[Appendix]
[Detailed Budget Estimates by Agency]
[Department of Health and Human Services]
[From the U.S. Government Publishing Office, www.gpo.gov]
<h1>DEPARTMENT OF HEALTH AND HUMAN SERVICES
</h1>
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Food and Drug Administration
Federal Funds
Salaries and expenses
For necessary expenses of the Food and Drug Administration, including hire and purchase of passenger motor vehicles; for payment
of space rental and related costs pursuant to Public Law 92–313 for programs and activities of the Food and Drug Administration
which are included in this Act; for rental of special purpose space in the District of Columbia or elsewhere; for miscellaneous
and emergency expenses of enforcement activities, authorized and approved by the Secretary and to be accounted for solely
on the Secretary's certificate, not to exceed $25,000; and notwithstanding section 521 of Public Law 107–188; [$4,681,392,000] $4,755,944,000: Provided, That of the amount provided under this heading, [$851,481,000] $865,653,000 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; [$137,677,000] $144,859,000 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; [$318,363,000] $324,085,000 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; [$21,540,000] $22,079,000 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; [$22,818,000] $22,977,000 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; [$9,705,000] $10,367,000 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; [$599,000,000] $635,000,000 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 [2016] 2017 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 [2016] 2017, including any such fees collected prior to fiscal year [2016] 2017 but credited for fiscal year [2016] 2017, shall be subject to the fiscal year [2016] 2017 limitations: Provided further, That the Secretary may accept payment during fiscal year [2016] 2017 of user fees specified under this heading and authorized for fiscal year [2017] 2018, prior to the due date for such fees, and that amounts of such fees assessed for fiscal year [2017] 2018 for which the Secretary accepts payment in fiscal year [2016] 2017 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) $987,328,000 shall be for the Center for Food Safety and Applied Nutrition and
related field activities in the Office of Regulatory Affairs; (2) $1,394,136,000 shall be for the Center for Drug Evaluation
and Research and related field activities in the Office of Regulatory Affairs; (3) $354,901,000 shall be for the Center for
Biologics Evaluation and Research and for related field activities in the Office of Regulatory Affairs; (4) $187,825,000 shall
be for the Center for Veterinary Medicine and for related field activities in the Office of Regulatory Affairs; (5) $430,443,000
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) $564,117,000 shall be for the Center for
Tobacco Products and for related field activities in the Office of Regulatory Affairs; (8) not to exceed $171,418,000 shall
be for Rent and Related activities, of which $52,346,000 is for White Oak Consolidation, other than the amounts paid to the
General Services Administration for rent; (9) not to exceed $238,274,000 shall be for payments to the General Services Administration
for rent; and (10) $289,619,000 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. (Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2016.)
Buildings and facilities
For plans, construction, repair, improvement, extension, alteration, demolition, and purchase of fixed equipment or facilities of or used by the Food and Drug Administration, where not otherwise provided,
[$8,788,000] $11,788,000, to remain available until expended. (Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2016.)
Special and Trust Fund Receipts (in millions of dollars)
Identification code 075–9911–0–1–554
2015 actual
2016 est.
2017 est.
0100
Balance, start of year
1
1
2
Receipts:
Current law:
1130
Cooperative Research and Development Agreements, FDA
2
3
3
2000
Total: Balances and receipts
3
4
5
Appropriations:
Current law:
2101
Salaries and Expenses
–2
–2
–2
5099
Balance, end of year
1
2
3
Program and Financing (in millions of dollars)
Identification code 075–9911–0–1–554
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Foods
903
987
1,013
0002
Drugs
482
492
492
0003
Devices and Radiological Products
321
323
326
0004
National Center for Toxicological Research
63
63
60
0005
Other Activities
173
182
178
0006
Other Rent and Rent Related Activities
116
121
115
0007
Rental Payments
169
177
170
0008
Buildings and Facilities
9
9
12
0009
CRADAs
2
2
2
0010
Animal Drugs and Feed
147
159
162
0011
Biologics
211
215
215
0012
Food and Drug Safety (no-year)
12
0013
Ebola (Emergency pursuant to 2011 BCA)
11
0799
Total direct obligations
2,619
2,730
2,745
0801
Reimbursable program (User fees)
1,898
2,009
2,074
0802
Reimbursable program (Federal sources)
43
0899
Total reimbursable obligations
1,941
2,009
2,074
0900
Total new obligations
4,560
4,739
4,819
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
973
947
948
1001
Discretionary unobligated balance brought fwd, Oct 1
973
947
1021
Recoveries of prior year unpaid obligations
16
1050
Unobligated balance (total)
989
947
948
Budget authority:
Appropriations, discretionary:
1100
Appropriation
2,622
2,730
2,743
1120
Appropriations transferred to other accts [075–0128]
–2
–2
1160
Appropriation, discretionary (total)
2,620
2,728
2,743
Appropriations, mandatory:
1201
Appropriation (special or trust fund)
2
2
2
Spending authority from offsetting collections, discretionary:
1700
Collected
1,958
2,010
2,075
1700
Collected
59
1701
Change in uncollected payments, Federal sources
27
–59
1702
Offsetting collections (previously unavailable)
533
567
333
1725
Spending authority from offsetting collections precluded from obligation (limitation on obligations)
–630
–567
–333
1750
Spending auth from offsetting collections, disc (total)
1,888
2,010
2,075
Spending authority from offsetting collections, mandatory:
1800
Collected
8
1900
Budget authority (total)
4,518
4,740
4,820
1930
Total budgetary resources available
5,507
5,687
5,768
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
947
948
949
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
2,677
2,781
2,988
3010
Obligations incurred, unexpired accounts
4,560
4,739
4,819
3011
Obligations incurred, expired accounts
2
3020
Outlays (gross)
–4,373
–4,532
–4,683
3040
Recoveries of prior year unpaid obligations, unexpired
–16
3041
Recoveries of prior year unpaid obligations, expired
–69
3050
Unpaid obligations, end of year
2,781
2,988
3,124
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–51
–59
3070
Change in uncollected pymts, Fed sources, unexpired
–27
59
3071
Change in uncollected pymts, Fed sources, expired
19
3090
Uncollected pymts, Fed sources, end of year
–59
Memorandum (non-add) entries:
3100
Obligated balance, start of year
2,626
2,722
2,988
3200
Obligated balance, end of year
2,722
2,988
3,124
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
4,508
4,738
4,818
Outlays, gross:
4010
Outlays from new discretionary authority
2,062
3,602
3,676
4011
Outlays from discretionary balances
2,297
928
1,005
4020
Outlays, gross (total)
4,359
4,530
4,681
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–31
–59
4033
Non-Federal sources
–1,942
–2,010
–2,075
4040
Offsets against gross budget authority and outlays (total)
–1,973
–2,069
–2,075
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–27
59
4052
Offsetting collections credited to expired accounts
15
4060
Additional offsets against budget authority only (total)
–12
59
4070
Budget authority, net (discretionary)
2,523
2,728
2,743
4080
Outlays, net (discretionary)
2,386
2,461
2,606
Mandatory:
4090
Budget authority, gross
10
2
2
Outlays, gross:
4100
Outlays from new mandatory authority
1
2
2
4101
Outlays from mandatory balances
13
4110
Outlays, gross (total)
14
2
2
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120
Federal sources
–1
4123
Non-Federal sources
–7
4130
Offsets against gross budget authority and outlays (total)
–8
4160
Budget authority, net (mandatory)
2
2
2
4170
Outlays, net (mandatory)
6
2
2
4180
Budget authority, net (total)
2,525
2,730
2,745
4190
Outlays, net (total)
2,392
2,463
2,608
Memorandum (non-add) entries:
5090
Unexpired unavailable balance, SOY: Offsetting collections
541
638
638
5092
Unexpired unavailable balance, EOY: Offsetting collections
638
638
638
Summary of Budget Authority and Outlays (in millions of dollars)
2015 actual
2016 est.
2017 est.
Enacted/requested:
Budget Authority
2,525
2,730
2,745
Outlays
2,392
2,463
2,608
Legislative proposal, subject to PAYGO:
Budget Authority
75
Outlays
15
Total:
Budget Authority
2,525
2,730
2,820
Outlays
2,392
2,463
2,623
[In millions of dollars]
2015
2016
2017
Distribution of discretionary budget authority by account:
Salaries and expenses
2,587
2,719
2,731
Buildings and facilities
9
9
12
Distribution of discretionary outlays by account:
Salaries and expenses
2,376
2,512
2,599
Buildings and facilities
10
8
7
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 2017 Budget provides funding to support food and medical
product safety, including implementation of the Food Safety Modernization Act , encourages development of innovative diagnostics
and therapeutics, including cancer diagnostics and treatments, and improves the integrity of operations and infrastructure.
Object Classification (in millions of dollars)
Identification code 075–9911–0–1–554
2015 actual
2016 est.
2017 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
864
896
909
11.3
Other than full-time permanent
89
92
94
11.5
Other personnel compensation
37
39
40
11.7
Military personnel
63
63
64
11.8
Special personal services payments
1
1
1
11.9
Total personnel compensation
1,054
1,091
1,108
12.1
Civilian personnel benefits
318
329
335
12.2
Military personnel benefits
31
32
32
21.0
Travel and transportation of persons
47
50
50
22.0
Transportation of things
4
4
4
23.1
Rental payments to GSA
169
177
170
23.2
Rental payments to others
5
6
6
23.3
Communications, utilities, and miscellaneous charges
31
33
33
24.0
Printing and reproduction
2
2
2
25.1
Advisory and assistance services
69
70
70
25.2
Other services from non-Federal sources
345
365
364
25.3
Other goods and services from Federal sources
126
131
131
25.4
Operation and maintenance of facilities
81
86
86
25.5
Research and development contracts
17
16
16
25.7
Operation and maintenance of equipment
76
81
81
26.0
Supplies and materials
46
48
48
31.0
Equipment
71
75
75
32.0
Land and structures
1
1
1
41.0
Grants, subsidies, and contributions
125
132
132
42.0
Insurance claims and indemnities
1
1
1
99.0
Direct obligations
2,619
2,730
2,745
99.0
Reimbursable obligations
1,941
2,009
2,074
99.9
Total new obligations
4,560
4,739
4,819
Employment Summary
Identification code 075–9911–0–1–554
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
9,435
9,687
9,715
1101
Direct military average strength employment
696
696
696
2001
Reimbursable civilian full-time equivalent employment
5,052
5,520
5,629
2101
Reimbursable military average strength employment
373
373
373
3001
Allocation account civilian full-time equivalent employment
27
27
27
3101
Allocation account military average strength employment
1
1
1
Salaries and Expenses
(Legislative proposal, not subject to PAYGO)
In addition, contingent upon the enactment of authorizing legislation, the Secretary shall assess user fees with respect to
food facility registrations and inspections, food imports, food contact notification activities, cosmetic activities, and
international express courier import activities, and such fees shall be credited to this account and remain available until
expended.
Program and Financing (in millions of dollars)
Identification code 075–9911–2–1–554
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0801
Food Facility Registration and Inspection
61
0802
Food Import
105
0803
International Courier
6
0804
Food Contact Substance Notification
5
0805
Cosmetics
20
0806
Export Certification Fee Increase
4
0899
Total reimbursable obligations
201
0900
Total new obligations
201
Budgetary resources:
Budget authority:
Spending authority from offsetting collections, discretionary:
1700
Collected
201
1900
Budget authority (total)
201
1930
Total budgetary resources available
201
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
201
3020
Outlays (gross)
–201
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
201
Outlays, gross:
4010
Outlays from new discretionary authority
201
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4033
Non-Federal sources
–201
4040
Offsets against gross budget authority and outlays (total)
–201
4180
Budget authority, net (total)
4190
Outlays, net (total)
The FY 2017 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 $105 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
$61 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.
Object Classification (in millions of dollars)
Identification code 075–9911–2–1–554
2015 actual
2016 est.
2017 est.
Reimbursable obligations:
Personnel compensation:
11.1
Full-time permanent
29
11.3
Other than full-time permanent
4
11.5
Other personnel compensation
3
11.9
Total personnel compensation
36
12.1
Civilian personnel benefits
20
21.0
Travel and transportation of persons
2
23.1
Rental payments to GSA
6
25.1
Advisory and assistance services
10
25.2
Other services from non-Federal sources
61
25.3
Other goods and services from Federal sources
35
25.4
Operation and maintenance of facilities
3
25.5
Research and development contracts
2
25.7
Operation and maintenance of equipment
4
26.0
Supplies and materials
2
31.0
Equipment
3
41.0
Grants, subsidies, and contributions
17
99.0
Reimbursable obligations
201
99.9
Total new obligations
201
Employment Summary
Identification code 075–9911–2–1–554
2015 actual
2016 est.
2017 est.
2001
Reimbursable civilian full-time equivalent employment
242
Salaries and Expenses
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 075–9911–4–1–554
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0014
Cancer Initiative
15
0799
Total direct obligations
15
Budgetary resources:
Budget authority:
Appropriations, mandatory:
1221
Appropriations transferred from other acct [075–9915]
75
1900
Budget authority (total)
75
1930
Total budgetary resources available
75
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
60
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
15
3020
Outlays (gross)
–15
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
75
Outlays, gross:
4100
Outlays from new mandatory authority
15
4180
Budget authority, net (total)
75
4190
Outlays, net (total)
15
Object Classification (in millions of dollars)
Identification code 075–9911–4–1–554
2015 actual
2016 est.
2017 est.
11.1
Direct obligations: Personnel compensation: Full-time permanent
7
11.9
Total personnel compensation
7
12.1
Civilian personnel benefits
2
23.1
Rental payments to GSA
1
25.1
Advisory and assistance services
1
25.2
Other services from non-Federal sources
2
25.3
Other goods and services from Federal sources
1
41.0
Grants, subsidies, and contributions
1
99.0
Direct obligations
15
99.9
Total new obligations
15
Employment Summary
Identification code 075–9911–4–1–554
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
51
Revolving Fund for Certification and Other Services
Program and Financing (in millions of dollars)
Identification code 075–4309–0–3–554
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0801
Revolving Fund for Certification and Other Services (Reimbursable)
7
9
10
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
5
5
5
Budget authority:
Spending authority from offsetting collections, mandatory:
1800
Collected
7
9
9
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)
7
9
10
1900
Budget authority (total)
7
9
10
1930
Total budgetary resources available
12
14
15
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
5
5
5
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
2
1
1
3010
Obligations incurred, unexpired accounts
7
9
10
3020
Outlays (gross)
–8
–9
–10
3050
Unpaid obligations, end of year
1
1
1
Memorandum (non-add) entries:
3100
Obligated balance, start of year
2
1
1
3200
Obligated balance, end of year
1
1
1
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
7
9
10
Outlays, gross:
4100
Outlays from new mandatory authority
1
9
10
4101
Outlays from mandatory balances
7
4110
Outlays, gross (total)
8
9
10
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123
Non-Federal sources
–7
–9
–9
4180
Budget authority, net (total)
1
4190
Outlays, net (total)
1
1
Memorandum (non-add) entries:
5090
Unexpired unavailable balance, SOY: Offsetting collections
1
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 . These services are financed wholly by fees paid by the industries affected.
Object Classification (in millions of dollars)
Identification code 075–4309–0–3–554
2015 actual
2016 est.
2017 est.
Reimbursable obligations:
11.1
Personnel compensation: Full-time permanent
3
5
5
12.1
Civilian personnel benefits
1
1
2
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
7
9
10
Employment Summary
Identification code 075–4309–0–3–554
2015 actual
2016 est.
2017 est.
2001
Reimbursable civilian full-time equivalent employment
36
37
37
Health Resources and Services Administration
Federal Funds
Primary health care
For carrying out titles II and III of the Public Health Service Act (referred to in this Act as the "PHS Act") with respect
to primary health care and the Native Hawaiian Health Care Act of 1988, [$1,491,522,000 (in addition to the $3,600,000,000 previously appropriated to the Community Health Center Fund for fiscal year
2016)] $1,342,422,000: Provided, That no more than [$100,000] $1,000,000 shall be available until expended for carrying out the provisions of section 224(o) of the PHS Act: Provided further, That no more than $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 2016, not less than $200,000,000 shall be obligated in fiscal year 2016 to support new access points,
grants to expand medical services, behavioral health, oral health, pharmacy, or vision services, and not less than $150,000,000
shall be obligated in fiscal year 2016 for construction and capital improvement costs: Provided further, That the time limitation in section 330(e)(3) of the PHS Act shall not apply in fiscal year 2016].
Health workforce
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, [$786,895,000] $536,745,000: Provided, That $20,000,000, to remain available until expended, shall be for the National Health Service Corps Program: Provided further, That sections 747(c)(2) [, 751(j)(2),] and 762(k), and the proportional funding amounts in paragraphs (1) through (4) of section 756(e) of the PHS Act shall not apply
to funds made available under this heading: [Provided further, That for any program operating under section 751 of the PHS Act on or before January 1, 2009, the Secretary of Health and
Human Services (referred to in this title as 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.
maternal and child health
For carrying out titles III, XI, XII, and XIX of the PHS Act with respect to maternal and child health, title V of the Social
Security Act, and section 712 of the American Jobs Creation Act of 2004, $845,117,000: Provided, That notwithstanding sections 502(a)(1) and 502(b)(1) of the Social Security Act, not more than $77,093,000 shall be available
for carrying out special projects of regional and national significance pursuant to section 501(a)(2) of such Act and $10,276,000
shall be available for projects described in subparagraphs (A) through (F) of section 501(a)(3) of such Act.
Ryan white HIV/AIDS program
For carrying out title XXVI of the PHS Act with respect to the Ryan White HIV/AIDS program, [$2,322,781,000] $2,297,781,000, of which $1,970,881,000 shall remain available to the Secretary of Health and Human Services (referred to in this title as the "Secretary") through September 30, [2018] 2019, for parts A and B of title XXVI of the PHS Act, and of which not less than $900,313,000 shall be for State AIDS Drug Assistance
Programs under the authority of section 2616 or 311(c) of such Act: Provided, That in addition to amounts provided herein, $34,000,000 shall be available under section 241 of the PHS Act to
carry out section 2691 of such Act, notwithstanding subsection (a) of such section 2691.
health care systems
For carrying out titles III and XII of the PHS Act with respect to health care systems, and the Stem Cell Therapeutic and
Research Act of 2005, [$103,193,000] $110,193,000, of which $122,000 shall be available until expended for facilities renovations at the Gillis W. Long Hansen's Disease Center: Provided, That the Secretary may collect a fee of 0.1 percent of each purchase of 340B drugs from entities participating
in the Drug Pricing Program pursuant to section 340B of the PHS Act to pay for the operating costs of such program: Provided
further, That fees pursuant to the 340B Drug Pricing Program shall be collected by the Secretary based on sales data that
shall be submitted by drug manufacturers and shall be credited to this account to remain available until expended.
Rural health
For carrying out titles III and IV of the PHS Act with respect to rural health, section 427(a) of the Federal Coal Mine Health
and Safety Act of 1969, and sections 711 and 1820 of the Social Security Act, [$149,571,000] $144,162,000, 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 shall be available for State Offices of Rural Health.
Family Planning
For carrying out the program under title X of the PHS Act to provide for voluntary family planning projects, [$286,479,000] $300,000,000: Provided, That amounts provided to said projects under such title shall not be expended for abortions, that all pregnancy counseling
shall be nondirective, and that such amounts shall not be expended for any activity (including the publication or distribution
of literature) that in any way tends to promote public support or opposition to any legislative proposal or candidate for
public office.
program management
For program support in the Health Resources and Services Administration ("HRSA"), [$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 discretionary funds (pursuant to the Balanced Budget and Emergency
Deficit Control Act of 1985) which are appropriated for the current fiscal year for HRSA in this Act 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, 2016.)
Program and Financing (in millions of dollars)
Identification code 075–0350–0–1–550
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0009
Free Clinics Medical Malpractice
1
1
0010
Health Centers
1,392
1,392
1,242
0012
National Health Service Corps
20
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
NURSE Corps Scholarship and Loan Repayment Program
82
83
83
0017
Health Workforce
402
407
433
0018
Maternal and Child Health Block Grant
637
638
638
0019
Healthy Start
102
104
104
0020
Poison Control Centers
19
19
19
0021
Emergency Medical Services for Children
20
20
20
0022
James T.Walsh Universal Newborn Hearing Screening
18
18
18
0023
HIV/AIDS
2,318
2,323
2,298
0024
Organ Transplantation
24
24
24
0025
C.W. Bill Young Cell Transplantation Program
22
22
22
0026
Rural Health Policy Development
9
9
9
0027
Rural Health Outreach Grants
59
64
64
0028
Rural Hospital Flexibility Grants
42
42
26
0030
Telehealth
15
17
17
0031
Program Management
154
154
157
0032
Family Planning
286
286
300
0033
Loan Repayment/Faculty Fellowships
1
1
1
0035
Health Centers Tort Claims
102
100
100
0036
Heritable Disorders
14
14
14
0038
Children's Hospital Graduate Medical Education
265
295
0041
State Offices of Rural Health
10
10
10
0043
Radiation Exposure Screening and Education Program
2
2
2
0044
Traumatic Brain Injury
9
0045
Autism and Other Developmental Disorders
47
47
47
0046
National Cord Blood Inventory
11
11
11
0048
Sickle Cell Service Demonstrations
4
4
4
0049
340 B Drug Pricing Program/Office of Pharmacy Affairs
10
10
17
0050
Family to Family Health Information Centers ACA
5
5
5
0073
Health Centers ACA
3,309
3,695
3,695
0075
National Health Service Corps ACA
290
324
310
0076
School Based Health Centers ACA
1
0077
GME Payments THC ACA
121
60
60
0079
Rural & Community Access to Emergency Devices
5
0080
Prevention Fund
57
0082
Rural Opioid Overdose Reversal Grant Program
10
0300
Total direct programs
9,889
10,224
9,805
0799
Total direct obligations
9,889
10,224
9,805
0801
Health Resources and Services (Reimbursable)
48
48
61
0802
Reimbursable program: PHS evaluation
34
0899
Total reimbursable obligations
48
48
95
0900
Total new obligations
9,937
10,272
9,900
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
298
407
296
1001
Discretionary unobligated balance brought fwd, Oct 1
146
139
1012
Unobligated balance transfers between expired and unexpired accounts
70
1021
Recoveries of prior year unpaid obligations
25
1050
Unobligated balance (total)
393
407
296
Budget authority:
Appropriations, discretionary:
1100
Appropriation
6,105
6,140
5,733
Appropriations, mandatory:
1200
Appropriation
3,915
3,975
3,975
1220
Appropriations transferred to other acct [015–5606]
–5
–5
1230
Appropriations and/or unobligated balance of appropriations permanently reduced
–114
1260
Appropriations, mandatory (total)
3,801
3,970
3,970
Spending authority from offsetting collections, discretionary:
1700
Collected
25
35
75
1701
Change in uncollected payments, Federal sources
9
1750
Spending auth from offsetting collections, disc (total)
34
35
75
Spending authority from offsetting collections, mandatory:
1800
Offsetting collections (cash)(HPSL&NSL)
20
16
16
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)
20
16
17
1900
Budget authority (total)
9,960
10,161
9,795
1930
Total budgetary resources available
10,353
10,568
10,091
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–9
1941
Unexpired unobligated balance, end of year
407
296
191
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
6,232
7,398
7,995
3010
Obligations incurred, unexpired accounts
9,937
10,272
9,900
3011
Obligations incurred, expired accounts
1
3020
Outlays (gross)
–8,607
–9,675
–10,744
3040
Recoveries of prior year unpaid obligations, unexpired
–25
3041
Recoveries of prior year unpaid obligations, expired
–140
3050
Unpaid obligations, end of year
7,398
7,995
7,151
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–66
–36
–36
3070
Change in uncollected pymts, Fed sources, unexpired
–9
3071
Change in uncollected pymts, Fed sources, expired
39
3090
Uncollected pymts, Fed sources, end of year
–36
–36
–36
Memorandum (non-add) entries:
3100
Obligated balance, start of year
6,166
7,362
7,959
3200
Obligated balance, end of year
7,362
7,959
7,115
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
6,139
6,175
5,808
Outlays, gross:
4010
Outlays from new discretionary authority
1,902
2,323
2,176
4011
Outlays from discretionary balances
3,731
3,995
3,792
4020
Outlays, gross (total)
5,633
6,318
5,968
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–45
–13
–44
4033
Non-Federal sources
–21
–22
–22
4033
Non-Federal sources
–9
4040
Offsets against gross budget authority and outlays (total)
–66
–35
–75
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–9
4052
Offsetting collections credited to expired accounts
41
4060
Additional offsets against budget authority only (total)
32
4070
Budget authority, net (discretionary)
6,105
6,140
5,733
4080
Outlays, net (discretionary)
5,567
6,283
5,893
Mandatory:
4090
Budget authority, gross
3,821
3,986
3,987
Outlays, gross:
4100
Outlays from new mandatory authority
1,464
1,927
1,964
4101
Outlays from mandatory balances
1,510
1,430
2,812
4110
Outlays, gross (total)
2,974
3,357
4,776
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123
Non-Federal sources
–20
–16
–16
4180
Budget authority, net (total)
9,906
10,110
9,704
4190
Outlays, net (total)
8,521
9,624
10,653
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 Budget Authority and Outlays (in millions of dollars)
2015 actual
2016 est.
2017 est.
Enacted/requested:
Budget Authority
9,906
10,110
9,704
Outlays
8,521
9,624
10,653
Legislative proposal, subject to PAYGO:
Budget Authority
495
Outlays
219
Total:
Budget Authority
9,906
10,110
10,199
Outlays
8,521
9,624
10,872
Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in millions of dollars)
Identification code 075–0350–0–1–550
2015 actual
2016 est.
2017 est.
Guaranteed loan levels supportable by subsidy budget authority:
215001
Health centers: Facilities renovation loan guarantee levels
9
4
215002
Health centers: Managed care network development loan guarantee
1
215003
Health centers: Managed care plan loan guarantee levels
1
215999
Total loan guarantee levels
9
6
Guaranteed loan subsidy (in percent):
232001
Health centers: Facilities renovation loan guarantee levels
2.67
2.67
2.65
232002
Health centers: Managed care network development loan guarantee
0.00
0.00
9.48
232003
Health centers: Managed care plan loan guarantee levels
0.00
0.00
5.69
232999
Weighted average subsidy rate
0.00
2.67
4.30
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 workforce
training, maternal and child health care services, promotion of organ and bone marrow donation, rural health activities, 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 2017 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 2014–2015 data reported in the Annual Operating Report.
Health Professions Revolving Loan Programs Federal Capital Contribution
Program
Account Balance
HPSL
405,831,597
NSL
182,345,335
PCL
251,721,912
LDS
149,818,689
Total
989,717,533
Object Classification (in millions of dollars)
Identification code 075–0350–0–1–550
2015 actual
2016 est.
2017 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
163
191
191
11.3
Other than full-time permanent
7
7
7
11.5
Other personnel compensation
3
3
3
11.7
Military personnel
18
19
19
11.9
Total personnel compensation
191
220
220
12.1
Civilian personnel benefits
52
61
61
12.2
Military personnel benefits
10
10
10
21.0
Travel and transportation of persons
3
3
3
23.1
Rental payments to GSA
23
23
23
23.2
Rental payments to others
1
1
1
23.3
Communications, utilities, and miscellaneous charges
6
6
6
25.1
Advisory and assistance services
11
10
10
25.2
Other services from non-Federal sources
180
179
181
25.3
Other goods and services from Federal sources
288
274
266
25.4
Operation and maintenance of facilities
1
1
1
25.6
Medical care
3
3
3
25.7
Operation and maintenance of equipment
11
11
10
26.0
Supplies and materials
1
1
1
31.0
Equipment
22
22
19
41.0
Grants, subsidies, and contributions
8,992
9,309
8,900
42.0
Insurance claims and indemnities
94
90
90
99.0
Direct obligations
9,889
10,224
9,805
99.0
Reimbursable obligations
48
48
95
99.9
Total new obligations
9,937
10,272
9,900
Employment Summary
Identification code 075–0350–0–1–550
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
1,576
1,800
1,780
1101
Direct military average strength employment
184
184
183
2001
Reimbursable civilian full-time equivalent employment
51
60
69
2101
Reimbursable military average strength employment
3
3
3
Health Resources and Services
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 075–0350–4–1–550
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0012
National Health Service Corps
50
0073
Health Centers
150
0081
Children's Hospital Graduate Medical Education
295
0300
Total direct programs
495
0900
Total new obligations
495
Budgetary resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
495
1930
Total budgetary resources available
495
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
495
3020
Outlays (gross)
–219
3050
Unpaid obligations, end of year
276
Memorandum (non-add) entries:
3200
Obligated balance, end of year
276
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
495
Outlays, gross:
4100
Outlays from new mandatory authority
219
4180
Budget authority, net (total)
495
4190
Outlays, net (total)
219
Object Classification (in millions of dollars)
Identification code 075–0350–4–1–550
2015 actual
2016 est.
2017 est.
11.1
Direct obligations: Personnel compensation: Full-time permanent
2
11.9
Total personnel compensation
2
12.1
Civilian personnel benefits
1
25.2
Other services from non-Federal sources
52
25.3
Other goods and services from Federal sources
7
31.0
Equipment
2
41.0
Grants, subsidies, and contributions
431
99.9
Total new obligations
495
Employment Summary
Identification code 075–0350–4–1–550
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
21
1101
Direct military average strength employment
1
Vaccine Injury Compensation
Program and Financing (in millions of dollars)
Identification code 075–0320–0–1–551
2015 actual
2016 est.
2017 est.
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
23
28
28
Budget authority:
Spending authority from offsetting collections, mandatory:
1800
Collected
5
1930
Total budgetary resources available
28
28
28
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
28
28
28
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
5
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120
Federal sources
–5
4180
Budget authority, net (total)
4190
Outlays, net (total)
–5
The Vaccine Injury Compensation Program was established pursuant to Public Law 99–660 and Public Law 100–203, and serves as
a source of funds to pay claims for compensation for vaccine related injury or death. Payment of claims associated with vaccine
related injury or death occurring before October 1, 1988, are financed from the General Fund and are reflected in this account.
Given sufficient carry-over funds from prior years' appropriations to pay for the balance of the pre-1988 claims yet to be
adjudicated, no appropriation is requested to cover payment of pre-1988 claims. By statute, no new claims are accepted for
this account. Payment of claims associated with vaccine related injury or death occurring after October 1, 1988, are reflected
in the Vaccine Injury Compensation Program trust fund account.
Covered Countermeasure Process Fund
Program and Financing (in millions of dollars)
Identification code 075–0343–0–1–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Claims
4
1
1
0103
Admin Expense
3
2
0900
Total new obligations
4
4
3
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
3
3
1011
Unobligated balance transfer from other acct [075–0140]
4
1
3
1050
Unobligated balance (total)
7
4
3
1930
Total budgetary resources available
7
4
3
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
3
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
2
1
1
3010
Obligations incurred, unexpired accounts
4
4
3
3020
Outlays (gross)
–5
–4
–3
3050
Unpaid obligations, end of year
1
1
1
Memorandum (non-add) entries:
3100
Obligated balance, start of year
2
1
1
3200
Obligated balance, end of year
1
1
1
Budget authority and outlays, net:
Discretionary:
Outlays, gross:
4011
Outlays from discretionary balances
5
4
3
4180
Budget authority, net (total)
4190
Outlays, net (total)
5
4
3
The Covered Countermeasure Process Fund is established pursuant to the PHS Act, as amended by Division C of Public Law 109–148,
to serve as a source of funds to pay for compensation for injuries, illnesses or death, or losses resulting from the administration
to or use by an individual of a covered countermeasure for which a Secretarial Declaration has been issued, pursuant to section
319F-3(b) of the PHS Act. Additionally, authority is provided to address any unexpected claims that may arise under the Smallpox
Emergency Personnel Protection Act of 2003 (P.L. 108–20).
Object Classification (in millions of dollars)
Identification code 075–0343–0–1–551
2015 actual
2016 est.
2017 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent
1
1
1
25.2
Other services from non-Federal sources
1
1
1
42.0
Insurance claims and indemnities
2
2
1
99.0
Direct obligations
4
4
3
99.9
Total new obligations
4
4
3
Employment Summary
Identification code 075–0343–0–1–551
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
5
7
7
1101
Direct military average strength employment
1
1
1
Maternal, Infant, and Early Childhood Home Visiting Programs
Program and Financing (in millions of dollars)
Identification code 075–0321–0–1–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0010
Maternal, Infant, and Early Childhood Home Visiting Programs
430
413
403
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
27
16
3
1012
Unobligated balance transfers between expired and unexpired accounts
2
1021
Recoveries of prior year unpaid obligations
17
1050
Unobligated balance (total)
46
16
3
Budget authority:
Appropriations, mandatory:
1200
Appropriation
400
400
400
1930
Total budgetary resources available
446
416
403
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
16
3
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
703
750
770
3010
Obligations incurred, unexpired accounts
430
413
403
3020
Outlays (gross)
–364
–393
–395
3040
Recoveries of prior year unpaid obligations, unexpired
–17
3041
Recoveries of prior year unpaid obligations, expired
–2
3050
Unpaid obligations, end of year
750
770
778
Memorandum (non-add) entries:
3100
Obligated balance, start of year
703
750
770
3200
Obligated balance, end of year
750
770
778
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
400
400
400
Outlays, gross:
4100
Outlays from new mandatory authority
12
16
16
4101
Outlays from mandatory balances
352
377
379
4110
Outlays, gross (total)
364
393
395
4180
Budget authority, net (total)
400
400
400
4190
Outlays, net (total)
364
393
395
Public Law 114–10 provides resources to Maternal, Infant and Early Childhood Home Visiting Program through FY 2017 to provide
comprehensive services for at risk communities. These activities are administered by HRSA.
Object Classification (in millions of dollars)
Identification code 075–0321–0–1–551
2015 actual
2016 est.
2017 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
2
3
3
11.7
Military personnel
1
1
1
11.9
Total personnel compensation
3
4
4
12.1
Civilian personnel benefits
1
1
1
25.1
Advisory and assistance services
20
20
20
41.0
Grants, subsidies, and contributions
406
388
378
99.9
Total new obligations
430
413
403
Employment Summary
Identification code 075–0321–0–1–551
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
20
24
24
1101
Direct military average strength employment
5
5
5
Health Center Guaranteed Loan Financing Account
Program and Financing (in millions of dollars)
Identification code 075–4442–0–3–551
2015 actual
2016 est.
2017 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
4180
Budget authority, net (total)
4190
Outlays, net (total)
Status of Guaranteed Loans (in millions of dollars)
Identification code 075–4442–0–3–551
2015 actual
2016 est.
2017 est.
Position with respect to appropriations act limitation on commitments:
2121
Limitation available from carry-forward
15
15
6
2143
Uncommitted limitation carried forward
–15
–6
2150
Total guaranteed loan commitments
9
6
2199
Guaranteed amount of guaranteed loan commitments
7
5
Cumulative balance of guaranteed loans outstanding:
2210
Outstanding, start of year
80
76
73
2231
Disbursements of new guaranteed loans
8
6
2251
Repayments and prepayments
–4
–10
–10
2263
Adjustments: Terminations for default that result in claim payments
–1
–1
2290
Outstanding, end of year
76
73
68
Memorandum:
2299
Guaranteed amount of guaranteed loans outstanding, end of year
75
73
68
Public Law 104–299 and Public Law 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.
Balance Sheet (in millions of dollars)
Identification code 075–4442–0–3–551
2014 actual
2015 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
Medical Facilities Guarantee and Loan Fund
Status of Direct Loans (in millions of dollars)
Identification code 075–9931–0–3–551
2015 actual
2016 est.
2017 est.
Cumulative balance of direct loans outstanding:
1210
Outstanding, start of year
6
6
6
1290
Outstanding, end of year
6
6
6
Titles VI and XVI of the PHS 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 the
event of default, $30 million as a revolving fund for direct loans, and an amount for interest subsidy payments on guaranteed
loans.
Balance Sheet (in millions of dollars)
Identification code 075–9931–0–3–551
2014 actual
2015 actual
ASSETS:
1601
Direct loans, gross
6
6
1999
Total assets
6
6
LIABILITIES:
2201
Non-Federal liabilities: Accounts payable
6
6
4999
Total liabilities and net position
6
6
Trust Funds
Vaccine injury compensation program trust fund
For payments from the Vaccine Injury Compensation Program Trust Fund (the "Trust Fund"), such sums as may be necessary for
claims associated with vaccine-related injury or death with respect to vaccines administered after September 30, 1988, pursuant
to subtitle 2 of title XXI of the PHS Act, to remain available until expended: Provided, That for necessary administrative expenses, not to exceed [$7,500,000] $9,200,000 shall be available from the Trust Fund to the Secretary. (Department of Health and Human Services Appropriations Act, 2016.)
Special and Trust Fund Receipts (in millions of dollars)
Identification code 075–8175–0–7–551
2015 actual
2016 est.
2017 est.
0100
Balance, start of year
3,356
3,452
3,586
Receipts:
Current law:
1110
Deposits, Vaccine Injury Compensation Trust Fund
275
311
318
1140
Interest and Profits on Investments, Vaccine Injury Compensation Trust Fund
62
83
117
1199
Total current law receipts
337
394
435
1999
Total receipts
337
394
435
2000
Total: Balances and receipts
3,693
3,846
4,021
Appropriations:
Current law:
2101
Vaccine Injury Compensation Program Trust Fund
–18
–23
–27
2101
Vaccine Injury Compensation Program Trust Fund
–221
–237
–240
2102
Vaccine Injury Compensation Program Trust Fund
–2
2199
Total current law appropriations
–241
–260
–267
2999
Total appropriations
–241
–260
–267
5099
Balance, end of year
3,452
3,586
3,754
Program and Financing (in millions of dollars)
Identification code 075–8175–0–7–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Compensation: Claims for post - FY 1989 injuries
229
237
240
0103
Claims processing (Claims Court)
5
6
6
0104
Claims processing (HRSA)
8
8
9
0105
Claims processing (Dept. of Justice)
5
9
12
0191
Total, administrative expenses
18
23
27
0900
Total new obligations
247
260
267
Budgetary resources:
Unobligated balance:
1021
Recoveries of prior year unpaid obligations
3
1050
Unobligated balance (total)
3
Budget authority:
Appropriations, discretionary:
1101
Appropriation (special or trust fund)
18
23
27
1102
Appropriation (previously unavailable)
2
1160
Appropriation, discretionary (total)
20
23
27
Appropriations, mandatory:
1201
Appropriation (special or trust fund)
221
237
240
Spending authority from offsetting collections, mandatory:
1800
Collected
3
1900
Budget authority (total)
244
260
267
1930
Total budgetary resources available
247
260
267
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
11
15
3010
Obligations incurred, unexpired accounts
247
260
267
3020
Outlays (gross)
–240
–275
–267
3040
Recoveries of prior year unpaid obligations, unexpired
–3
3050
Unpaid obligations, end of year
15
Memorandum (non-add) entries:
3100
Obligated balance, start of year
11
15
3200
Obligated balance, end of year
15
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
20
23
27
Outlays, gross:
4010
Outlays from new discretionary authority
14
23
27
4011
Outlays from discretionary balances
2
15
4020
Outlays, gross (total)
16
38
27
Mandatory:
4090
Budget authority, gross
224
237
240
Outlays, gross:
4100
Outlays from new mandatory authority
224
237
240
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120
Federal sources
–3
4180
Budget authority, net (total)
241
260
267
4190
Outlays, net (total)
237
275
267
Memorandum (non-add) entries:
5000
Total investments, SOY: Federal securities: Par value
3,360
3,453
3,615
5001
Total investments, EOY: Federal securities: Par value
3,453
3,615
3,810
The Vaccine Injury Compensation Program was established pursuant to Public Law 99–660 and Public Law 100–203 and serves as
a source of funds to pay claims for compensation for vaccine-related injury or death. This account reflects payments for claims
for vaccine-related injury or death occurring after October 1, 1988.
Object Classification (in millions of dollars)
Identification code 075–8175–0–7–551
2015 actual
2016 est.
2017 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent
2
3
3
12.1
Civilian personnel benefits
1
1
1
25.3
Other goods and services from Federal sources
4
4
6
42.0
Insurance claims and indemnities
240
252
257
99.9
Total new obligations
247
260
267
Employment Summary
Identification code 075–8175–0–7–551
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
16
23
23
1101
Direct military average strength employment
2
2
2
Indian Health Service
Federal Funds
Indian health services
For expenses necessary to carry out the Act of August 5, 1954 (68 Stat. 674), the Indian Self-Determination and Education
Assistance Act, the Indian Health Care Improvement Act, and titles II and III of the Public Health Service Act with respect
to the Indian Health Service, [$3,566,387,000] $3,815,109,000, 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] $962,331,000 for Purchased/Referred Care, including [$51,500,000] $53,000,000 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, of the funds provided, [$2,000,000] $11,000,000 shall [be used] remain available until expended to supplement funds available for operational costs at tribal clinics operated under an Indian Self-Determination and Education
Assistance Act compact or contract where health care is delivered in space acquired through a full service lease, which is
not eligible for maintenance and improvement and equipment funds from the Indian Health Service [, and $2,000,000 shall be for accreditation emergencies]: 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] Substance Abuse and Suicide Prevention Program, for the [domestic violence prevention initiative] Domestic Violence Prevention Program, for the Zero Suicide Initiative, for aftercare pilots at Youth Regional Treatment Centers, to improve collections from public and private insurance at Indian Health Service and tribally operated facilities, and for
accreditation emergencies 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, 2016.)
Program and Financing (in millions of dollars)
Identification code 075–0390–0–1–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Clinical services
3,197
3,241
3,474
0002
Preventive health
154
156
166
0003
Urban health
44
45
48
0004
Indian health professions
48
48
49
0005
Tribal management
2
2
2
0006
Direct operations
68
68
70
0007
Self-governance
6
6
6
0008
Contract support costs
663
0009
Diabetes funds
150
150
150
0799
Total direct obligations
4,332
3,716
3,965
0801
Indian Health Services (Reimbursable)
1,335
1,194
1,194
0900
Total new obligations
5,667
4,910
5,159
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
668
740
968
1001
Discretionary unobligated balance brought fwd, Oct 1
63
63
1021
Recoveries of prior year unpaid obligations
99
1050
Unobligated balance (total)
767
740
968
Budget authority:
Appropriations, discretionary:
1100
Appropriation
4,182
3,566
3,815
Appropriations, mandatory:
1200
Appropriation
150
150
150
Spending authority from offsetting collections, discretionary:
1700
Collected
1,371
1,422
1,422
1900
Budget authority (total)
5,703
5,138
5,387
1930
Total budgetary resources available
6,470
5,878
6,355
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–63
1941
Unexpired unobligated balance, end of year
740
968
1,196
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
807
917
578
3010
Obligations incurred, unexpired accounts
5,667
4,910
5,159
3011
Obligations incurred, expired accounts
36
40
3020
Outlays (gross)
–5,472
–5,269
–5,345
3040
Recoveries of prior year unpaid obligations, unexpired
–99
3041
Recoveries of prior year unpaid obligations, expired
–22
–20
3050
Unpaid obligations, end of year
917
578
392
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–68
–67
–67
3071
Change in uncollected pymts, Fed sources, expired
1
3090
Uncollected pymts, Fed sources, end of year
–67
–67
–67
Memorandum (non-add) entries:
3100
Obligated balance, start of year
739
850
511
3200
Obligated balance, end of year
850
511
325
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
5,553
4,988
5,237
Outlays, gross:
4010
Outlays from new discretionary authority
4,570
4,346
4,551
4011
Outlays from discretionary balances
755
773
644
4020
Outlays, gross (total)
5,325
5,119
5,195
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–243
–271
–271
4033
Non-Federal sources
–1,130
–1,151
–1,151
4040
Offsets against gross budget authority and outlays (total)
–1,373
–1,422
–1,422
Additional offsets against gross budget authority only:
4052
Offsetting collections credited to expired accounts
2
4060
Additional offsets against budget authority only (total)
2
4070
Budget authority, net (discretionary)
4,182
3,566
3,815
4080
Outlays, net (discretionary)
3,952
3,697
3,773
Mandatory:
4090
Budget authority, gross
150
150
150
Outlays, gross:
4100
Outlays from new mandatory authority
47
144
144
4101
Outlays from mandatory balances
100
6
6
4110
Outlays, gross (total)
147
150
150
4180
Budget authority, net (total)
4,332
3,716
3,965
4190
Outlays, net (total)
4,099
3,847
3,923
Summary of Budget Authority and Outlays (in millions of dollars)
2015 actual
2016 est.
2017 est.
Enacted/requested:
Budget Authority
4,332
3,716
3,965
Outlays
4,099
3,847
3,923
Legislative proposal, subject to PAYGO:
Budget Authority
25
Outlays
12
Total:
Budget Authority
4,332
3,716
3,990
Outlays
4,099
3,847
3,935
The Indian Health Services account provides medical care, public health services, and health professions training opportunities
to American Indians and Alaska Natives. More than $2 .7 billion, primarily through self-determination contracts and compacts,
will be administered by tribal governments in 2017.
Object Classification (in millions of dollars)
Identification code 075–0390–0–1–551
2015 actual
2016 est.
2017 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
389
393
400
11.3
Other than full-time permanent
18
18
18
11.5
Other personnel compensation
56
57
58
11.7
Military personnel
71
72
73
11.9
Total personnel compensation
534
540
549
12.1
Civilian personnel benefits
148
150
153
12.2
Military personnel benefits
32
32
33
13.0
Benefits for former personnel
12
12
12
21.0
Patient travel
44
46
48
22.0
Transportation of things
6
6
6
23.1
Rental payments to GSA
15
16
17
23.2
Rental payments to others
1
1
1
23.3
Communications, utilities, and miscellaneous charges
10
10
11
25.1
Advisory and assistance services
5
5
5
25.2
Other services from non-Federal sources
95
101
130
25.3
Other goods and services from Federal sources
72
76
79
25.4
Operation and maintenance of facilities
2
6
6
25.6
Medical care
324
339
355
25.7
Operation and maintenance of equipment
11
13
12
25.8
Subsistence and support of persons
5
4
5
26.0
Supplies and materials
100
107
113
31.0
Equipment
12
13
14
41.0
Grants, subsidies, and contributions
2,876
2,211
2,387
42.0
Insurance claims and indemnities
28
28
29
99.0
Direct obligations
4,332
3,716
3,965
99.0
Reimbursable obligations
1,335
1,194
1,194
99.9
Total new obligations
5,667
4,910
5,159
Employment Summary
Identification code 075–0390–0–1–551
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
6,506
6,520
6,541
1101
Direct military average strength employment
989
991
986
2001
Reimbursable civilian full-time equivalent employment
5,469
5,469
5,476
2101
Reimbursable military average strength employment
832
832
825
Indian Health Services
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 075–0390–4–1–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Clinical services
15
0004
Indian health professions
10
0799
Total direct obligations
25
0900
Total new obligations
25
Budgetary resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
25
1930
Total budgetary resources available
25
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
25
3020
Outlays (gross)
–12
3050
Unpaid obligations, end of year
13
Memorandum (non-add) entries:
3200
Obligated balance, end of year
13
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
25
Outlays, gross:
4100
Outlays from new mandatory authority
12
4180
Budget authority, net (total)
25
4190
Outlays, net (total)
12
Object Classification (in millions of dollars)
Identification code 075–0390–4–1–551
2015 actual
2016 est.
2017 est.
Direct obligations:
25.1
Advisory and assistance services
15
25.3
Other goods and services from Federal sources
10
99.0
Direct obligations
25
99.9
Total new obligations
25
Contract support costs
For payments to tribes and tribal organizations for contract support costs associated with Indian Self-Determination and Education
Assistance Act agreements with the Indian Health Service for fiscal year [2016] 2017, such sums as may be necessary: Provided, That amounts obligated but not expended by a tribe or tribal organization for contract support costs for such agreements
for the current fiscal year shall be applied to contract support costs otherwise due for such agreements for subsequent fiscal
years: Provided further, That, notwithstanding any other provision of law, no amounts made available under this heading shall be available for transfer
to another budget account. (Department of the Interior, Environment, and Related Agencies Appropriations Act, 2016.)
Program and Financing (in millions of dollars)
Identification code 075–0344–0–1–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Contract Support Costs
718
800
0900
Total new obligations (object class 25.3)
718
800
Budgetary resources:
Budget authority:
Appropriations, discretionary:
1100
Appropriation
718
800
1930
Total budgetary resources available
718
800
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
718
800
3020
Outlays (gross)
–718
–800
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
718
800
Outlays, gross:
4010
Outlays from new discretionary authority
718
800
4180
Budget authority, net (total)
718
800
4190
Outlays, net (total)
718
800
The Contract Support Costs account provides for the reasonable and allowable costs for direct program expenses for the operation
of, and any additional administrative or other expense related to, the overhead incurred by tribes and tribal organizations
who operate health programs through self-determination contracts and compacts. An estimated $800 million in contract support
costs funds will be provided to tribal governments and tribal organizations in 2017.
Indian health facilities
For construction, repair, maintenance, improvement, and equipment of health and related auxiliary facilities, including quarters
for personnel; preparation of plans, specifications, and drawings; acquisition of sites, purchase and erection of modular
buildings, and purchases of trailers; and for provision of domestic and community sanitation facilities for Indians, as authorized
by section 7 of the Act of August 5, 1954 (42 U.S.C. 2004a), the Indian Self-Determination Act, and the Indian Health Care
Improvement Act, and for expenses necessary to carry out such Acts and titles II and III of the Public Health Service Act
with respect to environmental health and facilities support activities of the Indian Health Service, [$523,232,000] $569,906,000, 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, 2016.)
Special and Trust Fund Receipts (in millions of dollars)
Identification code 075–0391–0–1–551
2015 actual
2016 est.
2017 est.
0100
Balance, start of year
Receipts:
Current law:
1130
Rent and Charges for Quarters, Indian Health Service
7
8
8
2000
Total: Balances and receipts
7
8
8
Appropriations:
Current law:
2101
Indian Health Facilities
–7
–8
–8
5099
Balance, end of year
Program and Financing (in millions of dollars)
Identification code 075–0391–0–1–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Sanitation and health facilities
114
204
235
0002
Maintenance
54
74
77
0003
Facilities and environmental health
207
222
234
0004
Equipment
23
23
24
0100
Total direct program
398
523
570
0799
Total direct obligations
398
523
570
0801
Indian Health Facilities (Reimbursable)
9
9
9
0900
Total new obligations
407
532
579
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
171
236
290
1001
Discretionary unobligated balance brought fwd, Oct 1
165
165
1021
Recoveries of prior year unpaid obligations
5
1050
Unobligated balance (total)
176
236
290
Budget authority:
Appropriations, discretionary:
1100
Appropriation
460
523
570
Appropriations, mandatory:
1201
Appropriation (special or trust fund)
7
8
8
Spending authority from offsetting collections, discretionary:
1700
Collected
55
56
1900
Budget authority (total)
467
586
634
1930
Total budgetary resources available
643
822
924
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
236
290
345
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
504
453
421
3010
Obligations incurred, unexpired accounts
407
532
579
3020
Outlays (gross)
–451
–564
–581
3040
Recoveries of prior year unpaid obligations, unexpired
–5
3041
Recoveries of prior year unpaid obligations, expired
–2
3050
Unpaid obligations, end of year
453
421
419
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
499
448
416
3200
Obligated balance, end of year
448
416
414
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
460
578
626
Outlays, gross:
4010
Outlays from new discretionary authority
243
212
227
4011
Outlays from discretionary balances
199
344
346
4020
Outlays, gross (total)
442
556
573
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–55
–56
4040
Offsets against gross budget authority and outlays (total)
–55
–56
Mandatory:
4090
Budget authority, gross
7
8
8
Outlays, gross:
4100
Outlays from new mandatory authority
3
8
8
4101
Outlays from mandatory balances
6
4110
Outlays, gross (total)
9
8
8
4180
Budget authority, net (total)
467
531
578
4190
Outlays, net (total)
451
509
525
The Indian Health Facilities account supports construction, repair and improvement, equipment, and environmental health and
facilities support for the Indian Health Service. More than $368 million, primarily through self-determination contracts and
compacts, will be administered by tribal governments in 2017.
Object Classification (in millions of dollars)
Identification code 075–0391–0–1–551
2015 actual
2016 est.
2017 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
49
46
48
11.3
Other than full-time permanent
2
2
2
11.5
Other personnel compensation
2
2
2
11.7
Military personnel
23
23
23
11.9
Total personnel compensation
76
73
75
12.1
Civilian personnel benefits
16
16
16
12.2
Military personnel benefits
8
8
9
21.0
Travel and transportation of persons
2
3
3
22.0
Transportation of things
3
3
3
23.1
Rental payments to GSA
1
1
1
23.3
Communications, utilities, and miscellaneous charges
14
15
15
25.1
Advisory and assistance services
1
1
2
25.2
Other services from non-Federal sources
63
86
113
25.3
Other goods and services from Federal sources
3
3
3
25.4
Operation and maintenance of facilities
6
16
18
25.7
Operation and maintenance of equipment
3
13
14
25.8
Subsistence and support of persons
2
2
2
26.0
Supplies and materials
6
7
7
31.0
Equipment
14
23
24
32.0
Land and structures
32
89
93
41.0
Grants, subsidies, and contributions
148
164
172
99.0
Direct obligations
398
523
570
99.0
Reimbursable obligations
9
9
9
99.9
Total new obligations
407
532
579
Employment Summary
Identification code 075–0391–0–1–551
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
1,104
1,106
1,094
1101
Direct military average strength employment
171
169
181
2001
Reimbursable civilian full-time equivalent employment
32
32
32
ADMINISTRATIVE PROVISIONS—INDIAN HEALTH SERVICE
Administrative provisions—indian health service
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: Provided further, That the Indian Health Service shall develop a strategic plan for the Urban Indian Health program in consultation with urban
Indians and the National Academy of Public Administration, and shall publish such plan not later than one year after the date
of enactment of this Act]. (Department of the Interior, Environment, and Related Agencies Appropriations Act, 2016.)
Centers for Disease Control and Prevention
Federal Funds
Immunization and respiratory diseases
For carrying out titles II, III, XVII, and XXI, and section 2821 of the PHS Act, titles II and IV of the Immigration and Nationality
Act, and section 501 of the Refugee Education Assistance Act, with respect to immunization and respiratory diseases, [$459,055,000] $411,716,000.
HIV/AIDS, viral hepatitis, sexually transmitted diseases, and tuberculosis prevention
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, [$1,122,278,000] $1,127,278,000.
Emerging and zoonotic infectious diseases
For carrying out titles II, III, and XVII, and section 2821 of the PHS Act, titles II and IV of the Immigration and Nationality
Act, and section 501 of the Refugee Education Assistance Act, with respect to emerging and zoonotic infectious diseases, [$527,885,000] $577,485,000: Provided, That of the amounts available to pay for the transportation, medical care, treatment, and other related
costs of persons quarantined or isolated under federal or state quarantine law, up to $1,000,000 shall remain available until
expended.
Chronic disease prevention and health promotion
For carrying out titles II, III, XI, XV, XVII, and XIX of the PHS Act with respect to chronic disease prevention and health
promotion, [$838,146,000] $679,745,000: 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, $10,000,000 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 the proportional funding requirements under section 1503(a) of the PHS Act shall not apply to funds made available
under this heading.
Birth defects, developmental disabilities, disabilities and health
For carrying out titles II, III, XI, and XVII of the PHS Act with respect to birth defects, developmental disabilities, disabilities
and health, [$135,610,000] $67,644,000.
Public Health Scientific Services
For carrying out titles II, III, and XVII of the PHS Act with respect to health statistics, surveillance, health informatics,
and workforce development, [$491,597,000] $464,355,000.
Environmental health
For carrying out titles II, III, and XVII of the PHS Act with respect to environmental health, [$165,303,000] $167,825,000.
Injury prevention and control
For carrying out titles II, III, and XVII of the PHS Act with respect to injury prevention and control, [$236,059,000: Provided, That of the funds provided under this heading, $70,000,000 shall be available for an evidence-based opioid drug overdose
prevention program] $268,629,000.
National Institute for Occupational Safety and Health
For carrying out titles II, III, and XVII of the PHS Act, sections 101, 102, 103, 201, 202, 203, 301, and 501 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, [$339,121,000] $213,621,000: Provided, That in addition to the amounts provided herein, $72,000,000 shall be available from amounts available
under section 241 of the PHS Act.
Energy employees occupational illness compensation program
For necessary expenses to administer the Energy Employees Occupational Illness Compensation Program Act, $55,358,000, to remain
available until expended: Provided, That this amount shall be available consistent with the provision regarding administrative expenses in section 151(b) of
division B, title I of Public Law 106–554.
Global health
For carrying out titles II, III, and XVII of the PHS Act with respect to global health, [$427,121,000] $442,121,000, of which [$128,421,000] $128,421,000 for international HIV/AIDS shall remain available through September 30, [2017] 2018: Provided, That funds may be used for purchase and insurance of official motor vehicles in foreign countries.
public health preparedness and response
For carrying out titles II, III, and XVII of the PHS Act with respect to public health preparedness and response, and for
expenses necessary to support activities related to countering potential biological, nuclear, radiological, and chemical threats
to civilian populations, [$1,405,000,000] $1,402,166,000, of which [$575,000,000] $575,000,000 shall remain available until expended for the Strategic National Stockpile: Provided, That [in the event the Director of the CDC activates the Emergency Operations Center,] the Director of the 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 [90] 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].
cdc-wide activities and program support
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: 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, [2017] 2018: 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 discretionary funds (pursuant to the Balanced Budget and Emergency Deficit Control Act of 1985)
which are appropriated for the current fiscal year for CDC in this Act 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, 2016.)
Special and Trust Fund Receipts (in millions of dollars)
Identification code 075–0943–0–1–999
2015 actual
2016 est.
2017 est.
0100
Balance, start of year
Receipts:
Current law:
1130
Cooperative Research and Development Agreements, Centers for Disease Control
2
2
2
2000
Total: Balances and receipts
2
2
2
Appropriations:
Current law:
2101
CDC-Wide Activities and Program Support
–2
–2
–2
5099
Balance, end of year
Program and Financing (in millions of dollars)
Identification code 075–0943–0–1–999
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Birth Defects, Developmental Disabilities, Disability and Health (0958)
131
136
136
0002
CDC Wide Activities and Program Support (0943)
478
274
114
0004
Chronic Disease Prevention and Health Promotion (0948)
1,192
1,177
1,117
0005
Emerging and Zoonotics Infectious Diseases (0949)
405
580
629
0006
Energy Employee Illness Occupational Compensation Program Act (EEOICPA) (0954)
50
55
55
0007
Environmental Health (0947)
179
182
182
0008
Global Health (0955)
447
427
442
0012
HIV/AIDS, Viral Hepatitis, STD and TB Prevention (0950)
1,118
1,122
1,127
0013
Immunization and Respiratory Diseases (0951)
798
799
748
0015
Injury Prevention and Control (0952)
170
236
269
0016
Occupational Safety and Health (0953)
334
339
286
0019
Public Health Preparedness and Response (0956)
1,352
1,405
1,402
0020
Public Health Scientific Services (0959)
481
492
501
0021
Cooperative Research and Development Agreements (CRADA) (5146)
4
2
2
0022
Ebola (Emergency pursuant to 2011 BCA)
526
0799
Total direct obligations
7,665
7,226
7,010
0802
CDC-Wide Activities and Program Support (Reimbursable)
194
516
516
0809
Reimbursable program activities, subtotal
194
516
516
0900
Total new obligations
7,859
7,742
7,526
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
126
1,223
1,207
1001
Discretionary unobligated balance brought fwd, Oct 1
90
1,214
1010
Unobligated balance transfer to other accts [075–4553]
–2
1011
Unobligated balance transfer from other acct [075–0140]
15
1012
Unobligated balance transfers between expired and unexpired accounts
35
1021
Recoveries of prior year unpaid obligations
12
1050
Unobligated balance (total)
186
1,223
1,207
Budget authority:
Appropriations, discretionary:
1100
Appropriation
7,759
6,261
5,937
1121
Appropriations transferred from other acct [075–0140]
15
1160
Appropriation, discretionary (total)
7,774
6,261
5,937
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]
887
892
944
1230
Appropriations and/or unobligated balance of appropriations permanently reduced
–5
1260
Appropriations, mandatory (total)
939
949
1,001
Spending authority from offsetting collections, discretionary:
1700
Collected
130
512
512
1701
Change in uncollected payments, Federal sources
56
1750
Spending auth from offsetting collections, disc (total)
186
512
512
Spending authority from offsetting collections, mandatory:
1800
Collected
5
4
4
1900
Budget authority (total)
8,904
7,726
7,454
1930
Total budgetary resources available
9,090
8,949
8,661
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–8
1941
Unexpired unobligated balance, end of year
1,223
1,207
1,135
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
5,822
6,501
7,009
3010
Obligations incurred, unexpired accounts
7,859
7,742
7,526
3011
Obligations incurred, expired accounts
31
3020
Outlays (gross)
–7,016
–7,234
–7,982
3040
Recoveries of prior year unpaid obligations, unexpired
–12
3041
Recoveries of prior year unpaid obligations, expired
–183
3050
Unpaid obligations, end of year
6,501
7,009
6,553
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–215
–132
–132
3070
Change in uncollected pymts, Fed sources, unexpired
–56
3071
Change in uncollected pymts, Fed sources, expired
139
3090
Uncollected pymts, Fed sources, end of year
–132
–132
–132
Memorandum (non-add) entries:
3100
Obligated balance, start of year
5,607
6,369
6,877
3200
Obligated balance, end of year
6,369
6,877
6,421
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
7,960
6,773
6,449
Outlays, gross:
4010
Outlays from new discretionary authority
2,778
3,012
2,876
4011
Outlays from discretionary balances
3,466
3,616
4,286
4020
Outlays, gross (total)
6,244
6,628
7,162
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–252
–512
–512
4033
Non-Federal sources
–6
4040
Offsets against gross budget authority and outlays (total)
–258
–512
–512
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–56
4052
Offsetting collections credited to expired accounts
128
4060
Additional offsets against budget authority only (total)
72
4070
Budget authority, net (discretionary)
7,774
6,261
5,937
4080
Outlays, net (discretionary)
5,986
6,116
6,650
Mandatory:
4090
Budget authority, gross
944
953
1,005
Outlays, gross:
4100
Outlays from new mandatory authority
150
161
168
4101
Outlays from mandatory balances
622
445
652
4110
Outlays, gross (total)
772
606
820
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123
Non-Federal sources
–5
–4
–4
4180
Budget authority, net (total)
8,713
7,210
6,938
4190
Outlays, net (total)
6,753
6,718
7,466
Summary of Budget Authority and Outlays (in millions of dollars)
2015 actual
2016 est.
2017 est.
Enacted/requested:
Budget Authority
8,713
7,210
6,938
Outlays
6,753
6,718
7,466
Legislative proposal, subject to PAYGO:
Budget Authority
30
Outlays
12
Total:
Budget Authority
8,713
7,210
6,968
Outlays
6,753
6,718
7,478
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.
Object Classification (in millions of dollars)
Identification code 075–0943–0–1–999
2015 actual
2016 est.
2017 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
681
806
824
11.3
Other than full-time permanent
112
112
113
11.5
Other personnel compensation
39
38
38
11.7
Military personnel
77
75
77
11.8
Special personal services payments
7
7
7
11.9
Total personnel compensation
916
1,038
1,059
12.1
Civilian personnel benefits
265
304
310
12.2
Military personnel benefits
52
51
52
13.0
Benefits for former personnel
1
1
21.0
Travel and transportation of persons
79
53
54
22.0
Transportation of things
13
12
12
23.1
Rental payments to GSA
6
33
34
23.2
Rental payments to others
2
1
1
23.3
Communications, utilities, and miscellaneous charges
26
52
53
24.0
Printing and reproduction
3
3
3
25.1
Advisory and assistance services
826
763
655
25.2
Other services from non-Federal sources
234
297
227
25.3
Other goods and services from Federal sources
752
353
276
25.4
Operation and maintenance of facilities
16
40
24
25.5
Research and development contracts
47
50
39
25.6
Medical care
34
31
23
25.7
Operation and maintenance of equipment
39
74
56
25.8
Subsistence and support of persons
1
1
1
26.0
Supplies and materials
461
468
488
31.0
Equipment
67
70
83
32.0
Land and structures
2
7
1
41.0
Grants, subsidies, and contributions
3,823
3,523
3,557
42.0
Insurance claims and indemnities
1
1
1
99.0
Direct obligations
7,665
7,226
7,010
99.0
Reimbursable obligations
194
516
516
99.9
Total new obligations
7,859
7,742
7,526
Employment Summary
Identification code 075–0943–0–1–999
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
8,181
8,193
8,193
1101
Direct military average strength employment
850
850
850
2001
Reimbursable civilian full-time equivalent employment
257
257
257
2101
Reimbursable military average strength employment
43
43
43
CDC-Wide Activities and Program Support
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 075–0943–4–1–999
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0024
Behavioral Health Init.
30
0900
Total new obligations (object class 41.0)
30
Budgetary resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation (Health Behavioral Int.)
30
1930
Total budgetary resources available
30
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
30
3020
Outlays (gross)
–12
3050
Unpaid obligations, end of year
18
Memorandum (non-add) entries:
3200
Obligated balance, end of year
18
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
30
Outlays, gross:
4100
Outlays from new mandatory authority
12
4180
Budget authority, net (total)
30
4190
Outlays, net (total)
12
buildings and facilities
(including transfer of funds)
For [acquisition of real property,] equipment, construction, demolition, and renovation of facilities, [$10,000,000] $31,221,000, [which shall] to remain available until September 30, [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: Provided further, That in addition, the prior year unobligated balance of any amounts assigned to former employees in accounts of CDC made
available for Individual Learning Accounts shall be credited to and merged with the amounts made available under this heading
to support the replacement of the mine safety research facility] 2021. (Department of Health and Human Services Appropriations Act, 2016.)
Program and Financing (in millions of dollars)
Identification code 075–0960–0–1–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Buildings and Facilities (0960)
8
10
31
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
2
2
Budget authority:
Appropriations, discretionary:
1100
Appropriation
10
10
31
1930
Total budgetary resources available
10
12
33
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
2
2
2
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
6
6
3010
Obligations incurred, unexpired accounts
8
10
31
3020
Outlays (gross)
–2
–10
–17
3050
Unpaid obligations, end of year
6
6
20
Memorandum (non-add) entries:
3100
Obligated balance, start of year
6
6
3200
Obligated balance, end of year
6
6
20
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
10
10
31
Outlays, gross:
4010
Outlays from new discretionary authority
2
4
12
4011
Outlays from discretionary balances
6
5
4020
Outlays, gross (total)
2
10
17
4180
Budget authority, net (total)
10
10
31
4190
Outlays, net (total)
2
10
17
Object Classification (in millions of dollars)
Identification code 075–0960–0–1–551
2015 actual
2016 est.
2017 est.
Direct obligations:
25.1
Advisory and assistance services
2
2
8
25.4
Operation and maintenance of facilities
5
5
10
31.0
Equipment
5
32.0
Land and structures
1
3
8
99.9
Total new obligations
8
10
31
CDC Working Capital Fund
Program and Financing (in millions of dollars)
Identification code 075–4553–0–4–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
CDC Working Capital Fund (Direct)
2
0801
CDC Working Capital Fund (Reimbursable)
521
545
545
0900
Total new obligations
523
545
545
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
27
52
52
1011
Unobligated balance transfer from other acct [075–0943]
2
1021
Recoveries of prior year unpaid obligations
1
1050
Unobligated balance (total)
30
52
52
Budget authority:
Spending authority from offsetting collections, discretionary:
1700
Collected
545
545
545
1930
Total budgetary resources available
575
597
597
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
52
52
52
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
150
175
9
3010
Obligations incurred, unexpired accounts
523
545
545
3020
Outlays (gross)
–497
–711
–545
3040
Recoveries of prior year unpaid obligations, unexpired
–1
3050
Unpaid obligations, end of year
175
9
9
Memorandum (non-add) entries:
3100
Obligated balance, start of year
150
175
9
3200
Obligated balance, end of year
175
9
9
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
545
545
545
Outlays, gross:
4010
Outlays from new discretionary authority
365
545
545
4011
Outlays from discretionary balances
132
166
4020
Outlays, gross (total)
497
711
545
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–545
–545
–545
4180
Budget authority, net (total)
4190
Outlays, net (total)
–48
166
Implemented in fiscal year 2014, CDC's Working Capital Fund has extended availability and serves as the funding mechanism
to finance centralized business services support across CDC. Services rendered under the fund are performed at pre-established
rates that are used to cover the full cost of operations and future investments. Contributions are collected for services,
thereby creating market-like incentives to maximize efficiency and quality.
Object Classification (in millions of dollars)
Identification code 075–4553–0–4–551
2015 actual
2016 est.
2017 est.
25.3
Direct obligations: Other goods and services from Federal sources
2
Reimbursable obligations:
Personnel compensation:
11.1
Full-time permanent
137
157
157
11.3
Other than full-time permanent
3
3
3
11.5
Other personnel compensation
3
3
3
11.7
Military personnel
3
3
3
11.9
Total personnel compensation
146
166
166
12.1
Civilian personnel benefits
45
46
46
12.2
Military personnel benefits
1
1
1
21.0
Travel and transportation of persons
1
1
1
22.0
Transportation of things
1
1
1
23.1
Rental payments to GSA
33
33
33
23.3
Communications, utilities, and miscellaneous charges
35
35
35
25.1
Advisory and assistance services
25
25
25
25.2
Other services from non-Federal sources
73
78
78
25.3
Other goods and services from Federal sources
58
63
63
25.4
Operation and maintenance of facilities
37
37
37
25.7
Operation and maintenance of equipment
42
42
42
26.0
Supplies and materials
2
2
2
31.0
Equipment
14
7
7
32.0
Land and structures
8
8
8
99.0
Reimbursable obligations
521
545
545
99.9
Total new obligations
523
545
545
Employment Summary
Identification code 075–4553–0–4–551
2015 actual
2016 est.
2017 est.
2001
Reimbursable civilian full-time equivalent employment
1,486
1,486
1,486
2101
Reimbursable military average strength employment
28
28
28
Toxic substances and environmental public health
For necessary expenses for the Agency for Toxic Substances and Disease Registry (ATSDR) in carrying out activities set forth
in sections 104(i) and 111(c)(4) of the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA)
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 [2016] 2017, and existing profiles may be updated as necessary. (Department of the Interior, Environment, and Related Agencies Appropriations Act, 2016.)
Program and Financing (in millions of dollars)
Identification code 075–0944–0–1–551
2015 actual
2016 est.
2017 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
0799
Total direct obligations
77
75
75
0801
Agency for Toxic Substances and Disease Registry, Toxic Substanc (Reimbursable)
6
6
6
0900
Total new obligations
83
81
81
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
12
27
24
1001
Discretionary unobligated balance brought fwd, Oct 1
3
Budget authority:
Appropriations, discretionary:
1100
Appropriation
74
75
75
Appropriations, mandatory:
1200
Appropriation
20
1230
Appropriations and/or unobligated balance of appropriations permanently reduced
–1
1260
Appropriations, mandatory (total)
19
Spending authority from offsetting collections, discretionary:
1700
Collected
2
3
3
1701
Change in uncollected payments, Federal sources
3
1750
Spending auth from offsetting collections, disc (total)
5
3
3
1900
Budget authority (total)
98
78
78
1930
Total budgetary resources available
110
105
102
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
27
24
21
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
45
44
38
3010
Obligations incurred, unexpired accounts
83
81
81
3020
Outlays (gross)
–81
–87
–84
3041
Recoveries of prior year unpaid obligations, expired
–3
3050
Unpaid obligations, end of year
44
38
35
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–7
–5
–5
3070
Change in uncollected pymts, Fed sources, unexpired
–3
3071
Change in uncollected pymts, Fed sources, expired
5
3090
Uncollected pymts, Fed sources, end of year
–5
–5
–5
Memorandum (non-add) entries:
3100
Obligated balance, start of year
38
39
33
3200
Obligated balance, end of year
39
33
30
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
79
78
78
Outlays, gross:
4010
Outlays from new discretionary authority
52
53
53
4011
Outlays from discretionary balances
27
26
22
4020
Outlays, gross (total)
79
79
75
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–7
–3
–3
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–3
4052
Offsetting collections credited to expired accounts
5
4060
Additional offsets against budget authority only (total)
2
4070
Budget authority, net (discretionary)
74
75
75
4080
Outlays, net (discretionary)
72
76
72
Mandatory:
4090
Budget authority, gross
19
Outlays, gross:
4101
Outlays from mandatory balances
2
8
9
4180
Budget authority, net (total)
93
75
75
4190
Outlays, net (total)
74
84
81
Object Classification (in millions of dollars)
Identification code 075–0944–0–1–551
2015 actual
2016 est.
2017 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
23
21
21
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
29
27
27
12.1
Civilian personnel benefits
8
7
8
12.2
Military personnel benefits
1
1
2
25.1
Advisory and assistance services
6
8
8
25.2
Other services from non-Federal sources
4
5
4
25.3
Other goods and services from Federal sources
11
11
10
25.7
Operation and maintenance of equipment
1
1
1
41.0
Grants, subsidies, and contributions
17
15
15
99.0
Direct obligations
77
75
75
99.0
Reimbursable obligations
6
6
6
99.9
Total new obligations
83
81
81
Employment Summary
Identification code 075–0944–0–1–551
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
219
229
229
1101
Direct military average strength employment
36
36
36
2001
Reimbursable civilian full-time equivalent employment
10
10
10
World Trade Center Health Program Fund
Program and Financing (in millions of dollars)
Identification code 075–0946–0–1–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Federal Share
261
300
335
0002
NYC
29
33
37
0900
Total new obligations
290
333
372
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
30
Budget authority:
Appropriations, mandatory:
1200
Appropriation (WTC (CDC Direct))
272
330
346
1200
Appropriation (WTC—NYC DHSS—CDC)
31
33
35
1230
Appropriations and/or unobligated balance of appropriations permanently reduced
–23
1260
Appropriations, mandatory (total)
280
363
381
Spending authority from offsetting collections, mandatory:
1800
Collected
10
1900
Budget authority (total)
290
363
381
1930
Total budgetary resources available
290
363
411
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
30
39
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
153
161
230
3010
Obligations incurred, unexpired accounts
290
333
372
3011
Obligations incurred, expired accounts
9
3020
Outlays (gross)
–261
–264
–301
3041
Recoveries of prior year unpaid obligations, expired
–30
3050
Unpaid obligations, end of year
161
230
301
Memorandum (non-add) entries:
3100
Obligated balance, start of year
153
161
230
3200
Obligated balance, end of year
161
230
301
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
290
363
381
Outlays, gross:
4100
Outlays from new mandatory authority
176
167
175
4101
Outlays from mandatory balances
85
97
126
4110
Outlays, gross (total)
261
264
301
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123
Non-Federal sources
–23
Additional offsets against gross budget authority only:
4142
Offsetting collections credited to expired accounts
13
4160
Budget authority, net (mandatory)
280
363
381
4170
Outlays, net (mandatory)
238
264
301
4180
Budget authority, net (total)
280
363
381
4190
Outlays, net (total)
238
264
301
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 World Trade Center (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 WTC Health Program has been extended through FY 2090 under the James Zadroga 9/11 Health and
Compensation Reauthorization Act of 2015 (P.L. 114–113, Division O, Title III). The amounts included for 2016 and 2017 in
the Budget reflect estimated Federal obligations for the WTC Health Program.
Object Classification (in millions of dollars)
Identification code 075–0946–0–1–551
2015 actual
2016 est.
2017 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
12.1
Civilian personnel benefits
1
1
1
25.1
Advisory and assistance services
24
24
24
25.2
Other services from non-Federal sources
67
67
67
25.3
Other goods and services from Federal sources
11
11
11
25.6
Medical care
1
1
1
41.0
Grants, subsidies, and contributions
23
23
23
42.0
Insurance claims and indemnities
160
203
242
99.9
Total new obligations
290
333
372
Employment Summary
Identification code 075–0946–0–1–551
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
15
15
15
1101
Direct military average strength employment
4
4
4
National Institutes of Health
Federal Funds
national cancer institute
For carrying out section 301 and title IV of the PHS Act with respect to cancer, [$5,214,701,000] $5,097,287,000, of which up to [$16,000,000]$50,000,000 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, 2016.)
national heart, lung, and blood institute
For carrying out section 301 and title IV of the PHS Act with respect to cardiovascular, lung, and blood diseases, and blood
and blood products, [$3,115,538,000] $3,069,901,000. (Department of Health and Human Services Appropriations Act, 2016.)
national institute of dental and craniofacial research
For carrying out section 301 and title IV of the PHS Act with respect to dental and craniofacial diseases, [$415,582,000] $404,560,000. (Department of Health and Human Services Appropriations Act, 2016.)
national institute of diabetes and digestive and kidney diseases
For carrying out section 301 and title IV of the PHS Act with respect to diabetes and digestive and kidney disease, [$1,818,357,000] $1,786,086,000. (Department of Health and Human Services Appropriations Act, 2016.)
national institute of neurological disorders and stroke
For carrying out section 301 and title IV of the PHS Act with respect to neurological disorders and stroke, [$1,696,139,000] $1,659,416,000. (Department of Health and Human Services Appropriations Act, 2016.)
national institute of allergy and infectious diseases
For carrying out section 301 and title IV of the PHS Act with respect to allergy and infectious diseases, [$4,629,928,000] $4,700,548,000. (Department of Health and Human Services Appropriations Act, 2016.)
national institute of general medical sciences
For carrying out section 301 and title IV of the PHS Act with respect to general medical sciences, [$2,512,073,000] $2,434,144,000, of which [$780,000,000] $847,489,000 shall be from funds available under section 241 of the PHS Act [: Provided, That not less than $320,840,000 is provided for the Institutional Development Awards program]. (Department of Health and Human Services Appropriations Act, 2016.)
eunice kennedy shriver national institute of child health and human development
For carrying out section 301 and title IV of the PHS Act with respect to child health and human development, [$1,339,802,000] $1,316,607,000. (Department of Health and Human Services Appropriations Act, 2016.)
national eye institute
For carrying out section 301 and title IV of the PHS Act with respect to eye diseases and visual disorders, [$715,903,000] $687,249,000. (Department of Health and Human Services Appropriations Act, 2016.)
national institute of environmental health sciences
For carrying out section 301 and title IV of the PHS Act with respect to environmental health sciences, [$693,702,000] $681,613,000. (Department of Health and Human Services Appropriations Act, 2016.)
National institute of environmental health sciences
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. (Department of the Interior, Environment, and Related Agencies Appropriations Act, 2016.)
national institute on aging
For carrying out section 301 and title IV of the PHS Act with respect to aging, [$1,600,191,000] $1,265,133,000. (Department of Health and Human Services Appropriations Act, 2016.)
national institute of arthritis and musculoskeletal and skin diseases
For carrying out section 301 and title IV of the PHS Act with respect to arthritis and musculoskeletal and skin diseases,
[$542,141,000] $532,753,000. (Department of Health and Human Services Appropriations Act, 2016.)
national institute on deafness and other communication disorders
For carrying out section 301 and title IV of the PHS Act with respect to deafness and other communication disorders, [$423,031,000] $416,146,000. (Department of Health and Human Services Appropriations Act, 2016.)
national institute of nursing research
For carrying out section 301 and title IV of the PHS Act with respect to nursing research, [$146,485,000] $143,942,000. (Department of Health and Human Services Appropriations Act, 2016.)
national institute on alcohol abuse and alcoholism
For carrying out section 301 and title IV of the PHS Act with respect to alcohol abuse and alcoholism, [$467,700,000] $459,578,000. (Department of Health and Human Services Appropriations Act, 2016.)
national institute on drug abuse
For carrying out section 301 and title IV of the PHS Act with respect to drug abuse, [$1,077,488,000] $1,020,459,000. (Department of Health and Human Services Appropriations Act, 2016.)
national institute of mental health
For carrying out section 301 and title IV of the PHS Act with respect to mental health, [$1,548,390,000] $1,459,700,000. (Department of Health and Human Services Appropriations Act, 2016.)
national human genome research institute
For carrying out section 301 and title IV of the PHS Act with respect to human genome research, [$518,956,000] $509,762,000. (Department of Health and Human Services Appropriations Act, 2016.)
national institute of biomedical imaging and bioengineering
For carrying out section 301 and title IV of the PHS Act with respect to biomedical imaging and bioengineering research, [$346,795,000] $334,025,000. (Department of Health and Human Services Appropriations Act, 2016.)
national center for complementary and integrative health
For carrying out section 301 and title IV of the PHS Act with respect to complementary and integrative health, [$130,789,000] $126,673,000. (Department of Health and Human Services Appropriations Act, 2016.)
national institute on minority health and health disparities
For carrying out section 301 and title IV of the PHS Act with respect to minority health and health disparities research,
[$279,718,000] $279,680,000. (Department of Health and Human Services Appropriations Act, 2016.)
john e. fogarty international center
For carrying out the activities of the John E. Fogarty International Center (described in subpart 2 of part E of title IV
of the PHS Act), [$70,447,000] $69,175,000. (Department of Health and Human Services Appropriations Act, 2016.)
national library of medicine
For carrying out section 301 and title IV of the PHS Act with respect to health information communications, [$394,664,000] $395,110,000: Provided, That of the amounts available for improvement of information systems, $4,000,000 shall be available until September 30,
[2017] 2018: Provided further, That in fiscal year [2016] 2017, 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, 2016.)
national center for advancing translational sciences
For carrying out section 301 and title IV of the PHS Act with respect to translational sciences, [$685,417,000] $660,131,000: Provided, That up to $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 $500,000,000 is provided to the Clinical and Translational Sciences Awards program]. (Department of Health and Human Services Appropriations Act, 2016.)
office of the director
For carrying out the responsibilities of the Office of the Director, NIH, [$1,558,600,000] $1,432,859,000, of which up to [$30,000,000] $40,000,000 may be used to carry out section [215] 213 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 Follow-on: Provided further, That NIH shall submit a spend plan on the next phase of the study in the previous proviso 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 [$663,039,000] $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 up to [$130,000,000] $20,000,000 of the funds provided to the Common Fund are available to support the trans-NIH Precision Medicine Initiative: [Provided further, That of the amount provided to the NIH, the Director of the NIH shall enter into an agreement with the National Academy
of Sciences, as part of the studies conducted under section 489 of the PHS Act, to conduct a comprehensive study on policies
affecting the next generation of researchers in the United States:] Provided further, That, [of the funds from Institute, Center, and Office of the Director accounts within "Department of Health and Human Services,
National Institutes of Health,"] in order to strengthen privacy protections for human research participants, NIH shall require investigators receiving NIH
funding, from amounts appropriated in this Act to NIH accounts, for new and competing research projects designed to generate and analyze large volumes of data derived from human research
participants to obtain a certificate of confidentiality: 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 discretionary 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, 2016.)
Buildings and facilities
For the study of, construction or demolition of, renovation of, and acquisition of equipment for, facilities of or used by NIH, including the acquisition of real property,
$128,863,000 , to remain available through September 30, [2020] 2021. (Department of Health and Human Services Appropriations Act, 2016.)
Special and Trust Fund Receipts (in millions of dollars)
Identification code 075–9915–0–1–552
2015 actual
2016 est.
2017 est.
0100
Balance, start of year
1
Receipts:
Current law:
1130
Cooperative Research and Development Agreements, NIH
28
17
17
2000
Total: Balances and receipts
28
17
18
Appropriations:
Current law:
2101
National Institutes of Health
–28
–16
–16
5099
Balance, end of year
1
2
Program and Financing (in millions of dollars)
Identification code 075–9915–0–1–552
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
National Cancer Institute (0849)
4,952
5,203
5,078
0002
National Heart, Lung, and Blood Institute (0872)
2,996
3,107
3,050
0003
National Institute of Dental and Craniofacial Research (0873)
398
411
403
0004
National Institute of Diabetes and Digestive and Kidney Disease (0884)
1,749
1,965
1,921
0005
National Institute of Neurological Disorders and Stroke (0886)
1,605
1,694
1,645
0006
National Institute of Allergy and Infectious Diseases (0885)
4,604
4,708
4,680
0007
National Institute of General Medical Sciences (0851)
1,657
1,660
1,577
0008
National Institute of Child Health and Human Development (0844)
1,287
1,334
1,317
0009
National Eye Institute (0887)
677
705
686
0010
National Institute of Environmental Health Sciences (0862)
745
768
755
0011
National Institute on Aging (0843)
1,197
1,591
1,254
0012
National Institute of Arthritis and Musculoskeletal and Skin Disease (0888)
521
539
533
0013
National Institute on Deafness and Other Communication Disorder (0890)
405
420
416
0014
National Institute of Mental Health (0892)
1,434
1,512
1,449
0015
National Institute on Drug Abuse (0893)
1,016
1,046
1,010
0016
National Institute on Alcohol Abuse and Alcoholism (0894)
447
465
455
0017
National Institute of Nursing Research (0889)
141
143
142
0018
National Human Genome Research Institute (0891)
499
510
508
0019
National Institute of Biomedical Imaging and Bioengineering (0898)
327
340
334
0021
National Center for Complementary and Integrative Health (0896)
124
127
127
0022
National Institute on Minority Health and Health Disparities (0897)
270
278
278
0023
John E. Fogarty International Center (0819)
68
70
69
0024
National Library of Medicine (0807)
337
393
393
0025
Office of the Director (0846)
1,414
1,560
1,435
0026
Buildings and facilities (0838)
115
128
129
0027
Cooperative Research and Development Agreements
24
16
16
0028
National Center for Advancing Translational Sciences (0875)
633
685
656
0031
Type 1 Diabetes
150
150
150
0799
Total direct obligations
29,792
31,528
30,466
0801
Reimbursable - Other
3,440
3,349
3,543
0802
Royalties
95
105
105
0809
Reimbursable program activities, subtotal
3,535
3,454
3,648
0899
Total reimbursable obligations
3,535
3,454
3,648
0900
Total new obligations
33,327
34,982
34,114
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
725
722
539
1001
Discretionary unobligated balance brought fwd, Oct 1
725
722
1021
Recoveries of prior year unpaid obligations
75
1050
Unobligated balance (total)
800
722
539
Budget authority:
Appropriations, discretionary:
1100
Appropriation
29,672
31,368
30,301
1121
Appropriations transferred from other acct [075–5736]
13
13
13
1160
Appropriation, discretionary (total)
29,685
31,381
30,314
Appropriations, mandatory:
1200
Appropriation
150
150
150
1201
Appropriation (special or trust fund)
28
16
16
1260
Appropriations, mandatory (total)
178
166
166
Spending authority from offsetting collections, discretionary:
1700
Collected
3,247
3,252
3,559
1701
Change in uncollected payments, Federal sources
164
1750
Spending auth from offsetting collections, disc (total)
3,411
3,252
3,559
1900
Budget authority (total)
33,274
34,799
34,039
1930
Total budgetary resources available
34,074
35,521
34,578
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–25
1941
Unexpired unobligated balance, end of year
722
539
464
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
31,700
31,352
32,861
3001
Adjustments to unpaid obligations, brought forward, Oct 1
8
3010
Obligations incurred, unexpired accounts
33,327
34,982
34,114
3011
Obligations incurred, expired accounts
288
3020
Outlays (gross)
–33,380
–33,473
–35,314
3040
Recoveries of prior year unpaid obligations, unexpired
–75
3041
Recoveries of prior year unpaid obligations, expired
–516
3050
Unpaid obligations, end of year
31,352
32,861
31,661
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–1,559
–979
–979
3061
Adjustments to uncollected pymts, Fed sources, brought forward, Oct 1
–8
3070
Change in uncollected pymts, Fed sources, unexpired
–164
3071
Change in uncollected pymts, Fed sources, expired
752
3090
Uncollected pymts, Fed sources, end of year
–979
–979
–979
Memorandum (non-add) entries:
3100
Obligated balance, start of year
30,141
30,373
31,882
3200
Obligated balance, end of year
30,373
31,882
30,682
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
33,096
34,633
33,873
Outlays, gross:
4010
Outlays from new discretionary authority
9,274
11,725
11,744
4011
Outlays from discretionary balances
23,991
21,582
23,403
4020
Outlays, gross (total)
33,265
33,307
35,147
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–3,907
–3,252
–3,559
4033
Non-Federal sources
–179
4040
Offsets against gross budget authority and outlays (total)
–4,086
–3,252
–3,559
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–164
4052
Offsetting collections credited to expired accounts
839
4060
Additional offsets against budget authority only (total)
675
4070
Budget authority, net (discretionary)
29,685
31,381
30,314
4080
Outlays, net (discretionary)
29,179
30,055
31,588
Mandatory:
4090
Budget authority, gross
178
166
166
Outlays, gross:
4100
Outlays from new mandatory authority
1
52
52
4101
Outlays from mandatory balances
114
114
115
4110
Outlays, gross (total)
115
166
167
4180
Budget authority, net (total)
29,863
31,547
30,480
4190
Outlays, net (total)
29,294
30,221
31,755
Summary of Budget Authority and Outlays (in millions of dollars)
2015 actual
2016 est.
2017 est.
Enacted/requested:
Budget Authority
29,863
31,547
30,480
Outlays
29,294
30,221
31,755
Legislative proposal, subject to PAYGO:
Budget Authority
1,825
Outlays
547
Total:
Budget Authority
29,863
31,547
32,305
Outlays
29,294
30,221
32,302
DISTRIBUTION OF PROGRAM LEVEL FUNDING AND OUTLAYS BY ACCOUNT (in millions of dollars)
2015*
2016
2017
Distribution of Program Level Funding by account:
National Cancer Institute
4,953
5,214
5,894
National Heart, Lung, and Blood Institute
2,996
3,114
3,114
National Institute of Dental and Craniofacial Research
398
414
413
National Institute of Diabetes and Digestive and Kidney Diseases
1,899
1,996
1,966
National Institute of Neurological Disorder and Stroke
1,605
1,695
1,695
National Institute of Allergy and Infectious Diseases
4,418
4,716
4,716
National Institute of General Medical Sciences
2,372
2,512
2,512
Eunice Kennedy Shriver National Institute of Child Health and Human Development
1,287
1,338
1,338
National Eye Institute
677
708
708
National Institute of Environmental Health Sciences
745
771
771
National Institute on Aging
1,198
1,598
1,598
National Institute of Arthritis and Musculoskeletal and Skin Diseases
522
542
542
National Institute on Deafness and Other Communication Disorders
405
423
423
National Institute of Nursing Research
141
146
146
National Institute on Alcohol Abuse and Alcoholism
447
467
467
National Institute on Drug Abuse
1,016
1,051
1,051
National Institute of Mental Health
1,434
1,519
1,519
National Human Genome Research Institute
499
513
513
National Institute of Biomedical Imaging and Bioengineering
327
344
344
National Center for Complementary and Integrative Health
124
130
130
National Institute on Minority Health and Health Disparities
271
281
281
John E. Fogarty International Center
68
70
70
National Library of Medicine
337
396
396
National Center for Advancing Translational Sciences
633
685
685
Office of the Director
1,414
1,571
1,716
Buildings and Facilities
129
129
129
Total Program Level, NIH
30,311
32,311
33,136
2015
2016
2017
Distribution of Outlays by account:
National Cancer Institute
4,914
5,083
5,902
National Heart, Lung, and Blood Institute
2,992
2,874
3,076
National Institute of Dental and Craniofacial Research
410
406
409
National Institute of Diabetes and Digestive and Kidney Diseases
1,843
2,084
1,795
National Institute of Neurological Disorders and Stroke
1,569
1,728
1,675
National Institute of Allergy and Infectious Diseases
4,361
3,987
4,625
National Institute of General Medical Sciences
1,592
1,698
1,735
Eunice Kennedy Shriver National Institute of Child Health and Human Development
1,322
1,345
1,325
National Eye Institute
677
660
700
National Institute of Environmental Health Sciences
716
752
699
National Institute on Aging
1,062
1,339
1,508
National Institute of Arthritis and Musculoskeletal and Skin Diseases
516
525
536
National Institute on Deafness and Other Communication Disorders
407
401
419
National Institute of Nursing Research
150
129
144
National Institute on Alcohol Abuse and Alcoholism
467
424
461
National Institute on Drug Abuse
1,030
933
1,038
National Institute of Mental Health
1,415
1,455
1,500
National Human Genome Research Institute
504
545
510
National Institute of Biomedical Imaging and Bioengineering
334
316
338
National Center for Complementary and Integrative Health
125
124
128
National Institute on Minority Health and Health Disparities
255
233
276
John E. Fogarty International Center
65
74
69
National Library of Medicine
393
290
388
National Center for Advancing Translational Sciences
591
570
674
Office of the Director
1,364
1,374
1,517
Buildings and Facilities
99
113
121
Total Outlays, NIH
29,173
29,462
30,835
*In addition, the FY 2015 appropriation (P.L. 113–235) provided NIH $239 million of emergency resources for Ebola response
and preparedness research activities.
This program funds biomedical research and research training. These accounts will continue to be appropriated separately,
and are displayed in a consolidated format to improve the readability of the presentation. Detailed information is available
through the Department of Health and Human Services.
Object Classification (in millions of dollars)
Identification code 075–9915–0–1–552
2015 actual
2016 est.
2017 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
915
969
977
11.3
Other than full-time permanent
463
472
476
11.5
Other personnel compensation
33
36
36
11.7
Military personnel
20
20
20
11.8
Special personal services payments
162
165
166
11.9
Total personnel compensation
1,593
1,662
1,675
12.1
Civilian personnel benefits
452
480
489
12.2
Military personnel benefits
13
14
14
21.0
Travel and transportation of persons
50
51
52
22.0
Transportation of things
5
5
5
23.1
Rental payments to GSA
22
22
23
23.3
Communications, utilities, and miscellaneous charges
25
26
27
24.0
Printing and reproduction
1
1
1
25.1
Advisory and assistance services
120
118
137
25.2
Other services from non-Federal sources
1,026
1,101
1,177
25.3
Other goods and services from Federal sources
2,952
3,069
3,235
25.4
Operation and maintenance of facilities
214
229
240
25.5
Research and development contracts
1,558
1,590
1,701
25.6
Medical care
28
28
28
25.7
Operation and maintenance of equipment
100
101
103
26.0
Supplies and materials
190
198
200
31.0
Equipment
154
162
165
41.0
Grants, subsidies, and contributions
21,289
22,675
21,191
99.0
Direct obligations
29,792
31,532
30,463
99.0
Reimbursable obligations
3,535
3,450
3,651
99.9
Total new obligations
33,327
34,982
34,114
Employment Summary
Identification code 075–9915–0–1–552
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
12,956
13,085
13,085
1101
Direct military average strength employment
185
185
185
2001
Reimbursable civilian full-time equivalent employment
4,577
4,624
4,624
2101
Reimbursable military average strength employment
105
106
106
National Institutes of Health
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 075–9915–4–1–552
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
National Cancer Institute (0849)
796
0002
National Heart, Lung, and Blood Institute (0872)
44
0003
National Institute of Dental and Craniofacial Research (0873)
9
0004
National Institute of Diabetes and Digestive and Kidney Disease (0884)
30
0005
National Institute of Neurological Disorders and Stroke (0886)
36
0006
National Institute of Allergy and Infectious Diseases (0885)
15
0007
National Institute of General Medical Sciences (0851)
78
0008
National Institute of Child Health and Human Development (0844)
22
0009
National Eye Institute (0887)
21
0010
National Institute of Environmental Health Sciences (0862)
12
0011
National Institute on Aging (0843)
333
0012
National Institute of Arthritis and Musculoskeletal and Skin Disease (0888)
9
0013
National Institute on Deafness and Other Communication Disorder (0890)
7
0014
National Institute of Mental Health (0892)
59
0015
National Institute on Drug Abuse (0893)
30
0016
National Institute on Alcohol Abuse and Alcoholism (0894)
8
0017
National Institute of Nursing Research (0889)
2
0018
National Human Genome Research Institute (0891)
4
0019
National Institute of Biomedical Imaging and Bioengineering (0898)
9
0021
National Center for Complementary and Integrative Health (0896)
1
0022
National Institute on Minority Health and Health Disparities (0897)
3
0023
John E. Fogarty International Center (0819)
1
0024
National Library of Medicine (0807)
1
0025
Office of the Director (0846)
270
0028
National Center for Advancing Translational Sciences (0875)
25
0900
Total new obligations (object class 41.0)
1,825
Budgetary resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
1,900
1220
Appropriations transferred to other acct [075–9911]
–75
1260
Appropriations, mandatory (total)
1,825
1930
Total budgetary resources available
1,825
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
1,825
3020
Outlays (gross)
–547
3050
Unpaid obligations, end of year
1,278
Memorandum (non-add) entries:
3200
Obligated balance, end of year
1,278
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
1,825
Outlays, gross:
4100
Outlays from new mandatory authority
547
4180
Budget authority, net (total)
1,825
4190
Outlays, net (total)
547
10-Year Pediatric Research Initiative Fund
Special and Trust Fund Receipts (in millions of dollars)
Identification code 075–5736–0–2–552
2015 actual
2016 est.
2017 est.
0100
Balance, start of year
38
26
13
Receipts:
Current law:
1140
Transfers from Presidential Election Campaign Fund
1
2000
Total: Balances and receipts
39
26
13
Appropriations:
Current law:
2101
10-Year Pediatric Research Initiative Fund
–13
–13
–13
5099
Balance, end of year
26
13
Program and Financing (in millions of dollars)
Identification code 075–5736–0–2–552
2015 actual
2016 est.
2017 est.
Budgetary resources:
Budget authority:
Appropriations, discretionary:
1101
Appropriation (special or trust fund)
13
13
13
1120
Appropriations transferred to other accts [075–9915]
–13
–13
–13
4180
Budget authority, net (total)
4190
Outlays, net (total)
Substance Abuse and Mental Health Services Administration
Federal Funds
MENTAL HEALTH
For carrying out titles III, V, and XIX of the PHS Act with respect to mental health, and the Protection and Advocacy for
Individuals with Mental Illness Act, [$1,133,948,000] $1,117,727,000: 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] $31,039,000 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 [2016] 2017: [Provided further, That of the amount appropriated under this heading, $46,887,000 shall be for the National Child Traumatic Stress Initiative
as described in section 582 of the PHS Act:] 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 10 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: Provided further, That of the funds made available under this heading, $15,000,000 shall be to carry out section 224 of the Protecting Access
to Medicare Act of 2014 (Public Law 113–93; 42 U.S.C. 290aa 22 note): Provided further, That up to 10 percent of the amounts made available to carry out the Children's Mental Health Services
program may be used to carry out demonstration grants or contracts for early interventions with persons not more than 25 years
of age at clinical high risk of developing a first episode of psychosis.
SUBSTANCE ABUSE TREATMENT
For carrying out titles III [,] and V [, and XIX] of the PHS Act with respect to substance abuse treatment and [section 1922(a) of the PHS Act] title XIX of such Act with respect to substance abuse treatment and prevention, [$2,114,224,000] $2,077,148,000: 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: Provided further, That notwithstanding section 508 of the PHS Act, up to 25 percent of the amounts made available to carry
out such section may be used to carry out demonstration grants to provide intensive outpatient services and treatment as well
as any of the services listed in section 508(d).
SUBSTANCE ABUSE PREVENTION
For carrying out titles III and V of the PHS Act with respect to substance abuse prevention, [$211,219,000] $194,680,000: Provided, That in addition to amounts provided herein, $16,468,000 shall be available under section 241 of
the PHS Act to supplement funds otherwise available for substance abuse prevention activities.
HEALTH SURVEILLANCE AND PROGRAM SUPPORT
For program support and cross-cutting activities that supplement activities funded under the headings "Mental Health", "Substance
Abuse Treatment", and "Substance Abuse Prevention" in carrying out titles III, V, and XIX of the PHS Act and the Protection
and Advocacy for Individuals with Mental Illness Act in the Substance Abuse and Mental Health Services Administration ("SAMHSA"), [$174,878,000] $99,228,000: Provided, That in addition to amounts provided herein, [$31,428,000] $56,828,000 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, [2017] 2018: 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 discretionary funds (pursuant to the Balanced Budget and Emergency
Deficit Control Act of 1985) which are appropriated for the current fiscal year for SAMHSA in this Act 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, 2016.)
Program and Financing (in millions of dollars)
Identification code 075–1362–0–1–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0006
Mental Health
1,046
1,134
1,118
0007
Substance Abuse Treatment
2,103
2,114
2,077
0008
Substance Abuse Prevention
175
211
195
0009
Health Surveillance and Program Support
149
175
99
0011
Prevention Fund
12
12
28
0100
Total, direct program
3,485
3,646
3,517
0799
Total direct obligations
3,485
3,646
3,517
0802
Reimbursables
109
117
117
0810
Reimbursable: PHS Evaluation
134
134
214
0899
Total reimbursable obligations
243
251
331
0900
Total new obligations
3,728
3,897
3,848
Budgetary resources:
Budget authority:
Appropriations, discretionary:
1100
Appropriation
3,474
3,634
3,489
Appropriations, mandatory:
1221
Appropriations transferred from the Prevention and Public Health Fund [075–0116]
12
12
28
Spending authority from offsetting collections, discretionary:
1700
Collected
148
251
331
1701
Change in uncollected payments, Federal sources
95
1750
Spending auth from offsetting collections, disc (total)
243
251
331
1900
Budget authority (total)
3,729
3,897
3,848
1930
Total budgetary resources available
3,729
3,897
3,848
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–1
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
3,495
3,727
3,563
3010
Obligations incurred, unexpired accounts
3,728
3,897
3,848
3011
Obligations incurred, expired accounts
9
3020
Outlays (gross)
–3,396
–4,061
–3,849
3041
Recoveries of prior year unpaid obligations, expired
–109
3050
Unpaid obligations, end of year
3,727
3,563
3,562
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–155
–126
–126
3070
Change in uncollected pymts, Fed sources, unexpired
–95
3071
Change in uncollected pymts, Fed sources, expired
124
3090
Uncollected pymts, Fed sources, end of year
–126
–126
–126
Memorandum (non-add) entries:
3100
Obligated balance, start of year
3,340
3,601
3,437
3200
Obligated balance, end of year
3,601
3,437
3,436
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
3,717
3,885
3,820
Outlays, gross:
4010
Outlays from new discretionary authority
1,103
1,189
1,163
4011
Outlays from discretionary balances
2,253
2,792
2,667
4020
Outlays, gross (total)
3,356
3,981
3,830
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–255
–249
–329
4033
Non-Federal sources
–2
–2
4040
Offsets against gross budget authority and outlays (total)
–255
–251
–331
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–95
4052
Offsetting collections credited to expired accounts
107
4060
Additional offsets against budget authority only (total)
12
4070
Budget authority, net (discretionary)
3,474
3,634
3,489
4080
Outlays, net (discretionary)
3,101
3,730
3,499
Mandatory:
4090
Budget authority, gross
12
12
28
Outlays, gross:
4100
Outlays from new mandatory authority
4
9
4101
Outlays from mandatory balances
40
76
10
4110
Outlays, gross (total)
40
80
19
4180
Budget authority, net (total)
3,486
3,646
3,517
4190
Outlays, net (total)
3,141
3,810
3,518
Summary of Budget Authority and Outlays (in millions of dollars)
2015 actual
2016 est.
2017 est.
Enacted/requested:
Budget Authority
3,486
3,646
3,517
Outlays
3,141
3,810
3,518
Legislative proposal, subject to PAYGO:
Budget Authority
590
Outlays
183
Total:
Budget Authority
3,486
3,646
4,107
Outlays
3,141
3,810
3,701
This program provides Federal support to strengthen the capacity of the Nation's health care delivery system to provide effective
substance abuse prevention, addiction treatment, and mental health services for people at risk for or experiencing substance
abuse or mental illness. SAMHSA builds partnerships with States, communities, tribal, and private not-for-profit organizations
to enhance health and reduce the adverse impact of substance abuse and mental illness on America's communities.
Object Classification (in millions of dollars)
Identification code 075–1362–0–1–551
2015 actual
2016 est.
2017 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
47
51
52
11.3
Other than full-time permanent
3
3
3
11.5
Other personnel compensation
1
1
1
11.7
Military personnel
4
4
4
11.9
Total personnel compensation
55
59
60
12.1
Civilian personnel benefits
15
16
17
12.2
Military personnel benefits
2
2
2
21.0
Travel and transportation of persons
1
1
1
23.1
Rental payments to GSA
10
9
6
23.3
Communications, utilities, and miscellaneous charges
1
1
1
24.0
Printing and reproduction
2
2
1
25.1
Advisory and assistance services
29
37
35
25.2
Other services from non-Federal sources
168
172
143
25.3
Other goods and services from Federal sources
32
35
29
25.4
Operation and maintenance of facilities
2
2
2
26.0
Supplies and materials
2
1
41.0
Grants, subsidies, and contributions
3,166
3,309
3,220
99.0
Direct obligations
3,485
3,646
3,517
99.0
Reimbursable obligations
243
251
331
99.9
Total new obligations
3,728
3,897
3,848
Employment Summary
Identification code 075–1362–0–1–551
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
457
494
494
1101
Direct military average strength employment
38
41
41
2001
Reimbursable civilian full-time equivalent employment
104
114
114
2101
Reimbursable military average strength employment
20
16
16
Substance Abuse and Mental Health Services Administration
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 075–1362–4–1–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0006
Mental Health
115
0007
Substance Abuse Treatment
475
0100
Total, direct program
590
0799
Total direct obligations
590
0900
Total new obligations (object class 41.0)
590
Budgetary resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
590
1930
Total budgetary resources available
590
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
590
3020
Outlays (gross)
–183
3050
Unpaid obligations, end of year
407
Memorandum (non-add) entries:
3200
Obligated balance, end of year
407
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
590
Outlays, gross:
4100
Outlays from new mandatory authority
183
4180
Budget authority, net (total)
590
4190
Outlays, net (total)
183
Agency for Healthcare Research and Quality
Federal Funds
Healthcare research and quality
For carrying out titles III and IX of the PHS Act, part A of title XI of the Social Security Act, and section 1013 of the
Medicare Prescription Drug, Improvement, and Modernization Act of 2003, [$334,000,000] $363,698,000, of which $83,458,000 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 [2016] 2017: 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, 2017] expended. (Department of Health and Human Services Appropriations Act, 2016.)
Program and Financing (in millions of dollars)
Identification code 075–1700–0–1–552
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Research on Health Costs, Quality and Outcomes
228
197
141
0002
Medical Expenditure Panel Survey
65
66
69
0003
Program Support
70
71
71
0799
Total direct obligations
363
334
281
0803
Research on Health Costs, Quality and Outcomes
18
18
102
0805
Program Support
1
0899
Total reimbursable obligations
19
18
102
0900
Total new obligations
382
352
383
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
18
16
13
1021
Recoveries of prior year unpaid obligations
2
1050
Unobligated balance (total)
20
16
13
Budget authority:
Appropriations, discretionary:
1100
Appropriation
364
334
280
Spending authority from offsetting collections, discretionary:
1700
Collected
1
15
15
1700
Collected
83
1701
Change in uncollected payments, Federal sources
13
1750
Spending auth from offsetting collections, disc (total)
14
15
98
1900
Budget authority (total)
378
349
378
1930
Total budgetary resources available
398
365
391
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
16
13
8
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
417
392
534
3010
Obligations incurred, unexpired accounts
382
352
383
3011
Obligations incurred, expired accounts
1
3020
Outlays (gross)
–375
–210
–492
3040
Recoveries of prior year unpaid obligations, unexpired
–2
3041
Recoveries of prior year unpaid obligations, expired
–31
3050
Unpaid obligations, end of year
392
534
425
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–361
–156
–156
3070
Change in uncollected pymts, Fed sources, unexpired
–13
3071
Change in uncollected pymts, Fed sources, expired
218
3090
Uncollected pymts, Fed sources, end of year
–156
–156
–156
Memorandum (non-add) entries:
3100
Obligated balance, start of year
56
236
378
3200
Obligated balance, end of year
236
378
269
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
378
349
378
Outlays, gross:
4010
Outlays from new discretionary authority
136
132
196
4011
Outlays from discretionary balances
233
76
296
4020
Outlays, gross (total)
369
208
492
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–200
–15
–98
4040
Offsets against gross budget authority and outlays (total)
–200
–15
–98
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–13
4052
Offsetting collections credited to expired accounts
199
4060
Additional offsets against budget authority only (total)
186
4070
Budget authority, net (discretionary)
364
334
280
4080
Outlays, net (discretionary)
169
193
394
Mandatory:
Outlays, gross:
4101
Outlays from mandatory balances
6
2
4180
Budget authority, net (total)
364
334
280
4190
Outlays, net (total)
175
195
394
This activity supports the development of scientific evidence and tools to improve the quality, safety, and effectiveness
of all aspects of the health care system, and initiatives to disseminate and translate scientific findings into health care
practice.
Object Classification (in millions of dollars)
Identification code 075–1700–0–1–552
2015 actual
2016 est.
2017 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
31
33
33
11.3
Other than full-time permanent
3
3
3
11.5
Other personnel compensation
1
1
11.7
Military personnel
1
1
1
11.9
Total personnel compensation
36
37
38
12.1
Civilian personnel benefits
10
10
10
12.2
Military personnel benefits
1
1
1
23.1
Rental payments to GSA
5
4
4
23.3
Communications, utilities, and miscellaneous charges
1
1
1
24.0
Printing and reproduction
1
1
25.2
Other services from non-Federal sources
13
14
15
25.3
Other goods and services from Federal sources
19
20
20
25.5
Research and development contracts
158
129
92
31.0
Equipment
2
2
2
41.0
Grants, subsidies, and contributions
117
114
98
99.0
Direct obligations
363
333
281
99.0
Reimbursable obligations
19
19
102
99.9
Total new obligations
382
352
383
Employment Summary
Identification code 075–1700–0–1–552
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
281
294
294
1101
Direct military average strength employment
6
6
6
2001
Reimbursable civilian full-time equivalent employment
5
6
6
3001
Allocation account civilian full-time equivalent employment
10
25
25
Centers for Medicare and Medicaid Services
Federal Funds
Grants to states for medicaid
For carrying out, except as otherwise provided, titles XI and XIX of the Social Security Act, [$243,545,410,000] $262,003,967,000, to remain available until expended.
[For making,] In addition, for carrying out such titles after May 31, [2016, 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] 2017 for the last quarter of fiscal year [2016] 2017 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 [2017] 2018, [$115,582,502,000] $125,219,452,000, 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, 2016.)
Program and Financing (in millions of dollars)
Identification code 075–0512–0–1–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Medicaid vendor payments
354,018
345,718
354,224
0002
State and local administration
20,284
18,870
18,976
0003
Vaccines for Children
3,845
4,161
4,386
0799
Total direct obligations
378,147
368,749
377,586
0801
Medicare Part B premiums
749
869
954
0802
Medicare Part D
3
3
0899
Total reimbursable obligations
749
872
957
0900
Total new obligations
378,896
369,621
378,543
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
1,407
343
1021
Recoveries of prior year unpaid obligations
22,150
1050
Unobligated balance (total)
23,557
343
Budget authority:
Appropriations, discretionary:
1100
Appropriation
4
Appropriations, mandatory:
1200
Appropriation Medicaid
251,444
255,134
262,000
Advance appropriations, mandatory:
1270
Advance appropriation
103,472
113,272
115,582
Spending authority from offsetting collections, mandatory:
1800
Collected
766
872
957
1900
Budget authority (total)
355,682
369,278
378,543
1930
Total budgetary resources available
379,239
369,621
378,543
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
343
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
36,003
42,221
43,741
3010
Obligations incurred, unexpired accounts
378,896
369,621
378,543
3020
Outlays (gross)
–350,528
–368,101
–377,547
3040
Recoveries of prior year unpaid obligations, unexpired
–22,150
3050
Unpaid obligations, end of year
42,221
43,741
44,737
Memorandum (non-add) entries:
3100
Obligated balance, start of year
36,003
42,221
43,741
3200
Obligated balance, end of year
42,221
43,741
44,737
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
4
Outlays, gross:
4010
Outlays from new discretionary authority
4
Mandatory:
4090
Budget authority, gross
355,682
369,278
378,539
Outlays, gross:
4100
Outlays from new mandatory authority
316,021
327,399
377,543
4101
Outlays from mandatory balances
34,507
40,702
4110
Outlays, gross (total)
350,528
368,101
377,543
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120
Federal sources
–749
–872
–957
4123
Non-Federal sources
–17
4130
Offsets against gross budget authority and outlays (total)
–766
–872
–957
4160
Budget authority, net (mandatory)
354,916
368,406
377,582
4170
Outlays, net (mandatory)
349,762
367,229
376,586
4180
Budget authority, net (total)
354,916
368,406
377,586
4190
Outlays, net (total)
349,762
367,229
376,590
Summary of Budget Authority and Outlays (in millions of dollars)
2015 actual
2016 est.
2017 est.
Enacted/requested:
Budget Authority
354,916
368,406
377,586
Outlays
349,762
367,229
376,590
Amounts included in the adjusted baseline:
Budget Authority
–14
Outlays
–14
Legislative proposal, not subject to PAYGO:
Budget Authority
28
Outlays
28
Legislative proposal, subject to PAYGO:
Budget Authority
8,982
Outlays
8,982
Total:
Budget Authority
354,916
368,406
386,582
Outlays
349,762
367,229
385,586
Medicaid assists States in providing medical care to their low-income populations by granting Federal matching payments under
title XIX of the Social Security Act to States with approved plans.
Medicaid estimates assume budget authority for expenses that are incurred but not reported (IBNR).
Authorized as part of title XIX, Vaccines for Children (VFC) finances the purchase of vaccines for low-income, eligible children.
VFC is administered by the Centers for Disease Control and Prevention and is funded entirely by the Federal Government.
Vaccines for Children (in millions of dollars)
Obligations
2015
2016
2017
Vaccine Purchase
3,558
3,973
4,072
Vaccine Stockpile
122
9
131
Ordering, Distribution, and Operations
127
131
134
Vaccine Management Contract Support
0
0
0
Evaluation Activities
44
48
50
Total Obligations
3,851
4,161
4,387
Object Classification (in millions of dollars)
Identification code 075–0512–0–1–551
2015 actual
2016 est.
2017 est.
41.0
Direct obligations: Grants, subsidies, and contributions
378,147
368,749
377,586
99.0
Reimbursable obligations
749
872
957
99.9
Total new obligations
378,896
369,621
378,543
Grants to States for Medicaid
(Amounts included in the adjusted baseline)
Program and Financing (in millions of dollars)
Identification code 075–0512–7–1–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Medicaid vendor payments
–14
0900
Total new obligations (object class 41.0)
–14
Budgetary resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
–14
1930
Total budgetary resources available
–14
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
–14
3020
Outlays (gross)
14
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
–14
Outlays, gross:
4100
Outlays from new mandatory authority
–14
4180
Budget authority, net (total)
–14
4190
Outlays, net (total)
–14
Grants to States for Medicaid
(Legislative proposal, not subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 075–0512–2–1–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Medicaid vendor payments
28
0799
Total direct obligations
28
0900
Total new obligations (object class 41.0)
28
Budgetary resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation Medicaid
28
1900
Budget authority (total)
28
1930
Total budgetary resources available
28
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
28
3020
Outlays (gross)
–28
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
28
Outlays, gross:
4100
Outlays from new mandatory authority
28
4180
Budget authority, net (total)
28
4190
Outlays, net (total)
28
This schedule reflects the non-PAYGO impacts of the Administration's Medicaid proposals.
Grants to States for Medicaid
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 075–0512–4–1–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Medicaid vendor payments
8,982
0799
Total direct obligations
8,982
0900
Total new obligations (object class 41.0)
8,982
Budgetary resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation Medicaid
8,982
1900
Budget authority (total)
8,982
1930
Total budgetary resources available
8,982
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
8,982
3020
Outlays (gross)
–8,982
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
8,982
Outlays, gross:
4100
Outlays from new mandatory authority
8,982
4180
Budget authority, net (total)
8,982
4190
Outlays, net (total)
8,982
This schedule reflects the Administration's Medicaid proposals.
State Grants and Demonstrations
Program and Financing (in millions of dollars)
Identification code 075–0516–0–1–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Ticket to Work
1
0011
Emergency health services for undocumented aliens
5
2
0012
Medicaid integrity program
75
114
84
0018
Money follows the person (MFP) demonstration
546
1,515
0019
MFP evaluations and technical support
1
1
0023
Grants to improve outreach and enrollment
5
40
0025
Medicaid emergency psychiatric demonstration
34
0026
Incentives for prevention of chronic diseases in Medicaid
7
0027
Demonstration Programs to Improve Mental Health Services
1
24
0799
Total direct obligations
675
1,696
84
0801
Reimbursable program activity
5
0900
Total new obligations
680
1,696
84
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
2,415
2,252
1,116
1012
Unobligated balance transfers between expired and unexpired accounts
9
1021
Recoveries of prior year unpaid obligations
13
1050
Unobligated balance (total)
2,437
2,252
1,116
Budget authority:
Appropriations, mandatory:
1200
Appropriation
533
598
84
1230
Appropriations and/or unobligated balance of appropriations permanently reduced
–39
–38
1260
Appropriations, mandatory (total)
494
560
84
Spending authority from offsetting collections, mandatory:
1800
Collected
6
1900
Budget authority (total)
500
560
84
1930
Total budgetary resources available
2,937
2,812
1,200
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–5
1941
Unexpired unobligated balance, end of year
2,252
1,116
1,116
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
694
787
1,849
3010
Obligations incurred, unexpired accounts
680
1,696
84
3011
Obligations incurred, expired accounts
16
3020
Outlays (gross)
–590
–634
–543
3040
Recoveries of prior year unpaid obligations, unexpired
–13
3050
Unpaid obligations, end of year
787
1,849
1,390
Memorandum (non-add) entries:
3100
Obligated balance, start of year
694
787
1,849
3200
Obligated balance, end of year
787
1,849
1,390
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
500
560
84
Outlays, gross:
4100
Outlays from new mandatory authority
1
58
21
4101
Outlays from mandatory balances
589
576
522
4110
Outlays, gross (total)
590
634
543
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123
Non-Federal sources
–22
Additional offsets against gross budget authority only:
4142
Offsetting collections credited to expired accounts
16
4160
Budget authority, net (mandatory)
494
560
84
4170
Outlays, net (mandatory)
568
634
543
4180
Budget authority, net (total)
494
560
84
4190
Outlays, net (total)
568
634
543
Summary of Budget Authority and Outlays (in millions of dollars)
2015 actual
2016 est.
2017 est.
Enacted/requested:
Budget Authority
494
560
84
Outlays
568
634
543
Legislative proposal, subject to PAYGO:
Budget Authority
525
Outlays
25
Total:
Budget Authority
494
560
609
Outlays
568
634
568
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), the Protecting Access to Medicare Act of 2014 (P.L. 113–93),
and the Medicare Access and CHIP Reauthorization Act of 2015 (P.L. 114–10).
The Budget includes an unobligated balance of approximately $13 million for activities authorized by Section 203 and $130
million for activities authorized by Section 204 of the Ticket to Work and Work Incentives Improvement Act. Thus, pursuant
to 31 U.S.C. 1555, any remaining balance (whether obligated or unobligated) will be withdrawn and returned to the Treasury
two years after there has been no disbursement made against the appropriation.
Object Classification (in millions of dollars)
Identification code 075–0516–0–1–551
2015 actual
2016 est.
2017 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent - Medicaid Integrity Program
8
9
9
12.1
Civilian personnel benefits - Medicaid Integrity Program
3
4
4
41.0
Grants, subsidies, and contributions - Emergency services for undocumented aliens
5
2
41.0
Grants, subsidies, and contributions - Medicaid Integrity Program
64
101
71
41.0
Grants, subsidies, and contributions - Money follows the person (MFP) demonstrations
546
1,515
41.0
Grants, subsidies, and contributions - MFP evaluations and technical support
1
1
41.0
Grants, subsidies, and contributions - Grants to improve outreach and enrollment
5
40
41.0
Grants, subsidies, and contributions - Medicaid emergency psychiatric demonstration
34
41.0
Grants, subsidies, and contributions - Incentives for prevention of chronic diseases in Medicaid
7
41.0
Grants, subsidies, and contributions - Demos to Improve Mental Health
1
24
41.0
Grants, subsidies, and contributions - Ticket to Work
1
99.0
Direct obligations
675
1,696
84
99.0
Reimbursable obligations
5
99.9
Total new obligations
680
1,696
84
Employment Summary
Identification code 075–0516–0–1–551
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
86
97
96
State Grants and Demonstrations
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 075–0516–4–1–551
2015 actual
2016 est.
2017 est.
Budgetary resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
525
1930
Total budgetary resources available
525
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
525
Change in obligated balance:
Unpaid obligations:
3020
Outlays (gross)
–25
3050
Unpaid obligations, end of year
–25
Memorandum (non-add) entries:
3200
Obligated balance, end of year
–25
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
525
Outlays, gross:
4100
Outlays from new mandatory authority
25
4180
Budget authority, net (total)
525
4190
Outlays, net (total)
25
Payments to health care trust funds
For payment to the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund, as provided
under sections 217(g), 1844, and 1860D-16 of the Social Security Act, sections 103(c) and 111(d) of the Social Security Amendments
of 1965, section 278(d)(3) of Public Law 97–248, and for administrative expenses incurred pursuant to section 201(g) of the
Social Security Act, [$283,171,800,000] $299,187,700,000.
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, 2016.)
Program and Financing (in millions of dollars)
Identification code 075–0580–0–1–571
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Federal contribution to match premiums (SMI)
188,348
237,231
214,944
0002
Part D benefits (Rx Drug)
72,342
82,453
82,512
0003
Part D Federal administration (Rx Drug)
418
691
405
0004
General Fund Transfers to HI
1,103
1,493
1,324
0006
Federal Bureau of Investigation (HCFAC)
129
130
141
0007
Federal payments from taxation of OASDI benefits (HI)
20,208
23,208
25,987
0008
Criminal fines (HCFAC)
57
550
590
0009
Civil penalties and damages (HCFAC - DOJ and CMS administration)
15
32
32
0010
Asset Forfeiture
15
29
30
0011
State Low Income Determinations
5
3
0900
Total new obligations
282,635
345,822
325,968
Budgetary resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation (definite, annual)
268,206
283,172
299,188
1200
Appropriation (indefinite, permanent)
20,208
23,208
25,987
1200
Appropriation (HCFAC for FBI)
129
130
141
1200
Appropriation (indefinite for HCFAC)
87
611
652
1200
Appropriation (indefinite, annual)
6
38,701
1260
Appropriations, mandatory (total)
288,636
345,822
325,968
1930
Total budgetary resources available
288,636
345,822
325,968
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–6,001
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
16,314
14,161
20,916
3010
Obligations incurred, unexpired accounts
282,635
345,822
325,968
3011
Obligations incurred, expired accounts
562
3020
Outlays (gross)
–284,944
–339,067
–325,712
3041
Recoveries of prior year unpaid obligations, expired
–406
3050
Unpaid obligations, end of year
14,161
20,916
21,172
Memorandum (non-add) entries:
3100
Obligated balance, start of year
16,314
14,161
20,916
3200
Obligated balance, end of year
14,161
20,916
21,172
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
288,636
345,822
325,968
Outlays, gross:
4100
Outlays from new mandatory authority
273,294
325,614
325,712
4101
Outlays from mandatory balances
11,650
13,453
4110
Outlays, gross (total)
284,944
339,067
325,712
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120
Federal sources
–130
Additional offsets against gross budget authority only:
4142
Offsetting collections credited to expired accounts
130
4160
Budget authority, net (mandatory)
288,636
345,822
325,968
4170
Outlays, net (mandatory)
284,814
339,067
325,712
4180
Budget authority, net (total)
288,636
345,822
325,968
4190
Outlays, net (total)
284,814
339,067
325,712
Summary of Budget Authority and Outlays (in millions of dollars)
2015 actual
2016 est.
2017 est.
Enacted/requested:
Budget Authority
288,636
345,822
325,968
Outlays
284,814
339,067
325,712
Legislative proposal, not subject to PAYGO:
Budget Authority
–819
Outlays
–819
Total:
Budget Authority
288,636
345,822
325,149
Outlays
284,814
339,067
324,893
Payments are made to the Federal Hospital Insurance and Federal Supplementary Medical Insurance trust funds from the general
fund of the Treasury to finance Medicare's medical and drug benefits for beneficiaries, and administrative expenses that are
properly chargeable to the general fund.
Object Classification (in millions of dollars)
Identification code 075–0580–0–1–571
2015 actual
2016 est.
2017 est.
Direct obligations:
41.0
Grants, subsidies, and contributions
280,927
343,638
324,239
42.0
Insurance claims and indemnities
187
158
147
94.0
Financial transfers (Federal admin)
1,521
2,026
1,582
99.9
Total new obligations
282,635
345,822
325,968
Payments to Health Care Trust Funds
(Legislative proposal, not subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 075–0580–2–1–571
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Federal contribution to match premiums (SMI)
–179
0002
Part D benefits (Rx Drug)
–640
0900
Total new obligations (object class 41.0)
–819
Budgetary resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation (definite, annual)
–819
1930
Total budgetary resources available
–819
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
–819
3020
Outlays (gross)
819
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
–819
Outlays, gross:
4100
Outlays from new mandatory authority
–819
4180
Budget authority, net (total)
–819
4190
Outlays, net (total)
–819
Quality Improvement Organizations
Program and Financing (in millions of dollars)
Identification code 075–0519–0–1–571
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
QIO contracts
546
509
404
0002
QIO support contracts
150
177
176
0900
Total new obligations
696
686
580
Budgetary resources:
Budget authority:
Spending authority from offsetting collections, mandatory:
1800
Collected
110
686
580
1801
Change in uncollected payments, Federal sources
802
1850
Spending auth from offsetting collections, mand (total)
912
686
580
1930
Total budgetary resources available
912
686
580
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–216
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
1,461
1,488
1,488
3010
Obligations incurred, unexpired accounts
696
686
580
3020
Outlays (gross)
–669
–686
–580
3050
Unpaid obligations, end of year
1,488
1,488
1,488
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–2,188
–2,431
–2,431
3070
Change in uncollected pymts, Fed sources, unexpired
–802
3071
Change in uncollected pymts, Fed sources, expired
559
3090
Uncollected pymts, Fed sources, end of year
–2,431
–2,431
–2,431
Memorandum (non-add) entries:
3100
Obligated balance, start of year
–727
–943
–943
3200
Obligated balance, end of year
–943
–943
–943
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
912
686
580
Outlays, gross:
4100
Outlays from new mandatory authority
122
266
143
4101
Outlays from mandatory balances
547
420
437
4110
Outlays, gross (total)
669
686
580
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120
Federal sources
–669
–686
–580
Additional offsets against gross budget authority only:
4140
Change in uncollected pymts, Fed sources, unexpired
–802
4142
Offsetting collections credited to expired accounts
559
4150
Additional offsets against budget authority only (total)
–243
4180
Budget authority, net (total)
4190
Outlays, net (total)
Memorandum (non-add) entries:
5093
Expired unavailable balance, SOY: Offsetting collections
50
50
50
5095
Expired unavailable balance, EOY: Offsetting collections
50
50
50
Part B of title XI of the Social Security Act, as amended by the Peer Review Improvement Act of 1982, provides the statutory
authority for the Medicare Quality Improvement Organization (QIO) Program. The mission of the program is to promote the effectiveness,
efficiency, economy, and quality of services delivered to Medicare beneficiaries and to ensure that those services are reasonable
and necessary. The program is funded through transfers from the Medicare Hospital Insurance Trust Fund and the Medicare Supplementary
Medical Insurance Trust Fund. In FY 2012, a Treasury account specific to the QIO program was established to improve budgetary
operations.
Object Classification (in millions of dollars)
Identification code 075–0519–0–1–571
2015 actual
2016 est.
2017 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent
28
14
11
23.3
Communications, utilities, and miscellaneous charges
1
3
2
25.2
Other services from non-Federal sources
639
653
554
25.3
Other goods and services from Federal sources
22
11
9
25.4
Operation and maintenance of facilities
6
5
4
99.9
Total new obligations
696
686
580
Employment Summary
Identification code 075–0519–0–1–571
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
204
226
227
Program management
For carrying out, except as otherwise provided, titles XI, XVIII, XIX, and XXI of the Social Security Act, titles XIII and
XXVII of the PHS Act, the Clinical Laboratory Improvement Amendments of 1988, and other responsibilities of the Centers for
Medicare and Medicaid Services, not to exceed [$3,669,744,000] $4,109,549,000, 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, 2021] 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 [2016] 2017 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, 2016.)
Program and Financing (in millions of dollars)
Identification code 075–0511–0–1–550
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Program operations
2,886
3,215
3,183
0002
Federal administration
767
786
783
0003
State survey and certification
421
428
463
0004
Research, demonstrations, and evaluation projects
122
88
49
0007
ARRA Medicare/Medicaid HIT
95
144
73
0008
Risk Corridor
2,870
2,870
2,870
0100
Total direct program
7,161
7,531
7,421
0799
Total direct obligations
7,161
7,531
7,421
0801
Clinical laboratory improvement amendments
58
47
50
0802
Sale of data
5
8
8
0803
Coordination of benefits
33
27
30
0804
Medicare advantage/Prescription drug plan
75
85
89
0805
Provider enrollment
30
30
32
0806
Recovery audit contractors
143
152
191
0808
Marketplace User Fees
879
1,197
1,554
0810
Risk Adjustment Administrative Expenses
29
50
0813
Other reimbursable program activity
219
11
23
0899
Total reimbursable obligations
1,442
1,586
2,027
0900
Total new obligations
8,603
9,117
9,448
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
916
–1,091
–3,979
1001
Discretionary unobligated balance brought fwd, Oct 1
95
–1,091
1020
Adjustment of unobligated bal brought forward, Oct 1
290
1021
Recoveries of prior year unpaid obligations
57
1050
Unobligated balance (total)
1,263
–1,091
–3,979
Budget authority:
Appropriations, mandatory:
1200
Appropriation
193
68
3
1230
Appropriations and/or unobligated balance of appropriations permanently reduced
–14
–4
1260
Appropriations, mandatory (total)
179
64
3
Spending authority from offsetting collections, discretionary:
1700
Collected
2,074
4,345
4,480
1701
Change in uncollected payments, Federal sources
2,133
1750
Spending auth from offsetting collections, disc (total)
4,207
4,345
4,480
Spending authority from offsetting collections, mandatory:
1800
Collected
1,303
1,856
2,157
1801
Change in uncollected payments, Federal sources
681
1802
Offsetting collections (previously unavailable)
34
76
92
1823
New and/or unobligated balance of spending authority from offsetting collections temporarily reduced
–121
–112
1850
Spending auth from offsetting collections, mand (total)
1,897
1,820
2,249
1900
Budget authority (total)
6,283
6,229
6,732
1930
Total budgetary resources available
7,546
5,138
2,753
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–34
1941
Unexpired unobligated balance, end of year
–1,091
–3,979
–6,695
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
4,116
6,739
9,092
3010
Obligations incurred, unexpired accounts
8,603
9,117
9,448
3011
Obligations incurred, expired accounts
179
3020
Outlays (gross)
–5,883
–6,764
–6,959
3040
Recoveries of prior year unpaid obligations, unexpired
–57
3041
Recoveries of prior year unpaid obligations, expired
–219
3050
Unpaid obligations, end of year
6,739
9,092
11,581
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–4,465
–5,011
–5,011
3070
Change in uncollected pymts, Fed sources, unexpired
–2,814
3071
Change in uncollected pymts, Fed sources, expired
2,268
3090
Uncollected pymts, Fed sources, end of year
–5,011
–5,011
–5,011
Memorandum (non-add) entries:
3100
Obligated balance, start of year
–349
1,728
4,081
3200
Obligated balance, end of year
1,728
4,081
6,570
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
4,207
4,345
4,480
Outlays, gross:
4010
Outlays from new discretionary authority
2,199
4,345
4,480
4011
Outlays from discretionary balances
2,363
4020
Outlays, gross (total)
4,562
4,345
4,480
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–4,286
–4,337
–4,472
4033
Non-Federal sources
–20
–8
–8
4040
Offsets against gross budget authority and outlays (total)
–4,306
–4,345
–4,480
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–2,133
4052
Offsetting collections credited to expired accounts
2,232
4060
Additional offsets against budget authority only (total)
99
4080
Outlays, net (discretionary)
256
Mandatory:
4090
Budget authority, gross
2,076
1,884
2,252
Outlays, gross:
4100
Outlays from new mandatory authority
362
1,932
2,252
4101
Outlays from mandatory balances
959
487
227
4110
Outlays, gross (total)
1,321
2,419
2,479
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120
Federal sources
–179
–244
–239
4123
Non-Federal sources
–1,137
–1,612
–1,918
4130
Offsets against gross budget authority and outlays (total)
–1,316
–1,856
–2,157
Additional offsets against gross budget authority only:
4140
Change in uncollected pymts, Fed sources, unexpired
–681
4142
Offsetting collections credited to expired accounts
13
4150
Additional offsets against budget authority only (total)
–668
4160
Budget authority, net (mandatory)
92
28
95
4170
Outlays, net (mandatory)
5
563
322
4180
Budget authority, net (total)
92
28
95
4190
Outlays, net (total)
261
563
322
Memorandum (non-add) entries:
5090
Unexpired unavailable balance, SOY: Offsetting collections
43
130
166
5092
Unexpired unavailable balance, EOY: Offsetting collections
130
166
74
5093
Expired unavailable balance, SOY: Offsetting collections
59
59
59
5095
Expired unavailable balance, EOY: Offsetting collections
59
59
59
Summary of Budget Authority and Outlays (in millions of dollars)
2015 actual
2016 est.
2017 est.
Enacted/requested:
Budget Authority
92
28
95
Outlays
261
563
322
Legislative proposal, subject to PAYGO:
Budget Authority
414
Outlays
39
Total:
Budget Authority
92
28
509
Outlays
261
563
361
Note: The figures for the risk corridors program in this table for fiscal years 2016 and 2017 are not estimates. Amounts for
fiscal years 2016 and 2017 are uncertain and therefore the figures in this table simply reflect imbalances between payments
out and payments in by participating plans equal to those that occurred for fiscal year 2015. In the event of a shortfall
over the life of the three-year Risk Corridors program, the Administration will work with Congress to provide necessary funds
for outstanding payments.
Program management activities include funding for program operations, survey and certification, the Clinical Laboratory Improvement
Amendments (CLIA), Medicare Advantage, Medicare Part D coordination of benefits, recovery audit contracts and other administrative
costs.
Object Classification (in millions of dollars)
Identification code 075–0511–0–1–550
2015 actual
2016 est.
2017 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
460
478
450
11.3
Other than full-time permanent
13
16
16
11.5
Other personnel compensation
8
8
8
11.7
Military personnel
13
18
18
11.9
Total personnel compensation
494
520
492
12.1
Civilian personnel benefits
157
143
138
12.2
Military personnel benefits
7
9
9
21.0
Travel and transportation of persons
5
4
5
22.0
Transportation of things
1
23.1
Rental payments to GSA
6
8
8
23.3
Communications, utilities, and miscellaneous charges
29
24.0
Printing and reproduction
40
2
3
25.2
Other services from non-Federal sources
2,641
2,508
2,455
25.3
Other goods and services from Federal sources
72
9
8
25.4
Operation and maintenance of facilities
2
25.5
Research and development contracts
2
40
22
25.6
Medical care
650
1,269
1,334
25.7
Operation and maintenance of equipment
1
26.0
Supplies and materials
1
1
1
31.0
Equipment
2
41.0
Grants, subsidies, and contributions
85
109
37
42.0
Insurance claims and indemnities
2,966
2,909
2,909
99.0
Direct obligations
7,161
7,531
7,421
99.0
Reimbursable obligations
1,442
1,586
2,027
99.9
Total new obligations
8,603
9,117
9,448
Employment Summary
Identification code 075–0511–0–1–550
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
4,306
4,193
3,927
1001
Direct civilian full-time equivalent employment
109
118
72
1101
Direct military average strength employment
179
185
185
2001
Reimbursable civilian full-time equivalent employment
103
125
542
Program Management
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 075–0511–4–1–550
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Program operations
409
0002
Federal administration
5
0100
Total direct program
414
0799
Total direct obligations
414
0801
Federal Payment Levy Program
2
0802
Home Health Civil Monetary Penalties
1
0803
Appeals Filing Fee
4
0804
Provider Application Fee
9
0805
Clearinghouse Registration Fees
15
0806
RAC Recoveries for PI
170
0899
Total reimbursable obligations
201
0900
Total new obligations
615
Budgetary resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
414
Spending authority from offsetting collections, mandatory:
1800
Collected
201
1900
Budget authority (total)
615
1930
Total budgetary resources available
615
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
615
3020
Outlays (gross)
–240
3050
Unpaid obligations, end of year
375
Memorandum (non-add) entries:
3200
Obligated balance, end of year
375
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
615
Outlays, gross:
4100
Outlays from new mandatory authority
240
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123
Non-Federal sources
–201
4180
Budget authority, net (total)
414
4190
Outlays, net (total)
39
Object Classification (in millions of dollars)
Identification code 075–0511–4–1–550
2015 actual
2016 est.
2017 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
411
99.0
Direct obligations
414
99.0
Reimbursable obligations
201
99.9
Total new obligations
615
Employment Summary
Identification code 075–0511–4–1–550
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
20
Children's Health Insurance Fund
Program and Financing (in millions of dollars)
Identification code 075–0515–0–1–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Grants to States and U.S. Territories
11,349
13,499
15,901
0003
Child health quality improvement
4
26
15
0900
Total new obligations (object class 41.0)
11,353
13,525
15,916
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
3,158
7,501
8,597
1011
Unobligated balance transfer from other acct [075–5551]
3,899
1012
Unobligated balance transfers between expired and unexpired accounts
928
1021
Recoveries of prior year unpaid obligations
1
1050
Unobligated balance (total)
4,087
7,501
12,496
Budget authority:
Appropriations, discretionary:
1120
Delay in transfer from other acct [075–5551]
–570
1130
Appropriations permanently reduced
–2,050
1131
Unobligated balance of appropriations permanently reduced
–3,899
1160
Appropriation, discretionary (total)
–6,519
Appropriations, mandatory:
1200
Appropriation
21,061
19,300
20,400
1221
Appropriations transferred from other acct [075–5551]
2,618
1230
Appropriations and/or unobligated balance of appropriations permanently reduced
–6,294
–4,679
1260
Appropriations, mandatory (total)
14,767
14,621
23,018
1900
Budget authority (total)
14,767
14,621
16,499
1930
Total budgetary resources available
18,854
22,122
28,995
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
7,501
8,597
13,079
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
6,708
8,722
7,821
3010
Obligations incurred, unexpired accounts
11,353
13,525
15,916
3011
Obligations incurred, expired accounts
143
3020
Outlays (gross)
–9,233
–14,426
–15,015
3040
Recoveries of prior year unpaid obligations, unexpired
–1
3041
Recoveries of prior year unpaid obligations, expired
–248
3050
Unpaid obligations, end of year
8,722
7,821
8,722
Memorandum (non-add) entries:
3100
Obligated balance, start of year
6,708
8,722
7,821
3200
Obligated balance, end of year
8,722
7,821
8,722
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
–6,519
Mandatory:
4090
Budget authority, gross
14,767
14,621
23,018
Outlays, gross:
4100
Outlays from new mandatory authority
313
5,600
9,200
4101
Outlays from mandatory balances
8,920
8,826
5,815
4110
Outlays, gross (total)
9,233
14,426
15,015
4180
Budget authority, net (total)
14,767
14,621
16,499
4190
Outlays, net (total)
9,233
14,426
15,015
Summary of Budget Authority and Outlays (in millions of dollars)
2015 actual
2016 est.
2017 est.
Enacted/requested:
Budget Authority
14,767
14,621
16,499
Outlays
9,233
14,426
15,015
Legislative proposal, subject to PAYGO:
Budget Authority
180
Outlays
180
Total:
Budget Authority
14,767
14,621
16,679
Outlays
9,233
14,426
15,195
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 Medicare Access and CHIP Reauthorization Act of 2015 (P.L. 114–10, MACRA)
extended funding for CHIP for two years, through 2017. The Budget proposes a two-year extension of CHIP funding through 2019.
Children's Health Insurance Fund
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 075–0515–4–1–551
2015 actual
2016 est.
2017 est.
Budgetary resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
180
1930
Total budgetary resources available
180
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
180
Change in obligated balance:
Unpaid obligations:
3020
Outlays (gross)
–180
3050
Unpaid obligations, end of year
–180
Memorandum (non-add) entries:
3200
Obligated balance, end of year
–180
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
180
Outlays, gross:
4100
Outlays from new mandatory authority
180
4180
Budget authority, net (total)
180
4190
Outlays, net (total)
180
This schedule reflects the Administration's Children's Health Insurance Program (CHIP) proposals.
Center for Medicare and Medicaid Innovation
Program and Financing (in millions of dollars)
Identification code 075–0522–0–1–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Administration
257
345
350
0002
Innovation Activities
1,095
1,484
1,133
0900
Total new obligations
1,352
1,829
1,483
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
7,009
5,669
3,840
1021
Recoveries of prior year unpaid obligations
12
1050
Unobligated balance (total)
7,021
5,669
3,840
1930
Total budgetary resources available
7,021
5,669
3,840
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
5,669
3,840
2,357
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
1,114
1,483
1,904
3010
Obligations incurred, unexpired accounts
1,352
1,829
1,483
3020
Outlays (gross)
–971
–1,408
–1,595
3040
Recoveries of prior year unpaid obligations, unexpired
–12
3050
Unpaid obligations, end of year
1,483
1,904
1,792
Memorandum (non-add) entries:
3100
Obligated balance, start of year
1,114
1,483
1,904
3200
Obligated balance, end of year
1,483
1,904
1,792
Budget authority and outlays, net:
Mandatory:
Outlays, gross:
4101
Outlays from mandatory balances
971
1,408
1,595
4180
Budget authority, net (total)
4190
Outlays, net (total)
971
1,408
1,595
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 Patient Protection and 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 the Children's Health Insurance Program (CHIP). The statute provides
$10 billion in mandatory funding for these purposes in fiscal years 2011 through 2019.
Object Classification (in millions of dollars)
Identification code 075–0522–0–1–551
2015 actual
2016 est.
2017 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent
46
59
48
12.1
Civilian personnel benefits
15
18
15
23.3
Communications, utilities, and miscellaneous charges
3
4
4
25.2
Other services from non-Federal sources
650
796
645
41.0
Grants, subsidies, and contributions
575
823
666
42.0
Insurance claims and indemnities
63
129
105
99.9
Total new obligations
1,352
1,829
1,483
Employment Summary
Identification code 075–0522–0–1–551
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
479
625
654
Child Enrollment Contingency Fund
Special and Trust Fund Receipts (in millions of dollars)
Identification code 075–5551–0–2–551
2015 actual
2016 est.
2017 est.
0100
Balance, start of year
2,048
Receipts:
Current law:
1140
Interest, Child Enrollment Contingency Fund
3
39
16
2000
Total: Balances and receipts
3
39
2,064
Appropriations:
Current law:
2101
Child Enrollment Contingency Fund
–3
–39
–16
2103
Child Enrollment Contingency Fund
–2,048
2132
Child Enrollment Contingency Fund
2,048
2134
Child Enrollment Contingency Fund
570
2199
Total current law appropriations
–3
2,009
–1,494
2999
Total appropriations
–3
2,009
–1,494
5099
Balance, end of year
2,048
570
Program and Financing (in millions of dollars)
Identification code 075–5551–0–2–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Grants to States and US Territories
53
0900
Total new obligations (object class 41.0)
53
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
2,098
2,048
3,899
1010
Unobligated balance transfer to other accts [075–0515]
–3,899
1050
Unobligated balance (total)
2,098
2,048
Budget authority:
Appropriations, discretionary:
1121
Delay of transfer to other acct [075–0515]
570
1134
Appropriations precluded from obligation
–570
Appropriations, mandatory:
1200
Appropriation
3,860
1,140
1201
Appropriation (special or trust fund)
3
39
16
1203
Appropriation (previously unavailable)
2,048
1220
Appropriations transferred to other acct [075–0515]
–2,618
1232
Appropriations and/or unobligated balance of appropriations temporarily reduced
–2,048
1260
Appropriations, mandatory (total)
3
1,851
586
1900
Budget authority (total)
3
1,851
586
1930
Total budgetary resources available
2,101
3,899
586
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
2,048
3,899
586
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
9
53
3010
Obligations incurred, unexpired accounts
53
3020
Outlays (gross)
–9
–53
3050
Unpaid obligations, end of year
53
Memorandum (non-add) entries:
3100
Obligated balance, start of year
9
53
3200
Obligated balance, end of year
53
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
3
1,851
586
Outlays, gross:
4101
Outlays from mandatory balances
9
53
4180
Budget authority, net (total)
3
1,851
586
4190
Outlays, net (total)
9
53
Memorandum (non-add) entries:
5000
Total investments, SOY: Federal securities: Par value
2,101
2,053
3,899
5001
Total investments, EOY: Federal securities: Par value
2,053
3,899
1,156
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 Medicare Access and CHIP Reauthorization Act of 2015 (P.L. 114–10) extended the Contingency
Fund through 2017. The Budget proposes a two-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 2017, the statute appropriates the amount necessary to make payments to eligible States, but not to exceed
20 percent of the total annual appropriation for CHIP allotments to States. Any amounts in excess of this aggregate cap will
be made available for CHIP performance bonus payments. The Contingency Fund is invested in interest bearing securities of
the United States, and the income derived from these investments constitutes a part of the fund.
Medicare Health Information Technology Incentive Payments, Recovery Act
Program and Financing (in millions of dollars)
Identification code 075–0508–0–1–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0801
Incentive payments to hospitals
2,690
2,040
1,005
0802
Incentive payments to eligible professionals
1,592
760
440
0900
Total new obligations (object class 42.0)
4,282
2,800
1,445
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
162
Budget authority:
Spending authority from offsetting collections, mandatory:
1800
Collected from the HI Trust Fund
3,196
2,040
1,005
1800
Collected from the SMI Trust Fund
1,862
760
440
1801
Change in uncollected payments, Federal sources
–938
1850
Spending auth from offsetting collections, mand (total)
4,120
2,800
1,445
1930
Total budgetary resources available
4,282
2,800
1,445
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
729
51
51
3010
Obligations incurred, unexpired accounts
4,282
2,800
1,445
3020
Outlays (gross)
–4,960
–2,800
–1,445
3050
Unpaid obligations, end of year
51
51
51
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–1,165
–227
–227
3070
Change in uncollected pymts, Fed sources, unexpired
938
3090
Uncollected pymts, Fed sources, end of year
–227
–227
–227
Memorandum (non-add) entries:
3100
Obligated balance, start of year
–436
–176
–176
3200
Obligated balance, end of year
–176
–176
–176
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
4,120
2,800
1,445
Outlays, gross:
4100
Outlays from new mandatory authority
4,120
2,749
1,394
4101
Outlays from mandatory balances
840
51
51
4110
Outlays, gross (total)
4,960
2,800
1,445
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120
Federal sources
–5,058
–2,800
–1,445
Additional offsets against gross budget authority only:
4140
Change in uncollected pymts, Fed sources, unexpired
938
4170
Outlays, net (mandatory)
–98
4180
Budget authority, net (total)
4190
Outlays, net (total)
–98
Memorandum (non-add) entries:
5090
Unexpired unavailable balance, SOY: Offsetting collections
133
133
133
5092
Unexpired unavailable balance, EOY: Offsetting collections
133
133
133
Rate Review Grants
Program and Financing (in millions of dollars)
Identification code 075–0112–0–1–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Premium rate review grants
22
0900
Total new obligations (object class 41.0)
22
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
7
10
1012
Unobligated balance transfers between expired and unexpired accounts
7
1021
Recoveries of prior year unpaid obligations
25
25
1050
Unobligated balance (total)
7
32
35
1930
Total budgetary resources available
7
32
35
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
7
10
35
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
156
105
73
3010
Obligations incurred, unexpired accounts
22
3011
Obligations incurred, expired accounts
10
3020
Outlays (gross)
–35
–29
–39
3040
Recoveries of prior year unpaid obligations, unexpired
–25
–25
3041
Recoveries of prior year unpaid obligations, expired
–26
3050
Unpaid obligations, end of year
105
73
9
Memorandum (non-add) entries:
3100
Obligated balance, start of year
156
105
73
3200
Obligated balance, end of year
105
73
9
Budget authority and outlays, net:
Mandatory:
Outlays, gross:
4101
Outlays from mandatory balances
35
29
39
4180
Budget authority, net (total)
4190
Outlays, net (total)
35
29
39
The Patient Protection and Affordable Care Act (P.L. 111–148) amended Section 2794 of the Public Health Service Act and provided
that the Secretary carry out a program to award grants to States for a five-year period beginning in fiscal year 2010. The
program provided $250 million in grants to help States develop or enhance their current rate review activities from 2010 through
2014, with remaining unobligated balances subsequently available for state implementation of consumer protections and other
insurance reform activities.
Pre-Existing Condition Insurance Plan Program
Program and Financing (in millions of dollars)
Identification code 075–0113–0–1–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Pre-Existing Condition Insurance Plan Program (Direct)
1
0002
Administration
1
1
0799
Total direct obligations
1
2
0900
Total new obligations
1
2
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
166
173
397
1021
Recoveries of prior year unpaid obligations
8
226
1050
Unobligated balance (total)
174
399
397
1930
Total budgetary resources available
174
399
397
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
173
397
397
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
250
230
3010
Obligations incurred, unexpired accounts
1
2
3020
Outlays (gross)
–13
–6
3040
Recoveries of prior year unpaid obligations, unexpired
–8
–226
3050
Unpaid obligations, end of year
230
Memorandum (non-add) entries:
3100
Obligated balance, start of year
250
230
3200
Obligated balance, end of year
230
Budget authority and outlays, net:
Mandatory:
Outlays, gross:
4101
Outlays from mandatory balances
13
6
4180
Budget authority, net (total)
4190
Outlays, net (total)
13
6
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 Patient Protection and 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.
Object Classification (in millions of dollars)
Identification code 075–0113–0–1–551
2015 actual
2016 est.
2017 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent
1
25.2
Other services from non-Federal sources
1
41.0
Grants, subsidies, and contributions
1
99.0
Direct obligations
1
2
99.9
Total new obligations
1
2
Employment Summary
Identification code 075–0113–0–1–551
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
5
2
Early Retiree Reinsurance Program
Program and Financing (in millions of dollars)
Identification code 075–0114–0–1–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0002
Administration
1
1
1
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
13
26
25
Budget authority:
Spending authority from offsetting collections, mandatory:
1800
Collected
14
1900
Budget authority (total)
14
1930
Total budgetary resources available
27
26
25
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
26
25
24
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
13
11
5
3010
Obligations incurred, unexpired accounts
1
1
1
3020
Outlays (gross)
–3
–7
–6
3050
Unpaid obligations, end of year
11
5
Memorandum (non-add) entries:
3100
Obligated balance, start of year
13
11
5
3200
Obligated balance, end of year
11
5
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
14
Outlays, gross:
4101
Outlays from mandatory balances
3
7
6
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123
Non-Federal sources
–14
4180
Budget authority, net (total)
4190
Outlays, net (total)
–11
7
6
The Patient Protection and 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 sunset on January 1, 2014, and is no longer providing reimbursements to plan sponsors.
Object Classification (in millions of dollars)
Identification code 075–0114–0–1–551
2015 actual
2016 est.
2017 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent
1
25.2
Other services from non-Federal sources
1
1
99.9
Total new obligations
1
1
1
Employment Summary
Identification code 075–0114–0–1–551
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
4
1
1
Affordable Insurance Exchange Grants
Program and Financing (in millions of dollars)
Identification code 075–0115–0–1–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Planning and establishment grants
449
0002
Administration
21
30
32
0900
Total new obligations
470
30
32
Budgetary resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
508
32
32
1230
Appropriations and/or unobligated balance of appropriations permanently reduced
–38
–2
1260
Appropriations, mandatory (total)
470
30
32
1930
Total budgetary resources available
470
30
32
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
1,976
1,006
324
3010
Obligations incurred, unexpired accounts
470
30
32
3011
Obligations incurred, expired accounts
60
3020
Outlays (gross)
–1,372
–712
–319
3041
Recoveries of prior year unpaid obligations, expired
–128
3050
Unpaid obligations, end of year
1,006
324
37
Memorandum (non-add) entries:
3100
Obligated balance, start of year
1,976
1,006
324
3200
Obligated balance, end of year
1,006
324
37
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
470
30
32
Outlays, gross:
4100
Outlays from new mandatory authority
95
9
10
4101
Outlays from mandatory balances
1,277
703
309
4110
Outlays, gross (total)
1,372
712
319
4180
Budget authority, net (total)
470
30
32
4190
Outlays, net (total)
1,372
712
319
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.
Object Classification (in millions of dollars)
Identification code 075–0115–0–1–551
2015 actual
2016 est.
2017 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent
6
7
7
25.2
Other services from non-Federal sources
15
23
25
41.0
Grants, subsidies, and contributions
449
99.9
Total new obligations
470
30
32
Employment Summary
Identification code 075–0115–0–1–551
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
49
50
50
Risk Adjustment Program Payments
Special and Trust Fund Receipts (in millions of dollars)
Identification code 075–5733–0–2–551
2015 actual
2016 est.
2017 est.
0100
Balance, start of year
174
262
Receipts:
Current law:
1110
Receipts, Risk Adjustment Program
2,375
3,858
4,639
2000
Total: Balances and receipts
2,375
4,032
4,901
Appropriations:
Current law:
2101
Risk Adjustment Program Payments
–2,375
–3,858
–4,639
2103
Risk Adjustment Program Payments
–174
–262
2132
Risk Adjustment Program Payments
174
262
2199
Total current law appropriations
–2,201
–3,770
–4,901
2999
Total appropriations
–2,201
–3,770
–4,901
5099
Balance, end of year
174
262
Program and Financing (in millions of dollars)
Identification code 075–5733–0–2–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Risk Adjustment Program Payments (Direct)
2,201
3,646
4,901
0900
Total new obligations (object class 41.0)
2,201
3,646
4,901
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
124
Budget authority:
Appropriations, mandatory:
1201
Appropriation (special or trust fund)
2,375
3,858
4,639
1203
Appropriation (previously unavailable)
174
262
1232
Appropriations and/or unobligated balance of appropriations temporarily reduced
–174
–262
1260
Appropriations, mandatory (total)
2,201
3,770
4,901
1930
Total budgetary resources available
2,201
3,770
5,025
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
124
124
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
442
3010
Obligations incurred, unexpired accounts
2,201
3,646
4,901
3020
Outlays (gross)
–1,759
–4,088
–4,560
3050
Unpaid obligations, end of year
442
341
Memorandum (non-add) entries:
3100
Obligated balance, start of year
442
3200
Obligated balance, end of year
442
341
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
2,201
3,770
4,901
Outlays, gross:
4100
Outlays from new mandatory authority
1,759
3,646
4,437
4101
Outlays from mandatory balances
442
123
4110
Outlays, gross (total)
1,759
4,088
4,560
4180
Budget authority, net (total)
2,201
3,770
4,901
4190
Outlays, net (total)
1,759
4,088
4,560
Section 1343 of the Patient Protection and 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. Risk adjustment charges and
payments were made for the first time in FY 2015 to reflect program year 2014.
Transitional Reinsurance Program
Special and Trust Fund Receipts (in millions of dollars)
Identification code 075–5735–0–2–551
2015 actual
2016 est.
2017 est.
0100
Balance, start of year
649
443
Receipts:
Current law:
1110
Contributions, Transitional Reinsurance Program
8,898
6,521
4,335
2000
Total: Balances and receipts
8,898
7,170
4,778
Appropriations:
Current law:
2101
Transitional Reinsurance Program
–8,898
–6,521
–4,335
2103
Transitional Reinsurance Program
–649
–443
2132
Transitional Reinsurance Program
649
443
2199
Total current law appropriations
–8,249
–6,727
–4,778
2999
Total appropriations
–8,249
–6,727
–4,778
5099
Balance, end of year
649
443
Program and Financing (in millions of dollars)
Identification code 075–5735–0–2–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Transitional reinsurance payments
7,308
7,493
4,551
0002
Administrative expenses
6
0900
Total new obligations
7,308
7,493
4,557
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
941
175
Budget authority:
Appropriations, mandatory:
1201
Appropriation (special or trust fund)
8,898
6,521
4,335
1203
Appropriation (previously unavailable)
649
443
1232
Appropriations and/or unobligated balance of appropriations temporarily reduced
–649
–443
1260
Appropriations, mandatory (total)
8,249
6,727
4,778
1930
Total budgetary resources available
8,249
7,668
4,953
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
941
175
396
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
34
3010
Obligations incurred, unexpired accounts
7,308
7,493
4,557
3020
Outlays (gross)
–7,308
–7,459
–4,554
3050
Unpaid obligations, end of year
34
37
Memorandum (non-add) entries:
3100
Obligated balance, start of year
34
3200
Obligated balance, end of year
34
37
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
8,249
6,727
4,778
Outlays, gross:
4100
Outlays from new mandatory authority
7,308
6,518
4,345
4101
Outlays from mandatory balances
941
209
4110
Outlays, gross (total)
7,308
7,459
4,554
4180
Budget authority, net (total)
8,249
6,727
4,778
4190
Outlays, net (total)
7,308
7,459
4,554
Section 1341 of the Patient Protection and 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. Reinsurance collections and payments were made for the first time in FY 2015 to reflect program year 2014.
Object Classification (in millions of dollars)
Identification code 075–5735–0–2–551
2015 actual
2016 est.
2017 est.
Direct obligations:
41.0
Grants, subsidies, and contributions - Transitional Reinsurance
7,308
7,493
4,551
41.0
Grants, subsidies, and contributions - Administration
6
99.9
Total new obligations
7,308
7,493
4,557
Consumer Operated and Oriented Plan Program Contingency Fund
Program and Financing (in millions of dollars)
Identification code 075–0524–0–1–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
Credit program obligations:
0701
Direct loan subsidy
42
0703
Subsidy for modifications of direct loans
1
0705
Reestimates of direct loan subsidy
89
0706
Interest on reestimates of direct loan subsidy
4
0709
Administrative expenses
10
2
0900
Total new obligations
53
95
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
56
3
Budget authority:
Appropriations, mandatory:
1200
Appropriation
92
1930
Total budgetary resources available
56
95
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
3
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
154
69
4
3010
Obligations incurred, unexpired accounts
53
95
3020
Outlays (gross)
–138
–160
–2
3050
Unpaid obligations, end of year
69
4
2
Memorandum (non-add) entries:
3100
Obligated balance, start of year
154
69
4
3200
Obligated balance, end of year
69
4
2
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
92
Outlays, gross:
4100
Outlays from new mandatory authority
92
4101
Outlays from mandatory balances
138
68
2
4110
Outlays, gross (total)
138
160
2
4180
Budget authority, net (total)
92
4190
Outlays, net (total)
138
160
2
Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in millions of dollars)
Identification code 075–0524–0–1–551
2015 actual
2016 est.
2017 est.
Direct loan levels supportable by subsidy budget authority:
115002
Solvency Loans
88
115999
Total direct loan levels
88
Direct loan subsidy (in percent):
132002
Solvency Loans
48.22
0.00
0.00
132999
Weighted average subsidy rate
48.22
0.00
0.00
Direct loan subsidy budget authority:
133002
Solvency Loans
42
133999
Total subsidy budget authority
42
Direct loan subsidy outlays:
134001
Startup Loans
3
134002
Solvency Loans
126
61
134999
Total subsidy outlays
129
61
Direct loan reestimates:
135001
Startup Loans
–1
4
135002
Solvency Loans
88
135999
Total direct loan reestimates
–1
92
Administrative expense data:
3580
Outlays from balances
9
7
2
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 Patient Protection and Affordable Care Act (P.L. 111–148).
Object Classification (in millions of dollars)
Identification code 075–0524–0–1–551
2015 actual
2016 est.
2017 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent
2
23.1
Rental payments to GSA
2
25.2
Other services from non-Federal sources
6
2
41.0
Grants, subsidies, and contributions
43
93
99.9
Total new obligations
53
95
Employment Summary
Identification code 075–0524–0–1–551
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
15
Consumer Operated and Oriented Plan Program Account
Special and Trust Fund Receipts (in millions of dollars)
Identification code 075–0118–0–1–551
2015 actual
2016 est.
2017 est.
0100
Balance, start of year
7
7
Receipts:
Current law:
1130
Consumer Operated and Oriented Plan Direct Loan Program, Negative Subsidies
7
2000
Total: Balances and receipts
7
7
7
5099
Balance, end of year
7
7
7
Program and Financing (in millions of dollars)
Identification code 075–0118–0–1–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
Credit program obligations:
0703
Subsidy for modifications of direct loans
3
0705
Reestimates of direct loan subsidy
23
430
0706
Interest on reestimates of direct loan subsidy
2
46
0709
Administrative expenses
6
0900
Total new obligations
28
482
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
9
7
1
Budget authority:
Appropriations, mandatory:
1200
Appropriation
26
476
1930
Total budgetary resources available
35
483
1
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
7
1
1
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
282
98
2
3010
Obligations incurred, unexpired accounts
28
482
3020
Outlays (gross)
–212
–578
–1
3050
Unpaid obligations, end of year
98
2
1
Memorandum (non-add) entries:
3100
Obligated balance, start of year
282
98
2
3200
Obligated balance, end of year
98
2
1
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
26
476
Outlays, gross:
4100
Outlays from new mandatory authority
26
476
4101
Outlays from mandatory balances
186
102
1
4110
Outlays, gross (total)
212
578
1
4180
Budget authority, net (total)
26
476
4190
Outlays, net (total)
212
578
1
Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in millions of dollars)
Identification code 075–0118–0–1–551
2015 actual
2016 est.
2017 est.
Direct loan subsidy outlays:
134002
Startup Loans
3
134003
Solvency Loans
182
97
134999
Total subsidy outlays
185
97
Direct loan reestimates:
135002
Startup Loans
–5
57
135003
Solvency Loans
26
416
135999
Total direct loan reestimates
21
473
Administrative expense data:
3580
Outlays from balances
4
1
Section 1322 of the Patient Protection and 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.
Object Classification (in millions of dollars)
Identification code 075–0118–0–1–551
2015 actual
2016 est.
2017 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent
3
25.2
Other services from non-Federal sources
1
25.3
Other goods and services from Federal sources
2
41.0
Grants, subsidies, and contributions
28
476
99.9
Total new obligations
28
482
Employment Summary
Identification code 075–0118–0–1–551
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
15
Consumer Operated and Oriented Plan Financing Account
Program and Financing (in millions of dollars)
Identification code 075–4418–0–3–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
Credit program obligations:
0713
Payment of interest to Treasury
24
35
34
0741
Modification savings
6
0742
Downward reestimate paid to receipt account
5
3
0900
Total new obligations
35
38
34
Budgetary resources:
Financing authority:
Borrowing authority, mandatory:
1400
Borrowing authority
2
38
34
Spending authority from offsetting collections, mandatory:
1800
Collected
217
600
26
1801
Change in uncollected payments, Federal sources
–184
–97
1825
Spending authority from offsetting collections applied to repay debt
–503
–26
1850
Spending auth from offsetting collections, mand (total)
33
1900
Budget authority (total)
35
38
34
1930
Total budgetary resources available
35
38
34
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
642
225
3010
Obligations incurred, unexpired accounts
35
38
34
3020
Outlays (gross)
–452
–263
–34
3050
Unpaid obligations, end of year
225
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–281
–97
3070
Change in uncollected pymts, Fed sources, unexpired
184
97
3090
Uncollected pymts, Fed sources, end of year
–97
Memorandum (non-add) entries:
3100
Obligated balance, start of year
361
128
3200
Obligated balance, end of year
128
Financing authority and disbursements, net:
Mandatory:
4090
Budget authority, gross
35
38
34
Financing disbursements:
4110
Outlays, gross (total)
452
263
34
Offsets against gross financing authority and disbursements:
Offsetting collections (collected) from:
4120
Federal sources
–212
–574
4122
Interest on uninvested funds
–5
–5
–5
4123
Non-Federal sources
–21
–21
4130
Offsets against gross budget authority and outlays (total)
–217
–600
–26
Additional offsets against financing authority only (total):
4140
Change in uncollected pymts, Fed sources, unexpired
184
97
4160
Budget authority, net (mandatory)
2
–465
8
4170
Outlays, net (mandatory)
235
–337
8
4180
Budget authority, net (total)
2
–465
8
4190
Outlays, net (total)
235
–337
8
Status of Direct Loans (in millions of dollars)
Identification code 075–4418–0–3–551
2015 actual
2016 est.
2017 est.
Cumulative balance of direct loans outstanding:
1210
Outstanding, start of year
1,315
1,727
1,931
1231
Disbursements: Direct loan disbursements
417
225
1251
Repayments: Repayments and prepayments
–21
–21
1263
Write-offs for default: Direct loans
–5
–19
1290
Outstanding, end of year
1,727
1,931
1,891
Balance Sheet (in millions of dollars)
Identification code 075–4418–0–3–551
2014 actual
2015 actual
Group heading
ASSETS:
Federal assets:
1101
Fund balances with Treasury
99
68
Investments in US securities:
1106
Receivables, net
6
79
Net value of assets related to post-1991 direct loans receivable:
1401
Direct loans receivable, gross
1,315
1,727
1405
Allowance for subsidy cost (-)
–570
–813
1499
Net present value of assets related to direct loans
745
914
1999
Total assets
850
1,061
LIABILITIES:
2103
Federal liabilities: Debt
850
1,061
4999
Total liabilities and net position
850
1,061
Consumer Operated and Oriented Plan Program Contingency Fund Financing Account
Program and Financing (in millions of dollars)
Identification code 075–4482–0–3–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
Credit program obligations:
0710
Direct loan obligations
87
0713
Payment of interest to Treasury
6
9
9
0741
Modification savings
1
0742
Downward reestimate paid to receipt account
1
0900
Total new obligations
95
9
9
Budgetary resources:
Financing authority:
Borrowing authority, mandatory:
1400
Borrowing authority
49
5
8
Spending authority from offsetting collections, mandatory:
1800
Collected
133
158
4
1801
Change in uncollected payments, Federal sources
–87
–61
1825
Spending authority from offsetting collections applied to repay debt
–93
–3
1850
Spending auth from offsetting collections, mand (total)
46
4
1
1900
Budget authority (total)
95
9
9
1930
Total budgetary resources available
95
9
9
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
355
148
2
3010
Obligations incurred, unexpired accounts
95
9
9
3020
Outlays (gross)
–302
–155
–8
3050
Unpaid obligations, end of year
148
2
3
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–149
–62
–1
3070
Change in uncollected pymts, Fed sources, unexpired
87
61
3090
Uncollected pymts, Fed sources, end of year
–62
–1
–1
Memorandum (non-add) entries:
3100
Obligated balance, start of year
206
86
1
3200
Obligated balance, end of year
86
1
2
Financing authority and disbursements, net:
Mandatory:
4090
Budget authority, gross
95
9
9
Financing disbursements:
4110
Outlays, gross (total)
302
155
8
Offsets against gross financing authority and disbursements:
Offsetting collections (collected) from:
4120
Federal sources
–130
–154
4122
Interest on uninvested funds
–3
–1
–1
4123
Non-Federal sources
–3
–3
4130
Offsets against gross budget authority and outlays (total)
–133
–158
–4
Additional offsets against financing authority only (total):
4140
Change in uncollected pymts, Fed sources, unexpired
87
61
4160
Budget authority, net (mandatory)
49
–88
5
4170
Outlays, net (mandatory)
169
–3
4
4180
Budget authority, net (total)
49
–88
5
4190
Outlays, net (total)
169
–3
4
Status of Direct Loans (in millions of dollars)
Identification code 075–4482–0–3–551
2015 actual
2016 est.
2017 est.
Position with respect to appropriations act limitation on obligations:
1121
Limitation available from carry-forward
87
1150
Total direct loan obligations
87
Cumulative balance of direct loans outstanding:
1210
Outstanding, start of year
49
343
486
1231
Disbursements: Direct loan disbursements
294
146
1251
Repayments: Repayments and prepayments
–3
–3
1290
Outstanding, end of year
343
486
483
Balance Sheet (in millions of dollars)
Identification code 075–4482–0–3–551
2014 actual
2015 actual
ASSETS:
1101
Federal assets: Fund balances with Treasury
6
44
1206
Non-Federal assets: Receivables, net
16
Net value of assets related to post-1991 direct loans receivable:
1401
Direct loans receivable, gross
49
343
1402
Interest receivable
1
1
1405
Allowance for subsidy cost (-)
–19
–153
1499
Net present value of assets related to direct loans
31
191
1999
Total assets
37
251
LIABILITIES:
2104
Federal liabilities: Resources payable to Treasury
37
244
2207
Non-Federal liabilities: Other
7
2999
Total liabilities
37
251
4999
Total liabilities and net position
37
251
Trust Funds
Federal Hospital Insurance Trust Fund
Special and Trust Fund Receipts (in millions of dollars)
Identification code 075–8005–0–7–571
2015 actual
2016 est.
2017 est.
0100
Balance, start of year
171,674
161,965
156,831
0198
Adjustment - account receivable in cancelling annual account
71
0199
Balance, start of year
171,745
161,965
156,831
Receipts:
Current law:
1110
FHI Trust Fund, Transfers from General Fund (FICA Taxes)
215,403
226,589
234,557
1110
FHI Trust Fund, Receipts from Railroad Retirement Board
565
614
625
1110
FHI Trust Fund, Transfers from General Fund (SECA Taxes)
18,221
16,335
18,111
1110
FHI Trust Fund, Civil Penalties and Damages
512
734
775
1130
FHI Trust Fund, Other Proprietary Interest from the Public
3
2
2
1130
FHI Trust Fund, Basic Premium, Medicare Advantage
321
326
357
1130
FHI Trust Fund, Medicare Refunds
4,852
6,000
6,050
1130
Affordable Care Act Medicare Shared Savings Models (HI)
7
2
2
1130
FHI Trust Fund, Premiums Collected for Uninsured Individuals not Otherwise Eligible
3,277
3,461
3,649
1140
FHI Trust Fund, Federal Employer Contributions (FICA)
3,450
3,619
3,702
1140
FHI Trust Fund, Postal Service Employer Contributions (FICA)
623
660
680
1140
FHI Trust Fund, Interest Received by Trust Funds
8,594
8,038
7,986
1140
FHI Trust Fund, Taxation on OASDI Benefits
20,208
23,208
25,987
1140
FHI Trust Fund, Payment from the General Fund for Health Care Fraud and Abuse Control Account
129
130
141
1140
FHI Trust Fund, Transfers from General Fund (criminal Fines)
57
550
590
1140
FHI Trust Fund, Transfers from General Fund (civil Monetary Penalties)
46
35
36
1140
FHI Trust Fund, Transfers from General Fund (asset Forfeitures)
15
29
30
1140
FHI Trust Fund, Interest Payments by Railroad Retirement Board
30
30
35
1140
FHI Trust Fund, Payments from the General Fund (uninsured and Program Management)
900
1,387
1,149
1199
Total current law receipts
277,213
291,749
304,464
Proposed:
1210
FHI Trust Fund, Transfers from General Fund (FICA Taxes)
8
506
1230
FHI Trust Fund, Premiums Collected for Uninsured Individuals not Otherwise Eligible
–33
1240
FHI Trust Fund, Interest Received by Trust Funds
7
74
1240
FHI Trust Fund, Transfers from General Fund (civil Monetary Penalties)
2
1299
Total proposed receipts
15
549
1999
Total receipts
277,213
291,764
305,013
2000
Total: Balances and receipts
448,958
453,729
461,844
Appropriations:
Current law:
2101
Federal Hospital Insurance Trust Fund
–3,211
–2,662
–2,567
2101
Federal Hospital Insurance Trust Fund
–272,149
–287,128
–299,848
2101
Health Care Fraud and Abuse Control Account
–672
–681
–725
2101
Health Care Fraud and Abuse Control Account
–1,325
–744
–1,149
2101
Health Care Fraud and Abuse Control Account
825
2103
Federal Hospital Insurance Trust Fund
–9,696
–5,733
–2,028
2132
Federal Hospital Insurance Trust Fund
8
2132
Health Care Fraud and Abuse Control Account
52
50
2199
Total current law appropriations
–286,993
–296,898
–305,492
Proposed:
2203
Federal Hospital Insurance Trust Fund
2,961
2999
Total appropriations
–286,993
–296,898
–302,531
5099
Balance, end of year
161,965
156,831
159,313
Program and Financing (in millions of dollars)
Identification code 075–8005–0–7–571
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Benefit payments, HI
277,368
290,051
300,069
0002
HIT Incentive Payments
3,196
2,040
1,005
0003
Administration, HI
3,780
2,985
2,906
0004
Quality improvement organizations, HI
730
447
463
0799
Total direct obligations
285,074
295,523
304,443
0900
Total new obligations
285,074
295,523
304,443
Budgetary resources:
Unobligated balance:
1021
Recoveries of prior year unpaid obligations
13
1050
Unobligated balance (total)
13
Budget authority:
Appropriations, discretionary:
1101
Appropriation (special or trust fund)
3,211
2,662
2,567
Appropriations, mandatory:
1201
Appropriation (special or trust fund)
272,149
287,128
299,848
1203
Appropriation (previously unavailable)
9,696
5,733
2,028
1232
Appropriations and/or unobligated balance of appropriations temporarily reduced
–8
1260
Appropriations, mandatory (total)
281,837
292,861
301,876
Spending authority from offsetting collections, mandatory:
1800
Collected
13
1900
Budget authority (total)
285,061
295,523
304,443
1930
Total budgetary resources available
285,074
295,523
304,443
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
29,103
32,217
32,000
3010
Obligations incurred, unexpired accounts
285,074
295,523
304,443
3020
Outlays (gross)
–281,947
–295,740
–304,643
3040
Recoveries of prior year unpaid obligations, unexpired
–13
3050
Unpaid obligations, end of year
32,217
32,000
31,800
Memorandum (non-add) entries:
3100
Obligated balance, start of year
29,103
32,217
32,000
3200
Obligated balance, end of year
32,217
32,000
31,800
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
3,211
2,662
2,567
Outlays, gross:
4010
Outlays from new discretionary authority
2,734
1,952
1,959
4011
Outlays from discretionary balances
733
853
787
4020
Outlays, gross (total)
3,467
2,805
2,746
Mandatory:
4090
Budget authority, gross
281,850
292,861
301,876
Outlays, gross:
4100
Outlays from new mandatory authority
250,291
264,096
272,502
4101
Outlays from mandatory balances
28,189
28,839
29,395
4110
Outlays, gross (total)
278,480
292,935
301,897
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123
Non-Federal sources
–13
4180
Budget authority, net (total)
285,048
295,523
304,443
4190
Outlays, net (total)
281,934
295,740
304,643
Memorandum (non-add) entries:
5000
Total investments, SOY: Federal securities: Par value
202,207
195,458
189,724
5001
Total investments, EOY: Federal securities: Par value
195,458
189,724
187,696
Summary of Budget Authority and Outlays (in millions of dollars)
2015 actual
2016 est.
2017 est.
Enacted/requested:
Budget Authority
285,048
295,523
304,443
Outlays
281,934
295,740
304,643
Legislative proposal, subject to PAYGO:
Budget Authority
–2,961
Outlays
–2,961
Total:
Budget Authority
285,048
295,523
301,482
Outlays
281,934
295,740
301,682
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 encouraging delivery system
reform; promoting high-quality, efficient care; increasing value in provider payments; and encouraging beneficiaries to seek
high-value services. The status of the trust fund is as follows.
Status of Funds (in millions of dollars)
Identification code 075–8005–0–7–571
2015 actual
2016 est.
2017 est.
Unexpended balance, start of year:
0100
Balance, start of year
202,362
196,064
190,147
0999
Total balance, start of year
202,362
196,064
190,147
Cash income during the year:
Current law:
Receipts:
1110
FHI Trust Fund, Transfers from General Fund (FICA Taxes)
215,403
226,589
234,557
1110
FHI Trust Fund, Receipts from Railroad Retirement Board
565
614
625
1110
FHI Trust Fund, Transfers from General Fund (SECA Taxes)
18,221
16,335
18,111
1110
FHI Trust Fund, Civil Penalties and Damages
512
734
775
1130
FHI Trust Fund, Basic Premium, Medicare Advantage
321
326
357
1130
FHI Trust Fund, Medicare Refunds
4,852
6,000
6,050
1130
Affordable Care Act Medicare Shared Savings Models (HI)
7
2
2
1130
FHI Trust Fund, Premiums Collected for Uninsured Individuals not Otherwise Eligible
3,277
3,461
3,649
1130
Federal Hospital Insurance Trust Fund
13
1150
FHI Trust Fund, Interest Received by Trust Funds
8,594
8,038
7,986
1150
FHI Trust Fund, Other Proprietary Interest from the Public
3
2
2
1150
FHI Trust Fund, Interest Payments by Railroad Retirement Board
30
30
35
1160
FHI Trust Fund, Federal Employer Contributions (FICA)
3,450
3,619
3,702
1160
FHI Trust Fund, Postal Service Employer Contributions (FICA)
623
660
680
1160
FHI Trust Fund, Taxation on OASDI Benefits
20,208
23,208
25,987
1160
FHI Trust Fund, Payment from the General Fund for Health Care Fraud and Abuse Control Account
129
130
141
1160
FHI Trust Fund, Transfers from General Fund (criminal Fines)
57
550
590
1160
FHI Trust Fund, Transfers from General Fund (civil Monetary Penalties)
46
35
36
1160
FHI Trust Fund, Transfers from General Fund (asset Forfeitures)
15
29
30
1160
FHI Trust Fund, Payments from the General Fund (uninsured and Program Management)
900
1,387
1,149
1199
Income under present law
277,226
291,749
304,464
Proposed:
1210
FHI Trust Fund, Transfers from General Fund (FICA Taxes)
1210
FHI Trust Fund, Transfers from General Fund (FICA Taxes)
8
506
Offsetting receipts (proprietary):
1230
FHI Trust Fund, Premiums Collected for Uninsured Individuals not Otherwise Eligible
–33
1230
Federal Hospital Insurance Trust Fund
5
1250
FHI Trust Fund, Interest Received by Trust Funds
7
74
Offsetting governmental receipts:
1260
FHI Trust Fund, Transfers from General Fund (Net Investment Tax)
1260
FHI Trust Fund, Transfers from General Fund (civil Monetary Penalties)
2
1299
Income proposed
15
554
1999
Total cash income
277,226
291,764
305,018
Cash outgo during year:
Current law:
2100
Federal Hospital Insurance Trust Fund [009–38–8005–0]
–281,947
–295,740
–304,643
2100
Health Care Fraud and Abuse Control Account [009–38–8393–0]
–1,575
–1,941
–1,905
2100
Health Care Fraud and Abuse Control Account [009–38–8393–7]
825
2199
Outgo under current law
–283,522
–297,681
–305,723
Proposed:
2200
Federal Hospital Insurance Trust Fund
2,956
2299
Outgo under proposed legislation
2,956
2999
Total cash outgo (-)
–283,522
–297,681
–302,767
Surplus or deficit::
3110
Excluding interest
–14,923
–13,994
–5,846
3120
Interest
8,627
8,077
8,097
3199
Subtotal, surplus or deficit
–6,296
–5,917
2,251
3298
Rounding adjustment
–2
3299
Total adjustments
–2
Unexpended balance, end of year::
4100
Uninvested balance (net), end of year
606
423
4,702
4200
Federal Hospital Insurance Trust Fund
195,458
189,724
187,696
4999
Total balance, end of year
196,064
190,147
192,398
Object Classification (in millions of dollars)
Identification code 075–8005–0–7–571
2015 actual
2016 est.
2017 est.
Direct obligations:
41.0
Payment for Quality Improvement Organization (QIO) activities
730
447
463
42.0
Insurance claims and indemnities (benefits)
280,564
292,091
301,074
94.0
Financial transfers
3,780
2,985
2,906
99.9
Total new obligations
285,074
295,523
304,443
Federal Hospital Insurance Trust Fund
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 075–8005–4–7–571
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Benefit payments, HI
–3,055
0003
Administration, HI
94
0799
Total direct obligations
–2,961
0801
Reimbursable program activity
5
0900
Total new obligations
–2,956
Budgetary resources:
Budget authority:
Appropriations, mandatory:
1203
Appropriation (previously unavailable)
–2,961
Spending authority from offsetting collections, mandatory:
1800
Collected
5
1900
Budget authority (total)
–2,956
1930
Total budgetary resources available
–2,956
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
–2,956
3020
Outlays (gross)
2,956
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
–2,956
Outlays, gross:
4100
Outlays from new mandatory authority
–2,956
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123
Non-Federal sources
–5
4180
Budget authority, net (total)
–2,961
4190
Outlays, net (total)
–2,961
Object Classification (in millions of dollars)
Identification code 075–8005–4–7–571
2015 actual
2016 est.
2017 est.
Direct obligations:
42.0
Insurance claims and indemnities (benefits)
–3,055
94.0
Financial transfers
94
99.0
Direct obligations
–2,961
99.0
Reimbursable obligations
5
99.9
Total new obligations
–2,956
health care fraud and abuse control account
In addition to amounts otherwise available for program integrity and program management, [$681,000,000] $725,000,000, to remain available through September 30, [2017] 2018, 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 [$486,120,000] $486,936,000 shall be for the [Medicare Integrity Program at the Centers for Medicare and Medicaid Services, including administrative costs, to conduct oversight
activities for Medicare Advantage under Part C and the Medicare Prescription Drug Program under Part D of the Social Security
Act and for activities described in section 1893(b) of such Act,] Centers for Medicare and Medicaid Services program integrity activities, of which [$67,200,000] $121,824,000 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)(C) 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] $116,240,000 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 [2016] 2017 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 [$370,000,000] $414,000,000 is additional new budget authority specified for purposes of section 251(b)(2)(C) of such Act: Provided further, That the Secretary shall support the [full cost of the] Senior Medicare Patrol program to combat health care fraud and abuse from the funds provided to this account. (Department of Health and Human Services Appropriations Act, 2016.)
Program and Financing (in millions of dollars)
Identification code 075–8393–0–7–571
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Medicare integrity program
860
866
882
0002
FBI fraud and abuse control
142
130
141
0003
Other fraud and abuse control
316
282
301
0005
Undistributed Savings, HCFAC and SSA
–585
–175
0091
Total Mandatory
1,318
693
1,149
0101
CMS discretionary
385
553
487
0102
Other discretionary
134
128
238
0191
Total Discretionary
519
681
725
0900
Total new obligations
1,837
1,374
1,874
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
166
322
323
1001
Discretionary unobligated balance brought fwd, Oct 1
29
188
1021
Recoveries of prior year unpaid obligations
48
1050
Unobligated balance (total)
214
322
323
Budget authority:
Appropriations, discretionary:
1101
Appropriation (special or trust fund)
672
681
725
Appropriations, mandatory:
1201
Appropriation (special or trust fund)
1,325
744
1,149
1232
Appropriations and/or unobligated balance of appropriations temporarily reduced
–52
–50
1260
Appropriations, mandatory (total)
1,273
694
1,149
1900
Budget authority (total)
1,945
1,375
1,874
1930
Total budgetary resources available
2,159
1,697
2,197
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
322
323
323
Special and non-revolving trust funds:
1952
Expired unobligated balance, start of year
36
17
44
1953
Expired unobligated balance, end of year
17
44
44
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
1,312
1,499
932
3010
Obligations incurred, unexpired accounts
1,837
1,374
1,874
3020
Outlays (gross)
–1,575
–1,941
–1,905
3040
Recoveries of prior year unpaid obligations, unexpired
–48
3041
Recoveries of prior year unpaid obligations, expired
–27
3050
Unpaid obligations, end of year
1,499
932
901
Memorandum (non-add) entries:
3100
Obligated balance, start of year
1,312
1,499
932
3200
Obligated balance, end of year
1,499
932
901
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
672
681
725
Outlays, gross:
4010
Outlays from new discretionary authority
119
681
725
4011
Outlays from discretionary balances
200
188
4020
Outlays, gross (total)
319
869
725
Mandatory:
4090
Budget authority, gross
1,273
694
1,149
Outlays, gross:
4100
Outlays from new mandatory authority
287
328
734
4101
Outlays from mandatory balances
969
744
446
4110
Outlays, gross (total)
1,256
1,072
1,180
4180
Budget authority, net (total)
1,945
1,375
1,874
4190
Outlays, net (total)
1,575
1,941
1,905
Summary of Budget Authority and Outlays (in millions of dollars)
2015 actual
2016 est.
2017 est.
Enacted/requested:
Budget Authority
1,945
1,375
1,874
Outlays
1,575
1,941
1,905
Amounts included in the adjusted baseline:
Budget Authority
–825
Outlays
–825
Total:
Budget Authority
1,945
1,375
1,049
Outlays
1,575
1,941
1,080
The Health Insurance Portability and Accountability Act of 1996 (P.L. 104–191) established the Health Care Fraud and Abuse
Control (HCFAC) account within the Federal Hospital Insurance Trust Fund and appropriated funds from the Trust Fund to the
HCFAC account for specified health care fraud and abuse control activities of the Department of Health and Human Services
(HHS), the Department of Justice, and other agencies.
The Budget includes a discretionary request for efforts to safeguard Centers for Medicare and Medicaid Services (CMS) program
integrity that will supplement other CMS program integrity funds. See additional discussion in the Budget Process chapter
in the Analytical Perspectives volume.
Object Classification (in millions of dollars)
Identification code 075–8393–0–7–571
2015 actual
2016 est.
2017 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent (CMS)
47
73
73
12.1
Civilian personnel benefits (CMS)
14
20
20
23.3
Communications, utilities, and miscellaneous charges
13
20
20
25.2
Other services (CMS/Medicaid)
40
56
44
25.3
Other purchases of goods and services from Government accounts (HHS/DOJ)
157
119
179
25.3
Other purchases of goods and services from Government accounts (HHS/OIG)
256
255
322
25.3
Other purchases of goods and services from Government accounts (HHS/AoA)
9
9
10
25.3
Other purchases of goods and services from Government accounts (HHS/OGC)
10
10
11
25.3
Other goods and services from Federal sources (HHS/CMS)
14
14
14
25.3
Other goods and services from Government accounts (HHS/FDA)
3
3
3
25.6
Medical care (CMS)
1,132
1,250
1,212
92.0
Undistributed
–585
–175
94.0
Financial transfers (FBI)
142
130
141
99.9
Total new obligations
1,837
1,374
1,874
Employment Summary
Identification code 075–8393–0–7–571
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
425
577
593
Health Care Fraud and Abuse Control Account
(Amounts included in the adjusted baseline)
Program and Financing (in millions of dollars)
Identification code 075–8393–7–7–571
2015 actual
2016 est.
2017 est.
Budgetary resources:
Budget authority:
Appropriations, mandatory:
1201
Appropriation (special or trust fund)
–825
1900
Budget authority (total)
–825
1930
Total budgetary resources available
–825
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
–825
Change in obligated balance:
Unpaid obligations:
3020
Outlays (gross)
825
3050
Unpaid obligations, end of year
825
Memorandum (non-add) entries:
3200
Obligated balance, end of year
825
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
–825
Outlays, gross:
4100
Outlays from new mandatory authority
–825
4180
Budget authority, net (total)
–825
4190
Outlays, net (total)
–825
Federal Supplementary Medical Insurance Trust Fund
Special and Trust Fund Receipts (in millions of dollars)
Identification code 075–8004–0–7–571
2015 actual
2016 est.
2017 est.
0100
Balance, start of year
35,073
39,267
50,191
0198
Adjustment - expired accounts, receipts withdrawn
491
0198
Prior year budgetary adjustments
–7
0199
Balance, start of year
35,557
39,267
50,191
Receipts:
Current law:
1110
Fee on Branded Prescription Pharmaceutical Manufacturers and Importers, SMI
2,991
2,969
3,980
1130
Other Proprietary Interest from the Public, FSMI Fund
12
3
3
1130
Premiums Collected for Medicare Prescription Drug Account, FSMI
3,815
4,300
5,310
1130
Payments from States, Medicare Prescription Drug Account, FSMI
8,797
9,569
10,688
1130
Basic Premium, Medicare Advantage, FSMI Trust Fund
358
367
403
1130
Medicare Refunds, SMI
5,666
5,500
5,550
1130
Affordable Care Act Medicare Shared Savings Models, SMI
6
8
8
1130
Premiums Collected for the Aged, FSMI Fund
56,997
61,110
67,535
1130
Premiums Collected for the Disabled, FSMI Fund
10,122
11,011
11,647
1140
Federal Contributions, FSMI Fund
195,835
237,231
214,944
1140
Interest Received by Trust Fund, FSMI Fund
2,471
1,926
2,093
1140
Federal Contribution, State Low-income Determinations, Prescription Drug Account, FSMI
3
3
1140
Interest, Medicare Prescription Drug Account, FSMI
11
11
14
1140
Federal Contribution for Admin. Contribution for Admin. Costs, Prescription Drug Account, FSMI
439
308
325
1140
Federal Contributions for Benefits, Prescription Drug Account, SMI
67,210
76,190
82,512
1140
Miscellaneous Federal Payments, Federal Supplementary Medical Insurance Trust Fund
1
1
1
1199
Total current law receipts
354,731
410,507
405,016
Proposed:
1230
Premiums Collected for Medicare Prescription Drug Account, FSMI
–130
1230
Payments from States, Medicare Prescription Drug Account, FSMI
–90
1230
Premiums Collected for the Aged, FSMI Fund
–47
1230
Premiums Collected for the Disabled, FSMI Fund
–15
1240
Federal Contributions, FSMI Fund
–179
1240
Federal Contributions for Benefits, Prescription Drug Account, SMI
–640
1299
Total proposed receipts
–1,101
1999
Total receipts
354,731
410,507
403,915
2000
Total: Balances and receipts
390,288
449,774
454,106
Appropriations:
Current law:
2101
Federal Supplementary Medical Insurance Trust Fund
–2,262
–2,959
–3,413
2101
Federal Supplementary Medical Insurance Trust Fund
–271,952
–311,575
–302,754
2101
Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund
–408
–303
–314
2101
Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund
–80,155
–95,670
–98,535
2103
Federal Supplementary Medical Insurance Trust Fund
–9,570
2134
Federal Supplementary Medical Insurance Trust Fund
3,756
10,924
2199
Total current law appropriations
–351,021
–399,583
–414,586
Proposed:
2201
Federal Supplementary Medical Insurance Trust Fund
819
2201
Federal Supplementary Medical Insurance Trust Fund
–578
2201
Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund
860
2203
Federal Supplementary Medical Insurance Trust Fund
–799
2203
Federal Supplementary Medical Insurance Trust Fund
799
2299
Total proposed appropriations
1,101
2999
Total appropriations
–351,021
–399,583
–413,485
5099
Balance, end of year
39,267
50,191
40,621
Program and Financing (in millions of dollars)
Identification code 075–8004–0–7–571
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Benefit payments, SMI
265,320
298,683
310,577
0002
Transfer to Medicaid for payment of SMI premiums
749
869
954
0003
HIT Incentive Payments
1,862
760
440
0004
Administration, SMI
2,355
3,186
3,650
0005
Quality Improvement Organizations, SMI
182
112
116
0799
Total direct obligations
270,468
303,610
315,737
0801
Federal Supplementary Medical Insurance Trust Fund (Reimbursable)
11,172
0900
Total new obligations
281,640
303,610
315,737
Budgetary resources:
Budget authority:
Appropriations, discretionary:
1101
Appropriation (special or trust fund)
2,262
2,959
3,413
Appropriations, mandatory:
1201
Appropriation (special or trust fund)
271,952
311,575
302,754
1203
Appropriation (previously unavailable)
9,570
1234
Appropriations precluded from obligation
–3,756
–10,924
1260
Appropriations, mandatory (total)
268,196
300,651
312,324
Spending authority from offsetting collections, mandatory:
1800
Collected
10
1801
Change in uncollected payments, Federal sources
11,172
1850
Spending auth from offsetting collections, mand (total)
11,182
1900
Budget authority (total)
281,640
303,610
315,737
1930
Total budgetary resources available
281,640
303,610
315,737
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
22,625
23,290
23,585
3010
Obligations incurred, unexpired accounts
281,640
303,610
315,737
3020
Outlays (gross)
–280,975
–303,315
–315,340
3050
Unpaid obligations, end of year
23,290
23,585
23,982
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–11,172
3061
Adjustments to uncollected pymts, Fed sources, brought forward, Oct 1
11,172
3070
Change in uncollected pymts, Fed sources, unexpired
–11,172
3090
Uncollected pymts, Fed sources, end of year
–11,172
Memorandum (non-add) entries:
3100
Obligated balance, start of year
22,625
23,290
23,585
3200
Obligated balance, end of year
12,118
23,585
23,982
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
2,262
2,959
3,413
Outlays, gross:
4010
Outlays from new discretionary authority
1,700
1,956
2,216
4011
Outlays from discretionary balances
337
641
778
4020
Outlays, gross (total)
2,037
2,597
2,994
Mandatory:
4090
Budget authority, gross
279,378
300,651
312,324
Outlays, gross:
4100
Outlays from new mandatory authority
258,444
279,811
285,206
4101
Outlays from mandatory balances
20,494
20,907
27,140
4110
Outlays, gross (total)
278,938
300,718
312,346
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123
Non-Federal sources
–10
Additional offsets against gross budget authority only:
4140
Change in uncollected pymts, Fed sources, unexpired
–11,172
4160
Budget authority, net (mandatory)
268,196
300,651
312,324
4170
Outlays, net (mandatory)
278,928
300,718
312,346
4180
Budget authority, net (total)
270,458
303,610
315,737
4190
Outlays, net (total)
280,965
303,315
315,340
Memorandum (non-add) entries:
5000
Total investments, SOY: Federal securities: Par value
68,391
66,128
78,344
5001
Total investments, EOY: Federal securities: Par value
66,128
78,344
68,997
Summary of Budget Authority and Outlays (in millions of dollars)
2015 actual
2016 est.
2017 est.
Enacted/requested:
Budget Authority
270,458
303,610
315,737
Outlays
280,965
303,315
315,340
Legislative proposal, not subject to PAYGO:
Budget Authority
–20
Outlays
–20
Legislative proposal, subject to PAYGO:
Budget Authority
–221
Outlays
–221
Total:
Budget Authority
270,458
303,610
315,496
Outlays
280,965
303,315
315,099
The Supplementary Medical Insurance (SMI) program is a voluntary program that affords protection against the costs of physician
care 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. The Budget also makes structural changes that will reduce Federal subsidies to high income beneficiaries
and create incentives for beneficiaries to seek high value services. The status of the trust fund is as follows.
Status of Funds (in millions of dollars)
Identification code 075–8004–0–7–571
2015 actual
2016 est.
2017 est.
Unexpended balance, start of year:
0100
Balance, start of year
71,328
69,122
80,344
0999
Total balance, start of year
71,328
69,122
80,344
Cash income during the year:
Current law:
Receipts:
1110
Fee on Branded Prescription Pharmaceutical Manufacturers and Importers, SMI
2,991
2,969
3,980
1130
Premiums Collected for Medicare Prescription Drug Account, FSMI
3,815
4,300
5,310
1130
Payments from States, Medicare Prescription Drug Account, FSMI
8,797
9,569
10,688
1130
Basic Premium, Medicare Advantage, FSMI Trust Fund
358
367
403
1130
Medicare Refunds, SMI
5,666
5,500
5,550
1130
Affordable Care Act Medicare Shared Savings Models, SMI
6
8
8
1130
Premiums Collected for the Aged, FSMI Fund
56,997
61,110
67,535
1130
Premiums Collected for the Disabled, FSMI Fund
10,122
11,011
11,647
1130
Federal Supplementary Medical Insurance Trust Fund
10
1130
Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund
6
1150
Interest Received by Trust Fund, FSMI Fund
2,471
1,926
2,093
1150
Other Proprietary Interest from the Public, FSMI Fund
12
3
3
1150
Interest, Medicare Prescription Drug Account, FSMI
11
11
14
1160
Federal Contributions, FSMI Fund
195,835
237,231
214,944
1160
Federal Contribution, State Low-income Determinations, Prescription Drug Account, FSMI
3
3
1160
Federal Contribution for Admin. Contribution for Admin. Costs, Prescription Drug Account, FSMI
439
308
325
1160
Federal Contributions for Benefits, Prescription Drug Account, SMI
67,210
76,190
82,512
1160
Miscellaneous Federal Payments, Federal Supplementary Medical Insurance Trust Fund
1
1
1
1199
Income under present law
354,747
410,507
405,016
Proposed:
Offsetting receipts (proprietary):
1230
Premiums Collected for Medicare Prescription Drug Account, FSMI
–130
1230
Payments from States, Medicare Prescription Drug Account, FSMI
–90
1230
Low Income Subsidy Part D Rebate
1230
Premiums Collected for the Aged, FSMI Fund
1230
Premiums Collected for the Aged, FSMI Fund
–47
1230
Premiums Collected for the Disabled, FSMI Fund
–15
1230
Federal Supplementary Medical Insurance Trust Fund
4
Offsetting governmental receipts:
1260
Federal Contributions, FSMI Fund
–179
1260
Federal Contributions for Benefits, Prescription Drug Account, SMI
–640
1299
Income proposed
–1,097
1999
Total cash income
354,747
410,507
403,919
Cash outgo during year:
Current law:
2100
Federal Supplementary Medical Insurance Trust Fund [009–38–8004–0]
–280,975
–303,315
–315,340
2100
Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund [009–38–8308–0]
–75,978
–95,970
–98,852
2199
Outgo under current law
–356,953
–399,285
–414,192
Proposed:
2200
Federal Supplementary Medical Insurance Trust Fund
20
2200
Federal Supplementary Medical Insurance Trust Fund
217
2200
Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund
860
2299
Outgo under proposed legislation
1,097
2999
Total cash outgo (-)
–356,953
–399,285
–413,095
Surplus or deficit::
3110
Excluding interest
–4,700
9,282
–11,286
3120
Interest
2,494
1,940
2,110
3199
Subtotal, surplus or deficit
–2,206
11,222
–9,176
Unexpended balance, end of year::
4100
Uninvested balance (net), end of year
2,994
2,000
2,171
4200
Federal Supplementary Medical Insurance Trust Fund
66,128
78,344
68,997
4999
Total balance, end of year
69,122
80,344
71,168
Object Classification (in millions of dollars)
Identification code 075–8004–0–7–571
2015 actual
2016 est.
2017 est.
Direct obligations:
41.0
Payment for Quality Improvement Organization (QIO) activity
182
112
116
42.0
Insurance claims and indemnities
267,931
300,312
311,971
94.0
Financial transfers
2,355
3,186
3,650
99.0
Direct obligations
270,468
303,610
315,737
99.0
Reimbursable obligations
11,172
99.9
Total new obligations
281,640
303,610
315,737
Employment Summary
Identification code 075–8004–0–7–571
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
3
3
3
Federal Supplementary Medical Insurance Trust Fund
(Legislative proposal, not subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 075–8004–2–7–571
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Benefit payments, SMI
–20
0799
Total direct obligations
–20
0900
Total new obligations (object class 42.0)
–20
Budgetary resources:
Budget authority:
Appropriations, mandatory:
1201
Appropriation (special or trust fund)
–819
1203
Appropriation (previously unavailable)
799
1260
Appropriations, mandatory (total)
–20
1900
Budget authority (total)
–20
1930
Total budgetary resources available
–20
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
–20
3020
Outlays (gross)
20
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
–20
Outlays, gross:
4100
Outlays from new mandatory authority
–20
4180
Budget authority, net (total)
–20
4190
Outlays, net (total)
–20
Federal Supplementary Medical Insurance Trust Fund
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 075–8004–4–7–571
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Benefit payments, SMI
–424
0004
Administration, SMI
203
0900
Total new obligations
–221
Budgetary resources:
Budget authority:
Appropriations, mandatory:
1201
Appropriation (special or trust fund)
578
1203
Appropriation (previously unavailable)
–799
1260
Appropriations, mandatory (total)
–221
Spending authority from offsetting collections, mandatory:
1800
Collected
4
1900
Budget authority (total)
–217
1930
Total budgetary resources available
–217
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
4
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
–221
3020
Outlays (gross)
217
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
–217
Outlays, gross:
4100
Outlays from new mandatory authority
–217
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123
Non-Federal sources
–4
4180
Budget authority, net (total)
–221
4190
Outlays, net (total)
–221
Object Classification (in millions of dollars)
Identification code 075–8004–4–7–571
2015 actual
2016 est.
2017 est.
Direct obligations:
42.0
Insurance claims and indemnities
–424
94.0
Financial transfers
203
99.0
Direct obligations
–221
99.9
Total new obligations
–221
Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund
Program and Financing (in millions of dollars)
Identification code 075–8308–0–7–571
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Prescription Drug Benefits
80,145
95,659
98,524
0002
Administrative Costs
418
314
325
0900
Total new obligations
80,563
95,973
98,849
Budgetary resources:
Budget authority:
Appropriations, discretionary:
1101
Appropriation (special or trust fund)
408
303
314
Appropriations, mandatory:
1201
Appropriation (special or trust fund)
80,155
95,670
98,535
1900
Budget authority (total)
80,563
95,973
98,849
1930
Total budgetary resources available
80,563
95,973
98,849
Memorandum (non-add) entries:
Special and non-revolving trust funds:
1952
Expired unobligated balance, start of year
179
132
132
1953
Expired unobligated balance, end of year
132
132
132
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
12,967
17,554
6,385
3001
Adjustments to unpaid obligations, brought forward, Oct 1
–11,172
3010
Obligations incurred, unexpired accounts
80,563
95,973
98,849
3011
Obligations incurred, expired accounts
21
3020
Outlays (gross)
–75,978
–95,970
–98,852
3041
Recoveries of prior year unpaid obligations, expired
–19
3050
Unpaid obligations, end of year
17,554
6,385
6,382
Memorandum (non-add) entries:
3100
Obligated balance, start of year
12,967
6,382
6,385
3200
Obligated balance, end of year
17,554
6,385
6,382
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
408
303
314
Outlays, gross:
4010
Outlays from new discretionary authority
236
236
248
4011
Outlays from discretionary balances
276
58
63
4020
Outlays, gross (total)
512
294
311
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4033
Non-Federal sources
–6
Additional offsets against gross budget authority only:
4052
Offsetting collections credited to expired accounts
6
4070
Budget authority, net (discretionary)
408
303
314
4080
Outlays, net (discretionary)
506
294
311
Mandatory:
4090
Budget authority, gross
80,155
95,670
98,535
Outlays, gross:
4100
Outlays from new mandatory authority
62,587
89,743
89,431
4101
Outlays from mandatory balances
12,879
5,933
9,110
4110
Outlays, gross (total)
75,466
95,676
98,541
4180
Budget authority, net (total)
80,563
95,973
98,849
4190
Outlays, net (total)
75,972
95,970
98,852
Summary of Budget Authority and Outlays (in millions of dollars)
2015 actual
2016 est.
2017 est.
Enacted/requested:
Budget Authority
80,563
95,973
98,849
Outlays
75,972
95,970
98,852
Legislative proposal, subject to PAYGO:
Budget Authority
–860
Outlays
–860
Total:
Budget Authority
80,563
95,973
97,989
Outlays
75,972
95,970
97,992
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 and address the rising
cost of pharmaceuticals.
Object Classification (in millions of dollars)
Identification code 075–8308–0–7–571
2015 actual
2016 est.
2017 est.
Direct obligations:
25.2
Other services from non-Federal sources
418
314
325
42.0
Insurance claims and indemnities
80,145
95,659
98,524
99.9
Total new obligations
80,563
95,973
98,849
Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 075–8308–4–7–571
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Prescription Drug Benefits
–860
0900
Total new obligations (object class 42.0)
–860
Budgetary resources:
Budget authority:
Appropriations, mandatory:
1201
Appropriation (special or trust fund)
–860
1900
Budget authority (total)
–860
1930
Total budgetary resources available
–860
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
–860
3020
Outlays (gross)
860
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
–860
Outlays, gross:
4100
Outlays from new mandatory authority
–860
4180
Budget authority, net (total)
–860
4190
Outlays, net (total)
–860
Administration for Children and Families
Federal Funds
Temporary Assistance for Needy Families
Program and Financing (in millions of dollars)
Identification code 075–1552–0–1–609
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
State family assistance grant
16,484
16,486
16,486
0002
Territories - family assistance grants
78
78
78
0006
Tribal work programs
7
8
8
0009
Healthy marriage and responsible fatherhood grants
147
148
150
0900
Total new obligations
16,716
16,720
16,722
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
2
Budget authority:
Appropriations, mandatory:
1200
Appropriation
16,739
16,739
16,739
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
16,737
16,741
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–21
–15
–15
1941
Unexpired unobligated balance, end of year
2
4
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
5,250
5,939
6,266
3010
Obligations incurred, unexpired accounts
16,716
16,720
16,722
3020
Outlays (gross)
–15,942
–16,393
–16,439
3041
Recoveries of prior year unpaid obligations, expired
–85
3050
Unpaid obligations, end of year
5,939
6,266
6,549
Memorandum (non-add) entries:
3100
Obligated balance, start of year
5,250
5,939
6,266
3200
Obligated balance, end of year
5,939
6,266
6,549
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
16,737
16,737
16,739
Outlays, gross:
4100
Outlays from new mandatory authority
12,784
13,042
13,043
4101
Outlays from mandatory balances
3,158
3,351
3,396
4110
Outlays, gross (total)
15,942
16,393
16,439
4180
Budget authority, net (total)
16,737
16,737
16,739
4190
Outlays, net (total)
15,942
16,393
16,439
Summary of Budget Authority and Outlays (in millions of dollars)
2015 actual
2016 est.
2017 est.
Enacted/requested:
Budget Authority
16,737
16,737
16,739
Outlays
15,942
16,393
16,439
Legislative proposal, subject to PAYGO:
Budget Authority
760
Outlays
593
Total:
Budget Authority
16,737
16,737
17,499
Outlays
15,942
16,393
17,032
This account provides funding for the Temporary Assistance for Needy Families (TANF) block grant and related activities authorized
by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (P.L. 104–193), as amended by the Deficit Reduction
Act of 2005 (P.L. 109–171). Since 2010, this account has been temporarily reauthorized by a series of Acts, most recently
in the Consolidated Appropriations Act, 2016 (P.L. 114–113). The Budget includes an $8 billion increase to the TANF block
grant over five years.
Object Classification (in millions of dollars)
Identification code 075–1552–0–1–609
2015 actual
2016 est.
2017 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
30
30
30
25.3
Other goods and services from Federal sources
1
1
3
41.0
Grants, subsidies, and contributions
16,683
16,686
16,686
99.9
Total new obligations
16,716
16,720
16,722
Employment Summary
Identification code 075–1552–0–1–609
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
15
14
19
Temporary Assistance for Needy Families
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 075–1552–4–1–609
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
State family assistance grants
747
0002
Territories - family assistance grants
3
0006
Monitoring and Oversight
10
0900
Total new obligations
760
Budgetary resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
750
1221
Appropriations transferred from other acct [075–1522]
10
1260
Appropriations, mandatory (total)
760
1930
Total budgetary resources available
760
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
760
3020
Outlays (gross)
–593
3050
Unpaid obligations, end of year
167
Memorandum (non-add) entries:
3200
Obligated balance, end of year
167
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
760
Outlays, gross:
4100
Outlays from new mandatory authority
593
4180
Budget authority, net (total)
760
4190
Outlays, net (total)
593
Object Classification (in millions of dollars)
Identification code 075–1552–4–1–609
2015 actual
2016 est.
2017 est.
Direct obligations:
25.1
Advisory and assistance services
10
41.0
Grants, subsidies, and contributions
750
99.9
Total new obligations
760
Contingency Fund
Program and Financing (in millions of dollars)
Identification code 075–1522–0–1–609
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Contingency fund
685
583
583
0900
Total new obligations (object class 41.0)
685
583
583
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
1
1
1012
Unobligated balance transfers between expired and unexpired accounts
81
1021
Recoveries of prior year unpaid obligations
22
1050
Unobligated balance (total)
103
1
1
Budget authority:
Appropriations, discretionary:
1120
Appropriations transferred to other acct [075–1553]
–15
1120
Appropriations transferred to other acct [013–0401]
–10
1160
Appropriation, discretionary (total)
–25
Appropriations, mandatory:
1200
Appropriation
608
608
608
1220
Appropriations transferred to other accts [075–1553]
–15
–15
1220
Appropriations transferred to other accts [013–0401]
–10
–10
1260
Appropriations, mandatory (total)
583
583
608
1900
Budget authority (total)
583
583
583
1930
Total budgetary resources available
686
584
584
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
1
1
1
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
131
60
87
3010
Obligations incurred, unexpired accounts
685
583
583
3011
Obligations incurred, expired accounts
1
3020
Outlays (gross)
–730
–556
–593
3040
Recoveries of prior year unpaid obligations, unexpired
–22
3041
Recoveries of prior year unpaid obligations, expired
–5
3050
Unpaid obligations, end of year
60
87
77
Memorandum (non-add) entries:
3100
Obligated balance, start of year
131
60
87
3200
Obligated balance, end of year
60
87
77
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
583
583
608
Outlays, gross:
4100
Outlays from new mandatory authority
564
525
547
4101
Outlays from mandatory balances
166
31
68
4110
Outlays, gross (total)
730
556
615
4180
Budget authority, net (total)
583
583
583
4190
Outlays, net (total)
730
556
593
Summary of Budget Authority and Outlays (in millions of dollars)
2015 actual
2016 est.
2017 est.
Enacted/requested:
Budget Authority
583
583
583
Outlays
730
556
593
Legislative proposal, subject to PAYGO:
Budget Authority
–10
Outlays
–9
Total:
Budget Authority
583
583
573
Outlays
730
556
584
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 through FY 2017. In FY 2017, the Budget includes a general provision
to transfer $15 million from the Contingency Fund to Welfare Research, and to transfer $10 million to support the Census Survey
of Income and Program Participation, consistent with the FY 2016 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 $473 million for the Pathways to Jobs initiative and $100 million for Two-Generation Demonstration
projects.
Contingency Fund
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 075–1522–4–1–609
2015 actual
2016 est.
2017 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 acct [075–1552]
–10
1930
Total budgetary resources available
–10
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
–10
3020
Outlays (gross)
9
3050
Unpaid obligations, end of year
–1
Memorandum (non-add) entries:
3200
Obligated balance, end of year
–1
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
–10
Outlays, gross:
4100
Outlays from new mandatory authority
–9
4180
Budget authority, net (total)
–10
4190
Outlays, net (total)
–9
TANF Economic Response Fund
TANF Economic Response Fund
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 075–1539–4–1–609
2015 actual
2016 est.
2017 est.
Budgetary resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
2,000
1930
Total budgetary resources available
2,000
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
2,000
Change in obligated balance:
Unpaid obligations:
3020
Outlays (gross)
–28
3050
Unpaid obligations, end of year
–28
Memorandum (non-add) entries:
3200
Obligated balance, end of year
–28
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
2,000
Outlays, gross:
4100
Outlays from new mandatory authority
28
4180
Budget authority, net (total)
2,000
4190
Outlays, net (total)
28
This account establishes a $2 billion TANF Economic Response Fund to assist States during periods of economic downturns.
It includes an effective economic trigger to determine if States qualify for funding under this account based on economic
need.
Emergency Aid and Service Connection Grants
Emergency Aid and Service Connection Grants
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 075–1538–4–1–609
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Direct program activity
40
0900
Total new obligations (object class 41.0)
40
Budgetary resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
40
1930
Total budgetary resources available
40
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
40
3020
Outlays (gross)
–1
3050
Unpaid obligations, end of year
39
Memorandum (non-add) entries:
3200
Obligated balance, end of year
39
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
40
Outlays, gross:
4100
Outlays from new mandatory authority
1
4180
Budget authority, net (total)
40
4190
Outlays, net (total)
1
This account establishes Emergency Aid and Service Connection Grants. This program would fund a robust round of pilots to
test new approaches for providing emergency aid for low-income families, including both short-term financial assistance and
connection to longer-term supports for those who need them. The Budget includes budget authority of $2 billion over five
years for this program.
Payments to states for child support enforcement and family support programs
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), [$2,944,906,000] $3,010,631,000, to remain available until expended; and for such purposes for the first quarter of fiscal year [2017] 2018, [$1,300,000,000] $1,400,000,000, 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, 2016.)
Program and Financing (in millions of dollars)
Identification code 075–1501–0–1–609
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
State child support administrative costs
3,726
3,727
3,881
0002
Child support incentive payments
564
517
586
0003
Access and visitation grants
10
10
10
0091
Subtotal, child support enforcement
4,300
4,254
4,477
0102
Payments to territories
33
33
33
0103
Repatriation
1
1
1
0191
Subtotal, other payments
34
34
34
0799
Total direct obligations
4,334
4,288
4,511
0801
Offset obligations (CSE grants to States)
13
16
13
0900
Total new obligations
4,347
4,304
4,524
Budgetary resources:
Unobligated balance:
1021
Recoveries of prior year unpaid obligations
189
200
200
1029
Other balances withdrawn to Treasury
–13
1050
Unobligated balance (total)
176
200
200
Budget authority:
Appropriations, mandatory:
1200
Appropriation
2,908
2,928
3,011
Advance appropriations, mandatory:
1270
Advance appropriation
1,250
1,160
1,300
Spending authority from offsetting collections, mandatory:
1800
Collected
13
16
13
1900
Budget authority (total)
4,171
4,104
4,324
1930
Total budgetary resources available
4,347
4,304
4,524
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
942
1,047
968
3010
Obligations incurred, unexpired accounts
4,347
4,304
4,524
3020
Outlays (gross)
–4,053
–4,183
–4,303
3040
Recoveries of prior year unpaid obligations, unexpired
–189
–200
–200
3050
Unpaid obligations, end of year
1,047
968
989
Memorandum (non-add) entries:
3100
Obligated balance, start of year
942
1,047
968
3200
Obligated balance, end of year
1,047
968
989
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
4,171
4,104
4,324
Outlays, gross:
4100
Outlays from new mandatory authority
3,586
3,542
3,734
4101
Outlays from mandatory balances
467
641
569
4110
Outlays, gross (total)
4,053
4,183
4,303
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123
Non-Federal sources
–13
–16
–13
4180
Budget authority, net (total)
4,158
4,088
4,311
4190
Outlays, net (total)
4,040
4,167
4,290
Summary of Budget Authority and Outlays (in millions of dollars)
2015 actual
2016 est.
2017 est.
Enacted/requested:
Budget Authority
4,158
4,088
4,311
Outlays
4,040
4,167
4,290
Legislative proposal, subject to PAYGO:
Budget Authority
31
Outlays
31
Total:
Budget Authority
4,158
4,088
4,342
Outlays
4,040
4,167
4,321
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.
Proposals target systems modernization, increased collections, expanded distribution, and improved program efficiency.
Object Classification (in millions of dollars)
Identification code 075–1501–0–1–609
2015 actual
2016 est.
2017 est.
41.0
Direct obligations: Grants, subsidies, and contributions
4,334
4,288
4,511
99.0
Reimbursable obligations
13
16
13
99.9
Total new obligations
4,347
4,304
4,524
Payments to States for Child Support Enforcement and Family Support Programs
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 075–1501–4–1–609
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
State child support administrative costs
31
0091
Subtotal, child support enforcement
31
0799
Total direct obligations
31
Budgetary resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
31
1900
Budget authority (total)
31
1930
Total budgetary resources available
31
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
31
3020
Outlays (gross)
–31
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
31
Outlays, gross:
4100
Outlays from new mandatory authority
31
4180
Budget authority, net (total)
31
4190
Outlays, net (total)
31
Object Classification (in millions of dollars)
Identification code 075–1501–4–1–609
2015 actual
2016 est.
2017 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent
2
12.1
Civilian personnel benefits
1
23.1
Rental payments to GSA
1
25.2
Other services from non-Federal sources
5
25.7
Operation and maintenance of equipment
2
41.0
Grants, subsidies, and contributions
20
99.0
Direct obligations
31
99.9
Total new obligations
31
Employment Summary
Identification code 075–1501–4–1–609
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
18
Low income home energy assistance
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] $3,000,304,000: Provided, That all but [$491,000,000] $435,000,000 of this amount shall be allocated as though the total appropriation for such payments for fiscal year [2016] 2017 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 2017 may use up to 40 percent of such allotment for residential weatherization or other energy-related
home repair activities without regard to the waiver process specified in such section. (Department of Health and Human Services Appropriations Act, 2016.)
Program and Financing (in millions of dollars)
Identification code 075–1502–0–1–609
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
LIHEAP Block Grant
3,395
3,390
3,000
Budgetary resources:
Unobligated balance:
1012
Unobligated balance transfers between expired and unexpired accounts
5
1050
Unobligated balance (total)
5
Budget authority:
Appropriations, discretionary:
1100
Appropriation
3,390
3,390
3,000
1930
Total budgetary resources available
3,395
3,390
3,000
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
1,201
1,134
1,311
3010
Obligations incurred, unexpired accounts
3,395
3,390
3,000
3020
Outlays (gross)
–3,437
–3,213
–2,805
3041
Recoveries of prior year unpaid obligations, expired
–25
3050
Unpaid obligations, end of year
1,134
1,311
1,506
Memorandum (non-add) entries:
3100
Obligated balance, start of year
1,201
1,134
1,311
3200
Obligated balance, end of year
1,134
1,311
1,506
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
3,390
3,390
3,000
Outlays, gross:
4010
Outlays from new discretionary authority
2,439
2,136
1,890
4011
Outlays from discretionary balances
998
1,077
915
4020
Outlays, gross (total)
3,437
3,213
2,805
4180
Budget authority, net (total)
3,390
3,390
3,000
4190
Outlays, net (total)
3,437
3,213
2,805
Summary of Budget Authority and Outlays (in millions of dollars)
2015 actual
2016 est.
2017 est.
Enacted/requested:
Budget Authority
3,390
3,390
3,000
Outlays
3,437
3,213
2,805
Legislative proposal, subject to PAYGO:
Budget Authority
769
Outlays
560
Total:
Budget Authority
3,390
3,390
3,769
Outlays
3,437
3,213
3,365
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 to establish a contingency fund
providing additional mandatory funds to respond to increases in the number of low-income households, spikes in the price of
natural gas, electricity, or oil, and extreme cold at the beginning of winter.
Object Classification (in millions of dollars)
Identification code 075–1502–0–1–609
2015 actual
2016 est.
2017 est.
Direct obligations:
25.1
Advisory and assistance services
2
2
2
41.0
Grants, subsidies, and contributions
3,393
3,388
2,998
99.9
Total new obligations
3,395
3,390
3,000
Low Income Home Energy Assistance
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 075–1502–4–1–609
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0002
Mandatory LIHEAP Contingency Fund
769
0900
Total new obligations (object class 41.0)
769
Budgetary resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriations, mandatory
769
1930
Total budgetary resources available
769
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
769
3020
Outlays (gross)
–560
3050
Unpaid obligations, end of year
209
Memorandum (non-add) entries:
3200
Obligated balance, end of year
209
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
769
Outlays, gross:
4100
Outlays from new mandatory authority
560
4180
Budget authority, net (total)
769
4190
Outlays, net (total)
560
Refugee and entrant assistance
For necessary expenses for refugee and entrant assistance activities authorized by section 414 of the Immigration and Nationality
Act and section 501 of the Refugee Education Assistance Act of 1980, and for carrying out section 462 of the Homeland Security
Act of 2002, section 235 of the William Wilberforce Trafficking Victims Protection Reauthorization Act of 2008, the Trafficking
Victims Protection Act of 2000 ("TVPA"), section 203 of the Trafficking Victims Protection Reauthorization Act of 2005, and
the Torture Victims Relief Act of 1998, [$1,674,691,000] $2,089,860,000, of which [$1,645,201,000] $2,044,485,000 shall remain available through September 30, [2018] 2019 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 the limitation in section 205 of this Act regarding transfers increasing any appropriation shall apply to transfers
to appropriations under this heading by substituting "10 percent" for "3 percent": Provided further, That the Secretary may accept and use money, funds, property, and services of any kind made available
by gift, devise, bequest, grant, or other donation for carrying out activities to combat human trafficking and to assist trafficking
victims under the authorities specified under this heading: Provided further, That, at any point after January 1, 2017, and
before October 1, 2017, if the Secretary has increased funding available under this heading by at least 3 percent by transfer
from other accounts to support higher than expected caseloads, and if the Secretary, 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 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 10 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. (Department of Health and Human Services Appropriations Act, 2016.)
Program and Financing (in millions of dollars)
Identification code 075–1503–0–1–609
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Refugee and entrant assistance
643
697
819
0002
Assistance for treatment of torture victims
11
11
23
0003
Unaccompanied alien children
728
1,226
1,321
0005
Trafficking Victims program
16
19
22
0900
Total new obligations
1,398
1,953
2,185
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
4
278
1021
Recoveries of prior year unpaid obligations
113
1050
Unobligated balance (total)
117
278
Budget authority:
Appropriations, discretionary:
1100
Base Appropriation
1,560
1,675
2,090
1100
UC Contingency Fund
95
1160
Appropriation, discretionary (total)
1,560
1,675
2,185
1930
Total budgetary resources available
1,677
1,953
2,185
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–1
1941
Unexpired unobligated balance, end of year
278
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
776
781
1,222
3010
Obligations incurred, unexpired accounts
1,398
1,953
2,185
3020
Outlays (gross)
–1,270
–1,512
–1,995
3040
Recoveries of prior year unpaid obligations, unexpired
–113
3041
Recoveries of prior year unpaid obligations, expired
–10
3050
Unpaid obligations, end of year
781
1,222
1,412
Memorandum (non-add) entries:
3100
Obligated balance, start of year
776
781
1,222
3200
Obligated balance, end of year
781
1,222
1,412
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
1,560
1,675
2,185
Outlays, gross:
4010
Outlays from new discretionary authority
770
838
1,092
4011
Outlays from discretionary balances
500
674
903
4020
Outlays, gross (total)
1,270
1,512
1,995
4180
Budget authority, net (total)
1,560
1,675
2,185
4190
Outlays, net (total)
1,270
1,512
1,995
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 2017 Budget includes funding to serve additional
refugees and eligible entrants, provide shelter to unaccompanied children, and expand direct services to domestic victims
of human trafficking.
Object Classification (in millions of dollars)
Identification code 075–1503–0–1–609
2015 actual
2016 est.
2017 est.
11.1
Direct obligations: Personnel compensation: Full-time permanent
7
8
8
11.9
Total personnel compensation
7
8
8
12.1
Civilian personnel benefits
2
2
3
23.1
Rental payments to GSA
4
4
4
25.1
Advisory and assistance services
44
256
350
25.2
Other services from non-Federal sources
17
4
7
25.3
Other goods and services from Federal sources
57
57
58
41.0
Grants, subsidies, and contributions
1,267
1,622
1,755
99.9
Total new obligations
1,398
1,953
2,185
Employment Summary
Identification code 075–1503–0–1–609
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
103
106
109
1101
Direct military average strength employment
2
3
3
Promoting Safe and Stable Families
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] $79,765,000: Provided, That of the funds available to carry out such section 437, $59,765,000 shall be allocated consistent
with subsections (b) and (c) of such section: Provided further, That $20,000,000 shall be used to increase the amount available
for allotments under subsection (c)(1) of such section 437, with subsection (d)(1) of such section not applying to such funds:
Provided further, That section 432(b)(2)(B) of such Act shall not apply to funds provided under this heading for fiscal year
2017: Provided further, That notwithstanding section 433(a) of such Act, each Indian tribe or tribal consortium with an approved
plan shall receive an allotment of not less than $10,000: 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, 2016.)
Program and Financing (in millions of dollars)
Identification code 075–1512–0–1–506
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Grants to States and Tribes
342
342
383
0002
Research, training and technical assistance
8
9
9
0003
State court improvement activities
29
31
33
0004
Family Connection Grants
2
2
2
0005
PREP
73
89
81
0006
Abstinence Education
47
75
75
0900
Total new obligations
501
548
583
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
2
26
10
1012
Unobligated balance transfers between expired and unexpired accounts
6
1021
Recoveries of prior year unpaid obligations
17
1050
Unobligated balance (total)
25
26
10
Budget authority:
Appropriations, discretionary:
1100
Appropriation
60
60
80
Appropriations, mandatory:
1200
Appropriation
470
495
495
1230
Appropriations and/or unobligated balance of appropriations permanently reduced
–25
–23
1260
Appropriations, mandatory (total)
445
472
495
1900
Budget authority (total)
505
532
575
1930
Total budgetary resources available
530
558
585
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–3
1941
Unexpired unobligated balance, end of year
26
10
2
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
609
537
579
3010
Obligations incurred, unexpired accounts
501
548
583
3020
Outlays (gross)
–526
–506
–529
3040
Recoveries of prior year unpaid obligations, unexpired
–17
3041
Recoveries of prior year unpaid obligations, expired
–30
3050
Unpaid obligations, end of year
537
579
633
Memorandum (non-add) entries:
3100
Obligated balance, start of year
609
537
579
3200
Obligated balance, end of year
537
579
633
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
60
60
80
Outlays, gross:
4010
Outlays from new discretionary authority
23
20
27
4011
Outlays from discretionary balances
42
40
40
4020
Outlays, gross (total)
65
60
67
Mandatory:
4090
Budget authority, gross
445
472
495
Outlays, gross:
4100
Outlays from new mandatory authority
109
100
107
4101
Outlays from mandatory balances
352
346
355
4110
Outlays, gross (total)
461
446
462
4180
Budget authority, net (total)
505
532
575
4190
Outlays, net (total)
526
506
529
Summary of Budget Authority and Outlays (in millions of dollars)
2015 actual
2016 est.
2017 est.
Enacted/requested:
Budget Authority
505
532
575
Outlays
526
506
529
Legislative proposal, subject to PAYGO:
Budget Authority
–17
Outlays
1
Total:
Budget Authority
505
532
558
Outlays
526
506
530
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) through FY 2022, a reauthorization of Family Connection Grants through FY 2021, an expansion of grants
to increase the well-being of, and to improve the permanency outcomes for, children affected by substance abuse, additional
funding for Tribal Court Improvement Programs, and a $20 million increase in discretionary appropriations for Promoting Safe
and Stable Families to increase capacity for tribal child welfare systems .
Object Classification (in millions of dollars)
Identification code 075–1512–0–1–506
2015 actual
2016 est.
2017 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent
1
1
1
25.1
Advisory and assistance services
12
12
13
25.3
Other goods and services from Federal sources
3
2
2
41.0
Grants, subsidies, and contributions
485
533
567
99.9
Total new obligations
501
548
583
Employment Summary
Identification code 075–1512–0–1–506
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
9
9
13
Promoting Safe and Stable Families
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 075–1512–4–1–506
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Grants to States and Tribes
40
0003
State court improvement activities
3
0004
Family Connection Grants
15
0006
Abstinence Education
–75
0900
Total new obligations
–17
Budgetary resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
–17
1930
Total budgetary resources available
–17
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
–17
3020
Outlays (gross)
–1
3050
Unpaid obligations, end of year
–18
Memorandum (non-add) entries:
3200
Obligated balance, end of year
–18
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
–17
Outlays, gross:
4100
Outlays from new mandatory authority
2
4101
Outlays from mandatory balances
–1
4110
Outlays, gross (total)
1
4180
Budget authority, net (total)
–17
4190
Outlays, net (total)
1
Object Classification (in millions of dollars)
Identification code 075–1512–4–1–506
2015 actual
2016 est.
2017 est.
Direct obligations:
25.1
Advisory and assistance services
9
41.0
Grants, subsidies, and contributions
–26
99.9
Total new obligations
–17
Child Care Entitlement to States
Program and Financing (in millions of dollars)
Identification code 075–1550–0–1–609
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Mandatory child care
1,178
1,178
1,178
0002
Matching child care
1,708
1,662
1,660
0003
Training and technical assistance
15
15
0004
Child care tribal grants
58
58
58
0005
Research
4
6
0900
Total new obligations
2,944
2,917
2,917
Budgetary resources:
Unobligated balance:
1012
Unobligated balance transfers between expired and unexpired accounts
27
1050
Unobligated balance (total)
27
Budget authority:
Appropriations, mandatory:
1200
Appropriation
2,917
2,917
2,917
1930
Total budgetary resources available
2,944
2,917
2,917
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
830
927
894
3010
Obligations incurred, unexpired accounts
2,944
2,917
2,917
3011
Obligations incurred, expired accounts
2
3020
Outlays (gross)
–2,821
–2,950
–2,937
3041
Recoveries of prior year unpaid obligations, expired
–28
3050
Unpaid obligations, end of year
927
894
874
Memorandum (non-add) entries:
3100
Obligated balance, start of year
830
927
894
3200
Obligated balance, end of year
927
894
874
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
2,917
2,917
2,917
Outlays, gross:
4100
Outlays from new mandatory authority
2,151
2,276
2,276
4101
Outlays from mandatory balances
670
674
661
4110
Outlays, gross (total)
2,821
2,950
2,937
4180
Budget authority, net (total)
2,917
2,917
2,917
4190
Outlays, net (total)
2,821
2,950
2,937
Summary of Budget Authority and Outlays (in millions of dollars)
2015 actual
2016 est.
2017 est.
Enacted/requested:
Budget Authority
2,917
2,917
2,917
Outlays
2,821
2,950
2,937
Legislative proposal, subject to PAYGO:
Budget Authority
3,665
Outlays
2,969
Total:
Budget Authority
2,917
2,917
6,582
Outlays
2,821
2,950
5,906
This account provides child care subsidies for low-income working families and was established by the Personal Responsibility
and Work Opportunity Reconciliation Act of 1996 (P.L. 104–193), as amended by the Deficit Reduction Act of 2005 (P.L. 109–171).
Since 2010, this account has been temporarily reauthorized by a series of Acts, most recently in the Consolidated Appropriations
Act, 2016 (P.L. 114–113). The Budget includes an $82 billion investment over ten years above current law to expand access
to high-quality child care for all low- and moderate-income families with young children.
Object Classification (in millions of dollars)
Identification code 075–1550–0–1–609
2015 actual
2016 est.
2017 est.
Direct obligations:
25.1
Advisory and assistance services
15
15
41.0
Grants, subsidies, and contributions
2,944
2,902
2,902
99.9
Total new obligations
2,944
2,917
2,917
Child Care Entitlement to States
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 075–1550–4–1–609
2015 actual
2016 est.
2017 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
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
Object Classification (in millions of dollars)
Identification code 075–1550–4–1–609
2015 actual
2016 est.
2017 est.
Direct obligations:
25.1
Advisory and assistance services
23
41.0
Grants, subsidies, and contributions
3,642
99.9
Total new obligations
3,665
Payments to states for the child care and development block grant
For carrying out the Child Care and Development Block Grant Act of 2014 ("CCDBG Act"), [$2,761,000,000] $2,961,672,000 shall be used to supplement, not supplant State general revenue funds for child care assistance for low-income families:
Provided, That, in addition to the amounts [required to be reserved by the States under section 658G of the CCDBG Act, $127,206,000 shall be for activities that improve
the quality of infant and toddler care] reserved under section 658O(a)(5) of the CCDBG Act, $40,000,000 shall be for carrying out a program of competitive grants
to States, territories, tribes, local governments, and public entities, to develop, implement, and evaluate models of providing
care for working families in rural communities, families needing child care on an emergency basis, families with non-traditional
work hours, or other family needs as identified by the Secretary: 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 all funds made available to carry out section 418 of the Social Security Act (42 U.S.C. 618), including funds appropriated
for that purpose in such section 418 or any other provision of law, shall be subject to the reservation of funds authority
in paragraphs (4) and (5) of section 658O(a) of the CCDBG Act. (Department of Health and Human Services Appropriations Act, 2016.)
Program and Financing (in millions of dollars)
Identification code 075–1515–0–1–609
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Block grant payments to States
2,425
2,751
2,912
0002
Child care pilots for working families
40
0004
Research and evaluation fund
10
10
10
0900
Total new obligations
2,435
2,761
2,962
Budgetary resources:
Budget authority:
Appropriations, discretionary:
1100
Appropriation
2,435
2,761
2,962
1930
Total budgetary resources available
2,435
2,761
2,962
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
713
829
793
3010
Obligations incurred, unexpired accounts
2,435
2,761
2,962
3020
Outlays (gross)
–2,313
–2,797
–2,940
3041
Recoveries of prior year unpaid obligations, expired
–6
3050
Unpaid obligations, end of year
829
793
815
Memorandum (non-add) entries:
3100
Obligated balance, start of year
713
829
793
3200
Obligated balance, end of year
829
793
815
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
2,435
2,761
2,962
Outlays, gross:
4010
Outlays from new discretionary authority
1,751
2,154
2,310
4011
Outlays from discretionary balances
562
643
630
4020
Outlays, gross (total)
2,313
2,797
2,940
4180
Budget authority, net (total)
2,435
2,761
2,962
4190
Outlays, net (total)
2,313
2,797
2,940
This program provides grants to States for child care subsidies for low-income working families and activities to improve
child care quality. In FY 2017, it also includes a new competitive pilot program to develop and evaluate effective strategies
for meeting the child care needs of working families in rural communities and families needing emergency or non-traditional
hour care.
Object Classification (in millions of dollars)
Identification code 075–1515–0–1–609
2015 actual
2016 est.
2017 est.
Direct obligations:
25.1
Advisory and assistance services
7
13
15
25.2
Other services from non-Federal sources
1
1
25.3
Other goods and services from Federal sources
16
1
1
41.0
Grants, subsidies, and contributions
2,412
2,746
2,945
99.9
Total new obligations
2,435
2,761
2,962
Employment Summary
Identification code 075–1515–0–1–609
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
3
Social services block grant
For making grants to States pursuant to section 2002 of the Social Security Act, supplementing research and evaluation related to activities funded by such grants, and for demonstration projects to improve
access to child-rearing supplies, $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 2017 shall be $1,681,500,000. (Department of Health and Human Services Appropriations Act, 2016.)
Program and Financing (in millions of dollars)
Identification code 075–1534–0–1–506
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Social Services Block Grant
1,576
1,584
1,700
0002
Health Profession Opportunity Grants
84
85
85
0900
Total new obligations
1,660
1,669
1,785
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
30
30
30
Budget authority:
Appropriations, mandatory:
1200
Appropriation
1,785
1,785
1,785
1230
Appropriations and/or unobligated balance of appropriations permanently reduced
–124
–116
1260
Appropriations, mandatory (total)
1,661
1,669
1,785
1930
Total budgetary resources available
1,691
1,699
1,815
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–1
1941
Unexpired unobligated balance, end of year
30
30
30
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
769
591
489
3010
Obligations incurred, unexpired accounts
1,660
1,669
1,785
3020
Outlays (gross)
–1,832
–1,771
–1,836
3041
Recoveries of prior year unpaid obligations, expired
–6
3050
Unpaid obligations, end of year
591
489
438
Memorandum (non-add) entries:
3100
Obligated balance, start of year
769
591
489
3200
Obligated balance, end of year
591
489
438
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
1,661
1,669
1,785
Outlays, gross:
4100
Outlays from new mandatory authority
1,320
1,319
1,415
4101
Outlays from mandatory balances
512
452
421
4110
Outlays, gross (total)
1,832
1,771
1,836
4180
Budget authority, net (total)
1,661
1,669
1,785
4190
Outlays, net (total)
1,832
1,771
1,836
Summary of Budget Authority and Outlays (in millions of dollars)
2015 actual
2016 est.
2017 est.
Enacted/requested:
Budget Authority
1,661
1,669
1,785
Outlays
1,832
1,771
1,836
Legislative proposal, subject to PAYGO:
Budget Authority
300
Outlays
300
Total:
Budget Authority
1,661
1,669
2,085
Outlays
1,832
1,771
2,136
Object Classification (in millions of dollars)
Identification code 075–1534–0–1–506
2015 actual
2016 est.
2017 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent
1
1
1
25.1
Advisory and assistance services
1
2
2
25.5
Research and development contracts
17
41.0
Grants, subsidies, and contributions
1,658
1,666
1,765
99.9
Total new obligations
1,660
1,669
1,785
Employment Summary
Identification code 075–1534–0–1–506
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
8
8
10
Social Services Block Grant
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 075–1534–4–1–506
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0003
Upward Mobility Project
300
0900
Total new obligations (object class 41.0)
300
Budgetary resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
300
1900
Budget authority (total)
300
1930
Total budgetary resources available
300
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
300
3020
Outlays (gross)
–300
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
300
Outlays, gross:
4100
Outlays from new mandatory authority
300
4180
Budget authority, net (total)
300
4190
Outlays, net (total)
300
Children and families services programs
For carrying out, except as otherwise provided, the Runaway and Homeless Youth Act, the Head Start Act, the Every Student Succeeds 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), part B-1 of title IV and sections 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"), and the Assets for Independence Act; for necessary administrative expenses
to carry out 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] Omnibus Budget Reconciliation 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, [$10,984,268,000] $11,725,057,000, of which $37,943,000, to remain available through September 30, [2017] 2018, shall be for grants to States for adoption and legal guardianship incentive payments, as defined by section 473A of the
Social Security Act and may be made for adoptions and legal guardianships completed before September 30, [2016] 2017: Provided, That [$9,168,095,000] $9,601,724,000 shall be for making payments under the Head Start Act: Provided further, That of the amount in the previous proviso, [$8,214,095,000] $8,639,724,000 shall be available for payments under section 640 of the Head Start Act, of which [$141,000,000] $131,629,000 shall be available for a cost of living adjustment notwithstanding section 640(a)(3)(A) of such Act: Provided further, That notwithstanding such section 640, of the amount in the second preceding proviso, [$294,000,000] $292,000,000 (of which up to one percent may be reserved for research and evaluation) shall be available through December 31, [2016] 2017 for award by the Secretary to grantees that apply for supplemental funding to increase their hours of program operations
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 notwithstanding such section 640, 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], [$635,000,000] $645,000,000 shall be available through March 31, [2017] 2018 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, 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,
for training and technical assistance for such activities, and for up to $14,000,000 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 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 $350,000,000 shall be available until December 31, 2017 for carrying out sections 9212 and 9213 of
the Every Student Succeeds Act: Provided further, That up to 5 percent of the funds in the previous proviso shall be available
for technical assistance, evaluation, early education research, pilots to support the transition from preschool to elementary
school, improve the early grades, and support exemplary child development practices, and other national activities related
to such grants: Provided further, That [$751,383,000] $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:] 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 under such Act: Provided further, That, notwithstanding section 675C(a)(3) of the CSBG Act, 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] such 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 the Secretary shall issue performance standards for [nonprofit organizations] entities 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] 2017, and include information on such implementation in the report required by section 678E(a)(2) of such Act: Provided further, That the percentage of amounts payable to a State under section 675A or 675B of such Act that may be used
for administrative expenses under section 675C(b)(2) may be increased above 5 percent, but not above 10 percent, to implement
State plans, approved by the Secretary, for one-time investments in data systems modernization, data analysis capacity, and
improved information exchange and interoperability of data systems: Provided further, That such plans must include improved
ability to analyze and report program results, streamline service enrollment systems, or increase program integrity: Provided
further, That the percentage specified in section 675C(a)(1) of such Act may be applied by decreasing it by the amount of
the percentage increase in the second preceding proviso: Provided further, That the lead State agency shall ensure that local
eligible entities will consider and include in their community action plans strategies to meet the needs of concentrated,
persistent poverty in their service areas: Provided further, That notwithstanding the prior notice and hearing provisions
in section 676(b)(8) and 678C of such Act, if the State determines that immediate temporary suspension of financial assistance
to an eligible entity is necessary because of a serious risk of a substantial injury to property or loss of project funds,
or because of a violation of a Federal, State, or local criminal statute, the State may submit a written request that the
Secretary allow a temporary suspension of financial assistance to the eligible entity, in whole or part, and a reallocation
of suspended financial assistance to other eligible entities for the provision of comparable services: Provided further, That, to the extent funds for the Assets for Independence (AFI) Act provided in this Act are distributed as grant funds
to a qualified entity and have not been expended by such entity within 3 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 5 years: Provided further, That notwithstanding section 414(e) of the AFI 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 provided for carrying out
the AFI Act shall be for grants to projects for which the Secretary may allow grantees to use any amount of such grant funds
to assist participants in obtaining the skills and information necessary to achieve economic self-sufficiency, notwithstanding
any provision of such Act, and for which the Secretary may expand the definition of "qualified expenses" under section 404(8)
of such Act and waive the limitation of matching contribution to only earned income deposits under section 410(a)(1) 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, for fiscal year 2017, section 414(d)(1) of the AFI Act shall be applied as if it stated: "(1) INTERIM REPORTS.—The Secretary
shall submit to Congress an annual, interim report based on the Federal fiscal year setting forth the results of the reports
submitted pursuant to section 412(b). Such report shall be submitted by July 31 of the year following the period of the report.":
Provided further, That of the amounts available for carrying out the Runaway and Homeless Youth Act, $2,350,000 shall be available
for demonstration projects as described in section 343 of such Act, notwithstanding section 388(a) 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, 2016.)
Program and Financing (in millions of dollars)
Identification code 075–1536–0–1–506
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0101
Head Start
8,717
9,168
9,602
0102
Head Start Emergency Hurricane Sandy funding
71
0103
Runaway and homeless youth (basic centers)
53
54
57
0104
Transitional living
44
48
49
0105
Prevalence, Needs and Characteristics of Homeless Youth
2
0106
Education grants to reduce sexual abuse of runaway youth
17
17
17
0107
Preschool Development Grants
350
0109
Child abuse State grants
25
25
25
0110
Child abuse discretionary activities
29
33
44
0111
Community-based child abuse prevention
40
40
40
0112
Child welfare services
269
269
269
0113
Child welfare training, research, or demonstration projects
16
18
22
0114
Adoption opportunities
39
39
39
0115
Abandoned infants assistance
11
0116
Adoption incentives
38
38
38
0117
Independent living training vouchers
43
43
43
0124
Native American programs
47
50
53
0125
Social services and income maintenance research
6
6
11
0128
Federal administration
199
205
206
0129
Center for faith-based and community initiatives
1
0131
Disaster human services case management
1
2
2
0191
Direct program activities, subtotal
9,666
10,055
10,869
0301
Community services block grant
674
715
674
0303
Rural community facilities
7
7
0304
Community services discretionary (JOLI & CED)
30
30
0306
Assets for independence
19
19
19
0308
Domestic violence hotline
4
8
12
0309
Family violence prevention and services
135
150
151
0391
Direct program activities, subtotal
869
929
856
0400
Total, direct program
10,535
10,984
11,725
0799
Total direct obligations
10,535
10,984
11,725
0801
Children and Families Services Programs (Reimbursable)
6
20
20
0809
Reimbursable program activities, subtotal
6
20
20
0900
Total new obligations
10,541
11,004
11,745
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
562
377
382
1001
Discretionary unobligated balance brought fwd, Oct 1
562
377
1021
Recoveries of prior year unpaid obligations
6
1050
Unobligated balance (total)
568
377
382
Budget authority:
Appropriations, discretionary:
1100
Appropriation
10,346
10,984
11,725
Spending authority from offsetting collections, discretionary:
1700
Collected
1
24
24
1701
Change in uncollected payments, Federal sources
1
1750
Spending auth from offsetting collections, disc (total)
2
24
24
Spending authority from offsetting collections, mandatory:
1800
Collected
1
1
1
1801
Change in uncollected payments, Federal sources
1
1850
Spending auth from offsetting collections, mand (total)
2
1
1
1900
Budget authority (total)
10,350
11,009
11,750
1930
Total budgetary resources available
10,918
11,386
12,132
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
377
382
387
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
6,646
7,114
7,107
3010
Obligations incurred, unexpired accounts
10,541
11,004
11,745
3011
Obligations incurred, expired accounts
3
3020
Outlays (gross)
–9,984
–11,011
–11,344
3040
Recoveries of prior year unpaid obligations, unexpired
–6
3041
Recoveries of prior year unpaid obligations, expired
–86
3050
Unpaid obligations, end of year
7,114
7,107
7,508
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–10
–5
–5
3070
Change in uncollected pymts, Fed sources, unexpired
–2
3071
Change in uncollected pymts, Fed sources, expired
7
3090
Uncollected pymts, Fed sources, end of year
–5
–5
–5
Memorandum (non-add) entries:
3100
Obligated balance, start of year
6,636
7,109
7,102
3200
Obligated balance, end of year
7,109
7,102
7,503
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
10,348
11,008
11,749
Outlays, gross:
4010
Outlays from new discretionary authority
4,059
4,639
4,950
4011
Outlays from discretionary balances
5,922
6,372
6,394
4020
Outlays, gross (total)
9,981
11,011
11,344
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–6
–18
–18
4033
Non-Federal sources
–6
–6
4040
Offsets against gross budget authority and outlays (total)
–6
–24
–24
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–1
4052
Offsetting collections credited to expired accounts
5
4060
Additional offsets against budget authority only (total)
4
4070
Budget authority, net (discretionary)
10,346
10,984
11,725
4080
Outlays, net (discretionary)
9,975
10,987
11,320
Mandatory:
4090
Budget authority, gross
2
1
1
Outlays, gross:
4100
Outlays from new mandatory authority
2
4101
Outlays from mandatory balances
1
4110
Outlays, gross (total)
3
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120
Federal sources
–3
–1
–1
Additional offsets against gross budget authority only:
4140
Change in uncollected pymts, Fed sources, unexpired
–1
4142
Offsetting collections credited to expired accounts
2
4150
Additional offsets against budget authority only (total)
1
4170
Outlays, net (mandatory)
–1
–1
4180
Budget authority, net (total)
10,346
10,984
11,725
4190
Outlays, net (total)
9,975
10,986
11,319
The request totals $11.7 billion, including almost $10 billion for priority investments in early learning programs, such as
Head Start and the newly transferred Preschool Development Grants program, that will expand access to high quality early care
and education for young children. Relative to FY 2016, the Budget also requests an additional $5 million for family violence
prevention and services, $11 million to provide comprehensive services to youth in the child welfare system, including those
who are victims of or at-risk of human trafficking, $7 million to improve services for homeless youth, $2 million to support
energy assistance evaluations, and $3 million for Native youth development. This request discontinues funding for the Rural
Communities Facilities and the Community Economic Development programs.
Object Classification (in millions of dollars)
Identification code 075–1536–0–1–506
2015 actual
2016 est.
2017 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
104
122
124
11.3
Other than full-time permanent
4
5
6
11.7
Military personnel
1
1
1
11.9
Total personnel compensation
109
128
131
12.1
Civilian personnel benefits
32
38
38
21.0
Travel and transportation of persons
3
4
4
23.1
Rental payments to GSA
14
15
16
23.2
Rental payments to others
1
23.3
Communications, utilities, and miscellaneous charges
2
2
2
24.0
Printing and reproduction
1
1
1
25.1
Advisory and assistance services
212
215
237
25.2
Other services from non-Federal sources
6
7
245
25.3
Other goods and services from Federal sources
59
60
51
25.4
Operation and maintenance of facilities
2
2
2
26.0
Supplies and materials
1
1
1
41.0
Grants, subsidies, and contributions
10,093
10,511
10,997
99.0
Direct obligations
10,535
10,984
11,725
99.0
Reimbursable obligations
6
20
20
99.9
Total new obligations
10,541
11,004
11,745
Employment Summary
Identification code 075–1536–0–1–506
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
1,022
1,123
1,192
1101
Direct military average strength employment
8
9
9
2001
Reimbursable civilian full-time equivalent employment
15
8
10
Children's Research and Technical Assistance
For expenses necessary, including for grants and technical assistance, for improving integration and interoperability of enrollment
systems and data systems for federal, state, tribal, and local health and human services programs, including establishment
of a Systems Innovation Center, $10,000,000.
Program and Financing (in millions of dollars)
Identification code 075–1553–0–1–609
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Training and technical assistance
10
15
12
0002
Federal parent locator service
25
26
25
0004
Welfare research
14
14
15
0005
Advancing Human Services Interoperability - Discretionary
10
0799
Total direct obligations
49
55
62
0801
Reimbursable program FPLS REIMB
23
35
37
0802
Reimbursable program activity CCDBG Research
14
0899
Total reimbursable obligations
37
35
37
0900
Total new obligations
86
90
99
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
4
6
1
1021
Recoveries of prior year unpaid obligations
2
1050
Unobligated balance (total)
6
6
1
Budget authority:
Appropriations, discretionary:
1100
Appropriation - Advancing Human Services Interoperability
10
1121
Appropriations transferred from other acct [075–1522]
15
1160
Appropriation, discretionary (total)
25
Appropriations, mandatory:
1200
Appropriation
37
37
37
1200
Appropriation [Pop-up]
1
1221
Appropriations transferred from other acct [075–1522]
15
15
1230
Appropriations and/or unobligated balance of appropriations permanently reduced
–4
–3
1260
Appropriations, mandatory (total)
48
50
37
Spending authority from offsetting collections, discretionary:
1700
Collected
15
Spending authority from offsetting collections, mandatory:
1800
Collected
23
35
36
1801
Change in uncollected payments, Federal sources
1
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)
23
35
37
1900
Budget authority (total)
86
85
99
1930
Total budgetary resources available
92
91
100
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
6
1
1
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
63
78
77
3010
Obligations incurred, unexpired accounts
86
90
99
3020
Outlays (gross)
–69
–91
–82
3040
Recoveries of prior year unpaid obligations, unexpired
–2
3050
Unpaid obligations, end of year
78
77
94
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–5
–6
–6
3070
Change in uncollected pymts, Fed sources, unexpired
–1
3090
Uncollected pymts, Fed sources, end of year
–6
–6
–6
Memorandum (non-add) entries:
3100
Obligated balance, start of year
58
72
71
3200
Obligated balance, end of year
72
71
88
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
15
25
Outlays, gross:
4010
Outlays from new discretionary authority
3
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4033
Non-Federal sources
–15
Mandatory:
4090
Budget authority, gross
71
85
74
Outlays, gross:
4100
Outlays from new mandatory authority
19
23
22
4101
Outlays from mandatory balances
50
68
57
4110
Outlays, gross (total)
69
91
79
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120
Federal sources
–9
–10
–10
4123
Non-Federal sources
–14
–25
–26
4130
Offsets against gross budget authority and outlays (total)
–23
–35
–36
Additional offsets against gross budget authority only:
4140
Change in uncollected pymts, Fed sources, unexpired
–1
4160
Budget authority, net (mandatory)
47
50
38
4170
Outlays, net (mandatory)
46
56
43
4180
Budget authority, net (total)
47
50
63
4190
Outlays, net (total)
31
56
46
Memorandum (non-add) entries:
5090
Unexpired unavailable balance, SOY: Offsetting collections
1
2
2
5092
Unexpired unavailable balance, EOY: Offsetting collections
2
2
1
Summary of Budget Authority and Outlays (in millions of dollars)
2015 actual
2016 est.
2017 est.
Enacted/requested:
Budget Authority
47
50
63
Outlays
31
56
46
Legislative proposal, subject to PAYGO:
Budget Authority
50
Outlays
5
Total:
Budget Authority
47
50
113
Outlays
31
56
51
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 and FY 2016, annual appropriations
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 2017 to Welfare Research. The Budget proposes an initiative for
Advancing Human Services Interoperability, as well as a number of proposals to provide access to the National Directory of
New Hires while maintaining the integrity and privacy of the data in the directory.
Object Classification (in millions of dollars)
Identification code 075–1553–0–1–609
2015 actual
2016 est.
2017 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent
6
8
8
12.1
Civilian personnel benefits
2
2
2
23.1
Rental payments to GSA
3
3
3
25.1
Advisory and assistance services
12
12
17
25.2
Other services from non-Federal sources
16
17
16
25.3
Other goods and services from Federal sources
5
6
6
25.7
Operation and maintenance of equipment
3
3
3
41.0
Grants, subsidies, and contributions
2
4
8
99.0
Direct obligations
49
55
63
99.0
Reimbursable obligations
37
35
36
99.9
Total new obligations
86
90
99
Employment Summary
Identification code 075–1553–0–1–609
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
48
60
67
Children's Research and Technical Assistance
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 075–1553–4–1–609
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0003
Advance Human Services Interoperability - Mandatory proposal
50
0799
Total direct obligations
50
0801
Reimbursable program FPLS REIMB
3
0899
Total reimbursable obligations
3
0900
Total new obligations
53
Budgetary resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
50
Spending authority from offsetting collections, mandatory:
1800
Collected
3
1900
Budget authority (total)
53
1930
Total budgetary resources available
53
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
53
3020
Outlays (gross)
–8
3050
Unpaid obligations, end of year
45
Memorandum (non-add) entries:
3200
Obligated balance, end of year
45
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
53
Outlays, gross:
4100
Outlays from new mandatory authority
8
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120
Federal sources
–3
4180
Budget authority, net (total)
50
4190
Outlays, net (total)
5
Object Classification (in millions of dollars)
Identification code 075–1553–4–1–609
2015 actual
2016 est.
2017 est.
Direct obligations:
25.1
Advisory and assistance services
5
41.0
Grants, subsidies, and contributions
45
99.0
Direct obligations
50
99.0
Reimbursable obligations
3
99.9
Total new obligations
53
Employment Summary
Identification code 075–1553–4–1–609
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
5
Payments for foster care and permanency
For carrying out, except as otherwise provided, title IV-E of the Social Security Act, [$5,298,000,000] $5,764,000,000.
For carrying out, except as otherwise provided, title IV-E of the Social Security Act, for the first quarter of fiscal year
[2017] 2018, [$2,300,000,000] $2,500,000,000.
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, 2016.)
Program and Financing (in millions of dollars)
Identification code 075–1545–0–1–609
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Foster care
4,669
4,801
4,992
0002
Independent living
140
140
140
0004
Adoption assistance
2,473
2,674
2,780
0005
Guardianship
101
135
152
0006
Tribal T&TA
3
3
3
0900
Total new obligations
7,386
7,753
8,067
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
2
Budget authority:
Appropriations, mandatory:
1200
Appropriation
5,186
5,457
5,767
1230
Appropriations and/or unobligated balance of appropriations permanently reduced
–2
1260
Appropriations, mandatory (total)
5,186
5,455
5,767
Advance appropriations, mandatory:
1270
Advance appropriation
2,200
2,300
2,300
1900
Budget authority (total)
7,386
7,755
8,067
1930
Total budgetary resources available
7,386
7,755
8,069
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
2
2
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
1,232
1,090
1,365
3010
Obligations incurred, unexpired accounts
7,386
7,753
8,067
3011
Obligations incurred, expired accounts
1
3020
Outlays (gross)
–7,314
–7,478
–7,805
3041
Recoveries of prior year unpaid obligations, expired
–215
3050
Unpaid obligations, end of year
1,090
1,365
1,627
Memorandum (non-add) entries:
3100
Obligated balance, start of year
1,232
1,090
1,365
3200
Obligated balance, end of year
1,090
1,365
1,627
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
7,386
7,755
8,067
Outlays, gross:
4100
Outlays from new mandatory authority
6,530
6,602
6,928
4101
Outlays from mandatory balances
784
876
877
4110
Outlays, gross (total)
7,314
7,478
7,805
4180
Budget authority, net (total)
7,386
7,755
8,067
4190
Outlays, net (total)
7,314
7,478
7,805
Summary of Budget Authority and Outlays (in millions of dollars)
2015 actual
2016 est.
2017 est.
Enacted/requested:
Budget Authority
7,386
7,755
8,067
Outlays
7,314
7,478
7,805
Legislative proposal, subject to PAYGO:
Budget Authority
505
Outlays
253
Total:
Budget Authority
7,386
7,755
8,572
Outlays
7,314
7,478
8,058
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 174,500 children
per month are estimated to be served in FY 2017.
Adoption Assistance—The proposed funding level will support subsidies for families adopting eligible low-income children with special needs.
An average of 467,500 children per month are estimated to be served in FY 2017.
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 29,300 children per month are estimated to be served in FY 2017.
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, to invest in the child welfare workforce by expanding
support for caseworkers to pursue BSW/MSW degrees and incentivizing grantees to hire caseworkers with such degrees, to enhance
support for child welfare IT investments, and to provide additional support for new direct Tribal IV-E programs. Additionally,
this account includes a proposed demonstration project to address the over-prescription of psychotropic medications for children
in foster care, and a new requirement to use child support collected on behalf of children in foster care in the best interest
of the child. 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 and
provides additional funding to establish an evidence base for how to best serve older youth in the child welfare system.
Object Classification (in millions of dollars)
Identification code 075–1545–0–1–609
2015 actual
2016 est.
2017 est.
Direct obligations:
23.1
Rental payments to GSA
1
1
1
25.1
Advisory and assistance services
30
37
35
41.0
Grants, subsidies, and contributions
7,355
7,715
8,031
99.9
Total new obligations
7,386
7,753
8,067
Employment Summary
Identification code 075–1545–0–1–609
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
4
4
4
Payments for Foster Care and Permanency
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 075–1545–4–1–609
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Foster care
251
0002
Independent living
4
0003
Demonstration to Address Over-Prescription of Psychotropic Drugs for Children in Foster Care
50
0900
Total new obligations
305
Budgetary resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
505
1900
Budget authority (total)
505
1930
Total budgetary resources available
505
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
200
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
305
3020
Outlays (gross)
–253
3050
Unpaid obligations, end of year
52
Memorandum (non-add) entries:
3200
Obligated balance, end of year
52
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
505
Outlays, gross:
4100
Outlays from new mandatory authority
253
4180
Budget authority, net (total)
505
4190
Outlays, net (total)
253
Object Classification (in millions of dollars)
Identification code 075–1545–4–1–609
2015 actual
2016 est.
2017 est.
Direct obligations:
25.1
Advisory and assistance services
23
41.0
Grants, subsidies, and contributions
282
99.9
Total new obligations
305
Employment Summary
Identification code 075–1545–4–1–609
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
2
Administration for Community Living
Federal Funds
aging and disability services programs
(including transfer of funds)
For carrying out, to the extent not otherwise provided, the Older Americans Act of 1965 ("OAA"), titles III and XXIX of the
PHS Act, sections 1252 and 1253 of the PHS Act, section 119 of the Medicare Improvements for Patients and Providers Act of
2008, 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, [$1,912,735,000] $1,941,179,000, 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 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 of amounts made available under this heading to carry out sections 311, 331, and 336 of the OAA, up
to one percent of such amounts shall be available for developing and implementing evidence-based practices for enhancing senior
nutrition: Provided further, That notwithstanding any other provision of this Act, funds made available under this heading to carry out section 311 of
the OAA may be transferred to the Secretary of Agriculture in accordance with such section [: Provided further, That $2,000,000 shall be for competitive grants to support alternative financing programs that provide for the purchase
of assistive technology devices, such as a low-interest loan fund; an interest buy-down program; a revolving loan fund; a
loan guarantee; or an insurance program: Provided further, That applicants shall provide an assurance that, and information describing the manner in which, the alternative financing
program will expand and emphasize consumer choice and control: Provided further, That State agencies and community-based disability organizations that are directed by and operated for individuals with
disabilities shall be eligible to compete: Provided further, That in addition, the unobligated balance of amounts previously made available for the Health Resources and Services Administration
to carry out functions under sections 1252 and 1253 of the PHS Act shall be transferred to this account, except for such sums
as may be necessary to provide for an orderly transition of such functions to the Administration for Community Living: Provided further, That none of the funds made available under this heading may be used by an eligible system (as defined in section 102 of
the Protection and Advocacy for Individuals with Mental Illness Act (42 U.S.C. 10802)) to continue to pursue any legal action
in a Federal or State court on behalf of an individual or group of individuals with a developmental disability (as defined
in section 102(8)(A) of the Developmental Disabilities and Assistance and Bill of Rights Act of 2000 (20 U.S.C. 15002(8)(A))
that is attributable to a mental impairment (or a combination of mental and physical impairments), that has as the requested
remedy the closure of State operated intermediate care facilities for people with intellectual or developmental disabilities,
unless reasonable public notice of the action has been provided to such individuals (or, in the case of mental incapacitation,
the legal guardians who have been specifically awarded authority by the courts to make healthcare and residential decisions
on behalf of such individuals) who are affected by such action, within 90 days of instituting such legal action, which informs
such individuals (or such legal guardians) of their legal rights and how to exercise such rights consistent with current Federal
Rules of Civil Procedure: Provided further, That the limitations in the immediately preceding proviso shall not apply in the case of an individual who is neither competent
to consent nor has a legal guardian, nor shall the proviso apply in the case of individuals who are a ward of the State or
subject to public guardianship]. (Department of Health and Human Services Appropriations Act, 2016.)
Program and Financing (in millions of dollars)
Identification code 075–0142–0–1–506
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0101
Home and community-based supportive services
348
348
358
0102
Preventive health services
20
20
20
0103
National family caregiver support program
146
150
150
0104
Native American caregiver support program
6
8
8
0105
Congregate nutrition services
438
448
454
0106
Home-delivered nutrition services
216
227
234
0107
Nutrition services incentive program
158
158
159
0108
Native American nutrition and supportive services
26
31
31
0110
Aging network support activities
10
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
5
5
0114
Program administration
35
40
41
0115
Lifespan respite care program
2
3
5
0116
Paralysis Resource Center
7
8
8
0117
Aging and Disability Resource Centers (ADRC)
6
6
8
0118
Chronic Disease Self-Management Education Program PPHF
8
8
8
0121
Senior Medicare Patrol program
9
0122
Elder Rights Support Activities
8
12
14
0123
Falls Prevention - PPHF
5
5
5
0127
Alzheimer's Disease Communications Campaign PPHF
4
4
4
0133
Alzheimer's Disease Initiative - Services PPHF
10
11
11
0136
Voting Access for People With Disabilities (HAVA)
5
5
5
0138
State Councils on Developmental Disabilities
71
73
73
0139
Protection and Advocacy
39
39
39
0141
University Centers for Excellence in Developmental Disabilities
38
39
39
0142
Projects of National Significance
9
10
10
0144
Limb Loss Resource Center
3
3
3
0145
National Institute on Disability, Independent Living & Rehab Research
103
104
104
0146
Independent Living - State Grants
23
23
0147
Independent Living - Centers (CILs)
78
78
78
0148
Assistive Technology
2
34
32
0149
Traumatic Brain Injury (TBI)
9
9
0300
Total, direct program
1,835
1,940
1,969
0799
Total direct obligations
1,835
1,940
1,969
0801
Reimbursable program - HCFAC and Other
12
9
9
0802
ADRC's MIPPA (MACRA)
5
5
5
0803
Area Agencies on Aging - MIPPA (MACRA)
7
8
8
0804
MIPPA - Natl Center Benefits Outreach Enrollment (MACRA)
5
12
12
0805
SHIP - (DISC)
52
52
52
0806
Senior Medicare Patrol Program (Disc - CMS)
9
9
0899
Total reimbursable obligations
81
95
95
0900
Total new obligations
1,916
2,035
2,064
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
3
1
Budget authority:
Appropriations, discretionary:
1100
Appropriation
1,621
1,913
1,941
1120
Appropriations transferred to other accts [012–3507]
–3
–2
1121
Appropriations transferred from other acct [091–0301]
184
1121
Appropriations transferred from other acct [091–0800]
5
1160
Appropriation, discretionary (total)
1,807
1,911
1,941
Appropriations, mandatory:
1221
PPHF Appropriations transferred from other accounts [075–0116]
28
28
28
Spending authority from offsetting collections, discretionary:
1700
Collected
6
61
61
1701
Change in uncollected payments, Federal sources
47
1750
Spending auth from offsetting collections, disc (total)
53
61
61
Spending authority from offsetting collections, mandatory:
1800
Collected
10
34
34
1801
Change in uncollected payments, Federal sources
17
1850
Spending auth from offsetting collections, mand (total)
27
34
34
1900
Budget authority (total)
1,915
2,034
2,064
1930
Total budgetary resources available
1,918
2,035
2,064
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
895
1,247
979
3010
Obligations incurred, unexpired accounts
1,916
2,035
2,064
3011
Obligations incurred, expired accounts
2
3020
Outlays (gross)
–1,750
–2,303
–2,024
3031
Unpaid obligations transferred from other accts [091–0301]
196
3041
Recoveries of prior year unpaid obligations, expired
–12
3050
Unpaid obligations, end of year
1,247
979
1,019
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–94
–104
–104
3070
Change in uncollected pymts, Fed sources, unexpired
–64
3071
Change in uncollected pymts, Fed sources, expired
54
3090
Uncollected pymts, Fed sources, end of year
–104
–104
–104
Memorandum (non-add) entries:
3100
Obligated balance, start of year
801
1,143
875
3200
Obligated balance, end of year
1,143
875
915
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
1,860
1,972
2,002
Outlays, gross:
4010
Outlays from new discretionary authority
975
1,216
1,235
4011
Outlays from discretionary balances
727
1,059
743
4020
Outlays, gross (total)
1,702
2,275
1,978
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–52
–61
–61
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–47
4052
Offsetting collections credited to expired accounts
46
4060
Additional offsets against budget authority only (total)
–1
4070
Budget authority, net (discretionary)
1,807
1,911
1,941
4080
Outlays, net (discretionary)
1,650
2,214
1,917
Mandatory:
4090
Budget authority, gross
55
62
62
Outlays, gross:
4100
Outlays from new mandatory authority
2
8
8
4101
Outlays from mandatory balances
46
20
38
4110
Outlays, gross (total)
48
28
46
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120
Federal sources
–18
–34
–34
Additional offsets against gross budget authority only:
4140
Change in uncollected pymts, Fed sources, unexpired
–17
4142
Offsetting collections credited to expired accounts
8
4150
Additional offsets against budget authority only (total)
–9
4160
Budget authority, net (mandatory)
28
28
28
4170
Outlays, net (mandatory)
30
–6
12
4180
Budget authority, net (total)
1,835
1,939
1,969
4190
Outlays, net (total)
1,680
2,208
1,929
Note.—The reimbursable program (HCFAC) in the Administration for Community Living (ACL) reflects the actual distribution of
the allocation account for 2015. Future allocations will be determined annually.
This account funds formula and discretionary grants that provide home and community-based services and supports to assist
older adults and people of all ages with disabilities to live independently and to fully participate in their communities.
ACL works with states, localities, tribal organizations, nonprofit organizations, businesses and families, and through networks
of aging and disability organizations, to provide these services and supports which include nutrition, supportive, caregiver,
independent living and protection and advocacy services. Beginning in FY 2016, this account also provides funding for the
Traumatic Brain Injury (TBI) program, which was transferred to ACL from the Health Resources and Services Administration.
Object Classification (in millions of dollars)
Identification code 075–0142–0–1–506
2015 actual
2016 est.
2017 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent
19
22
25
12.1
Civilian personnel benefits
6
6
7
23.1
Rental payments to GSA
2
3
4
25.1
Advisory and assistance services
24
28
29
25.3
Other goods and services from Federal sources
8
8
8
41.0
Grants, subsidies, and contributions
1,776
1,874
1,898
99.0
Direct obligations
1,835
1,941
1,971
99.0
Reimbursable obligations
81
94
93
99.9
Total new obligations
1,916
2,035
2,064
Employment Summary
Identification code 075–0142–0–1–506
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
167
184
211
2001
Reimbursable civilian full-time equivalent employment
18
22
23
Departmental Management
Federal Funds
General departmental management
For necessary expenses, not otherwise provided, for general departmental management, including hire of [six] passenger motor vehicles, and for carrying out titles III, XVII, XXI, and section 229 of the PHS Act, the United States-Mexico
Border Health Commission Act, and research studies under section 1110 of the Social Security Act, [$456,009,000] $463,492,000, 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,] 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, $10,000,000 shall be for making competitive grants which exclusively
implement education in sexual risk avoidance (defined as voluntarily refraining from non-marital sexual activity): Provided further, That funding for such competitive grants for sexual risk avoidance shall use medically accurate information referenced to
peer-reviewed publications by educational, scientific, governmental, or health organizations; implement an evidence-based
approach integrating research findings with practical implementation that aligns with the needs and desired outcomes for the
intended audience; and teach the benefits associated with self-regulation, success sequencing for poverty prevention, healthy
relationships, goal setting, and resisting sexual coercion, dating violence, and other youth risk behaviors such as underage
drinking or illicit drug use without normalizing teen sexual activity: Provided further, That no more than 10 percent of the funding for such competitive grants for sexual risk avoidance shall be available for
technical assistance and administrative costs of such programs: 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 of the funds made available under this heading, $1,750,000 shall be for strengthening the Department's
workforce capacity and capabilities, 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 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.
In addition, for a Digital Service team for HHS, $5,000,000. (Department of Health and Human Services Appropriations Act, 2016.)
Program and Financing (in millions of dollars)
Identification code 075–9912–0–1–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
General Departmental Management
448
456
479
0801
GDM (Collected)
153
170
171
0802
HCFAC (Mandatory)
9
10
10
0803
PHS Evaluation
65
65
66
0804
CMS Trust Funds (Mandatory)
12
5
5
0899
Total reimbursable obligations
239
250
252
0900
Total new obligations
687
706
731
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
2
9
9
1012
Unobligated balance transfers between expired and unexpired accounts
6
1050
Unobligated balance (total)
8
9
9
Budget authority:
Appropriations, discretionary:
1100
Appropriation
448
456
479
Spending authority from offsetting collections, discretionary:
1700
Collected
93
235
237
1701
Change in uncollected payments, Federal sources
128
1750
Spending auth from offsetting collections, disc (total)
221
235
237
Spending authority from offsetting collections, mandatory:
1800
Collected
9
15
15
1801
Change in uncollected payments, Federal sources
12
1850
Spending auth from offsetting collections, mand (total)
21
15
15
1900
Budget authority (total)
690
706
731
1930
Total budgetary resources available
698
715
740
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–2
1941
Unexpired unobligated balance, end of year
9
9
9
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
532
534
517
3010
Obligations incurred, unexpired accounts
687
706
731
3011
Obligations incurred, expired accounts
3
3020
Outlays (gross)
–673
–723
–724
3041
Recoveries of prior year unpaid obligations, expired
–15
3050
Unpaid obligations, end of year
534
517
524
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–244
–220
–220
3070
Change in uncollected pymts, Fed sources, unexpired
–140
3071
Change in uncollected pymts, Fed sources, expired
164
3090
Uncollected pymts, Fed sources, end of year
–220
–220
–220
Memorandum (non-add) entries:
3100
Obligated balance, start of year
288
314
297
3200
Obligated balance, end of year
314
297
304
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
669
691
716
Outlays, gross:
4010
Outlays from new discretionary authority
326
330
341
4011
Outlays from discretionary balances
333
378
368
4020
Outlays, gross (total)
659
708
709
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–231
–235
–237
4040
Offsets against gross budget authority and outlays (total)
–231
–235
–237
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–128
4052
Offsetting collections credited to expired accounts
138
4060
Additional offsets against budget authority only (total)
10
4070
Budget authority, net (discretionary)
448
456
479
4080
Outlays, net (discretionary)
428
473
472
Mandatory:
4090
Budget authority, gross
21
15
15
Outlays, gross:
4100
Outlays from new mandatory authority
10
10
10
4101
Outlays from mandatory balances
4
5
5
4110
Outlays, gross (total)
14
15
15
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120
Federal sources
–31
–15
–15
Additional offsets against gross budget authority only:
4140
Change in uncollected pymts, Fed sources, unexpired
–12
4142
Offsetting collections credited to expired accounts
22
4150
Additional offsets against budget authority only (total)
10
4170
Outlays, net (mandatory)
–17
4180
Budget authority, net (total)
448
456
479
4190
Outlays, net (total)
411
473
472
Note.—The reimbursable program (HCFAC) in the General Department Management (GDM) account reflects estimates of the allocation
account for 2017. 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 2017 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 grants standardization.
Object Classification (in millions of dollars)
Identification code 075–9912–0–1–551
2015 actual
2016 est.
2017 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
88
83
92
11.3
Other than full-time permanent
12
12
13
11.5
Other personnel compensation
3
3
3
11.7
Military personnel
3
3
3
11.9
Total personnel compensation
106
101
111
12.1
Civilian personnel benefits
27
26
28
12.2
Military personnel benefits
2
2
2
21.0
Travel and transportation of persons
4
5
5
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
27
22
25
25.2
Other services from non-Federal sources
37
42
36
25.3
Other goods and services from Federal sources
65
70
84
25.4
Operation and maintenance of facilities
5
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
148
155
155
99.0
Direct obligations
448
456
479
99.0
Reimbursable obligations
239
250
252
99.9
Total new obligations
687
706
731
Employment Summary
Identification code 075–9912–0–1–551
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
955
937
1,015
1101
Direct military average strength employment
29
27
27
2001
Reimbursable civilian full-time equivalent employment
458
503
501
2101
Reimbursable military average strength employment
18
24
24
General Departmental Management
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 075–9912–4–1–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0805
RAC Collections
2
0899
Total reimbursable obligations
2
0900
Total new obligations (object class 11.1)
2
Budgetary resources:
Budget authority:
Spending authority from offsetting collections, mandatory:
1800
Collected
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
4180
Budget authority, net (total)
4190
Outlays, net (total)
Employment Summary
Identification code 075–9912–4–1–551
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
16
Office for civil rights
For expenses necessary for the Office for Civil Rights, [$38,798,000] $42,705,000. (Department of Health and Human Services Appropriations Act, 2016.)
Program and Financing (in millions of dollars)
Identification code 075–0135–0–1–751
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Office for Civil Rights (Direct)
39
39
43
0801
Office for Civil Rights (Reimbursable)
5
6
6
0900
Total new obligations
44
45
49
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
7
4
4
1050
Unobligated balance (total)
7
4
4
Budget authority:
Appropriations, discretionary:
1100
Appropriation
39
39
43
Spending authority from offsetting collections, mandatory:
1800
Collected
2
6
6
1900
Budget authority (total)
41
45
49
1930
Total budgetary resources available
48
49
53
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
4
4
4
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
9
12
12
3010
Obligations incurred, unexpired accounts
44
45
49
3020
Outlays (gross)
–41
–45
–50
3050
Unpaid obligations, end of year
12
12
11
Memorandum (non-add) entries:
3100
Obligated balance, start of year
9
12
12
3200
Obligated balance, end of year
12
12
11
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
39
39
43
Outlays, gross:
4010
Outlays from new discretionary authority
33
31
34
4011
Outlays from discretionary balances
4
3
9
4020
Outlays, gross (total)
37
34
43
Mandatory:
4090
Budget authority, gross
2
6
6
Outlays, gross:
4100
Outlays from new mandatory authority
6
6
4101
Outlays from mandatory balances
4
5
1
4110
Outlays, gross (total)
4
11
7
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123
Non-Federal sources
–2
–6
–6
4180
Budget authority, net (total)
39
39
43
4190
Outlays, net (total)
39
39
44
The Office for Civil Rights funds activities that carry out the Department's civil rights nondiscrimination and health information
privacy and security compliance programs.
Object Classification (in millions of dollars)
Identification code 075–0135–0–1–751
2015 actual
2016 est.
2017 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
16
17
20
11.3
Other than full-time permanent
1
1
1
11.9
Total personnel compensation
17
18
21
12.1
Civilian personnel benefits
6
7
7
21.0
Travel and transportation of persons
1
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
12
10
9
25.4
Operation and maintenance of facilities
1
1
1
99.0
Direct obligations
39
39
43
99.0
Reimbursable obligations
5
6
6
99.9
Total new obligations
44
45
49
Employment Summary
Identification code 075–0135–0–1–751
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
165
177
195
1101
Direct military average strength employment
2
2
2
2001
Reimbursable civilian full-time equivalent employment
3
1
1
Office of the national coordinator for health information technology
For expenses necessary for the Office of the National Coordinator for Health Information Technology, including grants, contracts,
and cooperative agreements for the development and advancement of interoperable health information technology, [$60,367,000] $82,000,000 shall be available from amounts available under section 241 of the PHS Act. (Department of Health and Human Services Appropriations Act, 2016.)
Program and Financing (in millions of dollars)
Identification code 075–0130–0–1–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Health information technology
60
60
0002
Recovery Act activities
40
0799
Total direct obligations
100
60
0801
Office of the National Coordinator for Health Information Techno (Reimbursable)
19
22
22
0802
Reimbursable program activity: PHS Evaluation
82
0899
Total reimbursable obligations
19
22
104
0900
Total new obligations
119
82
104
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
2
3
3
1021
Recoveries of prior year unpaid obligations
41
1050
Unobligated balance (total)
43
3
3
Budget authority:
Appropriations, discretionary:
1100
Appropriation
60
60
Spending authority from offsetting collections, discretionary:
1700
PHS and Other
8
22
122
1701
Change in uncollected payments, Federal sources
11
1750
Spending auth from offsetting collections, disc (total)
19
22
122
1900
Budget authority (total)
79
82
122
1930
Total budgetary resources available
122
85
125
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
3
3
21
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
189
121
27
3010
Obligations incurred, unexpired accounts
119
82
104
3011
Obligations incurred, expired accounts
2
3020
Outlays (gross)
–144
–176
–124
3040
Recoveries of prior year unpaid obligations, unexpired
–41
3041
Recoveries of prior year unpaid obligations, expired
–4
3050
Unpaid obligations, end of year
121
27
7
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–50
–31
–31
3070
Change in uncollected pymts, Fed sources, unexpired
–11
3071
Change in uncollected pymts, Fed sources, expired
30
3090
Uncollected pymts, Fed sources, end of year
–31
–31
–31
Memorandum (non-add) entries:
3100
Obligated balance, start of year
139
90
–4
3200
Obligated balance, end of year
90
–4
–24
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
79
82
122
Outlays, gross:
4010
Outlays from new discretionary authority
46
70
104
4011
Outlays from discretionary balances
98
106
20
4020
Outlays, gross (total)
144
176
124
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–39
–22
–122
4040
Offsets against gross budget authority and outlays (total)
–39
–22
–122
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–11
4052
Offsetting collections credited to expired accounts
31
4060
Additional offsets against budget authority only (total)
20
4070
Budget authority, net (discretionary)
60
60
4080
Outlays, net (discretionary)
105
154
2
4180
Budget authority, net (total)
60
60
4190
Outlays, net (total)
105
154
2
This program supports coordination, leadership, and development of Federal health information technology activities and Federal
initiatives for the nationwide advancement of private and secure interoperable health information technology, in cooperation
with participants in the health sector. The Office of the National Coordinator for Health Information Technology was established
in the Health Information Technology for Economic and Clinical Health Act (P.L. 111–5, Title XIII), for the purpose of addressing
strategic planning, coordination, and the analysis of key technical, economic and other issues related to the public and private
adoption of health information technology.
Object Classification (in millions of dollars)
Identification code 075–0130–0–1–551
2015 actual
2016 est.
2017 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
17
17
11.3
Other than full-time permanent
3
11.5
Other personnel compensation
1
11.9
Total personnel compensation
17
21
12.1
Civilian personnel benefits
5
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
1
25.1
Advisory and assistance services
1
1
25.2
Other services from non-Federal sources
17
14
25.3
Other goods and services from Federal sources
13
12
25.4
Operation and maintenance of facilities
1
41.0
Grants, subsidies, and contributions
42
99.0
Direct obligations
100
60
99.0
Reimbursable obligations
19
22
104
99.9
Total new obligations
119
82
104
Employment Summary
Identification code 075–0130–0–1–551
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
158
198
198
1101
Direct military average strength employment
2
2
2
Office of medicare hearings and appeals
For expenses necessary for the Office of Medicare Hearings and Appeals, [$107,381,000] $120,000,000, to be transferred in appropriate part from the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical
Insurance Trust Fund. (Department of Health and Human Services Appropriations Act, 2016.)
Program and Financing (in millions of dollars)
Identification code 075–0139–0–1–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Office of Medicare Hearings and Appeals (Direct)
87
107
120
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
1
1
Budget authority:
Spending authority from offsetting collections, discretionary:
1700
Collected
68
107
120
1701
Change in uncollected payments, Federal sources
20
1750
Spending auth from offsetting collections, disc (total)
88
107
120
1930
Total budgetary resources available
88
108
121
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
1
1
1
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
17
19
1
3010
Obligations incurred, unexpired accounts
87
107
120
3020
Outlays (gross)
–84
–125
–120
3041
Recoveries of prior year unpaid obligations, expired
–1
3050
Unpaid obligations, end of year
19
1
1
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–19
–27
–27
3070
Change in uncollected pymts, Fed sources, unexpired
–20
3071
Change in uncollected pymts, Fed sources, expired
12
3090
Uncollected pymts, Fed sources, end of year
–27
–27
–27
Memorandum (non-add) entries:
3100
Obligated balance, start of year
–2
–8
–26
3200
Obligated balance, end of year
–8
–26
–26
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
88
107
120
Outlays, gross:
4010
Outlays from new discretionary authority
74
107
120
4011
Outlays from discretionary balances
10
18
4020
Outlays, gross (total)
84
125
120
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–80
–107
–120
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–20
4052
Offsetting collections credited to expired accounts
12
4060
Additional offsets against budget authority only (total)
–8
4080
Outlays, net (discretionary)
4
18
4180
Budget authority, net (total)
4190
Outlays, net (total)
4
18
This appropriation funds the operations of the Office of Medicare Hearings and Appeals (OMHA), as authorized by the Medicare
Prescription Drug, Improvement, and Modernization Act of 2003. OMHA provides an independent and impartial forum for the adjudication
of claims brought by or on behalf of Medicare beneficiaries related to their benefits and care.
Object Classification (in millions of dollars)
Identification code 075–0139–0–1–551
2015 actual
2016 est.
2017 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent
46
57
60
12.1
Civilian personnel benefits
14
17
19
21.0
Travel and transportation of persons
1
22.0
Transportation of things
1
1
23.1
Rental payments to GSA
7
9
10
23.3
Communications, utilities, and miscellaneous charges
4
3
4
25.2
Other services from non-Federal sources
5
5
6
25.3
Other goods and services from Federal sources
7
8
11
25.4
Operation and maintenance of facilities
1
4
1
25.7
Operation and maintenance of equipment
1
1
5
26.0
Supplies and materials
1
1
31.0
Equipment
1
2
1
99.9
Total new obligations
87
107
120
Employment Summary
Identification code 075–0139–0–1–551
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
526
642
749
Office of Medicare Hearings and Appeals
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 075–0139–4–1–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0801
Reimbursable program activity
130
Budgetary resources:
Budget authority:
Spending authority from offsetting collections, mandatory:
1800
Collected
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
4180
Budget authority, net (total)
4190
Outlays, net (total)
Object Classification (in millions of dollars)
Identification code 075–0139–4–1–551
2015 actual
2016 est.
2017 est.
Reimbursable obligations:
11.1
Personnel compensation: Full-time permanent
50
12.1
Civilian personnel benefits
18
22.0
Transportation of things
9
23.1
Rental payments to GSA
11
23.3
Communications, utilities, and miscellaneous charges
2
25.3
Other goods and services from Federal sources
14
25.4
Operation and maintenance of facilities
6
25.7
Operation and maintenance of equipment
4
26.0
Supplies and materials
1
31.0
Equipment
15
99.9
Total new obligations
130
Employment Summary
Identification code 075–0139–4–1–551
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
559
Public health and social services emergency fund
For expenses necessary to support activities related to countering potential biological, nuclear, radiological, chemical,
and cybersecurity threats to civilian populations, and for other public health emergencies, [$950,958,000] $956,108,000, of which $511,700,000 shall remain available through September 30, [2017] 2018, 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, 2018] until expended: Provided further, That up to 10 percent of the amounts made available in this paragraph to support advanced
research and development pursuant to section 319L of the PHS Act may also be used to supplement funds provided in the second
paragraph for the purposes provided therein.
For expenses necessary for procuring security countermeasures (as defined in section 319F-2(c)(1)(B) of the PHS Act), [$510,000,000] in addition to any other amounts available in the Special Reserve Fund, $350,000,000, to remain available until expended: Provided, That paragraphs (1) and (7)(C) of subsection (c) of section 319F-2 of the PHS Act, but no other provisions of
such subsection, shall apply to such security countermeasures procured with funds made available under this heading: Provided
further, That up to 10 percent of the amounts provided in this paragraph may also be used to supplement funds provided in
the first paragraph to support advanced research and development pursuant to section 319L of the PHS Act.
For an additional amount for expenses necessary to prepare for or respond to an influenza pandemic or emerging infectious disease, including the development and purchase of vaccine, antivirals, necessary medical supplies, diagnostics, and other surveillance
tools, [$72,000,000] $125,009,000; of which [$40,000,000] $111,000,000 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 to 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. (Department of Health and Human Services Appropriations Act, 2016.)
Program and Financing (in millions of dollars)
Identification code 075–0140–0–1–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Public Health and Social Services Emergency Fund
1,938
1,796
1,433
0100
Direct program activities, subtotal
1,938
1,796
1,433
0801
Reimbursable program (FEMA)
13
80
80
0802
Reimbursable program activity (OPP)
2
2
2
0899
Total reimbursable obligations
15
82
82
0900
Total new obligations
1,953
1,878
1,515
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
627
825
537
1010
Unobligated balance transfer to other accts [075–0343]
–4
–1
–3
1010
Unobligated balance transfer to other accts [075–0943]
–15
1021
Recoveries of prior year unpaid obligations
207
1050
Unobligated balance (total)
815
824
534
Budget authority:
Appropriations, discretionary:
1100
Appropriation
1,233
1,533
1,431
1100
Appropriation - Emergency Pursuant to 2011 BCA
733
1120
Appropriations transferred to other accts [075–0943]
–15
1160
Appropriation, discretionary (total)
1,951
1,533
1,431
Spending authority from offsetting collections, discretionary:
1700
Collected
5
82
82
1701
Change in uncollected payments, Federal sources
9
1750
Spending auth from offsetting collections, disc (total)
14
82
82
1900
Budget authority (total)
1,965
1,615
1,513
1930
Total budgetary resources available
2,780
2,439
2,047
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–2
–24
1941
Unexpired unobligated balance, end of year
825
537
532
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
4,095
4,051
3,550
3010
Obligations incurred, unexpired accounts
1,953
1,878
1,515
3011
Obligations incurred, expired accounts
10
3020
Outlays (gross)
–1,769
–2,348
–1,931
3040
Recoveries of prior year unpaid obligations, unexpired
–207
3041
Recoveries of prior year unpaid obligations, expired
–31
–31
3050
Unpaid obligations, end of year
4,051
3,550
3,134
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–126
–82
–82
3070
Change in uncollected pymts, Fed sources, unexpired
–9
3071
Change in uncollected pymts, Fed sources, expired
53
3090
Uncollected pymts, Fed sources, end of year
–82
–82
–82
Memorandum (non-add) entries:
3100
Obligated balance, start of year
3,969
3,969
3,468
3200
Obligated balance, end of year
3,969
3,468
3,052
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
1,965
1,615
1,513
Outlays, gross:
4010
Outlays from new discretionary authority
258
490
486
4011
Outlays from discretionary balances
1,511
1,858
1,445
4020
Outlays, gross (total)
1,769
2,348
1,931
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–58
–82
–82
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–9
4052
Offsetting collections credited to expired accounts
53
4060
Additional offsets against budget authority only (total)
44
4070
Budget authority, net (discretionary)
1,951
1,533
1,431
4080
Outlays, net (discretionary)
1,711
2,266
1,849
4180
Budget authority, net (total)
1,951
1,533
1,431
4190
Outlays, net (total)
1,711
2,266
1,849
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, Security and Strategic Information programs,
and the Medical Reserve Corps.
The PHSSEF continues to support the advanced development and procurement of biodefense and pandemic influenza countermeasures.
Object Classification (in millions of dollars)
Identification code 075–0140–0–1–551
2015 actual
2016 est.
2017 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
75
76
78
11.3
Other than full-time permanent
6
6
6
11.7
Military personnel
7
7
7
11.9
Total personnel compensation
88
89
91
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
4
4
4
23.1
Rental payments to GSA
17
17
17
23.3
Communications, utilities, and miscellaneous charges
24
24
24
25.1
Advisory and assistance services
349
275
206
25.2
Other services from non-Federal sources
140
140
108
25.3
Other goods and services from Federal sources
33
38
27
25.4
Operation and maintenance of facilities
20
22
20
25.5
Research and development contracts
487
436
289
25.7
Operation and maintenance of equipment
15
15
15
26.0
Supplies and materials
336
309
205
31.0
Equipment
16
17
16
41.0
Grants, subsidies, and contributions
382
383
383
99.0
Direct obligations
1,938
1,796
1,433
99.0
Reimbursable obligations
15
82
82
99.9
Total new obligations
1,953
1,878
1,515
Employment Summary
Identification code 075–0140–0–1–551
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
693
694
710
1101
Direct military average strength employment
82
74
74
Transfers from the Patient-Centered Outcomes Research Trust Fund
Program and Financing (in millions of dollars)
Identification code 075–0145–0–1–552
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
AHRQ
107
94
106
0002
Office of the Secretary
22
24
26
0900
Total new obligations
129
118
132
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
69
52
52
1021
Recoveries of prior year unpaid obligations
1
1050
Unobligated balance (total)
70
52
52
Budget authority:
Spending authority from offsetting collections, mandatory:
1800
Collected
111
118
132
1900
Budget authority (total)
111
118
132
1930
Total budgetary resources available
181
170
184
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
52
52
52
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
64
133
209
3010
Obligations incurred, unexpired accounts
129
118
132
3020
Outlays (gross)
–59
–42
–101
3040
Recoveries of prior year unpaid obligations, unexpired
–1
3050
Unpaid obligations, end of year
133
209
240
Memorandum (non-add) entries:
3100
Obligated balance, start of year
64
133
209
3200
Obligated balance, end of year
133
209
240
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
111
118
132
Outlays, gross:
4100
Outlays from new mandatory authority
2
4
4
4101
Outlays from mandatory balances
57
38
97
4110
Outlays, gross (total)
59
42
101
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120
Federal sources
–111
–118
–132
4180
Budget authority, net (total)
4190
Outlays, net (total)
–52
–76
–31
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.
Object Classification (in millions of dollars)
Identification code 075–0145–0–1–552
2015 actual
2016 est.
2017 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent
2
2
2
25.1
Advisory and assistance services
21
19
21
25.3
Other goods and services from Federal sources
20
18
20
41.0
Grants, subsidies, and contributions
86
79
89
99.9
Total new obligations
129
118
132
Employment Summary
Identification code 075–0145–0–1–552
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
4
4
4
Nonrecurring Expenses Fund
Program and Financing (in millions of dollars)
Identification code 075–0125–0–1–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Nonrecurring Expenses Fund Projects
398
580
590
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
425
870
666
1012
Unobligated balance transfers between expired and unexpired accounts
840
376
1021
Recoveries of prior year unpaid obligations
3
1050
Unobligated balance (total)
1,268
1,246
666
1930
Total budgetary resources available
1,268
1,246
666
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
870
666
76
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
372
350
464
3010
Obligations incurred, unexpired accounts
398
580
590
3020
Outlays (gross)
–417
–466
–516
3040
Recoveries of prior year unpaid obligations, unexpired
–3
3050
Unpaid obligations, end of year
350
464
538
Memorandum (non-add) entries:
3100
Obligated balance, start of year
372
350
464
3200
Obligated balance, end of year
350
464
538
Budget authority and outlays, net:
Discretionary:
Outlays, gross:
4011
Outlays from discretionary balances
417
466
516
4180
Budget authority, net (total)
4190
Outlays, net (total)
417
466
516
The Nonrecurring Expenses Fund is a no-year account that receives transfers of expired unobligated balances from discretionary
accounts prior to cancellation. The Fund is used for capital acquisition, including facilities infrastructure and information
technology infrastructure.
Object Classification (in millions of dollars)
Identification code 075–0125–0–1–551
2015 actual
2016 est.
2017 est.
Direct obligations:
25.2
Other services from non-Federal sources
98
143
145
25.3
Other goods and services from Federal sources
300
437
445
99.9
Total new obligations
398
580
590
Health Insurance Reform Implementation Fund
Program and Financing (in millions of dollars)
Identification code 075–0119–0–1–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Health Insurance Reform Implementation Fund (Direct)
23
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
26
5
5
1020
Adjustment of unobligated bal brought forward, Oct 1
–1
1021
Recoveries of prior year unpaid obligations
3
1050
Unobligated balance (total)
28
5
5
1930
Total budgetary resources available
28
5
5
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
5
5
5
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
88
32
3010
Obligations incurred, unexpired accounts
23
3020
Outlays (gross)
–76
–32
3040
Recoveries of prior year unpaid obligations, unexpired
–3
3050
Unpaid obligations, end of year
32
Memorandum (non-add) entries:
3100
Obligated balance, start of year
88
32
3200
Obligated balance, end of year
32
Budget authority and outlays, net:
Mandatory:
Outlays, gross:
4101
Outlays from mandatory balances
76
32
4180
Budget authority, net (total)
4190
Outlays, net (total)
76
32
Section 1005 of the Health Care and Education Reconciliation Act of 2010 (P.L. 111–152) appropriated $1,000,000,000 to the
Health Insurance Reform Implementation Fund within the Department of Health and Human Services. The Fund shall be used for
Federal administrative expenses necessary to carry out the requirements of the Patient Protection and Affordable Care Act
of 2010 (P.L. 111–148) and the Health Care and Education Reconciliation Act of 2010.
Object Classification (in millions of dollars)
Identification code 075–0119–0–1–551
2015 actual
2016 est.
2017 est.
Direct obligations:
21.0
Travel and transportation of persons
1
25.2
Other services from non-Federal sources
22
99.9
Total new obligations
23
Prevention and Public Health Fund
Program and Financing (in millions of dollars)
Identification code 075–0116–0–1–551
2015 actual
2016 est.
2017 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 [075–0943]
–887
–892
–944
1220
Appropriations transferred to other accts [075–1362]
–12
–12
–28
1230
Appropriations and/or unobligated balance of appropriations permanently reduced [SEQ]
–73
–68
4180
Budget authority, net (total)
4190
Outlays, net (total)
The Affordable Care Act (P.L. 111–148), established the Prevention and Public Health Fund to support prevention and public
health activities. In FY 2017, $1.00 billion is available to support a range of public health efforts intended to prevent
disease and reduce health care costs. The Secretary has authority to transfer to accounts within HHS.
Pregnancy Assistance Fund
Program and Financing (in millions of dollars)
Identification code 075–0117–0–1–551
2015 actual
2016 est.
2017 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
32
28
21
3010
Obligations incurred, unexpired accounts
23
23
25
3020
Outlays (gross)
–24
–26
–26
3041
Recoveries of prior year unpaid obligations, expired
–3
–4
3050
Unpaid obligations, end of year
28
21
20
Memorandum (non-add) entries:
3100
Obligated balance, start of year
32
28
21
3200
Obligated balance, end of year
28
21
20
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
23
23
25
Outlays, gross:
4100
Outlays from new mandatory authority
2
1
1
4101
Outlays from mandatory balances
22
25
25
4110
Outlays, gross (total)
24
26
26
4180
Budget authority, net (total)
23
23
25
4190
Outlays, net (total)
24
26
26
For awarding competitive grants to States to assist pregnant and parenting teens and women.
Object Classification (in millions of dollars)
Identification code 075–0117–0–1–551
2015 actual
2016 est.
2017 est.
Direct obligations:
25.3
Other goods and services from Federal sources
1
1
1
41.0
Grants, subsidies, and contributions
22
22
24
99.9
Total new obligations
23
23
25
Employment Summary
Identification code 075–0117–0–1–551
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
2
2
2
Section 241 Evaluation Transactions Account
Program and Financing (in millions of dollars)
Identification code 075–3902–0–1–552
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0801
Section 241 Evaluation Transactions Account (Reimbursable)
461
482
551
0809
Reimbursable program activities, subtotal
461
482
551
0900
Total new obligations (object class 25.3)
461
482
551
Budgetary resources:
Budget authority:
Spending authority from offsetting collections, discretionary:
1700
Collected
93
482
551
1701
Change in uncollected payments, Federal sources
368
1750
Spending auth from offsetting collections, disc (total)
461
482
551
1930
Total budgetary resources available
461
482
551
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
596
737
504
3010
Obligations incurred, unexpired accounts
461
482
551
3020
Outlays (gross)
–320
–715
–784
3050
Unpaid obligations, end of year
737
504
271
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–630
–739
–739
3070
Change in uncollected pymts, Fed sources, unexpired
–368
3071
Change in uncollected pymts, Fed sources, expired
259
3090
Uncollected pymts, Fed sources, end of year
–739
–739
–739
Memorandum (non-add) entries:
3100
Obligated balance, start of year
–34
–2
–235
3200
Obligated balance, end of year
–2
–235
–468
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
461
482
551
Outlays, gross:
4010
Outlays from new discretionary authority
78
482
551
4011
Outlays from discretionary balances
242
233
233
4020
Outlays, gross (total)
320
715
784
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–352
–482
–551
4040
Offsets against gross budget authority and outlays (total)
–352
–482
–551
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–368
4052
Offsetting collections credited to expired accounts
259
4060
Additional offsets against budget authority only (total)
–109
4080
Outlays, net (discretionary)
–32
233
233
4180
Budget authority, net (total)
4190
Outlays, net (total)
–32
233
233
The Public Health Service Act (PHS) Evaluation Transactions account supports the execution of section 241 of the PHS Act.
Program Support Center
Federal Funds
Retirement pay and medical benefits for commissioned officers
For retirement pay and medical benefits of Public Health Service Commissioned Officers as authorized by law, for payments
under the Retired Serviceman's Family Protection Plan and Survivor Benefit Plan, and for medical care of dependents and retired
personnel under the Dependents' Medical Care Act, such amounts as may be required during the current fiscal year. (Department of Health and Human Services Appropriations Act, 2016.)
Program and Financing (in millions of dollars)
Identification code 075–0379–0–1–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Retirement payments
421
439
457
0002
Survivors' benefits
29
30
32
0003
Medical care
121
128
141
0900
Total new obligations
571
597
630
Budgetary resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
572
597
630
1930
Total budgetary resources available
572
597
630
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–1
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
66
71
35
3010
Obligations incurred, unexpired accounts
571
597
630
3020
Outlays (gross)
–559
–633
–628
3041
Recoveries of prior year unpaid obligations, expired
–7
3050
Unpaid obligations, end of year
71
35
37
Memorandum (non-add) entries:
3100
Obligated balance, start of year
66
71
35
3200
Obligated balance, end of year
71
35
37
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
572
597
630
Outlays, gross:
4100
Outlays from new mandatory authority
510
567
598
4101
Outlays from mandatory balances
49
66
30
4110
Outlays, gross (total)
559
633
628
4180
Budget authority, net (total)
572
597
630
4190
Outlays, net (total)
559
633
628
The number of beneficiaries using the Commissioned Corps system is estimated as follows:
Retirement Pay, Survivor Benefits, and Medical Benefits
2015
2016
2017
Active Duty:
HHS
4970
4964
4964
DOJ, BOP
878
879
879
Homeland Security
477
566
578
EPA
58
58
58
All Other
300
308
308
Total Active Duty
6683
6775
6787
Retirees & Survivors:
Retirees
6010
6130
6200
Retiree family members and survivors
1088
1097
1105
Total Retirement Pay
7098
7227
7305
Total Beneficiaries (active duty, retirees, survivors)
13781
14002
14092
This activity funds annuities of retired Public Health Service (PHS) commissioned officers and survivors of retirees, and
medical benefits for active duty PHS commissioned officers, retirees, and dependents of members and retirees of the PHS Commissioned
Corps.
Object Classification (in millions of dollars)
Identification code 075–0379–0–1–551
2015 actual
2016 est.
2017 est.
Direct obligations:
13.0
Benefits for former personnel
450
469
489
25.6
Medical care
121
128
141
99.9
Total new obligations
571
597
630
HHS Accrual Contribution to the Uniformed Services Retiree Health Care Fund
Program and Financing (in millions of dollars)
Identification code 075–0170–0–1–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Medicare eligible accruals
28
26
29
0900
Total new obligations (object class 12.2)
28
26
29
Budgetary resources:
Budget authority:
Appropriations, discretionary:
1100
Appropriation
28
26
29
1930
Total budgetary resources available
28
26
29
Change in obligated balance:
Unpaid obligations:
3010
Obligations incurred, unexpired accounts
28
26
29
3020
Outlays (gross)
–28
–26
–29
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
28
26
29
Outlays, gross:
4010
Outlays from new discretionary authority
28
26
29
4180
Budget authority, net (total)
28
26
29
4190
Outlays, net (total)
28
26
29
Summary of Budget Authority and Outlays (in millions of dollars)
2015 actual
2016 est.
2017 est.
Enacted/requested:
Budget Authority
28
26
29
Outlays
28
26
29
Legislative proposal, not subject to PAYGO:
Budget Authority
–2
Outlays
–2
Total:
Budget Authority
28
26
27
Outlays
28
26
27
The cost of medical benefits for Medicare-eligible beneficiaries is paid from the Department of Defense Medicare-Eligible
Retiree Health Care Fund (10 U.S.C., ch. 56). Beginning in 2006, permanent indefinite authority is provided for a discretionary
appropriation of the annual accrual payment into this fund (P.L. No. 108–375, section 725).
HHS Accrual Contribution to the Uniformed Services Retiree Health Care Fund
(Legislative proposal, not subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 075–0170–2–1–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Medicare eligible accruals
–2
0900
Total new obligations (object class 12.2)
–2
Budgetary resources:
Budget authority:
Appropriations, discretionary:
1100
Appropriation
–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:
Discretionary:
4000
Budget authority, gross
–2
Outlays, gross:
4010
Outlays from new discretionary authority
–2
4180
Budget authority, net (total)
–2
4190
Outlays, net (total)
–2
Health Activities Funds
Program and Financing (in millions of dollars)
Identification code 075–9913–0–1–551
2015 actual
2016 est.
2017 est.
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
1
1
1
1930
Total budgetary resources available
1
1
1
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
1
1
1
4180
Budget authority, net (total)
4190
Outlays, net (total)
HHS Service and Supply Fund
Program and Financing (in millions of dollars)
Identification code 075–9941–0–4–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0801
Program Support Center
781
765
801
0802
OS activities
441
425
426
0900
Total new obligations
1,222
1,190
1,227
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
130
116
116
1021
Recoveries of prior year unpaid obligations
57
1050
Unobligated balance (total)
187
116
116
Budget authority:
Spending authority from offsetting collections, discretionary:
1700
Collected
1,095
1,190
1,227
1700
Collected from uncollected FY15 pmts - line 3090
428
1701
Change in uncollected payments, Federal sources
56
–428
1750
Spending auth from offsetting collections, disc (total)
1,151
1,190
1,227
1930
Total budgetary resources available
1,338
1,306
1,343
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
116
116
116
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
621
790
3010
Obligations incurred, unexpired accounts
1,222
1,190
1,227
3020
Outlays (gross)
–996
–1,980
–1,227
3040
Recoveries of prior year unpaid obligations, unexpired
–57
3050
Unpaid obligations, end of year
790
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–372
–428
3070
Change in uncollected pymts, Fed sources, unexpired
–56
428
3090
Uncollected pymts, Fed sources, end of year
–428
Memorandum (non-add) entries:
3100
Obligated balance, start of year
249
362
3200
Obligated balance, end of year
362
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
1,151
1,190
1,227
Outlays, gross:
4010
Outlays from new discretionary authority
619
1,190
1,227
4011
Outlays from discretionary balances
377
790
4020
Outlays, gross (total)
996
1,980
1,227
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–1,087
–1,190
–1,227
4030
Federal sources
–428
4033
Non-Federal sources
–8
4040
Offsets against gross budget authority and outlays (total)
–1,095
–1,618
–1,227
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–56
428
4080
Outlays, net (discretionary)
–99
362
4180
Budget authority, net (total)
4190
Outlays, net (total)
–99
362
The 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 the Secretary activities include the Service and Supply Fund Manager's Office, departmental
contracts, audit resolutions, Commissioned Corps force management, web management, claims, acquisition integration and modernization,
small business consolidation, grants tracking, the physical security component of the Department's implementation of Homeland
Security Presidential Directive 12, and commercial services management.
Most Commissioned Corps officers work for agencies in the Department of Health and Human Services and are reflected in the
agencies' personnel summaries. However, some officers are assigned to other Federal agencies. The allocation account section
in the following personnel summary shows officers assigned to other agencies, which are paid directly by that agency, either
through an allocation account or by directly citing that agency's appropriation.
Object Classification (in millions of dollars)
Identification code 075–9941–0–4–551
2015 actual
2016 est.
2017 est.
Reimbursable obligations:
Personnel compensation:
11.1
Full-time permanent
105
107
107
11.3
Other than full-time permanent
5
5
5
11.5
Other personnel compensation
3
3
3
11.7
Military personnel
7
7
7
11.9
Total personnel compensation
120
122
122
12.1
Civilian personnel benefits
40
37
40
12.2
Military personnel benefits
4
3
3
21.0
Travel and transportation of persons
2
2
2
22.0
Transportation of things
2
4
4
23.1
Rental payments to GSA
27
22
22
23.3
Communications, utilities, and miscellaneous charges
12
9
9
24.0
Printing and reproduction
3
13
13
25.1
Advisory and assistance services
37
40
40
25.2
Other services from non-Federal sources
745
735
744
25.3
Other goods and services from Federal sources
77
71
96
25.4
Operation and maintenance of facilities
17
9
9
25.6
Medical care
24
29
29
25.7
Operation and maintenance of equipment
69
48
48
26.0
Supplies and materials
34
36
36
31.0
Equipment
9
10
10
99.9
Total new obligations
1,222
1,190
1,227
Employment Summary
Identification code 075–9941–0–4–551
2015 actual
2016 est.
2017 est.
2001
Reimbursable civilian full-time equivalent employment
998
1,110
1,168
2101
Reimbursable military average strength employment
76
65
65
3101
Allocation account military average strength employment
1,655
1,753
1,765
Trust Funds
Miscellaneous Trust Funds
Special and Trust Fund Receipts (in millions of dollars)
Identification code 075–9971–0–7–551
2015 actual
2016 est.
2017 est.
0100
Balance, start of year
Receipts:
Current law:
1130
Contributions, Indian Health Facilities
65
48
48
1130
Contributions, N.I.H., Unconditional Gift Fund
4
3
3
1130
Centers for Disease Control, Gifts and Donations
22
15
15
1130
Contributions, N.I.H., Conditional Gift Fund
47
27
27
1130
Contributions to the Indian Health Service Gift Fund
1
1
1140
Interest, Miscellaneous Trust Funds
1
1198
Rounding adjustment
1
1199
Total current law receipts
140
94
94
1999
Total receipts
140
94
94
2000
Total: Balances and receipts
140
94
94
Appropriations:
Current law:
2101
Miscellaneous Trust Funds
–140
–94
–94
5099
Balance, end of year
Program and Financing (in millions of dollars)
Identification code 075–9971–0–7–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0002
Gifts
67
39
39
0003
Contributions, Indian Health Facilities
66
12
12
0900
Total new obligations
133
51
51
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
154
164
207
1021
Recoveries of prior year unpaid obligations
3
1050
Unobligated balance (total)
157
164
207
Budget authority:
Appropriations, mandatory:
1201
Appropriation (special or trust fund)
140
94
94
1930
Total budgetary resources available
297
258
301
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
164
207
250
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
76
93
80
3010
Obligations incurred, unexpired accounts
133
51
51
3020
Outlays (gross)
–113
–64
–77
3040
Recoveries of prior year unpaid obligations, unexpired
–3
3050
Unpaid obligations, end of year
93
80
54
Memorandum (non-add) entries:
3100
Obligated balance, start of year
76
93
80
3200
Obligated balance, end of year
93
80
54
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
140
94
94
Outlays, gross:
4100
Outlays from new mandatory authority
6
9
9
4101
Outlays from mandatory balances
107
55
68
4110
Outlays, gross (total)
113
64
77
4180
Budget authority, net (total)
140
94
94
4190
Outlays, net (total)
113
64
77
Memorandum (non-add) entries:
5000
Total investments, SOY: Federal securities: Par value
25
28
28
5001
Total investments, EOY: Federal securities: Par value
28
28
28
Gifts to the Public Health Service are for the benefit of patients and for research. Contributions are made for the construction,
improvement, extension, and provision of sanitation facilities.
Object Classification (in millions of dollars)
Identification code 075–9971–0–7–551
2015 actual
2016 est.
2017 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
3
3
3
11.3
Other than full-time permanent
1
1
1
11.9
Total personnel compensation
4
4
4
12.1
Civilian personnel benefits
1
1
1
21.0
Travel and transportation of persons
1
1
1
25.1
Advisory and assistance services
3
3
3
25.2
Other services from non-Federal sources
10
5
5
25.3
Other goods and services from Federal sources
73
34
34
25.5
Research and development contracts
3
25.6
Medical care
1
26.0
Supplies and materials
4
31.0
Equipment
4
41.0
Grants, subsidies, and contributions
29
3
3
99.9
Total new obligations
133
51
51
Employment Summary
Identification code 075–9971–0–7–551
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
27
27
27
Office of the Inspector General
Federal Funds
Office of inspector general
For expenses necessary for the Office of Inspector General, including the hire of passenger motor vehicles for investigations,
in carrying out the provisions of the Inspector General Act of 1978, [$75,000,000] in addition to funds otherwise available for such purposes other than for Medicare and Medicaid oversight, $85,000,000: 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, 2016.)
Program and Financing (in millions of dollars)
Identification code 075–0128–0–1–551
2015 actual
2016 est.
2017 est.
Obligations by program activity:
0001
Office of Inspector General (Direct)
75
77
85
0801
HCFAC Reimbursable program
190
199
203
0802
Direct Reimbursable program
16
21
21
0803
HCFAC Discretionary allocation adjustment
62
66
116
0899
Total reimbursable obligations
268
286
340
0900
Total new obligations
343
363
425
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
22
32
34
1001
Discretionary unobligated balance brought fwd, Oct 1
5
13
1050
Unobligated balance (total)
22
32
34
Budget authority:
Appropriations, discretionary:
1100
Appropriation
71
75
85
1121
Appropriations transferred from other acct [075–9911]
2
2
1160
Appropriation, discretionary (total)
73
77
85
Spending authority from offsetting collections, discretionary:
1700
Collected
62
67
122
1701
Change in uncollected payments, Federal sources
21
21
21
1750
Spending auth from offsetting collections, disc (total)
83
88
143
Spending authority from offsetting collections, mandatory:
1800
Collected
163
200
213
1801
Change in uncollected payments, Federal sources
35
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)
198
200
214
1900
Budget authority (total)
354
365
442
1930
Total budgetary resources available
376
397
476
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–1
1941
Unexpired unobligated balance, end of year
32
34
51
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
33
50
53
3010
Obligations incurred, unexpired accounts
343
363
425
3020
Outlays (gross)
–325
–360
–451
3041
Recoveries of prior year unpaid obligations, expired
–1
3050
Unpaid obligations, end of year
50
53
27
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–60
–105
–126
3070
Change in uncollected pymts, Fed sources, unexpired
–56
–21
–21
3071
Change in uncollected pymts, Fed sources, expired
11
3090
Uncollected pymts, Fed sources, end of year
–105
–126
–147
Memorandum (non-add) entries:
3100
Obligated balance, start of year
–27
–55
–73
3200
Obligated balance, end of year
–55
–73
–120
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
156
165
228
Outlays, gross:
4010
Outlays from new discretionary authority
134
150
207
4011
Outlays from discretionary balances
17
10
17
4020
Outlays, gross (total)
151
160
224
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–72
–67
–122
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–21
–21
–21
4052
Offsetting collections credited to expired accounts
10
4060
Additional offsets against budget authority only (total)
–11
–21
–21
4070
Budget authority, net (discretionary)
73
77
85
4080
Outlays, net (discretionary)
79
93
102
Mandatory:
4090
Budget authority, gross
198
200
214
Outlays, gross:
4100
Outlays from new mandatory authority
146
182
195
4101
Outlays from mandatory balances
28
18
32
4110
Outlays, gross (total)
174
200
227
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120
Federal sources
–153
–188
–201
4123
Non-Federal sources
–10
–12
–12
4130
Offsets against gross budget authority and outlays (total)
–163
–200
–213
Additional offsets against gross budget authority only:
4140
Change in uncollected pymts, Fed sources, unexpired
–35
4160
Budget authority, net (mandatory)
1
4170
Outlays, net (mandatory)
11
14
4180
Budget authority, net (total)
73
77
86
4190
Outlays, net (total)
90
93
116
Memorandum (non-add) entries:
5090
Unexpired unavailable balance, SOY: Offsetting collections
1
1
1
5092
Unexpired unavailable balance, EOY: Offsetting collections
1
1
The mission of the Office of Inspector General (OIG) is to protect the integrity of the U.S. Department of Health and Human
Services (HHS) programs and the health and welfare of the people they serve. As established by the Inspector General Act of
1978, OIG is an independent and objective organization that fights fraud, waste, and abuse and promotes efficiency, economy,
and effectiveness in HHS programs and operations. OIG works to ensure that Federal dollars are used appropriately and that
HHS programs well serve the people that use them. OIG fulfills its mission through a broad range of audits, evaluations, investigations,
and enforcement and compliance activities. In addition to discretionary appropriations, OIG receives funds through the Health
Care Fraud and Abuse Control (HCFAC) account created by the Health Insurance Portability and Accountability Act of 1996.
Object Classification (in millions of dollars)
Identification code 075–0128–0–1–551
2015 actual
2016 est.
2017 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
39
40
46
11.3
Other than full-time permanent
1
1
1
11.5
Other personnel compensation
1
1
1
11.9
Total personnel compensation
41
42
48
12.1
Civilian personnel benefits
15
15
17
21.0
Travel and transportation of persons
2
2
2
22.0
Transportation of things
1
1
1
23.1
Rental payments to GSA
4
4
4
23.3
Communications, utilities, and miscellaneous charges
1
1
1
25.2
Other services from non-Federal sources
2
2
2
25.3
Other goods and services from Federal sources
5
4
6
25.4
Operation and maintenance of facilities
1
1
1
31.0
Equipment
3
3
3
99.0
Direct obligations
75
75
85
99.0
Reimbursable obligations
268
288
340
99.9
Total new obligations
343
363
425
Employment Summary
Identification code 075–0128–0–1–551
2015 actual
2016 est.
2017 est.
1001
Direct civilian full-time equivalent employment
345
358
400
2001
Reimbursable civilian full-time equivalent employment
1,179
1,258
1,430
General and Administrative Provisions
GENERAL FUND RECEIPT ACCOUNTS
(in millions of dollars)
2015 actual
2016 est.
2017 est.
Offsetting receipts from the public:
075–267410
Consumer Operated and Oriented Plan Direct Loan Program, Negative Subsidies
7
075–267403
Consumer Operated and Oriented Plan Direct Loan Program, Downward Reestimate of Subsidies
6
3
075–322000
All Other General Fund Proprietary Receipts Including Budget Clearing Accounts
122
34
34
075–143500
General Fund Proprietary Interest Receipts, not Otherwise Classified
34
90
90
075–310700
Federal Share of Child Support Collections
689
639
631
Legislative proposal, subject to PAYGO
6
General Fund Offsetting receipts from the public
858
766
761
Intragovernmental payments:
075–388500
Undistributed Intragovernmental Payments and Receivables from Cancelled Accounts
173
General Fund Intragovernmental payments
173
GENERAL PROVISIONS
SEC. 201. Funds appropriated in this title shall be available for not to exceed $50,000 for official reception and representation expenses
when specifically approved by the Secretary.SEC. 202. None of the funds appropriated in this title shall be used to pay the salary of an individual, through a discretionary grant or other extramural mechanism, at a rate in excess of Executive Level II.SEC. 203. None of the funds appropriated in this Act may be expended pursuant to section 241 of the PHS Act, except for funds specifically
provided for in this Act, or for other taps and assessments made by any office located in HHS, prior to the preparation and
submission of a report by the Secretary to the Committees on Appropriations of the House of Representatives and the Senate
detailing the planned uses of such funds.SEC. 204. Notwithstanding section 241(a) of the PHS Act, such portion as the Secretary shall determine, but not more than [2.5] 3.0 percent, of any amounts appropriated for programs authorized under such Act shall be made available for the evaluation (directly,
or by grants or contracts) and the implementation and effectiveness of programs funded in this title.'
(transfer of funds)
SEC. 205. Not to exceed 1 percent of any discretionary funds (pursuant to the Balanced Budget and Emergency Deficit Control Act of 1985)
which are appropriated for the current fiscal year for HHS in this Act may be transferred between appropriations, but no such
appropriation shall be increased by more than 3 percent by any such transfer: Provided, That the transfer authority granted by this section shall not be used to create any new program or to fund any project or
activity for which no funds are provided in this Act: Provided further, That the Committees on Appropriations of the House of Representatives and the Senate are notified at least 15 days in advance
of any transfer.SEC. 206. In lieu of the timeframe specified in section 338E(c)(2) of the PHS Act, terminations described in such section may occur
up to 60 days after the execution of a contract awarded in fiscal year [2016] 2017 under section 338B of such Act.SEC. 207. None of the funds appropriated in this Act may be made available to any entity under title X of the PHS Act unless the applicant
for the award certifies to the Secretary that it encourages family participation in the decision of minors to seek family
planning services and that it provides counseling to minors on how to resist attempts to coerce minors into engaging in sexual
activities.SEC. 208. Notwithstanding any other provision of law, no provider of services under title X of the PHS Act shall be exempt from any
State law requiring notification or the reporting of child abuse, child molestation, sexual abuse, rape, or incest.SEC. 209. None of the funds appropriated by this Act (including funds appropriated to any trust fund) may be used to carry out the Medicare
Advantage program if the Secretary denies participation in such program to an otherwise eligible entity (including a Provider
Sponsored Organization) because the entity informs the Secretary that it will not provide, pay for, provide coverage of, or
provide referrals for abortions: Provided, That the Secretary shall make appropriate prospective adjustments to the capitation payment to such an entity (based on
an actuarially sound estimate of the expected costs of providing the service to such entity's enrollees): Provided further, That nothing in this section shall be construed to change the Medicare program's coverage for such services and a Medicare
Advantage organization described in this section shall be responsible for informing enrollees where to obtain information
about all Medicare covered services.[SEC. 210. None of the funds made available in this title may be used, in whole or in part, to advocate or promote gun control.][SEC. 211. The Secretary shall make available through assignment not more than 60 employees of the Public Health Service to assist in
child survival activities and to work in AIDS programs through and with funds provided by the Agency for International Development,
the United Nations International Children's Emergency Fund or the World Health Organization.]SEC. [212]210. In order for HHS to carry out international health activities, including HIV/AIDS and other infectious disease, chronic and
environmental disease, and other health activities abroad during fiscal year [2016] 2017:
(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, construct, 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.
'
(transfer of funds)
SEC. [213]211. The Director of the NIH, jointly with the Director of the Office of AIDS Research, may transfer up to 3 percent among institutes
and centers from the total amounts identified by these two Directors as funding for research pertaining to the human immunodeficiency
virus: Provided, That the Committees on Appropriations of the House of Representatives and the Senate are notified at least 15 days in advance
of any transfer.'
(transfer of funds)
SEC. [214]212. Of the amounts made available in this Act for NIH, the amount for research related to the human immunodeficiency virus, as
jointly determined by the Director of NIH and the Director of the Office of AIDS Research, shall be made available to the
"Office of AIDS Research" account. The Director of the Office of AIDS Research shall transfer from such account amounts necessary
to carry out section 2353(d)(3) of the PHS Act.SEC. [215]213. (a) Authority.—Notwithstanding any other provision of law, the Director of NIH ("Director") may use funds available under section 402(b)(7)
or 402(b)(12) of the PHS Act to enter into transactions (other than contracts, cooperative agreements, or grants) to carry
out research identified pursuant to such section 402(b)(7) (pertaining to the Common Fund) or research and activities described
in such section 402(b)(12).
(b) Peer review.—In entering into transactions under subsection (a), the Director may utilize such peer review procedures (including consultation
with appropriate scientific experts) as the Director determines to be appropriate to obtain assessments of scientific and
technical merit. Such procedures shall apply to such transactions in lieu of the peer review and advisory council review procedures
that would otherwise be required under sections 301(a)(3), 405(b)(1)(B), 405(b)(2), 406(a)(3)(A), 492, and 494 of the PHS
Act.
SEC. [216]214. Not to exceed $45,000,000 of funds appropriated by this Act to the institutes and centers of the National Institutes of Health
may be used for alteration, repair, or improvement of facilities, as necessary for the proper and efficient conduct of the
activities authorized herein, at not to exceed $3,500,000 per project.'
(transfer of funds)
SEC. [217]215. Of the amounts made available for NIH, 1 percent of the amount made available for National Research Service Awards ("NRSA")
shall be made available to the Administrator of the Health Resources and Services Administration to make NRSA awards for research
in primary medical care to individuals affiliated with entities who have received grants or contracts under sections 736,
739, or 747 of the PHS Act, and 1 percent of the amount made available for NRSA shall be made available to the Director of
the Agency for Healthcare Research and Quality to make NRSA awards for health service research.SEC. [218]216. In addition to amounts provided herein, payments made for research organisms or substances, authorized under section 301(a)
of the PHS Act, shall be retained and credited to the appropriations accounts of the Institutes and Centers of the NIH making
the substance or organism available under section 301(a). When such substances and organisms are made available through contractors, the Director may direct such contractors to collect
such payments on behalf of the NIH and to forward amounts so collected to the NIH in the time and manner specified by the
Director. Amounts credited to the account under this authority shall be available for obligation through September 30, [2017] 2018.SEC. [219]217. (a) The Biomedical Advanced Research and Development Authority ("BARDA") may enter into a contract, for more than one but no more
than 10 program years, for purchase of research services or of security countermeasures, as that term is defined in section
319F-2(c)(1)(B) of the PHS Act (42 U.S.C. 247d-6b(c)(1)(B)), if—
(1) funds are available and obligated—
(A) for the full period of the contract or for the first fiscal year in which the contract is in effect; and
(B) for the estimated costs associated with a necessary termination of the contract; and
(2) the Secretary determines that a multi-year contract will serve the best interests of the Federal Government by encouraging
full and open competition or promoting economy in administration, performance, and operation of BARDA's programs.
(b) A contract entered into under this section—
(1) shall include a termination clause as described by subsection (c) of section 3903 of title 41, United States Code; and
(2) shall be subject to the congressional notice requirement stated in subsection (d) of such section.
[SEC. 220. (a) The Secretary shall establish a publicly accessible Web site to provide information regarding the uses of funds made available
under section 4002 of the Patient Protection and Affordable Care Act of 2010 ("ACA").
(b) With respect to funds provided under section 4002 of the ACA, the Secretary shall include on the Web site established under
subsection (a) at a minimum the following information:
(1) In the case of each transfer of funds under section 4002(c), a statement indicating the program or activity receiving funds,
the operating division or office that will administer the funds, and the planned uses of the funds, to be posted not later
than the day after the transfer is made.
(2) Identification (along with a link to the full text) of each funding opportunity announcement, request for proposals, or other
announcement or solicitation of proposals for grants, cooperative agreements, or contracts intended to be awarded using such
funds, to be posted not later than the day after the announcement or solicitation is issued.
(3) Identification of each grant, cooperative agreement, or contract with a value of $25,000 or more awarded using such funds,
including the purpose of the award and the identity of the recipient, to be posted not later than 5 days after the award is
made.
(4) A report detailing the uses of all funds transferred under section 4002(c) during the fiscal year, to be posted not later
than 90 days after the end of the fiscal year.
(c) With respect to awards made in fiscal years 2013 through 2016, the Secretary shall also include on the Web site established
under subsection (a), semi-annual reports from each entity awarded a grant, cooperative agreement, or contract from such funds
with a value of $25,000 or more, summarizing the activities undertaken and identifying any sub-grants or sub-contracts awarded
(including the purpose of the award and the identity of the recipient), to be posted not later than 30 days after the end
of each 6-month period.
(d) In carrying out this section, the Secretary shall—
(1) present the information required in subsection (b)(1) on a single webpage or on a single database;
(2) ensure that all information required in this section is directly accessible from the single webpage or database; and
(3) ensure that all information required in this section is able to be organized by program or State.]
'
[(Transfer of Funds)]
[SEC. 221. (a) Within 45 days of enactment of this Act, the Secretary shall transfer funds appropriated under section 4002 of the ACA to
the accounts specified, in the amounts specified, and for the activities specified under the heading "Prevention and Public
Health Fund" in the explanatory statement described in section 4 (in the matter preceding division A of this consolidated
Act).
(b) Notwithstanding section 4002(c) of the ACA, the Secretary may not further transfer these amounts.
(c) Funds transferred for activities authorized under section 2821 of the PHS Act shall be made available without reference to
section 2821(b) of such Act.]
[SEC. 222. (a) The Secretary shall publish in the fiscal year 2017 budget justification and on Departmental Web sites information concerning
the employment of full-time equivalent Federal employees or contractors for the purposes of implementing, administering, enforcing,
or otherwise carrying out the provisions of the ACA, and the amendments made by that Act, in the proposed fiscal year and
each fiscal year since the enactment of the ACA.
(b) With respect to employees or contractors supported by all funds appropriated for purposes of carrying out the ACA (and the
amendments made by that Act), the Secretary shall include, at a minimum, the following information:
(1) For each such fiscal year, the section of such Act under which such funds were appropriated, a statement indicating the program,
project, or activity receiving such funds, the Federal operating division or office that administers such program, and the
amount of funding received in discretionary or mandatory appropriations.
(2) For each such fiscal year, the number of full-time equivalent employees or contracted employees assigned to each authorized
and funded provision detailed in accordance with paragraph (1).
(c) In carrying out this section, the Secretary may exclude from the report employees or contractors who—
(1) are supported through appropriations enacted in laws other than the ACA and work on programs that existed prior to the passage
of the ACA;
(2) spend less than 50 percent of their time on activities funded by or newly authorized in the ACA; or
(3) work on contracts for which FTE reporting is not a requirement of their contract, such as fixed-price contracts.]
[SEC. 223. The Secretary shall publish, as part of the fiscal year 2017 budget of the President submitted under section 1105(a) of title
31, United States Code, information that details the uses of all funds used by the Centers for Medicare and Medicaid Services
specifically for Health Insurance Exchanges for each fiscal year since the enactment of the ACA and the proposed uses for
such funds for fiscal year 2017. Such information shall include, for each such fiscal year, the amount of funds used for each
activity specified under the heading "Health Insurance Exchange Transparency" in the explanatory statement described in section
4 (in the matter preceding division A of this consolidated Act).][SEC. 224. (a) The Secretary shall provide to the Committees on Appropriations of the House of Representatives and the Senate:
(1) Detailed monthly enrollment figures from the Exchanges established under the Patient Protection and Affordable Care Act of
2010 pertaining to enrollments during the open enrollment period; and
(2) Notification of any new or competitive grant awards, including supplements, authorized under section 330 of the Public Health
Service Act.
(b) The Committees on Appropriations of the House and Senate must be notified at least 2 business days in advance of any public
release of enrollment information or the award of such grants.]
[SEC. 225. None of the funds made available by this Act from the Federal Hospital Insurance Trust Fund or the Federal Supplemental Medical
Insurance Trust Fund, or transferred from other accounts funded by this Act to the "Centers for Medicare and Medicaid Services—Program
Management" account, may be used for payments under section 1342(b)(1) of Public Law 111–148 (relating to risk corridors).][SEC. 226. In addition to the amounts otherwise available for "Centers for Medicare and Medicaid Services, Program Management", the Secretary
of Health and Human Services may transfer up to $305,000,000 to such account from the Federal Hospital Insurance Trust Fund
and the Federal Supplementary Medical Insurance Trust Fund to support program management activity related to the Medicare
Program: Provided, That except for the foregoing purpose, such funds may not be used to support any provision of Public Law 111–148 or Public
Law 111–152 (or any amendment made by either such Public Law) or to supplant any other amounts within such account.]'
[(rescission)]
[SEC. 227. The following unobligated balances of amounts appropriated prior to fiscal year 2007 for "Department of Health and Human Services,
Health Resources and Services Administration" are hereby permanently rescinded:
(1) $281,003 appropriated to carry out section 1610(b) of the PHS Act;
(2) $3,611 appropriated to carry out section 1602(c) of the PHS Act;
(3) $105,576 appropriated in section 167 of division H of Public Law 108–199; and
(4) $55,793 appropriated to carry out the National Cord Blood Stem Cell Bank Program.]
[SEC. 228. The Secretary shall include in the fiscal year 2017 budget justification an analysis of how section 2713 of the PHS Act will
impact eligibility for discretionary HHS programs.][SEC. 229. Effective during the period beginning on November 1, 2015 and ending January 1, 2018, any provision of law that refers (including
through cross-reference to another provision of law) to the current recommendations of the United States Preventive Services
Task Force with respect to breast cancer screening, mammography, and prevention shall be administered by the Secretary involved
as if—
(1) such reference to such current recommendations were a reference to the recommendations of such Task Force with respect to
breast cancer screening, mammography, and prevention last issued before 2009; and
(2) such recommendations last issued before 2009 applied to any screening mammography modality under section 1861(jj) of the Social
Security Act (42 U.S.C. 1395x(jj)).]
'
(transfer of funds)
SEC. [230]218. [(a) In general.—Subject to the succeeding provisions of this section, activities authorized under part A of title IV and section 1108(b)
of the Social Security Act shall continue through September 30, 2016, in the manner authorized for fiscal year 2015, and out
of any money in the Treasury of the United States not otherwise appropriated, there are hereby appropriated such sums as may
be necessary for such purpose. Grants and payments may be made pursuant to this authority through September 30, 2016 at the
level provided for such activities for fiscal year 2015, except as provided in subsection (b).]([b]a) Contingency fund.—In the case of the Contingency Fund for State Welfare Programs established under section 403(b) of the Social Security Act[—], the amount appropriated for such section 403(b) shall be $608,000,000 for fiscal year 2018, to remain available until expended.
[(1) the amount appropriated for such section 403(b) shall be $608,000,000 for each of fiscal years 2016 and 2017, notwithstanding
section 228(b)(1) of the Department of Health and Human Services Appropriations Act, 2015;]
[(2) the requirement to reserve funds provided for in section 403(b)(2) of the Social Security Act shall not apply during fiscal
years 2016 and 2017; and]
[(3) grants and payments may only be made from such Fund for fiscal year 2016 after the application of subsection (c).]
([c]b) Census research and welfare research.—Of the amount made available under [subsection (b)(1)] section 230(b)(1) of division H of Public Law 114–113 for section 403(b) of the Social Security Act for fiscal year [2016] 2017—
(1) $15,000,000 is hereby transferred to the Children's Research and Technical Assistance account in the Administration for Children
and Families at the Department of Health and Human Services 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.
[SEC. 231. Section 1886(m)(6) of the Social Security Act (42 U.S.C. 1395ww(m)(6)) is amended—
(1) in subparagraph (A)(i) by striking "subparagraph (C)" and inserting "subparagraphs (C) and (E)"; and
(2) by adding at the end the following new subparagraph:
"(E) Temporary exception for certain severe wound discharges from certain long-term care hospitals.—
"(i) In general.—In the case of a discharge occurring prior to January 1, 2017, subparagraph (A)(i) shall not apply (and payment shall be
made to a long-term care hospital without regard to this paragraph) if such discharge—
"(I) is from a long-term care hospital that is—
"(aa) identified by the amendment made by section 4417(a) of the Balanced Budget Act of 1997 (42 U.S.C. 1395ww note, Public
Law 105–33); and
"(bb) located in a rural area (as defined in subsection (d)(2)(D)) or treated as being so located pursuant to subsection (d)(8)(E);
and
"(II) the individual discharged has a severe wound.
"(ii) Severe wound defined.—In this subparagraph, the term 'severe wound' means a stage 3 wound, stage 4 wound, unstageable wound, non-healing surgical
wound, infected wound, fistula, osteomyelitis, or wound with morbid obesity, as identified in the claim from the long-term
care hospital.".]
SEC. 219. Section 1864(e) of the Social Security Act (42 U.S.C. 1395aa(e)) is amended to read as follows—
"(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.".
SEC. 220. Funds which are available for Individual Learning Accounts for employees of CDC and the Agency for Toxic Substances and Disease
Registry ("ATSDR") may be transferred between appropriate accounts of CDC, to be available only for Individual Learning Accounts:
Provided, That such funds may be used for any individual full-time equivalent employee while such employee is employed either
by CDC or ATSDR. SEC. 221. Section 1204(9) of the Omnibus Crime Control and Safe Streets Act of 1968 (42 U.S.C. 3796b(9)) is amended— (1) in subparagraph (C)(ii) by striking "or";
(2) in subparagraph (D), by striking the period and inserting "; or"; and
(3) by adding at the end the following new subparagraph:
"(E) an intermittent disaster-response appointee of the National Disaster Medical System under section 2812 of the Public
Health Service Act (42 U.S.C. 300hh-11) who is performing official duties of the Service, if those official duties are determined
by the Secretary of Health and Human Services to be hazardous duties.".
SEC. 222. In the event of a public health emergency declared under section 319 of the PHS Act, the Secretary may, during the duration
of the emergency, transfer discretionary funds (as defined pursuant to the Balanced Budget and Emergency Deficit Control Act
of 1985) which are appropriated in this Act for the current fiscal year for the Department of Health and Human Services between
appropriations for costs of responding to and aiding in recovery from such public health emergency: Provided, That no appropriation
may be reduced by more than 10 percent under this section: Provided further, That the Committees on Appropriations of the
House of Representatives and the Senate shall be promptly notified of such transfers: Provided further, That this transfer
authority is in addition to any other transfer authority. SEC. 223. Section 340B of the Public Health Service Act (42 U.S.C. 256b) is amended by adding at the end the following new subsection: "(f) The Secretary may issue regulations with binding and future effect for the program authorized by this section.".
SEC. 224. (a) In General.—Under the conditions listed in subsection (b), the Secretary or the head of a major organizational unit within
the Department may in this fiscal year enter into a reimbursable agreement with the head of another major organizational unit
within the Department or of another agency under which— (1) the head of the ordering agency or unit delegates to the head of the servicing agency or unit the authority to issue a grant
or cooperative agreement on behalf of the ordering agency or unit;
(2) the servicing agency or unit will execute or manage a grant or cooperative agreement on behalf of the ordering agency or unit;
and
(3) the ordering agency or unit will reimburse the servicing unit or agency for the amount of the grant or cooperative agreement
and for the service of executing or managing the grant or cooperative agreement.
(b) Conditions.—The conditions for making an agreement described in subsection (a) are that—
(1) amounts are available;
(2) the head of the ordering agency or unit decides the agreement is in the best interest of the United States Government; and
(3) the agency or unit to execute or manage the grant or cooperative agreement is able to provide that service.
(c) Payment.—Payment shall be made promptly through the Intra-governmental Payment and Collection system at the request of the
agency or unit providing the service. Payment may be in advance or on providing all or part of the service, and shall be for
any part of the estimated or actual cost as determined by the agency or unit providing the service. A bill submitted or a
request for payment is not subject to audit or certification in advance of payment. Proper adjustment of amounts paid in advance
shall be made as agreed to by the heads of the agencies or units on the basis of the amount of the grant or cooperative agreement
and the actual cost of service provided.
(d) Limitations on Funds.—A condition or limitation applicable to amounts for grant or cooperative agreements of the ordering
agency or unit applies to an agreement made under this section and to a grant or cooperative agreement made under such agreement.
(e) Obligation of Appropriations.—An agreement made under this section obligates an appropriation of the ordering agency or unit.
The amount obligated is deobligated to the extent that the agency or unit providing the service has not incurred obligations,
before the end of the period of availability of the appropriation, in—
(1) awarding the grant or cooperative agreement; or
(2) providing the agreed-on services.
(f) No Effect on Other Laws—This section does not affect other laws about reimbursable agreements.
SEC. 225. Notwithstanding subparagraph (B)(i) of section 303(g)(2) of the Controlled Substances Act (21 U.S.C. 823(g)(2)), the Secretary
of Health and Human Services may, using amounts made available in this Act to carry out title V of the Public Health Service
Act, establish and carry out a demonstration through fiscal year 2021 in which, for purposes of prescribing buprenorphine
under such section 303(g)(2), the term "practitioner" shall be deemed to include non-physician providers authorized to prescribe
buprenorphine by the jurisdiction in which the provider is licensed who meet such criteria as determined appropriate by the
Secretary, in consultation with the Attorney General, for participation in the project. In implementing this demonstration
project, the Secretary and Attorney General shall not be subject to the requirements of 5 U.S.C. 553. The Secretary may enter
into grants, contracts, or cooperative agreements with one or more research institutions, and public and nonprofit entities
to assist in carrying out such demonstration. In addition, amounts available for this fiscal year in other Acts to the Attorney
General for carrying out section 303 of the Controlled Substances Act shall also be available to the Attorney General to facilitate
and support the efficient operation of the demonstration under this section. Any authority for a provider to prescribe buprenorphine
that results from participating in this demonstration project shall end no later than the date such provider ceases to participate
in this demonstration. (Department of Health and Human Services Appropriations Act, 2016.)