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DEPARTMENT OF HEALTH AND HUMAN SERVICES 24.40 FOOD AND DRUG ADMINISTRATION Unobligated balance available, end of year: Uninvested balance ................................................... 67 38 38 882 878 878 91 108 113 Total new budget authority (gross) .......................... 973 986 991 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 ............................................................. 281 961 –951 –11 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$904,694,000¿ $911,284,000, of which not to exceed ø$84,723,000¿ $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 ø1996¿ 1997 shall be subject to the fiscal year ø1996¿ 1997 limitationø: 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¿. In addition, fees pursuant to section 354 of the Public Health Service Act may be credited to this account, to remain available until expended. BUILDINGS AND 70.00 72.40 279 305 1,015 991 –985 –994 –6 ................... 279 305 302 86.90 86.93 86.97 Outlays (gross), detail: Outlays from new current authority .............................. Outlays from current balances ...................................... Outlays from new permanent authority ......................... 686 174 91 685 192 108 685 196 113 87.00 Total outlays (gross) ................................................. 951 985 994 Offsets: Against gross budget authority and outlays: Offsetting collections (cash) from: 88.00 Federal sources ..................................................... 88.40 Non-Federal sources ............................................. –17 –74 –10 –98 –12 –101 88.90 Total, offsetting collections (cash) .................. –91 –108 –113 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 882 860 878 877 878 881 FACILITIES 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$12,150,000¿ $8,350,000, 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, 1996.) Program and Financing (in millions of dollars) Identification code 75–9911–0–1–554 1995 actual 1996 est. 1997 est. 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 Program management ............................................... 00.06 Rental payments ....................................................... 00.07 Buildings and facilities ............................................. 00.08 CRADAs ...................................................................... 00.09 Contingency Fund ...................................................... 216 222 225 364 362 362 157 157 157 38 38 38 42 42 42 46 46 46 5 40 8 1 ................... ................... 1 ................... ................... 00.91 01.01 Total direct program ............................................. Reimbursable program .................................................. 870 91 907 108 878 113 10.00 Total obligations ........................................................ 961 1,015 991 Budgetary resources available for obligation: 21.40 Unobligated balance available, start of year: Uninvested balance ................................................... 22.00 New budget authority (gross) ........................................ 54 973 67 986 38 991 1,027 –961 1,053 –1,015 1,029 –991 23.90 23.95 New budget authority (gross), detail: Current: 40.00 Appropriation ............................................................. Permanent: 68.00 Spending authority from offsetting collections: Offsetting collections (cash) ..................................... Total budgetary resources available for obligation New obligations ............................................................. [In millions of dollars] 1995 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 .......................................................... 1996 1997 818 46 18 820 46 12 824 46 8 806 37 17 808 46 23 820 46 15 Summary of Budget Authority and Outlays [In millions of dollars] Enacted/requested: 1995 actual 1996 est. 1997 est. Budget Authority ..................................................................... 882 878 878 Outlays .................................................................................... 860 877 881 Legislative proposal, not subject to PAYGO: Budget Authority ..................................................................... .................... .................... .................... Outlays .................................................................................... .................... .................... .................... Total: Budget Authority ..................................................................... Outlays .................................................................................... 882 860 878 877 878 881 The Food and Drug Administration (FDA) administers laws concerning misbranded and adulterated foods, drugs, human biologics, medical devices, cosmetics, and man-made sources of radiation. The buildings and facilities appropriation provides funds for projects related to the repair, construction, alteration, and improvement of all buildings and facilities of FDA. 471 472 FOOD AND DRUG ADMINISTRATION—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 1997 87.00 RENTAL PAYMENTS (FDA)—Continued (INCLUDING TRANSFERS OF FUNDS)—Continued Object Classification (in millions of dollars) 1995 actual Identification code 75–9911–0–1–554 11.1 11.3 11.5 11.9 12.1 21.0 22.0 23.1 23.2 23.3 24.0 25.1 25.2 25.3 25.4 25.5 25.7 26.0 31.0 32.0 41.0 42.0 1996 est. Total outlays (gross) ................................................. ................... ................... 39 Offsets: Against gross budget authority and outlays: 88.40 Offsetting collections (cash) from: Non-Federal sources .................................................................. ................... ................... General and special funds—Continued –39 1997 est. 89.00 90.00 Direct obligations: Personnel compensation: Full-time permanent ............................................. Other than full-time permanent ........................... Other personnel compensation ............................. 402 28 15 417 29 15 427 29 16 Total personnel compensation ......................... 445 Civilian personnel benefits ....................................... 95 Travel and transportation of persons ....................... 18 Transportation of things ........................................... 1 Rental payments to GSA ........................................... 42 Rental payments to others ........................................ 7 Communications, utilities, and miscellaneous charges ................................................................. 26 Printing and reproduction ......................................... 3 Advisory and assistance services ............................. 6 Other services ............................................................ 19 Purchases of goods and services from Government accounts ................................................................ 39 Operation and maintenance of facilities .................. 19 Research and development contracts ....................... 37 Operation and maintenance of equipment ............... 30 Supplies and materials ............................................. 22 Equipment ................................................................. 39 Land and structures .................................................. ................... Grants, subsidies, and contributions ........................ 20 Insurance claims and indemnities ........................... 2 461 99 17 1 42 6 472 101 17 1 42 5 24 3 7 36 24 3 6 19 40 37 18 18 34 33 31 28 20 20 37 33 10 ................... 19 18 2 1 99.0 99.0 Subtotal, direct obligations .................................. Reimbursable obligations .............................................. 870 91 907 108 878 113 99.9 Total obligations ........................................................ 961 1,015 991 Net budget authority and outlays: Budget authority ............................................................ ................... ................... ................... Outlays ........................................................................... ................... ................... ................... Object Classification (in millions of dollars) 1995 actual Identification code 75–9911–2–1–554 99.0 99.9 1996 est. 1997 est. Reimbursable obligations: Subtotal, reimbursable obligations ....................................................................... ................... ................... 39 Total obligations ........................................................ ................... ................... 39 Personnel Summary 1995 actual Identification code 75–9911–2–1–554 2001 1996 est. 1997 est. Total compensable workyears: Full-time equivalent employment ............................................................... ................... ................... 109 Public enterprise funds: REVOLVING FUND FOR CERTIFICATION AND OTHER SERVICES Program and Financing (in millions of dollars) Identification code 75–4309–0–3–554 1995 actual 1996 est. 1997 est. 1995 actual Identification code 75–9911–0–1–554 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 1996 est. 3 1 4 1 4 1 10.00 Personnel Summary Obligations by program activity: Operating expenses: 00.01 Color additives .......................................................... 00.02 Insulin ........................................................................ Total obligations ........................................................ 4 5 5 Budgetary resources available for obligation: Unobligated balance available, start of year: Fund balance ...................................................................... 22.00 New budget authority (gross) ........................................ 2 5 3 5 3 5 7 –4 8 –5 8 –5 3 3 2 5 5 5 1 4 –3 1 5 –4 2 5 –4 1 2 3 1997 est. 21.90 8,721 87 8,690 87 8,487 87 481 532 626 EXPENSES 23.90 23.95 24.90 68.00 (Legislative proposal, not subject to PAYGO) Program and Financing (in millions of dollars) Identification code 75–9911–2–1–554 1995 actual 1996 est. 1997 est. 15 24 10.00 39 68.00 73.10 73.20 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: Uninvested balance ........................... 72.90 Obligations by program activity: Direct program: 00.01 Foods ......................................................................... ................... ................... 00.02 Devices and radiological products ............................ ................... ................... 22.00 23.95 Total budgetary resources available for obligation New obligations ............................................................. Unobligated balance available, end of year: Fund balance ...................................................................... Total obligations ........................................................ ................... ................... 39 –39 New budget authority (gross), detail: Spending authority from offsetting collections (gross): Offsetting collections (cash) ..................................... ................... ................... Outlays (gross), detail: Outlays from new permanent authority ......................... 3 3 4 87.00 Budgetary resources available for obligation: New budget authority (gross) ........................................ ................... ................... New obligations ............................................................. ................... ................... 86.97 Total outlays (gross) ................................................. 3 4 4 Offsets: Against gross budget authority and outlays: 88.40 Offsetting collections (cash) from: Non-Federal sources .................................................................. –5 –5 –5 39 Change in unpaid obligations: New obligations ............................................................. ................... ................... Total outlays (gross) ...................................................... ................... ................... Outlays (gross), detail: 86.97 Outlays from new permanent authority ......................... ................... ................... 39 –39 39 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ ................... ................... ................... Outlays ........................................................................... –2 –1 –1 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 HEALTH RESOURCES AND SERVICES ADMINISTRATION Federal Funds DEPARTMENT OF HEALTH AND HUMAN SERVICES Object Classification (in millions of dollars) 1995 actual Identification code 75–4309–0–3–554 11.1 12.1 23.1 31.0 99.0 99.9 1996 est. Personnel compensation: Full-time permanent ............. 2 Civilian personnel benefits ............................................ 1 Rental payments to GSA ................................................ 1 Equipment ...................................................................... ................... Subtotal, reimbursable obligations ............................... 4 Total obligations ........................................................ 1997 est. 2 1 1 1 5 5 4 2 1 1 1 5 5 Personnel Summary 1995 actual Identification code 75–4309–0–3–554 2001 Total compensable workyears: Full-time equivalent employment ............................................................... 40 1996 est. 42 1997 est. 42 HEALTH RESOURCES AND SERVICES ADMINISTRATION Federal Funds 65 65 9 ................... 4 5 4 ................... ................... ................... ................... ................... 4 ................... ................... ................... ................... 8 ................... ................... ................... 00.12 00.13 00.14 00.15 00.16 00.17 00.18 00.19 00.20 00.21 00.23 00.24 00.25 00.26 00.27 00.28 00.29 00.30 00.31 00.33 00.34 00.35 Migrant health centers .............................................. Health care for the homeless ................................... Public housing health services ................................. Programs for special populations ............................. Black lung clinics ..................................................... Alzheimer’s demonstration grants ............................ Native Hawaiian health care .................................... Payment to Hawaii for the treatment of Hansen’s disease .................................................................. Hansen’s disease center ........................................... Health professions clusters ....................................... Health professions curriculum assistance ................ National Health Service Corps .................................. National Health Service Corps recruitment .............. Nursing loan repayment ............................................ Maternal and child health block grant .................... Healthy start .............................................................. Emergency medical services cluster ......................... Pediatric emergency medical services ...................... Bone marrow donor program .................................... Health care facilities ................................................. Organ transplantation ............................................... Family planning ......................................................... Buildings and facilities ............................................. Program management ............................................... Rural health research ............................................... Rural health cluster .................................................. Health services outreach demonstration .................. HIV ............................................................................. Malpractice claims fund ........................................... Other HRSA activities ................................................ 3 21 ................... 278 42 78 2 684 104 ................... 10 ................... 10 3 193 1 121 9 ................... 26 656 ................... 2 ................... 16 ................... 278 39 78 ................... 684 50 ................... 10 15 ................... 2 193 1 112 ................... ................... 26 663 1 ................... ................... 16 366 ................... ................... ................... ................... 681 75 9 ................... 15 ................... 2 198 1 113 8 30 ................... 831 6 1 00.91 01.01 U.S.C. 346a, 356, 357, 376). These services are financed wholly by fees paid by the industries affected. 00.03 00.04 00.05 00.06 00.07 00.09 00.10 00.11 473 Total direct program ............................................. Reimbursable obligations (Cash) .................................. 3,008 151 2,928 156 3,119 65 10.00 Total obligations ........................................................ 3,159 3,084 3,184 General and special funds: HEALTH RESOURCES AND SERVICES For carrying out titles II, III, VII, VIII, X, XII, 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, Public Law 101–527, and the Native Hawaiian Health Care Act of 1988, as amended, $3,113,483,000, of which $297,000 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, and of which $52,000,000 shall be used only for State AIDS Drug Assistance Programs authorized by section 2616 of the Public Health Service Act and shall be distributed to States as authorized by section 2618(b)(2) of such Act: Provided, That when the Department of Health and Human Services administers or operates an employee health program for any Federal department or agency, payment for the full estimated cost shall be made by way of reimbursement or in advance to this appropriation: Provided further, That of the funds made available under this heading, $828,000 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, 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: Provided further, That funds made available for activities authorized by part A of title XXVI of the Public Health Service Act are available only for those metropolitan areas previously funded in FY 1996 or with a cumulative total of more than 2,000 cases of AIDS, as reported to the Centers for Disease Control and Prevention as of March 31, 1996, and have a population of 500,000 or more: Provided further, the Secretary shall use amounts available for section 2603(b) of the Public Health Service Act as necessary to ensure that FY 1997 grant awards made under section 2603(a) of such Act to eligible areas that received such grants in FY 1996 are not less than the FY 1996 level. Note.—A regular 1996 appropriation for this account had not been enacted at the time this budget was prepared. The 1996 amounts included in this budget are based on the levels provided in three continuing resolutions: P.L. 104–91, P.L. 104–92, and P.L. 104– 99. Program and Financing (in millions of dollars) Identification code 75–0350–0–1–550 1995 actual 1996 est. 1997 est. Obligations by program activity: Direct program: 00.01 Consolidated health centers ..................................... ................... 756 759 00.02 Community health centers ........................................ 613 ................... ................... 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 ................................................... New budget authority (gross), detail: Current: 40.00 Appropriation ............................................................. Permanent: 68.00 Spending authority from offsetting collections: Offsetting collections (cash) ..................................... 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 ............................................................. 17 22 19 3,164 3,081 3,175 –1 ................... ................... 3,180 –3,159 3,103 –3,084 3,194 –3,184 22 19 10 3,011 2,927 3,113 153 154 62 3,164 3,081 3,175 72.40 2,512 3,053 3,233 3,159 3,084 3,184 –2,605 –2,904 –2,980 –12 ................... ................... 3,053 3,233 3,437 86.90 86.93 86.97 Outlays (gross), detail: Outlays from new current authority .............................. Outlays from current balances ...................................... Outlays from new permanent authority ......................... 1,093 1,359 153 1,116 1,634 154 1,186 1,732 62 87.00 Total outlays (gross) ................................................. 2,605 2,904 2,980 Offsets: Against gross budget authority and outlays: Offsetting collections (cash) from: 88.00 Federal sources ..................................................... 88.40 Non-Federal sources ............................................. –142 –11 –146 –8 –56 –6 88.90 Total, offsetting collections (cash) .................. –153 –154 –62 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 3,011 2,452 2,927 2,750 3,113 2,918 474 HEALTH RESOURCES AND SERVICES ADMINISTRATION—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 1997 33.0 41.0 42.0 General and special funds—Continued HEALTH RESOURCES AND SERVICES—Continued [Dollars in millions] 1995 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 ........................................ 1996 Investments and loans .............................................. 8 Grants, subsidies, and contributions ........................ 2,766 Insurance claims and indemnities ........................... ................... 2,927 0 3,113 0 2,452 0 2,749 1 Subtotal, direct obligations .................................. Reimbursable obligations .............................................. 3,008 151 2,928 156 3,119 65 99.9 Total obligations ........................................................ 3,159 3,084 3,184 2,912 6 Personnel Summary Identification code 75–0350–0–1–550 Summary of Budget Authority and Outlays [In millions of dollars] Total: Budget Authority ..................................................................... Outlays .................................................................................... 1996 est. 2,927 2,750 1997 est. 3,113 2,918 153 .................... 50 58 3,011 2,452 3,080 2,800 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 .......................................... 1995 actual 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 ............................................................... 3,113 2,976 1995 actual 1996 est. 1997 est. 1,655 10 170 1,650 10 168 1,650 10 168 289 335 205 VACCINE INJURY COMPENSATION For 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. Status of Direct Loans (in millions of dollars) Identification code 75–0350–0–1–550 8 2,874 6 99.0 99.0 1997 3,006 5 Enacted/requested: 1995 actual Budget Authority ..................................................................... 3,011 Outlays .................................................................................... 2,452 Adjustment to 1996 continuing resolution levels: Budget Authority ..................................................................... .................... Outlays .................................................................................... .................... 8 2,690 1 1996 est. 531 17 –15 797 17 –14 1997 est. 800 18 –14 –2 ................... ................... 266 ................... ................... 797 800 Note.—A regular 1996 appropriation for this account had not been enacted at the time this budget was prepared. The 1996 amounts included in this budget are based on the levels provided in three continuing resolutions: P.L. 104–91, P.L. 104–92, and P.L. 104– 99. Program and Financing (in millions of dollars) Identification code 75–0320–0–1–551 1995 actual 1996 est. 1997 est. Status of Guaranteed Loans (in millions of dollars) Obligations by program activity: Total obligations (object class 42.0) ............................ 67 110 110 Budgetary resources available for obligation: Unobligated balance available, start of year: Uninvested balance ................................................... 22.00 New budget authority (gross) ........................................ 804 26 110 69 110 69 110 136 –67 179 –110 179 –110 69 69 69 110 110 110 4 67 –68 2 110 –68 45 110 –68 2 45 87 10.00 21.40 Identification code 75–0350–0–1–550 1995 actual 1996 est. 1997 est. Cumulative balance of guaranteed loans outstanding: 2210 Outstanding, start of year ............................................. 2251 Repayments and prepayments ...................................... 13 –2 11 –1 10 –1 2290 Outstanding, end of year .......................................... 11 10 9 2299 Memorandum: Guaranteed amount of guaranteed loans outstanding, end of year ................................................................ 11 10 9 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. 23.90 23.95 24.40 40.05 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 ............................................................. 73.10 New obligations ............................................................. 73.20 Total outlays (gross) ...................................................... 74.40 Unpaid obligations, end of year: Obligated balance: Appropriation ............................................................. 72.40 Object Classification (in millions of dollars) Identification code 75–0350–0–1–550 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 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 ................................................................ Supplies and materials ............................................. Equipment ................................................................. 1995 actual 1996 est. 1997 est. 89 2 4 86 2 3 91 2 3 95 23 3 2 1 9 91 23 1 2 1 9 96 24 1 2 1 9 4 1 24 29 4 1 27 25 4 1 25 25 36 3 4 42 2 1 36 3 4 86.90 86.93 Outlays (gross), detail: Outlays from new current authority .............................. Outlays from current balances ...................................... 87.00 Total outlays (gross) ................................................. 68 68 68 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 110 68 110 68 110 68 38 ................... ................... 30 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. Payment of claims associated with vaccine related injury or death occurring after October 1, 1988 are reflected in the Vaccine Improvement Trust Fund account. HEALTH RESOURCES AND SERVICES ADMINISTRATION—Continued Federal Funds—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES Credit accounts: HEALTH PROFESSIONS GRADUATE STUDENT LOAN INSURANCE PROGRAM ACCOUNT 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 $140,000,000. In addition, for administrative expenses to carry out the guaranteed loan program, $2,695,000. Note.—A regular 1996 appropriation for this account had not been enacted at the time this budget was prepared. The 1996 amounts included in this budget are based on the levels provided in three continuing resolutions: P.L. 104–91, P.L. 104–92, and P.L. 104– 99. Identification code 75–0340–0–1–552 1995 actual 1996 est. 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. Object Classification (in millions of dollars) 1997 est. 00.02 00.09 Obligations by program activity: Guaranteed loan subsidy ............................................... Administrative expenses subject to limitation .............. 22 4 10.00 Total obligations ........................................................ 26 5 11.1 25.2 41.0 99.5 Personnel compensation: Full-time permanent ............. Other services ................................................................ Grants, subsidies, and contributions ............................ Below reporting threshold .............................................. Total obligations ........................................................ 1 ................... 4 4 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ New obligations ............................................................. 1995 actual Identification code 75–0340–0–1–552 99.9 Program and Financing (in millions of dollars) 4 26 –26 5 –5 4 –4 3 3 3 New budget authority (gross), detail: Current: 40.00 Appropriation ............................................................. Permanent: 60.05 Appropriation (indefinite) .......................................... 62.00 Transferred from other accounts .............................. 22 1 Appropriation (total) ............................................. 23 2 1 70.00 Total new budget authority (gross) .......................... 26 5 1996 est. 1997 est. 1 2 2 2 2 2 22 1 ................... 1 ................... ................... 26 5 4 Personnel Summary Identification code 75–0340–0–1–552 Total compensable workyears: 1001 Full-time equivalent employment .................................. 1011 Exempt Full-time equivalent employment ..................... 1 ................... 1 1 63.00 475 1995 actual 18 5 1996 est. 1997 est. 25 7 25 7 4 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 ............................................................. HEALTH PROFESSIONS GRADUATE STUDENT LOAN GUARANTEED LOAN FINANCING ACCOUNT Program and Financing (in millions of dollars) Identification code 75–4304–0–3–552 1 ................... 5 4 –5 –4 1 ................... ................... Outlays (gross), detail: 86.90 Outlays from new current authority .............................. 86.97 Outlays from new permanent authority ......................... 3 23 3 1 3 1 87.00 25 5 Net budget authority and outlays: 89.00 Budget authority ............................................................ 90.00 Outlays ........................................................................... 26 25 5 5 4 4 1997 est. 2 3 7 Budgetary resources available for obligation: Unobligated balance available, start of year: Fund balance ...................................................................... 22.00 New financing authority (gross) .................................... 153 52 202 31 230 28 205 –2 233 –3 258 –7 202 230 251 –1 –1 –1 52 31 28 21.90 23.90 23.95 24.90 4 Total outlays (gross) ................................................. 1996 est. Obligations by program activity: Total obligations ............................................................ 10.00 1 26 –25 1995 actual 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) .............................................. 70.00 Total new financing authority (gross) ...................... 52 31 28 73.10 73.20 Change in unpaid obligations: New obligations ............................................................. Total financing disbursements (gross) ......................... 2 –2 3 –3 7 –7 87.00 Outlays (gross), detail: Total financing disbursements (gross) ......................... 2 3 7 Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in millions of dollars) Identification code 75–0340–0–1–552 1995 actual 1996 est. 1997 est. Guaranteed loan levels supportable by subsidy budget authority: 2150 Loan guarantee levels ................................................... 275 210 140 2159 275 210 140 0.01 0.34 0.34 Total loan guarantee levels ...................................... Guaranteed loan subsidy (in percent): 2320 Subsidy rate ................................................................... Guaranteed loan subsidy budget authority: 2330 Subsidy budget authority ............................................... 22 1 ................... Total subsidy budget authority ................................. Guaranteed loan subsidy outlays: 2340 Subsidy outlays .............................................................. 22 1 ................... 22 1 ................... 2349 22 Offsets: Against gross financing authority and financing disbursements: Offsetting collections (cash) from: 88.00 Federal sources ..................................................... 88.25 Interest on uninvested funds ............................... 88.40 Premium income ................................................... –22 ................... ................... –11 –16 –18 –19 –15 –10 88.90 Total, offsetting collections (cash) .................. –52 89.00 90.00 Net financing authority and financing disbursements: Financing authority ........................................................ Financing disbursements ............................................... 1 ................... 2339 Total subsidy outlays ................................................ The Health Education Assistance Loan (HEAL) program guarantees loans from private lenders to health professions –31 –28 –1 ................... ................... –51 –28 –21 476 HEALTH RESOURCES AND SERVICES ADMINISTRATION—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 1997 Credit accounts—Continued HEALTH PROFESSIONS GRADUATE STUDENT LOAN INSURANCE FUND LIQUIDATING ACCOUNT HEALTH PROFESSIONS GRADUATE STUDENT LOAN GUARANTEED LOAN FINANCING ACCOUNT—Continued Program and Financing (in millions of dollars) Status of Guaranteed Loans (in millions of dollars) 1995 actual 1996 est. 1997 est. 00.01 00.02 1996 est. Obligations by program activity: Operating expenses: death and disability ..................... Capital investment ........................................................ 4 33 5 31 5 31 10.00 1995 actual Identification code 75–4304–0–3–552 Identification code 75–4305–0–3–552 Total obligations ........................................................ 37 36 36 Budgetary resources available for obligation: Unobligated balance available, start of year: Fund balance ...................................................................... 22.00 New budget authority (gross) ........................................ 26 34 24 16 4 31 60 –37 40 –36 35 –36 1997 est. Position with respect to appropriations act limitation on commitments: 2111 Limitation on guaranteed loans made by private lenders .............................................................................. 275 210 140 2150 275 210 140 Total guaranteed loan commitments ........................ Cumulative balance of guaranteed loans outstanding: 2210 Outstanding, start of year ............................................. 889 1,163 2231 Disbursements of new guaranteed loans ...................... 275 210 Adjustments: 2261 Terminations for default that result in loans receivable ....................................................................... –1 –3 2263 Terminations for default that result in claim payments .................................................................... ................... ................... 2290 Outstanding, end of year .......................................... 2299 Memorandum: Guaranteed amount of guaranteed loans outstanding, end of year ................................................................ 1,163 1,370 1,370 140 23.90 23.95 24.90 –7 –1 1,502 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) .............................................. 1,163 Outstanding, end of year ...................................... 1,370 1 4 18 ................... 14 16 16 17 34 16 31 73.10 73.20 Change in unpaid obligations: New obligations ............................................................. Total outlays (gross) ...................................................... 37 –37 36 –36 36 –36 86.97 86.98 Outlays (gross), detail: Outlays from new permanent authority ......................... Outlays from permanent balances ................................ 17 20 16 20 31 4 87.00 Total outlays (gross) ................................................. 37 36 36 Offsets: Against gross budget authority and outlays: 88.40 Offsetting collections (cash) from: Non-Federal sources .................................................................. –16 –16 –17 18 ................... 20 20 14 19 11 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... Status of Guaranteed Loans (in millions of dollars) Identification code 75–4305–0–3–552 Balance Sheet (in millions of dollars) 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 .................................. 4 ................... Total new budget authority (gross) .......................... 1,502 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. Identification code 75–4304–0–3–552 24 70.00 Addendum: Cumulative balance of defaulted guaranteed loans that result in loans receivable: 2310 Outstanding, start of year ........................................ ................... 1 4 2331 Disbursements for guaranteed loan claims ............. 1 3 7 2351 Repayments of loans receivable ............................... ................... ................... ................... 2390 21.90 1994 actual 1995 actual 1996 est. 1997 est. 115 153 202 230 24 22 .................. 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 .................................................................... 2210 2251 1995 actual 1996 est. 1997 est. 1,721 –39 1,657 –43 1,589 –48 –21 –20 –20 .................. .................. 16 11 19 16 15 18 10 Total assets ........................................ LIABILITIES: 2204 Non-Federal liabilities: Liabilities for loan guarantees .................................. 155 205 233 889 –5 –5 Outstanding, end of year .......................................... 1,657 1,589 1,516 2299 Memorandum: Guaranteed amount of guaranteed loans outstanding, end of year ................................................................ 1,657 1,589 1,516 353 33 –6 8 388 31 –9 13 423 31 –9 13 388 423 458 258 2999 –4 2290 1999 1,163 1,370 1,502 Total liabilities .................................... NET POSITION: 3300 Cumulative results of operations ............ 889 1,163 1,370 1,502 –734 –958 –1,137 –1,244 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 ................................... 3999 Total net position ................................ –734 –958 –1,137 –1,244 2390 4999 Total liabilities and net position ............ 155 205 233 258 Outstanding, end of year ...................................... 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 Govern- HEALTH RESOURCES AND SERVICES ADMINISTRATION—Continued Federal Funds—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES ment 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. 1995 actual Dollar volume of loans insured ($ in millions) .......................... Number of students .................................................................... Average value of loans ............................................................... 1996 est. 275 25,650 $10,720 210 19,090 $11,000 1997 est. 140 12,727 $11,000 Statement of Operations (in millions of dollars) 1994 actual 1995 actual 1996 est. 1997 est. 0101 0102 Revenue ................................................... Expense .................................................... 56 –44 87 –36 64 –36 40 –36 0109 Net loss ................................................... 12 51 28 4 1994 actual ASSETS: 1101 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 ..................... 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 Identification code 75–9931–0–3–550 1995 actual 1996 est. 1997 est. 00.01 01.01 Obligations by program activity: Operating expenses: Interest subsidies, private ........... Capital investment: Direct loans ................................... 9 1 8 1 8 1 Total obligations ........................................................ 10 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 21 –12 55 20 –12 55 19 –12 64 –10 63 –9 62 –9 55 55 55 21.90 23.90 23.95 24.90 Total budgetary resources available for obligation New obligations ............................................................. Unobligated balance available, end of year: Fund balance ...................................................................... 1995 actual 22 20 1996 est. 1997 est. 20 New budget authority (gross), detail: Current: 40.00 Appropriation ............................................................. Permanent: 68.00 Spending authority from offsetting collections: Offsetting collections (cash) ..................................... 9 8 7 12 12 11 70.00 Balance Sheet (in millions of dollars) Identification code 75–4305–0–3–552 Program and Financing (in millions of dollars) 10.00 DATA ON LOANS Identification code 75–4305–0–3–552 477 Total new budget authority (gross) .......................... 21 20 19 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 ............................................................. 7 10 –9 8 9 –8 10 9 –8 8 10 10 Outlays (gross), detail: Outlays from new current authority .............................. 9 8 Outlays from current balances ...................................... ................... ................... 7 1 4 72.40 353 .................. 388 5 423 .................. 458 .................. .................. –3 .................. .................. 353 390 423 458 353 390 423 458 44 37 36 36 419 447 479 498 5 39 4 33 5 31 5 31 Total liabilities .................................... NET POSITION: 3300 Cumulative results of operations ............ 44 37 36 36 375 410 443 462 3999 Total net position ................................ 375 410 443 Total liabilities and net position ............ 419 447 479 498 87.00 Total outlays (gross) ................................................. 9 8 8 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 Interest collections from FFB ........................... –1 –10 –1 –1 –10 –1 –1 –9 –1 88.90 Total, offsetting collections (cash) .................. –12 –12 –11 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 9 –3 8 –4 8 –3 462 4999 86.90 86.93 Object Classification (in millions of dollars) 1995 actual Identification code 75–4305–0–3–552 25.2 42.0 Other services ................................................................ Insurance claims and indemnities ................................ 99.9 Total obligations ........................................................ Status of Direct Loans (in millions of dollars) 1996 est. 1997 est. 1 ................... ................... 36 36 36 37 36 36 AND Cumulative balance of direct loans outstanding: Outstanding, start of year ............................................. Disbursements: Purchase of loans assets from the public ......................................................................... 1251 Repayments: Repayments and prepayments ................. 1264 Write-offs for default: Other adjustments, net ............. 1210 1232 1290 HEALTH LOAN FUNDS MEDICAL FACILITIES GUARANTEE Identification code 75–9931–0–3–550 Outstanding, end of year .......................................... 1995 actual 1996 est. 64 45 1997 est. 34 2 1 1 –12 –12 –11 –9 ................... ................... 45 34 24 LOAN FUND Status of Guaranteed Loans (in millions of dollars) FEDERAL INTEREST SUBSIDIES FOR MEDICAL FACILITIES For carrying out subsections (d) and (e) of section 1602 of the Public Health Service Act, $7,000,000, 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. Note.—A regular 1996 appropriation for this account had not been enacted at the time this budget was prepared. The 1996 amounts included in this budget are based on the levels provided in three continuing resolutions: P.L. 104–91, P.L. 104–92, and P.L. 104– 99. Identification code 75–9931–0–3–550 1995 actual 1996 est. 1997 est. 2210 2251 Cumulative balance of guaranteed loans outstanding: Outstanding, start of year ............................................. Repayments and prepayments ...................................... 309 –48 261 –39 222 –31 2290 Outstanding, end of year .......................................... 261 222 191 2299 Memorandum: Guaranteed amount of guaranteed loans outstanding, end of year ................................................................ 261 222 191 478 HEALTH RESOURCES AND SERVICES ADMINISTRATION—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 1997 01.04 01.05 Claims processing (Public Health Service) ............... Claims processing (Dept. of Justice) ........................ 3 2 3 4 3 4 FEDERAL INTEREST SUBSIDIES FOR MEDICAL FACILITIES—Continued 01.91 Total, administrative expenses ............................. 7 9 9 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. 10.00 Total obligations ........................................................ 51 66 66 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ New obligations ............................................................. 51 –51 66 –66 66 –66 40.26 40.27 New budget authority (gross), detail: Appropriation (trust fund, definite) ............................... Appropriation (trust fund, indefinite) ............................ 7 44 9 57 9 57 43.00 Appropriation (total) .................................................. 51 66 66 70.00 Total new budget authority (gross) .......................... 51 66 66 73.10 73.20 Change in unpaid obligations: New obligations ............................................................. Total outlays (gross) ...................................................... 51 –51 66 –66 66 –66 86.90 Outlays (gross), detail: Outlays from new current authority .............................. 51 66 66 87.00 Total outlays (gross) ................................................. 51 66 66 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 51 51 66 66 66 66 Credit accounts—Continued MEDICAL FACILITIES GUARANTEE AND LOAN FUND—Continued Object Classification (in millions of dollars) 1995 actual Identification code 75–9931–0–3–550 1996 est. 1997 est. 33.0 41.0 43.0 Investments and loans .................................................. Grants, subsidies, and contributions ............................ Interest and dividends ................................................... 1 8 1 1 7 1 1 7 1 99.9 Total obligations ........................................................ 10 9 9 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. Object Classification (in millions of dollars) Trust Funds 1995 actual Identification code 20–8175–0–7–551 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. Note.—A regular 1996 appropriation for this account had not been enacted at the time this budget was prepared. The 1996 amounts included in this budget are based on the levels provided in three continuing resolutions: P.L. 104–91, P.L. 104–92, and P.L. 104– 99. 25.2 25.3 1996 est. 1997 est. 3 3 3 42.0 Other services ................................................................ Purchases of goods and services from Government accounts .................................................................... Insurance claims and indemnities ................................ 4 44 6 57 6 57 99.9 Total obligations ........................................................ 51 66 66 INDIAN HEALTH SERVICE Federal Funds General and special funds: Unavailable Collections (in millions of dollars) INDIAN HEALTH SERVICES Identification code 20–8175–0–7–551 1995 actual 1996 est. 1997 est. Balance, start of year: Balance, start of year .................................................... Receipts: 02.01 Deposits ......................................................................... 02.03 Interest income .............................................................. 824 945 1,041 138 34 123 39 123 43 02.99 Total receipts ............................................................. 172 162 166 Total: Balances and collections .................................... Appropriation: 05.01 Vaccine injury compensation program trust fund ........ 996 1,107 1,207 –51 –66 –66 05.99 07.99 –51 945 –66 1,041 –66 1,141 01.99 04.00 Subtotal appropriation ................................................... Total balance, end of year ............................................ Program and Financing (in millions of dollars) Identification code 20–8175–0–7–551 Obligations by program activity: Compensation: Claims for post—FY 1989 injuries ...... Administrative expenses: 01.03 Claims processing (Claims Court) ............................ 00.01 1995 actual 1996 est. 1997 est. 44 57 57 2 2 2 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, $1,898,941,000, 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 Health 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 $357,533,000 for contract medical care shall remain available for obligation until September 30, 1998: Provided further, That of the funds provided, not less than $11,789,100 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 INDIAN HEALTH SERVICE—Continued Federal Funds—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES 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 be available for two fiscal years after the fiscal year in which they were collected 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 from the funds provided under this heading, not otherwise earmarked, amounts may be made available for the Indian Self-Determination Fund, 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, of which $7,500,000 shall remain available until expended: 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, 1998: 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. Note.—A regular 1996 appropriation for this account had not been enacted at the time this budget was prepared. The 1996 amounts included in this budget are based on the levels provided in the three continuing resolutions: P.L. 104–91, P.L. 104–92, and P.L. 104–99. 88.40 Non-Federal sources ............................................. –196 –198 –208 88.90 Total, offsetting collections (cash) .................. –207 –210 –221 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 1,707 1,710 1,748 1,620 1,899 1,752 Summary of Budget Authority and Outlays [In millions of dollars] Enacted/requested: 1995 actual Budget Authority ..................................................................... 1,707 Outlays .................................................................................... 1,710 Adjustment to 1996 continuing resolution levels: Budget Authority ..................................................................... .................... Outlays .................................................................................... .................... Total: Budget Authority ..................................................................... Outlays .................................................................................... 1995 actual 1996 est. 1997 est. Obligations by program activity: Clinical services ............................................................. Preventive health ........................................................... Urban health .................................................................. Indian health professions .............................................. Tribal management ........................................................ Direct operations ............................................................ Self-governance ............................................................. Contract support costs .................................................. 1,370 77 23 27 5 50 9 145 1,406 78 23 26 2 49 9 153 1,497 82 27 29 2 52 9 201 00.91 04.01 Total direct program ................................................. Reimbursable program .................................................. 1,706 208 1,748 210 1,899 221 10.00 Total obligations ........................................................ 1,914 1,958 2,120 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) ..................................... 70.00 Total new budget authority (gross) .......................... 1995 actual Identification code 75–0390–0–1–551 11.1 11.3 11.5 1,899 1,752 13 .................... 9 2 1,761 1,629 1,899 1,754 1996 est. 1997 est. 363 17 29 385 18 29 425 19 30 409 119 32 10 10 2 432 125 32 11 10 2 474 133 34 14 10 2 1,969 –1,914 2,013 –1,958 2,175 –2,120 55 55 55 1,707 1,748 24 2 2 421 24 2 2 430 24 2 2 523 25.4 25.6 25.7 25.8 26.0 31.0 41.0 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 .................. Medical care .............................................................. Operation and maintenance of equipment ............... Subsistence and support of persons ........................ Supplies and materials ............................................. Equipment ................................................................. Grants, subsidies, and contributions ........................ 6 8 226 7 8 98 16 307 7 8 231 8 8 99 16 301 7 8 230 8 8 101 17 302 Subtotal, direct obligations .................................. Reimbursable obligations .............................................. 1,707 207 1,748 210 1,899 221 99.9 59 55 55 1,914 1,958 2,120 –4 ................... ................... 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 ............................. Total obligations ........................................................ 1,914 1,958 2,120 24.0 25.1 25.2 25.3 1,899 207 210 221 1,914 1,958 2,120 Personnel Summary Identification code 75–0390–0–1–551 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. 99.0 99.0 21.40 23.90 23.95 24.40 1,748 1,620 Object Classification (in millions of dollars) 00.01 00.02 00.03 00.04 00.05 00.06 00.07 00.08 Budgetary resources available for obligation: Unobligated balance available, start of year: Uninvested balance ................................................... 22.00 New budget authority (gross) ........................................ 22.30 Unobligated balance expiring ........................................ 1,707 1,710 1996 est. The Indian Health Services account provides medical care, public health services, and health professions training opportunities to American Indians and Alaska Natives. Program and Financing (in millions of dollars) Identification code 75–0390–0–1–551 479 622 602 729 1,914 1,958 2,120 –1,919 –1,829 –1,973 –16 ................... ................... 602 729 876 Outlays (gross), detail: 86.90 Outlays from new current authority .............................. 86.93 Outlays from current balances ...................................... 86.97 Outlays from new permanent authority ......................... 1,233 477 207 1,234 386 210 Total outlays (gross) ................................................. 1,919 1,829 1,973 Offsets: Against gross budget authority and outlays: Offsetting collections (cash) from: 88.00 Federal sources ..................................................... –11 –12 –13 1996 est. 1997 est. 10,763 192 18 10,777 191 18 10,791 191 18 2,520 58 2,520 58 2,520 58 1,341 411 221 87.00 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 1995 actual INDIAN HEALTH FACILITIES For construction, repair, maintenance, improvement, and equipment of health and related auxiliary facilities, including quarters for personnel; preparation of plans, specifications, and drawings; acquisition of sites, purchase and erection of modular buildings, and purchases of trailers; and for provision of domestic and community sanitation 480 INDIAN HEALTH SERVICE—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 1997 General and special funds—Continued The Indian health facilities account supports construction, repair and improvement, equipment, and environmental health and facilities support for the Indian health services. INDIAN HEALTH FACILITIES—Continued 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, $275,251,000 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. Note.—A regular 1996 appropriation for this account had not been enacted at the time this budget was prepared. The 1996 amounts included in this budget are based on the levels provided in the three continuing resolutions: P.L. 104–91, P.L. 104–92, and P.L. 104–99. Unavailable Collections (in millions of dollars) Identification code 75–0391–0–1–551 1995 actual 1996 est. 1997 est. Balance, start of year: 01.99 Balance, start of year .................................................... ................... ................... ................... Receipts: 02.01 Rent and charges for quarters, Indian Health Service, HRSA, HHS ................................................................. 4 4 4 Appropriation: 05.01 Indian health facilities .................................................. –4 –4 –4 07.99 Total balance, end of year ............................................ ................... ................... ................... Object Classification (in millions of dollars) 1995 actual Identification code 75–0391–0–1–551 11.9 12.1 21.0 22.0 23.3 25.1 25.2 25.4 25.6 25.8 26.0 31.0 32.0 41.0 43.0 Total personnel compensation .............................. 53 58 54 Civilian personnel benefits ............................................ 16 18 18 Travel and transportation of persons ............................ 4 5 4 Transportation of things ................................................ 4 4 4 Communications, utilities, and miscellaneous charges 7 8 8 Advisory and assistance services .................................. 1 ................... ................... Other services ................................................................ 102 41 19 Operation and maintenance of facilities ...................... 59 23 31 Medical care .................................................................. ................... ................... 1 Subsistence and support of persons ............................. 14 5 35 Supplies and materials ................................................. 8 10 8 Equipment ...................................................................... 4 4 4 Land and structures ...................................................... 75 64 57 Grants, subsidies, and contributions ............................ 14 28 27 Interest and dividends ................................................... 10 12 10 99.9 Total obligations ........................................................ 1996 est. 1001 1005 1997 est. 00.01 01.01 02.01 05.01 Obligations by program activity: Construction ................................................................... Maintenance ................................................................... Facilities and environmental health .............................. Equipment ...................................................................... 188 84 93 6 116 51 99 14 128 43 95 13 10.00 Total obligations ........................................................ 371 280 279 Budgetary resources available for obligation: Unobligated balance available, start of year: Uninvested balance ................................................... 22.00 New budget authority (gross) ........................................ 149 258 36 ................... 244 279 21.40 23.90 23.95 24.40 Total budgetary resources available for obligation New obligations ............................................................. Unobligated balance available, end of year: Uninvested balance ................................................... 407 –371 280 –280 280 –279 36 ................... ................... New budget authority (gross), detail: Current: 40.00 Appropriation ............................................................. Permanent: 60.25 Appropriation (special fund, indefinite) .................... 253 239 275 4 4 4 70.00 Total new budget authority (gross) .......................... 258 244 279 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 ............................................................. 345 371 –302 413 280 –303 390 279 –291 413 390 378 Outlays (gross), detail: Outlays from new current authority .............................. 124 Outlays from current balances ...................................... 178 Outlays from new permanent authority ......................... ................... Outlays from permanent balances ................................ ................... 80 219 2 2 92 196 2 2 72.40 86.90 86.93 86.97 86.98 87.00 Total outlays (gross) ................................................. 302 303 291 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 257 302 244 303 279 291 45 6 2 371 49 6 3 280 46 5 3 279 Personnel Summary Identification code 75–0391–0–1–551 1995 actual 1997 est. 11.1 11.3 11.5 Program and Financing (in millions of dollars) Identification code 75–0391–0–1–551 1996 est. Personnel compensation: Full-time permanent .................................................. Other than full-time permanent ............................... Other personnel compensation .................................. Total compensable workyears: Full-time equivalent employment .................................. Full-time equivalent of overtime and holiday hours 1995 actual 1,471 36 1996 est. 1,460 36 1997 est. 1,446 35 ADMINISTRATIVE PROVISIONS, INDIAN HEALTH SERVICE 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 passenger motor vehicles and aircraft; purchase of medical equipment; purchase of reprints; purchase, renovation and erection of modular buildings and renovation of existing facilities; payments for telephone service in private residences in the field, when authorized under regulations approved by the Secretary; and for uniforms or allowances therefor 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 the Indian Health Service shall neither bill nor charge those Indians who may have the economic means to pay unless and until such time as Congress has agreed upon a specific policy to do so and has directed the Indian Health Service to implement such a policy: 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 CENTERS FOR DISEASE CONTROL AND PREVENTION Federal Funds DEPARTMENT OF HEALTH AND HUMAN SERVICES 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 for such costs that 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 the appropriation structure for the Indian Health Service may not be altered without advance notice to the House and Senate Committees on Appropriations. 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 101–103, and 201–203 of the Federal Mine Safety and Health Act of 1977, and sections 20–22 of the Occupational Safety and Health Act of 1970; including insurance of official motor vehicles in foreign countries; and hire, maintenance, and operation of aircraft, $2,198,258,000, of which $8,353,000 shall remain available until expended for equipment, construction, and renovation of facilities, and of which $32,000,000 shall be available until expended for mine safety and health research; and in addition, such sums as may be derived from authorized user fees, which shall be credited to this account: Provided, That for fiscal year 1997 and subsequent fiscal years training of private persons shall be made subject to reimbursement or advances to this appropriation for not in excess of the full cost of such training: Provided further, That funds appropriated under this heading for fiscal year 1997 and subsequent fiscal years shall be available for payment of the costs of medical care, related expenses, and burial expenses hereafter incurred by or on behalf of any person who had participated in the study of untreated syphilis initiated in Tuskegee, Alabama, in 1932, in such amounts and subject to such terms and conditions as prescribed by the Secretary of Health and Human Services and for payment, in such amounts and subject to such terms and conditions, of such costs and expenses hereafter incurred by or on behalf of such person’s wife or offspring determined by the Secretary to have suffered injury or disease from syphilis contracted from such person: Provided further, That for fiscal year 1997 and subsequent fiscal years amounts received by the National Center for Health Statistics from reimbursements and interagency agreements and the sale of data tapes may be credited to this appropriation and shall remain available until expended: Provided further, That in addition to amounts provided herein, up to $53,063,000 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. Note.—A regular 1996 appropriation for this account had not been enacted at the time this budget was prepared. The 1996 amounts included in this budget are based on the levels provided in three continuing resolutions: P.L. 104–91, P.L. 104–92, and P.L. 104– 99. VIOLENT CRIME REDUCTION PROGRAMS For Education and Prevention Grants to reduce sexual assaults against women and to establish Community Programs on Domestic Violence, as authorized by sections 40151, 40261, and 40293 of Public Law 103–322 (including administrative costs), $31,642,000, to remain available until expended, which shall be derived from the Violent Crime Reduction Trust Fund. Unavailable Collections (in millions of dollars) Identification code 75–0943–0–1–999 1995 actual 1996 est. 05.01 07.99 481 Appropriation: Disease control, research, and training ........................ –1 –1 –1 Total balance, end of year ............................................ ................... ................... ................... Program and Financing (in millions of dollars) Identification code 75–0943–0–1–999 Obligations by program activity: Direct program: 00.01 Preventive health block grant ................................... 00.02 Prevention centers ..................................................... 00.03 Sexually transmitted diseases .................................. 00.04 STD TB Performance Partnership .............................. 00.05 Immunization ............................................................. 00.06 Immunization Performance Partnership .................... 00.07 Infectious diseases .................................................... 00.08 Chronic and environmental diseases ........................ 00.09 Chronic Disease Disability Performance Partnership 00.10 Occupational Safety and Health ............................... 00.11 Mine Safety and Health ............................................ 00.12 Epidemic services ...................................................... 00.13 Health statistics ........................................................ 00.14 HIV ............................................................................. 00.15 HIV Performance Partnership .................................... 00.16 Buildings and facilities ............................................. 00.17 Program management ............................................... 00.18 Violence Prevention Activities ................................... 00.19 Violent crime reduction programs ............................. 1995 actual 158 8 105 ................... 464 ................... 173 320 ................... 132 ................... 73 54 590 ................... 6 3 ................... ................... 1996 est. 1997 est. 145 145 8 7 106 22 ................... 185 468 311 ................... 177 183 104 348 230 ................... 117 129 137 ................... 32 68 67 38 35 585 320 ................... 298 48 8 3 3 32 ................... ................... 32 00.91 01.01 Total direct program ............................................. Reimbursable program .................................................. 2,086 134 2,161 173 2,230 173 10.00 Total obligations ........................................................ 2,220 2,334 2,403 Budgetary resources available for obligation: Unobligated balance available, start of year: Uninvested balance ................................................... 22.00 New budget authority (gross) ........................................ 48 2,218 46 ................... 2,288 2,403 21.40 23.90 23.95 24.40 Total budgetary resources available for obligation New obligations ............................................................. Unobligated balance available, end of year: Uninvested balance ................................................... 2,266 –2,220 2,334 –2,334 2,403 –2,403 46 ................... ................... New budget authority (gross), detail: Current: 40.00 Appropriation ............................................................. 2,083 2,115 42.00 Transferred from other accounts .............................. ................... ................... 2,198 32 43.00 60.25 68.00 70.00 Appropriation (total) ............................................. Permanent: Appropriation (special fund, indefinite) .................... Spending authority from offsetting collections: Offsetting collections (cash) ..................................... 2,083 2,115 2,230 1 1 1 134 173 173 Total new budget authority (gross) .......................... 2,218 2,288 2,403 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 86.90 86.93 86.97 86.98 87.00 1,834 2,124 2,315 2,220 2,334 2,403 –1,920 –2,142 –2,237 –10 ................... ................... 2,124 2,315 2,483 Outlays (gross), detail: Outlays from new current authority .............................. 836 Outlays from current balances ...................................... 1,084 Outlays from new permanent authority ......................... ................... Outlays from permanent balances ................................ ................... 701 1,267 173 1 740 1,323 173 1 Total outlays (gross) ................................................. 1,920 2,142 2,237 Offsets: Against gross budget authority and outlays: Offsetting collections (cash) from: 88.00 Federal sources ..................................................... 88.40 Non-Federal sources ............................................. –133 –1 –171 –2 –171 –2 88.90 Total, offsetting collections (cash) .................. –134 –173 –173 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 2,084 1,786 2,115 1,969 2,230 2,064 1997 est. Balance, start of year: 01.99 Balance, start of year .................................................... ................... ................... ................... Receipts: 02.01 Cooperative Research and Development Agreements, Centers for Disease Control ...................................... 1 1 1 482 CENTERS FOR DISEASE CONTROL AND PREVENTION—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 1997 General and special funds—Continued ALLOCATIONS RECEIVED FROM OTHER ACCOUNTS VIOLENT CRIME REDUCTION PROGRAMS—Continued 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.’’ [Dollars in millions] 1995 Distribution of budget authority by account: Disease control, research and training .................................. Violent crime reduction programs .......................................... Distribution of outlays by account: Disease control, research and training .................................. Violent crime reduction programs .......................................... 1996 1997 2,084 0 2,115 0 2,198 32 1,786 0 1,969 0 2,053 11 NATIONAL INSTITUTES OF HEALTH Federal Funds General and special funds: Summary of Budget Authority and Outlays NATIONAL CANCER INSTITUTE [In millions of dollars] For carrying out section 301 and title IV (except section 417B(d)) of the Public Health Service Act with respect to cancer, $2,060,392,000. 1995 actual Enacted/requested: Budget Authority ..................................................................... 2,084 Outlays .................................................................................... 1,786 Adjustment to 1996 continuing resolution levels: Budget Authority ..................................................................... .................... Outlays .................................................................................... .................... Total: Budget Authority ..................................................................... Outlays .................................................................................... 2,084 1,786 1996 est. 1997 est. 2,116 1,969 2,231 2,064 8 .................... 3 3 2,124 1,972 2,231 2,067 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. Beginning in FY 1997, CDC also includes funding for mine safety and health research previously conducted by the former Bureau of Mines. This display also includes amounts derived from the Violent Crime Reduction Trust Fund. Object Classification (in millions of dollars) 1995 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 23.2 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 ............................. 242 11 12 NATIONAL HEART, LUNG, 233 12 12 1997 est. 262 12 12 Total personnel compensation ......................... 265 257 286 Civilian personnel benefits ....................................... 68 66 74 Benefits for former personnel ................................... 8 3 ................... Travel and transportation of persons ....................... 16 16 17 Transportation of things ........................................... 3 3 3 Rental payments to GSA ........................................... 14 15 15 Rental payments to others ........................................ 1 1 1 Communications, utilities, and miscellaneous charges ................................................................. 17 12 13 Printing and reproduction ......................................... 5 4 4 Advisory and assistance services ............................. 2 2 2 Other services ............................................................ 68 62 53 Research and development contracts ....................... 175 177 198 Operation and maintenance of equipment ............... ................... ................... 10 Supplies and materials ............................................. 99 116 137 Equipment ................................................................. 34 36 42 Land and structures .................................................. 1 46 6 Grants, subsidies, and contributions ........................ 1,310 1,345 1,369 99.0 99.0 99.5 Subtotal, direct obligations .................................. Reimbursable obligations .............................................. Below reporting threshold .............................................. 2,086 133 1 2,161 172 1 2,230 172 1 99.9 Total obligations ........................................................ 2,220 2,334 NATIONAL INSTITUTE NATIONAL INSTITUTE OF NATIONAL INSTITUTE 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 1995 actual 1996 est. 1997 est. 5,294 36 60 5,707 36 60 684 2 884 2 884 2 AND KIDNEY OF NEUROLOGICAL DISORDERS AND STROKE 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, $584,362,000. 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, $936,573,000. 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, $543,441,000. 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, $310,072,000. NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES For carrying out section 301 and 311, and title IV of the Public Health Service Act with respect to environmental health sciences, $289,114,000. NATIONAL INSTITUTE ON AGING For carrying out section 301 and title IV of the Public Health Service Act with respect to aging, $461,541,000. 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, $243,169,000. NATIONAL INSTITUTE 5,487 32 60 DIABETES AND DIGESTIVE DISEASES For carrying out section 301 and title IV of the Public Health Service Act with respect to neurological disorders and stroke, $671,148,000. NATIONAL INSTITUTE Identification code 75–0943–0–1–999 DENTAL RESEARCH OF For carrying out section 301 and title IV of the Public Health Service Act with respect to diabetes and digestive and kidney diseases, $772,975,000. 2,403 Personnel Summary BLOOD INSTITUTE For carrying out section 301 and title IV of the Public Health Service Act with respect to dental disease, $174,463,000. NATIONAL INSTITUTE 1996 est. AND 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, $1,320,555,000. 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, $179,090,000. NATIONAL INSTITUTE OF NURSING RESEARCH For carrying out section 301 and title IV of the Public Health Service Act with respect to nursing research, $51,951,000. NATIONAL INSTITUTES OF HEALTH—Continued Federal Funds—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES NATIONAL INSTITUTE ALCOHOL ABUSE ON AND ALCOHOLISM For carrying out section 301 and title IV of the Public Health Service Act with respect to alcohol abuse, and alcoholism, $192,280,000. NATIONAL INSTITUTE ON DRUG ABUSE Receipts: Cooperative Research and Development Agreements, NIH ............................................................................. 8 8 8 Appropriation: 05.01 National Institutes of Health ......................................... –8 –8 –8 07.99 Total balance, end of year ............................................ ................... ................... ................... 02.01 For carrying out section 301 and title IV of the Public Health Service Act with respect to drug abuse, $312,014,000. NATIONAL INSTITUTE OF MENTAL HEALTH NATIONAL CENTER 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, $309,344,000: 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. NATIONAL CENTER FOR HUMAN GENOME RESEARCH For carrying out section 301 and title IV of the Public Health Service Act with respect to human genome research, $177,788,000. JOHN E. FOGARTY INTERNATIONAL CENTER For carrying out the activities at the John E. Fogarty International Center, $15,790,000. NATIONAL LIBRARY OF MEDICINE For carrying out section 301 and title IV of the Public Health Service Act with respect to health information communications, $143,268,000, of which $4,000,000 shall be available until expended for improvement of information systems: Provided, That in fiscal year 1997 and thereafter, 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. OFFICE OF THE DIRECTOR (INCLUDING TRANSFER OF FUNDS) OF Obligations by program activity: National Cancer Institute .............................................. National Heart, Lung, and Blood Institute .................... National Institute of Dental Research ........................... National Institute of Diabetes and Digestive and Kidney Disease ............................................................... 00.05 National Institute of Neurological Disorders and Stroke 00.06 National Institute of Allergy and Infectious Diseases 00.07 National Institute of General Medical Sciences ............ 00.08 National Institute of Child Health and Human Development ....................................................................... 00.09 National Eye Institute .................................................... 00.10 National Institute of Environmental Health Sciences 00.11 National Institute on Aging ........................................... 00.12 National Institute of Arthritis and Musculoskeletal and Skin Disease .............................................................. 00.13 National Institute on Deafness and Other Communication Disorder .............................................................. 00.14 National Institute of Nursing Research ......................... 00.15 National Institute of Alcohol Abuse and Alcoholism 00.16 National Institute on Drug Abuse .................................. 00.17 National Institute of Mental Health .............................. 00.18 National Center for Research Resources ....................... 00.19 National Center for Human Genome Research ............. 00.20 John E. Fogarty International Center ............................. 00.21 National Library of Medicine ......................................... 00.22 Office of the Director ..................................................... 00.23 Office of AIDS Research ................................................ 00.24 Buildings and facilities ................................................. 00.25 Cooperative research and development agreements .... 01.01 Reimbursements ............................................................ 00.01 00.02 00.03 00.04 10.00 For carrying out the responsibilities of the Office of the Director, National Institutes of Health, $226,913,000: 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 third party payments for the cost of clinical services that are incurred in National Institutes of Health research facilities 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 deposited. OFFICE Program and Financing (in millions of dollars) Identification code 75–9915–0–1–552 For carrying out section 301 and title IV of the Public Health Service Act with respect to mental health, $578,149,000. AIDS RESEARCH 483 Total obligations ........................................................ Budgetary resources available for obligation: Unobligated balance available, start of year: Uninvested balance ................................................... 22.00 New budget authority (gross) ........................................ 22.30 Unobligated balance expiring ........................................ 1995 actual 1996 est. 1997 est. 1,939 1,266 165 2,271 1,363 187 2,080 1,328 178 741 631 556 895 786 686 1,190 967 788 676 606 956 541 301 357 436 625 326 370 460 572 322 371 467 231 246 247 169 181 50 61 183 201 293 461 547 669 294 399 153 171 25 36 138 153 272 321 1,333 ................... 154 302 6 8 5 5 183 59 194 315 588 318 179 27 155 286 1,432 422 8 23 11,681 12,445 12,780 21.40 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: 60.25 Appropriation (special fund, indefinite) .................... Spending authority from offsetting collections: 68.00 Offsetting collections (cash) ................................ 68.10 Change in orders on hand from Federal sources 267 153 ................... 11,569 12,292 12,780 –2 ................... ................... 11,834 –11,681 12,445 –12,445 12,780 –12,780 153 ................... ................... 11,240 11,939 12,406 8 8 8 264 345 366 57 ................... ................... (INCLUDING TRANSFER OF FUNDS) For carrying out part D of title XXIII of the Public Health Service Act, $1,431,908,000: 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, construction, and acquisition of equipment for, facilities of or used by the National Institutes of Health, including the acquisition of real property, $420,000,000, to remain available until expended. Note.—A regular 1996 appropriation for this account had not been enacted at the time this budget was prepared. The 1996 amounts included in this budget are based on the levels provided in three continuing resolutions: P.L. 104–91, P.L. 104–92, and P.L. 104– 99. Unavailable Collections (in millions of dollars) Identification code 75–9915–0–1–552 01.99 1995 actual 1996 est. 1997 est. Balance, start of year: Balance, start of year .................................................... ................... ................... ................... 68.90 Spending authority from offsetting collections (total) ........................................................... 321 345 366 Total new budget authority (gross) .......................... 11,569 12,292 12,780 Change in unpaid obligations: Unpaid obligations, start of year: 72.40 Obligated balance: Appropriation ............................. 72.95 Orders on hand from Federal sources ...................... 7,283 4,137 7,714 4,194 8,890 4,194 70.00 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 86.90 11,420 11,908 13,084 11,681 12,445 12,780 –11,147 –11,269 –12,323 –46 ................... ................... 7,714 4,194 8,890 4,194 9,347 4,194 Total unpaid obligations, end of year .................. 11,908 13,084 13,541 Outlays (gross), detail: Outlays from new current authority .............................. 5,515 5,090 5,259 484 NATIONAL INSTITUTES OF HEALTH—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 1997 Buildings and Facilities .......................................................... AND FACILITIES—Continued Program and Financing (in millions of dollars)—Continued 1995 actual Identification code 75–9915–0–1–552 1996 est. Outlays from current balances ...................................... Outlays from new permanent authority ......................... 5,360 272 5,826 353 6,690 374 87.00 Total outlays (gross) ................................................. 11,147 11,269 12,323 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 10,875 8 10,916 8 11,949 8 10,883 10,924 11,957 This program funds biomedical research and research training. 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. –264 –345 –366 –57 ................... ................... Object Classification (in millions of dollars) 11,947 10,924 12,414 11,957 1995 1996 1997 1,912 1,259 162 2,251 1,356 183 2,060 1,321 174 726 627 535 880 512 291 266 432 771 682 1,170 947 595 314 289 454 773 671 584 937 543 310 289 462 228 242 243 167 177 48 56 181 199 290 458 542 661 287 390 153 170 15 25 125 141 214 261 1,334 .................... 54 146 179 52 192 312 578 309 178 16 143 227 1,432 420 Subtotal .......................................................................... Cooperative Research and Development Agreements ............ 11,240 8 11,939 8 12,406 8 Total Budget Authority, NIH ........................................... 11,248 11,947 11.1 11.3 11.5 11.8 11.9 12.1 13.0 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 .................... 25.4 25.5 25.6 25.7 25.8 26.0 31.0 41.0 42.0 Total personnel compensation ......................... Civilian personnel benefits ....................................... Benefits for former personnel ................................... 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 ........................... 99.0 99.0 99.5 Subtotal, direct obligations .................................. Reimbursable obligations .............................................. Below reporting threshold .............................................. 99.9 Total obligations ........................................................ 24.0 25.1 25.2 25.3 12,414 1995 1996 1997 1,809 1,220 157 2,085 1,262 162 2,024 1,300 172 712 608 516 857 519 281 271 424 706 637 1,025 877 543 301 261 410 756 660 567 922 534 307 284 451 221 224 239 163 166 54 46 172 180 271 421 511 609 277 366 134 154 15 22 124 132 175 222 1,280 .................... 176 50 185 303 564 315 171 15 140 212 1,380 1996 est. 1997 est. 439 94 21 78 449 99 21 84 464 102 22 88 632 132 5 19 4 6 6 653 136 2 18 4 6 6 676 141 2 19 4 6 4 42 17 16 347 42 14 18 529 43 15 18 637 847 84 727 5 33 21 126 92 8,195 3 795 74 831 4 27 7 129 82 8,722 2 824 74 769 4 27 7 128 81 8,933 2 11,359 12,101 12,414 321 344 366 1 ................... ................... 11,681 12,445 12,780 Personnel Summary 1995 actual Identification code 75–9915–0–1–552 [Dollars in millions] 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 ............. National Institute on Drug Abuse ........................................... National Institute of Mental Health ....................................... National Center for Research Resources ................................ National Center for Human Genome Research ...................... John E. Fogarty International Center ...................................... National Library of Medicine .................................................. Office of the Director .............................................................. Office of AIDS Research ......................................................... 1995 actual Identification code 75–9915–0–1–552 11,248 10,883 [Dollars in millions] Distribution of budget authority 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 Disorder 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 ............. National Institute on Drug Abuse ........................................... National Institute of Mental Health ....................................... National Center for Research Resources ................................ National Center for Human Genome Research ...................... John E. Fogarty International Center ...................................... National Library of Medicine .................................................. Office of the Director .............................................................. Office of AIDS Research ......................................................... Buildings and Facilities .......................................................... 222 1997 est. 86.93 86.97 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 ......... 105 Total Outlays, NIH .......................................................... BUILDINGS 103 Subtotal Outlays ............................................................ Cooperative Research and Development Agreements ............ General and special funds—Continued 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 est. 1997 est. 15,275 211 15,388 200 15,388 200 86 86 86 SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION Federal Funds General and special funds: SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES For carrying out the Public Health Service Act with respect to substance abuse and mental health services, section 612 of Public Law 100–77, as amended, and the Protection and Advocacy for Mentally Ill Individuals Act of 1986, $2,098,011,000. Note.—A regular 1996 appropriation for this account had not been enacted at the time this budget was prepared. The 1996 amounts included in this budget are based on the levels provided in three continuing resolutions: P.L. 104–91, P.L. 104–92, and P.L. 104– 99. AGENCY FOR HEALTH CARE POLICY AND RESEARCH Federal Funds DEPARTMENT OF HEALTH AND HUMAN SERVICES Program and Financing (in millions of dollars) 1995 actual Identification code 75–1362–0–1–550 Object Classification (in millions of dollars) 1996 est. 1997 est. Obligations by program activity: Mental health and substance abuse activities ............ Mental health partnership ............................................. Substance abuse partnership ........................................ Program management ................................................... 588 305 1,241 61 223 275 1,234 57 496 275 1,272 55 00.91 01.01 Total direct program ................................................. Reimbursable program .................................................. 2,195 19 1,789 20 2,098 20 10.00 Total obligations ........................................................ 2,214 1,809 2,118 Total budgetary resources available for obligation New obligations ............................................................. Unobligated balance available, end of year: Uninvested balance ................................................... Direct obligations: Personnel compensation: Full-time permanent ............................................. Other than full-time permanent ........................... Other personnel compensation ............................. 11.1 11.3 11.5 2 2,214 2 1,809 2 2,118 2,216 –2,214 1,811 –1,809 2,120 –2,118 2 2 2 New budget authority (gross), detail: Current: 40.00 Appropriation ............................................................. 42.00 Transferred from other accounts .............................. Appropriation (total) ............................................. Permanent: Spending authority from offsetting collections: Offsetting collections (cash) ..................................... 2,195 1,789 2,098 19 20 20 Total new budget authority (gross) .......................... 2,214 1,809 2,118 70.00 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 ............................................................. 31 2 1 32 2 1 33 2 1 34 7 2 3 35 7 1 3 36 7 1 3 2 4 51 103 2 2 33 70 2 2 43 90 31.0 41.0 42.0 18 2 1,967 2 8 1 1,625 2 16 1 1,895 2 99.0 99.0 Subtotal, direct obligations .................................. Reimbursable obligations .............................................. 2,195 19 1,789 20 2,098 20 Total obligations ........................................................ 2,214 1,809 2,118 24.0 25.1 25.2 25.3 Personnel Summary 1995 actual Identification code 75–1362–0–1–550 68.00 1997 est. 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 ........................... 2,181 1,789 2,098 14 ................... ................... 43.00 11.9 12.1 21.0 23.1 23.3 1996 est. 99.9 21.40 23.90 23.95 24.40 1995 actual Identification code 75–1362–0–1–550 00.01 00.02 00.03 00.04 Budgetary resources available for obligation: Unobligated balance available, start of year: Uninvested balance ................................................... 22.00 New budget authority (gross) ........................................ 485 1,514 1,250 969 2,214 1,809 2,118 –2,463 –2,090 –2,015 –15 ................... ................... 1,250 969 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 ................. 1996 est. 1997 est. 628 2 647 2 647 2 2 74 2 74 2 74 AGENCY FOR HEALTH CARE POLICY AND RESEARCH 1,072 Federal Funds General and special funds: 86.90 86.93 86.97 Outlays (gross), detail: Outlays from new current authority .............................. Outlays from current balances ...................................... Outlays from new permanent authority ......................... 1,183 1,261 19 967 1,103 20 1,134 861 20 87.00 Total outlays (gross) ................................................. 2,463 2,090 2,015 Offsets: Against gross budget authority and outlays: 88.00 Offsetting collections (cash) from: Federal sources –19 –20 –20 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 2,195 2,444 1,789 2,070 2,098 1,995 89.00 90.00 Summary of Budget Authority and Outlays [In millions of dollars] 1995 actual Enacted/requested: Budget Authority ..................................................................... 2,195 Outlays .................................................................................... 2,444 Adjustment to 1996 continuing resolution levels: Budget Authority ..................................................................... .................... Outlays .................................................................................... .................... Total: Budget Authority ..................................................................... Outlays .................................................................................... 2,195 2,444 1996 est. 1,789 2,070 1997 est. HEALTH CARE POLICY AND Note.—A regular 1996 appropriation for this account had not been enacted at the time this budget was prepared. The 1996 amounts included in this budget are based on the levels provided in three continuing resolutions: P.L. 104–91, P.L. 104–92, and P.L. 104– 99. 2,098 1,995 Program and Financing (in millions of dollars) Identification code 75–1700–0–1–552 65 .................... 35 29 1,854 2,105 2,098 2,024 This program provides Federal support for treatment and prevention in the areas of alcoholism, drug abuse, and mental health. 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, $84,000,000, together with not to exceed $5,796,000 to be transferred from the Federal Hospital Insurance and the Federal Supplementary Medical Insurance Trust Funds, as authorized by sections 1142 and 201(g) of the Social Security Act; 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; and in addition, $53,984,000 from amounts available pursuant to section 241 of the Public Health Service Act, to be transferred and credited to this appropriation for authorized purposes under this heading: Provided, That $44,700,000 of the funds provided shall be for the Medical Expenditure Panel Survey. 1995 actual 1996 est. 1997 est. 01.01 01.02 01.03 01.04 Obligations by program activity: Research on Health Care Systems and Access ............ Health Insurance and Expenditure Survey .................... Research on Health Care Outcomes and Quality .......... Program support ............................................................ 49 10 74 2 25 10 25 2 29 10 43 2 01.91 04.01 Total direct program ................................................. Reimbursable program .................................................. 135 33 62 74 84 69 10.00 Total obligations ........................................................ 168 136 153 486 AGENCY FOR HEALTH CARE POLICY AND RESEARCH—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 1997 General and special funds—Continued 99.0 Reimbursable obligations .............................................. 33 74 69 HEALTH CARE POLICY 99.9 Total obligations ........................................................ 168 136 153 AND RESEARCH—Continued Program and Financing (in millions of dollars)—Continued Personnel Summary 1995 actual Identification code 75–1700–0–1–552 1996 est. 1997 est. 1995 actual Identification code 75–1700–0–1–552 Budgetary resources available for obligation: 22.00 New budget authority (gross) ........................................ 23.95 New obligations ............................................................. New budget authority (gross), detail: Current: 40.00 Appropriation ............................................................. Permanent: 68.00 Spending authority from offsetting collections: Offsetting collections (cash) ..................................... 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 ............................................................. 168 –168 136 –136 153 –153 135 62 84 33 74 136 153 72.40 158 159 98 168 136 153 –166 –197 –153 –1 ................... ................... 159 98 98 86.90 86.93 86.97 Outlays (gross), detail: Outlays from new current authority .............................. Outlays from current balances ...................................... Outlays from new permanent authority ......................... 23 110 33 12 111 74 14 69 69 87.00 Total outlays (gross) ................................................. 166 197 153 Offsets: Against gross budget authority and outlays: 88.00 Offsetting collections (cash) from: Federal sources –33 –74 –69 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 135 133 62 123 84 84 89.00 90.00 1996 est. 1997 est. 69 168 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 ............................................................... Summary of Budget Authority and Outlays [In millions of dollars] Enacted/requested: 1995 actual Budget Authority ..................................................................... 135 Outlays .................................................................................... 133 Adjustment to 1996 continuing resolution levels: Budget Authority ..................................................................... .................... Outlays .................................................................................... .................... 1996 est. 1997 est. 62 123 84 83 15 .................... 3 8 170 1 183 1 183 1 84 84 84 ASSISTANT SECRETARY FOR HEALTH Activities of the Office of the Assistant Secretary for Health have been transferred to the Office of the Secretary effective in FY 1996 and are now displayed in the Departmental Management or Program Support Center bureaus. 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, $75,056,618,000, to remain available until expended. For making, after May 31, 1997, payments to States under title XIX for the last quarter of fiscal year 1997 for unanticipated cost incurred for the current fiscal year, such sums as may be necessary. For making payments to States under title XIX for the first quarter of fiscal year 1998, $27,988,993,000, 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. Note.—A regular 1996 appropriation for this account had not been enacted at the time this budget was prepared. The 1996 amounts included in this budget are based on the levels provided in three continuing resolutions: P.L. 104–91, P.L. 104–92, and P.L. 104– 99. Program and Financing (in millions of dollars) Total: Budget Authority ..................................................................... Outlays .................................................................................... 135 133 77 126 84 91 Identification code 75–0512–0–1–551 1995 actual 1996 est. 1997 est. 00.01 00.02 00.03 Obligations by program activity: Medicaid vendor payments ............................................ State and local administration ..................................... Vaccine purchases ......................................................... 85,278 3,835 420 90,481 4,198 213 97,653 4,172 469 10.00 This activity supports research and information dissemination on health care services and technology, medical effectiveness, and patient outcomes. Total obligations (object class 41.0) ........................ 89,533 94,892 102,294 Budgetary resources available for obligation: Unobligated balance available, start of year: Uninvested balance ................................................... 22.00 New budget authority (gross) ........................................ 13,033 89,241 12,740 83,252 1,101 101,193 102,274 –89,533 95,992 –94,892 102,294 –102,294 Object Classification (in millions of dollars) Identification code 75–1700–0–1–552 11.1 11.3 11.9 12.1 23.1 23.3 Direct obligations: Personnel compensation: Full-time permanent ............................................. Other than full-time permanent ........................... Total personnel compensation ......................... Civilian personnel benefits ....................................... Rental payments to GSA ........................................... Communications, utilities, and miscellaneous charges ................................................................. Printing and reproduction ......................................... Other services ............................................................ Purchases of goods and services from Government accounts ................................................................ Research and development contracts ....................... Equipment ................................................................. Grants, subsidies, and contributions ........................ 1995 actual 1996 est. 1997 est. 9 1 9 1 10 1 10 2 1 10 3 3 11 3 3 21.40 23.90 23.95 24.40 Total budgetary resources available for obligation New obligations ............................................................. Unobligated balance available, end of year: Uninvested balance ................................................... 12,740 1,101 ................... 25.5 31.0 41.0 99.0 Subtotal, direct obligations .................................. 5 36 1 73 135 2 25 1 13 62 2 22 1 37 84 New budget authority (gross), detail: Current: 40.00 Appropriation ............................................................. Permanent: 65.00 Advance appropriation (definite) .............................. 62,641 56,204 75,057 26,600 27,048 26,136 70.00 Total new budget authority (gross) .......................... 89,241 83,252 101,193 72.40 24.0 25.2 25.3 1 ................... ................... 2 2 2 4 3 3 Change in unpaid obligations: Unpaid obligations, start of year: Obligated balance: Appropriation ............................................................. 4,144 4,606 4,606 HEALTH CARE FINANCING ADMINISTRATION—Continued Federal Funds—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES 73.10 73.20 74.40 New obligations ............................................................. Total outlays (gross) ...................................................... Unpaid obligations, end of year: Obligated balance: Appropriation ............................................................. 89,533 –89,070 94,892 –94,892 102,294 –102,294 4,606 4,606 4,606 Outlays (gross), detail: Outlays from new current authority .............................. Outlays from current balances ...................................... Outlays from new permanent authority ......................... 45,293 17,177 26,600 50,498 17,346 27,048 70,450 5,707 26,136 87.00 Total outlays (gross) ................................................. 89,070 94,892 102,294 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 89,241 89,070 83,252 94,892 101,193 102,294 Summary of Budget Authority and Outlays STATES FOR 89,241 89,070 83,252 94,892 1997 est. 36,955 406 56 130 61,331 358 61 149 59,456 405 76 142 3,913 –1 4,069 –10 4,349 1 Total obligations ........................................................ 41,459 65,958 64,429 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ New obligations ............................................................. 41,459 –41,459 65,958 –65,958 64,429 –64,429 New budget authority (gross), detail: Current: 40.00 Appropriation ............................................................. Permanent: 60.05 Appropriation (indefinite) .......................................... 37,547 61,899 60,079 3,912 4,059 4,350 70.00 Total new budget authority (gross) .......................... 41,459 65,958 64,429 73.10 73.20 73.40 Change in unpaid obligations: New obligations ............................................................. Total outlays (gross) ...................................................... Adjustments in expired accounts .................................. 41,459 65,958 64,429 –41,492 –65,958 –64,429 33 ................... ................... 86.90 86.93 86.97 101,193 102,293 3,277 3,277 104,470 105,570 Outlays (gross), detail: Outlays from new current authority .............................. Outlays from current balances ...................................... Outlays from new permanent authority ......................... 37,547 61,899 60,079 33 ................... ................... 3,912 4,059 4,350 87.00 Total outlays (gross) ................................................. 41,492 65,958 64,429 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 41,459 41,492 65,958 65,958 64,429 64,429 MEDICAID (Legislative proposal, subject to PAYGO) Program and Financing (in millions of dollars) 1995 actual Identification code 75–0512–4–1–551 Obligations by program activity: Supplementary medical insurance (SMI) ....................... Hospital Insurance for uninsured (HI) ........................... Federal uninsured payment (HI) .................................... Program management (HI) ............................................ Federal payments from taxation of OASDI benefits (HI) ............................................................................. 00.07 SECA tax credits (HI) ..................................................... 00.01 00.02 00.03 00.04 00.06 1996 est. 1997 est. 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. TO 1995 actual Identification code 75–0580–0–1–571 10.00 [In millions of dollars] Enacted/requested: 1995 actual 1996 est. Budget Authority ..................................................................... 89,241 83,252 Outlays .................................................................................... 89,070 94,892 Legislative proposal, subject to PAYGO: Budget Authority ..................................................................... .................... .................... Outlays .................................................................................... .................... .................... GRANTS Note.—A regular 1996 appropriation for this account had not been enacted at the time this budget was prepared. The 1996 amounts included in this budget are based on the levels provided in three continuing resolutions: P.L. 104–91, P.L. 104–92, and P.L. 104– 99. Program and Financing (in millions of dollars) 86.90 86.93 86.97 Total: Budget Authority ..................................................................... Outlays .................................................................................... 487 1996 est. 1997 est. 10.00 Obligations by program activity: Total obligations (object class 41.0) ............................ ................... ................... 3,277 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ ................... ................... New obligations ............................................................. ................... ................... 3,277 –3,277 40.00 New budget authority (gross), detail: Appropriation .................................................................. ................... ................... 3,277 Summary of Budget Authority and Outlays [In millions of dollars] Change in unpaid obligations: 73.10 New obligations ............................................................. ................... ................... 73.20 Total outlays (gross) ...................................................... ................... ................... 3,277 –3,277 86.90 Outlays (gross), detail: Outlays from new current authority .............................. ................... ................... 3,277 87.00 Total outlays (gross) ................................................. ................... ................... 3,277 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ ................... ................... Outlays ........................................................................... ................... ................... 3,277 3,277 This schedule reflects the effects of the Medicaid, Medicare, and Veterans’ reform proposals contained in the Administration’s balanced budget proposal on the Grants to States for Medicaid account. Enacted/requested: 1995 actual 1996 est. Budget Authority ..................................................................... 41,459 65,958 Outlays .................................................................................... 41,492 65,958 Legislative proposal, not subject to PAYGO: Budget Authority ..................................................................... .................... .................... Outlays .................................................................................... .................... .................... Total: Budget Authority ..................................................................... Outlays .................................................................................... 41,459 41,492 65,958 65,958 1997 est. 64,429 64,429 7,867 7,867 72,296 72,296 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 were included for non-Medicare activities of HCFA Program Management. Object Classification (in millions of dollars) 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, $60,079,000,000. Identification code 75–0580–0–1–571 1995 actual 1996 est. 1997 est. 41.0 42.0 92.0 Grants, subsidies, and contributions ............................ Insurance claims and indemnities ................................ Undistributed ................................................................. 40,867 462 130 65,390 419 149 63,806 481 142 99.9 Total obligations ........................................................ 41,459 65,958 64,429 488 HEALTH CARE FINANCING ADMINISTRATION—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 1997 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 General and special funds—Continued PAYMENTS TO HEALTH CARE TRUST FUNDS (Legislative proposal, not subject to PAYGO) 68.90 Program and Financing (in millions of dollars) Identification code 75–0580–2–1–571 10.00 1995 actual 1996 est. Obligations by program activity: Total obligations (object class 42.0) ............................ ................... ................... 1997 est. 7,867 Budgetary resources available for obligation: 22.00 New budget authority (gross) ........................................ ................... ................... 23.95 New obligations ............................................................. ................... ................... 7,867 –7,867 New budget authority (gross), detail: Appropriation .................................................................. ................... ................... 7,867 2,142 2,165 2,245 47 ................... ................... Spending authority from offsetting collections (total) ................................................................ 2,189 2,165 2,245 Total new budget authority (gross) .......................... 2,189 2,165 2,245 Change in unpaid obligations: Unpaid obligations, start of year: 72.40 Obligated balance: Appropriation ............................. 72.95 Orders on hand from Federal sources ...................... 428 27 445 74 445 74 70.00 74.40 74.95 Change in unpaid obligations: 73.10 New obligations ............................................................. ................... ................... 73.20 Total outlays (gross) ...................................................... ................... ................... 7,867 –7,867 86.90 Outlays (gross), detail: Outlays from new current authority .............................. ................... ................... 7,867 87.00 Total outlays (gross) ................................................. ................... ................... 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 .................. 86.97 86.98 Outlays (gross), detail: Outlays from new permanent authority ......................... Outlays from permanent balances ................................ 87.00 40.00 72.99 73.10 73.20 73.40 455 519 519 2,194 2,165 2,245 –2,145 –2,165 –2,245 15 ................... ................... Total outlays (gross) ................................................. 2,145 2,165 2,245 Offsets: Against gross budget authority and outlays: Offsetting collections (cash) from: 88.00 Federal sources ..................................................... 88.40 Non-Federal sources ............................................. –2,109 –33 –2,128 –37 –2,202 –43 88.90 88.95 –2,142 –2,165 –2,245 –47 ................... ................... 445 74 445 74 445 74 519 519 519 7,867 Net budget authority and outlays: 89.00 Budget authority ............................................................ ................... ................... 90.00 Outlays ........................................................................... ................... ................... 7,867 7,867 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. 89.00 90.00 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, the Clinical Laboratory Improvement Amendments of 1988, section 4360 of Public Law 101–508, and section 4005(e) of Public Law 100–203, not to exceed $2,202,284,000, 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: 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. Note.—A regular 1996 appropriation for this account had not been enacted at the time this budget was prepared. The 1996 amounts included in this budget are based on the levels provided in three continuing resolutions: P.L. 104–91, P.L. 104–92, and P.L. 104– 99. Total, offsetting collections (cash) .................. Change in orders on hand from Federal sources ......... 2,110 2,165 2,245 35 ................... ................... Net budget authority and outlays: Budget authority ............................................................ ................... ................... ................... Outlays ........................................................................... 3 ................... ................... Summary of Budget Authority and Outlays [In millions of dollars] Enacted/requested: Budget Authority ..................................................................... Outlays .................................................................................... Legislative proposal, not subject to PAYGO: Budget Authority ..................................................................... Outlays .................................................................................... Legislative proposal, subject to PAYGO: Budget Authority ..................................................................... Outlays .................................................................................... Adjustment to 1996 continuing resolution levels: Budget Authority ..................................................................... Outlays .................................................................................... 1995 actual 1996 est. 1997 est. .................... .................... .................... 3 .................... .................... .................... .................... .................... .................... .................... .................... .................... .................... .................... .................... 1,544 1,544 .................... .................... .................... .................... .................... .................... Total: Budget Authority ..................................................................... .................... .................... Outlays .................................................................................... 3 .................... 1,544 1,544 Program and Financing (in millions of dollars) Identification code 75–0511–0–1–550 1995 actual 1996 est. 1997 est. 00.01 00.02 00.03 00.04 00.05 00.06 Obligations by program activity: Research, demonstrations, and evaluation projects ..... Medicare contractors ..................................................... Medicare anti-fraud and abuse .................................... State certification .......................................................... Administrative costs ...................................................... Clinical laboratories improvement amendment (CLIA) 76 1,189 396 145 354 34 50 1,208 396 146 328 37 55 1,218 396 174 359 43 10.00 Total obligations ........................................................ 2,194 2,165 2,245 Budgetary resources available for obligation: Unobligated balance available, start of year: Uninvested balance ................................................... 22.00 New budget authority (gross) ........................................ 19 2,189 15 2,165 15 2,245 2,208 –2,194 2,180 –2,165 2,260 –2,245 15 15 15 21.40 23.90 23.95 24.40 Total budgetary resources available for obligation New obligations ............................................................. Unobligated balance available, end of year: Uninvested balance ................................................... 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 1995 actual 1996 est. 1997 est. 11.1 11.3 11.5 Personnel compensation: Full-time permanent .................................................. Other than full-time permanent ............................... Other personnel compensation .................................. 206 5 3 223 5 1 233 5 2 11.9 12.1 21.0 23.1 23.3 24.0 25.1 25.2 25.6 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 ................................................................ Medical care .................................................................. 214 37 9 16 6 29 1 250 1,585 229 38 3 25 4 3 21 254 1,564 240 41 4 23 4 3 27 274 1,614 HEALTH CARE FINANCING ADMINISTRATION—Continued Federal Funds—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES 26.0 31.0 41.0 99.5 99.9 Supplies and materials ................................................. 2 ................... ................... Equipment ...................................................................... 8 ................... ................... Grants, subsidies, and contributions ............................ 37 23 14 Below reporting threshold .............................................. ................... 1 1 Total obligations ........................................................ 2,194 2,165 2,245 Personnel Summary Identification code 75–0511–0–1–550 1001 1005 1995 actual Total compensable workyears: Full-time equivalent employment .................................. Full-time equivalent of overtime and holiday hours 1996 est. 1997 est. 70.00 Total new budget authority (gross) .......................... ................... 440 2,044 73.10 73.20 Change in unpaid obligations: New obligations ............................................................. ................... Total outlays (gross) ...................................................... ................... 440 –440 2,044 –2,044 86.90 86.97 86.98 Outlays (gross), detail: Outlays from new current authority .............................. ................... ................... 1,544 Outlays from new permanent authority ......................... ................... 440 500 Outlays from permanent balances ................................ ................... ................... ................... 87.00 4,099 9 4,100 9 4,100 9 Total outlays (gross) ................................................. ................... 440 2,044 Offsets: Against gross budget authority and outlays: 88.00 Offsetting collections (cash) from: Federal sources ................... –440 –500 Net budget authority and outlays: Budget authority ............................................................ ................... ................... Outlays ........................................................................... ................... ................... 1,544 1,544 PROGRAM MANAGEMENT 89.00 90.00 (Legislative proposal, not subject to PAYGO) 489 Program and Financing (in millions of dollars) Identification code 75–0511–2–1–550 1995 actual 1996 est. 1997 est. 10.00 Obligations by program activity: Total obligations (object class 25.2) ............................ ................... –396 –396 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ ................... New obligations ............................................................. ................... –396 396 –396 396 68.00 This schedule reflects the effects on the Program Management account of the Administration’s proposals to: (1) shift spending on Medicare anti-fraud activities from discretionary to mandatory, (2) create a five-year demonstration program to finance health insurance for the temporarily unemployed and (3) create a State grant to foster the development of purchasing cooperatives. Object Classification (in millions of dollars) New budget authority (gross), detail: Spending authority from offsetting collections (gross): Offsetting collections (cash) ..................................... ................... –396 –396 Identification code 75–0511–4–1–550 25.2 41.0 Change in unpaid obligations: 73.10 New obligations ............................................................. ................... 73.20 Total outlays (gross) ...................................................... ................... –396 396 –396 396 86.97 Outlays (gross), detail: Outlays from new permanent authority ......................... ................... –396 Total outlays (gross) ................................................. ................... –396 –396 1996 est. 1997 est. Other services ................................................................ ................... 440 Grants, subsidies, and contributions ............................ ................... ................... 500 1,544 –396 87.00 1995 actual Offsets: Against gross budget authority and outlays: 88.00 Offsetting collections (cash) from: Federal sources ................... 89.00 90.00 396 396 Net budget authority and outlays: Budget authority ............................................................ ................... ................... ................... Outlays ........................................................................... ................... ................... ................... This schedule reflects the effects on the Program Management account of the Administration’s proposal to shift spending on Medicare anti-fraud activities from discretionary to mandatory. 99.9 Total obligations ........................................................ ................... HEALTH MAINTENANCE ORGANIZATION LOAN FUND 440 2,044 LOAN GUARANTEE AND For carrying out subsections (d) and (e) of section 1308 of the Public Health Service Act, any amounts received by the Secretary in connection with loans and loan guarantees under title XIII of such Act, to be available without fiscal year limitation for the payment of outstanding obligations. During fiscal year 1997, no commitments for direct loans or loan guarantees shall be made. Note.—A regular 1996 appropriation for this account had not been enacted at the time this budget was prepared. The 1996 amounts included in this budget are based on the levels provided in three continuing resolutions: P.L. 104–91, P.L. 104–92, and P.L. 104– 99. Program and Financing (in millions of dollars) Identification code 75–4420–0–3–551 1995 actual 1996 est. 1997 est. (Legislative proposal, subject to PAYGO) 00.05 00.06 Obligations by program activity: Interest payments to FFB .............................................. Premium payments to FFB ............................................ Program and Financing (in millions of dollars) 10.00 Total obligations (object class 43.0) ........................ 2 1 1 Budgetary resources available for obligation: Unobligated balance available, start of year: Fund balance ...................................................................... 22.00 New budget authority (gross) ........................................ 22.60 Redemption of debt ....................................................... 9 22 –18 11 4 –3 10 3 –2 13 –2 12 –1 11 –1 11 10 10 PROGRAM MANAGEMENT Identification code 75–0511–4–1–550 1995 actual 1996 est. 1997 est. 1 1 1 1 ................... ................... 21.90 00.01 00.02 00.03 Obligations by program activity: Health insurance for the temporarily unemployed ........ ................... ................... Grants for health insurance cooperatives ..................... ................... ................... Payment safeguards ...................................................... ................... 440 1,519 25 500 10.00 Total obligations ........................................................ ................... 440 2,044 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ ................... New obligations ............................................................. ................... 440 –440 2,044 –2,044 New budget authority (gross), detail: Current: 40.00 Appropriation ............................................................. ................... ................... Permanent: 68.00 Spending authority from offsetting collections: Offsetting collections (cash) ..................................... ................... 440 1,544 500 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) ..................................... 70.00 Total new budget authority (gross) .......................... 15 ................... ................... 7 4 3 22 4 3 490 HEALTH CARE FINANCING ADMINISTRATION—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 1997 General and special funds—Continued HEALTH MAINTENANCE ORGANIZATION LOAN FUND—Continued LOAN GUARANTEE AND 00.04 00.05 41 42 319 ................... 10.00 Total obligations ........................................................ 109,861 127,003 138,208 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ New obligations ............................................................. 109,861 –109,861 127,003 –127,003 138,208 –138,208 60.27 60.28 60.45 60.75 New budget authority (gross), detail: Appropriation (trust fund, indefinite) ............................ 114,847 120,459 127,166 Appropriation (unavailable balances) ........................... ................... 6,544 11,042 Portion precluded from obligation ................................. –4,984 ................... ................... Procurement reduction pursuant to P.L. 103–[333] –2 ................... ................... Program and Financing (in millions of dollars)—Continued 1995 actual Identification code 75–4420–0–3–551 Research, HI ................................................................... 58 Quinquennial adjustment for military service credits ................... 1996 est. 1997 est. 73.10 73.20 Change in unpaid obligations: New obligations ............................................................. Total outlays (gross) ...................................................... 2 –3 1 –1 1 –1 86.93 Outlays (gross), detail: Outlays from current balances ...................................... 3 1 1 87.00 Total outlays (gross) ................................................. 3 1 1 Offsets: Against gross budget authority and outlays: Offsetting collections (cash) from: Non-Federal sources: 88.40 Interest ............................................................. –7 88.40 Other ................................................................. ................... –1 –3 –1 –2 88.90 Total, offsetting collections (cash) .................. –4 –3 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 63.00 Appropriation (total) .................................................. 109,861 127,003 138,208 70.00 Total new budget authority (gross) .......................... 109,861 127,003 138,208 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 ......................................... 19,712 109,861 –114,883 14,689 127,003 –126,642 15,051 138,208 –138,372 14,689 15,051 14,887 72.41 –7 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 ................................ 1,142 158 96,546 17,037 1,076 151 110,876 14,539 1,183 134 122,139 14,916 87.00 Total outlays (gross) ................................................. 114,883 126,642 138,372 89.00 90.00 15 ................... ................... –4 –3 –2 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 109,861 114,883 127,003 126,642 138,208 138,372 Trust Funds FEDERAL HOSPITAL INSURANCE TRUST FUND Unavailable Collections (in millions of dollars) Identification code 20–8005–0–7–571 1995 actual 1996 est. Balance, start of year: Balance, start of year .................................................... 109,844 114,828 108,391 Receipts: 02.01 Transfers from general fund (FICA taxes) ..................... 88,934 94,695 100,843 02.02 Receipts from Railroad Retirement Board .................... 358 369 369 02.03 Transfers from general fund (SECA taxes) ................... 6,732 6,771 7,558 02.04 Federal employer contributions (FICA) ........................... 1,824 1,744 1,798 02.05 Postal service employer contributions (FICA) ................ 564 549 562 02.06 Refunds .......................................................................... ................... 13 ................... 02.07 Interest received by trust funds .................................... 10,833 10,479 9,735 02.08 Other proprietary receipts from the public ................... 1 ................... ................... 02.09 Interest received by trust funds, legislative proposal ................... –4 172 02.10 Taxation on OASDI benefits ........................................... 3,913 4,069 4,349 02.12 Interest payments by Railroad Retirement Board ......... 38 39 34 02.13 Payments from the general fund (uninsured and program management) ................................................... 591 558 624 02.14 Payments for military service credits ............................ 61 73 70 02.15 Premiums collected for uninsured individuals not otherwise eligible ........................................................... 998 1,100 1,224 02.17 Premiums collected for uninsured individuals not otherwise eligible, proposed legislation ......................... ................... ................... –123 01.99 02.99 Total receipts ............................................................. Summary of Budget Authority and Outlays 1997 est. 114,847 120,455 127,215 Total: Balances and collections .................................... 224,691 Appropriation: 05.01 Federal hospital insurance trust fund .......................... –109,863 05.02 Federal hospital insurance trust fund, adjustment to 1996 Continuing Resolution level ............................. ................... 05.03 Federal hospital insurance trust fund, proposed legislation ......................................................................... ................... 05.04 Federal hospital insurance trust fund, legislative proposal, not subject to PAYGO ..................................... ................... 235,283 .................... .................... Total: Budget Authority ..................................................................... Outlays .................................................................................... 109,861 114,883 1995 actual 1996 est. 1997 est. 109,861 114,883 127,003 126,642 138,208 138,372 .................... .................... –77 –77 –77 –77 .................... .................... –74 –74 –14,107 –14,107 40 .................... 40 .................... 126,892 126,531 124,024 124,188 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: 235,606 –127,003 [In millions of dollars] Enacted/requested: Budget Authority ..................................................................... Outlays .................................................................................... Legislative proposal, not subject to PAYGO: Budget Authority ..................................................................... Outlays .................................................................................... Legislative proposal, subject to PAYGO: Budget Authority ..................................................................... Outlays .................................................................................... Adjustment to 1996 continuing resolution levels: Budget Authority ..................................................................... Outlays .................................................................................... –138,208 04.00 –40 ................... 74 14,107 77 –124,024 111,582 Identification code 20–8005–0–7–571 Unexpended balance, start of year: 0100 Treasury balance ............................................................ 0101 U.S. Securities: Par value .............................................. Subtotal appropriation ................................................... Total balance, end of year ............................................ –109,863 114,828 Program and Financing (in millions of dollars) Identification code 20–8005–0–7–571 00.01 00.02 00.03 Obligations by program activity: Benefit payments, HI ..................................................... Administration, HI .......................................................... Peer review organizations, HI ........................................ 1995 actual 108,512 1,247 44 1996 est. 1997 est. 840 128,715 –344 129,862 1 123,441 Total balance, start of year ...................................... 129,555 Cash income during the year: Governmental receipts: 0200 FHI Trust Fund, Transfers from general fund (FICA taxes) .................................................................... 88,934 0201 FHI Trust Fund, Transfers from general fund (SECA taxes) .................................................................... 6,732 0202 Refunds ..................................................................... ................... 0205 FHI Trust Fund, Receipts from Railroad Retirement Board ..................................................................... 358 Proprietary receipts: 0221 FHI Trust Fund, Premiums collected for uninsured individuals not otherwise eligible ........................ 998 129,518 123,442 94,695 100,843 0199 05.99 07.99 1995 actual 77 –126,892 108,391 Status of Funds (in millions of dollars) 1996 est. 124,841 1,169 633 1997 est. 136,799 1,283 84 6,771 7,558 13 ................... 369 369 1,100 1,224 HEALTH CARE FINANCING ADMINISTRATION—Continued Trust Funds—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES 0222 0223 0240 0241 0242 0243 0244 0245 0246 0248 0249 0250 0251 0297 0298 FHI Trust Fund, Premiums collected for uninsured individuals not otherwise eligible ........................ ................... ................... –123 Proprietary receipts ................................................... 1 ................... ................... Intragovernmental transactions: FHI Trust Fund, Federal employer contributions (FICA) .................................................................... 1,824 1,744 1,798 FHI Trust Fund, Postal service employer contributions (FICA) ........................................................... 564 549 562 FHI Trust Fund, Federal payment for transitional coverage for uninsured Federal employees .......... 56 61 76 FHI Trust Fund, Federal payment for transitional coverage for the uninsured .................................. 406 358 405 FHI Trust Fund, Federal payment for SECA tax credits ................................................................... –1 –10 1 FHI Trust Fund, General Fund transfer, Program management (HI) .................................................. 130 149 142 FHI Trust Fund, Federal payments for OASDI taxes 3,913 4,069 4,349 FHI Trust fund, Interest payment from Railroad Retirement Board .................................................. 38 39 34 FHI Trust Fund, Interest on investments .................. 10,833 10,479 9,735 FHI Trust Fund, Interest on investments .................. ................... –4 172 FHI Trust Fund, Transfer from Department of Defense for military service credits ......................... 61 73 70 Income under present law ............................................. 114,847 120,459 127,166 Income under proposed legislation ............................... ................... –4 49 0299 Total cash income ..................................................... Cash outgo during year: 0500 Benefit payments ........................................................... 0501 Benefit payments (proposed legislation) ....................... 0502 Administration ................................................................ Cash outgo during the year (–) Budget Acct: 0503 Administration (proposed legislation) ....................... 0503 Administration (proposed legislation) ....................... 0503 Administration (proposed legislation) ....................... 0504 Peer review organizations .............................................. 0505 Research ........................................................................ 0507 Quinquennial Adjustment for Military Service Credits 0597 Outgo under present law (–) ......................................... 0598 Outgo under proposed legislation (–) ........................... 0599 0625 Total cash outgo (–) ...................................................... Balances expired or permanently cancelled .................. Unexpended balance, end of year: 0700 Uninvested balance ....................................................... 0701 U.S. Securities: Par value .............................................. 0799 Total balance, end of year ........................................ 114,847 120,455 –124,841 205 –1,174 –136,799 14,256 –1,272 ................... ................... ................... –181 –54 ................... –114,883 ................... 77 77 –131 –149 –40 ................... –255 –256 –53 –45 –319 ................... –126,642 –138,372 111 14,184 New obligations ............................................................. ................... 77 77 60.28 New budget authority (gross), detail: Appropriation (unavailable balances) ........................... ................... –77 –77 73.10 73.20 Change in unpaid obligations: New obligations ............................................................. ................... Total outlays (gross) ...................................................... ................... –77 77 –77 77 86.90 Outlays (gross), detail: Outlays from new current authority .............................. ................... –77 –77 87.00 Total outlays (gross) ................................................. ................... –77 –77 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ ................... Outlays ........................................................................... ................... –77 –77 –77 –77 This schedule reflects the effects on the Hospital Insurance Trust Fund of the Administration’s proposal to shift spending on Medicare anti-fraud activities from discretionary to mandatory. Object Classification (in millions of dollars) Identification code 20–8005–2–7–571 25.3 92.0 99.9 –344 129,862 1 123,441 123,442 126,469 1995 actual 1996 est. 1997 est. 1996 est. 1997 est. Purchases of goods and services from Government accounts .................................................................... ................... Reimbursement for administrative expenses for other than SSA LAE ............................................................ ................... –67 –67 –10 –10 Total obligations ........................................................ ................... –77 –77 (Legislative proposal, subject to PAYGO) 1 126,468 129,518 1995 actual FEDERAL HOSPITAL INSURANCE TRUST FUND –114,883 –126,531 –124,188 –2 ................... ................... Object Classification (in millions of dollars) Identification code 20–8005–0–7–571 23.95 127,215 –113,402 ................... –1,246 491 Program and Financing (in millions of dollars) Identification code 20–8005–4–7–571 00.01 00.02 00.06 1995 actual 1996 est. Obligations by program activity: Benefit payments, HI ..................................................... ................... ................... Administration, HI .......................................................... ................... 131 Benefits—program integrity .......................................... ................... –205 1997 est. –13,640 149 –616 41.0 42.0 92.0 92.0 93.0 99.5 99.9 Total obligations ........................................................ ................... –74 –14,107 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ ................... New obligations ............................................................. ................... –74 74 –14,107 14,107 60.27 60.28 New budget authority (gross), detail: Appropriation (trust fund, indefinite) ............................ ................... Appropriation (unavailable balances) ........................... ................... –4 –70 49 –14,156 63.00 Appropriation (total) .................................................. ................... –74 –14,107 70.00 Total new budget authority (gross) .......................... ................... –74 –14,107 73.10 73.20 Change in unpaid obligations: New obligations ............................................................. ................... Total outlays (gross) ...................................................... ................... –74 74 –14,107 14,107 86.90 86.97 Outlays (gross), detail: Outlays from new current authority .............................. ................... Outlays from new permanent authority ......................... ................... 131 –205 149 –14,256 (Legislative proposal, not subject to PAYGO) 41.0 10.00 FEDERAL HOSPITAL INSURANCE TRUST FUND 25.3 87.00 Total outlays (gross) ................................................. ................... –74 –14,107 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ ................... Outlays ........................................................................... ................... –74 –74 –14,107 –14,107 Purchases of goods and services from Government accounts .................................................................... 728 671 722 Grants, subsidies, and contributions: Payment for health insurance experiments and demonstration projects ......................................... 58 41 42 Payment for peer review organization (PRO) activities ........................................................................ 44 633 84 Insurance claims and indemnities ................................ 108,512 124,841 136,799 Undistributed: Quinquennial Adjustment for Military Service Credits .......................................................................... ................... 319 ................... Reimbursement for administrative expenses for other than SSA LAE .............................................. 45 39 39 Administrative expenses: Portion of limitation on salaries and expenses: Social Security Administration 475 459 522 Below reporting threshold .............................................. –1 ................... ................... Total obligations ........................................................ 109,861 127,003 138,208 Program and Financing (in millions of dollars) Identification code 20–8005–2–7–571 1995 actual 1996 est. 1997 est. Obligations by program activity: Total obligations ............................................................ ................... –77 –77 Budgetary resources available for obligation: 22.00 New budget authority (gross) ........................................ ................... –77 –77 10.00 This schedule reflects the effects of the Medicare reform proposals contained in the Administration’s balanced budget proposal on the Hospital Insurance Trust Fund. 492 HEALTH CARE FINANCING ADMINISTRATION—Continued Trust Funds—Continued THE BUDGET FOR FISCAL YEAR 1997 86.90 86.93 86.97 86.98 Object Classification (in millions of dollars) Identification code 20–8005–4–7–571 25.3 42.0 42.0 92.0 99.9 Purchases of goods and services from Government accounts .................................................................... Insurance claims and indemnities: Insurance claims and indemnities ........................... Insurance claims and indemnities ........................... Reimbursement for administrative expenses for other than SSA LAE ............................................................ 1995 actual ................... 1996 est. 74 1,679 123 64,165 4,904 1,757 127 71,369 4,931 Total outlays (gross) ................................................. 65,213 70,871 78,184 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 66,953 65,213 70,903 70,871 78,177 78,184 84 ................... –205 ................... ................... –616 –13,640 ................... 57 65 Total obligations ........................................................ ................... –74 –14,107 Unavailable Collections (in millions of dollars) Identification code 20–8004–0–7–571 Balance, start of year: Balance, start of year .................................................... Receipts: 02.01 Federal contributions ..................................................... 02.02 Interest received by trust fund ...................................... 02.03 Other proprietary receipts from the public ................... 02.05 Premiums collected for the aged .................................. 02.06 Premiums collected for the disabled ............................ 02.07 Federal contributions, proposed legislation .................. 02.08 Interest received by trust fund, proposed legislation 02.09 Premiums collected for the aged, proposed legislation 02.10 Premiums collected for the disabled, proposed legislation ............................................................................ 01.99 Total receipts ............................................................. 1995 actual 17,632 1996 est. 8,848 1997 est. 19,777 36,988 61,331 59,456 1,935 1,786 2,203 3 ................... ................... 17,126 16,622 16,813 2,117 2,120 2,250 ................... ................... 7,867 ................... –1 –2 ................... ................... –146 ................... ................... –19 58,169 81,858 88,422 Total: Balances and collections .................................... 75,801 Appropriation: 05.01 Federal supplementary medical insurance trust fund –66,953 05.02 Federal supplementary medical insurance trust fund, adjustment to 1996 Continuing Resolution level ................... 05.03 Federal supplementary medical insurance trust fund, proposed legislation .................................................. ................... 05.04 Federal supplementary medical insurance trust fund, legislative proposal, not subject to PAYGO .............. ................... 90,706 108,199 –70,903 –78,177 04.00 05.99 07.99 1,619 103 60,308 3,183 1997 est. FEDERAL SUPPLEMENTARY MEDICAL INSURANCE TRUST FUND 02.99 Outlays (gross), detail: Outlays from new current authority .............................. Outlays from current balances ...................................... Outlays from new permanent authority ......................... Outlays from permanent balances ................................ 87.00 FEDERAL HOSPITAL INSURANCE TRUST FUND—Continued Subtotal appropriation ................................................... Total balance, end of year ............................................ –66,953 8,848 Summary of Budget Authority and Outlays [In millions of dollars] Enacted/requested: Budget Authority ..................................................................... Outlays .................................................................................... Legislative proposal, not subject to PAYGO: Budget Authority ..................................................................... Outlays .................................................................................... Legislative proposal, subject to PAYGO: Budget Authority ..................................................................... Outlays .................................................................................... Adjustment to 1996 continuing resolution levels: Budget Authority ..................................................................... Outlays .................................................................................... .................... .................... Total: Budget Authority ..................................................................... Outlays .................................................................................... 66,953 65,213 –8,071 337 –85,911 22,288 Identification code 20–8004–0–7–571 0100 0101 Unexpended balance, start of year: Treasury balance ............................................................ U.S. Securities: U.S. securities: Par value .................... 0199 Program and Financing (in millions of dollars) Identification code 20–8004–0–7–571 1995 actual 1996 est. 1997 est. Obligations by program activity: 00.01 Benefit payments, SMI ................................................... 00.02 Administration, SMI ....................................................... 00.03 Peer review organizations, SMI ...................................... 00.04 Research, SMI ................................................................ 65,182 1,750 2 19 69,055 1,806 33 9 76,287 1,872 4 13 10.00 Total obligations ........................................................ 66,953 70,903 78,177 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ New obligations ............................................................. 66,953 –66,953 70,903 –70,903 78,177 –78,177 60.27 60.28 60.45 New budget authority (gross), detail: Appropriation (trust fund, indefinite) ............................ 58,169 81,859 80,722 Appropriation (unavailable balances) ........................... 8,784 ................... ................... Portion precluded from obligation ................................. ................... –10,956 –2,545 63.00 Appropriation (total) .................................................. 66,953 70,903 78,177 70.00 Total new budget authority (gross) .......................... 66,953 70,903 78,177 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 ......................................... 72.41 3,287 66,953 –65,213 5,027 70,903 –70,871 5,059 78,177 –78,184 5,027 5,059 5,052 1997 est. 70,903 70,871 78,177 78,184 .................... .................... –337 –337 –337 –337 .................... .................... 327 327 8,071 8,071 36 .................... 36 .................... 70,929 70,897 85,911 85,918 Status of Funds (in millions of dollars) 337 –70,929 19,777 1996 est. 66,953 65,213 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: –36 ................... –327 1995 actual 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, proposed law, FSMI Fund ............................................................. Proprietary receipts Receipt Acct: 0223 Premiums collected for the disabled, FSMI Fund 0223 Premiums collected for the disabled, proposed law, FSMI Fund ................................................. 0224 Proprietary receipts ................................................... Intragovernmental transactions: 0240 Federal contributions, FSMI Fund ............................. 0241 Federal Contributions, proposed law, FSMI Fund 0242 Interest received by trust fund, FSMI Fund .............. 0243 Interest received by trust fund, proposed law, FSMI Fund ...................................................................... 0297 Income under present law ............................................. 0298 Income under proposed legislation ............................... 0299 Total cash income ..................................................... Cash outgo during year: Cash outgo during the year (–) Budget Acct: 0501 Cash outgo for benefit payments & ESRD ............... 0501 Benefit payments, proposed legislation .................... 0502 Cash outgo for administration ...................................... Cash outgo during the year (–) Budget Acct: 0503 Administration, proposed legislation ........................ 0503 Administration, proposed legislation ........................ 0503 Administration, proposed legislation ........................ 0504 Cash outgo for peer review organizations .................... Cash outgo during the year (–) Budget Acct: 0505 Cash outgo for research ........................................... 0505 Cash outgo for research ........................................... 0597 Outgo under present law (–) ......................................... 1995 actual 1996 est. 1997 est. –570 21,489 361 13,513 1 24,834 20,919 13,874 24,835 17,126 16,622 16,813 ................... ................... –146 2,117 2,120 2,250 ................... ................... –19 3 ................... ................... 36,988 61,331 ................... ................... 1,935 1,786 59,456 7,867 2,203 ................... 58,169 ................... –1 81,859 –1 –2 80,722 7,700 58,169 81,858 88,422 –63,482 ................... –1,704 –69,055 86 –1,790 –76,287 –7,601 –1,869 ................... ................... ................... –9 337 337 –413 –470 –32 ................... –13 –14 –18 ................... –65,213 –13 –14 –4 ................... –70,871 –78,184 ADMINISTRATION FOR CHILDREN AND FAMILIES Federal Funds DEPARTMENT OF HEALTH AND HUMAN SERVICES 0598 Outgo under proposed legislation (–) ........................... ................... 0599 Total cash outgo (–) ...................................................... Unexpended balance, end of year: 0700 Treasury balance ............................................................ 0701 U.S. Securities: U.S. securities: Par value .................... 0799 Total balance, end of year ........................................ 493 –26 –7,734 FEDERAL SUPPLEMENTARY MEDICAL INSURANCE TRUST FUND –65,213 –70,897 –85,918 (Legislative proposal, subject to PAYGO) 361 13,513 1 24,834 1 27,338 13,874 24,835 27,339 Program and Financing (in millions of dollars) 00.01 00.02 00.05 Object Classification (in millions of dollars) 1995 actual Identification code 20–8004–4–7–571 1996 est. 1997 est. Obligations by program activity: Benefit payments, SMI ................................................... ................... ................... Administration, SMI ....................................................... ................... 413 Benefits—program integrity .......................................... ................... –86 7,860 470 –259 10.00 Total obligations ........................................................ ................... 327 8,071 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ ................... New obligations ............................................................. ................... 327 –327 8,071 –8,071 60.27 60.28 New budget authority (gross), detail: Appropriation (trust fund, indefinite) ............................ ................... Appropriation (unavailable balances) ........................... ................... –1 328 7,700 371 63.00 Appropriation (total) .................................................. ................... 327 8,071 70.00 Total new budget authority (gross) .......................... ................... 327 8,071 73.10 73.20 Change in unpaid obligations: New obligations ............................................................. ................... Total outlays (gross) ...................................................... ................... 327 –327 8,071 –8,071 (Legislative proposal, not subject to PAYGO) 86.90 86.97 Outlays (gross), detail: Outlays from new current authority .............................. ................... Outlays from new permanent authority ......................... ................... 413 –86 470 7,601 Program and Financing (in millions of dollars) 87.00 Total outlays (gross) ................................................. ................... 327 8,071 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ ................... Outlays ........................................................................... ................... 327 327 8,071 8,071 Identification code 20–8004–0–7–571 25.3 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 ........................................................ 1995 actual 1996 est. 1997 est. 1,393 1,457 1,475 2 33 4 19 65,182 9 69,055 13 76,287 357 349 397 66,953 70,903 78,177 FEDERAL SUPPLEMENTARY MEDICAL INSURANCE TRUST FUND Identification code 20–8004–2–7–571 1995 actual Obligations by program activity: 10.00 Total obligations ............................................................ ................... Budgetary resources available for obligation: 22.00 New budget authority (gross) ........................................ ................... 23.95 New obligations ............................................................. ................... 1996 est. –337 –337 337 1997 est. –337 –337 337 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. Object Classification (in millions of dollars) New budget authority (gross), detail: 60.28 Appropriation (unavailable balances) ........................... ................... –337 –337 73.10 73.20 Change in unpaid obligations: New obligations ............................................................. ................... Total outlays (gross) ...................................................... ................... –337 337 –337 337 86.90 Outlays (gross), detail: Outlays from new current authority .............................. ................... –337 –337 25.3 42.0 42.0 92.0 99.9 87.00 Total outlays (gross) ................................................. ................... –337 Net budget authority and outlays: Budget authority ............................................................ ................... Outlays ........................................................................... ................... –337 –337 –337 –337 Purchases of goods and services from Government accounts .................................................................... Insurance claims and indemnities: Insurance claims and indemnities ........................... Insurance claims and indemnities ........................... Reimbursement for Administrative Expenses for Other Than SSA LAE ............................................................ 1996 est. ................... 1997 est. 366 416 ................... –86 ................... ................... –259 7,860 ................... 47 54 Total obligations ........................................................ ................... 327 8,071 –337 89.00 90.00 1995 actual Identification code 20–8004–4–7–571 This schedule reflects the effects on the Supplementary Medical Insurance Trust Fund of the Administration’s proposal to shift spending on Medicare anti-fraud activities from discretionary to mandatory. Object Classification (in millions of dollars) Identification code 20–8004–2–7–571 25.3 1995 actual 1996 est. 1997 est. 92.0 Purchases of goods and services from Government accounts .................................................................... ................... Undistributed ................................................................. ................... –329 –8 –329 –8 99.9 Total obligations ........................................................ ................... –337 –337 ADMINISTRATION FOR CHILDREN AND FAMILIES Federal Funds General and special funds: FAMILY SUPPORT PAYMENTS TO STATES For making payments to States or other non-Federal entities, except as otherwise provided, under titles I, IV–A (other than section 402(g)(6)) and D, X, XI, XIV, and XVI of the Social Security Act, and the Act of July 5, 1960 (24 U.S.C. ch. 9), $13,301,000,000, to remain available until expended. For making, after May 31 of the current fiscal year, payments to States or other non-Federal entities under titles I, IV–A and 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. For making payments to States or other non-Federal entities under titles I, IV–A (other than section 402(g)(6)) and D, X, XI, XIV, and XVI of the Social Security Act and the Act of July 5, 1960 (24 U.S.C. 494 ADMINISTRATION FOR CHILDREN AND FAMILIES—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 1997 General and special funds—Continued FAMILY SUPPORT PAYMENTS TO LOW INCOME HOME ENERGY ASSISTANCE STATES—Continued ch. 9) for the first quarter of fiscal year 1998, $4,700,000,000, to remain available until expended. Note.—A regular 1996 appropriation for this account had not been enacted at the time this budget was prepared. The 1996 amounts included in this budget are based on the levels provided in three continuing resolutions: P.L. 104–91, P.L. 104–92, and P.L. 104– 99. Program and Financing (in millions of dollars) Identification code 75–1501–0–1–609 1995 actual 1996 est. 1997 est. Obligations by program activity: Aid to families with dependent children (AFDC) payments: Benefit payments: 00.01 Properly issued payments ..................................... 11,436 00.02 Erroneously issued payments ............................... 743 00.03 Collection of excess State errors .......................... ................... 10,698 683 –41 11,022 691 –52 00.91 01.02 01.03 01.04 01.05 01.06 01.07 01.08 11,340 25 1,687 1 820 249 335 1,679 11,661 25 1,867 1 879 268 300 1,875 Subtotal, benefit payments ....................................... 12,179 Payments to territories .................................................. 25 Emergency assistance ................................................... 984 Repatriation ................................................................... ................... AFDC day care ............................................................... 655 Transitional day care ..................................................... 200 At-risk day care ............................................................. 297 State welfare administrative costs ............................... 1,780 For making payments under title XXVI of the Omnibus Budget Reconciliation Act of 1981: (1) $1,000,000,000, to be available in the period October 1, 1996 through September 30, 1997; (2) an additional $300,000,000, which is hereby designated by Congress to be emergency requirements pursuant to section 251(b)(2)(D)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985, as amended, and which 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 that Act; and (3) $1,000,000,000, to be available for the period October 1, 1997 through September 30, 1998. Note.—A regular 1996 appropriation for this account had not been enacted at the time this budget was prepared. The 1996 amounts included in this budget are based on the levels provided in three continuing resolutions: P.L. 104–91, P.L. 104–92, and P.L. 104– 99. Program and Financing (in millions of dollars) 01.91 Subtotal, other payments .......................................... 3,941 4,796 5,215 02.00 02.01 02.02 02.03 Subtotal, AFDC .......................................................... Gross Federal share of collections ................................ Federal incentive payments to States ........................... State child support administrative costs ...................... 16,120 –1,212 390 2,124 16,136 –1,282 429 1,916 16,876 –1,366 459 2,132 1995 actual Identification code 75–1502–0–1–609 1996 est. 1997 est. 10.00 Obligations by program activity: Total obligations (object class 41.0) ............................ 1,419 1,000 1,000 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ New obligations ............................................................. 1,419 –1,419 1,000 –1,000 1,000 –1,000 New budget authority (gross), detail: Current: 40.00 Appropriation ............................................................. Permanent: 65.00 Advance appropriation (definite) .............................. 1,319 1,000 1,000 70.00 1,419 1,000 1,000 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 ............................................................. 100 ................... ................... 72.40 02.91 03.01 Subtotal, CSE ............................................................ Federal administration ................................................... 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) ........................................ 1,302 1,063 1,225 1 ................... ................... 17,423 17,199 18,101 21.40 23.90 23.95 24.40 Total budgetary resources available for obligation New obligations ............................................................. Unobligated balance available, end of year: Uninvested balance ................................................... 37 17,491 17,528 –17,423 105 ................... 17,094 18,101 17,199 –17,199 18,101 –18,101 105 ................... ................... New budget authority (gross), detail: Current: 40.00 Appropriation ............................................................. 40.05 Appropriation (indefinite) .......................................... 12,762 12,694 13,301 529 ................... ................... 43.00 13,291 12,694 13,301 65.00 Appropriation (total) ............................................. Permanent: Advance appropriation (definite) .............................. 4,200 4,400 4,800 70.00 Total new budget authority (gross) .......................... 17,491 17,094 18,101 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 ............................................................. 1,400 17,423 –17,133 1,690 17,199 –17,366 1,523 18,101 –17,956 1,690 1,523 1,667 86.90 86.93 86.97 86.98 87.00 88.95 89.00 90.00 Outlays (gross), detail: Outlays from new current authority .............................. Outlays from current balances ...................................... Outlays from new permanent authority ......................... Outlays from permanent balances ................................ 86.90 86.93 86.97 Outlays (gross), detail: Outlays from new current authority .............................. Outlays from current balances ...................................... Outlays from new permanent authority ......................... 11,957 1,354 3,822 11,597 1,765 4,004 11,632 1,523 4,800 87.00 Total outlays (gross) ................................................. 17,133 17,366 17,956 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 17,491 17,133 17,094 17,366 18,101 17,956 346 94 69 100 ................... ................... 85 ................... ................... 1,013 940 940 221 312 83 Total outlays (gross) ................................................. 1,419 1,252 1,025 Change in orders on hand from Federal sources ......... ................... ................... ................... Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 1,419 1,419 1,000 1,252 1,000 1,025 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 72.40 347 346 94 1,419 1,000 1,000 –1,419 –1,252 –1,025 –1 ................... ................... 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), $381,536,000. Note.—A regular 1996 appropriation for this account had not been enacted at the time this budget was prepared. The 1996 amounts included in this budget are based on the levels provided in three continuing resolutions: P.L. 104–91, P.L. 104–92, and P.L. 104– 99. øREFUGEE RESETTLEMENT ASSISTANCE¿ 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, 1996.) ADMINISTRATION FOR CHILDREN AND FAMILIES—Continued Federal Funds—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES 73.10 73.20 74.40 Program and Financing (in millions of dollars) 1995 actual Identification code 75–1503–0–1–609 Obligations by program activity: 10.00 Total obligations ............................................................ 396 40.00 1997 est. 405 382 86.90 86.93 Budgetary resources available for obligation: 21.40 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 1996 est. 2 2 2 406 405 382 –10 ................... ................... Total budgetary resources available for obligation New obligations ............................................................. Unobligated balance available, end of year: Uninvested balance ................................................... 398 –396 407 –405 384 –382 2 2 405 382 150 –38 225 –132 240 –201 171 264 303 Outlays (gross), detail: Outlays from new current authority .............................. ................... Outlays from current balances ...................................... 38 34 98 36 165 87.00 Total outlays (gross) ................................................. 38 132 201 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 150 38 225 132 240 201 2 406 New obligations ............................................................. Total outlays (gross) ...................................................... Unpaid obligations, end of year: Obligated balance: Appropriation ............................................................. 495 Object Classification (in millions of dollars) New budget authority (gross), detail: Appropriation .................................................................. 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 ............................................................. 297 297 303 396 405 382 –393 –399 –389 –3 ................... ................... 297 303 Identification code 75–1512–0–1–506 25.1 25.3 41.0 Advisory and assistance services .................................. Purchases of goods and services from Government accounts .................................................................... Grants, subsidies, and contributions ............................ 99.9 Total obligations ........................................................ 1995 actual 1996 est. 3 1997 est. 6 6 2 ................... ................... 145 219 234 150 225 240 296 86.90 86.93 Outlays (gross), detail: Outlays from new current authority .............................. Outlays from current balances ...................................... 219 174 229 170 216 173 87.00 Total outlays (gross) ................................................. 393 399 389 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 406 393 405 399 382 389 States are subsidized for administering the refugee assistance program. PAYMENTS TO STATES FOR THE JOB OPPORTUNITIES SKILLS TRAINING PROGRAM AND BASIC For carrying out the Job Opportunities and Basic Skills Training Program (JOBS), as authorized by part F of title IV of the Social Security Act, $1,000,000,000. Note.—A regular 1996 appropriation for this account had not been enacted at the time this budget was prepared. The 1996 amounts included in this budget are based on the levels provided in three continuing resolutions: P.L. 104–91, P.L. 104–92, and P.L. 104– 99. Program and Financing (in millions of dollars) Object Classification (in millions of dollars) Identification code 75–1509–0–1–504 1995 actual Identification code 75–1503–0–1–609 25.3 1996 est. 3 393 3 402 3 379 99.9 Total obligations ........................................................ 396 405 382 For carrying $240,000,000. out Section 430 AND of SUPPORT the Social Security Program and Financing (in millions of dollars) 1995 actual 1997 est. 1996 est. 10.00 Obligations by program activity: Total obligations (object class 41.0) ............................ 1,012 22.00 22.30 Budgetary resources available for obligation: New budget authority (gross) ........................................ Unobligated balance expiring ........................................ 1,300 –288 Total budgetary resources available for obligation New obligations ............................................................. 1,012 –1,012 990 –990 1,000 –1,000 40.00 New budget authority (gross), detail: Appropriation .................................................................. 1,300 1,000 1,000 Act, Note.—A regular 1996 appropriation for this account had not been enacted at the time this budget was prepared. The 1996 amounts included in this budget are based on the levels provided in three continuing resolutions: P.L. 104–91, P.L. 104–92, and P.L. 104– 99. Identification code 75–1512–0–1–506 1996 est. 23.90 23.95 41.0 Purchases of goods and services from Government accounts .................................................................... Grants, subsidies, and contributions ............................ FAMILY PRESERVATION 1995 actual 1997 est. 1997 est. 00.01 00.02 00.03 Obligations by program activity: Grants to States and Tribes .......................................... Training and technical assistance ................................ State court assessment activities ................................. 139 6 5 209 6 10 224 6 10 10.00 Total obligations ........................................................ 150 225 240 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ New obligations ............................................................. 150 –150 225 –225 240 –240 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 ............................................................. 990 1,000 1,000 1,000 –10 ................... 72.40 281 314 345 1,012 990 1,000 –953 –959 –988 –26 ................... ................... 314 345 357 86.90 86.93 Outlays (gross), detail: Outlays from new current authority .............................. Outlays from current balances ...................................... 759 194 743 216 750 238 87.00 Total outlays (gross) ................................................. 953 959 988 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 1,300 953 1,000 959 1,000 988 New budget authority (gross), detail: 40.00 Appropriation .................................................................. 150 225 240 89.00 90.00 Change in unpaid obligations: Unpaid obligations, start of year: Obligated balance: Appropriation ............................................................. 59 171 264 This appropriation funds employment, training, and education activities created by the Family Support Act of 1988. 72.40 ADMINISTRATION FOR CHILDREN AND FAMILIES—Continued Federal Funds—Continued 496 THE BUDGET FOR FISCAL YEAR 1997 86.93 Outlays (gross), detail: Outlays from current balances ...................................... 933 935 946 87.00 Total outlays (gross) ................................................. 933 935 946 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 935 933 935 935 1,049 946 General and special funds—Continued STATE LEGALIZATION IMPACT-ASSISTANCE GRANTS Program and Financing (in millions of dollars) 1995 actual Identification code 75–1508–0–1–506 1996 est. 1997 est. 00.01 00.03 Obligations by program activity: Grants to States ............................................................ Citizenship grants .......................................................... 191 ................... ................... 4 ................... ................... 10.00 Total obligations (object class 41.0) ........................ 195 ................... ................... This appropriation helps low-income families pay for child care and related services. Object Classification (in millions of dollars) Budgetary resources available for obligation: 22.00 New budget authority (gross) ........................................ 23.95 New obligations ............................................................. 195 ................... ................... –195 ................... ................... Identification code 75–1515–0–1–609 New budget authority (gross), detail: Current: 40.00 Appropriation ............................................................. Permanent: 60.05 Appropriation (indefinite) .......................................... 4 ................... ................... 25.1 25.2 41.0 99.5 191 ................... ................... 99.9 70.00 1995 actual 1996 est. 1997 est. 195 ................... ................... Total new budget authority (gross) .......................... Total obligations ........................................................ 935 935 1,049 SOCIAL SERVICES BLOCK GRANT 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 86.93 86.97 86.98 Advisory and assistance services .................................. 2 2 3 Other services ................................................................ 1 ................... ................... Grants, subsidies, and contributions ............................ 932 932 1,046 Below reporting threshold .............................................. ................... 1 ................... 363 4 1 195 ................... ................... –358 –3 –1 –196 ................... ................... 4 1 ................... Outlays (gross), detail: Outlays from current balances ...................................... ................... 3 1 Outlays from new permanent authority ......................... 191 ................... ................... Outlays from permanent balances ................................ 167 ................... ................... For making grants to States pursuant to section 2002 of the Social Security Act, $2,800,000,000. Note.—A regular 1996 appropriation for this account had not been enacted at the time this budget was prepared. The 1996 amounts included in this budget are based on the levels provided in three continuing resolutions: P.L. 104–91, P.L. 104–92, and P.L. 104– 99. Program and Financing (in millions of dollars) Identification code 75–1534–0–1–506 1995 actual 1996 est. 1997 est. 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... PAYMENTS TO STATES FOR THE BLOCK 00.01 00.02 Obligations by program activity: Block grant .................................................................... Empowerment zone ........................................................ 195 ................... ................... 358 3 1 Total outlays (gross) ................................................. 1 00.91 01.01 Total direct program ................................................. Reimbursable ................................................................. 10.00 87.00 Total obligations (object class 41.0) ........................ 3,446 3,160 Budgetary resources available for obligation: Unobligated balance available, start of year: Uninvested balance ................................................... 22.00 New budget authority (gross) ........................................ 1,000 2,806 360 ................... 2,800 2,800 358 CHILD CARE GRANT AND 3 DEVELOPMENT 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), $1,048,825,000, which shall be available for obligation under the same statutory terms and conditions applicable in the prior fiscal year. Note.—A regular 1996 appropriation for this account had not been enacted at the time this budget was prepared. The 1996 amounts included in this budget are based on the levels provided in three continuing resolutions: P.L. 104–91, P.L. 104–92, and P.L. 104– 99. Program and Financing (in millions of dollars) Identification code 75–1515–0–1–609 1995 actual 1996 est. 3,440 3,160 2,800 6 ................... ................... 2,800 21.40 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) ..................................... 70.00 932 3 932 3 1,046 3 10.00 Total obligations ........................................................ 935 935 1,049 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ New obligations ............................................................. 935 –935 935 –935 1,049 –1,049 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 ............................................................. 2,800 2,800 360 ................... 3,806 –3,446 3,160 –3,160 2,800 –2,800 360 ................... ................... 2,800 2,800 2,800 6 ................... ................... 1997 est. Obligations by program activity: 00.01 Block grant payments to States .................................... 00.02 Advisory and assistance services .................................. New budget authority (gross), detail: 40.00 Appropriation .................................................................. 2,800 640 Total new budget authority (gross) .......................... 2,806 2,800 2,800 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 ............................................................. 319 3,446 –2,803 962 3,160 –3,183 939 2,800 –2,839 962 939 900 72.40 935 1,049 1,413 935 –933 1,415 935 –935 1,415 1,049 –946 1,415 1,415 1,518 72.40 Outlays (gross), detail: Outlays from new current authority .............................. Outlays from current balances ...................................... Outlays from new permanent authority ......................... 87.00 935 86.90 86.93 86.97 Total outlays (gross) ................................................. Offsets: Against gross budget authority and outlays: 88.45 Offsetting collections (cash) from: Offsetting governmental collections ............................................ 2,519 2,520 2,520 278 663 319 6 ................... ................... 2,803 3,183 2,839 –6 ................... ................... ADMINISTRATION FOR CHILDREN AND FAMILIES—Continued Federal Funds—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 03.02 2,800 2,797 2,800 3,183 2,800 2,839 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. CHILDREN AND FAMILIES SERVICES PROGRAMS 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, chapters 1 and 2 of subtitle B of title III of the Anti-Drug Abuse Act of 1988, the Family Violence Prevention and Services Act, the Native American Programs Act of 1974, title II of Public Law 95–266 (adoption opportunities), the Abandoned Infants Assistance Act of 1988, part B(1) of title IV and section 1110 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, Public Law 100–77, sections 30401, 40211, 40241, and title III of Public Law 103–322, and section 126 and titles IV and V of Public Law 100–485, $5,251,328,000, of which $30,000,000 for the Teen Pregnancy Prevention Program under section 1110 of the Social Security Act shall remain available until expended. Note.—A regular 1996 appropriation for this account had not been enacted at the time this budget was prepared. The 1996 amounts included in this budget are based on the levels provided in three continuing resolutions: P.L. 104–91, P.L. 104–92, and P.L. 104– 99. Program and Financing (in millions of dollars) Identification code 75–1536–0–1–506 1995 actual 1996 est. 1997 est. Obligations by program activity: Head Start ...................................................................... 3,534 3,397 3,981 Social services programs: Children, youth, and families: 01.01 Child development associate scholarships .......... 1 ................... ................... 01.03 Runaway and homeless youth .............................. 40 40 ................... 01.04 Runaway youth transitional living ........................ 14 14 ................... 01.05 Runaway youth activities—drugs ........................ 14 ................... ................... 01.06 Comprehensive runaway and homeless youth ..... ................... ................... 69 01.07 Child abuse state grants ..................................... 23 23 23 01.08 Child abuse discretionary grants ......................... 15 15 ................... 01.09 Community based resource centers ..................... 31 ................... 51 01.10 Teen pregnancy prevention initiative ................... ................... ................... 30 01.11 Abandoned infants assistance ............................. 14 12 14 01.12 Dependent care grants ......................................... 13 ................... ................... 01.13 Temporary child care and crisis nurseries ........... 12 10 ................... 01.14 Child welfare services .......................................... 292 292 292 01.15 Child welfare training ........................................... 4 2 ................... 01.16 Child welfare research and demonstration .......... 6 ................... ................... 01.17 Adoption opportunities .......................................... 13 11 ................... 01.18 Drug abuse preventions for youth gangs ............. 10 ................... ................... 01.19 Family violence grants .......................................... 33 33 33 01.20 Social services and income maintenance research ............................................................... 15 ................... 10 01.21 Family support centers ......................................... 7 ................... ................... 01.22 Child welfare innovative programs ...................... ................... ................... 39 Developmental disabilities: 01.23 State grants and advocacy .................................. 97 67 97 01.24 Special projects and university affiliated projects 24 13 24 01.25 Native american programs ................................... 38 35 38 00.01 01.91 02.01 02.03 Subtotal social services programs ....................... ACF Federal administration ........................................... White House Conference on Aging ................................ 02.91 Subtotal, administrative activities ............................ 162 151 160 02.93 Total direct program ................................................. Community services programs: Community services block grants ............................. 4,412 4,115 4,861 389 390 390 03.01 716 567 720 161 151 160 1 ................... ................... 497 03.03 03.04 Community services emergency services for the homeless ............................................................... Community food and nutrition .................................. Community services discretionary ............................. 03.91 04.01 Subtotal, community services ................................... Reimbursable program .................................................. 458 24 429 22 390 22 10.00 Total obligations ........................................................ 4,894 4,566 5,273 Budgetary resources available for obligation: Unobligated balance available, start of year: Uninvested balance ................................................... 22.00 New budget authority (gross) ........................................ 22.30 Unobligated balance expiring ........................................ 20 ................... ................... 9 ................... ................... 40 39 ................... 21.40 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) ..................................... 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 ............................................................. 9 13 13 4,903 4,566 5,273 –4 ................... ................... 4,908 –4,894 4,579 –4,566 5,286 –5,273 13 13 13 4,874 4,545 5,251 28 22 22 4,903 4,566 5,273 72.40 86.90 86.93 86.97 86.98 87.00 3,211 3,308 3,067 4,894 4,566 5,273 –4,754 –4,807 –4,867 –45 ................... ................... 3,308 3,067 3,473 Outlays (gross), detail: Outlays from new current authority .............................. 2,093 2,006 2,261 Outlays from current balances ...................................... 2,633 2,780 2,584 Outlays from new permanent authority ......................... 28 22 22 Outlays from permanent balances ................................ ................... ................... ................... Total outlays (gross) ................................................. 4,754 4,807 4,867 Offsets: Against gross budget authority and outlays: 88.00 Offsetting collections (cash) from: Federal sources –28 –22 –22 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 4,875 4,726 4,544 4,785 5,251 4,845 89.00 90.00 Summary of Budget Authority and Outlays [In millions of dollars] 1995 actual Enacted/requested: Budget Authority ..................................................................... 4,874 Outlays .................................................................................... 4,726 Adjustment to 1996 continuing resolution levels: Budget Authority ..................................................................... .................... Outlays .................................................................................... .................... Total: Budget Authority ..................................................................... Outlays .................................................................................... 4,874 4,726 1996 est. 4,545 4,786 1997 est. 5,251 4,845 272 .................... 112 142 4,817 4,898 5,251 4,987 Head Start.—The proposed level will enable Head Start projects to continue comprehensive early childhood education services. Social Services.—The proposed level will continue to support State, local, and private efforts to provide developmental and other services for children, grants to improve support networks for persons with developmental disabilities, and economic development assistance to Native American populations. 498 ADMINISTRATION FOR CHILDREN AND FAMILIES—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 1997 73.20 74.40 General and special funds—Continued CHILDREN AND FAMILIES SERVICES PROGRAMS—Continued Object Classification (in millions of dollars) 11.1 11.3 11.5 11.9 12.1 13.0 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 ............................. –7 –12 12 29 1996 est. 96 1 1 1997 est. 96 1 1 100 1 1 25.5 25.7 26.0 31.0 41.0 Total personnel compensation ......................... Civilian personnel benefits ....................................... Benefits for former personnel ................................... 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 ................................................................ Research and development contracts ....................... Operation and maintenance of equipment ............... Supplies and materials ............................................. Equipment ................................................................. Grants, subsidies, and contributions ........................ 99.0 99.0 99.5 Subtotal, direct obligations .................................. Reimbursable obligations .............................................. Below reporting threshold .............................................. 4,871 24 –1 4,545 22 –1 5,252 22 –1 99.9 Total obligations ........................................................ 4,894 4,566 Outlays (gross), detail: Outlays from new current authority .............................. ................... Outlays from current balances ...................................... ................... 2 5 6 6 Total outlays (gross) ................................................. ................... 7 12 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ 11 Outlays ........................................................................... ................... 8 7 29 12 5,273 24.0 25.1 25.2 25.3 98 98 102 16 17 18 3 1 1 4 2 4 1 1 1 13 13 14 1 ................... ................... 86.90 86.93 87.00 1995 actual Identification code 75–1536–0–1–506 Total outlays (gross) ...................................................... ................... Unpaid obligations, end of year: Obligated balance: Appropriation ............................................................. 11 3 1 70 3 2 1 60 5 2 1 65 9 23 19 20 3 ................... ................... 5 1 1 1 1 1 4 1 1 4,622 4,323 5,012 Personnel Summary Identification code 75–1536–0–1–506 1001 1005 Total compensable workyears: Full-time equivalent employment .................................. Full-time equivalent of overtime and holiday hours Summary of Budget Authority and Outlays [In millions of dollars] Enacted/requested: 1995 actual Budget Authority ..................................................................... 11 Outlays .................................................................................... .................... Adjustment to 1996 continuing resolution levels: Budget Authority ..................................................................... .................... Outlays .................................................................................... .................... Total: Budget Authority ..................................................................... 11 Outlays .................................................................................... .................... 1996 est. 1,803 3 1997 est. 1,803 2 1,803 3 Note.—A regular 1996 appropriation for this account had not been enacted at the time this budget was prepared. The 1996 amounts included in this budget are based on the levels provided in three continuing resolutions: P.L. 104–91, P.L. 104–92, and P.L. 104– 99. Program and Financing (in millions of dollars) Obligations by program activity: 00.02 Community schools ........................................................ 00.03 Battered women’s shelters and domestic violence hotline ............................................................................. 10 1996 est. 1997 est. 8 14 1 ................... 15 10.00 Total obligations ........................................................ 11 8 29 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ New obligations ............................................................. 11 –11 8 –8 29 –29 New budget authority (gross), detail: 42.00 Transferred from other accounts ................................... 11 Change in unpaid obligations: Unpaid obligations, start of year: Obligated balance: Appropriation ............................................................. ................... 73.10 New obligations ............................................................. 11 29 12 5 .................... 1 3 13 8 29 15 25.1 41.0 Advisory and assistance services .................................. Grants, subsidies, and contributions ............................ 99.9 Total obligations ........................................................ TO STATES FOR FOSTER CARE 1996 est. 1997 est. 1 ................... 10 8 11 AND 1 28 29 8 ADOPTION ASSISTANCE For making payments to States or other non-Federal entities, under title IV–E of the Social Security Act, $4,445,000,000; and in addition, for the first quarter of fiscal year 1998, $1,111,000,000. Note.—A regular 1996 appropriation for this account had not been enacted at the time this budget was prepared. The 1996 amounts included in this budget are based on the levels provided in three continuing resolutions: P.L. 104–91, P.L. 104–92, and P.L. 104– 99. Program and Financing (in millions of dollars) For activities authorized by sections 30401, 40211, and 40241 of Public Law 103–322, $29,000,000, to remain available until expended, which shall be derived from the Violent Crime Reduction Trust Fund, of which $13,600,000 shall be for the Community Schools Youth Services and Supervision Grant Program; $15,000,000 for grants for Battered Women’s Shelters; and $400,000 for the National Domestic Violence Hotline. 1995 actual 1995 actual Identification code 75–8605–0–1–754 VIOLENT CRIME REDUCTION PROGRAMS Identification code 75–8605–0–1–754 1997 est. 8 7 Object Classification (in millions of dollars) PAYMENTS 1995 actual 1996 est. Identification code 75–1545–0–1–506 1995 actual 1996 est. 1997 est. 00.01 00.02 00.03 Obligations by program activity: Foster care ..................................................................... Independent living ......................................................... Adoption assistance ....................................................... 2,899 70 434 3,742 70 510 3,807 70 568 10.00 Total obligations (object class 41.0) ........................ 3,403 4,322 4,445 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 ............................................................. 3,403 –3,403 4,322 –4,322 4,445 –4,445 40.00 New budget authority (gross), detail: Appropriation .................................................................. 3,597 4,322 4,445 760 3,403 –3,244 919 4,322 –3,740 1,501 4,445 –4,144 919 1,501 1,802 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 ............................................................. 3,597 4,322 4,445 –194 ................... ................... 72.40 29 Outlays (gross), detail: Outlays from new current authority .............................. Outlays from current balances ...................................... 2,762 481 3,108 632 3,086 1,058 87.00 8 86.90 86.93 Total outlays (gross) ................................................. 3,244 3,740 4,144 89.00 Net budget authority and outlays: Budget authority ............................................................ 3,597 4,322 4,445 72.40 11 8 12 29 DEPARTMENTAL MANAGEMENT Federal Funds DEPARTMENT OF HEALTH AND HUMAN SERVICES 90.00 Outlays ........................................................................... 3,244 3,740 4,144 Foster care.—The proposed level will support eligible lowincome children who must be placed outside the home. An average of 285,000 children per month will be served in 1997. Adoption assistance.—The proposed funding level will support subsidies for families adopting eligible low-income children with special needs. An average of 131,000 children per month will be served in 1997. ADMINISTRATION ON AGING 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 876 951 781 742 1,328 994 Summary of Budget Authority and Outlays [In millions of dollars] Enacted/requested: 1995 actual Budget Authority ..................................................................... 876 Outlays .................................................................................... 952 Adjustment to 1996 continuing resolution levels: Budget Authority ..................................................................... .................... Outlays .................................................................................... .................... Total: Budget Authority ..................................................................... Outlays .................................................................................... Federal Funds 499 1996 est. 781 743 1997 est. 1,328 994 47 .................... 33 12 876 952 828 776 1,328 1,006 General and special funds: AGING SERVICES PROGRAMS For carrying out, to the extent not otherwise provided, the Older Americans Act of 1965, as amended, and section 10404 of Public Law 101–239 (volunteer senior aides demonstration), $828,137,000. Note.—A regular 1996 appropriation for this account had not been enacted at the time this budget was prepared. The 1996 amounts included in this budget are based on the levels provided in three continuing resolutions: P.L. 104–91, P.L. 104–92, and P.L. 104– 99. 01.01 01.02 01.03 01.04 01.05 01.06 01.07 01.08 01.09 01.10 01.12 01.13 01.14 01.15 1995 actual Object Classification (in millions of dollars) 1995 actual Identification code 75–0142–0–1–506 11.1 Program and Financing (in millions of dollars) Identification code 75–0142–0–1–506 Administration on Aging.—The proposed level will continue to provide supportive and nutrition services, research, training and demonstration projects for the elderly. 1996 est. 1997 est. Obligations by program activity: Supportive services and centers ................................... 307 294 295 Preventive health ........................................................... 17 ................... 17 Ombudsman services ..................................................... 4 ................... 4 Elder abuse prevention .................................................. 5 ................... 5 Congregate meals .......................................................... 377 358 357 Home-delivered meals ................................................... 94 89 94 In-home services ............................................................ 9 9 9 Grants to Indian tribes .................................................. 17 16 16 Research, training and discretionary projects .............. 26 ................... 12 Federal administration ................................................... 16 15 17 Pension counseling ........................................................ 2 ................... 2 White House Conference on Aging ................................ 3 ................... ................... Transfer from USDA for nutrition program .................... ................... ................... 150 DOL transfer for senior community service employment program ..................................................................... ................... ................... 350 10.00 Total obligations ........................................................ 877 781 Budgetary resources available for obligation: New budget authority (gross) ........................................ New obligations ............................................................. 877 –877 781 –781 11.9 12.1 23.1 25.1 25.2 41.0 99.5 Total personnel compensation .............................. Civilian personnel benefits ............................................ Rental payments to GSA ................................................ Advisory and assistance services .................................. Other services ................................................................ Grants, subsidies, and contributions ............................ Below reporting threshold .............................................. 99.9 Total obligations ........................................................ 1996 est. 10 10 1997 est. 11 10 10 11 2 1 2 1 1 1 3 ................... ................... 6 2 2 851 766 1,311 4 1 1 877 781 1,328 Personnel Summary 1995 actual Identification code 75–0142–0–1–506 Total compensable workyears: 1001 Full-time equivalent employment .................................. 1005 Full-time equivalent of overtime and holiday hours 1,328 –1,328 1996 est. 177 1 158 1 1997 est. 177 1 1,328 22.00 23.95 Personnel compensation: Full-time permanent .................................................. DEPARTMENTAL MANAGEMENT Federal Funds General and special funds: New budget authority (gross), detail: Current: 40.00 Appropriation ............................................................. 876 781 42.00 Transferred from other accounts .............................. ................... ................... 43.00 68.00 70.00 Appropriation (total) ............................................. Permanent: Spending authority from offsetting collections: Offsetting collections (cash) ..................................... 876 Total new budget authority (gross) .......................... 877 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 ............................................................. 86.90 86.93 86.97 Outlays (gross), detail: Outlays from new current authority .............................. Outlays from current balances ...................................... Outlays from new permanent authority ......................... 87.00 Total outlays (gross) ................................................. 781 GENERAL DEPARTMENTAL MANAGEMENT 828 500 1,328 1 ................... ................... 781 1,328 290 877 –951 216 781 –742 253 1,328 –994 216 253 587 698 555 775 254 188 219 1 ................... ................... 951 742 994 For necessary expenses, not otherwise provided, for general departmental management, including hire of six medium sedans, and for carrying out titles III, XVII, and XX of the Public Health Service Act, $136,163,000, together with $9,187,000, 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. OFFICE OF OFFICE Offsets: Against gross budget authority and outlays: 88.00 Offsetting collections (cash) from: Federal sources –1 ................... ................... CONSUMER AFFAIRS For necessary expenses of the Office of Consumer Affairs, including services authorized by 5 U.S.C. 3109, $1,811,000: Provided, That notwithstanding any other provision of law, that Office may accept and deposit to this account, during fiscal year 1997, gifts for the purpose of defraying its costs of printing, publishing, and distributing consumer information and educational materials; may expend up to $1,100,000 of those gifts for those purposes, in addition to amounts otherwise appropriated; and the balance shall remain available for expenditure for such purposes to the extent authorized 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. FOR CIVIL RIGHTS For expenses necessary of the Office for Civil Rights, $18,188,000, together with not to exceed $3,602,000, to be transferred and expended as authorized by section 201(g)(1) of the Social Security Act from 500 DEPARTMENTAL MANAGEMENT—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 1997 Office for Civil Rights ............................................................. Policy research ........................................................................ General and special funds—Continued OFFICE FOR CIVIL RIGHTS—Continued the Hospital Insurance Trust Fund and the Supplemental Medical Insurance Trust Fund. POLICY RESEARCH For carrying out, to the extent not otherwise provided, research studies under section 1110 of the Social Security Act, $9,000,000. Note.—A regular 1996 appropriation for this account had not been enacted at the time this budget was prepared. The 1996 amounts included in this budget are based on the levels provided in three continuing resolutions: P.L. 104–91, P.L. 104–92, and P.L. 104– 99. Program and Financing (in millions of dollars) 1995 actual Identification code 75–9912–0–1–999 1996 est. 1997 est. 00.01 00.02 00.03 00.04 00.05 Obligations by program activity: General departmental management .............................. U.S Office of Consumer Affairs ..................................... Office for Civil Rights .................................................... Policy research ............................................................... Emergency supplemental ............................................... 173 2 22 9 1 140 145 2 2 19 22 9 9 7 ................... 00.91 01.01 Subtotal, direct activities .......................................... Reimbursable activities ................................................. 207 88 177 92 178 92 10.00 Total obligations ........................................................ 295 269 18 15 16 17 19 7 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. 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. DM also incorporates the activities of the former Office of the Assistant Secretary for Health, including adolescent family life, disease prevention and health promotion, physical fitness and sports, minority health, research integrity, women’s health, and emergency preparedness. These schedules include six months of resources for general departmental management, civil rights, and policy research activities transferred to the independent Social Security Administration on March 31, 1995. 270 Object Classification (in millions of dollars) Budgetary resources available for obligation: 21.40 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 ................................................... 1995 actual Identification code 75–9912–0–1–999 8 7 ................... 295 262 270 –1 ................... ................... 302 –295 269 –269 270 –270 11.1 11.3 11.5 1996 est. 97 5 1 1997 est. 90 5 1 82 5 1 70.00 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 ............................................................. 184 160 165 111 102 104 295 262 270 187 108 61 295 269 270 –363 –316 –259 –11 ................... ................... 108 61 72 Outlays (gross), detail: 86.90 Outlays from new current authority .............................. 86.93 Outlays from current balances ...................................... 86.97 Outlays from new permanent authority ......................... 151 101 111 123 90 102 Total outlays (gross) ................................................. 363 316 259 Offsets: Against gross budget authority and outlays: 88.00 Offsetting collections (cash) from: Federal sources –111 –102 –104 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 184 252 160 214 99.0 99.0 Subtotal, direct obligations .................................. Reimbursable obligations .............................................. 207 88 184 85 178 92 Total obligations ........................................................ 295 269 270 24.0 25.1 25.2 25.3 127 30 104 87.00 25.5 25.7 26.0 31.0 41.0 Total personnel compensation ......................... Civilian personnel benefits ....................................... Benefits for former personnel ................................... 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 ....................... Operation and maintenance of equipment ............... Supplies and materials ............................................. Equipment ................................................................. Grants, subsidies, and contributions ........................ 99.9 New budget authority (gross), detail: Current: 40.00 Appropriation ............................................................. Permanent: 68.00 Spending authority from offsetting collections: Offsetting collections (cash) ..................................... 7 ................... ................... 11.9 12.1 13.0 21.0 23.1 23.3 Direct obligations: Personnel compensation: Full-time permanent ............................................. Other than full-time permanent ........................... Other personnel compensation ............................. 103 96 88 18 17 16 4 ................... ................... 2 1 1 14 11 12 4 1 4 12 4 1 3 15 3 1 4 14 16 3 4 1 2 19 9 3 4 1 1 18 10 2 3 1 4 19 166 155 Personnel Summary 1995 actual Identification code 75–9912–0–1–999 89.00 90.00 1996 est. 1997 est. 1,810 8 1,356 8 1,356 8 141 141 141 PROGRAM SUPPORT CENTER [Dollars in millions] 1995 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 ..................................................... 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 1997 155 2 18 9 133 2 16 9 136 2 18 9 145 2 159 3 127 2 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 PROGRAM SUPPORT CENTER—Continued Federal Funds—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES 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. Note.—A regular 1996 appropriation for this account had not been enacted at the time this budget was prepared. The 1996 amounts included in this budget are based on the levels provided in three continuing resolutions: P.L. 104–91, P.L. 104–92, and P.L. 104– 99. 73.10 73.20 74.40 501 New obligations ............................................................. ................... ................... ................... Total outlays (gross) ...................................................... –1 –1 –1 Unpaid obligations, end of year: Obligated balance: Appropriation ............................................................. 12 11 10 86.93 Outlays (gross), detail: Outlays from current balances ...................................... 87.00 Total outlays (gross) ................................................. 1 ................... ................... 1 1 1 Program and Financing (in millions of dollars) Identification code 75–0379–0–1–551 1995 actual 1996 est. 1997 est. 89.00 90.00 00.01 00.02 00.03 00.04 Obligations by program activity: Retirement payments ..................................................... Survivors’ benefits ......................................................... Medical care .................................................................. Military service credits .................................................. 112 8 22 2 130 9 25 3 136 11 26 3 10.00 Total obligations ........................................................ 144 167 176 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 ............................................................. 144 –144 167 –167 176 –176 New budget authority (gross), detail: 40.05 Appropriation (indefinite) ............................................... 159 167 176 00.01 00.02 00.03 25 14 14 144 167 176 –152 –167 –176 –3 ................... ................... 10.00 Net budget authority and outlays: Budget authority ............................................................ ................... ................... ................... Outlays ........................................................................... 1 1 1 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 ............................................................. 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. Intragovernmental funds: 159 167 176 –15 ................... ................... HHS SERVICE AND SUPPLY FUND Program and Financing (in millions of dollars) Identification code 75–9941–0–4–999 1995 actual 1996 est. Obligations by program activity: Program support center ................................................. 145 184 Federal employee occupational health .......................... ................... ................... OS activities ................................................................... 83 62 1997 est. 244 90 7 72.40 14 14 14 86.90 86.93 Outlays (gross), detail: Outlays from new current authority .............................. Outlays from current balances ...................................... 138 14 159 8 168 8 87.00 Total outlays (gross) ................................................. 152 167 176 Net budget authority and outlays: 89.00 Budget authority ............................................................ 90.00 Outlays ........................................................................... 159 152 167 167 176 176 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. 1995 actual 1996 est. 1997 est. 139 25 228 246 341 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 ....................................................................... 32 217 30 246 30 341 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: Spending authority from offsetting collections: 68.00 Offsetting collections (cash) ..................................... 68.10 Change in orders on hand from Federal sources 13.0 25.2 25.3 Benefits for former personnel ........................................ Other services ................................................................ Purchases of goods and services from Government accounts .................................................................... 120 22 147 26 2 3 3 99.9 Total obligations ........................................................ 144 167 176 68.90 22.00 1997 est. Budgetary resources available for obligation: New budget authority (gross) ........................................ ................... ................... ................... New budget authority (gross), detail: 70.00 Total new budget authority (gross) ............................... ................... ................... ................... 72.40 Change in unpaid obligations: Unpaid obligations, start of year: Obligated balance: Appropriation ............................................................. 13 12 371 –341 30 30 30 205 246 341 12 ................... ................... 246 341 Total new budget authority (gross) .......................... 217 246 341 75 57 68 69 58 69 70.00 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: Uninvested balance ...................................................................... Orders on hand from Federal sources ...................... 74.90 11 132 137 127 228 246 341 –214 –256 –341 –9 ................... ................... 68 69 58 69 58 69 Total unpaid obligations, end of year .................. 137 127 127 86.97 86.98 Outlays (gross), detail: Outlays from new permanent authority ......................... Outlays from permanent balances ................................ 196 18 246 341 10 ................... 87.00 Total outlays (gross) ................................................. 214 256 Program and Financing (in millions of dollars) 1996 est. 276 –246 217 74.99 HEALTH ACTIVITIES FUNDS 1995 actual 258 –228 Spending authority from offsetting collections (total) ................................................................ 74.95 Identification code 75–9913–0–1–550 9 ................... ................... Change in unpaid obligations: Unpaid obligations, start of year: 72.90 Obligated balance: Fund balance ............................. 72.95 Orders on hand from Federal sources ...................... Object Classification (in millions of dollars) Identification code 75–0379–0–1–551 Total obligations ........................................................ 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 ......... 89.00 341 –205 –246 –341 –12 ................... ................... Net budget authority and outlays: Budget authority ............................................................ ................... ................... ................... 502 PROGRAM SUPPORT CENTER—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 1997 Intragovernmental funds—Continued HHS SERVICE AND Program and Financing (in millions of dollars) SUPPLY FUND—Continued Program and Financing (in millions of dollars)—Continued 1995 actual Identification code 75–9941–0–4–999 90.00 Outlays ........................................................................... 9 1996 est. 1997 est. 10 ................... The HHS Service and Supply Fund (SSF) provides common centralized services to HHS components. Beginning in FY 1995, all PHS SSF activities are reflected in the Program Support Center. For FY 1995 and FY 1996, all OS Working Capital Fund (WCF) activities are included in the OS Activities line. The WCF will be terminated in FY 1997 and both PSC and OS activities will be funded through the SSF. The OS Activity line includes the Fund Manager, Departmental Contracts Information System, Audit Resolution, OS Graphics, and the Regional Health Administrators. For FY 1995 and FY 1996, Federal Occupational Health funds operate through the Health Resources and Services Administration general fund account, but will be funded through the SSF in FY 1997. Object Classification (in millions of dollars) 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 Personnel compensation: Full-time permanent .................................................. Other than full-time permanent ............................... Other personnel compensation .................................. 1996 est. 1997 est. 00.02 00.03 Obligations by program activity: Gifts ............................................................................... Contributions, Indian health facilities .......................... 11 37 20 33 20 33 10.00 Total obligations ........................................................ 48 53 53 Budgetary resources available for obligation: Unobligated balance available, start of year: Uninvested balance ................................................... 22.00 New budget authority (gross) ........................................ 37 53 42 53 42 53 90 –48 95 –53 95 –53 42 42 42 53 53 53 93 48 –46 95 53 –47 101 53 –50 95 101 104 21.40 23.90 23.95 24.40 60.27 Total budgetary resources available for obligation New obligations ............................................................. Unobligated balance available, end of year: Uninvested balance ................................................... New budget authority (gross), detail: Appropriation (trust fund, indefinite) ............................ 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 86.97 86.98 1995 actual Identification code 75–9941–0–4–999 1995 actual Identification code 75–9971–0–7–551 63 2 2 1996 est. 64 2 2 Outlays (gross), detail: Outlays from new permanent authority ......................... Outlays from permanent balances ................................ 9 37 9 38 9 40 87.00 Total outlays (gross) ................................................. 46 47 50 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 53 46 53 47 53 50 1997 est. 74 3 2 26.0 31.0 99.0 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 .................................................................... Supplies and materials ................................................. Equipment ...................................................................... Subtotal, reimbursable obligations ............................... 67 68 79 13 13 15 4 ................... ................... 1 2 3 1 2 2 13 11 11 8 12 14 2 2 2 4 4 4 51 59 130 25 34 5 228 29 39 5 246 30 46 5 341 99.9 Total obligations ........................................................ 228 246 341 [Dollars in millions] 1995 Distribution of budget authority by account: Gifts ........................................................................................ Contributions, Indian health facilities ................................... Distribution of outlays by account: Gifts ........................................................................................ Contributions, Indian health facilities ................................... 1996 1997 20 33 20 33 20 33 16 30 16 31 17 33 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) Personnel Summary Identification code 75–9941–0–4–999 2001 2005 Total compensable workyears: Full-time equivalent employment .................................. Full-time equivalent of overtime and holiday hours 1,456 14 1996 est. 1,308 14 1997 est. 1,438 17 Unavailable Collections (in millions of dollars) 1995 actual 11.3 11.5 11.8 11.9 12.1 21.0 22.0 25.2 25.3 MISCELLANEOUS TRUST FUNDS Identification code 75–9971–0–7–551 1995 actual Identification code 75–9971–0–7–551 1995 actual 1996 est. Balance, start of year: Balance, start of year .................................................... ................... ................... ................... Receipts: 02.01 Contributions, Indian health facilities, Health Services Administration ........................................................... 32 33 33 02.02 Gifts and contributions, Miscellaneous trust funds 19 19 19 02.03 Interest, Miscellaneous trust funds ............................... 1 1 1 Total receipts ............................................................. 53 53 53 Appropriation: 05.01 Miscellaneous trust funds ............................................. –53 –53 –53 07.99 Total balance, end of year ............................................ ................... ................... ................... 1996 est. 1997 est. 3 1 1 3 1 1 3 1 1 5 1 1 1 8 5 1 1 1 11 5 1 1 1 11 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 .................................................................... Supplies and materials ................................................. Equipment ...................................................................... Land and structures ...................................................... Grants, subsidies, and contributions ............................ 5 4 2 20 1 7 4 2 20 1 7 4 2 20 1 99.9 Total obligations ........................................................ 48 53 53 1997 est. 01.99 Personnel compensation: Other than full-time permanent ............................... Other personnel compensation .................................. Special personal services payments ......................... Personnel Summary 02.99 Identification code 75–9971–0–7–551 Total compensable workyears: 1001 Full-time equivalent employment .................................. 1995 actual 100 1996 est. 100 1997 est. 100 OFFICE OF THE INSPECTOR GENERAL Federal Funds—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES 1005 Full-time equivalent of overtime and holiday hours 20 20 20 OFFICE OF THE INSPECTOR GENERAL OF INSPECTOR GENERAL For necessary expenses of the Office of Inspector General in carrying out the Inspector General Act of 1978, as amended, $56,139,000, together with not to exceed $18,810,000, 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. Note.—A regular 1996 appropriation for this account had not been enacted at the time this budget was prepared. The 1996 amounts included in this budget are based on the levels provided in three continuing resolutions: P.L. 104–91, P.L. 104–92, and P.L. 104– 99. 1995 actual Object Classification (in millions of dollars) 1995 actual Identification code 75–0128–0–1–609 11.1 11.5 1996 est. 1997 est. 56 49 51 1 ................... ................... 99.0 99.0 Subtotal, direct obligations .................................. Reimbursable obligations .............................................. 91 5 74 7 75 7 82 –81 83 –82 99.9 Total obligations ........................................................ 96 81 82 1 1 91 5 74 7 75 7 10.00 Total obligations ........................................................ 96 81 82 Budgetary resources available for obligation: Unobligated balance available, start of year: Uninvested balance ................................................... 22.00 New budget authority (gross) ........................................ 1 96 1 81 97 –96 1 21.40 11.9 12.1 13.0 21.0 23.1 23.3 Direct obligations: Personnel compensation: Full-time permanent ............................................. Other personnel compensation ............................. 1 82 1997 est. Obligations by program activity: Direct program ............................................................... Reimbursable program .................................................. Total budgetary resources available for obligation New obligations ............................................................. Unobligated balance available, end of year: Uninvested balance ................................................... 32 31 25.6 26.0 31.0 1996 est. 00.01 01.01 23.90 23.95 24.40 31 24 Total personnel compensation ......................... Civilian personnel benefits ....................................... Benefits for former personnel ................................... Travel and transportation of persons ....................... Rental payments to GSA ........................................... Communications, utilities, and miscellaneous charges ................................................................. Other services ............................................................ Purchases of goods and services from Government accounts ................................................................ Medical care .............................................................. Supplies and materials ............................................. Equipment ................................................................. Program and Financing (in millions of dollars) Identification code 75–0128–0–1–609 60 70 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. General and special funds: OFFICE Total: Budget Authority ..................................................................... Outlays .................................................................................... 503 25.2 25.3 60 56 36 25 96 81 1 1 1 1 8 5 5 1 ................... ................... 1 ................... ................... 2 ................... ................... 1995 actual 82 1996 est. 1997 est. 26 70.00 2 1 Personnel Summary Identification code 75–0128–0–1–609 New budget authority (gross), detail: Current: 40.00 Appropriation ............................................................. Permanent: 68.00 Spending authority from offsetting collections: Offsetting collections (cash) ..................................... 57 49 51 11 11 11 1 ................... ................... 3 2 1 4 5 5 Total new budget authority (gross) .......................... Change in unpaid obligations: 72.40 Unpaid obligations, start of year: Obligated balance: Appropriation ............................................................. 9 ................... 73.10 New obligations ............................................................. 96 81 73.20 Total outlays (gross) ...................................................... –105 –74 74.40 Unpaid obligations, end of year: Obligated balance: Appropriation ............................................................. ................... 7 56 Total compensable workyears: 1001 Full-time equivalent employment .................................. 1005 Full-time equivalent of overtime and holiday hours OFFICE OF THE 1,051 927 927 5 ................... ................... INSPECTOR GENERAL (Legislative proposal, not subject to PAYGO) 7 82 –81 Program and Financing (in millions of dollars) Identification code 75–0128–2–1–609 8 1995 actual 1996 est. 1997 est. 10.00 Outlays (gross), detail: 86.90 Outlays from new current authority .............................. 86.93 Outlays from current balances ...................................... 86.97 Outlays from new permanent authority ......................... 87.00 Total outlays (gross) ................................................. Offsets: Against gross budget authority and outlays: 88.00 Offsetting collections (cash) from: Federal sources Net budget authority and outlays: 89.00 Budget authority ............................................................ 90.00 Outlays ........................................................................... 60 49 10 ................... 36 25 105 –36 60 70 74 –25 49 6 26 81 –26 Obligations by program activity: Total obligations ............................................................ ................... –43 –43 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ ................... New obligations ............................................................. ................... –43 43 –43 43 –25 –24 –18 –19 New budget authority (gross), detail: Current: 40.00 Appropriation ............................................................. ................... Permanent: 68.00 Spending authority from offsetting collections: Offsetting collections (cash) ..................................... ................... 56 55 Summary of Budget Authority and Outlays 70.00 Total new budget authority (gross) .......................... ................... –43 –43 73.10 73.20 56 49 Change in unpaid obligations: New obligations ............................................................. ................... Total outlays (gross) ...................................................... ................... –43 43 –43 43 86.90 86.97 Outlays (gross), detail: Outlays from new current authority .............................. ................... Outlays from new permanent authority ......................... ................... –25 –18 –24 –19 87.00 Total outlays (gross) ................................................. ................... –43 –43 Offsets: Against gross budget authority and outlays: 88.00 Offsetting collections (cash) from: Federal sources ................... 18 19 [In millions of dollars] Enacted/requested: Budget Authority ..................................................................... Outlays .................................................................................... Legislative proposal, not subject to PAYGO: Budget Authority ..................................................................... Outlays .................................................................................... Legislative proposal, subject to PAYGO: Budget Authority ..................................................................... Outlays .................................................................................... 1995 actual 1996 est. 1997 est. 60 70 56 49 56 55 .................... .................... –25 –25 –24 –24 .................... .................... .................... .................... .................... .................... 504 OFFICE OF THE INSPECTOR GENERAL—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 1997 87.00 OFFICE OF THE INSPECTOR GENERAL—Continued Program and Financing (in millions of dollars)—Continued 1995 actual Identification code 75–0128–2–1–609 1996 est. Net budget authority and outlays: 89.00 Budget authority ............................................................ ................... 90.00 Outlays ........................................................................... ................... –25 –25 –24 –24 Object Classification (in millions of dollars) 11.1 12.1 21.0 23.1 23.3 25.3 1995 actual 99.9 Personnel compensation: Full-time permanent ............. Civilian personnel benefits ............................................ Travel and transportation of persons ............................ Rental payments to GSA ................................................ Communications, utilities, and miscellaneous charges Purchases of goods and services from Government accounts .................................................................... 1996 est. 1997 est. ................... ................... ................... ................... ................... –29 –6 –1 –3 –1 –29 –6 –1 –3 –1 ................... –3 –3 Total obligations ........................................................ ................... –43 –43 Personnel Summary 1995 actual Identification code 75–0128–2–1–609 1001 1996 est. Total compensable workyears: Full-time equivalent employment ............................................................... ................... –430 84 97 –84 –97 1997 est. This schedule reflects the effects of a legislative proposal to shift base funding for Medicare anti-fraud and abuse activities from discretionary to mandatory. Identification code 75–0128–2–1–609 Total outlays (gross) ................................................. ................... Offsets: Against gross budget authority and outlays: 88.00 Offsetting collections (cash) from: Federal sources ................... General and special funds—Continued 1997 est. –430 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ ................... ................... ................... Outlays ........................................................................... ................... ................... ................... The Budget reflects a legislative proposal to authorize mandatory funding for the Department of Health and Human Services and the Department of Justice to expand efforts to combat Medicare fraud and abuse. This schedule reflects an estimated distribution of these funds. Final distribution will be determined by the Secretary of HHS and the Attorney General. Object Classification (in millions of dollars) 1995 actual Identification code 75–0128–4–1–609 11.1 12.1 21.0 23.1 23.3 25.1 25.2 25.3 26.0 31.0 99.9 Personnel compensation: Full-time permanent ............. 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 ...................................................................... 1996 est. 1997 est. ................... ................... ................... ................... ................... ................... ................... 41 15 2 4 2 9 2 51 17 3 4 2 9 2 ................... ................... ................... 6 1 2 6 1 2 Total obligations ........................................................ ................... 84 97 Personnel Summary OFFICE OF THE INSPECTOR GENERAL Identification code 75–0128–4–1–609 (Legislative proposal, subject to PAYGO) 1001 Program and Financing (in millions of dollars) Identification code 75–0128–4–1–609 1995 actual 1996 est. 1996 est. 430 1997 est. 430 1997 est. 10.00 Obligations by program activity: Total obligations ............................................................ ................... 84 97 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ ................... New obligations ............................................................. ................... 84 –84 97 –97 New budget authority (gross), detail: Spending authority from offsetting collections (gross): Offsetting collections (cash) ..................................... ................... 84 97 73.10 73.20 Change in unpaid obligations: New obligations ............................................................. ................... Total outlays (gross) ...................................................... ................... 84 –84 97 –97 86.97 Outlays (gross), detail: Outlays from new permanent authority ......................... ................... 84 97 68.00 1995 actual Total compensable workyears: Full-time equivalent employment ............................................................... ................... 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 in this title 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.
@FedFRASER