[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; $2,527,960,000: Provided, That of the amount provided under this heading, $24,142,000 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; $12,100,000 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; $672,000,000 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 animal drug user fees and animal generic drug user fees that exceed the respective fiscal year 2018 limitations are appropriated and shall be credited to this account and remain available until expended: Provided further, That fees derived from animal drug and animal generic drug assessments for fiscal year 2018, including any such fees collected prior to fiscal year 2018 but credited for fiscal year 2018, shall be subject to the fiscal year 2018 limitations: Provided further, That the Secretary may accept payment during fiscal year 2018 of user fees specified under this heading and authorized for fiscal year 2019, prior to the due date for such fees, and that amounts of such fees assessed for fiscal year 2019 for which the Secretary accepts payment in fiscal year 2018 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 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 funds may be transferred from one specified activity to another with the prior 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), third-party logistics provider licensing and inspection fees authorized by 21 U.S.C. 360eee-3(c)(1), third-party auditor fees authorized by 21 U.S.C. 384d(c)(8), and Medical Countermeasure Priority Review Voucher User Fees authorized by 21 U.S.C. 360bbb-4a, shall be credited to this account, to remain available until expended.
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,
$8,771,000, to remain available until expended.
Note.—A full-year 2017 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
budget assumes this account is operating under the Further Continuing Appropriations Act, 2017 (P.L. 114–254). The amounts
included for 2017 reflect the annualized level provided by the continuing resolution.
Special and Trust Fund Receipts (in millions of dollars)
Identification code 075–9911–0–1–554
2016 actual
2017 est.
2018 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
2016 actual
2017 est.
2018 est.
Obligations by program activity:
0001
Foods
1,002
985
910
0002
Human Drugs
491
491
179
0003
Devices and Radiological Health
323
323
140
0004
National Center for Toxicological Research
63
63
60
0005
FDA Other Activities (FDA Headquaters)
182
183
125
0006
FDA Other Rent and Rent Related Activities (Including White Oak Consolidation)
121
121
73
0007
FDA GSA Rental Payments
162
176
128
0008
FDA Buildings and Facilities
8
9
9
0009
Cooperative Research and Development (CRADA)
2
2
2
0010
Animal Drugs and Feed
159
158
108
0011
Biologics
215
215
96
0012
Food and Drug Safety (no-year)
2
0013
Ebola (Emergency pursuant to 2011 BCA)
9
0014
Zika Activities
2
0015
CURES Act
20
60
0799
Total direct obligations
2,741
2,746
1,890
0801
FDA Reimbursable program (User fees)
1,930
1,908
757
0802
FDA Reimbursable program (Federal sources)
40
0899
Total reimbursable obligations
1,970
1,908
757
0900
Total new obligations, unexpired accounts
4,711
4,654
2,647
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
948
1,117
1,116
1001
Discretionary unobligated balance brought fwd, Oct 1
948
1,117
1021
Recoveries of prior year unpaid obligations
17
1050
Unobligated balance (total)
965
1,117
1,116
Budget authority:
Appropriations, discretionary:
1100
Appropriation
2,730
2,724
1,828
1120
Appropriations transferred to other accts [075–0128]
–2
–1
1121
Appropriations transferred from other acct [075–5629]
20
60
1160
Appropriation, discretionary (total)
2,728
2,743
1,888
Appropriations, mandatory:
1201
Appropriation (special or trust fund)
2
2
2
Spending authority from offsetting collections, discretionary:
1700
Collected
2,108
1,908
761
1700
Collected
33
1701
Change in uncollected payments, Federal sources
33
–33
1702
Offsetting collections (previously unavailable)
615
333
1723
New and/or unobligated balance of spending authority from offsetting collections temporarily reduced
–4
1725
Spending authority from offsetting collections precluded from obligation (limitation on obligations)
–620
–333
1750
Spending auth from offsetting collections, disc (total)
2,136
1,904
761
Spending authority from offsetting collections, mandatory:
1800
Collected
1
4
1801
Change in uncollected payments, Federal sources
4
1850
Spending auth from offsetting collections, mand (total)
5
4
1900
Budget authority (total)
4,871
4,653
2,651
1930
Total budgetary resources available
5,836
5,770
3,767
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–8
1941
Unexpired unobligated balance, end of year
1,117
1,116
1,120
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
2,781
2,710
2,721
3010
New obligations, unexpired accounts
4,711
4,654
2,647
3011
Obligations ("upward adjustments"), expired accounts
20
3020
Outlays (gross)
–4,693
–4,643
–2,840
3040
Recoveries of prior year unpaid obligations, unexpired
–17
3041
Recoveries of prior year unpaid obligations, expired
–92
3050
Unpaid obligations, end of year
2,710
2,721
2,528
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–59
–71
–38
3070
Change in uncollected pymts, Fed sources, unexpired
–37
33
3071
Change in uncollected pymts, Fed sources, expired
25
3090
Uncollected pymts, Fed sources, end of year
–71
–38
–38
Memorandum (non-add) entries:
3100
Obligated balance, start of year
2,722
2,639
2,683
3200
Obligated balance, end of year
2,639
2,683
2,490
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
4,864
4,647
2,649
Outlays, gross:
4010
Outlays from new discretionary authority
2,654
3,631
1,967
4011
Outlays from discretionary balances
2,032
1,006
871
4020
Outlays, gross (total)
4,686
4,637
2,838
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–28
–33
4033
Non-Federal sources
–2,098
–1,908
–761
4040
Offsets against gross budget authority and outlays (total)
–2,126
–1,941
–761
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–33
33
4052
Offsetting collections credited to expired accounts
18
4060
Additional offsets against budget authority only (total)
–15
33
4070
Budget authority, net (discretionary)
2,723
2,739
1,888
4080
Outlays, net (discretionary)
2,560
2,696
2,077
Mandatory:
4090
Budget authority, gross
7
6
2
Outlays, gross:
4100
Outlays from new mandatory authority
5
6
2
4101
Outlays from mandatory balances
2
4110
Outlays, gross (total)
7
6
2
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120
Federal sources
–4
4123
Non-Federal sources
–1
4130
Offsets against gross budget authority and outlays (total)
–1
–4
Additional offsets against gross budget authority only:
4140
Change in uncollected pymts, Fed sources, unexpired
–4
4160
Budget authority, net (mandatory)
2
2
2
4170
Outlays, net (mandatory)
6
2
2
4180
Budget authority, net (total)
2,725
2,741
1,890
4190
Outlays, net (total)
2,566
2,698
2,079
Memorandum (non-add) entries:
5090
Unexpired unavailable balance, SOY: Offsetting collections
638
643
647
5092
Unexpired unavailable balance, EOY: Offsetting collections
643
647
647
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 2018 Budget provides funding to support food and medical
product safety, including implementation of the 21st Century Cures Act. The budget also includes a package of administrative
actions designed to achieve regulatory efficiency and speed the development of safe and effective medical products.
Object Classification (in millions of dollars)
Identification code 075–9911–0–1–554
2016 actual
2017 est.
2018 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
910
886
613
11.3
Other than full-time permanent
92
90
62
11.5
Other personnel compensation
40
39
27
11.7
Military personnel
64
63
64
11.8
Special personal services payments
1
1
1
11.9
Total personnel compensation
1,107
1,079
767
12.1
Civilian personnel benefits
338
330
228
12.2
Military personnel benefits
33
32
33
13.0
Benefits for former personnel
1
21.0
Travel and transportation of persons
50
51
33
22.0
Transportation of things
3
3
2
23.1
Rental payments to GSA
162
176
128
23.2
Rental payments to others
3
3
2
23.3
Communications, utilities, and miscellaneous charges
19
19
12
24.0
Printing and reproduction
2
2
1
25.1
Advisory and assistance services
57
55
36
25.2
Other services from non-Federal sources
361
372
242
25.3
Other goods and services from Federal sources
135
139
91
25.4
Operation and maintenance of facilities
104
108
70
25.5
Research and development contracts
20
20
13
25.7
Operation and maintenance of equipment
91
94
61
26.0
Supplies and materials
47
48
31
31.0
Equipment
47
48
31
32.0
Land and structures
3
3
2
41.0
Grants, subsidies, and contributions
156
162
105
42.0
Insurance claims and indemnities
2
2
2
99.0
Direct obligations
2,741
2,746
1,890
99.0
Reimbursable obligations
1,970
1,908
757
99.9
Total new obligations, unexpired accounts
4,711
4,654
2,647
Employment Summary
Identification code 075–9911–0–1–554
2016 actual
2017 est.
2018 est.
1001
Direct civilian full-time equivalent employment
9,605
9,768
6,663
1101
Direct military average strength employment
692
703
703
2001
Reimbursable civilian full-time equivalent employment
5,737
6,163
1,292
2101
Reimbursable military average strength employment
413
420
56
3001
Allocation account civilian full-time equivalent employment
43
43
43
3101
Allocation account military average strength employment
1
1
1
Salaries and Expenses
(Legislative proposal, not subject to PAYGO)
Contingent upon the enactment of authorizing legislation, the Secretary shall charge a fee for prescription drug review activities,
medical device review activities, biosimilar biological products review activities, and human generic drugs review activities:
Provided, That fees of $1,262,182,000, for prescription drug reviews, shall be credited to this account and remain available
until expended; $439,001,000 for medical device reviews, shall be credited to this account and remain available until expended;
$615,746,000 for human generic drug reviews, shall be credited to this account and remain available until expended; and $86,736,000
for biosimilar biological product reviews, shall be credited to this account and remain available until expended: Provided
further, That, in addition and notwithstanding any other provision under this heading, amounts collected for prescription
drug user fees, medical device user fees, biosimilar biological product user fees, and human generic drug user fees that exceed
the respective fiscal year 2018 limitations are appropriated and shall be credited to this account and remain available until
expended: Provided further, That fees derived from prescription drug reviews, medical device reviews, biosimilar biological
products reviews, and human generic drugs reviews for fiscal year 2018 received during fiscal year 2018, including any such
fees assessed prior to fiscal year 2018 but credited for fiscal year 2018, shall be subject to the fiscal year 2018 limitations:
Provided further, That the Secretary may accept payment during fiscal year 2018 of user fees specified in this paragraph and
authorized for fiscal year 2019, prior to the due date for such fees, and that amounts of such fees assessed for fiscal year
2019 for which the Secretary accepts payment in fiscal year 2018 shall not be included in amounts in this paragraph.
In addition, contingent upon the enactment of authorizing legislation, the Secretary shall increase the fees for animal drug
review activities and animal generic drug review activities: Provided, That additional fees of $46,110,000, for animal drug
reviews, shall be credited to this account and remain available until expended; and $6,375,000, for animal generic drug reviews,
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
2016 actual
2017 est.
2018 est.
Obligations by program activity:
0801
Reimbursable program (User fees)
2,458
0899
Total reimbursable obligations
2,458
Budgetary resources:
Budget authority:
Spending authority from offsetting collections, discretionary:
1700
Collected
2,458
1900
Budget authority (total)
2,458
1930
Total budgetary resources available
2,458
Change in obligated balance:
Unpaid obligations:
3010
New obligations, unexpired accounts
2,458
3020
Outlays (gross)
–2,458
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
2,458
Outlays, gross:
4010
Outlays from new discretionary authority
2,458
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4033
Non-Federal sources
–2,458
4040
Offsets against gross budget authority and outlays (total)
–2,458
4180
Budget authority, net (total)
4190
Outlays, net (total)
The FY 2018 Budget includes proposals to reauthorize expiring fee programs and amend currently authorized fee programs. The
Budget includes a total of $1.3 billion in prescription drug fees, $439 million in medical device fees, $616 million in human
generic drug fees, and $87 million in biosimilar user fees. The proposed legislation authorizes the collection and spending
of these fees subject to appropriations. FDA also proposes to increase animal drug user fees by $46 million and animal generic
drug user fees by $7 million in their final year of authorization.
Object Classification (in millions of dollars)
Identification code 075–9911–2–1–554
2016 actual
2017 est.
2018 est.
Reimbursable obligations:
Personnel compensation:
11.1
Full-time permanent
720
11.3
Other than full-time permanent
102
11.5
Other personnel compensation
77
11.7
Military personnel
32
11.9
Total personnel compensation
931
12.1
Civilian personnel benefits
278
12.2
Military personnel benefits
18
21.0
Travel and transportation of persons
16
23.1
Rental payments to GSA
92
23.3
Communications, utilities, and miscellaneous charges
4
24.0
Printing and reproduction
3
25.1
Advisory and assistance services
74
25.2
Other services from non-Federal sources
467
25.3
Other goods and services from Federal sources
262
25.4
Operation and maintenance of facilities
31
25.5
Research and development contracts
18
25.7
Operation and maintenance of equipment
44
26.0
Supplies and materials
17
31.0
Equipment
27
41.0
Grants, subsidies, and contributions
176
99.0
Reimbursable obligations
2,458
99.9
Total new obligations, unexpired accounts
2,458
Employment Summary
Identification code 075–9911–2–1–554
2016 actual
2017 est.
2018 est.
2001
Reimbursable civilian full-time equivalent employment
8,456
2101
Reimbursable military average strength employment
364
Payment to the FDA Innovation Account, CURES Act
Program and Financing (in millions of dollars)
Identification code 075–0148–0–1–554
2016 actual
2017 est.
2018 est.
Obligations by program activity:
0001
Direct program activity
20
60
0900
Total new obligations, unexpired accounts (object class 94.0)
20
60
Budgetary resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
20
60
1930
Total budgetary resources available
20
60
Change in obligated balance:
Unpaid obligations:
3010
New obligations, unexpired accounts
20
60
3020
Outlays (gross)
–20
–60
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
20
60
Outlays, gross:
4100
Outlays from new mandatory authority
20
60
4180
Budget authority, net (total)
20
60
4190
Outlays, net (total)
20
60
This account, and a related special receipt account, were established to support the execution structure necessary to implement
the 21st Century Cures Act.
FDA Innovation, CURES Act
For necessary expenses to carry out the purposes described under section 1002(b)(4) of the 21st Century Cures Act, in addition
to amounts available for such purposes under the heading "Salaries and Expenses", $60,000,000, to remain available until expended:
Provided, That amounts appropriated in this paragraph are appropriated pursuant to section 1002(b)(3) of the 21st Century
Cures Act, are to be derived from amounts transferred under section 1002(b)(2)(A) of such Act, and may be transferred by the
Secretary of Health and Human Services to other accounts of the Department solely for the purposes provided in such Act: Provided
further, That such transfer authority is in addition to any other transfer authority provided by law.
Special and Trust Fund Receipts (in millions of dollars)
Identification code 075–5629–0–2–554
2016 actual
2017 est.
2018 est.
0100
Balance, start of year
Receipts:
Current law:
1140
General Fund Payment, FDA Innovation, CURES Act
20
60
2000
Total: Balances and receipts
20
60
Appropriations:
Current law:
2101
FDA Innovation, Cures Act
–20
–60
5099
Balance, end of year
Program and Financing (in millions of dollars)
Identification code 075–5629–0–2–554
2016 actual
2017 est.
2018 est.
Budgetary resources:
Budget authority:
Appropriations, discretionary:
1101
Appropriation (special or trust fund)
20
60
1120
Appropriations transferred to other acct [075–9911]
–20
–60
4180
Budget authority, net (total)
4190
Outlays, net (total)
The 21st Century Cures Act was enacted into law on December 13, 2016. The Act includes authorities FDA can use to help modernize
drug, biological, and device product development and review, and to create greater efficiencies and predictability in product
development and review.
Revolving Fund for Certification and Other Services
Program and Financing (in millions of dollars)
Identification code 075–4309–0–3–554
2016 actual
2017 est.
2018 est.
Obligations by program activity:
0801
Revolving Fund for Certification and Other Services (Reimbursable)
9
10
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
9
10
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)
9
10
10
1900
Budget authority (total)
9
10
10
1930
Total budgetary resources available
14
15
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
2
2
3010
New obligations, unexpired accounts
9
10
10
3020
Outlays (gross)
–9
–10
–10
3050
Unpaid obligations, end of year
2
2
2
Memorandum (non-add) entries:
3100
Obligated balance, start of year
2
2
2
3200
Obligated balance, end of year
2
2
2
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
9
10
10
Outlays, gross:
4100
Outlays from new mandatory authority
3
10
10
4101
Outlays from mandatory balances
6
4110
Outlays, gross (total)
9
10
10
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123
Non-Federal sources
–9
–10
–9
4180
Budget authority, net (total)
1
4190
Outlays, net (total)
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
2016 actual
2017 est.
2018 est.
Reimbursable obligations:
11.1
Personnel compensation: Full-time permanent
4
5
5
12.1
Civilian personnel benefits
1
1
1
23.1
Rental payments to GSA
1
1
1
25.7
Operation and maintenance of equipment
1
1
1
26.0
Supplies and materials
1
1
1
31.0
Equipment
1
1
1
99.9
Total new obligations, unexpired accounts
9
10
10
Employment Summary
Identification code 075–4309–0–3–554
2016 actual
2017 est.
2018 est.
2001
Reimbursable civilian full-time equivalent employment
36
36
36
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, $1,488,687,000: Provided, That no more than $100,000 shall be available until expended for carrying out the provisions of section 224(o) of the PHS Act: Provided further, That no more than $99,703,000 shall be available until expended for carrying out subsections (g) through (n) and (q) of section 224 of the PHS Act, 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.
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, $382,631,000: Provided, That sections 751 and 762(k) of the PHS Act shall not apply to funds made available under this heading: 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, $795,290,000: Provided, That notwithstanding sections 502(a)(1) and 502(b)(1) of the Social Security Act, not more than $76,946,000 shall be available for carrying out special projects of regional and national significance pursuant to section 501(a)(2)
of such Act and $10,256,000 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, $2,260,008,000, of which $1,967,134,000 shall remain available to the Secretary of Health and Human Services (referred to in this title as the "Secretary") through September 30, 2020, for parts A and B of title XXVI of the PHS Act, and of which not less than $898,602,000 shall be for State AIDS Drug Assistance Programs under the authority of section 2616 or 311(c) of such Act: Provided, That section 2691 of the PHS Act shall not apply to funds appropriated under this heading.
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, $99,351,000.
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 section 711 of the Social Security Act, $74,395,000.
Family Planning
For carrying out the program under title X of the PHS Act to provide for voluntary family planning projects, $286,479,000: Provided, That amounts provided to said projects under such title shall not be expended for abortions, that all pregnancy counseling
shall be nondirective, and that such amounts shall not be expended for any activity (including the publication or distribution
of literature) that in any way tends to promote public support or opposition to any legislative proposal or candidate for
public office.
program management
For program support in the Health Resources and Services Administration, $151,993,000: 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".
Note.—A full-year 2017 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
budget assumes this account is operating under the Further Continuing Appropriations Act, 2017 (P.L. 114–254). The amounts
included for 2017 reflect the annualized level provided by the continuing resolution.
Program and Financing (in millions of dollars)
Identification code 075–0350–0–1–550
2016 actual
2017 est.
2018 est.
Obligations by program activity:
0005
Primary Health Care (Health Centers, Free Clinics)
1,492
1,489
1,489
0010
Primary Health Care (Mandatory)
3,651
3,607
2
0015
Health Workforce
785
785
383
0020
Health Workforce (Mandatory)
368
367
0025
Maternal and Child Health
843
859
795
0030
Maternal and Child Health (Mandatory)
5
5
0035
Ryan White HIV/AIDS
2,266
2,396
2,260
0040
Health Care Systems
103
103
99
0045
Rural Health
151
149
74
0050
Family Planning
286
286
286
0055
HRSA Program Management
154
154
152
0300
Total direct programs
10,104
10,200
5,540
0799
Total direct obligations
10,104
10,200
5,540
0801
Health Resources and Services (Reimbursable)
57
58
47
0899
Total reimbursable obligations
57
58
47
0900
Total new obligations, unexpired accounts
10,161
10,258
5,587
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
406
482
273
1001
Discretionary unobligated balance brought fwd, Oct 1
141
211
1012
Unobligated balance transfers between expired and unexpired accounts
1
1020
Adjustment of unobligated bal brought forward, Oct 1
2
1021
Recoveries of prior year unpaid obligations
80
1031
Other balances not available
–1
1050
Unobligated balance (total)
488
482
273
Budget authority:
Appropriations, discretionary:
1100
Appropriation
6,140
6,143
5,539
1120
Appropriations transferred to other acct [075–0140]
–7
1160
Appropriation, discretionary (total)
6,133
6,143
5,539
Appropriations, mandatory:
1200
Appropriation
3,975
3,975
1220
Appropriations transferred to other acct [015–5606]
–5
–5
1230
Appropriations and/or unobligated balance of appropriations permanently reduced
–115
1260
Appropriations, mandatory (total)
3,970
3,855
Spending authority from offsetting collections, discretionary:
1700
Collected
24
31
26
1701
Change in uncollected payments, Federal sources
12
1750
Spending auth from offsetting collections, disc (total)
36
31
26
Spending authority from offsetting collections, mandatory:
1800
Offsetting collections (cash)(HPSL&NSL)
24
19
19
1802
Offsetting collections (previously unavailable)
1
2
1
1823
New and/or unobligated balance of spending authority from offsetting collections temporarily reduced
–2
–1
1850
Spending auth from offsetting collections, mand (total)
23
20
20
1900
Budget authority (total)
10,162
10,049
5,585
1930
Total budgetary resources available
10,650
10,531
5,858
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–7
1941
Unexpired unobligated balance, end of year
482
273
271
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
7,399
7,701
8,229
3010
New obligations, unexpired accounts
10,161
10,258
5,587
3011
Obligations ("upward adjustments"), expired accounts
19
3020
Outlays (gross)
–9,674
–9,730
–8,623
3040
Recoveries of prior year unpaid obligations, unexpired
–80
3041
Recoveries of prior year unpaid obligations, expired
–124
3050
Unpaid obligations, end of year
7,701
8,229
5,193
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–36
–22
–22
3070
Change in uncollected pymts, Fed sources, unexpired
–12
3071
Change in uncollected pymts, Fed sources, expired
26
3090
Uncollected pymts, Fed sources, end of year
–22
–22
–22
Memorandum (non-add) entries:
3100
Obligated balance, start of year
7,363
7,679
8,207
3200
Obligated balance, end of year
7,679
8,207
5,171
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
6,169
6,174
5,565
Outlays, gross:
4010
Outlays from new discretionary authority
1,938
1,953
1,733
4011
Outlays from discretionary balances
3,987
3,993
4,265
4020
Outlays, gross (total)
5,925
5,946
5,998
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–27
–13
–8
4033
Non-Federal sources
–23
–18
–18
4040
Offsets against gross budget authority and outlays (total)
–50
–31
–26
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–12
4052
Offsetting collections credited to expired accounts
26
4060
Additional offsets against budget authority only (total)
14
4070
Budget authority, net (discretionary)
6,133
6,143
5,539
4080
Outlays, net (discretionary)
5,875
5,915
5,972
Mandatory:
4090
Budget authority, gross
3,993
3,875
20
Outlays, gross:
4100
Outlays from new mandatory authority
1,480
1,537
20
4101
Outlays from mandatory balances
2,269
2,247
2,605
4110
Outlays, gross (total)
3,749
3,784
2,625
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123
Non-Federal sources
–24
–19
–19
4180
Budget authority, net (total)
10,102
9,999
5,540
4190
Outlays, net (total)
9,600
9,680
8,578
Memorandum (non-add) entries:
5090
Unexpired unavailable balance, SOY: Offsetting collections
1
2
1
5092
Unexpired unavailable balance, EOY: Offsetting collections
2
1
Summary of Budget Authority and Outlays (in millions of dollars)
2016 actual
2017 est.
2018 est.
Enacted/requested:
Budget Authority
10,102
9,999
5,540
Outlays
9,600
9,680
8,578
Legislative proposal, subject to PAYGO:
Budget Authority
3,970
Outlays
1,561
Total:
Budget Authority
10,102
9,999
9,510
Outlays
9,600
9,680
10,139
Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in millions of dollars)
Identification code 075–0350–0–1–550
2016 actual
2017 est.
2018 est.
Guaranteed loan levels supportable by subsidy budget authority:
215001
Health centers: Facilities renovation loan guarantee levels
9
3
3
215999
Total loan guarantee levels
9
3
3
Guaranteed loan subsidy (in percent):
232001
Health centers: Facilities renovation loan guarantee levels
2.67
2.65
2.69
232999
Weighted average subsidy rate
2.67
2.65
2.69
Guaranteed loan reestimates:
235001
Health centers: Facilities renovation loan guarantee levels
–1
235999
Total guaranteed loan reestimates
–1
Resources displayed here support 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.
HRSA Program Activity Crosswalk FY 2018 President's Budget to FY 2017 President's Budget Dollars in Millions
FY 2018 Program Activities
FY 2017 Program Activities
FY 2016 Obligations
FY 2017 Obligations
FY 2018 Obligations
0005 Primary Health Care (Health Centers, Free Clinics)
1,492
1,489
1,489
Health Centers
1,390
1,389
1,389
Free Clinics Medical Malpractice
0
0
0
Health Centers Tort Claims
102
100
100
0010 Primary Health Care (Health Centers Mandatory)
3,651
3,607
2
Health Centers ACA
3,650
3,605
0
School Based Health Centers ACA
1
2
2
0015 Health Workforce
785
785
383
Health Workforce
407
407
5
Children's Hospital Graduate Medical Education
294
294
295
NURSE Corps Scholarship and Loan Repayment Program
83
83
83
Loan Repayment/Faculty Fellowships
1
1
0
0020 Health Workforce Mandatory
368
367
0
National Health Service Corps ACA
308
311
0
GME Payments THC ACA
60
56
0
0025 Maternal and Child Health
843
859
795
Maternal and Child Health Block Grant
637
637
667
Healthy Start
103
119
128
Emergency Medical Services for Children
20
20
0
James T. Walsh Universal Newborn Hearing Screening
18
18
0
Heritable Disorders
14
14
0
Autism and Other Developmental Disorders
47
47
0
Sickle Cell Service Demonstrations
4
4
0
0030 Maternal and Child Health Mandatory
5
5
0
Family to Family Health Information Centers ACA
5
5
0
0035 Ryan White HIV/AIDS
2,266
2,396
2,260
HIV/AIDS
2,266
2,396
2,260
0040 Health Care Systems
103
103
99
Organ Transplantation
24
24
24
C.W. Bill Young Cell Transplantation Program
22
22
22
Poison Control Centers
19
19
19
Hansen's Disease Center
15
15
11
Payment to Hawaii for the Treatment of Hansen's Disease
2
2
2
National Cord Blood Inventory
11
11
11
340 B Drug Pricing Program/Office of Pharmacy Affairs
10
10
10
0045 Rural Health
151
149
74
Rural Health Outreach Grants
64
63
50
Rural Hospital Flexibility Grants
42
42
0
Telehealth
17
17
10
State Offices of Rural Health
10
9
0
Rural Health Policy Development
9
9
5
Black Lung Clinics
7
7
7
Radiation Exposure Screening and Education Program
2
2
2
0050 Family Planning
286
286
286
Family Planning
286
286
286
0055 HRSA Program Management
154
154
152
Program Management
154
154
152
0801 Health Resources and Services (Reimbursable)
57
58
47
Health Resources and Services (Reimbursable)
0
0
0802 HRSA reimbursable program: PHS evaluation
0
0
0
Reimbursable program: PHS evaluation
0
0
0
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 2015–2016 data reported in the Annual Operating Report.
Health Professions Revolving Loan Programs Federal Capital Contribution
Program
Account Balance
HPSL
412,794,283
NSL
186,799,617
PCL
247,553,867
LDS
154,323,482
Total
1,001,471,249
Object Classification (in millions of dollars)
Identification code 075–0350–0–1–550
2016 actual
2017 est.
2018 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
177
199
146
11.3
Other than full-time permanent
8
8
5
11.5
Other personnel compensation
3
3
2
11.7
Military personnel
19
20
15
11.9
Total personnel compensation
207
230
168
12.1
Civilian personnel benefits
58
64
47
12.2
Military personnel benefits
11
11
9
21.0
Travel and transportation of persons
3
3
2
23.1
Rental payments to GSA
28
28
23
23.2
Rental payments to others
1
1
1
23.3
Communications, utilities, and miscellaneous charges
7
7
5
25.1
Advisory and assistance services
10
10
7
25.2
Other services from non-Federal sources
238
240
187
25.3
Other goods and services from Federal sources
292
278
152
25.4
Operation and maintenance of facilities
1
1
1
25.6
Medical care
3
3
25.7
Operation and maintenance of equipment
4
4
3
26.0
Supplies and materials
1
1
1
31.0
Equipment
9
9
6
41.0
Grants, subsidies, and contributions
9,138
9,219
4,837
42.0
Insurance claims and indemnities
93
91
91
99.0
Direct obligations
10,104
10,200
5,540
99.0
Reimbursable obligations
57
58
47
99.9
Total new obligations, unexpired accounts
10,161
10,258
5,587
Employment Summary
Identification code 075–0350–0–1–550
2016 actual
2017 est.
2018 est.
1001
Direct civilian full-time equivalent employment
1,692
1,873
1,362
1101
Direct military average strength employment
187
207
160
2001
Reimbursable civilian full-time equivalent employment
51
58
53
2101
Reimbursable military average strength employment
4
4
4
Health Resources and Services
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 075–0350–4–1–550
2016 actual
2017 est.
2018 est.
Obligations by program activity:
0010
Primary Health Care (Mandatory)
3,595
0020
Health Workforce (Mandatory)
370
0030
Maternal and Child Health (Mandatory)
5
0300
Total direct programs
3,970
0900
Total new obligations, unexpired accounts
3,970
Budgetary resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
3,975
1220
Appropriations transferred to other acct [015–5606]
–5
1260
Appropriations, mandatory (total)
3,970
1900
Budget authority (total)
3,970
1930
Total budgetary resources available
3,970
Change in obligated balance:
Unpaid obligations:
3010
New obligations, unexpired accounts
3,970
3020
Outlays (gross)
–1,561
3050
Unpaid obligations, end of year
2,409
Memorandum (non-add) entries:
3200
Obligated balance, end of year
2,409
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
3,970
Outlays, gross:
4100
Outlays from new mandatory authority
1,561
4180
Budget authority, net (total)
3,970
4190
Outlays, net (total)
1,561
Resources displayed here support grants and contracts managed by Health Resources and Services Administration (HRSA). These
activities include support for Health Centers, health workforce programs, and maternal and child health care services.
Object Classification (in millions of dollars)
Identification code 075–0350–4–1–550
2016 actual
2017 est.
2018 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
49
11.3
Other than full-time permanent
2
11.5
Other personnel compensation
1
11.7
Military personnel
4
11.9
Total personnel compensation
56
12.1
Civilian personnel benefits
15
12.2
Military personnel benefits
2
23.1
Rental payments to GSA
5
23.3
Communications, utilities, and miscellaneous charges
2
25.2
Other services from non-Federal sources
37
25.3
Other goods and services from Federal sources
125
31.0
Equipment
2
41.0
Grants, subsidies, and contributions
3,726
99.9
Total new obligations, unexpired accounts
3,970
Employment Summary
Identification code 075–0350–4–1–550
2016 actual
2017 est.
2018 est.
1001
Direct civilian full-time equivalent employment
425
1101
Direct military average strength employment
41
Vaccine Injury Compensation
Program and Financing (in millions of dollars)
Identification code 075–0320–0–1–551
2016 actual
2017 est.
2018 est.
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
27
29
29
1033
Recoveries of prior year paid obligations
2
1050
Unobligated balance (total)
29
29
29
1930
Total budgetary resources available
29
29
29
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
29
29
29
Budget authority and outlays, net:
Mandatory:
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123
Non-Federal sources
–2
Additional offsets against gross budget authority only:
4143
Recoveries of prior year paid obligations, unexpired accounts
2
4170
Outlays, net (mandatory)
–2
4180
Budget authority, net (total)
4190
Outlays, net (total)
–2
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
2016 actual
2017 est.
2018 est.
Obligations by program activity:
0001
Claims
3
1
1
0103
Admin Expense
1
2
2
0900
Total new obligations, unexpired accounts
4
3
3
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
2
1011
Unobligated balance transfer from other acct [075–0140]
2
3
3
1050
Unobligated balance (total)
4
3
3
1930
Total budgetary resources available
4
3
3
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
2
2
3010
New obligations, unexpired accounts
4
3
3
3020
Outlays (gross)
–2
–3
–3
3050
Unpaid obligations, end of year
2
2
2
Memorandum (non-add) entries:
3100
Obligated balance, start of year
2
2
3200
Obligated balance, end of year
2
2
2
Budget authority and outlays, net:
Discretionary:
Outlays, gross:
4011
Outlays from discretionary balances
2
3
3
4180
Budget authority, net (total)
4190
Outlays, net (total)
2
3
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
2016 actual
2017 est.
2018 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
1
1
99.0
Direct obligations
4
3
3
99.9
Total new obligations, unexpired accounts
4
3
3
Employment Summary
Identification code 075–0343–0–1–551
2016 actual
2017 est.
2018 est.
1001
Direct civilian full-time equivalent employment
5
5
5
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
2016 actual
2017 est.
2018 est.
Obligations by program activity:
0010
Maternal, Infant, and Early Childhood Home Visiting Programs
391
405
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
16
37
4
1012
Unobligated balance transfers between expired and unexpired accounts
1
1021
Recoveries of prior year unpaid obligations
11
1050
Unobligated balance (total)
28
37
4
Budget authority:
Appropriations, mandatory:
1200
Appropriation
400
400
1230
Appropriations and/or unobligated balance of appropriations permanently reduced
–28
1260
Appropriations, mandatory (total)
400
372
1930
Total budgetary resources available
428
409
4
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
37
4
4
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
750
739
750
3010
New obligations, unexpired accounts
391
405
3020
Outlays (gross)
–390
–394
–375
3040
Recoveries of prior year unpaid obligations, unexpired
–11
3041
Recoveries of prior year unpaid obligations, expired
–1
3050
Unpaid obligations, end of year
739
750
375
Memorandum (non-add) entries:
3100
Obligated balance, start of year
750
739
750
3200
Obligated balance, end of year
739
750
375
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
400
372
Outlays, gross:
4100
Outlays from new mandatory authority
14
15
4101
Outlays from mandatory balances
376
379
375
4110
Outlays, gross (total)
390
394
375
4180
Budget authority, net (total)
400
372
4190
Outlays, net (total)
390
394
375
Summary of Budget Authority and Outlays (in millions of dollars)
2016 actual
2017 est.
2018 est.
Enacted/requested:
Budget Authority
400
372
Outlays
390
394
375
Legislative proposal, subject to PAYGO:
Budget Authority
400
Outlays
16
Total:
Budget Authority
400
372
400
Outlays
390
394
391
The Maternal, Infant and Early Childhood Home Visiting Program provides 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
2016 actual
2017 est.
2018 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
4
5
11.7
Military personnel
1
1
11.9
Total personnel compensation
5
6
12.1
Civilian personnel benefits
1
1
25.1
Advisory and assistance services
25
25
41.0
Grants, subsidies, and contributions
360
373
99.9
Total new obligations, unexpired accounts
391
405
Employment Summary
Identification code 075–0321–0–1–551
2016 actual
2017 est.
2018 est.
1001
Direct civilian full-time equivalent employment
33
39
1101
Direct military average strength employment
5
5
Maternal, Infant, and Early Childhood Home Visiting Programs
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 075–0321–4–1–551
2016 actual
2017 est.
2018 est.
Obligations by program activity:
0010
Maternal, Infant, and Early Childhood Home Visiting Programs
400
Budgetary resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
400
1930
Total budgetary resources available
400
Change in obligated balance:
Unpaid obligations:
3010
New obligations, unexpired accounts
400
3020
Outlays (gross)
–16
3050
Unpaid obligations, end of year
384
Memorandum (non-add) entries:
3200
Obligated balance, end of year
384
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
400
Outlays, gross:
4100
Outlays from new mandatory authority
16
4180
Budget authority, net (total)
400
4190
Outlays, net (total)
16
The Maternal, Infant and Early Childhood Home Visiting Program provides comprehensive services for at risk communities. These
activities are administered by HRSA.
Object Classification (in millions of dollars)
Identification code 075–0321–4–1–551
2016 actual
2017 est.
2018 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
5
11.7
Military personnel
1
11.9
Total personnel compensation
6
12.1
Civilian personnel benefits
1
25.1
Advisory and assistance services
25
41.0
Grants, subsidies, and contributions
368
99.9
Total new obligations, unexpired accounts
400
Employment Summary
Identification code 075–0321–4–1–551
2016 actual
2017 est.
2018 est.
1001
Direct civilian full-time equivalent employment
39
1101
Direct military average strength employment
5
Health Center Guaranteed Loan Financing Account
Program and Financing (in millions of dollars)
Identification code 075–4442–0–3–551
2016 actual
2017 est.
2018 est.
Obligations by program activity:
Credit program obligations:
0711
Default claim payments on principal
1
0742
Downward reestimates paid to receipt accounts
1
0900
Total new obligations, unexpired accounts
2
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
2
2
1930
Total budgetary resources available
2
2
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
2
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
2
3010
New obligations, unexpired accounts
2
3050
Unpaid obligations, end of year
2
2
Memorandum (non-add) entries:
3100
Obligated balance, start of year
2
3200
Obligated balance, end of year
2
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
2016 actual
2017 est.
2018 est.
Position with respect to appropriations act limitation on commitments:
2121
Limitation available from carry-forward
15
6
3
2143
Uncommitted limitation carried forward
–6
–3
2150
Total guaranteed loan commitments
9
3
3
2199
Guaranteed amount of guaranteed loan commitments
4
2
2
Cumulative balance of guaranteed loans outstanding:
2210
Outstanding, start of year
76
74
66
2231
Disbursements of new guaranteed loans
9
3
3
2251
Repayments and prepayments
–30
–10
–10
Adjustments:
2263
Terminations for default that result in claim payments
–1
–1
2264
Other adjustments, net
19
2290
Outstanding, end of year
74
66
58
Memorandum:
2299
Guaranteed amount of guaranteed loans outstanding, end of year
57
50
44
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
2015 actual
2016 actual
ASSETS:
1101
Federal assets: Fund balances with Treasury
3
2
1999
Total assets
3
2
LIABILITIES:
2204
Non-Federal liabilities: Liabilities for loan guarantees
3
2
4999
Total liabilities and net position
3
2
Medical Facilities Guarantee and Loan Fund
Status of Direct Loans (in millions of dollars)
Identification code 075–9931–0–3–551
2016 actual
2017 est.
2018 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
2015 actual
2016 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 $9,200,000 shall be available from the Trust Fund to the Secretary.
Note.—A full-year 2017 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
budget assumes this account is operating under the Further Continuing Appropriations Act, 2017 (P.L. 114–254). The amounts
included for 2017 reflect the annualized level provided by the continuing resolution.
Special and Trust Fund Receipts (in millions of dollars)
Identification code 075–8175–0–7–551
2016 actual
2017 est.
2018 est.
0100
Balance, start of year
3,452
3,571
3,691
0198
Rounding adjustment
1
0199
Balance, start of year
3,453
3,571
3,691
Receipts:
Current law:
1110
Deposits, Vaccine Injury Compensation Trust Fund
291
293
300
1140
Interest and Profits on Investments, Vaccine Injury Compensation Trust Fund
99
110
135
1199
Total current law receipts
390
403
435
1999
Total receipts
390
403
435
2000
Total: Balances and receipts
3,843
3,974
4,126
Appropriations:
Current law:
2101
Vaccine Injury Compensation Program Trust Fund
–22
–23
–27
2101
Vaccine Injury Compensation Program Trust Fund
–253
–260
–268
2199
Total current law appropriations
–275
–283
–295
2999
Total appropriations
–275
–283
–295
Special and trust fund receipts returned:
3010
Vaccine Injury Compensation Program Trust Fund
1
5098
Rounding adjustment
2
5099
Balance, end of year
3,571
3,691
3,831
Program and Financing (in millions of dollars)
Identification code 075–8175–0–7–551
2016 actual
2017 est.
2018 est.
Obligations by program activity:
0001
Compensation: Claims for post - FY 1989 injuries
253
260
268
0103
Claims processing (Claims Court)
5
6
9
0104
Claims processing (HRSA)
8
8
9
0105
Claims processing (Dept. of Justice)
9
9
9
0191
Direct program activities, subtotal
22
23
27
0900
Total new obligations, unexpired accounts
275
283
295
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
1
1
1001
Discretionary unobligated balance brought fwd, Oct 1
1
1021
Recoveries of prior year unpaid obligations
2
1030
Other balances withdrawn to special or trust funds
–1
1033
Recoveries of prior year paid obligations
3
1035
Unobligated balance of appropriations withdrawn
–3
1050
Unobligated balance (total)
1
1
1
Budget authority:
Appropriations, discretionary:
1101
Appropriation (special or trust fund)
22
23
27
Appropriations, mandatory:
1201
Appropriation (special or trust fund)
253
260
268
1900
Budget authority (total)
275
283
295
1930
Total budgetary resources available
276
284
296
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
1
1
1
Special and non-revolving trust funds:
1950
Other balances withdrawn and returned to unappropriated receipts
1
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
15
12
3010
New obligations, unexpired accounts
275
283
295
3020
Outlays (gross)
–276
–295
–295
3040
Recoveries of prior year unpaid obligations, unexpired
–2
3050
Unpaid obligations, end of year
12
Memorandum (non-add) entries:
3100
Obligated balance, start of year
15
12
3200
Obligated balance, end of year
12
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
22
23
27
Outlays, gross:
4010
Outlays from new discretionary authority
18
23
27
4011
Outlays from discretionary balances
5
12
4020
Outlays, gross (total)
23
35
27
Mandatory:
4090
Budget authority, gross
253
260
268
Outlays, gross:
4100
Outlays from new mandatory authority
253
260
268
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123
Non-Federal sources
–3
Additional offsets against gross budget authority only:
4143
Recoveries of prior year paid obligations, unexpired accounts
3
4160
Budget authority, net (mandatory)
253
260
268
4170
Outlays, net (mandatory)
250
260
268
4180
Budget authority, net (total)
275
283
295
4190
Outlays, net (total)
273
295
295
Memorandum (non-add) entries:
5000
Total investments, SOY: Federal securities: Par value
3,453
3,605
3,718
5001
Total investments, EOY: Federal securities: Par value
3,605
3,718
3,854
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
2016 actual
2017 est.
2018 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent
2
2
2
12.1
Civilian personnel benefits
1
1
1
25.3
Other goods and services from Federal sources
4
4
4
42.0
Insurance claims and indemnities
268
276
288
99.9
Total new obligations, unexpired accounts
275
283
295
Employment Summary
Identification code 075–8175–0–7–551
2016 actual
2017 est.
2018 est.
1001
Direct civilian full-time equivalent employment
14
13
16
1101
Direct military average strength employment
4
6
6
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, $3,574,365,000, 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 for Purchased/Referred Care, including $51,500,000 for the Indian Catastrophic Health Emergency Fund, shall remain available
until expended: Provided further, That, of the funds provided, up to $36,000,000 shall remain available until expended for implementation of the loan repayment
program under section 108 of the Indian Health Care Improvement Act: Provided further, That, of the funds provided, $2,000,000 shall 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 Substance Abuse and Suicide Prevention Program, for the Domestic Violence Prevention Program, 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.
Note.—A full-year 2017 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
budget assumes this account is operating under the Further Continuing Appropriations Act, 2017 (P.L. 114–254). The amounts
included for 2017 reflect the annualized level provided by the continuing resolution.
Program and Financing (in millions of dollars)
Identification code 075–0390–0–1–551
2016 actual
2017 est.
2018 est.
Obligations by program activity:
0001
Clinical services
3,237
3,231
3,252
0002
Preventive health
156
155
157
0003
Urban health
45
45
45
0004
Indian health professions
48
48
43
0005
Tribal management
2
2
0006
Direct operations
72
72
72
0007
Self-governance
6
6
5
0009
Diabetes funds
150
150
0799
Total direct obligations
3,716
3,709
3,574
0801
Indian Health Services (Reimbursable)
1,491
1,194
1,194
0900
Total new obligations, unexpired accounts
5,207
4,903
4,768
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
741
828
1,053
1001
Discretionary unobligated balance brought fwd, Oct 1
741
828
1021
Recoveries of prior year unpaid obligations
131
1050
Unobligated balance (total)
872
828
1,053
Budget authority:
Appropriations, discretionary:
1100
Appropriation
3,566
3,559
3,574
Appropriations, mandatory:
1200
Appropriation
150
150
1230
Appropriations and/or unobligated balance of appropriations permanently reduced
–3
1260
Appropriations, mandatory (total)
150
147
Spending authority from offsetting collections, discretionary:
1700
Collected
1,426
1,422
1,450
1701
Change in uncollected payments, Federal sources
30
1750
Spending auth from offsetting collections, disc (total)
1,456
1,422
1,450
1900
Budget authority (total)
5,172
5,128
5,024
1930
Total budgetary resources available
6,044
5,956
6,077
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–9
1941
Unexpired unobligated balance, end of year
828
1,053
1,309
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
917
984
542
3010
New obligations, unexpired accounts
5,207
4,903
4,768
3011
Obligations ("upward adjustments"), expired accounts
44
3020
Outlays (gross)
–5,031
–5,345
–5,028
3040
Recoveries of prior year unpaid obligations, unexpired
–131
3041
Recoveries of prior year unpaid obligations, expired
–22
3050
Unpaid obligations, end of year
984
542
282
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–67
–98
–98
3070
Change in uncollected pymts, Fed sources, unexpired
–30
3071
Change in uncollected pymts, Fed sources, expired
–1
3090
Uncollected pymts, Fed sources, end of year
–98
–98
–98
Memorandum (non-add) entries:
3100
Obligated balance, start of year
850
886
444
3200
Obligated balance, end of year
886
444
184
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
5,022
4,981
5,024
Outlays, gross:
4010
Outlays from new discretionary authority
4,038
4,340
4,381
4011
Outlays from discretionary balances
827
858
641
4020
Outlays, gross (total)
4,865
5,198
5,022
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–231
–271
–276
4033
Non-Federal sources
–1,196
–1,151
–1,174
4040
Offsets against gross budget authority and outlays (total)
–1,427
–1,422
–1,450
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–30
4052
Offsetting collections credited to expired accounts
1
4060
Additional offsets against budget authority only (total)
–29
4070
Budget authority, net (discretionary)
3,566
3,559
3,574
4080
Outlays, net (discretionary)
3,438
3,776
3,572
Mandatory:
4090
Budget authority, gross
150
147
Outlays, gross:
4100
Outlays from new mandatory authority
58
141
4101
Outlays from mandatory balances
108
6
6
4110
Outlays, gross (total)
166
147
6
4180
Budget authority, net (total)
3,716
3,706
3,574
4190
Outlays, net (total)
3,604
3,923
3,578
Summary of Budget Authority and Outlays (in millions of dollars)
2016 actual
2017 est.
2018 est.
Enacted/requested:
Budget Authority
3,716
3,706
3,574
Outlays
3,604
3,923
3,578
Legislative proposal, subject to PAYGO:
Budget Authority
150
Outlays
144
Total:
Budget Authority
3,716
3,706
3,724
Outlays
3,604
3,923
3,722
The Indian Health Services account provides medical care, public health services, and health professions training opportunities
to American Indians and Alaska Natives. More than $2.2 billion, primarily through self-determination contracts and compacts,
will be administered by tribal governments in 2018.
Object Classification (in millions of dollars)
Identification code 075–0390–0–1–551
2016 actual
2017 est.
2018 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
393
398
406
11.3
Other than full-time permanent
18
18
18
11.5
Other personnel compensation
58
59
60
11.7
Military personnel
66
67
68
11.9
Total personnel compensation
535
542
552
12.1
Civilian personnel benefits
156
158
161
12.2
Military personnel benefits
29
30
30
13.0
Benefits for former personnel
2
1
2
21.0
Patient travel
46
46
43
22.0
Transportation of things
6
6
6
23.1
Rental payments to GSA
16
16
15
23.2
Rental payments to others
1
1
1
23.3
Communications, utilities, and miscellaneous charges
14
14
13
25.1
Advisory and assistance services
5
5
5
25.2
Other services from non-Federal sources
106
106
101
25.3
Other goods and services from Federal sources
72
71
66
25.4
Operation and maintenance of facilities
2
2
2
25.6
Medical care
392
391
371
25.7
Operation and maintenance of equipment
12
12
10
25.8
Subsistence and support of persons
4
4
4
26.0
Supplies and materials
98
98
93
31.0
Equipment
13
13
12
41.0
Grants, subsidies, and contributions
2,207
2,193
2,087
99.0
Direct obligations
3,716
3,709
3,574
99.0
Reimbursable obligations
1,491
1,194
1,194
99.9
Total new obligations, unexpired accounts
5,207
4,903
4,768
Employment Summary
Identification code 075–0390–0–1–551
2016 actual
2017 est.
2018 est.
1001
Direct civilian full-time equivalent employment
6,563
6,595
6,595
1101
Direct military average strength employment
963
968
968
2001
Reimbursable civilian full-time equivalent employment
5,460
5,460
5,460
2101
Reimbursable military average strength employment
802
802
802
Indian Health Services
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 075–0390–4–1–551
2016 actual
2017 est.
2018 est.
Obligations by program activity:
0009
Diabetes funds
150
0799
Total direct obligations
150
Budgetary resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
150
1930
Total budgetary resources available
150
Change in obligated balance:
Unpaid obligations:
3010
New obligations, unexpired accounts
150
3020
Outlays (gross)
–144
3050
Unpaid obligations, end of year
6
Memorandum (non-add) entries:
3200
Obligated balance, end of year
6
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
150
Outlays, gross:
4100
Outlays from new mandatory authority
144
4180
Budget authority, net (total)
150
4190
Outlays, net (total)
144
This activity supports evidence-based diabetes treatment and prevention services across Indian Country.
Object Classification (in millions of dollars)
Identification code 075–0390–4–1–551
2016 actual
2017 est.
2018 est.
Direct obligations:
21.0
Patient travel
2
23.1
Rental payments to GSA
1
25.2
Other services from non-Federal sources
5
25.3
Other goods and services from Federal sources
3
25.6
Medical care
20
25.7
Operation and maintenance of equipment
1
26.0
Supplies and materials
5
31.0
Equipment
1
41.0
Grants, subsidies, and contributions
112
99.0
Direct obligations
150
99.9
Total new obligations, unexpired accounts
150
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 2018, 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.
Note.—A full-year 2017 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
budget assumes this account is operating under the Further Continuing Appropriations Act, 2017 (P.L. 114–254). The amounts
included for 2017 reflect the annualized level provided by the continuing resolution.
Program and Financing (in millions of dollars)
Identification code 075–0344–0–1–551
2016 actual
2017 est.
2018 est.
Obligations by program activity:
0001
Contract Support Costs
670
716
718
0900
Total new obligations (object class 25.3)
670
716
718
Budgetary resources:
Budget authority:
Appropriations, discretionary:
1100
Appropriation
670
716
718
1930
Total budgetary resources available
670
716
718
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
40
3010
New obligations, unexpired accounts
670
716
718
3020
Outlays (gross)
–630
–756
–718
3050
Unpaid obligations, end of year
40
Memorandum (non-add) entries:
3100
Obligated balance, start of year
40
3200
Obligated balance, end of year
40
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
670
716
718
Outlays, gross:
4010
Outlays from new discretionary authority
630
716
718
4011
Outlays from discretionary balances
40
4020
Outlays, gross (total)
630
756
718
4180
Budget authority, net (total)
670
716
718
4190
Outlays, net (total)
630
756
718
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 $718 million in contract support
costs funds will be provided to tribal governments and tribal organizations in 2018.
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, $446,956,000, 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.
Note.—A full-year 2017 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
budget assumes this account is operating under the Further Continuing Appropriations Act, 2017 (P.L. 114–254). The amounts
included for 2017 reflect the annualized level provided by the continuing resolution.
Special and Trust Fund Receipts (in millions of dollars)
Identification code 075–0391–0–1–551
2016 actual
2017 est.
2018 est.
0100
Balance, start of year
Receipts:
Current law:
1130
Rent and Charges for Quarters, Indian Health Service
7
9
9
2000
Total: Balances and receipts
7
9
9
Appropriations:
Current law:
2101
Indian Health Facilities
–7
–9
–9
5099
Balance, end of year
Program and Financing (in millions of dollars)
Identification code 075–0391–0–1–551
2016 actual
2017 est.
2018 est.
Obligations by program activity:
0001
Maintenance
198
204
175
0002
Maintenance
74
73
60
0003
Facilities and environmental health
223
222
192
0004
Equipment
23
23
20
0100
Total direct program
518
522
447
0799
Total direct obligations
518
522
447
0801
Indian Health Facilities (Reimbursable)
9
9
9
0900
Total new obligations, unexpired accounts
527
531
456
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
236
284
340
1001
Discretionary unobligated balance brought fwd, Oct 1
236
284
1021
Recoveries of prior year unpaid obligations
11
1050
Unobligated balance (total)
247
284
340
Budget authority:
Appropriations, discretionary:
1100
Appropriation
523
522
447
Appropriations, mandatory:
1201
Appropriation (special or trust fund)
7
9
9
Spending authority from offsetting collections, discretionary:
1700
Collected
31
56
57
1701
Change in uncollected payments, Federal sources
3
1750
Spending auth from offsetting collections, disc (total)
34
56
57
1900
Budget authority (total)
564
587
513
1930
Total budgetary resources available
811
871
853
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
284
340
397
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
455
492
455
3010
New obligations, unexpired accounts
527
531
456
3020
Outlays (gross)
–479
–568
–556
3040
Recoveries of prior year unpaid obligations, unexpired
–11
3050
Unpaid obligations, end of year
492
455
355
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–5
–8
–8
3070
Change in uncollected pymts, Fed sources, unexpired
–3
3090
Uncollected pymts, Fed sources, end of year
–8
–8
–8
Memorandum (non-add) entries:
3100
Obligated balance, start of year
450
484
447
3200
Obligated balance, end of year
484
447
347
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
557
578
504
Outlays, gross:
4010
Outlays from new discretionary authority
293
213
191
4011
Outlays from discretionary balances
181
346
356
4020
Outlays, gross (total)
474
559
547
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–31
–56
–57
4040
Offsets against gross budget authority and outlays (total)
–31
–56
–57
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–3
4070
Budget authority, net (discretionary)
523
522
447
4080
Outlays, net (discretionary)
443
503
490
Mandatory:
4090
Budget authority, gross
7
9
9
Outlays, gross:
4100
Outlays from new mandatory authority
3
9
9
4101
Outlays from mandatory balances
2
4110
Outlays, gross (total)
5
9
9
4180
Budget authority, net (total)
530
531
456
4190
Outlays, net (total)
448
512
499
The Indian Health Facilities account supports construction, repair and improvement, equipment, and environmental health and
facilities support for the Indian Health Service. More than $186 million, primarily through self-determination contracts and
compacts, will be administered by tribal governments in 2018.
Object Classification (in millions of dollars)
Identification code 075–0391–0–1–551
2016 actual
2017 est.
2018 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
52
53
54
11.3
Other than full-time permanent
2
2
2
11.5
Other personnel compensation
2
2
3
11.7
Military personnel
22
22
23
11.9
Total personnel compensation
78
79
82
12.1
Civilian personnel benefits
18
18
19
12.2
Military personnel benefits
8
8
8
21.0
Travel and transportation of persons
3
3
3
22.0
Transportation of things
3
3
3
23.1
Rental payments to GSA
1
1
1
23.3
Communications, utilities, and miscellaneous charges
15
15
15
25.1
Advisory and assistance services
3
3
3
25.2
Other services from non-Federal sources
76
76
76
25.3
Other goods and services from Federal sources
2
2
2
25.4
Operation and maintenance of facilities
6
6
6
25.7
Operation and maintenance of equipment
2
2
2
25.8
Subsistence and support of persons
13
13
13
26.0
Supplies and materials
7
7
7
31.0
Equipment
13
13
13
32.0
Land and structures
107
107
102
41.0
Grants, subsidies, and contributions
163
166
92
99.0
Direct obligations
518
522
447
99.0
Reimbursable obligations
9
9
9
99.9
Total new obligations, unexpired accounts
527
531
456
Employment Summary
Identification code 075–0391–0–1–551
2016 actual
2017 est.
2018 est.
1001
Direct civilian full-time equivalent employment
1,071
1,076
1,076
1101
Direct military average strength employment
163
158
158
2001
Reimbursable civilian full-time equivalent employment
37
37
37
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
the House and Senate Committees on Appropriations are notified 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, notwithstanding any other provision of law, for any lease under section 105(l) of the Indian Self-Determination
and Education Assistance Act, as amended, no additional compensation is required by the Act above the amount provided to the
tribe or tribal organization under section 106(a)(1), except the Secretary, in the discretion of the Secretary, may award
compensation for such leases, above the section 106(a)(1) amount, and if the Secretary awards such additional compensation
the amount of such compensation may be based on such reasonable expenses, if any, as the Secretary determines to be appropriate,
which may include the expenses described in section 105(l)(2), and the exercise of this discretion to award additional compensation
and determine its amount is not subject to sections 102(a)-(b), (e) or 507(b)-(d) of the Act.
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, $497,228,000.
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, $934,000,000.
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, $377,000,000: 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, $452,250,000: Provided, That amounts in this account, including amounts transferred to this account, are available for the Director of the
Centers for Disease Control and Prevention (CDC) to administer a program, to be known as America's Health State Block Grant,
to provide increased flexibility for States, territories, tribes, and tribal organizations to improve public health: Provided
further, That for purposes of carrying out such program, the Director is hereby authorized to award grants to States, territories,
tribes, and tribal organizations, and such grant awards shall be provided through a formula, as determined by the Director,
that takes into account the population and disease burden of the grantee: Provided further, That the Director may set aside
not more than 15 percent of the amounts awarded for grants described in the previous proviso for the same purposes, on a competitive
basis, to cities, Federally-recognized tribes, and public health entities serving rural and frontier areas or other entities:
Provided further, 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 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, $100,000,000.
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, $317,032,000: Provided, That in addition to amounts provided herein, $142,968,000 shall be available from amounts available under section
241 of the PHS Act to carry out the Public Health Scientific Services.
Environmental health
For carrying out titles II, III, and XVII of the PHS Act with respect to environmental health, $157,000,000.
Injury prevention and control
For carrying out titles II, III, and XVII of the PHS Act with respect to injury prevention and control, $216,165,000.
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, $200,000,000.
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, $350,000,000, of which $69,547,000 for international HIV/AIDS shall remain available through September 30, 2019: 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, $1,266,000,000, of which $575,000,000 shall remain available until expended for the Strategic National Stockpile: Provided, That the Director of the CDC or the Administrator of the Agency for Toxic Substances and Disease Registry may detail staff without reimbursement for up to 180 days to support an activation of the CDC Emergency Operations Center: Provided further, That in making awards under section 319C-1 of the PHS Act from funds made available under this heading,
the Secretary may determine the amounts of such awards without regard to paragraph (3)(B)-(D) and paragraph (4)(C) of subsection
(h) of such section.
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, $105,000,000: 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, 2019: 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.
Note.—A full-year 2017 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
budget assumes this account is operating under the Further Continuing Appropriations Act, 2017 (P.L. 114–254). The amounts
included for 2017 reflect the annualized level provided by the continuing resolution.
Special and Trust Fund Receipts (in millions of dollars)
Identification code 075–0943–0–1–999
2016 actual
2017 est.
2018 est.
0100
Balance, start of year
Receipts:
Current law:
1130
Cooperative Research and Development Agreements, Centers for Disease Control
1
2
2
2000
Total: Balances and receipts
1
2
2
Appropriations:
Current law:
2101
CDC-wide Activities and Program Support
–1
–2
–2
5099
Balance, end of year
Program and Financing (in millions of dollars)
Identification code 075–0943–0–1–999
2016 actual
2017 est.
2018 est.
Obligations by program activity:
0001
Birth Defects, Developmental Disabilities, Disability and Health (0958)
135
135
100
0002
CDC-Wide Activities and Program Support (0943)
464
273
105
0004
Chronic Disease Prevention and Health Promotion (0948)
1,173
1,175
952
0005
Emerging and Zoonotic Infectious Diseases (0949)
583
579
514
0006
Energy Employee Illness Occupational Compensation Program Act (EEOICPA) (0954)
49
50
55
0007
Environmental Health (0947)
182
217
157
0008
Global Health (0955)
426
426
350
0012
HIV/AIDS, Viral Hepatitis, STD and TB Prevention (0950)
1,121
1,120
934
0013
Immunization and Respiratory Diseases (0951)
797
783
701
0015
Injury Prevention and Control (0952)
236
236
216
0016
Occupational Safety and Health (0953)
338
338
200
0019
Public Health Preparedness and Response (0956)
1,370
1,402
1,266
0020
Public Health Scientific Services (0959)
490
491
317
0021
Cooperative Research and Development Agreements (CRADA) (5146)
1
2
2
0022
Ebola (Emergency pursuant to 2011 BCA)
380
0799
Total direct obligations
7,745
7,227
5,869
0802
CDC-Wide Activities and Program Support (Reimbursable)
322
412
411
0809
Reimbursable program activities, subtotal
322
412
411
0900
Total new obligations, unexpired accounts
8,067
7,639
6,280
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
1,223
1,155
1,155
1001
Discretionary unobligated balance brought fwd, Oct 1
1,107
1,110
1010
Unobligated balance transfer to other accts [075–9915]
–3
1010
Unobligated balance transfer to other accts [075–0140]
–14
1011
Unobligated balance transfer from other acct [075–0140]
15
1011
Unobligated balance transfer from other acct [075–0140]
10
1012
Unobligated balance transfers between expired and unexpired accounts
20
1021
Recoveries of prior year unpaid obligations
40
1050
Unobligated balance (total)
1,291
1,155
1,155
Budget authority:
Appropriations, discretionary:
1100
Appropriation
6,655
6,284
4,972
1121
Appropriations transferred from other acct [075–9912]
1
1121
Appropriations transferred from other acct [075–1362]
4
1160
Appropriation, discretionary (total)
6,660
6,284
4,972
Appropriations, mandatory:
1200
Appropriation (075–0954 - EEOICPA)
55
55
55
1200
Appropriation (075–0943 - Chilhood Obesity Demonstration Project)
10
1201
Appropriation (075–5146 CRADA)
1
2
2
1221
Appropriations transferred from other acct [075–0116]
892
891
841
1230
Appropriations and/or unobligated balance of appropriations permanently reduced
–5
–5
1260
Appropriations, mandatory (total)
953
943
898
Spending authority from offsetting collections, discretionary:
1700
Collected
138
408
408
1700
Collected
4
1701
Change in uncollected payments, Federal sources
177
1750
Spending auth from offsetting collections, disc (total)
319
408
408
Spending authority from offsetting collections, mandatory:
1800
Collected
4
4
4
1900
Budget authority (total)
7,936
7,639
6,282
1930
Total budgetary resources available
9,227
8,794
7,437
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–5
1941
Unexpired unobligated balance, end of year
1,155
1,155
1,157
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
6,500
6,949
6,639
3010
New obligations, unexpired accounts
8,067
7,639
6,280
3011
Obligations ("upward adjustments"), expired accounts
51
3020
Outlays (gross)
–7,426
–7,949
–7,253
3040
Recoveries of prior year unpaid obligations, unexpired
–40
3041
Recoveries of prior year unpaid obligations, expired
–203
3050
Unpaid obligations, end of year
6,949
6,639
5,666
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–132
–232
–232
3070
Change in uncollected pymts, Fed sources, unexpired
–177
3071
Change in uncollected pymts, Fed sources, expired
77
3090
Uncollected pymts, Fed sources, end of year
–232
–232
–232
Memorandum (non-add) entries:
3100
Obligated balance, start of year
6,368
6,717
6,407
3200
Obligated balance, end of year
6,717
6,407
5,434
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
6,979
6,692
5,380
Outlays, gross:
4010
Outlays from new discretionary authority
2,663
2,916
2,381
4011
Outlays from discretionary balances
3,842
4,317
3,911
4020
Outlays, gross (total)
6,505
7,233
6,292
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–199
–408
–408
4033
Non-Federal sources
–7
4040
Offsets against gross budget authority and outlays (total)
–206
–408
–408
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–177
4052
Offsetting collections credited to expired accounts
64
4060
Additional offsets against budget authority only (total)
–113
4070
Budget authority, net (discretionary)
6,660
6,284
4,972
4080
Outlays, net (discretionary)
6,299
6,825
5,884
Mandatory:
4090
Budget authority, gross
957
947
902
Outlays, gross:
4100
Outlays from new mandatory authority
177
158
155
4101
Outlays from mandatory balances
744
558
806
4110
Outlays, gross (total)
921
716
961
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123
Non-Federal sources
–4
–4
–4
4180
Budget authority, net (total)
7,613
7,227
5,870
4190
Outlays, net (total)
7,216
7,537
6,841
The Centers for Disease Control and Prevention (CDC) supports a number of categorical programs designed to improve the health,
safety, and protection of all Americans. These activities include immunization and respiratory diseases, HIV/AIDS, Hepatitis,
STDs, and Tuberculosis prevention, emerging and zoonotic infectious diseases, chronic disease prevention and health promotion,
occupational safety and health, public health and scientific services, injury prevention and control, environmental health,
global health, programs that reduce the occurrence of birth defects and developmental disabilities, public health preparedness
and emergency response, and CDC-wide activities and program support. The FY 2018 Budget reforms CDC's funding by establishing
a new $500 million block grant to increase flexibility for States to address their population's unique public health needs.
Object Classification (in millions of dollars)
Identification code 075–0943–0–1–999
2016 actual
2017 est.
2018 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
714
802
800
11.3
Other than full-time permanent
124
107
107
11.5
Other personnel compensation
39
35
35
11.7
Military personnel
77
75
75
11.8
Special personal services payments
9
8
8
11.9
Total personnel compensation
963
1,027
1,025
12.1
Civilian personnel benefits
287
308
308
12.2
Military personnel benefits
54
50
49
13.0
Benefits for former personnel
1
1
1
21.0
Travel and transportation of persons
78
46
34
22.0
Transportation of things
16
13
10
23.1
Rental payments to GSA
8
28
21
23.2
Rental payments to others
1
23.3
Communications, utilities, and miscellaneous charges
17
36
27
24.0
Printing and reproduction
3
3
2
25.1
Advisory and assistance services
922
866
684
25.2
Other services from non-Federal sources
197
251
188
25.3
Other goods and services from Federal sources
780
351
268
25.4
Operation and maintenance of facilities
19
57
40
25.5
Research and development contracts
35
35
26
25.6
Medical care
31
28
21
25.7
Operation and maintenance of equipment
52
90
66
25.8
Subsistence and support of persons
2
2
2
26.0
Supplies and materials
456
438
333
31.0
Equipment
59
69
51
32.0
Land and structures
6
10
1
41.0
Grants, subsidies, and contributions
3,758
3,518
2,711
99.0
Direct obligations
7,745
7,227
5,868
99.0
Reimbursable obligations
322
412
412
99.9
Total new obligations, unexpired accounts
8,067
7,639
6,280
Employment Summary
Identification code 075–0943–0–1–999
2016 actual
2017 est.
2018 est.
1001
Direct civilian full-time equivalent employment
9,096
9,287
9,287
1101
Direct military average strength employment
876
877
877
2001
Reimbursable civilian full-time equivalent employment
218
184
184
2101
Reimbursable military average strength employment
37
30
30
buildings and facilities
For equipment, construction, demolition, and renovation of facilities, $20,000,000, to remain available until September 30, 2022.
Note.—A full-year 2017 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
budget assumes this account is operating under the Further Continuing Appropriations Act, 2017 (P.L. 114–254). The amounts
included for 2017 reflect the annualized level provided by the continuing resolution.
Program and Financing (in millions of dollars)
Identification code 075–0960–0–1–551
2016 actual
2017 est.
2018 est.
Obligations by program activity:
0001
CDC Buildings and Facilities (0960)
9
10
20
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
2
3
3
Budget authority:
Appropriations, discretionary:
1100
Appropriation
10
10
20
1930
Total budgetary resources available
12
13
23
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
3
3
3
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
6
6
7
3010
New obligations, unexpired accounts
9
10
20
3020
Outlays (gross)
–9
–9
–14
3050
Unpaid obligations, end of year
6
7
13
Memorandum (non-add) entries:
3100
Obligated balance, start of year
6
6
7
3200
Obligated balance, end of year
6
7
13
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
10
10
20
Outlays, gross:
4010
Outlays from new discretionary authority
2
4
8
4011
Outlays from discretionary balances
7
5
6
4020
Outlays, gross (total)
9
9
14
4180
Budget authority, net (total)
10
10
20
4190
Outlays, net (total)
9
9
14
Object Classification (in millions of dollars)
Identification code 075–0960–0–1–551
2016 actual
2017 est.
2018 est.
Direct obligations:
25.1
Advisory and assistance services
2
2
3
25.4
Operation and maintenance of facilities
4
4
4
25.7
Operation and maintenance of equipment
1
2
32.0
Land and structures
3
3
11
99.9
Total new obligations, unexpired accounts
9
10
20
CDC Working Capital Fund
Program and Financing (in millions of dollars)
Identification code 075–4553–0–4–551
2016 actual
2017 est.
2018 est.
Obligations by program activity:
0801
CDC Working Capital Fund (Reimbursable)
590
532
532
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
52
52
52
1021
Recoveries of prior year unpaid obligations
19
1050
Unobligated balance (total)
71
52
52
Budget authority:
Spending authority from offsetting collections, discretionary:
1700
Collected
569
532
532
1701
Change in uncollected payments, Federal sources
2
1750
Spending auth from offsetting collections, disc (total)
571
532
532
1930
Total budgetary resources available
642
584
584
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
175
217
204
3010
New obligations, unexpired accounts
590
532
532
3020
Outlays (gross)
–529
–545
–534
3040
Recoveries of prior year unpaid obligations, unexpired
–19
3050
Unpaid obligations, end of year
217
204
202
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–2
–2
3070
Change in uncollected pymts, Fed sources, unexpired
–2
3090
Uncollected pymts, Fed sources, end of year
–2
–2
–2
Memorandum (non-add) entries:
3100
Obligated balance, start of year
175
215
202
3200
Obligated balance, end of year
215
202
200
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
571
532
532
Outlays, gross:
4010
Outlays from new discretionary authority
377
351
351
4011
Outlays from discretionary balances
152
194
183
4020
Outlays, gross (total)
529
545
534
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–569
–532
–532
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–2
4080
Outlays, net (discretionary)
–40
13
2
4180
Budget authority, net (total)
4190
Outlays, net (total)
–40
13
2
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
2016 actual
2017 est.
2018 est.
Reimbursable obligations:
Personnel compensation:
11.1
Full-time permanent
143
160
160
11.3
Other than full-time permanent
4
4
4
11.5
Other personnel compensation
3
3
3
11.7
Military personnel
3
3
3
11.9
Total personnel compensation
153
170
170
12.1
Civilian personnel benefits
48
53
53
12.2
Military personnel benefits
1
1
1
21.0
Travel and transportation of persons
1
2
2
22.0
Transportation of things
1
1
1
23.1
Rental payments to GSA
33
33
33
23.3
Communications, utilities, and miscellaneous charges
27
27
27
25.1
Advisory and assistance services
31
25
25
25.2
Other services from non-Federal sources
89
57
57
25.3
Other goods and services from Federal sources
66
63
63
25.4
Operation and maintenance of facilities
54
40
40
25.7
Operation and maintenance of equipment
55
40
40
26.0
Supplies and materials
1
3
3
31.0
Equipment
22
9
9
32.0
Land and structures
8
8
8
99.9
Total new obligations, unexpired accounts
590
532
532
Employment Summary
Identification code 075–4553–0–4–551
2016 actual
2017 est.
2018 est.
2001
Reimbursable civilian full-time equivalent employment
1,265
1,256
1,256
2101
Reimbursable military average strength employment
22
22
22
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, $62,000,000: 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 2018, and existing profiles may be updated as necessary.
Note.—A full-year 2017 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
budget assumes this account is operating under the Further Continuing Appropriations Act, 2017 (P.L. 114–254). The amounts
included for 2017 reflect the annualized level provided by the continuing resolution.
Program and Financing (in millions of dollars)
Identification code 075–0944–0–1–551
2016 actual
2017 est.
2018 est.
Obligations by program activity:
0001
Agency for Toxic Substances and Disease Registry, Toxic Substanc (Direct)
78
75
62
0801
Agency for Toxic Substances and Disease Registry, Toxic Substanc (Reimbursable)
5
6
6
0900
Total new obligations, unexpired accounts
83
81
68
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
27
25
25
1021
Recoveries of prior year unpaid obligations
1
1050
Unobligated balance (total)
28
25
25
Budget authority:
Appropriations, discretionary:
1100
Appropriation
75
75
62
Spending authority from offsetting collections, discretionary:
1700
Collected
2
6
3
1701
Change in uncollected payments, Federal sources
3
1750
Spending auth from offsetting collections, disc (total)
5
6
3
1900
Budget authority (total)
80
81
65
1930
Total budgetary resources available
108
106
90
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
25
25
22
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
44
47
28
3010
New obligations, unexpired accounts
83
81
68
3011
Obligations ("upward adjustments"), expired accounts
1
3020
Outlays (gross)
–79
–100
–76
3040
Recoveries of prior year unpaid obligations, unexpired
–1
3041
Recoveries of prior year unpaid obligations, expired
–1
3050
Unpaid obligations, end of year
47
28
20
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–5
–5
–5
3070
Change in uncollected pymts, Fed sources, unexpired
–3
3071
Change in uncollected pymts, Fed sources, expired
3
3090
Uncollected pymts, Fed sources, end of year
–5
–5
–5
Memorandum (non-add) entries:
3100
Obligated balance, start of year
39
42
23
3200
Obligated balance, end of year
42
23
15
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
80
81
65
Outlays, gross:
4010
Outlays from new discretionary authority
49
56
45
4011
Outlays from discretionary balances
27
44
31
4020
Outlays, gross (total)
76
100
76
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–5
–6
–3
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–3
4052
Offsetting collections credited to expired accounts
3
4070
Budget authority, net (discretionary)
75
75
62
4080
Outlays, net (discretionary)
71
94
73
Mandatory:
Outlays, gross:
4101
Outlays from mandatory balances
3
4180
Budget authority, net (total)
75
75
62
4190
Outlays, net (total)
74
94
73
Object Classification (in millions of dollars)
Identification code 075–0944–0–1–551
2016 actual
2017 est.
2018 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
22
20
20
11.3
Other than full-time permanent
2
2
2
11.7
Military personnel
4
4
4
11.9
Total personnel compensation
28
26
26
12.1
Civilian personnel benefits
7
7
7
12.2
Military personnel benefits
1
1
1
21.0
Travel and transportation of persons
1
1
1
25.1
Advisory and assistance services
11
11
7
25.2
Other services from non-Federal sources
4
4
3
25.3
Other goods and services from Federal sources
10
11
7
25.7
Operation and maintenance of equipment
1
1
1
41.0
Grants, subsidies, and contributions
16
13
9
99.0
Direct obligations
79
75
62
99.0
Reimbursable obligations
4
6
6
99.9
Total new obligations, unexpired accounts
83
81
68
Employment Summary
Identification code 075–0944–0–1–551
2016 actual
2017 est.
2018 est.
1001
Direct civilian full-time equivalent employment
222
227
227
1101
Direct military average strength employment
38
33
33
2001
Reimbursable civilian full-time equivalent employment
9
9
9
World Trade Center Health Program Fund
Program and Financing (in millions of dollars)
Identification code 075–0946–0–1–551
2016 actual
2017 est.
2018 est.
Obligations by program activity:
0001
World Trade Center Health Program - Federal Share (CDC/NIOSH)
313
347
366
0002
World Trade Center Health Program - NYC
39
41
0900
Total new obligations, unexpired accounts
313
386
407
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
797
967
1012
Unobligated balance transfers between expired and unexpired accounts
98
160
1050
Unobligated balance (total)
98
957
967
Budget authority:
Appropriations, mandatory:
1200
Appropriation (WTC (CDC Direct))
990
346
380
1200
Appropriation (WTC—NYC DHSS—CDC)
33
38
42
1230
Appropriations and/or unobligated balance of appropriations permanently reduced
–23
1260
Appropriations, mandatory (total)
1,000
384
422
Spending authority from offsetting collections, mandatory:
1800
Collected
12
12
1900
Budget authority (total)
1,012
396
422
1930
Total budgetary resources available
1,110
1,353
1,389
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
797
967
982
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
161
168
275
3010
New obligations, unexpired accounts
313
386
407
3011
Obligations ("upward adjustments"), expired accounts
31
3020
Outlays (gross)
–293
–279
–345
3041
Recoveries of prior year unpaid obligations, expired
–44
3050
Unpaid obligations, end of year
168
275
337
Memorandum (non-add) entries:
3100
Obligated balance, start of year
161
168
275
3200
Obligated balance, end of year
168
275
337
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
1,012
396
422
Outlays, gross:
4100
Outlays from new mandatory authority
204
182
194
4101
Outlays from mandatory balances
89
97
151
4110
Outlays, gross (total)
293
279
345
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123
Non-Federal sources
–48
–12
Additional offsets against gross budget authority only:
4142
Offsetting collections credited to expired accounts
36
4160
Budget authority, net (mandatory)
1,000
384
422
4170
Outlays, net (mandatory)
245
267
345
4180
Budget authority, net (total)
1,000
384
422
4190
Outlays, net (total)
245
267
345
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 2017 and 2018 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
2016 actual
2017 est.
2018 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
23
32
36
25.2
Other services from non-Federal sources
58
74
72
25.3
Other goods and services from Federal sources
11
13
13
25.6
Medical care
1
41.0
Grants, subsidies, and contributions
15
24
24
42.0
Insurance claims and indemnities
201
239
258
99.9
Total new obligations, unexpired accounts
313
386
407
Employment Summary
Identification code 075–0946–0–1–551
2016 actual
2017 est.
2018 est.
1001
Direct civilian full-time equivalent employment
16
16
16
1101
Direct military average strength employment
7
7
7
National Institutes of Health
Federal Funds
national cancer institute
For carrying out section 301 and title IV of the PHS Act with respect to cancer, $4,174,222,000, of which up to $10,000,000 may be used for facilities repairs and improvements at the National Cancer Institute—Frederick Federally Funded Research
and Development Center in Frederick, Maryland.
national heart, lung, and blood institute
For carrying out section 301 and title IV of the PHS Act with respect to cardiovascular, lung, and blood diseases, and blood
and blood products, $2,534,803,000.
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, $320,749,000.
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, $1,449,534,000.
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, $1,312,998,000.
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, $3,782,670,000.
national institute of general medical sciences
For carrying out section 301 and title IV of the PHS Act with respect to general medical sciences, $2,185,509,000, of which $780,000,000 shall be from funds available under section 241 of the PHS Act.
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, $1,032,029,000.
national eye institute
For carrying out section 301 and title IV of the PHS Act with respect to eye diseases and visual disorders, $549,847,000.
national institute of environmental health sciences
For carrying out section 301 and title IV of the PHS Act with respect to environmental health sciences, $533,537,000.
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, $59,607,000.
national institute on aging
For carrying out section 301 and title IV of the PHS Act with respect to aging, $1,303,541,000.
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,
$417,898,000.
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, $325,846,000.
national institute of nursing research
For carrying out section 301 and title IV of the PHS Act with respect to nursing research, $113,688,000.
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, $361,356,000
national institute on drug abuse
For carrying out section 301 and title IV of the PHS Act with respect to drug abuse, $864,998,000.
national institute of mental health
For carrying out section 301 and title IV of the PHS Act with respect to mental health, $1,201,901,000.
national human genome research institute
For carrying out section 301 and title IV of the PHS Act with respect to human genome research, $399,622,000.
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, $282,614,000.
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, $101,793,000.
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,
$214,723,000.
john e. fogarty international center
national library of medicine
For carrying out section 301 and title IV of the PHS Act with respect to health information communications, $373,258,000: Provided, That of the amounts available for improvement of information systems, $4,000,000 shall be available until September 30,
2019: Provided further, That in fiscal year 2018, 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").
national center for advancing translational sciences
For carrying out section 301 and title IV of the PHS Act with respect to translational sciences, $557,373,000: Provided, That up to $24,496,593 shall be available to implement section 480 of the PHS Act, relating to the Cures Acceleration Network.
office of the director
For carrying out the responsibilities of the Office of the Director, NIH, $1,329,833,000: 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 $441,823,000 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 $4,000,000 to make grants for construction or renovation of facilities as provided for in section 2354(a)(5)(B) of the PHS Act.
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.
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, $98,615,000, to remain available through September 30, 2022.
National Institute for Research on Safety 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, $272,000,000: Provided, That section 947(c) of the
PHS Act shall not apply in fiscal year 2018: 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 expended.
Note.—A full-year 2017 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
budget assumes this account is operating under the Further Continuing Appropriations Act, 2017 (P.L. 114–254). The amounts
included for 2017 reflect the annualized level provided by the continuing resolution.
Special and Trust Fund Receipts (in millions of dollars)
Identification code 075–9915–0–1–552
2016 actual
2017 est.
2018 est.
0100
Balance, start of year
11
Receipts:
Current law:
1130
Cooperative Research and Development Agreements, NIH
34
17
17
2000
Total: Balances and receipts
34
17
28
Appropriations:
Current law:
2101
National Institutes of Health
–34
–16
–16
2134
National Institutes of Health
10
2199
Total current law appropriations
–34
–6
–16
2999
Total appropriations
–34
–6
–16
5099
Balance, end of year
11
12
Program and Financing (in millions of dollars)
Identification code 075–9915–0–1–552
2016 actual
2017 est.
2018 est.
Obligations by program activity:
0001
National Cancer Institute (0849)
5,356
5,505
4,474
0002
National Heart, Lung, and Blood Institute (0872)
3,109
3,110
2,535
0003
National Institute of Dental and Craniofacial Research (0873)
413
415
321
0004
National Institute of Diabetes and Digestive and Kidney Disease (0884)
1,814
1,815
1,450
0005
National Institute of Neurological Disorders and Stroke (0886)
1,693
1,693
1,356
0006
National Institute of Allergy and Infectious Diseases (0885)
4,827
4,621
3,783
0007
National Institute of General Medical Sciences (0851)
1,729
1,729
1,406
0008
National Institute of Child Health and Human Development (0844)
1,338
1,337
1,032
0009
National Eye Institute (0887)
707
715
550
0010
National Institute of Environmental Health Sciences (0862)
695
770
593
0011
National Institute on Aging (0843)
1,602
1,597
1,304
0012
National Institute of Arthritis and Musculoskeletal and Skin Disease (0888)
541
541
418
0013
National Institute on Deafness and Other Communication Disorder (0890)
422
422
326
0014
National Institute of Mental Health (0892)
1,516
1,545
1,245
0015
National Institute on Drug Abuse (0893)
1,049
1,075
865
0016
National Institute on Alcohol Abuse and Alcoholism (0894)
467
467
361
0017
National Institute of Nursing Research (0889)
146
146
114
0018
National Human Genome Research Institute (0891)
512
518
400
0019
National Institute of Biomedical Imaging and Bioengineering (0898)
343
346
283
0021
National Center for Complementary and Integrative Health (0896)
130
131
102
0022
National Institute on Minority Health and Health Disparities (0897)
280
279
215
0023
John E. Fogarty International Center (0819)
70
70
0024
National Library of Medicine (0807)
395
394
373
0025
NIH Office of the Director (0846)
1,571
1,568
1,342
0026
NIH Buildings and facilities (0838)
80
129
99
0027
NIH Cooperative Research and Development Agreements
26
16
16
0028
National Center for Advancing Translational Sciences (0875)
684
684
557
0029
National Institute for Research on Safety and Quality
272
0031
Type 1 Diabetes
150
140
0799
Total direct obligations
31,665
31,778
25,792
0801
NIH Reimbursable - Other
3,598
3,767
3,609
0802
NIH Royalties
132
105
105
0809
Reimbursable program activities, subtotal
3,730
3,872
3,714
0899
Total reimbursable obligations
3,730
3,872
3,714
0900
Total new obligations, unexpired accounts
35,395
35,650
29,506
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
722
1,363
1,049
1001
Discretionary unobligated balance brought fwd, Oct 1
722
1,363
1011
Unobligated balance transfer from other acct [075–0140]
47
1011
Unobligated balance transfer from other acct [075–0140]
4
1011
Unobligated balance transfer from other acct [075–0943]
3
1021
Recoveries of prior year unpaid obligations
131
1033
Recoveries of prior year paid obligations
35
1050
Unobligated balance (total)
942
1,363
1,049
Budget authority:
Appropriations, discretionary:
1100
Appropriation
31,521
31,308
25,374
1121
Appropriations transferred from other acct [075–5736]
13
13
13
1121
Appropriations transferred from other acct [075–5628]
300
386
1160
Appropriation, discretionary (total)
31,534
31,621
25,773
Appropriations, mandatory:
1200
Appropriation
150
150
1201
Appropriation (special or trust fund)
34
16
16
1234
Appropriations precluded from obligation
–10
1260
Appropriations, mandatory (total)
184
156
16
Spending authority from offsetting collections, discretionary:
1700
Collected
3,563
3,559
3,559
1701
Change in uncollected payments, Federal sources
540
1750
Spending auth from offsetting collections, disc (total)
4,103
3,559
3,559
1900
Budget authority (total)
35,821
35,336
29,348
1930
Total budgetary resources available
36,763
36,699
30,397
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–5
1941
Unexpired unobligated balance, end of year
1,363
1,049
891
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
31,352
32,959
32,945
3010
New obligations, unexpired accounts
35,395
35,650
29,506
3011
Obligations ("upward adjustments"), expired accounts
883
3020
Outlays (gross)
–33,453
–35,664
–33,667
3040
Recoveries of prior year unpaid obligations, unexpired
–131
3041
Recoveries of prior year unpaid obligations, expired
–1,087
3050
Unpaid obligations, end of year
32,959
32,945
28,784
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–979
–1,207
–1,207
3070
Change in uncollected pymts, Fed sources, unexpired
–540
3071
Change in uncollected pymts, Fed sources, expired
312
3090
Uncollected pymts, Fed sources, end of year
–1,207
–1,207
–1,207
Memorandum (non-add) entries:
3100
Obligated balance, start of year
30,373
31,752
31,738
3200
Obligated balance, end of year
31,752
31,738
27,577
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
35,637
35,180
29,332
Outlays, gross:
4010
Outlays from new discretionary authority
9,817
12,096
11,933
4011
Outlays from discretionary balances
23,462
23,403
21,609
4020
Outlays, gross (total)
33,279
35,499
33,542
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–4,013
–3,559
–3,559
4033
Non-Federal sources
–157
4040
Offsets against gross budget authority and outlays (total)
–4,170
–3,559
–3,559
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–540
4052
Offsetting collections credited to expired accounts
575
4053
Recoveries of prior year paid obligations, unexpired accounts
32
4060
Additional offsets against budget authority only (total)
67
4070
Budget authority, net (discretionary)
31,534
31,621
25,773
4080
Outlays, net (discretionary)
29,109
31,940
29,983
Mandatory:
4090
Budget authority, gross
184
156
16
Outlays, gross:
4100
Outlays from new mandatory authority
2
50
16
4101
Outlays from mandatory balances
172
115
109
4110
Outlays, gross (total)
174
165
125
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120
Federal sources
–3
Additional offsets against gross budget authority only:
4143
Recoveries of prior year paid obligations, unexpired accounts
3
4160
Budget authority, net (mandatory)
184
156
16
4170
Outlays, net (mandatory)
171
165
125
4180
Budget authority, net (total)
31,718
31,777
25,789
4190
Outlays, net (total)
29,280
32,105
30,108
Summary of Budget Authority and Outlays (in millions of dollars)
2016 actual
2017 est.
2018 est.
Enacted/requested:
Budget Authority
31,718
31,777
25,789
Outlays
29,280
32,105
30,108
Legislative proposal, subject to PAYGO:
Budget Authority
150
Outlays
36
Total:
Budget Authority
31,718
31,777
25,939
Outlays
29,280
32,105
30,144
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. The FY 2018 Budget consolidates
the Agency for Healthcare Research and Quality within the National Institutes of Health as the National Institute for Research
on Safety and Quality, and dissolves the Fogarty International Center. 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
2016 actual
2017 est.
2018 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
941
971
1,021
11.3
Other than full-time permanent
505
514
527
11.5
Other personnel compensation
37
37
38
11.7
Military personnel
19
20
20
11.8
Special personal services payments
168
168
160
11.9
Total personnel compensation
1,670
1,710
1,766
12.1
Civilian personnel benefits
482
496
518
12.2
Military personnel benefits
12
12
14
21.0
Travel and transportation of persons
53
53
33
22.0
Transportation of things
5
5
3
23.1
Rental payments to GSA
22
23
18
23.3
Communications, utilities, and miscellaneous charges
26
26
18
24.0
Printing and reproduction
1
1
1
25.1
Advisory and assistance services
171
166
120
25.2
Other services from non-Federal sources
1,244
1,130
790
25.3
Other goods and services from Federal sources
3,048
3,092
2,769
25.4
Operation and maintenance of facilities
168
215
167
25.5
Research and development contracts
1,515
1,457
1,250
25.6
Medical care
34
34
21
25.7
Operation and maintenance of equipment
116
117
80
26.0
Supplies and materials
209
212
114
31.0
Equipment
173
168
97
41.0
Grants, subsidies, and contributions
22,716
22,861
18,013
99.0
Direct obligations
31,665
31,778
25,792
99.0
Reimbursable obligations
3,730
3,872
3,714
99.9
Total new obligations, unexpired accounts
35,395
35,650
29,506
Employment Summary
Identification code 075–9915–0–1–552
2016 actual
2017 est.
2018 est.
1001
Direct civilian full-time equivalent employment
12,958
13,335
13,581
1101
Direct military average strength employment
175
165
165
2001
Reimbursable civilian full-time equivalent employment
4,490
4,515
4,516
2101
Reimbursable military average strength employment
100
90
90
National Institutes of Health
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 075–9915–4–1–552
2016 actual
2017 est.
2018 est.
Obligations by program activity:
0031
Type 1 Diabetes
150
0799
Total direct obligations
150
0900
Total new obligations, unexpired accounts (object class 41.0)
150
Budgetary resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
150
1900
Budget authority (total)
150
1930
Total budgetary resources available
150
Change in obligated balance:
Unpaid obligations:
3010
New obligations, unexpired accounts
150
3020
Outlays (gross)
–36
3050
Unpaid obligations, end of year
114
Memorandum (non-add) entries:
3200
Obligated balance, end of year
114
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
150
Outlays, gross:
4100
Outlays from new mandatory authority
36
4180
Budget authority, net (total)
150
4190
Outlays, net (total)
36
Payment to the NIH Innovation Account, CURES Act
Program and Financing (in millions of dollars)
Identification code 075–0147–0–1–552
2016 actual
2017 est.
2018 est.
Obligations by program activity:
0001
Payment to NIH Innovation (object class 94.0)
352
496
0900
Total new obligations, unexpired accounts (object class 94.0)
352
496
Budgetary resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
352
496
1930
Total budgetary resources available
352
496
Change in obligated balance:
Unpaid obligations:
3010
New obligations, unexpired accounts
352
496
3020
Outlays (gross)
–352
–496
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
352
496
Outlays, gross:
4100
Outlays from new mandatory authority
352
496
4180
Budget authority, net (total)
352
496
4190
Outlays, net (total)
352
496
This account, and a related special receipt account, were established to support the execution structure necessary to implement
the 21st Century Cures Act.
NIH Innovation, CURES Act
For necessary expenses to carry out the purposes described in section 1001(b)(4) of the 21st Century Cures Act, in addition
to amounts available for such purposes in the appropriations provided to the National Institutes of Health in this Act, $496,000,000,
to remain available until expended: Provided, That such amounts are appropriated pursuant to section 1001(b)(3) of such Act
and are to be derived from amounts transferred under section 1001(b)(2)(A) of such Act: Provided further, That of the amount
appropriated under this heading, $300,000,000 shall be transferred to the "National Cancer Institute" for the purposes described
in section 1001(b)(4)(C) of such Act, $43,000,000 shall be transferred to the "National Institute of Neurological Disorders
and Stroke" for the purposes described in section 1001(b)(4)(B) of such Act, and $43,000,000 shall be transferred to the "National
Institute of Mental Health" for the purposes described in section 1001(b)(4)(B) of such Act: Provided further, That remaining
amounts may be transferred by the Director of the National Institutes of Health to any accounts of the National Institutes
of Health: Provided further, That upon a determination by the Director that funds transferred pursuant to any of the previous
provisos are not necessary for the purposes provided, such amounts may be transferred back to this account: Provided further,
That the transfer authority provided under this heading is in addition to any other transfer authority provided by law.
Special and Trust Fund Receipts (in millions of dollars)
Identification code 075–5628–0–2–552
2016 actual
2017 est.
2018 est.
0100
Balance, start of year
Receipts:
Current law:
1140
General Fund Payment, NIH Innovation, CURES Act
352
496
2000
Total: Balances and receipts
352
496
Appropriations:
Current law:
2101
NIH Innovation, Cures Act
–352
–496
5099
Balance, end of year
Program and Financing (in millions of dollars)
Identification code 075–5628–0–2–552
2016 actual
2017 est.
2018 est.
Obligations by program activity:
0001
CURES obligations
52
110
0900
Total new obligations, unexpired accounts (object class 41.0)
52
110
Budgetary resources:
Budget authority:
Appropriations, discretionary:
1101
Appropriation (special or trust fund)
352
496
1120
Appropriations transferred to other acct [075–9915]
–300
–386
1160
Appropriation, discretionary (total)
52
110
1930
Total budgetary resources available
52
110
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
40
3010
New obligations, unexpired accounts
52
110
3020
Outlays (gross)
–12
–51
3050
Unpaid obligations, end of year
40
99
Memorandum (non-add) entries:
3100
Obligated balance, start of year
40
3200
Obligated balance, end of year
40
99
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
52
110
Outlays, gross:
4010
Outlays from new discretionary authority
12
26
4011
Outlays from discretionary balances
25
4020
Outlays, gross (total)
12
51
4180
Budget authority, net (total)
52
110
4190
Outlays, net (total)
12
51
The Cures Act was enacted into law on December 13, 2016. The Cures Act authorizes $4.8 billion over 10 years for four NIH
Innovation Projects, and includes amendments to the Public Health Service Act to advance Precision Medicine and other high
priority NIH activities.
10-Year Pediatric Research Initiative Fund
Special and Trust Fund Receipts (in millions of dollars)
Identification code 075–5736–0–2–552
2016 actual
2017 est.
2018 est.
0100
Balance, start of year
26
13
Receipts:
Current law:
1140
Transfers from Presidential Election Campaign Fund
13
2000
Total: Balances and receipts
26
13
13
Appropriations:
Current law:
2101
10-Year Pediatric Research Initiative Fund
–13
–13
–13
5099
Balance, end of year
13
Program and Financing (in millions of dollars)
Identification code 075–5736–0–2–552
2016 actual
2017 est.
2018 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, $896,808,000: 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, $15,539,000 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 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: 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, $14,971,000 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).
SUBSTANCE ABUSE TREATMENT
For carrying out titles III and V of the PHS Act with respect to substance abuse treatment and title XIX of such Act with respect to substance abuse treatment and prevention, $2,115,235,000: Provided, That in addition to amounts provided herein, $81,200,000 shall be available under section 241 of the PHS Act 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: Provided further, That none of the funds provided for section 1921 of the PHS Act shall be subject to section 241 of such Act.
SUBSTANCE ABUSE PREVENTION
For carrying out titles III and V of the PHS Act with respect to substance abuse prevention, $149,703,000.
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"), $108,922,000: Provided, That in addition to amounts provided herein, $23,426,000 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(o) of the PHS Act shall remain available through September 30, 2019: 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 Assistant Secretary for Mental Health and Substance Use 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.
Note.—A full-year 2017 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
budget assumes this account is operating under the Further Continuing Appropriations Act, 2017 (P.L. 114–254). The amounts
included for 2017 reflect the annualized level provided by the continuing resolution.
Program and Financing (in millions of dollars)
Identification code 075–1362–0–1–551
2016 actual
2017 est.
2018 est.
Obligations by program activity:
0006
Mental Health
1,133
1,132
897
0007
Substance Abuse Treatment
2,111
2,615
2,615
0008
Substance Abuse Prevention
211
223
150
0009
Health Surveillance and Program Support
175
175
109
0011
SAMHSA Prevention Fund
12
12
0100
Total, direct program
3,642
4,157
3,771
0799
Total direct obligations
3,642
4,157
3,771
0802
SAMHSA Reimbursables
117
117
117
0810
SAMHSA Reimbursable: PHS Evaluation
133
133
120
0899
Total reimbursable obligations
250
250
237
0900
Total new obligations, unexpired accounts
3,892
4,407
4,008
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
1
1
1001
Discretionary unobligated balance brought fwd, Oct 1
1
1
Budget authority:
Appropriations, discretionary:
1100
Appropriation
3,634
3,644
3,271
1120
Appropriations transferred to other acct [075–0943]
–4
1121
Appropriations transferred from other acct [075–5627]
500
500
1160
Appropriation, discretionary (total)
3,630
4,144
3,771
Appropriations, mandatory:
1221
Appropriations transferred from the Prevention and Public Health Fund [075–0116]
12
12
Spending authority from offsetting collections, discretionary:
1700
Collected
53
250
237
1701
Change in uncollected payments, Federal sources
197
1750
Spending auth from offsetting collections, disc (total)
250
250
237
1900
Budget authority (total)
3,892
4,406
4,008
1930
Total budgetary resources available
3,893
4,407
4,008
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
1
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
3,728
3,977
4,462
3010
New obligations, unexpired accounts
3,892
4,407
4,008
3011
Obligations ("upward adjustments"), expired accounts
20
3020
Outlays (gross)
–3,575
–3,922
–3,925
3041
Recoveries of prior year unpaid obligations, expired
–88
3050
Unpaid obligations, end of year
3,977
4,462
4,545
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–126
–245
–245
3070
Change in uncollected pymts, Fed sources, unexpired
–197
3071
Change in uncollected pymts, Fed sources, expired
78
3090
Uncollected pymts, Fed sources, end of year
–245
–245
–245
Memorandum (non-add) entries:
3100
Obligated balance, start of year
3,602
3,732
4,217
3200
Obligated balance, end of year
3,732
4,217
4,300
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
3,880
4,394
4,008
Outlays, gross:
4010
Outlays from new discretionary authority
1,118
1,222
1,114
4011
Outlays from discretionary balances
2,417
2,686
2,803
4020
Outlays, gross (total)
3,535
3,908
3,917
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–131
–248
–235
4033
Non-Federal sources
–1
–2
–2
4040
Offsets against gross budget authority and outlays (total)
–132
–250
–237
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–197
4052
Offsetting collections credited to expired accounts
79
4060
Additional offsets against budget authority only (total)
–118
4070
Budget authority, net (discretionary)
3,630
4,144
3,771
4080
Outlays, net (discretionary)
3,403
3,658
3,680
Mandatory:
4090
Budget authority, gross
12
12
Outlays, gross:
4100
Outlays from new mandatory authority
4
4101
Outlays from mandatory balances
40
10
8
4110
Outlays, gross (total)
40
14
8
4180
Budget authority, net (total)
3,642
4,156
3,771
4190
Outlays, net (total)
3,443
3,672
3,688
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
2016 actual
2017 est.
2018 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
47
48
48
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
56
56
12.1
Civilian personnel benefits
16
16
16
12.2
Military personnel benefits
2
2
2
21.0
Travel and transportation of persons
1
1
1
23.1
Rental payments to GSA
10
6
6
23.3
Communications, utilities, and miscellaneous charges
1
1
1
24.0
Printing and reproduction
1
1
1
25.1
Advisory and assistance services
30
33
33
25.2
Other services from non-Federal sources
185
172
174
25.3
Other goods and services from Federal sources
93
99
45
25.4
Operation and maintenance of facilities
1
1
1
26.0
Supplies and materials
1
1
1
41.0
Grants, subsidies, and contributions
3,246
3,768
3,434
99.0
Direct obligations
3,642
4,157
3,771
99.0
Reimbursable obligations
250
250
237
99.9
Total new obligations, unexpired accounts
3,892
4,407
4,008
Employment Summary
Identification code 075–1362–0–1–551
2016 actual
2017 est.
2018 est.
1001
Direct civilian full-time equivalent employment
462
455
451
1101
Direct military average strength employment
41
40
40
2001
Reimbursable civilian full-time equivalent employment
103
105
104
2101
Reimbursable military average strength employment
14
15
15
Agency for Healthcare Research and Quality
Federal Funds
Healthcare research and quality
Note.—A full-year 2017 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
budget assumes this account is operating under the Further Continuing Appropriations Act, 2017 (P.L. 114–254). The amounts
included for 2017 reflect the annualized level provided by the continuing resolution.
Program and Financing (in millions of dollars)
Identification code 075–1700–0–1–552
2016 actual
2017 est.
2018 est.
Obligations by program activity:
0001
Research on Health Costs, Quality and Outcomes
197
196
0002
Medical Expenditure Panel Survey
66
66
0003
AHRQ Program Support
71
71
0799
Total direct obligations
334
333
0803
Research on Health Costs, Quality and Outcomes (Reimbursable)
22
22
0899
Total reimbursable obligations
22
22
0900
Total new obligations, unexpired accounts
356
355
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
16
15
19
Budget authority:
Appropriations, discretionary:
1100
Appropriation
334
333
Spending authority from offsetting collections, discretionary:
1700
Collected
1
26
1701
Change in uncollected payments, Federal sources
20
1750
Spending auth from offsetting collections, disc (total)
21
26
1900
Budget authority (total)
355
359
1930
Total budgetary resources available
371
374
19
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
15
19
19
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
392
382
411
3010
New obligations, unexpired accounts
356
355
3011
Obligations ("upward adjustments"), expired accounts
2
3020
Outlays (gross)
–349
–326
–288
3041
Recoveries of prior year unpaid obligations, expired
–19
3050
Unpaid obligations, end of year
382
411
123
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–156
–85
–85
3070
Change in uncollected pymts, Fed sources, unexpired
–20
3071
Change in uncollected pymts, Fed sources, expired
91
3090
Uncollected pymts, Fed sources, end of year
–85
–85
–85
Memorandum (non-add) entries:
3100
Obligated balance, start of year
236
297
326
3200
Obligated balance, end of year
297
326
38
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
355
359
Outlays, gross:
4010
Outlays from new discretionary authority
123
143
4011
Outlays from discretionary balances
218
183
288
4020
Outlays, gross (total)
341
326
288
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–80
–26
4040
Offsets against gross budget authority and outlays (total)
–80
–26
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–20
4052
Offsetting collections credited to expired accounts
79
4060
Additional offsets against budget authority only (total)
59
4070
Budget authority, net (discretionary)
334
333
4080
Outlays, net (discretionary)
261
300
288
Mandatory:
Outlays, gross:
4101
Outlays from mandatory balances
8
4180
Budget authority, net (total)
334
333
4190
Outlays, net (total)
269
300
288
The FY 2018 Budget consolidates the Agency for Healthcare Research and Quality within the National Institutes of Health as
the National Institute for Research on Safety and Quality.
Object Classification (in millions of dollars)
Identification code 075–1700–0–1–552
2016 actual
2017 est.
2018 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
31
31
11.3
Other than full-time permanent
4
4
11.5
Other personnel compensation
1
1
11.7
Military personnel
1
1
11.9
Total personnel compensation
37
37
12.1
Civilian personnel benefits
10
10
23.1
Rental payments to GSA
4
4
23.3
Communications, utilities, and miscellaneous charges
1
1
25.2
Other services from non-Federal sources
10
10
25.3
Other goods and services from Federal sources
25
25
25.5
Research and development contracts
135
135
31.0
Equipment
1
1
41.0
Grants, subsidies, and contributions
111
110
99.0
Direct obligations
334
333
99.0
Reimbursable obligations
22
22
99.9
Total new obligations, unexpired accounts
356
355
Employment Summary
Identification code 075–1700–0–1–552
2016 actual
2017 est.
2018 est.
1001
Direct civilian full-time equivalent employment
275
293
1101
Direct military average strength employment
7
7
2001
Reimbursable civilian full-time equivalent employment
2
6
3001
Allocation account civilian full-time equivalent employment
10
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, $284,798,384,000, to remain available until expended.
In addition, for carrying out such titles after May 31, 2018, for the last quarter of fiscal year 2018 for unanticipated costs incurred for the current fiscal year, such sums as may be necessary, to remain available until expended.
In addition, for carrying out such titles for the first quarter of fiscal year 2019, $134,847,759,000, 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.
Note.—A full-year 2017 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
budget assumes this account is operating under the Further Continuing Appropriations Act, 2017 (P.L. 114–254). The amounts
included for 2017 reflect the annualized level provided by the continuing resolution.
Program and Financing (in millions of dollars)
Identification code 075–0512–0–1–551
2016 actual
2017 est.
2018 est.
Obligations by program activity:
0001
Medicaid Vendor Payments
372,603
354,194
384,609
0002
State and local administration
20,451
20,831
20,811
0003
Vaccines for Children
4,396
4,437
4,598
0799
Total direct obligations
397,450
379,462
410,018
0801
Medicare Part B premiums
767
941
1,026
0802
Medicare Part D
3
3
0899
Total reimbursable obligations
767
944
1,029
0900
Total new obligations, unexpired accounts
398,217
380,406
411,047
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
343
413
1
1021
Recoveries of prior year unpaid obligations
30,729
1033
Recoveries of prior year paid obligations
14
1050
Unobligated balance (total)
31,086
413
1
Budget authority:
Appropriations, mandatory:
1200
Appropriation
253,400
263,467
284,798
Advance appropriations, mandatory:
1270
Advance appropriation
113,272
115,583
125,219
Spending authority from offsetting collections, mandatory:
1800
Collected
767
944
1,029
1801
Change in uncollected payments, Federal sources
105
1850
Spending auth from offsetting collections, mand (total):
872
944
1,029
1900
Budget authority (total)
367,544
379,994
411,046
1930
Total budgetary resources available
398,630
380,407
411,047
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
413
1
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
42,222
40,649
41,656
3010
New obligations, unexpired accounts
398,217
380,406
411,047
3020
Outlays (gross)
–369,061
–379,399
–408,599
3040
Recoveries of prior year unpaid obligations, unexpired
–30,729
3050
Unpaid obligations, end of year
40,649
41,656
44,104
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–105
–105
3070
Change in uncollected pymts, Fed sources, unexpired
–105
3090
Uncollected pymts, Fed sources, end of year
–105
–105
–105
Memorandum (non-add) entries:
3100
Obligated balance, start of year
42,222
40,544
41,551
3200
Obligated balance, end of year
40,544
41,551
43,999