005
               
               
                  1930
                  Total budgetary resources available
                  2,183
                  2,671
                  3,170
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1940
                  Unobligated balance expiring
                  â1
                  â29
                  
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  627
                  1,168
                  1,551
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  4,655
                  4,095
                  3,467
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  1,555
                  1,474
                  1,619
               
               
                  3020
                  Outlays (gross)
                  â2,015
                  â2,062
                  â2,401
               
               
                  3040
                  Recoveries of prior year unpaid obligations, unexpired
                  â60
                  
                  
               
               
                  3041
                  Recoveries of prior year unpaid obligations, expired
                  â40
                  â40
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  4,095
                  3,467
                  2,685
               
               
                  
                  Uncollected payments:
               
               
                  3060
                  Uncollected pymts, Fed sources, brought forward, Oct 1
                  â153
                  â126
                  â126
               
               
                  3070
                  Change in uncollected pymts, Fed sources, unexpired
                  â25
                  
                  
               
               
                  3071
                  Change in uncollected pymts, Fed sources, expired
                  52
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3090
                  Uncollected pymts, Fed sources, end of year
                  â126
                  â126
                  â126
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  4,502
                  3,969
                  3,341
               
               
                  3200
                  Obligated balance, end of year
                  3,969
                  3,341
                  2,559
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Discretionary:
               
               
                  4000
                  Budget authority, gross
                  1,277
                  2,047
                  2,005
               
               
                  
                  Outlays, gross:
               
               
                  4010
                  Outlays from new discretionary authority
                  251
                  507
                  544
               
               
                  4011
                  Outlays from discretionary balances
                  1,764
                  1,555
                  1,857
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4020
                  Outlays, gross (total)
                  2,015
                  2,062
                  2,401
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4030
                  Federal sources
                  â45
                  â81
                  â95
               
               
                  
                  Additional offsets against gross budget authority only:
               
               
                  4050
                  Change in uncollected pymts, Fed sources, unexpired
                  â25
                  
                  
               
               
                  4052
                  Offsetting collections credited to expired accounts
                  44
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4060
                  Additional offsets against budget authority only (total)
                  19
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4070
                  Budget authority, net (discretionary)
                  1,251
                  1,966
                  1,910
               
               
                  4080
                  Outlays, net (discretionary)
                  1,970
                  1,981
                  2,306
               
               
                  4180
                  Budget authority, net (total)
                  1,251
                  1,966
                  1,910
               
               
                  4190
                  Outlays, net (total)
                  1,970
                  1,981
                  2,306
               
               
                  
                     
                  
               
            
         
      
      
         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.
            
         
         The FY 2015 funding level includes $733 million in one-time emergency funding for the U.S. Government response to contain,
            treat, and prevent the spread of Ebola.
         
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0140â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  
                  Personnel compensation:
               
               
                  11.1
                  Full-time permanent
                  68
                  75
                  77
               
               
                  11.3
                  Other than full-time permanent
                  6
                  6
                  6
               
               
                  11.7
                  Military personnel
                  7
                  7
                  7
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  11.9
                  Total personnel compensation
                  81
                  88
                  90
               
               
                  12.1
                  Civilian personnel benefits
                  22
                  22
                  23
               
               
                  12.2
                  Military personnel benefits
                  3
                  3
                  3
               
               
                  21.0
                  Travel and transportation of persons
                  2
                  2
                  2
               
               
                  22.0
                  Transportation of things
                  5
                  4
                  4
               
               
                  23.1
                  Rental payments to GSA
                  17
                  17
                  18
               
               
                  23.3
                  Communications, utilities, and miscellaneous charges
                  15
                  8
                  17
               
               
                  25.1
                  Advisory and assistance services
                  367
                  205
                  200
               
               
                  25.2
                  Other services from non-Federal sources
                  224
                  140
                  140
               
               
                  25.3
                  Other goods and services from Federal sources
                  36
                  33
                  52
               
               
                  25.4
                  Operation and maintenance of facilities
                  20
                  20
                  20
               
               
                  25.5
                  Research and development contracts
                  104
                  118
                  302
               
               
                  25.7
                  Operation and maintenance of equipment
                  15
                  15
                  15
               
               
                  26.0
                  Supplies and materials
                  336
                  336
                  336
               
               
                  31.0
                  Equipment
                  17
                  16
                  20
               
               
                  41.0
                  Grants, subsidies, and contributions
                  265
                  365
                  265
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.0
                  Direct obligations
                  1,529
                  1,392
                  1,507
               
               
                  99.0
                  Reimbursable obligations
                  26
                  82
                  112
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  1,555
                  1,474
                  1,619
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0140â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  619
                  682
                  698
               
               
                  1101
                  Direct military average strength employment
                  77
                  75
                  75
               
               
                  
                     
                  
               
            
         
      
         Transfers from the Patient-Centered Outcomes Research Trust Fund                                                         
            
         Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0145â0â1â552
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0801
                  AHRQ
                  50
                  130
                  116
               
               
                  0802
                  Office of the Secretary
                  12
                  31
                  29
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0809
                  Reimbursable program activities, subtotal
                  62
                  161
                  145
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  62
                  161
                  145
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  49
                  69
                  47
               
               
                  
                  Budget authority:
               
               
                  
                  Spending authority from offsetting collections, mandatory:
               
               
                  1800
                  Collected
                  82
                  139
                  145
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1850
                  Spending auth from offsetting collections, mand (total)
                  82
                  139
                  145
               
               
                  1900
                  Budget authority (total)
                  82
                  139
                  145
               
               
                  1930
                  Total budgetary resources available
                  131
                  208
                  192
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  69
                  47
                  47
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  49
                  65
                  193
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  62
                  161
                  145
               
               
                  3020
                  Outlays (gross)
                  â46
                  â33
                  â88
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  65
                  193
                  250
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  49
                  65
                  193
               
               
                  3200
                  Obligated balance, end of year
                  65
                  193
                  250
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  82
                  139
                  145
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  2
                  4
                  4
               
               
                  4101
                  Outlays from mandatory balances
                  44
                  29
                  84
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4110
                  Outlays, gross (total)
                  46
                  33
                  88
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4120
                  Federal sources
                  â82
                  â139
                  â145
               
               
                  4190
                  Outlays, net (total)
                  â36
                  â106
                  â57
               
               
                  
                     
                  
               
            
         
      
      
         Public Law 111â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 coordinate Federal health programs to 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 075â0145â0â1â552
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  25.5
                  Reimbursable obligations: Research and development contracts
                  12
                  31
                  29
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.0
                  Reimbursable obligations
                  12
                  31
                  29
               
               
                  
                  Allocation Account - reimbursable:
               
               
                  11.1
                  Personnel compensation: Full-time permanent
                  2
                  2
                  2
               
               
                  25.5
                  Research and development contracts
                  18
                  49
                  44
               
               
                  41.0
                  Grants, subsidies, and contributions
                  30
                  79
                  70
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.0
                  Allocation account - reimbursable
                  50
                  130
                  116
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  62
                  161
                  145
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0145â0â1â552
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  2001
                  Reimbursable civilian full-time equivalent employment
                  2
                  3
                  3
               
               
                  3001
                  Allocation account civilian full-time equivalent employment
                  13
                  25
                  25
               
               
                  
                     
                  
               
            
         
      
         Prevention and Wellness Fund, Recovery Act                                                                               
            
         
         The Prevention and Wellness Fund is authorized under the American Recovery and Reinvestment Act (ARRA), (P.L. 111â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 075â0125â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Nonrecurring Expenses Fund Projects
                  545
                  600
                  100
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  286
                  425
                  175
               
               
                  1012
                  Unobligated balance transfers between expired and unexpired accounts
                  682
                  350
                  
               
               
                  1021
                  Recoveries of prior year unpaid obligations
                  2
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1050
                  Unobligated balance (total)
                  970
                  775
                  175
               
               
                  1930
                  Total budgetary resources available
                  970
                  775
                  175
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  425
                  175
                  75
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  505
                  372
                  493
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  545
                  600
                  100
               
               
                  3020
                  Outlays (gross)
                  â676
                  â479
                  â402
               
               
                  3040
                  Recoveries of prior year unpaid obligations, unexpired
                  â2
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  372
                  493
                  191
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  505
                  372
                  493
               
               
                  3200
                  Obligated balance, end of year
                  372
                  493
                  191
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Discretionary:
               
               
                  
                  Outlays, gross:
               
               
                  4011
                  Outlays from discretionary balances
                  676
                  479
                  402
               
               
                  4190
                  Outlays, net (total)
                  676
                  479
                  402
               
               
                  
                     
                  
               
            
         
      
      
         The Nonrecurring Expenses Fund is a no-year account that receives transfers of expired unobligated balances from discretionary
            accounts prior to cancellation. The Fund is used for capital acquisition, including facilities infrastructure and information
            technology infrastructure.
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0125â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  11.1
                  Personnel compensation: Full-time permanent
                  1
                  
                  
               
               
                  25.2
                  Other services from non-Federal sources
                  5
                  50
                  10
               
               
                  25.3
                  Other goods and services from Federal sources
                  13
                  100
                  6
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.0
                  Direct obligations
                  19
                  150
                  16
               
               
                  
                  Allocation Account - direct:
               
               
                  25.2
                  Other services from non-Federal sources
                  525
                  448
                  83
               
               
                  25.3
                  Other goods and services from Federal sources
                  1
                  2
                  1
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.0
                  Allocation account - direct
                  526
                  450
                  84
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  545
                  600
                  100
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0125â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  8
                  
                  
               
               
                  
                     
                  
               
            
         
      
         Health Insurance Reform Implementation Fund                                                                              
            
         Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0119â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Health Insurance Reform Implementation Fund (Direct)
                  70
                  26
                  
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  87
                  26
                  
               
               
                  1021
                  Recoveries of prior year unpaid obligations
                  9
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1050
                  Unobligated balance (total)
                  96
                  26
                  
               
               
                  1930
                  Total budgetary resources available
                  96
                  26
                  
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  26
                  
                  
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  197
                  88
                  14
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  70
                  26
                  
               
               
                  3020
                  Outlays (gross)
                  â170
                  â100
                  â14
               
               
                  3040
                  Recoveries of prior year unpaid obligations, unexpired
                  â9
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  88
                  14
                  
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  197
                  88
                  14
               
               
                  3200
                  Obligated balance, end of year
                  88
                  14
                  
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  
                  Outlays, gross:
               
               
                  4101
                  Outlays from mandatory balances
                  170
                  100
                  14
               
               
                  4190
                  Outlays, net (total)
                  170
                  100
                  14
               
               
                  
                     
                  
               
            
         
      
      
         Section 1005 of the Health Care and Education Reconciliation Act of 2010 (P.L. 111â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. 111â148) and the Health Care and Education Reconciliation Act of 2010.
         
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0119â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  21.0
                  Travel and transportation of persons
                  
                  1
                  
               
               
                  25.2
                  Other services from non-Federal sources
                  20
                  25
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.0
                  Direct obligations
                  20
                  26
                  
               
               
                  25.2
                  Allocation Account - direct: Other services from non-Federal sources
                  50
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  70
                  26
                  
               
               
                  
                     
                  
               
            
         
      
         Prevention and Public Health Fund                                                                                        
            
         Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0116â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriation
                  1,000
                  1,000
                  1,000
               
               
                  1220
                  Appropriations transferred to other accts [075â0142]
                  â28
                  â28
                  â28
               
               
                  1220
                  Appropriations transferred to other accts [075â1700]
                  â7
                  
                  
               
               
                  1220
                  Appropriations transferred to other accts [075â0943]
                  â831
                  â886
                  â914
               
               
                  1220
                  Appropriations transferred to other accts [075â1362]
                  â62
                  â12
                  â58
               
               
                  1230
                  Appropriations and/or unobligated balance of appropriations permanently reduced [SEQ]
                  â72
                  â74
                  
               
               
                  
                     
                  
               
            
         
      
      
         The Affordable Care Act, (P.L. 111â148) established the Prevention and Public Health Fund to support prevention and public
            health activities. In FY 2016, $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 075â0117â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Pregnancy Assistance Fund (Direct)
                  23
                  23
                  25
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriation
                  25
                  25
                  25
               
               
                  1230
                  Appropriations and/or unobligated balance of appropriations permanently reduced
                  â2
                  â2
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  23
                  23
                  25
               
               
                  1930
                  Total budgetary resources available
                  23
                  23
                  25
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  34
                  32
                  47
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  23
                  23
                  25
               
               
                  3020
                  Outlays (gross)
                  â20
                  â8
                  â29
               
               
                  3041
                  Recoveries of prior year unpaid obligations, expired
                  â5
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  32
                  47
                  43
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  34
                  32
                  47
               
               
                  3200
                  Obligated balance, end of year
                  32
                  47
                  43
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  23
                  23
                  25
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  1
                  2
                  2
               
               
                  4101
                  Outlays from mandatory balances
                  19
                  6
                  27
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4110
                  Outlays, gross (total)
                  20
                  8
                  29
               
               
                  4180
                  Budget authority, net (total)
                  23
                  23
                  25
               
               
                  4190
                  Outlays, net (total)
                  20
                  8
                  29
               
               
                  
                     
                  
               
            
         
      
      
         For awarding competitive grants to States to assist pregnant and parenting teens and women.
      
      Object Classification (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0117â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  25.3
                  Other goods and services from Federal sources
                  1
                  1
                  
               
               
                  41.0
                  Grants, subsidies, and contributions
                  22
                  22
                  25
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  23
                  23
                  25
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0117â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  2
                  2
                  2
               
               
                  
                     
                  
               
            
         
      
         Section 241 Evaluation Transactions Account                                                                              
            
         Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â3902â0â1â552
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0801
                  Section 241 Evaluation Transactions Account (Reimbursable)
                  1,060
                  415
                  481
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0809
                  Reimbursable program activities, subtotal
                  1,060
                  415
                  481
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  1,060
                  415
                  481
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Spending authority from offsetting collections, discretionary:
               
               
                  1700
                  Collected
                  430
                  415
                  481
               
               
                  1701
                  Change in uncollected payments, Federal sources
                  630
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1750
                  Spending auth from offsetting collections, disc (total)
                  1,060
                  415
                  481
               
               
                  1930
                  Total budgetary resources available
                  1,060
                  415
                  481
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  
                  596
                  30
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  1,060
                  415
                  481
               
               
                  3020
                  Outlays (gross)
                  â464
                  â981
                  â481
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  596
                  30
                  30
               
               
                  
                  Uncollected payments:
               
               
                  3060
                  Uncollected pymts, Fed sources, brought forward, Oct 1
                  
                  â630
                  â630
               
               
                  3070
                  Change in uncollected pymts, Fed sources, unexpired
                  â630
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3090
                  Uncollected pymts, Fed sources, end of year
                  â630
                  â630
                  â630
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  
                  â34
                  â600
               
               
                  3200
                  Obligated balance, end of year
                  â34
                  â600
                  â600
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Discretionary:
               
               
                  4000
                  Budget authority, gross
                  1,060
                  415
                  481
               
               
                  
                  Outlays, gross:
               
               
                  4010
                  Outlays from new discretionary authority
                  464
                  415
                  481
               
               
                  4011
                  Outlays from discretionary balances
                  
                  566
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4020
                  Outlays, gross (total)
                  464
                  981
                  481
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4030
                  Federal sources
                  â429
                  â415
                  â481
               
               
                  4033
                  Non-Federal sources
                  â1
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4040
                  Offsets against gross budget authority  and outlays (total)
                  â430
                  â415
                  â481
               
               
                  
                  Additional offsets against gross budget authority only:
               
               
                  4050
                  Change in uncollected pymts, Fed sources, unexpired
                  â630
                  
                  
               
               
                  4080
                  Outlays, net (discretionary)
                  34
                  566
                  
               
               
                  4190
                  Outlays, net (total)
                  34
                  566
                  
               
               
                  
                     
                  
               
            
         
      
      
         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 075â3902â0â1â552
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  25.3
                  Reimbursable obligations: Other goods and services from Federal sources
                  1,060
                  415
                  481
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.0
                  Reimbursable obligations
                  1,060
                  415
                  481
               
               
                  
                     
                  
               
            
         
      
         Program Support Center                                                                                                   
            
         Federal Funds
         Retirement pay and medical benefits for commissioned officersFor 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, 2015.)
      Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0379â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Retirement payments
                  407
                  423
                  441
               
               
                  0002
                  Survivors' benefits
                  27
                  28
                  29
               
               
                  0003
                  Medical care
                  106
                  111
                  116
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  540
                  562
                  586
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1200
                  Appropriation
                  540
                  562
                  586
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  540
                  562
                  586
               
               
                  1930
                  Total budgetary resources available
                  540
                  562
                  586
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  66
                  65
                  31
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  540
                  562
                  586
               
               
                  3011
                  Obligations incurred, expired accounts
                  1
                  
                  
               
               
                  3020
                  Outlays (gross)
                  â538
                  â596
                  â585
               
               
                  3041
                  Recoveries of prior year unpaid obligations, expired
                  â4
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  65
                  31
                  32
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  66
                  65
                  31
               
               
                  3200
                  Obligated balance, end of year
                  65
                  31
                  32
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  540
                  562
                  586
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  482
                  534
                  557
               
               
                  4101
                  Outlays from mandatory balances
                  56
                  62
                  28
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4110
                  Outlays, gross (total)
                  538
                  596
                  585
               
               
                  4180
                  Budget authority, net (total)
                  540
                  562
                  586
               
               
                  4190
                  Outlays, net (total)
                  538
                  596
                  585
               
               
                  
                     
                  
               
            
         
      
      
         The number of beneficiaries using the Commissioned Corps system is estimated as follows:
         Retirement Pay, Survivor Benefits, and Medical Benefits
         
            
               
                  
                     
                        
                     
                  
                  
                      
                     2014
                     2015
                     2016
                  
                  
                     
                        
                     
                  
                  
                     Active Duty:
                     
                     
                     
                  
                  
                     HHS
                     5000
                     5023
                     5016
                  
                  
                     DOJ, BOP
                     882
                     885
                     885
                  
                  
                     Homeland Security
                     494
                     566
                     566
                  
                  
                     EPA
                     63
                     57
                     57
                  
                  
                     All Other
                     366
                     372
                     375
                  
                  
                     
                     
                        
                     
                     
                        
                     
                     
                        
                     
                  
                  
                     Total Active Duty
                     6805
                     6903
                     6899
                  
                  
                     
                     
                     
                     
                  
                  
                     Retirees & Survivors:
                     
                     
                     
                  
                  
                     Retirees
                     5860
                     6010
                     6130
                  
                  
                     Retiree family members and survivors
                     1058
                     1088
                     1097
                  
                  
                     
                     
                        
                     
                     
                        
                     
                     
                        
                     
                  
                  
                     Total Retirement Pay
                     6918
                     7098
                     7227
                  
                  
                     Total Beneficiaries (active duty, retirees, survivors)
                     13723
                     14001
                     14126
                  
                  
                     
                     
                        
                     
                     
                        
                     
                     
                        
                     
                  
                  
                     
                        
                     
                  
               
            
         
         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 075â0379â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  13.0
                  Benefits for former personnel
                  441
                  451
                  470
               
               
                  25.6
                  Medical care
                  99
                  111
                  116
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  540
                  562
                  586
               
               
                  
                     
                  
               
            
         
      
         HHS Accrual Contribution to the Uniformed Services Retiree Health Care Fund                                              
            
         Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0170â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Medicare eligible accruals
                  27
                  28
                  29
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations (object class 12.2)
                  27
                  28
                  29
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, discretionary:
               
               
                  1100
                  Appropriation
                  27
                  28
                  29
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1160
                  Appropriation, discretionary (total)
                  27
                  28
                  29
               
               
                  1930
                  Total budgetary resources available
                  27
                  28
                  29
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  27
                  28
                  29
               
               
                  3020
                  Outlays (gross)
                  â27
                  â28
                  â29
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Discretionary:
               
               
                  4000
                  Budget authority, gross
                  27
                  28
                  29
               
               
                  
                  Outlays, gross:
               
               
                  4010
                  Outlays from new discretionary authority
                  27
                  28
                  29
               
               
                  4180
                  Budget authority, net (total)
                  27
                  28
                  29
               
               
                  4190
                  Outlays, net (total)
                  27
                  28
                  29
               
               
                  
                     
                  
               
            
         
      
      
         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. 108â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 075â0170â2â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Medicare eligible accruals
                  
                  
                  â1
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations (object class 12.2)
                  
                  
                  â1
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, discretionary:
               
               
                  1100
                  Appropriation
                  
                  
                  â1
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1160
                  Appropriation, discretionary (total)
                  
                  
                  â1
               
               
                  1930
                  Total budgetary resources available
                  
                  
                  â1
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  
                  
                  â1
               
               
                  3020
                  Outlays (gross)
                  
                  
                  1
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Discretionary:
               
               
                  4000
                  Budget authority, gross
                  
                  
                  â1
               
               
                  
                  Outlays, gross:
               
               
                  4010
                  Outlays from new discretionary authority
                  
                  
                  â1
               
               
                  4180
                  Budget authority, net (total)
                  
                  
                  â1
               
               
                  4190
                  Outlays, net (total)
                  
                  
                  â1
               
               
                  
                     
                  
               
            
         
      
         HHS Service and Supply Fund                                                                                              
            
         Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â9941â0â4â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0801
                  Program Support Center
                  689
                  765
                  776
               
               
                  0802
                  OS activities
                  353
                  422
                  426
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  1,042
                  1,187
                  1,202
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  117
                  130
                  130
               
               
                  1021
                  Recoveries of prior year unpaid obligations
                  40
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1050
                  Unobligated balance (total)
                  157
                  130
                  130
               
               
                  
                  Budget authority:
               
               
                  
                  Spending authority from offsetting collections, discretionary:
               
               
                  1700
                  Collected
                  884
                  1,187
                  1,202
               
               
                  1700
                  Collected from uncollected FY14 pmts - line 3090
                  
                  372
                  
               
               
                  1701
                  Change in uncollected payments, Federal sources
                  131
                  
                  
               
               
                  1701
                  Change in uncollected payments, Federal sources
                  
                  â372
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1750
                  Spending auth from offsetting collections, disc (total)
                  1,015
                  1,187
                  1,202
               
               
                  1930
                  Total budgetary resources available
                  1,172
                  1,317
                  1,332
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  130
                  130
                  130
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  515
                  621
                  
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  1,042
                  1,187
                  1,202
               
               
                  3020
                  Outlays (gross)
                  â896
                  â1,808
                  â1,202
               
               
                  3040
                  Recoveries of prior year unpaid obligations, unexpired
                  â40
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  621
                  
                  
               
               
                  
                  Uncollected payments:
               
               
                  3060
                  Uncollected pymts, Fed sources, brought forward, Oct 1
                  â241
                  â372
                  
               
               
                  3070
                  Change in uncollected pymts, Fed sources, unexpired
                  â131
                  372
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3090
                  Uncollected pymts, Fed sources, end of year
                  â372
                  
                  
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  274
                  249
                  
               
               
                  3200
                  Obligated balance, end of year
                  249
                  
                  
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Discretionary:
               
               
                  4000
                  Budget authority, gross
                  1,015
                  1,187
                  1,202
               
               
                  
                  Outlays, gross:
               
               
                  4010
                  Outlays from new discretionary authority
                  568
                  1,187
                  1,202
               
               
                  4011
                  Outlays from discretionary balances
                  328
                  621
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4020
                  Outlays, gross (total)
                  896
                  1,808
                  1,202
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4030
                  Federal sources
                  â875
                  â1,187
                  â1,202
               
               
                  4030
                  Federal sources
                  
                  â372
                  
               
               
                  4033
                  Non-Federal sources
                  â9
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4040
                  Offsets against gross budget authority  and outlays (total)
                  â884
                  â1,559
                  â1,202
               
               
                  
                  Additional offsets against gross budget authority only:
               
               
                  4050
                  Change in uncollected pymts, Fed sources, unexpired
                  â131
                  372
                  
               
               
                  4080
                  Outlays, net (discretionary)
                  12
                  249
                  
               
               
                  4190
                  Outlays, net (total)
                  12
                  249
                  
               
               
                  
                     
                  
               
            
         
      
      
         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 075â9941â0â4â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Reimbursable obligations:
               
               
                  
                  Personnel compensation:
               
               
                  11.1
                  Full-time permanent
                  103
                  106
                  108
               
               
                  11.3
                  Other than full-time permanent
                  2
                  2
                  2
               
               
                  11.5
                  Other personnel compensation
                  3
                  3
                  3
               
               
                  11.7
                  Military personnel
                  8
                  8
                  8
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  11.9
                  Total personnel compensation
                  116
                  119
                  121
               
               
                  12.1
                  Civilian personnel benefits
                  29
                  29
                  31
               
               
                  12.2
                  Military personnel benefits
                  2
                  2
                  2
               
               
                  21.0
                  Travel and transportation of persons
                  2
                  2
                  2
               
               
                  22.0
                  Transportation of things
                  4
                  4
                  4
               
               
                  23.1
                  Rental payments to GSA
                  22
                  24
                  24
               
               
                  23.3
                  Communications, utilities, and miscellaneous charges
                  6
                  6
                  6
               
               
                  24.0
                  Printing and reproduction
                  3
                  3
                  3
               
               
                  25.1
                  Advisory and assistance services
                  27
                  32
                  31
               
               
                  25.2
                  Other services from non-Federal sources
                  656
                  745
                  754
               
               
                  25.3
                  Other goods and services from Federal sources
                  51
                  70
                  71
               
               
                  25.4
                  Operation and maintenance of facilities
                  16
                  16
                  16
               
               
                  25.6
                  Medical care
                  24
                  29
                  29
               
               
                  25.7
                  Operation and maintenance of equipment
                  49
                  71
                  73
               
               
                  26.0
                  Supplies and materials
                  32
                  32
                  32
               
               
                  31.0
                  Equipment
                  3
                  3
                  3
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  1,042
                  1,187
                  1,202
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â9941â0â4â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  2001
                  Reimbursable civilian full-time equivalent employment
                  1,131
                  1,232
                  1,236
               
               
                  2101
                  Reimbursable military average strength employment
                  79
                  75
                  75
               
               
                  3101
                  Allocation account military average strength employment
                  1,742
                  1,823
                  1,826
               
               
                  
                     
                  
               
            
         
      
      Trust Funds
         Miscellaneous Trust Funds                                                                                                
            
         Special and Trust Fund Receipts (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â9971â0â7â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  0100
                  Balance, start of year
                  
                  
                  31
               
               
                  
                  Receipts:
               
               
                  0220
                  Contributions, Indian Health Facilities
                  14
                  48
                  48
               
               
                  0221
                  Contributions, N.I.H., Unconditional Gift Fund
                  4
                  3
                  3
               
               
                  0222
                  Centers for Disease Control, Gifts and Donations
                  10
                  15
                  15
               
               
                  0223
                  Contributions, N.I.H., Conditional Gift Fund
                  49
                  27
                  27
               
               
                  0224
                  Contributions to the Indian Health Service Gift Fund
                  1
                  1
                  1
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0299
                  Total receipts and collections
                  78
                  94
                  94
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0400
                  Total: Balances and collections
                  78
                  94
                  125
               
               
                  
                  Appropriations:
               
               
                  0500
                  Miscellaneous Trust Funds
                  â78
                  â63
                  â94
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0799
                  Balance, end of year
                  
                  31
                  31
               
               
                  
                     
                  
               
            
         
      
      Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â9971â0â7â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0002
                  Gifts
                  77
                  39
                  39
               
               
                  0003
                  Contributions, Indian Health Facilities
                  
                  12
                  12
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  77
                  51
                  51
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  149
                  154
                  166
               
               
                  1021
                  Recoveries of prior year unpaid obligations
                  4
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1050
                  Unobligated balance (total)
                  153
                  154
                  166
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, mandatory:
               
               
                  1201
                  Appropriation (special or trust fund)
                  78
                  63
                  94
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1260
                  Appropriations, mandatory (total)
                  78
                  63
                  94
               
               
                  1930
                  Total budgetary resources available
                  231
                  217
                  260
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  154
                  166
                  209
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  67
                  76
                  70
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  77
                  51
                  51
               
               
                  3020
                  Outlays (gross)
                  â64
                  â57
                  â64
               
               
                  3040
                  Recoveries of prior year unpaid obligations, unexpired
                  â4
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  76
                  70
                  57
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  67
                  76
                  70
               
               
                  3200
                  Obligated balance, end of year
                  76
                  70
                  57
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  78
                  63
                  94
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  2
                  6
                  9
               
               
                  4101
                  Outlays from mandatory balances
                  62
                  51
                  55
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4110
                  Outlays, gross (total)
                  64
                  57
                  64
               
               
                  4180
                  Budget authority, net (total)
                  78
                  63
                  94
               
               
                  4190
                  Outlays, net (total)
                  64
                  57
                  64
               
               
                  
                     
                  
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  5000
                  Total investments, SOY: Federal securities: Par value
                  28
                  25
                  25
               
               
                  5001
                  Total investments, EOY: Federal securities: Par value
                  25
                  25
                  25
               
               
                  
                     
                  
               
            
         
      
      
         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 075â9971â0â7â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  
                  Personnel compensation:
               
               
                  11.1
                  Full-time permanent
                  6
                  3
                  3
               
               
                  11.3
                  Other than full-time permanent
                  3
                  1
                  1
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  11.9
                  Total personnel compensation
                  9
                  4
                  4
               
               
                  12.1
                  Civilian personnel benefits
                  3
                  1
                  1
               
               
                  21.0
                  Travel and transportation of persons
                  1
                  1
                  1
               
               
                  25.1
                  Advisory and assistance services
                  5
                  3
                  3
               
               
                  25.2
                  Other services from non-Federal sources
                  15
                  10
                  10
               
               
                  25.3
                  Other goods and services from Federal sources
                  4
                  3
                  3
               
               
                  25.5
                  Research and development contracts
                  5
                  3
                  3
               
               
                  25.6
                  Medical care
                  1
                  1
                  1
               
               
                  26.0
                  Supplies and materials
                  6
                  4
                  4
               
               
                  31.0
                  Equipment
                  6
                  4
                  4
               
               
                  41.0
                  Grants, subsidies, and contributions
                  22
                  17
                  17
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  77
                  51
                  51
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â9971â0â7â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  27
                  27
                  27
               
               
                  
                     
                  
               
            
         
      
         Office of the Inspector General                                                                                          
            
         Federal Funds
         Office of inspector generalFor 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] $83,000,000: 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, 2015.)
      Program and Financing (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0128â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Obligations by program activity:
               
               
                  0001
                  Office of Inspector General (Direct)
                  74
                  76
                  83
               
               
                  0801
                  HCFAC Reimbursable program
                  197
                  194
                  207
               
               
                  0802
                  Direct Reimbursable program
                  15
                  21
                  21
               
               
                  0803
                  HCFAC Discretionary allocation adjustment
                  29
                  54
                  94
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0899
                  Total reimbursable obligations
                  241
                  269
                  322
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  0900
                  Total new obligations
                  315
                  345
                  405
               
               
                  
                     
                  
               
               
                  
                  Budgetary resources:
               
               
                  
                  Unobligated balance:
               
               
                  1000
                  Unobligated balance brought forward, Oct 1
                  20
                  22
                  36
               
               
                  1001
                  Discretionary unobligated balance brought fwd, Oct 1
                  7
                  5
                  
               
               
                  1021
                  Recoveries of prior year unpaid obligations
                  3
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1050
                  Unobligated balance (total)
                  23
                  22
                  36
               
               
                  
                  Budget authority:
               
               
                  
                  Appropriations, discretionary:
               
               
                  1100
                  Appropriation
                  71
                  71
                  83
               
               
                  1121
                  Appropriations transferred from other acct [075â9911]
                  
                  2
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1160
                  Appropriation, discretionary (total)
                  71
                  73
                  83
               
               
                  
                  Spending authority from offsetting collections, discretionary:
               
               
                  1700
                  Collected
                  27
                  88
                  140
               
               
                  1701
                  Change in uncollected payments, Federal sources
                  16
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1750
                  Spending auth from offsetting collections, disc (total)
                  43
                  88
                  140
               
               
                  
                  Spending authority from offsetting collections, mandatory:
               
               
                  1800
                  Collected
                  181
                  198
                  215
               
               
                  1801
                  Change in uncollected payments, Federal sources
                  20
                  
                  
               
               
                  1802
                  Offsetting collections (previously unavailable)
                  
                  1
                  1
               
               
                  1823
                  New and/or unobligated balance of spending authority from offsetting collections temporarily reduced
                  â1
                  â1
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  1850
                  Spending auth from offsetting collections, mand (total)
                  200
                  198
                  216
               
               
                  1900
                  Budget authority (total)
                  314
                  359
                  439
               
               
                  1930
                  Total budgetary resources available
                  337
                  381
                  475
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  1941
                  Unexpired unobligated balance, end of year
                  22
                  36
                  70
               
               
                  
                     
                  
               
               
                  
                  Change in obligated balance:
               
               
                  
                  Unpaid obligations:
               
               
                  3000
                  Unpaid obligations, brought forward, Oct 1
                  34
                  32
                  32
               
               
                  3010
                  Obligations incurred, unexpired accounts
                  315
                  345
                  405
               
               
                  3011
                  Obligations incurred, expired accounts
                  3
                  
                  
               
               
                  3020
                  Outlays (gross)
                  â315
                  â345
                  â436
               
               
                  3040
                  Recoveries of prior year unpaid obligations, unexpired
                  â3
                  
                  
               
               
                  3041
                  Recoveries of prior year unpaid obligations, expired
                  â2
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3050
                  Unpaid obligations, end of year
                  32
                  32
                  1
               
               
                  
                  Uncollected payments:
               
               
                  3060
                  Uncollected pymts, Fed sources, brought forward, Oct 1
                  â35
                  â60
                  â60
               
               
                  3070
                  Change in uncollected pymts, Fed sources, unexpired
                  â36
                  
                  
               
               
                  3071
                  Change in uncollected pymts, Fed sources, expired
                  11
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  3090
                  Uncollected pymts, Fed sources, end of year
                  â60
                  â60
                  â60
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  3100
                  Obligated balance, start of year
                  â1
                  â28
                  â28
               
               
                  3200
                  Obligated balance, end of year
                  â28
                  â28
                  â59
               
               
                  
                     
                  
               
               
                  
                  Budget authority and outlays, net:
               
               
                  
                  Discretionary:
               
               
                  4000
                  Budget authority, gross
                  114
                  161
                  223
               
               
                  
                  Outlays, gross:
               
               
                  4010
                  Outlays from new discretionary authority
                  99
                  146
                  203
               
               
                  4011
                  Outlays from discretionary balances
                  14
                  11
                  17
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4020
                  Outlays, gross (total)
                  113
                  157
                  220
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4030
                  Federal sources
                  â37
                  â88
                  â140
               
               
                  
                  Additional offsets against gross budget authority only:
               
               
                  4050
                  Change in uncollected pymts, Fed sources, unexpired
                  â16
                  
                  
               
               
                  4052
                  Offsetting collections credited to expired accounts
                  10
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4060
                  Additional offsets against budget authority only (total)
                  â6
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4070
                  Budget authority, net (discretionary)
                  71
                  73
                  83
               
               
                  4080
                  Outlays, net (discretionary)
                  76
                  69
                  80
               
               
                  
                  Mandatory:
               
               
                  4090
                  Budget authority, gross
                  200
                  198
                  216
               
               
                  
                  Outlays, gross:
               
               
                  4100
                  Outlays from new mandatory authority
                  175
                  180
                  197
               
               
                  4101
                  Outlays from mandatory balances
                  27
                  8
                  19
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4110
                  Outlays, gross (total)
                  202
                  188
                  216
               
               
                  
                  Offsets against gross budget authority and outlays:
               
               
                  
                  Offsetting collections (collected) from:
               
               
                  4120
                  Federal sources
                  â170
                  â186
                  â203
               
               
                  4123
                  Non-Federal sources
                  â12
                  â12
                  â12
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4130
                  Offsets against gross budget authority and outlays (total)
                  â182
                  â198
                  â215
               
               
                  
                  Additional offsets against gross budget authority only:
               
               
                  4140
                  Change in uncollected pymts, Fed sources, unexpired
                  â20
                  
                  
               
               
                  4142
                  Offsetting collections credited to expired accounts
                  1
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4150
                  Additional offsets against budget authority only (total)
                  â19
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  4160
                  Budget authority, net (mandatory)
                  â1
                  
                  1
               
               
                  4170
                  Outlays, net (mandatory)
                  20
                  â10
                  1
               
               
                  4180
                  Budget authority, net (total)
                  70
                  73
                  84
               
               
                  4190
                  Outlays, net (total)
                  96
                  59
                  81
               
               
                  
                     
                  
               
               
                  
                  Memorandum (non-add) entries:
               
               
                  5090
                  Unexpired unavailable balance, SOY: Offsetting collections
                  
                  1
                  1
               
               
                  5092
                  Unexpired unavailable balance, EOY: Offsetting collections
                  1
                  1
                  
               
               
                  
                     
                  
               
            
         
      
      
         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 075â0128â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  
                  Direct obligations:
               
               
                  
                  Personnel compensation:
               
               
                  11.1
                  Full-time permanent
                  40
                  42
                  47
               
               
                  11.3
                  Other than full-time permanent
                  1
                  1
                  1
               
               
                  11.5
                  Other personnel compensation
                  1
                  1
                  1
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  11.9
                  Total personnel compensation
                  42
                  44
                  49
               
               
                  12.1
                  Civilian personnel benefits
                  14
                  15
                  17
               
               
                  21.0
                  Travel and transportation of persons
                  1
                  3
                  2
               
               
                  22.0
                  Transportation of things
                  1
                  1
                  
               
               
                  23.1
                  Rental payments to GSA
                  4
                  4
                  4
               
               
                  23.3
                  Communications, utilities, and miscellaneous charges
                  2
                  1
                  1
               
               
                  25.2
                  Other services from non-Federal sources
                  1
                  1
                  1
               
               
                  25.3
                  Other goods and services from Federal sources
                  6
                  6
                  7
               
               
                  25.4
                  Operation and maintenance of facilities
                  1
                  1
                  1
               
               
                  26.0
                  Supplies and materials
                  1
                  
                  1
               
               
                  31.0
                  Equipment
                  1
                  1
                  1
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.0
                  Direct obligations
                  74
                  77
                  84
               
               
                  99.0
                  Reimbursable obligations
                  241
                  268
                  321
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  99.9
                  Total new obligations
                  315
                  345
                  405
               
               
                  
                     
                  
               
            
         
      
      Employment Summary
      
         
            
               
                  
                     
                  
               
               
                  Identification code 075â0128â0â1â551
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  1001
                  Direct civilian full-time equivalent employment
                  376
                  376
                  414
               
               
                  2001
                  Reimbursable civilian full-time equivalent employment
                  1,198
                  1,215
                  1,407
               
               
                  
                     
                  
               
            
         
      
         General and Administrative Provisions                                                                                    
            
         
         GENERAL FUND RECEIPT ACCOUNTS                                                                                            
            
         (in millions of dollars)
      
         
            
               
                  
                     
                  
               
               
                  
                  2014 actual
                  2015 est.
                  2016 est.
               
               
                  
                     
                  
               
               
                  Offsetting receipts from the public:
               
               
                  075â274530
                  Health Education Assistance Loans, Downward Reestimates of Subsidies
                  43
                  
                  
               
               
                  075â267403
                  Consumer Operated and Oriented Plan Direct Loan Program, Downward Reestimate of Subsidies
                  6
                  5
                  
               
               
                  075â322000
                  All Other General Fund Proprietary Receipts Including Budget Clearing Accounts
                  102
                  34
                  34
               
               
                  075â143500
                  General Fund Proprietary Interest Receipts, not Otherwise Classified
                  201
                  90
                  90
               
               
                  075â310700
                  Federal Share of Child Support Collections
                  743
                  664
                  664
               
               
                  Legislative proposal, subject to PAYGO
                  
                  
                  5
               
               
                  General Fund Offsetting receipts from the public
                  1,095
                  793
                  793
               
               
                  
                     
                  
               
               
                  
               
               
                  Intragovernmental payments:
               
               
                  075â388500
                  Undistributed Intragovernmental Payments and Receivables from Cancelled Accounts
                  â865
                  
                  
               
               
                  
                  
                  
                     
                  
                  
                     
                  
                  
                     
                  
               
               
                  General Fund Intragovernmental payments
                  â865
                  
                  
               
               
                  
                     
                  
               
            
         
      
      
         
      
         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 funds appropriated in this title shall be used to pay the salary of an individual, through a discretionary 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 [2015] 2016:
      (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 Centers for Disease Control and Prevention may acquire, lease, construct, alter, renovate, equip, furnish, or manage facilities
               outside of the United States, as necessary to conduct such programs, in consultation with the Secretary of State, either directly
               for the use of the United States Government or for the use, pursuant to grants, direct assistance, or cooperative agreements,
               of public or nonprofit private institutions or agencies in participating foreign countries.  
      ([3]4) 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.â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.â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 sections 736,
      739, or 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 through 2015, 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)), ifâ
      (1) funds are available and obligatedâ
         (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 2016 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 111â148 or Public
      Law 111â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 [2015] 2016 under section 338B of such Act.[SEC. 224. Title IV of the PHS Act is amended by:
      (1) Striking "National Center for Complementary and Alternative Medicine" in each place it appears and replacing it with "National
         Center for Complementary and Integrative Health";
      
      (2) Striking "alternative medicine" in each place it appears and replacing it with "integrative health";
      (3) Striking all references to "alternative and complementary medical treatment" or "complementary and alternative treatment"
         in each place either appears and inserting "complementary and integrative health";
      
      (4) Striking references to "alternative medical treatment" in each place it appears and inserting "integrative health treatment";
         and
      
      (5) Striking section 485D(c) and inserting:
         "(c) In carrying out subsection (a), the Director of the Center shall, as appropriate, study the integration of new and non-traditional
            approaches to health care treatment and consumption, including but not limited to non-traditional treatment, diagnostic and
            prevention systems, modalities, and disciplines.".]
      SEC. [225]218. In addition to amounts provided herein, payments made for research organisms or substances, authorized under section 301(a)
      of the PHS Act, shall be retained and credited to the appropriations accounts of the Institutes and Centers of the NIH making
      the substance or organism available under section 301(a). Amounts credited to the account under this authority shall be available
      for obligation through September 30, [2016] 2017.[SEC. 226. The Secretary shall publish, as part of the fiscal year 2016 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 111â148) and the proposed uses for such funds for fiscal year 2016. Such information shall include, for
      each such fiscal yearâ
      (1) the amount of funds used for each activity specified under the heading "Health Insurance Marketplace Transparency" in the
         explanatory statement described in section 4 (in the matter preceding division A of this Consolidated Act) accompanying this
         Act; and
      
      (2) the milestones completed for data hub functionality and implementation readiness.][SEC. 227. None of the funds made available by this Act from the Federal Hospital Insurance Trust Fund or the Federal Supplemental Medical
      Insurance Trust Fund, or transferred from other accounts funded by this Act to the" Centers for Medicare and Medicaid ServicesâProgram
      Management" account, may be used for payments under section 1342(b)(1) of Public Law 111â148 (relating to risk corridors).][SEC. 228. (a) Subject to the succeeding provisions of this section, activities authorized under part A of title IV and section 1108(b) of
      the Social Security Act shall continue through September 30, 2015, in the manner authorized for fiscal year 2014, 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. Grants and payments may be made pursuant to this authority through September 30, 2015, at the
      level provided for such activities for fiscal year 2014, except as provided in subsections (b) and (c).
      (b) In the case of the Contingency Fund for State Welfare Programs established under section 403(b) of the Social Security Actâ
         (1) the amount appropriated for section 403(b) of such Act shall be $608,000,000 for each of fiscal years 2015 and 2016;
         (2) the requirement to reserve funds provided for in section 403(b)(2) of such Act shall not apply during fiscal years 2015 and
            2016; and
         
         (3) grants and payments may only be made from such Fund for fiscal year 2015 after the application of subsection (d).
      
      (c) In the case of research, evaluations, and national studies funded under section 413(h)(1) of the Social Security Act, no funds
         shall be appropriated under that section for fiscal year 2015 or any fiscal year thereafter.
      
      (d) Of the amount made available under subsection (b)(1) for section 403(b) of the Social Security Act for fiscal year 2015â
         (1) $15,000,000 is hereby transferred and made available to carry out section 413(h) of the Social Security Act; and
         (2) $10,000,000 is hereby transferred and made available to the Bureau of the Census to conduct activities using the Survey of
            Income and Program Participation to obtain information to enable interested parties to evaluate the impact of the amendments
            made by title I of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996.
         
      
      (e) Section 413(h)(1) of the Social Security Act (42 U.S.C. 613(h)(1)) is amended, in the matter preceding subparagraph (A), by
         striking "Out of any money in the Treasury of the United States not otherwise appropriated, there are appropriated $15,000,000
         for fiscal year 2012" and inserting "Funds made available to carry out this section for a fiscal year shall be used".
      
      (f) Section 414 of the Social Security Act (42 U.S.C. 614) is repealed.
      (g) Expenditures made pursuant to Public Law 113â164 for section 403(b) of the Social Security Act for fiscal year 2015 shall
         be charged to the appropriation provided by subsection (b)(1) for such fiscal year.][SEC. 229. The remaining unobligated balances of the amount appropriated for fiscal year 2015 by section 510(d) of the Social Security
      Act (42 U.S.C. 710(d)) for which no application has been received by the Funding Opportunity Announcement deadline, shall
      be made available to States that require the implementation of each element described in subparagraphs (A) through (H) of
      the definition of abstinence education in section 510(b)(2). The remaining unobligated balances shall be reallocated to such
      States that submit a valid application consistent with the original formula for this funding.][SEC. 230. Hereafter, for each fiscal year through fiscal year 2025, the Director of the National Institutes of Health shall prepare
      and submit directly to the President for review and transmittal to Congress, after reasonable opportunity for comment, but
      without change, by the Secretary of Health and Human Services and the Advisory Council on Alzheimer's Research, Care, and
      Services, an annual budget estimate (including an estimate of the number and type of personnel needs for the Institutes) for
      the initiatives of the National Institutes of Health pursuant to the National Alzheimer's Plan, as required under section
      2(d)(2) of Public Law 111â375.]SEC. 219.   In the event of a public health emergency declared under section 319 of the PHS Act, the Secretary may, during the duration
            of the emergency, transfer discretionary funds (as defined pursuant to the Balanced Budget and Emergency Deficit Control Act
            of 1985) which are appropriated in this Act for the current fiscal year for the Department of Health and Human Services 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. SEC. 220. (a)   The amount appropriated for the Contingency Fund for State Welfare Programs established under section 403(b) of the Social
            Security Act (42 U.S.C. 603(b)) shall be $608,000,000 for fiscal year 2017. (b)   Of the amount made available by Public Law 113â235 for section 403(b) for fiscal year 2016â (1)   $15,000,000 is hereby transferred to the Children's Research and Technical Assistance account in the Administration for Children
                  and Families of the Department of Health and Human Services and made available to carry out section 413(h) of the Social Security
                  Act (42 U.S.C. 613(h)); and 
         (2)   $10,000,000 is hereby transferred to the Current Surveys and Programs account in the Bureau of the Census of the Department
                  of Commerce and made available to the Bureau of the Census to conduct activities using the Survey of Income and Program Participation
                  to obtain information to enable interested parties to evaluate the impact of the amendments made by title I of the Personal
                  Responsibility and Work Opportunity Reconciliation Act of 1996 (Public Law 104â193). 
      SEC. 221.   Subsection 1864(e) of the Social Security Act (42 U.S.C. 1395aa(e)) is amended to read as followsâ  
         "(e) FEES FOR CONDUCTING REVISIT SURVEYS.âThe Secretary may impose fees upon facilities or entities referred to in this section
                  for conducting revisit surveys in cases where such facilities or entities have been cited for deficiencies during initial
                  certification, recertification, or substantiated complaint surveys. Such fees shall be established and collected in accordance
                  with regulations prescribed by the Secretary that provide for a gradual phase-in of the fee amounts, and collected funds shall
                  be available to supplement funding appropriated for such surveys. Fee amounts assessed upon an entity in an entity class shall
                  not exceed the estimated average cost of performing such surveys for an entity in such class. Such fees shall be collected
                  and available only to the extent and in such amounts as provided in advance in appropriations acts.".
      SEC. 222.   The following unobligated balances of amounts appropriated prior to fiscal year 2007 for "Department of Health and Human
            Services, Health Resources and Services Administration" are hereby permanently cancelled: (a)  $281,003 appropriated to carry out section 1610(b) of the PHS Act; 
      (b)  $3,611 appropriated to carry out section 1602(c) of the PHS Act; 
      (c)  $105,576 appropriated in section 167 of Division H of Public Law 108â199; and 
      (d)  $55,793 appropriated to carry out the National Cord Blood Stem Cell Bank Program.  (Department of Health and Human Services Appropriations Act, 2015.)[SEC. 601. For purposes of preventing, preparing for, and responding to Ebola domestically or internationally, the Secretary of Health
      and Human Services may use funds provided in this titleâ
      (1) for the CDC to acquire, lease, construct, alter, renovate, equip, furnish, or manage facilities outside of the United States,
         as necessary to conduct such programs, in consultation with the Secretary of State, either directly for the use of the United
         States Government or for the use, pursuant to grants, direct assistance, or cooperative agreements, of public or nonprofit
         private institutions or agencies in participating foreign countries;
      
      (2) for the CDC to obtain by contract (in accordance with section 3109 of title 5, but without regard to the limitations in such
         section on the period of service and on pay) the personal services of experts or consultants who have scientific or other
         professional qualifications, except that in no case shall the compensation provided to any such expert or consultant exceed
         the daily equivalent of the annual rate of compensation for Executive Level II employees; and
      
      (3) to use available resources to provide Federal assistance as necessary for repatriation notwithstanding the limitation on temporary
         assistance in section 1113(d) of the Social Security Act.][SEC. 602. The Secretary shall provide notice to the Committees on Appropriations of the House of Representatives and the Senate within
      15 days of the use of the provisions in section 601.][SEC. 603. A grant awarded by the Department of Health and Human Services with funds made available by this title may be made conditional
      on agreement by the awardee to comply with existing and future guidance from the Secretary regarding control of the spread
      of the Ebola virus.]'
      			
      [(transfer of funds)][SEC. 604. Funds appropriated in this title may be transferred to, and merged with, other appropriation accounts of the Centers for Disease
      Control and Prevention, the Assistant Secretary for Preparedness and Response, or the National Institutes of Health for the
      purposes specified in this title following consultation with the Office of Management and Budget: Provided, That the Committees on Appropriations of the House of Representatives and the Senate shall be notified 10 days in advance
      of any such transfer: Provided further, That, upon a determination that all or part of the funds transferred from an appropriation are not necessary, such amounts
      may be transferred back to that appropriation: Provided further, That none of the funds made available by this title may be transferred pursuant to the authority in section 206 of this
      Act or section 241(a) of the PHS Act.] (Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2015.)