Full text of Budget of the United States Government - Appendix : Fiscal Year 2000 : Department of Health and Human Services

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DEPARTMENT OF HEALTH AND HUMAN SERVICES
FOOD AND DRUG ADMINISTRATION
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 payment
of space rental and related costs pursuant to Public Law 92–313
for programs and activities of the Food and Drug Administration
which are included in this Act; for rental of special purpose space
in the District of Columbia or elsewhere; 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$1,103,140,000¿
$1,255,384,000, of which not to exceed ø$132,273,000¿ $145,434,000
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 øfees derived from applications received during fiscal year 1999 shall be subject to the fiscal year
1999 limitation: Provided further, That none of these funds shall
be used to develop, establish, or operate any program of user fees
authorized by 31 U.S.C. 9701: Provided further, That of the total
amount appropriated: (1) $231,580,000 shall be for the Center for
Food Safety and Applied Nutrition and related field activities in
the Office of Regulatory Affairs, of which, and notwithstanding section 409(h)(5)(A) of the Federal Food, Drug, and Cosmetic Act (21
U.S.C. 301 et seq.), an amount of $500,000 shall be made available
for the development of systems, regulations, and pilot programs, if
any, that would be required to permit full implementation, consistent
with section 409(h)(5) of that Act, in fiscal year 2000 of the food
contact substance notification program under section 409(h) of such
Act; (2) $291,981,000 shall be for the Center for Drug Evaluation
and Research and related field activities in the Office of Regulatory
Affairs; (3) $125,095,000 shall be for the Center for Biologics Evaluation and Research and for related field activities in the Office of
Regulatory Affairs; (4) $41,973,000 shall be for the Center for Veterinary Medicine and for related field activities in the Office of Regulatory Affairs; (5) $145,736,000 shall be for the Center for Devices
and Radiological Health and for related field activities in the Office
of Regulatory Affairs; (6) $31,579,000 shall be for the National Center
for Toxicological Research; (7) $34,000,000 shall be for the Office
of Tobacco; (8) $25,855,000 shall be for Rent and Related activities,
other than the amounts paid to the General Services Administration;
(9) $88,294,000 shall be for payments to the General Services Administration for rent and related costs; and (10) $87,047,000 shall be
for other activities, including the Office of the Commissioner, the
Office of Policy, the Office of External Affairs, the Office of Operations, the Office of Management and Systems, and central services
for these offices: Provided further, That funds may be transferred
from one specified activity to another with the prior approval of
the Committee on Appropriations of both Houses of Congress¿ no
more than $100,180,000 shall be for payments to the General Services
Administration for rent and related costs: Provided further, That effective October 1, 1999, (1) the functions and authorities related to fish
or fishery products under such Act, including inspections and other
activities authorized under section 203(h) of that Act, are transferred
from the Secretary of Commerce to the Secretary of Health and Human
Services (hereafter ‘‘HHS’’) acting through the Commissioner for Food
and Drugs; (2) the Secretary of Commerce shall transfer to the Secretary of HHS (A) all personnel of the Seafood Inspection Division
of the National Oceanic and Atmospheric Administration of the Department of Commerce and such other employees of the Department
of Commerce as may be designated by the Secretary of Commerce,
with the concurrence of the Secretary of HHS, all of whom shall
become personnel of a voluntary seafood inspection unit within the
Food and Drug Administration; and (B) all assets and liabilities
of the Department of Commerce or its components pertaining to the
activities specified in clause (1), which shall become assets and liabilities of such seafood inspection unit, including facilities, contracts,

property, records, accounts payable and receivable, and unexpended
and unobligated balances of funds; (3) all rules, regulations, administrative directives, grants, contracts, and other determinations and
agreements in effect on such date with respect to (or to the extent
they apply to) the functions and authorities specified in clause (1)
shall remain in effect until modified, terminated, suspended, set aside,
or repealed by the Secretary of HHS or the Commissioner of Food
and Drugs; (4) the Secretary of HHS is authorized to promulgate,
without need for comment, a final rule transferring to or duplicating
in title 21 of the Code of Federal Regulations (as appropriate) regulations of the Secretary of Commerce necessary to carry out the functions
specified in clause (1); (5) activities of such seafood inspection unit
to carry out provisions of the Agricultural Marketing Act shall be
funded exclusively from fees charged for, and other amounts specifically appropriated for, such activities, and fees collected and amounts
appropriated for such activities shall not be used for any other purpose; and (6) for purposes of any reduction in the personnel complement of the Food and Drug Administration or of such unit on
or before September 30, 2004, such unit will be deemed a distinct
competitive area within the Food and Drug Administration, under
5 CFR 351.402: Provided further, That of the total amount appropriated, $3,000,000 shall be available until expended for the costs
of transferring functions related to fish and fishery products (including costs of relocation, personnel training, and public information),
and shall be deposited, together with fees derived from performance
of such functions, into a separate account.
In addition, fees pursuant to section 354 of the Public Health Service Act may be credited to this account, to remain available until
expended.
In addition, fees pursuant to section 801 of the Federal Food, Drug,
and Cosmetic Act may be credited to this account, to remain available
until expended.
BUILDINGS

AND

FACILITIES

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$11,350,000¿ $31,750,000, to remain available until expended (7
U.S.C. 2209b). (Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 1999, as included in Public Law 105–277, section 101(a).)
Unavailable Collections (in millions of dollars)
Identification code 75–9911–0–1–554

1998 actual

1999 est.

2000 est.

Balance, start of year:
01.99 Balance, start of year .................................................... ................... ................... ...................
Receipts:
02.01 Cooperative research and development agreements ....
1
1
1
Appropriation:
05.01 Salaries and expenses ...................................................
¥1
¥1
¥1
07.99 Total balance, end of year ............................................ ................... ................... ...................

Program and Financing (in millions of dollars)
Identification code 75–9911–0–1–554

1998 actual

1999 est.

2000 est.

Obligations by program activity:
Direct program:
00.01
Foods .........................................................................
206
232
00.02
Drugs .........................................................................
337
337
00.03
Devices and radiological products ............................
144
146
00.04
National center for toxicological research ................
32
32
00.05
Tobacco ......................................................................
34
34
00.06
Other activities ..........................................................
79
81
00.07
Other rent and rent related activities ......................
26
26
00.08
Rental payments .......................................................
46
83
00.09
Buildings and facilities .............................................
28
20
00.10
CRADAs ......................................................................
1
1
00.11
Seafood inspection program—transfer .................... ................... ...................
09.01 Reimbursable program ..................................................
130
164

425

266
373
164
34
68
81
26
95
32
1
3
192

426

FOOD AND DRUG ADMINISTRATION—Continued
Federal Funds—Continued

THE BUDGET FOR FISCAL YEAR 2000
Legislative proposal, not subject to PAYGO:
Budget Authority ..................................................................... .................... .................... ....................
Outlays .................................................................................... .................... .................... ....................

General and special funds—Continued
SALARIES

AND

EXPENSES—Continued

BUILDINGS

AND

FACILITIES—Continued

Total:
Budget Authority .....................................................................
Outlays ....................................................................................

Program and Financing (in millions of dollars)—Continued
1998 actual

Identification code 75–9911–0–1–554

10.00

Total new obligations ................................................

21.40
22.00
22.10

23.90
23.95
24.40

Total budgetary resources available for obligation
Total new obligations ....................................................
Unobligated balance available, end of year .................

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
From Federal sources: Change in receivables
and unpaid, unfilled orders .............................
68.90
70.00

1999 est.

1,063

1,156

1,335

68
1,092

100
1,147

92
1,335

3 ................... ...................
1,163
¥1,063
100

1,247
¥1,156
92

1,427
¥1,335
92

925

982

1,142

163

161

189

166

164

192

Total new budget authority (gross) ..........................

1,092

1,147

1,335

72.40

276
330
340
1,063
1,156
1,335
¥1,001
¥1,143
¥1,301
¥3 ................... ...................
330

340

Total unpaid obligations, end of year ..................

333

343

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 ................................

668
170
163
1

751
227
164
1

862
246
192
1

87.00

Total outlays (gross) .................................................

1,001

1,143

1,301

Offsets:
Against gross budget authority and outlays:
88.40
Offsetting collections (cash) from: Non-Federal
sources ..................................................................
88.95 From Federal sources: Change in receivables and
unpaid, unfilled orders ..............................................

¥163

¥161

¥189

¥3

926
838

983
982

1,143
1,112

Object Classification (in millions of dollars)

[In millions of dollars]

1998

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 ..........................................................

1999

2000

859
46
21

889
83
11

1,016
95
32

777
48
13

873
87
22

998
95
19

1998 actual

Identification code 75–9911–0–1–554

374

Net budget authority and outlays:
Budget authority ............................................................
Outlays ...........................................................................

1,143
1,112

The Food and Drug Administration (FDA) administers laws
concerning misbranded and adulterated foods, drugs, human
biologics, medical devices, cosmetics, and human-made
sources of radiation. The Budget provides a $190.2 million
(+17 percent) increase over the FY 1999 enacted program
level. The Budget includes $1,109.9 million for Salaries and
Expenses, which includes funding for the food safety initiative
and tobacco regulation, as well as new initiatives for injury
reporting and product safety assurance in order to help meet
FDA responsibilities under the FDA Modernization Act of
1997. Of the Salaries and Expenses amount, $94.5 million
will be used for payments to the General Services Administration for rent and rent related costs (an additional $5.6 million
will be derived from fees). The Budget reflects the transfer
of the Seafood Inspection Division of the National Oceanic
and Atmospheric Administration of the Department of Commerce to the FDA, which will be financed with $12.7 million
in currently authorized fees. In addition, the Budget includes
$183.2 million for user fees, an increase of $30.7 million in
user fees over FY 1999, which will be used to finance FDA
activities. Of the $183.2 million in user fees, $17 million consists of new user fees related to the review of direct and
indirect food additive petitions and for the review of medical
device applications, which are represented in the legislative
proposal schedule. The buildings and facilities appropriation
of $31.7 million provides funds for projects related to the
repair, construction, alteration, and improvement of all buildings and facilities of FDA.

371

74.99

89.00
90.00

983
982

2000 est.

Spending authority from offsetting collections
(total) ...........................................................

Change in unpaid obligations:
Unpaid obligations, start of year: Obligated balance,
start of year ..............................................................
73.10 Total new obligations ....................................................
73.20 Total outlays (gross) ......................................................
73.45 Adjustments in unexpired accounts ..............................
Unpaid obligations, end of year:
74.40
Obligated balance, end of year ................................
74.95
From Federal sources: Receivables and unpaid, unfilled orders ...........................................................

926
839

11.1
11.3
11.5

Direct obligations:
Personnel compensation:
Full-time permanent .............................................
Other than full-time permanent ...........................
Other personnel compensation .............................

1999 est.

2000 est.

425
26
15

451
27
16

497
29
17

466
105
16
3
46
5

494
112
16
3
83
5

543
123
20
3
95
7

21
4
16
63

20
4
15
63

25
5
19
79

25.4
25.5
25.7
26.0
31.0
32.0
41.0
42.0

Total personnel compensation .........................
Civilian personnel benefits .......................................
Travel and transportation of persons .......................
Transportation of things ...........................................
Rental payments to GSA ...........................................
Rental payments to others ........................................
Communications, utilities, and miscellaneous
charges .................................................................
Printing and reproduction .........................................
Advisory and assistance services .............................
Other services ............................................................
Purchases of goods and services from Government
accounts ................................................................
Operation and maintenance of facilities ..................
Research and development contracts .......................
Operation and maintenance of equipment ...............
Supplies and materials .............................................
Equipment .................................................................
Land and structures ..................................................
Grants, subsidies, and contributions ........................
Insurance claims and indemnities ...........................

39
23
10
21
15
29
27
22
2

38
23
10
21
15
29
18
21
2

47
28
12
25
19
35
30
26
2

99.0
99.0

Subtotal, direct obligations ..................................
Reimbursable obligations ..............................................

933
130

992
164

1,143
192

99.9

Total new obligations ................................................

1,063

1,156

1,335

11.9
12.1
21.0
22.0
23.1
23.2
23.3
24.0
25.1
25.2
25.3

Personnel Summary
Summary of Budget Authority and Outlays
Identification code 75–9911–0–1–554

(in millions of dollars)

Enacted/requested:
Budget Authority .....................................................................
Outlays ....................................................................................

1998 actual

926
839

1999 est.

983
982

2000 est.

1,143
1,112

1001

Direct:
Total compensable workyears: Full-time equivalent
employment ...............................................................

1998 actual

8,083

1999 est.

8,090

2000 est.

8,479

HEALTH RESOURCES AND SERVICES ADMINISTRATION
Federal Funds

DEPARTMENT OF HEALTH AND HUMAN SERVICES

2001

Reimbursable:
Total compensable workyears: Full-time equivalent
employment ...............................................................

427

Public enterprise funds:
788

819

REVOLVING FUND

1,049

FOR

CERTIFICATION

AND

OTHER SERVICES

Program and Financing (in millions of dollars)
1998 actual

Identification code 75–4309–0–3–554

SALARIES

AND

Obligations by program activity:
Total new obligations ....................................................

21.40
22.00

Budgetary resources available for obligation:
Unobligated balance available, start of year ...............
New budget authority (gross) ........................................

4
4

5
4

23.90
23.95
24.40

Total budgetary resources available for obligation
Total new obligations ....................................................
Unobligated balance available, end of year .................

9
¥4
5

68.00

New budget authority (gross), detail:
Spending authority from offsetting collections (gross):
Offsetting collections (cash) .....................................

2
4
¥3

2
4
¥4

Outlays (gross), detail:
Outlays from new permanent authority .........................

Offsets:
Against gross budget authority and outlays:
88.40
Offsetting collections (cash) from: Non-Federal
sources ..................................................................

¥4

(Legislative proposal, not subject to PAYGO)
Contingent upon the enactment of authorizing legislation, up to
$17,000,000 derived from fees assessed for activities related to the
review of direct and indirect food additive petitions and the review
of medical device applications may be collected and credited to this
appropriation, to remain available until expended for those activities.
Program and Financing (in millions of dollars)
1998 actual

1999 est.

2000 est.

09.01

Obligations by program activity:
Additive user fees .......................................................... ................... ...................

10.00

Total new obligations ................................................ ................... ...................

22.00
23.95

Budgetary resources available for obligation:
New budget authority (gross) ........................................ ................... ...................
Total new obligations .................................................... ................... ...................

17
¥17

72.40

86.97
New budget authority (gross), detail:
68.00 Spending authority from offsetting collections (gross):
Offsetting collections (cash) ..................................... ................... ...................

17
¥17

73.10
73.20

86.97

Outlays (gross), detail:
Outlays from new permanent authority ......................... ................... ...................

89.00
90.00

Net budget authority and outlays:
Budget authority ............................................................ ................... ................... ...................
Outlays ...........................................................................
¥1 ................... ...................

¥17

The Budget includes $183.2 million in user fees, of which
$17 million are new user fees to finance FDA activities as
reflected in the legislative proposal schedule. Additional appropriations language is being proposed contingent upon the
enactment of authorizing legislation. The authorizing legislation will be proposed to authorize the collection and spending
of the fees subject to appropriation action.

FDA certifies color additives for use in foods, drugs, and
cosmetics. It also lists color additives for use in foods, drugs,
medical devices, and cosmetics (21 U.S.C. 346a, 356, 357,
376). These services are financed wholly by fees paid by the
industries affected.
Object Classification (in millions of dollars)
1998 actual

Identification code 75–4309–0–3–554

1998 actual

99.0
99.9

2000 est.

Reimbursable obligations: Subtotal, reimbursable obligations ....................................................................... ................... ...................

2
1
1

99.9

Total new obligations ................................................

Personnel Summary
1998 actual

Total compensable workyears: Full-time equivalent
employment ...............................................................

1999 est.

2000 est.

Total new obligations ................................................ ................... ...................

2000 est.

Personnel compensation: Full-time permanent .............
Rental payments to GSA ................................................
Supplies and materials .................................................

2001
1999 est.

1999 est.

11.1
23.1
26.0

Identification code 75–4309–0–3–554

Object Classification (in millions of dollars)
Identification code 75–9911–2–1–554

2000 est.

10.00

EXPENSES

Identification code 75–9911–2–1–554

1999 est.

Federal Funds

Personnel Summary
Identification code 75–9911–2–1–554

HEALTH RESOURCES AND SERVICES
ADMINISTRATION
General and special funds:

1998 actual

1999 est.

2000 est.

Direct:
1001 Total compensable workyears: Full-time equivalent
employment ............................................................... ................... ................... ...................
Reimbursable:
2001 Total compensable workyears: Full-time equivalent
employment ............................................................... ................... ...................
89

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 and section 1820 of the Social
Security Act, the Health Care Quality Improvement Act of 1986,
as amended, and the Native Hawaiian Health Care Act of 1988,
as amended, ø$4,108,040,000¿ $4,101,083,000, of which $150,000

428

HEALTH RESOURCES AND SERVICES ADMINISTRATION—Continued
Federal Funds—Continued

THE BUDGET FOR FISCAL YEAR 2000

General and special funds—Continued
HEALTH RESOURCES

AND

SERVICES—Continued

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, øand of which $65,345,000 shall
be available for the construction and renovation of health care and
other facilities,¿ and of which $25,000,000 from general revenues,
notwithstanding section 1820(j) of the Social Security Act, shall be
available for carrying out the Medicare rural hospital flexibility
grants program under section 1820 of such Act: Provided, That the
Division of Federal Occupational Health may utilize personal services
contracting to employ professional management/administrative and
occupational health professionals: Provided further, That of the funds
made available under this heading, $250,000 shall be available until
expended for facilities renovations at the Gillis W. Long Hansen’s
Disease Center: Provided further, That in addition to fees authorized
by section 427(b) of the Health Care Quality Improvement Act of
1986, fees shall be collected for the full disclosure of information
under the Act sufficient to recover the full costs of operating the
National Practitioner Data Bank, and shall remain available until
expended to carry out that Act: Provided further, That no more than
$5,000,000 is available for carrying out the provisions of Public Law
104–73: Provided further, That of the funds made available under
this heading, ø$215,000,000¿ $239,952,000 shall be for the program
under title X of the Public Health Service Act to provide for voluntary
family planning projects: Provided further, That amounts provided
to said projects under such title shall not be expended for abortions,
that all pregnancy counseling shall be nondirective, and that such
amounts shall not be expended for any activity (including the publication or distribution of literature) that in any way tends to promote
public support or opposition to any legislative proposal or candidate
for public office: Provided further, That ø$461,000,000¿ $496,000,000
shall be for State AIDS Drug Assistance Programs authorized by
section 2616 of the Public Health Service Act: øProvided further,
That notwithstanding any other provision of law, funds made available under this heading may be used to continue operating the Council on Graduate Medical Education established by section 301 of Public Law 102–408: Provided further, That, notwithstanding section
502(a)(1) of the Social Security Act, not to exceed $107,434,000 is
available for carrying out special projects of regional and national
significance pursuant to section 501(a)(2) of such Act: Provided further, That of the amount provided, $2,000,000 shall be for support
of the Center for Sustainable Health Outreach at the University
of Southern Mississippi in affiliation with Harrison Institute at
Georgetown University for the establishment of demonstration programs that create model health access programs, health-related jobs
and sustainability of community-based providers of health services
in rural and urban communities; and $1,250,000 shall be for the
American Federation for Negro Affairs Education and Research
Fund:¿ Provided further, That fees collected for the full disclosure
of information under the ‘‘Health Care Fraud and Abuse Data Collection Program,’’ authorized by section 221 of the Health Insurance
Portability and Accountability Act of 1996, shall be sufficient to recover the full costs of operating the Program, and shall remain available to carry out that Act until expended. (Department of Health
and Human Services Appropriations Act, 1999, as included in Public
Law 105–277, section 101(f).)

1998 actual

Organ transplantation ...............................................
Health care facilities .................................................
Bone marrow donor registry ......................................
Rural health policy development ..............................
Rural health outreach grants ...................................
Program management ...............................................
Family planning .........................................................
Abstinence education ................................................
Health centers tort claims fund ...............................
Rural health flexibility grants ...................................
Telehealth ..................................................................
Critical care programs ..............................................
Universal newborn hearing .......................................
Health centers loan guarantee program account
Reimbursable program ..................................................

10.00

Total new obligations ................................................

3,729

4,250

4,249

21.40
22.00

Budgetary resources available for obligation:
Unobligated balance available, start of year ...............
New budget authority (gross) ........................................

39
3,736

47
4,249

46
4,246

23.90
23.95
23.98
24.40

Total budgetary resources available for obligation
Total new obligations ....................................................
Unobligated balance expiring ........................................
Unobligated balance available, end of year .................

3,775
4,296
4,292
¥3,729
¥4,250
¥4,249
¥1 ................... ...................
47
46
43

New budget authority (gross), detail:
Current:
40.00
Appropriation .............................................................
41.00
Transferred to other accounts ...................................

3,618
4,108
4,101
¥7 ................... ...................

43.00

Appropriation (total) .............................................
Permanent:
Appropriation .............................................................
Spending authority from offsetting collections: Offsetting collections (cash) .....................................

3,611

4,108

4,101

Total new budget authority (gross) ..........................

3,736

4,249

4,246

60.00
68.00
70.00

Change in unpaid obligations:
Unpaid obligations, start of year: Obligated balance,
start of year ..............................................................
73.10 Total new obligations ....................................................
73.20 Total outlays (gross) ......................................................
73.40 Adjustments in expired accounts ..................................
74.40 Unpaid obligations, end of year: Obligated balance,
end of year ................................................................

3
10
10
28
65 ...................
15
18
18
12
12
6
32
39
32
114
119
122
203
215
240
50
50
50
2
2
5
...................
25
25
................... ...................
13
................... ...................
23
................... ...................
4
...................
4
4
75
92
93

72.40

86.90
86.93
86.97
86.98

1999 est.

87.00

2,397
2,726
3,064
3,729
4,250
4,249
¥3,382
¥3,912
¥4,184
¥18 ................... ...................
2,726

3,064

3,129

Outlays (gross), detail:
Outlays from new current authority ..............................
1,397
Outlays from current balances ......................................
1,891
Outlays from new permanent authority .........................
94
Outlays from permanent balances ................................ ...................

1,565
2,213
110
24

1,554
2,487
114
29

Total outlays (gross) .................................................

3,382

3,912

4,184

Offsets:
Against gross budget authority and outlays:
Offsetting collections (cash) from:
88.00
Federal sources .....................................................
88.40
Non-Federal sources .............................................

¥63
¥12

¥79
¥12

¥79
¥16

88.90

Total, offsetting collections (cash) ..................

¥75

¥91

¥95

89.00
90.00

Program and Financing (in millions of dollars)
Identification code 75–0350–0–1–550

00.15
00.16
00.17
00.18
00.19
00.20
00.21
00.22
00.23
00.24
00.25
00.27
00.28
00.29
09.01

Net budget authority and outlays:
Budget authority ............................................................
Outlays ...........................................................................

3,661
3,307

4,158
3,821

4,151
4,089

2000 est.
[Dollars in millions]

Obligations by program activity:
Direct program:
00.01
Health centers ...........................................................
00.02
National Health Service Corps ..................................
00.03
National Health Service Corps recruitment ..............
00.04
Hansen’s disease center ...........................................
00.05
Payment to Hawaii for the treatment of Hansen’s
disease ..................................................................
00.06
Buildings and facilities .............................................
00.07
Black lung clinics .....................................................
00.08
State Alzheimer’s demonstration grants ...................
00.09
Nursing loan repayment ............................................
00.10
Health professions .....................................................
00.11
Maternal and child health block grant ....................
00.12
Emergency medical services for children .................
00.13
Healthy start ..............................................................
00.14
HIV/AIDS .....................................................................

1998

816
37
78
17

920
37
78
22

940
37
78
17

2
2
2
3 ................... ...................
5
5
5
6 ................... ...................
2
2
2
289
302
212
681
700
695
13
15 ...................
96
105
105
1,150
1,411
1,511

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 ........................................

1999

2000

3,656
5

4,153
5

4,186
5

3,305
2

3,819
2

4,111
2

Summary of Budget Authority and Outlays
(in millions of dollars)

Enacted/requested:
1998 actual
1999 est.
Budget Authority .....................................................................
3,661
4,158
Outlays ....................................................................................
3,307
3,821
Legislative proposal, not subject to PAYGO:
Budget Authority ..................................................................... .................... ....................
Outlays .................................................................................... .................... ....................

2000 est.

4,151
4,089
40
15

HEALTH RESOURCES AND SERVICES ADMINISTRATION—Continued
Federal Funds—Continued

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Total:
Budget Authority .....................................................................
Outlays ....................................................................................

Personnel Summary
3,661
3,307

4,158
3,821

4,191
4,104

Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in
millions of dollars)
Identification code 75–0350–0–1–550

1998 actual

Guaranteed loan levels supportable by subsidy budget
authority:
2150 Health Centers: Facilities Renovation Loan guarantee
levels ......................................................................... ...................
2150 Health Centers: Managed Care Network Development
Loan guarantee levels ............................................... ...................
2150 Health Centers: Managed Care Plan Loan guarantee
levels .........................................................................
9

1999 est.

2000 est.

20
26

Direct:
Total compensable workyears:
1001
Full-time equivalent employment ..............................
1011
Exempt Full-time equivalent employment .................
Reimbursable:
2001 Total compensable workyears: Full-time equivalent
employment ...............................................................
Allocation account:
3001 Total compensable workyears: Full-time equivalent
employment ...............................................................

2.21

2.26

0.71

8.40
5.03

8.59
5.11

8.19
4.16

Weighted average subsidy rate .................................
5.11
Guaranteed loan subsidy budget authority:
2330 Facilities Loan Subsidy budget authority ...................... ...................
2330 Managed Care Network Development Loan Subsidy
budget authority ........................................................ ...................
2330 Managed Care Plan Loan Subsidy budget authority ...................

5.32

2.41

2
1

...................

HEALTH RESOURCES

100

Total loan guarantee levels ......................................
Guaranteed loan subsidy (in percent):
2320 Facilities Loan Subsidy rate ..........................................
2320 Managed Care Network Development Loan Subsidy
rate ............................................................................
2320 Managed Care Plan Loan Subsidy rate .........................

Total subsidy budget authority .................................
Guaranteed loan subsidy outlays:
2340 Facilities Loan Subsidy outlays .....................................
2340 Managed Care Network Development Loan Subsidy
outlays .......................................................................
2340 Managed Care Plan Loan Subsidy outlays ....................
2349

...................
...................

2
1

Total subsidy outlays ................................................ ...................

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.

11.1
11.3
11.5
11.9
12.1
13.0
21.0
22.0
23.1
23.3
24.0
25.1
25.2
25.3
25.4
25.6
25.7
25.8
26.0
31.0
41.0
42.0

1,578
1,705
146 ...................

198

211

221

AND

SERVICES

Program and Financing (in millions of dollars)
Identification code 75–0350–2–1–550

1998 actual

1999 est.

2000 est.

Obligations by program activity:
Direct program:
00.01
Pediatric GME service delivery .................................. ................... ...................

10.00

Total new obligations (object class 41.0) ................ ................... ...................

22.00
23.95

40
¥40

New budget authority (gross), detail:
Appropriation .................................................................. ................... ...................

1998 actual

73.10
73.20
74.40

Change in unpaid obligations:
Total new obligations .................................................... ................... ...................
Total outlays (gross) ...................................................... ................... ...................
Unpaid obligations, end of year: Obligated balance,
end of year ................................................................ ................... ...................

40
¥15
25

1999 est.

86.90

Outlays (gross), detail:
Outlays from new current authority .............................. ................... ...................

89.00
90.00

Object Classification (in millions of dollars)

2000 est.

(Legislative proposal, not subject to PAYGO)

2
1

Identification code 75–0350–0–1–550

1,543
101

1999 est.

40.00

2329

2339

1998 actual

Identification code 75–0350–0–1–550

2159

429

Net budget authority and outlays:
Budget authority ............................................................ ................... ...................
Outlays ........................................................................... ................... ...................

40
15

2000 est.

90
2
5

101
2
5

105
2
5

Total personnel compensation .........................
97
Civilian personnel benefits .......................................
24
Benefits for former personnel ................................... ...................
Travel and transportation of persons .......................
3
Transportation of things ...........................................
1
Rental payments to GSA ...........................................
9
Communications, utilities, and miscellaneous
charges .................................................................
4
Printing and reproduction .........................................
2
Advisory and assistance services .............................
34
Other services ............................................................
51
Purchases of goods and services from Government
accounts ................................................................
39
Operation and maintenance of facilities ..................
2
Medical care .............................................................. ...................
Operation and maintenance of equipment ...............
3
Subsistence and support of persons ........................ ...................
Supplies and materials .............................................
3
Equipment .................................................................
4
Grants, subsidies, and contributions ........................
3,376
Insurance claims and indemnities ...........................
2

108
25
1
3
1
8

112
26
1
3
1
9

4
1
33
48

5
1
33
49

34
1
1
1
2
2
1
3,882
2

34
1
1
1
2
2
1
3,869
5

The Children’s Hospitals Graduate Medical Education grant
program is designed to provide temporary financial assistance
for graduate medical education at free-standing children’s hospitals. By providing grants to such hospitals to help pay for
a portion of their direct medical education costs, this new
program will improve the financial viability of these hospitals,
allowing them to focus on expanded services and improved
patient care.
VACCINE INJURY COMPENSATION
øFor payment of claims resolved by the United States Court of
Federal Claims related to the administration of vaccines before October 1, 1988, $100,000,000, to remain available until expended.¿ (Department of Health and Human Services Appropriations Act, 1999,
as included in Public Law 105–277, Section 101(f).)
Program and Financing (in millions of dollars)
Identification code 75–0320–0–1–551

1998 actual

10.00

Obligations by program activity:
Total new obligations (object class 42.0) .....................

Budgetary resources available for obligation:
Unobligated balance available, start of year ...............
145
New budget authority (gross) ........................................ ...................

99.0
99.0

Subtotal, direct obligations ..................................
Reimbursable obligations ..............................................

3,654
75

4,158
92

4,156
93

21.40
22.00

99.9

Total new obligations ................................................

3,729

4,250

4,249

23.90
23.95

Total budgetary resources available for obligation
Total new obligations ....................................................

145
¥84

1999 est.

2000 est.

61
82
100 ...................
161
¥79

82
¥73

430

HEALTH RESOURCES AND SERVICES ADMINISTRATION—Continued
Federal Funds—Continued

THE BUDGET FOR FISCAL YEAR 2000

General and special funds—Continued

Status of Guaranteed Loans (in millions of dollars)

VACCINE INJURY COMPENSATION—Continued
Program and Financing (in millions of dollars)—Continued
Identification code 75–0320–0–1–551

24.40

Unobligated balance available, end of year .................

1998 actual

1999 est.

2000 est.

Position with respect to appropriations act limitation
on commitments:
2111 Limitation on guaranteed loans made by private lenders ..............................................................................
2113 Uncommitted limitation carried forward .......................
2150

New budget authority (gross), detail:
40.00 Appropriation .................................................................. ...................
Change in unpaid obligations:
Unpaid obligations, start of year: Obligated balance,
start of year ..............................................................
73.10 Total new obligations ....................................................
73.20 Total outlays (gross) ......................................................
74.40 Unpaid obligations, end of year: Obligated balance,
end of year ................................................................

100 ...................
2210
2231
2261

72.40

3
84
¥85

2
79
¥79

2
73
¥73

Outlays (gross), detail:
86.90 Outlays from new current authority .............................. ...................
86.93 Outlays from current balances ......................................
85

16 ...................
63
73

87.00

89.00
90.00

Total outlays (gross) .................................................

Net budget authority and outlays:
Budget authority ............................................................ ...................
Outlays ...........................................................................
85

1998 actual

Identification code 75–4442–0–3–551

100 ...................
79
73

The Vaccine Improvement Program was established pursuant to Public Law 99–660 and Public Law 100–203, and
serves as a source of funds to pay claims for compensation
for vaccine related injury or death. Payment of claims associated with vaccine related injury or death occurring before
October 1, 1988 are financed from the General Fund and
are reflected in this account. Given sufficient carry-over funds
from prior years’ appropriations to pay for the balance of
the pre-1988 backlog of claims yet to be adjudicated, no appropriation is requested in FY 2000 to cover payment of pre1988 claims. Payment of claims associated with vaccine related injury or death occurring after October 1, 1988 are reflected in the Vaccine Improvement Trust Fund account.

160
¥151

Total guaranteed loan commitments ........................

1999 est.

2000 est.

151
51
¥51 ...................
100

Cumulative balance of guaranteed loans outstanding:
Outstanding, start of year ............................................. ...................
9
82
Disbursements of new guaranteed loans ......................
9
73
48
Adjustments: Terminations for default that result in
loans receivable ........................................................ ................... ................... ...................

2290

Outstanding, end of year ..........................................

130

2299

Memorandum:
Guaranteed amount of guaranteed loans outstanding,
end of year ................................................................

130

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 ............................... ................... ................... ...................
2390

Outstanding, end of year ...................................... ................... ................... ...................

P.L. 104–299 and P.L. 104–208 authorize HRSA to guarantee up to $80 million in private loans to Health Centers
for the costs of developing and operating managed care networks or plans and for the construction, renovation and modernization of medical facilities. Since this program has only
used $9 million of its available $160 million in loan guarantee
authority, HRSA will use the remaining existing loan guarantee limit over FY 1999 and FY 2000. As required by the
Federal Credit Reform Act of 1990, this Financing Account
records all cash flows to and from the Government resulting
from the Health Center Loan Guarantee Program. The Program Account for this activity is displayed in the Health
Resources and Services account (75–0350) as a line in the
Program and Financing Schedule.
Balance Sheet (in millions of dollars)

Credit accounts:

1998 actual

ASSETS:
Investments in US securities:
1106
Federal assets: Receivables, net ........

..................

109

160

1999

Program and Financing (in millions of dollars)
Identification code 75–4442–0–3–551

1997 actual

Total assets ........................................
LIABILITIES:
2204 Non-Federal liabilities: Liabilities for
loan guarantees ..................................

..................

109

160

..................

109

160

2999

Total liabilities ....................................

..................

109

160

4999

Total liabilities and net position ............

..................

109

160

Identification code 75–4442–0–3–551

HEALTH CENTER GUARANTEED LOAN FINANCING ACCOUNT

1998 actual

1999 est.

2000 est.

1999 est.

2000 est.

21.40
22.00

Budgetary resources available for obligation:
Unobligated balance available, start of year ............... ...................
New financing authority (gross) .................................... ...................

1
5

6
5

23.90
24.40

Total budgetary resources available for obligation ...................
Unobligated balance available, end of year .................
1

6
6

11
11

68.00

New financing authority (gross), detail:
Spending authority from offsetting collections (gross):
(Federal Sources: from program account) ................ ...................

¥4
¥1

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. For administrative expenses to carry out the guaranteed loan program, including section 709 of the Public Health Service Act, $3,688,000. (Department of Health and Human Services Appropriations Act, 1999, as included in Public Law 105–277, section
101(f).)

88.90

¥5

Program and Financing (in millions of dollars)

89.00
90.00

Total, offsetting collections (cash) .................. ...................

Net financing authority and financing disbursements:
Financing authority ........................................................ ................... ................... ...................
Financing disbursements ...............................................
¥1
¥5
¥5

HEALTH EDUCATION ASSISTANCE LOANS PROGRAM ACCOUNT

Identification code 75–0340–0–1–552

00.02

Obligations by program activity:
Guaranteed loan subsidy ...............................................

1998 actual

1999 est.

2000 est.

1 ................... ...................

HEALTH RESOURCES AND SERVICES ADMINISTRATION—Continued
Federal Funds—Continued

DEPARTMENT OF HEALTH AND HUMAN SERVICES
00.09

Administrative expenses subject to limitation ..............

25.3

10.00

Total new obligations ................................................

22.00
23.95

Budgetary resources available for obligation:
New budget authority (gross) ........................................
Total new obligations ....................................................

5
¥5

4
¥4

New budget authority (gross), detail:
Current:
40.00
Appropriation .............................................................
Permanent:
68.00
Spending authority from offsetting collections: Offsetting collections (cash) .....................................
70.00

431

1
1
1
1 ................... ...................

99.0
99.5

Subtotal, direct obligations ..................................
Below reporting threshold ..............................................

4
1

3
1

99.9

41.0

Purchases of goods and services from Government
accounts ....................................................................
Grants, subsidies, and contributions ............................

Total new obligations ................................................

Personnel Summary

4
Identification code 75–0340–0–1–552

1 ................... ...................

Total new budget authority (gross) ..........................

1
5
¥5

Total compensable workyears:
1001 Full-time equivalent employment ..................................
1011 Exempt Full-time equivalent employment .....................

1998 actual

1999 est.

21
7

2000 est.

20
25
7 ...................

72.40

2 ...................
4
4
¥5
¥4

2 ................... ...................

Outlays (gross), detail:
86.90 Outlays from new current authority ..............................
86.93 Outlays from current balances ......................................
86.97 Outlays from new permanent authority .........................

3
4
4
1
1 ...................
1 ................... ...................

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 ...........................................................................

4
5

4
4

Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in
millions of dollars)
Identification code 75–0340–0–1–552

1998 actual

1999 est.

Program and Financing (in millions of dollars)
Identification code 75–4304–0–3–552

1998 actual

1999 est.

2000 est.

00.01
00.02

Obligations by program activity:
Death and disability claims ..........................................
Default claims ...............................................................

3
13

1
15

1
21

10.00

Total new obligations ................................................

21.40
22.00

Budgetary resources available for obligation:
Unobligated balance available, start of year ...............
New financing authority (gross) ....................................

247
28

259
26

268
28

23.90
23.95
24.40

Total budgetary resources available for obligation
Total new obligations ....................................................
Unobligated balance available, end of year .................

275
¥16
259

285
¥16
268

296
¥22
274

68.00

¥1 ................... ...................

4
3

HEALTH EDUCATION ASSISTANCE LOANS FINANCING ACCOUNT

New financing authority (gross), detail:
Spending authority from offsetting collections (gross):
Offsetting collections (cash) .....................................

16
¥16
16

22
¥22
22

73.10
73.20
87.00

Guaranteed loan levels supportable by subsidy budget
authority:
2150 Loan guarantee levels ...................................................

85 ................... ...................

in unpaid obligations:
new obligations ....................................................
financing disbursements (gross) .........................
financing disbursements (gross) .........................

85 ................... ...................

2159

Change
Total
Total
Total

Total loan guarantee levels ......................................
Guaranteed loan subsidy (in percent):
2320 Subsidy rate ...................................................................

1.09

0.00

2329

1.09

0.00

Weighted average subsidy rate .................................
Guaranteed loan subsidy budget authority:
2330 Subsidy budget authority ...............................................
2339

1 ................... ...................

Total subsidy budget authority .................................
Guaranteed loan subsidy outlays:
2340 Subsidy outlays ..............................................................

1 ................... ...................

2349

Total subsidy outlays ................................................

1 ................... ...................

3510
3590

Administrative expense data:
Budget authority ............................................................
Outlays from new authority ...........................................

88.90

4
2

4
4

1998 actual

1999 est.

89.00
90.00

4
4

Object Classification (in millions of dollars)

Personnel compensation: Full-time permanent .............

¥28

¥26

¥28

Status of Guaranteed Loans (in millions of dollars)
Identification code 75–4304–0–3–552

2111
2150

1998 actual

1999 est.

2000 est.

Position with respect to appropriations act limitation
on commitments:
Limitation on guaranteed loans made by private lenders ..............................................................................

85 ................... ...................

Total guaranteed loan commitments ........................

85 ................... ...................

Cumulative balance of guaranteed loans outstanding:
Outstanding, start of year .............................................
Disbursements of new guaranteed loans ......................
Adjustments:
2261
Terminations for default that result in loans receivable .......................................................................
2263
Terminations for default that result in claim payments ....................................................................
2210
2231

1,494
1,562
1,546
85 ................... ...................

¥14

¥15

¥20

¥3

¥1

1,562

1,546

1,525

2000 est.

2290
11.1

Total, offsetting collections (cash) ..................

1 ................... ...................

The Health Education Assistance Loan (HEAL) program
guarantees loans from private lenders to health professions
students to help pay for the costs of their training. As required by the Federal Credit Reform Act of 1990, this account
records, for the HEAL program, the subsidy costs associated
with HEAL loan guarantees committed in 1992 and beyond
(including modifications of HEAL loan guarantees that resulted from obligations or commitments in any year), as well
as administrative expenses of the program. The subsidy
amounts are estimated on a present value basis; the administrative expenses are estimated on a cash basis.

Identification code 75–0340–0–1–552

Offsets:
Against gross financing authority and financing disbursements:
Offsetting collections (cash) from:
88.00
Federal sources .....................................................
¥1 ................... ...................
88.25
Interest on uninvested funds ...............................
¥22
¥25
¥26
Non-Federal sources:
88.40
Premium income ...............................................
¥5 ................... ...................
88.40
Recoveries of defaulted loans .......................... ...................
¥1
¥2

Outstanding, end of year ..........................................

432

HEALTH RESOURCES AND SERVICES ADMINISTRATION—Continued
Federal Funds—Continued

THE BUDGET FOR FISCAL YEAR 2000
Change in unpaid obligations:
Unpaid obligations, start of year: Obligated balance,
start of year ..............................................................
73.10 Total new obligations ....................................................
73.20 Total outlays (gross) ......................................................
74.40 Unpaid obligations, end of year: Obligated balance,
end of year ................................................................

Credit accounts—Continued

72.40

HEALTH EDUCATION ASSISTANCE LOANS FINANCING ACCOUNT—
Continued
Status of Guaranteed Loans (in millions of dollars)—Continued
1998 actual

Identification code 75–4304–0–3–552

1999 est.

6
38
¥39

5 ...................
57
52
¥62
¥52

5 ................... ...................

2000 est.

86.97
86.98
1,562

1,546

Addendum:
Cumulative balance of defaulted guaranteed loans
that result in loans receivable:
2310
Outstanding, start of year ........................................
18
2331
Disbursements for guaranteed loan claims .............
14
2351
Repayments of loans receivable ............................... ...................
2390

Outstanding, end of year ......................................

45
20
¥2

This account records all cash flows to and from the Government resulting from (HEAL) loan guarantees committed between 1992 and 1998.
Balance Sheet (in millions of dollars)
Identification code 75–4304–0–3–552

ASSETS:
Federal assets:
1101
Fund balances with Treasury .............
Investments in US securities:
1106
Receivables, net .............................
Non-Federal assets:
1201
Investments in non-Federal securities,
net ..................................................
1206
Receivables, net ..................................
1999

1999 est.

33
6

57
52
5 ...................

Total outlays (gross) .................................................

Offsets:
Against gross budget authority and outlays:
88.40
Offsetting collections (cash) from: Non-Federal
sources ..................................................................

¥21

¥20

Net budget authority and outlays:
Budget authority ............................................................
Outlays ...........................................................................

12
18

37
42

32
32

1,525

32
15
¥2

Outlays (gross), detail:
Outlays from new permanent authority .........................
Outlays from permanent balances ................................

87.00

Memorandum:
2299 Guaranteed amount of guaranteed loans outstanding,
end of year ................................................................

1997 actual

1998 actual

2000 est.

226

247

259

268

..................

19
14

22
5

25
1

26
2

89.00
90.00

Status of Guaranteed Loans (in millions of dollars)
1998 actual

Identification code 75–4305–0–3–552

Cumulative balance of guaranteed loans outstanding:
2210 Outstanding, start of year .............................................
2251 Repayments and prepayments ......................................
Adjustments:
2261
Terminations for default that result in loans receivable .......................................................................
2263
Terminations for default that result in claim payments ....................................................................

1999 est.

2000 est.

1,478
¥52

1,412
¥58

1,321
¥69

¥12

¥28

¥21

¥2

¥5

¥6

2290

Total assets ........................................
LIABILITIES:
2204 Non-Federal liabilities: Liabilities for
loan guarantees ..................................

259

275

285

1,562

1,546

1,525

2999

1,412

1,321

1,225

2299

Memorandum:
Guaranteed amount of guaranteed loans outstanding,
end of year ................................................................

1,412

1,321

1,225

296

1,494

Outstanding, end of year ..........................................

Total liabilities ....................................
NET POSITION:
3300 Cumulative results of operations ............

1,494

1,562

1,546

1,525

–1,235

–1,287

–1,261

–1,229

3999

Total net position ................................

–1,235

–1,287

–1,261

–1,229

4999

Total liabilities and net position ............

259

275

285

296

Program and Financing (in millions of dollars)
1998 actual

1999 est.

2390

Outstanding, end of year ......................................

470
494
500
29
40
34
¥14
¥14
¥14
¥20
¥20
¥20
29 ................... ...................
494

500

Note.—Includes carryover commitments from prior years.
Note.—The adjustment to loans receivable represents interest, which had not previously been reflected in cumulative
outstanding balances.

HEALTH EDUCATION ASSISTANCE LOANS LIQUIDATING ACCOUNT

Identification code 75–4305–0–3–552

Addendum:
Cumulative balance of defaulted guaranteed loans
that result in loans receivable:
2310
Outstanding, start of year ........................................
2331
Disbursements for guaranteed loan claims .............
2351
Repayments of loans receivable ...............................
2361
Write-offs of loans receivable ...................................
2364
Other adjustments, net .............................................

2000 est.

This account records all cash flows to and from the Government resulting from HEAL loan guarantees committed prior
to 1992.
DATA ON LOANS

00.01
00.02
00.03

Obligations by program activity:
Death and disability claims ..........................................
Defaulted loans ..............................................................
Debt collection ...............................................................

4
29
5

9
40
8

10
34
8

10.00

Total new obligations ................................................

1998 actual

Dollar volume of loans insured ($ in millions) ..........................
Number of students ....................................................................
Average value of loans ...............................................................

1999 est.

2000 est.

84.9 .................... ....................
6,581 .................... ....................
12,906 .................... ....................

Statement of Operations (in millions of dollars)
Budgetary resources available for obligation:
21.40 Unobligated balance available, start of year ...............
22.00 New budget authority (gross) ........................................
23.90
23.95

Total budgetary resources available for obligation
Total new obligations ....................................................

New budget authority (gross), detail:
Appropriation (indefinite) ...............................................
Spending authority from offsetting collections:
68.00
Offsetting collections (cash) .....................................
68.27
Capital transfer to general fund ..............................
60.05

68.90
70.00

5 ................... ...................
33
57
52
38
¥38

57
¥57

52
¥52

21
20
20
¥18 ................... ...................

Spending authority from offsetting collections
(total) ................................................................

Total new budget authority (gross) ..........................

1997 actual

1998 actual

0101
0102

Revenue ...................................................
Expense ....................................................

74
–57

48
–38

57
–57

52
–52

0109

Net loss ...................................................

..................

1999 est.

2000 est.

Identification code 75–4305–0–3–552

1999 est.

2000 est.

Balance Sheet (in millions of dollars)
Identification code 75–4305–0–3–552

ASSETS:
Net value of assets related to pre–1992
direct loans receivable and acquired defaulted guaranteed loans
receivable:
1701
Defaulted guaranteed loans, gross ....

1997 actual

1998 actual

470

494

500

HEALTH RESOURCES AND SERVICES ADMINISTRATION—Continued
Trust Funds

DEPARTMENT OF HEALTH AND HUMAN SERVICES
1702
1704

Interest receivable ..............................
Defaulted guaranteed loans and interest receivable, net .....................

1799

Value of assets related to loan
guarantees .................................
Other Federal assets: Cash and other
monetary assets ..................................

1801
1999

Total assets ........................................
LIABILITIES:
2104 Federal liabilities: Resources payable to
Treasury ...............................................
2201 Non-Federal liabilities: Accounts payable
2999

476

475

499

505

476

475

499

505

533

513

556

557

3
47

2
29

5
40

6
34

Total liabilities ....................................
NET POSITION:
3300 Cumulative results of operations ............

482

511

517

3999

Total net position ................................

483

482

511

517

4999

Total liabilities and net position ............

533

513

556

557

Offsets:
Against gross budget authority and outlays:
Offsetting collections (cash) from:
Non-Federal sources:
88.40
Principal repaid on loans not sold ..................
88.40
Principal collections from FFB .........................

¥2
¥6

¥1
¥4

¥2
¥1

88.90

Total, offsetting collections (cash) ..................

¥8

¥5

¥3

89.00
90.00

Net budget authority and outlays:
Budget authority ............................................................
Outlays ...........................................................................

¥5
¥4

1
¥4

1
¥2

Status of Direct Loans (in millions of dollars)

483

433

1998 actual

Identification code 75–9931–0–3–551

1210
1251

Cumulative balance of direct loans outstanding:
Outstanding, start of year .............................................
Repayments: Repayments and prepayments .................

24
¥7

1290

Outstanding, end of year ..........................................

1999 est.

2000 est.

17
¥7

10
¥10

10 ...................

Object Classification (in millions of dollars)
Identification code 75–4305–0–3–552

1998 actual

1999 est.

Status of Guaranteed Loans (in millions of dollars)

2000 est.

25.2
42.0

Other services ................................................................
Insurance claims and indemnities ................................

6
32

6
51

6
46

99.9

Total new obligations ................................................

1998 actual

Identification code 75–9931–0–3–551

1999 est.

2000 est.

142
¥60

82
¥40

42
¥30

2290

MEDICAL FACILITIES GUARANTEE

AND

2299

For carrying out subsections (d) and (e) of section 1602 of the
Public Health Service Act, $1,000,000, together with any amounts
received by the Secretary in connection with loans and loan guarantees under title VI of the Public Health Service Act, to be available
without fiscal year limitation for the payment of interest subsidies.
During the fiscal year, no commitments for direct loans or loan guarantees shall be made. (Department of Health and Human Services
Appropriations Act, 1999, as included in Public Law 105–277, section
101(f).)
Program and Financing (in millions of dollars)

00.01
01.01

Memorandum:
Guaranteed amount of guaranteed loans outstanding,
end of year ................................................................

LOAN FUND

FEDERAL INTEREST SUBSIDIES FOR MEDICAL FACILITIES

Identification code 75–9931–0–3–551

Outstanding, end of year ..........................................

1998 actual

Obligations by program activity:
Operating expenses: Interest subsidies, private ...........
4
Capital investment: Direct loans ................................... ...................

1999 est.

2000 est.

4
1

10.00

Total new obligations ................................................

21.40
22.00
22.60

57
3
¥6

50
6
¥12

39
4
¥12

23.90
23.95
24.40

Total budgetary resources available for obligation
Total new obligations ....................................................
Unobligated balance available, end of year .................

54
¥4
50

44
¥5
39

31
¥5
26

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.
Object Classification (in millions of dollars)
1998 actual

Identification code 75–9931–0–3–551

¥5

Total new budget authority (gross) ..........................

15
4
¥4

15
5
¥1

19
5
¥1

Investments and loans .................................................. ...................
Grants, subsidies, and contributions ............................
4
Interest and dividends ................................................... ...................

2000 est.

1
3
1

33.0
41.0
43.0

1999 est.

70.00

99.9

Total new obligations ................................................

72.40

86.90

Outlays (gross), detail:
Outlays from new current authority ..............................

Trust Funds
VACCINE INJURY COMPENSATION PROGRAM TRUST FUND
For payments from the Vaccine Injury Compensation Program
Trust Fund, such sums as may be necessary for claims associated
with vaccine-related injury or death with respect to vaccines administered after September 30, 1988, pursuant to subtitle 2 of title XXI
of the Public Health Service Act, to remain available until expended:

434

HEALTH RESOURCES AND SERVICES ADMINISTRATION—Continued
Trust Funds—Continued

THE BUDGET FOR FISCAL YEAR 2000
Object Classification (in millions of dollars)

VACCINE INJURY COMPENSATION PROGRAM TRUST FUND—Continued
Provided, That for necessary administrative expenses, not to exceed
$3,000,000 shall be available from the Trust Fund to the Secretary
of Health and Human Services. (Department of Health and Human
Services Appropriations Act, 1999, as included in Public Law 105–
277, section 101(f).)

Balance, start of year:
Balance, start of year ....................................................
Receipts:
02.01 Deposits .........................................................................
02.03 Interest income ..............................................................
01.99

1998 actual

1999 est.

25.2
25.3

1999 est.

2000 est.

42.0

Other services ................................................................
Purchases of goods and services from Government
accounts ....................................................................
Insurance claims and indemnities ................................

9
52

7
60

99.9

Unavailable Collections (in millions of dollars)
Identification code 20–8175–0–7–551

1998 actual

Identification code 20–8175–0–7–551

Total new obligations ................................................

2000 est.

INDIAN HEALTH SERVICE
1,193

1,264

1,373

116
16

112
67

113
73

Total receipts .............................................................

132

179

186

Total: Balances and collections ....................................
Appropriation:
05.01 Vaccine injury compensation program trust fund ........

1,325

1,443

1,559

¥61

¥70

05.99
07.99

¥61
1,264

¥70
1,373

¥70
1,489

02.99
04.00

Subtotal appropriation ...................................................
Total balance, end of year ............................................

Federal Funds

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) ............................
01.04
Claims processing (Public Health Service) ...............
01.05
Claims processing (Dept. of Justice) ........................

00.01

1998 actual

1999 est.

2000 est.

2
3
7

3
3
4

01.91

Total, administrative expenses .............................

10.00

Total new obligations ................................................

21.40
22.00

Budgetary resources available for obligation:
Unobligated balance available, start of year ...............
New budget authority (gross) ........................................

23.90
23.95

Total budgetary resources available for obligation
Total new obligations ....................................................

64
¥64

70
¥70

40.26
40.27

New budget authority (gross), detail:
Appropriation (trust fund, definite) ...............................
Appropriation (trust fund, indefinite) ............................

9
52

10
60

43.00

Appropriation (total) ..................................................

73.10
73.20

Change in unpaid obligations:
Total new obligations ....................................................
Total outlays (gross) ......................................................

64
¥64

70
¥70

86.90
86.93

Outlays (gross), detail:
Outlays from new current authority ..............................
Outlays from current balances ......................................

87.00

Total outlays (gross) .................................................

89.00
90.00

Net budget authority and outlays:
Budget authority ............................................................
Outlays ...........................................................................

61
64

70
70

Memorandum (non-add) entries:
Total investments, start of year: U.S. securities: Par
value ..........................................................................
92.02 Total investments, end of year: U.S. securities: Par
value ..........................................................................

3 ................... ...................
61
70
70

61
70
70
3 ................... ...................

92.01

1,256

1,285 ...................

General and special funds:
INDIAN HEALTH SERVICES
For expenses necessary to carry out the Act of August 5, 1954
(68 Stat. 674), the Indian Self-Determination Act, the Indian Health
Care Improvement Act, and titles II and III of the Public Health
Service Act with respect to the Indian Health Service,
ø$1,950,322,000¿ $2,094,922,000, together with payments received
during the fiscal year pursuant to 42 U.S.C. 238(b) for services furnished by the Indian Health Service: Provided, That funds made
available to tribes and tribal organizations through contracts, grant
agreements, or any other agreements or compacts authorized by the
Indian Self-Determination and Education Assistance Act of 1975 (25
U.S.C. 450), shall be deemed to be obligated at the time of the
grant or contract award and thereafter shall remain available to
the tribe or tribal organization without fiscal year limitation: Provided further, That $12,000,000 shall remain available until expended, for the Indian Catastrophic Health Emergency Fund: Provided further, That ø$373,801,000¿ $398,442,000 for contract medical
care shall remain available for obligation until September 30, ø2000¿
2001: Provided further, That of the funds provided, up to $17,000,000
shall be used to carry out the loan repayment program under section
108 of the Indian Health Care Improvement Act: Provided further,
That funds provided in this Act may be used for one-year contracts
and grants which are to be performed in two fiscal years, so long
as the total obligation is recorded in the year for which the funds
are appropriated: Provided further, That the amounts collected by
the Secretary of Health and Human Services under the authority
of title IV of the Indian Health Care Improvement Act shall remain
available until expended for the purpose of achieving compliance with
the applicable conditions and requirements of titles XVIII and XIX
of the Social Security Act (exclusive of planning, design, or construction of new facilities): Provided further, That 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, ø2000¿
2001: Provided further, That amounts received by tribes and tribal
organizations under title IV of the Indian Health Care Improvement
Act shall be reported and accounted for and available to the receiving
tribes and tribal organizations until expended: Provided further, That,
notwithstanding any other provision of law, of the amounts provided
herein, not to exceed ø$203,781,000¿ $238,781,000 shall be for payments to tribes and tribal organizations for contract or grant support
costs associated with contracts, grants, self-governance compacts or
annual funding agreements between the Indian Health Service and
a tribe or tribal organization pursuant to the Indian Self-Determination Act of 1975, as amended, prior to or during fiscal year ø1999:
Provided further, That funds provided to the Ponca Indian Tribe
of Nebraska in previous fiscal years that were retained by the tribe
to carry out the programs and functions of the Indian Health Service
may be used by the tribe to obtain approved clinical space to carry
out the program¿ 2000. (Department of the Interior and Related Agencies Appropriations Act, 1999, as included in Public Law 105–277,
section 101(e).)

1,285 ................... ...................

Program and Financing (in millions of dollars)

Identification code 75–0390–0–1–551

Obligations by program activity:
Direct program:
00.01
Clinical services ........................................................
00.02
Preventive health .......................................................
00.03
Urban health .............................................................

1998 actual

1,477
82
25

1999 est.

1,543
87
26

2000 est.

1,643
92
29

INDIAN HEALTH SERVICE—Continued
Federal Funds—Continued

DEPARTMENT OF HEALTH AND HUMAN SERVICES
00.04
00.05
00.06
00.07
00.08
00.09
09.01

Indian health professions .........................................
Tribal management ...................................................
Direct operations .......................................................
Self-governance .........................................................
Contract support costs ..............................................
Diabetes funds ..........................................................
Reimbursable program ..................................................

29
2
47
11
169
27
402

30
2
49
9
204
33
436

30
2
51
9
239
30
436

10.00

Total new obligations ................................................

2,271

2,419

2,561

21.40
22.00

Budgetary resources available for obligation:
Unobligated balance available, start of year ...............
New budget authority (gross) ........................................

105
2,273

103
2,416

100
2,561

23.90
23.95
23.98
24.40

New budget authority (gross), detail:
Current:
40.00
Appropriation .............................................................
Permanent:
62.00
Transferred from HCFA for Diabetes .........................
68.00
Spending authority from offsetting collections: Offsetting collections (cash) .....................................
70.00

Total new budget authority (gross) ..........................

Change in unpaid obligations:
72.40 Unpaid obligations, start of year: Obligated balance,
start of year ..............................................................
73.10 Total new obligations ....................................................
73.20 Total outlays (gross) ......................................................
74.40 Unpaid obligations, end of year: Obligated balance,
end of year ................................................................

86.90
86.93
86.97
86.98
87.00

2,378
2,519
2,661
¥2,271
¥2,419
¥2,561
¥4 ................... ...................
103
100
100

25.3

435

25.4
25.5
25.6
25.7
25.8
26.0
31.0
32.0
41.0
43.0

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 .................................................................
Land and structures ..................................................
Grants, subsidies, and contributions ........................
Interest and dividends ..............................................

25
19
1
208
13
8
88
22
2
800
2

26
19
1
216
13
9
91
23
2
867
2

26
20
1
221
14
9
92
23
2
970
2

99.0
99.0

Subtotal, direct obligations ..................................
Reimbursable obligations ..............................................

1,869
402

1,983
436

2,125
436

99.9

Total new obligations ................................................

2,271

2,419

2,561

Personnel Summary
1,841

1,950

2,095

402

436

2,273

2,416

2,561

476
2,271
¥2,264
483

483
2,419
¥2,409

Identification code 75–0390–0–1–551

493
2,561
¥2,481

493

573

Outlays (gross), detail:
Outlays from new current authority ..............................
1,631
1,521
Outlays from current balances ......................................
213
434
Outlays from new permanent authority .........................
420
454
Outlays from permanent balances ................................ ................... ...................

1,634
374
461
12

Total outlays (gross) .................................................

2,264

2,409

2,481

¥179
¥223

¥143
¥293

88.90

Total, offsetting collections (cash) ..................

¥402

¥436

89.00
90.00

Net budget authority and outlays:
Budget authority ............................................................
Outlays ...........................................................................

1,871
1,862

1,980
1,973

2,125
2,045

The Indian Health Services account provides medical care,
public health services, and health professions training opportunities to American Indians and Alaska Natives. An estimated $564 million will be administered by tribal governments under self-governance compacts in FY 2000.

1998 actual

1999 est.

2000 est.

9,814
14

9,981
10,104
14 ...................

3,192

3,233

INDIAN HEALTH FACILITIES
For construction, repair, maintenance, improvement, and equipment of health and related auxiliary facilities, including quarters
for personnel; preparation of plans, specifications, and drawings; acquisition of sites, purchase and erection of modular buildings, and
purchases of trailers; and for provision of domestic and community
sanitation facilities for Indians, as authorized by section 7 of the
Act of August 5, 1954 (42 U.S.C. 2004a), the Indian Self-Determination Act, and the Indian Health Care Improvement Act, and for
expenses necessary to carry out such Acts and titles II and III of
the Public Health Service Act with respect to environmental health
and facilities support activities of the Indian Health Service,
ø$289,465,000¿ $281,407,000, to remain available until expended:
Provided, That notwithstanding any other provision of law, funds
appropriated for the planning, design, construction or renovation of
health facilities for the benefit of an Indian tribe or tribes may
be used to purchase land for sites to construct, improve, or enlarge
health or related facilities.
In addition, to become available on October 1 of the fiscal year
specified and remain available until expended: for construction of
the health facility at Fort Defiance, Arizona up to $29,000,000 for
fiscal year 2000, up to $24,000,000 for fiscal year 2001, and up to
$10,000,000 for fiscal year 2002; for construction of a replacement
of the health facility at Parker, Arizona, up to $7,058,000 for fiscal
year 2000, and up to $10,234,000 for fiscal year 2001. (Department
of the Interior and Related Agencies Appropriations Act, 1999, as
included in Public Law 105–277, section 101(e).)
Unavailable Collections (in millions of dollars)

Object Classification (in millions of dollars)
Identification code 75–0391–0–1–551
Identification code 75–0390–0–1–551

11.1
11.3
11.5
11.9
12.1
13.0
21.0
22.0
23.1
23.2
23.3
24.0
25.1
25.2

1998 actual

1999 est.

2000 est.

1998 actual

1999 est.

2000 est.

Balance, start of year:
Balance, start of year .................................................... ................... ................... ...................
Receipts:
02.01 Rent and charges for quarters, Indian Health Service,
HHS ............................................................................
5
5
5
Appropriation:
05.01 Indian health facilities ..................................................
¥5
¥5
¥5
07.99 Total balance, end of year ............................................ ................... ................... ...................
01.99

363
16
31

382
17
33

398
18
34

Total personnel compensation .........................
410
432
Civilian personnel benefits .......................................
120
126
Benefits for former personnel ...................................
6
6
Travel and transportation of persons .......................
29
30
Transportation of things ...........................................
11
11
Rental payments to GSA ...........................................
9
9
Rental payments to others ........................................ ................... ...................
Communications, utilities, and miscellaneous
charges .................................................................
20
21
Printing and reproduction .........................................
2
2
Advisory and assistance services .............................
11
11
Other services ............................................................
63
66

450
133
7
30
12
9
3
21
2
11
67

Program and Financing (in millions of dollars)
Identification code 75–0391–0–1–551

Obligations by program activity:
Direct program:
00.01
Sanitation and health facilities ................................
00.02
Maintenance ..............................................................
00.03
Facilities and environmental health .........................

1998 actual

112
48
90

1999 est.

130
46
108

2000 est.

135
53
120

436

INDIAN HEALTH SERVICE—Continued
Federal Funds—Continued

THE BUDGET FOR FISCAL YEAR 2000
25.7
26.0
31.0
32.0
41.0

General and special funds—Continued
INDIAN HEALTH FACILITIES—Continued
Program and Financing (in millions of dollars)—Continued
Identification code 75–0391–0–1–551

1998 actual

1999 est.

2000 est.

Operation and maintenance of equipment ............... ...................
Supplies and materials .............................................
11
Equipment .................................................................
3
Land and structures ..................................................
13
Grants, subsidies, and contributions ........................
38

12 ...................
11
11
3
4
11
11
38
39

99.0
99.0

Equipment .................................................................

Total direct program .............................................
Reimbursable program ..................................................

263
10

297
10

Total new obligations ................................................

273

307

322
10

Total new obligations ................................................

273

307

332

322
10

10.00

297
10

01.00
09.01

263
10

99.9

00.04

Subtotal, direct obligations ..................................
Reimbursable obligations ..............................................

332

Personnel Summary
Identification code 75–0391–0–1–551

Budgetary resources available for obligation:
21.40 Unobligated balance available, start of year ...............
22.00 New budget authority (gross) ........................................
22.10 Resources available from recoveries of prior year obligations .......................................................................
23.90
23.95
24.40

Total budgetary resources available for obligation
Total new obligations ....................................................
Unobligated balance available, end of year .................

New budget authority (gross), detail:
Current:
40.00
Appropriation .............................................................
Permanent:
60.25
Appropriation (special fund, indefinite) ....................
68.00
Spending authority from offsetting collections: Offsetting collections (cash) .....................................
70.00

Total new budget authority (gross) ..........................

Change in unpaid obligations:
Unpaid obligations, start of year: Obligated balance,
start of year ..............................................................
73.10 Total new obligations ....................................................
73.20 Total outlays (gross) ......................................................
73.45 Adjustments in unexpired accounts ..............................
74.40 Unpaid obligations, end of year: Obligated balance,
end of year ................................................................

11
273

22
307

22
332

295
¥273
22

329
¥307
22

354
¥332
22

258

292

317

273

307

332

392
355
383
273
307
332
¥299
¥279
¥308
¥11 ................... ...................
355

383

407

86.90
86.93
86.97

99
185
15

88
176
15

95
198
15

87.00

Total outlays (gross) .................................................

299

279

308

Offsets:
Against gross budget authority and outlays:
88.45
Offsetting collections (cash) from: Offsetting governmental collections ............................................

¥10

Net budget authority and outlays:
Budget authority ............................................................
Outlays ...........................................................................

263
288

297
269

322
298

The Indian health facilities account supports construction,
repair and improvement, equipment, and environmental
health and facilities support for the Indian health services.
Object Classification (in millions of dollars)
Identification code 75–0391–0–1–551

11.1
11.3
11.5
11.9
12.1
21.0
22.0
23.3
25.1
25.2
25.3
25.4
25.6

Total compensable workyears: Full-time equivalent
employment ...............................................................

1998 actual

1,447

1999 est.

1,461

2000 est.

1,468

11 ................... ...................

72.40

89.00
90.00

1001

1998 actual

44
5
2

1999 est.

2000 est.

48
5
2

51
6
3

Total personnel compensation .........................
51
55
Civilian personnel benefits .......................................
14
15
Travel and transportation of persons .......................
4
4
Transportation of things ...........................................
3
3
Communications, utilities, and miscellaneous
charges .................................................................
6
6
Advisory and assistance services ............................. ...................
3
Other services ............................................................
87
122
Purchases of goods and services from Government
accounts ................................................................ ................... ...................
Operation and maintenance of facilities ..................
18
14
Medical care ..............................................................
15 ...................

60
16
4
3
6
2
94
16
45
11

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
therefore as authorized by 5 U.S.C. 5901–5902; and for expenses
of attendance at meetings which are concerned with the functions
or activities for which the appropriation is made or which will contribute to improved conduct, supervision, or management of those functions or activities: Provided, That in accordance with the provisions
of the Indian Health Care Improvement Act, non-Indian patients
may be extended health care at all tribally administered or Indian
Health Service facilities, subject to charges, and the proceeds along
with funds recovered under the Federal Medical Care Recovery Act
(42 U.S.C. 2651–2653) shall be credited to the account of the facility
providing the service and shall be available without fiscal year limitation: Provided further, That notwithstanding any other law or regulation, funds transferred from the Department of Housing and Urban
Development to the Indian Health Service shall be administered
under Public Law 86–121 (the Indian Sanitation Facilities Act) and
Public Law 93–638, as amended: Provided further, That funds appropriated to the Indian Health Service in this Act, except those used
for administrative and program direction purposes, shall not be subject to limitations directed at curtailing Federal travel and transportation: Provided further, That notwithstanding any other provision
of law, funds previously or herein made available to a tribe or tribal
organization through a contract, grant, or agreement authorized by
title I or title III of the Indian Self-Determination and Education
Assistance Act of 1975 (25 U.S.C. 450), may be deobligated and reobligated to a self-determination contract under title I, or a self-governance agreement under title III of such Act and thereafter shall remain available to the tribe or tribal organization without fiscal year
limitation: Provided further, That none of the funds made available
to the Indian Health Service in this Act shall be used to implement
the final rule published in the Federal Register on September 16,
1987, by the Department of Health and Human Services, relating
to the eligibility for the health care services of the Indian Health
Service until the Indian Health Service has submitted a budget request reflecting the increased costs associated with the proposed final
rule, and such request has been included in an appropriations Act
and enacted into law: Provided further, That funds made available
in this Act are to be apportioned to the Indian Health Service as
appropriated in this Act, and accounted for in the appropriation structure set forth in this Act: Provided further, That with respect to
functions transferred by the Indian Health Service to tribes or tribal
organizations, the Indian Health Service is authorized to provide
goods and services to those entities, on a reimbursable basis, including payment in advance with subsequent adjustment, and the reimbursements received therefrom, along with the funds received from
those entities pursuant to the Indian Self-Determination Act, may
be credited to the same or subsequent appropriation account which
provided the funding, said amounts to remain available until expended: Provided further, That, heretofore and hereafter and notwithstanding any other provision of law, funds available to the Indian

CENTERS FOR DISEASE CONTROL AND PREVENTION
Federal Funds

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Service in this Act or any other Act for Indian self-determination or self-governance contract or grant support costs may be expended only for costs directly attributable to contracts, grants and
compacts pursuant to the Indian Self-Determination Act and no funds
appropriated by this or any other Act shall be available for any
contract support costs or indirect costs associated with any contract,
grant, cooperative agreement, self-governance compact, or funding
agreement entered into between an Indian tribe or tribal organization
and any entity other than the Indian Health Service: Provided further, That reimbursements for training, technical assistance, or services provided by the Indian Health Service will contain total costs,
including direct, administrative, and overhead associated with the
provision of goods, services, or technical assistance: Provided further,
That the appropriation structure for the Indian Health Service may
not be altered without advance øapproval of¿ notice submitted to
the House and Senate Committees on Appropriations. (Department
of the Interior and Related Agencies Appropriations Act, 1999, as
included in Public Law 105–277, section 101(e).)

CENTERS FOR DISEASE CONTROL AND
PREVENTION

Program and Financing (in millions of dollars)
Identification code 75–0943–0–1–999

TRAINING

To carry out titles II, III, VII, XI, XV, XVII, XIX and XXVI of
the Public Health Service Act, sections 101, 102, 103, 201, 202, 203,
301, and 501 of the Federal Mine Safety and Health Act of 1977,
sections 20, 21 and 22 of the Occupational Safety and Health Act
of 1970, title IV of the Immigration and Nationality Act and section
501 of the Refugee Education Assistance Act of 1980; including insurance of official motor vehicles in foreign countries; and hire, maintenance, and operation of aircraft, ø$2,558,520,000¿ $2,769,440,000, of
which ø$17,800,000¿ $39,800,000 shall remain available until expended for equipment and construction and renovation of facilities,
and in addition, such sums as may be derived from authorized user
fees, which shall be credited to this account: Provided, That in addition to amounts provided herein, up to ø$67,793,000¿ $109,573,000
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: Provided further, That none of the funds made
available for injury prevention and control at the Centers for Disease
Control and Prevention may be used to advocate or promote gun
control: Provided further, That the Director may redirect the total
amount made available under authority of Public Law 101–502, section 3, dated November 3, 1990, to activities the Director may so
designate: Provided further, That the Congress is to be notified
promptly of any such transferø: Provided further, That notwithstanding any other provison of law, a single contract or related contracts
for the development and construction of the infectious disease laboratory through the General Services Administration may be employed
which collectively include the full scope of the project: Provided further, That the solicitation and contract shall contain the clause ‘‘availability of funds’’ found at 48 CFR 52.232–18: Provided further, That
hereinafter obligations may be incurred related to agreement with
private entities without receipt of advance payment¿.
In addition, $51,000,000, to be derived from the Violent Crime
Reduction Trust Fund, for carrying out sections 40151 and 40261
of Public Law 103–322. (Department of Health and Human Services
Appropriations Act, 1999, as included in Public Law 105–277 section
101(f).)
Unavailable Collections (in millions of dollars)
Identification code 75–0943–0–1–999

1998 actual

1999 est.

2000 est.

10.00

Total new obligations ................................................

21.40
22.00
22.10

General and special funds:
AND

1998 actual

Obligations by program activity:
Direct program:
00.01
Preventive health block grant ...................................
149
150
120
00.02
Prevention centers .....................................................
8
14
14
00.03
Sexually transmitted diseases ..................................
112
124
131
00.04
Immunization .............................................................
430
421
526
00.05
Infectious diseases ....................................................
231
258
301
00.06
Other chronic and environmental diseases ..............
414
474
493
00.07
Tobacco ......................................................................
28
74
101
00.08
Occupational safety and health ................................
152
200
212
00.09
Mine safety and health .............................................
36 ................... ...................
00.10
Epidemic services ......................................................
67
86
85
00.11
Health statistics ........................................................
26
27 ...................
00.12
HIV .............................................................................
625
657
666
00.13
Prevention research ................................................... ...................
15
15
00.14
Buildings and facilities .............................................
64
75
40
00.15
Office of the director .................................................
33
30
30
00.16
Violent crime reduction programs .............................
51
51
51
00.17
Eliminating racial and ethnic disparities ................. ...................
10
35
09.01 Reimbursable program ..................................................
148
148
189

23.90
23.95
23.98
24.40

2,632
2,817
3,016
¥2,574
¥2,814
¥3,009
¥1 ................... ...................
56
4
8

2,336
2,558
2,768
¥4 ................... ...................
52
51
51

43.00

Appropriation (total) .............................................
Permanent:
Appropriation (special fund, indefinite) ....................
Transferred from other accounts ..............................

2,384

2,610

2,820

1
3

Appropriation (total) .............................................
Spending authority from offsetting collections:
Offsetting collections (cash) ................................
From Federal sources: Change in receivables
and unpaid, unfilled orders .............................

148

189

Federal Funds

DISEASE CONTROL, RESEARCH,

437

2000 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
Appropriation:
05.01 Disease control, research, and training ........................
¥1
¥1
¥1
07.99 Total balance, end of year ............................................ ................... ................... ...................

60.25
62.00
63.00
68.00
68.10
68.90

2,574

2,814

3,009

52
2,576

56
2,761

4
3,012

4 ................... ...................

40 ................... ...................

Spending authority from offsetting collections
(total) ...........................................................

188

148

189

Total new budget authority (gross) ..........................

2,576

2,761

3,012

Change in unpaid obligations:
Unpaid obligations, start of year:
72.40
Obligated balance, start of year ...............................
72.95
From Federal sources: Receivables and unpaid, unfilled orders ...........................................................

2,070

2,042

2,299

70.00

72.99
73.10
73.20
73.45
74.40
74.95

Total unpaid obligations, start of year ................
Total new obligations ....................................................
Total outlays (gross) ......................................................
Adjustments in unexpired accounts ..............................
Unpaid obligations, end of year:
Obligated balance, end of year ................................
From Federal sources: Receivables and unpaid, unfilled orders ...........................................................

2,075
2,087
2,344
2,574
2,814
3,009
¥2,558
¥2,557
¥2,844
¥4 ................... ...................
2,042

2,299

2,464

74.99

Total unpaid obligations, end of year ..................

2,087

2,344

2,509

86.90
86.93
86.97
86.98

918
1,491
148
1

915
1,490
151
1

989
1,662
192
1

87.00

Total outlays (gross) .................................................

2,558

2,557

2,844

438

CENTERS FOR DISEASE CONTROL AND PREVENTION—Continued
Federal Funds—Continued

THE BUDGET FOR FISCAL YEAR 2000

General and special funds—Continued
DISEASE CONTROL, RESEARCH,

AND

ALLOCATIONS RECEIVED FROM OTHER ACCOUNTS
TRAINING—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.’’

Program and Financing (in millions of dollars)—Continued
1998 actual

Identification code 75–0943–0–1–999

89.00
90.00

Total, offsetting collections (cash) ..................
From Federal sources: Change in receivables and
unpaid, unfilled orders ..............................................
Net budget authority and outlays:
Budget authority ............................................................
Outlays ...........................................................................

1999 est.

2000 est.

NATIONAL INSTITUTES OF HEALTH
Federal Funds
¥147
¥1

¥147
¥1

¥188
¥1

General and special funds:

¥148

¥189

For carrying out section 301 and title IV of the Public Health
Service Act with respect to cancer, ø$2,927,187,000¿ $2,732,795,000.
(Department of Health and Human Services Appropriations Act, 1999,
as included in Public Law 105–277, section 101(f).)

¥40 ................... ...................

2,388
2,410

2,613
2,409

2,823
2,655

[Dollars in millions]

1998

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 ..........................................

1999

2000

2,337
51

2,563
51

2,773
51

2,388
22

2,362
47

2,585
70

The Centers for Disease Control and Prevention (CDC) supports a number of categorical programs including grants for
immunizations, control of sexually transmitted diseases, HIV
prevention, and control of other infectious and chronic diseases. CDC also supports the Preventive Health Block Grant.
This display also includes amounts derived from the Violent
Crime Reduction Trust Fund.
Object Classification (in millions of dollars)
1998 actual

Identification code 75–0943–0–1–999

11.1
11.3
11.5
11.9
12.1
21.0
22.0
23.1
23.2
23.3

1999 est.

2000 est.

272
18
15

306
21
16

322
23
17

305
91
26
5
16
2

343
99
27
5
18
2

362
104
28
5
24
3

24
6
4
48

27
7
11
55

29
8
15
58

25.4
25.5
25.7
26.0
31.0
32.0
41.0

90
11
164
23
98
53
23
1,437

95
12
178
24
126
55
34
1,548

96
14
190
25
130
57
54
1,618

99.0
99.0

Subtotal, direct obligations ..................................
Reimbursable obligations ..............................................

2,426
148

2,666
148

2,820
189

99.9

Total new obligations ................................................

2,574

2,814

3,009

24.0
25.1
25.2
25.3

Personnel Summary
Identification code 75–0943–0–1–999

1998 actual

1999 est.

2000 est.

NATIONAL CANCER INSTITUTE

NATIONAL HEART, LUNG,

6,508
6,555
66 ...................

1,012

1,013

1,141

BLOOD INSTITUTE

NATIONAL INSTITUTE

DENTAL

AND

CRANIOFACIAL RESEARCH

For carrying out section 301 and title IV of the Public Health
Service Act with respect to dental disease, ø$234,338,000¿
$225,709,000. (Department of Health and Human Services Appropriations Act, 1999, as included in Public Law 105–277, section 101(f).)
NATIONAL INSTITUTE

DIABETES AND DIGESTIVE
DISEASES

AND

KIDNEY

For carrying out section 301 and title IV of the Public Health
Service Act with respect to diabetes and digestive and kidney disease,
ø$994,218,000¿ $1,002,747,000. (Department of Health and Human
Services Appropriations Act, 1999, as included in Public Law 105–
277, section 101(f).)
NATIONAL INSTITUTE

NEUROLOGICAL DISORDERS

AND

STROKE

For carrying out section 301 and title IV of the Public Health
Service Act with respect to neurological disorders and stroke,
ø$903,278,000¿ $890,816,000. (Department of Health and Human
Services Appropriations Act, 1999, as included in Public Law 105–
277, section 101(f).)
NATIONAL INSTITUTE

ALLERGY

AND

INFECTIOUS DISEASES

For carrying out section 301 and title IV of the Public Health
Service Act with respect to allergy and infectious diseases,
ø$1,570,102,000¿ $789,156,000. (Department of Health and Human
Services Appropriations Act, 1999, as included in Public Law 105–
277, section 101(f).)
NATIONAL INSTITUTE

GENERAL MEDICAL SCIENCES

For carrying out section 301 and title IV of the Public Health
Service Act with respect to general medical sciences, ø$1,197,825,000¿
$1,194,068,000. (Department of Health and Human Services Appropriations Act, 1999, as included in Public Law 105–277, section
101(f).)
NATIONAL INSTITUTE

CHILD HEALTH

AND

HUMAN DEVELOPMENT

For carrying out section 301 and title IV of the Public Health
Service Act with respect to child health and human development,
ø$750,982,000¿ $694,114,000. (Department of Health and Human
Services Appropriations Act, 1999, as included in Public Law 105–
277, section 101(f).)
NATIONAL EYE INSTITUTE
For carrying out section 301 and title IV of the Public Health
Service Act with respect to eye diseases and visual disorders,
ø$395,857,000¿ $395,935,000. (Department of Health and Human
Services Appropriations Act, 1999, as included in Public Law 105–
277, section 101(f).)
NATIONAL INSTITUTE

6,076
16

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, ø$1,793,697,000¿ $1,759,806,000. (Department of Health and Human Services Appropriations Act, 1999,
as included in Public Law 105–277, section 101(f).)

ENVIRONMENTAL HEALTH SCIENCES

For carrying out sections 301 and 311 and title IV of the Public
Health Service Act with respect to environmental health sciences,
ø$375,743,000¿ $390,718,000. (Department of Health and Human
Services Appropriations Act, 1999, as included in Public Law 105–
277, section 101(f).)

NATIONAL INSTITUTES OF HEALTH—Continued
Federal Funds—Continued

DEPARTMENT OF HEALTH AND HUMAN SERVICES
NATIONAL INSTITUTE

AGING

For carrying out section 301 and title IV of the Public Health
Service Act with respect to aging, ø$596,521,000¿ $612,599,000. (Department of Health and Human Services Appropriations Act, 1999,
as included in Public Law 105–277, section 101(f).)
NATIONAL INSTITUTE

ARTHRITIS AND MUSCULOSKELETAL
SKIN DISEASES

AND

For carrying out section 301 and title IV of the Public Health
Service Act with respect to arthritis and musculoskeletal and skin
diseases, ø$308,164,000¿ $309,953,000. (Department of Health and
Human Services Appropriations Act, 1999, as included in Public Law
105–277, section 101(f).)
NATIONAL INSTITUTE

DEAFNESS AND OTHER COMMUNICATION
DISORDERS

For carrying out section 301 and title IV of the Public Health
Service Act with respect to deafness and other communication disorders, ø$229,887,000¿ $235,297,000. (Department of Health and
Human Services Appropriations Act, 1999, as included in Public Law
105–277, section 101(f).)
NATIONAL INSTITUTE

NURSING RESEARCH

For carrying out section 301 and title IV of the Public Health
Service Act with respect to nursing research, ø$69,834,000¿
$65,335,000. (Department of Health and Human Services Appropriations Act, 1999, as included in Public Law 105–277, section 101(f).)
NATIONAL INSTITUTE

ALCOHOL ABUSE

AND

ALCOHOLISM

For carrying out section 301 and title IV of the Public Health
Service Act with respect to alcohol abuse and alcoholism,
ø$259,747,000¿ $248,916,000. (Department of Health and Human
Services Appropriations Act, 1999, as included in Public Law 105–
277, section 101(f).)
NATIONAL INSTITUTE

DRUG ABUSE

For carrying out section 301 and title IV of the Public Health
Service Act with respect to drug abuse, ø$603,274,000¿ $429,246,000.
(Department of Health and Human Services Appropriations Act, 1999,
as included in Public Law 105–277, section 101(f).)
NATIONAL INSTITUTE

MENTAL HEALTH

For carrying out section 301 and title IV of the Public Health
Service Act with respect to mental health, ø$861,208,000¿
$758,892,000. (Department of Health and Human Services Appropriations Act, 1999, as included in Public Law 105–277, section 101(f).)
NATIONAL HUMAN GENOME RESEARCH INSTITUTE
For carrying out section 301 and title IV of the Public Health
Service Act with respect to human genome research, ø$264,892,000¿
$271,536,000. (Department of Health and Human Services Appropriations Act, 1999, as included in Public Law 105–277, section 101(f).)
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, ø$554,819,000¿ $469,684,000: Provided, That none
of these funds shall be used to pay recipients of the general research
support grants program any amount for indirect expenses in connection with such grants: Provided further, That $30,000,000 shall be
for extramural facilities construction grants. (Department of Health
and Human Services ppropriations Act, 1999, as included in Public
Law 105–277, section 101(f).)
NATIONAL CENTER

FOR

COMPLEMENTARY
MEDICINE

AND

ALTERNATIVE

For carrying out section 301 and title IV of the Public Health
Service Act with respect to complementary and alternative medicine,
$50,168,000, to be available for obligation through September 30,
2001.
JOHN E. FOGARTY INTERNATIONAL CENTER
For carrying out the activities at the John E. Fogarty International
Center, ø$35,426,000¿ $23,498,000. (Department of Health and
Human Services Appropriations Act, 1999, as included in Public Law
105–277, section 101(f).)
NATIONAL LIBRARY

MEDICINE

For carrying out section 301 and title IV of the Public Health
Service Act with respect to health information communications,

439

ø$181,309,000¿ $181,443,000, of which $4,000,000 shall be available
until expended for improvement of information systems: Provided,
That in fiscal year ø1999¿ 2000, the Library may enter into personal
services contracts for the provision of services in facilities owned,
operated, or constructed under the jurisdiction of the National Institutes of Health. (Department of Health and Human Services Appropriations Act, 1999, as included in Public Law 105–277, section
101(f).)
OFFICE

OF THE

DIRECTOR

(INCLUDING TRANSFER OF FUNDS)

For carrying out the responsibilities of the Office of the Director,
National Institutes of Health, ø$306,559,000, of which $43,493,000
shall be for the Office of AIDS Research¿ $218,153,000: Provided,
That funding shall be available for the purchase of not to exceed
twenty-nine 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 or any other Act to all National
Institutes of Health appropriations to activities the Director may
so designate: Provided further, That no such appropriation shall be
decreased by more than 1 percent by any such transfers and that
the Congress is promptly notified of the transfer: 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
depositedø: Provided further, That up to $500,000 shall be available
to carry out section 499 of the Public Health Service Act: Provided
further, That, notwithstanding section 499(k)(10) of the Public Health
Service Act, funds from the National Foundation for Biomedical Research may be transferred to the National Institutes of Health: Provided further, That $50,000,000 shall be available to carry out section
404E of the Public Health Service Act¿. (Department of Health and
Human Services Appropriations Act, 1999, as included in Public Law
105–277, section 101(f).)
OFFICE

AIDS RESEARCH (INCLUDING TRANSFER

FUNDS)

For carrying out part D of title XXIII of the Public Health Service
Act, $1,833,826,000: Provided, That the Director of the Office of AIDS
Research shall transfer funds from this appropriation as authorized
by subsection 2353(d) of the Act.
BUILDINGS

AND

FACILITIES

For the study of, construction of, and acquisition of equipment
for, facilities of or used by the National Institutes of Health, including
the acquisition of real property, ø$237,519,000¿ $108,376,000, to remain available until expendedø, of which $90,000,000 of the fiscal
year 1999 funds shall be for the clinical research center and
$40,000,000 shall become available on October 1, 1999 and $9,143,000
shall be for the Vaccine Facility: Provided, That notwithstanding
any other provision of law, a single contract or related contracts
for the development and construction of the clinical research center
may be employed which collectively include the full scope of the
project: Provided further, That the solicitation and contract shall contain the clause ‘‘availability of funds’’ found at 48 CFR 52.232–18¿.
(Department of Health and Human Services Appropriations Act, 1999,
as included in Public Law 105–277, section 101(f).)
Unavailable Collections (in millions of dollars)
Identification code 75–9915–0–1–552

1998 actual

1999 est.

2000 est.

Balance, start of year:
01.99 Balance, start of year .................................................... ................... ................... ...................
Receipts:
02.01 Cooperative research and development agreements,
NIH .............................................................................
15
15
15
Appropriation:
05.01 National Institutes of Health .........................................
¥15
¥15
¥15
07.99 Total balance, end of year ............................................ ................... ................... ...................

Program and Financing (in millions of dollars)
Identification code 75–9915–0–1–552

Obligations by program activity:
Direct program:
00.01
National Cancer Institute ..........................................

1998 actual

2,551

1999 est.

2,927

2000 est.

2,733

440

NATIONAL INSTITUTES OF HEALTH—Continued
Federal Funds—Continued

THE BUDGET FOR FISCAL YEAR 2000

General and special funds—Continued
BUILDINGS

AND

74.40
74.95

FACILITIES—Continued

Program and Financing (in millions of dollars)—Continued

Unpaid obligations, end of year:
Obligated balance, end of year ................................
From Federal sources: Receivables and unpaid, unfilled orders ...........................................................

12,119

13,762

14,253

3,984

16,103

17,746

18,237

74.99
Identification code 75–9915–0–1–552

00.02
00.03
00.04
00.05
00.06
00.07
00.08
00.09
00.10
00.11
00.12
00.13
00.14
00.15
00.16
00.17
00.18
00.19
00.20
00.21
00.22
00.23
00.24
00.25
00.26
00.27
09.00

1998 actual

1999 est.

National Heart, Lung, and Blood Institute ...............
1,526
1,794
National Institute of Dental and Craniofacial Research ...................................................................
210
234
National Institute of Diabetes and Digestive and
Kidney Disease ......................................................
897
1,021
National Institute of Neurological Disorders and
Stroke ....................................................................
778
903
National Institute of Allergy and Infectious Diseases .....................................................................
1,352
1,570
National Institute of General Medical Sciences .......
1,062
1,198
National Institute of Child Health and Human Development ..............................................................
672
751
National Eye Institute ................................................
354
396
National Institute of Environmental Health Sciences
329
376
National Institute on Aging .......................................
517
597
National Institute of Arthritis and Musculoskeletal
and Skin Disease ..................................................
274
308
National Institute on Deafness and Other Communication Disorder ...................................................
200
230
National Institute of Nursing Research ....................
63
70
National Institute of Alcohol Abuse and Alcoholism
226
260
National Institute on Drug Abuse .............................
537
603
National Institute of Mental Health ..........................
748
861
National Center for Research Resources ..................
452
555
National Human Genome Research Institute ............
218
265
John E. Fogarty International Center ........................
28
34
National Library of Medicine .....................................
162
181
Office of the Director ................................................
295
307
Office of AIDS Research ............................................ ................... ...................
Buildings and facilities .............................................
235
197
Cooperative research and development agreements
19
15
Royalities ...................................................................
22
24
National Center for Complementary and Alternative
Medicine ................................................................ ................... ...................
Reimbursable program ..................................................
1,117
1,160

Total unpaid obligations, end of year ..................

86.90
86.93
86.97
86.98

87.00

Total outlays (gross) .................................................

13,312

15,194

16,655

Offsets:
Against gross budget authority and outlays:
88.00
Offsetting collections (cash) from: Federal sources
88.95 From Federal sources: Change in receivables and
unpaid, unfilled orders ..............................................

¥811

¥1,160

¥1,187

2000 est.

1,760
226
1,030

3,880
4,682
4,773
8,414
9,313
10,645
1,015
1,199
1,237
2 ................... ...................

891
789
1,194
694
396
391
613
310
235
65
249
429
759
470
272
23
181
218
1,834
108
15
24
50
1,187

10.00

Total new obligations ................................................

14,844

16,837

17,146

21.40
22.00

Budgetary resources available for obligation:
Unobligated balance available, start of year ...............
New budget authority (gross) ........................................

197
14,799

147
16,814

123
17,162

23.90
23.95
23.98
24.40

14,996
16,961
17,285
¥14,844
¥16,837
¥17,146
¥4 ................... ...................
147
123
139

13,648
15,612
15,893
¥25 ................... ...................
9 ................... ...................

43.00

13,632

15,612
15
27

15
27

Net budget authority and outlays:
Budget authority ............................................................
Outlays ...........................................................................

13,674
12,501

15,654
14,034

15,975
15,468

[Dollars in millions]

Distribution of budget authority by account:
1998
1999
National Cancer Institute .......................................................
2,551
2.927
National Heart, Lung, and Blood Institute .............................
1,526
1,794
National Institute of Dental and Craniofacial Research .......
210
234
National Institute of Diabetes and Digestive and Kidney
Diseases .............................................................................
897
1,021
National Institute of Neurological Disorder and Stroke .........
779
903
National Institute of Allergy and Infectious Diseases ...........
1,352
1,570
National Institute of General Medical Sciences .....................
1,062
1,198
National Institute of Child Health and Human Development
672
751
National Eye Institute .............................................................
354
396
National Institute of Environmental Health Sciences ............
329
376
National Institute on Aging ....................................................
517
597
National Institute of Arthritis and Musculoskeletal and Skin
Diseases .............................................................................
273
308
National Institute on Deafness and Other Communication
Disorders .............................................................................
200
230
National Institute of Nursing Research ..................................
64
70
National Institute on Alcohol Abuse and Alcoholism .............
226
260
National Institute on Drug Abuse ...........................................
537
603
National Institute of Mental Health .......................................
748
861
National Center for Research Resources ................................
452
555
National Human Genome Research Institute .........................
219
265
National Center for Complementary and Alternative Medicine ..................................................................................... .................... ....................
John E. Fogarty International Center ......................................
28
35
National Library of Medicine ..................................................
161
181
Office of the Director ..............................................................
295
307
Office of AIDS Research ......................................................... .................... ....................
Buildings and Facilities ..........................................................
207
197

2000

2,733
1,760
226
1,030
891
789
1,194
694
396
391
613
310

15,893

15
27

89.00
90.00

¥314 ................... ...................

60.25
62.00
63.00
65.00
68.00
68.10
68.90

Appropriation (total) .............................................
42
42
42
Advance appropriation (definite) .............................. ................... ...................
40
Spending authority from offsetting collections:
Offsetting collections (cash) ................................
811
1,160
1,187
From Federal sources: Change in receivables
and unpaid, unfilled orders .............................
314 ................... ...................
1,125

1,160

1,187

Total new budget authority (gross) ..........................

14,799

16,814

17,162

10,973

12,119

13,762

3,670

3,984

72.99
73.10
73.20
73.40

50
23
181
218
1,834
148

14,643
16,103
17,746
14,844
16,837
17,146
¥13,312
¥15,194
¥16,655
¥72 ................... ...................

Subtotal ..........................................................................
Cooperative Research and Development Agreements ............

13,659
15

15,639
15

15,960
15

Total Budget Authority, NIH ...........................................

Spending authority from offsetting collections
(total) ...........................................................

70.00

235
65
249
429
759
470
272

13,674

15,654

15,975

[Dollars in millions]

1998

Distribution of outlays by account:
National Cancer Institute .......................................................
National Heart, Lung, and Blood Institute .............................
National Institute of Dental and Craniofacial 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 .......................................

1999

2000

2,381
1,389
200

2,613
1,575
214

2,651
1,692
216

814
721
1,211
992
627
339
312
471

922
805
1,390
1,090
694
366
336
526

995
858
755
1,160
674
385
373
585

252

282

301

187
60
203
500
689

206
64
232
538
769

227
63
240
409
734

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION
Federal Funds

DEPARTMENT OF HEALTH AND HUMAN SERVICES
National Center for Research Resources ................................
416
478
448
National Human Genome Research Institute .........................
197
229
260
National Center for Complementary and Alternative Medicine ..................................................................................... .................... ....................
21
John E. Fogarty International Center ......................................
29
28
22
National Library of Medicine ..................................................
153
169
177
Office of the Director ..............................................................
273
288
230
Office of AIDS Research ......................................................... .................... ....................
1,769
Buildings and Facilities ..........................................................
125
205
208
Service and Supply Fund/Management Fund .........................
–57 .................... ....................
Subtotal Outlays ............................................................
Cooperative Research and Development Agreements ............

12,484
17

14,019
15

15,453
15

Total Outlays, NIH ..........................................................

12,501

14,034

15,468

Note: The total amount for FY 1999 AIDS research was $1,775,523,000 which was jointly determined by the
Director of NIH and the Director of the Office of AIDS Research pursuant to section 209 of P.L. 105–277. $1,723,030
was made available to OAR. This amount is net of the $43,493,000 in AIDS funds earmarked in P.L. 105–
277 in the Office of the Director account. Amounts available under section 4921 of P.L. 105–33 for research
on diabetes are included in the National Institute of Diabetes and Digestive and Kidney Disorders.

This program funds biomedical research and research training. These accounts will continue to be appropriated separately, and are displayed in a consolidated format to improve
the readability of the presentation. Detailed information is
available through the Department of Health and Human
Services.
NIH research and related activities are included in the
21st Century Research Fund.
Object Classification (in millions of dollars)
1998 actual

Identification code 75–9915–0–1–552

11.1
11.3
11.5
11.8
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
25.6
25.7
26.0
31.0
32.0
41.0
42.0

1999 est.

2000 est.

SUBSTANCE ABUSE AND MENTAL HEALTH
SERVICES ADMINISTRATION
Federal Funds
General and special funds:
SUBSTANCE ABUSE

554
124
35
93

597
132
36
97

Total personnel compensation .........................
740
Civilian personnel benefits .......................................
152
Travel and transportation of persons .......................
22
Transportation of things ...........................................
4
Rental payments to GSA ...........................................
5
Rental payments to others ........................................
7
Communications, utilities, and miscellaneous
charges .................................................................
39
Printing and reproduction .........................................
13
Advisory and assistance services .............................
29
Other services ............................................................
442
Purchases of goods and services from Government
accounts ................................................................
789
Operation and maintenance of facilities ..................
104
Research and development contracts .......................
842
Medical care ..............................................................
11
Operation and maintenance of equipment ...............
25
Supplies and materials .............................................
137
Equipment .................................................................
120
Land and structures .................................................. ...................
Grants, subsidies, and contributions ........................
10,243
Insurance claims and indemnities ...........................
3

806
171
26
5
8
14

862
185
25
6
7
15

38
14
35
457

40
14
35
381

908
119
924
12
36
153
130
1
11,818
3

900
93
911
13
36
156
125
1
12,151
3

Identification code 75–1362–0–1–551

Obligations by program activity:
Direct program:
00.01
Mental health and substance abuse activities ........
00.02
Mental health partnership ........................................
00.03
Substance abuse partnership ...................................
00.04
Substance abuse partnership temporary supplement (mandatory) .................................................
00.05
Program management ...............................................
09.01 Reimbursable program ..................................................
Total new obligations ................................................

22.00
23.95
23.98

Budgetary resources available for obligation:
New budget authority (gross) ........................................
Total new obligations ....................................................
Unobligated balance expiring ........................................

New budget authority (gross), detail:
Current:
40.00
Appropriation .............................................................
Permanent:
65.00
Advance appropriation (definite) ..............................
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,
start of year ..............................................................
73.10 Total new obligations ....................................................
73.20 Total outlays (gross) ......................................................
73.40 Adjustments in expired accounts ..................................
74.40 Unpaid obligations, end of year: Obligated balance,
end of year ................................................................

1998 actual

504
275
1,310

1999 est.

561
289
1,585

2000 est.

595
359
1,615

50 ................... ...................
55
53
58
20
22
22
2,214

2,510

2,649

2,217
2,510
2,649
¥2,214
¥2,510
¥2,649
¥4 ................... ...................

2,147

2,488

2,627

50 ................... ...................
20

2,217

2,510

2,649

72.40

99.0
99.0

Subtotal, direct obligations ..................................
Reimbursable obligations ..............................................

13,727
1,117

15,678
1,159

15,959
1,187

99.9

Total new obligations ................................................

14,844

16,837

17,146

87.00

1,642
1,620
1,777
2,214
2,510
2,649
¥2,254
¥2,353
¥2,541
20 ................... ...................
1,620

1,777

1,885

Outlays (gross), detail:
Outlays from new current authority ..............................
970
Outlays from current balances ......................................
1,245
Outlays from new permanent authority .........................
39
Outlays from permanent balances ................................ ...................

1,110
1,199
22
22

1,169
1,347
22
3

1998 actual

10,876
21

4,283

1999 est.

2,254

2,353

2,541

¥20

¥22

Net budget authority and outlays:
Budget authority ............................................................
Outlays ...........................................................................

2,197
2,236

2,488
2,331

2,627
2,519

2000 est.

11,637
12,071
33 ...................

4,580

Total outlays (gross) .................................................

Offsets:
Against gross budget authority and outlays:
88.00
Offsetting collections (cash) from: Federal sources

Personnel Summary

MENTAL HEALTH SERVICES

Program and Financing (in millions of dollars)

86.90
86.93
86.97
86.98

Identification code 75–9915–0–1–552

AND

For carrying out titles V and XIX of the Public Health Service
Act with respect to substance abuse and mental health services, the
Protection and Advocacy for Mentally Ill Individuals Act of 1986,
and section 301 of the Public Health Service Act with respect to
program management, ø$2,488,005,000: Provided, That of the amount
provided, $300,000 shall be for the Philadelphia City-wide Improvement and Planning Agency¿ $2,726,505,000, of which $100,000,000
shall become available on October 1, 2000 and remain available until
September 30, 2001. (Department of Health and Human Services Appropriations Act, 1999, as included in Public Law 105–277, section
101(f).)

10.00
507
107
34
92

441

4,580

89.00
90.00

This program provides Federal support for treatment and
prevention in the areas of alcoholism, drug abuse, and mental
health.

442

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION—Continued
Federal Funds—Continued

THE BUDGET FOR FISCAL YEAR 2000

General and special funds—Continued
SUBSTANCE ABUSE

AND

MENTAL HEALTH SERVICES—Continued

68.00
68.10

Object Classification (in millions of dollars)
1998 actual

Identification code 75–1362–0–1–551

11.1
11.3
11.5
11.9
12.1
21.0
23.1
23.3

1999 est.

2000 est.

34
1
1

37
1
1

38
1
1

36
7
2
4

39
8
1
5

40
9
1
5

1
4
14
159

1
4
15
164

1
4
16
169

31.0
41.0

23
2
1,942

24
2
2,225

25
2
2,355

99.0
99.0

Subtotal, direct obligations ..................................
Reimbursable obligations ..............................................

2,194
20

2,488
22

99.9

Total new obligations ................................................

2,214

2,510

2,649

191

1 ................... ...................

68.90

Spending authority from offsetting collections
(total) ...........................................................

191

70.00

Total new budget authority (gross) ..........................

160

182

218

129

139

137

135
146
158
182
¥145
¥183
¥2 ...................

144
218
¥281
¥2

2,627
22

24.0
25.1
25.2
25.3

Permanent:
Spending authority from offsetting collections:
Offsetting collections (cash) ................................
From Federal sources: Change in receivables
and unpaid, unfilled orders .............................

72.99
73.10
73.20
73.40
74.40
74.95

Total unpaid obligations, start of year ................
Total new obligations ....................................................
Total outlays (gross) ......................................................
Adjustments in expired accounts ..................................
Unpaid obligations, end of year:
Obligated balance, end of year ................................
From Federal sources: Receivables and unpaid, unfilled orders ...........................................................

139

137

74.99

Total unpaid obligations, end of year ..................

146

144

86.90
86.93
86.97

¥10
87
69

10
91
82

3
87
191

87.00

Total outlays (gross) .................................................

145

183

281

¥69

¥82

¥191

Personnel Summary
1998 actual

Identification code 75–1362–0–1–551

Direct:
Total compensable workyears: Full-time equivalent
employment ...............................................................
Reimbursable:
Total compensable workyears:
2001
Full-time equivalent employment ..............................
2011
Exempt Full-time equivalent employment .................

1999 est.

2000 est.

1001

549

2
68

574

565

2
94
92 ...................
89.00
90.00

AGENCY FOR HEALTH CARE POLICY AND
RESEARCH
General and special funds:

100
101

27
90

Object Classification (in millions of dollars)
AND

RESEARCH

For carrying out titles III and IX of the Public Health Service
Act, and part A of title XI of the Social Security Act, ø$100,408,000¿
$26,667,000; in addition, amounts received from Freedom of Information Act fees, reimbursable and interagency agreements, and the sale
of data tapes shall be credited to this appropriation and shall remain
available until expended: Provided, That the amount made available
pursuant to section 926(b) of the Public Health Service Act shall
not exceed ø$70,647,000¿ $179,588,000. (Department of Health and
Human Services Appropriations Act, 1999, as included in Public Law
105–277, section 101(f).)
Program and Financing (in millions of dollars)
Identification code 75–1700–0–1–552

Obligations by program activity:
Direct program:
01.01
Research on health costs, quality, and outcomes
01.04
Program support ........................................................
09.00 Reimbursable program ..................................................
10.00

90
77

This activity supports research and information dissemination on health care services and technology, medical effectiveness, and patient outcomes.

Federal Funds
HEALTH CARE POLICY

Net budget authority and outlays:
Budget authority ............................................................
Outlays ...........................................................................

¥1 ................... ...................

Total new obligations ................................................

1998 actual

1999 est.

2000 est.

88
2
68

98
2
82

25
2
191

158

182

218

160
182
218
¥158
¥182
¥218
2 ................... ...................

11.1
11.3
11.9
12.1
21.0
23.1
23.3
24.0
25.2
25.3
25.5
31.0
41.0

100

Direct obligations:
Personnel compensation:
Full-time permanent .............................................
Other than full-time permanent ...........................

1999 est.

2000 est.

10
3

13
2
2 ...................

Total personnel compensation .........................
13
Civilian personnel benefits .......................................
3
Travel and transportation of persons ....................... ...................
Rental payments to GSA ...........................................
2
Communications, utilities, and miscellaneous
charges .................................................................
1
Printing and reproduction .........................................
1
Other services ............................................................
5
Purchases of goods and services from Government
accounts ................................................................
3
Research and development contracts .......................
16
Equipment .................................................................
1
Grants, subsidies, and contributions ........................
45

15
2
3 ...................
1 ...................
3 ...................
1 ...................
1 ...................
5
1
2 ...................
24
4
1 ...................
44
20

99.0
99.0

Subtotal, direct obligations ..................................
Reimbursable obligations ..............................................

90
68

100
82

27
191

99.9

Total new obligations ................................................

158

182

218

Personnel Summary
Identification code 75–1700–0–1–552

1001
90

1998 actual

Identification code 75–1700–0–1–552

Direct:
Total compensable workyears: Full-time equivalent
employment ...............................................................

1998 actual

200

1999 est.

211

2000 est.

HEALTH CARE FINANCING ADMINISTRATION
Federal Funds

DEPARTMENT OF HEALTH AND HUMAN SERVICES

2001

Reimbursable:
Total compensable workyears: Full-time equivalent
employment ...............................................................

74.40
64

General and special funds:
STATES

FOR

MEDICAID

For carrying out, except as otherwise provided, titles XI and XIX
of the Social Security Act, ø$74,593,733,000¿ $86,087,393,000, to remain available until expended: Provided, That beginning in fiscal
year 2000 and thereafter, for expenses incurred by Medicaid under
title XXI of the Social Security Act, Medicaid may accept as reimbursement in advance amounts from the ‘‘State Children’s Health Insurance
Fund,’’ such amounts to remain available as provided under title
XXI.
For making, after May 31, ø1999¿ 2000, payments to States under
title XIX of the Social Security Act for the last quarter of fiscal
year ø1999¿ 2000 for unanticipated costs, incurred for the current
fiscal year, such sums as may be necessary.
For making payments to States or in the case of section 1928
on behalf of States, under title XIX of the Social Security Act for
the first quarter of fiscal year ø2000, $28,733,605,000¿ 2001,
$30,589,003,000, to remain available until expended.
Payment under title XIX may be made for any quarter with respect
to a State plan or plan amendment in effect during such quarter,
if submitted in or prior to such quarter and approved in that or
any subsequent quarter. (Department of Health and Human Services
Appropriations Act, 1999, as included in Public Law 105–277, section
101(f).)
Program and Financing (in millions of dollars)
Identification code 75–0512–0–1–551

00.01
00.02
00.03
09.00
09.01

Total new obligations ................................................

21.40
22.00
22.10

Budgetary resources available for obligation:
Unobligated balance available, start of year ...............
New budget authority (gross) ........................................
Resources available from recoveries of prior year obligations .......................................................................
Total budgetary resources available for obligation
Total new obligations ....................................................
Unobligated balance available, end of year .................

104,495

65.00

68.00
68.00
68.90
70.00

108,594

86.90
86.93
86.97

60,087
13,158
27,989

69,217
11,516
27,861

80,583
5,504
29,299

Total outlays (gross) .................................................

101,234

108,594

115,386

Offsets:
Against gross budget authority and outlays:
Offsetting collections (cash) from:
Federal sources:
88.00
Federal sources ................................................ ...................
¥60
88.00
Federal sources ................................................ ................... ...................

¥90
¥475

88.90

¥60

¥565

102,522
108,534

114,821
114,821

2000 est.

108,258
6,018
545
90
475
115,386

89.00
90.00

Total, offsetting collections (cash) .................. ...................
Net budget authority and outlays:
Budget authority ............................................................
Outlays ...........................................................................

99,591
101,234

Summary of Budget Authority and Outlays
(in millions of dollars)

Enacted/requested:
1998 actual
1999 est.
Budget Authority .....................................................................
99,591
102,522
Outlays ....................................................................................
101,234
108,534
Legislative proposal, subject to PAYGO:
Budget Authority ..................................................................... .................... ....................
Outlays .................................................................................... .................... ....................
Total:
Budget Authority .....................................................................
Outlays ....................................................................................

99,591
101,234

102,522
108,534

2000 est.

114,821
114,821
–161
–161
114,660
114,660

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.
Object Classification (in millions of dollars)
1998 actual

Identification code 75–0512–0–1–551

41.0
99.0

4,026 ................... ...................

Direct obligations: Grants, subsidies, and contributions ...........................................................................
104,495
Reimbursable obligations: Subtotal, reimbursable obligations ....................................................................... ...................
Total new obligations ................................................

GRANTS

110,507
108,594
115,386
¥104,495 ¥108,594 ¥115,386
6,012 ................... ...................

104,495

1999 est.

2000 est.

108,534

114,821

565

108,594

115,386

STATES

FOR

MEDICAID

Program and Financing (in millions of dollars)
Identification code 75–0512–4–1–551

74,594
86,087
127 ...................

(Legislative proposal, subject to PAYGO)

1998 actual

1999 est.

2000 est.

99,591

10.00

Obligations by program activity:
Total new obligations (object class 41.0) ..................... ................... ...................

¥161

28,734

22.00
23.95

¥161
161

90
475

40.00

New budget authority (gross), detail:
Appropriation .................................................................. ................... ...................

¥161

73.10
73.20

¥161
161

86.90

Spending authority from offsetting collections
(total) ........................................................... ...................

5,504

6,012 ...................
102,582
115,386

Appropriation (total) .............................................
71,602
74,721
Permanent:
Advance appropriation (definite) ..............................
27,989
27,801
Spending authority from offsetting collections:
Offsetting collections (cash):
Offsetting collections (cash) ............................ ...................
60
Offsetting collections (cash) ............................ ................... ...................

Total new budget authority (gross) ..........................

5,504

99.9
6,890
99,591

New budget authority (gross), detail:
Current:
40.00
Appropriation .............................................................
71,602
40.05
Appropriation (indefinite) .......................................... ...................
43.00

1999 est.

Obligations by program activity:
Medicaid vendor payments ............................................
99,137
102,265
State and local administration .....................................
4,973
5,740
Vaccine purchases .........................................................
385
528
Medicare Part B premium transfer ............................... ...................
60
State Children’s Health Insurance Program .................. ................... ...................

10.00

23.90
23.95
24.40

1998 actual

5,504

259

Federal Funds

Unpaid obligations, end of year: Obligated balance,
end of year ................................................................

87.00

HEALTH CARE FINANCING ADMINISTRATION

GRANTS

443

Outlays (gross), detail:
Outlays from new current authority .............................. ................... ...................

¥161

89.00
90.00

¥161
¥161

86,087

565

102,582

115,386

6,268
5,504
5,504
104,495
108,594
115,386
¥101,234 ¥108,594 ¥115,386
¥4,026 ................... ...................

444

HEALTH CARE FINANCING ADMINISTRATION—Continued
Federal Funds—Continued

THE BUDGET FOR FISCAL YEAR 2000

General and special funds—Continued
GRANTS

STATES

FOR

MEDICAID—Continued

This schedule reflects the effects of proposals contained in
the Budget on the Grants to States for Medicaid account.
PAYMENTS

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. Since
1992, amounts have been included for non-Medicare activities
of HCFA Program Management.
Object Classification (in millions of dollars)

HEALTH CARE TRUST FUNDS

For payment to the Federal Hospital Insurance and the Federal
Supplementary Medical Insurance Trust Funds, as provided under
sections 217(g) and 1844 of the Social Security Act, sections 103(c)
and 111(d) of the Social Security Amendments of 1965, section 278(d)
of Public Law 97–248, and for administrative expenses incurred pursuant to section 201(g) of the Social Security Act, ø$62,953,000,000¿
$69,289,100,000. (Department of Health and Human Services Appropriations Act, 1999, as included in Public Law 105–277, section
101(f).)

1998 actual

Identification code 75–0580–0–1–571

1999 est.

2000 est.

41.0
42.0
92.0

Grants, subsidies, and contributions ............................
Insurance claims and indemnities ................................
Undistributed .................................................................

65,049
34
101

68,164
652
125

75,188
470
129

99.9

Total new obligations ................................................

65,184

68,941

75,787

PAYMENTS

Program and Financing (in millions of dollars)

HEALTH CARE TRUST FUNDS

Legislative proposal, not subject to PAYGO)
1998 actual

Identification code 75–0580–0–1–571

1999 est.

2000 est.

Program and Financing (in millions of dollars)
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) .............................................................................
00.08 Fraud and abuse control, FBI ........................................
00.10 Fraud and abuse control, criminal fines ......................
00.11 Fraud and abuse control, civil monetary penalties
00.12 Other ..............................................................................
00.01
00.02
00.03
00.04
00.06

10.00

Total new obligations ................................................

Budgetary resources available for obligation:
22.00 New budget authority (gross) ........................................
23.95 Total new obligations ....................................................
23.98 Unobligated balance expiring ........................................
New budget authority (gross), detail:
Current:
40.00
Appropriation .............................................................
Permanent:
60.00
Appropriation .............................................................
60.05
Appropriation (indefinite) ..........................................

59,919
¥52
86
101

61,879
555
97
125

68,690
349
121
129

1998 actual

1999 est.

2000 est.

65,184

66,033
¥65,184
¥849

68,941

60,904

62,953

69,289

56
5,073

66
6,219

76
6,422

Appropriation (total) .............................................

5,129

6,285

6,498

70.00

Total new budget authority (gross) ..........................

66,033

69,238

75,787

73.10
73.20

Change in unpaid obligations:
Total new obligations ....................................................
Total outlays (gross) ......................................................

65,184
¥65,184

68,941
¥68,941

75,787
¥75,787

86.90
86.97

Outlays (gross), detail:
Outlays from new current authority ..............................
Outlays from new permanent authority .........................

60,055
5,129

62,656
6,285

69,289
6,498

87.00

Total outlays (gross) .................................................

65,184

68,941

75,787

89.00
90.00

Net budget authority and outlays:
Budget authority ............................................................
Outlays ...........................................................................

66,033
65,184

69,238
68,941

75,787
75,787

Summary of Budget Authority and Outlays
(in millions of dollars)

66,033
65,184

69,238
68,941

Obligations by program activity:
Supplementary medical insurance (SMI) ....................... ................... ...................

¥469

10.00

Total new obligations (object class 41.0) ................ ................... ...................

¥469

22.00
23.95

¥469
469

New budget authority (gross), detail:
Appropriation .................................................................. ................... ...................

¥469

73.10
73.20

¥469
469

86.90

Outlays (gross), detail:
Outlays from new current authority .............................. ................... ...................

¥469

89.00
90.00

¥469
¥469

75,787

69,238
75,787
¥68,941
¥75,787
¥297 ...................

Enacted/requested:
1998 actual
1999 est.
Budget Authority .....................................................................
66,033
69,238
Outlays ....................................................................................
65,184
68,941
Legislative proposal, not subject to PAYGO:
Budget Authority ..................................................................... .................... ....................
Outlays .................................................................................... .................... ....................

00.01

40.00

5,067
6,213
6,416
56
66
76
3
4
4
2
2
2
2 ................... ...................

63.00

Total:
Budget Authority .....................................................................
Outlays ....................................................................................

Identification code 75–0580–2–1–571

2000 est.

75,787
75,787
–469
–469
75,318
75,318

Payments are made (1) to the Federal Supplementary Medical Insurance Trust Fund; and (2) to the Federal Hospital

This schedule reflects the effects of the Medicare proposals
contained in the Budget on the Payments to Health Care
Trust Funds account.
PROGRAM MANAGEMENT
For carrying out, except as otherwise provided, titles XI, XVIII,
XIX and XXI of the Social Security Act, titles XIII and XXVII of
the Public Health Service Act, and the Clinical Laboratory Improvement Amendments of 1988, not to exceed ø$1,946,500,000¿
$2,016,126,000, 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 and such sums as may be collected from authorized user
fees and the sale of data, which shall remain available until expended, and together with administrative fees collected relative to
Medicare overpayment recovery activities, which shall be transferred
to the Health Care Fraud and Abuse Control (HCFAC) account and
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 shall be credited
to and available for carrying out the purposes of this appropriation:
øProvided further, That $1,000,000 shall be for carrying out section
4021 of Public Law 105–33:¿ Provided further, That ø$45,000,000¿
$18,000,000 appropriated under this heading for the øtransition to
a single Part A and Part B processing system and for Year 2000
century date change conversion requirements of external contractor
systems¿ managed care system redesign shall remain available until

HEALTH CARE FINANCING ADMINISTRATION—Continued
Federal Funds—Continued

DEPARTMENT OF HEALTH AND HUMAN SERVICES
expended: øProvided further, That $2,000,000 of the amount available
for research, demonstration, and evaluation activities shall be available to continue carrying out demonstration projects on Medicaid
coverage of community-based attendant care services for people with
disabilities which ensures maximum control by the consumer to select
and manage their attendant care services: Provided further, That
funds appropriated under this heading may be obligated to increase
Medicare provider audits and implement the Department’s corrective
action plan to the Chief Financial Officer’s audit of the Health Care
Financing Administration’s oversight of Medicare:¿ Provided further,
That the Secretary of Health and Human Services is directed to
collect, in aggregate, ø$95,000,000¿ $100,000,000 in fees in fiscal
year ø1999¿ 2000 from Medicare∂Choice organizations pursuant to
section 1857(e)(2) of the Social Security Act and from eligible organizations with risk-sharing contracts under section 1876 of that Act
pursuant to section 1876(k)(4)(D) of that Act. (Department of Health
and Human Services Appropriations Act, 1999, as included in Public
Law 105–277, section 101(f).)
Program and Financing (in millions of dollars)
Identification code 75–0511–0–1–550

1998 actual

1999 est.

2000 est.

89.00
90.00

Total, offsetting collections (cash) ..................
From Federal sources: Adjustment to receivables and
unpaid, unfilled orders ..............................................

445

¥1,631
¥143

¥1,947
¥140

¥2,016
¥145

¥1,774

¥2,087

¥2,161

¥114 ................... ...................

Net budget authority and outlays:
Budget authority ............................................................
Outlays ...........................................................................

44 ................... ...................
¥40
20 ...................

Summary of Budget Authority and Outlays
(in millions of dollars)

.................... ....................
.................... ....................

10
10

44 ....................
–41
20

10
10

1998 actual

1999 est.

2000 est.

44 .................... ....................
–41
20 ....................
.................... .................... ....................
.................... .................... ....................

Obligations by program activity:
Direct program:
00.01
Research, demonstrations, and evaluation projects
00.02
Medicare contractors .................................................
00.04
State certification ......................................................
00.05
Administrative costs ..................................................

51
1,192
153
367

50
1,290
171
456

55
1,274
204
483

Total:
Budget Authority .....................................................................
Outlays ....................................................................................

00.91

1,763

1,967

2,016

08.01
08.02

Total direct program .............................................
Reimbursable program:
CLIA ...........................................................................
Other reimbursements ...............................................

33
95

43
97

43
102

Program management activities include funding for research, Medicare contractors, survey and certification, CLIA,
Medicare + Choice, and administrative costs.

08.91

Total reimbursable program .................................

128

140

145

10.00

Total new obligations ................................................

1,891

2,107

2,161

21.40
22.00
22.10
23.90
23.95
23.98
24.40

18
1,932

55
2,087

35
2,161

2 ................... ...................

1,952
2,142
2,196
¥1,891
¥2,107
¥2,161
¥6 ................... ...................
55
35
35

New budget authority (gross), detail:
Current:
42.00
Transferred from other accounts ..............................

44 ................... ...................

43.00

44 ................... ...................

68.00
68.00
68.15
68.90
70.00

Appropriation (total) .............................................
Permanent:
Spending authority from offsetting collections:
Offsetting collections (cash):
Offsetting collections (cash) ............................
Offsetting collections (cash) ............................
From Federal sources: Adjustments to receivables and unpaid, unfilled orders ...................

1,631
143

1,947
140

2,016
145

1,888

2,087

2,161

Total new budget authority (gross) ..........................

1,932

2,087

2,161

495
280
280
1,891
2,107
2,161
¥1,733
¥2,107
¥2,161
¥370 ................... ...................
¥2 ................... ...................
280

280

Outlays (gross), detail:
86.97 Outlays from new permanent authority .........................
86.98 Outlays from permanent balances ................................

1,732
1

2,087
2,161
20 ...................

87.00

1,733

2,107

Total outlays (gross) .................................................

2,161

1998 actual

Identification code 75–0511–0–1–550

11.1
11.3
11.5
11.9
12.1
21.0
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 ..................................

1999 est.

2000 est.

227
5
2

269
5
2

285
5
4

234
46
6
13
22
22
3
318

276
53
7
25
19
28
5
372

294
56
11
21
18
29
5
416

25.6
26.0
31.0
32.0
41.0

Total personnel compensation ..............................
Civilian personnel benefits ............................................
Travel and transportation of persons ............................
Rental payments to GSA ................................................
Communications, utilities, and miscellaneous charges
Printing and reproduction ..............................................
Advisory and assistance services ..................................
Other services ................................................................
Purchases of goods and services from Government
accounts ....................................................................
Medical care ..................................................................
Supplies and materials .................................................
Equipment ......................................................................
Land and structures ......................................................
Grants, subsidies, and contributions ............................

16
1,163
2
13
10
23

7
1,286
1
7
10
11

17
1,270
1
2
10
11

99.9

Total new obligations ................................................

1,891

2,107

2,161

114 ................... ...................

Spending authority from offsetting collections
(total) ...........................................................

Change in unpaid obligations:
72.40 Unpaid obligations, start of year: Obligated balance,
start of year ..............................................................
73.10 Total new obligations ....................................................
73.20 Total outlays (gross) ......................................................
73.40 Adjustments in expired accounts ..................................
73.45 Adjustments in unexpired accounts ..............................
74.40 Unpaid obligations, end of year: Obligated balance,
end of year ................................................................

Object Classification (in millions of dollars)

Personnel Summary
Identification code 75–0511–0–1–550

1998 actual

1999 est.

Direct:
Total compensable workyears: Full-time equivalent
employment ...............................................................
3,942
4,267
Allocation account:
3001 Total compensable workyears: Full-time equivalent
employment ............................................................... ................... ...................

2000 est.

1001

4,232

PROGRAM MANAGEMENT
(Legislative proposal, not subject to PAYGO)
Contingent upon enactment of authorization to establish fees to cover
administrative costs of the Health Care Financing Administration and
its contractors, such fees may be collected and credited to this account
as offsetting collections, to remain available until expended for authorized purposes: Provided, That upon enactment of such authorizing
legislation, the amount appropriated for fiscal year 2000 from the

446

HEALTH CARE FINANCING ADMINISTRATION—Continued
Federal Funds—Continued

THE BUDGET FOR FISCAL YEAR 2000

General and special funds—Continued
PROGRAM MANAGEMENT—Continued
Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds shall be reduced by $194,450,000: Provided further, That contingent upon enactment of an amendment to section
1857(e)(2) of the Social Security Act which increases fees, the Secretary
of Health and Human Services is directed to collect, in aggregate,
$150,000,000 in user fees in fiscal year 2000 from Medicare+Choice
organizations to implement the Medicare+Choice education campaign.

posed contingent upon the enactment of authorizing legislation. The authorizing legislation will be proposed to authorize
the collection and spending of the fee subject to appropriations action.
Object Classification (in millions of dollars)
Identification code 75–0511–2–1–550

25.2
99.0

Program and Financing (in millions of dollars)
Identification code 75–0511–2–1–550

1998 actual

1999 est.

Obligations by program activity:
Direct program:
00.02
Medicare contractor appropriation ............................ ................... ...................
00.03
Survey and certification appropriation ..................... ................... ...................
00.04
Federal administration appropriation ....................... ................... ...................
01.92
09.02
09.03
09.04
09.05
09.06
09.07
09.08

Total direct program/appropriation ...........................
Reimbursable program:
Medicare + Choice Information Campaign ..............
Initial survey and certification ..................................
Survey and certification recertification .....................
Duplicate and unprocessable claims ........................
Paper claims .............................................................
Provider enrollment ...................................................
Health plan applications ...........................................

................... ...................
...................
...................
...................
...................
...................
...................
...................

2000 est.

99.9

¥93
¥65
¥37

09.09

Total reimbursable program ...................................... ................... ...................

244

10.00

Total new obligations ................................................ ................... ...................

Outlays (gross), detail:
86.97 Outlays from new permanent authority ......................... ................... ...................
Offsets:
Against gross budget authority and outlays:
Offsetting collections (cash) from:
88.00
Federal sources ..................................................... ................... ...................
88.40
Non-Federal sources ............................................. ................... ...................
88.90

89.00
90.00

Total, offsetting collections (cash) .................. ................... ...................

Direct obligations: Other services ................................. ................... ...................
Reimbursable obligations: Subtotal, reimbursable obligations ....................................................................... ................... ...................

¥194

Total new obligations ................................................ ................... ...................

244

PROGRAM MANAGEMENT

Program and Financing (in millions of dollars)

2000 est.

(Legislative proposal, subject to PAYGO)
50
10
55
18
55
20
37

New budget authority (gross), detail:
68.00 Spending authority from offsetting collections (gross):
Offsetting collections (cash) ..................................... ................... ...................

1999 est.

¥194

...................
...................
...................
...................
...................
...................
...................

1998 actual

Identification code 75–0511–4–1–550

1998 actual

1999 est.

2000 est.

10.00

Total new obligations (object class 41.0) ................ ................... ...................

22.00
23.95

10
¥10

60.00

New budget authority (gross), detail:
Appropriation .................................................................. ................... ...................

73.10
73.20

10
¥10

86.97

Outlays (gross), detail:
Outlays from new permanent authority ......................... ................... ...................

89.00
90.00

50
¥50

Obligations by program activity:
Direct program:
00.01
Research, demonstrations, and evaluation projects ................... ...................

10
10

50
¥50

194
¥244
¥50

The Budget includes $194.5 million in new user fees to
finance HCFA activities. Proposed fees include: a duplicate
or unprocessable claims fee; a paper claims fee; a physician,
provider, and supplier enrollment registration fee, a managed
care organization application and renewal fee; an initial survey and certification fee; and a recertification fee. If the authorizing legislation is enacted, the amount appropriated from
the Federal Hospital Insurance and Federal Supplementary
Medical Insurance Trust Funds will be reduced by $194.5
million. Additional appropriations language is being proposed
contingent upon the enactment of authorizing legislation. The
authorizing legislation will be proposed to authorize the collection and spending of the fee subject to appropriations action. Contingent upon the enactment of authorizing legislation, the budget also authorizes the Secretary to collect up
to $150 million in user fees to finance the Medicare+Choice
education campaign, $50 million more than is currently authorized. Additional appropriations language is being pro-

This schedule reflects the effects on the Program Management account of the Administration’s proposal to create a
time-limited demonstration of Medicare coverage of patient
care costs associated with Medicare beneficiary participation
in certain clinical trials for cancer.

STATE CHILDREN’S HEALTH INSURANCE FUND
øSEC. 706. (a) Section 2104(c) of the Social Security Act (42 U.S.C.
1397dd(c)) is amended by adding at the end the following new paragraph:
‘‘(4) ADDITIONAL ALLOTMENT.—
‘‘(A) IN GENERAL.—In addition to the allotment under paragraph (1), the Secretary shall allot each commonwealth and territory described in paragraph (3) the applicable percentage specified in paragraph (2) of the amount appropriated under subparagraph (B).
‘‘(B) APPROPRIATIONS.—For purposes of providing allotments
pursuant to subparagraph (A), there is appropriated, out of any
money in the Treasury not otherwise appropriated $32,000,000
for fiscal year 1999.’’.
(b) Section 2104(b)(1) of such Act (42 U.S.C. 1397dd(b)(1)) is amended by inserting ‘‘(determined without regard to paragraph (4) thereof)’’
after ‘‘subsection (c)’’.¿ (Departments of Labor, Health and Human
Services, and Education, and Related Agencies Appropriations Act,
1999, as included in Public Law 105–277, section 101(f).)

HEALTH CARE FINANCING ADMINISTRATION—Continued
Trust Funds

DEPARTMENT OF HEALTH AND HUMAN SERVICES
73.10
73.20
74.40

Program and Financing (in millions of dollars)
1998 actual

Identification code 75–0515–0–1–551

10.00

Obligations by program activity:
Total obligations (object class 41.0) ............................

1999 est.

2000 est.

Outlays (gross), detail:
Outlays from new permanent authority ......................... ................... ...................
Outlays from permanent balances ................................ ................... ...................

34
2

485 ...................
4,247
4,215

87.00

Total outlays (gross) ................................................. ................... ...................

4,235
4,732
4,215
¥3,750
¥4,732
¥4,215
485 ................... ...................

89.00
90.00

34
36

4,732

4,215

23.90
23.95
24.40

Total budgetary resources available for obligation
Total new obligations ....................................................
Unobligated balance available, end of year .................

60.00
61.00

New budget authority (gross), detail:
Appropriation ..................................................................
Transferred to other accounts .......................................

4,295
¥60

4,307
¥60

4,275
¥60

63.00

Appropriation (total) ..................................................

4,235

4,247

4,215

Change in unpaid obligations:
Unpaid obligations, start of year: Obligated balance,
start of year .............................................................. ...................
73.10 Total new obligations ....................................................
3,750
73.20 Total outlays (gross) ......................................................
¥5
74.40 Unpaid obligations, end of year: Obligated balance,
end of year ................................................................
3,745

3,745
4,732
¥1,437

7,040
4,215
¥1,900

7,040

9,355

32
1,405

475
1,425

72.40

Outlays (gross), detail:
Outlays from new permanent authority .........................
5
Outlays from permanent balances ................................ ...................

87.00

Total outlays (gross) .................................................

1,437

1,900

89.00
90.00

Net budget authority and outlays:
Budget authority ............................................................
Outlays ...........................................................................

4,235
5

4,247
1,437

4,215
1,900

This schedule reflects the effects of the CHIP proposals
contained in the Budget on the State Children’s Health Insurance Fund.
HEALTH MAINTENANCE ORGANIZATION LOAN
FUND

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
the Public Health Service Act, to be available without fiscal year
limitation for the payment of outstanding obligations. During fiscal
year ø1999¿ 2000, no commitments for direct loans or loan guarantees shall be made. (Department of Health and Human Services Appropriations Act, 1999, as included in Public Law 105–277, section
101(f).)
Program and Financing (in millions of dollars)
1998 actual

Identification code 75–4420–0–3–551

Summary of Budget Authority and Outlays

1999 est.

Enacted/requested:
1998 actual
1999 est.
Budget Authority .....................................................................
4,235
4,247
Outlays ....................................................................................
5
1,437
Legislative proposal, subject to PAYGO:
Budget Authority ..................................................................... .................... ....................
Outlays .................................................................................... .................... ....................
4,235
5

4,247
1,437

2000 est.

4,215
1,900
34
36

21.40
22.00
22.60

10
2
¥1

11
2
¥1

11
1
¥1

23.90
24.40

Total budgetary resources available for obligation
Unobligated balance available, end of year .................

11
11

12
11

11
11

New budget authority (gross), detail:
Spending authority from offsetting collections (gross):
Offsetting collections (cash) .....................................

Offsets:
Against gross budget authority and outlays:
88.40
Offsetting collections (cash) from: Other .................

¥2

¥1

4,249
1,936

The Balanced Budget Act of 1997 established the Children’s
Health Insurance Program (CHIP) under Title XXI of the
Social Security Act. Title XXI provides Federal matching
funds to States to enable them to extend coverage to uninsured children from low-income families. States are able to
use Title XXI funds for obtaining health benefit coverage for
uninsured children through a CHIP State program, a CHIP
Medicaid expansion program, or a combination of both.

89.00
90.00

STATE CHILDREN’S HEALTH INSURANCE FUND

Trust Funds

(Legislative proposal, subject to PAYGO)

FEDERAL HOSPITAL INSURANCE TRUST FUND

Program and Financing (in millions of dollars)

Unavailable Collections (in millions of dollars)

Identification code 75–0515–4–1–551

1998 actual

1999 est.

Identification code 20–8005–0–7–571

2000 est.

10.00

Obligations by program activity:
Total obligations (object class 41.0) ............................ ................... ...................

22.00
23.95

34
¥34

60.00

New budget authority (gross), detail:
Appropriation .................................................................. ................... ...................

72.40

2000 est.

68.00

(in millions of dollars)

Total:
Budget Authority .....................................................................
Outlays ....................................................................................

Total new obligations .................................................... ................... ...................
34
Total outlays (gross) ...................................................... ................... ...................
¥36
Unpaid obligations, end of year: Obligated balance,
end of year ................................................................ ...................
2 ...................

86.97
86.98

3,750

Budgetary resources available for obligation:
21.40 Unobligated balance available, start of year ............... ...................
22.00 New budget authority (gross) ........................................
4,235

86.97
86.98

447

1998 actual

1999 est.

2000 est.

Balance, start of year:
Balance, start of year ....................................................
115,440
116,434
116,938
Receipts:
02.01 Transfers from general fund (FICA taxes) .....................
110,455
118,474
122,677
02.02 Receipts from Railroad Retirement Board ....................
381
404
410
02.03 Transfers from general fund (SECA taxes) ...................
9,029
8,485
8,895
02.04 Federal employer contributions (FICA) ...........................
1,825
1,886
1,983
02.05 Postal service employer contributions (FICA) ................
607
610
638
02.07 Interest received by trust funds ....................................
9,115
9,112
9,068
02.08 Other proprietary receipts from the public ...................
1 ................... ...................
02.09 Transfers from general fund (FICA taxes), legislative
proposal subject to PAYGO ....................................... ................... ...................
2
02.10 Taxation on OASDI benefits ...........................................
5,067
6,213
6,416
02.11 Deposits by States .........................................................
¥2 ................... ...................
01.99

448

HEALTH CARE FINANCING ADMINISTRATION—Continued
Trust Funds—Continued

THE BUDGET FOR FISCAL YEAR 2000
Memorandum (non-add) entries:
Total investments, start of year: U.S. securities: Par
value ..........................................................................
92.02 Total investments, end of year: U.S. securities: Par
value ..........................................................................

FEDERAL HOSPITAL INSURANCE TRUST FUND—Continued

92.01

Unavailable Collections (in millions of dollars)—Continued
Identification code 20–8005–0–7–571

02.12
02.13

1998 actual

1999 est.

777
71

599
63

1,352
66
4

1,393
76
4

2
108
2

2
113
11

147,605

152,387

Total: Balances and collections ....................................
253,644
264,039
Appropriation:
05.01 Federal hospital insurance trust fund .......................... ¥136,537 ¥146,337
05.02 Health care fraud and abuse control account ..............
¥659
¥764
05.04 Federal hospital insurance trust fund, legislative proposal subject to PAYGO ............................................ ................... ...................
05.05 Federal hospital insurance trust fund, legislative proposal, discretionary offset ......................................... ................... ...................
05.06 Federal hospital insurance trust fund, legislative proposal not subject to PAYGO ...................................... ................... ...................

269,325

02.20
02.21
02.99

Total receipts .............................................................

Subtotal appropriation ...................................................
Unobligated balance returned to receipts .....................
Total balance, end of year ............................................

138,204

¥145,985
¥864
163
645
116

¥137,196 ¥147,101 ¥145,925
¥14 ................... ...................
116,434
116,938
123,400

Program and Financing (in millions of dollars)
Identification code 20–8005–0–7–571

1998 actual

118,250

117,633

123,973

(in millions of dollars)

04.00

05.99
06.10
07.99

117,633

Summary of Budget Authority and Outlays

02.16
02.17
02.18

118,250

2000 est.

02.14
02.15

Interest payments by Railroad Retirement Board .........
39
Payments from the general fund (uninsured and program management) ...................................................
136
Payments for military service credits ............................
67
Premiums collected for uninsured individuals not otherwise eligible ...........................................................
1,320
FBI, Payment from the general fund .............................
56
Criminal fines, transfers from the general fund ..........
3
Civil monetary penalties, transfers from the general
fund ...........................................................................
2
Civil penalties and damages ........................................
103
Transfers from DOD, HI ................................................. ...................

116,621

1999 est.

2000 est.

Enacted/requested:
Budget Authority .....................................................................
Outlays ....................................................................................
Legislative proposal, not subject to PAYGO:
Budget Authority .....................................................................
Outlays ....................................................................................
Legislative proposal, subject to PAYGO:
Budget Authority .....................................................................
Outlays ....................................................................................
Legislative proposal, discretionary offset:
Budget Authority .....................................................................
Outlays ....................................................................................
Total:
Budget Authority .....................................................................
Outlays ....................................................................................

1998 actual

136,537
136,690

1999 est.

2000 est.

146,336
146,018

145,985
146,106

.................... ....................
.................... ....................

–116
–116

.................... ....................
.................... ....................

–163
–163

.................... ....................
.................... ....................

–645
–645

136,537
136,690

146,336
146,018

145,061
145,182

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:
Status of Funds (in millions of dollars)
Identification code 20–8005–0–7–571

0100
0101

Unexpended balance, start of year:
Treasury balance ............................................................
U.S. Securities: Par value ..............................................

1998 actual

¥619
116,621

1999 est.

¥1,342
118,250

2000 est.

2
117,633

0199

Obligations by program activity:
00.01 Benefit payments, HI .....................................................
00.02 Administration, HI ..........................................................
00.03 Peer review organizations, HI ........................................
00.04 Research, HI ...................................................................
00.05 HI partial transfer of home health to SMI ....................

134,283
1,209
36
31
978

130,990
1,346
553
30
13,417

136,116
1,436
89
33
8,311

10.00

Total new obligations ................................................

136,537

146,336

145,985

22.00
23.95

Budgetary resources available for obligation:
New budget authority (gross) ........................................
Total new obligations ....................................................

136,537
¥136,537

146,336
¥146,336

145,985
¥145,985

New budget authority (gross), detail:
Current:
40.26
Appropriation (trust fund, definite) ..........................
Permanent:
60.27
Appropriation (trust fund, indefinite) .......................
60.28
Appropriation (unavailable balances) .......................

1,196

1,331

1,423

136,348
¥1,007

145,510
¥504

150,098
¥5,536

63.00

Appropriation (total) .............................................

135,341

145,005

144,562

70.00

Total new budget authority (gross) ..........................

136,537

146,336

145,985

505
136,537
¥136,690

352
146,336
¥146,019

669
145,985
¥146,107

352

669

547

72.40

86.90
86.93
86.97
86.98

1,077
127
135,108
378

1,211
130
144,456
221

1,301
145
144,136
524

87.00

Total outlays (gross) .................................................

136,690

146,019

146,107

89.00
90.00

Net budget authority and outlays:
Budget authority ............................................................
Outlays ...........................................................................

136,537
136,690

146,336
146,019

145,985
146,107

Total balance, start of year ......................................
116,002
116,908
117,635
Cash income during the year:
Governmental receipts:
Governmental receipts:
0200
FHI trust fund, transfers from general fund
(FICA taxes) ......................................................
110,455
118,474
122,677
0200
FHI trust fund, transfers from general fund
(FICA taxes) ...................................................... ................... ...................
2
0201
FHI trust fund, transfers from general fund (SECA
taxes) ....................................................................
9,029
8,485
8,895
0205
FHI trust fund, receipts from Railroad Retirement
Board .....................................................................
381
404
410
0206
HCFAC: Civil penalties and damages .......................
103
108
113
0207
FHI trust fund, deposits by States ...........................
¥2 ................... ...................
Proprietary receipts:
0221
FHI trust fund, premiums collected for uninsured
individuals not otherwise eligible ........................
1,320
1,352
1,393
0222
Other proprietary receipts .........................................
1 ................... ...................
Intragovernmental transactions:
0240
FHI trust fund, Federal employer contributions
(FICA) ....................................................................
1,825
1,886
1,983
0241
FHI trust fund, Postal Service employer contributions (FICA) ...........................................................
607
610
638
0242
FHI trust fund, Federal payment for transitional
coverage for uninsured Federal employees ..........
86
97
121
0243
FHI trust fund, Federal payment for transitional
coverage for the uninsured ..................................
¥52
555
349
0245
FHI trust fund, general fund transfer, Program
management (HI) ..................................................
102
125
129
0246
FHI trust fund, Federal payments for OASDI taxes
5,067
6,213
6,416
0248
FHI trust fund, interest payment from Railroad
Retirement Board ..................................................
39
39
37
0249
FHI trust fund, interest on investments ...................
9,115
9,112
9,068
0251
FHI trust fund, transfer from Department of Defense for military service credits .........................
67
71
63
0252
HCFAC: FBI ................................................................
56
66
76
0253
HCFAC: Criminal fines ...............................................
3
4
4
0254
HCFAC: Civil monetary penalties ..............................
2
2
2
0255
Other intragovernmental transactions ...................... ...................
2
11
Offsetting collections:
0281
HCFAC user fees ........................................................
1 ................... ...................
0297 Income under present law .............................................
138,205
147,605
152,385
0298 Income under proposed legislation ............................... ................... ...................
2
0299

Total cash income .....................................................
Cash outgo during year:
0500 Benefit payments ...........................................................

138,205

147,605

152,387

¥134,321

¥130,989

¥136,115

HEALTH CARE FINANCING ADMINISTRATION—Continued
Trust Funds—Continued

DEPARTMENT OF HEALTH AND HUMAN SERVICES

0501
0501
0502
0503
0504
0505
0506
0507
0597
0598

Cash outgo during the year (¥):
Benefit payments (proposed legislation) ..................
Benefit payments (proposed legislation) ..................
Administration ................................................................
Administration ................................................................
Peer review organizations ..............................................
Research ........................................................................
HCFAC ............................................................................
HI partial transfer of home health to SMI ....................
Outgo under present law (¥) ......................................
Outgo under proposed legislation (¥) .........................

449

FEDERAL HOSPITAL INSURANCE TRUST FUND
...................
...................
¥1,171
...................
¥188
¥32
¥609
¥978
¥137,299
...................

...................
...................
¥1,311
...................
¥270
¥31
¥860
¥13,417
¥146,878
...................

163
645
¥1,415
116
¥233
¥32
¥864
¥8,311
¥146,970
924

¥137,299

¥146,878

¥146,046

¥1,342
118,250

2
117,633

3
123,973

116,908

117,635

123,976

(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 20–8005–4–7–571

1998 actual

1999 est.

2000 est.

Total cash outgo (¥) ...................................................
Unexpended balance, end of year:
0700 Treasury Balance ...........................................................
0701 U.S. Securities: Par value ..............................................
0799

Total balance, end of year ........................................

Obligations by program activity:
Total new obligations (object class 42.0) ..................... ................... ...................

¥163

22.00
23.95

¥163
163

60.27
60.28

New budget authority (gross), detail:
Appropriation (trust fund, indefinite) ............................ ................... ...................
Appropriation (unavailable balances) ........................... ................... ...................

2
¥165

63.00

0599

10.00

Appropriation (total) .................................................. ................... ...................

¥163

73.10
73.20

¥163
163

86.97

Outlays (gross), detail:
Outlays from new permanent authority ......................... ................... ...................

¥163

¥163
¥163

Object Classification (in millions of dollars)
Identification code 20–8005–0–7–571

41.0
41.0
42.0
92.0
92.0
92.0
93.0
99.9

Grants, subsidies, and contributions:
Payment for health insurance experiments and
demonstration projects .........................................
Payment for peer review organization (PRO) activities ........................................................................
Insurance claims and indemnities ................................
Undistributed:
HI Partial Transfer of Home Health to SMI ..............
Reimbursement for administrative expenses for
other than SSA LAE ..............................................
Purchases of goods and services .............................
Administrative expenses: Portion of limitation on salaries and expenses: Social Security Administration
Total new obligations ................................................

1998 actual

1999 est.

2000 est.

36
134,283

553
130,990

89
136,116

978

13,417

8,311

89.00
90.00

44
639

45
737

46
784

92.01

526

564

606

136,537

146,336

145,985

Memorandum (non-add) entries:
Total investments, start of year: U.S. securities: Par
value .......................................................................... ................... ................... ...................
92.02 Total investments, end of year: U.S. securities: Par
value .......................................................................... ................... ...................
163

This schedule reflects the effects of the Medicare proposals
contained in the Budget on the Hospital Insurance Trust
Fund.

FEDERAL HOSPITAL INSURANCE TRUST FUND
(Legislative proposal, subject to PAYGO)

FEDERAL HOSPITAL INSURANCE TRUST FUND

Program and Financing (in millions of dollars)
Identification code 20–8005–2–7–571

1998 actual

(Legislative proposal, subject to offset)
1999 est.

Obligations by program activity:
10.00 Total new obligations (object class 92.0) ..................... ................... ...................

2000 est.

¥116

Program and Financing (in millions of dollars)
Identification code 20–8005–6–7–571

1998 actual

1999 est.

2000 est.

New budget authority (gross), detail:
40.26 Appropriation (trust fund, definite) ............................... ................... ...................

10.00

Obligations by program activity:
Total new obligations (object class 42.0) ..................... ................... ...................

¥645

22.00
23.95

¥645
645

60.28

New budget authority (gross), detail:
Appropriation (unavailable balances) ........................... ................... ...................

¥645

73.10
73.20

¥645
645

86.97

Outlays (gross), detail:
Outlays from new permanent authority ......................... ................... ...................

¥645

89.00
90.00

¥645
¥645

¥116
116

¥116

¥116
116

86.90

Outlays (gross), detail:
Outlays from new current authority .............................. ................... ...................

¥116

89.00
90.00

¥116
¥116

Memorandum (non-add) entries:
Total investments, start of year: U.S. securities: Par
value .......................................................................... ................... ................... ...................
92.02 Total investments, end of year: U.S. securities: Par
value .......................................................................... ................... ...................
116

Memorandum (non-add) entries:
Total investments, start of year: U.S. securities: Par
value .......................................................................... ................... ................... ...................
92.02 Total investments, end of year: U.S. securities: Par
value .......................................................................... ................... ...................
645

92.01

This schedule reflects the effects of the HCFA user fees
proposed in this Budget on the Hospital Insurance Trust
Fund.

This schedule reflects the effects on the Hospital Insurance
Trust Fund of the Medicare proposals contained in this Budget used to offset discretionary spending.

450

HEALTH CARE FINANCING ADMINISTRATION—Continued
Trust Funds—Continued

HEALTH CARE FRAUD
(FEDERAL

AND

THE BUDGET FOR FISCAL YEAR 2000

21.0
21.0

ABUSE CONTROL ACCOUNT

HOSPITAL INSURANCE TRUST FUND)

Program and Financing (in millions of dollars)
Identification code 75–8393–0–7–571

00.01
00.02
00.03
09.01

Obligations by program activity:
Medicare integrity program ...........................................
FBI fraud and abuse control .........................................
Other fraud and abuse control ......................................
Reimbursable .................................................................

10.00

Total new obligations ................................................

60.26
68.00
70.00

New budget authority (gross), detail:
Appropriation (trust fund, definite) ...............................
Spending authority from offsetting collections: Offsetting collections (cash) ..............................................
Total new budget authority (gross) ..........................

Change in unpaid obligations:
Unpaid obligations, start of year: Obligated balance,
start of year ..............................................................
73.10 Total new obligations ....................................................
73.20 Total outlays (gross) ......................................................
73.40 Adjustments in expired accounts ..................................
74.40 Unpaid obligations, end of year: Obligated balance,
end of year ................................................................

1998 actual

1999 est.

2000 est.

23.1
23.1
23.1
23.3

499
560
630
56
66
76
104
138
158
1 ................... ...................

25.2
25.2
25.2

660

25.3

764

864

25.3
660
¥660

764
¥764

864
¥864

659

764

864

1 ................... ...................
660

764

57
122
26
660
764
864
¥609
¥860
¥864
14 ................... ...................
26

86.97
86.98

Outlays (gross), detail:
Outlays from new permanent authority .........................
Outlays from permanent balances ................................

552
57

764
864
96 ...................

87.00

Total outlays (gross) .................................................

609

860

Net budget authority and outlays:
89.00 Budget authority ............................................................
90.00 Outlays ...........................................................................

659
608

764
860

864
864

Object Classification (in millions of dollars)

99.0

11.1
11.1
11.1
11.3
11.8

12.1
12.1

9
3
1

10
3
1

5
6
6
1 ................... ...................
1
2 ...................

2
1
1
1

2
1
2
2

2
1
3
1

Subtotal, allocation account .................................

105

138

158

99.9

Total new obligations ................................................

660

764

864

This schedule reflects estimated distribution of the allocation account. Actual FY 2000 distribution will be determined
by the Secretary of HHS and the Attorney General.
1998 actual

1999 est.

2000 est.

Department of Justice (DOJ) .......................................................
Office of the Inspector General, HHS ..........................................
Health Care Financing Administration ........................................
Office of General Counsel, HHS ..................................................
Administration on Aging .............................................................
Other HHS ....................................................................................

28
72
1
2
1
1

32
100
0
2
1
3

34
120
0
3
1
0

Total ....................................................................................

105

138

158

1998 actual

Unavailable Collections (in millions of dollars)
Identification code 20–8004–0–7–571

Balance, start of year:
01.99 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 Transfers from DOD, SMI ...............................................
02.09 Premiums collected for the aged, proposed legislation
02.10 Premiums collected for the disabled, proposed legislation ............................................................................
02.12 Federal contributions, proposed legislation not subject
to PAYGO ...................................................................
02.99

Total receipts .............................................................

1998 actual

34,808

1999 est.

40,395

2000 est.

499
56

560
66

630
76

Subtotal, direct obligations ..................................
Allocation Account:
Personnel compensation:
Full-time permanent:
Full-time permanent (OIG) ...............................
Full-time permanent (DoJ) ...............................
Full-time permanent (OGC) ..............................
Other than full-time permanent (DoJ) ..................
Special personal services payments (DOJ) ...........

555

626

706

43
57
11
13
1
1
2
2
1 ...................

69
14
2
2
1

Total personnel compensation .........................
Civilian personnel benefits:
Civilian personnel benefits (OIG) .........................
Civilian personnel benefits (DoJ) ..........................

................... ...................
................... ...................
81,955

13
4

15
4

¥17
¥469
92,601

Total: Balances and collections ....................................
116,763
125,109
Appropriation:
05.01 Federal supplementary medical insurance trust fund
¥76,368
¥79,455
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 .............. ................... ...................

138,255
¥94,023

9
3

45,654

59,919
61,879
68,690
2,606
2,887
2,928
3 ................... ...................
17,153
17,529
18,914
2,274
2,418
2,662
...................
1
11
................... ...................
¥118

04.00

1999 est.

2000 est.

84,714

05.99
07.99

Subtotal appropriation ...................................................
Total balance, end of year ............................................

¥76,368
40,395

455
115
78

¥79,455
45,654

¥93,375
44,880

1999 est.

2000 est.

Program and Financing (in millions of dollars)
Identification code 20–8004–0–7–571

11.9

6
2
1

FEDERAL SUPPLEMENTARY MEDICAL INSURANCE TRUST FUND

The Health Care Fraud and Abuse Control (HCFAC) account was established by sec. 201 of Public Law 104–191,
the Health Insurance Portability and Accountability Act of
1996. P.L. 104–191 established the HCFAC account within
the Federal Hospital Insurance Trust Fund and appropriated
funds, to be available without further appropriation, from
the trust fund to the HCFAC account for specified health
care fraud and abuse control activities of the Department
of Health and Human Services (HHS), the Department of
Justice, and other agencies.

25.6
92.0

6
1

99.0

¥1 ................... ...................

Direct obligations:
Medical care (HCFA) ..................................................
Undistributed (FBI) ....................................................

5
1

864

Offsets:
Against gross budget authority and outlays:
88.00
Offsetting collections (cash) from: Federal sources

Identification code 75–8393–0–7–571

3
1

864

72.40

122

26.0
31.0
41.0

Travel and transportation of persons:
Travel and transportation of persons (OIG) .........
Travel and transportation of persons (DoJ) .........
Rental payments to GSA:
Rental payments to GSA (OIG) .............................
Rental payments to GSA (DoJ) .............................
Rental payments to GSA (OGC) ............................
Communications, utilities, and miscellaneous
charges (DOJ) ........................................................
Other services:
Other services (DoJ) ..............................................
Other services (HCFA) ...........................................
Other services (HRSA) ...........................................
Purchases of goods and services from Government
accounts:
Purchases of goods and services from Government accounts (OIG) ........................................
Purchases of goods and services from Government accounts (DoJ) ........................................
Supplies and materials (OIG) ...................................
Equipment (OIG) ........................................................
Grants, subsidies, and contributions (AoA) ..............

00.01
00.02

Obligations by program activity:
Benefit payments, SMI ...................................................
Administration, SMI .......................................................

1998 actual

74,804
1,511

77,595
1,642

92,210
1,679

HEALTH CARE FINANCING ADMINISTRATION—Continued
Trust Funds—Continued

DEPARTMENT OF HEALTH AND HUMAN SERVICES
00.03
00.04
00.06
09.01

Peer review organizations, SMI ......................................
33
Research, SMI ................................................................
20
Transfer to Medicaid for payment of SMI premiums ...................
HI partial transfer of home health ................................
978

138
20
60
13,417

22
22
90
8,311

Status of Funds (in millions of dollars)
Identification code 20–8004–0–7–571

10.00

Total new obligations ................................................

77,346

92,872

102,334

0100
0101

22.00
23.95

Budgetary resources available for obligation:
New budget authority (gross) ........................................
Total new obligations ....................................................

77,346
¥77,346

92,872
¥92,872

102,334
¥102,334

1998 actual

Unexpended balance, start of year:
Treasury balance ............................................................
U.S. Securities: Par value ..............................................

0199

New budget authority (gross), detail:
Current:
40.26
Appropriation (trust fund, definite) ..........................
1,527
1,658
1,697
Permanent:
60.27
Appropriation (trust fund, indefinite) .......................
80,428
83,056
91,508
60.28
Appropriation (unavailable balances) ....................... ................... ...................
818
60.45
Portion precluded from obligation ............................
¥5,587
¥5,259 ...................
63.00
68.00

Appropriation (total) .............................................
Spending authority from offsetting collections: Offsetting collections (cash) .....................................

74,841

77,797

92,326

978

13,417

8,311

Total new budget authority (gross) ..........................

77,346

92,872

102,334

398
77,346
¥77,250

494
92,872
¥92,821

545
102,334
¥102,368

494

545

511

70.00

72.40

86.90
86.93
86.97
86.98

1,261
170
75,787
32

1,411
236
91,097
77

1,464
228
100,621
55

87.00

Total outlays (gross) .................................................

77,250

92,821

102,368

Offsets:
Against gross budget authority and outlays:
88.00
Offsetting collections (cash) from: Federal sources

¥978

¥13,417

¥8,311

Net budget authority and outlays:
Budget authority ............................................................
Outlays ...........................................................................

76,368
76,272

79,455
79,404

94,023
94,057

89.00
90.00

Memorandum (non-add) entries:
92.01 Total investments, start of year: U.S. securities: Par
value ..........................................................................
92.02 Total investments, end of year: U.S. securities: Par
value ..........................................................................

34,464

39,502

46,199

39,502

46,199

45,391

Summary of Budget Authority and Outlays
(in millions of dollars)

1998 actual

76,368
76,272

1999 est.

2000 est.

79,455
79,404

94,023
94,057

.................... ....................
.................... ....................

–78
–78

.................... ....................
.................... ....................

Total balance, start of year ......................................
Cash income during the year:
Proprietary receipts:
0221
Premiums collected for the aged, FSMI Fund ..........
0222
Premiums collected for the aged, FSMI Fund, proposed legislation ...................................................
Proprietary receipts:
0223
Premiums collected for the disabled, FSMI Fund
0223
Premiums collected for the disabled, FSMI Fund,
proposed legislation .........................................
0225
Other Proprietary receipts .........................................
Intragovernmental transactions:
0240
Federal contributions, FSMI Fund .............................
0241
Federal contributions, FSMI Fund, proposed legislation ........................................................................
0242
Interest received by trust fund, FSMI Fund ..............
0243
Intragovernmental transactions ................................
Offsetting collections:
0280
HI Partial Transfer of Home Health ..........................
0297 Income under present law .............................................
0298 Income under proposed legislation ...............................
Total cash income .....................................................
Cash outgo during year:
Cash outgo during the year (¥):
0501
Benefit payments & ESRD ........................................
0501
Benefit payments, proposed legislation ....................
0501
Benefit payments, proposed legislation (¥) ...........
0502 Administration ................................................................
0503 Administration ................................................................
0504 Peer review organizations ..............................................
0505 Research ........................................................................
0506 HI Partial Transfer of Home Health ...............................
0507 Transfer to Medicaid for payment of SMI premiums
0597 Outgo under present law (¥) ......................................
0598 Outgo under proposed legislation (¥) .........................
0599

Total cash outgo (¥) ...................................................
Unexpended balance, end of year:
0700 Treasury balance ............................................................
0701 U.S. Securities: Par value ..............................................
0799

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:

35,206

40,889

46,199

17,153

17,529

18,914

................... ...................

¥118

2,274

2,418

2,662

................... ...................
¥17
3 ................... ...................
59,919

61,879

68,690

................... ...................
2,606
2,887
...................
1

¥469
2,928
11

978
13,417
82,933
98,131
................... ...................

8,311
101,516
¥604

82,933

98,131

100,912

¥74,808
...................
...................
¥1,410
...................
¥33
¥21
¥978
...................
¥77,250
...................

¥77,599
...................
...................
¥1,627
...................
¥98
¥20
¥13,417
¥60
¥92,821
...................

¥92,214
115
455
¥1,671
78
¥61
¥21
¥8,311
¥90
¥102,368
648

¥77,250

¥92,821

¥101,720

1,387 ................... ...................
39,502
46,199
45,391
40,889

line 0280: HI partial transfer of Home Health .................................................
line 0501: Benefit payments and ESRD ...........................................................
line 0506: HI partial transfer of Home Health .................................................

46,199

45,391

line deleted
–91,012
+13,417

–100,521
+8,311

The totals would also be decreased in FYs 1999 and 2000 by $13,417 and $8,311 respectively, so as to
leave end of year balances unchanged.

Object Classification (in millions of dollars)

41.0
93,375
93,409

1,387 ...................
39,502
46,199

Total balance, end of year ........................................

Identification code 20–8004–0–7–571

79,455
79,404

2000 est.

Note.—This status of funds table displays the gross outlay and income effect on the SMI trust fund of
the administrative mechanism used to implement the home health transfer policy authorized in PL 105–33. Showing
the net outlay and income effect of this administrative mechanism requires the following substitutions to the
table above:
FY 1999
FY 2000

–455
–455

76,368
76,272

1999 est.

742
34,464

0299

–115
–115

.................... ....................
.................... ....................

451

41.0
42.0
92.0
93.0

Direct obligations:
Grants, subsidies, and contributions:
Payment for peer review organization (PRO) activity ..................................................................
Payment for health insurance experiments and
demonstration projects .....................................
Insurance claims and indemnities ...........................
Undistributed .............................................................
Administrative expenses: Portion of limitation on
salaries and expenses: Social Security Administration ...................................................................

1998 actual

1999 est.

2000 est.

138

20
74,804
1,093

20
77,655
1,200

22
92,300
1,198

418

442

481

99.0
99.0

Subtotal, direct obligations ..................................
Reimbursable obligations ..............................................

76,368
978

79,455
13,417

94,023
8,311

99.9

Total new obligations ................................................

77,346

92,872

102,334

452

HEALTH CARE FINANCING ADMINISTRATION—Continued
Trust Funds—Continued

THE BUDGET FOR FISCAL YEAR 2000
FEDERAL SUPPLEMENTARY MEDICAL INSURANCE TRUST FUND

FEDERAL SUPPLEMENTARY MEDICAL INSURANCE TRUST FUND

(Legislative proposal, discretionary offset)

(Legislative proposal, not subject to PAYGO)

Program and Financing (in millions of dollars)

Program and Financing (in millions of dollars)
1998 actual

Identification code 20–8004–6–7–571
Identification code 20–8004–2–7–571

1998 actual

1999 est.

2000 est.

10.00

Obligations by program activity:
Total new obligations (object class 42.0) ..................... ................... ...................

¥455

22.00
23.95

¥455
455

60.27

New budget authority (gross), detail:
Appropriation (trust fund, indefinite) ............................ ................... ...................

¥455

73.10
73.20

¥455
455

86.97

Obligations by program activity:
10.00 Total new obligations (object class 92.0) ..................... ................... ...................

Outlays (gross), detail:
Outlays from new permanent authority ......................... ................... ...................

¥455

89.00
90.00

¥455
¥455

¥78

¥78
78

New budget authority (gross), detail:
40.26 Appropriation (trust fund, definite) ............................... ................... ...................

¥78

¥78
78

Outlays (gross), detail:
86.90 Outlays from new current authority .............................. ................... ...................

¥78

Net budget authority and outlays:
89.00 Budget authority ............................................................ ................... ...................
90.00 Outlays ........................................................................... ................... ...................

¥78
¥78

92.01

This schedule reflects the effects on the Supplemental Medical Insurance Trust Fund of the Medicare proposals contained
in this Budget used to offset discretionary spending.

This schedule reflects the effects of the HCFA user fees
proposed in this Budget on the Supplemental Medical Insurance Trust Fund.

Note.—Obligations incurred under allocations from other accounts are included in the
schedule of the parent appropriation as follows: Health Care Financing Administration:
‘‘Health Care Fraud and Abuse Control Account.’’

Memorandum (non-add) entries:
Total investments, start of year: U.S. securities: Par
value .......................................................................... ................... ................... ...................
92.02 Total investments, end of year: U.S. securities: Par
value .......................................................................... ................... ...................
78

ALLOCATION RECEIVED FROM OTHER ACCOUNTS

ADMINISTRATION FOR CHILDREN AND
FAMILIES

FEDERAL SUPPLEMENTARY MEDICAL INSURANCE TRUST FUND
(Legislative proposal, subject to PAYGO)

Federal Funds

Program and Financing (in millions of dollars)
Identification code 20–8004–4–7–571

1998 actual

1999 est.

2000 est.

General and special funds:
TEMPORARY ASSISTANCE

Obligations by program activity:
10.00 Total new obligations (object class 42.0) ..................... ................... ...................

¥115

¥115
115

New budget authority (gross), detail:
60.27 Appropriation (trust fund, indefinite) ............................ ................... ...................
60.28 Appropriation (unavailable balances) ........................... ................... ...................

¥149
34

63.00

Appropriation (total) .................................................. ................... ...................

¥115

73.10
73.20

¥115
115

22.00
23.95

NEEDY FAMILIES

Program and Financing (in millions of dollars)
Identification code 75–1552–0–1–609

00.01
00.02
00.03
00.05
00.06
00.07
00.08

1998 actual

¥115

¥115
¥115

Memorandum (non-add) entries:
92.01 Total investments, start of year: U.S. securities: Par
value .......................................................................... ................... ................... ...................
92.02 Total investments, end of year: U.S. securities: Par
value .......................................................................... ................... ...................
115

This schedule reflects the effects of the Medicare proposals
contained in the Budget on the Supplementary Medical Insurance Trust Fund.

1999 est.

Obligations by program activity:
State family assistance grant .......................................
16,489
16,489
State penalties ............................................................... ................... ...................
Territories—family assistance grants ...........................
78
78
Bonus to reward decrease in illegitimacy ..................... ...................
100
Supplemental grants for population increases .............
79
160
Bonus to reward high performance States ................... ...................
200
Tribal work programs .....................................................
7
7

10.00

Outlays (gross), detail:
86.97 Outlays from new permanent authority ......................... ................... ...................

89.00
90.00

FOR

Total obligations (object class 41.0) ........................

16,653

22.00
23.95
23.98

16,672
¥16,653
¥19

60.05

New budget authority (gross), detail:
Appropriation (indefinite) ...............................................

16,672

Change in unpaid obligations:
Unpaid obligations, start of year: Obligated balance,
start of year ..............................................................
73.10 Total new obligations ....................................................
73.20 Total outlays (gross) ......................................................
73.40 Adjustments in expired accounts ..................................
74.40 Unpaid obligations, end of year: Obligated balance,
end of year ................................................................

17,034

2000 est.

16,489
¥30
78
100
243
200
7
17,087

17,053
17,087
¥17,034
¥17,087
¥19 ...................

17,053

17,087

72.40

86.97

Outlays (gross), detail:
Outlays from new permanent authority .........................

3,807
16,653
¥13,284
36

7,212
10,921
17,034
17,087
¥13,071
¥14,496
¥254 ...................

7,212

10,921

13,512

10,894

9,877

9,079

ADMINISTRATION FOR CHILDREN AND FAMILIES—Continued
Federal Funds—Continued

DEPARTMENT OF HEALTH AND HUMAN SERVICES
86.98
87.00

Outlays from permanent balances ................................
Total outlays (gross) .................................................

2,390

3,194

13,284

13,071

5,417

TEMPORARY ASSISTANCE

FOR

453

NEEDY FAMILIES

(Legislative proposal, discretionary offset)

14,496

Program and Financing (in millions of dollars)
Net budget authority and outlays:
89.00 Budget authority ............................................................
90.00 Outlays ...........................................................................

16,672
13,284

17,053
13,071

17,087
14,496

1998 actual

Identification code 75–1552–6–1–609

1999 est.

2000 est.

10.00

Obligations by program activity:
Total obligations (object class 41.0) ............................ ................... ...................

¥83

22.00
23.95

¥83
83

60.05

New budget authority (gross), detail:
Appropriation (indefinite) ............................................... ................... ...................

¥83

Summary of Budget Authority and Outlays
(in millions of dollars)

Enacted/requested:
Budget Authority .....................................................................
Outlays ....................................................................................
Legislative proposal, subject to PAYGO:
Budget Authority .....................................................................
Outlays ....................................................................................
Legislative proposal, discretionary offset:
Budget Authority .....................................................................
Outlays ....................................................................................
Total:
Budget Authority .....................................................................
Outlays ....................................................................................

1998 actual

1999 est.

16,672
13,284

17,053
13,071

2000 est.

17,087
14,496

.................... .................... ....................
.................... ....................
–364
.................... ....................
.................... ....................

–83
–45

73.10
73.20
74.40

¥38

¥83
45

17,004
14,087

86.97

Outlays (gross), detail:
Outlays from new permanent authority ......................... ................... ...................

¥45

This account provides funding for activities established by
the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (P.L. 104–193). The Temporary Assistance
for Needy Families block grant provides funding to States
for aid to low-income families with children.
This account also includes Federal loans for State welfare
programs, established by section 406 of the Social Security
Act as amended.

89.00
90.00

¥83
¥45

16,672
13,284

17,053
13,071

The Administration will propose legislation that freezes
TANF supplemental grant funds in 2000 at the 1999 level
for all eligible states, and will apply the offset to discretionary
spending.
CONTINGENCY FUND
Program and Financing (in millions of dollars)

TEMPORARY ASSISTANCE

FOR

NEEDY FAMILIES
1998 actual

Identification code 75–1522–0–1–609

1999 est.

2000 est.

(Legislative proposal, subject to PAYGO)
10.00

Identification code 75–1552–4–1–609

1998 actual

1999 est.

Obligations by program activity:
Total new obligations (object class 41.0) ..................... ................... ...................

236

23.95
24.40

Budgetary resources available for obligation:
Total new obligations .................................................... ................... ...................
Unobligated balance available, end of year ................. ................... ...................

¥236
¥236

Outlays (gross), detail:
86.97 Outlays from new permanent authority ......................... ................... ...................

89.00
90.00

Budgetary resources available for obligation:
Unobligated balance available, start of year ............... ...................
1,958
1,958
New budget authority (gross) ........................................
1,960 ................... ...................

2000 est.

10.00

73.10
73.20
74.40

Obligations by program activity:
Total obligations (object class 41.0) ............................

21.40
22.00

Program and Financing (in millions of dollars)

236
364

23.90
23.95
24.40

Total budgetary resources available for obligation
Total new obligations ....................................................
Unobligated balance available, end of year .................

60.00

New budget authority (gross), detail:
Appropriation ..................................................................

73.10
73.20
74.40

600

¥364

This reflects interactions with the Administration’s proposal
on the allocation of common State administrative costs between the Medicaid and Temporary Assistance for Needy
Families programs.
This proposal also reduces the cap on TANF transfers to
SSBG from 10 percent to 4.25 percent in 2000, consistent
with the level already enacted for 2001.

86.97
86.98

2 ...................

1,960
1,958
¥2 ...................
1,958
1,958

1,958
¥11
1,947

1,960 ................... ...................

Change in unpaid obligations:
Total new obligations ....................................................
2 ...................
Total outlays (gross) ......................................................
¥2 ...................
Unpaid obligations, end of year: Obligated balance,
end of year ................................................................ ................... ...................

11
¥3
8

Outlays (gross), detail:
Outlays from new permanent authority .........................
2 ................... ...................
Outlays from permanent balances ................................ ................... ...................
3

87.00

Total outlays (gross) .................................................

89.00
90.00

Net budget authority and outlays:
Budget authority ............................................................
Outlays ...........................................................................

2 ...................

1,960 ................... ...................
2 ...................
3

Summary of Budget Authority and Outlays
(in millions of dollars)

Enacted/requested:
1998 actual
1999 est.
2000 est.
Budget Authority .....................................................................
1,960 .................... ....................
Outlays ....................................................................................
2 ....................
3
Legislative proposal, not subject to PAYGO:
Budget Authority ..................................................................... .................... ....................
–1,644

454

ADMINISTRATION FOR CHILDREN AND FAMILIES—Continued
Federal Funds—Continued

THE BUDGET FOR FISCAL YEAR 2000

CONTINGENCY FUND—Continued

00.91
01.02
01.03

Subtotal, child support enforcement ........................
Payments to territories ..................................................
Repatriation ...................................................................

2,556
38
1

3,009
38
1

3,252
38
1

Summary of Budget Authority and Outlays—Continued

01.91

02.01
02.02
02.03
02.04
02.05

Subtotal, other payments ..........................................
Aid to families with dependent children (AFDC) payments:
AFDC benefit payments .............................................
Emergency assistance ...............................................
State and local welfare administration ....................
AFDC/JOBS child care ................................................
At-risk child care ......................................................

02.91

Subtotal, AFDC Programs .....................................

616

10.00

Total obligations (object class 41.0) ........................

3,211

3,148

3,291

21.40
22.00
22.10

2,696
1,010

1,564
3,075

2,591
1,169

1,069

1,100 ...................

23.90
23.95
24.40

Total budgetary resources available for obligation
Total new obligations ....................................................
Unobligated balance available, end of year .................

4,775
¥3,211
1,564

General and special funds—Continued

(in millions of dollars)

1998 actual

1999 est.

2000 est.

Outlays .................................................................................... .................... .................... ....................
Total:
Budget Authority .....................................................................
Outlays ....................................................................................

1,960 ....................
2 ....................

–1,644
3

CONTINGENCY FUND
(Legislative proposal, not subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 75–1522–2–1–609

1998 actual

1999 est.

Budgetary resources available for obligation:
22.00 New budget authority (gross) ........................................ ................... ...................
24.40 Unobligated balance available, end of year ................. ................... ...................
New budget authority (gross), detail:
40.36 Unobligated balance rescinded ..................................... ................... ...................

89.00
90.00

98
35 ...................
309
65 ...................
174 ................... ...................
26 ................... ...................
9 ................... ...................
100 ...................

2000 est.

¥1,644
¥1,644

¥1,644

Net budget authority and outlays:
Budget authority ............................................................ ................... ...................
¥1,644
Outlays ........................................................................... ................... ................... ...................

New budget authority (gross), detail:
Current:
40.00
Appropriation ............................................................. ...................
Permanent:
65.00
Advance appropriation (definite) ..............................
607
68.00
Spending authority from offsetting collections: Offsetting collections (cash) .....................................
403
70.00

The Budget proposes authorizing action that reduces budget
authority by $1.6 billion in FY 2000, repeals the existing
Contingency Fund authority, and creates a new uncapped
fund that could more effectively respond to State needs in
the event of an unforeseen economic downturn.

Total new budget authority (gross) ..........................

1,010

Change in unpaid obligations:
Unpaid obligations, start of year: Obligated balance,
start of year ..............................................................
73.10 Total new obligations ....................................................
73.20 Total outlays (gross) ......................................................
73.45 Adjustments in unexpired accounts ..............................
74.40 Unpaid obligations, end of year: Obligated balance,
end of year ................................................................

1,952
3,211
¥2,574
¥1,069

3,760
¥3,291
469

1,989 ...................
660

750

426

419

3,075

1,169

72.40

øFAMILY SUPPORT¿ PAYMENTS TO STATES FOR CHILD SUPPORT
ENFORCEMENT AND FAMILY SUPPORT PROGRAMS
For making payments to States or other non-Federal entities under
titles I, IV–D, X, XI, XIV, and XVI of the Social Security Act and
the Act of July 5, 1960 (24 U.S.C. ch. 9), øto remain available until
expended, $1,989,000,000; and for such purposes¿ for the first quarter
of fiscal year ø2000, $750,000,000¿ 2001, $650,000,000, to remain
available until expended.
For making payments to each State for carrying out the program
of Aid to Families with Dependent Children under title IV–A of
the Social Security Act before the effective date of the program of
Temporary Assistance to Needy Families (TANF) with respect to such
State, such sums as may be necessary: Provided, That the sum of
the amounts available to a State with respect to expenditures under
such title IV–A in fiscal year 1997 under this appropriation and
under such title IV–A as amended by the Personal Responsibility
and Work Opportunity Reconciliation Act of 1996 shall not exceed
the limitations under section 116(b) of such Act.
For making, after May 31 of the current fiscal year, payments
to States or other non-Federal entities under titles I, IV–D, X, XI,
XIV, and XVI of the Social Security Act and the Act of July 5,
1960 (24 U.S.C. ch. 9), for the last three months of the current
year for unanticipated costs, incurred for the current fiscal year,
such sums as may be necessary. (Department of Health and Human
Services Appropriations Act, 1999, as included in Public Law 105–
277, section 101(f).)

5,739
¥3,148
2,591

86.90
86.93
86.97
87.00

1,520

Outlays (gross), detail:
Outlays from new current authority .............................. ...................
Outlays from current balances ......................................
1,564
Outlays from new permanent authority .........................
1,010

1,520
404
3,148
3,291
¥3,164
¥3,369
¥1,100 ...................
404

326

1,520 ...................
558
2,200
1,086
1,169

Total outlays (gross) .................................................

2,574

3,164

3,369

Offsets:
Against gross budget authority and outlays:
88.40
Offsetting collections (cash) from: Non-Federal
sources ..................................................................

¥403

¥426

¥419

Net budget authority and outlays:
Budget authority ............................................................
Outlays ...........................................................................

607
2,171

2,649
2,738

750
2,950

89.00
90.00

Summary of Budget Authority and Outlays
(in millions of dollars)

Enacted/requested:
1998 actual
1999 est.
Budget Authority .....................................................................
607
2,649
Outlays ....................................................................................
2,171
2,738
Legislative proposal, subject to PAYGO:
Budget Authority ..................................................................... .................... ....................
Outlays .................................................................................... .................... ....................
Total:
Budget Authority .....................................................................
Outlays ....................................................................................

607
2,171

2,649
2,738

2000 est.

750
2,950
–9
–9
741
2,941

Program and Financing (in millions of dollars)
Identification code 75–1501–0–1–609

Obligations by program activity:
Child support enforcement (CSE):
Benefit payments:
00.01
State child support administrative costs .............
00.02
Federal incentive/hold harmless payments to
States ...............................................................
00.03
Access and visitation grants ................................

1998 actual

1999 est.

2000 est.

2,143

2,573

2,823

403
10

426
10

419
10

AFDC expenditure claims for the period prior to States’
transition to the Temporary Assistance to Needy Families
Program have been lower than anticipated. As a result, unobligated balances remain in this account which are sufficient
to cover expected State needs for child support enforcement
activities through fiscal year 2000. The account is expected
to return to its traditional appropriations cycle after then.
As a result of P.L. 104–93, the Federal share of collections

ADMINISTRATION FOR CHILDREN AND FAMILIES—Continued
Federal Funds—Continued

DEPARTMENT OF HEALTH AND HUMAN SERVICES

is no longer used to reduce the budget authority requested
in this account. Instead, spending authority from collections
is limited to incentive and hold harmless payments. The net
Federal share of collections after incentive and hold harmless
payments are made to States is returned to the treasury
in a receipt account. The text table below shows the traditional display of child support enforcement costs:
Net Federal Costs of Child Support Enforcement
(In millions of dollars)

1998

1999

2000

Gross Federal share of collections ..............................................
Federal incentive payments to States ........................................
Hold harmless payments .............................................................
State child support administrative costs ...................................
Access and visitation grants ......................................................

–1,348
389
14
2,143
10

–1,371
385
41
2,573
10

–1,384
354
65
2,823
10

Subtotal ..............................................................................

1,208

1,638

LOW INCOME HOME ENERGY ASSISTANCE
For making payments under title XXVI of the Omnibus Budget
Reconciliation Act of 1981, $1,100,000,000, to be available for obligation in the period October 1, ø1999¿ 2000 through September 30,
ø2000¿ 2001.
For making payments under title XXVI of such Act, $300,000,000:
Provided, That these funds are hereby designated by Congress to
be emergency requirements pursuant to section 251(b)(2)(A) of the
Balanced Budget and Deficit Emergency Control Act of 1985: Provided further, That these funds shall be made available only after
submission to Congress of a formal budget request by the President
that includes designation of the entire amount of the request as
an emergency requirement as defined in the Balanced Budget and
Emergency Deficit Control Act. (Department of Health and Human
Services Appropriations Act, 1999, as included in Public Law 105–
277, section 101(f).)

1,868

Program and Financing (in millions of dollars)
1998 actual

Identification code 75–1502–0–1–609

PAYMENTS

STATES FOR CHILD SUPPORT ENFORCEMENT
FAMILY SUPPORT PROGRAMS

1999 est.

Obligations by program activity:
Total obligations (object class 41.0) ............................

1,160

1,100

22.00
23.95

Budgetary resources available for obligation:
New budget authority (gross) ........................................
Total new obligations ....................................................

1,160
¥1,160

1,100
¥1,100

2000 est.

New budget authority (gross), detail:
Current:
40.15
Appropriation (emergency) ........................................ ...................
40.60
Contingent emergency appropriation not available
for obligations ....................................................... ...................

300

¥300

Obligations by program activity:
Child support enforcement (CSE):
Benefit payments:
00.01
State child support administrative costs ............. ................... ...................
00.02
Federal incentive/hold harmless payments to
States ............................................................... ................... ...................

¥65

60.65
65.00

10.00

Total obligations (object class 41.0) ........................ ................... ...................

¥74

70.00

22.00
23.95

¥74
74

43.00
¥9

New budget authority (gross), detail:
Current:
40.00
Appropriation ............................................................. ................... ...................
Permanent:
68.00
Spending authority from offsetting collections: Offsetting collections (cash) ..................................... ................... ...................

¥65

70.00

Total new budget authority (gross) .......................... ................... ...................

¥74

73.10
73.20

¥74
74

86.90
86.97

Outlays (gross), detail:
Outlays from new current authority .............................. ................... ...................
Outlays from new permanent authority ......................... ................... ...................

¥9
¥65

87.00

Total outlays (gross) ................................................. ................... ...................

¥74

89.00
90.00

2000 est.

10.00

Program and Financing (in millions of dollars)
1998 actual

1999 est.

AND

(Legislative proposal, subject to PAYGO)

Identification code 75–1501–4–1–609

455

¥9

Appropriation (total) ............................................. ................... ................... ...................
Permanent:
Contingent emergency appropriation released .........
160 ................... ...................
Advance appropriation (definite) ..............................
1,000
1,100
1,100
Total new budget authority (gross) ..........................

Change in unpaid obligations:
Unpaid obligations, start of year: Obligated balance,
start of year ..............................................................
73.10 Total new obligations ....................................................
73.20 Total outlays (gross) ......................................................
73.40 Adjustments in expired accounts ..................................
74.40 Unpaid obligations, end of year: Obligated balance,
end of year ................................................................

1,160

1,100

72.40

351
377
343
1,160
1,100
1,100
¥1,132
¥1,134
¥1,135
¥2 ................... ...................
377

343

308

This proposal: (1) conforms the match rate for paternity
testing with the basic administrative match rate; (2) repeals
the hold harmless provision established in welfare reform;
and, (3) starting in 2001, requires review of child support
orders for families receiving welfare at least every three
years.

Outlays (gross), detail:
Outlays from current balances ......................................
Outlays from new permanent authority .........................
Outlays from permanent balances ................................

300
825
7

302
814
18

56
814
264

87.00

¥9
¥9

86.93
86.97
86.98

Total outlays (gross) .................................................

1,132

1,134

1,135

89.00
90.00

Net budget authority and outlays:
Budget authority ............................................................
Outlays ...........................................................................

1,160
1,132

1,100
1,134

1,100
1,135

This program makes grants to States and Indian tribes
to aid low-income households with high energy costs through
payments to eligible households, energy suppliers, and weatherization providers.
REFUGEE

AND

ENTRANT ASSISTANCE

For making payments for refugee and entrant assistance activities
authorized by title IV of the Immigration and Nationality Act and
section 501 of the Refugee Education Assistance Act of 1980 (Public
Law 96–422), ø$415,000,000¿ $423,000,000, to remain available
through September 30, 2002: Provided, That funds appropriated pursuant to section 414(a) of the Immigration and Nationality Act under
Public Law ø104–208¿ 105–78 for fiscal year ø1997¿ 1998, and under
Public Law 105–277 for fiscal year 1999 shall be available for the
costs of assistance provided and other activities øconducted in such
year and in fiscal years 1998 and 1999¿ through September 30, 2001.
For carrying out section 5 of the Torture Victims Relief Act of
1998 (Public Law 105–320), $7,500,000, to remain available until

456

ADMINISTRATION FOR CHILDREN AND FAMILIES—Continued
Federal Funds—Continued

THE BUDGET FOR FISCAL YEAR 2000
10.00

REFUGEE

AND

Total new obligations ................................................

22.00
23.95
23.98

40.00

General and special funds—Continued

New budget authority (gross), detail:
Appropriation ..................................................................

ENTRANT ASSISTANCE—Continued

expended. (Department of Health and Human Services Appropriations
Act, 1999, as included in Public Law 105–277, section 101(f).)
Program and Financing (in millions of dollars)
Identification code 75–1503–0–1–609

00.01
00.02

1998 actual

1999 est.

2000 est.

Obligations by program activity:
Refugee and entrant assistance ...................................
411
435
Assistance for treatment of torture victims .................. ................... ...................

435
8

10.00

Total new obligations ................................................

411

435

443

21.40
22.00

Budgetary resources available for obligation:
Unobligated balance available, start of year ...............
New budget authority (gross) ........................................

2
423

2
435

2
443

23.90
23.95
23.98
24.40

40.00
50.00

New budget authority (gross), detail:
Appropriation ..................................................................
Reappropriation ..............................................................

420
3

415
20

431
12

70.00

Total new budget authority (gross) ..........................

423

435

Change in unpaid obligations:
Unpaid obligations, start of year: Obligated balance,
start of year ..............................................................
73.10 Total new obligations ....................................................
73.20 Total outlays (gross) ......................................................
73.40 Adjustments in expired accounts ..................................
74.40 Unpaid obligations, end of year: Obligated balance,
end of year ................................................................

437
411
¥326
¥12

511
509
435
436
¥420
¥430
¥17 ...................

511

509

Outlays (gross), detail:
Outlays from new current authority ..............................
Outlays from current balances ......................................

123
202

131
289

255

275

295

293
274
325
239
275
295
¥214
¥224
¥258
¥44 ................... ...................
274

325

362

Outlays (gross), detail:
Outlays from new current authority ..............................
Outlays from current balances ......................................

28
186

33
191

35
222

87.00

Total outlays (gross) .................................................

214

224

258

89.00
90.00

Net budget authority and outlays:
Budget authority ............................................................
Outlays ...........................................................................

255
214

275
224

295
258

Object Classification (in millions of dollars)
1998 actual

1999 est.

2000 est.

25.1
41.0

Advisory and assistance services ..................................
Grants, subsidies, and contributions ............................

4
235

6
269

6
289

99.9

Total new obligations ................................................

239

275

295

133
296

87.00

Total outlays (gross) .................................................

326

420

430

89.00
90.00

Net budget authority and outlays:
Budget authority ............................................................
Outlays ...........................................................................

423
326

435
420

443
430

States are subsidized for administering the refugee assistance program. Funds are also provided to assist in the rehabilitation of victims of torture.

1998 actual

JOB OPPORTUNITIES

AND

BASIC SKILLS TRAINING PROGRAM

Program and Financing (in millions of dollars)
Identification code 75–1509–0–1–504

Change in unpaid obligations:
Unpaid obligations, start of year: Obligated balance,
start of year ..............................................................
73.20 Total outlays (gross) ......................................................
73.40 Adjustments in expired accounts ..................................
74.40 Unpaid obligations, end of year: Obligated balance,
end of year ................................................................

1998 actual

1999 est.

2000 est.

72.40

158
¥48
¥33

77
23
¥39
¥15
¥15 ...................

86.93

Object Classification (in millions of dollars)

25.2
25.3

255
275
295
¥239
¥275
¥295
¥16 ................... ...................

517

86.90
86.93

Identification code 75–1503–0–1–609

295

86.90
86.93

Identification code 75–1512–0–1–506

72.40

275

72.40

443

425
437
445
¥411
¥435
¥443
¥12 ................... ...................
2
2
2

239

1999 est.

Outlays (gross), detail:
Outlays from current balances ......................................

89.00
90.00

2000 est.

41.0

Other services ................................................................
Purchases of goods and services from Government
accounts ....................................................................
Grants, subsidies, and contributions ............................

1
409

1
433

1
441

99.9

Total new obligations ................................................

411

435

443

This activity is replaced by Temporary Assistance for Needy
Families.
STATE LEGALIZATION IMPACT-ASSISTANCE GRANTS

øFAMILY PRESERVATION AND SUPPORT¿ PROMOTING SAFE
STABLE FAMILIES

Program and Financing (in millions of dollars)

AND

For carrying out section 430 of the Social Security Act,
ø$275,000,000¿ $295,000,000. (Department of Health and Human
Services Appropriations Act, 1999, as included in Public Law 105–
277, section 101(f).)
Program and Financing (in millions of dollars)
Identification code 75–1512–0–1–506

1998 actual

Obligations by program activity:
00.01 Grants to States and Tribes ..........................................
235
00.02 Training and technical assistance ................................
4
00.03 State court assessment activities ................................. ...................

1999 est.

259
6
10

Identification code 75–1508–0–1–506

Change in unpaid obligations:
Unpaid obligations, start of year: Obligated balance,
start of year ..............................................................
73.20 Total outlays (gross) ......................................................
74.40 Unpaid obligations, end of year: Obligated balance,
end of year ................................................................

1998 actual

1999 est.

2000 est.

72.40

7
11
11
4 ................... ...................
11

2000 est.

279
6
10

86.93

Outlays (gross), detail:
Outlays from current balances ......................................

89.00

Net budget authority and outlays:
Budget authority ............................................................ ................... ................... ...................

¥4 ................... ...................

ADMINISTRATION FOR CHILDREN AND FAMILIES—Continued
Federal Funds—Continued

DEPARTMENT OF HEALTH AND HUMAN SERVICES
90.00

Outlays ...........................................................................

¥4 ................... ...................

CHILD CARE ENTITLEMENT

457

STATES

(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
CHILD CARE ENTITLEMENT

STATES

1998 actual

1999 est.

...................
...................
...................
...................

600
1,129
23
3

10.00

Total new obligations ................................................ ................... ...................

1,755

22.00
23.95

1,755
¥1,755

60.00

New budget authority (gross), detail:
Appropriation .................................................................. ................... ...................

1,755

Identification code 75–1550–4–1–609

2000 est.

Program and Financing (in millions of dollars)
1998 actual

Identification code 75–1550–0–1–609

1999 est.

2000 est.

00.01
00.02
00.03

Obligations by program activity:
Mandatory child care .....................................................
Matching child care .......................................................
Training and technical assistance ................................

1,219
846
5

1,221
941
5

1,225
1,136
6

10.00

Total new obligations ................................................

2,070

2,167

2,367

22.00
23.95

Budgetary resources available for obligation:
New budget authority (gross) ........................................
Total new obligations ....................................................

2,070
¥2,070

2,167
¥2,167

2,367
¥2,367

New budget authority (gross), detail:
Current:
50.00
Reappropriation .........................................................
Permanent:
60.00
Appropriation .............................................................

2,067

2,167

2,367

70.00

2,070

2,167

00.01
00.02
00.03
00.04

2,367

3 ................... ...................

73.10
73.20
74.40

Obligations by program activity:
Early learning fund ........................................................
Matching funds to States ..............................................
Tribal mandatory funds .................................................
Training and technical assistance ................................

1,755
¥1,200
555

86.97

Total new budget authority (gross) ..........................

Change in unpaid obligations:
Unpaid obligations, start of year: Obligated balance,
start of year ..............................................................
73.10 Total new obligations ....................................................
73.20 Total outlays (gross) ......................................................
73.40 Adjustments in expired accounts ..................................
74.40 Unpaid obligations, end of year: Obligated balance,
end of year ................................................................
72.40

569
608
473
2,070
2,167
2,367
¥2,028
¥2,302
¥2,460
¥3 ................... ...................
608

473

380

86.97
86.98

Outlays (gross), detail:
Outlays from new permanent authority .........................
Outlays from permanent balances ................................

1,523
505

1,725
577

2,019
441

87.00

Total outlays (gross) .................................................

2,028

2,302

2,460

89.00
90.00

Net budget authority and outlays:
Budget authority ............................................................
Outlays ...........................................................................

2,070
2,028

2,167
2,302

2,367
2,460

Outlays (gross), detail:
Outlays from new permanent authority ......................... ................... ...................

1,200

89.00
90.00

1,755
1,200

This legislative proposal will provide child care funding for
low-income working families and provide challenge grants to
communities to support programs to improve early learning
and the quality and safety of child care for children ages
zero to five.
Object Classification (in millions of dollars)
1998 actual

Identification code 75–1550–4–1–609

1999 est.

2000 est.

25.1
41.0

Advisory and assistance services .................................. ................... ...................
Grants, subsidies, and contributions ............................ ................... ...................

3
1,752

99.9

Total new obligations ................................................ ................... ...................

1,755

Summary of Budget Authority and Outlays
(in millions of dollars)

PAYMENTS

1998 actual
1999 est.
Enacted/requested:
Budget Authority .....................................................................
2,070
2,167
Outlays ....................................................................................
2,028
2,302
Legislative proposal, subject to PAYGO:
Budget Authority ..................................................................... .................... ....................
Outlays .................................................................................... .................... ....................

Total:
Budget Authority .....................................................................
Outlays ....................................................................................

2,070
2,028

2,167
2,302

2000 est.

2,367
2,460
1,755
1,200

4,122
3,660

This account provides child care funding for welfare recipients and low-income working families established by the Personal Responsibility and Work Opportunity Reconciliation Act
of 1996 (P.L. 104–193).
Object Classification (in millions of dollars)
Identification code 75–1550–0–1–609

1998 actual

1999 est.

2000 est.

25.1
41.0

Advisory and assistance services ..................................
Grants, subsidies, and contributions ............................

5
2,065

5
2,162

6
2,361

99.9

Total new obligations ................................................

2,070

2,167

2,367

STATES

FOR THE
BLOCK

CHILD CARE
GRANT

AND

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), to become available on October 1, ø1999¿ 2000
and remain available through September 30, ø2000¿ 2001,
$1,182,672,000: Provided, That $19,120,000 shall be available for
child care resource and referral and school-aged child care activities:
øProvided further, That of the funds provided for fiscal year 1999
under Public Law 105–78, $50,000,000 shall be reserved by the States
for activities authorized under section 658G of the Omnibus Budget
Reconciliation Act of 1981 (the Child Care and Development Block
Grant Act of 1990), such funds to be in addition to the amounts
required to be reserved by States under such section 658G:¿ Provided
further, That of the funds provided for fiscal year ø2000¿ 2001,
$222,672,000 shall be reserved by the States for activities authorized
under section 658G of the Omnibus Budget Reconciliation Act of
1981 (The Child Care and Development Block Grant Act of 1990),
such funds to be in addition to the amounts required to be reserved
by the States under such section 658G: Provided further, That of
the funds provided for fiscal year ø2000¿ 2001, $10,000,000 shall
be for use by the Secretary for child care research, demonstration
and evaluation activities (directly or by grants or contracts). (Department of Health and Human Services Appropriations Act, 1999, as
included in Public Law 105–277, section 101(f).)

ADMINISTRATION FOR CHILDREN AND FAMILIES—Continued
Federal Funds—Continued

458

THE BUDGET FOR FISCAL YEAR 2000

General and special funds—Continued
PAYMENTS

Program and Financing (in millions of dollars)

STATES FOR THE CHILD CARE AND DEVELOPMENT
BLOCK GRANT—Continued

1998 actual

Identification code 75–1534–0–1–506

1999 est.

2000 est.

10.00

Obligations by program activity:
00.01 Block grant payments to States ....................................
00.02 Advisory and assistance services ..................................
10.00

Total new obligations ................................................

Budgetary resources available for obligation:
22.00 New budget authority (gross) ........................................
23.95 Total new obligations ....................................................
New budget authority (gross), detail:
Current:
40.00
Appropriation .............................................................
42.00
Transferred from other accounts ..............................
43.00
65.00
70.00

1999 est.

Total new budget authority (gross) ..........................

999
3

997
3

2,380

Budgetary resources available for obligation:
New budget authority (gross) ........................................
Total new obligations ....................................................

2,299
¥2,299

1,909
¥1,909

2,380
¥2,380

New budget authority (gross), detail:
Appropriation ..................................................................

2,299

1,909

2,380

1,180
3

1,002

1,000

1,183
Change in unpaid obligations:
Unpaid obligations, start of year: Obligated balance,
start of year ..............................................................
1,149
73.10 Total new obligations ....................................................
2,299
73.20 Total outlays (gross) ......................................................
¥2,441
73.40 Adjustments in expired accounts .................................. ...................
74.40 Unpaid obligations, end of year: Obligated balance,
end of year ................................................................
1,007
72.40

1,002
¥1,002

1,000
¥1,000

1,183
¥1,183

1,000 ................... ...................
2 ................... ...................

1,007
864
1,909
2,380
¥2,050
¥2,445
¥2 ...................
864

799

1,000

406

472

87.00

Total outlays (gross) .................................................

1,095

1,004

1,117

89.00
90.00

Net budget authority and outlays:
Budget authority ............................................................
Outlays ...........................................................................

1,002
1,095

1,000
1,004

1,183
1,117

This appropriation helps low-income families pay for child
care and related services and supports grants to states for
child care quality activities.
Object Classification (in millions of dollars)
1998 actual

1999 est.

Outlays (gross), detail:
Outlays from new current authority ..............................
Outlays from current balances ......................................

2,075
366

1,718
332

2,142
303

87.00

Total outlays (gross) .................................................

2,441

2,050

2,445

Net budget authority and outlays:
Budget authority ............................................................
Outlays ...........................................................................

2,299
2,441

1,909
2,050

2,380
2,445

1,183

515
410
406
1,002
1,000
1,183
¥1,095
¥1,004
¥1,117
¥12 ................... ...................
410

86.90
86.93

89.00
90.00

1,002

Outlays (gross), detail:
Outlays from new current authority ..............................
725 ................... ...................
Outlays from current balances ......................................
369
277
120
Outlays from new permanent authority ......................... ...................
727
857
Outlays from permanent balances ................................ ................... ...................
140

Identification code 75–1515–0–1–609

1,909

2000 est.

Appropriation (total) .............................................
1,002 ................... ...................
Permanent:
Advance appropriation (definite) .............................. ...................
1,000
1,183

Change in unpaid obligations:
72.40 Unpaid obligations, start of year: Obligated balance,
start of year ..............................................................
73.10 Total new obligations ....................................................
73.20 Total outlays (gross) ......................................................
73.40 Adjustments in expired accounts ..................................
74.40 Unpaid obligations, end of year: Obligated balance,
end of year ................................................................

86.90
86.93
86.97
86.98

1998 actual

2,299

40.00

Identification code 75–1515–0–1–609

Obligations by program activity:
Total obligations (object class 41.0) ............................

22.00
23.95

Program and Financing (in millions of dollars)

2000 est.

25.1
41.0

Advisory and assistance services ..................................
Grants, subsidies, and contributions ............................

3
999

3
997

3
1,180

99.9

Total new obligations ................................................

1,002

1,000

1,183

SOCIAL SERVICES BLOCK GRANT
For making grants to States pursuant to section 2002 of the Social
Security Act, ø$1,909,000,000: Provided, That (1) notwithstanding
section 2003(c) of such Act, as amended, the amount specified for
allocation under such section for fiscal year 1999 shall be
$1,909,000,000 and (2) notwithstanding subparagraph (B) of section
404(d)(2) of such Act, the applicable percent specified under such
subparagraph for a State to carry out State programs pursuant to
title XX of such Act for fiscal years 1999 and 2000 shall be 10
percent¿ $2,380,000,000. (Department of Health and Human Services
Appropriations Act, 1999, as included in Public Law 105–277, section
101(f).)

Social services block grant.—The proposed level will support
grants to States for social services.
CHILDREN

AND

FAMILIES SERVICES PROGRAMS

ø(INCLUDING

RESCISSIONS)¿

For carrying out, except as otherwise provided, the Runaway and
Homeless Youth Act, the Developmental Disabilities Assistance and
Bill of Rights Act, the Head Start Act, the Child Abuse Prevention
and Treatment Act ø(including section 105(a)(2) of the Child Abuse
Prevention and Treatment Act)¿, the Native American Programs Act
of 1974, title II of Public Law 95–266 (adoption opportunities), the
Adoption and Safe Families Act of 1997 (Public Law 105–89), the
Abandoned Infants Assistance Act of 1988, part B(1) of title IV and
sections 413, 429A, 1110, and 1115 of the Social Security Act; for
making payments under the Community Services Block Grant Act,
section 473A of the Social Security Act, and title IV of Public Law
105–285; 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,
section 5 of the Torture Victims Relief Act of 1998 (Public Law 105–
320), sections 40155, 40211 and 40241 of Public Law 103–322 and
section 126 and titles IV and V of Public Law 100–485,
ø$6,032,087,000, of which $10,000,000 shall be used to establish Individual Development Accounts, for the purpose of encouraging lowincome families and individuals to acquire productive assets, contingent upon enactment of authorizing legislation, and¿ $6,587,953,000,
of which $20,000,000, to remain available until September 30, ø2000¿
2001, shall be for grants to States for adoption incentive payments,
as authorized by section 473A of title IV of the Social Security Act
(42 U.S.C. 670–679); of which ø$563,565,000¿ $500,000,000 shall be
for making payments under the Community Services Block Grant
Act; and of which ø$4,660,000,000¿ $5,267,000,000 shall be for making payments under the Head Start Actø: Provided, That, notwithstanding section 640(a)(6), of the funds made available for the Head
Start Act, $337,500,000 shall be set aside for the Head Start Program
for Families with Infants and Toddlers (Early Head Start): Provided
further, That to the extent Community Services Block Grant funds
are distributed as grant funds by a State to an eligible entity as
provided under the Act, and have not been expended by such entity,
they shall remain with such entity for carryover into the next fiscal
year for expenditure by such entity consistent with program purposes¿.

ADMINISTRATION FOR CHILDREN AND FAMILIES—Continued
Federal Funds—Continued

DEPARTMENT OF HEALTH AND HUMAN SERVICES
øIn addition, $105,000,000, to be derived from the Violent Crime
Reduction Trust Fund for carrying out sections 40155, 40211 and
40241 of Public Law 103–322.¿
øFunds appropriated for fiscal year 1999 under section 429A(e),
part B of title IV of the Social Security Act shall be reduced by
$6,000,000.¿
øFunds appropriated for fiscal year 1999 under section 413(h)(1)
of the Social Security Act shall be reduced by $15,000,000.¿ (Department of Health and Human Services Appropriations Act, 1999, as
included in Public Law 105–277, section 101(f).)
Program and Financing (in millions of dollars)
Identification code 75–1536–0–1–506

1998 actual

86.90
86.93
86.97

2,384
2,945
13

2,463
3,378
13

2,688
3,522
13

87.00

Total outlays (gross) .................................................

5,342

5,854

6,223

Offsets:
Against gross budget authority and outlays:
88.00
Offsetting collections (cash) from: Federal sources

¥13

Net budget authority and outlays:
Budget authority ............................................................
Outlays ...........................................................................

5,676
5,329

6,032
5,841

6,588
6,210

89.00
90.00
1999 est.

459

2000 est.

Obligations by program activity:
Head Start ......................................................................
4,346
4,660
5,267
Social services programs:
Children, youth, and families:
01.03
Runaway and homeless youth ..............................
44
44
44
01.04
Runaway youth transitional living ........................
15
15
20
01.07
Child abuse state grants .....................................
21
21
21
01.08
Child abuse discretionary grants .........................
14
14
14
01.09
Community based resource centers .....................
33
33
33
01.11
Abandoned infants assistance .............................
12
12
12
01.14
Child welfare services ..........................................
291
292
292
01.15
Child welfare training ...........................................
6
7
7
01.16
Adoption Initiative ................................................. ...................
20
20
01.17
Adoption opportunities ..........................................
23
25
27
01.19
Family violence grants ..........................................
10 ................... ...................
01.20
Social services and income maintenance research ...............................................................
26
27
6
Developmental disabilities:
01.23
State grants ..........................................................
65
65
65
01.24
Protection and advocacy .......................................
27
27
27
01.25
Special projects ....................................................
5
10
10
01.26
University affiliated projects ................................
17
17
17
01.28
Native American programs ........................................
37
35
35
00.01

Head Start.—The proposed level will enable Head Start
projects to continue comprehensive early childhood development services and is consistent with the President’s goal to
serve 1 million children by 2002, including a doubling of
the number of infants and toddlers in Early Head Start. The
proposed level will allow Head Start to expand beyond the
1999 enrollment level of 835,000 slots, adding 35,000 preschool slots and 7,000 Early Head Start slots in 2000, for
total enrollment of 877,000.
Social Services.—The proposed level will continue to support State, local, and private efforts to provide developmental
and other services for children and youth, grants to improve
support networks for persons with developmental disabilities,
and economic development assistance to Native American
populations.
Adoption Incentive Payments.—The proposed level includes
$20 million for bonus payments to States that increase the
number of children adopted from the foster care system.
Object Classification (in millions of dollars)

01.91
02.01

Subtotal social services programs .......................
ACF Federal administration ...........................................

02.93

Total Head Start, social services programs, Federal
administration .......................................................
5,135
Community services programs:
Community services block grants .............................
490
Community food and nutrition ..................................
4
Community services discretionary .............................
33
National youth sports ................................................
14
Individual development accounts .................................. ...................

03.01
03.03
03.04
03.05
03.06

646
143

664
144
5,468

648
151
6,068

500
500
5 ...................
34 ...................
15 ...................
10
20

1998 actual

Identification code 75–1536–0–1–506

11.1
11.3

1999 est.

2000 est.

90
2

92
1

95
1

92
16
2
12

93
17
2
13

96
17
3
14

03.91

Subtotal, community services ...................................

541

564

520

04.00
09.01

Total direct programs ................................................
Reimbursable program ..................................................

5,676
13

6,032
13

6,588
13

10.00

Total new obligations ................................................

5,689

6,045

6,601

24.0
25.1
25.2
25.3

3 ................... ...................
5,689
6,045
6,601

25.7
31.0
41.0

99.0
99.0

Subtotal, direct obligations ..................................
Reimbursable obligations ..............................................

5,676
13

6,032
13

6,588
13

99.9

Total new obligations ................................................

5,689

6,045

6,601

11.9
12.1
21.0
23.1
23.3

Direct obligations:
Personnel compensation:
Full-time permanent .............................................
Other than full-time permanent ...........................

Total budgetary resources available for obligation
Total new obligations ....................................................
Unobligated balance expiring ........................................

5,692
6,045
6,601
¥5,689
¥6,045
¥6,601
¥2 ................... ...................

5,683
6,032
6,588
¥6 ................... ...................

Identification code 75–1536–0–1–506

43.00

Appropriation (total) .............................................
Permanent:
Spending authority from offsetting collections: Offsetting collections (cash) .....................................

5,677

1001

5,690

6,045

6,601

2
1
64
5

2
2
57
4

19
1
3
5,458

15
2
1
5,817

15
2
1
6,375

Total new budget authority (gross) ..........................

2
1
64
6

68.00
70.00

Change in unpaid obligations:
72.40 Unpaid obligations, start of year: Obligated balance,
start of year ..............................................................
73.10 Total new obligations ....................................................
73.20 Total outlays (gross) ......................................................
73.40 Adjustments in expired accounts ..................................
74.40 Unpaid obligations, end of year: Obligated balance,
end of year ................................................................

Personnel Summary

3,605
5,689
¥5,342
¥1
3,951

6,032

6,588

3,951
4,097
6,045
6,601
¥5,854
¥6,223
¥45 ...................
4,097

4,475

Total compensable workyears: Full-time equivalent
employment ...............................................................

1998 actual

1999 est.

1,569

1,530

2000 est.

1,510

VIOLENT CRIME REDUCTION PROGRAMS
For activities authorized by sections 40155, 40211, and 40241 of
Public Law 103–322, $118,500,000, to remain available until expended, of which $101,000,000 shall be derived from the Violent Crime
Reduction Trust Fund: Provided, That $102,300,000 shall be for Family Violence (including Battered Women’s Shelters); $15,000,000 for
Education and Prevention Grants to reduce Sexual Abuse of Runaway,
Homeless and Street Youth; and $1,200,000 for the National Domestic
Violence Hotline.

460

ADMINISTRATION FOR CHILDREN AND FAMILIES—Continued
Federal Funds—Continued

THE BUDGET FOR FISCAL YEAR 2000

60.00
68.00

Permanent:
Appropriation .............................................................
Spending authority from offsetting collections: Offsetting collections (cash) .....................................

70.00

Total new budget authority (gross) ..........................

40
63
¥38

65
59
¥52

72
65
¥58

General and special funds—Continued
VIOLENT CRIME REDUCTION PROGRAMS—Continued
Program and Financing (in millions of dollars)
1998 actual

Identification code 75–8605–0–1–754

1999 est.

Obligations by program activity:
Family violence/battered women’s shelters and domestic violence hotline .............................................
00.02 Education and prevention grants to reduce sexual
abuse of runaway, homeless and street youth ........

104

10.00

105

119

40.00
42.00
43.00

72.40

93
105
119
¥92
¥105
¥119
¥1 ................... ...................

New budget authority (gross), detail:
Appropriation .................................................................. ................... ...................
Transferred from other accounts ...................................
93
105
Appropriation (total) ..................................................

2000 est.

00.01

Total new obligations ................................................

105

18
101
119

86.97
86.98

Outlays (gross), detail:
Outlays from new permanent authority .........................
Outlays from permanent balances ................................

25
13

12
40

48
10

87.00

Total outlays (gross) .................................................

Offsets:
Against gross budget authority and outlays:
88.40
Offsetting collections (cash) from: Non-Federal
sources ..................................................................

¥3

Net budget authority and outlays:
Budget authority ............................................................
Outlays ...........................................................................

53
35

52
49

62
55

89.00
90.00

72.40

28
92
¥39

82
105
¥79

108
119
¥105

108

122

86.90
86.93

Outlays (gross), detail:
Outlays from new current authority ..............................
Outlays from current balances ......................................

17
22

19
60

21
84

87.00

Total outlays (gross) .................................................

This account provides funding for research and technical
assistance activities established in P.L. 104–193. Amounts
for child welfare study and welfare research are in addition
to research amounts in the Children and Families Services
Program account.

105

Object Classification (in millions of dollars)
1998 actual

Identification code 75–1553–0–1–609

1999 est.

2000 est.

105
79

1998 actual

1999 est.

Subtotal, direct obligations ..................................
Reimbursable obligations ..............................................

60
3

56
3

62
3

Total new obligations ................................................

21.0
23.3
25.1
25.2
25.3

Object Classification (in millions of dollars)
Identification code 75–8605–0–1–754

25.7
31.0
41.0

99.9

119
105

Direct obligations:
Travel and transportation of persons .......................
Communications, utilities, and miscellaneous
charges .................................................................
Advisory and assistance services .............................
Other services ............................................................
Purchases of goods and services from Government
accounts ................................................................
Operation and maintenance of equipment ...............
Equipment .................................................................
Grants, subsidies, and contributions ........................

99.0
99.0

93
39

2000 est.

25.1
41.0

Advisory and assistance services ..................................
Grants, subsidies, and contributions ............................

2
90

2
103

2
117

99.9

Total new obligations ................................................

105

1
14
19

1
14
14

1
11
14

19
3
1
2

20
3
1
2

17
3
1
14

119

CHILDREN’S RESEARCH

AND

TECHNICAL ASSISTANCE

Program and Financing (in millions of dollars)
Identification code 75–1553–0–1–609

00.01
00.02
00.03
00.04
00.05
00.06
09.01

1998 actual

1999 est.

PAYMENTS

2000 est.

Obligations by program activity:
Training and technical assistance ................................
13
14
13
Federal parent locator service .......................................
35
30
28
Child welfare study ........................................................ ................... ...................
6
Welfare research ............................................................ ................... ...................
15
Evaluation of welfare to work .......................................
9
9 ...................
Evaluation of abstinence education ..............................
3
3 ...................
Reimbursable program ..................................................
3
3
3

09.09

Reimbursable program—subtotal line .....................

10.00

Total new obligations ................................................

21.40
22.00

Budgetary resources available for obligation:
Unobligated balance available, start of year ...............
New budget authority (gross) ........................................

11
56

4 ...................
55
65

23.90
23.95
24.40

Total budgetary resources available for obligation
Total new obligations ....................................................
Unobligated balance available, end of year .................

New budget authority (gross), detail:
Current:
41.00
Transferred to other accounts ...................................

STATES

FOR

FOSTER CARE

AND

ADOPTION ASSISTANCE

For making payments to States or other non-Federal entities under
title IV–E of the Social Security Act, ø$3,764,000,000¿
$4,272,000,000.
For making payments to States or other non-Federal entities under
title IV–E of the Social Security Act, for the first quarter of fiscal
year ø2000, $1,355,000,000¿ 2001, $1,538,000,000. (Department of
Health and Human Services Appropriations Act, 1999, as included
in Public Law 105–277, section 101(f).)
Program and Financing (in millions of dollars)
Identification code 75–1545–0–1–506

1998 actual

1999 est.

2000 est.

¥2 ................... ...................

Obligations by program activity:
Foster care .....................................................................
Independent living .........................................................
Adoption assistance .......................................................

3,540
70
701

3,983
70
869

4,537
70
1,020

10.00

Total obligations (object class 41.0) ........................

4,311

4,922

5,627

22.00
23.95

67
59
65
¥63
¥59
¥65
4 ................... ...................

00.01
00.02
00.03

Budgetary resources available for obligation:
New budget authority (gross) ........................................
Total new obligations ....................................................

4,311
¥4,311

4,922
¥4,922

5,627
¥5,627

ADMINISTRATION ON AGING
Federal Funds

DEPARTMENT OF HEALTH AND HUMAN SERVICES
New budget authority (gross), detail:
Current:
40.00
Appropriation .............................................................
Permanent:
65.00
Advance appropriation (definite) ..............................

3,200

3,764

4,272

1,111

1,158

1,355

70.00

Total new budget authority (gross) ..........................

4,311

4,922

5,627

829
4,311
¥4,451

688
4,922
¥4,939

673
5,627
¥5,485

688

673

815

90.00

461

Outlays ........................................................................... ................... ...................

This proposal assists children aging out of the foster care
system by providing additional funding for supportive services
under the Independent Living Program and grants to States
to fund the living expenses of children in transitional living
programs.

72.40

ADMINISTRATION ON AGING
Federal Funds
General and special funds:

86.90
86.93
86.97

2,868
629
954

3,309
613
1,017

3,730
580
1,175

87.00

Total outlays (gross) .................................................

4,451

4,939

5,485

89.00
90.00

Net budget authority and outlays:
Budget authority ............................................................
Outlays ...........................................................................

4,311
4,451

4,922
4,939

5,627
5,485

Summary of Budget Authority and Outlays
(in millions of dollars)

Enacted/requested:
1998 actual
1999 est.
Budget Authority .....................................................................
4,311
4,922
Outlays ....................................................................................
4,451
4,939
Legislative proposal, subject to PAYGO:
Budget Authority ..................................................................... .................... ....................
Outlays .................................................................................... .................... ....................
Total:
Budget Authority .....................................................................
Outlays ....................................................................................

4,311
4,451

4,922
4,939

2000 est.

5,627
5,485
40
6

AGING SERVICES PROGRAMS
For carrying out, to the extent not otherwise provided, the Older
Americans Act of 1965, as amended, and øsections 339A,¿ section
398ø, and 399¿ of the Public Health Service Act, ø$882,020,000: Provided, That notwithstanding section 308(b)(1) of the Older Americans
Act of 1965, as amended, the amounts available to each State for
administration of the State plan under title III of such Act shall
be reduced not more than 5 percent below the amount that was
available to such State for such purpose for fiscal year 1995¿
$923,055,000: Provided øfurther¿, That in considering grant applications for nutrition services for elder Indian recipients, the Assistant
Secretary shall provide maximum flexibility to applicants who seek
to take into account subsistence, local customs, and other characteristics that are appropriate to the unique cultural, regional, and geographic needs of the American Indian, Alaska and Hawaiian Native
communities to be served. (Department of Health and Human Services
Appropriations Act, 1999, as included in Public Law 105–277, section
101(f).)
Program and Financing (in millions of dollars)

5,667
5,491

Identification code 75–0142–0–1–506

Foster care.—The proposed level will support eligible lowincome children who must be placed outside the home. An
average of 339,000 children per month will be served in 2000.
Adoption assistance.—The proposed funding level will support subsidies for families adopting eligible low-income children with special needs. An average of 217,000 children per
month will be served in 2000.
PAYMENTS

STATES

FOR

FOSTER CARE

AND

ADOPTION ASSISTANCE

(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
Identification code 75–1545–4–1–506

1998 actual

1999 est.

Obligations by program activity:
Supportive services and centers ...................................
300
300
Preventive health ...........................................................
16
16
Congregate meals ..........................................................
374
374
Home-delivered meals ...................................................
112
112
In-home services ............................................................
10
10
Grants to Indian tribes ..................................................
18
18
State and local innovations and projects of national
significance ...............................................................
10
18
01.10 Federal administration ...................................................
15
15
01.12 Health disparities interventions .................................... ................... ...................
01.13 Alzheimer’s disease demonstration grants to States ...................
6
01.14 Grants to States for the protection of vulnerable
older Americans .........................................................
9
12
01.01
01.02
01.05
01.06
01.07
01.08
01.09

2000 est.

300
16
374
147
10
18
18
17
4
6
12

10.00
1999 est.

865

882

923

22.00
23.95

Budgetary resources available for obligation:
New budget authority (gross) ........................................
Total new obligations ....................................................

865
¥865

882
¥882

923
¥923

40.00

New budget authority (gross), detail:
Appropriation ..................................................................

865

882

923

2000 est.

Obligations by program activity:
00.01 Independent living ......................................................... ................... ...................
00.02 Grants to support transitional living expenses ............. ................... ...................

35
5

10.00

Total obligations (object class 41.0) ........................ ................... ...................

22.00
23.95

40
¥40

40.00

New budget authority (gross), detail:
Appropriation .................................................................. ................... ...................

Change in unpaid obligations:
73.10 Total new obligations .................................................... ................... ...................
73.20 Total outlays (gross) ...................................................... ................... ...................
74.40 Unpaid obligations, end of year: Obligated balance,
end of year ................................................................ ................... ...................

Total new obligations ................................................

40
¥6

Change in unpaid obligations:
Unpaid obligations, start of year: Obligated balance,
start of year ..............................................................
73.10 Total new obligations ....................................................
73.20 Total outlays (gross) ......................................................
73.40 Adjustments in expired accounts ..................................
74.40 Unpaid obligations, end of year: Obligated balance,
end of year ................................................................
72.40

223
260
279
865
882
923
¥828
¥864
¥890
¥1 ................... ...................
260

279

312

Outlays (gross), detail:
Outlays from new current authority .............................. ................... ...................

Net budget authority and outlays:
89.00 Budget authority ............................................................ ................... ...................

Outlays (gross), detail:
Outlays from new current authority ..............................
Outlays from current balances ......................................

622
206

621
243

647
243

87.00
86.90

Total outlays (gross) .................................................

828

864

890

89.00
90.00

86.90
86.93

Net budget authority and outlays:
Budget authority ............................................................
Outlays ...........................................................................

865
828

882
864

923
890

462

ADMINISTRATION ON AGING—Continued
Federal Funds—Continued

THE BUDGET FOR FISCAL YEAR 2000

General and special funds—Continued
AGING SERVICES PROGRAMS—Continued

are chronically ill or disabled. Funded activities will include
information, education, counseling, and respite services.

Summary of Budget Authority and Outlays

Object Classification (in millions of dollars)

(in millions of dollars)

Total:
Budget Authority .....................................................................
Outlays ....................................................................................

1998 actual

Identification code 75–0142–2–1–506

Enacted/requested:
1998 actual
1999 est.
Budget Authority .....................................................................
865
882
Outlays ....................................................................................
828
864
Legislative proposal, not subject to PAYGO:
Budget Authority ..................................................................... .................... ....................
Outlays .................................................................................... .................... ....................
865
828

882
864

2000 est.

1999 est.

2000 est.

923
890

25.1
41.0

2
123

125
81

99.9

Total new obligations ................................................ ................... ...................

125

1,048
971

DEPARTMENTAL MANAGEMENT
Federal Funds

Administration on Aging.—The proposed level will provide
supportive and nutrition services, research, training and demonstration projects for the elderly.
Object Classification (in millions of dollars)
1998 actual

Identification code 75–0142–0–1–506

1999 est.

2000 est.

11.1
12.1
23.1
25.2
41.0

Personnel compensation: Full-time permanent .............
Civilian personnel benefits ............................................
Rental payments to GSA ................................................
Other services ................................................................
Grants, subsidies, and contributions ............................

9
1
1
4
850

9
2
1
4
866

10
2
1
5
905

99.9

Total new obligations ................................................

865

882

923

Personnel Summary
Identification code 75–0142–0–1–506

Direct:
Total compensable workyears: Full-time equivalent
employment ...............................................................
Allocation account:
3001 Total compensable workyears: Full-time equivalent
employment ...............................................................

1998 actual

1999 est.

2000 est.

1001

120

130

142

(Legislative proposal, not subject to PAYGO)

1998 actual

1999 est.

2000 est.

01.01
01.02
01.03

Obligations by program activity:
Formula grants to states ............................................... ................... ...................
Competitive innovation grants ...................................... ................... ...................
Collaborative national activities .................................... ................... ...................

110
13
2

10.00

Total new obligations ................................................ ................... ...................

125

22.00
23.95

125
¥125

40.00

New budget authority (gross), detail:
Appropriation .................................................................. ................... ...................

125

FOR

CIVIL RIGHTS

For expenses necessary for the Office for Civil Rights,
ø$17,345,000¿, $18,845,000, together with not to exceed $3,314,000,
to be transferred and expended as authorized by section 201(g)(1)
of the Social Security Act from the Hospital Insurance Trust Fund
and the Supplemental Medical Insurance Trust Fund. (Department
of Health and Human Services Appropriations Act, 1999
POLICY RESEARCH

Program and Financing (in millions of dollars)

73.10
73.20
74.40

GENERAL DEPARTMENTAL MANAGEMENT
For necessary expenses, not otherwise provided, for general departmental management, including hire of six sedans, and for carrying
out titles III, XVII, and XX of the Public Health Service Act, and
the United States-Mexico Border Health Commission Act,
ø$180,051,000¿ $185,561,000, together with ø$5,851,000¿ $6,851,000,
to be transferred and expended as authorized by section 201(g)(1)
of the Social Security Act from the Hospital Insurance Trust Fund
and the Supplemental Medical Insurance Trust Fundø: Provided,
That of the funds made available under this heading for carrying
out title XVII of the Public Health Service Act, $1,000,000 shall
be available until expended for extramural construction: Provided
further, That $890,000 shall be for a contract with the National
Academy of Sciences to conduct a study of all the available scientific
literature examining the cause-and-effect relationship between repetitive tasks in the workplace and musculoskeletal disorders: Provided
further, That said contract shall be awarded not later than January
1, 1999¿. (Department of Health and Human Services Appropriations
Act, 1999, as included in Public Law 105–277, section 101(f).)
OFFICE

AGING SERVICES PROGRAMS

Identification code 75–0142–2–1–506

General and special funds:

125
¥81
44

86.90

Outlays (gross), detail:
Outlays from new current authority .............................. ................... ...................

89.00
90.00

125
81

This legislative proposal will establish a state grant program to support families that care for elderly relatives who

For carrying out, to the extent not otherwise provided, research
studies under section 1110 of the Social Security Act, $14,000,000.
(Department of Health and Human Services Appropriations Act, 1999,
as included in Public Law 105–277, section 101(f).)
PUBLIC HEALTH

AND

SOCIAL SERVICES EMERGENCY FUND

For expenses necessary to support activities related to countering
potential biological, disease and chemical threats to civilian populations, ø$216,922,000: Provided, That the entire amount is hereby
designated by Congress to be emergency requirements pursuant to
section 251(b)(2)(A) of the Balanced Budget and Emergency Deficit
Control Act of 1985, as amended: Provided further, That the entire
amount shall be available only to the extent that an official budget
request for $216,922,000, that includes designation of the entire
amount of the request as an emergency requirement as defined in
the Balanced Budget and Emergency Deficit Control Act of 1985,
as amended, is transmitted by the President to the Congress: Provided further, That of the amount provided under this heading,
$51,000,000, to remain available until expended, shall be for pharmaceutical and vaccine stockpiling activities at the Centers for Disease
Control and Prevention; and $3,000,000 shall be for the renovation
and modernization of the Noble Army Hospital facility at Fort McClellan, Alabama; and $322,000 shall be in payment to the health department of Calhoun County, Michigan: Provided further, That no funds
shall be obligated until the Department of Health and Human Services submits an operating plan to the House and Senate Committees
on Appropriations¿ $186,022,000; Provided, That this amount is distributed as follows: Centers for Disease Control and Prevention,
$118,000,000; Office of the Secretary, $30,000,000; Office of Emergency
Preparedness, $24,622,000; and Food and Drug Administration,
$13,400,000: Provided further, That the Secretary of HHS may trans-

DEPARTMENTAL MANAGEMENT—Continued
Federal Funds—Continued

DEPARTMENT OF HEALTH AND HUMAN SERVICES
fer some or all of these funds to other Department of Health and
Human Services accounts in this title to carry out these purposes.
In addition, $50,000,000 shall be made available for minority AIDS
prevention and treatment activities, and $150,000,000 shall be made
available for the Department’s Year 2000 computer conversion activities. (Department of Health and Human Services Appropriations Act,
1999, as included in Public Law 105–277, section 101(f).)
Program and Financing (in millions of dollars)
Identification code 75–9912–0–1–551

1998 actual

1999 est.

2000 est.

Obligations by program activity:
Direct activities:
00.01
General departmental management .........................
00.02
Office for Civil Rights ...............................................
00.03
Policy research ..........................................................
00.04
Public Health and Social Services Emergency Fund
09.01 Reimbursable program ..................................................

177
20
14
1
78

186
21
14
425
88

193
22
14
386
88

10.00

290

734

703

25
295

20 ...................
713
702

171
16
14
....................
....................
....................
....................

180
17
14
406
189
134
83

186
19
14
386
150
186
50

170
15
5
1

189
19
15
242

187
19
14
305

Total new budget authority (gross) ..........................

295

713

702

Object Classification (in millions of dollars)

43.00

202

616

604

Appropriation (total) .............................................
Permanent:
Spending authority from offsetting collections:
Offsetting collections (cash) ................................
From Federal sources: Change in receivables
and unpaid, unfilled orders .............................

Change in unpaid obligations:
Unpaid obligations, start of year: Obligated balance,
start of year ..............................................................
73.10 Total new obligations ....................................................
73.20 Total outlays (gross) ......................................................
73.40 Adjustments in expired accounts ..................................
73.45 Adjustments in unexpired accounts ..............................
Unpaid obligations, end of year:
74.40
Obligated balance, end of year ................................
74.95
From Federal sources: Receivables and unpaid, unfilled orders ...........................................................

45 ................... ...................

Identification code 75–9912–0–1–551

72.40

74.99

2000 est.

315
733
702
¥290
¥734
¥703
¥5 ................... ...................
20 ................... ...................

428
604
¥1 ...................
189 ...................

70.00

1999 est.

1 ................... ...................
¥6 ................... ...................

New budget authority (gross), detail:
Current:
40.00
Appropriation .............................................................
202
41.00
Transferred to other accounts ................................... ...................
42.00
Transferred from other accounts .............................. ...................

68.90

1998 actual

Distribution of budget authority by account:
General departmental management .......................................
Office for Civil Rights .............................................................
Policy research ........................................................................
Public Health and Social Services Emergency Fund ..............
Year 2000 computer conversion ........................................
Bioterrorism ........................................................................
Minority AIDS/Other ............................................................
Distribution of outlays by account:
General departmental management .......................................
Office for Civil Rights .............................................................
Policy research ........................................................................
Public Health and Social Services Emergency Fund ..............

Spending authority from offsetting collections
(total) ...........................................................

Total new obligations ................................................

Budgetary resources available for obligation:
Unobligated balance available, start of year ...............
New budget authority (gross) ........................................
Resources available from recoveries of prior year obligations .......................................................................
22.21 Unobligated balance transferred to other accounts

68.00
68.10

[Dollars in millions]

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; and support research to develop policy
initiatives and improve existing HHS programs. DM also includes the activities of the Office of Public Health and
Science, including adolescent family life, disease prevention
and health promotion, physical fitness and sports, minority
health, research integrity, women’s health, and emergency
preparedness. These accounts will continue to be appropriated
separately, and are being displayed in a consolidated format
to improve the readability of the presentation. Detailed information will continue to be available through the Department
of Health and Human Services.
The Public Health and Social Services Emergency Fund
supports three main activities in both the FY 1999 appropriation and FY 2000 Budget: Year 2000 computer conversion,
preparing for and responding to the medical and public health
consequences of potential bioterrorist events, and minority
AIDS prevention and treatment. In FY 1999, $189,053,000
was appropriated for Year 2000 computer conversion activities; $133,600,000 was provided for bioterrorism activities;
and $50,000,000 for minority AIDS prevention and treatment.
In FY 2000, a total of $150,000,000 is provided for HHS’
Year 2000 computer conversion activities; $186,022,000 is provided for bioterrorism; and $50,000,000 is provided for minority AIDS prevention and treatment.

21.40
22.00
22.10

23.90
23.95
23.98
24.40

463

Total unpaid obligations, end of year ..................

196
193
365
290
734
703
¥239
¥562
¥623
¥7 ................... ...................
¥1 ................... ...................
193

365

445

45 ................... ...................
238

365

445

128
63
48

352
114
97

314
210
98

87.00

Total outlays (gross) .................................................

239

562

623

¥48

¥97

¥98

¥45 ................... ...................

11.1
11.3
11.5
11.9
12.1
21.0
23.1
23.2
23.3
24.0
25.1
25.2
25.3
25.4
25.5
25.6
25.7
26.0
31.0
41.0

1998 actual

1999 est.

2000 est.

78
3
1

89
3
2

100
3
4

Total personnel compensation .........................
82
Civilian personnel benefits .......................................
16
Travel and transportation of persons .......................
2
Rental payments to GSA ...........................................
13
Rental payments to others ........................................ ...................
Communications, utilities, and miscellaneous
charges .................................................................
4
Printing and reproduction .........................................
1
Advisory and assistance services ............................. ...................
Other services ............................................................
13
Purchases of goods and services from Government
accounts ................................................................
20
Operation and maintenance of facilities ..................
3
Research and development contracts .......................
6
Medical care .............................................................. ...................
Operation and maintenance of equipment ...............
3
Supplies and materials .............................................
1
Equipment .................................................................
4
Grants, subsidies, and contributions ........................
44

94
18
5
14
1

107
20
9
15
2

5
1
18
42

5
2
1
48

29
3
12
99
11
58
44
192

32
4
42
121
6
58
15
128

99.0
99.0
202
191

616
465

604
525

Subtotal, direct obligations ..................................
Reimbursable obligations ..............................................

212
78

646
88

615
88

99.9

Total new obligations ................................................

290

734

703

464

DEPARTMENTAL MANAGEMENT—Continued
Federal Funds—Continued

THE BUDGET FOR FISCAL YEAR 2000

General and special funds—Continued
PUBLIC HEALTH

AND

year. (Department of Health and Human Services Appropriations Act,
1999, as included in Public Law 105–277, section 101(f).)

SOCIAL SERVICES EMERGENCY FUND—
Continued

Program and Financing (in millions of dollars)

Personnel Summary

Identification code 75–0379–0–1–551
1998 actual

Identification code 75–9912–0–1–551

Direct:
1001 Total compensable workyears: Full-time equivalent
employment ...............................................................
Reimbursable:
2001 Total compensable workyears: Full-time equivalent
employment ...............................................................
Allocation account:
3001 Total compensable workyears: Full-time equivalent
employment ...............................................................

PUBLIC HEALTH SERVICES

1999 est.

2000 est.

00.01
00.02
00.03
00.04

Obligations by program activity:
Retirement payments .....................................................
Survivors’ benefits .........................................................
Medical care ..................................................................
Military service credits ..................................................

150
11
28
2

159
12
29
2

172
12
30
1

1,444

155

167

10.00

Total new obligations ................................................

191

202

215

FOR THE

1,344

22.00
23.95

Budgetary resources available for obligation:
New budget authority (gross) ........................................
Total new obligations ....................................................

191
¥191

202
¥202

215
¥215

40.05

New budget authority (gross), detail:
Appropriation (indefinite) ...............................................

191

202

215

19
191
¥186

23
202
¥201

26
215
¥213

UNINSURED

Program and Financing (in millions of dollars)

10.00

1999 est.

1,239

(Legislative proposal, not subject to PAYGO)

1998 actual

Identification code 75–0138–2–1–551

1998 actual

1999 est.

2000 est.

Obligations by program activity:
Total new obligations (object class 41.0) ..................... ................... ...................

New budget authority (gross), detail:
40.00 Appropriation .................................................................. ................... ...................
Change in unpaid obligations:
73.10 Total new obligations .................................................... ................... ...................
73.20 Total outlays (gross) ...................................................... ................... ...................
74.40 Unpaid obligations, end of year: Obligated balance,
end of year ................................................................ ................... ...................

Outlays (gross), detail:
Outlays from new current authority ..............................
Outlays from current balances ......................................

173
13

183
16

195
18

Total outlays (gross) .................................................

186

201

213

89.00
90.00

25
¥25

86.90
86.93
87.00

Net budget authority and outlays:
Budget authority ............................................................
Outlays ...........................................................................

191
186

202
201

215
213

25
¥4
21

86.90

Outlays (gross), detail:
Outlays from new current authority .............................. ................... ...................

89.00
90.00

25
4

The public health initiative will assist communities and
safety-net providers to develop and expand integrated care
systems to improve quality standards and accessibility to
health care for the uninsured. By coordinating service delivery
and establishing accountability within the health care system,
the initiative will assure adequate patient care, improve the
quality of care provided, and allow more uninsured people
to get health services.

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.
Object Classification (in millions of dollars)
Identification code 75–0379–0–1–551

13.0
25.2
25.3
99.9

1998 actual

1999 est.

2000 est.

Benefits for former personnel ........................................
Other services ................................................................
Purchases of goods and services from Government
accounts ....................................................................

161
28

171
29

184
30

Total new obligations ................................................

191

202

215

HEALTH ACTIVITIES FUNDS
Program and Financing (in millions of dollars)

ALLOCATIONS RECEIVED FROM OTHER ACCOUNTS
Note.—Obligations incurred under allocations from other accounts are included in the
schedules of the parent appropriation as follows: Health Care Financing Administration:
‘‘Health Care Fraud and Abuse Control Account.’’

PROGRAM SUPPORT CENTER

Identification code 75–9913–0–1–552

Change in unpaid obligations:
Unpaid obligations, start of year: Obligated balance,
start of year ..............................................................
73.20 Total outlays (gross) ......................................................
74.40 Unpaid obligations, end of year: Obligated balance,
end of year ................................................................

AND

MEDICAL BENEFITS
OFFICERS

FOR

COMMISSIONED

For retirement pay and medical benefits of Public Health Service
Commissioned Officers as authorized by law, for payments under
the Retired Serviceman’s Family Protection Plan and Survivor Benefit
Plan, for medical care of dependents and retired personnel under
the Dependents’ Medical Care Act (10 U.S.C. ch. 55), and for payments pursuant to section 229(b) of the Social Security Act (42 U.S.C.
429(b)), such amounts as may be required during the current fiscal

1999 est.

2000 est.

72.40

General and special funds:
RETIREMENT PAY

1998 actual

10
¥1

9
¥1

86.93

Outlays (gross), detail:
Outlays from current balances ......................................

89.00
90.00

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.

PROGRAM SUPPORT CENTER—Continued
Trust Funds

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Intragovernmental funds:
HHS SERVICE

465

Object Classification (in millions of dollars)
AND

SUPPLY FUND

Program and Financing (in millions of dollars)
Identification code 75–9941–0–4–551

1998 actual

1999 est.

2000 est.

09.01
09.02
09.03

Obligations by program activity:
Program support center .................................................
Federal employee occupational health ..........................
OS activities ...................................................................

281
84
7

271
103
7

282
120
7

10.00

Total new obligations ................................................

372

381

409

21.40
22.00
22.22

23.90
23.95
24.40

Total budgetary resources available for obligation
Total new obligations ....................................................
Unobligated balance available, end of year .................

42
35
35
359
381
409
6 ................... ...................
407
¥372
35

1998 actual

Identification code 75–9941–0–4–551

416
¥381
35

444
¥409
35

11.1
11.3
11.5

1999 est.

2000 est.

54
9
3

60
9
3

62
10
3

66
14
2
2
10
35
1
8
102

72
15
3
2
12
39
1
7
103

75
16
4
2
12
41
1
7
113

26.0
31.0

Total personnel compensation ..............................
Civilian personnel benefits ............................................
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 ......................................................................

25
98
9

25
96
6

26
105
7

99.9

Total new obligations ................................................

372

381

409

11.9
12.1
21.0
22.0
23.1
23.3
24.0
25.1
25.2
25.3

Personnel Summary
New budget authority (gross), detail:
Spending authority from offsetting collections:
68.00
Offsetting collections (cash) .....................................
68.10
From Federal sources: Change in receivables and
unpaid, unfilled orders .........................................
68.90

Spending authority from offsetting collections
(total) ................................................................

381

409

359

381

Total compensable workyears: Full-time equivalent
employment ...............................................................

409

1,216

1999 est.

1,260

2000 est.

1,260

Trust Funds
MISCELLANEOUS TRUST FUNDS
Unavailable Collections (in millions of dollars)

¥14
131

¥41 ...................
173
132
381
¥340

173

117
372
¥357

173

74.99

Total unpaid obligations, end of year ..................

132

173

86.97
86.98

Outlays (gross), detail:
Outlays from new permanent authority .........................
Outlays from permanent balances ................................

359
¥2

87.00

Total outlays (gross) .................................................

357

2001

42 ................... ...................

Total unpaid obligations, start of year ................
Total new obligations ....................................................
Total outlays (gross) ......................................................
Unpaid obligations, end of year:
Obligated balance, end of year ................................
From Federal sources: Receivables and unpaid, unfilled orders ...........................................................

74.40
74.95

1998 actual

Identification code 75–9941–0–4–551

317

173
409
¥409

¥41 ................... ...................

¥317

Identification code 75–9971–0–7–551

¥381

409

¥409

¥42 ................... ...................

Net budget authority and outlays:
89.00 Budget authority ............................................................ ................... ................... ...................
90.00 Outlays ...........................................................................
41
¥41 ...................

The HHS Service and Supply Fund (SSF) provides common
centralized services to HHS components. The Program Support Center (PSC) line includes activities such as personnel
and payroll administration, financial management operations,
and a wide array of administrative services, including acquisitions management, building and property management, and
technical support. The Office of the Secretary (OS) activities
line includes the fund manager, departmental contracts and
grants, audit resolution, OS graphics, and the regional health
administrators. The Federal Employee Occupational Health
(FOH) program is also funded through the SSF. FOH includes
clinical services, environmental health services and employee
assistance programs.

1999 est.

2000 est.

02.99

Total receipts .............................................................
53
53
53
Appropriation:
05.01 Miscellaneous trust funds .............................................
¥53
¥53
¥53
07.99 Total balance, end of year ............................................ ................... ................... ...................

381
409
¥41 ...................
340

1998 actual

Balance, start of year:
01.99 Balance, start of year .................................................... ................... ................... ...................
Receipts:
02.01 Contributions, Indian health facilities, Health Services
Administration ...........................................................
35
35
35
02.02 Gifts and contributions, Miscellaneous trust funds
17
17
17
02.03 Interest, Miscellaneous trust funds ...............................
1
1
1

Program and Financing (in millions of dollars)
Identification code 75–9971–0–7–551

1998 actual

1999 est.

2000 est.

00.02
00.03

Obligations by program activity:
Gifts ...............................................................................
Contributions, Indian health facilities ..........................

25
42

18
35

10.00

Total new obligations ................................................

21.40
22.00
22.10

37
53

27
53

4 ................... ...................

23.90
23.95
24.40

Total budgetary resources available for obligation
Total new obligations ....................................................
Unobligated balance available, end of year .................

94
¥67
27

80
¥53
27

60.27

New budget authority (gross), detail:
Appropriation (trust fund, indefinite) ............................

Change in unpaid obligations:
Unpaid obligations, start of year: Obligated balance,
start of year ..............................................................
73.10 Total new obligations ....................................................
73.20 Total outlays (gross) ......................................................
73.45 Adjustments in unexpired accounts ..............................
74.40 Unpaid obligations, end of year: Obligated balance,
end of year ................................................................
72.40

88
96
103
67
53
53
¥56
¥46
¥48
¥4 ................... ...................
96

103

108

466

PROGRAM SUPPORT CENTER—Continued
Trust Funds—Continued

THE BUDGET FOR FISCAL YEAR 2000

Intragovernmental funds—Continued

Program and Financing (in millions of dollars)

MISCELLANEOUS TRUST FUNDS—Continued

1998 actual

Identification code 75–9971–0–7–551

1998 actual

Identification code 75–0128–0–1–551

Program and Financing (in millions of dollars)—Continued
1999 est.

1999 est.

2000 est.

00.01
09.01

2000 est.

Obligations by program activity:
Direct program ...............................................................
Reimbursable program ..................................................

32
9

29
14

32
14

10.00

Total new obligations ................................................

86.97
86.98

Outlays (gross), detail:
Outlays from new permanent authority .........................
Outlays from permanent balances ................................

13
43

12
34

12
36

87.00

Total outlays (gross) .................................................

21.40
22.00

Budgetary resources available for obligation:
Unobligated balance available, start of year ...............
New budget authority (gross) ........................................

1
41

1
43

1
46

89.00
90.00

Net budget authority and outlays:
Budget authority ............................................................
Outlays ...........................................................................

53
56

53
46

53
48

23.90
23.95
24.40

Total budgetary resources available for obligation
Total new obligations ....................................................
Unobligated balance available, end of year .................

42
¥41
1

44
¥43
1

47
¥46
1

13
3
41
43
¥50
¥42
¥1 ...................

4
46
¥46
¥1

[Dollars in millions]

70.00
1998

Distribution of budget authority by account:
Gifts ........................................................................................
Contributions, Indian health facilities ...................................
Distribution of outlays by account:
Gifts ........................................................................................
Contributions, Indian health facilities ...................................

1999

18
35

16
40

17
29

18
30

11.3
11.5
11.8
11.9
12.1
21.0
22.0
25.2
25.3

Personnel compensation:
Other than full-time permanent ...............................
Other personnel compensation ..................................
Special personal services payments .........................

25.4
25.5
25.7
26.0
31.0
32.0
41.0

Total personnel compensation ..............................
Civilian personnel benefits ............................................
Travel and transportation of persons ............................
Transportation of things ................................................
Other services ................................................................
Purchases of goods and services from Government
accounts ....................................................................
Operation and maintenance of facilities ......................
Research and development contracts ...........................
Operation and maintenance of equipment ...................
Supplies and materials .................................................
Equipment ......................................................................
Land and structures ......................................................
Grants, subsidies, and contributions ............................

99.9

Total new obligations ................................................

1999 est.

2000 est.

1001

86.90
86.93
86.97

31
10
9

26
2
14

29
3
14

Total outlays (gross) .................................................

Offsets:
Against gross budget authority and outlays:
88.00
Offsetting collections (cash) from: Federal sources

¥9

¥14

5
1
1
2
3

5
1
1
2
2

89.00
90.00

Net budget authority and outlays:
Budget authority ............................................................
Outlays ...........................................................................

32
41

29
28

32
32

1
1
1
6
3
3
3
3
3
13
12
12
5
2
2
1 ................... ...................
16
14
14
10
7
7
67

1999 est.

The Office of Inspector General identifies and recommends
actions to correct fraud, waste, and abuse in HHS administered and assisted programs and operations through audits
and investigations.
In addition to the discretionary resources appropriated to
the Office of the Inspector General (OIG), the Health Insurance Portability and Accountability Act of 1996 makes available mandatory funding for use by the OIG to combat Medicare fraud and abuse through a coordinated Health Care
Fraud and Abuse Control (HCFAC) Program with the Department of Justice. The following table shows total funding resources for the OIG:

2000 est.

(In millions of dollars)
76

General and special funds:
OF

3
1
1

OFFICE OF THE INSPECTOR GENERAL
OFFICE

3
1
1

1998 actual

Total compensable workyears: Full-time equivalent
employment ...............................................................

3
1
1

Personnel Summary
Identification code 75–9971–0–7–551

Change in unpaid obligations:
Unpaid obligations, start of year: Obligated balance,
start of year ..............................................................
73.10 Total new obligations ....................................................
73.20 Total outlays (gross) ......................................................
73.40 Adjustments in expired accounts ..................................
74.40 Unpaid obligations, end of year: Obligated balance,
end of year ................................................................
72.40

87.00

Object Classification (in millions of dollars)
1998 actual

Total new budget authority (gross) ..........................

2000

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.

Identification code 75–9971–0–7–551

INSPECTOR GENERAL

For expenses necessary for the Office of Inspector General in carrying out the provisions of the Inspector General Act of 1978, as amended, ø$29,000,000¿ $31,500,000. (Department of Health and Human
Services Appropriations Act, 1999, as included in Public Law 105–
277, section 101(f).)

1998 actual

Budget Authority:
Discretionary appropriations ...................................................
Mandatory (HCFAC Account) ...................................................

1999 est.

2000 est.

32
72

29
100

32
120

Total ...............................................................................
Outlays:
Discretionary appropriations ...................................................
Mandatory (HCFAC Account) ...................................................

104

129

152

41
66

28
100

32
120

Total ...............................................................................

107

128

152

This schedule reflects estimated distribution of mandatory
funds from the HCFAC account in FY 2000. Actual FY 2000
distribution will be determined by the Secretary of HHS and
the Attorney General.

GENERAL PROVISIONS

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Object Classification (in millions of dollars)
1998 actual

Identification code 75–0128–0–1–551

1999 est.

2000 est.

31.0

Direct obligations:
Personnel compensation: Full-time permanent ........
Civilian personnel benefits .......................................
Travel and transportation of persons .......................
Rental payments to GSA ...........................................
Purchases of goods and services from Government
accounts ................................................................
Equipment .................................................................

99.0
99.0

Subtotal, direct obligations ..................................
Reimbursable obligations ..............................................

32
9

29
14

32
14

99.9

Total new obligations ................................................

11.1
12.1
21.0
23.1
25.3

19
4
2
2

18
4
2
2

19
4
2
2

4
3
1 ...................

4
1

Personnel Summary
1998 actual

Identification code 75–0128–0–1–551

1999 est.

2000 est.

312

283

292

834

963

1,060

ALLOCATIONS RECEIVED FROM OTHER ACCOUNTS
Note.—Obligations incurred under allocations from other accounts are included in the
schedules of the parent appropriations as follows: Health Care Financing Administration:
‘‘Health Care Fraud and Abuse Control Account.’’

GENERAL FUND RECEIPT ACCOUNTS
(in millions of dollars)
1998 actual

1999 est.

Offsetting receipts from the public:
75–310700 Federal share of child support collections ......
1,007
945
Legislative proposal, subject to PAYGO ............................. ................... ...................
General Fund Offsetting receipts from the public .....................

1,007

945

2000 est.

965
65
1,030

GENERAL PROVISIONS

SEC. 201. Funds appropriated in this title shall be available for
not to exceed $37,000 for official reception and representation expenses when specifically approved by the Secretary.
SEC. 202. The Secretary shall make available through assignment
not more than 60 employees of the Public Health Service to assist
in child survival activities and to work in AIDS programs through
and with funds provided by the Agency for International Development, the United Nations International Children’s Emergency Fund
or the World Health Organization.
SEC. 203. None of the funds appropriated under this Act may
be used to implement section 399L(b) of the Public Health Service
Act or section 1503 of the National Institutes of Health Revitalization
Act of 1993, Public Law 103–43.
SEC. 204. None of the funds appropriated in this Act for the National Institutes of Health and the Substance Abuse and Mental
Health Services Administration shall be used to pay the salary of
an individual, through a grant or other extramural mechanism, at
a rate in excess of Executive Level III.
SEC. 205. øNone of the funds appropriated in this Act may be
expended pursuant to section 241 of the Public Health Service Act,
except for funds specifically provided for in this Act, or for other
taps and assessments made by any office located in the Department
of Health and Human Services, prior to the Secretary’s preparation
and submission of a report to the Committee on Appropriations of

467

the Senate and of the House detailing the planned uses of such
funds.¿ Notwithstanding section 241(a) of the Public Health Service
Act, such portion as the Secretary shall determine, but not more than
1.5 percent, of any amounts appropriated for programs authorized
under the PHS Act shall be made available for the evaluation (directly, or by grants or contracts) of the implementation and effectiveness of such programs.
øSEC. 206. None of the funds appropriated in this Act or subsequent
Departments of Labor, Health and Human Services, and Education,
and Related Agencies Appropriations Acts, may be obligated or expended for the Federal Council on Aging under the Older Americans
Act or the Advisory Board on Child Abuse and Neglect under the
Child Abuse Prevention and Treatment Act.¿
(TRANSFER OF FUNDS)

SEC. ø207¿ 206. Not to exceed 1 percent of any discretionary funds
(pursuant to the Balanced Budget and Emergency Deficit Control
Act, as amended) which are appropriated for the current fiscal year
for the Department of Health and Human Services in this Act may
be transferred between appropriations, but no such appropriation
(except the Public Health and Social Services Emergency Fund) shall
be increased by more than 3 percent by any such transfer: Provided,
That the Appropriations Committees of both Houses of Congress are
notified at least fifteen days in advance of any transfer.
SEC. ø208¿ 207. The Director of the National Institutes of Health,
jointly with the Director of the Office of AIDS Research, may transfer
up to 3 percent among institutes, centers, and divisions from the
total amounts identified by these two Directors as funding for research pertaining to the human immunodeficiency virus: Provided,
That the Congress is promptly notified of the transfer.
øSEC. 209. Of the amounts made available in this Act for the
National Institutes of Health, the amount for research related to
the human immunodeficiency virus, as jointly determined by the Director of NIH and the Director of the Office of AIDS Research, shall
be made available to the ‘‘Office of AIDS Research’’ account. The
Director of the Office of AIDS Research shall transfer from such
account amounts necessary to carry out section 2353(d)(3) of the
Public Health Service Act.¿
øSEC. 210. Funds appropriated in this Act or subsequent Departments of Labor, Health and Human Services, and Education, and
Related Agencies Appropriations Acts, for the National Institutes of
Health may be used to provide transit subsidies in amounts consistent with the transportation subsidy programs authorized under section 629 of Public Law 101–509 to non-FTE bearing positions including trainees, visiting fellows and volunteers.¿
SEC. ø211¿ 208. None of the funds appropriated in this Act may
be made available to any entity under title X of the Public Health
Service Act unless the applicant for the award certifies to the Secretary that it encourages family participation in the decision of minors to seek family planning services and that it provides counseling
to minors on how to resist attempts to coerce minors into engaging
in sexual activities.
øSEC. 212. Subsection (b)(1)(H) of section 401 of the Public Health
Service Act (42 U.S.C. 281 (b)(1)(H)) is amended by striking ‘‘National
Institute of Dental Research’’ and inserting ‘‘National Institute of
Dental and Craniofacial Research’’.¿
SEC. ø213. (a) The final rule entitled ‘‘Organ Procurement and
Transplantation Network’’, promulgated by the Secretary of Health
and Human Services on April 2, 1998 (63 FR 16295 et seq.) (relating
to part 121 of title 42, Code of Federal Regulations), shall not become
effective before the expiration of the 1-year period beginning on the
date of the enactment of this Act.
(b)(1) The Institute of Medicine under contract with and subject
to review by the Comptroller General, in consultation with the Secretary and with the Organ Procurement and Transplantation Network (in this section referred to as the ‘‘OPTN’’), shall conduct a
review of the current polices of the OPTN and the final rule specified
in subsection (a) in order to determine the following:
(A) The potential impact on access to transplantation services
for low-income populations and for racial and ethnic minority
groups. With respect to State policies in carrying out the program
under title XIX of the Social Security Act, the determination made
under this subparagraph shall include determining the impact of
such policies regarding payment for services for patients that are
provided to the patients outside of the States in which the patients
reside.
(B) With respect to organ procurement organizations (qualified
under section 371 of the Public Health Service Act):

468

GENERAL PROVISIONS—Continued

(i) The potential impact on the ability of the organizations
to facilitate an appropriate rate of organ donation within the
service areas of the organizations.
(ii) The reasons underlying the variations in performance
among such organizations.
(iii) The potential impact of requiring sharing of organs based
on medical criteria instead of geography on the ability of the
organizations to facilitate an appropriate rate of organ donation
within the service areas of the organizations.
(C) The potential impact on waiting times for organ transplants,
including determinations specific to the various geographic regions
of the United States, and if practicable, waiting times for each
transplant center by organ and medical status category. The determination made under this subparagraph shall include determining
the impact of recent changes made by the OPTN in patient listing
criteria and in measures of medical status.
(D) The potential impact on patient survival rates and organ
failure rates which lead to retransplantation, including any variance by income status, ethnicity, gender, race, or blood type.
(E) The potential impact on the costs of organ transplantation
services.
(F) The potential impact on the liability, under State laws and
procedures regarding peer review, of members of the OPTN.
(G) The potential impact on the confidential status of information
that relates to the transplantation of organs.
(H) Recommendations, if any, to change existing policies and
the final rule.
(2)(A) Not later than May 1, 1999, the Comptroller General of
the United States shall submit to the congressional committees specified in subparagraph (B) a report describing the results of the review
conducted under paragraph (1).
(B) The congressional committees referred to in subparagraph (A)
are the Committee on Commerce of the House of Representatives,
the Committee on Appropriations of the House, the Committee on
Labor and Human Resources of the Senate, and the Committee on
Appropriations of the Senate.
(c)(1) Beginning promptly after the date of the enactment of this
Act, the Secretary may conduct a series of discussions with the OPTN
in order to resolve issues raised by the final rule referred to in
subsection (a).
(2) The Secretary and the OPTN may utilize the services of a
mediator in conducting the discussions under paragraph (1). An individual may not be selected to serve as the mediator unless the Secretary and the OPTN both approve the selection of the individual
to so serve, and the individual agrees that, not later than June
30, 1999, the individual will submit to the congressional committees
specified in subsection (b)(2)(B) a report describing the extent of
progress that has been made through the discussions under paragraph (1).
(d)(1) Beginning on the date of enactment of this Act, the OPTN
shall provide to the Secretary, the Institutes of Medicine, and the
Comptroller General, upon request, any data necessary to assess the
effectiveness of the Nation’s organ donation, procurement and organ
allocation systems, or to assess the quality of care provided to all
transplant patients, and analysis of such data in a scientifically and
clinically valid manner. If necessary, the OPTN may provide additional data as they deem appropriate.
(2) The OPTN shall make available to the public timely and accurate program-specific information on the performance of transplant
programs. These data shall be updated as frequently as possible,
and the OPTN shall work to shorten the time period for data collection and analysis in producing its center-specific outcomes report,
including severity adjusted long term survival rates. Such data shall
also include such other cost or performance information including
but not limited to transplant program-specific information on waiting
time within medical status, organ waitings, and refusal of organ
offers.
(e) Data provided under subsection (d) shall be specific (if possible)
to individual transplant centers and must be determined in a scientifically and clinically valid manner.
(f) Any disclosure of patient specific medical information under
subsection (d) shall be subject to the restrictions contained in the
Freedom of Information Act, the Privacy Act, and State laws.
(g) Of the amount appropriated in this title for ‘‘OFFICE OF THE
SECRETARY—GENERAL DEPARTMENTAL MANAGEMENT’’, $500,000 shall,
not later than 30 days after the date of the enactment of this Act,
be transferred to the Comptroller General for purposes of carrying
out the studies required and specified in this section.

THE BUDGET FOR FISCAL YEAR 2000
(h) For purposes of this section:
(1) The term ‘‘Comptroller General’’ means the Comptroller General of the United States.
(2) The term ‘‘Organ Procurement and Transplantation Network’’
means the network operated under section 372 of the Public Health
Service Act.
(3) The term ‘‘Secretary’’ means the Secretary of Health and
Human Services.¿ 209. (a)(1) In fiscal year 2000 and thereafter,
the Organ Procurement and Transplantation Network (‘‘OPTN’’)
shall provide to the Secretary, upon request, any data necessary
to assess the effectiveness of the Nation’s organ donation, procurement and organ allocation systems, or to assess the quality of care
provided to all transplant patients, and analysis of such data in
a scientifically and clinically valid manner. If necessary, the OPTN
may provide additional data as they deem appropriate.
(2) The OPTN shall make available to the public timely and accurate program-specific information on the performance of transplant
programs. These data shall be updated as frequently as possible, and
the OPTN shall work to shorten the time period for data collection
and analysis in producing its center-specific outcomes report, including severity adjusted long term survival rates. Such data shall also
include such other cost or performance information including but not
limited to transplant program-specific information on waiting time
within medical status, organ waitings, and refusal of organ offers.
(b) Data provided under subsection (a) shall be specific (if possible)
to individual transplant centers and must be determined in a scientifically and clinically valid manner.
(c) Any disclosure of patient specific medical information under
subsection (a) shall be subject to the restrictions contained in the
Freedom of Information Act, the Privacy Act, and State laws.
(d) For purposes of this section:
(1) The term ‘‘Organ Procurement and Transportation Network’’
means the network operated under section 372 of the Public Health
Service Act.
(2) The term ‘‘Secretary’’ means the Secretary of Health and
Human Services.
øSEC. 214. (a) Section 2003(c) of the Social Security Act (42 U.S.C.
1397b(c)) is amended by striking paragraph (8) and inserting the
following:
‘‘(8) $2,299,000,000 for the fiscal year 1998;’’.
(b) The amendment made by this section takes effect immediately
after the amendments made by section 8401 of the Transportation
Equity Act for the 21st Century take effect.¿
øSEC. 215. The Consolidated Laboratory Building (Building 50) at
the National Institutes of Health is hereby named the Louis Stokes
Laboratories.¿
SEC. ø216¿ 210. None of the funds appropriated by this Act (including funds appropriated to any trust fund) may be used to carry
out the Medicare+Choice program if the Secretary denies participation in such program to an otherwise eligible entity (including a
Provider Sponsored Organization) because the entity informs the Secretary that it will not provide, pay for, provide coverage of, or provide
referrals for abortions: Provided, That the Secretary shall make appropriate prospective adjustments to the capitation payment to such
an entity (based on an actuarially sound estimate of the expected
costs of providing the service to such entity’s enrollees): Provided
further, That nothing in this section shall be construed to change
the Medicare program’s coverage for such services and a
Medicare+Choice organization described in this section shall be responsible for informing enrollees where to obtain information about
all Medicare covered services.
øSEC. 217. The Vaccine Research Facility (Building 40) at the National Institutes of Health is hereby named the Dale and Betty Bumpers Vaccine Research Facility.¿
øSEC. 218. (a) MENTAL HEALTH.—Section 1918(b) of the Public
Health Service Act (42 U.S.C. 300x–7(b)) is amended to read as
follows:
‘‘(b) MINIMUM ALLOTMENTS FOR STATES.—
‘‘(1) IN GENERAL.—With respect to fiscal year 1999, the amount
of the allotment of a State under section 1911 shall not be less
than the amount the State received under section 1911 for fiscal
year 1998.’’.
(b) SUBSTANCE ABUSE.—Section 1933(b) of the Public Health Service Act (42 U.S.C. 300x–33(b)) is amended to read as follows:
‘‘(b) MINIMUM ALLOTMENTS FOR STATES.—
‘‘(1) IN GENERAL.—With respect to fiscal year 1999, the amount
of the allotment of a State under section 1921 shall not be less
than the amount the State received under section 1921 for fiscal

DEPARTMENT OF HEALTH AND HUMAN SERVICES
year 1998 increased by 30.65 percent of the percentage by which
the amount allotted to the States for fiscal year 1999 exceeds the
amount allotted to the States for fiscal year 1998.
‘‘(2) LIMITATION.—
‘‘(A) IN GENERAL.—Except as provided in subparagraph (B),
a State shall not receive an allotment under section 1921 for
fiscal year 1999 in an amount that is less than an amount
equal to 0.375 percent of the amount appropriated under section 1935(a) for such fiscal year.
‘‘(B) EXCEPTION.—In applying subparagraph (A), the Secretary shall ensure that no State receives an increase in its
allotment under section 1921 for fiscal year 1999 (as compared
to the amount allotted to the State in the fiscal year 1998)
that is in excess of an amount equal to 300 percent of the
percentage by which the amount appropriated under section
1935(a) for fiscal year 1999 exceeds the amount appropriated
for the prior fiscal year.
‘‘(3) Only for the purposes of calculating minimum allotments
under this subsection, any reference to the amount appropriated
under section 1935(a) for fiscal year 1998, allotments to States

GENERAL PROVISIONS—Continued

469

under section 21 and any references to amounts received by States
in fiscal year 1998 shall include amounts appropriated or received
under the amendments made by section 105 of the Contract with
America Advancement Act of 1996 (Public Law 104–121).’’.
(c) EFFECTIVE DATE.—
(1) IN GENERAL.—The amendments made by subsections (a) and
(b) shall become effective as if enacted on October 1, 1998 and
shall only apply during fiscal year 1999.
(2) APPLICATION.—Upon the expiration of the fiscal year described
in paragraph (1), the provisions of sections 1918(b) and 1933(b)
of the Public Health Service Act (42 U.S.C. 300x–7(b) and 300x–
33(b)), as in effect on September 30, 1998, shall be applied as
if the amendments made by this section had not been enacted.¿
SEC. ø219¿ 211. Notwithstanding any other provision of law, no
provider of services under title X of the Public Health Service Act
shall be exempt from any State law requiring notification or the
reporting of child abuse, child molestation, sexual abuse, rape, or
incest. (Department of Health and Human Services Appropriations
Act, 1999, as included in Public Law 105–277, section 101(f).)