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DEPARTMENT OF HEALTH AND HUMAN SERVICES 00.07 00.08 00.09 Federal Funds General and special funds: SALARIES AND EXPENSES For necessary expenses of the Food and Drug Administration, including hire and purchase of passenger motor vehicles; for rental of special purpose space in the District of Columbia or elsewhere; and 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; ø$907,499,000, of which not to exceed $87,528,000 in fees pursuant to section 736 of the Federal Food, Drug, and Cosmetic Act may be credited to this appropriation and remain available until expended: Provided, That fees derived from applications received during fiscal year 1997 shall be subject to the fiscal year 1997 limitation: 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¿ $750,922,000. øIn addition, fees pursuant to section 354 of the Public Health Service Act may be credited to this account, to remain available until expended.¿ In addition, fees pursuant to section 801 of the Federal Food, Drug, and Cosmetic Act may be credited to this account, to remain available until expended. BUILDINGS AND FACILITIES Other rent and rent related activities ...................... Rental payments ....................................................... Buildings and facilities ............................................. 22 46 25 23 46 40 23 46 23 00.91 01.01 FOOD AND DRUG ADMINISTRATION Total direct program ............................................. Reimbursable program .................................................. 890 109 907 114 820 13 10.00 Total obligations ........................................................ 999 1,021 833 Budgetary resources available for obligation: Unobligated balance available, start of year: Uninvested balance ................................................... 22.00 New budget authority (gross) ........................................ 22.22 Unobligated balance transferred from other accounts 67 986 4 58 39 1,002 833 1 ................... 21.40 23.90 23.95 24.40 1,057 –999 1,061 –1,021 872 –833 58 39 39 877 888 820 109 114 13 Total new budget authority (gross) .......................... 986 1,002 833 Change in unpaid obligations: Unpaid obligations, start of year: Obligated balance: Appropriation ............................................................. 73.10 New obligations ............................................................. 73.20 Total outlays (gross) ...................................................... 73.40 Adjustments in expired accounts .................................. 74.40 Unpaid obligations, end of year: Obligated balance: Appropriation ............................................................. 279 999 –975 –13 New budget authority (gross), detail: Current: 40.00 Appropriation ............................................................. Permanent: 68.00 Spending authority from offsetting collections: Offsetting collections (cash) ..................................... 70.00 72.40 For plans, construction, repair, improvement, extension, alteration, and purchase of fixed equipment or facilities of or used by the Food and Drug Administration, where not otherwise provided, ø$21,350,000¿ $22,900,000, to remain available until expended (7 U.S.C. 2209b). RENTAL PAYMENTS (FDA) (INCLUDING TRANSFERS OF FUNDS) 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, $46,294,000: Provided, That in the event the Food and Drug Administration should require modification of space needs, a share of the salaries and expenses appropriation may be transferred to this appropriation, or a share of this appropriation may be transferred to the salaries and expenses appropriation, but such transfers shall not exceed 5 percent of the funds made available for rental payments (FDA) to or from this account. (Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 1997.) 86.90 86.93 86.97 86.98 87.00 Balance, start of year: Balance, start of year .................................................... Receipts: 02.01 User fees, FDA, legislative proposal .............................. Appropriation: 05.01 Salaries and expenses, legislative proposal ................. 07.99 Total balance, end of year ............................................ 01.99 1996 actual 1997 est. 1998 est. ................... ................... ................... 237 ................... ................... –237 ................... ................... ................... 1996 actual 1997 est. 273 241 Outlays (gross), detail: Outlays from new current authority .............................. 682 684 631 Outlays from current balances ...................................... 184 234 221 Outlays from new permanent authority ......................... 109 114 13 Outlays from permanent balances ................................ ................... ................... ................... 975 1,032 865 Offsets: Against gross budget authority and outlays: Offsetting collections (cash) from: 88.00 Federal sources ..................................................... 88.40 Non-Federal sources ............................................. –14 –95 –11 –103 –11 –2 88.90 Total, offsetting collections (cash) .................. –109 –114 –13 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 877 866 888 918 820 852 [In millions of dollars] 1996 ................... ................... Program and Financing (in millions of dollars) Identification code 75–9911–0–1–554 290 290 273 1,021 833 –1,032 –865 –6 ................... Total outlays (gross) ................................................. Unavailable Collections (in millions of dollars) Identification code 75–9911–0–1–554 Total budgetary resources available for obligation New obligations ............................................................. Unobligated balance available, end of year: Uninvested balance ................................................... Distribution of budget authority by account: Salaries and expenses ............................................................ Rental payments (FDA) ........................................................... Buildings and facilities .......................................................... Distribution of outlays by account: Salaries and expenses ............................................................ Rental payments (FDA) ........................................................... Buildings and facilities .......................................................... 1997 1998 818 46 12 820 46 21 751 46 23 788 66 12 852 49 17 785 46 21 1998 est. Summary of Budget Authority and Outlays Obligations by program activity: Direct program: 00.01 Foods ......................................................................... 00.02 Drugs ......................................................................... 00.03 Devices and radiological products ............................ 00.04 National center for toxicological research ................ 00.05 Tobacco ...................................................................... 00.06 Other activities .......................................................... (in millions of dollars) 201 326 144 31 5 90 200 329 147 31 5 86 174 296 107 31 34 86 Enacted/requested: 1996 actual 1997 est. Budget Authority ..................................................................... 877 888 Outlays .................................................................................... 866 918 Legislative proposal, subject to PAYGO: Budget Authority ..................................................................... .................... .................... Outlays .................................................................................... .................... .................... 1998 est. 491 820 852 237 237 492 FOOD AND DRUG ADMINISTRATION—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 1998 General and special funds—Continued Personnel Summary RENTAL PAYMENTS (FDA)—Continued Summary of Budget Authority and Outlays—Continued (in millions of dollars) Total: Budget Authority ..................................................................... Outlays .................................................................................... 1996 actual 877 866 1996 actual Identification code 75–9911–0–1–554 (INCLUDING TRANSFERS OF FUNDS)—Continued 1997 est. 1998 est. 888 918 1,057 1,089 The Food and Drug Administration (FDA) administers laws concerning misbranded and adulterated foods, drugs, human biologics, medical devices, cosmetics, and human-made sources of radiation. The Budget includes $750.9 million for Salaries and Expenses, which includes funding for new food safety initiatives and tobacco regulation. In addition, the Budget includes $244 million for user fees, an increase of $136 million in user fees over FY 1997, which will be used to finance FDA activities. Of the $244 million in user fees, $237 million consists of reauthorized and new user fees, which are represented in the legislative proposal schedule. The buildings and facilities appropriation of $22.9 million provides funds for projects related to the repair, construction, alteration, and improvement of all buildings and facilities of FDA, while the rental payments appropriation of $46.3 million provides funds for payment of GSA space rental and related costs. Direct: Total compensable workyears: 1001 Full-time equivalent employment .............................. 1005 Full-time equivalent of overtime and holiday hours Reimbursable: 2001 Total compensable workyears: Full-time equivalent employment ............................................................... SALARIES AND 1997 est. 1998 est. 8,459 87 8,475 87 7,353 87 671 663 28 EXPENSES (Legislative proposal, subject to PAYGO) Program and Financing (in millions of dollars) Identification code 75–9911–4–1–554 1996 actual 1997 est. 1998 est. 47 131 59 10.00 Total obligations ........................................................ ................... ................... 237 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ ................... ................... New obligations ............................................................. ................... ................... 237 –237 40.25 Comparable Presentation of Budget Authority Under New User Fee Policy Obligations by program activity: Direct program: 00.01 Foods ......................................................................... ................... ................... 00.02 Drugs ......................................................................... ................... ................... 00.03 Devices and radiological products ............................ ................... ................... New budget authority (gross), detail: Appropriation (special fund, indefinite) ........................ ................... ................... 237 73.10 73.20 Change in unpaid obligations: New obligations ............................................................. ................... ................... Total outlays (gross) ...................................................... ................... ................... 237 –237 86.90 Outlays (gross), detail: Outlays from new current authority .............................. ................... ................... 237 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ ................... ................... Outlays ........................................................................... ................... ................... 237 237 (in millions of dollars) 1996 actual Enacted/requested: Budget Authority ..................................................................... User Fees collected/requested: Budget Authority ..................................................................... Total: Budget Authority ..................................................................... 1997 est. 1998 est. 877 888 820 103 108 244 980 996 1,064 As shown in the table above, the total resources (budget authority plus user fees) available to FDA increase from $996 million in FY 1997 to $1.06 billion in FY 1998, a six percent increase. Object Classification (in millions of dollars) Identification code 75–9911–0–1–554 11.1 11.3 11.5 Direct obligations: Personnel compensation: Full-time permanent ............................................. Other than full-time permanent ........................... Other personnel compensation ............................. 1996 actual 1997 est. 1998 est. 405 28 16 423 30 17 379 27 15 449 98 17 1 42 6 470 102 16 1 42 6 421 91 12 1 42 4 23 3 10 28 21 3 7 51 16 2 5 83 25.4 25.5 25.7 26.0 31.0 32.0 41.0 42.0 Total personnel compensation ......................... Civilian personnel benefits ....................................... Travel and transportation of persons ....................... Transportation of things ........................................... Rental payments to GSA ........................................... Rental payments to others ........................................ Communications, utilities, and miscellaneous charges ................................................................. Printing and reproduction ......................................... Advisory and assistance services ............................. Other services ............................................................ Purchases of goods and services from Government accounts ................................................................ Operation and maintenance of facilities .................. Research and development contracts ....................... Operation and maintenance of equipment ............... Supplies and materials ............................................. Equipment ................................................................. Land and structures .................................................. Grants, subsidies, and contributions ........................ Insurance claims and indemnities ........................... 49 24 30 34 19 34 1 20 2 35 21 28 25 18 32 10 18 1 25 16 20 17 13 23 15 13 1 99.0 99.0 Subtotal, direct obligations .................................. Reimbursable obligations .............................................. 890 109 907 114 820 13 11.9 12.1 21.0 22.0 23.1 23.2 23.3 24.0 25.1 25.2 25.3 99.9 Total obligations ........................................................ 999 1,021 This legislative proposal seeks $237 million in user fees to finance FDA activities. These user fees build upon the successful implementation of the Prescription Drug User Fee Act (PDUFA) of 1992, which authorized the collection of fees paid by the pharmaceutical industry to expedite FDA’s review of human drug applications and the Mammography Quality Standards Act (MQSA), which authorized the collection of fees for the inspection of mammography facilities. The Budget includes continued collection of PDUFA and MQSA fees, as well as fees for medical device reviews, animal drug approvals, import inspections, food additive petition reviews, generic/ over-the-counter drug applications, and fees for postmarket surveillance of products. This is one of several proposals in the budget to charge fees to users directly availing themselves of, or subject to, a government service, program, or activity, in order to cover the government’s costs. Legislation will be proposed to authorize the fees and, upon enactment of the authorization, a budget amendment to the current appropriations language will be proposed to make the fees available for expenditure. Because the current requirements of the Budget Enforcement Act of 1990 make it difficult to fund discretionary programs with receipts that are not authorized in appropriations acts, the Administration is proposing a change in the requirements to facilitate the enactment of proposals such as this one. Object Classification (in millions of dollars) Identification code 75–9911–4–1–554 833 11.1 1996 actual 1997 est. Personnel compensation: Full-time permanent .................................................. ................... ................... 1998 est. 128 HEALTH RESOURCES AND SERVICES ADMINISTRATION Federal Funds DEPARTMENT OF HEALTH AND HUMAN SERVICES 11.3 11.9 12.1 21.0 23.1 23.3 24.0 25.1 25.2 25.3 25.4 25.5 25.7 26.0 31.0 99.9 Other than full-time permanent ............................... ................... ................... Total personnel compensation .............................. Civilian personnel benefits ............................................ Travel and transportation of persons ............................ Rental payments to GSA ................................................ Communications, utilities, and miscellaneous charges Printing and reproduction .............................................. Advisory and assistance services .................................. Other services ................................................................ Purchases of goods and services from Government accounts .................................................................... Operation and maintenance of facilities ...................... Research and development contracts ........................... Operation and maintenance of equipment ................... Supplies and materials ................................................. Equipment ...................................................................... 5 ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... 133 28 4 1 4 1 3 18 ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... 7 4 11 9 4 10 Total obligations ........................................................ ................... ................... Object Classification (in millions of dollars) 237 Personnel Summary 1996 actual Identification code 75–9911–4–1–554 1001 1997 est. 1,757 Public enterprise funds: REVOLVING FUND FOR CERTIFICATION AND OTHER SERVICES Program and Financing (in millions of dollars) Identification code 75–4309–0–3–554 1996 actual 1997 est. 1998 est. 00.01 00.02 Obligations by program activity: Color additives ............................................................... Insulin ............................................................................ 3 1 3 1 3 1 10.00 Total obligations ........................................................ 4 4 4 Budgetary resources available for obligation: Unobligated balance available, start of year: Fund balance ...................................................................... 22.00 New budget authority (gross) ........................................ 3 5 4 5 4 5 8 –4 9 –4 9 –4 4 4 5 5 5 5 21.90 68.00 Total budgetary resources available for obligation New obligations ............................................................. Unobligated balance available, end of year: Fund balance ...................................................................... New budget authority (gross), detail: Spending authority from offsetting collections (gross): Offsetting collections (cash) ..................................... Change in unpaid obligations: Unpaid obligations, start of year: Obligated balance: Fund balance ............................................................. 73.10 New obligations ............................................................. 73.20 Total outlays (gross) ...................................................... 74.90 Unpaid obligations, end of year: Obligated balance: Fund balance ............................................................. 72.90 1 4 –4 1 ................... 4 4 –5 –5 1 ................... ................... Outlays (gross), detail: Outlays from new permanent authority ......................... 4 5 5 Offsets: Against gross budget authority and outlays: 88.40 Offsetting collections (cash) from: Non-Federal sources .................................................................. –5 –5 –5 86.97 89.00 90.00 1997 est. 1998 est. 11.1 12.1 23.1 99.0 Personnel compensation: Full-time permanent ............. Civilian personnel benefits ............................................ Rental payments to GSA ................................................ Subtotal, reimbursable obligations ............................... 2 1 1 4 2 1 1 4 2 1 1 4 99.9 Total obligations ........................................................ 4 4 4 Personnel Summary 1996 actual Identification code 75–4309–0–3–554 2001 Total compensable workyears: Full-time equivalent employment ............................................................... 42 1997 est. 42 1998 est. 42 HEALTH RESOURCES AND SERVICES ADMINISTRATION 1998 est. Total compensable workyears: Full-time equivalent employment ............................................................... ................... ................... 1996 actual Identification code 75–4309–0–3–554 Federal Funds General and special funds: HEALTH RESOURCES 23.90 23.95 24.90 493 Net budget authority and outlays: Budget authority ............................................................ ................... ................... ................... Outlays ........................................................................... ................... ................... ................... FDA certifies batches of insulin and color additives for use in foods, drugs, and cosmetics. It also lists color additives for use in foods, drugs, medical devices, and cosmetics (21 U.S.C. 346a, 356, 357, 376). These services are financed wholly by fees paid by the industries affected. AND SERVICES For carrying out titles II, III, VII, VIII, X, XII, XVI, XIX, and XXVI of the Public Health Service Act, section 427(a) of the Federal Coal Mine Health and Safety Act, title V of the Social Security Act, the Health Care Quality Improvement Act of 1986, as amended, and the Native Hawaiian Health Care Act of 1988, as amended, ø$3,405,019,000¿ $3,266,479,000, of which ø$297,000¿ $225,000 shall remain available until expended for interest subsidies on loan guarantees made prior to fiscal year 1981 under part B of title VII of the Public Health Service Act: Provided, That the Division of Federal Occupational Health may utilize personal services contracting to employ professional management/administrative and occupational health professionals: Provided further, That of the funds made available under this heading, ø$828,000¿ $500,000 shall be available until expended for facilities renovations at the Gillis W. Long Hansen’s Disease Center: Provided further, That in addition to fees authorized by section 427(b) of the Health Care Quality Improvement Act of 1986, fees shall be collected for the full disclosure of information under the Act sufficient to recover the full costs of operating the National Practitioner Data Bank, and shall remain available until expended to carry out that Act: Provided further, That no more than $5,000,000 is available for carrying out the provisions of Public Law 104–73: øProvided further, That of the funds made available under this heading, $198,452,000 shall be for the program under title X of the Public Health Service Act to provide for voluntary family planning projects: Provided further, 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:¿ Provided further, That $167,000,000 shall be for State AIDS Drug Assistance Programs authorized by section 2616 of the Public Health Service Act øand shall be distributed to States as authorized by section 2618(b)(2) of such Act¿: Provided further, That notwithstanding any other provision of law, funds made available under this heading may be used to continue operating the Council on Graduate Medical Education established by section 301 of Public law 102–408: Provided further, Thatø, of the funds made available under this heading, not more than $8,000,000 shall be made available and shall remain available until expended for loan guarantees for loans made by non-Federal lenders for the construction, renovation, and modernization of medical facilities that are owned and operated by health centers funded under part A of title XVI of the Public Health Service Act as amended, and, subject to authorization, for loans made to health centers for the costs of developing and operating managed care networks or plans, and that such funds be available to subsidize guarantees of total loan principal in an amount not to exceed $80,000,000: Provided further, That notwithstanding section 502(a)(1) of the Social Security Act, not to exceed $103,609,000 is available for carrying out special projects of regional and national significance pursuant to section 501(a)(2) of such Act¿ user fees to be collected by the Secretary pursuant to 31 U.S.C. 9701 related to 494 HEALTH RESOURCES AND SERVICES ADMINISTRATION—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 1998 HEALTH RESOURCES AND SERVICES—Continued activities authorized by section 340B(a)(8) of the Public Health Service Act shall be available to fund such activities and shall remain available until expended. (Department of Health and Human Services Appropriations Act, 1997.) Program and Financing (in millions of dollars) Identification code 75–0350–0–1–550 1996 actual 1997 est. Offsets: Against gross budget authority and outlays: Offsetting collections (cash) from: 88.00 Federal sources ..................................................... 88.40 Non-Federal sources ............................................. –133 –8 –68 –6 –68 –8 88.90 Total, offsetting collections (cash) .................. –141 –74 –76 89.00 90.00 General and special funds—Continued Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 3,077 3,825 3,405 3,252 3,316 3,337 1998 est. [Dollars in millions] Obligations by program activity: Direct program: 00.01 Consolidated health centers ..................................... 00.02 National Health Service Corps .................................. 00.03 National Health Service Corps recruitment .............. 00.04 Hansen’s disease center ........................................... 00.05 Payment to Hawaii for the treatment of Hansen’s disease .................................................................. 00.06 Buildings and facilities ............................................. 00.07 Hansen’s disease services cluster ............................ 00.08 Black lung clinics ..................................................... 00.09 Alzheimer’s demonstration grants ............................ 00.10 Nursing loan repayment ............................................ 00.11 Health professions curriculum assistance ................ 00.12 Health professions clusters ....................................... 00.13 Maternal and child health block grant .................... 00.14 Healthy start .............................................................. 00.15 Emergency medical services for children ................. 00.16 Organ transplantation ............................................... 00.17 Bone marrow donor registry ...................................... 00.18 Health care facilities ................................................. 00.19 Family planning ......................................................... 00.20 Program management ............................................... 00.21 Rural health policy development .............................. 00.22 Rural health outreach ............................................... 00.23 HIV ............................................................................. 00.24 Malpractice claims fund ........................................... 00.25 LA emergency funds .................................................. 00.26 Abstinence education ................................................ 00.27 Other HRSA programs ............................................... 00.28 CHC loan guarantee program account ..................... 00.91 01.01 10.00 Total direct program ............................................. Reimbursable obligations (cash) ................................... Total obligations ........................................................ Budgetary resources available for obligation: Unobligated balance available, start of year: Uninvested balance ................................................... 22.00 New budget authority (gross) ........................................ 22.22 Unobligated balance transferred from other accounts 1996 753 37 75 17 791 805 37 37 78 78 17 ................... 2 1 ................... 4 4 2 257 ................... 678 93 11 2 15 18 193 112 11 28 757 ................... 4 ................... 1 ................... 2 1 ................... 4 6 2 290 ................... 681 96 13 2 15 13 198 113 9 28 996 1 ................... ................... 2 5 ................... ................... 17 2 ................... ................... ................... 130 681 96 12 4 15 ................... 203 111 9 25 1,036 1 ................... 50 ................... 1 3,075 140 3,400 81 3,313 79 3,215 3,481 3,392 Total budgetary resources available for obligation New obligations ............................................................. Unobligated balance available, end of year: Uninvested balance ................................................... 1997 1998 3,072 5 3,400 5 3,311 5 3,820 5 3,247 5 3,332 5 Status of Direct Loans (in millions of dollars) Identification code 75–0350–0–1–550 Cumulative balance of direct loans outstanding: Outstanding, start of year ............................................. Disbursements: Direct loan disbursements ................... Repayments: Repayments and prepayments ................. Write-offs for default: 1263 Direct loans ............................................................... 1264 Other adjustments, net ............................................. 1210 1231 1251 1290 Outstanding, end of year .......................................... 1996 actual 1997 est. 798 25 –18 1998 est. 800 800 20 ................... –18 –18 –1 –4 –1 –1 –1 –1 800 800 780 Status of Guaranteed Loans (in millions of dollars) Identification code 75–0350–0–1–550 1996 actual 1997 est. 1998 est. Position with respect to appropriations act limitation on commitments: 2111 Limitation on guaranteed loans made by private lenders .............................................................................. ................... 80 ................... 2150 Total guaranteed loan commitments ........................ ................... 80 ................... 2210 2231 2251 Cumulative balance of guaranteed loans outstanding: Outstanding, start of year ............................................. 10 Disbursements of new guaranteed loans ...................... ................... Repayments and prepayments ...................................... ................... 10 76 67 13 –1 ................... 2290 21.40 23.90 23.95 24.40 Distribution of budget authority by account: Health resources and services ............................................... Health centers malpractice claims ........................................ Distribution of outlays by account: Health resources and services ............................................... Health centers malpractice claims ........................................ 22 29 27 3,218 3,479 3,392 4 ................... ................... 3,244 –3,215 3,508 –3,481 3,419 –3,392 29 27 28 New budget authority (gross), detail: Current: 40.00 Appropriation ............................................................. 3,077 3,405 Permanent: 60.00 Appropriation ............................................................. ................... ................... 68.00 Spending authority from offsetting collections: Offsetting collections (cash) ..................................... 141 74 Outstanding, end of year .......................................... 10 76 89 2299 Memorandum: Guaranteed amount of guaranteed loans outstanding, end of year ................................................................ 10 76 89 Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in millions of dollars) Identification code 75–0350–0–1–550 1996 actual 1997 est. 1998 est. Total new budget authority (gross) .......................... Change in unpaid obligations: 72.40 Unpaid obligations, start of year: Obligated balance: Appropriation ............................................................. 73.10 New obligations ............................................................. 73.20 Total outlays (gross) ...................................................... 73.40 Adjustments in expired accounts .................................. 74.40 Unpaid obligations, end of year: Obligated balance: Appropriation ............................................................. 3,218 3,479 50 23 22 22 5 4 4 2159 70.00 3,266 Guaranteed loan levels supportable by subsidy budget authority: 2150 Loan guarantee levels ................................................... ................... 2150 Loan guarantee levels ................................................... ................... 2150 Loan guarantee levels ................................................... ................... 76 3,392 3,053 2,299 2,454 3,215 3,481 3,392 –3,966 –3,326 –3,413 –3 ................... ................... Total loan guarantee levels ...................................... Guaranteed loan subsidy (in percent): 2320 Subsidy rate ................................................................... 2320 Subsidy rate ................................................................... 2320 Subsidy rate ................................................................... ................... 67 13 ................... ................... ................... 5.41 13.26 4.35 5.41 13.26 4.35 2329 ................... 7.67 7.67 2,454 2,431 ................... ................... ................... 2 1 1 ................... 2 ................... 2339 2,299 Weighted average subsidy rate ................................. Guaranteed loan subsidy budget authority: 2330 Subsidy budget authority ............................................... 2330 Subsidy budget authority ............................................... 2330 Subsidy budget authority ............................................... ................... 5 ................... ................... ................... 2 1 1 ................... 2 ................... Outlays (gross), detail: 86.90 Outlays from new current authority .............................. 86.93 Outlays from current balances ...................................... 86.97 Outlays from new permanent authority ......................... 1,271 2,554 141 1,362 1,890 74 1,306 2,011 96 Total subsidy budget authority ................................. Guaranteed loan subsidy outlays: 2340 Subsidy outlays .............................................................. 2340 Subsidy outlays .............................................................. 2340 Subsidy outlays .............................................................. 87.00 3,966 3,326 3,413 2349 Total outlays (gross) ................................................. Total subsidy outlays ................................................ ................... 5 1 1 HEALTH RESOURCES AND SERVICES ADMINISTRATION—Continued Federal Funds—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES Activities displayed here support categorical health resources and services grants and the Medical Malpractice Claims Fund, which pays malpractice claims filed against employees of federally-supported health centers. 73.10 73.20 74.40 Object Classification (in millions of dollars) 86.90 86.93 Outlays (gross), detail: Outlays from new current authority .............................. Outlays from current balances ...................................... 87.00 Total outlays (gross) ................................................. 76 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 110 76 1996 actual Identification code 75–0350–0–1–550 11.1 11.3 11.5 11.9 12.1 13.0 21.0 23.1 23.3 24.0 25.1 25.2 25.3 26.0 31.0 41.0 42.0 Direct obligations: Personnel compensation: Full-time permanent ............................................. Other than full-time permanent ........................... Other personnel compensation ............................. 87 2 4 Total personnel compensation ......................... 93 Civilian personnel benefits ....................................... 22 Benefits for former personnel ................................... 1 Travel and transportation of persons ....................... 2 Rental payments to GSA ........................................... 7 Communications, utilities, and miscellaneous charges ................................................................. 4 Printing and reproduction ......................................... 1 Advisory and assistance services ............................. 10 Other services ............................................................ 39 Purchases of goods and services from Government accounts ................................................................ 67 Supplies and materials ............................................. 2 Equipment ................................................................. 2 Grants, subsidies, and contributions ........................ 2,825 Insurance claims and indemnities ........................... ................... 1997 est. New obligations ............................................................. 74 Total outlays (gross) ...................................................... –76 Unpaid obligations, end of year: Obligated balance: Appropriation ............................................................. ................... 495 75 –68 75 –68 7 14 5 ................... ................... 71 68 68 1998 est. 91 2 3 93 2 3 96 98 22 23 1 ................... 2 2 8 9 4 1 11 37 4 1 14 36 73 2 3 3,139 1 62 2 3 3,058 1 99.0 99.0 Subtotal, direct obligations .................................. Reimbursable obligations .............................................. 3,075 140 3,400 81 Total obligations ........................................................ 3,215 3,481 3,392 68 110 ................... 68 68 The Vaccine Improvement 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 backlog of claims yet to be adjudicated, no appropriation is requested in FY 1998 to cover payment of pre1988 claims. Payment of claims associated with vaccine related injury or death occurring after October 1, 1988 are reflected in the Vaccine Improvement Trust Fund account. 3,313 79 99.9 68 Credit accounts: HEALTH CENTER GUARANTEED LOAN FINANCING ACCOUNT Personnel Summary Identification code 75–0350–0–1–550 Direct: Total compensable workyears: 1001 Full-time equivalent employment .............................. 1005 Full-time equivalent of overtime and holiday hours 1011 Exempt Full-time equivalent employment ................. Reimbursable: 2001 Total compensable workyears: Full-time equivalent employment ............................................................... Allocation account: 3001 Total compensable workyears: Full-time equivalent employment ............................................................... Status of Guaranteed Loans (in millions of dollars) 1996 actual 1997 est. 1998 est. Identification code 75–4442–0–3–551 1996 actual 1997 est. 1998 est. 1,563 10 137 1,563 10 137 304 170 Position with respect to appropriations act limitation on commitments: 2111 Limitation on guaranteed loans made by private lenders .............................................................................. ................... 80 ................... 2150 1,534 10 145 80 ................... 170 3 3 3 2210 2231 2261 Total guaranteed loan commitments ........................ ................... Cumulative balance of guaranteed loans outstanding: Outstanding, start of year ............................................. ................... ................... Disbursements of new guaranteed loans ...................... ................... 67 Adjustments: Terminations for default that result in loans receivable ........................................................ ................... ................... 67 7 –1 2290 Outstanding, end of year .......................................... ................... 67 73 2299 Memorandum: Guaranteed amount of guaranteed loans outstanding, end of year ................................................................ ................... 67 73 VACCINE INJURY COMPENSATION øFor payment of claims resolved by the United States Court of Federal Claims related to the administration of vaccines before October 1, 1988, $110,000,000, to remain available until expended.¿ (Department of Health and Human Services Appropriations Act, 1997.) Program and Financing (in millions of dollars) Identification code 75–0320–0–1–551 1996 actual 1997 est. 1998 est. Obligations by program activity: Total obligations (object class 42.0) ............................ 74 Budgetary resources available for obligation: Unobligated balance available, start of year: Uninvested balance ................................................... 22.00 New budget authority (gross) ........................................ 69 110 106 141 110 ................... 179 –74 216 –75 141 –75 106 141 68 110 110 ................... 10.00 75 75 21.40 23.90 23.95 24.40 40.05 72.40 Total budgetary resources available for obligation New obligations ............................................................. Unobligated balance available, end of year: Uninvested balance ................................................... New budget authority (gross), detail: Appropriation (indefinite) ............................................... Change in unpaid obligations: Unpaid obligations, start of year: Obligated balance: Appropriation ............................................................. 2 ................... 7 Addendum: Cumulative balance of defaulted guaranteed loans that result in loans receivable: 2310 Outstanding, start of year ........................................ ................... ................... ................... 2331 Disbursements for guaranteed loan claims ............. ................... ................... 1 2351 Repayments of loans receivable ............................... ................... ................... ................... 2390 Outstanding, end of year ...................................... ................... ................... 1 P.L. 104–299 and P.L. 104–208 authorize HRSA to guarantee up to $80 million in private loans to Health Centers for the costs of developing and operating managed care networks or plans and for the construction, renovation and modernization of medical facilities. Since this new program will not begin to operate until late into FY 1997, HRSA will use this $80 million loan guarantee limit over FY 1997 and FY 1998. As required by the Federal Credit Reform Act of 1990, this Financing Account records all cash flows to and from the Government resulting from the Health Center Loan Guarantee Program. 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. 496 HEALTH RESOURCES AND SERVICES ADMINISTRATION—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 1998 Credit accounts—Continued 89.00 90.00 HEALTH CENTER GUARANTEED LOAN FINANCING ACCOUNT— Continued 1995 actual 1996 actual 1997 est. .................. 80 .................. 1996 actual .................. 1 .................. .................. .................. 1 Total assets ........................................ LIABILITIES: 2204 Non-Federal liabilities: Liabilities for loan guarantees .................................. .................. .................. 80 1 .................. .................. 80 2999 Total liabilities .................................... .................. .................. 4999 Total liabilities and net position ............ .................. .................. 1999 1997 est. 1998 est. Guaranteed loan levels supportable by subsidy budget authority: 2150 Loan guarantee levels ................................................... 210 140 85 140 85 0.34 0.34 1.09 0.34 0.34 1.09 Weighted average subsidy rate ................................. Guaranteed loan subsidy budget authority: 2330 Subsidy budget authority ............................................... 1 ................... 1 1 ................... 1 .................. 1 ................... 1 80 .................. 2349 1 ................... 1 80 .................. For the cost of guaranteed loans, such sums as may be necessary to carry out the purpose of the program, as authorized by title VII of the Public Health Service Act, as amended: Provided, That such costs, including the cost of modifying such loans, shall be as defined in section 502 of the Congressional Budget Act of 1974: Provided further, That these funds are available to subsidize gross obligations for the total loan principal any part of which is to be guaranteed at not to exceed ø$140,000,000¿ $85,000,000. In addition, for administrative expenses to carry out the guaranteed loan program, $2,688,000. 1997 est. 2339 1998 est. Object Classification (in millions of dollars) Total obligations ........................................................ 4 3 5 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ New obligations ............................................................. 4 –4 3 –3 5 –5 1997 est. 1998 est. Personnel compensation: Full-time permanent ............. 2 2 Other services ................................................................ 2 1 Grants, subsidies, and contributions ............................ ................... ................... Total obligations ........................................................ 1 4 10.00 1996 actual Identification code 75–0340–0–1–552 99.9 Obligations by program activity: 00.02 Guaranteed loan subsidy ............................................... ................... ................... 00.09 Administrative expenses subject to limitation .............. 4 3 Total subsidy outlays ................................................ The Health Education Assistance Loan (HEAL) program guarantees loans from private lenders to health professions students to help pay for the costs of their training. As required by the Federal Credit Reform Act of 1990, this account records, for the HEAL program, the subsidy costs associated with HEAL loan guarantees committed in 1992 and beyond (including modifications of HEAL loan guarantees that resulted from obligations or commitments in any year), as well as administrative expenses of the program. The subsidy amounts are estimated on a present value basis; the administrative expenses are estimated on a cash basis. 11.1 25.2 41.0 Program and Financing (in millions of dollars) 1996 actual 210 Total subsidy budget authority ................................. Guaranteed loan subsidy outlays: 2340 Subsidy outlays .............................................................. HEALTH øEDUCATION ASSISTANCE LOANS PROGRAM¿ PROFESSIONS GRADUATE STUDENT LOAN INSURANCE PROGRAM ACCOUNT Identification code 75–0340–0–1–552 Total loan guarantee levels ...................................... Guaranteed loan subsidy (in percent): 2320 Subsidy rate ................................................................... 2329 .................. Net present value of assets related to defaulted guaranteed loans 5 5 2159 .................. .................. 1599 3 5 1998 est. Identification code 75–0340–0–1–552 ASSETS: Investments in US securities: 1106 Federal assets: Receivables, net ........ Net value of assets related to post– 1991 acquired defaulted guaranteed loans receivable: 1501 Defaulted guaranteed loans receivable, gross ...................................... 4 3 Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in millions of dollars) Balance Sheet (in millions of dollars) Identification code 75–4442–0–3–551 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 4 2 2 1 3 5 Personnel Summary Identification code 75–0340–0–1–552 1001 1011 Total compensable workyears: Full-time equivalent employment .................................. Exempt Full-time equivalent employment ..................... 1996 actual 20 6 1997 est. 1998 est. 20 6 20 6 New budget authority (gross), detail: Current: 40.00 Appropriation ............................................................. 3 3 Permanent: 60.05 Appropriation (indefinite) .......................................... ................... ................... 62.00 Transferred from other accounts .............................. 1 ................... 3 HEALTH PROFESSIONS GRADUATE STUDENT LOAN GUARANTEED LOAN FINANCING ACCOUNT 1 1 Program and Financing (in millions of dollars) 63.00 Appropriation (total) ............................................. 1 ................... 2 70.00 Total new budget authority (gross) .......................... 4 5 Change in unpaid obligations: 72.40 Unpaid obligations, start of year: Obligated balance: Appropriation ............................................................. 73.10 New obligations ............................................................. 73.20 Total outlays (gross) ...................................................... 74.40 Unpaid obligations, end of year: Obligated balance: Appropriation ............................................................. 1 4 –3 86.90 86.97 86.98 87.00 3 2 ................... 3 5 –5 –5 2 ................... ................... Outlays (gross), detail: Outlays from new current authority .............................. 3 3 3 Outlays from new permanent authority ......................... ................... ................... 2 Outlays from permanent balances ................................ ................... 2 ................... Total outlays (gross) ................................................. 3 5 5 Identification code 75–4304–0–3–552 1996 actual 1997 est. 1998 est. Obligations by program activity: Total obligations ............................................................ 6 7 11 Budgetary resources available for obligation: Unobligated balance available, start of year: Fund balance ...................................................................... 22.00 New financing authority (gross) .................................... 202 30 226 31 250 27 232 –6 257 –7 277 –11 226 250 268 –1 ................... –1 31 28 10.00 21.90 23.90 23.95 24.90 61.00 68.00 Total budgetary resources available for obligation New obligations ............................................................. Unobligated balance available, end of year: Fund balance ...................................................................... New financing authority (gross), detail: Transferred to other accounts ....................................... Spending authority from offsetting collections: Offsetting collections (cash) .............................................. 31 HEALTH RESOURCES AND SERVICES ADMINISTRATION—Continued Federal Funds—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES 70.00 Total new financing authority (gross) ...................... 30 31 27 2204 73.10 73.20 87.00 Change in unpaid obligations: New obligations ............................................................. Total financing disbursements (gross) ......................... Total financing disbursements (gross) ......................... 6 –6 6 7 –7 7 11 –11 11 Offsets: Against gross financing authority and financing disbursements: Offsetting collections (cash) from: 88.00 Federal sources ..................................................... ................... ................... –1 88.25 Interest on uninvested funds ............................... –15 –20 –21 Non-Federal sources: 88.40 Premium income ............................................... –16 –10 –5 88.40 Recoveries of defaulted loans .......................... ................... ................... –1 88.40 Below threshold ................................................ ................... –1 ................... 88.90 Total, offsetting collections (cash) .................. –31 –31 LIABILITIES: Non-Federal liabilities: Liabilities for loan guarantees .................................. 1,163 1,366 1,498 1,571 Total liabilities .................................... NET POSITION: 3300 Cumulative results of operations ............ 1,163 1,366 1,498 1,571 –958 –1,134 –1,241 –1,294 3999 Total net position ................................ –958 –1,134 –1,241 –1,294 4999 Total liabilities and net position ............ 205 232 257 277 2999 HEALTH PROFESSIONS GRADUATE STUDENT LOAN INSURANCE FUND LIQUIDATING ACCOUNT Program and Financing (in millions of dollars) –28 Identification code 75–4305–0–3–552 Net financing authority and financing disbursements: 89.00 Financing authority ........................................................ 90.00 Financing disbursements ............................................... –1 ................... –25 –24 –1 –17 Status of Guaranteed Loans (in millions of dollars) 00.01 00.02 00.03 00.04 10.00 1996 actual Identification code 75–4304–0–3–552 1997 est. 210 140 85 2150 210 140 85 1,163 210 1,366 140 Outstanding, end of year .......................................... Memorandum: 2299 Guaranteed amount of guaranteed loans outstanding, end of year ................................................................ Obligations by program activity: Operating expenses: death and disability ..................... 5 Capital investment ........................................................ 38 Collection costs .............................................................. 1 Consolidation transfers .................................................. ................... 1998 est. 7 55 2 6 8 39 2 1 50 44 70 Budgetary resources available for obligation: Unobligated balance available, start of year: Fund balance ...................................................................... 22.00 New budget authority (gross) ........................................ 24 33 12 ................... 58 51 21.90 –6 –7 –11 –1 –1 1,498 60.05 68.00 Total budgetary resources available for obligation New obligations ............................................................. Unobligated balance available, end of year: Fund balance ...................................................................... New budget authority (gross), detail: Appropriation (indefinite) ............................................... Spending authority from offsetting collections: Offsetting collections (cash) .............................................. 57 –44 70 –70 51 –50 12 ................... ................... 13 38 30 20 20 21 Total new budget authority (gross) .......................... 33 58 51 Change in unpaid obligations: Unpaid obligations, start of year: Obligated balance: Appropriation ............................................................. 73.10 New obligations ............................................................. 73.20 Total outlays (gross) ...................................................... 74.40 Unpaid obligations, end of year: Obligated balance: Appropriation ............................................................. 4 44 –40 –1 1,366 23.90 23.95 24.90 1,571 70.00 2290 1997 est. Total obligations ........................................................ 1,498 85 Cumulative balance of guaranteed loans outstanding: Outstanding, start of year ............................................. Disbursements of new guaranteed loans ...................... Adjustments: 2261 Terminations for default that result in loans receivable ....................................................................... 2263 Terminations for default that result in claim payments .................................................................... 2210 2231 1996 actual 1998 est. Position with respect to appropriations act limitation on commitments: 2111 Limitation on guaranteed loans made by private lenders .............................................................................. Total guaranteed loan commitments ........................ 497 72.40 1,366 1,498 1,571 8 ................... 70 50 –78 –51 Addendum: Cumulative balance of defaulted guaranteed loans that result in loans receivable: 2310 Outstanding, start of year ........................................ 1 7 2331 Disbursements for guaranteed loan claims ............. 6 7 2351 Repayments of loans receivable ............................... ................... ................... 14 11 –1 86.97 86.98 Outlays (gross), detail: Outlays from new permanent authority ......................... Outlays from permanent balances ................................ 13 27 58 51 20 ................... 2390 24 87.00 Total outlays (gross) ................................................. 40 78 51 Offsets: Against gross budget authority and outlays: 88.40 Offsetting collections (cash) from: Non-Federal sources .................................................................. –20 –20 –21 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 13 20 38 58 30 30 Outstanding, end of year ...................................... 7 14 As required by the Federal Credit Reform Act of 1990, this non-budgetary account records all cash flows to and from the Government resulting from Health Education Assistance Loan (HEAL) guarantees committed in 1992 and beyond (including modifications of loan guarantees that resulted from commitments in any year). The amounts in this account are a means of financing and are not included in the budget totals. 89.00 90.00 8 ................... ................... Status of Guaranteed Loans (in millions of dollars) Balance Sheet (in millions of dollars) Identification code 75–4305–0–3–552 Identification code 75–4304–0–3–552 ASSETS: Federal assets: 1101 Fund balances with Treasury ............. Investments in US securities: 1106 Receivables, net ............................. Non-Federal assets: 1201 Investments in non-Federal securities, net .................................................. 1206 Receivables, net .................................. 1995 actual 1996 actual 1997 est. Cumulative balance of guaranteed loans outstanding: Outstanding, start of year ............................................. Repayments and prepayments ...................................... Adjustments: 2261 Terminations for default that result in loans receivable ....................................................................... 2263 Terminations for default that result in claim payments .................................................................... 2264 Other adjustments, net ............................................. 2210 2251 153 202 226 250 22 .................. .................. 1 11 19 15 15 20 11 21 5 205 232 257 277 2290 1999 Total assets ........................................ 1996 actual 1997 est. 1998 est. 1998 est. Outstanding, end of year .......................................... 1,620 –43 1,549 –48 1,454 –52 –24 –35 –25 –3 –1 –4 –8 –5 –3 1,549 1,454 1,369 HEALTH RESOURCES AND SERVICES ADMINISTRATION—Continued Federal Funds—Continued 498 THE BUDGET FOR FISCAL YEAR 1998 3999 Credit accounts—Continued HEALTH PROFESSIONS GRADUATE STUDENT LOAN INSURANCE FUND LIQUIDATING ACCOUNT—Continued Total net position ................................ 410 434 495 533 4999 Total liabilities and net position ............ 447 477 556 578 Object Classification (in millions of dollars) Status of Guaranteed Loans (in millions of dollars)—Continued 1996 actual Identification code 75–4305–0–3–552 2299 Memorandum: Guaranteed amount of guaranteed loans outstanding, end of year ................................................................ 1997 est. 1998 est. 1,549 1,454 1,368 388 422 480 38 55 39 –6 –6 –6 9 9 9 –7 ................... ................... 2390 422 480 522 1 Includes carryover commitments from prior years. Note.—The adjustment to loans receivable represents interest, which had not previously been reflected in cumulative outstanding balances. As required by the Federal Credit Reform Act of 1990, this account records, for the Health Education Assistance Loan program (HEAL), all cash flows to and from the Government resulting from HEAL loan guarantees committed prior to 1992. This account is shown on a cash basis. All new activity in this program in 1992 and beyond (including modifications of loan guarantees that resulted from obligations or commitments in any year) is recorded in corresponding program and financing accounts. DATA ON LOANS 1996 actual Dollar volume of loans insured ($ in millions) .......................... Number of students .................................................................... Average value of loans ............................................................... 1997 est. 209 18,422 11,324 140 12,727 11,000 1998 est. 85 7,727 11,000 Statement of Operations (in millions of dollars) Identification code 75–4305–0–3–552 1995 actual 1996 actual 1997 est. 1998 est. 0101 0102 Revenue ................................................... Expense .................................................... 87 –36 80 –44 82 –70 50 –50 0109 Net loss ................................................... 51 36 12 .................. Balance Sheet (in millions of dollars) Identification code 75–4305–0–3–552 ASSETS: Federal assets: Fund balances with Treasury ............................................... Net value of assets related to pre–1992 direct loans receivable and acquired defaulted guaranteed loans receivable: 1701 Defaulted guaranteed loans, gross .... 1702 Interest receivable .............................. 1703 Allowance for estimated uncollectible loans and interest (–) .................... 1704 Defaulted guaranteed loans and interest receivable, net ..................... 1995 actual 1996 actual 1997 est. 1998 est. 20 12 .................. .................. 388 5 422 6 480 6 522 6 –3 –7 .................. .................. 390 421 486 528 390 421 486 528 37 44 70 50 447 477 556 578 4 33 5 38 6 55 6 39 37 43 61 45 410 434 495 533 1101 1799 1801 Value of assets related to loan guarantees ................................. Other Federal assets: Cash and other monetary assets .................................. 1999 Total assets ........................................ LIABILITIES: 2104 Federal liabilities: Resources payable to Treasury ............................................... 2201 Non-Federal liabilities: Accounts payable 2999 Total liabilities .................................... NET POSITION: 3300 Cumulative results of operations ............ 1997 est. 1998 est. 25.2 42.0 Addendum: Cumulative balance of defaulted guaranteed loans that result in loans receivable: 2310 Outstanding, start of year ........................................ 2331 Disbursements for guaranteed loan claims ............. 2351 Repayments of loans receivable ............................... 2361 Write-offs of loans receivable ................................... 2364 Other adjustments, net ............................................. Outstanding, end of year ...................................... 1996 actual Identification code 75–4305–0–3–552 Other services ................................................................ Insurance claims and indemnities ................................ 1 43 8 62 3 47 99.9 Total obligations ........................................................ 44 70 50 HEALTH LOAN FUNDS MEDICAL FACILITIES GUARANTEE AND LOAN FUND FEDERAL INTEREST SUBSIDIES FOR MEDICAL FACILITIES For carrying out subsections (d) and (e) of section 1602 of the Public Health Service Act, ø$7,000,000¿ $6,000,000, together with any amounts received by the Secretary in connection with loans and loan guarantees under title VI of the Public Health Service Act, to be available without fiscal year limitation for the payment of interest subsidies. During the fiscal year, no commitments for direct loans or loan guarantees shall be made. (Department of Health and Human Services Appropriations Act, 1997.) Program and Financing (in millions of dollars) Identification code 75–9931–0–3–550 00.01 01.01 10.00 1996 actual Obligations by program activity: Operating expenses: Interest subsidies, private ........... 8 Capital investment: Direct loans ................................... ................... 1997 est. 1998 est. 8 1 8 1 Total obligations ........................................................ 8 9 9 Budgetary resources available for obligation: Unobligated balance available, start of year: Fund balance ...................................................................... 22.00 New budget authority (gross) ........................................ 22.60 Redemption of debt ....................................................... 55 16 –5 58 15 –12 52 15 –12 66 –8 61 –9 55 –9 58 52 46 8 7 6 21.90 23.90 23.95 24.90 Total budgetary resources available for obligation New obligations ............................................................. Unobligated balance available, end of year: Fund balance ...................................................................... New budget authority (gross), detail: Current: 40.00 Appropriation ............................................................. Permanent: 68.00 Spending authority from offsetting collections: Offsetting collections (cash) ..................................... 8 8 8 Total new budget authority (gross) .......................... 16 15 14 Change in unpaid obligations: Unpaid obligations, start of year: Obligated balance: Appropriation ............................................................. 73.10 New obligations ............................................................. 73.20 Total outlays (gross) ...................................................... 74.40 Unpaid obligations, end of year: Obligated balance: Appropriation ............................................................. 8 8 –7 8 9 –8 10 9 –6 8 10 13 70.00 72.40 86.90 86.93 87.00 Outlays (gross), detail: Outlays from new current authority .............................. 7 Outlays from current balances ...................................... ................... Total outlays (gross) ................................................. 7 7 6 1 ................... 8 6 Offsets: Against gross budget authority and outlays: Offsetting collections (cash) from: Non-Federal sources: 88.40 Interest repaid on loans not sold .................... 88.40 Principal collections from FFB ......................... 88.40 Default collections, principal ........................... 88.40 Interest collections from FFB ........................... –1 –1 –1 –5 –6 –6 –1 ................... ................... –1 –1 –1 88.90 Total, offsetting collections (cash) .................. –8 –8 –8 89.00 Net budget authority and outlays: Budget authority ............................................................ 8 7 7 HEALTH RESOURCES AND SERVICES ADMINISTRATION—Continued Trust Funds DEPARTMENT OF HEALTH AND HUMAN SERVICES 90.00 Outlays ........................................................................... –1 ................... –2 02.03 Interest income .............................................................. 58 66 74 02.99 Total receipts ............................................................. 173 191 126 Total: Balances and collections .................................... Appropriation: 05.01 Vaccine injury compensation program trust fund ........ Status of Direct Loans (in millions of dollars) 1,085 1,238 1,305 –38 –59 –51 05.99 07.99 –38 1,047 –59 1,179 –51 1,254 04.00 1996 actual Identification code 75–9931–0–3–550 1997 est. 1998 est. 1210 1251 1264 Cumulative balance of direct loans outstanding: Outstanding, start of year ............................................. Repayments: Repayments and prepayments ................. Write-offs for default: Other adjustments, net ............. 45 –7 –4 34 –7 –4 23 –5 –2 1290 Outstanding, end of year .......................................... 34 23 16 1996 actual Subtotal appropriation ................................................... Total balance, end of year ............................................ Program and Financing (in millions of dollars) Identification code 20–8175–0–7–551 Status of Guaranteed Loans (in millions of dollars) Identification code 75–9931–0–3–550 499 1997 est. 1998 est. Obligations by program activity: Compensation: Claims for post—FY 1989 injuries ...... Administrative expenses: 01.03 Claims processing (Claims Court) ............................ 01.04 Claims processing (Public Health Service) ............... 01.05 Claims processing (Dept. of Justice) ........................ 00.01 Cumulative balance of guaranteed loans outstanding: 2210 Outstanding, start of year ............................................. 2251 Repayments and prepayments ...................................... 261 –73 188 –50 138 –40 2290 188 138 1996 actual 1997 est. 1998 est. 30 50 42 2 3 3 2 3 4 2 3 4 98 Outstanding, end of year .......................................... 01.91 Memorandum: 2299 Guaranteed amount of guaranteed loans outstanding, end of year ................................................................ 138 1996 actual 99.9 1997 est. Investments and loans .................................................. ................... Grants, subsidies, and contributions ............................ 7 Interest and dividends ................................................... 1 Total obligations ........................................................ 9 Total obligations ........................................................ 38 59 51 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ New obligations ............................................................. 38 –38 59 –59 51 –51 40.26 40.27 New budget authority (gross), detail: Appropriation (trust fund, definite) ............................... Appropriation (trust fund, indefinite) ............................ 8 30 9 50 9 42 43.00 Appropriation (total) .................................................. 38 59 51 70.00 Total new budget authority (gross) .......................... 38 59 51 Change in unpaid obligations: Unpaid obligations, start of year: Obligated balance: Appropriation ............................................................. 73.10 New obligations ............................................................. 73.20 Total outlays (gross) ...................................................... 74.40 Unpaid obligations, end of year: Obligated balance: Appropriation ............................................................. 1 38 –37 72.40 2 ................... 59 51 –61 –51 2 ................... ................... Outlays (gross), detail: Outlays from new current authority .............................. Outlays from current balances ...................................... 36 1 59 51 2 ................... 87.00 Total outlays (gross) ................................................. 37 61 51 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 38 37 59 61 51 51 1998 est. 1 7 1 1 7 1 9 8 86.90 86.93 89.00 90.00 Object Classification (in millions of dollars) 33.0 41.0 43.0 9 98 Title VII, part C of the Public Health Service Act established a revolving fund from which health professions schools could borrow in order to provide loans to their students. Public Law 89–751, the Allied Health Professions Personnel Training Act of 1966, amended the Public Health Service Act to authorize the Federal Government to pay the difference between the interest paid by students to the schools and the interest payable by the schools to the Government National Mortgage Association (GNMA) and the Treasury. Title VI and subsequently title XVI of the Public Health Service Act established a loan and loan guarantee fund for medical facilities with a maximum amount allowable for the Government’s liability. Direct loans were made available for public facilities and guaranteed loans for private, nonprofit facilities. Funds under this authority were established in the amount of $50 million for use in fulfilling guarantees in event of default, $30 million as a revolving fund for direct loans and an amount for interest subsidy payments on guaranteed loans. Default and interest subsidy funds are replenished as necessary through the annual appropriation process. Identification code 75–9931–0–3–550 8 10.00 188 Total, administrative expenses ............................. 9 Trust Funds VACCINE INJURY COMPENSATION PROGRAM TRUST FUND For payments from the Vaccine Injury Compensation Program 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 Public Health Service Act, to remain available until expended: Provided, That for necessary administrative expenses, not to exceed $3,000,000 shall be available from the Trust Fund to the Secretary of Health and Human Services. (Department of Health and Human Services Appropriations Act, 1997.) The Vaccine Improvement 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. Current and projected vaccine excise tax receipts to the Vaccine Injury Compensation Program Trust Fund far exceed current and projected claims on the Trust Fund. The Budget proposes lowering revenue to the Trust Fund by exempting Federal programs (which provide free vaccine to low-income, uninsured and underinsured children) from payment of the vaccine excise tax in FY 1998. Exempting these programs will result in Federal savings in mandatory (HCFA Grants to States for Medicaid) and discretionary (Centers for Disease Control and Prevention) programs displayed in those accounts. The estimated reduction in receipts to the Trust Fund is $73 million. Unavailable Collections (in millions of dollars) Object Classification (in millions of dollars) Identification code 20–8175–0–7–551 Balance, start of year: Balance, start of year .................................................... Receipts: 02.01 Deposits ......................................................................... 01.99 1996 actual 1997 est. 1998 est. Identification code 20–8175–0–7–551 912 1,047 1,179 115 125 52 25.2 25.3 Other services ................................................................ Purchases of goods and services from Government accounts .................................................................... 1996 actual 1997 est. 1998 est. 3 3 3 5 6 6 500 HEALTH RESOURCES AND SERVICES ADMINISTRATION—Continued Trust Funds—Continued THE BUDGET FOR FISCAL YEAR 1998 VACCINE INJURY COMPENSATION PROGRAM TRUST FUND—Continued Object Classification (in millions of dollars)—Continued 1996 actual Identification code 20–8175–0–7–551 1997 est. 1998 est. Insurance claims and indemnities ................................ 30 50 42 99.9 Total obligations ........................................................ 38 59 51 INDIAN HEALTH SERVICE General and special funds: INDIAN HEALTH SERVICES For expenses necessary to carry out the Act of August 5, 1954 (68 Stat. 674), the Indian Self-Determination 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, ø$1,806,269,000¿, $1,835,465,000 together with payments received during the fiscal year pursuant to 42 U.S.C. 238(b) 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 $12,000,000 shall remain available until expended, for the Indian Catastrophic Health Emergency Fund: Provided further, That ø$356,325,000¿ $362,348,000 for contract medical care shall remain available for obligation until September 30, ø1998¿ 1999: Provided further, That of the funds provided, not less than ø$11,706,000¿ $11,889,000 shall be used to carry out the loan repayment program under section 108 of the Indian Health Care Improvement Act: Provided further, That funds provided in this Act may be used for one-year contracts and grants which are to be performed in two fiscal years, so long as the total obligation is recorded in the year for which the funds are appropriated: Provided further, That the amounts collected by the Secretary of Health and Human Services under the authority of title IV of the Indian Health Care Improvement Act shall remain available until expended for the purpose of achieving compliance with the applicable conditions and requirements of titles XVIII and XIX of the Social Security Act (exclusive of planning, design, or construction of new facilities): Provided further, That of the funds provided, ø$7,500,000¿ $12,000,000 shall remain available until expended, for the Indian Self-Determination Fund, which shall be available for the transitional costs of initial or expanded tribal contracts, compacts, grants or cooperative agreements with the Indian Health Service under the provisions of the Indian Self-Determination Act: Provided further, That funding contained herein, and in any earlier appropriations Acts for scholarship programs under the Indian Health Care Improvement Act (25 U.S.C. 1613) shall remain available for obligation until September 30, ø1998¿ 1999: 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. (Department of the Interior and Related Agencies Appropriations Act, 1997.) Program and Financing (in millions of dollars) 1997 est. 1998 est. Obligations by program activity: Direct program: 00.01 Clinical services ........................................................ 00.02 Preventive health ....................................................... 00.03 Urban health ............................................................. 00.04 Indian health professions ......................................... 00.05 Tribal management ................................................... 00.06 Direct operations ....................................................... 00.07 Self-governance ......................................................... 00.08 Contract support costs .............................................. 1,412 78 24 26 2 48 13 146 1,451 81 25 28 2 49 9 161 1,468 82 26 28 2 47 9 173 00.91 04.01 1,749 245 1,806 283 1,835 285 Total direct program ............................................. Reimbursable program .................................................. Budgetary resources available for obligation: Unobligated balance available, start of year: Uninvested balance ................................................... 22.00 New budget authority (gross) ........................................ 22.30 Unobligated balance expiring ........................................ 23.90 23.95 24.40 Total budgetary resources available for obligation New obligations ............................................................. Unobligated balance available, end of year: Uninvested balance ................................................... New budget authority (gross), detail: Current: 40.00 Appropriation ............................................................. Permanent: 68.00 Spending authority from offsetting collections: Offsetting collections (cash) ..................................... Federal Funds 1996 actual Total obligations ........................................................ 1,994 2,089 2,120 21.40 42.0 Identification code 75–0390–0–1–551 10.00 70.00 Total new budget authority (gross) .......................... Change in unpaid obligations: Unpaid obligations, start of year: Obligated balance: Appropriation ............................................................. 73.10 New obligations ............................................................. 73.20 Total outlays (gross) ...................................................... 73.40 Adjustments in expired accounts .................................. 74.40 Unpaid obligations, end of year: Obligated balance: Appropriation ............................................................. 60 76 76 2,012 2,089 2,120 –2 ................... ................... 2,070 –1,994 2,165 –2,089 2,196 –2,120 76 76 76 1,745 1,806 1,835 267 283 285 2,012 2,089 2,120 72.40 602 565 540 1,994 2,089 2,120 –2,012 –2,114 –2,109 –19 ................... ................... 565 540 551 86.90 86.93 86.97 Outlays (gross), detail: Outlays from new current authority .............................. Outlays from current balances ...................................... Outlays from new permanent authority ......................... 1,287 458 267 1,319 512 283 1,340 484 285 87.00 Total outlays (gross) ................................................. 2,012 2,114 2,109 Offsets: Against gross budget authority and outlays: Offsetting collections (cash) from: 88.00 Federal sources ..................................................... 88.40 Non-Federal sources ............................................. –60 –207 –64 –219 –64 –221 88.90 Total, offsetting collections (cash) .................. –267 –283 –285 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 1,745 1,746 1,806 1,831 1,835 1,824 The Indian Health Services account provides medical care, public health services, and health professions training opportunities to American Indians and Alaska Natives. An estimated $390,000,000 will be administered by tribal governments under self-governance compacts in FY 1998. Object Classification (in millions of dollars) Identification code 75–0390–0–1–551 11.1 11.3 11.5 11.9 12.1 13.0 21.0 22.0 23.1 23.3 24.0 25.1 25.2 25.3 25.4 25.6 25.7 25.8 26.0 31.0 Direct obligations: Personnel compensation: Full-time permanent ............................................. Other than full-time permanent ........................... Other personnel compensation ............................. Total personnel compensation ......................... Civilian personnel benefits ....................................... Benefits for former personnel ................................... Travel and transportation of persons ....................... Transportation of things ........................................... Rental payments to GSA ........................................... Communications, utilities, and miscellaneous charges ................................................................. Printing and reproduction ......................................... Advisory and assistance services ............................. Other services ............................................................ Purchases of goods and services from Government accounts ................................................................ Operation and maintenance of facilities .................. Medical care .............................................................. Operation and maintenance of equipment ............... Subsistence and support of persons ........................ Supplies and materials ............................................. Equipment ................................................................. 1996 actual 1997 est. 1998 est. 365 16 26 391 16 27 404 16 28 407 117 3 27 10 10 434 122 3 28 13 10 448 125 3 28 14 10 25 1 1 463 26 1 1 465 14 1 1 472 2 8 211 7 5 97 18 1 7 214 7 5 99 18 2 8 223 8 5 100 18 INDIAN HEALTH SERVICE—Continued Federal Funds—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES 32.0 41.0 Land and structures .................................................. Grants, subsidies, and contributions ........................ 2 ................... ................... 335 352 355 99.0 99.0 Subtotal, direct obligations .................................. Reimbursable obligations .............................................. 1,749 245 1,806 283 1,835 285 99.9 Total obligations ........................................................ 1,994 2,089 2,120 Personnel Summary Identification code 75–0390–0–1–551 Direct: Total compensable workyears: Full-time equivalent employment .............................. Full-time equivalent of overtime and holiday hours Exempt Full-time equivalent employment ................. Reimbursable: Total compensable workyears: 2001 Full-time equivalent employment .............................. 2005 Full-time equivalent of overtime and holiday hours 1001 1005 1011 1996 actual 1997 est. 1998 est. 10,331 183 6 10,345 191 5 10,345 191 5 2,517 57 2,517 57 2,517 57 For construction, repair, maintenance, improvement, and equipment of health and related auxiliary facilities, including quarters for personnel; preparation of plans, specifications, and drawings; acquisition of sites, purchase and erection of modular buildings, and purchases of trailers; and for provision of domestic and community sanitation facilities for Indians, as authorized by section 7 of the Act of August 5, 1954 (42 U.S.C. 2004a), the Indian Self-Determination Act, and the Indian Health Care Improvement Act, and for expenses necessary to carry out such Acts and titles II and III of the Public Health Service Act with respect to environmental health and facilities support activities of the Indian Health Service, ø$247,731,000¿ $247,635,000, to remain available until expended: Provided, That notwithstanding any other provision of law, funds appropriated for the planning, design, construction or renovation of health facilities for the benefit of an Indian tribe or tribes may be used to purchase land for sites to construct, improve, or enlarge health or related facilities. In addition, to become available on October 1 of the fiscal year specified and remain available until expended: for construction of a replacement of the health facility at Fort Defiance, Arizona, up to $25,000,000 for fiscal year 1998, up to $25,000,000 for fiscal year 1999, and up to $28,000,000 for fiscal year 2000; for construction of a replacement of the health facility at Keams Canyon, Arizona, up to $13,900,000 for fiscal year 1998, up to $13,900,000 for fiscal year 1999, and up to $3,200,000 for fiscal year 2000. (Department of the Interior and Related Agencies Appropriations Act, 1997.) Unavailable Collections (in millions of dollars) 1996 actual 1997 est. 1998 est. Balance, start of year: Balance, start of year .................................................... ................... ................... ................... Receipts: 02.01 Rent and charges for quarters, Indian Health Service, HRSA, HHS ................................................................. 4 5 5 Appropriation: 05.01 Indian health facilities .................................................. –4 –5 –5 07.99 Total balance, end of year ............................................ ................... ................... ................... 01.99 Identification code 75–0391–0–1–551 1996 actual 1997 est. 110 47 93 15 112 45 100 16 129 44 105 13 10.00 Total obligations ........................................................ 265 273 –291 25 16 28 239 248 287 4 5 5 11 11 11 264 303 Change in unpaid obligations: Unpaid obligations, start of year: Obligated balance: Appropriation ............................................................. 73.10 New obligations ............................................................. 73.20 Total outlays (gross) ...................................................... 74.40 Unpaid obligations, end of year: Obligated balance: Appropriation ............................................................. 412 265 –297 380 273 –302 351 291 –283 380 351 360 72.40 86.90 86.93 86.97 Outlays (gross), detail: Outlays from new current authority .............................. Outlays from current balances ...................................... Outlays from new permanent authority ......................... 65 217 15 62 224 16 72 195 16 87.00 Total outlays (gross) ................................................. 297 302 283 Offsets: Against gross budget authority and outlays: 88.45 Offsetting collections (cash) from: Offsetting governmental collections ............................................ –11 –11 –11 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 243 286 253 291 292 272 89.00 90.00 The Indian health facilities account supports construction, repair and improvement, equipment, and environmental health and facilities support for the Indian health services. Object Classification (in millions of dollars) 1996 actual Identification code 75–0391–0–1–551 1997 est. 1998 est. 11.1 11.3 11.5 Personnel compensation: Full-time permanent .................................................. Other than full-time permanent ............................... Other personnel compensation .................................. 45 6 2 45 6 2 45 6 2 11.9 12.1 21.0 22.0 23.3 25.1 25.2 25.4 25.7 25.8 26.0 31.0 32.0 41.0 43.0 Total personnel compensation .............................. 53 Civilian personnel benefits ............................................ 15 Travel and transportation of persons ............................ 4 Transportation of things ................................................ 4 Communications, utilities, and miscellaneous charges 6 Advisory and assistance services .................................. 2 Other services ................................................................ 41 Operation and maintenance of facilities ...................... 37 Operation and maintenance of equipment ................... 10 Subsistence and support of persons ............................. 10 Supplies and materials ................................................. 11 Equipment ...................................................................... 12 Land and structures ...................................................... 38 Grants, subsidies, and contributions ............................ 22 Interest and dividends ................................................... ................... 53 15 5 4 8 2 37 19 3 10 12 5 60 28 12 53 15 4 4 19 3 56 18 3 10 11 4 54 27 10 273 291 Total obligations ........................................................ 265 Personnel Summary Identification code 75–0391–0–1–551 Obligations by program activity: Construction ................................................................... Maintenance ................................................................... Facilities and environmental health .............................. Equipment ...................................................................... –273 254 1998 est. 00.01 01.01 02.01 05.01 –265 Total new budget authority (gross) .......................... 99.9 Program and Financing (in millions of dollars) New obligations ............................................................. Unobligated balance available, end of year: Uninvested balance ................................................... New budget authority (gross), detail: Current: 40.00 Appropriation ............................................................. Permanent: 60.25 Appropriation (special fund, indefinite) .................... 68.00 Spending authority from offsetting collections: Offsetting collections (cash) ..................................... 70.00 INDIAN HEALTH FACILITIES Identification code 75–0391–0–1–551 23.95 24.40 501 1996 actual 1997 est. 1998 est. 291 1,454 21 1,454 21 1,454 21 ADMINISTRATIVE PROVISIONS, INDIAN HEALTH SERVICE Budgetary resources available for obligation: Unobligated balance available, start of year: Uninvested balance ................................................... 22.00 New budget authority (gross) ........................................ 36 254 25 264 16 303 23.90 290 289 319 21.40 Total budgetary resources available for obligation Total compensable workyears: 1001 Full-time equivalent employment .................................. 1005 Full-time equivalent of overtime and holiday hours Appropriations in this Act to the Indian Health Service shall be available for services as authorized by 5 U.S.C. 3109 but 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 pas- 502 INDIAN HEALTH SERVICE—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 1998 General and special funds—Continued ADMINISTRATIVE PROVISIONS, INDIAN HEALTH SERVICE—Continued senger 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; and for uniforms or allowances therefore as authorized by 5 U.S.C. 5901–5902; and for expenses of attendance at meetings which are concerned with the functions or activities for which the appropriation is made or which will contribute to improved conduct, supervision, or management of those functions or activities: 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. 2651–53) 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, as amended: 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 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 III of the Indian Self-Determination and Education Assistance Act of 1975 (25 U.S.C. 450), may be deobligated and reobligated to a self-determination contract under title I, or a self-governance agreement under title III 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 funds made available in this Act are to be apportioned to the Indian Health Service as appropriated in this Act, and accounted for in the appropriation structure set forth in this Act: Provided further, That funds received from any source, including tribal contractors and compactors for previously transferred functions which tribal contractors and compactors no longer wish to retain, for services, goods, or training and technical assistance, shall be retained by the Indian Health Service and shall remain available until expended by the Indian Health Service: Provided further, That reimbursements for training, technical assistance, or services provided by the Indian Health Service will contain total costs, including direct, administrative, and overhead associated with the provision of goods, services, or technical assistance: Provided further, That the appropriation structure for the Indian Health Service may not be altered without advance øapproval of¿ notice submitted to the House and Senate Committees on Appropriations. (Department of the Interior and Related Agencies Appropriations Act, 1997.) CENTERS FOR DISEASE CONTROL AND PREVENTION Federal Funds General and special funds: DISEASE CONTROL, RESEARCH, AND TRAINING To carry out titles II, III, VII, XI, XV, XVII, and XIX of the Public Health Service Act, sections 101, 102, 103, 201, 202, 203, 301, and 501 of the Federal Mine Safety and Health Act of 1977, and sections 20, 21 and 22 of the Occupational Safety and Health Act of 1970, title IV of the Immigration and Nationality Act and section 501 of the Refugee Education Assistance Act of 1980; including insurance of official motor vehicles in foreign countries; and hire, maintenance, and operation of aircraft, ø$2,262,698,000¿ $2,252,900,000, of which ø$30,553,000¿ $23,007,000 shall remain available until expended for equipment and construction and renovation of facilities, and of which $32,000,000 shall remain available until September 30, ø1998¿ 1999 for mine safety and health activities, and in addition, such sums as may be derived from authorized user fees, which shall be credited to this account: Provided, That in addition to amounts provided herein, up to ø$48,400,000¿ $70,063,000 shall be available from amounts available under section 241 of the Public Health Service Act, to carry out the National Center for Health Statistics surveys: øProvided further, That none of the funds made available for injury prevention and control at the Centers for Disease Control and Prevention may be used to advocate or promote gun control: Provided further, That the Director may redirect the total amount made available under authority of Public Law 101–502, section 3, dated November 3, 1990, to activities the Director may so designate: Provided further, That the Congress is to be notified promptly of any such transfer: Provided further, That the functions described in clause (1) of the first proviso under the subheading ‘‘mines and minerals’’ under the heading ‘‘Bureau of Mines’’ in the text of title I of the Department of the Interior and Related Agencies Appropriations Act, 1996, as enacted by section 101 (c) of the Omnibus Consolidated Rescissions and Appropriations Act of 1996 (Public Law 104–134), are hereby transferred to, and vested in, the Secretary of Health and Human Services, subject to section 1531 of title 31, United States Code: Provided further, That of the amount provided, $23,000,000 is designated by Congress as an emergency requirement pursuant to section 251(b)(2)(D)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985, as amended.¿ In addition, not to exceed $17,895,000 to carry out Title III of the Public Health Service Act: Provided, That all purchases of vaccine with grants from appropriations for fiscal year 1998 authorized by section 317(j) of the Public Health Act or section 1928 of the Social Security Act shall be exempt from the payment of excise tax on vaccine. In addition, ø$41,000,000¿ $45,000,000, to be derived from the Violent Crime Reduction Trust Fund, for carrying out øsections¿ section 40151 øand 40261¿ of Public Law 103–322. (Department of Health and Human Services Appropriations Act, 1997.) Unavailable Collections (in millions of dollars) Identification code 75–0943–0–1–999 1996 actual 1997 est. 1998 est. Balance, start of year: Balance, start of year .................................................... ................... ................... ................... Receipts: 02.01 Cooperative Research and Development Agreements, Centers for Disease Control ...................................... 1 1 1 Appropriation: 05.01 Disease control, research, and training ........................ –1 –1 –1 07.99 Total balance, end of year ............................................ ................... ................... ................... 01.99 Program and Financing (in millions of dollars) Identification code 75–0943–0–1–999 1996 actual 1997 est. Obligations by program activity: Direct program: 00.01 Preventive health block grant ................................... 145 154 00.02 Prevention centers ..................................................... 8 8 00.03 Sexually transmitted diseases .................................. 105 106 00.04 Immunization ............................................................. 468 468 00.05 Infectious diseases .................................................... 181 207 00.06 Chronic and environmental diseases ........................ 348 388 00.07 Occupational safety and health ................................ 129 141 00.08 Mine safety and health ............................................. ................... 32 00.09 Epidemic services ...................................................... 67 70 00.10 Health statistics ........................................................ 37 38 00.11 HIV ............................................................................. 585 617 00.12 Buildings and facilities ............................................. 17 79 00.13 Program management ............................................... 3 3 00.14 Violent crime reduction programs ............................. 32 41 00.15 Office of the Director savings ................................... ................... ................... 1998 est. 144 8 111 429 232 421 149 32 70 19 637 24 3 45 –8 00.91 01.01 Total direct program ............................................. Reimbursable program .................................................. 2,125 134 2,352 134 2,316 134 10.00 Total obligations ........................................................ 2,259 2,486 2,450 Budgetary resources available for obligation: Unobligated balance available, start of year: Uninvested balance ................................................... 22.00 New budget authority (gross) ........................................ 46 2,248 51 ................... 2,437 2,451 21.40 NATIONAL INSTITUTES OF HEALTH Federal Funds DEPARTMENT OF HEALTH AND HUMAN SERVICES 22.10 23.90 23.95 24.40 Resources available from recoveries of prior year obligations ....................................................................... Total budgetary resources available for obligation New obligations ............................................................. Unobligated balance available, end of year: Uninvested balance ................................................... Object Classification (in millions of dollars) 18 ................... ................... 2,312 –2,259 2,488 –2,486 2,451 –2,450 51 ................... ................... New budget authority (gross), detail: Current: 40.00 Appropriation ............................................................. 2,081 40.75 Reduction pursuant to P.L. 104–208 ....................... ................... 42.00 Transferred from other accounts .............................. 32 2,263 2,271 –2 ................... 41 45 43.00 60.25 68.00 70.00 Appropriation (total) ............................................. Permanent: Appropriation (special fund, indefinite) .................... Spending authority from offsetting collections: Offsetting collections (cash) ..................................... 2,113 2,302 2,316 1 1 1 134 134 134 Total new budget authority (gross) .......................... 2,248 2,437 2,451 Change in unpaid obligations: Unpaid obligations, start of year: Obligated balance: Appropriation ............................................................. 73.10 New obligations ............................................................. 73.20 Total outlays (gross) ...................................................... 73.40 Adjustments in expired accounts .................................. 73.45 Adjustments in unexpired accounts .............................. 74.40 Unpaid obligations, end of year: Obligated balance: Appropriation ............................................................. 503 72.40 2,124 2,061 2,223 2,259 2,486 2,450 –2,301 –2,324 –2,406 –4 ................... ................... –18 ................... ................... 2,061 2,223 2,267 1996 actual Identification code 75–0943–0–1–999 11.1 11.3 11.5 11.9 12.1 13.0 21.0 22.0 23.1 23.3 24.0 25.1 25.2 25.5 25.7 26.0 31.0 32.0 41.0 Direct obligations: Personnel compensation: Full-time permanent ............................................. Other than full-time permanent ........................... Other personnel compensation ............................. 1997 est. 223 10 11 1998 est. 255 10 11 258 10 11 Total personnel compensation ......................... 244 276 279 Civilian personnel benefits ....................................... 72 80 81 Benefits for former personnel ................................... 2 ................... ................... Travel and transportation of persons ....................... 16 16 17 Transportation of things ........................................... 3 4 4 Rental payments to GSA ........................................... 15 16 16 Communications, utilities, and miscellaneous charges ................................................................. 19 20 20 Printing and reproduction ......................................... 5 4 5 Advisory and assistance services ............................. 2 2 2 Other services ............................................................ 71 76 72 Research and development contracts ....................... 179 232 225 Operation and maintenance of equipment ............... ................... 1 1 Supplies and materials ............................................. 145 167 162 Equipment ................................................................. 40 96 75 Land and structures .................................................. 3 31 18 Grants, subsidies, and contributions ........................ 1,309 1,331 1,339 99.0 99.0 Subtotal, direct obligations .................................. Reimbursable obligations .............................................. 2,125 134 2,352 134 2,316 134 99.9 Total obligations ........................................................ 2,259 2,486 2,450 Personnel Summary 86.90 86.93 86.97 86.98 Outlays (gross), detail: Outlays from new current authority .............................. Outlays from current balances ...................................... Outlays from new permanent authority ......................... Outlays from permanent balances ................................ 684 1,482 134 1 721 1,468 134 1 726 1,545 134 1 87.00 Total outlays (gross) ................................................. 2,301 2,324 2,406 Offsets: Against gross budget authority and outlays: 88.00 Offsetting collections (cash) from: Federal sources –134 –134 –134 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 2,114 2,167 2,303 2,190 2,317 2,272 89.00 90.00 1996 actual Identification code 75–0943–0–1–999 Direct: Total compensable workyears: 1001 Full-time equivalent employment .............................. 1005 Full-time equivalent of overtime and holiday hours 1011 Exempt Full-time equivalent employment ................. Reimbursable: Total compensable workyears: 2001 Full-time equivalent employment .............................. 2005 Full-time equivalent of overtime and holiday hours 1997 est. 1998 est. 5,109 29 48 5,351 29 45 5,351 29 45 875 2 1,052 2 1,052 2 ALLOCATIONS RECEIVED FROM OTHER ACCOUNTS [Dollars in millions] 1996 Distribution of budget authority by account: Disease control, research and training .................................. 2,075 Violent crime reduction programs .......................................... 32 Distribution of outlays by account: Disease control, research and training .................................. .................... Violent crime reduction programs .......................................... .................... 1997 1998 2,263 41 2,271 45 2,163 27 2,233 39 The Centers for Disease Control and Prevention (CDC) supports a number of categorical programs including grants for immunizations, control of sexually transmitted diseases, HIV prevention, and control of other infectious and chronic diseases. CDC also supports the Preventive Health Block Grant. This display also includes amounts derived from the Violent Crime Reduction Trust Fund. Current and projected vaccine excise tax receipts to the Vaccine Injury Compensation Program Trust Fund far exceed current and projected claims on the Trust Fund. The Budget exempts Federal programs which provide free vaccine to lowincome, uninsured and underinsured children from payment of vaccine excise tax for FY 1998, lowering the cost to the Government of providing vaccine to these children. The savings to CDC’s discretionary immunization program and the funding provided above will allow CDC to purchase as much vaccine in FY 1998 as in FY 1997. The $18 million in the savings resulting from the combined effects of the exemption of the mandatory Vaccines for Children from the excise tax on mandatory costs and tax receipts will offset some of the cost of CDC’s prevention activities. Funds carried-over by States from prior-year appropriations permit additional immunization savings. Note.—Obligations incurred under allocations from other accounts are included in the schedules of the parent appropriation as follows: Environmental Protection Agency: ‘‘Hazardous substance response trust fund.’’ NATIONAL INSTITUTES OF HEALTH Federal Funds General and special funds: NATIONAL CANCER INSTITUTE For carrying out section 301 and title IV (except section 417B(d)) of the Public Health Service Act with respect to cancer, ø$2,382,532,000¿ $2,217,482,000. (Department of Health and Human Services Appropriations Act, 1997.) NATIONAL HEART, LUNG, AND BLOOD INSTITUTE For carrying out section 301 and title IV of the Public Health Service Act with respect to cardiovascular, lung, and blood diseases, and blood and blood products, ø$1,433,001,000¿ $1,404,770,000. (Department of Health and Human Services Appropriations Act, 1997.) NATIONAL INSTITUTE OF DENTAL RESEARCH For carrying out section 301 and title IV of the Public Health Service Act with respect to dental disease, ø$195,997,000¿ $190,081,000. (Department of Health and Human Services Appropriations Act, 1997.) NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE DISEASES AND KIDNEY For carrying out section 301 and title IV of the Public Health Service Act with respect to diabetes and digestive and kidney disease, ø$815,982,000¿ $821,164,000. (Department of Health and Human Services Appropriations Act, 1997.) 504 NATIONAL INSTITUTES OF HEALTH—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 1998 General and special funds—Continued NATIONAL INSTITUTE NATIONAL CENTER NEUROLOGICAL DISORDERS OF AND STROKE For carrying out section 301 and title IV of the Public Health Service Act with respect to neurological disorders and stroke, ø$726,746,000¿ $722,712,000. (Department of Health and Human Services Appropriations Act, 1997.) NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES For carrying out section 301 and title IV of the Public Health Service Act with respect to allergy and infectious diseases, ø$1,257,234,000¿ $634,272,000. (Department of Health and Human Services Appropriations Act, 1997.) NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES For carrying out section 301 and title IV of the Public Health Service Act with respect to general medical sciences, ø$998,470,000¿ $992,032,000. (Department of Health and Human Services Appropriations Act, 1997.) NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT For carrying out section 301 and title IV of the Public Health Service Act with respect to child health and human development, ø$631,703,000¿ $582,032,000. (Department of Health and Human Services Appropriations Act, 1997.) NATIONAL EYE INSTITUTE For carrying out section 301 and title IV of the Public Health Service Act with respect to eye diseases and visual disorders, ø$332,735,000¿ $330,955,000. (Department of Health and Human Services Appropriations Act, 1997.) NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES For carrying out sections 301 and 311 and title IV of the Public Health Service Act with respect to environmental health sciences, ø$308,819,000¿ $313,583,000. (Department of Health and Human Services Appropriations Act, 1997.) NATIONAL INSTITUTE ON AGING For carrying out section 301 and title IV of the Public Health Service Act with respect to aging, ø$486,047,000¿ $495,202,000. (Department of Health and Human Services Appropriations Act, 1997.) NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL SKIN DISEASES AND For carrying out section 301 and title IV of the Public Health Service Act with respect to arthritis and musculoskeletal and skin diseases, ø$257,111,000¿ $258,932,000. (Department of Health and Human Services Appropriations Act, 1997.) NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS For carrying out section 301 and title IV of the Public Health Service Act with respect to deafness and other communication disorders, ø$188,422,000¿ $192,447,000. (Department of Health and Human Services Appropriations Act, 1997.) NATIONAL INSTITUTE OF NURSING RESEARCH For carrying out section 301 and title IV of the Public Health Service Act with respect to nursing research, ø$59,743,000¿ $55,692,000. (Department of Health and Human Services Appropriations Act, 1997.) NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM For carrying out section 301 and title IV of the Public Health Service Act with respect to alcohol abuse and alcoholism, ø$212,004,000¿ $208,112,000. (Department of Health and Human Services Appropriations Act, 1997.) NATIONAL INSTITUTE ON DRUG ABUSE For carrying out section 301 and title IV of the Public Health Service Act with respect to drug abuse, ø$489,375,000¿ $358,475,000. (Department of Health and Human Services Appropriations Act, 1997.) NATIONAL INSTITUTE OF MENTAL HEALTH For carrying out section 301 and title IV of the Public Health Service Act with respect to mental health, ø$701,585,000¿ $629,739,000. (Department of Health and Human Services Appropriations Act, 1997.) FOR RESEARCH RESOURCES For carrying out section 301 and title IV of the Public Health Service Act with respect to research resources and general research support grants, ø$415,145,000¿ $333,868,000: Provided, That none of these funds shall be used to pay recipients of the general research support grants program any amount for indirect expenses in connection with such grants: Provided further, That ø$20,000,000¿ $4,000,000 shall be for extramural facilities construction grants. (Department of Health and Human Services Appropriations Act, 1997.) NATIONAL øCENTER FOR¿ HUMAN GENOME RESEARCH INSTITUTE For carrying out section 301 and title IV of the Public Health Service Act with respect to human genome research, ø$189,657,000¿ $202,197,000. (Department of Health and Human Services Appropriations Act, 1997.) JOHN E. FOGARTY INTERNATIONAL CENTER For carrying out the activities at the John E. Fogarty International Center, ø$26,586,000¿ $16,755,000. (Department of Health and Human Services Appropriations Act, 1997.) NATIONAL LIBRARY OF MEDICINE For carrying out section 301 and title IV of the Public Health Service Act with respect to health information communications, ø$151,103,000¿ $152,689,000, of which $4,000,000 shall be available until expended for improvement of information systems: Provided, That in fiscal year ø1997¿ 1998, the Library 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. (Department of Health and Human Services Appropriations Act, 1997.) OFFICE OF THE DIRECTOR (INCLUDING TRANSFER OF FUNDS) For carrying out the responsibilities of the Office of the Director, National Institutes of Health, ø$287,206,000, of which $35,589,000 shall be for the Office of AIDS Research¿ $234,247,000: Provided, That funding shall be available for the purchase of not to exceed five passenger motor vehicles for replacement only: Provided further, That the Director may direct up to 1 percent of the total amount made available in this Act to all National Institutes of Health appropriations to activities the Director may so designate: Provided further, That no such appropriation shall be increased or decreased by more than 1 percent by any such transfers and that the Congress is promptly notified of the transfer: Provided further, That NIH is authorized to collect $15,000,000 in third party payments for the cost of clinical services that are incurred in National Institutes of Health research facilities in FY 1998 and that such payments shall be credited to the National Institutes of Health Management Fund: 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 depositedø: Provided further, That up to $200,000 shall be available to carry out section 499 of the Public Health Service Act¿. (Department of Health and Human Services Appropriations Act, 1997.) OFFICE OF (INCLUDING AIDS RESEARCH TRANSFER OF FUNDS) For carrying out part D of title XXIII of the Public Health Service Act, $1,540,765,000: Provided, That the Director of the Office of AIDS Research shall transfer from this appropriation the amounts necessary to carry out subsection 2353(d) of the Act. BUILDINGS AND FACILITIES For the study of, construction of, and acquisition of equipment for, facilities of or used by the National Institutes of Health, including the acquisition of real property, ø$200,000,000¿ $100,000,000, to remain available until expendedø, of which $90,000,000 shall be for the clinical research center: Provided, That, notwithstanding any other provision of law, a single contract or related contracts for the development and construction of the clinical research center may be employed which collectively include the full scope of the project: Provided further, That the solicitation and contract shall contain the clause ‘‘availability of funds’’ found at 48 CFR 52.232–18¿. In addition, to become available on October 1 of the fiscal year specified and remain available until expended, for the clinical research center, $90,000,000 for each of fiscal years 1998 and 1999, and $40,000,000 NATIONAL INSTITUTES OF HEALTH—Continued Federal Funds—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES for fiscal year 2000. (Department of Health and Human Services Appropriations Act, 1997.) Unavailable Collections (in millions of dollars) Identification code 75–9915–0–1–552 1996 actual 1997 est. 1998 est. Balance, start of year: 01.99 Balance, start of year .................................................... ................... ................... ................... Receipts: 02.01 Cooperative Research and Development Agreements, NIH ............................................................................. 7 12 15 Appropriation: 05.01 National Institutes of Health ......................................... –7 –12 –15 07.99 Total balance, end of year ............................................ ................... ................... ................... Program and Financing (in millions of dollars) Identification code 75–9915–0–1–552 1996 actual 1997 est. Obligations by program activity: National Cancer Institute .............................................. 2,255 2,381 National Heart, Lung, and Blood Institute .................... 1,351 1,433 National Institute of Dental Research ........................... 184 196 National Institute of Diabetes and Digestive and Kidney Disease ............................................................... 768 816 00.05 National Institute of Neurological Disorders and Stroke 684 726 00.06 National Institute of Allergy and Infectious Diseases 1,171 1,257 00.07 National Institute of General Medical Sciences ............ 944 998 00.08 National Institute of Child Health and Human Development ....................................................................... 593 631 00.09 National Eye Institute .................................................... 313 333 00.10 National Institute of Environmental Health Sciences 288 308 00.11 National Institute on Aging ........................................... 454 486 00.12 National Institute of Arthritis and Musculoskeletal and Skin Disease .............................................................. 243 257 00.13 National Institute on Deafness and Other Communication Disorder .............................................................. 176 188 00.14 National Institute of Nursing Research ......................... 56 60 00.15 National Institute of Alcohol Abuse and Alcoholism 199 212 00.16 National Institute on Drug Abuse .................................. 458 489 00.17 National Institute of Mental Health .............................. 660 701 00.18 National Center for Research Resources ....................... 390 415 00.19 National Human Genome Research Institute ................ 169 190 00.20 John E. Fogarty International Center ............................. 25 27 00.21 National Library of Medicine ......................................... 139 152 00.22 Office of the Director ..................................................... 260 287 00.23 Office of AIDS Research ................................................ ................... ................... 00.24 Buildings and facilities ................................................. 101 387 00.25 Cooperative research and development agreements .... 6 24 00.26 Royalities ........................................................................ 13 20 00.01 00.02 00.03 00.04 1998 est. 2,217 1,405 190 821 723 634 992 582 331 314 495 259 192 56 208 358 630 334 202 17 153 234 1,541 190 15 20 00.91 01.01 Total direct program ................................................. Reimbursable program .................................................. 11,900 330 12,974 360 13,113 384 10.00 Total obligations ........................................................ 12,230 13,334 13,497 Budgetary resources available for obligation: Unobligated balance available, start of year: Uninvested balance ................................................... 22.00 New budget authority (gross) ........................................ 22.30 Unobligated balance expiring ........................................ 21.40 23.90 23.95 24.40 Total budgetary resources available for obligation New obligations ............................................................. Unobligated balance available, end of year: Uninvested balance ................................................... 164 221 ................... 12,285 13,113 13,497 2 ................... ................... 12,451 –12,230 13,334 –13,334 13,497 –13,497 221 ................... ................... 12,747 13,078 –6 ................... 43.00 11,928 12,741 13,078 7 12 15 60.25 68.00 68.10 68.90 70.00 250 360 404 100 ................... ................... Spending authority from offsetting collections (total) ........................................................... 350 360 404 Total new budget authority (gross) .......................... 12,285 13,113 13,497 Change in unpaid obligations: Unpaid obligations, start of year: 72.40 Obligated balance: Appropriation ............................. 7,647 Orders on hand from Federal sources ...................... 72.99 73.10 73.20 73.40 74.40 74.95 Total unpaid obligations, start of year ................ New obligations ............................................................. Total outlays (gross) ...................................................... Adjustments in expired accounts .................................. Unpaid obligations, end of year: Obligated balance: Appropriation ............................. Orders on hand from Federal sources ...................... 74.99 Total unpaid obligations, end of year .................. 86.90 86.93 86.97 86.98 87.00 9,247 10,063 4,422 4,422 11,969 13,669 14,485 12,230 13,334 13,497 –10,467 –12,518 –13,205 –63 ................... ................... 9,247 4,422 10,063 4,422 10,355 4,422 13,669 14,485 14,777 Outlays (gross), detail: Outlays from new current authority .............................. 4,489 4,935 5,067 Outlays from current balances ...................................... 5,723 7,211 7,719 Outlays from new permanent authority ......................... 255 372 419 Outlays from permanent balances ................................ ................... ................... ................... Total outlays (gross) ................................................. Offsets: Against gross budget authority and outlays: 88.00 Offsetting collections (cash) from: Federal sources 88.95 Change in orders on hand from Federal sources ......... 89.00 90.00 4,322 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 10,467 12,518 13,205 –250 –360 –404 –100 ................... ................... 11,935 10,217 12,753 12,158 13,093 12,801 [Dollars in millions] Distribution of budget authority by account: 1996 1997 National Cancer Institute ....................................................... 2,255 2,381 National Heart, Lung, and Blood Institute ............................. 1,351 1,432 National Institute of Dental Research .................................... 184 196 National Institute of Diabetes and Digestive and Kidney Diseases ............................................................................. 769 816 National Institute of Neurological Disorder and Stroke ......... 684 726 National Institute of Allergy and Infectious Diseases ........... 1,171 1,257 National Institute of General Medical Sciences ..................... 944 998 National Institute of Child Health and Human Development 593 631 National Eye Institute ............................................................. 313 333 National Institute of Environmental Health Sciences ............ 288 308 National Institute on Aging .................................................... 454 486 National Institute of Arthritis and Musculoskeletal and Skin Diseases ............................................................................. 243 257 National Institute on Deafness and Other Communication Disorders ............................................................................. 176 188 National Institute of Nursing Research .................................. 56 60 National Institute on Alcohol Abuse and Alcoholism ............. 199 212 National Institute on Drug Abuse ........................................... 458 489 National Institute of Mental Health ....................................... 660 701 National Center for Research Resources ................................ 389 415 National Human Genome Research Institute ......................... 169 190 John E. Fogarty International Center ...................................... 25 27 National Library of Medicine .................................................. 141 151 Office of the Director .............................................................. 260 287 Office of AIDS Research ......................................................... .................... .................... Buildings and Facilities .......................................................... 146 200 1998 2,217 1,405 190 821 723 634 992 582 331 314 495 259 192 56 208 358 630 334 202 17 153 234 1,541 190 Subtotal .......................................................................... Cooperative Research and Development Agreements ............ 11,928 7 12,741 12 13,078 15 Total Budget Authority, NIH ........................................... 11,935 12,753 13,093 [Dollars in millions] 1996 New budget authority (gross), detail: Current: 40.00 Appropriation ............................................................. 11,928 40.75 Reduction pursuant to P.L. 104–208 ....................... ................... Appropriation (total) ............................................. Permanent: Appropriation (special fund, indefinite) .................... Spending authority from offsetting collections: Offsetting collections (cash) ................................ Change in orders on hand from Federal sources 72.95 505 Distribution of outlays by account: National Cancer Institute ....................................................... National Heart, Lung, and Blood Institute ............................. National Institute of Dental Research .................................... National Institute of Diabetes and Digestive and Kidney Diseases ............................................................................. National Institute of Neurological Disorders and Stroke ....... National Institute of Allergy and Infectious Diseases ........... National Institute of General Medical Sciences ..................... National Institute of Child Health and Human Development National Eye Institute ............................................................. National Institute of Environmental Health Sciences ............ National Institute on Aging .................................................... National Institute of Arthritis and Musculoskeletal and Skin Diseases ............................................................................. National Institute on Deafness and Other Communication Disorders ............................................................................. National Institute of Nursing Research .................................. National Institute on Alcohol Abuse and Alcoholism ............. 1997 1998 2,011 1,214 126 2,299 1,387 187 2,178 1,391 184 794 501 893 803 542 229 212 359 790 693 1,185 957 607 318 296 461 811 709 608 979 571 322 310 484 208 247 253 152 37 222 179 56 204 187 55 203 506 NATIONAL INSTITUTES OF HEALTH—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 1998 General and special funds—Continued OFFICE OF (INCLUDING SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION AIDS RESEARCH—Continued Federal Funds TRANSFER OF FUNDS)—Continued 1996 1997 General and special funds: 1998 National Institute on Drug Abuse ........................................... 407 461 National Institute of Mental Health ....................................... 617 669 National Center for Research Resources ................................ 289 400 National Human Genome Research Institute ......................... 145 176 John E. Fogarty International Center ...................................... 28 23 National Library of Medicine .................................................. 117 145 Office of the Director .............................................................. 195 245 Office of AIDS Research ......................................................... .................... .................... Buildings and Facilities .......................................................... 118 161 339 608 344 191 17 152 224 1,478 188 Subtotal Outlays ............................................................ Cooperative Research and Development Agreements ............ 10,212 5 12,146 12 12,786 15 Total Outlays, NIH .......................................................... 10,217 12,158 12,801 Note: The total amount for FY 1997 AIDS research was $1,501,720,000, which was jointly determined by the Director of NIH and the Director of the Office of AIDS Research pursuant to section 211 of P.L. 104–208. $1,466,131,000 was made available to OAR. This amount is net of the $35,589,000 in AIDS funds earmarked in P.L. 104– 208 in the Office of the Director account. This program funds biomedical research and research training. These accounts will continue to be appropriated separately, and are displayed in a consolidated format to improve the readability of the presentation. Detailed information is available through the Department of Health and Human Services. Object Classification (in millions of dollars) 11.1 11.3 11.5 11.8 11.9 12.1 21.0 22.0 23.1 23.2 23.3 Direct obligations: Personnel compensation: Full-time permanent ............................................. Other than full-time permanent ........................... Other personnel compensation ............................. Special personal services payments .................... 1997 est. 1998 est. 457 96 24 81 476 106 26 88 496 108 23 92 658 138 18 3 4 7 696 145 19 4 5 6 719 151 19 4 5 6 44 14 19 342 45 12 21 631 45 12 27 416 25.4 25.5 25.6 25.7 25.8 26.0 31.0 41.0 42.0 Total personnel compensation ......................... Civilian personnel benefits ....................................... Travel and transportation of persons ....................... Transportation of things ........................................... Rental payments to GSA ........................................... Rental payments to others ........................................ Communications, utilities, and miscellaneous charges ................................................................. Printing and reproduction ......................................... Advisory and assistance services ............................. Other services ............................................................ Purchases of goods and services from Government accounts ................................................................ Operation and maintenance of facilities .................. Research and development contracts ....................... Medical care .............................................................. Operation and maintenance of equipment ............... Subsistence and support of persons ........................ Supplies and materials ............................................. Equipment ................................................................. Grants, subsidies, and contributions ........................ Insurance claims and indemnities ........................... 857 97 710 5 34 8 120 105 8,714 3 99.0 99.0 Subtotal, direct obligations .................................. Reimbursable obligations .............................................. 11,900 330 12,974 360 13,093 404 99.9 Total obligations ........................................................ 12,230 13,334 13,497 24.0 25.1 25.2 25.3 MENTAL HEALTH SERVICES Program and Financing (in millions of dollars) Identification code 75–1362–0–1–550 1996 actual 1997 est. 1998 est. Obligations by program activity: Mental health and substance abuse activities ............ 320 494 Mental health partnership ............................................. 275 275 Substance abuse partnership ........................................ 1,234 1,310 Substance abuse partnership—temporary supplement (mandatory) ............................................................... ................... 50 00.05 Program management ................................................... 56 55 00.06 Building and facilities ................................................... ................... ................... 00.01 00.02 00.03 00.04 505 275 1,320 50 55 1 00.91 01.01 Total direct program ................................................. Reimbursable program .................................................. 1,885 20 2,184 20 2,206 20 Total obligations ........................................................ 1,905 2,204 2,226 Budgetary resources available for obligation: Unobligated balance available, start of year: Uninvested balance ................................................... 22.00 New budget authority (gross) ........................................ 2 1,905 2 2,204 2 2,226 1,907 –1,905 2,206 –2,204 2,228 –2,226 2 2 2 21.40 23.90 23.95 24.40 1996 actual Direct: Total compensable workyears: 1001 Full-time equivalent employment .............................. 15,050 1005 Full-time equivalent of overtime and holiday hours 196 1011 Exempt Full-time equivalent employment ................. ................... Reimbursable: 2001 Total compensable workyears: Full-time equivalent employment ............................................................... 65 Total budgetary resources available for obligation New obligations ............................................................. Unobligated balance available, end of year: Uninvested balance ................................................... New budget authority (gross), detail: Current: 40.00 Appropriation ............................................................. 42.00 Transferred from other accounts .............................. 43.00 764 764 166 164 688 705 5 5 33 33 11 ................... 124 123 102 98 9,494 9,794 3 3 65.00 68.00 70.00 1,883 2,134 2,156 2 ................... ................... Appropriation (total) ............................................. 1,885 Permanent: Advance appropriation (definite) .............................. ................... Spending authority from offsetting collections: Offsetting collections (cash) ..................................... 20 Total new budget authority (gross) .......................... Change in unpaid obligations: Unpaid obligations, start of year: Obligated balance: Appropriation ............................................................. 73.10 New obligations ............................................................. 73.20 Total outlays (gross) ...................................................... 73.40 Adjustments in expired accounts .................................. 74.40 Unpaid obligations, end of year: Obligated balance: Appropriation ............................................................. 1,905 2,134 2,156 50 50 20 20 2,204 2,226 72.40 1,250 1,048 1,327 1,905 2,204 2,226 –2,104 –1,925 –2,109 –3 ................... ................... 1,048 1,327 1,444 1997 est. 1998 est. 15,047 196 14 15,088 196 14 66 86.90 86.93 86.97 Outlays (gross), detail: Outlays from new current authority .............................. Outlays from current balances ...................................... Outlays from new permanent authority ......................... 905 1,179 20 1,067 813 45 1,078 986 45 87.00 Personnel Summary Identification code 75–9915–0–1–552 AND 10.00 1996 actual Identification code 75–9915–0–1–552 SUBSTANCE ABUSE For carrying out øtitles V and XIX of¿ the Public Health Service Act with respect to substance abuse and mental health services, the Protection and Advocacy for Mentally Ill Individuals Act of 1986, øsection 30401 of Public Law 103–322 and section 301 of the Public Health Service Act with respect to program management, $2,134,743,000, of which $5,000,000 shall be for grants to rural and Native American projects and $12,800,000 shall be for activities authorized by section 30401 of Public Law 103–322¿ $2,155,943,000, of which $1,000,000, together with unobligated balances for facilities renovation, shall be available for sealing off and preserving the Federally-owned unoccupied facilities at St. Elizabeths Hospital and shall remain available until September 30, 1999. (Department of Health and Human Services Appropriations Act, 1997.) Total outlays (gross) ................................................. 2,104 1,925 2,109 Offsets: Against gross budget authority and outlays: 88.00 Offsetting collections (cash) from: Federal sources –20 –20 –20 Net budget authority and outlays: Budget authority ............................................................ 1,885 2,184 2,206 65 89.00 AGENCY FOR HEALTH CARE POLICY AND RESEARCH Federal Funds DEPARTMENT OF HEALTH AND HUMAN SERVICES 90.00 Outlays ........................................................................... 2,083 1,905 2,089 This program provides Federal support for treatment and prevention in the areas of alcoholism, drug abuse, and mental health. Object Classification (in millions of dollars) 1996 actual Identification code 75–1362–0–1–550 Direct obligations: Personnel compensation: Full-time permanent ............................................. Other than full-time permanent ........................... Other personnel compensation ............................. 11.1 11.3 11.5 11.9 12.1 21.0 23.1 23.3 1997 est. 1998 est. 31 1 1 32 1 1 32 1 1 33 7 1 3 34 7 1 3 34 7 1 3 2 2 33 64 1 2 38 102 1 1 70 125 31.0 41.0 42.0 Total personnel compensation ......................... Civilian personnel benefits ....................................... Travel and transportation of persons ....................... Rental payments to GSA ........................................... Communications, utilities, and miscellaneous charges ................................................................. Printing and reproduction ......................................... Advisory and assistance services ............................. Other services ............................................................ Purchases of goods and services from Government accounts ................................................................ Equipment ................................................................. Grants, subsidies, and contributions ........................ Insurance claims and indemnities ........................... 14 1 1,723 2 13 1 1,980 2 11 1 1,950 2 99.0 99.0 Subtotal, direct obligations .................................. Reimbursable obligations .............................................. 1,885 20 2,184 20 2,206 20 99.9 Total obligations ........................................................ 1,905 2,204 2,226 24.0 25.1 25.2 25.3 22.00 23.95 24.40 New budget authority (gross), detail: Current: 40.00 Appropriation ............................................................. Permanent: 68.00 Spending authority from offsetting collections: Offsetting collections (cash) ..................................... 70.00 1996 actual Direct: Total compensable workyears: 1001 Full-time equivalent employment .............................. 1005 Full-time equivalent of overtime and holiday hours Reimbursable: Total compensable workyears: 2001 Full-time equivalent employment .............................. 2011 Exempt Full-time equivalent employment ................. 1997 est. 1998 est. Total new budget authority (gross) .......................... Change in unpaid obligations: Unpaid obligations, start of year: Obligated balance: Appropriation ............................................................. 73.10 New obligations ............................................................. 73.20 Total outlays (gross) ...................................................... 73.40 Adjustments in expired accounts .................................. 74.40 Unpaid obligations, end of year: Obligated balance: Appropriation ............................................................. 134 –134 153 –153 158 –158 1 ................... ................... 65 96 87 69 57 71 134 153 158 72.40 159 142 143 134 153 158 –150 –152 –159 –1 ................... ................... 142 143 142 86.90 86.93 86.97 Outlays (gross), detail: Outlays from new current authority .............................. Outlays from current balances ...................................... Outlays from new permanent authority ......................... –25 106 69 16 79 57 15 73 71 87.00 Total outlays (gross) ................................................. 150 152 159 Offsets: Against gross budget authority and outlays: 88.00 Offsetting collections (cash) from: Federal sources –69 –57 –71 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 65 81 96 95 87 88 Personnel Summary Identification code 75–1362–0–1–550 Budgetary resources available for obligation: New budget authority (gross) ........................................ New obligations ............................................................. Unobligated balance available, end of year: Uninvested balance ................................................... 507 89.00 90.00 590 2 590 2 590 2 This activity supports research and information dissemination on health care services and technology, medical effectiveness, and patient outcomes. 2 64 2 61 2 61 Object Classification (in millions of dollars) 1996 actual Identification code 75–1700–0–1–552 AGENCY FOR HEALTH CARE POLICY AND RESEARCH 11.1 11.3 11.5 Direct obligations: Personnel compensation: Full-time permanent ............................................. 6 Other than full-time permanent ........................... 1 Other personnel compensation ............................. ................... 1997 est. 1998 est. 12 13 1 2 1 ................... Federal Funds General and special funds: HEALTH CARE POLICY AND RESEARCH For carrying out titles III and IX of the Public Health Service Act, and part A of title XI of the Social Security Act, ø$96,175,000¿ $87,000,000; in addition, amounts received from Freedom of Information Act fees, reimbursable and interagency agreements, and the sale of data tapes shall be credited to this appropriation and shall remain available until expended: Provided, That the amount made available pursuant to section 926(b) of the Public Health Service Act shall not exceed ø$47,412,000¿ $62,000,000. (Department of Health and Human Services Appropriations Act, 1997.) 11.9 12.1 23.1 23.3 24.0 25.2 25.3 25.5 31.0 41.0 Total personnel compensation ......................... 7 Civilian personnel benefits ....................................... 1 Rental payments to GSA ........................................... 1 Communications, utilities, and miscellaneous charges ................................................................. 1 Printing and reproduction ......................................... 1 Other services ............................................................ 2 Purchases of goods and services from Government accounts ................................................................ 1 Research and development contracts ....................... 11 Equipment ................................................................. ................... Grants, subsidies, and contributions ........................ 40 14 4 3 15 4 3 1 2 4 1 2 4 2 11 1 54 2 30 1 25 Identification code 75–1700–0–1–552 1996 actual 1997 est. Subtotal, direct obligations .................................. Reimbursable obligations .............................................. 65 69 96 57 87 71 99.9 Program and Financing (in millions of dollars) 99.0 99.0 Total obligations ........................................................ 134 153 158 1998 est. Personnel Summary Obligations by program activity: Direct program: 01.01 Research on health care systems cost and access 7 01.02 Health insurance and expenditure surveys ............... ................... 01.03 Research on health care outcomes and quality 56 01.04 Program support ........................................................ 2 36 10 48 2 17 10 58 2 01.91 04.01 Total direct program ............................................. Reimbursable program .................................................. 65 69 96 57 87 71 10.00 Total obligations ........................................................ 134 153 158 Identification code 75–1700–0–1–552 Direct: Total compensable workyears: 1001 Full-time equivalent employment .............................. 1005 Full-time equivalent of overtime and holiday hours Reimbursable: 2001 Total compensable workyears: Full-time equivalent employment ............................................................... 1996 actual 1997 est. 1998 est. 104 1 197 1 197 1 148 55 55 508 HEALTH CARE FINANCING ADMINISTRATION Federal Funds THE BUDGET FOR FISCAL YEAR 1998 HEALTH CARE FINANCING ADMINISTRATION Federal Funds General and special funds: GRANTS TO STATES FOR MEDICAID For carrying out, except as otherwise provided, titles XI and XIX of the Social Security Act, ø$75,056,618,000¿ $71,530,429,000, to remain available until expended. For making, after May 31, ø1997¿ 1998, payments to States under title XIX of the Social Security Act for the last quarter of fiscal year ø1997¿ 1998 for unanticipated costs, incurred for the current fiscal year, such sums as may be necessary. For making payments to States under title XIX of the Social Security Act for the first quarter of fiscal year ø1998, $27,988,993,000¿ 1999, $27,800,689,000, to remain available until expended. Payment under title XIX may be made for any quarter with respect to a State plan or plan amendment in effect during such quarter, if submitted in or prior to such quarter and approved in that or any subsequent quarter. (Department of Health and Human Services Appropriations Act, 1997.) Program and Financing (in millions of dollars) 1996 actual Identification code 75–0512–0–1–551 99,144 4,875 365 10.00 92,728 98,503 104,384 21.40 Total budgetary resources available for obligation New obligations ............................................................. Unobligated balance available, end of year: Uninvested balance ................................................... 12,740 82,142 2,155 101,212 4,864 99,519 94,882 –92,728 103,367 –98,503 104,384 –104,384 1997 est. Obligations by program activity: Total obligations (object class 41.0) ............................ ................... 1998 est. –39 1,456 23.90 23.95 24.40 Total budgetary resources available for obligation ................... ................... 1,417 New obligations ............................................................. ................... –39 –1,417 Unobligated balance available, end of year: Uninvested balance ................................................... ................... –39 ................... New budget authority (gross), detail: Appropriation .................................................................. ................... ................... 73.10 73.20 2,155 40.00 Change in unpaid obligations: New obligations ............................................................. ................... Total outlays (gross) ...................................................... ................... 39 –39 1,417 –1,417 Outlays (gross), detail: Outlays from new current authority .............................. ................... 39 Outlays from current balances ...................................... ................... ................... 1,456 –39 4,864 ................... 27,048 26,155 27,989 86.90 86.93 70.00 82,142 101,212 99,519 87.00 72.40 4,606 92,728 –91,990 5,344 98,503 –98,503 5,344 104,384 –104,384 5,344 5,344 5,344 86.90 86.93 86.97 Outlays (gross), detail: Outlays from new current authority .............................. Outlays from current balances ...................................... Outlays from new permanent authority ......................... 47,596 17,346 27,048 64,849 7,499 26,155 66,187 10,208 27,989 87.00 Total outlays (gross) ................................................. 91,990 98,503 89.00 90.00 82,142 91,990 101,212 98,503 99,519 104,384 Summary of Budget Authority and Outlays (in millions of dollars) Enacted/requested: 1996 actual 1997 est. Budget Authority ..................................................................... 82,142 101,212 Outlays .................................................................................... 91,990 98,503 Legislative proposal, subject to PAYGO: Budget Authority ..................................................................... .................... .................... Outlays .................................................................................... .................... 39 82,142 91,990 101,212 98,542 1998 est. 100,975 105,801 39 1,417 Net budget authority and outlays: Budget authority ............................................................ ................... ................... Outlays ........................................................................... ................... 39 1,456 1,417 PAYMENTS TO HEALTH CARE TRUST FUNDS For payment to the Federal Hospital Insurance and the Federal Supplementary Medical Insurance Trust Funds, as provided under sections 217(g) and 1844 of the Social Security Act, sections 103(c) and 111(d) of the Social Security Amendments of 1965, section 278(d) of Public Law 97–248, and for administrative expenses incurred pursuant to section 201(g) of the Social Security Act, ø$60,079,000,000¿ $63,581,000,000. (Department of Health and Human Services Appropriations Act, 1997.) 99,519 104,384 1,456 1,417 Total outlays (gross) ................................................. ................... 1,456 This schedule reflects the effects of Medicaid, Medicare, welfare, children’s health, and other mandatory proposals included in the Budget on the Grants to States for Medicaid account. 104,384 Total: Budget Authority ..................................................................... Outlays .................................................................................... 1996 actual Budgetary resources available for obligation: Unobligated balance available, start of year: Uninvested balance ................................................... ................... ................... 22.00 New budget authority (gross) ........................................ ................... ................... 71,530 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... MEDICAID 21.40 75,057 89.00 90.00 FOR 1,417 55,094 Change in unpaid obligations: Unpaid obligations, start of year: Obligated balance: Appropriation ............................................................. 73.10 New obligations ............................................................. 73.20 Total outlays (gross) ...................................................... 74.40 Unpaid obligations, end of year: Obligated balance: Appropriation ............................................................. STATES 39 New budget authority (gross), detail: Current: 40.00 Appropriation ............................................................. Permanent: 65.00 Advance appropriation (definite) .............................. Total new budget authority (gross) .......................... TO Program and Financing (in millions of dollars) 10.00 93,346 4,634 523 23.90 23.95 24.40 GRANTS (Legislative proposal, subject to PAYGO) 1998 est. 88,642 3,881 204 Budgetary resources available for obligation: Unobligated balance available, start of year: Uninvested balance ................................................... 22.00 New budget authority (gross) ........................................ Current and projected vaccine excise tax receipts to the Vaccine Injury Compensation Program Trust Fund far exceed current and projected claims to the Trust Fund. The Budget proposes lowering revenue to the Trust Fund by exempting Federal programs (which provide free vaccine to low-income, uninsured, and underinsured children) from payment of the vaccine excise tax in FY 1998. Exempting these programs will result in Federal savings to the Grants to States for Medicaid account. Identification code 75–0512–4–1–551 1997 est. Obligations by program activity: 00.01 Medicaid vendor payments ............................................ 00.02 State and local administration ..................................... 00.03 Vaccine purchases ......................................................... Total obligations (object class 41.0) ........................ Medicaid assists States in providing medical care to their low-income population by granting Federal matching payments under title XIX of the Social Security Act to States with approved plans. Program and Financing (in millions of dollars) Identification code 75–0580–0–1–571 00.01 00.02 00.03 00.04 Obligations by program activity: Supplementary medical insurance (SMI) ....................... Hospital insurance for uninsured (HI) ........................... Federal uninsured payment (HI) .................................... Program management (HI) ............................................ 1996 actual 61,702 358 61 145 1997 est. 59,354 405 76 142 1998 est. 63,416 –52 86 131 HEALTH CARE FINANCING ADMINISTRATION—Continued Federal Funds—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES 00.06 00.07 00.08 00.10 00.11 10.00 Federal payments from taxation of OASDI benefits (HI) ............................................................................. 4,069 4,163 4,351 SECA tax credits (HI) ..................................................... –10 ................... ................... Fraud and abuse control, FBI ........................................ ................... 47 56 Fraud and abuse control, criminal fines ...................... ................... 15 15 Fraud and abuse control, civil monetary penalties ................... 218 237 Total obligations ........................................................ Budgetary resources available for obligation: 22.00 New budget authority (gross) ........................................ 22.30 Unobligated balance expiring ........................................ 23.90 23.95 Total budgetary resources available for obligation New obligations ............................................................. 509 66,325 –66,325 14,668 –14,668 40.00 New budget authority (gross), detail: Appropriation .................................................................. ................... ................... 14,668 Change in unpaid obligations: New obligations ............................................................. ................... ................... Total outlays (gross) ...................................................... ................... ................... 14,668 –14,668 86.90 Outlays (gross), detail: Outlays from new current authority .............................. ................... ................... 14,668 89.00 90.00 67,372 –1,047 64,420 Budgetary resources available for obligation: New budget authority (gross) ........................................ ................... ................... New obligations ............................................................. ................... ................... 73.10 73.20 66,325 22.00 23.95 Net budget authority and outlays: Budget authority ............................................................ ................... ................... Outlays ........................................................................... ................... ................... 14,668 14,668 68,240 64,522 68,240 –102 ................... 64,420 –64,420 68,240 –68,240 New budget authority (gross), detail: Current: 40.00 Appropriation ............................................................. Permanent: 60.05 Appropriation (indefinite) .......................................... 63,313 60,079 63,581 4,059 4,443 4,659 70.00 Total new budget authority (gross) .......................... 67,372 64,522 68,240 73.10 73.20 Change in unpaid obligations: New obligations ............................................................. Total outlays (gross) ...................................................... 66,325 –66,325 64,420 –64,420 68,240 –68,240 86.90 86.97 Outlays (gross), detail: Outlays from new current authority .............................. Outlays from new permanent authority ......................... 62,266 4,059 59,977 4,443 63,581 4,659 87.00 Total outlays (gross) ................................................. 66,325 64,420 68,240 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 67,372 66,325 64,522 64,420 68,240 68,240 Summary of Budget Authority and Outlays (in millions of dollars) Enacted/requested: 1996 actual 1997 est. Budget Authority ..................................................................... 67,372 64,522 Outlays .................................................................................... 66,325 64,420 Legislative proposal, not subject to PAYGO: Budget Authority ..................................................................... .................... .................... Outlays .................................................................................... .................... .................... Total: Budget Authority ..................................................................... Outlays .................................................................................... 67,372 66,325 64,522 64,420 1998 est. 68,240 68,240 This schedule reflects the effects of the Medicare reform proposals contained in the Administration’s balanced budget proposal on the Payments to Health Care Trust Funds account. PROGRAM MANAGEMENT For carrying out, except as otherwise provided, titles XI, XVIII, and XIX of the Social Security Act, title XIII of the Public Health Service Act, and the Clinical Laboratory Improvement Amendments of 1988, not to exceed ø$1,735,125,000¿ $1,774,500,000, to be transferred from the Federal Hospital Insurance and the Federal Supplementary Medical Insurance Trust Funds, as authorized by section 201(g) of the Social Security Act; together with all funds collected in accordance with section 353 of the Public Health Service Act, the latter funds to remain available until expended, together with such sums as may be collected from authorized user fees and the sale of data, which shall remain available until expended: Provided, That all funds derived in accordance with 31 U.S.C. 9701 from organizations established under title XIII of the Public Health Service Act are to be credited to and available for carrying out the purposes of this appropriation. (Department of Health and Human Services Appropriations Act, 1997.) 14,668 14,668 82,908 82,908 Payments are made (1) to the Federal Supplementary Medical Insurance Trust Fund; and (2) to the Federal Hospital Insurance Trust Fund for individuals aged 65 and over who meet certain transitional insured status requirements, and for civil service employees and annuitants who worked before 1983 and who were employed during January 1983. Beginning in 1992, amounts are included for non-Medicare activities of HCFA Program Management. Object Classification (in millions of dollars) Unavailable Collections (in millions of dollars) Identification code 75–0511–0–1–550 Balance, start of year: 01.99 Balance, start of year .................................................... Receipts: 02.01 Survey and certification fees, HCFA, legislative proposal .......................................................................... Appropriation: 05.01 Program management, legislative proposal .................. 07.99 Total balance, end of year ............................................ 1996 actual 1997 est. 1998 est. ................... ................... ................... ................... ................... 10 ................... ................... –10 ................... ................... ................... Program and Financing (in millions of dollars) Identification code 75–0511–0–1–550 1996 actual 1997 est. 1998 est. 63,797 481 142 68,075 34 131 99.9 Total obligations ........................................................ 66,325 64,420 Total direct program ................................................. Reimbursable program: CLIA ........................................................................... Other reimbursements ............................................... 2,078 1,734 1,775 29 4 43 2 43 2 Total reimbursable program ...................................... 33 45 45 10.00 65,761 419 145 45 1,223 148 359 08.91 1998 est. Grants, subsidies, and contributions ............................ Insurance claims and indemnities ................................ Undistributed ................................................................. 44 1,207 158 325 08.01 08.02 1997 est. 41.0 42.0 92.0 53 1,555 145 325 00.91 1996 actual Identification code 75–0580–0–1–571 Obligations by program activity: Direct program: 00.01 Research, demonstrations, and evaluation projects 00.02 Medicare contractors ................................................. 00.04 State certification ...................................................... 00.05 Administrative costs .................................................. Total obligations ........................................................ 2,111 1,779 1,820 68,240 PAYMENTS TO HEALTH CARE TRUST FUNDS (Legislative proposal, not subject to PAYGO) Program and Financing (in millions of dollars) Budgetary resources available for obligation: Unobligated balance available, start of year: Uninvested balance ................................................... 22.00 New budget authority (gross) ........................................ 22.30 Unobligated balance expiring ........................................ 15 17 17 2,159 1,779 1,820 –46 ................... ................... 23.90 2,128 21.40 Identification code 75–0580–2–1–571 10.00 1996 actual 1997 est. Obligations by program activity: Total obligations (object class 41.0) ............................ ................... ................... 1998 est. 14,668 Total budgetary resources available for obligation 1,796 1,837 510 HEALTH CARE FINANCING ADMINISTRATION—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 1998 General and special funds—Continued Personnel Summary PROGRAM MANAGEMENT—Continued Identification code 75–0511–0–1–550 Program and Financing (in millions of dollars)—Continued 1996 actual Identification code 75–0511–0–1–550 23.95 24.40 New obligations ............................................................. Unobligated balance available, end of year: Uninvested balance ................................................... New budget authority (gross), detail: 68.00 Spending authority from offsetting collections (gross): Offsetting collections (cash) ..................................... 1997 est. 1998 est. –2,111 –1,779 17 17 86.97 86.98 87.00 4,081 9 4,085 9 1998 est. 4,085 9 PROGRAM MANAGEMENT (Legislative proposal, subject to PAYGO) 2,159 2,159 1,779 1,779 Program and Financing (in millions of dollars) 1,820 1,820 1996 actual 1997 est. ................... ................... ................... ................... ................... ................... ................... ................... 1,738 25 750 10 Total obligations ........................................................ ................... ................... 2,523 Identification code 75–0511–4–1–550 Change in unpaid obligations: 72.40 Unpaid obligations, start of year: Obligated balance: Appropriation ............................................................. 73.10 New obligations ............................................................. 73.20 Total outlays (gross) ...................................................... 73.40 Adjustments in expired accounts .................................. 74.40 Unpaid obligations, end of year: Obligated balance: Appropriation ............................................................. 1997 est. –1,820 17 1996 actual Total compensable workyears: 1001 Full-time equivalent employment .................................. 1005 Full-time equivalent of overtime and holiday hours 445 452 452 2,111 1,779 1,820 –2,116 –1,779 –1,820 12 ................... ................... 00.01 00.02 00.03 00.04 452 10.00 Outlays (gross), detail: Outlays from new permanent authority ......................... 2,116 1,779 1,820 Outlays from permanent balances ................................ ................... ................... ................... Obligations by program activity: Healthy working families grants ................................... Grants for health insurance cooperatives ..................... Healthy kids State partnership grants .......................... Survey and certification user fee .................................. 1998 est. 21.40 Total outlays (gross) ................................................. 452 2,116 452 1,779 Budgetary resources available for obligation: Unobligated balance available, start of year: Uninvested balance ................................................... ................... ................... ................... 22.00 New budget authority (gross) ........................................ ................... ................... 2,610 1,820 23.90 23.95 24.40 Offsets: Against gross budget authority and outlays: Offsetting collections (cash) from: 88.00 Federal sources ..................................................... 88.40 Non-Federal sources ............................................. –2,124 –35 –1,734 –45 –1,775 –45 88.90 –2,159 –1,779 –1,820 Total budgetary resources available for obligation ................... ................... New obligations ............................................................. ................... ................... Unobligated balance available, end of year: Uninvested balance ................................................... ................... ................... 2,610 –2,523 87 60.00 60.25 New budget authority (gross), detail: Appropriation .................................................................. ................... ................... Appropriation (special fund, indefinite) ........................ ................... ................... 2,600 10 63.00 Appropriation (total) .................................................. ................... ................... 2,610 70.00 Total new budget authority (gross) .......................... ................... ................... 2,610 (in millions of dollars) 73.10 73.20 Change in unpaid obligations: New obligations ............................................................. ................... ................... Total outlays (gross) ...................................................... ................... ................... 2,523 –2,523 1996 actual 1997 est. 1998 est. Enacted/requested: Budget Authority ..................................................................... .................... .................... .................... Outlays .................................................................................... –43 .................... .................... Legislative proposal, subject to PAYGO: Budget Authority ..................................................................... .................... .................... 2,610 Outlays .................................................................................... .................... .................... 2,523 86.97 Outlays (gross), detail: Outlays from new permanent authority ......................... ................... ................... 2,523 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ ................... ................... Outlays ........................................................................... ................... ................... 2,610 2,523 89.00 90.00 Total, offsetting collections (cash) .................. Net budget authority and outlays: Budget authority ............................................................ ................... ................... ................... Outlays ........................................................................... –43 ................... ................... Summary of Budget Authority and Outlays Total: Budget Authority ..................................................................... .................... .................... Outlays .................................................................................... –43 .................... 2,610 2,523 Program management activities include funding for research, Medicare contractors, survey and certification, CLIA, and administrative costs. Object Classification (in millions of dollars) Identification code 75–0511–0–1–550 1996 actual 1997 est. 1998 est. 11.1 11.3 11.5 Personnel compensation: Full-time permanent .................................................. Other than full-time permanent ............................... Other personnel compensation .................................. 228 5 2 239 5 2 11.9 12.1 21.0 23.1 23.3 24.0 25.1 25.2 25.6 26.0 31.0 41.0 99.5 Total personnel compensation .............................. 222 235 Civilian personnel benefits ............................................ 38 41 Travel and transportation of persons ............................ 5 3 Rental payments to GSA ................................................ 16 23 Communications, utilities, and miscellaneous charges 7 4 Printing and reproduction .............................................. 5 3 Advisory and assistance services .................................. 34 27 Other services ................................................................ 274 225 Medical care .................................................................. 1,466 1,205 Supplies and materials ................................................. 3 1 Equipment ...................................................................... 13 ................... Grants, subsidies, and contributions ............................ 28 12 Below reporting threshold .............................................. ................... ................... 246 47 5 31 8 6 29 213 1,221 1 6 6 1 99.9 Total obligations ........................................................ 216 5 1 2,111 1,779 1,820 This schedule reflects the effects on the Program Management account of the Administration’s proposals to: (1) create a four year demonstration called ‘‘Healthy Working Families’’ to finance health insurance for the temporarily unemployed, (2) create a State grant program to foster the development of purchasing cooperatives, (3) create a State grant demonstration program called ‘‘Healthy Kids’’ to support State efforts to expand insurance options for uninsured children, and (4) require States to collect and retain fees from providers to cover the cost of initial surveys required for participation in the Medicare program. Object Classification (in millions of dollars) Identification code 75–0511–4–1–550 1996 actual 1997 est. 1998 est. 25.2 41.0 Other services ................................................................ ................... ................... Grants, subsidies, and contributions ............................ ................... ................... 10 2,513 99.9 Total obligations ........................................................ ................... ................... 2,523 HEALTH MAINTENANCE ORGANIZATION LOAN FUND AND LOAN GUARANTEE For carrying out subsections (d) and (e) of section 1308 of the Public Health Service Act, any amounts received by the Secretary HEALTH CARE FINANCING ADMINISTRATION—Continued Trust Funds DEPARTMENT OF HEALTH AND HUMAN SERVICES in connection with loans and loan guarantees under title XIII of the Public Health Service Act, to be available without fiscal year limitation for the payment of outstanding obligations. During fiscal year ø1997¿ 1998, no commitments for direct loans or loan guarantees shall be made. (Department of Health and Human Services Appropriations Act, 1997.) Program and Financing (in millions of dollars) 1996 actual Identification code 75–4420–0–3–551 1997 est. 02.20 50 50 127,980 132,063 Total: Balances and collections .................................... 238,329 234,209 Appropriation: 05.01 Federal hospital insurance trust fund .......................... –132,100 –137,259 05.02 Health care fraud and abuse control account .............. ................... –591 05.04 Federal hospital insurance trust fund, legislative proposal subject to PAYGO ............................................ ................... ................... 228,426 02.99 Civil penalties and damages ........................................ ................... 511 Total receipts ............................................................. 123,499 04.00 –148,484 –676 19,410 1998 est. Obligations by program activity: 00.05 Interest payments to FFB .............................................. 1 1 ................... 10.00 1 05.99 06.20 07.99 Subtotal appropriation ................................................... –132,100 Reduction pursuant to Public Law 104–208 ................ ................... Total balance, end of year ............................................ 106,229 –137,850 –129,750 4 ................... 96,363 98,676 1 ................... Total obligations (object class 43.0) ........................ Program and Financing (in millions of dollars) Budgetary resources available for obligation: 21.90 Unobligated balance available, start of year: Fund balance ...................................................................... 22.00 New budget authority (gross) ........................................ 22.60 Redemption of debt ....................................................... 1996 actual Identification code 20–8005–0–7–571 11 4 –3 11 2 –2 10 2 –2 12 –1 11 10 –1 ................... 11 10 1997 est. 1998 est. Total budgetary resources available for obligation New obligations ............................................................. Unobligated balance available, end of year: Fund balance ...................................................................... New budget authority (gross), detail: 68.00 Spending authority from offsetting collections (gross): Offsetting collections (cash) ..................................... 4 73.10 73.20 Change in unpaid obligations: New obligations ............................................................. Total outlays (gross) ...................................................... 1 –1 86.93 Outlays (gross), detail: Outlays from current balances ...................................... 1 10 2 2 1 ................... –1 –1 Obligations by program activity: Benefit payments, HI ..................................................... Administration, HI .......................................................... Peer review organizations, HI ........................................ Research, HI ................................................................... Quinquennial adjustment for military service credits 10.00 23.90 23.95 24.90 00.01 00.02 00.03 00.04 00.05 Total obligations ........................................................ 132,100 137,255 148,484 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ New obligations ............................................................. 132,100 –132,100 137,255 –137,255 148,484 –148,484 1,114 1,209 128,003 136,021 147,171 1,172 1,123 1,218 521 80 63 38 31 31 2,366 ................... ................... 1 126,866 130,732 9,279 16,543 –4 ................... 63.00 1 New budget authority (gross), detail: Current: 40.26 Appropriation (trust fund, definite) .......................... 1,169 Permanent: 60.27 Appropriation (trust fund, indefinite) ....................... 122,330 60.28 Appropriation (unavailable balances) ....................... 8,601 60.75 Reduction pursuant to P.L. 104–208 ....................... ................... Appropriation (total) ............................................. 130,931 136,141 147,274 Offsets: Against gross budget authority and outlays: Offsetting collections (cash) from: Non-Federal sources: 88.40 Interest ............................................................. 88.40 Other ................................................................. –1 ................... ................... –3 –2 –2 70.00 Total new budget authority (gross) .......................... 132,100 137,255 148,484 88.90 –4 Change in unpaid obligations: Unpaid obligations, start of year: Obligated balance: U.S. Securities: Par value ......................................... 73.10 New obligations ............................................................. 73.20 Total outlays (gross) ...................................................... 74.41 Unpaid obligations, end of year: Obligated balance: U.S. Securities: Par value ......................................... 14,691 132,100 –127,683 19,107 137,255 –137,471 18,890 148,484 –148,686 19,107 18,890 18,688 89.00 90.00 Total, offsetting collections (cash) .................. –2 –2 Net budget authority and outlays: Budget authority ............................................................ ................... ................... ................... Outlays ........................................................................... –3 –1 –1 86.90 86.93 86.97 86.98 Trust Funds FEDERAL HOSPITAL INSURANCE TRUST FUND Unavailable Collections (in millions of dollars) Identification code 20–8005–0–7–571 Balance, start of year: Balance, start of year .................................................... Receipts: 02.01 Transfers from general fund (FICA taxes) ..................... 02.02 Receipts from Railroad Retirement Board .................... 02.03 Transfers from general fund (SECA taxes) ................... 02.04 Federal employer contributions (FICA) ........................... 02.05 Postal service employer contributions (FICA) ................ 02.06 Refunds .......................................................................... 02.07 Interest received by trust funds .................................... 02.08 Other proprietary receipts from the public ................... 02.09 Interest received by trust funds, legislative proposal 02.10 Taxation on OASDI benefits ........................................... 02.11 Premiums collected for uninsured individuals not otherwise eligible, legislative proposal .......................... 02.12 Interest payments by Railroad Retirement Board ......... 02.13 Payments from the general fund (uninsured and program management) ................................................... 02.14 Payments for military service credits ............................ 02.15 Premiums collected for uninsured individuals not otherwise eligible ........................................................... 02.16 Payment from the general fund .................................... 02.17 Criminal fines, transfers from the general fund .......... 02.18 Civil monetary penalties, transfers from the general fund ........................................................................... 01.99 1996 actual 114,830 72.41 1997 est. 106,229 1998 est. 96,363 97,866 102,064 105,744 362 366 367 6,752 6,750 8,056 1,787 1,805 1,943 522 595 618 17 ................... ................... 10,350 9,914 8,855 1 ................... ................... ................... ................... 302 4,069 4,163 4,351 ................... ................... 39 35 –180 35 554 73 623 70 165 64 1,107 ................... ................... 1,265 47 15 1,385 56 15 ................... 218 237 Outlays (gross), detail: Outlays from new current authority .............................. Outlays from current balances ...................................... Outlays from new permanent authority ......................... Outlays from permanent balances ................................ 1,098 130 111,894 14,561 1,045 148 117,319 18,959 1,140 113 128,656 18,777 87.00 Total outlays (gross) ................................................. 127,683 137,471 148,686 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 132,100 127,683 137,255 137,471 148,484 148,686 Summary of Budget Authority and Outlays (in millions of dollars) Enacted/requested: 1996 actual 1997 est. Budget Authority ..................................................................... 132,100 137,255 Outlays .................................................................................... 127,683 137,471 Legislative proposal, subject to PAYGO: Budget Authority ..................................................................... .................... .................... Outlays .................................................................................... .................... .................... Total: Budget Authority ..................................................................... Outlays .................................................................................... 132,100 127,683 137,255 137,471 1998 est. 148,483 148,686 –19,410 –19,410 129,073 129,276 The Hospital Insurance (HI) program funds the costs of hospital and related care for individuals age 65 or older and for eligible disabled people. The status of the trust fund is as follows: 512 HEALTH CARE FINANCING ADMINISTRATION—Continued Trust Funds—Continued THE BUDGET FOR FISCAL YEAR 1998 FEDERAL HOSPITAL INSURANCE TRUST FUND—Continued 92.0 Status of Funds (in millions of dollars) 92.0 Identification code 20–8005–0–7–571 0100 0101 Unexpended balance, start of year: Treasury balance ............................................................ U.S. Securities: Par value .............................................. 0199 Total balance, start of year ...................................... Cash income during the year: Governmental receipts: 0200 FHI Trust Fund, Transfers from general fund (FICA taxes) .................................................................... 0201 FHI Trust Fund, Transfers from general fund (SECA taxes) .................................................................... 0202 Refunds ..................................................................... 0205 FHI Trust Fund, Receipts from Railroad Retirement Board ..................................................................... 0206 HCFAC: Civil Penalties and Damages ....................... Proprietary receipts: 0221 FHI Trust Fund, Premiums collected for uninsured individuals not otherwise eligible ........................ 0222 FHI Trust Fund, Premiums collected for uninsured individuals not otherwise eligible, proposed legislation .................................................................. 0223 Other proprietary receipts ......................................... Intragovernmental transactions: 0240 FHI Trust Fund, Federal employer contributions (FICA) .................................................................... 0241 FHI Trust Fund, Postal service employer contributions (FICA) ........................................................... 0242 FHI Trust Fund, Federal payment for transitional coverage for uninsured Federal employees .......... 0243 FHI Trust Fund, Federal payment for transitional coverage for the uninsured .................................. 0244 FHI Trust Fund, Federal payment for SECA tax credits ................................................................... 0245 FHI Trust Fund, General Fund transfer, Program management (HI) .................................................. 0246 FHI Trust Fund, Federal payments for OASDI taxes 0248 FHI Trust fund, Interest payment from Railroad Retirement Board .................................................. 0249 FHI Trust Fund, Interest on investments .................. 0250 FHI Trust Fund, Interest on investments .................. 0251 FHI Trust Fund, Transfer from Department of Defense for military service credits ......................... 0252 HCFAC: FBI ................................................................ 0253 HCFAC: Criminal Fines .............................................. 0254 HCFAC: Civil Monetary Penalties ............................... 0297 Income under present law ............................................. 0298 Income under proposed legislation ............................... 1996 actual 1997 est. 1998 est. 93.0 99.5 –344 129,864 –467 125,803 1 115,253 129,520 125,336 115,254 97,865 102,064 105,744 6,752 6,750 8,056 17 ................... ................... 362 ................... 366 50 367 50 1,107 1,265 1,385 ................... ................... –180 1 ................... ................... 99.9 0799 Total balance, end of year ........................................ 132,100 137,255 1,787 1,805 1,943 522 595 148,484 618 61 76 86 FEDERAL HOSPITAL INSURANCE TRUST FUND 358 405 –52 (Legislative proposal, subject to PAYGO) Program and Financing (in millions of dollars) –10 ................... ................... 145 4,069 142 4,163 131 4,351 39 35 10,350 9,914 ................... ................... 35 8,855 302 73 70 ................... 47 ................... 15 ................... 218 123,499 127,980 ................... ................... 64 56 15 237 131,941 122 Total cash income ..................................................... 123,499 127,980 132,063 Cash outgo during year: 0500 Benefit payments ........................................................... –123,908 –136,022 –147,171 0501 Benefit payments (proposed legislation) ....................... ................... ................... 19,410 0502 Administration ................................................................ –1,178 –1,139 –1,215 0504 Peer review organizations .............................................. –181 –257 –262 0505 Research ........................................................................ –50 –54 –38 0506 HCFAC ............................................................................ ................... –591 –676 0507 Quinquennial Adjustment for Military Service Credits –2,366 ................... ................... 0597 Outgo under present law (–) ......................................... –127,683 –138,062 –149,362 0598 Outgo under proposed legislation (–) ........................... ................... ................... 19,410 Total cash outgo (–) ...................................................... Unexpended balance, end of year: 0700 Uninvested balance ....................................................... 0701 U.S. Securities: Par value .............................................. Total obligations ........................................................ The estimate of administrative expenses borne by each of the financing sources, including the Hospital Insurance (HI) and Supplemental Medical Insurance (SMI) trust funds for Medicare-related activities performed by the Social Security Administration (SSA), has been made by SSA based on the current cost allocation methodology. Pursuant to section 201(g) of the Social Security Act, a final accounting of actual payments is made after the close of each fiscal year. In the Conference Committee Report for Public Law 103–296, The Social Security Independence and Program Improvements Act of 1994, the conferees requested that the Secretary of Health and Human Services and the Commissioner of Social Security make a joint examination of the most appropriate cost allocation methodology and report their joint findings to the Congress within 36 months of enactment. The Secretary and the Commissioner are in the process of designing and carrying out this study and preparing the required report to Congress. –127,683 –138,062 –129,952 –467 125,803 1 115,253 1 117,364 125,336 115,254 1996 actual Identification code 20–8005–4–7–571 1997 est. 1998 est. 00.01 Obligations by program activity: Benefit payments, HI ..................................................... ................... ................... –19,410 10.00 Total obligations (object class 42.0) ........................ ................... ................... –19,410 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ ................... ................... New obligations ............................................................. ................... ................... –19,410 19,410 60.28 New budget authority (gross), detail: Appropriation (unavailable balances) ........................... ................... ................... –19,410 73.10 73.20 Change in unpaid obligations: New obligations ............................................................. ................... ................... Total outlays (gross) ...................................................... ................... ................... –19,410 19,410 86.97 Outlays (gross), detail: Outlays from new permanent authority ......................... ................... ................... –19,410 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ ................... ................... Outlays ........................................................................... ................... ................... –19,410 –19,410 0299 0599 Undistributed: Quinquennial Adjustment for Military Service Credits .......................................................................... 2,366 ................... ................... Reimbursement for administrative expenses for other than SSA LAE .............................................. 41 40 40 Administrative expenses: Portion of limitation on salaries and expenses: Social Security Administration 458 481 560 Below reporting threshold .............................................. ................... –1 1 This schedule reflects the effects of the Medicare reform proposals contained in the Administration’s balanced budget proposal on the Hospital Insurance Trust Fund. 117,365 HEALTH CARE FRAUD (FEDERAL Object Classification (in millions of dollars) AND ABUSE CONTROL ACCOUNT HOSPITAL INSURANCE TRUST FUND) Program and Financing (in millions of dollars) Identification code 20–8005–0–7–571 25.3 41.0 41.0 42.0 Purchases of goods and services from Government accounts .................................................................... Grants, subsidies, and contributions: Payment for health insurance experiments and demonstration projects ......................................... Payment for peer review organization (PRO) activities ........................................................................ Insurance claims and indemnities ................................ 1996 actual 1997 est. 1998 est. Identification code 75–8393–0–7–571 673 603 618 38 31 31 521 128,003 80 136,021 63 147,171 1996 actual 1997 est. 1998 est. 00.01 00.02 00.03 Obligations by program activity: Medicare integrity program ........................................... ................... FBI fraud and abuse control ......................................... ................... Other fraud and abuse control ...................................... ................... 440 47 104 500 56 120 10.00 Total obligations ........................................................ ................... 591 676 HEALTH CARE FINANCING ADMINISTRATION—Continued Trust Funds—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ ................... New obligations ............................................................. ................... 591 –591 676 –676 60.26 New budget authority (gross), detail: Appropriation (trust fund, definite) ............................... ................... 591 676 73.10 73.20 Change in unpaid obligations: New obligations ............................................................. ................... Total outlays (gross) ...................................................... ................... 591 –591 676 –676 86.97 Outlays (gross), detail: Outlays from new permanent authority ......................... ................... 591 676 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ ................... Outlays ........................................................................... ................... 591 591 676 676 Object Classification (in millions of dollars) Identification code 75–8393–0–7–571 1996 actual This schedule reflects estimated distribution of the Allocation Account. Actual FY 1998 distribution will be determined by the Secretary of HHS and the Attorney General. 1996 actual The Health Care Fraud and Abuse Control (HCFAC) Account was established by Sec. 201 of Public Law 104–191, the Health Insurance Portability and Accountability Act of 1996. P.L. 104–191 established the HCFAC Account within the Federal Hospital Insurance Trust Fund and appropriated funds, to be available without further appropriation, from the Trust Fund to the HCFAC Account for specified health care fraud and abuse control activities of the Department of Health and Human Services (HHS), the Department of Justice, and other agencies. 1997 est. Department of Justice (DOJ) ....................................................... Office of the Inspector General, HHS .......................................... Health Care Financing Administration ........................................ Office of General Counsel, HHS .................................................. Administration on Aging ............................................................. Other HHS .................................................................................... Other non-HHS/DOJ ...................................................................... 99.0 11.1 11.1 11.1 11.9 12.1 12.1 21.0 21.0 21.0 23.1 23.1 23.3 Subtotal, direct obligations .................................. Allocation Account: Personnel compensation: Full-time permanent: Full-time permanent (OIG) ............................... Full-time permanent (DoJ) ............................... Full-time permanent (OGC) .............................. Total personnel compensation ......................... Civilian personnel benefits: Civilian personnel benefits (OIG) ......................... Civilian personnel benefits (DoJ) .......................... Travel and transportation of persons: Travel and transportation of persons (OIG) ......... Travel and transportation of persons (DoJ) ......... Travel and transportation of persons (OGC) ........ Rental payments to GSA: Rental payments to GSA (OIG) ............................. Rental payments to GSA (DoJ) ............................. Communications, utilities, and miscellaneous charges: Communications, utilities, and miscellaneous charges (OIG) ................................................... Communications, utilities, and miscellaneous charges (DoJ) .................................................... Advisory and assistance services: Advisory and assistance services (OIG) ............... Advisory and assistance services (HCFA) ............ Other services: Other services (OIG) .............................................. Other services (DoJ) .............................................. Other services (AoA) ............................................. Other services (Adverse Action Data Bank) ......... Other services (Other non-HHS, non-DoJ) ............ Purchases of goods and services from Government accounts (OIG) ...................................................... Supplies and materials: Supplies and materials (OIG) ............................... Supplies and materials (DoJ) ............................... Equipment: Equipment (OIG) ................................................... Equipment (DoJ) .................................................... ................... 1997 est. 1998 est. .................... .................... .................... .................... .................... .................... .................... 24 70 2 2 1 2 3 28 81 2 2 1 2 4 Total .................................................................................... .................... 104 120 FEDERAL SUPPLEMENTARY MEDICAL INSURANCE TRUST FUND Unavailable Collections (in millions of dollars) Identification code 20–8004–0–7–571 1996 actual 1997 est. 1998 est. Balance, start of year: Balance, start of year .................................................... 8,848 21,963 25,369 Receipts: 02.01 Federal contributions ..................................................... 61,702 59,354 63,416 02.02 Interest received by trust fund ...................................... 1,388 1,440 1,424 02.03 Other proprietary receipts from the public ................... 4 ................... ................... 02.05 Premiums collected for the aged .................................. 16,858 16,779 18,060 02.06 Premiums collected for the disabled ............................ 2,073 2,249 2,538 02.07 Federal contributions, proposed legislation .................. ................... ................... 14,668 02.09 Premiums collected for the aged, proposed legislation ................... ................... –30 02.10 Premiums collected for the disabled, proposed legislation ............................................................................ ................... ................... –1 01.99 1998 est. 02.99 25.6 92.0 Direct obligations: Medical care (HCFA) .................................................. ................... Undistributed (FBI) .................................................... ................... 513 440 47 500 56 487 556 ................... ................... ................... 43 7 1 50 9 1 ................... 51 9 2 82,025 79,822 100,075 Total: Balances and collections .................................... 90,873 101,785 Appropriation: 05.01 Federal supplementary medical insurance trust fund –68,910 –76,416 05.03 Federal supplementary medical insurance trust fund, proposed legislation .................................................. ................... ................... 125,444 –84,010 05.99 07.99 –98,899 26,545 04.00 10 3 Subtotal appropriation ................................................... Total balance, end of year ............................................ –68,910 21,963 –76,416 25,369 –14,889 60 ................... ................... Total receipts ............................................................. Program and Financing (in millions of dollars) Identification code 20–8004–0–7–571 1996 actual 1997 est. 1998 est. 3 1 1 3 1 1 ................... ................... 4 1 5 1 ................... 1 1 1 ................... ................... 1 2 1 2 ................... ................... ................... ................... ................... 1 9 1 2 3 2 10 1 2 4 ................... 6 7 ................... ................... 1 1 1 1 ................... ................... 1 2 1 2 99.0 Subtotal, allocation account ................................. ................... 104 120 99.9 Total obligations ........................................................ ................... 591 676 67,107 1,759 27 17 74,923 1,476 4 13 82,456 1,537 3 14 10.00 Total obligations ........................................................ 68,910 76,416 84,010 Budgetary resources available for obligation: New budget authority (gross) ........................................ New obligations ............................................................. 68,910 –68,910 76,416 –76,416 84,010 –84,010 1,770 1,484 1,546 80,255 –13,115 78,338 –3,406 83,892 –1,428 1 ................... Obligations by program activity: Benefit payments, SMI ................................................... Administration, SMI ....................................................... Peer review organizations, SMI ...................................... Research, SMI ................................................................ 22.00 23.95 ................... ................... ................... 00.01 00.02 00.03 00.04 23.3 25.1 25.1 25.2 25.2 25.2 25.2 25.2 25.3 26.0 26.0 31.0 31.0 New budget authority (gross), detail: Current: 40.26 Appropriation (trust fund, definite) .......................... Permanent: 60.27 Appropriation (trust fund, indefinite) ....................... 60.28 Appropriation (unavailable balances) ....................... 63.00 Appropriation (total) ............................................. 67,139 74,931 82,463 70.00 Total new budget authority (gross) .......................... 68,910 76,416 84,010 Change in unpaid obligations: Unpaid obligations, start of year: Obligated balance: U.S. Securities: Par value ......................................... 73.10 New obligations ............................................................. 73.20 Total outlays (gross) ...................................................... 74.41 Unpaid obligations, end of year: Obligated balance: U.S. Securities: Par value ......................................... 5,027 68,910 –68,946 4,991 76,416 –76,487 4,919 84,010 –84,015 4,991 4,919 4,914 1,647 123 62,272 1,361 189 70,135 1,420 124 77,676 72.41 86.90 86.93 86.97 Outlays (gross), detail: Outlays from new current authority .............................. Outlays from current balances ...................................... Outlays from new permanent authority ......................... 514 HEALTH CARE FINANCING ADMINISTRATION—Continued Trust Funds—Continued THE BUDGET FOR FISCAL YEAR 1998 Object Classification (in millions of dollars) FEDERAL SUPPLEMENTARY MEDICAL INSURANCE TRUST FUND— Continued Identification code 20–8004–0–7–571 Program and Financing (in millions of dollars)—Continued 1996 actual Identification code 20–8004–0–7–571 1997 est. 25.3 1998 est. 86.98 Outlays from permanent balances ................................ 4,904 4,802 4,795 87.00 Total outlays (gross) ................................................. 68,946 76,487 84,015 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 68,910 68,946 76,416 76,487 84,010 84,015 Summary of Budget Authority and Outlays (in millions of dollars) Enacted/requested: 1996 actual 1997 est. Budget Authority ..................................................................... 68,909 76,415 Outlays .................................................................................... 68,946 76,487 Legislative proposal, subject to PAYGO: Budget Authority ..................................................................... .................... .................... Outlays .................................................................................... .................... .................... Total: Budget Authority ..................................................................... Outlays .................................................................................... 68,909 68,946 76,415 76,487 1998 est. 84,009 84,015 14,889 14,889 98,898 98,904 The Supplementary Medical Insurance (SMI) program is a voluntary program which affords protection against the costs of physician and certain other medical services. The program also covers treatment of end-stage renal disease for eligible enrollees. SMI costs are financed by premium payments from enrollees and contributions from the general revenues. The status of the trust fund is as follows: 41.0 41.0 42.0 93.0 99.9 Purchases of goods and services from Government accounts .................................................................... Grants, subsidies, and contributions: Payment for peer review organization (PRO) activity Payment for health insurance experiments and demonstration projects ......................................... Insurance claims and indemnities ................................ Administrative expenses: Portion of limitation on salaries and expenses: Social Security Administration Total obligations ........................................................ 1996 actual 1997 est. 1998 est. 1,405 1,110 1,133 27 4 3 17 67,107 13 74,923 14 82,456 354 365 404 68,910 76,416 84,010 The estimate of administrative expenses borne by each of the financing sources, including the Hospital Insurance (HI) and Supplemental Medical Insurance (SMI) trust funds for Medicare-related activities performed by the Social Security Administration (SSA), has been made by SSA based on the current cost allocation methodology. Pursuant to section 201(g) of the Social Security Act, a final accounting of actual payments is made after the close of each fiscal year. In the Conference Committee Report for Public Law 103–296, The Social Security Independence and Program Improvements Act of 1994, the conferees requested that the Secretary of Health and Human Services and the Commissioner of Social Security make a joint examination of the most appropriate cost allocation methodology and report their joint findings to the Congress within 36 months of enactment. The Secretary and the Commissioner are in the process of designing and carrying out this study and preparing the required report to Congress. FEDERAL SUPPLEMENTARY MEDICAL INSURANCE TRUST FUND (Legislative proposal, subject to PAYGO) Status of Funds (in millions of dollars) Program and Financing (in millions of dollars) Identification code 20–8004–0–7–571 0100 0101 Unexpended balance, start of year: Treasury balance ............................................................ U.S. Securities: Par value .............................................. 0199 Total balance, start of year ...................................... Cash income during the year: Proprietary receipts: 0221 Premiums collected for the aged, FSMI Fund .......... 0222 Premiums collected for the aged, FSMI Fund, proposed legislation ................................................... Proprietary receipts: 0223 Premiums collected for the disabled, FSMI Fund 0223 Premiums collected for the disabled, FSMI Fund, proposed legislation ......................................... 0224 Proprietary receipts ................................................... Intragovernmental transactions: 0240 Federal contributions, FSMI Fund ............................. 0241 Federal contributions, FSMI Fund, proposed legislation ........................................................................ 0242 Interest received by trust fund, FSMI Fund .............. 0297 Income under present law ............................................. 0298 Income under proposed legislation ............................... 1996 actual 1997 est. 1998 est. Identification code 20–8004–4–7–571 361 13,513 –222 27,175 1 30,287 13,874 26,953 30,288 16,858 16,779 18,060 ................... ................... 2,073 2,249 –30 61,702 59,354 14,668 1,424 85,438 14,637 Total cash income ..................................................... 82,025 79,822 Cash outgo during year: Cash outgo during the year (–): 0501 Benefit payments & ESRD ........................................ –67,167 –74,924 0501 Benefit payments, proposed legislation .................... ................... ................... 0502 Administration ................................................................ –1,747 –1,526 0504 Peer review organizations .............................................. –10 –14 0505 Research ........................................................................ –23 –24 0597 Outgo under present law (–) ......................................... –68,946 –76,487 0598 Outgo under proposed legislation (–) ........................... ................... ................... 14,889 10.00 Total obligations (object class 42.0) ........................ ................... ................... 14,889 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ ................... ................... New obligations ............................................................. ................... ................... 14,889 –14,889 New budget authority (gross), detail: Appropriation (trust fund, indefinite) ............................ ................... ................... ................... ................... 14,889 14,889 73.10 73.20 Change in unpaid obligations: New obligations ............................................................. ................... ................... Total outlays (gross) ...................................................... ................... ................... 14,889 –14,889 86.97 Outlays (gross), detail: Outlays from new permanent authority ......................... ................... ................... 14,889 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ ................... ................... Outlays ........................................................................... ................... ................... 14,889 14,889 60.27 100,075 –82,457 –14,889 –1,527 –14 –17 –84,015 –14,889 0599 0299 Total cash outgo (–) ...................................................... Unexpended balance, end of year: 0700 Treasury balance ............................................................ 0701 U.S. Securities: Par value .............................................. 0799 Total balance, end of year ........................................ 1998 est. Obligations by program activity: Benefit payments, SMI ................................................... ................... ................... 63,416 ................... ................... 1,388 1,440 82,025 79,822 ................... ................... 1997 est. 00.01 2,538 ................... ................... –1 4 ................... ................... 1996 actual This schedule reflects the effects of the Medicare reform proposals contained in the Administration’s balanced budget proposal on the Supplementary Medical Insurance Trust Fund. –68,946 –76,487 –98,904 –222 27,175 1 30,287 1 31,458 ALLOCATIONS RECEIVED FROM OTHER ACCOUNTS 26,953 30,288 31,459 Note.—Obligations incurred under allocations from other accounts are included in the schedules of the parent appropriation as follows: Health Care Financing Administration: ‘‘Health Care Fraud and Abuse Control Account.’’ ADMINISTRATION FOR CHILDREN AND FAMILIES Federal Funds DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATION FOR CHILDREN AND FAMILIES 60.00 Change in unpaid obligations: Unpaid obligations, start of year: Obligated balance: Fund balance ............................................................. 73.10 New obligations ............................................................. 73.20 Total outlays (gross) ...................................................... 74.90 Unpaid obligations, end of year: Obligated balance: Fund balance ............................................................. Federal Funds FOR NEEDY FAMILIES Program and Financing (in millions of dollars) 1996 actual Identification code 75–1552–0–1–609 Obligations by program activity: 00.01 State family assistance grant ....................................... 00.02 Territories—family assistance grants ........................... 00.03 Matching grants to territories ....................................... 00.05 Supplemental grants for population increases ............. 00.07 Tribal work programs ..................................................... 00.91 01.01 01.02 1997 est. 1998 est. 86.97 86.98 111 13,535 ................... 78 ................... 11 ................... ................... ................... 8 16,489 78 11 87 8 Subtotal ..................................................................... 111 13,632 Loan program: Loan fund disbursements ......................................... ................... 26 Loan fund repayments .............................................. ................... ................... 80 ................... ................... ................... 45 ................... –23 22 80 –96 ................... 22 6 Outlays (gross), detail: Outlays from new permanent authority ......................... ................... 23 Outlays from permanent balances ................................ ................... ................... 74 22 16,673 01.91 Total loan program .................................................... ................... 10.00 Total obligations (object class 41.0) ........................ 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ New obligations ............................................................. 60.05 45 72.90 General and special funds: TEMPORARY ASSISTANCE New budget authority (gross), detail: Appropriation .................................................................. ................... 515 121 –38 83 111 13,658 16,756 111 –111 New budget authority (gross), detail: Appropriation (indefinite) ............................................... 26 13,658 –13,658 Total outlays (gross) ................................................. ................... 23 96 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ ................... Outlays ........................................................................... ................... 45 23 80 96 The Contingency Fund for State Welfare Programs supplements the Temporary Assistance for Needy Families block grant by providing matching amounts to States that reach certain unemployment or Food Stamp caseload thresholds and maintain 100 percent of historical State spending on blockgranted programs. 16,756 –16,756 111 Change in unpaid obligations: Unpaid obligations, start of year: Obligated balance: Appropriation ............................................................. ................... 73.10 New obligations ............................................................. 111 73.20 Total outlays (gross) ...................................................... ................... 73.40 Adjustments in expired accounts .................................. ................... 74.40 Unpaid obligations, end of year: Obligated balance: Appropriation ............................................................. 111 13,658 16,756 72.40 111 1,369 13,658 16,756 –12,365 –16,586 –35 ................... 1,369 1,539 86.97 86.98 Outlays (gross), detail: Outlays from new permanent authority ......................... ................... Outlays from permanent balances ................................ ................... 12,295 70 15,422 1,164 87.00 Total outlays (gross) ................................................. ................... 12,365 16,586 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ 111 Outlays ........................................................................... ................... 13,658 12,365 16,756 16,586 This account provides funding for activities established by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (P.L. 104–193). The Temporary Assistance for Needy Families block grant provides funding to States for aid to poor families with children. This account also includes Federal loans for State welfare programs, established by section 406 of the Social Security Act as amended. Administrative expenses for this activity are estimated to be $300,000 in fiscal year 1998 and are funded through ACF Federal administration in the Children and Families Services Programs account. CONTINGENCY FUND Program and Financing (in millions of dollars) Identification code 75–1522–0–1–609 87.00 1996 actual 1997 est. 1998 est. 10.00 Obligations by program activity: Total obligations (object class 41.0) ............................ ................... 45 80 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ ................... New obligations ............................................................. ................... 45 –45 80 –80 FAMILY SUPPORT PAYMENTS TO STATES øFor making payments of such sums as necessary to each State for carrying out the program of Aid to Families with Dependent Children under title IV–A of the Social Security Act in fiscal year 1997 before the effective date of the program of Temporary Assistance to Needy Families (TANF) with respect to such State: Provided, That the sum of the amounts available to a State with respect to expenditures under such title IV–A in fiscal year 1997 under this appropriation and under such title IV–A as amended by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 shall not exceed the limitations under section 116(b) of such Act.¿ øFor making payments to States for carrying out title IV–A (other than section 402(g)(6)) of the Social Security Act in calendar quarters prior to October 1, 1996, such sums as may be necessary.¿ øFor making payments to States or other non-Federal entities under titles I, IV–D, X, XI, XIV, and XVI of the Social Security Act and the Act of July 5, 1960 (24 U.S.C. ch. 9), $2,158,000,000 to remain available until expended.¿ øFor making, after May 31 of the current fiscal year, payments to States or other non-Federal entities under titles I, IV–D, X, XI, XIV, and XVI of the Social Security Act, for the last three months of the current year for unanticipated costs, incurred for the current fiscal year, such sums as may be necessary.¿ øFor making payments to States or other non-Federal entities under titles I, IV–D, X, XI, XIV, and XVI of the Social Security Act and the Act of July 5, 1960 (24 U.S.C. ch. 9) for the first quarter of fiscal year 1998, $607,000,000 to remain available until expended.¿ (Department of Health and Human Services Appropriations Act, 1997.) Program and Financing (in millions of dollars) Identification code 75–1501–0–1–609 1996 actual 1997 est. 1998 est. Obligations by program activity: Aid to families with dependent children (AFDC) payments: Benefit payments: 00.01 Properly issued payments ..................................... 10,420 2,054 28 00.02 Erroneously issued payments ............................... 665 ................... ................... 00.03 Collection of excess State errors .......................... ................... ................... –15 00.91 01.02 01.03 01.04 01.05 01.06 01.07 01.08 01.91 Subtotal, benefit payments ....................................... 11,085 2,054 13 Payments to territories .................................................. 27 27 27 Emergency assistance ................................................... 1,546 743 233 Repatriation ................................................................... ................... 1 1 AFDC day care ............................................................... 761 26 13 Transitional day care ..................................................... 303 11 5 At-risk day care ............................................................. 291 ................... ................... State welfare administrative costs ............................... 1,531 235 8 Subtotal, other payments .......................................... 4,459 1,043 287 516 ADMINISTRATION FOR CHILDREN AND FAMILIES—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 1998 Federal incentive payments to States ........................................ 406 State child support administrative costs ................................... 1,984 Access and visitation grants ...................................................... .................... General and special funds—Continued FAMILY SUPPORT PAYMENTS TO STATES—Continued Program and Financing (in millions of dollars)—Continued 1996 actual Identification code 75–1501–0–1–609 02.00 02.01 02.02 02.03 02.04 1997 est. Subtotal .............................................................................. 02.91 Subtotal, CSE ........................................................ 1,127 2,782 2,833 10.00 Total obligations (object class 41.0) ........................ 16,671 5,879 3,133 21.40 23.90 23.95 24.40 Total budgetary resources available for obligation New obligations ............................................................. Unobligated balance available, end of year: Uninvested balance ................................................... 105 1,343 3,089 18,014 7,625 1,044 –105 ................... ................... 18,014 –16,671 8,968 –5,879 4,133 –3,133 1,343 3,089 LOW INCOME HOME ENERGY ASSISTANCE For making payments under title XXVI of the Omnibus Budget Reconciliation Act of 1981, ø$1,000,000,000.¿ $300,000,000: Provided, That these funds are hereby designated by Congress to be emergency requirements pursuant to section 251(b)(2)(D) of the Balanced Budget and Emergency Deficit Control Act of 1985: Provided further, That these funds shall be made available only after submission to Congress of a formal budget request by the President that includes designation of the entire amount of the request as an emergency requirement as defined in the Balanced Budget and Emergency Deficit Control Act. For making payments under title XXVI of øthe Omnibus Budget Reconciliation¿ such Act øof 1981¿, $1,000,000,000, to be available for obligation in the period October 1, ø1997¿ 1998 through September 30, ø1998¿ 1999. (Department of Health and Human Services Appropriations Act, 1997.) Program and Financing (in millions of dollars) 1996 actual Identification code 75–1502–0–1–609 Total new budget authority (gross) .......................... Change in unpaid obligations: Unpaid obligations, start of year: Obligated balance: Appropriation ............................................................. 73.10 New obligations ............................................................. 73.20 Total outlays (gross) ...................................................... 74.40 Unpaid obligations, end of year: Obligated balance: Appropriation ............................................................. 1,364 1,000 New budget authority (gross), detail: Current: 40.00 Appropriation ............................................................. 13,614 Permanent: 65.00 Advance appropriation (definite) .............................. 4,400 68.00 Spending authority from offsetting collections: Offsetting collections (cash) ..................................... ................... 70.00 1,276 1,126 437 2,386 10 1998 est. Subtotal, AFDC .......................................................... 15,544 3,097 300 Child support enforcement (CSE): Gross Federal share of collections ............................ –1,263 ................... ................... Federal incentive payments to States ...................... 406 437 437 State child support administrative costs ................. 1,984 2,335 2,386 Access and Visitation Grants .................................... ................... 10 10 Budgetary resources available for obligation: Unobligated balance available, start of year: Uninvested balance ................................................... 22.00 New budget authority (gross) ........................................ 22.30 Unobligated balance expiring ........................................ 437 2,335 10 18,014 2,158 ................... 4,800 437 7,625 1,044 72.40 1,690 16,671 –16,670 1,691 5,879 –7,093 475 3,133 –3,461 1,691 475 1998 est. 10.00 Obligations by program activity: Total obligations (object class 41.0) ............................ 1,080 1,005 1,000 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ New obligations ............................................................. 1,080 –1,080 1,005 –1,005 1,000 –1,000 New budget authority (gross), detail: Current: 40.00 Appropriation ............................................................. 180 40.79 Contingent appropriation not available .................... ................... 1,415 –415 300 –300 43.00 1,000 ................... 607 667 1997 est. 147 65.00 87.00 Total outlays (gross) ................................................. 16,670 Offsets: Against gross budget authority and outlays: 88.40 Offsetting collections (cash) from: Non-Federal sources .................................................................. ................... 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 18,014 16,670 7,093 3,461 –667 –437 6,958 6,426 607 3,024 States have transitioned to the new Temporary Assistance for Needy Families program more quickly than anticipated. As a result, unobligated balances remain in this account which are sufficient to cover expected State needs for child support enforcement activities through the first quarter of fiscal year 1999. It is anticipated that this account will return to its traditional appropriations cycle after then. P.L. 104–193 modified the treatment of child support collections, making it a combination of offsetting collections and receipts rather than a reduction in obligations to States. The text table below shows the traditional display of child support enforcement costs: Net Costs of Child Support Enforcement (In millions of dollars) 1996 Gross Federal share of collections .............................................. –1,263 1997 –1,506 1998 –1,469 900 5 1,000 70.00 Outlays (gross), detail: 86.90 Outlays from new current authority .............................. 10,592 1,158 ................... 86.93 Outlays from current balances ...................................... 1,678 2,754 519 86.97 Outlays from new permanent authority ......................... 4,400 3,181 1,044 86.98 Outlays from permanent balances ................................ ................... ................... 1,898 Appropriation (total) ............................................. Permanent: Advance appropriation (definite) .............................. Total new budget authority (gross) .......................... 1,080 1,005 1,000 Change in unpaid obligations: Unpaid obligations, start of year: Obligated balance: Appropriation ............................................................. 73.10 New obligations ............................................................. 73.20 Total outlays (gross) ...................................................... 73.40 Adjustments in expired accounts .................................. 74.40 Unpaid obligations, end of year: Obligated balance: Appropriation ............................................................. 180 72.40 86.90 86.93 86.97 86.98 346 358 267 1,080 1,005 1,000 –1,067 –1,097 –996 –1 ................... ................... 358 267 271 Outlays (gross), detail: Outlays from new current authority .............................. 135 750 ................... Outlays from current balances ...................................... ................... ................... 230 Outlays from new permanent authority ......................... 627 5 750 Outlays from permanent balances ................................ 305 342 16 87.00 Total outlays (gross) ................................................. 1,067 1,097 996 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 1,080 1,067 1,005 1,097 1,000 996 This program makes grants to States and Indian tribes to aid low-income households with high energy costs through payments to eligible households, energy suppliers, and weatherization providers. REFUGEE AND ENTRANT ASSISTANCE For making payments for refugee and entrant assistance activities authorized by title IV of the Immigration and Nationality Act and section 501 of the Refugee Education Assistance Act of 1980 (Public Law 96–422), ø$412,076,000¿ $392,332,000: Provided, That funds appropriated pursuant to section 414(a) of the Immigration and Nationality Act under Public Law ø103–333¿ 104–134 for fiscal year ø1995¿ ADMINISTRATION FOR CHILDREN AND FAMILIES—Continued Federal Funds—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES 1996 shall be available for the costs of assistance provided and other activities conducted in øsuch year and in¿ fiscal years ø1996 and 1997¿ 1997 and 1998. (Department of Health and Human Services Appropriations Act, 1997.) 517 Program and Financing (in millions of dollars) 1996 actual Identification code 75–1512–0–1–506 1997 est. 1998 est. øFor necessary expenses for the targeted assistance program authorized by title IV of the Immigration and Nationality Act and section 501 of the Refugee Education Assistance Act of 1980 and administered by the Office of Refugee Resettlement of the Department of Health and Human Services, in addition to amounts otherwise available for such purposes, $5,000,000¿. (Foreign Operations, Export Financing, and Related Appropriations Act, 1997.) 00.01 00.02 00.03 Obligations by program activity: Grants to States and Tribes .......................................... Training and technical assistance ................................ State court assessment activities ................................. 209 6 10 224 6 10 239 6 10 10.00 Total obligations ........................................................ 225 240 255 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ New obligations ............................................................. 225 –225 240 –240 255 –255 40.00 øREFUGEE RESETTLEMENT ASSISTANCE¿ New budget authority (gross), detail: Appropriation .................................................................. 225 240 255 171 225 –126 270 240 –186 324 255 –227 270 324 352 Program and Financing (in millions of dollars) 1996 actual Identification code 75–1503–0–1–609 1997 est. 1998 est. 408 Budgetary resources available for obligation: Unobligated balance available, start of year: Uninvested balance ................................................... 22.00 New budget authority (gross) ........................................ 22.30 Unobligated balance expiring ........................................ 2 2 2 413 427 396 –5 ................... ................... 427 396 21.40 23.90 23.95 24.40 Total budgetary resources available for obligation New obligations ............................................................. Unobligated balance available, end of year: Uninvested balance ................................................... 429 –427 398 –396 2 2 86.90 86.93 Outlays (gross), detail: Outlays from new current authority .............................. Outlays from current balances ...................................... 18 108 19 167 20 207 87.00 410 –408 Total outlays (gross) ................................................. 126 186 227 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 225 126 240 186 255 227 2 New budget authority (gross), detail: 40.00 Appropriation .................................................................. 41.00 Transferred to other accounts ....................................... 407 417 392 –4 ................... ................... 43.00 50.00 Appropriation (total) .................................................. Reappropriation .............................................................. 403 10 417 10 392 4 70.00 Total new budget authority (gross) .......................... 413 427 396 Change in unpaid obligations: Unpaid obligations, start of year: Obligated balance: Appropriation ............................................................. 73.10 New obligations ............................................................. 73.20 Total outlays (gross) ...................................................... 73.40 Adjustments in expired accounts .................................. 74.40 Unpaid obligations, end of year: Obligated balance: Appropriation ............................................................. Change in unpaid obligations: Unpaid obligations, start of year: Obligated balance: Appropriation ............................................................. 73.10 New obligations ............................................................. 73.20 Total outlays (gross) ...................................................... 74.40 Unpaid obligations, end of year: Obligated balance: Appropriation ............................................................. 72.40 Obligations by program activity: 10.00 Total obligations ............................................................ Object Classification (in millions of dollars) 1996 actual Identification code 75–1512–0–1–506 1998 est. Advisory and assistance services .................................. Grants, subsidies, and contributions ............................ 6 219 6 234 6 249 99.9 72.40 Total obligations ........................................................ 225 240 255 297 337 335 408 427 396 –361 –429 –405 –7 ................... ................... 337 335 326 86.90 86.93 Outlays (gross), detail: Outlays from new current authority .............................. Outlays from current balances ...................................... 171 190 205 224 190 215 87.00 Total outlays (gross) ................................................. 361 429 øJOB OPPORTUNITIES AND BASIC SKILLS¿ øFor carrying out aid to families with dependent children work programs, as authorized by part F of title IV of the Social Security Act, $1,000,000,000.¿ (Department of Health and Human Services Appropriations Act, 1997.) 405 Program and Financing (in millions of dollars) Identification code 75–1509–0–1–504 Net budget authority and outlays: 89.00 Budget authority ............................................................ 90.00 Outlays ........................................................................... 1997 est. 25.1 41.0 413 361 427 427 1996 actual 1997 est. 1998 est. 396 404 10.00 Obligations by program activity: Total obligations (object class 41.0) ............................ 879 169 ................... States are subsidized for administering the refugee assistance program. 22.00 22.30 Budgetary resources available for obligation: New budget authority (gross) ........................................ Unobligated balance expiring ........................................ 1,000 –121 1,000 ................... –831 ................... 23.90 23.95 Total budgetary resources available for obligation New obligations ............................................................. 879 –879 169 ................... –169 ................... 40.00 New budget authority (gross), detail: Appropriation .................................................................. 1,000 1,000 ................... Object Classification (in millions of dollars) 1996 actual Identification code 75–1503–0–1–609 25.1 25.3 25.6 41.0 Advisory and assistance services .................................. Purchases of goods and services from Government accounts .................................................................... Medical care .................................................................. Grants, subsidies, and contributions ............................ 99.9 Total obligations ........................................................ FAMILY PRESERVATION AND 2 1997 est. 1998 est. 2 2 4 ................... ................... 3 ................... ................... 399 425 394 408 427 396 Change in unpaid obligations: Unpaid obligations, start of year: Obligated balance: Appropriation ............................................................. 73.10 New obligations ............................................................. 73.20 Total outlays (gross) ...................................................... 73.40 Adjustments in expired accounts .................................. 74.40 Unpaid obligations, end of year: Obligated balance: Appropriation ............................................................. 72.40 314 254 99 879 169 ................... –931 –324 –89 –7 ................... ................... 254 99 10 SUPPORT For carrying out Section 430 of the Social Security Act, ø$240,000,000¿ $255,000,000. (Department of Health and Human Services Appropriations Act, 1997.) 86.90 86.93 Outlays (gross), detail: Outlays from new current authority .............................. Outlays from current balances ...................................... 695 236 133 ................... 191 89 518 ADMINISTRATION FOR CHILDREN AND FAMILIES—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 1998 86.98 General and special funds—Continued øJOB OPPORTUNITIES AND BASIC SKILLS¿—Continued 87.00 1996 actual Total outlays (gross) ................................................. 1997 est. 931 Net budget authority and outlays: 89.00 Budget authority ............................................................ 90.00 Outlays ........................................................................... 1998 est. 324 1,000 931 Total outlays (gross) ................................................. ................... 1,592 1,922 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ ................... Outlays ........................................................................... ................... 1,967 1,592 2,175 1,922 89 1,000 ................... 324 89 This account provides child care funding for welfare recipients and low-income working families established by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (P.L. 104–193). This activity is replaced by Temporary Assistance for Needy Families. CHILD CARE AND DEVELOPMENT BLOCK GRANT ø(INCLUDING STATE LEGALIZATION IMPACT-ASSISTANCE GRANTS Program and Financing (in millions of dollars) Identification code 75–1508–0–1–506 1996 actual 1997 est. 1998 est. Change in unpaid obligations: Unpaid obligations, start of year: Obligated balance: Appropriation ............................................................. ................... 2 ................... 73.20 Total outlays (gross) ...................................................... 2 –2 ................... 73.40 Adjustments in expired accounts .................................. 1 ................... ................... 74.40 Unpaid obligations, end of year: Obligated balance: Appropriation ............................................................. 2 ................... ................... 72.40 86.93 86.98 87.00 89.00 90.00 Outlays (gross), detail: Outlays from current balances ...................................... ................... 2 ................... Outlays from permanent balances ................................ –2 ................... ................... Total outlays (gross) ................................................. –2 256 87.00 Program and Financing (in millions of dollars)—Continued Identification code 75–1509–0–1–504 Outlays from permanent balances ................................ ................... ................... Program and Financing (in millions of dollars) 2 ................... Net budget authority and outlays: Budget authority ............................................................ ................... ................... ................... Outlays ........................................................................... –2 2 ................... TRANSFER OF FUNDS)¿ For carrying out sections 658A through 658R of the Omnibus Budget Reconciliation Act of 1981 (The Child Care and Development Block Grant Act of 1990), ø$956,120,000, of which $937,000,000 shall become available on October 1, 1997 and shall remain available through September 30, 1998¿ in addition to amounts already appropriated for fiscal year 1998, $63,000,000; and to become available on October 1, 1998 and remain available until September 30, 1999, $1,000,000,000: Provided, That of funds appropriated for each of fiscal years 1998 and 1999, $19,120,000 shall øbecome¿ be available øfor obligation on October 1, 1996¿ for child care resource and referral and school-aged child care activitiesø, of which $6,120,000 shall be derived from an amount that shall be transferred from the amount appropriated under section 452(j) of the Social Security Act (42 U.S.C. 652(j)) for fiscal year 1996 and remaining available for expenditure¿. (Department of Health and Human Services Appropriations Act, 1997.) Identification code 75–1515–0–1–609 1996 actual 1997 est. 1998 est. TO Total obligations ........................................................ 935 19 1,000 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ New obligations ............................................................. 935 –935 19 –19 1,000 –1,000 932 19 3 ................... 997 3 STATES Program and Financing (in millions of dollars) Identification code 75–1550–0–1–609 Obligations by program activity: Block grant payments to States .................................... Advisory and assistance services .................................. 10.00 CHILD CARE ENTITLEMENT 00.01 00.02 1996 actual 1997 est. 1998 est. Obligations by program activity: 00.01 Mandatory child care ..................................................... ................... 00.02 Matching child care ....................................................... ................... 00.03 Training and technical assistance ................................ ................... 1,238 717 5 1,240 896 5 10.00 1,960 2,141 Total obligations (object class 41.0) ........................ ................... New budget authority (gross), detail: Current: 40.00 Appropriation ............................................................. 935 42.00 Transferred from other accounts .............................. ................... 43.00 65.00 Budgetary resources available for obligation: 22.00 New budget authority (gross) ........................................ ................... 22.30 Unobligated balance expiring ........................................ ................... 70.00 13 63 6 ................... Appropriation (total) ............................................. 935 19 Permanent: Advance appropriation (definite) .............................. ................... ................... Total new budget authority (gross) .......................... 935 19 63 937 1,000 1,967 –7 2,175 –34 1,960 –1,960 2,141 –2,141 New budget authority (gross), detail: Current: 50.00 Reappropriation ......................................................... ................... ................... Permanent: 60.00 Appropriation ............................................................. ................... 1,967 108 2,067 70.00 1,967 2,175 86.90 86.93 86.97 ................... ................... ................... 1,960 ................... –1,592 ................... ................... 368 2,141 –1,922 –108 87.00 Total outlays (gross) ................................................. 933 959 998 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 935 933 19 959 1,000 998 23.90 23.95 Total budgetary resources available for obligation ................... New obligations ............................................................. ................... Total new budget authority (gross) .......................... ................... Change in unpaid obligations: Unpaid obligations, start of year: Obligated balance: Appropriation ............................................................. 73.10 New obligations ............................................................. 73.20 Total outlays (gross) ...................................................... 73.40 Adjustments in expired accounts .................................. 74.40 Unpaid obligations, end of year: Obligated balance: Appropriation ............................................................. Change in unpaid obligations: Unpaid obligations, start of year: Obligated balance: Appropriation ............................................................. 73.10 New obligations ............................................................. 73.20 Total outlays (gross) ...................................................... 73.40 Adjustments in expired accounts .................................. 74.40 Unpaid obligations, end of year: Obligated balance: Appropriation ............................................................. 72.40 1,415 1,413 473 935 19 1,000 –933 –959 –998 –4 ................... ................... 1,413 473 475 Outlays (gross), detail: Outlays from new current authority .............................. ................... 13 Outlays from current balances ...................................... 933 946 Outlays from new permanent authority ......................... ................... ................... 42 328 628 72.40 86.97 ................... 368 479 Outlays (gross), detail: Outlays from new permanent authority ......................... ................... 1,592 1,666 This appropriation helps low-income families pay for child care and related services. ADMINISTRATION FOR CHILDREN AND FAMILIES—Continued Federal Funds—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES Object Classification (in millions of dollars) 1996 actual Identification code 75–1515–0–1–609 25.1 41.0 99.5 Advisory and assistance services .................................. Grants, subsidies, and contributions ............................ Below reporting threshold .............................................. 99.9 Total obligations ........................................................ 1997 est. 1998 est. 2 ................... 3 932 19 997 1 ................... ................... 935 19 1,000 SOCIAL SERVICES BLOCK GRANT For making grants to States pursuant to section 2002 of the Social Security Act, ø$2,500,000,000: Provided, That notwithstanding section 2003(c) of such Act, as amended, the amount specified for allocation under such section for fiscal year 1997 shall be $2,500,000,000¿ $2,380,000,000. (Department of Health and Human Services Appropriations Act, 1997.) Program and Financing (in millions of dollars) 1996 actual Identification code 75–1534–0–1–506 00.01 00.02 Obligations by program activity: Block grant .................................................................... Empowerment zone ........................................................ 10.00 Total obligations (object class 41.0) ........................ Budgetary resources available for obligation: Unobligated balance available, start of year: Uninvested balance ................................................... 22.00 New budget authority (gross) ........................................ 1997 est. 1998 est. 2,381 2,500 2,380 360 ................... ................... 2,741 2,500 2,380 21.40 360 ................... ................... 2,381 2,500 2,380 23.90 23.95 Total budgetary resources available for obligation New obligations ............................................................. 2,741 –2,741 2,500 –2,500 2,380 –2,380 40.00 New budget authority (gross), detail: Appropriation .................................................................. 2,381 2,500 Act,¿ the Native American Programs Act of 1974, title II of Public Law 95–266 (adoption opportunities), the Abandoned Infants Assistance Act of 1988, and part B(1) of title IV of the Social Security Act; for making payments under the Community Services Block Grant Act; and for necessary administrative expenses to carry out said Acts and titles I, IV, X, XI, XIV, XVI, and XX of the Social Security Act, the Act of July 5, 1960 (24 U.S.C. ch. 9), the Omnibus Budget Reconciliation Act of 1981, title IV of the Immigration and Nationality Act, section 501 of the Refugee Education Assistance Act of 1980, and section 126 and titles IV and V of Public Law 100–485, ø$5,363,569,000¿, $5,498,900,000 of which ø$536,432,000¿ $414,720,000 shall be for making payments under the Community Services Block Grant Actø: Provided, That to the extent Community Services Block Grant funds are distributed as grant funds by a State to an eligible entity as provided under the Act, and have not been expended by such entity, they shall remain with such entity for carryover into the next fiscal year for expenditure by such entity consistent with program purposes: Provided further, That of the amount appropriated for fiscal year 1997 under section 672(a) of the Community Services Block Grant Act, the Secretary shall use up to one percent of the funds available to correct allocation errors that occurred in fiscal year 1995 and fiscal year 1996 to ensure that the minimum allotment to each State for each of fiscal years 1995 and 1996 would be $2,222,460: Provided further, That no more than one-half of one percent of the funds available under section 672(a) shall be used for the purposes of section 674(a) of the Community Services Block Grant Act¿. øIn addition, $20,000,000, to be derived from the Violent Crime Reduction Trust Fund, for carrying out sections 40155, 40211 and 40241 of Public Law 103–322.¿ øFunds appropriated for fiscal year 1996 and fiscal year 1997 under section 429A(e), part B of title IV of the Social Security Act shall be reduced by $6,000,000 in each such year.¿ øFunds appropriated for fiscal year 1997 under section 413(h)(1) of the Social Security Act shall be reduced by $15,000,000.¿ (Department of Health and Human Services Appropriations Act, 1997.) 2,380 Change in unpaid obligations: 72.40 Unpaid obligations, start of year: Obligated balance: Appropriation ............................................................. 73.10 New obligations ............................................................. 73.20 Total outlays (gross) ...................................................... 73.40 Adjustments in expired accounts .................................. 74.40 Unpaid obligations, end of year: Obligated balance: Appropriation ............................................................. 86.90 86.93 86.98 Program and Financing (in millions of dollars) Identification code 75–1536–0–1–506 962 1,217 1,023 2,741 2,500 2,380 –2,484 –2,694 –2,621 –2 ................... ................... 1,217 1,023 782 Outlays (gross), detail: Outlays from new current authority .............................. 2,203 Outlays from current balances ...................................... 281 Outlays from permanent balances ................................ ................... 2,250 261 183 2,142 249 230 87.00 Total outlays (gross) ................................................. 2,484 2,694 2,621 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 2,381 2,484 2,500 2,694 2,380 2,621 Social services block grant.—The proposed level will support grants to States for social services to: (1) prevent, reduce, or eliminate dependency; (2) prevent neglect, abuse, or exploitation of children and adults; (3) prevent or reduce inappropriate institutional care; (4) secure admission or referral for institutional care when other forms of care are not appropriate; and (5) provide services to individuals in institutions. 519 1996 actual 1997 est. 1998 est. Obligations by program activity: Head Start ...................................................................... 3,569 3,981 4,305 Social services programs: Children, youth, and families: 01.03 Runaway and homeless youth .............................. 44 44 44 01.04 Runaway youth transitional living ........................ 15 15 15 01.07 Child abuse state grants ..................................... 21 21 21 01.08 Child abuse discretionary grants ......................... 14 14 14 01.09 Community based resource centers ..................... 23 33 33 01.11 Abandoned infants assistance ............................. 12 12 12 01.13 Temporary child care and crisis nurseries ........... 10 ................... ................... 01.14 Child welfare services .......................................... 277 292 292 01.15 Child welfare training ........................................... 2 4 4 01.17 Adoption opportunities .......................................... 11 13 13 01.18 Adoption Initiative ................................................. ................... ................... 21 01.19 Family violence grants .......................................... 33 62 ................... 01.20 Social services and income maintenance research ............................................................... ................... 44 18 Developmental disabilities: 01.23 State grants .......................................................... 65 65 65 01.24 Protection and advocacy ....................................... 27 27 27 01.25 Special projects .................................................... 5 5 5 01.26 University affiliated projects ..................................... 17 17 17 01.27 Native american programs ........................................ 35 35 35 00.01 AND FAMILIES SERVICES PROGRAMS ø(INCLUDING RESCISSIONS)¿ For carrying out, except as otherwise provided, the Runaway and Homeless Youth Act, the Developmental Disabilities Assistance and Bill of Rights Act, the Head Start Act, the Child Abuse Prevention and Treatment Act, øthe Temporary Child Care for Children with Disabilities and Crisis Nurseries Act of 1986,¿ Adoption Initiative activities under title IV–E and IV–B of the Social Security Act, section 429A, part B of title IV of the Social Security Act, section 413 of the Social Security Act, øthe Family Violence Prevention and Services Subtotal social services programs ....................... ACF Federal administration ........................................... 611 150 703 143 636 143 02.93 CHILDREN 01.91 02.01 4,330 4,827 5,084 03.01 03.03 03.04 Total direct program ................................................. Community services programs: Community services block grants ............................. Community food and nutrition .................................. Community services discretionary ............................. 390 4 41 490 415 4 ................... 43 ................... 03.91 04.01 Subtotal, community services ................................... Reimbursable program .................................................. 435 7 537 11 415 11 10.00 Total obligations ........................................................ 4,772 5,375 5,510 21.40 Budgetary resources available for obligation: Unobligated balance available, start of year: Uninvested balance ................................................... 13 7 7 520 ADMINISTRATION FOR CHILDREN AND FAMILIES—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 1998 23.1 23.3 General and special funds—Continued CHILDREN AND FAMILIES SERVICES PROGRAMS—Continued ø(INCLUDING Program and Financing (in millions of dollars)—Continued 22.00 22.30 New budget authority (gross) ........................................ Unobligated balance expiring ........................................ 23.90 23.95 24.40 Total budgetary resources available for obligation New obligations ............................................................. Unobligated balance available, end of year: Uninvested balance ................................................... New budget authority (gross), detail: Current: 40.00 Appropriation ............................................................. Permanent: Spending authority from offsetting collections: 68.00 Offsetting collections (cash) ................................ 68.10 Change in orders on hand from Federal sources 68.90 70.00 1996 actual 1997 est. 99.0 99.0 Subtotal, direct obligations .................................. Reimbursable obligations .............................................. 4,766 6 5,364 11 5,499 11 99.9 Total obligations ........................................................ 4,772 5,375 5,510 1998 est. 4,768 5,375 5,510 –2 ................... ................... 4,779 –4,772 5,382 –5,375 5,517 –5,510 7 7 7 4,766 5,364 12 12 2 1 69 2 2 2 77 2 2 1 85 2 12 13 13 4 3 3 1 ................... ................... 2 1 1 4,543 5,139 5,268 Personnel Summary Identification code 75–1536–0–1–506 1 11 11 1 ................... ................... Spending authority from offsetting collections (total) ........................................................... 2 11 Total new budget authority (gross) .......................... 4,768 5,375 1001 1005 5,510 Total compensable workyears: Full-time equivalent employment .................................. Full-time equivalent of overtime and holiday hours 1996 actual 1997 est. 1,732 2 1,669 2 1998 est. 1,627 2 11 74.40 74.95 Total unpaid obligations, start of year ................ New obligations ............................................................. Total outlays (gross) ...................................................... Adjustments in expired accounts .................................. Unpaid obligations, end of year: Obligated balance: Appropriation ............................. Orders on hand from Federal sources ...................... 74.99 3,225 1 3,523 1 3,308 3,226 3,524 4,772 5,375 5,510 –4,752 –5,078 –5,403 –103 ................... ................... 3,225 1 3,523 1 Total unpaid obligations, end of year .................. 3,226 3,524 3,631 86.90 86.93 86.97 Outlays (gross), detail: Outlays from new current authority .............................. Outlays from current balances ...................................... Outlays from new permanent authority ......................... 2,073 2,678 1 2,335 2,732 11 2,392 3,000 11 87.00 Total outlays (gross) ................................................. 4,752 5,078 5,403 VIOLENT CRIME REDUCTION PROGRAMS For activities authorized by sections 30401, 40155, 40211, and 40241 of Public Law 103–322, $99,000,000, to remain available until expended, which shall be derived from the Violent Crime Reduction Trust Fund, of which $12,800,000 shall be for the Community Schools Youth Services and Supervision Grant Program; $70,000,000 for Family Violence (including grants for Battered Women’s Shelters); $15,000,000 for Education and Prevention Grants to Reduce Sexual Abuse of Runaway, Homeless, and Street Youth; and $1,200,000 for the National Domestic Violence Hotline. 3,630 1 Offsets: Against gross budget authority and outlays: 88.00 Offsetting collections (cash) from: Federal sources 88.95 Change in orders on hand from Federal sources ......... 89.00 90.00 13 5,499 Change in unpaid obligations: Unpaid obligations, start of year: 72.40 Obligated balance: Appropriation ............................. 3,308 72.95 Orders on hand from Federal sources ...................... ................... 72.99 73.10 73.20 73.40 25.7 26.0 31.0 41.0 24.0 25.1 25.2 25.3 RESCISSIONS)¿—Continued Identification code 75–1536–0–1–506 Rental payments to GSA ........................................... Communications, utilities, and miscellaneous charges ................................................................. Printing and reproduction ......................................... Advisory and assistance services ............................. Other services ............................................................ Purchases of goods and services from Government accounts ................................................................ Operation and maintenance of equipment ............... Supplies and materials ............................................. Equipment ................................................................. Grants, subsidies, and contributions ........................ Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... Program and Financing (in millions of dollars) Identification code 75–8605–0–1–754 1997 est. 1998 est. –1 –11 –11 –1 ................... ................... 4,766 4,750 5,364 5,067 5,499 5,392 Obligations by program activity: Family violence/battered women’s shelters and domestic violence hotline ............................................. 15 12 00.02 Education and prevention grants to reduce sexual abuse of runaway, homeless and street youth ........ 6 8 00.03 Community schools program ......................................... ................... ................... 15 13 10.00 Head Start.—The proposed level is consistent with the President’s goal to serve 1 million children by 2002, and will enable Head Start projects to continue comprehensive early childhood development services. Social Services.—The proposed level will continue to support State, local, and private efforts to provide developmental and other services for children and youth, grants to improve support networks for persons with developmental disabilities, and economic development assistance to Native American populations. Total obligations ........................................................ 21 20 99 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ New obligations ............................................................. 21 –21 20 –20 99 –99 42.00 New budget authority (gross), detail: Transferred from other accounts ................................... 21 20 99 11 21 –11 21 20 –17 24 99 –35 21 24 88 00.01 Change in unpaid obligations: Unpaid obligations, start of year: Obligated balance: Appropriation ............................................................. 73.10 New obligations ............................................................. 73.20 Total outlays (gross) ...................................................... 74.40 Unpaid obligations, end of year: Obligated balance: Appropriation ............................................................. 1996 actual 1997 est. 1998 est. 11.1 11.3 Direct obligations: Personnel compensation: Full-time permanent ............................................. Other than full-time permanent ........................... 96 1 93 1 93 1 11.9 12.1 21.0 Total personnel compensation ......................... Civilian personnel benefits ....................................... Travel and transportation of persons ....................... 97 17 3 94 16 3 94 17 1 71 72.40 86.90 86.93 Outlays (gross), detail: Outlays from new current authority .............................. Outlays from current balances ...................................... 4 7 4 13 20 15 87.00 Total outlays (gross) ................................................. 11 17 35 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 21 11 20 17 99 35 Object Classification (in millions of dollars) Identification code 75–1536–0–1–506 1996 actual Object Classification (in millions of dollars) Identification code 75–8605–0–1–754 25.1 41.0 1996 actual Advisory and assistance services .................................. ................... Grants, subsidies, and contributions ............................ 21 1997 est. 1 19 1998 est. 4 95 ADMINISTRATION ON AGING Federal Funds DEPARTMENT OF HEALTH AND HUMAN SERVICES 99.9 Total obligations ........................................................ CHILDREN’S RESEARCH AND 21 20 99 1996 actual 1997 est. 1998 est. Obligations by program activity: 00.01 Training and technical assistance ................................ ................... 19 00.02 Federal parent locator service ....................................... 24 25 00.03 Child welfare study ........................................................ ................... ................... 00.04 Welfare research ............................................................ ................... ................... 15 30 6 15 10.00 66 Total obligations (object class 41.0) ........................ 24 44 Budgetary resources available for obligation: 21.40 Unobligated balance available, start of year: Uninvested balance ................................................... ................... 12 ................... 22.00 New budget authority (gross) ........................................ 37 32 66 22.30 Unobligated balance expiring ........................................ –1 ................... ................... 23.90 23.95 24.40 Total budgetary resources available for obligation New obligations ............................................................. Unobligated balance available, end of year: Uninvested balance ................................................... 36 –24 44 –44 66 –66 12 ................... ................... New budget authority (gross), detail: Current: 41.00 Transferred to other accounts ................................... ................... Permanent: 60.00 Appropriation ............................................................. 37 –6 ................... 38 66 70.00 32 66 Total new budget authority (gross) .......................... 37 Change in unpaid obligations: Unpaid obligations, start of year: Obligated balance: Appropriation ............................................................. ................... 73.10 New obligations ............................................................. 24 73.20 Total outlays (gross) ...................................................... ................... 74.40 Unpaid obligations, end of year: Obligated balance: Appropriation ............................................................. 24 72.40 24 44 –41 27 66 –59 27 34 86.97 86.98 Outlays (gross), detail: Outlays from new permanent authority ......................... ................... Outlays from permanent balances ................................ ................... 29 12 35 24 87.00 Total outlays (gross) ................................................. ................... 41 59 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ 37 Outlays ........................................................................... ................... 32 41 66 59 This provides funding for research and technical assistance activities established in P.L. 104–193. Amounts for child welfare study and welfare research are in addition to research amounts in the Children and Families Services Program account. PAYMENTS TO STATES FOR FOSTER CARE AND ADOPTION ASSISTANCE For making payments to States or other non-Federal entities, under title IV–E of the Social Security Act, ø$4,445,031,000¿ $3,200,000,000 of which $200,000,000 shall be placed in reserve for use only in such amounts and in such times as may become necessary to make payments to States. For making payments to States or other non-Federal entities, under title IV–E of the Social Security Act, for the first quarter of fiscal year ø1998, $1,111,000,000¿ 1999, $1,157,500,000. (Department of Health and Human Services Appropriations Act, 1997.) Program and Financing (in millions of dollars) Identification code 75–1545–0–1–506 Obligations by program activity: 00.01 Foster care ..................................................................... 00.02 Independent living ......................................................... 00.03 Adoption assistance ....................................................... 1996 actual 3,148 70 486 1997 est. 3,319 70 568 Total obligations (object class 41.0) ........................ 3,704 3,957 4,111 Budgetary resources available for obligation: New budget authority (gross) ........................................ Unobligated balance expiring ........................................ 4,322 –618 4,445 –488 4,311 –200 23.90 23.95 Program and Financing (in millions of dollars) 10.00 22.00 22.30 TECHNICAL ASSISTANCE Identification code 75–1553–0–1–609 521 Total budgetary resources available for obligation New obligations ............................................................. 3,704 –3,704 3,957 –3,957 4,111 –4,111 New budget authority (gross), detail: Current: 40.00 Appropriation ............................................................. 4,322 4,445 Permanent: 65.00 Advance appropriation (definite) .............................. ................... ................... 3,200 70.00 4,311 Change in unpaid obligations: Unpaid obligations, start of year: Obligated balance: Appropriation ............................................................. 73.10 New obligations ............................................................. 73.20 Total outlays (gross) ...................................................... 73.40 Adjustments in expired accounts .................................. 74.40 Unpaid obligations, end of year: Obligated balance: Appropriation ............................................................. 4,322 4,445 1,111 72.40 86.90 86.93 86.97 919 870 1,038 3,704 3,957 4,111 –3,691 –3,789 –4,071 –62 ................... ................... 870 1,038 1,078 Outlays (gross), detail: Outlays from new current authority .............................. 2,993 3,117 Outlays from current balances ...................................... 698 672 Outlays from new permanent authority ......................... ................... ................... 2,408 796 867 87.00 Total outlays (gross) ................................................. 3,691 3,789 4,071 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 4,322 3,691 4,445 3,789 4,311 4,071 Foster care.—The proposed level will support eligible lowincome children who must be placed outside the home. An average of 300,000 children per month will be served in 1998. Adoption assistance.—The proposed funding level will support subsidies for families adopting eligible low-income children with special needs. An average of 153,000 children per month will be served in 1998. The budget includes funding for the adoption initiative that seeks to double by 2002 the number of children adopted or permanently placed from the foster care system each year. Incentive payments to States increasing adoptions would begin in 1999. Discretionary resources to support the initiative are included in the Children and Families Services Programs account. ADMINISTRATION ON AGING Federal Funds General and special funds: AGING SERVICES PROGRAMS For carrying out, to the extent not otherwise provided, the Older Americans Act of 1965, as amended, ø$830,168,000¿ $838,168,000: Provided, That notwithstanding section 308(b)(1) of such Act, the amounts available to each State for administration of the State plan under title III of such Act shall be reduced not more than 5 percent below the amount that was available to such State for such purpose for fiscal year 1995: Provided further, That in considering grant applications for nutrition services for elder Indian recipients, the Assistant Secretary shall provide maximum flexibility to applicants who seek to take into account subsistence, local customs and other characteristics that are appropriate to the unique cultural, regional and geographic needs of the American Indian, Alaskan and Hawaiian native communities to be served. (Department of Health and Human Services Appropriations Act, 1997.) 1998 est. 3,340 70 701 Total new budget authority (gross) .......................... Program and Financing (in millions of dollars) Identification code 75–0142–0–1–506 01.01 Obligations by program activity: Supportive services and centers ................................... 1996 actual 301 1997 est. 301 1998 est. 292 522 ADMINISTRATION ON AGING—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 1998 General and special funds—Continued DEPARTMENTAL MANAGEMENT AGING SERVICES PROGRAMS—Continued Federal Funds General and special funds: Program and Financing (in millions of dollars)—Continued 1996 actual Identification code 75–0142–0–1–506 01.02 01.03 01.05 01.06 01.07 01.08 01.09 01.10 01.13 01.15 1997 est. Preventive health ........................................................... 15 15 Grants for protection of vulnerable older Americans ................... ................... Congregate meals .......................................................... 365 365 Home-delivered meals ................................................... 105 105 In-home services ............................................................ 9 9 Grants to Indian tribes .................................................. 16 16 Research, training and discretionary projects .............. 3 4 Federal administration ................................................... 15 15 Alzheimer’s Initiative ..................................................... ................... ................... DOL transfer for senior community service employment program ..................................................................... ................... ................... 15 9 360 110 9 16 4 15 8 440 10.00 Total obligations ........................................................ 829 830 1,278 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ New obligations ............................................................. 829 –829 830 –830 1,278 –1,278 40.00 42.00 New budget authority (gross), detail: Appropriation .................................................................. 829 830 Transferred from other accounts ................................... ................... ................... 838 440 43.00 Appropriation (total) .................................................. 829 830 1,278 70.00 Total new budget authority (gross) .......................... 829 830 1,278 Change in unpaid obligations: Unpaid obligations, start of year: Obligated balance: Appropriation ............................................................. 73.10 New obligations ............................................................. 73.20 Total outlays (gross) ...................................................... 73.40 Adjustments in expired accounts .................................. 74.40 Unpaid obligations, end of year: Obligated balance: Appropriation ............................................................. GENERAL DEPARTMENTAL MANAGEMENT 1998 est. 72.40 215 223 201 829 830 1,278 –818 –851 –914 –3 ................... ................... 223 201 564 86.90 86.93 Outlays (gross), detail: Outlays from new current authority .............................. Outlays from current balances ...................................... 647 171 645 206 732 182 87.00 Total outlays (gross) ................................................. 818 851 914 For necessary expenses, not otherwise provided, for general departmental management, including hire of six sedans, and for carrying out titles III, XVII, and XX of the Public Health Service Act, and research studies under section 1110 of the Social Security Act, ø$174,523,000¿ $166,326,000, together with $5,851,000, to be transferred and expended as authorized by section 201(g)(1) of the Social Security Act from the Hospital Insurance Trust Fund and the Supplemental Medical Insurance Trust Fundø: Provided, That of the funds made available under this heading for carrying out title XVII of the Public Health Service Act, $11,500,000 shall be available until expended for extramural construction: Provided further, That notwithstanding section 2010 (b) and (c) under title XX of the Public Health Service Act, as amended, of the funds made available under this heading, $10,879,000 shall be for activities specified under section 2003(b)(2) of title XX of the Public Health Service Act, as amended, and of which $9,011,000 shall be for prevention grants under section 510(b)(2) of title V of the Social Security Act, as amended: Provided further, That of the amount provided, $5,775,000 is designated by Congress as an emergency requirement pursuant to section 251(b)(2)(D)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985, as amended¿. (Department of Health and Human Services Appropriations Act, 1997.) OFFICE OF OFFICE Net budget authority and outlays: 89.00 Budget authority ............................................................ 90.00 Outlays ........................................................................... 829 818 830 851 1,278 914 Administration on Aging.—The proposed level will continue to provide supportive and nutrition services, research, training and demonstration projects for the elderly. Object Classification (in millions of dollars) 1996 actual Identification code 75–0142–0–1–506 1997 est. 1998 est. 11.1 12.1 23.1 25.2 41.0 Personnel compensation: Full-time permanent ............. Civilian personnel benefits ............................................ Rental payments to GSA ................................................ Other services ................................................................ Grants, subsidies, and contributions ............................ 9 2 2 2 814 9 2 1 2 816 9 2 1 2 1,264 99.9 Total obligations ........................................................ 829 830 1,278 CONSUMER AFFAIRS For necessary expenses of the Office of Consumer Affairs, including services authorized by 5 U.S.C. 3109ø, but at rates for individuals not to exceed the per diem rate equivalent to the rate for GS-18, $1,500,000¿ $1,800,000: Provided, That the Office may accept and deposit to this account, during fiscal year 1998, gifts for the purpose of defraying its costs of printing, publishing, and distributing consumer information and educational materials; not to exceed $1,110,000 of total gift fund balances are available for those purposes, in addition to any amounts appropriated herein; and any balance shall remain available for such purposes to the extent provided in subsequent appropriations Acts: Provided further, That none of the funds provided under this heading may be made available for any other activities within the Department of Health and Human Services. (Omnibus Consolidated Appropriations Act, 1997.) FOR CIVIL RIGHTS For expenses necessary for the Office for Civil Rights, ø$16,216,000¿ $17,216,000, together with not to exceed $3,314,000, to be transferred and expended as authorized by section 201(g)(1) of the Social Security Act from the Hospital Insurance Trust Fund and the Supplemental Medical Insurance Trust Fund. (Department of Health and Human Services Appropriations Act, 1997.) øPOLICY RESEARCH¿ øFor carrying out, to the extent not otherwise provided, research studies under section 1110 of the Social Security Act and section 301(l) of Public Law 104–191, $18,500,000: Provided, That $9,500,000, to remain available until September 30, 1998, shall be for carrying out section 301(l) of Public Law 104–191¿. (Department of Health and Human Services Appropriations Act, 1997.) Program and Financing (in millions of dollars) Identification code 75–9912–0–1–551 1996 actual 1997 est. 1998 est. Identification code 75–0142–0–1–506 1001 1005 Total compensable workyears: Full-time equivalent employment .................................. Full-time equivalent of overtime and holiday hours 1996 actual 149 1 1997 est. 150 1 1998 est. 150 1 ALLOCATIONS RECEIVED FROM OTHER ACCOUNTS Note.—Obligations incurred under allocations from other accounts are included in the schedules of the parent appropriation as follows: Health Care Financing Administration: ‘‘Health Care Fraud and Abuse Control Account.’’ Obligations by program activity: Direct activities: 00.01 General Departmental Management ......................... 00.02 U.S.Office of Consumer Affairs ................................. 00.03 Office for Civil Rights ............................................... 00.04 Policy Research ......................................................... 00.05 Emergency Supplement ............................................. 139 180 172 2 2 2 20 19 21 9 19 ................... 25 ................... ................... 00.91 01.01 Personnel Summary Total direct activities ............................................ Reimbursable activities ................................................. 195 61 220 67 195 67 10.00 Total obligations ........................................................ 256 287 262 21.40 Budgetary resources available for obligation: Unobligated balance available, start of year: Uninvested balance ................................................... 16 26 26 PROGRAM SUPPORT CENTER DEPARTMENT OF HEALTH AND HUMAN SERVICES 523 22.00 New budget authority (gross) ........................................ 267 287 262 11.5 Other personnel compensation ............................. 1 1 1 23.90 23.95 24.40 Total budgetary resources available for obligation New obligations ............................................................. Unobligated balance available, end of year: Uninvested balance ................................................... 283 –256 313 –287 288 –262 26 26 26 11.9 12.1 21.0 23.1 23.3 80 12 2 13 86 16 1 13 87 17 1 12 25.5 25.6 25.7 26.0 31.0 41.0 Total personnel compensation ......................... Civilian personnel benefits ....................................... Travel and transportation of persons ....................... Rental payments to GSA ........................................... Communications, utilities, and miscellaneous charges ................................................................. Printing and reproduction ......................................... Advisory and assistance services ............................. Other services ............................................................ Purchases of goods and services from Government accounts ................................................................ Research and development contracts ....................... Medical care .............................................................. Operation and maintenance of equipment ............... Supplies and materials ............................................. Equipment ................................................................. Grants, subsidies, and contributions ........................ 99.0 99.0 Subtotal, direct obligations .................................. Reimbursable obligations .............................................. 195 61 220 67 195 67 99.9 Total obligations ........................................................ 256 287 262 New budget authority (gross), detail: Current: 40.00 Appropriation ............................................................. 42.00 Transferred from other accounts .............................. 188 210 185 2 ................... ................... 43.00 Appropriation (total) ............................................. Permanent: Spending authority from offsetting collections: Offsetting collections (cash) ..................................... 190 77 77 77 Total new budget authority (gross) .......................... 267 287 262 68.00 70.00 Change in unpaid obligations: Unpaid obligations, start of year: Obligated balance: Appropriation ............................................................. 73.10 New obligations ............................................................. 73.20 Total outlays (gross) ...................................................... 73.40 Adjustments in expired accounts .................................. 74.40 Unpaid obligations, end of year: Obligated balance: Appropriation ............................................................. 210 185 72.40 108 153 139 256 287 262 –223 –300 –270 12 ................... ................... 153 139 106 117 77 100 93 77 87.00 223 300 270 Offsets: Against gross budget authority and outlays: 88.00 Offsetting collections (cash) from: Federal sources –77 –77 190 145 210 223 185 193 Direct: Total compensable workyears: 1001 Full-time equivalent employment .............................. 1005 Full-time equivalent of overtime and holiday hours Reimbursable: 2001 Total compensable workyears: Full-time equivalent employment ............................................................... 1997 est. 1998 est. 1,326 8 1,352 8 1,331 8 118 83 83 –77 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 24 25 23 5 6 6 2 ................... ................... 5 5 ................... 4 1 2 3 2 3 31 41 30 1996 actual Identification code 75–9912–0–1–551 101 45 77 3 4 4 1 2 1 1 ................... ................... 9 18 9 Personnel Summary 131 Outlays (gross), detail: 86.90 Outlays from new current authority .............................. 86.93 Outlays from current balances ...................................... 86.97 Outlays from new permanent authority ......................... Total outlays (gross) ................................................. 24.0 25.1 25.2 25.3 89.00 90.00 ALLOCATIONS RECEIVED FROM OTHER ACCOUNTS Note.—Obligations incurred under allocations from other accounts are included in the schedules of the parent appropriation as follows: Health Care Financing Administration: ‘‘Health Care Fraud and Abuse Control Account.’’ [Dollars in millions] 1996 actual Distribution of budget authority by account: General departmental management ....................................... Office of Consumer Affairs ..................................................... Office for Civil Rights ............................................................. Policy research ........................................................................ Distribution of outlays by account: General departmental management ....................................... Office of Consumer Affairs ..................................................... Office for Civil Rights ............................................................. Policy research ........................................................................ Emergency supplemental ........................................................ 1997 est. 1998 est. 140 2 16 9 174 166 2 2 16 17 19 .................... 106 3 15 15 6 153 175 2 2 17 17 12 .................... 40 .................... Departmental Management (DM) is a consolidated display of accounts that fund activities which provide leadership, policy, legal, and administrative guidance to HHS components; carry out the Department’s civil rights and nondiscrimination enforcement programs; present consumer needs and viewpoints in the Federal government; and support research to develop policy initiatives and improve existing HHS programs. DM also includes the activities of the Office of Public Health and Science, including adolescent family life, disease prevention and health promotion, physical fitness and sports, minority health, research integrity, women’s health, and emergency preparedness. These accounts will continue to be appropriated separately, and are being displayed in a consolidated format to improve the readability of the presentation. Detailed information will continue to be available through the Department of Health and Human Services. Object Classification (in millions of dollars) Identification code 75–9912–0–1–551 11.1 11.3 Direct obligations: Personnel compensation: Full-time permanent ............................................. Other than full-time permanent ........................... 1996 actual 76 3 1997 est. 82 3 1998 est. 83 3 PROGRAM SUPPORT CENTER General and special funds: RETIREMENT PAY AND MEDICAL BENEFITS OFFICERS FOR COMMISSIONED For retirement pay and medical benefits of Public Health Service Commissioned Officers as authorized by law, and for payments under the Retired Serviceman’s Family Protection Plan and Survivor Benefit Plan and for medical care of dependents and retired personnel under the Dependents’ Medical Care Act (10 U.S.C. ch. 55), and for payments pursuant to section 229(b) of the Social Security Act (42 U.S.C. 429(b)), such amounts as may be required during the current fiscal year. (Department of Health and Human Services Appropriations Act, 1997.) Program and Financing (in millions of dollars) Identification code 75–0379–0–1–551 1996 actual 1997 est. 1998 est. 00.01 00.02 00.03 00.04 Obligations by program activity: Retirement payments ..................................................... Survivors’ benefits ......................................................... Medical care .................................................................. Military service credits .................................................. 119 9 24 3 139 11 26 3 149 12 28 2 10.00 Total obligations ........................................................ 155 179 191 22.00 22.30 Budgetary resources available for obligation: New budget authority (gross) ........................................ Unobligated balance expiring ........................................ 23.90 23.95 Total budgetary resources available for obligation New obligations ............................................................. 155 –155 179 –179 193 –191 40.05 New budget authority (gross), detail: Appropriation (indefinite) ............................................... 167 179 191 167 179 191 –12 ................... ................... 524 PROGRAM SUPPORT CENTER—Continued THE BUDGET FOR FISCAL YEAR 1998 00.02 00.03 General and special funds—Continued RETIREMENT PAY MEDICAL BENEFITS OFFICERS—Continued AND FOR COMMISSIONED 10.00 1996 actual Change in unpaid obligations: 72.40 Unpaid obligations, start of year: Obligated balance: Appropriation ............................................................. 73.10 New obligations ............................................................. 73.20 Total outlays (gross) ...................................................... 73.40 Adjustments in expired accounts .................................. 74.40 Unpaid obligations, end of year: Obligated balance: Appropriation ............................................................. 1997 est. 7 Total obligations ........................................................ 225 339 348 30 221 32 339 32 348 23.90 23.95 24.90 Total budgetary resources available for obligation New obligations ............................................................. Unobligated balance available, end of year: Fund balance ...................................................................... 148 22 172 8 183 7 New budget authority (gross), detail: Spending authority from offsetting collections: 68.00 Offsetting collections (cash) ..................................... 68.10 Change in orders on hand from Federal sources 87.00 170 180 190 68.90 Net budget authority and outlays: 89.00 Budget authority ............................................................ 90.00 Outlays ........................................................................... 167 170 179 180 191 190 This activity funds annuities of retired Public Health Service (PHS) commissioned officers and survivors of retirees, and medical care to active duty PHS commissioned officers, retirees, and dependents of members and retirees of the PHS Commissioned Corps. 1996 actual 13.0 25.2 25.3 1997 est. 371 –339 380 –348 32 32 32 221 339 348 Total new budget authority (gross) .......................... 221 339 348 Change in unpaid obligations: Unpaid obligations, start of year: 72.90 Obligated balance: Fund balance ............................. 72.95 Orders on hand from Federal sources ...................... 10 107 –9 ................... 149 149 70.00 74.90 74.95 1998 est. 179 339 348 42 ................... ................... Spending authority from offsetting collections (total) ................................................................ 72.99 73.10 73.20 73.45 Total unpaid obligations, start of year ................ New obligations ............................................................. Total outlays (gross) ...................................................... Adjustments in unexpired accounts .............................. Unpaid obligations, end of year: Obligated balance: Fund balance ............................. Orders on hand from Federal sources ...................... Object Classification (in millions of dollars) Identification code 75–0379–0–1–551 6 ................... ................... 257 –225 8 Outlays (gross), detail: 86.90 Outlays from new current authority .............................. 86.93 Outlays from current balances ...................................... Total outlays (gross) ................................................. 104 7 21.90 1998 est. 14 8 7 155 179 191 –170 –180 –190 9 ................... ................... 8 95 6 Budgetary resources available for obligation: Unobligated balance available, start of year: Fund balance ...................................................................... 22.00 New budget authority (gross) ........................................ 22.10 Resources available from recoveries of prior year obligations ....................................................................... Program and Financing (in millions of dollars)—Continued Identification code 75–0379–0–1–551 Federal employee occupational health .......................... ................... OS activities ................................................................... 7 117 140 149 225 339 348 –196 –330 –348 –6 ................... ................... –9 ................... ................... 149 149 149 128 24 150 26 161 28 74.99 Total unpaid obligations, end of year .................. 140 149 3 3 2 Total obligations ........................................................ 155 179 191 86.97 86.98 Outlays (gross), detail: Outlays from new permanent authority ......................... Outlays from permanent balances ................................ 178 18 339 348 –9 ................... 87.00 99.9 Benefits for former personnel ........................................ Other services ................................................................ Purchases of goods and services from Government accounts .................................................................... Total outlays (gross) ................................................. 196 330 Offsets: Against gross budget authority and outlays: 88.00 Offsetting collections (cash) from: Federal sources 88.95 Change in orders on hand from Federal sources ......... HEALTH ACTIVITIES FUNDS Program and Financing (in millions of dollars) 1996 actual Identification code 75–9913–0–1–550 Change in unpaid obligations: Unpaid obligations, start of year: Obligated balance: Appropriation ............................................................. 73.20 Total outlays (gross) ...................................................... 74.40 Unpaid obligations, end of year: Obligated balance: Appropriation ............................................................. 1997 est. 1998 est. 89.00 90.00 149 348 –179 –339 –348 –42 ................... ................... Net budget authority and outlays: Budget authority ............................................................ ................... ................... ................... Outlays ........................................................................... 18 –9 ................... 72.40 12 –1 11 –1 10 –1 11 10 9 1 1 1 86.93 Outlays (gross), detail: Outlays from current balances ...................................... 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ ................... ................... ................... Outlays ........................................................................... 1 1 1 This display shows activities in support of St. Elizabeths Hospital and scientific activities overseas that were supported by foreign currencies by the United States abroad. The HHS Service and Supply Fund (SSF) provides common centralized services to HHS components. The Program Support Center (PSC) line includes activities funded through the SSF and the OS Working Capital Fund (WCF) in FY 1996. The WCF terminated in FY 1997 and the PSC and OS activities are funded solely through the SSF. The OS activities line includes the Fund Manager, Departmental Contracts Information System, Audit Resolution, OS Graphics, and the Regional Health Administrators. For FY 1996, Federal Employee Occupational Health funds operated through the Health Resources and Services Administration general fund account, but are funded through the SSF beginning in FY 1997. Object Classification (in millions of dollars) Intragovernmental funds: HHS SERVICE Identification code 75–9941–0–4–551 AND SUPPLY FUND Program and Financing (in millions of dollars) Identification code 75–9941–0–4–551 Obligations by program activity: 00.01 Program support center ................................................. 1996 actual 218 1997 est. 238 1998 est. 237 1996 actual 1997 est. 1998 est. 11.1 11.3 11.5 Personnel compensation: Full-time permanent .................................................. Other than full-time permanent ............................... Other personnel compensation .................................. 58 3 1 66 2 2 67 2 2 11.9 12.1 21.0 Total personnel compensation .............................. Civilian personnel benefits ............................................ Travel and transportation of persons ............................ 62 12 1 70 14 3 71 14 3 OFFICE OF THE INSPECTOR GENERAL DEPARTMENT OF HEALTH AND HUMAN SERVICES 22.0 23.1 23.3 24.0 25.1 25.2 25.3 26.0 31.0 99.0 99.9 Transportation of things ................................................ 2 Rental payments to GSA ................................................ 12 Communications, utilities, and miscellaneous charges 11 Printing and reproduction .............................................. 1 Advisory and assistance services .................................. ................... Other services ................................................................ 63 Purchases of goods and services from Government accounts .................................................................... 28 Supplies and materials ................................................. 28 Equipment ...................................................................... 5 Subtotal, reimbursable obligations ............................... 225 Total obligations ........................................................ 225 2 12 15 1 1 140 2 10 16 1 1 144 29 47 5 339 27 53 6 348 339 348 Personnel Summary Identification code 75–9941–0–4–551 2001 2005 Total compensable workyears: Full-time equivalent employment .................................. Full-time equivalent of overtime and holiday hours 1996 actual 1,236 15 1997 est. 1,319 22 1998 est. 1,279 22 525 87.00 Total outlays (gross) ................................................. 53 51 48 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 45 53 45 51 45 48 [Dollars in millions] 1996 Distribution of budget authority by account: Gifts ........................................................................................ Contributions, Indian health facilities ................................... Distribution of outlays by account: Gifts ........................................................................................ Contributions, Indian health facilities ................................... 1997 1998 14 31 14 31 14 31 24 29 23 28 22 26 Gifts to the Public Health Service are for the benefit of patients and for research. Contributions are made for the construction, improvement, extension, and provision of sanitation facilities. Object Classification (in millions of dollars) Unavailable Collections (in millions of dollars) Identification code 75–9971–0–7–551 1996 actual 1997 est. 1998 est. Balance, start of year: Balance, start of year .................................................... ................... ................... ................... Receipts: 02.01 Contributions, Indian health facilities, Health Services Administration ........................................................... 31 31 31 02.02 Gifts and contributions, Miscellaneous trust funds 13 13 13 02.03 Interest, Miscellaneous trust funds ............................... 1 1 1 02.99 Total receipts ............................................................. 45 45 45 Appropriation: 05.01 Miscellaneous trust funds ............................................. –45 –45 –45 07.99 Total balance, end of year ............................................ ................... ................... ................... Program and Financing (in millions of dollars) 1996 actual 11.3 11.5 11.8 1997 est. 11.9 12.1 21.0 22.0 25.2 25.3 Personnel compensation: Other than full-time permanent ............................... Other personnel compensation .................................. Special personal services payments ......................... 1997 est. 1998 est. 3 1 1 3 1 1 3 1 1 5 1 1 1 2 5 1 1 1 2 5 1 1 1 2 25.5 25.7 26.0 31.0 32.0 41.0 Total personnel compensation .............................. Civilian personnel benefits ............................................ Travel and transportation of persons ............................ Transportation of things ................................................ Other services ................................................................ Purchases of goods and services from Government accounts .................................................................... Research and development contracts ........................... Operation and maintenance of equipment ................... Supplies and materials ................................................. Equipment ...................................................................... Land and structures ...................................................... Grants, subsidies, and contributions ............................ 2 11 5 3 1 19 3 1 7 3 3 1 19 1 1 7 3 3 1 19 1 99.9 01.99 Identification code 75–9971–0–7–551 1996 actual Identification code 75–9971–0–7–551 MISCELLANEOUS TRUST FUNDS Total obligations ........................................................ 54 45 45 1998 est. Personnel Summary Obligations by program activity: 00.02 Gifts ............................................................................... 00.03 Contributions, Indian health facilities .......................... 22 32 14 31 14 31 10.00 54 45 45 20 25 25 Total obligations ........................................................ Budgetary resources available for obligation: Unobligated balance available, start of year: 21.40 Uninvested balance ................................................... U.S. Securities: 21.41 Par value ............................................................... 21.42 Unrealized discounts ............................................. 23 9 9 –1 ................... ................... 21.99 22.00 Total unobligated balance, start of year ............. New budget authority (gross) ........................................ 42 45 34 45 34 45 23.90 23.95 87 –54 79 –45 79 –45 24.40 24.41 Total budgetary resources available for obligation New obligations ............................................................. Unobligated balance available, end of year: Uninvested balance ................................................... U.S. Securities: Par value ......................................... 25 9 25 9 25 9 24.99 Total unobligated balance, end of year .................... 34 34 34 60.27 New budget authority (gross), detail: Appropriation (trust fund, indefinite) ............................ 45 45 95 54 –53 96 45 –51 90 45 –48 96 90 87 15 38 12 39 12 36 1001 1005 45 Change in unpaid obligations: 72.40 Unpaid obligations, start of year: Obligated balance: Appropriation ............................................................. 73.10 New obligations ............................................................. 73.20 Total outlays (gross) ...................................................... 74.40 Unpaid obligations, end of year: Obligated balance: Appropriation ............................................................. Outlays (gross), detail: 86.97 Outlays from new permanent authority ......................... 86.98 Outlays from permanent balances ................................ 1996 actual Identification code 75–9971–0–7–551 Total compensable workyears: Full-time equivalent employment .................................. Full-time equivalent of overtime and holiday hours 100 20 1997 est. 1998 est. 100 20 100 20 OFFICE OF THE INSPECTOR GENERAL General and special funds: OFFICE OF INSPECTOR GENERAL For expenses necessary for the Office of Inspector General in carrying out the provisions of the Inspector General Act of 1978, as amended, ø$32,999,000, together with any funds, to remain available until expended, that represent the equitable share from the forfeiture of property in investigations in which the Office of Inspector General participated, and which are transferred to the Office of Inspector General by the Department of Justice, the Department of the Treasury, or the United States Postal Service¿ $31,921,000. (Department of Health and Human Services Appropriations Act, 1997.) Program and Financing (in millions of dollars) Identification code 75–0128–0–1–551 1996 actual 1997 est. 1998 est. 00.01 01.01 Obligations by program activity: Direct program ............................................................... Reimbursable program .................................................. 79 10 33 13 32 12 10.00 Total obligations ........................................................ 89 46 44 21.40 Budgetary resources available for obligation: Unobligated balance available, start of year: Uninvested balance ................................................... 1 1 1 526 OFFICE OF THE INSPECTOR GENERAL—Continued THE BUDGET FOR FISCAL YEAR 1998 General and special funds—Continued OFFICE OF Object Classification (in millions of dollars) INSPECTOR GENERAL—Continued Program and Financing (in millions of dollars)—Continued Identification code 75–0128–0–1–551 1996 actual 1996 actual Identification code 75–0128–0–1–551 1997 est. 11.1 11.5 1998 est. 22.00 New budget authority (gross) ........................................ 89 46 44 23.90 23.95 24.40 Total budgetary resources available for obligation New obligations ............................................................. Unobligated balance available, end of year: Uninvested balance ................................................... 90 –89 47 –46 45 –44 1 1 1 1997 est. 1998 est. 48 21 21 1 ................... ................... New budget authority (gross), detail: Current: 40.00 Appropriation ............................................................. Permanent: 68.00 Spending authority from offsetting collections: Offsetting collections (cash) ..................................... 58 33 32 26.0 31.0 Total personnel compensation ......................... Civilian personnel benefits ....................................... Travel and transportation of persons ....................... Rental payments to GSA ........................................... Communications, utilities, and miscellaneous charges ................................................................. Advisory and assistance services ............................. Other services ............................................................ Purchases of goods and services from Government accounts ................................................................ Supplies and materials ............................................. Equipment ................................................................. 31 13 12 99.0 99.0 Subtotal, direct obligations .................................. Reimbursable obligations .............................................. 79 10 33 13 32 12 70.00 89 46 44 99.9 Total obligations ........................................................ 89 46 44 Total new budget authority (gross) .......................... 11.9 12.1 21.0 23.1 23.3 Direct obligations: Personnel compensation: Full-time permanent ............................................. Other personnel compensation ............................. 25.1 25.2 25.3 Change in unpaid obligations: Unpaid obligations, start of year: Obligated balance: Appropriation ............................................................. ................... 73.10 New obligations ............................................................. 89 73.20 Total outlays (gross) ...................................................... –80 74.40 Unpaid obligations, end of year: Obligated balance: Appropriation ............................................................. 9 21 4 1 2 21 4 1 2 1 1 1 1 ................... ................... 1 1 ................... 7 3 3 1 ................... ................... 2 ................... ................... Personnel Summary 72.40 9 46 –50 5 44 –45 5 4 86.90 86.93 86.97 Outlays (gross), detail: Outlays from new current authority .............................. Outlays from current balances ...................................... Outlays from new permanent authority ......................... 52 –3 31 30 7 13 29 4 12 87.00 Total outlays (gross) ................................................. 80 50 45 Offsets: Against gross budget authority and outlays: 88.00 Offsetting collections (cash) from: Federal sources –31 –13 –12 Net budget authority and outlays: 89.00 Budget authority ............................................................ 90.00 Outlays ........................................................................... 49 10 2 5 1996 actual Identification code 75–0128–0–1–551 Direct: Total compensable workyears: 1001 Full-time equivalent employment .............................. 839 1005 Full-time equivalent of overtime and holiday hours 5 Reimbursable: 2001 Total compensable workyears: Full-time equivalent employment ............................................................... 87 Allocation account: 3001 Total compensable workyears: Full-time equivalent employment ............................................................... ................... 1997 est. 1998 est. 348 2 330 2 33 32 610 691 ALLOCATIONS RECEIVED FROM OTHER ACCOUNTS Note.—Obligations incurred under allocations from other accounts are included in the schedules of the parent appropriations as follows: Health Care Financing Administration: ‘‘Health Care Fraud and Abuse Control Account.’’ 58 49 33 37 32 33 The Office of Inspector General identifies and recommends actions to correct fraud, waste, and abuse in HHS administered and assisted programs and operations through audits and investigations. In addition to the discretionary resources appropriated to the Office of the Inspector General (IG), the Health Insurance Portability and Accountability Act of 1996 makes available mandatory funding for use by the IG to combat Medicare fraud and abuse through a coordinated Health Care Fraud and Abuse Control (HCFAC) Program with the Department of Justice. The following table shows total funding resources for the IG: 1966 actual 1997 est. Note for Entire HHS Chapter.—The personnel summaries for all HHS accounts reflect current estimates and add to the HHS totals shown in the Federal Employment in the Executive Branch table of the Budget. Within the HHS totals, account-by-account estimates may be subject to change as staffing plans are implemented. The HHS FTE totals reflect compliance with section 416 of the Social Security Act, as amended by Public Law 104–193, the Personal Responsibility and Work Opportunity Act of 1996, which requires a reduction of FTE consistent with the replacement of Aid to Families with Dependent Children and Job Opportunities and Basic Skills training program with Temporary Assistance for Needy Families. 1998 est. Budget Authority: Discretionary Appropriations ................................................... Medicare Trust Fund Transfers ............................................... Mandatory (HCFAC Account) ................................................... 58 21 0 33 0 70 32 0 81 Total ............................................................................... 79 103 113 Outlays: Discretionary Appropriations ................................................... Medicare Trust Fund Transfers ............................................... Mandatory (HCFAC Account) ................................................... 49 21 0 37 0 70 33 0 81 Total ............................................................................... 70 107 114 GENERAL FUND RECEIPT ACCOUNTS (in millions of dollars) 1996 actual This schedule reflects estimated distribution of mandatory funds from the HCFAC Account in FY 1998. Actual FY 1998 distribution will be determined by the Secretary of HHS and the Attorney General. 1997 est. 1998 est. Offsetting receipts from the public: 75–310700 Federal share of child support collections ...... ................... 839 1,032 General Fund Offsetting receipts from the public ..................... ................... 839 1,032 Intragovernmental payments: 20–310530 Quinquennial adjustment for military service credits, Federal hospital insurance ................................... 2,366 ................... ................... General Fund Intragovernmental payments ................................ 2,366 ................... ................... GENERAL PROVISIONS DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SEC. 201. Funds appropriated in this title shall be available for not to exceed $37,000 for official reception and representation expenses when specifically approved by the Secretary. SEC. 202. The Secretary shall make available through assignment not more than 60 employees of the Public Health Service to assist in child survival activities and to work in AIDS programs through and with funds provided by the Agency for International Development, the United Nations International Children’s Emergency Fund or the World Health Organization. SEC. 203. None of the funds appropriated under this Act may be used to implement section 399L(b) of the Public Health Service Act or section 1503 of the National Institutes of Health Revitalization Act of 1993, Public Law 103–43. øSEC. 204. None of the funds made available by this Act may be used to withhold payment to any State under the Child Abuse Prevention and Treatment Act by reason of a determination that the State is not in compliance with section 1340.2(d)(2)(ii) of title 45 of the Code of Federal Regulations. This provision expires upon the date of enactment of the reauthorization of the Child Abuse Prevention and Treatment Act.¿ SEC. ø205¿ 204. None of the funds appropriated in this Act for the National Institutes of Health and the Substance Abuse and Mental Health Services Administration shall be used to pay the salary of an individual, through a grant or other extramural mechanism, at a rate in excess of $125,000 per year. øSEC. 206. None of the funds appropriated in this Act may be expended pursuant to section 241 of the Public Health Service Act, except for funds specifically provided for in this Act, or for other taps and assessments made by any office located in the Department of Health and Human Services, prior to the Secretary’s preparation and submission of a report to the Committee on Appropriations of the Senate and of the House detailing the planned uses of such funds.¿ ø(TRANSFER OF FUNDS)¿ øSEC. 207. Of the funds appropriated or otherwise made available for the Department of Health and Human Services, General Departmental Management, for fiscal year 1997, the Secretary of Health and Human Services shall transfer to the Office of the Inspector General such sums as may be necessary for any expenses with respect to the provision of security protection for the Secretary of Health and Human Services.¿ øSEC. 208. None of the funds appropriated in this Act may be obligated or expended for the Federal Council on Aging under the Older Americans Act or the Advisory Board on Child Abuse and Neglect under the Child Abuse Prevention and Treatment Act.¿ ø(TRANSFER OF FUNDS)¿ øSEC. 209. Not to exceed 1 percent of any discretionary funds (pursuant to the Balanced Budget and Emergency Deficit Control 527 Act, as amended) which are appropriated for the current fiscal year for the Department of Health and Human Services in this Act may be transferred between appropriations, but no such appropriation shall be increased by more than 3 percent by any such transfer: Provided, That the Appropriations Committees of both House of Congress are notified at least fifteen days in advance of any transfer.¿ (TRANSFER OF FUNDS) SEC. ø210¿ 205. The Director of the National Institutes of Health, jointly with the Director of the Office of AIDS Research, may transfer up to 3 percent among institutes, centers, and divisions from the total amounts identified by these two Directors as funding for research pertaining to the human immunodeficiency virus: Provided, That the Congress is promptly notified of the transfer. ø(TRANSFER OF FUNDS)¿ øSEC. 211. Of the amounts made available in this Act for the National Institutes of Health, the amount for research related to the human immunodeficiency virus, as jointly determined by the Director of NIH and the Director of the Office of AIDS Research, shall be made available to the ‘‘Office of AIDS Research’’ account. The Director of the Office of AIDS Research shall transfer from such account amounts necessary to carry out section 2353(d)(3) of the Public Health Service Act.¿ øSEC. 212. Not later than January 1, 1997, the Administrator of the Health Care Financing Administration, with the advice and technical assistance of the Agency for Health Care Policy and Research, shall transmit to the appropriate committees of the Congress a report including— (1) a review of all available studies and research data on the treatment of end-stage emphysema and chronic obstructive pulmonary disease by both unilateral and bilateral lung volume reduction surgery, involving both invasive and noninvasive surgery and supplemental surgical methods, including laser applications; and (2) a recommendation, based on such review, as to the appropriateness of Medicare coverage of such procedures and the conditions, if necessary, that facilities and physicians should be required to meet, to ensure the efficacy of such procedures, as more detailed clinical studies are conducted.¿ øSEC. 213. Section 304(a)(1) of the Family Violence Prevention and Services Act (42 U.S.C. 10403(a)(1)) is amended by striking ‘‘$200,000’’ and inserting ‘‘$400,000’’.¿ øSEC. 214. The new clinical research center at the National Institutes of Health is hereby named the Mark O. Hatfield Clinical Research Center.¿ øSEC. 215. Section 345 of Public Law 104–193 is amended by replacing ‘‘section 457(a)’’ wherever it appears with ‘‘a plan approved under this part’’. Amounts available under such section shall be calculated as though such section were effective October 1, 1995.¿ (Department of Health and Human Services Appropriations Act, 1997.)
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