[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; in addition
to amounts appropriated to the FDA Innovation Account, for carrying out the activities described in section 1002(b)(4) of
the 21st Century Cures Act (Public Law 114–255); 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; $5,897,299,000: Provided, That of the amount provided under this heading, $1,119,188,000 shall be derived from prescription drug user fees authorized by 21 U.S.C. 379h, and shall be credited to this account and
remain available until expended; $238,595,000 shall be derived from medical device user fees authorized by 21 U.S.C. 379j, and shall be credited to this account and remain
available until expended; $526,039,000 shall be derived from human generic drug user fees authorized by 21 U.S.C. 379j-42, and shall be credited to this account
and remain available until expended; $42,998,000 shall be derived from biosimilar biological product user fees authorized by 21 U.S.C. 379j-52, and shall be credited to this
account and remain available until expended; $31,306,000 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; $20,609,000 shall be derived from generic new animal drug user fees authorized by 21 U.S.C. 379j-21, and shall be credited to this account
and remain available until expended; $712,000,000 shall be derived from tobacco product user fees authorized by 21 U.S.C.
387s, and shall be credited to this account and remain available until expended: Provided further, That in addition to and notwithstanding any other provision under this heading, amounts collected for prescription drug
user fees, medical device user fees, human generic drug user fees, biosimilar biological product user fees, animal drug user
fees, and generic new animal drug user fees that exceed the respective fiscal year 2021 limitations are appropriated and shall be credited to this account and remain available until expended: Provided further, That fees derived from prescription drug, medical device, human generic drug, biosimilar biological product, animal drug,
and generic new animal drug assessments for fiscal year 2021, including any such fees collected prior to fiscal year 2021 but credited for fiscal year 2021, shall be subject to the fiscal year 2021 limitations: Provided further, That the Secretary may accept payment during fiscal year 2021 of user fees specified under this heading and authorized for fiscal year 2022, prior to the due date for such fees, and that amounts of such fees assessed for fiscal year 2022 for which the Secretary accepts payment in fiscal year 2021 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 any transfer of funds pursuant to section 770(n) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379dd(n)) shall
only be from amounts made available under this heading for other activities: Provided further, That funds may be transferred from one specified activity to another with the prior notice to 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, and, contingent
upon the enactment of the Over-the-Counter Monograph User Fee Act of 2020, fees relating to over-the-counter monograph drugs authorized by part 10 of subchapter C of Chapter VII of the Federal Food,
Drug and Cosmetic Act shall be credited to this account, to remain available until expended.
(Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2020.)
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, $13,788,000, to remain available until expended.
(Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2020.)
Special and Trust Fund Receipts (in millions of dollars)
Identification code 075–9911–0–1–554
2019 actual
2020 est.
2021 est.
0100
Balance, start of year
1
1
2
Receipts:
Current law:
1130
Cooperative Research and Development Agreements, FDA
1
3
3
2000
Total: Balances and receipts
2
4
5
Appropriations:
Current law:
2101
Salaries and Expenses
–1
–2
–2
5099
Balance, end of year
1
2
3
Program and Financing (in millions of dollars)
Identification code 075–9911–0–1–554
2019 actual
2020 est.
2021 est.
Obligations by program activity:
0001
Foods
1,060
1,089
1,091
0002
Human Drugs
663
683
683
0003
Devices and Radiological Health
387
395
416
0004
National Center for Toxicological Research
67
67
66
0005
FDA Other Activities (FDA Headquaters)
186
185
187
0006
FDA Other Rent and Rent Related Activities (Including White Oak Consolidation)
115
126
154
0007
FDA GSA Rental Payments
170
171
167
0008
FDA Buildings and Facilities
12
32
14
0009
Cooperative Research and Development (CRADA)
1
2
2
0010
Animal Drugs and Feed
179
191
190
0011
Biologics
240
252
252
0015
CURES Activities
75
70
0016
Emerging Health Threats
5
0017
Opioids - IMF
65
0018
FDA HCFAC Wedge Fund
6
0799
Total direct obligations
3,156
3,268
3,292
0801
FDA Reimbursable program (User fees)
2,447
2,664
2,744
0802
FDA Reimbursable program (Federal sources)
32
0899
Total reimbursable obligations
2,479
2,664
2,744
0900
Total new obligations, unexpired accounts
5,635
5,932
6,036
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
927
1,022
1,017
1001
Discretionary unobligated balance brought fwd, Oct 1
926
1,000
1021
Recoveries of prior year unpaid obligations
57
1050
Unobligated balance (total)
984
1,022
1,017
Budget authority:
Appropriations, discretionary:
1100
Appropriation
3,080
3,192
3,220
1120
Appropriations transferred to other accts [075–0128]
–2
–2
1121
Appropriations transferred from other acct [075–5629]
75
70
1160
Appropriation, discretionary (total)
3,078
3,265
3,290
Appropriations, mandatory:
1201
Appropriation (special or trust fund)
1
2
2
Spending authority from offsetting collections, discretionary:
1700
Collected
2,557
2,660
2,743
1700
Collected
10
22
1701
Change in uncollected payments, Federal sources
22
–22
1702
Offsetting collections (previously unavailable)
772
1725
Spending authority from offsetting collections precluded from obligation (limitation on obligations)
–774
1750
Spending auth from offsetting collections, disc (total)
2,587
2,660
2,743
Spending authority from offsetting collections, mandatory:
1800
Collected
1
1801
Change in uncollected payments, Federal sources
6
1850
Spending auth from offsetting collections, mand (total)
7
1900
Budget authority (total)
5,673
5,927
6,035
1930
Total budgetary resources available
6,657
6,949
7,052
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
1,022
1,017
1,016
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
2,978
2,867
2,993
3010
New obligations, unexpired accounts
5,635
5,932
6,036
3011
Obligations ("upward adjustments"), expired accounts
26
3020
Outlays (gross)
–5,615
–5,806
–6,294
3040
Recoveries of prior year unpaid obligations, unexpired
–57
3041
Recoveries of prior year unpaid obligations, expired
–100
3050
Unpaid obligations, end of year
2,867
2,993
2,735
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–70
–66
–44
3070
Change in uncollected pymts, Fed sources, unexpired
–28
22
3071
Change in uncollected pymts, Fed sources, expired
32
3090
Uncollected pymts, Fed sources, end of year
–66
–44
–44
Memorandum (non-add) entries:
3100
Obligated balance, start of year
2,908
2,801
2,949
3200
Obligated balance, end of year
2,801
2,949
2,691
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
5,665
5,925
6,033
Outlays, gross:
4010
Outlays from new discretionary authority
3,323
4,735
4,832
4011
Outlays from discretionary balances
2,284
1,063
1,460
4020
Outlays, gross (total)
5,607
5,798
6,292
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources:
–35
–22
4033
Non-Federal sources:
–2,557
–2,660
–2,743
4040
Offsets against gross budget authority and outlays (total)
–2,592
–2,682
–2,743
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–22
22
4052
Offsetting collections credited to expired accounts
25
4060
Additional offsets against budget authority only (total)
3
22
4070
Budget authority, net (discretionary)
3,076
3,265
3,290
4080
Outlays, net (discretionary)
3,015
3,116
3,549
Mandatory:
4090
Budget authority, gross
8
2
2
Outlays, gross:
4100
Outlays from new mandatory authority
6
2
2
4101
Outlays from mandatory balances
2
6
4110
Outlays, gross (total)
8
8
2
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120
Federal sources:
–6
4123
Non-Federal sources:
–1
4130
Offsets against gross budget authority and outlays (total)
–1
–6
Additional offsets against gross budget authority only:
4140
Change in uncollected pymts, Fed sources, unexpired
–6
4142
Offsetting collections credited to expired accounts
6
4150
Additional offsets against budget authority only (total)
–6
6
4160
Budget authority, net (mandatory)
1
2
2
4170
Outlays, net (mandatory)
7
2
2
4180
Budget authority, net (total)
3,077
3,267
3,292
4190
Outlays, net (total)
3,022
3,118
3,551
Memorandum (non-add) entries:
5090
Unexpired unavailable balance, SOY: Offsetting collections
804
806
806
5092
Unexpired unavailable balance, EOY: Offsetting collections
806
806
806
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 advance innovations that make medicines
more effective, safe, and 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 2021 Budget includes $6.2 billion in total resources for FDA. The Budget
invests in priority activities such as artificial intelligence, regulation of cannabis and cannabis derivatives, modernizing
influenza vaccines, food safety track and trace, and infrastructure.
Object Classification (in millions of dollars)
Identification code 075–9911–0–1–554
2019 actual
2020 est.
2021 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
880
971
977
11.3
Other than full-time permanent
88
99
100
11.5
Other personnel compensation
39
45
45
11.7
Military personnel
59
61
62
11.8
Special personal services payments
1
1
1
11.9
Total personnel compensation
1,067
1,177
1,185
12.1
Civilian personnel benefits
332
367
369
12.2
Military personnel benefits
32
33
34
21.0
Travel and transportation of persons
50
47
48
22.0
Transportation of things
3
3
3
23.1
Rental payments to GSA
173
171
167
23.2
Rental payments to others
1
1
1
23.3
Communications, utilities, and miscellaneous charges
18
17
17
24.0
Printing and reproduction
2
2
2
25.1
Advisory and assistance services
44
42
43
25.2
Other services from non-Federal sources
412
412
416
25.3
Other goods and services from Federal sources
506
484
489
25.4
Operation and maintenance of facilities
139
133
135
25.5
Research and development contracts
20
19
20
25.7
Operation and maintenance of equipment
35
33
34
26.0
Supplies and materials
39
38
38
31.0
Equipment
63
60
61
32.0
Land and structures
3
3
3
41.0
Grants, subsidies, and contributions
215
223
225
42.0
Insurance claims and indemnities
2
2
2
99.0
Direct obligations
3,156
3,267
3,292
99.0
Reimbursable obligations
2,479
2,665
2,744
99.9
Total new obligations, unexpired accounts
5,635
5,932
6,036
Employment Summary
Identification code 075–9911–0–1–554
2019 actual
2020 est.
2021 est.
1001
Direct civilian full-time equivalent employment
8,439
8,576
8,637
1101
Direct military average strength employment
658
658
658
2001
Reimbursable civilian full-time equivalent employment
6,269
6,811
6,974
2101
Reimbursable military average strength employment
488
488
488
3001
Allocation account civilian full-time equivalent employment
25
25
25
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 innovative food products activities
and over-the-counter monograph drug activities: Provided, That fees of $28,000,000 for innovative food products shall be credited
to this account and remain available until expended; $28,400,000 for over-the-counter monograph drug activities 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 innovative food products and over-the-counter monograph drug user fees
that exceed the respective fiscal year 2021 limitations are appropriated and shall be credited to this account and remain
available until expended: Provided further, That fees derived from innovative food products and over-the-counter monograph
drug reviews for fiscal year 2021 received during fiscal year 2021, including any such fees assessed prior to fiscal year
2021 but credited for fiscal year 2021, shall be subject to the fiscal year 2021 limitations: Provided further, That the Secretary
may accept payment during fiscal year 2021 of user fees specified in this paragraph and authorized for fiscal year 2022, prior
to the due date for such fees, and that amounts of such fees assessed for fiscal year 2022 for which the Secretary accepts
payment in fiscal year 2021 shall not be included in amounts in this paragraph.
In addition, contingent upon the enactment of authorizing legislation establishing fees under 21 U.S.C. 387s with respect
to products deemed under 21 U.S.C. 387a(b) but not specified in 21 U.S.C. 387s(b)(2)(B), the Secretary shall assess and collect
such fees: Provided, That $100,000,000 shall be derived from such fees, which shall be credited to this account and remain
available until expended, in addition to amounts otherwise derived from fees authorized under 21 U.S.C. 387s.
Program and Financing (in millions of dollars)
Identification code 075–9911–2–1–554
2019 actual
2020 est.
2021 est.
Obligations by program activity:
0801
FDA Reimbursable program (Tobacco, OTC and Food innovation)
156
Budgetary resources:
Budget authority:
Spending authority from offsetting collections, discretionary:
1700
Collected
156
1900
Budget authority (total)
156
1930
Total budgetary resources available
156
Change in obligated balance:
Unpaid obligations:
3010
New obligations, unexpired accounts
156
3020
Outlays (gross)
–156
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
156
Outlays, gross:
4010
Outlays from new discretionary authority
156
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4033
Non-Federal sources:
–156
4040
Offsets against gross budget authority and outlays (total)
–156
4180
Budget authority, net (total)
4190
Outlays, net (total)
The FY 2021 Budget proposes reforms to the Over-the-Counter Monograph program and includes a total of $28 million in new over-the-counter
drug fees. The Budget proposes a new user fee program to support innovative food activities totaling $28 million. The Budget
also includes a legislative proposal to increase the user fee collected in support of the tobacco program by $100 million
and adds electronic nicotine delivery system manufacturers and importers as entities subject to the user fees.
Object Classification (in millions of dollars)
Identification code 075–9911–2–1–554
2019 actual
2020 est.
2021 est.
Reimbursable obligations:
Personnel compensation:
11.1
Full-time permanent
5
11.3
Other than full-time permanent
1
11.5
Other personnel compensation
1
11.9
Total personnel compensation
7
12.1
Civilian personnel benefits
2
21.0
Travel and transportation of persons
3
25.1
Advisory and assistance services
12
25.2
Other services from non-Federal sources
91
25.3
Other goods and services from Federal sources
41
99.0
Reimbursable obligations
156
99.9
Total new obligations, unexpired accounts
156
Employment Summary
Identification code 075–9911–2–1–554
2019 actual
2020 est.
2021 est.
2001
Reimbursable civilian full-time equivalent employment
52
FDA Working Capital Fund
Program and Financing (in millions of dollars)
Identification code 075–4613–0–4–554
2019 actual
2020 est.
2021 est.
Obligations by program activity:
0001
Direct program activity
324
324
324
0801
Reimbursable program activity
257
295
295
0900
Total new obligations, unexpired accounts
581
619
619
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
5
33
33
Budget authority:
Spending authority from offsetting collections, discretionary:
1700
Collected
609
619
619
1900
Budget authority (total)
609
619
619
1930
Total budgetary resources available
614
652
652
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
33
33
33
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
205
3010
New obligations, unexpired accounts
581
619
619
3020
Outlays (gross)
–376
–824
–619
3050
Unpaid obligations, end of year
205
Memorandum (non-add) entries:
3100
Obligated balance, start of year
205
3200
Obligated balance, end of year
205
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
609
619
619
Outlays, gross:
4010
Outlays from new discretionary authority
376
619
619
4011
Outlays from discretionary balances
205
4020
Outlays, gross (total)
376
824
619
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–609
–619
–619
4180
Budget authority, net (total)
4190
Outlays, net (total)
–233
205
Object Classification (in millions of dollars)
Identification code 075–4613–0–4–554
2019 actual
2020 est.
2021 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
73
73
73
11.3
Other than full-time permanent
1
1
1
11.5
Other personnel compensation
2
2
2
11.7
Military personnel
1
1
1
11.9
Total personnel compensation
77
77
77
12.1
Civilian personnel benefits
26
26
26
12.2
Military personnel benefits
1
1
1
21.0
Travel and transportation of persons
1
1
1
23.3
Communications, utilities, and miscellaneous charges
6
6
6
24.0
Printing and reproduction
1
1
1
25.1
Advisory and assistance services
15
15
15
25.2
Other services from non-Federal sources
77
77
77
25.3
Other goods and services from Federal sources
54
54
54
25.4
Operation and maintenance of facilities
3
3
3
25.7
Operation and maintenance of equipment
56
56
56
26.0
Supplies and materials
4
4
4
31.0
Equipment
1
1
1
41.0
Grants, subsidies, and contributions
1
1
1
42.0
Insurance claims and indemnities
1
1
1
99.0
Direct obligations
324
324
324
Reimbursable obligations:
Personnel compensation:
11.1
Full-time permanent
58
58
58
11.3
Other than full-time permanent
1
1
1
11.5
Other personnel compensation
1
1
1
11.7
Military personnel
1
1
1
11.9
Total personnel compensation
61
61
61
12.1
Civilian personnel benefits
20
20
20
21.0
Travel and transportation of persons
1
1
1
23.3
Communications, utilities, and miscellaneous charges
5
5
5
24.0
Printing and reproduction
1
1
1
25.1
Advisory and assistance services
12
12
12
25.2
Other services from non-Federal sources
63
63
63
25.3
Other goods and services from Federal sources
43
81
81
25.4
Operation and maintenance of facilities
2
2
2
25.7
Operation and maintenance of equipment
44
44
44
26.0
Supplies and materials
3
3
3
41.0
Grants, subsidies, and contributions
1
1
1
43.0
Interest and dividends
1
1
1
99.0
Reimbursable obligations
257
295
295
99.9
Total new obligations, unexpired accounts
581
619
619
Employment Summary
Identification code 075–4613–0–4–554
2019 actual
2020 est.
2021 est.
1001
Direct civilian full-time equivalent employment
697
697
697
1101
Direct military average strength employment
8
8
8
2001
Reimbursable civilian full-time equivalent employment
480
480
480
2101
Reimbursable military average strength employment
6
6
6
Payment to the FDA Innovation Account, CURES Act
Program and Financing (in millions of dollars)
Identification code 075–0148–0–1–554
2019 actual
2020 est.
2021 est.
Obligations by program activity:
0001
Direct program activity
70
75
70
0900
Total new obligations, unexpired accounts (object class 94.0)
70
75
70
Budgetary resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
70
75
70
1930
Total budgetary resources available
70
75
70
Change in obligated balance:
Unpaid obligations:
3010
New obligations, unexpired accounts
70
75
70
3020
Outlays (gross)
–70
–75
–70
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
70
75
70
Outlays, gross:
4100
Outlays from new mandatory authority
70
75
70
4180
Budget authority, net (total)
70
75
70
4190
Outlays, net (total)
70
75
70
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 Account, Cures Act
(including transfer of funds)
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", $70,000,000, 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 Commissioner
of Food and Drugs to the appropriation for "Department of Health and Human Services Food and Drug Administration Salaries
and Expenses" solely for the purposes provided in such Act: Provided further, That upon a determination by the Commissioner that funds transferred pursuant to the previous proviso are not necessary
for the purposes provided, such amounts may be transferred back to the account: Provided further, That such transfer authority is in addition to any other transfer authority provided by law.
(Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2020.)
Special and Trust Fund Receipts (in millions of dollars)
Identification code 075–5629–0–2–554
2019 actual
2020 est.
2021 est.
0100
Balance, start of year
Receipts:
Current law:
1140
General Fund Payment, FDA Innovation, CURES Act
70
75
70
2000
Total: Balances and receipts
70
75
70
Appropriations:
Current law:
2101
FDA Innovation, Cures Act
–70
–75
–70
5099
Balance, end of year
Program and Financing (in millions of dollars)
Identification code 075–5629–0–2–554
2019 actual
2020 est.
2021 est.
Obligations by program activity:
0001
New Obligations for CURES Activities
58
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
26
38
38
Budget authority:
Appropriations, discretionary:
1101
Appropriation (special or trust)
70
75
70
1120
Appropriations transferred to other acct [075–9911]
–75
–70
1160
Appropriation, discretionary (total)
70
1930
Total budgetary resources available
96
38
38
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
38
38
38
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
27
42
2
3010
New obligations, unexpired accounts
58
3020
Outlays (gross)
–43
–40
3050
Unpaid obligations, end of year
42
2
2
Memorandum (non-add) entries:
3100
Obligated balance, start of year
27
42
2
3200
Obligated balance, end of year
42
2
2
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
70
Outlays, gross:
4010
Outlays from new discretionary authority
17
4011
Outlays from discretionary balances
26
40
4020
Outlays, gross (total)
43
40
4180
Budget authority, net (total)
70
4190
Outlays, net (total)
43
40
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 product, and device product development and review and to create greater efficiencies and predictability
in product development and review.
Object Classification (in millions of dollars)
Identification code 075–5629–0–2–554
2019 actual
2020 est.
2021 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
13
11.3
Other than full-time permanent
3
11.5
Other personnel compensation
2
11.9
Total personnel compensation
18
12.1
Civilian personnel benefits
6
25.2
Other services from non-Federal sources
15
26.0
Supplies and materials
1
41.0
Grants, subsidies, and contributions
18
99.9
Total new obligations, unexpired accounts
58
Employment Summary
Identification code 075–5629–0–2–554
2019 actual
2020 est.
2021 est.
1001
Direct civilian full-time equivalent employment
136
Revolving Fund for Certification and Other Services
Program and Financing (in millions of dollars)
Identification code 075–4309–0–3–554
2019 actual
2020 est.
2021 est.
Obligations by program activity:
0801
Revolving Fund for Certification and Other Services (Reimbursable)
9
10
11
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
3
3
3
Budget authority:
Spending authority from offsetting collections, mandatory:
1800
Collected
9
10
10
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
11
1900
Budget authority (total)
9
10
11
1930
Total budgetary resources available
12
13
14
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
4
5
2
3010
New obligations, unexpired accounts
9
10
11
3020
Outlays (gross)
–8
–13
–11
3050
Unpaid obligations, end of year
5
2
2
Memorandum (non-add) entries:
3100
Obligated balance, start of year
4
5
2
3200
Obligated balance, end of year
5
2
2
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
9
10
11
Outlays, gross:
4100
Outlays from new mandatory authority
5
10
11
4101
Outlays from mandatory balances
3
3
4110
Outlays, gross (total)
8
13
11
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123
Non-Federal sources
–9
–10
–10
4180
Budget authority, net (total)
1
4190
Outlays, net (total)
–1
3
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
2019 actual
2020 est.
2021 est.
Reimbursable obligations:
Personnel compensation:
11.1
Full-time permanent
3
3
3
11.3
Other than full-time permanent
1
1
1
11.9
Total personnel compensation
4
4
4
12.1
Civilian personnel benefits
1
1
1
23.1
Rental payments to GSA
1
2
2
25.3
Other goods and services from Federal sources
1
1
1
25.4
Operation and maintenance of facilities
1
1
1
26.0
Supplies and materials
1
1
2
99.9
Total new obligations, unexpired accounts
9
10
11
Employment Summary
Identification code 075–4309–0–3–554
2019 actual
2020 est.
2021 est.
2001
Reimbursable civilian full-time equivalent employment
33
37
37
Health Resources and Services Administration
Federal Funds
Primary health care
For carrying out titles II and III of the Public Health Service Act (referred to in this Act as the "PHS Act") with respect
to primary health care and the Native Hawaiian Health Care Act of 1988, $1,728,522,000: Provided, That no more than $1,000,000 shall be available until expended for carrying out the provisions of section 224(o) of the
PHS Act: Provided further, That no more than $120,000,000 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 of
the Social Security Act, and the Health Care Quality Improvement Act of 1986, $370,425,000: Provided, That sections 751 and 762(k) of the PHS Act and the proportional funding amounts in paragraphs (1) through (4) of section 756(f) 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 section and subpart: Provided further, That $120,000,000 shall remain available until expended for the purposes of providing primary health services, assigning
National Health Service Corps ("NHSC") members to expand the delivery of substance use disorder treatment services, notwithstanding
the assignment priorities and limitations under sections 333(a)(1)(D), 333(b), and 333A(a)(1)(B)(ii) of the PHS Act, and making
payments under the NHSC Loan Repayment Program under section 338B of such Act: Provided further, That for purposes of the previous proviso, section 331(a)(3)(D) of the PHS Act shall be applied as if the term "primary health services" includes clinical substance
use disorder treatment services, including those provided by masters level, licensed substance use disorder treatment counselors.
Maternal and child health
For carrying out titles III, XI, XII, and XIX of the PHS Act with respect to maternal and child health and title V of the
Social Security Act, $919,018,000: Provided, That notwithstanding sections 502(a)(1) and 502(b)(1) of the Social Security Act, not more than $132,593,000 shall be available for carrying out special projects of regional and national significance pursuant to section 501(a)(2)
of such Act and $10,276,000 shall be available for projects described in subparagraphs (A) through (F) of section 501(a)(3)
of such Act.
Ryan white HIV/AIDS program
For carrying out title XXVI of the PHS Act with respect to the Ryan White HIV/AIDS program, $2,483,781,000, of which $1,970,881,000 shall remain available to the Secretary through September 30, 2023, for parts A and B of title XXVI of the PHS Act, and of which not less than $900,313,000 shall be for State AIDS Drug Assistance
Programs under the authority of section 2616 or 311(c) of such Act; and of which $165,000,000, to remain available until expended, shall be available to the Secretary for carrying out a program of grants and contracts
under title XXVI or section 311(c) of such Act focused on ending the nationwide HIV/AIDS epidemic, with any grants issued
under such section 311(c) administered in conjunction with title XXVI of the PHS Act, including the limitation on administrative
expenses.
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, $102,033,000: Provided, That in addition to amounts provided herein, $13,385,000 shall be from funds available under section
241 of the PHS Act to supplement funding for organ transplantation activities: Provided further, That the Secretary may collect
a fee of 0.1 percent of each purchase of 340B drugs from entities participating in the Drug Pricing Program pursuant to section
340B of the PHS Act to pay for the operating costs of such program: Provided further, That fees pursuant to the 340B Drug
Pricing Program shall be collected by the Secretary based on sales data that shall be submitted by drug manufacturers and
shall be credited to this account to remain available until expended.
Rural health
For carrying out titles III and IV of the PHS Act with respect to rural health, section 427(a) of the Federal Coal Mine Health
and Safety Act of 1969, and sections 711 and 1820 of the Social Security Act, $246,834,000.
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".
(Department of Health and Human Services Appropriations Act, 2020.)
Program and Financing (in millions of dollars)
Identification code 075–0350–0–1–550
2019 actual
2020 est.
2021 est.
Obligations by program activity:
0005
Primary Health Care (Health Centers, Free Clinics)
1,644
1,707
1,729
0010
Primary Health Care (Mandatory)
4,047
2,576
0015
Health Workforce
1,091
1,324
370
0020
Health Workforce (Mandatory)
439
281
0025
Maternal and Child Health
923
944
919
0030
Maternal and Child Health (Mandatory)
6
6
6
0035
Ryan White HIV/AIDS
2,332
2,390
2,484
0040
Health Care Systems
114
124
102
0045
Rural Health
352
361
247
0050
Family Planning
285
286
286
0055
HRSA Program Management
155
155
152
0091
Direct program activities, subtotal
11,388
10,154
6,295
0300
Total direct programs
11,388
10,154
6,295
Credit program obligations:
0702
Loan guarantee subsidy
1
2
0799
Total direct obligations
11,388
10,155
6,297
0801
Health Resources and Services (Reimbursable)
68
51
75
0802
HRSA Reimbursable program: PHS evaluation
13
0899
Total reimbursable obligations
68
51
88
0900
Total new obligations, unexpired accounts
11,456
10,206
6,385
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
454
460
201
1001
Discretionary unobligated balance brought fwd, Oct 1
336
345
1010
Unobligated balance transfer to other accts [075–0116]
–8
1010
Unobligated balance transfer to other accts [015–5606]
–5
–5
–5
1021
Recoveries of prior year unpaid obligations
72
1050
Unobligated balance (total)
513
455
196
Budget authority:
Appropriations, discretionary:
1100
Appropriation
6,844
7,037
6,289
1120
Appropriations transferred to other acct [075–1503]
–21
1121
Appropriations transferred from other acct [075–0140]
80
1160
Appropriation, discretionary (total)
6,903
7,037
6,289
Appropriations, mandatory:
1200
Appropriation
4,443
2,863
6
Spending authority from offsetting collections, discretionary:
1700
Collected
22
31
68
1701
Change in uncollected payments, Federal sources
10
1750
Spending auth from offsetting collections, disc (total)
32
31
68
Spending authority from offsetting collections, mandatory:
1800
Offsetting collections (cash)(HPSL&NSL)
27
20
20
1802
Offsetting collections (previously unavailable)
2
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)
27
21
21
1900
Budget authority (total)
11,405
9,952
6,384
1930
Total budgetary resources available
11,918
10,407
6,580
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–2
1941
Unexpired unobligated balance, end of year
460
201
195
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
7,969
8,278
8,025
3010
New obligations, unexpired accounts
11,456
10,206
6,385
3011
Obligations ("upward adjustments"), expired accounts
34
3020
Outlays (gross)
–11,002
–10,459
–8,565
3040
Recoveries of prior year unpaid obligations, unexpired
–72
3041
Recoveries of prior year unpaid obligations, expired
–107
3050
Unpaid obligations, end of year
8,278
8,025
5,845
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–16
–16
–16
3070
Change in uncollected pymts, Fed sources, unexpired
–10
3071
Change in uncollected pymts, Fed sources, expired
10
3090
Uncollected pymts, Fed sources, end of year
–16
–16
–16
Memorandum (non-add) entries:
3100
Obligated balance, start of year
7,953
8,262
8,009
3200
Obligated balance, end of year
8,262
8,009
5,829
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
6,935
7,068
6,357
Outlays, gross:
4010
Outlays from new discretionary authority
2,247
2,297
2,040
4011
Outlays from discretionary balances
4,388
4,476
4,822
4020
Outlays, gross (total)
6,635
6,773
6,862
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–12
–12
–25
4033
Non-Federal sources
–23
–19
–43
4040
Offsets against gross budget authority and outlays (total)
–35
–31
–68
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–10
4052
Offsetting collections credited to expired accounts
13
4060
Additional offsets against budget authority only (total)
3
4070
Budget authority, net (discretionary)
6,903
7,037
6,289
4080
Outlays, net (discretionary)
6,600
6,742
6,794
Mandatory:
4090
Budget authority, gross
4,470
2,884
27
Outlays, gross:
4100
Outlays from new mandatory authority
1,904
1,269
23
4101
Outlays from mandatory balances
2,463
2,417
1,680
4110
Outlays, gross (total)
4,367
3,686
1,703
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123
Non-Federal sources
–27
–20
–20
4180
Budget authority, net (total)
11,346
9,901
6,296
4190
Outlays, net (total)
10,940
10,408
8,477
Memorandum (non-add) entries:
5090
Unexpired unavailable balance, SOY: Offsetting collections
2
2
1
5092
Unexpired unavailable balance, EOY: Offsetting collections
2
1
5103
Unexpired unavailable balance, SOY: Fulfilled purpose
1
1
5104
Unexpired unavailable balance, EOY: Fulfilled purpose
1
Summary of Budget Authority and Outlays (in millions of dollars)
2019 actual
2020 est.
2021 est.
Enacted/requested:
Budget Authority
11,346
9,901
6,296
Outlays
10,940
10,408
8,477
Legislative proposal, subject to PAYGO:
Budget Authority
1,580
4,437
Outlays
689
2,771
Total:
Budget Authority
11,346
11,481
10,733
Outlays
10,940
11,097
11,248
Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in millions of dollars)
Identification code 075–0350–0–1–550
2019 actual
2020 est.
2021 est.
Guaranteed loan levels supportable by subsidy budget authority:
215001
Health centers: Facilities renovation loan guarantee levels
60
66
215999
Total loan guarantee levels
60
66
Guaranteed loan subsidy (in percent):
232001
Health centers: Facilities renovation loan guarantee levels
0.00
2.57
2.78
232999
Weighted average subsidy rate
0.00
2.57
2.78
Guaranteed loan subsidy budget authority:
233001
Health centers: Facilities renovation loan guarantee levels
2
2
233999
Total subsidy budget authority
2
2
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 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 program's 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 2018–2019 data reported in the Annual Operating Report.
Health Professions Revolving Loan Programs Federal Capital Contribution
Program
Account Balance
HPSL
436,419,789
NSL
201,922,803
PCL
216,454,324
LDS
187,255,691
Total
1,042,052,607
Object Classification (in millions of dollars)
Identification code 075–0350–0–1–550
2019 actual
2020 est.
2021 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
205
199
161
11.3
Other than full-time permanent
7
7
6
11.5
Other personnel compensation
5
5
4
11.7
Military personnel
20
18
14
11.9
Total personnel compensation
237
229
185
12.1
Civilian personnel benefits
67
64
52
12.2
Military personnel benefits
11
10
8
13.0
Benefits for former personnel
2
2
2
21.0
Travel and transportation of persons
4
4
3
23.1
Rental payments to GSA
20
20
16
23.2
Rental payments to others
1
1
1
23.3
Communications, utilities, and miscellaneous charges
5
4
2
25.1
Advisory and assistance services
12
12
9
25.2
Other services from non-Federal sources
266
268
210
25.3
Other goods and services from Federal sources
303
293
146
25.4
Operation and maintenance of facilities
1
1
1
25.6
Medical care
2
2
2
25.7
Operation and maintenance of equipment
5
5
4
26.0
Supplies and materials
1
1
1
31.0
Equipment
8
6
5
32.0
Land and structures
4
4
4
41.0
Grants, subsidies, and contributions
10,304
9,122
5,538
42.0
Insurance claims and indemnities
135
107
108
99.0
Direct obligations
11,388
10,155
6,297
99.0
Reimbursable obligations
68
51
88
99.9
Total new obligations, unexpired accounts
11,456
10,206
6,385
Employment Summary
Identification code 075–0350–0–1–550
2019 actual
2020 est.
2021 est.
1001
Direct civilian full-time equivalent employment
1,808
1,735
1,426
1101
Direct military average strength employment
191
178
144
2001
Reimbursable civilian full-time equivalent employment
52
52
68
2101
Reimbursable military average strength employment
1
1
1
Health Resources and Services
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 075–0350–4–1–550
2019 actual
2020 est.
2021 est.
Obligations by program activity:
0010
Primary Health Care (Mandatory)
1,425
4,000
0020
Health Workforce (Mandatory)
155
437
0091
Direct program activities, subtotal
1,580
4,437
0300
Total direct programs
1,580
4,437
0900
Total new obligations, unexpired accounts
1,580
4,437
Budgetary resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
1,580
4,437
1900
Budget authority (total)
1,580
4,437
1930
Total budgetary resources available
1,580
4,437
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
891
3010
New obligations, unexpired accounts
1,580
4,437
3020
Outlays (gross)
–689
–2,771
3050
Unpaid obligations, end of year
891
2,557
Memorandum (non-add) entries:
3100
Obligated balance, start of year
891
3200
Obligated balance, end of year
891
2,557
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
1,580
4,437
Outlays, gross:
4100
Outlays from new mandatory authority
689
1,935
4101
Outlays from mandatory balances
836
4110
Outlays, gross (total)
689
2,771
4180
Budget authority, net (total)
1,580
4,437
4190
Outlays, net (total)
689
2,771
Resources displayed here support grants and contracts managed by Health Resources and Services Administration (HRSA). These
activities include support for Health Centers and health workforce programs.
Object Classification (in millions of dollars)
Identification code 075–0350–4–1–550
2019 actual
2020 est.
2021 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
17
48
11.3
Other than full-time permanent
1
11.5
Other personnel compensation
1
11.7
Military personnel
2
6
11.9
Total personnel compensation
19
56
12.1
Civilian personnel benefits
6
16
12.2
Military personnel benefits
1
3
23.1
Rental payments to GSA
4
23.3
Communications, utilities, and miscellaneous charges
2
2
25.2
Other services from non-Federal sources
37
42
25.3
Other goods and services from Federal sources
112
122
25.7
Operation and maintenance of equipment
1
31.0
Equipment
3
41.0
Grants, subsidies, and contributions
1,403
4,188
99.9
Total new obligations, unexpired accounts
1,580
4,437
Employment Summary
Identification code 075–0350–4–1–550
2019 actual
2020 est.
2021 est.
1001
Direct civilian full-time equivalent employment
130
365
1101
Direct military average strength employment
13
36
Vaccine Injury Compensation
Program and Financing (in millions of dollars)
Identification code 075–0320–0–1–551
2019 actual
2020 est.
2021 est.
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
33
35
35
1033
Recoveries of prior year paid obligations
2
1050
Unobligated balance (total)
35
35
35
1930
Total budgetary resources available
35
35
35
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
35
35
35
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
2019 actual
2020 est.
2021 est.
Obligations by program activity:
0001
Claims
1
1
0103
Admin Expense
2
2
2
0900
Total new obligations, unexpired accounts
2
3
3
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
1
1
1
1011
Unobligated balance transfer from other acct [075–0140]
2
3
3
1050
Unobligated balance (total)
3
4
4
1930
Total budgetary resources available
3
4
4
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
1
1
1
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
1
1
1
3010
New obligations, unexpired accounts
2
3
3
3020
Outlays (gross)
–2
–3
3050
Unpaid obligations, end of year
1
1
4
Memorandum (non-add) entries:
3100
Obligated balance, start of year
1
1
1
3200
Obligated balance, end of year
1
1
4
Budget authority and outlays, net:
Discretionary:
Outlays, gross:
4011
Outlays from discretionary balances
2
3
4180
Budget authority, net (total)
4190
Outlays, net (total)
2
3
The Covered Countermeasure Process Fund is established pursuant to the Public Health Service (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
2019 actual
2020 est.
2021 est.
Direct obligations:
25.2
Other services from non-Federal sources
1
1
1
42.0
Insurance claims and indemnities
1
1
99.0
Direct obligations
1
2
2
99.5
Adjustment for rounding
1
1
1
99.9
Total new obligations, unexpired accounts
2
3
3
Employment Summary
Identification code 075–0343–0–1–551
2019 actual
2020 est.
2021 est.
1001
Direct civilian full-time equivalent employment
3
3
3
1101
Direct military average strength employment
2
2
2
Maternal, Infant, and Early Childhood Home Visiting Programs
Program and Financing (in millions of dollars)
Identification code 075–0321–0–1–551
2019 actual
2020 est.
2021 est.
Obligations by program activity:
0010
Maternal, Infant, and Early Childhood Home Visiting Programs
402
376
400
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
20
26
26
1021
Recoveries of prior year unpaid obligations
8
1050
Unobligated balance (total)
28
26
26
Budget authority:
Appropriations, mandatory:
1200
Appropriation
400
400
400
1230
Appropriations and/or unobligated balance of appropriations permanently reduced
–24
1260
Appropriations, mandatory (total)
400
376
400
1930
Total budgetary resources available
428
402
426
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
26
26
26
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
748
758
748
3010
New obligations, unexpired accounts
402
376
400
3020
Outlays (gross)
–384
–386
–392
3040
Recoveries of prior year unpaid obligations, unexpired
–8
3050
Unpaid obligations, end of year
758
748
756
Memorandum (non-add) entries:
3100
Obligated balance, start of year
748
758
748
3200
Obligated balance, end of year
758
748
756
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
400
376
400
Outlays, gross:
4100
Outlays from new mandatory authority
11
15
16
4101
Outlays from mandatory balances
373
371
376
4110
Outlays, gross (total)
384
386
392
4180
Budget authority, net (total)
400
376
400
4190
Outlays, net (total)
384
386
392
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
2019 actual
2020 est.
2021 est.
11.1
Direct obligations: Personnel compensation: Full-time permanent
5
5
5
11.9
Total personnel compensation
5
5
5
12.1
Civilian personnel benefits
2
2
2
25.1
Advisory and assistance services
14
13
13
41.0
Grants, subsidies, and contributions
381
356
380
99.9
Total new obligations, unexpired accounts
402
376
400
Employment Summary
Identification code 075–0321–0–1–551
2019 actual
2020 est.
2021 est.
1001
Direct civilian full-time equivalent employment
36
36
36
1101
Direct military average strength employment
2
2
2
Health Center Guaranteed Loan Financing Account
Program and Financing (in millions of dollars)
Identification code 075–4442–0–3–551
2019 actual
2020 est.
2021 est.
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
1
1
1
1930
Total budgetary resources available
1
1
1
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
1
1
1
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
1
3020
Outlays (gross)
–1
Memorandum (non-add) entries:
3100
Obligated balance, start of year
1
Financing authority and disbursements, net:
Mandatory:
Financing disbursements:
4110
Outlays, gross (total)
1
4180
Budget authority, net (total)
4190
Outlays, net (total)
1
Status of Guaranteed Loans (in millions of dollars)
Identification code 075–4442–0–3–551
2019 actual
2020 est.
2021 est.
Position with respect to appropriations act limitation on commitments:
2111
Guaranteed loan commitments from current-year authority
2121
Limitation available from carry-forward
888
888
828
2143
Uncommitted limitation carried forward
–888
–828
–762
2150
Total guaranteed loan commitments
60
66
2199
Guaranteed amount of guaranteed loan commitments
48
53
Cumulative balance of guaranteed loans outstanding:
2210
Outstanding, start of year
60
34
83
2231
Disbursements of new guaranteed loans
60
66
2251
Repayments and prepayments
–26
–10
–10
Adjustments:
2263
Terminations for default that result in claim payments
–1
–1
2264
Other adjustments, net
2290
Outstanding, end of year
34
83
138
Memorandum:
2299
Guaranteed amount of guaranteed loans outstanding, end of year
25
64
108
Public Law 104–299, Public Law 104–208, and Public Law 115–141 authorize Health Resources and Services Administration (HRSA)
to guarantee up to $1 billion 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
2018 actual
2019 actual
ASSETS:
1101
Federal assets: Fund balances with Treasury
1
1
1999
Total assets
1
1
LIABILITIES:
2204
Non-Federal liabilities: Liabilities for loan guarantees
1
1
NET POSITION:
3300
Cumulative results of operations
4999
Total liabilities and net position
1
1
Medical Facilities Guarantee and Loan Fund
Status of Direct Loans (in millions of dollars)
Identification code 075–9931–0–3–551
2019 actual
2020 est.
2021 est.
Cumulative balance of direct loans outstanding:
1210
Outstanding, start of year
5
5
5
1290
Outstanding, end of year
5
5
5
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
2018 actual
2019 actual
ASSETS:
1601
Direct loans, gross
5
5
1999
Total assets
5
5
LIABILITIES:
2201
Non-Federal liabilities: Accounts payable
5
5
NET POSITION:
3100
Unexpended appropriations
3300
Cumulative results of operations
3999
Total net position
4999
Total liabilities and net position
5
5
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 $16,200,000 shall be available from the Trust Fund to the Secretary.
(Department of Health and Human Services Appropriations Act, 2020.)
Special and Trust Fund Receipts (in millions of dollars)
Identification code 075–8175–0–7–551
2019 actual
2020 est.
2021 est.
0100
Balance, start of year
3,684
3,818
3,921
0198
Adjustment to reconcile to budgetary accounting
4
0199
Balance, start of year
3,688
3,818
3,921
Receipts:
Current law:
1110
Deposits, Vaccine Injury Compensation Trust Fund
280
303
309
1140
Interest and Profits on Investments, Vaccine Injury Compensation Trust Fund
94
92
101
1199
Total current law receipts
374
395
410
1999
Total receipts
374
395
410
2000
Total: Balances and receipts
4,062
4,213
4,331
Appropriations:
Current law:
2101
Vaccine Injury Compensation Program Trust Fund
–28
–32
–45
2101
Vaccine Injury Compensation Program Trust Fund
–346
–260
–266
2135
Vaccine Injury Compensation Program Trust Fund
120
2199
Total current law appropriations
–254
–292
–311
2999
Total appropriations
–254
–292
–311
4030
Vaccine Injury Compensation Program Trust Fund
9
5098
Adjustment to reconcile to budgetary accounting
1
5099
Balance, end of year
3,818
3,921
4,020
Program and Financing (in millions of dollars)
Identification code 075–8175–0–7–551
2019 actual
2020 est.
2021 est.
Obligations by program activity:
0001
Compensation: Claims for post - FY 1989 injuries
226
260
266
0103
Claims processing (Claims Court)
9
9
10
0104
Claims processing (HRSA)
9
10
16
0105
Claims processing (Dept. of Justice)
10
13
19
0191
Direct program activities, subtotal
28
32
45
0900
Total new obligations, unexpired accounts
254
292
311
Budgetary resources:
Unobligated balance:
1033
Recoveries of prior year paid obligations
9
1035
Unobligated balance of appropriations withdrawn
–9
Budget authority:
Appropriations, discretionary:
1101
Appropriation (special or trust)
28
32
45
Appropriations, mandatory:
1201
Appropriation (special or trust fund)
346
260
266
1235
Appropriations precluded from obligation (special or trust)
–120
1260
Appropriations, mandatory (total)
226
260
266
1900
Budget authority (total)
254
292
311
1930
Total budgetary resources available
254
292
311
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
19
13
3010
New obligations, unexpired accounts
254
292
311
3020
Outlays (gross)
–260
–305
–311
3050
Unpaid obligations, end of year
13
Memorandum (non-add) entries:
3100
Obligated balance, start of year
19
13
3200
Obligated balance, end of year
13
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
28
32
45
Outlays, gross:
4010
Outlays from new discretionary authority
21
32
45
4011
Outlays from discretionary balances
13
4020
Outlays, gross (total)
34
32
45
Mandatory:
4090
Budget authority, gross
226
260
266
Outlays, gross:
4100
Outlays from new mandatory authority
226
260
266
4101
Outlays from mandatory balances
13
4110
Outlays, gross (total)
226
273
266
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123
Non-Federal sources
–9
Additional offsets against gross budget authority only:
4143
Recoveries of prior year paid obligations, unexpired accounts
9
4160
Budget authority, net (mandatory)
226
260
266
4170
Outlays, net (mandatory)
217
273
266
4180
Budget authority, net (total)
254
292
311
4190
Outlays, net (total)
251
305
311
Memorandum (non-add) entries:
5000
Total investments, SOY: Federal securities: Par value
3,750
3,849
3,984
5001
Total investments, EOY: Federal securities: Par value
3,849
3,984
4,128
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
2019 actual
2020 est.
2021 est.
Direct obligations:
11.1
Personnel compensation: Full-time permanent
2
2
3
12.1
Civilian personnel benefits
1
1
1
25.3
Other goods and services from Federal sources
5
5
5
42.0
Insurance claims and indemnities
246
284
302
99.9
Total new obligations, unexpired accounts
254
292
311
Employment Summary
Identification code 075–8175–0–7–551
2019 actual
2020 est.
2021 est.
1001
Direct civilian full-time equivalent employment
14
16
23
1101
Direct military average strength employment
5
5
5
Indian Health Service
Federal Funds
Indian health service
For expenses necessary to carry out the Act of August 5, 1954 (68 Stat. 674), the Indian Self-Determination and Education
Assistance Act, the Indian Health Care Improvement Act, and titles II and III of the Public Health Service Act with respect
to the Indian Health Service, $4,507,113,000 to remain available until September 30, 2022, except as otherwise provided herein, together with payments received during the fiscal year pursuant to sections 231(b)
and 233 of the Public Health Service Act (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 $964,783,000 for Purchased/Referred Care, including $53,000,000 for the Indian Catastrophic Health Emergency Fund, shall remain available
until expended: Provided further, That of the funds provided, up to $44,000,000 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, $58,000,000 shall be for costs related to or resulting from accreditation emergencies, including supplementing activities
funded under the heading "Indian Health Facilities," of which up to $4,000,000 may be used to supplement amounts otherwise
available for Purchased/Referred Care: 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 in the Fund authorized
by section 108A of that Act (25 U.S.C. 1616a-1) and shall remain available until expended and, notwithstanding section 108A(c)
of that 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 that Act (25 U.S.C. 1613a and 1616a): Provided further, That the amounts made available within this account for the Substance Abuse and Suicide Prevention Program, for Opioid Prevention,
Treatment and Recovery Services, for the Domestic Violence Prevention Program, for the Zero Suicide Initiative, for recruitment and retention, including a housing subsidy authority for civilian employees, for Aftercare Pilot Programs at Youth Regional Treatment Centers, for transformation
and modernization costs of the Indian Health Service Electronic Health Record system, for national quality and oversight activities,to
improve collections from public and private insurance at Indian Health Service and tribally operated facilities, for an initiative to treat or reduce the transmission of HIV and HCV, for the Telebehaviorial Health Center of Excellence,
for a maternal health initiative, for Community Health, 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 (25 U.S.C. 1613) 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, and from 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 of the funds provided, $72,280,000 is for the Indian Health Care Improvement Fund and may be used, as needed, to carry
out activities typically funded under the Indian Health Facilities account.
(Department of the Interior, Environment, and Related Agencies Appropriations Act, 2020.)
Program and Financing (in millions of dollars)
Identification code 075–0390–0–1–551
2019 actual
2020 est.
2021 est.
Obligations by program activity:
0001
Clinical services
3,753
3,935
4,178
0002
Preventive health
165
178
142
0003
Urban health
49
58
49
0004
Indian health professions
60
65
52
0005
Tribal management
2
2
0006
Direct operations
70
72
81
0007
Self-governance
4
6
5
0009
Diabetes funds
150
97
0799
Total direct obligations
4,253
4,413
4,507
0801
Indian Health Services (Reimbursable)
1,641
1,704
1,771
0900
Total new obligations, unexpired accounts
5,894
6,117
6,278
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
1,219
1,510
1,606
1001
Discretionary unobligated balance brought fwd, Oct 1
1,192
1,504
1021
Recoveries of prior year unpaid obligations
192
1050
Unobligated balance (total)
1,411
1,510
1,606
Budget authority:
Appropriations, discretionary:
1100
Appropriation
4,103
4,315
4,507
Appropriations, mandatory:
1200
Appropriation
150
97
Spending authority from offsetting collections, discretionary:
1700
Collected
1,738
1,801
1,868
1701
Change in uncollected payments, Federal sources
4
1750
Spending auth from offsetting collections, disc (total)
1,742
1,801
1,868
1900
Budget authority (total)
5,995
6,213
6,375
1930
Total budgetary resources available
7,406
7,723
7,981
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–2
1941
Unexpired unobligated balance, end of year
1,510
1,606
1,703
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
1,139
1,199
767
3010
New obligations, unexpired accounts
5,894
6,117
6,278
3011
Obligations ("upward adjustments"), expired accounts
43
3020
Outlays (gross)
–5,670
–6,549
–6,341
3040
Recoveries of prior year unpaid obligations, unexpired
–192
3041
Recoveries of prior year unpaid obligations, expired
–15
3050
Unpaid obligations, end of year
1,199
767
704
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–106
–109
–109
3070
Change in uncollected pymts, Fed sources, unexpired
–4
3071
Change in uncollected pymts, Fed sources, expired
1
3090
Uncollected pymts, Fed sources, end of year
–109
–109
–109
Memorandum (non-add) entries:
3100
Obligated balance, start of year
1,033
1,090
658
3200
Obligated balance, end of year
1,090
658
595
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
5,845
6,116
6,375
Outlays, gross:
4010
Outlays from new discretionary authority
4,504
5,339
5,564
4011
Outlays from discretionary balances
1,018
1,111
773
4020
Outlays, gross (total)
5,522
6,450
6,337
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–437
–436
–436
4033
Non-Federal sources
–1,302
–1,365
–1,432
4040
Offsets against gross budget authority and outlays (total)
–1,739
–1,801
–1,868
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–4
4052
Offsetting collections credited to expired accounts
1
4060
Additional offsets against budget authority only (total)
–3
4070
Budget authority, net (discretionary)
4,103
4,315
4,507
4080
Outlays, net (discretionary)
3,783
4,649
4,469
Mandatory:
4090
Budget authority, gross
150
97
Outlays, gross:
4100
Outlays from new mandatory authority
52
93
4101
Outlays from mandatory balances
96
6
4
4110
Outlays, gross (total)
148
99
4
4180
Budget authority, net (total)
4,253
4,412
4,507
4190
Outlays, net (total)
3,931
4,748
4,473
Summary of Budget Authority and Outlays (in millions of dollars)
2019 actual
2020 est.
2021 est.
Enacted/requested:
Budget Authority
4,253
4,412
4,507
Outlays
3,931
4,748
4,473
Legislative proposal, subject to PAYGO:
Budget Authority
53
150
Outlays
51
146
Total:
Budget Authority
4,253
4,465
4,657
Outlays
3,931
4,799
4,619
The Indian Health Services account provides medical care, public health services, and health professions training opportunities
to American Indians and Alaska Natives. More than $2.7 billion, primarily through self-determination contracts and compacts,
will be administered by tribal governments in 2021.
Object Classification (in millions of dollars)
Identification code 075–0390–0–1–551
2019 actual
2020 est.
2021 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
416
440
445
11.3
Other than full-time permanent
18
19
18
11.5
Other personnel compensation
66
68
68
11.7
Military personnel
56
58
57
11.9
Total personnel compensation
556
585
588
12.1
Civilian personnel benefits
166
175
174
12.2
Military personnel benefits
29
30
30
13.0
Benefits for former personnel
1
1
1
21.0
Travel and transportation of persons
8
8
14
21.0
Patient travel
20
21
20
22.0
Transportation of things
6
6
6
23.1
Rental payments to GSA
14
14
14
23.2
Rental payments to others
1
1
1
23.3
Communications, utilities, and miscellaneous charges
10
10
10
25.1
Advisory and assistance services
5
5
5
25.2
Other services from non-Federal sources
291
301
384
25.3
Other goods and services from Federal sources
111
114
112
25.4
Operation and maintenance of facilities
2
2
2
25.6
Medical care
390
401
396
25.7
Operation and maintenance of equipment
9
9
9
25.8
Subsistence and support of persons
7
7
7
26.0
Supplies and materials
109
112
131
31.0
Equipment
8
8
45
41.0
Grants, subsidies, and contributions
2,495
2,588
2,543
42.0
Insurance claims and indemnities
15
15
15
99.0
Direct obligations
4,253
4,413
4,507
99.0
Reimbursable obligations
1,641
1,704
1,771
99.9
Total new obligations, unexpired accounts
5,894
6,117
6,278
Employment Summary
Identification code 075–0390–0–1–551
2019 actual
2020 est.
2021 est.
1001
Direct civilian full-time equivalent employment
6,449
6,449
6,468
1101
Direct military average strength employment
1,530
1,530
1,531
2001
Reimbursable civilian full-time equivalent employment
6,102
6,102
6,102
Indian Health Services
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 075–0390–4–1–551
2019 actual
2020 est.
2021 est.
Obligations by program activity:
0009
Diabetes funds
53
150
0799
Total direct obligations
53
150
Budgetary resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
53
150
1930
Total budgetary resources available
53
150
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
2
3010
New obligations, unexpired accounts
53
150
3020
Outlays (gross)
–51
–146
3050
Unpaid obligations, end of year
2
6
Memorandum (non-add) entries:
3100
Obligated balance, start of year
2
3200
Obligated balance, end of year
2
6
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
53
150
Outlays, gross:
4100
Outlays from new mandatory authority
51
144
4101
Outlays from mandatory balances
2
4110
Outlays, gross (total)
51
146
4180
Budget authority, net (total)
53
150
4190
Outlays, net (total)
51
146
The Budget proposes to extend the Special Diabetes Program for Indians through fiscal year 2021.
Object Classification (in millions of dollars)
Identification code 075–0390–4–1–551
2019 actual
2020 est.
2021 est.
11.1
Direct obligations: Personnel compensation: Full-time permanent
2
11.9
Total personnel compensation
2
12.1
Civilian personnel benefits
1
25.6
Medical care
10
31.0
Equipment
1
41.0
Grants, subsidies, and contributions
53
136
99.0
Direct obligations
53
150
99.9
Total new obligations, unexpired accounts
53
150
Employment Summary
Identification code 075–0390–4–1–551
2019 actual
2020 est.
2021 est.
1001
Direct civilian full-time equivalent employment
23
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 2021, such sums as may be necessary: Provided, That notwithstanding any other provision of law, no amounts made available under this heading shall be available for transfer
to another budget account: Provided further, 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 due for such agreements for subsequent
fiscal years.
(Department of the Interior, Environment, and Related Agencies Appropriations Act, 2020.)
Program and Financing (in millions of dollars)
Identification code 075–0344–0–1–551
2019 actual
2020 est.
2021 est.
Obligations by program activity:
0001
Contract Support Costs
799
855
855
Budgetary resources:
Budget authority:
Appropriations, discretionary:
1100
Appropriation
799
855
855
1930
Total budgetary resources available
799
855
855
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
62
59
37
3010
New obligations, unexpired accounts
799
855
855
3011
Obligations ("upward adjustments"), expired accounts
38
3020
Outlays (gross)
–830
–877
–892
3041
Recoveries of prior year unpaid obligations, expired
–10
3050
Unpaid obligations, end of year
59
37
Memorandum (non-add) entries:
3100
Obligated balance, start of year
62
59
37
3200
Obligated balance, end of year
59
37
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
799
855
855
Outlays, gross:
4010
Outlays from new discretionary authority
777
855
855
4011
Outlays from discretionary balances
53
22
37
4020
Outlays, gross (total)
830
877
892
4180
Budget authority, net (total)
799
855
855
4190
Outlays, net (total)
830
877
892
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 $855 million in contract support
costs funds will be provided to tribal governments and tribal organizations in 2021.
Object Classification (in millions of dollars)
Identification code 075–0344–0–1–551
2019 actual
2020 est.
2021 est.
Direct obligations:
25.3
Other goods and services from Federal sources
799
41.0
Grants, subsidies, and contributions
855
855
99.9
Total new obligations, unexpired accounts
799
855
855
Payments for Tribal Leases
For payments to tribes and tribal organizations for leases pursuant to section 105(l) of the Indian Self-Determination and
Education Assistance Act (25 U.S.C. 5324(l)) for fiscal year 2021, such sums as may be necessary: Provided, That notwithstanding
any other provision of law, no amounts made available under this heading shall be available for transfer to another budget
account.
Program and Financing (in millions of dollars)
Identification code 075–0200–0–1–551
2019 actual
2020 est.
2021 est.
Obligations by program activity:
0001
Payments for Tribal Leases
101
0900
Total new obligations, unexpired accounts (object class 41.0)
101
Budgetary resources:
Budget authority:
Appropriations, discretionary:
1100
Appropriation
101
1930
Total budgetary resources available
101
Change in obligated balance:
Unpaid obligations:
3010
New obligations, unexpired accounts
101
3020
Outlays (gross)
–101
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
101
Outlays, gross:
4010
Outlays from new discretionary authority
101
4180
Budget authority, net (total)
101
4190
Outlays, net (total)
101
The Payments for Tribal Leases account provides for the reasonable and allowable costs for leases with a Tribe or tribal organization
for a building owned or leased by the tribe or tribal organization that is used for administration or delivery of services
under the Indian Self-Determination and Education Assistance Act. An estimated $101 million in lease funds will be provided
to tribal governments and tribal organizations in 2021.
Indian health facilities
For construction, repair, maintenance, demolition, 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, $769,455,000 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.
(Department of the Interior, Environment, and Related Agencies Appropriations Act, 2020.)
Special and Trust Fund Receipts (in millions of dollars)
Identification code 075–0391–0–1–551
2019 actual
2020 est.
2021 est.
0100
Balance, start of year
Receipts:
Current law:
1130
Rent and Charges for Quarters, Indian Health Service
8
9
9
2000
Total: Balances and receipts
8
9
9
Appropriations:
Current law:
2101
Indian Health Facilities
–8
–9
–9
5099
Balance, end of year
Program and Financing (in millions of dollars)
Identification code 075–0391–0–1–551
2019 actual
2020 est.
2021 est.
Obligations by program activity:
0001
Maintenance
135
170
168
0002
Sanitation Facilities Construction
208
214
193
0003
Facilities and environmental health
244
261
259
0004
Equipment
24
28
24
0005
Health Care Facilities Construction
304
359
125
0100
Total direct program
915
1,032
769
0799
Total direct obligations
915
1,032
769
0801
Indian Health Facilities (Reimbursable)
8
9
9
0900
Total new obligations, unexpired accounts
923
1,041
778
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
621
630
569
1001
Discretionary unobligated balance brought fwd, Oct 1
617
614
1021
Recoveries of prior year unpaid obligations
14
1050
Unobligated balance (total)
635
630
569
Budget authority:
Appropriations, discretionary:
1100
Appropriation
879
912
769
Appropriations, mandatory:
1201
Appropriation (special or trust fund)
8
9
9
Spending authority from offsetting collections, discretionary:
1700
Collected
31
59
59
1900
Budget authority (total)
918
980
837
1930
Total budgetary resources available
1,553
1,610
1,406
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
630
569
628
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
678
862
990
3010
New obligations, unexpired accounts
923
1,041
778
3020
Outlays (gross)
–725
–913
–926
3040
Recoveries of prior year unpaid obligations, unexpired
–14
3050
Unpaid obligations, end of year
862
990
842
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–18
–18
–18
3090
Uncollected pymts, Fed sources, end of year
–18
–18
–18
Memorandum (non-add) entries:
3100
Obligated balance, start of year
660
844
972
3200
Obligated balance, end of year
844
972
824
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
910
971
828
Outlays, gross:
4010
Outlays from new discretionary authority
349
333
290
4011
Outlays from discretionary balances
370
564
627
4020
Outlays, gross (total)
719
897
917
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–31
–59
–59
4040
Offsets against gross budget authority and outlays (total)
–31
–59
–59
Mandatory:
4090
Budget authority, gross
8
9
9
Outlays, gross:
4100
Outlays from new mandatory authority
2
9
9
4101
Outlays from mandatory balances
4
7
4110
Outlays, gross (total)
6
16
9
4180
Budget authority, net (total)
887
921
778
4190
Outlays, net (total)
694
854
867
The Indian Health Facilities account supports construction, repair and improvement, equipment, and environmental health and
facilities support for the Indian Health Service. More than $340 million, primarily through self-determination contracts and
compacts, will be administered by tribal governments in 2021.
Object Classification (in millions of dollars)
Identification code 075–0391–0–1–551
2019 actual
2020 est.
2021 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
45
47
48
11.3
Other than full-time permanent
1
1
1
11.5
Other personnel compensation
2
2
2
11.7
Military personnel
20
21
22
11.9
Total personnel compensation
68
71
73
12.1
Civilian personnel benefits
16
17
17
12.2
Military personnel benefits
7
7
7
21.0
Travel and transportation of persons
1
1
1
22.0
Transportation of things
1
1
1
23.3
Communications, utilities, and miscellaneous charges
5
5
5
25.1
Advisory and assistance services
1
1
1
25.2
Other services from non-Federal sources
301
349
330
25.3
Other goods and services from Federal sources
4
3
4
25.4
Operation and maintenance of facilities
3
3
3
25.7
Operation and maintenance of equipment
1
1
1
26.0
Supplies and materials
3
3
3
31.0
Equipment
2
2
2
32.0
Land and structures
110
128
60
41.0
Grants, subsidies, and contributions
383
432
253
42.0
Insurance claims and indemnities
8
8
8
99.0
Direct obligations
914
1,032
769
99.0
Reimbursable obligations
9
9
9
99.9
Total new obligations, unexpired accounts
923
1,041
778
Employment Summary
Identification code 075–0391–0–1–551
2019 actual
2020 est.
2021 est.
1001
Direct civilian full-time equivalent employment
946
946
946
1101
Direct military average strength employment
151
151
151
2001
Reimbursable civilian full-time equivalent employment
40
40
40
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 of Health and Human Services; 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: 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 et seq.), 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 costs associated with the provision of goods, services, or technical
assistance: Provided further, That the Indian Health Service may provide to civilian medical personnel serving in hospitals operated by the Indian Health
Service housing allowances equivalent to those that would be provided to members of the Commissioned Corps of the United States
Public Health Service serving in similar positions at such hospitals: Provided further, That none of the funds made available in this Act may be used to compensate an Indian tribe or tribal organization for any lease
under section 105(l) of the Indian Self-Determination and Education Assistance Act relating to a facility exceeding 40,000
square feet unless funds for the lease are specifically appropriated in advance for such purpose.
(Department of the Interior, Environment, and Related Agencies Appropriations Act, 2020.)
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, $527,160,000.
HIV/AIDS, viral hepatitis, sexually transmitted diseases, and tuberculosis prevention
For carrying out titles II, III, XVII, and XXIII of the PHS Act with respect to HIV/AIDS, viral hepatitis, sexually transmitted
diseases, and tuberculosis prevention, $1,552,556,000.
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, $413,464,000: Provided, That of the amounts made available under this heading, up to $1,000,000 shall remain available until
expended to pay for the transportation, medical care, treatment, and other related costs of persons quarantined or isolated
under federal or state quarantine law.
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, $359,145,000: Provided, That such amounts and any amounts transferred to this appropriation shall be available for the Director of the Centers for
Disease Control and Prevention (CDC) to administer a program, to be known as The 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 the purposes of carrying out such program, the Director may award grants to States, territories, tribes, and tribal
organizations 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 such purposes, to make grant awards 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 made available under this heading 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, $112,250,000.
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, $58,000,000: Provided, That, in addition to amounts provided under this heading, $463,000,000 is available to this appropriation,
for the purposes under this heading, from amounts provided pursuant to section 241 of the PHS Act.
Environmental health
For carrying out titles II, III, and XVII of the PHS Act with respect to environmental health, $182,000,000.
Injury prevention and control
For carrying out titles II, III, and XVII of the PHS Act with respect to injury prevention and control and for carrying out the Drug-Free Communities Support Program (the Program) authorized by chapter 2 of subtitle A of title
I of the National Narcotics Leadership Act of 1988 (chapter 2), $730,159,000: Provided, That the Secretary shall have the
same authorities as those delegated by chapter 2 to the Office of National Drug Control Policy (ONDCP), the Director of ONDCP,
and the Administrator of the Program: Provided further, That the Secretary may make grants to, or enter into cooperative agreements
with, states, territories and Indian tribes for such entities to make subgrants under the Program to eligible coalitions,
as defined in section 1023 of chapter 2: Provided further, That for such purpose, the Secretary may delegate to such entities
those of the Secretary's authorities under subchapter I of chapter 2 and the previous proviso that the Secretary considers
necessary or appropriate for efficient and effective management of the Program: Provided further, That the limitation on administrative
costs in section 1024(b) of chapter 2 shall not apply to amounts made available under this heading.
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, $111,362,000: Provided, That, in addition to amounts provided herein, $78,638,000 shall be available to this appropriation,
for the purposes under this heading, from amounts provided pursuant to section 241 of the PHS Act.
Energy employees occupational illness compensation program
For necessary expenses to administer the Energy Employees Occupational Illness Compensation Program Act, $55,358,000, to remain
available until expended: Provided, That this amount shall be available consistent with the provision regarding administrative expenses in section 151(b) of
division B, title I of Public Law 106–554.
Global health
For carrying out titles II, III, and XVII of the PHS Act with respect to global health, $532,222,000, of which: (1) $69,547,000 shall remain available through September 30, 2022, for international HIV/AIDS; and (2) $225,000,000 shall be available for global public health protection: 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, $802,000,000: Provided, That the Director of the Centers for Disease Control and Prevention (referred to in this title as "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.
cdc-wide activities and program support
(including transfer of funds)
For carrying out titles II, III, XVII and XIX, and section 2821 of the PHS Act and for cross-cutting activities and program
support for activities funded in other appropriations included in this Act for the Centers for Disease Control and Prevention,
$155,000,000, of which up to $5,000,000 may be transferred to the reserve of the Working Capital Fund authorized under this heading in
division F of Public Law 112–74: 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 of the amounts made available under this heading, $50,000,000 shall be transferred to and merged with
the Infectious Diseases Rapid Response Reserve Fund established by section 231 of division B of Public Law 115–245: Provided
further, That any amounts made available by this Act to the Centers for Disease Control and Prevention may be used to support
the purchase, hire, maintenance, and operation of an 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, 2022.
(Department of Health and Human Services Appropriations Act, 2020.)
Special and Trust Fund Receipts (in millions of dollars)
Identification code 075–0943–0–1–999
2019 actual
2020 est.
2021 est.
0100
Balance, start of year
1
Receipts:
Current law:
1130
Cooperative Research and Development Agreements, Centers for Disease Control
1
2
2
2000
Total: Balances and receipts
1
2
3
Appropriations:
Current law:
2101
CDC-wide Activities and Program Support
–1
–1
–1
5099
Balance, end of year
1
2
Program and Financing (in millions of dollars)
Identification code 075–0943–0–1–999
2019 actual
2020 est.
2021 est.
Obligations by program activity:
0001
Birth Defects, Developmental Disabilities, Disability and Health (0958)
155
161
112
0002
CDC-Wide Activities and Program Support (0943)
483
359
155
0004
Chronic Disease Prevention and Health Promotion (0948)
1,196
1,240
813
0005
Emerging and Zoonotic Infectious Diseases (0949)
619
636
550
0006
Energy Employee Illness Occupational Compensation Program Act (EEOICPA) (0954)
52
55
55
0007
Environmental Health (0947)
213
214
182
0008
Global Health (0955)
480
571
532
0012
HIV/AIDS, Viral Hepatitis, STD and TB Prevention (0950)
1,130
1,274
1,553
0013
Immunization and Respiratory Diseases (0951)
838
790
830
0015
Injury Prevention and Control (0952)
702
677
730
0016
Occupational Safety and Health (0953)
335
343
111
0019
Public Health Preparedness and Response (0956)
860
827
802
0020
Public Health Scientific Services (0959)
494
578
58
0021
Cooperative Research and Development Agreements (CRADA) (5146)
1
1
1
0799
Total direct obligations
7,558
7,726
6,484
0802
CDC-Wide Activities and Program Support (Reimbursable)
158
366
399
0809
Reimbursable program activities, subtotal
158
366
399
0900
Total new obligations, unexpired accounts
7,716
8,092
6,883
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
934
307
224
1001
Discretionary unobligated balance brought fwd, Oct 1
439
174
1010
Unobligated balance transfer to other accts [075–0960]
–7
1010
Unobligated balance transfer to other accts [075–0140]
–425
1010
Unobligated balance transfer to other accts [075–0140]
–50
1011
Unobligated balance transfer from other acct [075–0140]
10
1012
Unobligated balance transfers between expired and unexpired accounts
36
1021
Recoveries of prior year unpaid obligations
111
1033
Recoveries of prior year paid obligations
1
1050
Unobligated balance (total)
610
307
224
Budget authority:
Appropriations, discretionary:
1100
Appropriation
7,058
6,815
5,535
1120
Appropriations transferred to other acct [075–1503]
–14
1120
Appropriations transferred to other acct [075–0140]
–604
1120
Appropriations transferred to other acct [075–4553]
–9
1120
Appropriations transferred to other acct [075–0945]
–50
–85
–50
1121
Appropriations transferred from other acct [075–0140]
20
1160
Appropriation, discretionary (total)
6,401
6,730
5,485
Appropriations, mandatory:
1200
Appropriation (075–0954 - EEOICPA)
55
55
55
1201
Appropriation (075–5146 CRADA)
1
1
1
1221
Appropriations transferred from other acct PPHF [075–0116]
805
854
894
1230
Appropriations and/or unobligated balance of appropriations permanently reduced
–5
1260
Appropriations, mandatory (total)
856
910
950
Spending authority from offsetting collections, discretionary:
1700
Collected
137
366
399
1701
Change in uncollected payments, Federal sources
24
1750
Spending auth from offsetting collections, disc (total)
161
366
399
Spending authority from offsetting collections, mandatory:
1800
Collected
4
3
3
1900
Budget authority (total)
7,422
8,009
6,837
1930
Total budgetary resources available
8,032
8,316
7,061
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–9
1941
Unexpired unobligated balance, end of year
307
224
178
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
6,934
6,671
7,189
3010
New obligations, unexpired accounts
7,716
8,092
6,883
3011
Obligations ("upward adjustments"), expired accounts
38
3020
Outlays (gross)
–7,395
–7,574
–7,879
3030
Unpaid obligations transferred to other accts [075–0140]
–242
3040
Recoveries of prior year unpaid obligations, unexpired
–111
3041
Recoveries of prior year unpaid obligations, expired
–269
3050
Unpaid obligations, end of year
6,671
7,189
6,193
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–127
–108
–108
3070
Change in uncollected pymts, Fed sources, unexpired
–24
3071
Change in uncollected pymts, Fed sources, expired
43
3090
Uncollected pymts, Fed sources, end of year
–108
–108
–108
Memorandum (non-add) entries:
3100
Obligated balance, start of year
6,807
6,563
7,081
3200
Obligated balance, end of year
6,563
7,081
6,085
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
6,562
7,096
5,884
Outlays, gross:
4010
Outlays from new discretionary authority
2,454
3,050
2,558
4011
Outlays from discretionary balances
4,121
3,658
4,401
4020
Outlays, gross (total)
6,575
6,708
6,959
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–167
–366
–399
4033
Non-Federal sources
–12
4040
Offsets against gross budget authority and outlays (total)
–179
–366
–399
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–24
4052
Offsetting collections credited to expired accounts
41
4053
Recoveries of prior year paid obligations, unexpired accounts
1
4060
Additional offsets against budget authority only (total)
18
4070
Budget authority, net (discretionary)
6,401
6,730
5,485
4080
Outlays, net (discretionary)
6,396
6,342
6,560
Mandatory:
4090
Budget authority, gross
860
913
953
Outlays, gross:
4100
Outlays from new mandatory authority
146
218
226
4101
Outlays from mandatory balances
674
648
694
4110
Outlays, gross (total)
820
866
920
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123
Non-Federal sources
–4
–3
–3
4180
Budget authority, net (total)
7,257
7,640
6,435
4190
Outlays, net (total)
7,212
7,205
7,477
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,
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 2021 Budget provides $371 million for CDC to undertake the second year of the Ending
the HIV Epidemic initative. The FY 2021 Budget maintains the proposal to establish a new block grant, proposed at $350 million,
to increase flexibility for States to address their population's unique public health needs. The FY 2021 Budget provides $175
million for global health security activities to protect Americans through partnerships and other activities that support
public health capacity improvements in countries at risk for uncontrolled outbreaks of infectious diseases.
Object Classification (in millions of dollars)
Identification code 075–0943–0–1–999
2019 actual
2020 est.
2021 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
766
744
761
11.3
Other than full-time permanent
112
99
101
11.5
Other personnel compensation
39
38
38
11.7
Military personnel
70
65
68
11.8
Special personal services payments
6
5
5
11.9
Total personnel compensation
993
951
973
12.1
Civilian personnel benefits
305
291
291
12.2
Military personnel benefits
55
53
54
13.0
Benefits for former personnel
2
2
2
21.0
Travel and transportation of persons
59
42
42
22.0
Transportation of things
9
7
7
23.1
Rental payments to GSA
6
4
4
23.2
Rental payments to others
1
1
1
23.3
Communications, utilities, and miscellaneous charges
9
5
5
24.0
Printing and reproduction
3
3
3
25.1
Advisory and assistance services
811
784
607
25.2
Other services from non-Federal sources
105
107
78
25.3
Other goods and services from Federal sources
890
899
662
25.4
Operation and maintenance of facilities
14
11
8
25.5
Research and development contracts
41
38
27
25.6
Medical care
31
33
24
25.7
Operation and maintenance of equipment
33
30
22
26.0
Supplies and materials
129
125
127
31.0
Equipment
70
63
63
32.0
Land and structures
1
41.0
Grants, subsidies, and contributions
3,984
4,269
3,476
42.0
Insurance claims and indemnities
7
8
8
99.0
Direct obligations
7,558
7,726
6,484
99.0
Reimbursable obligations
158
366
399
99.9
Total new obligations, unexpired accounts
7,716
8,092
6,883
Employment Summary
Identification code 075–0943–0–1–999
2019 actual
2020 est.
2021 est.
1001
Direct civilian full-time equivalent employment
8,486
8,477
8,630
1101
Direct military average strength employment
807
812
812
2001
Reimbursable civilian full-time equivalent employment
198
197
197
2101
Reimbursable military average strength employment
27
27
27
Buildings and facilities
For any cost related to the acquisition of real property, equipment, construction, installation, demolition, and renovation of facilities, $30,000,000, which shall remain available until September 30, 2025.
(Department of Health and Human Services Appropriations Act, 2020.)
Program and Financing (in millions of dollars)
Identification code 075–0960–0–1–551
2019 actual
2020 est.
2021 est.
Obligations by program activity:
0001
CDC Buildings and Facilities (0960)
153
25
30
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
500
384
384
1011
Unobligated balance transfer from other acct [075–0943]
7
1050
Unobligated balance (total)
507
384
384
Budget authority:
Appropriations, discretionary:
1100
Appropriation
30
25
30
1930
Total budgetary resources available
537
409
414
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
384
384
384
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
26
144
109
3010
New obligations, unexpired accounts
153
25
30
3020
Outlays (gross)
–35
–60
–49
3050
Unpaid obligations, end of year
144
109
90
Memorandum (non-add) entries:
3100
Obligated balance, start of year
26
144
109
3200
Obligated balance, end of year
144
109
90
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
30
25
30
Outlays, gross:
4010
Outlays from new discretionary authority
2
10
12
4011
Outlays from discretionary balances
33
50
37
4020
Outlays, gross (total)
35
60
49
4180
Budget authority, net (total)
30
25
30
4190
Outlays, net (total)
35
60
49
Object Classification (in millions of dollars)
Identification code 075–0960–0–1–551
2019 actual
2020 est.
2021 est.
Direct obligations:
25.1
Advisory and assistance services
1
1
1
25.4
Operation and maintenance of facilities
8
8
8
32.0
Land and structures
144
16
21
99.9
Total new obligations, unexpired accounts
153
25
30
CDC Working Capital Fund
Program and Financing (in millions of dollars)
Identification code 075–4553–0–4–551
2019 actual
2020 est.
2021 est.
Obligations by program activity:
0801
CDC Working Capital Fund (Reimbursable)
591
569
569
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
50
54
73
1021
Recoveries of prior year unpaid obligations
12
1050
Unobligated balance (total)
62
54
73
Budget authority:
Appropriations, discretionary:
1121
Appropriations transferred from other acct [075–0943]
9
Spending authority from offsetting collections, discretionary:
1700
Collected
573
588
532
1701
Change in uncollected payments, Federal sources
1
1750
Spending auth from offsetting collections, disc (total)
574
588
532
1900
Budget authority (total)
583
588
532
1930
Total budgetary resources available
645
642
605
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
54
73
36
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
198
210
197
3010
New obligations, unexpired accounts
591
569
569
3020
Outlays (gross)
–567
–582
–550
3040
Recoveries of prior year unpaid obligations, unexpired
–12
3050
Unpaid obligations, end of year
210
197
216
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–2
–3
–3
3070
Change in uncollected pymts, Fed sources, unexpired
–1
3090
Uncollected pymts, Fed sources, end of year
–3
–3
–3
Memorandum (non-add) entries:
3100
Obligated balance, start of year
196
207
194
3200
Obligated balance, end of year
207
194
213
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
583
588
532
Outlays, gross:
4010
Outlays from new discretionary authority
396
388
351
4011
Outlays from discretionary balances
171
194
199
4020
Outlays, gross (total)
567
582
550
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–573
–588
–532
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–1
4070
Budget authority, net (discretionary)
9
4080
Outlays, net (discretionary)
–6
–6
18
4180
Budget authority, net (total)
9
4190
Outlays, net (total)
–6
–6
18
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
2019 actual
2020 est.
2021 est.
Reimbursable obligations:
Personnel compensation:
11.1
Full-time permanent
148
148
148
11.3
Other than full-time permanent
3
4
4
11.5
Other personnel compensation
3
4
4
11.7
Military personnel
4
3
3
11.9
Total personnel compensation
158
159
159
12.1
Civilian personnel benefits
50
50
50
12.2
Military personnel benefits
2
2
2
21.0
Travel and transportation of persons
1
1
1
22.0
Transportation of things
2
2
2
23.1
Rental payments to GSA
33
32
32
23.3
Communications, utilities, and miscellaneous charges
17
22
22
25.1
Advisory and assistance services
34
31
31
25.2
Other services from non-Federal sources
86
77
77
25.3
Other goods and services from Federal sources
82
68
68
25.4
Operation and maintenance of facilities
53
10
10
25.7
Operation and maintenance of equipment
53
52
52
26.0
Supplies and materials
1
1
1
31.0
Equipment
10
12
12
32.0
Land and structures
9
50
50
99.9
Total new obligations, unexpired accounts
591
569
569
Employment Summary
Identification code 075–4553–0–4–551
2019 actual
2020 est.
2021 est.
2001
Reimbursable civilian full-time equivalent employment
1,484
1,484
1,484
2101
Reimbursable military average strength employment
34
34
34
Infectious Diseases Rapid Response Reserve Fund
Program and Financing (in millions of dollars)
Identification code 075–0945–0–1–551
2019 actual
2020 est.
2021 est.
Obligations by program activity:
0001
Direct program activity
85
50
0900
Total new obligations, unexpired accounts (object class 41.0)
85
50
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
50
50
Budget authority:
Appropriations, discretionary:
1121
Appropriations transferred from other acct [075–0943]
50
85
50
1930
Total budgetary resources available
50
135
100
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
50
50
50
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
35
3010
New obligations, unexpired accounts
85
50
3020
Outlays (gross)
–50
–85
3050
Unpaid obligations, end of year
35
Memorandum (non-add) entries:
3100
Obligated balance, start of year
35
3200
Obligated balance, end of year
35
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
50
85
50
Outlays, gross:
4011
Outlays from discretionary balances
50
85
4180
Budget authority, net (total)
50
85
50
4190
Outlays, net (total)
50
85
The FY 2021 Budget provides $50 million for the Infectious Diseases Rapid Response Reserve Fund within the Centers for Disease
Control and Prevention. This Fund will provide the ability to respond efficiently and rapidly to emerging infectious disease
threats or outbreaks.
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 2021, and existing profiles may be updated as necessary.
(Department of the Interior, Environment, and Related Agencies Appropriations Act, 2020.)
Program and Financing (in millions of dollars)
Identification code 075–0944–0–1–551
2019 actual
2020 est.
2021 est.
Obligations by program activity:
0001
Agency for Toxic Substances and Disease Registry, Toxic Substance (Direct)
87
62
62
0801
Agency for Toxic Substances and Disease Registry, Toxic Substance (Reimbursable)
3
0900
Total new obligations, unexpired accounts
90
62
62
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
20
18
36
Budget authority:
Appropriations, discretionary:
1100
Appropriation
75
77
62
1121
Appropriations transferred from other acct [097–0100]
10
1160
Appropriation, discretionary (total)
85
77
62
Spending authority from offsetting collections, discretionary:
1700
Collected
1
3
3
1701
Change in uncollected payments, Federal sources
2
1750
Spending auth from offsetting collections, disc (total)
3
3
3
1900
Budget authority (total)
88
80
65
1930
Total budgetary resources available
108
98
101
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
18
36
39
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
64
70
48
3010
New obligations, unexpired accounts
90
62
62
3020
Outlays (gross)
–81
–84
–69
3041
Recoveries of prior year unpaid obligations, expired
–3
3050
Unpaid obligations, end of year
70
48
41
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–15
–12
–12
3070
Change in uncollected pymts, Fed sources, unexpired
–2
3071
Change in uncollected pymts, Fed sources, expired
5
3090
Uncollected pymts, Fed sources, end of year
–12
–12
–12
Memorandum (non-add) entries:
3100
Obligated balance, start of year
49
58
36
3200
Obligated balance, end of year
58
36
29
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
88
80
65
Outlays, gross:
4010
Outlays from new discretionary authority
49
52
42
4011
Outlays from discretionary balances
30
32
27
4020
Outlays, gross (total)
79
84
69
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–6
–3
–3
4040
Offsets against gross budget authority and outlays (total)
–6
–3
–3
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–2
4052
Offsetting collections credited to expired accounts
5
4060
Additional offsets against budget authority only (total)
3
4070
Budget authority, net (discretionary)
85
77
62
4080
Outlays, net (discretionary)
73
81
66
Mandatory:
Outlays, gross:
4101
Outlays from mandatory balances
2
4180
Budget authority, net (total)
85
77
62
4190
Outlays, net (total)
75
81
66
Object Classification (in millions of dollars)
Identification code 075–0944–0–1–551
2019 actual
2020 est.
2021 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
22
14
14
11.3
Other than full-time permanent
2
1
1
11.5
Other personnel compensation
1
11.7
Military personnel
3
3
3
11.9
Total personnel compensation
28
18
18
12.1
Civilian personnel benefits
8
5
5
12.2
Military personnel benefits
1
1
1
21.0
Travel and transportation of persons
1
1
1
25.1
Advisory and assistance services
5
9
9
25.2
Other services from non-Federal sources
5
3
3
25.3
Other goods and services from Federal sources
16
15
15
25.7
Operation and maintenance of equipment
1
31.0
Equipment
1
1
1
41.0
Grants, subsidies, and contributions
21
9
9
99.0
Direct obligations
87
62
62
99.0
Reimbursable obligations
3
99.9
Total new obligations, unexpired accounts
90
62
62
Employment Summary
Identification code 075–0944–0–1–551
2019 actual
2020 est.
2021 est.
1001
Direct civilian full-time equivalent employment
198
198
198
1101
Direct military average strength employment
28
28
28
2001
Reimbursable civilian full-time equivalent employment
2
2
2
2101
Reimbursable military average strength employment
1
1
1
World Trade Center Health Program Fund
Program and Financing (in millions of dollars)
Identification code 075–0946–0–1–551
2019 actual
2020 est.
2021 est.
Obligations by program activity:
0001
World Trade Center Health Program—Federal Share (CDC/NIOSH)
530
541
540
0002
World Trade Center Health Program—NYC
59
60
60
0900
Total new obligations, unexpired accounts
589
601
600
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
873
797
735
1012
Unobligated balance transfers between expired and unexpired accounts
7
1021
Recoveries of prior year unpaid obligations
3
1033
Recoveries of prior year paid obligations
14
1050
Unobligated balance (total)
897
797
735
Budget authority:
Appropriations, mandatory:
1200
Appropriation (WTC (CDC Direct))
402
485
501
1200
Appropriation (WTC—NYC DHSS—CDC)
45
54
56
1260
Appropriations, mandatory (total)
447
539
557
Spending authority from offsetting collections, mandatory:
1800
Collected
42
1900
Budget authority (total)
489
539
557
1930
Total budgetary resources available
1,386
1,336
1,292
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
797
735
692
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
224
327
528
3010
New obligations, unexpired accounts
589
601
600
3020
Outlays (gross)
–483
–400
–479
3040
Recoveries of prior year unpaid obligations, unexpired
–3
3050
Unpaid obligations, end of year
327
528
649
Memorandum (non-add) entries:
3100
Obligated balance, start of year
224
327
528
3200
Obligated balance, end of year
327
528
649
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
489
539
557
Outlays, gross:
4100
Outlays from new mandatory authority
248
256
4101
Outlays from mandatory balances
483
152
223
4110
Outlays, gross (total)
483
400
479
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123
Non-Federal sources
–63
Additional offsets against gross budget authority only:
4142
Offsetting collections credited to expired accounts
7
4143
Recoveries of prior year paid obligations, unexpired accounts
14
4150
Additional offsets against budget authority only (total)
21
4160
Budget authority, net (mandatory)
447
539
557
4170
Outlays, net (mandatory)
420
400
479
4180
Budget authority, net (total)
447
539
557
4190
Outlays, net (total)
420
400
479
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 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 2020 and 2021 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
2019 actual
2020 est.
2021 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
4
4
4
11.7
Military personnel
1
1
1
11.9
Total personnel compensation
5
5
5
12.1
Civilian personnel benefits
2
2
2
12.2
Military personnel benefits
1
1
1
25.1
Advisory and assistance services
39
39
39
25.2
Other services from non-Federal sources
105
105
105
25.3
Other goods and services from Federal sources
12
12
12
31.0
Equipment
2
2
2
41.0
Grants, subsidies, and contributions
24
24
24
42.0
Insurance claims and indemnities
399
411
410
99.9
Total new obligations, unexpired accounts
589
601
600
Employment Summary
Identification code 075–0946–0–1–551
2019 actual
2020 est.
2021 est.
1001
Direct civilian full-time equivalent employment
38
43
43
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, $5,686,173,000, of which up to $30,000,000 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, $3,298,004,000.
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, $434,559,000.
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, $1,924,211,000.
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, $2,195,110,000.
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, $5,445,886,000.
national institute of general medical sciences
For carrying out section 301 and title IV of the PHS Act with respect to general medical sciences, $2,672,074,000, of which $741,000,000 shall be from funds available under section 241 of the PHS Act: Provided, That not less than $351,781,000 is provided for the Institutional Development Awards program.
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, $1,416,366,000.
national eye institute
For carrying out section 301 and title IV of the PHS Act with respect to eye diseases and visual disorders, $749,003,000.
national institute of environmental health sciences
For carrying out section 301 and title IV of the PHS Act with respect to environmental health sciences, $730,147,000.
(Department of Health and Human Services Appropriations Act, 2020.)
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, $73,688,000.
(Department of the Interior, Environment, and Related Agencies Appropriations Act, 2020.)
national institute on aging
For carrying out section 301 and title IV of the PHS Act with respect to aging, $3,225,782,000.
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,
$568,480,000.
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, $446,397,000.
national institute of nursing research
For carrying out section 301 and title IV of the PHS Act with respect to nursing research, $156,804,000.
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, $497,346,000.
National institute on drug abuse
For carrying out section 301 and title IV of the PHS Act with respect to drug abuse, $1,431,770,000.
national institute of mental health
For carrying out section 301 and title IV of the PHS Act with respect to mental health, $1,794,865,000.
national human genome research institute
For carrying out section 301 and title IV of the PHS Act with respect to human genome research, $550,116,000.
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, $368,111,000.
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, $138,167,000.
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,
$305,498,000: Provided, That funds may be used to implement a reorganization that is presented to an advisory council in a public meeting and for
which the Committees on Appropriations of the House of Representatives and the Senate have been notified 30 days in advance.
john e. fogarty international center
For carrying out the activities of the John E. Fogarty International Center (described in subpart 2 of part E of title IV
of the PHS Act), $73,531,000.
national library of medicine
For carrying out section 301 and title IV of the PHS Act with respect to health information communications, $415,665,000: Provided, That of the amounts available for improvement of information systems, $4,000,000 shall be available until September 30,
2022: Provided further, That in fiscal year 2021, 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, $787,703,000: Provided, That up to 10 percent of the amounts made available under this heading shall be available to implement section 480 of the PHS Act, relating to the Cures Acceleration Network.
office of the director
(Including Transfer of Funds)
For carrying out the responsibilities of the Office of the Director, NIH, $2,086,463,000: 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 $168,763,500 shall be for the Environmental Influences on Child Health Outcomes study: Provided further, That $583,867,000 shall be available for the Common Fund established under section 402A(c)(1) of the PHS Act: Provided further, That of the funds provided, $10,000 shall be for official reception and representation expenses when specifically approved
by the Director of the NIH: Provided further, That the Office of AIDS Research within the Office of the Director of the NIH may spend up to $8,000,000 to make grants
for construction or renovation of facilities as provided for in section 2354(a)(5)(B) of the PHS Act: Provided further, That amounts available under this heading are also available to establish, operate, and support the Research Policy Board
authorized by section 2034(f) of the 21st Century Cures 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 of, demolition of, renovation of, and acquisition of equipment for, facilities of or used by
NIH, including the acquisition of real property, $300,000,000, to remain available through September 30, 2025.
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, $256,660,000: Provided, That section 947(c) of the
PHS Act shall not apply in fiscal year 2021: 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.
(Department of Health and Human Services Appropriations Act, 2020.)
Special and Trust Fund Receipts (in millions of dollars)
Identification code 075–9915–0–1–552
2019 actual
2020 est.
2021 est.
0100
Balance, start of year
Receipts:
Current law:
1130
Cooperative Research and Development Agreements, NIH
51
68
51
2000
Total: Balances and receipts
51
68
51
Appropriations:
Current law:
2101
National Institutes of Health
–51
–68
–51
5099
Balance, end of year
Program and Financing (in millions of dollars)
Identification code 075–9915–0–1–552
2019 actual
2020 est.
2021 est.
Obligations by program activity:
0001
National Cancer Institute (0849)
5,994
6,606
5,881
0002
National Heart, Lung, and Blood Institute (0872)
3,482
3,625
3,298
0003
National Institute of Dental and Craniofacial Research (0873)
461
478
435
0004
National Institute of Diabetes and Digestive and Kidney Disease (0884)
2,025
2,115
1,924
0005
National Institute of Neurological Disorders and Stroke (0886)
2,414
2,449
2,245
0006
National Institute of Allergy and Infectious Diseases (0885)
5,567
5,897
5,446
0007
National Institute of General Medical Sciences (0851)
1,675
1,706
1,931
0008
National Institute of Child Health and Human Development (0844)
1,509
1,557
1,416
0009
National Eye Institute (0887)
794
823
749
0010
National Institute of Environmental Health Sciences (0862)
851
884
804
0011
National Institute on Aging (0843)
3,080
3,546
3,226
0012
National Institute of Arthritis and Musculoskeletal and Skin Disease (0888)
603
625
568
0013
National Institute on Deafness and Other Communication Disorder (0890)
473
491
446
0014
National Institute of Mental Health (0892)
1,870
2,045
1,845
0015
National Institute on Drug Abuse (0893)
1,621
1,458
1,432
0016
National Institute on Alcohol Abuse and Alcoholism (0894)
525
547
497
0017
National Institute of Nursing Research (0889)
163
172
157
0018
National Human Genome Research Institute (0891)
575
604
550
0019
National Institute of Biomedical Imaging and Bioengineering (0898)
388
405
368
0021
National Center for Complementary and Integrative Health (0896)
146
152
138
0022
National Institute on Minority Health and Health Disparities (0897)
313
336
305
0023
John E. Fogarty International Center (0819)
78
81
74
0024
National Library of Medicine (0807)
442
457
416
0025
NIH Office of the Director (0846)
1,926
2,247
2,099
0026
NIH Buildings and facilities (0838)
211
200
300
0027
NIH Cooperative Research and Development Agreements
47
68
51
0028
National Center for Advancing Translational Sciences (0875)
847
833
788
0029
National Institute for Research on Safety and Quality
257
0031
Type 1 Diabetes
74
297
0799
Total direct obligations
38,154
40,704
37,646
0801
NIH Reimbursable - Other
4,360
4,520
3,909
0802
NIH Royalties
130
129
129
0809
Reimbursable program activities, subtotal
4,490
4,649
4,038
0899
Total reimbursable obligations
4,490
4,649
4,038
0900
Total new obligations, unexpired accounts
42,644
45,353
41,684
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
1,475
1,145
754
1001
Discretionary unobligated balance brought fwd, Oct 1
1,226
862
1011
Unobligated balance transfer from other acct [075–0140]
15
1011
Unobligated balance transfer from other acct [075–1700]
16
1021
Recoveries of prior year unpaid obligations
94
1033
Recoveries of prior year paid obligations
2
1050
Unobligated balance (total)
1,586
1,145
770
Budget authority:
Appropriations, discretionary:
1100
Appropriation
37,294
39,805
37,287
1120
Appropriations transferred to other acct [075–1503]
–124
1120
Appropriations transferred to other acct [075–0128]
–5
–5
1121
Appropriations transferred from other acct [075–5628]
515
335
295
1121
Appropriations transferred from other acct [075–5736]
13
13
13
1160
Appropriation, discretionary (total)
37,693
40,148
37,595
Appropriations, mandatory:
1200
Appropriation
150
97
1201
Appropriation (special or trust fund)
51
68
51
1260
Appropriations, mandatory (total)
201
165
51
Spending authority from offsetting collections, discretionary:
1700
Collected
3,999
4,649
4,038
1701
Change in uncollected payments, Federal sources
317
1750
Spending auth from offsetting collections, disc (total)
4,316
4,649
4,038
Spending authority from offsetting collections, mandatory:
1800
Collected
3
1900
Budget authority (total)
42,213
44,962
41,684
1930
Total budgetary resources available
43,799
46,107
42,454
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–10
1941
Unexpired unobligated balance, end of year
1,145
754
770
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
37,409
40,480
43,800
3010
New obligations, unexpired accounts
42,644
45,353
41,684
3011
Obligations ("upward adjustments"), expired accounts
389
3020
Outlays (gross)
–39,069
–42,033
–43,642
3040
Recoveries of prior year unpaid obligations, unexpired
–94
3041
Recoveries of prior year unpaid obligations, expired
–799
3050
Unpaid obligations, end of year
40,480
43,800
41,842
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–564
–650
–650
3070
Change in uncollected pymts, Fed sources, unexpired
–317
3071
Change in uncollected pymts, Fed sources, expired
231
3090
Uncollected pymts, Fed sources, end of year
–650
–650
–650
Memorandum (non-add) entries:
3100
Obligated balance, start of year
36,845
39,830
43,150
3200
Obligated balance, end of year
39,830
43,150
41,192
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
42,009
44,797
41,633
Outlays, gross:
4010
Outlays from new discretionary authority
12,483
14,636
13,864
4011
Outlays from discretionary balances
26,382
27,270
29,620
4020
Outlays, gross (total)
38,865
41,906
43,484
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–3,906
–4,649
–4,038
4033
Non-Federal sources
–298
4040
Offsets against gross budget authority and outlays (total)
–4,204
–4,649
–4,038
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–317
4052
Offsetting collections credited to expired accounts
203
4053
Recoveries of prior year paid obligations, unexpired accounts
2
4060
Additional offsets against budget authority only (total)
–112
4070
Budget authority, net (discretionary)
37,693
40,148
37,595
4080
Outlays, net (discretionary)
34,661
37,257
39,446
Mandatory:
4090
Budget authority, gross
204
165
51
Outlays, gross:
4100
Outlays from new mandatory authority
24
22
13
4101
Outlays from mandatory balances
180
105
145
4110
Outlays, gross (total)
204
127
158
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123
Non-Federal sources
–3
4180
Budget authority, net (total)
37,894
40,313
37,646
4190
Outlays, net (total)
34,862
37,384
39,604
Summary of Budget Authority and Outlays (in millions of dollars)
2019 actual
2020 est.
2021 est.
Enacted/requested:
Budget Authority
37,894
40,313
37,646
Outlays
34,862
37,384
39,604
Legislative proposal, subject to PAYGO:
Budget Authority
53
150
Outlays
3
23
Total:
Budget Authority
37,894
40,366
37,796
Outlays
34,862
37,387
39,627
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 2021 Budget consolidates the
activities of the Agency for Healthcare Research and Quality within the National Institutes of Health as the National Institute
for Research on Safety and Quality. 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
2019 actual
2020 est.
2021 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
1,008
1,091
1,131
11.3
Other than full-time permanent
527
562
571
11.5
Other personnel compensation
49
52
54
11.7
Military personnel
18
19
20
11.8
Special personal services payments
199
210
210
11.9
Total personnel compensation
1,801
1,934
1,986
12.1
Civilian personnel benefits
528
600
632
12.2
Military personnel benefits
14
15
15
21.0
Travel and transportation of persons
61
64
54
22.0
Transportation of things
5
5
5
23.1
Rental payments to GSA
24
25
23
23.2
Rental payments to others
1
1
1
23.3
Communications, utilities, and miscellaneous charges
20
20
15
25.1
Advisory and assistance services
229
307
236
25.2
Other services from non-Federal sources
1,502
1,567
1,216
25.3
Other goods and services from Federal sources
3,496
3,763
3,549
25.4
Operation and maintenance of facilities
232
241
328
25.5
Research and development contracts
1,577
1,739
1,544
25.6
Medical care
44
38
34
25.7
Operation and maintenance of equipment
173
174
153
26.0
Supplies and materials
258
273
230
31.0
Equipment
188
200
164
32.0
Land and structures
41
25
41.0
Grants, subsidies, and contributions
28,002
29,697
27,436
99.0
Direct obligations
38,155
40,704
37,646
99.0
Reimbursable obligations
4,489
4,649
4,038
99.9
Total new obligations, unexpired accounts
42,644
45,353
41,684
Employment Summary
Identification code 075–9915–0–1–552
2019 actual
2020 est.
2021 est.
1001
Direct civilian full-time equivalent employment
12,540
13,258
13,467
1101
Direct military average strength employment
172
173
177
2001
Reimbursable civilian full-time equivalent employment
4,371
4,507
4,507
2101
Reimbursable military average strength employment
98
98
98
National Institutes of Health
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 075–9915–4–1–552
2019 actual
2020 est.
2021 est.
Obligations by program activity:
0001
Type 1 Diabetes
53
150
0900
Total new obligations, unexpired accounts (object class 41.0)
53
150
Budgetary resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
53
150
1930
Total budgetary resources available
53
150
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
50
3010
New obligations, unexpired accounts
53
150
3020
Outlays (gross)
–3
–23
3050
Unpaid obligations, end of year
50
177
Memorandum (non-add) entries:
3100
Obligated balance, start of year
50
3200
Obligated balance, end of year
50
177
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
53
150
Outlays, gross:
4100
Outlays from new mandatory authority
3
12
4101
Outlays from mandatory balances
11
4110
Outlays, gross (total)
3
23
4180
Budget authority, net (total)
53
150
4190
Outlays, net (total)
3
23
The Budget proposes to extend the Special Diabetes Program for Type 1 Diabetes through FY 2021.
Payment to the NIH Innovation Account, CURES Act
Program and Financing (in millions of dollars)
Identification code 075–0147–0–1–552
2019 actual
2020 est.
2021 est.
Obligations by program activity:
0001
Payment to NIH Innovation (object class 94.0)
711
492
404
0900
Total new obligations, unexpired accounts (object class 94.0)
711
492
404
Budgetary resources:
Budget authority:
Appropriations, mandatory:
1200
Appropriation
711
492
404
1930
Total budgetary resources available
711
492
404
Change in obligated balance:
Unpaid obligations:
3010
New obligations, unexpired accounts
711
492
404
3020
Outlays (gross)
–711
–492
–404
Budget authority and outlays, net:
Mandatory:
4090
Budget authority, gross
711
492
404
Outlays, gross:
4100
Outlays from new mandatory authority
711
492
404
4180
Budget authority, net (total)
711
492
404
4190
Outlays, net (total)
711
492
404
This account, and a related special fund receipt account, were established to support the execution structure necessary to
implement the 21st Century Cures Act.
NIH Innovation Account, CURES Act
(including transfer of funds)
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 NIH in this Act, $404,000,000, to remain available until expended: Provided, That such amounts are appropriated pursuant to section 1001(b)(3) of such Act, are to be derived from amounts transferred
under section 1001(b)(2)(A) of such Act, and may be transferred by the Director of the National Institutes of Health to other
accounts of the National Institutes of Health solely for the purposes provided in such Act: Provided further, That upon a determination by the Director that funds transferred pursuant to the previous proviso are not necessary for
the purposes provided, such amounts may be transferred back to the Account: Provided further, That the transfer authority provided under this heading is in addition to any other transfer authority provided by law.
(Department of Health and Human Services Appropriations Act, 2020.)
Special and Trust Fund Receipts (in millions of dollars)
Identification code 075–5628–0–2–552
2019 actual
2020 est.
2021 est.
0100
Balance, start of year
Receipts:
Current law:
1140
General Fund Payment, NIH Innovation, CURES Act
711
492
404
2000
Total: Balances and receipts
711
492
404
Appropriations:
Current law:
2101
NIH Innovation, Cures Act
–711
–492
–404
5099
Balance, end of year
Program and Financing (in millions of dollars)
Identification code 075–5628–0–2–552
2019 actual
2020 est.
2021 est.
Obligations by program activity:
0001
CURES obligations
185
216
109
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
48
59
Budget authority:
Appropriations, discretionary:
1101
Appropriation (special or trust)
711
492
404
1120
Appropriations transferred to other acct [075–9915]
–515
–335
–295
1160
Appropriation, discretionary (total)
196
157
109
1930
Total budgetary resources available
244
216
109
Memorandum (non-add) entries:
1941
Unexpired unobligated balance, end of year
59
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
95
228
264
3010
New obligations, unexpired accounts
185
216
109
3020
Outlays (gross)
–52
–180
–180
3050
Unpaid obligations, end of year
228
264
193
Memorandum (non-add) entries:
3100
Obligated balance, start of year
95
228
264
3200
Obligated balance, end of year
228
264
193
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
196
157
109
Outlays, gross:
4010
Outlays from new discretionary authority
17
31
23
4011
Outlays from discretionary balances
35
149
157
4020
Outlays, gross (total)
52
180
180
4180
Budget authority, net (total)
196
157
109
4190
Outlays, net (total)
52
180
180
The 21st Century Cures Act was enacted into law on December 13, 2016. The 21st Century 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. Amounts appropriated into the NIH Innovation Account are either transferred to the
individual institutes and centers or obligated directly in the NIH Innovation Account.
Object Classification (in millions of dollars)
Identification code 075–5628–0–2–552
2019 actual
2020 est.
2021 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
5
6
10
11.3
Other than full-time permanent
1
1
1
11.9
Total personnel compensation
6
7
11
12.1
Civilian personnel benefits
2
3
4
25.3
Other goods and services from Federal sources
6
1
25.5
Research and development contracts
3
41.0
Grants, subsidies, and contributions
174
200
93
99.9
Total new obligations, unexpired accounts
185
216
109
Employment Summary
Identification code 075–5628–0–2–552
2019 actual
2020 est.
2021 est.
1001
Direct civilian full-time equivalent employment
45
64
89
1101
Direct military average strength employment
1
1
1
10-Year Pediatric Research Initiative Fund
Special and Trust Fund Receipts (in millions of dollars)
Identification code 075–5736–0–2–552
2019 actual
2020 est.
2021 est.
0100
Balance, start of year
28
28
Receipts:
Current law:
1140
Transfers from Presidential Election Campaign Fund
41
13
2000
Total: Balances and receipts
41
41
28
Appropriations:
Current law:
2101
10-Year Pediatric Research Initiative Fund
–13
–13
–13
5099
Balance, end of year
28
28
15
Program and Financing (in millions of dollars)
Identification code 075–5736–0–2–552
2019 actual
2020 est.
2021 est.
Budgetary resources:
Budget authority:
Appropriations, discretionary:
1101
Appropriation (special or trust)
13
13
13
1120
Appropriations transferred to other accts [075–9915]
–13
–13
–13
4180
Budget authority, net (total)
4190
Outlays, net (total)
This special fund was created by the Gabriella Miller Kids First Research Act, enacted on April 3, 2014. This fund receives
transfers from the Presidential Election Campaign Fund, which are then appropriated to the NIH Common Fund to support pediatric
research.
Substance Abuse and Mental Health Services Administration
Federal Funds
MENTAL HEALTH
For carrying out titles III, V, and XIX of the PHS Act with respect to mental health, and the Protection and Advocacy for
Individuals with Mental Illness Act, $1,675,106,000: Provided, That notwithstanding section 520A(f)(2) of the PHS Act, no funds appropriated for carrying out section 520A shall be available
for carrying out section 1971 of the PHS Act: Provided further, That in addition to amounts provided herein, $21,039,000 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 $35,000,000 of the amounts appropriated for subpart I of part B shall be available to support evidence-based
crisis systems: 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 $225,000,000 shall be available until September 30, 2023 for grants to communities and community organizations who meet criteria for Certified Community Behavioral Health Clinics
pursuant to section 223(a) of Public Law 113–93: 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, $25,000,000 shall be to carry out section 224 of the Protecting Access to Medicare Act of 2014 (Public Law 113–93; 42 U.S.C. 290aa 22
note).
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, and the SUPPORT for Patients and Communities Act, $3,728,556,000: Provided, That $1,585,000,000 shall be for State Opioid Response Grants for carrying out activities pertaining to opioids and stimulants undertaken by the
State agency responsible for administering the substance abuse prevention and treatment block grant under subpart II of part
B of title XIX of the PHS Act (42 U.S.C. 300x-21 et seq.): Provided further, That of such amount $50,000,000 shall be made available to Indian Tribes or tribal organizations: Provided further, That 15 percent of the remaining amount shall be for the States with the highest mortality rate related to opioid use disorders:
Provided further, That of the amounts provided for State Opioid Response Grants not more than 2 percent shall be available for Federal administrative
expenses, training, technical assistance, and evaluation: Provided further, That of the amount not reserved by the previous three provisos, the Secretary shall make allocations to States, territories,
and the District of Columbia according to a formula using national survey results that the Secretary determines are the most
objective and reliable measure of drug use and drug-related deaths: Provided further, That prevention and treatment activities funded through such grants may include education, treatment (including the provision
of medication), behavioral health services for individuals in treatment programs, referral to treatment services, recovery
support, and medical screening associated with such treatment: Provided further, That each State, as well as the District of Columbia, shall receive not less than $4,000,000: Provided further, That in addition to amounts provided herein, $79,200,000 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 or State Opioid Response Grants 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, $96,985,000.
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, $97,004,000: Provided, That in addition to amounts provided herein, $42,453,000 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, 2022: 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".
(Department of Health and Human Services Appropriations Act, 2020.)
Program and Financing (in millions of dollars)
Identification code 075–1362–0–1–551
2019 actual
2020 est.
2021 est.
Obligations by program activity:
0006
Mental Health
1,493
1,633
1,675
0007
Substance Abuse Treatment
3,738
3,757
3,729
0008
Substance Abuse Prevention
205
206
97
0009
Health Surveillance and Program Support
132
129
97
0011
SAMHSA Prevention Fund
12
12
0100
Total, direct program
5,580
5,737
5,598
0799
Total direct obligations
5,580
5,737
5,598
0802
SAMHSA Reimbursables
121
2
2
0810
SAMHSA Reimbursable: PHS Evaluation
134
134
143
0899
Total reimbursable obligations
255
136
145
0900
Total new obligations, unexpired accounts
5,835
5,873
5,743
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
20
130
178
1001
Discretionary unobligated balance brought fwd, Oct 1
20
130
1010
Unobligated balance transfer to other accts [075–0116]
–8
1021
Recoveries of prior year unpaid obligations
2
1050
Unobligated balance (total)
14
130
178
Budget authority:
Appropriations, discretionary:
1100
Appropriation
5,597
5,736
5,598
1120
Appropriations transferred to other acct [075–1503]
–9
1121
Appropriations transferred from other acct [075–0140]
100
1160
Appropriation, discretionary (total)
5,688
5,736
5,598
Appropriations, mandatory:
1221
Appropriations transferred from the Prevention and Public Health Fund [075–0116]
12
12
Spending authority from offsetting collections, discretionary:
1700
Collected
135
173
173
1701
Change in uncollected payments, Federal sources
121
1750
Spending auth from offsetting collections, disc (total)
256
173
173
1900
Budget authority (total)
5,956
5,921
5,771
1930
Total budgetary resources available
5,970
6,051
5,949
Memorandum (non-add) entries:
1940
Unobligated balance expiring
–5
1941
Unexpired unobligated balance, end of year
130
178
206
Change in obligated balance:
Unpaid obligations:
3000
Unpaid obligations, brought forward, Oct 1
6,125
7,309
6,618
3010
New obligations, unexpired accounts
5,835
5,873
5,743
3011
Obligations ("upward adjustments"), expired accounts
49
3020
Outlays (gross)
–4,557
–6,564
–6,157
3040
Recoveries of prior year unpaid obligations, unexpired
–2
3041
Recoveries of prior year unpaid obligations, expired
–141
3050
Unpaid obligations, end of year
7,309
6,618
6,204
Uncollected payments:
3060
Uncollected pymts, Fed sources, brought forward, Oct 1
–164
–187
–187
3070
Change in uncollected pymts, Fed sources, unexpired
–121
3071
Change in uncollected pymts, Fed sources, expired
98
3090
Uncollected pymts, Fed sources, end of year
–187
–187
–187
Memorandum (non-add) entries:
3100
Obligated balance, start of year
5,961
7,122
6,431
3200
Obligated balance, end of year
7,122
6,431
6,017
Budget authority and outlays, net:
Discretionary:
4000
Budget authority, gross
5,944
5,909
5,771
Outlays, gross:
4010
Outlays from new discretionary authority
976
1,649
1,610
4011
Outlays from discretionary balances
3,570
4,906
4,539
4020
Outlays, gross (total)
4,546
6,555
6,149
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030
Federal sources
–229
–171
–171
4033
Non-Federal sources
–2
–2
4040
Offsets against gross budget authority and outlays (total)
–229
–173
–173
Additional offsets against gross budget authority only:
4050
Change in uncollected pymts, Fed sources, unexpired
–121
4052
Offsetting collections credited to expired accounts
94
4060
Additional offsets against budget authority only (total)
–27
4070
Budget authority, net (discretionary)
5,688
5,736
5,598
4080
Outlays, net (discretionary)
4,317
6,382
5,976
Mandatory:
4090
Budget authority, gross
12
12
Outlays, gross:
4100
Outlays from new mandatory authority
4
4101
Outlays from mandatory balances
11
5
8
4110
Outlays, gross (total)
11
9
8
4180
Budget authority, net (total)
5,700
5,748
5,598
4190
Outlays, net (total)
4,328
6,391
5,984
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 organizations, 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
2019 actual
2020 est.
2021 est.
Direct obligations:
Personnel compensation:
11.1
Full-time permanent
43
48
49
11.3
Other than full-time permanent
2
2
2
11.5
Other personnel compensation
2
1
1
11.7
Military personnel
3
3
4
11.9
Total personnel compensation
50
54
56
12.1
Civilian personnel benefits
14
15
15
12.2
Military personnel benefits
2
2
2
21.0
Travel and transportation of persons
1
1
1
23.1
Rental payments to GSA
5
5
5
23.3
Communications, utilities, and miscellaneous charges
1
1
1
24.0
Printing and reproduction
1
1
1
25.1
Advisory and assistance services
37
34
35
25.2
Other services from non-Federal sources
101
95
63
25.3
Other goods and services from Federal sources
39
36
37
25.4
Operation and maintenance of facilities
1
1
1
26.0
Supplies and materials
1
1
1
41.0
Grants, subsidies, and contributions
5,327
5,491
5,381
99.0
Direct obligations
5,580
5,737
5,599
99.0
Reimbursable obligations
255
136
144
99.9
Total new obligations, unexpired accounts
5,835
5,873
5,743
Employment Summary
Identification code 075–1362–0–1–551
2019 actual
2020 est.
2021 est.
1001
Direct civilian full-time equivalent employment
452
463
467
1101
Direct military average strength employment
30
31
32
2001
Reimbursable civilian full-time equivalent employment
9
104
108
2101
Reimbursable military average strength employment
8
8
Agency for Healthcare Research and Quality
Federal Funds
Healthcare research and quality
(Department of Health and Human Services Appropriations Act, 2020.)
Program and Financing (in millions of dollars)
Identification code 075–1700–0–1–552
2019 actual
2020 est.
2021 est.
Obligations by program activity:
0001
Research on Health Costs, Quality and Outcomes
196
190
0002
Medical Expenditure Panel Survey
70
70
0003
AHRQ Program Support
71
71
0799
Total direct obligations
337
331
0803
Research on Health Costs, Quality and Outcomes (Reimbursable)
31
31
0899
Total reimbursable obligations
31
31
0900
Total new obligations, unexpired accounts
368
362
Budgetary resources:
Unobligated balance:
1000
Unobligated balance brought forward, Oct 1
23
16
16
1001
Discretionary unobligated balance brought fwd, Oct 1
1
1
1010
Unobligated balance transfer to other accts [075–9915]
–16
1050
Unobligated balance (total)
23
16
Budget authority:
Appropriations, discretionary:
1100
Appropriation
338
338
1120
Appropriations transferred to other acct [075–1503]
–1