Appendix - Department of Health and Human Services

For necessary expenses of the Food and Drug Administration, including hire and purchase of passenger motor vehicles; for payment of space rental and related costs pursuant to Public Law 92–313 for programs and activities of the Food and Drug Administration which are included in this Act; for rental of special purpose space in the District of Columbia or elsewhere; for miscellaneous and emergency expenses of enforcement activities, authorized and approved by the Secretary and to be accounted for solely on the Secretary's certificate, not to exceed $25,000; and notwithstanding section 521 of Public Law 107–188; [$4,443,356,000] $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 Services—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.]

For plans, construction, repair, improvement, extension, alteration, and purchase of fixed equipment or facilities of or used by the Food and Drug Administration, where not otherwise provided, $8,788,000, to remain available until expended. (Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2015.)


Identification code 075–9911–0–1–554		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	–2	–2	–2

0799	Balance, end of year	1	2	3


Identification code 075–9911–0–1–554		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 [075–0128]		–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)	–494	–333	–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)	–3,915	–4,842	–4,752
3040	Recoveries of prior year unpaid obligations, unexpired	–4
3041	Recoveries of prior year unpaid obligations, expired	–69

3050	Unpaid obligations, end of year	2,676	2,334	2,505
	Uncollected payments:
3060	Uncollected pymts, Fed sources, brought forward, Oct 1	–51	–51	–51
3070	Change in uncollected pymts, Fed sources, unexpired	–22
3071	Change in uncollected pymts, Fed sources, expired	22

3090	Uncollected pymts, Fed sources, end of year	–51	–51	–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	–33	–1	–1
4033	Non-Federal sources	–1,915	–1,900	–1,977

4040	Offsets against gross budget authority and outlays (total)	–1,948	–1,901	–1,978
	Additional offsets against gross budget authority only:
4050	Change in uncollected pymts, Fed sources, unexpired	–22
4052	Offsetting collections credited to expired accounts	17

4060	Additional offsets against budget authority only (total)	–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


	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.


Identification code 075–9911–0–1–554		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


Identification code 075–9911–0–1–554		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

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.


Identification code 075–9911–2–1–554		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)			–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			–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.


Identification code 075–9911–2–1–554		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


Identification code 075–9911–2–1–554		2014 actual	2015 est.	2016 est.

2001	Reimbursable civilian full-time equivalent employment			242


Identification code 075–4309–0–3–554		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	–1	–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)	–8	–10	–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	–8	–8	–9
4180	Budget authority, net (total)	–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.


Identification code 075–4309–0–3–554		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


Identification code 075–4309–0–3–554		2014 actual	2015 est.	2016 est.

2001	Reimbursable civilian full-time equivalent employment	36	37	37

Federal Funds

For carrying out titles II and III of the Public Health Service Act (referred to in this Act as the "PHS Act") with respect to primary health care and the Native Hawaiian Health Care Act of 1988, [$1,491,522,000] $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 104–73 and for expenses incurred by the Department of Health and Human Services (referred to in this Act as "HHS") pertaining to administrative claims made under such law [: Provided further, That of funds provided for the Health Centers program, as defined by section 330 of the PHS Act, by this Act or any other Act for fiscal year 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].

For 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).

For carrying out titles III, XI, XII, and XIX of the PHS Act with respect to maternal and child health, title V of the Social Security Act, and section 712 of the American Jobs Creation Act of 2004, [$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.

For 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.

For carrying out titles III and XII of the PHS Act with respect to health care systems, and the Stem Cell Therapeutic and Research Act of 2005, [$103,193,000] $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.

For carrying out titles III and IV of the PHS Act with respect to rural health, section 427(a) of the Federal Coal Mine Health and Safety Act of 1969, [the Cardiac Arrest Survival Act of 2000,] and sections 711 and 1820 of the Social Security Act, [$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.

For 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.

For 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.)


Identification code 075–0350–0–1–550		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 [075–0511]	–10
1120	Appropriations transferred to other accts [075–1503]	–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	–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	–1	–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	–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)	–8,530	–8,809	–8,215
3040	Recoveries of prior year unpaid obligations, unexpired	–26
3041	Recoveries of prior year unpaid obligations, expired	–95

3050	Unpaid obligations, end of year	6,233	6,952	5,196
	Uncollected payments:
3060	Uncollected pymts, Fed sources, brought forward, Oct 1	–74	–67	–67
3070	Change in uncollected pymts, Fed sources, unexpired	–38
3071	Change in uncollected pymts, Fed sources, expired	45

3090	Uncollected pymts, Fed sources, end of year	–67	–67	–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	–43	–15	–15
4033	Non-Federal sources	–28	–20	–20
4033	Non-Federal sources			–8

4040	Offsets against gross budget authority and outlays (total)	–71	–35	–43
	Additional offsets against gross budget authority only:
4050	Change in uncollected pymts, Fed sources, unexpired	–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	–17	–17	–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 075–0350–0–1–550		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 2012–2013 data reported in the Annual Operating Report.


Program	Account Balance


HPSL	389,796,286
NSL	174,462,796
PCL	258,568,607
LDS	132,944,663

Total	955,772,352


Identification code 075–0350–0–1–550		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


Identification code 075–0350–0–1–550		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


Identification code 075–0350–4–1–550		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)			–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


Identification code 075–0350–4–1–550		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


Identification code 075–0350–4–1–550		2014 actual	2015 est.	2016 est.

1001	Direct civilian full-time equivalent employment			264
1101	Direct military average strength employment			50


Identification code 075–0320–0–1–551		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	–4
4190	Outlays, net (total)	–4

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


Identification code 075–0343–0–1–551		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 [075–0140]	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)	–5	–4	–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 109–148, to serve as a source of funds to pay for compensation for injuries, illnesses or death, or losses resulting from the administration to or use by an individual of a covered countermeasure for which a Secretarial Declaration has been issued, pursuant to section 319F-3(b) of the Public Health Service Act. Additionally, authority is provided to address any unexpected claims that may arise under the Smallpox Emergency Personal Protection Act of 2003.


Identification code 075–0343–0–1–551		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


Identification code 075–0343–0–1–551		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


Identification code 075–0321–0–1–551		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	–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)	–320	–322	–367
3041	Recoveries of prior year unpaid obligations, expired	–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. 113–93 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.


Identification code 075–0321–0–1–551		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


Identification code 075–0321–0–1–551		2014 actual	2015 est.	2016 est.

1001	Direct civilian full-time equivalent employment	18	18
1101	Direct military average strength employment	4	4


Identification code 075–0321–4–1–551		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)			–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


Identification code 075–0321–4–1–551		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


Identification code 075–0321–4–1–551		2014 actual	2015 est.	2016 est.

1001	Direct civilian full-time equivalent employment			18
1101	Direct military average strength employment			4


Identification code 075–4442–0–3–551		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


Identification code 075–4442–0–3–551		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	–15	–9	–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		–10	–10
2263	Adjustments: Terminations for default that result in claim payments		–1	–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. 104–299 and P.L. 104–208 authorize Health Resources and Services Administration (HRSA) to guarantee up to $160 million in private loans to health centers for the costs of developing and operating managed care networks or plans and for the construction, renovation and modernization of medical facilities. The program account for this activity is displayed in the Health Resources and Services account (75–0350) as a line in the program and financing schedule.


Identification code 075–4442–0–3–551		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


Identification code 075–0340–0–1–552		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 [091–0202]	–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)	–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 075–0340–0–1–552		2014 actual	2015 est.	2016 est.

	Guaranteed loan reestimates:
235001	HEAL Loan guarantee	–43

Pursuant to P.L. 113–76, 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.


Identification code 075–0340–0–1–552		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


Identification code 075–0340–0–1–552		2014 actual	2015 est.	2016 est.

1001	Direct civilian full-time equivalent employment	10


Identification code 075–4304–0–3–552		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 [091–4300]	–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 [091–4300]	–5
1930	Total budgetary resources available	46

	Change in obligated balance:
	Unpaid obligations:
3010	Obligations incurred, unexpired accounts	46
3020	Financing disbursements (gross)	–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	–5
4180	Financing authority, net (total)	–5
4190	Financing disbursements, net (total)	41


Identification code 075–4304–0–3–552		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	–2
2264	Other adjustments, net	–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	–192

2390	Outstanding, end of year

Pursuant to P.L. 113–76, the Consolidated Appropriations Act, in 2014 this activity was transferred to the Department of Education.


Identification code 075–4304–0–3–552		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 (-)	–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


Identification code 075–4305–0–3–552		2014 actual	2015 est.	2016 est.

	Budgetary resources:
	Budget authority:
	Appropriations, mandatory:
1200	Appropriation	1
1220	Appropriations transferred to other accts [091–4299]	–1
	Spending authority from offsetting collections, mandatory:
1800	Collected	6
1810	Spending authority from offsetting collections transferred to other accounts [091–4299]	–6

	Budget authority and outlays, net:
	Mandatory:
	Offsets against gross budget authority and outlays:
	Offsetting collections (collected) from:
4123	Non-Federal sources	–6
4180	Budget authority, net (total)	–6
4190	Outlays, net (total)	–6


Identification code 075–4305–0–3–552		2014 actual	2015 est.	2016 est.

	Cumulative balance of guaranteed loans outstanding:
2210	Outstanding, start of year	49
2264	Adjustments: Other adjustments, net	–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	–331

2390	Outstanding, end of year

Pursuant to P.L. 113–76, the Consolidated Appropriations Act, in 2014 this activity was transferred to the Department of Education.


Identification code 075–4305–0–3–552		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 (-)	–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


Identification code 075–9931–0–3–551		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	–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.


Identification code 075–9931–0–3–551		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

For payments from the Vaccine Injury Compensation Program Trust Fund (the "Trust Fund"), such sums as may be necessary for claims associated with vaccine-related injury or death with respect to vaccines administered after September 30, 1988, pursuant to subtitle 2 of title XXI of the PHS Act, to remain available until expended: Provided, That for necessary administrative expenses, not to exceed [$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.)


Identification code 075–8175–0–7–551		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	–18	–21	–23
0501	Vaccine Injury Compensation Program Trust Fund	–221	–230	–237

0599	Total appropriations	–239	–251	–260

0799	Balance, end of year	3,356	3,403	3,483


Identification code 075–8175–0–7–551		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)	–245	–262	–260
3040	Recoveries of prior year unpaid obligations, unexpired	–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	–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. 99–660 and P.L. 100–203 and serves as a source of funds to pay claims for compensation for vaccine-related injury or death. This account reflects payments for claims for vaccine-related injury or death occurring after October 1, 1988.


Identification code 075–8175–0–7–551		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


Identification code 075–8175–0–7–551		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

Federal Funds

For expenses necessary to carry out the Act of August 5, 1954 (68 Stat. 674), the Indian Self-Determination and Education Assistance Act, the Indian Health Care Improvement Act, and titles II and III of the Public Health Service Act with respect to the Indian Health Service, [$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 93–638, such individually identifiable health information relating to disabled children as may be necessary for the purpose of carrying out its functions under the Individuals with Disabilities Education Act (20 U.S.C. 1400, et seq.): Provided further, That the Indian Health Care Improvement Fund may be used, as needed, to carry out activities typically funded under the Indian Health Facilities account. (Department of the Interior, Environment, and Related Agencies Appropriations Act, 2015.)


Identification code 075–0390–0–1–551		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 [075–0390]	–55
1121	Appropriations transferred from other acct [075–0390]	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	–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	–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)	–5,305	–5,694	–5,721
3040	Recoveries of prior year unpaid obligations, unexpired	–130
3041	Recoveries of prior year unpaid obligations, expired	–20

3050	Unpaid obligations, end of year	805	549	422
	Uncollected payments:
3060	Uncollected pymts, Fed sources, brought forward, Oct 1	–67	–68	–68
3070	Change in uncollected pymts, Fed sources, unexpired	–1

3090	Uncollected pymts, Fed sources, end of year	–68	–68	–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	–354	–374	–375
4033	Non-Federal sources	–903	–797	–797

4040	Offsets against gross budget authority and outlays (total)	–1,257	–1,171	–1,172
	Additional offsets against gross budget authority only:
4050	Change in uncollected pymts, Fed sources, unexpired	–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.


Identification code 075–0390–0–1–551		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


Identification code 075–0390–0–1–551		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


Identification code 075–0390–4–1–551		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)			–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

For construction, repair, maintenance, improvement, and equipment of health and related auxiliary facilities, including quarters for personnel; preparation of plans, specifications, and drawings; acquisition of sites, purchase and erection of modular buildings, and purchases of trailers; and for provision of domestic and community sanitation facilities for Indians, as authorized by section 7 of the Act of August 5, 1954 (42 U.S.C. 2004a), the Indian Self-Determination Act, and the Indian Health Care Improvement Act, and for expenses necessary to carry out such Acts and titles II and III of the Public Health Service Act with respect to environmental health and facilities support activities of the Indian Health Service, [$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.)


Identification code 075–0391–0–1–551		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	–8	–8	–8

0799	Balance, end of year


Identification code 075–0391–0–1–551		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)	–511	–542	–599
3040	Recoveries of prior year unpaid obligations, unexpired	–7
3041	Recoveries of prior year unpaid obligations, expired	–1

3050	Unpaid obligations, end of year	504	478	574
	Uncollected payments:
3060	Uncollected pymts, Fed sources, brought forward, Oct 1	–5	–5	–5

3090	Uncollected pymts, Fed sources, end of year	–5	–5	–5
	Memorandum (non-add) entries:
3100	Obligated balance, start of year	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	–49	–55	–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.


Identification code 075–0391–0–1–551		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


Identification code 075–0391–0–1–551		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

Appropriations provided in this Act to the Indian Health Service shall be available for services as authorized by 5 U.S.C. 3109 at rates not to exceed the per diem rate equivalent to the maximum rate payable for senior-level positions under 5 U.S.C. 5376; hire of passenger motor vehicles and aircraft; purchase of medical equipment; purchase of reprints; purchase, renovation and erection of modular buildings and renovation of existing facilities; payments for telephone service in private residences in the field, when authorized under regulations approved by the Secretary; uniforms or allowances therefor as authorized by 5 U.S.C. 5901–5902; and for expenses of attendance at meetings that relate to the functions or activities of the Indian Health Service: Provided, That in accordance with the provisions of the Indian Health Care Improvement Act, non-Indian patients may be extended health care at all tribally administered or Indian Health Service facilities, subject to charges, and the proceeds along with funds recovered under the Federal Medical Care Recovery Act (42 U.S.C. 2651–2653) shall be credited to the account of the facility providing the service and shall be available without fiscal year limitation: Provided further, That notwithstanding any other law or regulation, funds transferred from the Department of Housing and Urban Development to the Indian Health Service shall be administered under Public Law 86–121, the Indian Sanitation Facilities Act and Public Law 93–638: 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.)

Federal Funds

For carrying out titles II, III, XVII, and XXI, and section 2821 of the PHS Act, titles II and IV of the Immigration and Nationality Act, and section 501 of the Refugee Education Assistance Act, with respect to immunization and respiratory diseases, [$573,105,000] $537,766,000. (Department of Health and Human Services Appropriations Act, 2015.)

For 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.)

For carrying out titles II, III, and XVII, and section 2821 of the PHS Act, titles II and IV of the Immigration and Nationality Act, and section 501 of the Refugee Education Assistance Act, with respect to emerging and zoonotic infectious diseases, [$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.)

For 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.)

For 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.)

For 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.)

For 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.)

For 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.)

For 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.)

For necessary expenses to administer the Energy Employees Occupational Illness Compensation Program Act, $55,358,000, to remain available until expended: Provided, That this amount shall be available consistent with the provision regarding administrative expenses in section 151(b) of division B, title I of Public Law 106–554. (Department of Health and Human Services Appropriations Act, 2015.)

For 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 113–164]. (Department of Health and Human Services Appropriations Act, 2015.)

For carrying out titles II, III, and XVII of the PHS Act with respect to public health preparedness and response, and for expenses necessary to support activities related to countering potential biological, nuclear, radiological, and chemical threats to civilian populations, [$1,352,551,000] $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.)

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.)

[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.)

For [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.)


Identification code 075–0943–0–1–999		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	–2	–2	–2

0799	Balance, end of year


Identification code 075–0943–0–1–999		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 [075–4553]	–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 [075–0511]	–13
1120	Appropriations transferred to other accts [075–1503]	–2
1120	Appropriations transferred to other accts [075–0140]	–1

1160	Appropriation, discretionary (total)	5,791	7,769	6,096
	Appropriations, mandatory:
1200	Appropriation (075–0954 - EEOICPA)	55	55	55
1201	Appropriation (075–5146 CRADA)	2	2	2
1221	Appropriations transferred from other acct [075–0116]	831	886	914
1230	Appropriations and/or unobligated balance of appropriations permanently reduced	–6	–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	–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)	–6,843	–7,896	–8,380
3040	Recoveries of prior year unpaid obligations, unexpired	–12
3041	Recoveries of prior year unpaid obligations, expired	–237

3050	Unpaid obligations, end of year	5,822	7,284	6,607
	Uncollected payments:
3060	Uncollected pymts, Fed sources, brought forward, Oct 1	–429	–215	–215
3070	Change in uncollected pymts, Fed sources, unexpired	–76
3071	Change in uncollected pymts, Fed sources, expired	290

3090	Uncollected pymts, Fed sources, end of year	–215	–215	–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	–615	–633	–633
4033	Non-Federal sources	–4

4040	Offsets against gross budget authority and outlays (total)	–619	–633	–633
	Additional offsets against gross budget authority only:
4050	Change in uncollected pymts, Fed sources, unexpired	–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	–4	–2	–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.


Identification code 075–0943–0–1–999		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


Identification code 075–0943–0–1–999		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


Identification code 075–4553–0–4–551		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 [075–0943]	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)	–345	–680	–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	–499	–530	–530
4190	Outlays, net (total)	–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.


Identification code 075–4553–0–4–551		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


Identification code 075–4553–0–4–551		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

For necessary expenses for the Agency for Toxic Substances and Disease Registry (ATSDR) in carrying out activities set forth in sections 104(i) and 111(c)(4) of the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA) 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.)


Identification code 075–0944–0–1–551		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)	–76	–91	–90
3041	Recoveries of prior year unpaid obligations, expired	–1

3050	Unpaid obligations, end of year	46	52	40
	Uncollected payments:
3060	Uncollected pymts, Fed sources, brought forward, Oct 1	–10	–7	–7
3070	Change in uncollected pymts, Fed sources, unexpired	–2
3071	Change in uncollected pymts, Fed sources, expired	5

3090	Uncollected pymts, Fed sources, end of year	–7	–7	–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	–6	–3	–3
	Additional offsets against gross budget authority only:
4050	Change in uncollected pymts, Fed sources, unexpired	–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


Identification code 075–0944–0–1–551		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


Identification code 075–0944–0–1–551		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


Identification code 075–0946–0–1–551		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 (WTC—NYC DHSS—CDC)	28	48	32
1230	Appropriations and/or unobligated balance of appropriations permanently reduced	–21	–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)	–196	–293	–261
3041	Recoveries of prior year unpaid obligations, expired	–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	–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. 111–347) on July 1, 2011, to provide monitoring and treatment benefits to eligible responders and survivors. CDC/NIOSH serves as the Program Administrator for the WTC Health Program. The WTC Health Program provides quality care for WTC-related health conditions, conducts WTC research, and maintains a health registry to collect data on victims of the September 11, 2001, terrorist attacks. The amounts included for 2015 and 2016 Budget reflect estimated Federal obligations for the WTC Health Program.


Identification code 075–0946–0–1–551		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


Identification code 075–0946–0–1–551		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

Federal Funds

For 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 Institute—Frederick Federally Funded Research and Development Center in Frederick, Maryland. (Department of Health and Human Services Appropriations Act, 2015.)

For carrying out section 301 and title IV of the PHS Act with respect to cardiovascular, lung, and blood diseases, and blood and blood products, [$2,997,870,000] $3,071,906,000. (Department of Health and Human Services Appropriations Act, 2015.)

For 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.)

For 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.)

For 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.)

For 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.)

For 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.)

For 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.)

For 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.)

For 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.)

For necessary expenses for the National Institute of Environmental Health Sciences in carrying out activities set forth in section 311(a) of the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (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.)

For 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.)

For 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.)

For 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.)

For 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.)

For 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.)

For 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.)

For 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.)

For 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.)

For 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.)

For 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.)

For 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.)

For carrying out the activities of the John E. Fogarty International Center (described in subpart 2 of part E of title IV of the PHS Act), [$67,786,000] $69,505,000. (Department of Health and Human Services Appropriations Act, 2015.)

For 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.)

For 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.)

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.)

For the study of, construction or demolition of, renovation of, and acquisition of equipment for, facilities of or used by NIH, including the acquisition of real property, [$128,863,000] $128,863,000, to remain available [through September 30, 2019] until expended. (Department of Health and Human Services Appropriations Act, 2015.)


Identification code 075–9915–0–1–552		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	–16	–17	–16

0799	Balance, end of year			1


Identification code 075–9915–0–1–552		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 [075–0511]	–75
1120	Appropriations transferred to other accts [075–0140]	–6
1121	Appropriations transferred from other acct [075–5736]		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	–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	–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)	–33,441	–32,766	–33,386
3040	Recoveries of prior year unpaid obligations, unexpired	–10
3041	Recoveries of prior year unpaid obligations, expired	–482

3050	Unpaid obligations, end of year	31,701	32,709	33,142
	Uncollected payments:
3060	Uncollected pymts, Fed sources, brought forward, Oct 1	–1,254	–1,559	–1,559
3070	Change in uncollected pymts, Fed sources, unexpired	–971
3071	Change in uncollected pymts, Fed sources, expired	666

3090	Uncollected pymts, Fed sources, end of year	–1,559	–1,559	–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	–3,955	–3,201	–3,489
4033	Non-Federal sources	–138

4040	Offsets against gross budget authority and outlays (total)	–4,093	–3,201	–3,489
	Additional offsets against gross budget authority only:
4050	Change in uncollected pymts, Fed sources, unexpired	–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

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.


Identification code 075–9915–0–1–552		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


Identification code 075–9915–0–1–552		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


Identification code 075–9915–4–1–552		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)			–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


Identification code 075–5736–0–2–552		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		–13	–13

0799	Balance, end of year	38	25	12


Identification code 075–5736–0–2–552		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 [075–9915]		–13	–13

Federal Funds

For carrying out titles III, V, and XIX of the PHS Act with respect to mental health, and the Protection and Advocacy for Individuals with Mental Illness Act, [$1,045,936,000] $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.

For carrying out titles III [,] and V [, and XIX] of the PHS Act with respect to substance abuse treatment and [section 1922(a) of the PHS Act] title XIX of such Act with respect to substance abuse treatment and prevention, [$2,102,658,000] $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.

For 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.

For program support and cross-cutting activities that supplement activities funded under the headings "Mental Health", "Substance Abuse Treatment", and "Substance Abuse Prevention" in carrying out titles III, V, and XIX of the PHS Act and the Protection and Advocacy for Individuals with Mental Illness Act in the Substance Abuse and Mental Health Services Administration, [$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.)


Identification code 075–1362–0–1–551		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 [075–0140]	–1
1120	Appropriations transferred to other accts [075–0511]	–9

1160	Appropriation, discretionary (total)	3,425	3,474	3,396
	Appropriations, mandatory:
1221	Appropriations transferred from the Prevention and Public Health Fund [075–0116]	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)	–3,416	–4,165	–3,787
3041	Recoveries of prior year unpaid obligations, expired	–35

3050	Unpaid obligations, end of year	3,493	3,059	3,048
	Uncollected payments:
3060	Uncollected pymts, Fed sources, brought forward, Oct 1	–143	–155	–155
3070	Change in uncollected pymts, Fed sources, unexpired	–112
3071	Change in uncollected pymts, Fed sources, expired	100

3090	Uncollected pymts, Fed sources, end of year	–155	–155	–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	–223	–243	–320
4033	Non-Federal sources		–2	–2

4040	Offsets against gross budget authority and outlays (total)	–223	–245	–322
	Additional offsets against gross budget authority only:
4050	Change in uncollected pymts, Fed sources, unexpired	–112
4052	Offsetting collections credited to expired accounts	98

4060	Additional offsets against budget authority only (total)	–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.


Identification code 075–1362–0–1–551		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


Identification code 075–1362–0–1–551		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

Federal Funds

For carrying out titles III and IX of the PHS Act, part A of title XI of the Social Security Act, and section 1013 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, $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.)


Identification code 075–1700–0–1–552		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 [075–0116]	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	–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)	–436	–488	–237
3040	Recoveries of prior year unpaid obligations, unexpired	–1
3041	Recoveries of prior year unpaid obligations, expired	–26

3050	Unpaid obligations, end of year	416	313	461
	Uncollected payments:
3060	Uncollected pymts, Fed sources, brought forward, Oct 1	–388	–361
3070	Change in uncollected pymts, Fed sources, unexpired	–227	361
3071	Change in uncollected pymts, Fed sources, expired	254

3090	Uncollected pymts, Fed sources, end of year	–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	–394	–21	–109
4030	Federal sources		–361

4040	Offsets against gross budget authority and outlays (total)	–394	–382	–109
	Additional offsets against gross budget authority only:
4050	Change in uncollected pymts, Fed sources, unexpired	–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.


Identification code 075–1700–0–1–552		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


Identification code 075–1700–0–1–552		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

Federal Funds

For 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.)


Identification code 075–0512–0–1–551		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)	–302,175	–328,955	–344,464
3040	Recoveries of prior year unpaid obligations, unexpired	–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	–688	–360	–5
4123	Non-Federal sources	–15

4130	Offsets against gross budget authority and outlays (total)	–703	–360	–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.


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


Identification code 075–0512–0–1–551		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


Identification code 075–0512–7–1–551		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)			–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


Identification code 075–0512–2–1–551		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)			–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		–370	–775
4180	Budget authority, net (total)		–370	–721
4190	Outlays, net (total)		–370	–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.


Identification code 075–0512–4–1–551		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)		–4,855	–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


Identification code 075–0512–4–1–551		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


Identification code 075–0516–0–1–551		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	–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)	–510	–572	–593
3040	Recoveries of prior year unpaid obligations, unexpired	–26
3041	Recoveries of prior year unpaid obligations, expired	–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	–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. 106–170), the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (P.L. 108–173), the Deficit Reduction Act of 2005 (P.L. 109–171), the Children's Health Insurance Program Reauthorization Act of 2009 (P.L. 111–3), the Patient Protection and Affordable Care Act (P.L. 111–148), the Health Care and Education Reconciliation Act of 2010 (P.L. 111–152), and the Protecting Access to Medicare Act of 2014 (P.L. 113–93).

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.


Identification code 075–0516–0–1–551		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


Identification code 075–0516–0–1–551		2014 actual	2015 est.	2016 est.

1001	Direct civilian full-time equivalent employment	80	91	97


Identification code 075–0516–4–1–551		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)			–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

For payment to the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund, as provided under sections 217(g), 1844, and 1860D-16 of the Social Security Act, sections 103(c) and 111(d) of the Social Security Amendments of 1965, section 278(d)(3) of Public Law 97–248, and for administrative expenses incurred pursuant to section 201(g) of the Social Security Act, [$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.)


Identification code 075–0580–0–1–571		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)	–265,656	–279,720	–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	–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.


Identification code 075–0580–0–1–571		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


Identification code 075–0580–7–1–571		2014 actual	2015 est.	2016 est.

	Obligations by program activity:
0001	Federal contribution to match premiums (SMI)		–11	7,970

0900	Total new obligations (object class 41.0)		–11	7,970

	Budgetary resources:
	Budget authority:
	Appropriations, mandatory:
1200	Appropriation (definite annual)		–11	7,970

1260	Appropriations, mandatory (total)		–11	7,970
1930	Total budgetary resources available		–11	7,970

	Change in obligated balance:
	Unpaid obligations:
3010	Obligations incurred, unexpired accounts		–11	7,970
3020	Outlays (gross)		11	–7,970

	Budget authority and outlays, net:
	Mandatory:
4090	Budget authority, gross		–11	7,970
	Outlays, gross:
4100	Outlays from new mandatory authority		–11	7,970
4180	Budget authority, net (total)		–11	7,970
4190	Outlays, net (total)		–11	7,970


Identification code 075–0580–2–1–571		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)			–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)		–370	–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


Identification code 075–0519–0–1–571		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	–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	–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)	–579	–770	–559

3050	Unpaid obligations, end of year	1,461	1,461	1,461
	Uncollected payments:
3060	Uncollected pymts, Fed sources, brought forward, Oct 1	–1,059	–2,189	–2,189
3070	Change in uncollected pymts, Fed sources, unexpired	–1,635
3071	Change in uncollected pymts, Fed sources, expired	505

3090	Uncollected pymts, Fed sources, end of year	–2,189	–2,189	–2,189
	Memorandum (non-add) entries:
3100	Obligated balance, start of year	–432	–728	–728
3200	Obligated balance, end of year	–728	–728	–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]	–570	–770	–559
	Additional offsets against gross budget authority only:
4140	Change in uncollected pymts, Fed sources, unexpired	–1,635
4142	Offsetting collections credited to expired accounts	506

4150	Additional offsets against budget authority only (total)	–1,129

4160	Budget authority, net (mandatory)	–50
4170	Outlays, net (mandatory)	9
4180	Budget authority, net (total)	–50
4190	Outlays, net (total)	9

	Memorandum (non-add) entries:
5091	Expiring unavailable balance: Offsetting collections	–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.


Identification code 075–0519–0–1–571		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


Identification code 075–0519–0–1–571		2014 actual	2015 est.	2016 est.

1001	Direct civilian full-time equivalent employment	196	224	225

For carrying out, except as otherwise provided, titles XI, XVIII, XIX, and XXI of the Social Security Act, titles XIII and XXVII of the PHS Act, the Clinical Laboratory Improvement Amendments of 1988, and other responsibilities of the Centers for Medicare and Medicaid Services, not to exceed [$3,669,744,000] $4,245,186,000, 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.)


Identification code 075–0511–0–1–550		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	–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 [075–9915]	75
1121	Appropriations transferred from other acct [075–1362]	9
1121	Appropriations transferred from other acct [075–0350]	10
1121	Appropriations transferred from other acct [075–0943]	13
1121	Appropriations transferred from other acct [075–1536]	5
1121	Appropriations transferred from other acct [075–0142]	4
1121	Appropriations transferred from other acct [075–9912]	1
1121	Appropriations transferred from other acct [075–0140]	2

1160	Appropriation, discretionary (total)	119
	Appropriations, mandatory:
1200	Appropriation	253	193	68
1230	Appropriations and/or unobligated balance of appropriations permanently reduced	–18	–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	–97	–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	–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)	–5,462	–11,800	–13,442
3040	Recoveries of prior year unpaid obligations, unexpired	–25
3041	Recoveries of prior year unpaid obligations, expired	–128

3050	Unpaid obligations, end of year	4,117	3,741	3,696
	Uncollected payments:
3060	Uncollected pymts, Fed sources, brought forward, Oct 1	–4,097	–4,465	–4,465
3070	Change in uncollected pymts, Fed sources, unexpired	–2,830
3071	Change in uncollected pymts, Fed sources, expired	2,462

3090	Uncollected pymts, Fed sources, end of year	–4,465	–4,465	–4,465
	Memorandum (non-add) entries:
3100	Obligated balance, start of year	101	–348	–724
3200	Obligated balance, end of year	–348	–724	–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	–4,260	–3,976	–4,246
4033	Non-Federal sources	–12	–5,457	–6,397

4040	Offsets against gross budget authority and outlays (total)	–4,272	–9,433	–10,643
	Additional offsets against gross budget authority only:
4050	Change in uncollected pymts, Fed sources, unexpired	–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)	–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	–414	–137	–28
4123	Non-Federal sources	–501	–1,563	–2,409

4130	Offsets against gross budget authority and outlays (total)	–915	–1,700	–2,437
	Additional offsets against gross budget authority only:
4140	Change in uncollected pymts, Fed sources, unexpired	–579
4142	Offsetting collections credited to expired accounts	45

4150	Additional offsets against budget authority only (total)	–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	–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.


Identification code 075–0511–0–1–550		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


Identification code 075–0511–0–1–550		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


Identification code 075–0511–4–1–550		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)			–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			–811
4123	Non-Federal sources			–25

4130	Offsets against gross budget authority and outlays (total)			–836

4160	Budget authority, net (mandatory)			401
4170	Outlays, net (mandatory)			–514
4180	Budget authority, net (total)			401
4190	Outlays, net (total)			–514


Identification code 075–0511–4–1–550		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


Identification code 075–0511–4–1–550		2014 actual	2015 est.	2016 est.

1001	Direct civilian full-time equivalent employment			20


Identification code 075–0515–0–1–551		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			–3,330

1160	Appropriation, discretionary (total)			–3,330
	Appropriations, mandatory:
1200	Appropriation	19,147	21,061	5,700
1230	Appropriations and/or unobligated balance of appropriations permanently reduced	–6,317	–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	–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)	–9,319	–10,558	–14,010
3040	Recoveries of prior year unpaid obligations, unexpired	–16
3041	Recoveries of prior year unpaid obligations, expired	–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			–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	–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. 111–3, CHIPRA) reauthorized the CHIP program and appropriated funding for CHIP through 2013. CHIPRA made some modifications to the program including increased funding for States and territories, bonus payments for States that exceed Medicaid child enrollment targets, and support for child health quality and outreach activities. A contingency fund to assist States who project spending above their available allocated CHIP funds was also created by CHIPRA and funding is included in a separate account. The Patient Protection and Affordable Care Act of 2010 (P.L. 111–148) extended funding for CHIP, providing appropriations through 2015. The Budget proposes a four-year extension of CHIP funding through 2019.


Identification code 075–0515–4–1–551		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)			–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.


Identification code 075–0522–0–1–551		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)	–997	–1,291	–1,590
3040	Recoveries of prior year unpaid obligations, unexpired	–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.


Identification code 075–0522–0–1–551		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


Identification code 075–0522–0–1–551		2014 actual	2015 est.	2016 est.

1001	Direct civilian full-time equivalent employment	355	518	625


Identification code 075–5551–0–2–551		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	–3
0502	Child Enrollment Contingency Fund			–50

0599	Total appropriations	–3		2,055

0799	Balance, end of year		6	2,061


Identification code 075–5551–0–2–551		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			–2,105

1160	Appropriation, discretionary (total)			–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	–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)	–3	–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			–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	–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. 111–3, CHIPRA) established the Child Enrollment Contingency Fund under Title XXI of the Social Security Act. Beginning in 2009, a State may qualify for a contingency fund payment if it projects a funding shortfall for the fiscal year and if its average monthly child enrollment exceeds its target average number of enrollees for the fiscal year. The Patient Protection and Affordable Care Act of 2010 (P.L. 111–148) extended the contingency fund through 2015. The 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.


Identification code 075–5551–4–2–551		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)			–50

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			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.


Identification code 075–0508–0–1–551		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	–1,277
1823	New and/or unobligated balance of spending authority from offsetting collections temporarily reduced	–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)	–6,385	–2,970	–3,596

3050	Unpaid obligations, end of year	729	729	729
	Uncollected payments:
3060	Uncollected pymts, Fed sources, brought forward, Oct 1	–2,442	–1,165	–1,165
3070	Change in uncollected pymts, Fed sources, unexpired	1,277

3090	Uncollected pymts, Fed sources, end of year	–1,165	–1,165	–1,165
	Memorandum (non-add) entries:
3100	Obligated balance, start of year	–2,137	–436	–436
3200	Obligated balance, end of year	–436	–436	–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	–6,509	–2,970	–3,596
	Additional offsets against gross budget authority only:
4140	Change in uncollected pymts, Fed sources, unexpired	1,277

4160	Budget authority, net (mandatory)	–133
4170	Outlays, net (mandatory)	–124
4180	Budget authority, net (total)	–133
4190	Outlays, net (total)	–124

	Memorandum (non-add) entries:
5090	Unexpired unavailable balance, SOY: Offsetting collections		133	133
5092	Unexpired unavailable balance, EOY: Offsetting collections	133	133	133


Identification code 075–0112–0–1–551		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	–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)	–27	–54	–40
3040	Recoveries of prior year unpaid obligations, unexpired	–3	–22	–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. 111–148) amends Section 2794 of the Public Health Service Act and provides that the Secretary shall carry out a program to award grants to States for a five-year period beginning in fiscal year 2010. The Grants to States for Health Insurance Premium Review program provides funding to help States develop or enhance their current rate review activities 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.


Identification code 075–0113–0–1–551		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)	–619	–33
3040	Recoveries of prior year unpaid obligations, unexpired	–140	–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	–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. 111–148). 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.


Identification code 075–0113–0–1–551		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


Identification code 075–0113–0–1–551		2014 actual	2015 est.	2016 est.

1001	Direct civilian full-time equivalent employment	7


Identification code 075–0114–0–1–551		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)	–14	–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	–1	–12
4190	Outlays, net (total)	13	–10

The Affordable Care Act (P.L. 111–148) authorized and appropriated $5 billion for the Early Retiree Reinsurance Program (ERRP). ERRP provides reimbursement to participating sponsors of certified plans that provide health benefits to early retirees (age 55 and older and not eligible for Medicare), their spouses, and surviving spouses and dependents. Reimbursement is equal to 80 percent of the actual cost of health expenses paid for an individual (net of price concessions) between a cost threshold of $15,000 and cost limit of $90,000 beginning in 2010. The cost threshold and cost limit are adjusted for inflation each year based on the Medical Care Component of the consumer price index for all urban consumers. Reimbursements to sponsors shall be used to reduce the sponsor's health benefit or premium costs, provide premium and cost sharing relief to plan participants, or both. By statute, ERRP sunsets on January 1, 2014 and is no longer providing reimbursements to plan sponsors.


Identification code 075–0114–0–1–551		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


Identification code 075–0114–0–1–551		2014 actual	2015 est.	2016 est.

1001	Direct civilian full-time equivalent employment	4	5


Identification code 075–0115–0–1–551		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	–61	–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)	–1,803	–2,144	–380
3041	Recoveries of prior year unpaid obligations, expired	–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. 111–148) provides amounts necessary to enable the Secretary to award grants to States beginning no later than March 23, 2011, and allows for renewal grants through January 1, 2015. The final round of grants was awarded to States in December 2014.


Identification code 075–0115–0–1–551		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


Identification code 075–0115–0–1–551		2014 actual	2015 est.	2016 est.

1001	Direct civilian full-time equivalent employment	51	65	66


Identification code 075–5733–0–2–551		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		–3,679	–5,641
0501	Risk Adjustment Program Payments			–269
0502	Risk Adjustment Program Payments		269

0599	Total appropriations		–3,410	–5,910

0799	Balance, end of year		269


Identification code 075–5733–0–2–551		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		–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)		–3,410	–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. 111–148) established a permanent risk adjustment program for non-grandfathered plans in the individual and small group markets. Charges are collected from health insurance issuers that enroll healthier than average enrollees and payments are made to issuers that enroll sicker than average enrollees. Risk adjustment may be operated by a State, or by the Federal government in the event a State chooses not to operate risk adjustment. Payments and charges are made in the year following the plan year for which they are calculated.


Identification code 075–5735–0–2–551		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		–10,020	–6,025
0501	Transitional Reinsurance Program			–731
0502	Transitional Reinsurance Program		731

0599	Total appropriations		–9,289	–6,756

0799	Balance, end of year		731


Identification code 075–5735–0–2–551		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		–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)		–9,289	–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. 111–148) established a transitional, temporary, three-year reinsurance program to minimize the impact of high-cost enrollees in plans in the individual market for plan years 2014, 2015, and 2016. The Centers for Medicare & Medicaid Services assesses 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.


Identification code 075–5735–0–2–551		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


Identification code 075–0524–0–1–551		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)	–27	–132	–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 075–0524–0–1–551		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		–1

135999	Total direct loan reestimates		–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. 112–240). This fund provides assistance and oversight to qualified nonprofit health insurance issuers that have been awarded loans or grants under section 1322 of the Affordable Care Act (P.L. 111–148).


Identification code 075–0524–0–1–551		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


Identification code 075–0524–0–1–551		2014 actual	2015 est.	2016 est.

1001	Direct civilian full-time equivalent employment	15	18


Identification code 075–0118–0–1–551		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)	–284	–188	–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 075–0118–0–1–551		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	–6	–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. 111–148) authorized and appropriated funding for the Consumer Operated and Oriented Plan (CO-OP) Program. The CO-OP Program fosters the creation of qualified nonprofit health insurance issuers that operate with a strong consumer focus to offer qualified health plans in the individual and small group markets in the States. The Secretary shall award loans to qualified nonprofit issuers to fund start-up costs and reserves which enable qualified issuers to meet state solvency requirements. The Secretary may also award loans for the purposes of encouraging the establishment of CO-OPs in states where no issuer applies to be a qualified nonprofit issuer under Section 1322.


Identification code 075–0118–0–1–551		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


Identification code 075–0118–0–1–551		2014 actual	2015 est.	2016 est.

1001	Direct civilian full-time equivalent employment			18


Identification code 075–4418–0–3–551		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	–264	–163	–111
1825	Spending authority from offsetting collections applied to repay debt		–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)	–633	–425	–307

3050	Unpaid obligations, end of year	641	267	13
	Uncollected payments:
3060	Uncollected pymts, Fed sources, brought forward, Oct 1	–545	–281	–118
3070	Change in uncollected pymts, Fed sources, unexpired	264	163	111

3090	Uncollected pymts, Fed sources, end of year	–281	–118	–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	–282	–189	–111
4122	Interest on uninvested funds	–10	–10	–10

4130	Offsets against gross financing auth and disbursements (total)	–292	–199	–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


Identification code 075–4418–0–3–551		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


Identification code 075–4418–0–3–551		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 (-)	–309	–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


Identification code 075–4482–0–3–551		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	–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	–78	–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)	–48	–296	–110

3050	Unpaid obligations, end of year	355	155	53
	Uncollected payments:
3060	Uncollected pymts, Fed sources, brought forward, Oct 1	–2	–149	–71
3070	Change in uncollected pymts, Fed sources, unexpired	–147	78	47

3090	Uncollected pymts, Fed sources, end of year	–149	–71	–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	–18	–121	–47
4122	Interest on uninvested funds	–1	–1	–1

4130	Offsets against gross financing auth and disbursements (total)	–19	–122	–48
	Additional offsets against financing authority only (total):
4140	Change in uncollected pymts, Fed sources, unexpired	–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


Identification code 075–4482–0–3–551		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


Identification code 075–4482–0–3–551		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 (-)	–1	–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


Identification code 075–8005–0–7–571		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			–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	–2,547	–2,508	–2,740
0501	Federal Hospital Insurance Trust Fund	–266,983	–278,986	–292,623
0502	Federal Hospital Insurance Trust Fund	–14,127	–21,126	–2,581
0503	Federal Hospital Insurance Trust Fund	5,442
0504	Federal Hospital Insurance Trust Fund	263
0505	Federal Hospital Insurance Trust Fund		–7	–69
0506	Federal Hospital Insurance Trust Fund		7	79
0507	Federal Hospital Insurance Trust Fund			–1,059
0508	Federal Hospital Insurance Trust Fund			3,600
0509	Federal Hospital Insurance Trust Fund		6	–32
0510	Federal Hospital Insurance Trust Fund		–6	32
0511	Health Care Fraud and Abuse Control Account	–294	–672	–706
0512	Health Care Fraud and Abuse Control Account	–1,314	–760	–1,196
0513	Health Care Fraud and Abuse Control Account	51	52
0514	Health Care Fraud and Abuse Control Account			781

0599	Total appropriations	–279,509	–304,000	–296,514

0799	Balance, end of year	171,674	150,555	152,434


Identification code 075–8005–0–7–571		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	–5,442
1234	Appropriations precluded from obligation	–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)	–273,796	–279,603	–297,850
3040	Recoveries of prior year unpaid obligations, unexpired	–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	–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.


Identification code 075–8005–0–7–571		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			–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	–273,796	–279,603	–297,850
4500	Health Care Fraud and Abuse Control Account	–1,358	–1,771	–1,829
4500	Health Care Fraud and Abuse Control Account			781

4599	Outgo under current law (-)	–275,154	–281,374	–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 (-)	–275,154	–281,374	–296,352
	Manual Adjustments:
7695	Rounding adjustment	–1

7699	Total adjustments	–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


Identification code 075–8005–0–7–571		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


Identification code 075–8005–7–7–571		2014 actual	2015 est.	2016 est.

	Budgetary resources:
	Budget authority:
	Appropriations, mandatory:
1201	Appropriation (special or trust fund)		–6	32
1203	Appropriation (previously unavailable)		6	–32


Identification code 075–8005–2–7–571		2014 actual	2015 est.	2016 est.

	Obligations by program activity:
0001	Benefit payments, HI			–10

0900	Total new obligations (object class 94.0)			–10

	Budgetary resources:
	Budget authority:
	Appropriations, mandatory:
1201	Appropriation (special or trust fund)		7	69
1234	Appropriations precluded from obligation		–7	–79

1260	Appropriations, mandatory (total)			–10
1900	Budget authority (total)			–10
1930	Total budgetary resources available			–10

	Change in obligated balance:
	Unpaid obligations:
3010	Obligations incurred, unexpired accounts			–10
3020	Outlays (gross)			10

	Budget authority and outlays, net:
	Mandatory:
4090	Budget authority, gross			–10
	Outlays, gross:
4100	Outlays from new mandatory authority			–10
4180	Budget authority, net (total)			–10
4190	Outlays, net (total)			–10


Identification code 075–8005–4–7–571		2014 actual	2015 est.	2016 est.

	Obligations by program activity:
0001	Benefit payments, HI			–2,650
0003	Administration, HI			104

0799	Total direct obligations			–2,546
0801	Appeals Fees			5

0900	Total new obligations			–2,541

	Budgetary resources:
	Budget authority:
	Appropriations, mandatory:
1201	Appropriation (special or trust fund)			1,059
1203	Appropriation (previously unavailable)			–3,600

1260	Appropriations, mandatory (total)			–2,541
	Spending authority from offsetting collections, mandatory:
1800	Collected			5

1850	Spending auth from offsetting collections, mand (total)			5
1900	Budget authority (total)			–2,536
1930	Total budgetary resources available			–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			–2,541
3020	Outlays (gross)			2,536

3050	Unpaid obligations, end of year			–5
	Memorandum (non-add) entries:
3200	Obligated balance, end of year			–5

	Budget authority and outlays, net:
	Mandatory:
4090	Budget authority, gross			–2,536
	Outlays, gross:
4100	Outlays from new mandatory authority			–2,536
	Offsets against gross budget authority and outlays:
	Offsetting collections (collected) from:
4123	Non-Federal sources			–5
4180	Budget authority, net (total)			–2,541
4190	Outlays, net (total)			–2,541


Identification code 075–8005–4–7–571		2014 actual	2015 est.	2016 est.

	Direct obligations:
42.0	Insurance claims and indemnities (benefits)			–2,650
94.0	Financial transfers			104

99.0	Direct obligations			–2,546
99.0	Reimbursable obligations			5

99.9	Total new obligations			–2,541

In 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.)


Identification code 075–8393–0–7–571		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		–565	–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	–51	–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	–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)	–1,358	–1,771	–1,829
3040	Recoveries of prior year unpaid obligations, unexpired	–43
3041	Recoveries of prior year unpaid obligations, expired	–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. 104–191) established the Health Care Fraud and Abuse Control (HCFAC) account within the Federal Hospital Insurance Trust Fund and appropriated funds from the Trust Fund to the HCFAC account for specified health care fraud and abuse control activities of the Department of Health and Human Services (HHS), the Department of Justice, and other agencies.

The Budget includes a discretionary request for efforts to safeguard Centers for Medicare and Medicaid Services (CMS) program integrity that will supplement other CMS program integrity funds. See additional discussion in the Budget Process chapter in the Analytical Perspectives volume.


Identification code 075–8393–0–7–571		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		–565	–146
94.0	Financial transfers (FBI)	135	129	141

99.9	Total new obligations	1,600	1,379	1,902


Identification code 075–8393–0–7–571		2014 actual	2015 est.	2016 est.

1001	Direct civilian full-time equivalent employment	387	470	472


Identification code 075–8393–7–7–571		2014 actual	2015 est.	2016 est.

	Budgetary resources:
	Budget authority:
	Appropriations, mandatory:
1201	Appropriation (special or trust fund)			–781

1260	Appropriations, mandatory (total)			–781
1900	Budget authority (total)			–781
1930	Total budgetary resources available			–781
	Memorandum (non-add) entries:
1941	Unexpired unobligated balance, end of year			–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			–781
	Outlays, gross:
4100	Outlays from new mandatory authority			–781
4180	Budget authority, net (total)			–781
4190	Outlays, net (total)			–781


Identification code 075–8004–0–7–571		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			–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			–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			–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			–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		–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		–142	–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			–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	–2,989	–2,826	–2,995
0501	Federal Supplementary Medical Insurance Trust Fund	–258,781	–269,138	–275,219
0502	Federal Supplementary Medical Insurance Trust Fund	–7,365		–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		–370	–694
0506	Federal Supplementary Medical Insurance Trust Fund			–51
0507	Federal Supplementary Medical Insurance Trust Fund			–576
0508	Federal Supplementary Medical Insurance Trust Fund		–260
0509	Federal Supplementary Medical Insurance Trust Fund			51
0510	Federal Supplementary Medical Insurance Trust Fund		153	–10,077
0511	Federal Supplementary Medical Insurance Trust Fund		–5,490	–1,168
0512	Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund	–370	–548	–573
0513	Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund	–70,674	–75,333	–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	–334,467	–352,743	–397,583

0799	Balance, end of year	35,073	30,392	20,045


Identification code 075–8004–0–7–571		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	–5,288
1234	Appropriations precluded from obligation		–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)	–265,932	–270,829	–287,308
3040	Recoveries of prior year unpaid obligations, unexpired	–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	–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.


Identification code 075–8004–0–7–571		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		–11	7,970
1240	Federal Contributions, FSMI Fund	191,431	194,775	198,530
1240	Interest Received by Trust Fund, FSMI Fund		–142	–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			–40
2220	Payments from States, Medicare Prescription Drug Account, FSMI			–80
2220	Premiums Collected for the Aged, FSMI Fund			–10
2220	Premiums Collected for the Aged, FSMI Fund			29
2220	Premiums Collected for the Disabled, FSMI Fund			–3
	Offsetting receipts (intragovernmental):
2240	Federal Contributions, FSMI Fund		370	1,264
2240	Federal Contributions for Benefits, Prescription Drug Account, SMI			–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	–265,932	–270,829	–287,308
4500	Federal Supplementary Medical Insurance Trust Fund		–5,337	–11,245
4500	Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund	–65,098	–75,851	–98,337

4599	Outgo under current law (-)	–331,030	–352,017	–396,890
	Proposed legislation:
5500	Federal Supplementary Medical Insurance Trust Fund		–370	–745
5500	Federal Supplementary Medical Insurance Trust Fund		–260	–529
5500	Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund			680

5599	Outgo under proposed legislation (-)		–630	–594

6599	Total cash outgo (-)	–331,030	–352,647	–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		–5,489	–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


Identification code 075–8004–0–7–571		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


Identification code 075–8004–7–7–571		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)		–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)		–5,337	–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			–5,489
5001	Total investments, EOY: Federal securities: Par value		–5,489	–6,657


Identification code 075–8004–2–7–571		2014 actual	2015 est.	2016 est.

	Obligations by program activity:
0001	Benefit payments, SMI			–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)		–370	–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


Identification code 075–8004–4–7–571		2014 actual	2015 est.	2016 est.

	Obligations by program activity:
0001	Benefit payments, SMI		260	–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			–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)		–260	–529

3050	Unpaid obligations, end of year			–4
	Memorandum (non-add) entries:
3200	Obligated balance, end of year			–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			–4
4180	Budget authority, net (total)		260	525
4190	Outlays, net (total)		260	525


Identification code 075–8004–4–7–571		2014 actual	2015 est.	2016 est.

	Direct obligations:
42.0	Insurance claims and indemnities		260	–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


Identification code 075–8308–0–7–571		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	–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)	–65,098	–75,851	–98,337
3040	Recoveries of prior year unpaid obligations, unexpired	–906
3041	Recoveries of prior year unpaid obligations, expired	–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.


Identification code 075–8308–0–7–571		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


Identification code 075–8308–4–7–571		2014 actual	2015 est.	2016 est.

	Obligations by program activity:
0001	Prescription Drug Benefits			–680

0900	Total new obligations (object class 42.0)			–680

	Budgetary resources:
	Budget authority:
	Appropriations, mandatory:
1201	Appropriation (special or trust fund)			–680

1260	Appropriations, mandatory (total)			–680
1900	Budget authority (total)			–680
1930	Total budgetary resources available			–680

	Change in obligated balance:
	Unpaid obligations:
3010	Obligations incurred, unexpired accounts			–680
3020	Outlays (gross)			680

	Budget authority and outlays, net:
	Mandatory:
4090	Budget authority, gross			–680
	Outlays, gross:
4100	Outlays from new mandatory authority			–680
4180	Budget authority, net (total)			–680
4190	Outlays, net (total)			–680

Federal Funds


Identification code 075–1552–0–1–609		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 [075–1552]	–36
1221	Appropriations transferred from other acct [075–1552]	36
1230	Appropriations and/or unobligated balance of appropriations permanently reduced	–2	–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	–15	–15	–15
1941	Unexpired unobligated balance, end of year	1	3	5

	Change in obligated balance:
	Unpaid obligations:
3000	Unpaid obligations, brought forward, Oct 1	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)	–16,305	–16,615	–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	–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. 104–193), as amended by the Deficit Reduction Act of 2005 (P.L. 109–171). Since 2010, this account has been temporarily reauthorized by a series of Acts, most recently in the Consolidated and Further Continuing Appropriations Act, 2015 (P.L. 113–235).


Identification code 075–1552–0–1–609		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


Identification code 075–1552–0–1–609		2014 actual	2015 est.	2016 est.

1001	Direct civilian full-time equivalent employment	15	18	19


Identification code 075–1552–4–1–609		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 [075–1522]			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)			–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


Identification code 075–1522–0–1–609		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 [075–1553]			–15
1120	Appropriations transferred to other accts [013–0401]			–10

1160	Appropriation, discretionary (total)			–25
	Appropriations, mandatory:
1200	Appropriation	612	608	608
1220	Appropriations transferred to other accts [075–1553]		–15
1220	Appropriations transferred to other accts [013–0401]		–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)	–624	–630	–610
3041	Recoveries of prior year unpaid obligations, expired	–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			–25
	Outlays, gross:
4010	Outlays from new discretionary authority			–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	–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. 104–193), as amended by the Deficit Reduction Act of 2005 (P.L. 109–171). The Consolidated and Further Continuing Appropriations Act, 2015 (P.L. 113–235) 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.


Identification code 075–1522–0–1–609		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


Identification code 075–1522–4–1–609		2014 actual	2015 est.	2016 est.

	Obligations by program activity:
0001	Contingency fund			–10

0900	Total new obligations (object class 41.0)			–10

	Budgetary resources:
	Budget authority:
	Appropriations, mandatory:
1220	Appropriations transferred to other accts [075–1552]			–10

1260	Appropriations, mandatory (total)			–10
1930	Total budgetary resources available			–10

	Change in obligated balance:
	Unpaid obligations:
3010	Obligations incurred, unexpired accounts			–10
3020	Outlays (gross)			8

3050	Unpaid obligations, end of year			–2
	Memorandum (non-add) entries:
3200	Obligated balance, end of year			–2

	Budget authority and outlays, net:
	Mandatory:
4090	Budget authority, gross			–10
	Outlays, gross:
4100	Outlays from new mandatory authority			–8
4180	Budget authority, net (total)			–10
4190	Outlays, net (total)			–8

For 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. 321–329), [$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. 321–329), for the last 3 months of the current fiscal year for unanticipated costs, incurred for the current fiscal year, such sums as may be necessary. (Department of Health and Human Services Appropriations Act, 2015.)


Identification code 075–1501–0–1–609		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)	–4,132	–4,310	–4,220
3040	Recoveries of prior year unpaid obligations, unexpired	–173	–200	–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	–20	–16	–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.


Identification code 075–1501–0–1–609		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


Identification code 075–1501–4–1–609		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)			–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


Identification code 075–1501–4–1–609		2014 actual	2015 est.	2016 est.

1001	Direct civilian full-time equivalent employment			2

For 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.)


Identification code 075–1502–0–1–609		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 [075–1503]	–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	–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)	–3,537	–2,955	–3,400
3041	Recoveries of prior year unpaid obligations, expired	–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.


Identification code 075–1502–0–1–609		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


Identification code 075–1502–4–1–609		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)			–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

For necessary expenses for refugee and entrant assistance activities authorized by section 414 of the Immigration and Nationality Act and section 501 of the Refugee Education Assistance Act of 1980, and for carrying out section 462 of the Homeland Security Act of 2002, section 235 of the William Wilberforce Trafficking Victims Protection Reauthorization Act of 2008, the Trafficking Victims Protection Act of 2000 ("TVPA"), section 203 of the Trafficking Victims Protection Reauthorization Act of 2005, and the Torture Victims Relief Act of 1998, [$1,559,884,000] $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.)


Identification code 075–1503–0–1–609		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 [075–1536]	2
1121	Appropriations transferred from other acct [075–0350]	5
1121	Appropriations transferred from other acct [075–1502]	34
1121	Appropriations transferred from other acct [075–0140]	1
1121	Appropriations transferred from other acct [075–0943]	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	–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)	–1,278	–1,174	–1,592
3040	Recoveries of prior year unpaid obligations, unexpired	–1
3041	Recoveries of prior year unpaid obligations, expired	–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.


Identification code 075–1503–0–1–609		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


Identification code 075–1503–0–1–609		2014 actual	2015 est.	2016 est.

1001	Direct civilian full-time equivalent employment	60	96	112

For 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.)


Identification code 075–1512–0–1–506		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	–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	–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)	–507	–518	–522
3040	Recoveries of prior year unpaid obligations, unexpired		–1
3041	Recoveries of prior year unpaid obligations, expired	–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.


Identification code 075–1512–0–1–506		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


Identification code 075–1512–0–1–506		2014 actual	2015 est.	2016 est.

1001	Direct civilian full-time equivalent employment	10	12	2


Identification code 075–1512–4–1–506		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)			–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


Identification code 075–1512–4–1–506		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


Identification code 075–1512–4–1–506		2014 actual	2015 est.	2016 est.

1001	Direct civilian full-time equivalent employment			11


Identification code 075–1550–0–1–609		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	–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)	–2,854	–2,957	–2,950
3041	Recoveries of prior year unpaid obligations, expired	–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	–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. 104–193), as amended by the Deficit Reduction Act of 2005 (P.L. 109–171). Since 2010, this account has been temporarily reauthorized by a series of Acts, most recently in the Consolidated and Further Continuing Appropriations Act, 2015 (P.L. 113–235). The Budget includes an $82 billion investment over ten years above current law to expand access to high-quality child care.


Identification code 075–1550–0–1–609		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


Identification code 075–1550–4–1–609		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)			–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


Identification code 075–1550–4–1–609		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

For 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.)


Identification code 075–1515–0–1–609		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 [075–0140]	–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)	–2,238	–2,472	–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	–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.


Identification code 075–1515–0–1–609		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


Identification code 075–1515–0–1–609		2014 actual	2015 est.	2016 est.

1001	Direct civilian full-time equivalent employment			3

For 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.)


Identification code 075–1534–0–1–506		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	–129	–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)	–1,748	–1,954	–1,761
3041	Recoveries of prior year unpaid obligations, expired	–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


Identification code 075–1534–0–1–506		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


Identification code 075–1534–0–1–506		2014 actual	2015 est.	2016 est.

1001	Direct civilian full-time equivalent employment	10	10


Identification code 075–1534–4–1–506		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)			–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


Identification code 075–1534–4–1–506		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


Identification code 075–1534–4–1–506		2014 actual	2015 est.	2016 est.

1001	Direct civilian full-time equivalent employment			10

For carrying out, except as otherwise provided, the Runaway and Homeless Youth Act, the Head Start Act, the Child Abuse Prevention and Treatment Act, sections 303 and 313 of the Family Violence Prevention and Services Act, the Native American Programs Act of 1974, title II of the Child Abuse Prevention and Treatment and Adoption Reform Act of 1978 (adoption opportunities), the Abandoned Infants Assistance Act of 1988, part B-1 of title IV and sections [413] 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 113–76 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.)


Identification code 075–1536–0–1–506		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 [075–0511]	–5
1120	Appropriations transferred to other accts [075–1503]	–2
1120	Appropriations transferred to other accts [075–0140]	–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	–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)	–9,407	–10,315	–10,753
3041	Recoveries of prior year unpaid obligations, expired	–59

3050	Unpaid obligations, end of year	6,646	6,703	7,887
	Uncollected payments:
3060	Uncollected pymts, Fed sources, brought forward, Oct 1	–16	–10	–10
3070	Change in uncollected pymts, Fed sources, unexpired	–7
3071	Change in uncollected pymts, Fed sources, expired	13

3090	Uncollected pymts, Fed sources, end of year	–10	–10	–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	–34	–18	–18
4033	Non-Federal sources		–6	–6

4040	Offsets against gross budget authority and outlays (total)	–34	–24	–24
	Additional offsets against gross budget authority only:
4050	Change in uncollected pymts, Fed sources, unexpired	–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	–1	–1	–1
	Additional offsets against gross budget authority only:
4140	Change in uncollected pymts, Fed sources, unexpired	–2
4142	Offsetting collections credited to expired accounts	1

4150	Additional offsets against budget authority only (total)	–1
4170	Outlays, net (mandatory)		–1	–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.


Identification code 075–1536–0–1–506		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


Identification code 075–1536–0–1–506		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


Identification code 075–1553–0–1–609		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 [075–1522]			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 [075–1522]		15
1230	Appropriations and/or unobligated balance of appropriations permanently reduced	–4	–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	–1	–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)	–71	–79	–82
3040	Recoveries of prior year unpaid obligations, unexpired	–2	–2	–2

3050	Unpaid obligations, end of year	63	69	69
	Uncollected payments:
3060	Uncollected pymts, Fed sources, brought forward, Oct 1	–5	–5	–5

3090	Uncollected pymts, Fed sources, end of year	–5	–5	–5
	Memorandum (non-add) entries:
3100	Obligated balance, start of year	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	–12	–13	–13
4123	Non-Federal sources	–11	–17	–17

4130	Offsets against gross budget authority and outlays (total)	–23	–30	–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. 104–193), as amended by the Deficit Reduction Act of 2005 (P.L. 109–171). For fiscal years 2010–2014, Welfare Research had been temporarily reauthorized ; for FY 2015, the Consolidated and Further Continuing Appropriations Act, 2015 (P.L. 113–235) 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.


Identification code 075–1553–0–1–609		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


Identification code 075–1553–0–1–609		2014 actual	2015 est.	2016 est.

1001	Direct civilian full-time equivalent employment	63	67	72


Identification code 075–1553–4–1–609		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)			–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			–2


Identification code 075–1553–4–1–609		2014 actual	2015 est.	2016 est.

25.1	Reimbursable obligations: Advisory and assistance services			2

99.0	Reimbursable obligations			2

For 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.)


Identification code 075–1545–0–1–609		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)	–6,868	–7,079	–7,412
3041	Recoveries of prior year unpaid obligations, expired	–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 Care—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 Assistance—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 Program—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.


Identification code 075–1545–0–1–609		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


Identification code 075–1545–0–1–609		2014 actual	2015 est.	2016 est.

1001	Direct civilian full-time equivalent employment	4	4	4


Identification code 075–1545–4–1–609		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)			–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


Identification code 075–1545–4–1–609		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


Identification code 075–1545–4–1–609		2014 actual	2015 est.	2016 est.

1001	Direct civilian full-time equivalent employment			2

Federal 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.)


Identification code 075–0142–0–1–506		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 [012–3507]	–3	–3
1120	Appropriations transferred to other accts [075–0511]	–4

1160	Appropriation, discretionary (total)	1,603	1,618	2,043
	Appropriations, mandatory:
1200	Appropriation	10
1221	PPHF Appropriations transferred from other accounts [075–0116]	28	28	28
1230	Appropriations and/or unobligated balance of appropriations permanently reduced	–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	–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)	–1,484	–1,742	–1,940
3041	Recoveries of prior year unpaid obligations, expired	–5

3050	Unpaid obligations, end of year	895	871	1,063
	Uncollected payments:
3060	Uncollected pymts, Fed sources, brought forward, Oct 1	–37	–94	–94
3070	Change in uncollected pymts, Fed sources, unexpired	–66
3071	Change in uncollected pymts, Fed sources, expired	9

3090	Uncollected pymts, Fed sources, end of year	–94	–94	–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	–2	–52	–52
	Additional offsets against gross budget authority only:
4050	Change in uncollected pymts, Fed sources, unexpired	–53
4052	Offsetting collections credited to expired accounts	1

4060	Additional offsets against budget authority only (total)	–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	–20	–19	–9
	Additional offsets against gross budget authority only:
4140	Change in uncollected pymts, Fed sources, unexpired	–13
4142	Offsetting collections credited to expired accounts	8

4150	Additional offsets against budget authority only (total)	–5

4160	Budget authority, net (mandatory)	37	28	28
4170	Outlays, net (mandatory)	19	–6	18
4180	Budget authority, net (total)	1,640	1,646	2,071
4190	Outlays, net (total)	1,462	1,671	1,879

Note.—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.


Identification code 075–0142–0–1–506		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


Identification code 075–0142–0–1–506		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

Federal Funds

For necessary expenses, not otherwise provided, for general departmental management, including hire of [six] passenger motor vehicles, and for carrying out titles III, XVII, XXI, and section 229 of the PHS Act, the United States-Mexico Border Health Commission Act, and research studies under section 1110 of the Social Security Act, [$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 113–101; 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.)


Identification code 075–9912–0–1–551		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 [075–0511]	–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	–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)	–672	–748	–734
3041	Recoveries of prior year unpaid obligations, expired	–22

3050	Unpaid obligations, end of year	533	472	468
	Uncollected payments:
3060	Uncollected pymts, Fed sources, brought forward, Oct 1	–257	–243	–243
3070	Change in uncollected pymts, Fed sources, unexpired	–109
3071	Change in uncollected pymts, Fed sources, expired	123

3090	Uncollected pymts, Fed sources, end of year	–243	–243	–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	–244	–244	–239
	Additional offsets against gross budget authority only:
4050	Change in uncollected pymts, Fed sources, unexpired	–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		–16	–13
	Additional offsets against gross budget authority only:
4140	Change in uncollected pymts, Fed sources, unexpired	–13
4170	Outlays, net (mandatory)	18	5	1
4180	Budget authority, net (total)	457	448	493
4190	Outlays, net (total)	428	488	482

Note.—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.


Identification code 075–9912–0–1–551		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


Identification code 075–9912–0–1–551		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


Identification code 075–9912–4–1–551		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)			–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			–2


Identification code 075–9912–4–1–551		2014 actual	2015 est.	2016 est.

25.3	Reimbursable obligations: Other goods and services from Federal sources			2

99.0	Reimbursable obligations			2

For expenses necessary for the Office for Civil Rights, [$38,798,000] $42,705,000. (Department of Health and Human Services Appropriations Act, 2015.)


Identification code 075–0135–0–1–751		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)	–43	–45	–51
3041	Recoveries of prior year unpaid obligations, expired	–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	–8	–5	–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.


Identification code 075–0135–0–1–751		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


Identification code 075–0135–0–1–751		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

For expenses necessary for the Office of the National Coordinator for Health Information Technology, including grants, contracts, and cooperative agreements for the development and advancement of interoperable health information technology, [$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.)


Identification code 075–0130–0–1–551		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	–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)	–342	–170	–174
3040	Recoveries of prior year unpaid obligations, unexpired	–10
3041	Recoveries of prior year unpaid obligations, expired	–1

3050	Unpaid obligations, end of year	189	101	41
	Uncollected payments:
3060	Uncollected pymts, Fed sources, brought forward, Oct 1	–34	–49
3070	Change in uncollected pymts, Fed sources, unexpired	–35	49
3071	Change in uncollected pymts, Fed sources, expired	20

3090	Uncollected pymts, Fed sources, end of year	–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	–48	–22	–125
4030	Federal sources		–49

4040	Offsets against gross budget authority and outlays (total)	–48	–71	–125
	Additional offsets against gross budget authority only:
4050	Change in uncollected pymts, Fed sources, unexpired	–35	49
4052	Offsetting collections credited to expired accounts	20

4060	Additional offsets against budget authority only (total)	–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. 111–5, Title XIII), for the purpose of addressing strategic planning, coordination, and the analysis of key technical, economic and other issues related to the public and private adoption of health information technology.


Identification code 075–0130–0–1–551		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


Identification code 075–0130–0–1–551		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


Identification code 075–0139–0–1–551		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)	–73	–103	–140
3041	Recoveries of prior year unpaid obligations, expired	–2

3050	Unpaid obligations, end of year	16
	Uncollected payments:
3060	Uncollected pymts, Fed sources, brought forward, Oct 1	–23	–18	–18
3070	Change in uncollected pymts, Fed sources, unexpired	–17
3071	Change in uncollected pymts, Fed sources, expired	22

3090	Uncollected pymts, Fed sources, end of year	–18	–18	–18
	Memorandum (non-add) entries:
3100	Obligated balance, start of year	–14	–2	–18
3200	Obligated balance, end of year	–2	–18	–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	–87	–87	–140
	Additional offsets against gross budget authority only:
4050	Change in uncollected pymts, Fed sources, unexpired	–17
4052	Offsetting collections credited to expired accounts	22

4060	Additional offsets against budget authority only (total)	5
4080	Outlays, net (discretionary)	–14	16
4190	Outlays, net (total)	–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.


Identification code 075–0139–0–1–551		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


Identification code 075–0139–0–1–551		2014 actual	2015 est.	2016 est.

1001	Direct civilian full-time equivalent employment	468	564	903


Identification code 075–0139–4–1–551		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)			–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			–130


Identification code 075–0139–4–1–551		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


Identification code 075–0139–4–1–551		2014 actual	2015 est.	2016 est.

1001	Direct civilian full-time equivalent employment			572

For expenses necessary to support activities related to countering potential biological, nuclear, radiological, chemical, and cybersecurity threats to civilian populations, and for other public health emergencies, [$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 113–164] 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.)

[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.)


Identification code 075–0140–0–1–551		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 [075–0343]	–5	–3	–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 [075–1503]	–1
1120	Appropriations transferred to other accts [075–0511]	–2
1121	Appropriations transferred from other acct [075–9915]	6
1121	Appropriations transferred from other acct [075–0943]	1
1121	Appropriations transferred from other acct [075–1362]	1
1121	Appropriations transferred from other acct [075–1515]	2
1121	Appropriations transferred from other acct [075–1536]	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	–1	–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)	–2,015	–2,062	–2,401
3040	Recoveries of prior year unpaid obligations, unexpired	–60
3041	Recoveries of prior year unpaid obligations, expired	–40	–40

3050	Unpaid obligations, end of year	4,095	3,467	2,685
	Uncollected payments:
3060	Uncollected pymts, Fed sources, brought forward, Oct 1	–153	–126	–126
3070	Change in uncollected pymts, Fed sources, unexpired	–25
3071	Change in uncollected pymts, Fed sources, expired	52

3090	Uncollected pymts, Fed sources, end of year	–126	–126	–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	–45	–81	–95
	Additional offsets against gross budget authority only:
4050	Change in uncollected pymts, Fed sources, unexpired	–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.


Identification code 075–0140–0–1–551		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


Identification code 075–0140–0–1–551		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


Identification code 075–0145–0–1–552		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)	–46	–33	–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	–82	–139	–145
4190	Outlays, net (total)	–36	–106	–57

Public Law 111–148 established the Patient-Centered Outcomes Research Trust Fund (PCORTF). Beginning in FY 2011, a total of 20 percent of the funds appropriated or credited to the PCORTF will be transferred each year to the Department of Health and Human Services (HHS). As authorized in section 937 of the Public Health Service Act, HHS will disseminate research findings from the Patient-Centered Outcomes Research Institute and other government-funded comparative clinical effectiveness research and 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.


Identification code 075–0145–0–1–552		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


Identification code 075–0145–0–1–552		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

The Prevention and Wellness Fund is authorized under the American Recovery and Reinvestment Act (ARRA), (P.L. 111–5). The Prevention and Wellness Fund administered evidence-based clinical and community-based prevention and wellness strategies.


Identification code 075–0125–0–1–551		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)	–676	–479	–402
3040	Recoveries of prior year unpaid obligations, unexpired	–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.


Identification code 075–0125–0–1–551		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


Identification code 075–0125–0–1–551		2014 actual	2015 est.	2016 est.

1001	Direct civilian full-time equivalent employment	8


Identification code 075–0119–0–1–551		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)	–170	–100	–14
3040	Recoveries of prior year unpaid obligations, unexpired	–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. 111–152) appropriated $1,000,000,000 to the Health Insurance Reform Implementation Fund within the Department of Health and Human Services. The Fund shall be used for Federal administrative expenses necessary to carry out the requirements of the Patient Protection and Affordable Care Act of 2010 (P.L. 111–148) and the Health Care and Education Reconciliation Act of 2010.


Identification code 075–0119–0–1–551		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


Identification code 075–0116–0–1–551		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 [075–0142]	–28	–28	–28
1220	Appropriations transferred to other accts [075–1700]	–7
1220	Appropriations transferred to other accts [075–0943]	–831	–886	–914
1220	Appropriations transferred to other accts [075–1362]	–62	–12	–58
1230	Appropriations and/or unobligated balance of appropriations permanently reduced [SEQ]	–72	–74

The Affordable Care Act, (P.L. 111–148) 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.


Identification code 075–0117–0–1–551		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	–2	–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)	–20	–8	–29
3041	Recoveries of prior year unpaid obligations, expired	–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.


Identification code 075–0117–0–1–551		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


Identification code 075–0117–0–1–551		2014 actual	2015 est.	2016 est.

1001	Direct civilian full-time equivalent employment	2	2	2


Identification code 075–3902–0–1–552		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)	–464	–981	–481

3050	Unpaid obligations, end of year	596	30	30
	Uncollected payments:
3060	Uncollected pymts, Fed sources, brought forward, Oct 1		–630	–630
3070	Change in uncollected pymts, Fed sources, unexpired	–630

3090	Uncollected pymts, Fed sources, end of year	–630	–630	–630
	Memorandum (non-add) entries:
3100	Obligated balance, start of year		–34	–600
3200	Obligated balance, end of year	–34	–600	–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	–429	–415	–481
4033	Non-Federal sources	–1

4040	Offsets against gross budget authority and outlays (total)	–430	–415	–481
	Additional offsets against gross budget authority only:
4050	Change in uncollected pymts, Fed sources, unexpired	–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.


Identification code 075–3902–0–1–552		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

Federal Funds

For retirement pay and medical benefits of Public Health Service Commissioned Officers as authorized by law, for payments under the Retired Serviceman's Family Protection Plan and Survivor Benefit Plan, and for medical care of dependents and retired personnel under the Dependents' Medical Care Act, such amounts as may be required during the current fiscal year. (Department of Health and Human Services Appropriations Act, 2015.)


Identification code 075–0379–0–1–551		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)	–538	–596	–585
3041	Recoveries of prior year unpaid obligations, expired	–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:


	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.


Identification code 075–0379–0–1–551		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


Identification code 075–0170–0–1–551		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)	–27	–28	–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. 108–375, section 725).


Identification code 075–0170–2–1–551		2014 actual	2015 est.	2016 est.

	Obligations by program activity:
0001	Medicare eligible accruals			–1

0900	Total new obligations (object class 12.2)			–1

	Budgetary resources:
	Budget authority:
	Appropriations, discretionary:
1100	Appropriation			–1

1160	Appropriation, discretionary (total)			–1
1930	Total budgetary resources available			–1

	Change in obligated balance:
	Unpaid obligations:
3010	Obligations incurred, unexpired accounts			–1
3020	Outlays (gross)			1

	Budget authority and outlays, net:
	Discretionary:
4000	Budget authority, gross			–1
	Outlays, gross:
4010	Outlays from new discretionary authority			–1
4180	Budget authority, net (total)			–1
4190	Outlays, net (total)			–1


Identification code 075–9941–0–4–551		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		–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)	–896	–1,808	–1,202
3040	Recoveries of prior year unpaid obligations, unexpired	–40

3050	Unpaid obligations, end of year	621
	Uncollected payments:
3060	Uncollected pymts, Fed sources, brought forward, Oct 1	–241	–372
3070	Change in uncollected pymts, Fed sources, unexpired	–131	372

3090	Uncollected pymts, Fed sources, end of year	–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	–875	–1,187	–1,202
4030	Federal sources		–372
4033	Non-Federal sources	–9

4040	Offsets against gross budget authority and outlays (total)	–884	–1,559	–1,202
	Additional offsets against gross budget authority only:
4050	Change in uncollected pymts, Fed sources, unexpired	–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.


Identification code 075–9941–0–4–551		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


Identification code 075–9941–0–4–551		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


Identification code 075–9971–0–7–551		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	–78	–63	–94

0799	Balance, end of year		31	31


Identification code 075–9971–0–7–551		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)	–64	–57	–64
3040	Recoveries of prior year unpaid obligations, unexpired	–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.


Identification code 075–9971–0–7–551		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


Identification code 075–9971–0–7–551		2014 actual	2015 est.	2016 est.

1001	Direct civilian full-time equivalent employment	27	27	27

Federal Funds

For expenses necessary for the Office of Inspector General, including the hire of passenger motor vehicles for investigations, in carrying out the provisions of the Inspector General Act of 1978, [$71,000,000] $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.)


Identification code 075–0128–0–1–551		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 [075–9911]		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	–1	–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)	–315	–345	–436
3040	Recoveries of prior year unpaid obligations, unexpired	–3
3041	Recoveries of prior year unpaid obligations, expired	–2

3050	Unpaid obligations, end of year	32	32	1
	Uncollected payments:
3060	Uncollected pymts, Fed sources, brought forward, Oct 1	–35	–60	–60
3070	Change in uncollected pymts, Fed sources, unexpired	–36
3071	Change in uncollected pymts, Fed sources, expired	11

3090	Uncollected pymts, Fed sources, end of year	–60	–60	–60
	Memorandum (non-add) entries:
3100	Obligated balance, start of year	–1	–28	–28
3200	Obligated balance, end of year	–28	–28	–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	–37	–88	–140
	Additional offsets against gross budget authority only:
4050	Change in uncollected pymts, Fed sources, unexpired	–16
4052	Offsetting collections credited to expired accounts	10

4060	Additional offsets against budget authority only (total)	–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	–170	–186	–203
4123	Non-Federal sources	–12	–12	–12

4130	Offsets against gross budget authority and outlays (total)	–182	–198	–215
	Additional offsets against gross budget authority only:
4140	Change in uncollected pymts, Fed sources, unexpired	–20
4142	Offsetting collections credited to expired accounts	1

4150	Additional offsets against budget authority only (total)	–19

4160	Budget authority, net (mandatory)	–1		1
4170	Outlays, net (mandatory)	20	–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.


Identification code 075–0128–0–1–551		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


Identification code 075–0128–0–1–551		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


		2014 actual	2015 est.	2016 est.

Offsetting receipts from the public:
075–274530	Health Education Assistance Loans, Downward Reestimates of Subsidies	43
075–267403	Consumer Operated and Oriented Plan Direct Loan Program, Downward Reestimate of Subsidies	6	5
075–322000	All Other General Fund Proprietary Receipts Including Budget Clearing Accounts	102	34	34
075–143500	General Fund Proprietary Interest Receipts, not Otherwise Classified	201	90	90
075–310700	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:
075–388500	Undistributed Intragovernmental Payments and Receivables from Cancelled Accounts	–865

General Fund Intragovernmental payments		–865

(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.

(b) Peer review.—In entering into transactions under subsection (a), the Director may utilize such peer review procedures (including consultation with appropriate scientific experts) as the Director determines to be appropriate to obtain assessments of scientific and technical merit. Such procedures shall apply to such transactions in lieu of the peer review and advisory council review procedures that would otherwise be required under sections 301(a)(3), 405(b)(1)(B), 405(b)(2), 406(a)(3)(A), 492, and 494 of the PHS Act.

(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.

(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.]

(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.]

(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.

(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.

(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).

(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.]

(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

"(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.".]

(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.]

(b) In the case of the Contingency Fund for State Welfare Programs established under section 403(b) of the Social Security Act—

(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 2015—

(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".

(g) Expenditures made pursuant to Public Law 113–164 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.]

(b) Of the amount made available by Public Law 113–235 for section 403(b) for fiscal year 2016—

(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 104–193).

"(e) FEES FOR CONDUCTING REVISIT SURVEYS.—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.".

(d) $55,793 appropriated to carry out the National Cord Blood Stem Cell Bank Program.

(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.]

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Food and Drug Administration

Federal Funds

Salaries and Expenses

Buildings and facilities

Salaries and Expenses

(Legislative proposal, not subject to PAYGO)

Revolving Fund for Certification and Other Services

Health Resources and Services Administration

Federal Funds

Primary health care

Health workforce

Maternal and child health

Ryan white HIV/AIDS program

Health care systems

Rural health

Family Planning

Program management

Health Resources and Services

(Legislative proposal, subject to PAYGO)

Vaccine Injury Compensation

Covered Countermeasure Process Fund

Maternal, Infant, and Early Childhood Home Visiting Programs

Maternal, Infant, and Early Childhood Home Visiting Programs

(Legislative proposal, subject to PAYGO)

Health Center Guaranteed Loan Financing Account

Health Education Assistance Loans Program Account

Health Education Assistance Loans Financing Account

Health Education Assistance Loans Liquidating Account

Medical Facilities Guarantee and Loan Fund

Trust Funds

Vaccine injury compensation program trust fund

Indian Health Service

Federal Funds

Indian health services

Indian Health Services

(Legislative proposal, subject to PAYGO)

Indian health facilities

ADMINISTRATIVE PROVISIONS—INDIAN HEALTH SERVICE

administrative provisions—Indian health service

Centers for Disease Control and Prevention

Federal Funds

Immunization and respiratory diseases

HIV/AIDS, viral hepatitis, sexually transmitted diseases, and tuberculosis prevention

Emerging and zoonotic infectious diseases

Chronic disease prevention and health promotion

Birth defects, developmental disabilities, disabilities and health

Public Health Scientific Services

Environmental health

Injury prevention and control

National Institute for Occupational Safety and Health

Energy employees occupational illness compensation program

Global health

Public health preparedness and response

CDC-wide activities and program support

(including transfer of funds)

[(including transfer of funds)]

Buildings and facilities

CDC Working Capital Fund

Agency for toxic substances and disease registry

Toxic substances and environmental public health

World Trade Center Health Program Fund

National Institutes of Health

Federal Funds

National cancer institute

National heart, lung, and blood institute

National institute of dental and craniofacial research

National institute of diabetes and digestive and kidney diseases

National institute of neurological disorders and stroke

National institute of allergy and infectious diseases

National institute of general medical sciences

Eunice kennedy shriver national institute of child health and human development

National eye institute

National institute of environmental health sciences

National institute of environmental health sciences

National institute on aging

National institute of arthritis and musculoskeletal and skin diseases

National institute on deafness and other communication disorders

National institute of nursing research

National institute on alcohol abuse and alcoholism