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DEPARTMENT OF HEALTH AND HUMAN SERVICES FOOD AND DRUG ADMINISTRATION 21.40 22.00 22.10 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; for miscellaneous and emergency expenses of enforcement activities, authorized and approved by the Secretary and to be accounted for solely on the Secretary’s certificate, not to exceed $25,000; and notwithstanding section 521 of P.L. 107–188; $1,673,632,000, of which not to exceed $249,825,000 shall be derived from prescription drug user fees authorized by 21 U.S.C. 379h and shall be credited to this account and remain available until expended: Provided, That of the amount provided under this heading, $29,190,000 shall be derived from medical device user fees authorized by 21 U.S.C. 379j and shall be credited to this account and remain available until expended: Provided further, That fees derived from prescription drug and medical device applications received during fiscal year 2004 shall be subject to the fiscal year 2004 limitation: Provided further, That any prescription drug or medical device user fee collected in fiscal year 2004 that exceed this limitation shall be credited to this account and remain available until expended, in accordance with 21 U.S.C. 379h(g)(4) and 379j(h)(4). In addition, mammography user fees authorized by 42 U.S.C. 263b may be credited to this account, to remain available until expended. In addition, export certification user fees authorized by 21 U.S.C. 381 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, $11,500,000, to remain available until expended (7 U.S.C. 2209b). Note.—A regular 2003 appropriation for this account had not been enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 107–229, as amended). The amounts included for 2003 in this budget reflect the Administration’s 2003 policy proposals. Unavailable Collections (in millions of dollars) 2002 actual Identification code 75–9911–0–1–554 2003 est. 2004 est. 01.99 Balance, start of year .................................................... ................... ................... ................... Receipts: 02.20 Cooperative research and development agreements .... 2 2 2 Appropriations: 05.00 Salaries and expenses ................................................... ¥2 ¥2 ¥1 07.99 23.90 23.95 24.40 2004 est. 00.01 00.02 00.03 00.04 00.05 00.06 00.07 00.08 00.09 09.01 Obligations by program activity: Foods .............................................................................. Drugs .............................................................................. Devices and radiological products ................................ National Center for Toxicological Research ................... Other activities .............................................................. Other rent and rent related activities ........................... Rental payments ............................................................ Buildings and facilities ................................................. CRADAs .......................................................................... Reimbursable program .................................................. 393 479 180 39 82 38 99 44 1 214 412 513 191 41 85 36 99 8 2 291 413 513 185 40 92 42 109 12 2 334 10.00 Total new obligations ................................................ 1,569 1,678 1,742 Frm 00001 Fmt 3616 VerDate Dec 13 2002 15:09 Jan 23, 2003 Jkt 193833 PO 00000 203 1,741 5 ................... ................... 1,772 ¥1,569 203 1,881 ¥1,678 203 1,944 ¥1,742 203 43.00 1,368 1,385 1,406 2 2 1 306 291 334 60.20 68.00 68.10 Appropriation (total discretionary) ........................ Mandatory: Appropriation (special fund) ..................................... Spending authority from offsetting collections: Discretionary: Offsetting collections (cash) ................................ Change in uncollected customer payments from Federal sources (unexpired) ............................. 68.90 70.00 22 ................... ................... Spending authority from offsetting collections (total discretionary) ..................................... 328 291 334 Total new budget authority (gross) .......................... 1,698 1,678 1,741 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Adjustments in expired accounts (net) ......................... Recoveries of prior year obligations .............................. Change in uncollected customer payments from Federal sources (unexpired) ............................................ 74.10 Change in uncollected customer payments from Federal sources (expired) ................................................ 74.40 Obligated balance, end of year ..................................... 72.40 73.10 73.20 73.40 73.45 74.00 393 488 503 1,569 1,678 1,742 ¥1,450 ¥1,663 ¥1,735 ¥5 ................... ................... ¥5 ................... ................... ¥22 ................... ................... 7 ................... ................... 488 503 510 86.90 86.93 86.97 Outlays (gross), detail: Outlays from new discretionary authority ..................... Outlays from discretionary balances ............................. Outlays from new mandatory authority ......................... 1,182 267 1 1,326 335 2 1,384 350 1 87.00 Total outlays (gross) ................................................. 1,450 1,663 1,735 Offsets: Against gross budget authority and outlays: Offsetting collections (cash) from: 88.00 Federal sources ..................................................... 88.40 Non-Federal sources ............................................. ¥32 ¥291 ¥25 ¥266 ¥37 ¥297 88.90 ¥323 ¥291 ¥334 88.95 Program and Financing (in millions of dollars) 2003 est. 203 1,678 1,369 1,385 1,406 ¥1 ................... ................... 88.96 2002 actual Total budgetary resources available for obligation Total new obligations .................................................... Unobligated balance carried forward, end of year ....... 69 1,698 New budget authority (gross), detail: Discretionary: 40.00 Appropriation ............................................................. 40.73 Reduction pursuant to P.L. 107–206 ....................... Balance, end of year ..................................................... ................... ................... ................... Identification code 75–9911–0–1–554 Budgetary resources available for obligation: Unobligated balance carried forward, start of year New budget authority (gross) ........................................ Resources available from recoveries of prior year obligations ....................................................................... 89.00 90.00 99.00 99.01 Total, offsetting collections (cash) .................. Against gross budget authority only: Change in uncollected customer payments from Federal sources (unexpired) .................................. Portion of offsetting collections (cash) credited to expired accounts ................................................... Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... ¥22 ................... ................... 17 ................... ................... 1,370 1,127 1,387 1,372 1,407 1,401 Additional net budget authority and outlays to cover cost of fully accruing retirement: Budget authority ............................................................ 56 60 Outlays ........................................................................... 56 60 67 67 [In millions of dollars] 2002 Distribution of budget authority by account: Salaries and expenses ............................................................ Buildings and facilities .......................................................... Distribution of outlays by account: Salaries and expenses ............................................................ Buildings and facilities .......................................................... Sfmt 3647 E:\BUDGET\HHS.XXX HHS 2003 2004 1,336 34 1,379 8 1,395 12 1,085 42 1,356 16 1,388 13 401 402 FOOD AND DRUG ADMINISTRATION—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 2004 General and special funds—Continued SALARIES AND SALARIES AND EXPENSES (Legislative proposal, not subject to PAYGO) EXPENSES—Continued Summary of Budget Authority and Outlays Program and Financing (in millions of dollars) (in millions of dollars) 2002 actual 2003 est. 2004 est. Enacted/requested: Budget Authority ..................................................................... 1,370 1,387 1,407 Outlays .................................................................................... 1,127 1,372 1,401 Legislative proposal, not subject to PAYGO: Budget Authority ..................................................................... .................... .................... .................... Outlays .................................................................................... .................... .................... .................... Total: Budget Authority ..................................................................... Outlays .................................................................................... 1,370 1,127 1,387 1,372 1,407 1,401 The Food and Drug Administration assures the safety of the nation’s foods, medicines, medical devices and other products through regulations, pre-market product and manufacturer reviews and post-market inspections. The budget includes funding for counter terrorism activities that specifically deal with the protection of products regulated by the FDA (such as drugs, vaccines, foods, and animal feed), and the availability of medical products for public health preparedness in the event of an attack. The budget also requests funding for food safety, improved access to generic drugs, and implementation of the Best Pharmaceuticals for Children Act. Object Classification (in millions of dollars) 2002 actual Identification code 75–9911–0–1–554 11.1 11.3 11.5 11.7 Direct obligations: Personnel compensation: Full-time permanent ............................................. Other than full-time permanent ........................... Other personnel compensation ............................. Military personnel ................................................. 2003 est. 584 35 20 32 612 37 21 36 589 134 17 26 4 99 5 671 142 15 28 7 99 6 706 147 18 27 7 109 6 20 3 41 67 29 3 19 85 29 3 16 76 25.4 25.5 25.7 26.0 31.0 32.0 41.0 42.0 Total personnel compensation ......................... Civilian personnel benefits ....................................... Military 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 ............................................................ Other 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 ........................... 61 55 52 38 28 43 37 31 22 25 80 62 38 ................... 30 27 2 2 48 33 43 27 24 59 2 26 2 99.0 99.0 Direct obligations .................................................. Reimbursable obligations .............................................. 1,355 214 1,387 291 1,408 334 99.9 Total new obligations ................................................ 1,569 1,678 1,742 24.0 25.1 25.2 25.3 Personnel Summary 2002 actual Identification code 75–9911–0–1–554 Direct: Total compensable workyears: 1001 Civilian full-time equivalent employment 1101 Military full-time equivalent employment Reimbursable: Total compensable workyears: 2001 Civilian full-time equivalent employment 2101 Military full-time equivalent employment VerDate Dec 13 2002 15:09 Jan 23, 2003 2003 est. 2003 est. 2004 est. 09.01 Obligations by program activity: Reimbursable program .................................................. ................... ................... 5 10.00 Total new obligations ................................................ ................... ................... 5 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ ................... ................... Total new obligations .................................................... ................... ................... 5 ¥5 New budget authority (gross), detail: Discretionary: 68.00 Spending authority from offsetting collections (gross): Offsetting collections (cash) ................... ................... ................... 5 73.10 73.20 Change in obligated balances: Total new obligations .................................................... ................... ................... Total outlays (gross) ...................................................... ................... ................... 5 ¥5 86.90 Outlays (gross), detail: Outlays from new discretionary authority ..................... ................... ................... 5 Offsets: Against gross budget authority and outlays: 88.40 Offsetting collections (cash) from: Non-Federal sources .................................................................. ................... ................... ¥5 2004 est. 497 41 18 33 11.9 12.1 12.2 21.0 22.0 23.1 23.2 23.3 2002 actual Identification code 75–9911–2–1–554 2004 est. 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ ................... ................... ................... Outlays ........................................................................... ................... ................... ................... The budget includes a total of $5,000,000 in animal drug user fees. Authorizing language for these fees will be proposed to authorize the collection and spending of the fees subject to appropriations language. Object Classification (in millions of dollars) 2002 actual Identification code 75–9911–2–1–554 2003 est. 2004 est. 99.0 Reimbursable obligations: Reimbursable obligations ... ................... ................... 5 99.9 Total new obligations ................................................ ................... ................... 5 Personnel Summary 2002 actual Identification code 75–9911–2–1–554 2003 est. 2004 est. Reimbursable: Total compensable workyears: 2001 Civilian full-time equivalent employment ................. ................... ................... 40 f Public enterprise funds: REVOLVING FUND FOR CERTIFICATION AND OTHER SERVICES Program and Financing (in millions of dollars) 2002 actual Identification code 75–4309–0–3–554 2003 est. 2004 est. 09.01 Obligations by program activity: Reimbursable program .................................................. 5 8 6 10.00 Total new obligations ................................................ 5 8 6 ................. ................. 7,748 564 8,402 577 8,485 587 21.40 22.00 Budgetary resources available for obligation: Unobligated balance carried forward, start of year New budget authority (gross) ........................................ 4 5 4 5 1 6 ................. ................. 1,107 76 1,378 84 1,588 103 23.90 23.95 24.40 Total budgetary resources available for obligation Total new obligations .................................................... Unobligated balance carried forward, end of year ....... 9 ¥5 4 9 ¥8 1 7 ¥6 1 Frm 00002 Fmt 3616 Jkt 193833 PO 00000 Sfmt 3643 E:\BUDGET\HHS.XXX HHS HEALTH RESOURCES AND SERVICES ADMINISTRATION Federal Funds DEPARTMENT OF HEALTH AND HUMAN SERVICES New budget authority (gross), detail: Mandatory: 69.00 Offsetting collections (cash) ..................................... 5 5 6 72.40 73.10 73.20 74.40 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Obligated balance, end of year ..................................... 1 5 ¥5 1 1 8 ¥8 1 1 6 ¥6 1 86.97 86.98 Outlays (gross), detail: Outlays from new mandatory authority ......................... 5 Outlays from mandatory balances ................................ ................... 87.00 5 6 3 ................... Total outlays (gross) ................................................. 5 8 6 Offsets: Against gross budget authority and outlays: 88.40 Offsetting collections (cash) from: Non-Federal sources .................................................................. ¥5 ¥5 ¥6 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ ................... ................... ................... Outlays ........................................................................... ................... 3 ................... 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) 2002 actual Identification code 75–4309–0–3–554 11.1 12.1 23.3 25.2 31.0 99.9 2003 est. 2004 est. Personnel compensation: Full-time permanent ............. 2 2 2 Civilian personnel benefits ............................................ 1 1 1 Communications, utilities, and miscellaneous charges ................... 2 2 Other services ................................................................ 1 3 1 Equipment ...................................................................... 1 ................... ................... Total new obligations ................................................ 5 8 6 Personnel Summary 2002 actual Identification code 75–4309–0–3–554 Reimbursable: Total compensable workyears: 2001 Civilian full-time equivalent employment ................. 2003 est. 33 2004 est. 38 Federal Funds General and special funds: AND SERVICES For carrying out titles II, III, IV, 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 (including section 510), and sections 711, 1128E, and 1820 of the Social Security Act, the Health Care Quality Improvement Act of 1986, as amended, the Native Hawaiian Health Care Act of 1988, as amended, the Cardiac Arrest Survival Act of 2000, and the Poison Control Center Enhancement and Awareness Act, $5,665,996,000, 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 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 fees collected for the full disclosure of information under the ‘‘Health VerDate Dec 13 2002 15:09 Jan 23, 2003 Jkt 193833 Note.—A regular 2003 appropriation for this account had not been enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 107–229, as amended). The amounts included for 2003 in this budget reflect the Administration’s 2003 policy proposals. Program and Financing (in millions of dollars) 2002 actual Identification code 75–0350–0–1–550 HEALTH RESOURCES AND SERVICES ADMINISTRATION HEALTH RESOURCES Care Fraud and Abuse Data Collection Program’’, authorized by section 1128E(d)(2) of the Social Security Act, shall be sufficient to recover the full costs of operating the program, and shall remain available until expended to carry out that Act: Provided further, That no more than $45,000,000 is available for carrying out the provisions of Public Law 104–73: Provided further, That an award for compensation under said provisions for actual and projected pain and suffering and emotional distress shall not exceed $250,000: Provided further, That of the funds made available under this heading, $264,808,000 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 $739,000,000 shall be for State AIDS Drug Assistance Programs authorized by section 2616 of the Public Health Service Act: Provided further, That, notwithstanding section 502(a)(1) of the Social Security Act, not to exceed $109,132,000 is for carrying out special projects of regional and national significance pursuant to section 501(a)(2): Provided further, That $73,044,000 is available for special projects of regional and national significance under section 501(a)(2) of the Social Security Act, which shall not be counted toward compliance with the allocation required in section 502(a)(1) of such Act, and which shall be used only for making competitive grants to provide abstinence education (as defined in section 510(b)(2) of such Act) to adolescents and for evaluations (including longitudinal evaluations) of activities under the grants and for Federal costs of administering the grants: Provided further, That grants under the immediately preceding proviso shall be made only to public and private entities which agree that, with respect to an adolescent to whom the entities provide abstinence education under such grant, the entities will not provide to that adolescent any other education regarding sexual conduct, except that, in the case of an entity expressly required by law to provide health information or services the adolescent shall not be precluded from seeking health information or services from the entity in a different setting than the setting in which the abstinence education was provided: Provided further, That the funds expended for such evaluations may not exceed 3.5 percent of such amount. 38 f PO 00000 Frm 00003 Fmt 3616 403 Obligations by program activity: Loan guarantee subsidy ................................................ Health centers ................................................................ National Health Service Corps ....................................... National Health Service Corps recruitment ................... Hansen’s disease center ................................................ Payment to Hawaii for the treatment of Hansen’s disease ...................................................................... 00.15 Black lung clinics .......................................................... 00.16 Nursing loan repayment ................................................ 00.17 Health professions ......................................................... 00.18 Maternal and child health block grant ......................... 00.19 Healthy start .................................................................. 00.20 Universal newborn hearing ............................................ 00.21 Emergency medical services for children ...................... 00.22 Poison control centers ................................................... 00.23 HIV/AIDS ......................................................................... 00.24 Organ transplantation ................................................... 00.25 Health care facilities ..................................................... 00.26 Bone marrow donor registry .......................................... 00.27 Rural health policy development ................................... 00.28 Rural health outreach grants ........................................ 00.29 Rural health flexibility grants ....................................... 00.30 Telehealth ....................................................................... 00.31 Program management ................................................... 00.32 Family planning ............................................................. 00.33 Abstinence education ..................................................... 00.34 State access program .................................................... 00.35 Community access program .......................................... 00.36 Health centers tort claim fund ...................................... 00.37 Trauma EMS ................................................................... 00.02 00.10 00.11 00.12 00.13 00.14 Sfmt 3643 E:\BUDGET\HHS.XXX HHS 2003 est. 2004 est. 1 1,328 46 99 18 1 1,433 46 143 18 1 1,582 45 167 18 2 6 10 377 731 99 10 19 21 1,911 20 315 22 15 52 40 37 149 265 44 15 105 16 3 2 6 15 94 732 99 ................... ................... ................... 1,911 25 ................... 22 6 38 25 6 147 265 25 ................... ................... 25 ................... 2 6 27 81 751 99 ................... ................... ................... 2,010 25 ................... 22 6 38 30 6 151 265 ................... ................... ................... 45 ................... 404 HEALTH RESOURCES AND SERVICES ADMINISTRATION—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 2004 General and special funds—Continued HEALTH RESOURCES AND 89.00 90.00 SERVICES—Continued Program and Financing (in millions of dollars)—Continued 2002 actual Identification code 75–0350–0–1–550 2003 est. 2004 est. 00.39 00.40 00.41 00.42 00.44 00.45 00.46 00.47 00.48 Childrens’ GME .............................................................. 285 200 199 Denali commission ......................................................... 20 ................... ................... Community based abstinence grants ............................ 40 73 73 State offices of rural health .......................................... 8 4 4 Rural access to emergency devices .............................. 12 2 2 Radiation Exposure Compensation Act .......................... 4 4 4 Traumatic brain injury ................................................... 7 7 7 Healthy communities innovation initiative .................... ................... 20 ................... Buildings and facilities ................................................. 1 ................... ................... 03.00 09.01 Total direct programs ................................................ Reimbursable program .................................................. 6,153 140 5,394 156 5,666 160 10.00 Total new obligations ................................................ 6,293 5,550 5,826 21.40 22.00 22.10 Budgetary resources available for obligation: Unobligated balance carried forward, start of year New budget authority (gross) ........................................ Resources available from recoveries of prior year obligations ....................................................................... 33 6,304 39 5,555 43 5,831 23.90 23.95 23.98 24.40 Total budgetary resources available for obligation Total new obligations .................................................... Unobligated balance expiring or withdrawn ................. Unobligated balance carried forward, end of year ....... 1 ................... ................... 6,338 5,594 5,874 ¥6,293 ¥5,550 ¥5,826 ¥7 ................... ................... 39 43 48 New budget authority (gross), detail: Discretionary: 40.00 Appropriation ............................................................. 40.71 Reduction pursuant to P.L. Labor HHS 107–116 40.73 Reduction pursuant to P.L. 107–206 ....................... 6,081 5,369 5,666 ¥1 ................... ................... ¥2 ................... ................... 43.00 55.00 6,078 5,369 5,666 30 ................... ................... 60.00 68.00 68.10 68.90 Appropriation (total discretionary) ........................ Advance appropriation .............................................. Mandatory: Appropriation ............................................................. Spending authority from offsetting collections: Discretionary: Offsetting collections (cash) ................................ Change in uncollected customer payments from Federal sources (unexpired) ............................. 69.00 Spending authority from offsetting collections (total discretionary) ..................................... Mandatory: Offsetting collections (cash)(HPSL&NSL) .................. 70.00 Total new budget authority (gross) .......................... Change in obligated balances: 72.40 Obligated balance, start of year ................................... 73.10 Total new obligations .................................................... 73.20 Total outlays (gross) ...................................................... 73.40 Adjustments in expired accounts (net) ......................... 73.45 Recoveries of prior year obligations .............................. 74.00 Change in uncollected customer payments from Federal sources (unexpired) ............................................ 74.40 Obligated balance, end of year ..................................... 50 122 25 ................... 130 130 1 ................... ................... 123 130 130 23 31 35 6,304 5,555 5,831 4,557 5,054 4,697 6,293 5,550 5,826 ¥5,753 ¥5,907 ¥5,953 ¥41 ................... ................... ¥1 ................... ................... ¥1 ................... ................... 5,054 4,697 4,570 Outlays (gross), detail: 86.90 Outlays from new discretionary authority ..................... 86.93 Outlays from discretionary balances ............................. 86.97 Outlays from new mandatory authority ......................... 86.98 Outlays from mandatory balances ................................ 2,328 3,354 35 36 2,072 3,760 38 37 2,201 3,691 35 26 87.00 Total outlays (gross) ................................................. 5,753 5,907 5,953 Offsets: Against gross budget authority and outlays: Offsetting collections (cash) from: 88.00 Federal sources ..................................................... 88.40 Non-Federal sources ............................................. 88.45 Offsetting governmental collections (from nonFederal sources) ............................................... ¥102 ¥20 ¥110 ¥20 ¥110 ¥20 ¥23 ¥31 ¥35 88.90 88.95 Total, offsetting collections (cash) .................. Against gross budget authority only: Change in uncollected customer payments from Federal sources (unexpired) .................................. VerDate Dec 13 2002 15:09 Jan 23, 2003 Jkt 193833 ¥145 ¥161 Frm 00004 Fmt 3616 6,158 5,608 5,394 5,746 5,666 5,788 Additional net budget authority and outlays to cover cost of fully accruing retirement: Budget authority ............................................................ 14 15 Outlays ........................................................................... 14 15 17 17 Summary of Budget Authority and Outlays (in millions of dollars) Enacted/requested: 2002 actual Budget Authority ..................................................................... 6,158 Outlays .................................................................................... 5,608 Legislative proposal, subject to PAYGO: Budget Authority ..................................................................... .................... Outlays .................................................................................... .................... Total: Budget Authority ..................................................................... Outlays .................................................................................... 6,158 5,608 2003 est. 2004 est. 5,394 5,746 5,666 5,788 25 7 50 37 5,419 5,753 5,716 5,825 Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in millions of dollars) 2002 actual Identification code 75–0350–0–1–550 Guaranteed loan levels supportable by subsidy budget authority: 215001 Health centers: Facilities renovation loan guarantee levels ......................................................................... 1 215002 Health centers: Managed care network development loan guarantee levels ................................................ ................... 215003 Health centers: Managed care plan loan guarantee levels ......................................................................... ................... 215901 Total loan guarantee levels ........................................... Guaranteed loan subsidy (in percent): 232001 Health centers: Facilities renovation loan guarantee levels ......................................................................... 232002 Health centers: Managed care network development loan guarantee levels ................................................ 232003 Health centers: Managed care plan loan guarantee levels ......................................................................... 2003 est. 2004 est. 10 10 2 2 5 5 1 17 17 8.71 3.49 3.52 9.27 9.02 9.28 5.00 7.65 7.77 232901 Weighted average subsidy rate ..................................... 8.71 5.88 5.88 Guaranteed loan subsidy budget authority: 233001 Health centers: Facilities renovation loan guarantee levels ......................................................................... ................... 1 1 233002 Health centers: Managed care network development loan guarantee levels ................................................ ................... ................... ................... 233003 Health centers: Managed care plan loan guarantee levels ......................................................................... ................... ................... ................... 233901 Total subsidy budget authority ...................................... Guaranteed loan subsidy outlays: 234001 Health centers: Facilities renovation loan guarantee levels ......................................................................... 234002 Health centers: Managed care network development loan guarantee levels ................................................ 234003 Health centers: Managed care plan loan guarantee levels ......................................................................... ................... 1 1 ................... 1 1 ................... ................... ................... ................... ................... ................... 234901 Total subsidy outlays ..................................................... ................... 1 1 Administrative expense data: 351001 Administrative expenses ................................................ 1 1 1 358001 Outlays from balances ................................................... ................... ................... ................... 359001 Outlays for administrative expenses ............................. 1 1 1 Activities displayed here support categorical health resources and services grants, treatment and care for those living with HIV/AIDS, and the Medical malpractice claims fund, which pays malpractice claims filed against employees of federally-supported health centers. Object Classification (in millions of dollars) 2002 actual Identification code 75–0350–0–1–550 ¥165 ¥1 ................... ................... PO 00000 99.00 99.01 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 11.1 11.3 11.5 Direct obligations: Personnel compensation: Full-time permanent ............................................. Other than full-time permanent ........................... Other personnel compensation ............................. Sfmt 3643 E:\BUDGET\HHS.XXX HHS 95 4 3 2003 est. 103 4 3 2004 est. 107 4 3 HEALTH RESOURCES AND SERVICES ADMINISTRATION—Continued Federal Funds—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES 11.7 Military personnel ................................................. 21 22 23 VACCINE INJURY COMPENSATION 11.9 12.1 12.2 13.0 21.0 23.1 23.3 123 22 11 3 4 12 132 24 14 3 4 13 137 25 17 3 4 13 Program and Financing (in millions of dollars) 4 1 52 80 5 2 48 87 5 2 48 96 25.4 25.6 25.7 26.0 31.0 41.0 42.0 Total personnel compensation ......................... Civilian personnel benefits ....................................... Military personnel benefits ........................................ Benefits for former personnel ................................... Travel and transportation of persons ....................... Rental payments to GSA ........................................... Communications, utilities, and miscellaneous charges ................................................................. Printing and reproduction ......................................... Advisory and assistance services ............................. Other services ............................................................ Other purchases of goods and services from Government accounts ................................................. Operation and maintenance of facilities .................. Medical care .............................................................. Operation and maintenance of equipment ............... Supplies and materials ............................................. Equipment ................................................................. Grants, subsidies, and contributions ........................ Insurance claims and indemnities ........................... 118 1 1 4 2 5 5,694 16 94 1 1 5 2 5 4,929 25 97 1 1 5 2 5 5,158 46 99.0 99.0 Direct obligations .................................................. Reimbursable obligations .............................................. 6,153 140 5,394 156 5,665 161 99.9 Total new obligations ................................................ 6,293 5,550 5,826 24.0 25.1 25.2 25.3 Personnel Summary 2002 actual Identification code 75–0350–0–1–550 Direct: Total compensable workyears: 1001 Civilian full-time equivalent employment 1101 Military full-time equivalent employment Reimbursable: Total compensable workyears: 2001 Civilian full-time equivalent employment 2101 Military full-time equivalent employment Allocation account: Total compensable workyears: 3001 Civilian full-time equivalent employment 3101 Military full-time equivalent employment 2003 est. 1,438 267 1,472 270 1,445 278 ................. ................. 85 5 128 5 128 5 ................. ................... ................. 8 12 21 12 21 f HEALTH RESOURCES AND SERVICES (Legislative proposal, subject to PAYGO) Program and Financing (in millions of dollars) 2002 actual Identification code 75–0350–4–1–550 2003 est. 2004 est. 00.33 Obligations by program activity: Abstinence education ..................................................... ................... 25 50 10.00 Total new obligations (object class 41.0) ................ ................... 25 50 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ ................... Total new obligations .................................................... ................... 25 ¥25 50 ¥50 New budget authority (gross), detail: Mandatory: 60.00 Appropriation ............................................................. ................... Change in obligated balances: 72.40 Obligated balance, start of year ................................... 73.10 Total new obligations .................................................... 73.20 Total outlays (gross) ...................................................... 74.40 Obligated balance, end of year ..................................... 86.97 86.98 25 50 18 50 ¥37 31 Outlays (gross), detail: Outlays from new mandatory authority ......................... ................... 7 Outlays from mandatory balances ................................ ................... ................... 14 23 87.00 Total outlays (gross) ................................................. ................... 7 37 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ ................... Outlays ........................................................................... ................... 25 7 50 37 Jkt 193833 PO 00000 Obligations by program activity: Direct program activity .................................................. 4 8 ................... 10.00 Total new obligations ................................................ 4 8 ................... 21.40 22.00 Budgetary resources available for obligation: Unobligated balance carried forward, start of year New budget authority (gross) ........................................ 11 8 ................... 1 ................... ................... 23.90 23.95 24.40 Total budgetary resources available for obligation Total new obligations .................................................... Unobligated balance carried forward, end of year ....... 12 8 ................... ¥4 ¥8 ................... 8 ................... ................... New budget authority (gross), detail: Mandatory: 69.00 Offsetting collections (cash) ..................................... 1 ................... ................... 72.40 73.10 73.20 74.40 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Obligated balance, end of year ..................................... 86.97 86.98 Outlays (gross), detail: Outlays from new mandatory authority ......................... Outlays from mandatory balances ................................ 87.00 Total outlays (gross) ................................................. Offsets: Against gross budget authority and outlays: 88.00 Offsetting collections (cash) from: Federal sources 89.00 90.00 3 3 4 8 ¥5 ¥11 3 ................... ................... ................... ................... ................... 1 ................... ................... 4 11 ................... 5 11 ................... ¥1 ................... ................... Net budget authority and outlays: Budget authority ............................................................ ................... ................... ................... Outlays ........................................................................... 3 11 ................... 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 2004 to cover payment of pre-1988 claims. By statute, no new claims are accepted for this account. Payment of claims associated with vaccine related injury or death occurring after October 1, 1988 are reflected in the Vaccine improvement trust fund account. 2002 actual Identification code 75–0320–0–1–551 42.0 99.0 Direct obligations: Insurance claims and indemnities Reimbursable obligations: Reimbursable obligations ... 99.9 Total new obligations ................................................ Frm 00005 Fmt 3616 2003 est. 2004 est. 3 8 ................... 1 ................... ................... 4 8 ................... f Credit accounts: HEALTH CENTER GUARANTEED LOAN FINANCING ACCOUNT Program and Financing (in millions of dollars) 2002 actual Identification code 75–4442–0–3–551 The budget extends funding for state-based abstinence education activities for five years. 15:09 Jan 23, 2003 2004 est. Object Classification (in millions of dollars) ................... ................... ................... 25 ................... ¥7 ................... 18 VerDate Dec 13 2002 2003 est. 00.01 2004 est. ................. ................. 2002 actual Identification code 75–0320–0–1–551 405 2003 est. 2004 est. 21.40 22.00 Budgetary resources available for obligation: Unobligated balance carried forward, start of year ................... New financing authority (gross) .................................... ................... 1 1 1 1 23.90 Total budgetary resources available for obligation ................... 2 2 Sfmt 3643 E:\BUDGET\HHS.XXX HHS 406 HEALTH RESOURCES AND SERVICES ADMINISTRATION—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 2004 Credit accounts—Continued 2204 HEALTH CENTER GUARANTEED LOAN FINANCING ACCOUNT— Continued 2999 Program and Financing (in millions of dollars)—Continued 2002 actual Identification code 75–4442–0–3–551 24.40 Unobligated balance carried forward, end of year ....... 2003 est. 1 2004 est. 1 1 1 1 Change in obligated balances: Total financing disbursements (gross) ......................... ................... Total financing disbursements (gross) ......................... ................... 1 ¥1 1 ¥1 ¥1 2003 est. 2210 2231 2251 2263 2290 Total guaranteed loan commitments ........................ Guaranteed amount of guaranteed loan commitments 1 1 17 14 22 18 Cumulative balance of guaranteed loans outstanding: Outstanding, start of year ............................................. 12 13 30 Disbursements of new guaranteed loans ...................... 1 17 22 Repayments and prepayments ...................................... ................... ................... ................... Adjustments: Terminations for default that result in claim payments ......................................................... ................... ................... ................... Outstanding, end of year .......................................... Memorandum: 2299 Guaranteed amount of guaranteed loans outstanding, end of year ................................................................ 13 10 30 24 42 Balance Sheet (in millions of dollars) 2001 actual 2002 actual 2003 est. 4 1 1 1 1999 4 1 1 1 Frm 00006 Fmt 3616 VerDate Dec 13 2002 15:09 Jan 23, 2003 Jkt 193833 PO 00000 1 1 .................. .................. .................. .................. 3999 Total net position ................................ .................. .................. .................. .................. 4999 Total liabilities and net position ............ 4 1 1 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, $3,389,000. Program and Financing (in millions of dollars) 2002 actual Identification code 75–0340–0–1–552 2003 est. 2004 est. 00.02 00.09 Obligations by program activity: Guarantee loan subsidy ................................................. Administrative expenses ................................................ 18 4 20 4 18 3 10.00 Total new obligations ................................................ 22 24 21 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ Total new obligations .................................................... 22 ¥22 24 ¥24 21 ¥21 New budget authority (gross), detail: Discretionary: 40.00 Appropriation ............................................................. Mandatory: 60.00 Appropriation ............................................................. 4 4 3 18 20 18 70.00 Total new budget authority (gross) .......................... 22 24 21 72.40 73.10 73.20 74.40 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Obligated balance, end of year ..................................... 86.90 86.97 Outlays (gross), detail: Outlays from new discretionary authority ..................... Outlays from new mandatory authority ......................... 4 18 4 20 3 18 87.00 Total outlays (gross) ................................................. 22 24 21 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 22 23 24 24 21 21 1 1 ................... 22 24 21 ¥22 ¥24 ¥21 1 ................... ................... Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in millions of dollars) 2002 actual Identification code 75–0340–0–1–552 Guaranteed loan levels supportable by subsidy budget authority: 215001 HEAL Loan guarantee .................................................... 2003 est. 2004 est. 165 160 150 165 160 150 12.43 12.43 12.19 232901 Weighted average subsidy rate ..................................... Guaranteed loan subsidy budget authority: 233001 HEAL Loan guarantee .................................................... 12.43 12.43 12.19 21 20 18 233901 Total subsidy budget authority ...................................... Guaranteed loan subsidy outlays: 234001 HEAL Loan guarantee .................................................... 21 20 18 18 20 18 234901 Total subsidy outlays ..................................................... 18 20 18 215901 Total loan guarantee levels ........................................... Guaranteed loan subsidy (in percent): 232001 HEAL Loan guarantee .................................................... 2004 est. ASSETS: 1101 Federal assets: Fund balances with Treasury ............................................... Total assets ........................................ 1 52 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. This program has used $0.5 million of its available $139 million in loan guarantee authority, HRSA plans to use approximately $39 million of the remaining existing loan guarantee limit over 2003 and 2004. 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. Identification code 75–4442–0–3–551 4 2004 est. Position with respect to appropriations act limitation on commitments: 2111 Limitation on guaranteed loans made by private lenders .............................................................................. ................... ................... ................... 2121 Limitation available from carry-forward ....................... 139 138 121 2143 Uncommitted limitation carried forward ....................... ¥138 ¥121 ¥99 2150 2199 1 Total liabilities .................................... NET POSITION: 3300 Cumulative results of operations ............ ¥1 Status of Guaranteed Loans (in millions of dollars) 2002 actual 1 Note.—A regular 2003 appropriation for this account had not been enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 107–229, as amended). The amounts included for 2003 in this budget reflect the Administration’s 2003 policy proposals. Net financing authority and financing disbursements: Financing authority ........................................................ ................... ................... ................... Financing disbursements ............................................... ................... ¥2 ¥2 Identification code 75–4442–0–3–551 1 HEALTH EDUCATION ASSISTANCE LOANS PROGRAM ACCOUNT Offsets: Against gross financing authority and financing disbursements: 88.00 Offsetting collections (cash) from: Federal sources ................... 89.00 90.00 4 f New financing authority (gross), detail: Discretionary: 68.00 Spending authority from offsetting collections (gross): (Federal sources: From program account) .................................................................... ................... 73.20 87.00 LIABILITIES: Non-Federal liabilities: Liabilities for loan guarantees .................................. Sfmt 3643 E:\BUDGET\HHS.XXX HHS HEALTH RESOURCES AND SERVICES ADMINISTRATION—Continued Federal Funds—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES Administrative expense data: 351001 Budget authority ............................................................ 359001 Outlays from new authority ........................................... 407 Status of Guaranteed Loans (in millions of dollars) 4 4 4 4 3 3 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 administrative expenses are estimated on a cash basis. Object Classification (in millions of dollars) 2002 actual Identification code 75–0340–0–1–552 2003 est. 2004 est. 2002 actual Identification code 75–4304–0–3–552 2003 est. 2004 est. Position with respect to appropriations act limitation on commitments: 2111 Limitation on guaranteed loans made by private lenders .............................................................................. 165 160 150 2150 2199 165 165 160 160 150 150 1,513 165 ¥5 1,646 160 ¥6 1,760 150 ¥6 ¥23 ¥38 ¥41 ¥4 ¥2 ¥2 Total guaranteed loan commitments ........................ Guaranteed amount of guaranteed loan commitments Cumulative balance of guaranteed loans outstanding: Outstanding, start of year ............................................. Disbursements of new guaranteed loans ...................... Repayments and prepayments ...................................... Adjustments: 2261 Terminations for default that result in loans receivable ....................................................................... 2263 Terminations for default that result in claim payments .................................................................... 2210 2231 2251 2 2 1 2290 Outstanding, end of year .......................................... 1,646 1,760 1,861 41.0 Personnel compensation: Full-time permanent ............. Other purchases of goods and services from Government accounts ........................................................... Grants, subsidies, and contributions ............................ 2 18 2 20 2 18 2299 Memorandum: Guaranteed amount of guaranteed loans outstanding, end of year ................................................................ 1,646 1,760 1,861 99.9 Total new obligations ................................................ 22 24 21 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 ............................... 373 23 ¥5 391 38 ¥6 423 41 ¥6 2390 391 423 458 11.1 25.3 Personnel Summary 2002 actual Identification code 75–0340–0–1–552 Direct: Total compensable workyears: 1001 Civilian full-time equivalent employment ................. 2003 est. 22 2004 est. 22 Outstanding, end of year ...................................... 17 This account records all cash flows to and from the Government resulting from HEAL loan guarantees committed between 1992 and 2004. f HEALTH EDUCATION ASSISTANCE LOANS FINANCING ACCOUNT Balance Sheet (in millions of dollars) Program and Financing (in millions of dollars) 2002 actual Identification code 75–4304–0–3–552 2003 est. 2004 est. 00.01 00.02 Obligations by program activity: Death and disability claims .......................................... Default claims ............................................................... 4 24 2 37 2 41 10.00 Total new obligations ................................................ 28 39 43 21.40 22.00 Budgetary resources available for obligation: Unobligated balance carried forward, start of year New financing authority (gross) .................................... 321 52 345 28 334 27 23.90 23.95 24.40 Total budgetary resources available for obligation Total new obligations .................................................... Unobligated balance carried forward, end of year ....... 373 ¥28 345 373 ¥39 334 361 ¥43 318 New financing authority (gross), detail: Discretionary: 68.00 Spending authority from offsetting collections (gross): Offsetting collections (cash) ................... 73.10 73.20 87.00 Change Total Total Total in obligated balances: new obligations .................................................... financing disbursements (gross) ......................... financing disbursements (gross) ......................... 52 28 27 28 ¥28 28 39 ¥39 39 43 ¥43 43 2003 est. 2004 est. 321 51 345 67 340 67 331 67 1999 Total assets ........................................ LIABILITIES: 2204 Non-Federal liabilities: Liabilities for loan guarantees .................................. 372 412 407 398 2999 372 412 407 398 Total liabilities .................................... NET POSITION: 3300 Cumulative results of operations ............ 372 412 407 398 .................. .................. .................. .................. 3999 Total net position ................................ .................. .................. .................. .................. 4999 Total liabilities and net position ............ 372 412 407 398 HEALTH EDUCATION ASSISTANCE LOANS LIQUIDATING ACCOUNT Program and Financing (in millions of dollars) ¥20 ¥2 ¥6 ¥18 ¥3 ¥6 ¥52 ¥28 89.00 90.00 2002 actual f Offsets: Against gross financing authority and financing disbursements: Offsetting collections (cash) from: 88.00 Federal sources ..................................................... ¥18 88.25 Interest on uninvested funds ............................... ................... 88.40 Recoveries of defaulted loans .............................. ¥34 88.90 2001 actual ASSETS: 1101 Federal assets: Fund balances with Treasury ............................................... 1206 Non-Federal assets: Receivables, net ..... Identification code 75–4304–0–3–552 2002 actual Identification code 75–4305–0–3–552 2003 est. 2004 est. 00.01 00.02 00.03 Obligations by program activity: Death and disability claims .......................................... Defaulted loans .............................................................. Debt collection ............................................................... 3 17 5 3 19 6 3 15 6 10.00 Total new obligations ................................................ 25 28 24 31 28 24 ¥27 22.00 22.10 Budgetary resources available for obligation: New budget authority (gross) ........................................ Resources available from recoveries of prior year obligations ....................................................................... 22.40 Capital transfer to general fund ................................... 17 ................... ................... ¥23 ................... ................... Net financing authority and financing disbursements: Financing authority ........................................................ ................... ................... ................... Financing disbursements ............................................... ¥24 11 16 23.90 23.95 25 ¥25 Total, offsetting collections (cash) .................. VerDate Dec 13 2002 15:09 Jan 23, 2003 Jkt 193833 PO 00000 Frm 00007 Fmt 3616 Total budgetary resources available for obligation Total new obligations .................................................... Sfmt 3643 E:\BUDGET\HHS.XXX HHS 28 ¥28 24 ¥24 408 HEALTH RESOURCES AND SERVICES ADMINISTRATION—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 2004 Credit accounts—Continued Balance Sheet (in millions of dollars) HEALTH EDUCATION ASSISTANCE LOANS LIQUIDATING ACCOUNT— Continued Program and Financing (in millions of dollars)—Continued 2002 actual Identification code 75–4305–0–3–552 2003 est. 2004 est. New budget authority (gross), detail: Mandatory: 60.00 Appropriation ............................................................. 69.00 Offsetting collections (cash) ......................................... 10 21 7 21 4 20 70.00 31 28 24 72.40 73.10 73.20 73.45 74.40 Total new budget authority (gross) .......................... Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Recoveries of prior year obligations .............................. Obligated balance, end of year ..................................... 2001 actual 2002 actual ASSETS: 1101 Federal assets: Fund balances with Treasury ............................................... 1206 Non-Federal assets: Receivables, net ..... 21 376 4 303 4 376 4 376 1999 Total assets ........................................ LIABILITIES: 2204 Non-Federal liabilities: Liabilities for loan guarantees .................................. 397 307 380 380 397 307 380 380 2999 397 307 380 380 Identification code 75–4305–0–3–552 21 4 3 25 28 24 ¥25 ¥28 ¥24 ¥17 ................... ................... 4 3 3 Outlays (gross), detail: Outlays from new mandatory authority ......................... 25 28 24 Offsets: Against gross budget authority and outlays: 88.40 Offsetting collections (cash) from: Non-Federal sources .................................................................. ¥21 ¥21 ¥20 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 10 4 7 7 4 4 89.00 90.00 .................. .................. .................. .................. 3999 Total net position ................................ .................. .................. .................. .................. 4999 Total liabilities and net position ............ 397 307 380 380 Object Classification (in millions of dollars) 2002 actual 2290 Outstanding, end of year .......................................... 2299 Memorandum: Guaranteed amount of guaranteed loans outstanding, end of year ................................................................ 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 ............................................. 2390 Outstanding, end of year ...................................... 2004 est. 25.2 42.0 Other services ................................................................ Insurance claims and indemnities ................................ 5 20 6 22 6 18 99.9 Total new obligations ................................................ 25 28 24 MEDICAL FACILITIES GUARANTEE AND LOAN FUND Program and Financing (in millions of dollars) 2002 actual 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 .................................................................... 2003 est. f Status of Guaranteed Loans (in millions of dollars) Identification code 75–4305–0–3–552 2004 est. Total liabilities .................................... NET POSITION: 3300 Cumulative results of operations ............ Identification code 75–4305–0–3–552 86.97 2003 est. 2003 est. 2004 est. 668 ¥39 619 ¥42 566 ¥35 ¥8 ¥9 ¥7 ¥2 ¥2 ¥2 619 566 522 619 566 2002 actual Identification code 75–9931–0–3–551 Budgetary resources available for obligation: Unobligated balance carried forward, start of year New budget authority (gross) ........................................ 67 1 68 1 69 1 23.90 24.40 Total budgetary resources available for obligation Unobligated balance carried forward, end of year ....... 68 68 69 69 70 70 New budget authority (gross), detail: Mandatory: 69.00 Offsetting collections (cash) ..................................... 1 1 1 72.40 73.20 74.40 Change in obligated balances: Obligated balance, start of year ................................... Total outlays (gross) ...................................................... Obligated balance, end of year ..................................... 1 1 1 1 ................... ................... 1 1 1 86.97 Outlays (gross), detail: Outlays from new mandatory authority ......................... ¥1 ................... ................... 522 497 488 458 8 9 7 ¥15 ¥15 ¥15 ¥24 ¥24 ¥24 22 ................... ................... 458 2004 est. 21.40 22.00 Offsets: Against gross budget authority and outlays: 88.40 Offsetting collections (cash) from: Non-Federal sources .................................................................. 488 2003 est. 89.00 90.00 ¥1 Status of Direct Loans (in millions of dollars) 2002 actual Identification code 75–9931–0–3–551 This account records all cash flows to and from the Government resulting from HEAL loan guarantees committed prior to 1992. ¥1 Net budget authority and outlays: Budget authority ............................................................ ................... ................... ................... Outlays ........................................................................... ¥1 ¥1 ¥1 426 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. ¥1 Cumulative balance of direct loans outstanding: 1210 Outstanding, start of year ............................................. 1251 Repayments: Repayments and prepayments ................. 1290 Outstanding, end of year .......................................... 2003 est. 2004 est. 9 ¥1 8 ¥1 7 ¥1 8 7 6 Status of Guaranteed Loans (in millions of dollars) Statement of Operations (in millions of dollars) 2002 actual Identification code 75–9931–0–3–551 Identification code 75–4305–0–3–552 2001 actual 2002 actual 2003 est. 2004 est. 2003 est. 2004 est. 0101 0102 Revenue ................................................... Expense .................................................... 14 –14 25 –25 28 –28 24 –24 2210 2251 Cumulative balance of guaranteed loans outstanding: Outstanding, start of year ............................................. Repayments and prepayments ...................................... 19 ¥3 16 ¥3 13 ¥3 0105 Net income or loss (–) ............................ .................. .................. .................. .................. 2290 Outstanding, end of year .......................................... 16 13 10 Frm 00008 Fmt 3616 VerDate Dec 13 2002 15:09 Jan 23, 2003 Jkt 193833 PO 00000 Sfmt 3643 E:\BUDGET\HHS.XXX HHS HEALTH RESOURCES AND SERVICES ADMINISTRATION—Continued Trust Funds DEPARTMENT OF HEALTH AND HUMAN SERVICES 2299 Memorandum: Guaranteed amount of guaranteed loans outstanding, end of year ................................................................ 16 13 10 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. Unobligated balances will be used to pay defaults and interest subsidy payments. 22.00 New budget authority (gross) ........................................ 23.90 23.95 24.40 Total budgetary resources available for obligation Total new obligations .................................................... Unobligated balance carried forward, end of year ....... 67 409 73 76 68 74 76 ¥67 ¥73 ¥76 1 ................... ................... New budget authority (gross), detail: Discretionary: 40.26 Appropriation (trust fund) ......................................... Mandatory: 60.26 Appropriation (trust fund) ......................................... 10 10 10 57 63 66 70.00 Total new budget authority (gross) .......................... 67 73 76 73.10 73.20 Change in obligated balances: Total new obligations .................................................... Total outlays (gross) ...................................................... 67 ¥67 73 ¥73 76 ¥76 86.90 86.97 Outlays (gross), detail: Outlays from new discretionary authority ..................... Outlays from new mandatory authority ......................... 10 57 10 63 10 66 87.00 Total outlays (gross) ................................................. 67 73 76 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 67 66 73 73 76 76 1,628 1,758 1,980 1,758 1,980 2,060 Memorandum (non-add) entries: Total investments, start of year: Federal securities: Par value ................................................................... 92.02 Total investments, end of year: Federal securities: Par value ................................................................... 92.01 f Trust Funds VACCINE INJURY COMPENSATION PROGRAM TRUST FUND For payments from the Vaccine Injury Compensation Program Trust Fund, such sums as may be necessary for claims associated with vaccine-related injury or death with respect to vaccines administered after September 30, 1988, pursuant to subtitle 2 of title XXI of the Public Health Service Act, to remain available until expended: Provided, That for necessary administrative expenses, not to exceed $2,991,000 shall be available from the Trust Fund to the Secretary of Health and Human Services. Note.—A regular 2003 appropriation for this account had not been enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 107–229, as amended). The amounts included for 2003 in this budget reflect the Administration’s 2003 policy proposals. Unavailable Collections (in millions of dollars) 2002 actual Identification code 20–8175–0–7–551 01.99 Balance, start of year .................................................... Receipts: 02.00 Deposits ......................................................................... 02.40 Interest income .............................................................. 2003 est. 2004 est. 1,627 1,759 1,907 109 90 124 97 124 105 Total receipts and collections ................................... 199 221 229 Total: Balances and collections .................................... Appropriations: 05.00 Vaccine injury compensation program trust fund ........ 1,826 1,980 2,136 ¥67 ¥73 ¥76 05.99 Total appropriations .................................................. ¥67 ¥73 ¥76 07.99 Balance, end of year ..................................................... 1,759 1,907 2,060 The Vaccine improvement program was established pursuant to Public Law 99–660 and Public Law 100–203, and serves as a source of funds to pay claims for compensation for vaccine related injury or death. This account reflects payments for claims for vaccine related injury or death occurring after October 1, 1988. Object Classification (in millions of dollars) 2002 actual Identification code 20–8175–0–7–551 25.2 25.3 2003 est. 2004 est. 3 3 3 42.0 Other services ................................................................ Other purchases of goods and services from Government accounts ........................................................... Insurance claims and indemnities ................................ 7 57 7 63 7 66 99.9 Total new obligations ................................................ 67 73 76 f RICKY RAY HEMOPHILIA RELIEF FUND Unavailable Collections (in millions of dollars) 02.99 04.00 2002 actual Identification code 75–8074–0–7–551 2003 est. 2004 est. 01.99 Balance, start of year .................................................... ................... ................... ................... Receipts: 02.41 Interest on investments, Ricky ...................................... 2 2 ................... Appropriations: 05.00 Ricky Ray hemophilia relief fund .................................. ¥2 ¥2 ................... 07.99 Balance, end of year ..................................................... ................... ................... ................... Program and Financing (in millions of dollars) Program and Financing (in millions of dollars) 2002 actual Identification code 20–8175–0–7–551 2003 est. 2004 est. 2002 actual Identification code 75–8074–0–7–551 Obligations by program activity: 00.01 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) ........................ 01.91 Total, administrative expenses ............................. 57 48 2 4 3 1 2 10.00 Total new obligations ................................................ 50 7 3 76 21.40 22.00 Budgetary resources available for obligation: Unobligated balance carried forward, start of year New budget authority (gross) ........................................ 145 2 1 ................... 23.90 23.95 Total budgetary resources available for obligation Total new obligations .................................................... 147 ¥50 10 10 10 21.40 Budgetary resources available for obligation: Unobligated balance carried forward, start of year 1 Jkt 193833 Obligations by program activity: Compensation—claims ................................................. Administrative expenses subject to limitation .............. 3 3 4 67 PO 00000 2004 est. 00.01 00.02 3 3 4 Total new obligations ................................................ 15:09 Jan 23, 2003 66 3 3 4 10.00 VerDate Dec 13 2002 63 2003 est. 73 Frm 00009 Fmt 3616 Sfmt 3643 E:\BUDGET\HHS.XXX HHS 97 92 2 ................... 99 ¥7 92 ¥3 410 HEALTH RESOURCES AND SERVICES ADMINISTRATION—Continued Trust Funds—Continued THE BUDGET FOR FISCAL YEAR 2004 RICKY RAY HEMOPHILIA RELIEF FUND—Continued Program and Financing (in millions of dollars)—Continued 2002 actual Identification code 75–8074–0–7–551 24.40 Unobligated balance carried forward, end of year ....... 97 New budget authority (gross), detail: Mandatory: 60.26 Appropriation (trust fund) ......................................... 2 2003 est. 2004 est. 92 89 2 ................... 72.40 73.10 73.20 74.40 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Obligated balance, end of year ..................................... 86.98 Outlays (gross), detail: Outlays from mandatory balances ................................ 53 8 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 2 53 2 ................... 8 3 130 91 ................... 3 1 ................... 50 7 3 ¥53 ¥8 ¥3 1 ................... ................... Memorandum (non-add) entries: Total investments, start of year: Federal securities: Par value ................................................................... 92.02 Total investments, end of year: Federal securities: Par value ................................................................... 3 92.01 91 ................... ................... The Ricky Ray hemophilia relief fund was established pursuant to Public Law 105–369 and serves as a source of funds to pay claims to eligible individuals on behalf of persons with HIV and a blood clotting disorder, who were treated with an anti-hemophiliac factor between July 1982 and December 1987. Object Classification (in millions of dollars) 2002 actual Identification code 75–8074–0–7–551 11.1 25.2 99.0 2 2002 actual Total compensable workyears: 6001 Civilian full-time equivalent employment ..................... Program and Financing (in millions of dollars) 1 2 1 1 3 2 2003 est. 19 12 2004 est. 6 f INDIAN HEALTH SERVICE Federal Funds INDIAN HEALTH SERVICES For expenses necessary to carry out the Act of August 5, 1954 (68 Stat. 674), the Indian Self-Determination 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, $2,502,393,000, 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 up to $18,000,000 shall remain available until expended, for the Indian Catastrophic Health Emergency Fund: Provided further, That $493,046,000 for contract medical care shall remain available for obligation until September 30, 2005: Provided further, That of the funds provided, up to $27,000,000 to remain available until expended, shall be used to carry out the loan repayment 15:09 Jan 23, 2003 Jkt 193833 PO 00000 2003 est. 2004 est. Obligations by program activity: Direct program: 00.01 Clinical services ........................................................ 00.02 Preventive health ....................................................... 00.03 Urban health ............................................................. 00.04 Indian health professions ......................................... 00.05 Tribal management ................................................... 00.06 Direct operations ....................................................... 00.07 Self-governance ......................................................... 00.08 Contract support costs .............................................. 00.09 Diabetes funds .......................................................... 09.01 Reimbursable program .................................................. 1,802 100 31 34 2 54 9 268 100 767 1,945 103 32 35 2 55 10 271 100 805 1,987 108 32 35 2 57 10 271 150 812 10.00 Total new obligations ................................................ 3,167 3,358 3,464 21.40 22.00 22.10 Budgetary resources available for obligation: Unobligated balance carried forward, start of year New budget authority (gross) ........................................ Resources available from recoveries of prior year obligations ....................................................................... 185 3,214 241 3,359 243 3,464 General and special funds: VerDate Dec 13 2002 2002 actual 2004 est. Personnel Summary Identification code 75–8074–0–7–551 Note.—A regular 2003 appropriation for this account had not been enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 107–229, as amended). The amounts included for 2003 in this budget reflect the Administration’s 2003 policy proposals. Identification code 75–0390–0–1–551 2003 est. Personnel compensation: Full-time permanent ............. 2 Other services ................................................................ ................... Limitation acct—direct obligations ..................... program under section 108 of the Indian Health Care Improvement Act: Provided further, That funds provided in this Act may be used for 1-year contracts and grants which are to be performed in 2 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 until expended: Provided further, That amounts received by tribes and tribal organizations under title IV of the Indian Health Care Improvement Act shall be reported and accounted for and available to the receiving tribes and tribal organizations until expended: Provided further, That, notwithstanding any other provision of law, of the amounts provided herein, not to exceed $270,734,000 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 2004, of which not to exceed $2,500,000 may be used for contract support costs associated with new or expanded self-determination contracts, grants, self-governance compacts or annual funding agreements: Provided further, That funds available for the Indian Health Care Improvement Fund may be used, as needed, to carry out activities typically funded under the Indian Health Facilities account. Frm 00010 Fmt 3616 23.90 23.95 23.98 24.40 11 ................... ................... Total budgetary resources available for obligation Total new obligations .................................................... Unobligated balance expiring or withdrawn ................. Unobligated balance carried forward, end of year ....... 3,410 3,600 3,707 ¥3,167 ¥3,358 ¥3,464 ¥2 ................... ................... 241 243 243 New budget authority (gross), detail: Discretionary: 40.00 Appropriation ............................................................. 40.73 Reduction pursuant to P.L. 107–206 ....................... 2,390 2,454 2,502 ¥1 ................... ................... 43.00 Appropriation (total discretionary) ........................ Mandatory: Appropriation ............................................................. Transferred from CMS for diabetes .......................... 2,389 Appropriation (total mandatory) ........................... Spending authority from offsetting collections: Discretionary: Offsetting collections (cash) ................................ Change in uncollected customer payments from Federal sources (unexpired) ............................. 100 100 150 692 805 812 60.00 62.00 62.50 68.00 68.10 Sfmt 3643 E:\BUDGET\HHS.XXX HHS 2,454 2,502 70 100 150 30 ................... ................... 33 ................... ................... INDIAN HEALTH SERVICE—Continued Federal Funds—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES 68.90 70.00 Spending authority from offsetting collections (total discretionary) ..................................... 725 805 812 Total new budget authority (gross) .......................... 3,214 3,359 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Adjustments in expired accounts (net) ......................... Recoveries of prior year obligations .............................. Change in uncollected customer payments from Federal sources (unexpired) ............................................ 74.10 Change in uncollected customer payments from Federal sources (expired) ................................................ 74.40 Obligated balance, end of year ..................................... 72.40 73.10 73.20 73.40 73.45 74.00 411 32.0 41.0 Land and structures .................................................. Grants, subsidies, and contributions ........................ 3 1,310 3 1,438 5 1,427 3,464 99.0 99.0 Direct obligations .................................................. Reimbursable obligations .............................................. 2,400 767 2,553 805 2,652 812 604 605 728 3,167 3,358 3,464 ¥3,212 ¥3,325 ¥3,463 9 9 ................... ¥11 ................... ................... 99.9 Total new obligations ................................................ 3,167 3,358 3,464 ¥33 ................... ................... 81 605 81 ................... 728 729 86.90 86.93 86.97 86.98 Outlays (gross), detail: Outlays from new discretionary authority ..................... Outlays from discretionary balances ............................. Outlays from new mandatory authority ......................... Outlays from mandatory balances ................................ 2,869 243 20 80 2,964 281 20 60 3,013 341 30 79 87.00 Total outlays (gross) ................................................. 3,212 3,325 3,463 Personnel Summary 2002 actual Identification code 75–0390–0–1–551 Direct: Total compensable workyears: 1001 Civilian full-time equivalent employment 1101 Military full-time equivalent employment Reimbursable: Total compensable workyears: 2001 Civilian full-time equivalent employment 2101 Military full-time equivalent employment 2003 est. 2004 est. ................. ................. 7,454 1,071 7,498 1,071 7,528 1,073 ................. ................. 4,415 619 4,416 618 4,420 614 f INDIAN HEALTH FACILITIES Offsets: Against gross budget authority and outlays: Offsetting collections (cash) from: 88.00 Federal sources ..................................................... 88.40 Non-Federal sources ............................................. ¥381 ¥386 ¥410 ¥395 ¥448 ¥364 88.90 ¥767 ¥805 ¥812 88.95 88.96 89.00 90.00 99.00 99.01 Total, offsetting collections (cash) .................. Against gross budget authority only: Change in uncollected customer payments from Federal sources (unexpired) .................................. Portion of offsetting collections (cash) credited to expired accounts ................................................... Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... ¥33 ................... ................... 75 ................... ................... 2,489 2,445 2,554 2,520 2,652 2,651 Additional net budget authority and outlays to cover cost of fully accruing retirement: Budget authority ............................................................ 59 62 Outlays ........................................................................... 59 62 67 67 The Indian health services account provides medical care, public health services, and health professions training opportunities to American Indians and Alaska Natives. An estimated $1,445 million will be administered by tribal governments under self-determination contracts and self-governance compacts in 2004. Object Classification (in millions of dollars) 2002 actual Identification code 75–0390–0–1–551 11.1 11.3 11.5 11.7 11.9 12.1 12.2 13.0 21.0 21.0 22.0 23.1 23.2 23.3 24.0 25.1 25.2 25.4 25.6 25.7 25.8 26.0 31.0 Direct obligations: Personnel compensation: Full-time permanent ............................................. Other than full-time permanent ........................... Other personnel compensation ............................. Military personnel ................................................. Total personnel compensation ......................... Civilian personnel benefits ....................................... Military personnel benefits ........................................ Benefits for former personnel ................................... Travel and transportation of persons: Travel and transportation of persons ................... Patient Travel ........................................................ 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 ............................................................ Operation and maintenance of facilities .................. Medical care .............................................................. Operation and maintenance of equipment ............... Subsistence and support of persons ........................ Supplies and materials ............................................. Equipment ................................................................. VerDate Dec 13 2002 15:09 Jan 23, 2003 Jkt 193833 2003 est. 2004 est. 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, $387,269,000, 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: Provided further, That not to exceed $500,000 shall be used by the Indian Health Service to purchase TRANSAM equipment from the Department of Defense for distribution to the Indian Health Service and tribal facilities: Provided further, That not to exceed $500,000 shall be used by the Indian Health Service to obtain ambulances for the Indian Health Service and tribal facilities in conjunction with an existing interagency agreement between the Indian Health Service and the General Services Administration: Provided further, That not to exceed $500,000 shall be placed in a Demolition Fund, available until expended, to be used by the Indian Health Service for demolition of Federal buildings. Note.—A regular 2003 appropriation for this account had not been enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 107–229, as amended). The amounts included for 2003 in this budget reflect the Administration’s 2003 policy proposals. Unavailable Collections (in millions of dollars) 312 17 29 72 333 18 22 77 346 19 35 81 430 86 30 7 450 91 33 8 481 97 38 10 29 8 8 11 2 27 8 8 11 2 29 10 10 13 4 18 1 5 91 6 215 4 1 126 9 19 1 5 87 6 215 4 2 126 9 21 3 7 89 8 251 6 4 128 11 Frm 00011 Fmt 3616 PO 00000 2002 actual Identification code 75–0391–0–1–551 2003 est. 2004 est. 01.99 Balance, start of year .................................................... ................... ................... ................... Receipts: 02.20 Rent and charges for quarters, Indian health service, HHS ............................................................................ 6 6 6 Appropriations: 05.00 Indian health facilities .................................................. ¥6 ¥6 ¥6 07.99 Balance, end of year ..................................................... ................... ................... ................... Program and Financing (in millions of dollars) 2002 actual Identification code 75–0391–0–1–551 2003 est. 2004 est. Obligations by program activity: Direct program: 00.01 Sanitation and health facilities ................................ 00.02 Maintenance .............................................................. 00.03 Facilities and environmental health ......................... 00.04 Equipment ................................................................. 190 48 127 13 166 53 134 16 184 53 140 16 01.00 09.01 378 2 369 2 393 2 Total direct program ............................................. Reimbursable program .................................................. Sfmt 3643 E:\BUDGET\HHS.XXX HHS 412 INDIAN HEALTH SERVICE—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 2004 General and special funds—Continued INDIAN HEALTH FACILITIES—Continued Program and Financing (in millions of dollars)—Continued 2002 actual Identification code 75–0391–0–1–551 10.00 Total new obligations ................................................ 2003 est. 380 2004 est. 371 32.0 41.0 Land and structures .................................................. Grants, subsidies, and contributions ........................ 15 96 15 98 15 99 99.0 99.0 Direct obligations .................................................. Reimbursable obligations .............................................. 378 2 369 2 393 2 99.9 Total new obligations ................................................ 380 371 395 395 Personnel Summary Budgetary resources available for obligation: 21.40 Unobligated balance carried forward, start of year 22.00 New budget authority (gross) ........................................ 23.90 23.95 24.40 Total budgetary resources available for obligation Total new obligations .................................................... Unobligated balance carried forward, end of year ....... New budget authority (gross), detail: Discretionary: 40.00 Appropriation ............................................................. Mandatory: 60.20 Appropriation (special fund) ..................................... Discretionary: 68.00 Spending authority from offsetting collections: Offsetting collections (cash) ..................................... 138 382 142 376 145 400 520 ¥380 142 518 ¥371 145 545 ¥395 150 369 363 387 6 6 6 7 7 7 Total new budget authority (gross) .......................... 382 376 400 72.40 73.10 73.20 74.40 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Obligated balance, end of year ..................................... 323 380 ¥379 323 323 371 ¥339 354 354 395 ¥385 364 86.90 86.93 86.97 Outlays (gross), detail: Outlays from new discretionary authority ..................... Outlays from discretionary balances ............................. Outlays from new mandatory authority ......................... 155 218 6 116 217 6 123 256 6 87.00 Total outlays (gross) ................................................. 379 339 385 Offsets: Against gross budget authority and outlays: 88.00 Offsetting collections (cash) from: Federal sources ¥7 ¥7 ¥7 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 375 372 369 332 393 378 99.00 99.01 Additional net budget authority and outlays to cover cost of fully accruing retirement: Budget authority ............................................................ 9 9 Outlays ........................................................................... 9 9 10 10 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) 2002 actual Identification code 75–0391–0–1–551 11.1 11.3 11.5 11.7 11.9 12.1 12.2 21.0 22.0 23.1 23.3 25.1 25.2 25.3 25.4 25.7 26.0 31.0 Direct obligations: Personnel compensation: Full-time permanent ............................................. Other than full-time permanent ........................... Other personnel compensation ............................. Military personnel ................................................. Total personnel compensation ......................... Civilian personnel benefits ....................................... Military personnel benefits ........................................ Travel and transportation of persons ....................... Transportation of things ........................................... Rental payments to GSA ........................................... Communications, utilities, and miscellaneous charges ................................................................. Advisory and assistance services ............................. Other services ............................................................ Other purchases of goods and services from Government accounts ................................................. Operation and maintenance of facilities .................. Operation and maintenance of equipment ............... Supplies and materials ............................................. Equipment ................................................................. VerDate Dec 13 2002 15:09 Jan 23, 2003 Jkt 193833 Direct: Total compensable workyears: 1001 Civilian full-time equivalent employment ................. 1101 Military full-time equivalent employment ................. 1,162 168 2003 est. 1,179 169 2004 est. 1,205 171 f 70.00 89.00 90.00 2002 actual Identification code 75–0391–0–1–551 2003 est. 2004 est. 35 6 1 17 38 6 1 18 40 7 1 20 59 9 6 3 2 1 63 10 6 3 3 1 68 11 7 3 3 1 11 2 150 11 2 134 12 4 151 1 9 1 10 3 1 8 1 10 3 1 3 1 11 3 Frm 00012 Fmt 3616 PO 00000 ADMINISTRATIVE PROVISIONS, INDIAN HEALTH SERVICE Appropriations in this Act to the Indian Health Service shall be available for services as authorized by 5 U.S.C. 3109 but at rates not to exceed the per diem rate equivalent to the maximum rate payable for senior-level positions under 5 U.S.C. 5376; hire of passenger motor vehicles and aircraft; purchase of medical equipment; purchase of reprints; purchase, renovation and erection of modular buildings and renovation of existing facilities; payments for telephone service in private residences in the field, when authorized under regulations approved by the Secretary; and for uniforms or allowances therefor as authorized by 5 U.S.C. 5901–5902; and for expenses of attendance at meetings which are concerned with the functions or activities for which the appropriation is made or which will contribute to improved conduct, supervision, or management of those functions or activities. 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. 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. 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. 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. 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. 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. 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. Such amounts shall remain available until expended. 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. Sfmt 3616 E:\BUDGET\HHS.XXX HHS CENTERS FOR DISEASE CONTROL AND PREVENTION Federal Funds DEPARTMENT OF HEALTH AND HUMAN SERVICES The appropriation structure for the Indian Health Service may not be altered without advance notice submitted to the House and Senate Committees on Appropriations. f CENTERS FOR DISEASE CONTROL AND PREVENTION Federal Funds General and special funds: DISEASE CONTROL, RESEARCH, AND Note.—A regular 2003 appropriations for this account had not been enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 107–229, as amended). The amounts included for 2003 in this budget reflect the Administration’s 2003 policy proposals. Unavailable Collections (in millions of dollars) 2002 actual 2003 est. 2004 est. 01.99 Balance, start of year .................................................... ................... ................... ................... Receipts: 02.20 Cooperative research and development agreements, Centers for Disease Contr ......................................... 1 1 1 Appropriations: 05.00 Disease control, research, and training ........................ ¥1 ¥1 ¥1 07.99 10.00 Total new obligations ................................................ Balance, end of year ..................................................... ................... ................... ................... 21.40 22.00 22.10 Budgetary resources available for obligation: Unobligated balance carried forward, start of year New budget authority (gross) ........................................ Resources available from recoveries of prior year obligations ....................................................................... 23.90 23.95 23.98 24.40 Total budgetary resources available for obligation Total new obligations .................................................... Unobligated balance expiring or withdrawn ................. Unobligated balance carried forward, end of year ....... 4,602 4,440 4,547 ¥4,535 ¥4,373 ¥4,479 ¥1 ................... ................... 66 67 68 New budget authority (gross), detail: Discretionary: 40.00 Appropriation ............................................................. 40.71 Reduction pursuant to P.L. 107–116 (Labor/HHS) 40.73 Reduction pursuant to P.L. 107–206 ....................... 42.00 Transferred from other accounts .............................. 4,306 4,166 4,267 ¥2 ................... ................... ¥3 ................... ................... 25 ................... ................... 43.00 Appropriation (total discretionary) ........................ Mandatory: Appropriation (special fund) ..................................... Transferred from other accounts .............................. 4,326 Appropriation (total mandatory) ........................... Spending authority from offsetting collections: Discretionary: Offsetting collections (cash) ................................ Change in uncollected customer payments from Federal sources (unexpired) ............................. 4 1 1 71 207 212 60.20 62.00 62.50 68.00 68.10 68.90 70.00 2002 actual Obligations by program activity: Direct program: 00.19 Birth defects/developmental disabilities/disability and health ............................................................ 00.20 Chronic disease prev & health promotion ................ 00.21 Environmental health ................................................ 00.22 Epidemic services and response ............................... 00.23 Health statistics ........................................................ 00.24 HIV/AIDS, STD and TB prevention ............................. 00.25 Immunization ............................................................. 00.26 Infectious disease control ......................................... 00.27 Injury prevention and control .................................... 00.28 Occupational safety and health ................................ 00.29 Preventive health and heath service block grant 00.30 Public health improvement ....................................... 00.31 Building and facilities .............................................. 00.32 Office of the Director ................................................ 00.33 Response and recovery .............................................. 09.01 Reimbursable program .................................................. VerDate Dec 13 2002 15:09 Jan 23, 2003 Jkt 193833 4,373 4,479 47 4,554 66 4,374 67 4,480 1 ................... ................... 2004 est. 90 89 87 747 690 834 157 152 150 81 78 76 103 79 73 1,148 1,235 1,281 627 628 621 348 335 331 149 145 145 281 248 246 135 135 135 148 117 114 236 184 114 49 51 60 12 ................... ................... 224 207 212 PO 00000 Frm 00013 Fmt 3616 4,267 1 1 1 3 ................... ................... 153 ................... ................... 224 207 212 Total new budget authority (gross) .......................... 4,554 4,374 4,480 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Adjustments in expired accounts (net) ......................... Recoveries of prior year obligations .............................. Change in uncollected customer payments from Federal sources (unexpired) ............................................ 74.10 Change in uncollected customer payments from Federal sources (expired) ................................................ 74.40 Obligated balance, end of year ..................................... 3,246 3,972 4,032 4,535 4,373 4,479 ¥3,708 ¥4,313 ¥4,396 ¥20 ................... ................... ¥1 ................... ................... ¥153 ................... ................... 75 ................... ................... 3,972 4,032 4,115 86.90 86.93 86.97 Outlays (gross), detail: Outlays from new discretionary authority ..................... Outlays from discretionary balances ............................. Outlays from new mandatory authority ......................... 1,597 2,110 1 1,582 2,730 1 1,620 2,775 1 87.00 Total outlays (gross) ................................................. 3,708 4,313 4,396 Offsets: Against gross budget authority and outlays: Offsetting collections (cash) from: 88.00 Federal sources ..................................................... ¥145 88.40 Non-Federal sources ............................................. ................... ¥205 ¥2 ¥210 ¥2 ¥145 ¥207 ¥212 88.95 2003 est. 4,166 Spending authority from offsetting collections (total discretionary) ..................................... 72.40 73.10 73.20 73.40 73.45 74.00 88.90 Program and Financing (in millions of dollars) Identification code 75–0943–0–1–999 4,535 TRAINING To carry out titles II, III, VII, XI, XV, XVII, XIX, XXI, 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, $4,267,330,000, of which $114,000,000 shall remain available until expended for equipment and construction and renovation of facilities; of which $293,763,000 for international HIV/AIDS shall remain available until September 30, 2005, including not less than $150,000,000, to remain available until expended, for the ‘‘International Mother and Child HIV Prevention Initiative.’’ 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 $51,982,000 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 transfer: Provided further, That not to exceed $10,000,000 may be available for making grants under section 1509 of the Public Health Service Act to not more than 15 States. Identification code 75–0943–0–1–999 413 88.96 89.00 90.00 99.00 99.01 Total, offsetting collections (cash) .................. Against gross budget authority only: Change in uncollected customer payments from Federal sources (unexpired) .................................. Portion of offsetting collections (cash) credited to expired accounts ................................................... Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... ¥153 ................... ................... 74 ................... ................... 4,330 3,565 4,167 4,106 4,268 4,184 Additional net budget authority and outlays to cover cost of fully accruing retirement: Budget authority ............................................................ 52 55 Outlays ........................................................................... 52 55 63 63 Summary of Budget Authority and Outlays (in millions of dollars) Enacted/requested: 2002 actual 2003 est. Budget Authority ..................................................................... 4,330 4,167 Outlays .................................................................................... 3,563 4,106 Legislative proposal, not subject to PAYGO: Budget Authority ..................................................................... .................... .................... Outlays .................................................................................... .................... .................... Sfmt 3647 E:\BUDGET\HHS.XXX HHS 2004 est. 4,268 4,184 –110 –48 414 CENTERS FOR DISEASE CONTROL AND PREVENTION—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 2004 General and special funds—Continued DISEASE CONTROL, RESEARCH, AND DISEASE CONTROL, RESEARCH, TRAINING—Continued Program and Financing (in millions of dollars) (in millions of dollars) 2002 actual 2003 est. 4,330 3,563 4,167 4,106 2004 est. 4,158 4,136 The Centers for Disease Control and Prevention (CDC) supports a number of categorical programs designed to improve the health, safety, and protection of all Americans. These programs include immunization, HIV prevention, chronic disease prevention and health promotion, infectious disease control, occupational safety and health, injury prevention and control, environmental health, and programs that reduce the occurrence of birth defects and developmental disabilities. CDC also supports bioterrorism and emergency response activities. Funding for these activities is included in the Public Health and Social Services Emergency Fund provided to CDC from the Office of the Secretary of Health and Human Services. The budget request for the 317 immunization program assumes enactment of a legislative proposal that reduces the discretionary request by $110 million. Object Classification (in millions of dollars) 2002 actual 11.1 11.3 11.5 11.7 11.8 11.9 12.1 12.2 21.0 22.0 23.1 23.2 23.3 Direct obligations: Personnel compensation: Full-time permanent ............................................. Other than full-time permanent ........................... Other personnel compensation ............................. Military personnel ................................................. Special personal services payments .................... 2003 est. 372 41 23 59 1 379 42 24 60 1 469 106 31 35 8 38 2 496 115 37 35 6 40 2 506 117 38 36 6 42 2 21 7 104 79 28 7 93 44 28 7 95 22 25.4 25.5 25.6 25.7 26.0 31.0 32.0 41.0 Total personnel compensation ......................... Civilian personnel benefits ....................................... Military 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 ............................................................ Other purchases of goods and services from Government accounts ................................................. Operation and maintenance of facilities .................. Research and development contracts ....................... Medical care .............................................................. Operation and maintenance of equipment ............... Supplies and materials ............................................. Equipment ................................................................. Land and structures .................................................. Grants, subsidies, and contributions ........................ 265 47 270 2 19 32 64 221 2,491 125 43 241 2 17 21 43 180 2,591 129 44 261 2 19 21 39 110 2,743 99.0 99.0 Direct obligations .................................................. Reimbursable obligations .............................................. 4,311 224 4,166 207 4,267 212 99.9 Total new obligations ................................................ 4,535 4,373 4,479 24.0 25.1 25.2 25.3 Personnel Summary 2002 actual Identification code 75–0943–0–1–999 Direct: Total compensable workyears: 1001 Civilian full-time equivalent employment 1101 Military full-time equivalent employment Reimbursable: Total compensable workyears: 2001 Civilian full-time equivalent employment 2101 Military full-time equivalent employment Allocation account: Total compensable workyears: 3001 Civilian full-time equivalent employment VerDate Dec 13 2002 15:09 Jan 23, 2003 2003 est. 2004 est. ................. ................. 6,599 796 6,559 797 6,558 796 ................. ................. 352 32 347 31 356 32 ................. Jkt 193833 420 PO 00000 497 497 Frm 00014 Fmt 3616 2003 est. 2004 est. Obligations by program activity: Direct program: 00.25 Immunization ............................................................. ................... ................... ¥110 10.00 Total new obligations (object class 41.0) ................ ................... ................... ¥110 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ ................... ................... Total new obligations .................................................... ................... ................... ¥110 110 New budget authority (gross), detail: Discretionary: 40.00 Appropriation ............................................................. ................... ................... ¥110 73.10 73.20 74.40 Change in obligated balances: Total new obligations .................................................... ................... ................... Total outlays (gross) ...................................................... ................... ................... Obligated balance, end of year ..................................... ................... ................... ¥110 48 ¥62 86.90 Outlays (gross), detail: Outlays from new discretionary authority ..................... ................... ................... ¥48 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ ................... ................... Outlays ........................................................................... ................... ................... ¥110 ¥48 2004 est. 354 41 23 50 1 2002 actual Identification code 75–0943–2–1–999 f Identification code 75–0943–0–1–999 TRAINING (Legislative proposal, not subject to PAYGO) Summary of Budget Authority and Outlays—Continued Total: Budget Authority ..................................................................... Outlays .................................................................................... AND The budget includes legislative proposals for the Vaccines for Children (VFC) program to expand access to immunizations for VFC-eligible children. Legislation amending the Vaccines for Children program will be proposed to allow underinsured children to receive immunizations at state and local public health clinics and to lift the price cap on the tetanusdiphtheria booster. These proposals will result in approximately $110 million in savings from the CDC discretionary 317 immunization program. The budget request for the 317 program assumes enactment of this proposal. f AGENCY FOR TOXIC SUBSTANCES AND DISEASE REGISTRY TOXIC SUBSTANCES AND ENVIRONMENTAL PUBLIC HEALTH For necessary expenses for the Agency for Toxic Substances and Disease Registry (ATSDR) in carrying out activities set forth in sections 104(i), 111(c)(4), and 111(c)(14) of the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA), as amended; section 118(f) of the Superfund Amendments and Reauthorization Act of 1986 (SARA), as amended; and section 3019 of the Solid Waste Disposal Act, as amended, $73,467,000, to be derived from the Hazardous Substance Superfund Trust Fund pursuant to section 517(a) of SARA (26 U.S.C. 9507): Provided, That notwithstanding any other provision of law, in lieu of performing a health assessment under section 104(i)(6) of CERCLA, the Administrator of ATSDR may conduct other appropriate health studies, evaluations, or activities, including, without limitation, biomedical testing, clinical evaluations, medical monitoring, and referral to accredited health care providers: Provided further, That in performing any such health assessment or health study, evaluation, or activity, the Administrator of ATSDR shall not be bound by the deadlines in section 104(i)(6)(A) of CERCLA: Provided further, That none of the funds appropriated under this heading shall be available for ATSDR to issue in excess of 40 toxicological profiles pursuant to section 104(i) of CERCLA during fiscal year 2004, and existing profiles may be updated as necessary. Note.—A regular 2003 appropriation for this account had not been enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 107–229, as amended). The amounts included for 2003 in this budget reflect the Administration’s 2003 policy proposals. Sfmt 3616 E:\BUDGET\HHS.XXX HHS NATIONAL INSTITUTES OF HEALTH Federal Funds DEPARTMENT OF HEALTH AND HUMAN SERVICES 21.0 23.3 Program and Financing (in millions of dollars) 2002 actual Identification code 75–8252–0–7–551 2003 est. Obligations by program activity: Direct program ............................................................... Reimbursable program .................................................. 78 31 77 25 73 25 10.00 Total new obligations ................................................ 109 102 98 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ Total new obligations .................................................... 109 ¥109 102 ¥102 98 ¥98 68.90 70.00 78 77 73 7 25 25 24 ................... ................... Spending authority from offsetting collections (total discretionary) .......................................... 31 25 25 Total new budget authority (gross) .......................... 109 102 98 30 109 ¥77 44 102 ¥114 32 98 ¥100 Change in obligated balances: 72.40 Obligated balance, start of year ................................... 73.10 Total new obligations .................................................... 73.20 Total outlays (gross) ...................................................... 74.00 Change in uncollected customer payments from Federal sources (unexpired) ............................................ 74.10 Change in uncollected customer payments from Federal sources (expired) ................................................ 74.40 Obligated balance, end of year ..................................... 2 2 2 1 5 2 1 4 2 1 4 1 9 3 3 20 7 7 2 18 5 6 2 18 99.0 99.0 Direct obligations .................................................. Reimbursable obligations .............................................. 78 31 77 25 73 25 99.9 Total new obligations ................................................ 109 102 98 2004 est. 00.01 09.01 New budget authority (gross), detail: Discretionary: 40.26 Appropriation (trust fund) ......................................... Spending authority from offsetting collections: 68.00 Offsetting collections (cash) ..................................... 68.10 Change in uncollected customer payments from Federal sources (unexpired) .................................. 25.5 31.0 41.0 Travel and transportation of persons ....................... Communications, utilities, and miscellaneous charges ................................................................. Advisory and assistance services ............................. Other services ............................................................ Other purchases of goods and services from Government accounts ................................................. Research and development contracts ....................... Equipment ................................................................. Grants, subsidies, and contributions ........................ 415 25.1 25.2 25.3 Personnel Summary 2002 actual Identification code 75–8252–0–7–551 Direct: Total compensable workyears: 1001 Civilian full-time equivalent employment 1101 Military full-time equivalent employment Reimbursable: Total compensable workyears: 2001 Civilian full-time equivalent employment 2101 Military full-time equivalent employment 2003 est. 2004 est. ................. ................. 308 63 301 63 301 63 ................. ................. 57 8 57 8 57 8 f NATIONAL INSTITUTES OF HEALTH ¥24 ................... ................... Federal Funds 6 ................... ................... 44 32 30 General and special funds: Outlays (gross), detail: 86.90 Outlays from new discretionary authority ..................... 86.93 Outlays from discretionary balances ............................. 60 17 77 37 75 25 For carrying out section 301 and title IV of the Public Health Service Act with respect to cancer, $4,770,519,000. 87.00 77 114 100 ¥13 ¥25 ¥25 NATIONAL CANCER INSTITUTE NATIONAL HEART, LUNG, Total outlays (gross) ................................................. Offsets: Against gross budget authority and outlays: 88.00 Offsetting collections (cash) from: Federal sources Against gross budget authority only: 88.95 Change in uncollected customer payments from Federal sources (unexpired) .................................. 88.96 Portion of offsetting collections (cash) credited to expired accounts ................................................... 89.00 90.00 99.00 99.01 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... ¥24 ................... ................... 6 ................... ................... 78 65 77 89 73 75 4 4 The Agency for Toxic Substances and Disease Registry (ATSDR) is authorized under the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA). ATSDR assesses health hazards at specific hazardous waste sites helping to prevent or reduce exposure and illnesses that result, and increasing knowledge and understanding of the health effects that may result from exposure to hazardous substances. ATSDR is financed through the EPA Superfund. 2002 actual Identification code 75–8252–0–7–551 2003 est. 2004 est. 11.1 11.3 11.5 11.7 20 1 1 4 20 1 1 4 21 1 1 4 11.9 12.1 12.2 Total personnel compensation ......................... Civilian personnel benefits ....................................... Military personnel benefits ........................................ 26 5 2 26 6 2 27 5 2 Frm 00015 Fmt 3616 15:09 Jan 23, 2003 Jkt 193833 NATIONAL INSTITUTE PO 00000 OF DENTAL AND CRANIOFACIAL RESEARCH OF DIABETES AND DIGESTIVE DISEASES AND KIDNEY For carrying out section 301 and title IV of the Public Health Service Act with respect to diabetes and digestive and kidney disease, $1,670,007,000. OF 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, $1,468,926,000. NATIONAL INSTITUTE OF ALLERGY (INCLUDING AND INFECTIOUS DISEASES TRANSFER OF FUNDS) For carrying out section 301 and title IV of the Public Health Service Act with respect to allergy and infectious diseases, $4,335,255,000: Provided, That $100,000,000 may be made available to International Assistance Programs, ‘‘Global Fund to Fight HIV/ AIDS, Malaria, and Tuberculosis’’, to remain available until expended, to further the Institute’s efforts to prevent and alleviate these diseases. OF GENERAL MEDICAL SCIENCES For carrying out section 301 and title IV of the Public Health Service Act with respect to general medical sciences, $1,923,133,000. NATIONAL INSTITUTE Direct obligations: Personnel compensation: Full-time permanent ............................................. Other than full-time permanent ........................... Other personnel compensation ............................. Military personnel ................................................. VerDate Dec 13 2002 NATIONAL INSTITUTE For carrying out section 301 and title IV of the Public Health Service Act with respect to dental disease, $382,396,000. NATIONAL INSTITUTE Object Classification (in millions of dollars) BLOOD INSTITUTE For carrying out section 301 and title IV of the Public Health Service Act with respect to cardiovascular, lung, and blood diseases, and blood and blood products, $2,867,995,000. NATIONAL INSTITUTE Additional net budget authority and outlays to cover cost of fully accruing retirement: Budget authority ............................................................ 3 3 Outlays ........................................................................... 3 3 AND OF CHILD HEALTH AND HUMAN DEVELOPMENT For carrying out section 301 and title IV of the Public Health Service Act with respect to child health and human development, $1,245,371,000. NATIONAL EYE INSTITUTE For carrying out section 301 and title IV of the Public Health Service Act with respect to eye diseases and visual disorders, $648,299,000. Sfmt 3616 E:\BUDGET\HHS.XXX HHS 416 NATIONAL INSTITUTES OF HEALTH—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 2004 General and special funds—Continued NATIONAL INSTITUTE ENVIRONMENTAL HEALTH SCIENCES OF For necessary expenses for the National Institute of Environmental Health Sciences in carrying out activities set forth in section 311(a) of the Comprehensive Environmental Response, Compensation, and Liability Act of 1980, as amended, and section 126(g) of the Superfund Amendments and Reauthorization Act of 1986, $78,774,000. For carrying out sections 301 and 311 and title IV of the Public Health Service Act with respect to environmental health sciences, $630,774,000. NATIONAL INSTITUTE ON AGING For carrying out section 301 and title IV of the Public Health Service Act with respect to aging, $994,411,000. NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL SKIN DISEASES AND For carrying out section 301 and title IV of the Public Health Service Act with respect to arthritis and musculoskeletal and skin diseases, $502,778,000. NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS For carrying out section 301 and title IV of the Public Health Service Act with respect to deafness and other communication disorders, $380,377,000. NATIONAL INSTITUTE OF ON ALCOHOL ABUSE AND ON ALCOHOLISM OF MENTAL HEALTH NATIONAL HUMAN GENOME RESEARCH INSTITUTE BIOMEDICAL IMAGING AND 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, $1,053,926,000: Provided, That none of these funds shall be used to pay recipients of the general research support grants program any amount for indirect expenses in connection with such grants. NATIONAL CENTER FOR 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, $116,202,000. NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES For carrying out section 301 and title IV of the Public Health Service Act with respect to minority health and health disparities research, $192,724,000. JOHN E. FOGARTY INTERNATIONAL CENTER For carrying out the activities at the John E. Fogarty International Center, $64,266,000. NATIONAL LIBRARY OF MEDICINE For carrying out section 301 and title IV of the Public Health Service Act with respect to health information communications, VerDate Dec 13 2002 15:09 Jan 23, 2003 Jkt 193833 PO 00000 2002 actual Identification code 75–9915–0–1–552 2003 est. 2004 est. Balance, start of year .................................................... ................... ................... ................... Receipts: 02.20 Cooperative research and development agreements, NIH ............................................................................. 15 15 15 Appropriations: 05.00 National Institutes of Health ......................................... ¥15 ¥15 ¥15 07.99 Balance, end of year ..................................................... ................... ................... ................... BIOENGINEERING For carrying out section 301 and title IV of the Public Health Service Act with respect to biomedical imaging and bioengineering research, $282,109,000. NATIONAL CENTER Note.—A regular 2003 appropriation for this account had not been enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 107–229, as amended). The amounts included for 2003 in this budget reflect the Administration’s 2003 policy proposals. 01.99 For carrying out section 301 and title IV of the Public Health Service Act with respect to human genome research, $478,072,000. OF For the study of, construction of, renovation of, and acquisition of equipment for, facilities of or used by the National Institutes of Health, including the acquisition of real property, $80,000,000, to remain available until expended. Unavailable Collections (in millions of dollars) For carrying out section 301 and title IV of the Public Health Service Act with respect to mental health, $1,382,114,000. NATIONAL INSTITUTE DIRECTOR TRANSFER OF FUNDS) For carrying out the responsibilities of the Office of the Director, National Institutes of Health, $317,983,000, of which $60,942,000 shall be for the Office of AIDS Research: Provided, That funding shall be available for the purchase of not to exceed 29 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 the National Institutes of Health 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 National Institutes of Health Management Fund shall remain available for one fiscal year after the fiscal year in which they are deposited. DRUG ABUSE For carrying out section 301 and title IV of the Public Health Service Act with respect to drug abuse, $995,614,000. NATIONAL INSTITUTE OF THE BUILDINGS AND FACILITIES For carrying out section 301 and title IV of the Public Health Service Act with respect to alcohol abuse and alcoholism, $430,121,000. NATIONAL INSTITUTE OFFICE (INCLUDING NURSING RESEARCH For carrying out section 301 and title IV of the Public Health Service Act with respect to nursing research, $134,579,000. NATIONAL INSTITUTE $316,040,000, of which $4,000,000 shall be available until expended for improvement of information systems: Provided, That in fiscal year 2004, 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. Frm 00016 Fmt 3616 Program and Financing (in millions of dollars) 2002 actual Identification code 75–9915–0–1–552 Obligations by program activity: Direct program: 00.01 National Cancer Institute .......................................... 00.02 National Heart, Lung, and Blood Institute ............... 00.03 National Institute of Dental and Craniofacial Research ................................................................... 00.04 National Institute of Diabetes and Digestive and Kidney Disease ...................................................... 00.05 National Institute of Neurological Disorders and Stroke .................................................................... 00.06 National Institute of Allergy and Infectious Diseases ..................................................................... 00.07 National Institute of General Medical Sciences ....... 00.08 National Institute of Child Health and Human Development .............................................................. 00.09 National Eye Institute ................................................ 00.10 National Institute of Environmental Health Sciences 00.11 National Institute on Aging ....................................... 00.12 National Institute of Arthritis and Musculoskeletal and Skin Disease .................................................. 00.13 National Institute on Deafness and Other Communication Disorder ................................................... 00.14 National Institute of Mental Health .......................... 00.15 National Institute on Drug Abuse ............................. 00.16 Natinal Institute on Alcohol Abuse and Alcoholism 00.17 National Institute of Nursing Research .................... 00.18 National Human Genome Research Institute ............ 00.19 National Institute of Biomedical Imaging and Bioengineering ........................................................... Sfmt 3643 E:\BUDGET\HHS.XXX HHS 2003 est. 2004 est. 4,178 2,570 4,673 2,779 4,771 2,868 342 370 382 1,560 1,704 1,820 1,325 1,432 1,469 2,340 1,723 3,984 1,874 4,335 1,923 1,111 580 645 891 1,196 626 685 958 1,245 648 710 994 448 486 503 341 1,245 892 383 120 428 366 1,344 961 415 130 458 380 1,382 996 430 135 478 111 120 282 NATIONAL INSTITUTES OF HEALTH—Continued Federal Funds—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES 00.20 00.21 00.23 00.24 00.25 00.26 00.27 00.28 09.00 National Center for Research Resources .................. National Center for Complementary and Alternative Medicine ................................................................ National Center on Minority Health and Health Disparities .................................................................. John E. Fogarty International Center ........................ National Library of Medicine ..................................... Office of the Director ................................................ Buildings and facilities ............................................. Cooperative Research and Development Agreements Royalities ................................................................... Reimbursable program .................................................. 10.00 Total new obligations ................................................ 24,853 29,214 29,794 21.40 22.00 Budgetary resources available for obligation: Unobligated balance carried forward, start of year New budget authority (gross) ........................................ 209 25,119 466 29,214 464 29,794 23.90 23.95 23.98 24.40 Total budgetary resources available for obligation Total new obligations .................................................... Unobligated balance expiring or withdrawn ................. Unobligated balance carried forward, end of year ....... 00.22 1,010 104 1,090 113 1,054 116 158 186 193 57 63 64 276 308 316 235 254 318 115 769 80 9 15 15 28 ................... ................... 1,628 1,855 1,887 99.00 99.01 417 Additional net budget authority and outlays to cover cost of fully accruing retirement: Budget authority ............................................................ 86 92 Outlays ........................................................................... 86 92 104 104 DISTRIBUTION OF BUDGET AUTHORITY AND OUTLAYS BY ACCOUNT [Dollars in millions] New budget authority (gross), detail: Discretionary: 40.00 Appropriation ............................................................. 40.35 Appropriation rescinded ............................................ 40.71 Reduction pursuant to P.L. 107–116 (Labor/HHS) 40.73 Reduction pursuant to P.L. 107–206 ....................... 41.00 Transferred to other accounts ................................... 42.00 Transferred from other accounts .............................. 23,366 ¥30 ¥9 ¥27 ¥125 7 27,244 ................... ................... ................... ................... ................... 27,742 ................... ................... ................... ................... ................... 43.00 Appropriation (total discretionary) ........................ Mandatory: Appropriation ............................................................. Appropriation (special fund) ..................................... Transferred from other accounts .............................. 23,182 27,244 27,742 Appropriation (total mandatory) ........................... Spending authority from offsetting collections: Discretionary: Offsetting collections (cash) ................................ Change in uncollected customer payments from Federal sources (unexpired) ............................. 112 115 165 Distribution of budget authority 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 Disorder and Stroke ......... National Institute of Allergy and Infectious Diseases ........... National Institute of General Medical Sciences ..................... National Institute of Child Health and Human Development National Eye Institute ............................................................. National Institute of Environmental Health Sciences ............ National Institute on Aging .................................................... National Institute of Arthritis and Musculoskeletal and Skin Diseases ............................................................................. National Institute on Deafness and Other Communication Disorders ............................................................................. National Institute of Nursing Research .................................. National Institute on Alcohol Abuse and Alcoholism ............. National Institute on Drug Abuse ........................................... National Institute of Mental Health ....................................... National Center for Research Resources ................................ National Human Genome Research Institute ......................... National Institute of Biomedical Imaging and Bioengineering ......................................................................... National Center for Complementary and Alternative Medicine ..................................................................................... National Center for Minority Health and Health Disparities John E. Fogarty International Center ...................................... National Library of Medicine .................................................. Office of the Director .............................................................. Buildings and facilities .......................................................... 1,533 1,855 1,887 Subtotal .......................................................................... Cooperative Research and Development Agreements ............ 23,279 15 27,344 15 27,892 15 292 ................... ................... Total Budget Authority, NIH ........................................... 23,294 27,359 27,907 60.00 60.20 62.00 62.50 68.00 68.10 68.90 25,328 29,680 30,258 ¥24,853 ¥29,214 ¥29,794 ¥8 ................... ................... 466 464 464 70 100 150 15 15 15 27 ................... ................... Spending authority from offsetting collections (total discretionary) ..................................... 1,825 1,855 1,887 Total new budget authority (gross) .......................... 25,119 29,214 29,794 2002 2003 4,673 2,779 370 4,771 2,868 382 1,561 1,325 2,340 1,723 1,111 580 645 891 1,704 1,432 3,984 1,874 1,196 626 685 958 1,820 1,469 4,335 1,923 1,245 648 710 994 448 486 503 341 120 383 893 1,245 1,010 428 366 130 415 961 1,344 1,090 458 380 135 430 996 1,382 1,054 478 112 120 282 104 158 57 276 235 204 113 186 63 308 254 769 116 193 64 316 318 80 [Dollars in millions] 2002 70.00 Change in obligated balances: 72.40 Obligated balance, start of year ................................... 73.10 Total new obligations .................................................... 73.20 Total outlays (gross) ...................................................... 73.40 Adjustments in expired accounts (net) ......................... 74.00 Change in uncollected customer payments from Federal sources (unexpired) ............................................ 74.10 Change in uncollected customer payments from Federal sources (expired) ................................................ 74.40 Obligated balance, end of year ..................................... 19,238 21,692 25,810 24,853 29,214 29,794 ¥22,201 ¥25,098 ¥28,386 ¥134 ................... ................... ¥292 ................... ................... 228 ................... ................... 21,692 25,810 27,218 86.90 86.93 86.97 86.98 Outlays (gross), detail: Outlays from new discretionary authority ..................... Outlays from discretionary balances ............................. Outlays from new mandatory authority ......................... Outlays from mandatory balances ................................ 7,095 15,022 33 51 8,829 16,166 34 69 8,989 19,267 51 79 87.00 Total outlays (gross) ................................................. 22,201 25,098 28,386 Offsets: Against gross budget authority and outlays: Offsetting collections (cash) from: 88.00 Federal sources ..................................................... 88.40 Non-Federal sources ............................................. ¥1,688 ¥1,855 ¥1,887 ¥63 ................... ................... 88.90 ¥1,751 88.95 88.96 Total, offsetting collections (cash) .................. Against gross budget authority only: Change in uncollected customer payments from Federal sources (unexpired) .................................. Portion of offsetting collections (cash) credited to expired accounts ................................................... Net budget authority and outlays: 89.00 Budget authority ............................................................ 90.00 Outlays ........................................................................... VerDate Dec 13 2002 15:09 Jan 23, 2003 Jkt 193833 ¥1,855 ¥1,887 ¥292 ................... ................... 218 ................... ................... 23,294 20,450 PO 00000 27,359 23,243 27,907 26,499 Frm 00017 Fmt 3616 2004 4,177 2,570 342 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 ....................................... National Center for Research Resources ................................ National Human Genome Research Institute ......................... National Institute of Biomedical Imaging and Bioengineering ......................................................................... National Center for Complementary and Alternative Medicine ..................................................................................... National Center for Minority Health and Health Disparities John E. Fogarty International Center ...................................... National Library of Medicine .................................................. Office of the Director .............................................................. Buildings and Facilities .......................................................... Service and Supply Fund/Management Fund ......................... 2003 2004 3,934 2,341 296 4,089 2,513 340 4,615 2,744 367 1,327 1,145 2,075 1,544 974 509 551 782 1,544 1.297 2,680 1,710 1,099 572 635 869 1,697 1,415 3,766 1,861 1,192 623 685 948 394 440 481 298 99 331 765 1,101 781 360 336 114 377 864 1,222 962 433 364 127 410 942 1,326 1,041 465 20 66 135 82 86 51 252 263 231 –152 99 136 54 282 232 268 0 112 165 61 307 272 368 0 Subtotal Outlays ............................................................ Cooperative Research and Development Agreements ............ 20,440 10 23,233 10 26,489 10 Total Outlays, NIH .......................................................... 20,450 23,243 26,499 Sfmt 3647 E:\BUDGET\HHS.XXX HHS 418 NATIONAL INSTITUTES OF HEALTH—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 2004 General and special funds—Continued SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION BUILDINGS AND FACILITIES—Continued 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. The National Institutes of Health (NIH) is working to meet the management challenges that can arise when an agency receives a substantial infusion of resources over a short period of time. NIH is in the process of identifying strategies and policies that could be implemented in 2004 and beyond to maximize budgetary and management flexibility in the future. Such strategies include funding the total costs of an increasing number of new grants in the grant’s first year and managing grant average cost increases. Federal Funds General and special funds: SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES 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, $3,393,315,000: Provided, That in addition to amounts provided herein, $16,000,000 shall be available from amounts available under section 241 of the Public Health Service Act to carry out national surveys on drug abuse. Note.—A regular 2003 appropriation for this account had not been enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 107–229, as amended). The amounts included for 2003 in this budget reflect the Administration’s 2003 policy proposals. Program and Financing (in millions of dollars) 2002 actual Identification code 75–1362–0–1–551 Object Classification (in millions of dollars) 2002 actual Identification code 75–9915–0–1–552 11.1 11.3 11.5 11.7 11.8 11.9 12.1 12.2 21.0 22.0 23.1 23.2 23.3 Direct obligations: Personnel compensation: Full-time permanent ............................................. Other than full-time permanent ........................... Other personnel compensation ............................. Military personnel ................................................. Special personal services payments .................... 2003 est. 2004 est. 600 267 37 24 117 636 285 31 25 130 657 294 32 26 133 1,045 227 13 44 6 5 18 1,107 241 14 51 7 6 23 1,142 250 15 53 7 7 30 31 16 93 432 38 19 90 527 39 19 92 550 25.4 25.5 25.6 25.7 26.0 31.0 41.0 42.0 Total personnel compensation ......................... Civilian personnel benefits ....................................... Military 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 ............................................................ Other purchases of goods and services from Government accounts ................................................. Operation and maintenance of facilities .................. Research and development contracts ....................... Medical care .............................................................. Operation and maintenance of equipment ............... Supplies and materials ............................................. Equipment ................................................................. Grants, subsidies, and contributions ........................ Insurance claims and indemnities ........................... 99.0 99.0 Direct obligations .................................................. Reimbursable obligations .............................................. 23,225 1,628 27,359 1,855 27,907 1,887 99.9 Total new obligations ................................................ 24,853 29,214 29,794 24.0 25.1 25.2 25.3 1,698 1,906 1,989 294 989 306 1,245 2,190 2,329 14 16 17 57 59 61 203 239 247 177 206 209 17,606 19,631 20,545 1 ................... ................... Personnel Summary 2002 actual Identification code 75–9915–0–1–552 Direct: Total compensable workyears: 1001 Civilian full-time equivalent employment 1101 Military full-time equivalent employment Reimbursable: Total compensable workyears: 2001 Civilian full-time equivalent employment 2101 Military full-time equivalent employment VerDate Dec 13 2002 15:09 Jan 23, 2003 2003 est. 2004 est. ................. ................. 12,259 379 12,528 387 12,352 382 ................. ................. 4,465 138 4,626 143 4,640 143 Jkt 193833 PO 00000 Frm 00018 Fmt 3616 2003 est. 2004 est. Obligations by program activity: Direct program: 00.01 Mental health and substance abuse activities ........ 00.02 Mental health partnership ........................................ 00.03 Substance abuse partnership ................................... 00.05 Program management ............................................... 09.01 Reimbursable program .................................................. 884 433 1,725 91 73 900 433 1,785 77 75 1,106 433 1,785 69 75 10.00 Total new obligations ................................................ 3,206 3,270 3,468 21.40 22.00 Budgetary resources available for obligation: Unobligated balance carried forward, start of year New budget authority (gross) ........................................ 7 3,209 6 3,270 6 3,468 23.90 23.95 23.98 24.40 Total budgetary resources available for obligation Total new obligations .................................................... Unobligated balance expiring or withdrawn ................. Unobligated balance carried forward, end of year ....... 3,215 3,276 3,474 ¥3,206 ¥3,270 ¥3,468 ¥3 ................... ................... 6 6 6 New budget authority (gross), detail: Discretionary: 40.00 Appropriation ............................................................. 40.71 Reduction pursuant to P.L. 107–116 ....................... 40.73 Reduction pursuant to P.L. 107–206 ....................... 3,139 3,195 3,393 ¥1 ................... ................... ¥2 ................... ................... 43.00 3,136 3,195 3,393 70 75 75 68.00 68.10 Appropriation (total discretionary) ........................ Spending authority from offsetting collections: Offsetting collections (cash) ..................................... Change in uncollected customer payments from Federal sources (unexpired) .................................. 3 ................... ................... 68.90 Spending authority from offsetting collections (total discretionary) .......................................... 73 75 75 70.00 Total new budget authority (gross) .......................... 3,209 3,270 3,468 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Adjustments in expired accounts (net) ......................... Change in uncollected customer payments from Federal sources (unexpired) ............................................ 74.10 Change in uncollected customer payments from Federal sources (expired) ................................................ 74.40 Obligated balance, end of year ..................................... 72.40 73.10 73.20 73.40 74.00 2,156 2,385 2,524 3,206 3,270 3,468 ¥2,957 ¥3,131 ¥3,349 ¥19 ................... ................... ¥3 ................... ................... 2 ................... ................... 2,385 2,524 2,643 86.90 86.93 Outlays (gross), detail: Outlays from new discretionary authority ..................... Outlays from discretionary balances ............................. 1,314 1,643 1,327 1,803 1,405 1,944 87.00 Total outlays (gross) ................................................. 2,957 3,131 3,349 ¥72 ¥75 ¥75 Offsets: Against gross budget authority and outlays: 88.00 Offsetting collections (cash) from: Federal sources Against gross budget authority only: 88.95 Change in uncollected customer payments from Federal sources (unexpired) .................................. Sfmt 3643 E:\BUDGET\HHS.XXX HHS ¥3 ................... ................... AGENCY FOR HEALTHCARE RESEARCH AND QUALITY Federal Funds DEPARTMENT OF HEALTH AND HUMAN SERVICES 88.96 89.00 90.00 99.00 99.01 Portion of offsetting collections (cash) credited to expired accounts ................................................... 2 ................... ................... Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 3,136 2,885 3,195 3,056 3,393 3,274 6 6 This program provides Federal support for treatment and prevention in the areas of alcoholism, drug abuse, and mental health. The Administration has proposed to retain the language of the HHS General Provisions dealing with the penalty in Sec. 1926 of the Public Health Service Act, known as the Synar Amendment. The only penalty allowed under the current law is disproportionally severe, and could penalize those needing substance abuse services. The Administration looks forward to working with Congress to achieve a permanent statutory change that would establish a more fair and sustainable penalty structure. Object Classification (in millions of dollars) 2002 actual 11.1 11.3 11.5 11.7 11.9 12.1 12.2 21.0 23.1 23.3 Direct obligations: Personnel compensation: Full-time permanent ............................................. Other than full-time permanent ........................... Other personnel compensation ............................. Military personnel ................................................. 2003 est. 2004 est. 36 2 1 2 37 2 1 2 38 2 1 2 41 9 1 2 4 42 9 1 2 6 43 9 1 2 7 2 4 19 221 2 6 19 221 2 6 18 204 31.0 41.0 42.0 Total personnel compensation ......................... Civilian personnel benefits ....................................... Military 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 ............................................................ Other purchases of goods and services from Government accounts ................................................. Equipment ................................................................. Grants, subsidies, and contributions ........................ Insurance claims and indemnities ........................... 124 1 2,703 2 124 1 2,760 2 122 1 2,976 2 99.0 99.0 Direct obligations .................................................. Reimbursable obligations .............................................. 3,133 73 3,195 75 3,393 75 99.9 Total new obligations ................................................ 3,206 3,270 3,468 24.0 25.1 25.2 25.3 Personnel Summary 2002 actual Identification code 75–1362–0–1–551 Direct: Total compensable workyears: 1001 Civilian full-time equivalent employment ................. 1101 Military full-time equivalent employment ................. Reimbursable: Total compensable workyears: 2101 Military full-time equivalent employment ................. 2003 est. made available pursuant to section 927(c) of the Public Health Service Act shall not exceed $279,000,000. Note.—A regular 2003 appropriation for this account had not been enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 107–229, as amended). The amounts included for 2003 in this budget reflect the Administration’s 2003 policy proposals. Program and Financing (in millions of dollars) Additional net budget authority and outlays to cover cost of fully accruing retirement: Budget authority ............................................................ 5 5 Outlays ........................................................................... 5 5 Identification code 75–1362–0–1–551 2004 est. 490 36 499 33 483 33 56 56 56 f AGENCY FOR HEALTHCARE RESEARCH AND QUALITY Federal Funds AND QUALITY 15:09 Jan 23, 2003 Jkt 193833 PO 00000 Frm 00019 Fmt 3616 2003 est. 2004 est. Obligations by program activity: Direct program: 01.04 Program support ........................................................ 09.00 Reimbursable program .................................................. 3 ................... ................... 320 275 304 10.00 Total new obligations ................................................ 323 275 304 21.40 22.00 Budgetary resources available for obligation: Unobligated balance carried forward, start of year New budget authority (gross) ........................................ 7 333 15 275 15 304 23.90 23.95 23.98 24.40 Total budgetary resources available for obligation Total new obligations .................................................... Unobligated balance expiring or withdrawn ................. Unobligated balance carried forward, end of year ....... New budget authority (gross), detail: Discretionary: 40.00 Appropriation ............................................................. Spending authority from offsetting collections: 68.00 Offsetting collections (cash) ..................................... 68.10 Change in uncollected customer payments from Federal sources (unexpired) .................................. 68.90 70.00 3 ................... ................... 329 275 304 1 ................... ................... 330 275 304 Total new budget authority (gross) .......................... 333 275 304 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Adjustments in expired accounts (net) ......................... Change in uncollected customer payments from Federal sources (unexpired) ............................................ 74.40 Obligated balance, end of year ..................................... 72.40 73.10 73.20 73.40 74.00 86.90 86.93 Outlays (gross), detail: Outlays from new discretionary authority ..................... Outlays from discretionary balances ............................. 87.00 Total outlays (gross) ................................................. Offsets: Against gross budget authority and outlays: 88.00 Offsetting collections (cash) from: Federal sources Against gross budget authority only: 88.95 Change in uncollected customer payments from Federal sources (unexpired) .................................. 89.00 90.00 340 290 319 ¥323 ¥275 ¥304 ¥1 ................... ................... 15 15 15 Spending authority from offsetting collections (total discretionary) .......................................... Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 278 337 337 323 275 304 ¥263 ¥275 ¥304 ¥1 ................... ................... ¥1 ................... ................... 337 337 337 87 275 304 176 ................... ................... 263 275 304 ¥329 ¥275 ¥304 ¥1 ................... ................... 3 ................... ................... ¥66 ................... ................... This activity supports the development of scientific evidence and tools to improve the quality, safety, and effectiveness of all aspects of the health care system, and initiatives to disseminate and translate scientific findings into health care practice. Object Classification (in millions of dollars) 2002 actual Identification code 75–1700–0–1–552 For carrying out titles III and IX of the Public Health Service Act, and part A of title XI of the Social Security Act, amounts received from Freedom of Information Act fees, reimbursable and interagency agreements, and the sale of data shall be credited to this appropriation and shall remain available until expended: Provided, That the amount VerDate Dec 13 2002 2002 actual Identification code 75–1700–0–1–552 General and special funds: HEALTHCARE RESEARCH 419 2003 est. 2004 est. 11.1 12.1 Direct obligations: Personnel compensation: Full-time permanent ........ Civilian personnel benefits ....................................... 2 ................... ................... 1 ................... ................... 99.0 99.0 Direct obligations .................................................. Reimbursable obligations .............................................. 3 ................... ................... 320 275 304 99.9 Total new obligations ................................................ Sfmt 3643 E:\BUDGET\HHS.XXX HHS 323 275 304 420 AGENCY FOR HEALTHCARE RESEARCH AND QUALITY—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 2004 General and special funds—Continued HEALTHCARE RESEARCH AND QUALITY—Continued Personnel Summary 2002 actual Identification code 75–1700–0–1–552 Direct: Total compensable workyears: 1001 Civilian full-time equivalent employment ................. Reimbursable: Total compensable workyears: 2001 Civilian full-time equivalent employment ................. 2101 Military full-time equivalent employment ................. 2003 est. 2004 est. Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Recoveries of prior year obligations .............................. Change in uncollected customer payments from Federal sources (unexpired) ............................................ 74.40 Obligated balance, end of year ..................................... 72.40 73.10 73.20 73.45 74.00 22 ................... ................... 246 10 284 10 284 10 5,626 5,557 5,557 151,644 162,493 176,754 ¥147,650 ¥162,493 ¥176,754 ¥4,198 ................... ................... 136 ................... ................... 5,557 5,557 5,557 86.97 86.98 Outlays (gross), detail: Outlays from new mandatory authority ......................... Outlays from mandatory balances ................................ 146,652 998 161,493 1,000 175,754 1,000 87.00 Total outlays (gross) ................................................. 147,650 162,493 176,754 f CENTERS FOR MEDICARE AND MEDICAID SERVICES Federal Funds Offsets: Against gross budget authority and outlays: 88.00 Offsetting collections (cash) from: Federal sources Against gross budget authority only: 88.95 Change in uncollected customer payments from Federal sources (unexpired) .................................. ¥138 ¥127 ................... 136 ................... ................... General and special funds: GRANTS TO STATES FOR MEDICAID For carrying out, except as otherwise provided, titles XI and XIX of the Social Security Act, $124,892,197,000, to remain available until expended. For making, after May 31, 2004, payments to States under title XIX of the Social Security Act for the last quarter of fiscal year 2004 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 2005, $58,416,275,000, to remain available until expended. Payment under title XIX may be made for any quarter with respect to a State plan or plan amendment in effect during such quarter, if submitted in or prior to such quarter and approved in that or any subsequent quarter. Note.—A regular 2003 appropriation for this account had not been enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 107–229, as amended). The amounts included for 2003 in this budget reflect the Administration’s 2003 policy proposals. Program and Financing (in millions of dollars) 2002 actual Identification code 75–0512–0–1–551 00.01 00.02 00.03 09.01 10.00 21.40 22.00 22.10 23.90 23.95 24.40 Obligations by program activity: Medicaid vendor payments ............................................ 142,585 State and local administration ..................................... 8,076 Vaccine purchases ......................................................... 983 Medicare Part B premiums ............................................ ................... Total new obligations ................................................ Budgetary resources available for obligation: Unobligated balance carried forward, 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 carried forward, end of year ....... New budget authority (gross), detail: Mandatory: Appropriation: 60.00 Appropriation ......................................................... 60.00 Appropriation ......................................................... 62.50 65.00 69.00 69.10 69.90 70.00 Appropriation (total mandatory) ........................... Advance appropriation .............................................. Offsetting collections (cash) ......................................... Change in uncollected customer payments from Federal sources (unexpired) ............................................ 151,644 110 147,342 162,493 176,754 7 ................... 162,486 176,754 162,359 162,366 176,754 176,754 (in millions of dollars) Enacted/requested: Budget Authority ..................................................................... Outlays .................................................................................... Legislative proposal, not subject to PAYGO: Budget Authority ..................................................................... Outlays .................................................................................... Legislative proposal, subject to PAYGO: Budget Authority ..................................................................... Outlays .................................................................................... Total: Budget Authority ..................................................................... Outlays .................................................................................... 2002 actual 2003 est. 2004 est. 147,341 147,512 162,359 162,366 176,753 176,754 .................... .................... –50 –50 –55 –55 .................... .................... 225 225 5,844 5,844 147,341 147,512 162,534 162,541 182,542 182,543 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) 2002 actual Identification code 75–0512–0–1–551 41.0 2003 est. 2004 est. 99.0 Direct obligations: Grants, subsidies, and contributions ........................................................................... Reimbursable obligations: Reimbursable obligations ... 151,642 2 162,443 176,754 50 ................... 99.9 Total new obligations ................................................ 151,644 162,493 176,754 f GRANTS TO STATES FOR MEDICAID (Legislative proposal, not subject to PAYGO) Program and Financing (in millions of dollars) 106,822 4,311 112,090 124,892 3,667 ................... 111,133 36,208 138 115,757 124,892 46,602 51,861 127 ................... 147,343 PO 00000 127 ................... 162,486 176,754 Frm 00020 Fmt 3616 2002 actual Identification code 75–0512–2–1–551 2003 est. 2004 est. Offsets: Against gross budget authority and outlays: 88.00 Offsetting collections (cash) from: Federal sources ................... ¥50 ¥55 Net budget authority and outlays: Budget authority ............................................................ ................... Outlays ........................................................................... ................... ¥50 ¥50 ¥55 ¥55 ¥136 ................... ................... Total new budget authority (gross) .......................... Jkt 193833 152,485 166,706 8,902 9,067 1,056 980 50 ................... 147,340 147,512 Summary of Budget Authority and Outlays 151,650 162,493 176,754 ¥151,644 ¥162,493 ¥176,754 7 ................... ................... 2 15:09 Jan 23, 2003 2004 est. Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 4,198 ................... ................... Spending authority from offsetting collections (total mandatory) ............................................................ VerDate Dec 13 2002 2003 est. 89.00 90.00 89.00 90.00 This schedule reflects the Administration’s Medicaid proposals. Sfmt 3616 E:\BUDGET\HHS.XXX HHS CENTERS FOR MEDICARE AND MEDICAID SERVICES—Continued Federal Funds—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS TO STATES FOR MEDICAID (Legislative proposal, subject to PAYGO) 73.10 73.20 74.40 Total new obligations .................................................... Total outlays (gross) ...................................................... Obligated balance, end of year ..................................... 25 ¥10 35 73 ¥37 71 95 ¥65 101 86.97 86.98 Outlays (gross), detail: Outlays from new mandatory authority ......................... Outlays from mandatory balances ................................ 2 8 14 23 29 36 87.00 Total outlays (gross) ................................................. 10 37 65 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 67 10 132 37 117 65 Program and Financing (in millions of dollars) 2002 actual Identification code 75–0512–4–1–551 00.01 09.00 09.21 2003 est. Obligations by program activity: Targeted reforms ............................................................ ................... 175 Reimbursable program—Medicare Part B premium .... ................... 50 Reimbursable program from SCHIP ............................... ................... ................... 2004 est. 3,356 55 2,433 10.00 Total new obligations ................................................ ................... 225 5,844 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ ................... Total new obligations .................................................... ................... 225 ¥225 5,844 ¥5,844 New budget authority (gross), detail: Mandatory: 60.00 Appropriation ............................................................. ................... 175 62.00 Transferred from other accounts .............................. ................... ................... 3,356 2,433 62.50 69.00 Appropriation (total mandatory) ........................... ................... Offsetting collections (cash) ......................................... ................... 175 50 5,789 55 70.00 Total new budget authority (gross) .......................... ................... 225 5,844 73.10 73.20 Change in obligated balances: Total new obligations .................................................... ................... Total outlays (gross) ...................................................... ................... 225 ¥225 5,844 ¥5,844 86.97 Outlays (gross), detail: Outlays from new mandatory authority ......................... ................... 225 5,844 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ ................... Outlays ........................................................................... ................... 225 225 5,844 5,844 This schedule reflects the Administration’s Medicaid proposals. Object Classification (in millions of dollars) 2002 actual Identification code 75–0512–4–1–551 41.0 2003 est. State Grants and Demonstrations provides funding for grant programs established under the Ticket to Work and Work Incentives Improvement Act and Title II of the Trade Act of 2002. The Ticket to Work and Work Incentives Improvement Act of 1999 (P.L. 106–170), Title II, established two grant programs. Section 203 provides funding for Medicaid infrastructure grants to support the design, establishment and operation of State infrastructures to help working people with disabilities purchase health coverage through Medicaid. Section 204 provides funding for States to establish Demonstrations to Maintain Independence and Employment, which will provide Medicaid benefits and services to working individuals who have a condition that, without medical assistance, will result in disability. Part of Title II of the Trade Act of 2002 (P.L. 107–210) amends the Public Health Service Act by adding section 2745, which addresses promotion of qualified high-risk pools for assisting ‘‘high-risk’’ individuals who may find private health insurance unavailable, unaffordable, or undesirable. This section establishes: (1) seed grants to states for the creation and initial operation of a qualified high-risk pool for those states that do not have one as of the legislative enactment, and (2) grants to states for operation of qualified high-risk pools. Object Classification (in millions of dollars) 2004 est. 2002 actual Identification code 75–0516–0–1–551 99.0 Direct obligations: Grants, subsidies, and contributions ........................................................................... ................... Reimbursable obligations: Reimbursable obligations ... ................... 175 50 3,356 2,488 99.9 Total new obligations ................................................ ................... 225 5,844 41.0 41.0 2003 est. Grants, subsidies, and contributions: Grants, subsidies, and contributions ........................ 25 Grants, subsidies, and contributions ........................ ................... 99.9 f 421 Total new obligations ................................................ 25 2004 est. 33 40 45 50 73 95 f STATE GRANTS AND DEMONSTRATIONS PAYMENTS Program and Financing (in millions of dollars) 2002 actual Identification code 75–0516–0–1–551 00.01 00.02 00.03 00.04 Obligations by program activity: TWWIIA—infrastructure grants ...................................... 21 TWWIIA—demo grants ................................................... 4 High Risk Pools—seed grants ...................................... ................... High Risk Pools—operations grants ............................. ................... 2003 est. 2004 est. 24 9 10 30 27 18 10 40 10.00 Total new obligations ................................................ 25 73 95 21.40 22.00 Budgetary resources available for obligation: Unobligated balance carried forward, start of year New budget authority (gross) ........................................ 40 67 83 132 142 117 23.90 23.95 24.40 Total budgetary resources available for obligation Total new obligations .................................................... Unobligated balance carried forward, end of year ....... 107 ¥25 83 215 ¥73 142 259 ¥95 164 New budget authority (gross), detail: Mandatory: Appropriation: 60.00 Appropriation ......................................................... 67 60.00 Appropriation ......................................................... ................... 72 60 77 40 62.50 Appropriation (total mandatory) ........................... 67 132 117 72.40 Change in obligated balances: Obligated balance, start of year ................................... 20 35 71 Frm 00021 Fmt 3616 VerDate Dec 13 2002 15:09 Jan 23, 2003 Jkt 193833 HEALTH CARE TRUST FUNDS Note.—A regular 2003 appropriation for this account had not been enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 107–229, as amended). The amounts included for 2003 in this budget reflect the Administration’s 2003 policy proposals. Program and Financing (in millions of dollars) 2002 actual Identification code 75–0580–0–1–571 Obligations by program activity: Supplementary medical insurance (SMI) ....................... 78,318 Hospital insurance for uninsured (HI) ........................... 292 Federal uninsured payment (HI) .................................... 150 Program management (HI) ............................................ 202 FHI trust fund, Transfers from general fund (civil monetary penalties) ................................................... ................... 00.06 Federal payments from taxation of OASDI benefits (HI) ............................................................................. 10,946 00.07 Fraud and abuse control, FBI ........................................ 101 00.08 Fraud and abuse control, criminal fines ...................... 440 00.01 00.02 00.03 00.04 00.05 10.00 PO 00000 TO For payment to the Federal Hospital Insurance and the Federal Supplementary Medical Insurance Trust Funds, as provided under section 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, $95,084,100,000. Sfmt 3643 Total new obligations ................................................ E:\BUDGET\HHS.XXX HHS 90,449 2003 est. 2004 est. 80,905 225 168 173 94,518 197 168 201 7 7 7,780 114 4 8,348 114 4 89,376 103,557 422 CENTERS FOR MEDICARE AND MEDICAID SERVICES—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 2004 General and special funds—Continued PAYMENTS TO PAYMENTS HEALTH CARE TRUST FUNDS—Continued Program and Financing (in millions of dollars)—Continued 2002 actual Identification code 75–0580–0–1–571 22.00 23.95 23.98 Budgetary resources available for obligation: New budget authority (gross) ........................................ Total new obligations .................................................... Unobligated balance expiring or withdrawn ................. 2003 est. TO HEALTH CARE TRUST FUNDS (Legislative proposal, not subject to PAYGO) Program and Financing (in millions of dollars) 2004 est. 2002 actual Identification code 75–0580–2–1–571 93,467 89,376 103,557 ¥90,449 ¥89,376 ¥103,557 ¥3,017 ................... ................... 2003 est. 2004 est. 00.09 Obligations by program activity: Military Service Credits (HI) .......................................... ................... ................... 150 10.00 Total new obligations (object class 42.0) ................ ................... ................... 150 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ ................... ................... Total new obligations .................................................... ................... ................... 150 ¥150 New budget authority (gross), detail: Mandatory: 60.00 Appropriation ............................................................. ................... ................... 150 New budget authority (gross), detail: Mandatory: Appropriation: 60.00 Appropriation ......................................................... 60.00 Appropriation ......................................................... 60.00 Appropriation ......................................................... 60.00 Appropriation ......................................................... 10,946 440 81,980 101 7,780 11 81,471 114 8,348 11 95,084 114 62.50 Appropriation (total mandatory) ........................... 93,467 89,376 103,557 73.10 73.20 Change in obligated balances: Total new obligations .................................................... ................... ................... Total outlays (gross) ...................................................... ................... ................... 150 ¥150 73.10 73.20 Change in obligated balances: Total new obligations .................................................... Total outlays (gross) ...................................................... 90,449 ¥90,450 89,376 ¥89,376 103,557 ¥103,557 86.97 Outlays (gross), detail: Outlays from new mandatory authority ......................... ................... ................... 150 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ ................... ................... Outlays ........................................................................... ................... ................... 150 150 Outlays (gross), detail: 86.97 Outlays from new mandatory authority ......................... 90,450 89,376 103,557 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 93,467 90,450 89,376 89,376 103,557 103,557 89.00 90.00 99.00 99.01 f Additional net budget authority and outlays to cover cost of fully accruing retirement: Budget authority ............................................................ 7 7 Outlays ........................................................................... 7 7 8 8 Summary of Budget Authority and Outlays (in millions of dollars) 2002 actual 2003 est. Enacted/requested: Budget Authority ..................................................................... 93,467 89,376 Outlays .................................................................................... 90,450 89,376 Legislative proposal, not subject to PAYGO: Budget Authority ..................................................................... .................... .................... Outlays .................................................................................... .................... .................... Total: Budget Authority ..................................................................... Outlays .................................................................................... 93,467 90,450 89,376 89,376 2004 est. 103,557 103,557 150 150 103,707 103,707 Payments are made (1) to the Federal Supplementary Medical Insurance trust fund; and (2) to the Federal Hospital Insurance trust fund for individuals aged 65 and over who meet certain transitional insured status requirements, and for civil service employees and annuitants who worked before 1983 and who were employed during January 1983. Since 1992, amounts have been included for non-Medicare activities of CMS program management. Object Classification (in millions of dollars) 2002 actual Identification code 75–0580–0–1–571 2003 est. The budget proposes to compensate HI for the equivalent of payroll taxes on deemed wages posted to the Social Security earnings records of uniformed services personnel in 2000 and 2001. 2004 est. 41.0 42.0 94.0 Grants, subsidies, and contributions ............................ Insurance claims and indemnities ................................ Financial transfers ......................................................... 89,805 442 202 88,810 393 173 102,991 365 201 99.0 Direct obligations .................................................. 90,449 89,376 103,557 99.9 Total new obligations ................................................ 90,449 89,376 103,557 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 $2,733,507,000, 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 section 1857(e)(2) of the Social Security 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 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: Provided further, That $65,000,000, to remain available until September 30, 2005, is for contract costs for CMS’ Systems Revitalization Plan: Provided further, That $56,991,000, to remain available until September 30, 2005, is for contract costs for the Healthcare Integrated General Ledger Accounting System: Provided further, That not less than $129,000,000 shall be for processing Medicare appeals: Provided further, That the Secretary of Health and Human Services may use alternate mechanisms in lieu of Administrative Law Judge review: Provided further, That the Secretaryis directed to collect fees in fiscal year 2004 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. Note.—A regular 2003 appropriation for this account had not been enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 107–229, as amended). The amounts included for 2003 in this budget reflect the Administration’s 2003 policy proposals. Program and Financing (in millions of dollars) 2002 actual Identification code 75–0511–0–1–550 Obligations by program activity: Direct program: 00.01 Medicare operations .................................................. VerDate Dec 13 2002 15:09 Jan 23, 2003 Jkt 193833 PO 00000 Frm 00022 Fmt 3616 Sfmt 3643 E:\BUDGET\HHS.XXX HHS 1,521 2003 est. 1,709 2004 est. 1,777 CENTERS FOR MEDICARE AND MEDICAID SERVICES—Continued Federal Funds—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES 00.02 00.03 00.04 00.05 Federal administration .............................................. 530 562 State survey and certification ................................... 253 248 Research, demonstrations, and evaluation projects 117 28 Revitalization plan .................................................... ................... ................... 581 248 63 65 01.00 09.01 09.03 09.06 Total direct program ................................................. CLIA ................................................................................ Other reimbursements ................................................... Medicare+Choice ........................................................... 2,421 35 28 21 2,547 43 2 16 2,734 43 2 14 09.09 Total reimbursable program ...................................... 84 61 59 10.00 Total new obligations ................................................ 2,505 2,608 2,793 21.40 22.00 22.10 Budgetary resources available for obligation: Unobligated balance carried forward, start of year New budget authority (gross) ........................................ Resources available from recoveries of prior year obligations ....................................................................... 80 2,498 99 2,608 99 2,793 23.90 23.95 23.98 24.40 Total budgetary resources available for obligation Total new obligations .................................................... Unobligated balance expiring or withdrawn ................. Unobligated balance carried forward, end of year ....... New budget authority (gross), detail: Spending authority from offsetting collections: Discretionary: 68.00 Offsetting collections (cash) ................................ 68.10 Change in uncollected customer payments from Federal sources (unexpired) ............................. 68.73 Reduction pursuant to P.L. 107–116 ................... 68.76 Reduction pursuant to P.L. 107–206 ................... 68.90 Spending authority from offsetting collections (total discretionary) ..................................... Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Adjustments in expired accounts (net) ......................... Recoveries of prior year obligations .............................. Change in uncollected customer payments from Federal sources (unexpired) ............................................ 74.10 Change in uncollected customer payments from Federal sources (expired) ................................................ 74.40 Obligated balance, end of year ..................................... 72.40 73.10 73.20 73.40 73.45 74.00 86.90 86.93 Outlays (gross), detail: Outlays from new discretionary authority ..................... Outlays from discretionary balances ............................. 87.00 Total outlays (gross) ................................................. 31 ................... ................... 2,609 2,707 2,892 ¥2,505 ¥2,608 ¥2,793 ¥5 ................... ................... 99 99 99 1,748 2,608 2,793 758 ................... ................... ¥4 ................... ................... ¥4 ................... ................... 2,498 2,608 24.0 25.1 25.2 25.3 25.6 26.0 31.0 32.0 41.0 Total new obligations ................................................ 2,505 2,608 2,793 Personnel Summary 2002 actual Identification code 75–0511–0–1–550 ¥758 ................... ................... 326 ................... ................... ¥219 ¥219 ¥219 1,818 2,608 2,793 585 ................... ................... 2,403 2,608 Direct: Total compensable workyears: 1001 Civilian full-time equivalent employment ................. 1101 Military full-time equivalent employment ................. Reimbursable: Total compensable workyears: 2001 Civilian full-time equivalent employment ................. 2003 est. 2004 est. 4,333 84 4,498 83 4,325 83 80 80 78 f 2,793 PROGRAM MANAGEMENT (Legislative proposal, not subject to PAYGO) ¥758 ................... ................... 271 ................... ................... ¥8 ................... ................... 384 ................... ................... Summary of Budget Authority and Outlays (in millions of dollars) Enacted/requested: 2002 actual 2003 est. Budget Authority ..................................................................... –8 .................... Outlays .................................................................................... 384 .................... Legislative proposal, not subject to PAYGO: Budget Authority ..................................................................... .................... .................... Outlays .................................................................................... .................... .................... Jkt 193833 Total personnel compensation ......................... 321 354 355 Civilian personnel benefits ....................................... 68 71 72 Military personnel benefits ........................................ 2 2 3 Travel and transportation of persons ....................... 10 9 10 Transportation of things ........................................... 1 ................... ................... Rental payments to GSA ........................................... 28 16 16 Communications, utilities, and miscellaneous charges ................................................................. 26 3 3 Printing and reproduction ......................................... 19 4 3 Advisory and assistance services ............................. 3 ................... ................... Other services ............................................................ 707 359 384 Other purchases of goods and services from Government accounts ................................................. 8 2 2 Medical care .............................................................. 1,134 1,709 1,834 Supplies and materials ............................................. 3 2 2 Equipment ................................................................. 6 ................... ................... Land and structures .................................................. ................... 10 10 Grants, subsidies, and contributions ........................ 85 6 40 99.9 ¥2,793 15:09 Jan 23, 2003 333 10 4 8 175 ¥219 ¥219 2,505 2,608 2,793 ¥2,403 ¥2,608 ¥2,793 ¥33 ................... ................... ¥31 ................... ................... ¥2,608 VerDate Dec 13 2002 332 10 5 7 2,734 59 ¥2,019 Total: Budget Authority ..................................................................... Outlays .................................................................................... 11.9 12.1 12.2 21.0 22.0 23.1 23.3 302 6 6 7 2004 est. 2,547 61 88.90 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 11.1 11.3 11.5 11.7 Direct obligations: Personnel compensation: Full-time permanent ............................................. Other than full-time permanent ........................... Other personnel compensation ............................. Military personnel ................................................. 2003 est. 2,421 84 ¥2,734 ¥59 89.00 90.00 2002 actual Identification code 75–0511–0–1–550 Direct obligations .................................................. Reimbursable obligations .............................................. ¥2,547 ¥61 88.96 Object Classification (in millions of dollars) 99.0 99.0 ¥1,959 ¥60 88.95 Program management activities include funding for research, Medicare operations, survey and certification, CLIA, Medicare+Choice, the CMS systems revitalization plan, and administrative costs. 2,793 Offsets: Against gross budget authority and outlays: Offsetting collections (cash) from: 88.00 Federal sources ..................................................... 88.40 Non-Federal sources ............................................. Total, offsetting collections (cash) .................. Against gross budget authority only: Change in uncollected customer payments from Federal sources (unexpired) .................................. Portion of offsetting collections (cash) credited to expired accounts ................................................... 423 Frm 00023 2002 actual Identification code 75–0511–2–1–550 00.01 09.01 Obligations by program activity: Medicare operations ....................................................... ................... Proposed user fees ........................................................ ................... 10.00 2003 est. ¥130 130 2004 est. ¥201 201 Total new obligations ................................................ ................... ................... ................... Offsets: Against gross budget authority and outlays: Offsetting collections (cash) from: 88.00 Federal sources ..................................................... ................... 88.40 Non-Federal sources ............................................. ................... 130 ¥130 201 ¥201 88.90 Total, offsetting collections (cash) .................. ................... ................... ................... 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ ................... ................... ................... Outlays ........................................................................... ................... ................... ................... 2004 est. .................... .................... .................... .................... –8 .................... .................... 384 .................... .................... PO 00000 Program and Financing (in millions of dollars) Fmt 3616 The budget includes $201 million in new user fees to finance CMS activities. Proposed fees include: a duplicate or unprocessable claims fee and a Medicare appeals filing fee. Authorizing legislation for these fees will be proposed to auSfmt 3616 E:\BUDGET\HHS.XXX HHS 424 CENTERS FOR MEDICARE AND MEDICAID SERVICES—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 2004 General and special funds—Continued PROGRAM MANAGEMENT—Continued thorize the collection and spending of the fees subject to appropriations language. If authorizing legislation is enacted, the amount appropriated from the Federal hospital insurance and Federal supplementary medical insurance trust funds will be reduced by $201 million. 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 SCHIP program, a SCHIP Medicaid expansion program, or a combination of both. f STATE CHILDREN’S HEALTH INSURANCE FUND Object Classification (in millions of dollars) (Legislative proposal, subject to PAYGO) 2002 actual Identification code 75–0511–2–1–550 25.6 99.0 99.9 2003 est. ¥130 130 Direct obligations: Medical care .................................... ................... Reimbursable obligations: Reimbursable obligations ... ................... 2004 est. ¥201 201 Program and Financing (in millions of dollars) 2002 actual Identification code 75–0515–4–1–551 2003 est. 2004 est. Total new obligations ................................................ ................... ................... ................... f 00.01 Obligations by program activity: Grants, subsidies, and contributions ............................ ................... ................... ¥2,433 STATE CHILDREN’S HEALTH INSURANCE FUND 10.00 Total new obligations (object class 41.0) ................ ................... ................... ¥2,433 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ ................... ................... Total new obligations .................................................... ................... ................... ¥2,433 2,433 New budget authority (gross), detail: Mandatory: 61.00 Transferred to other accounts ................................... ................... ................... ¥2,433 73.10 73.20 Change in obligated balances: Total new obligations .................................................... ................... ................... Total outlays (gross) ...................................................... ................... ................... ¥2,433 2,433 86.97 Outlays (gross), detail: Outlays from new mandatory authority ......................... ................... ................... ¥2,433 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ ................... ................... Outlays ........................................................................... ................... ................... ¥2,433 ¥2,433 Program and Financing (in millions of dollars) 2002 actual Identification code 75–0515–0–1–551 2003 est. 2004 est. 00.01 Obligations by program activity: Grants, subsidies, and contributions ............................ 5,934 5,382 3,175 10.00 Total new obligations (object class 41.0) ................ 5,934 5,382 3,175 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ Total new obligations .................................................... 5,934 ¥5,934 5,382 ¥5,382 3,175 ¥3,175 New budget authority (gross), detail: Mandatory: Appropriation: 60.00 Appropriation, BBA ................................................ 60.00 Appropriation, BBRA for territories ....................... 61.00 Transferred to other accounts ................................... 3,150 3,150 3,150 25 25 25 ¥60 ................... ................... 62.50 63.00 Appropriation (total mandatory) ........................... Reappropriation ......................................................... 3,115 2,819 3,175 3,175 2,207 ................... 70.00 Total new budget authority (gross) .......................... 5,934 5,382 3,175 72.40 73.10 73.20 73.40 74.40 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Adjustments in expired accounts (net) ......................... Obligated balance, end of year ..................................... 11,501 5,934 ¥3,682 ¥2,819 10,934 10,934 5,382 ¥4,751 ¥3,466 8,099 8,099 3,175 ¥5,090 ¥831 5,353 86.97 86.98 Outlays (gross), detail: Outlays from new mandatory authority ......................... Outlays from mandatory balances ................................ 413 3,269 12 4,739 381 4,709 87.00 Total outlays (gross) ................................................. 3,682 4,751 5,090 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 5,934 3,682 5,382 4,751 3,175 5,090 This schedule reflects SCHIP legislative proposals, including Medicaid/SCHIP reform. f HEALTH MAINTENANCE ORGANIZATION LOAN FUND AND LOAN GUARANTEE For carrying out subsections (d) and (e) of section 1308 of the Public Health Service Act, any amounts received by the Secretary 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 2004, no commitments for direct loans or loan guarantees shall be made. Note.—A regular 2003 appropriation for this account had not been enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 107–229, as amended). The amounts included in 2003 in this budget reflect the Administration’s 2003 policy proposals. Summary of Budget Authority and Outlays Program and Financing (in millions of dollars) (in millions of dollars) Enacted/requested: 2002 actual 2003 est. Budget Authority ..................................................................... 5,934 5,382 Outlays .................................................................................... 3,682 4,751 Legislative proposal, subject to PAYGO: Budget Authority ..................................................................... .................... .................... Outlays .................................................................................... .................... .................... Total: Budget Authority ..................................................................... Outlays .................................................................................... 5,934 3,682 5,382 4,751 2004 est. 3,175 5,090 –2,433 –2,433 VerDate Dec 13 2002 15:09 Jan 23, 2003 Jkt 193833 PO 00000 Frm 00024 Fmt 3616 2003 est. 2004 est. 21.40 23.98 24.40 Budgetary resources available for obligation: Unobligated balance carried forward, start of year 10 10 10 Unobligated balance expiring or withdrawn ................. ................... ................... ¥10 Unobligated balance carried forward, end of year ....... 10 10 ................... 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ ................... ................... ................... Outlays ........................................................................... ................... ................... ................... 742 2,657 The Balanced Budget Act of 1997 established the State Children’s Health Insurance Program (SCHIP) under Title XXI of the Social Security Act. Title XXI provides Federal matching funds to States to enable them to extend coverage 2002 actual Identification code 75–4420–0–3–551 The last loan commitments from the HMO loan fund were made in 1983. Sfmt 3616 E:\BUDGET\HHS.XXX HHS CENTERS FOR MEDICARE AND MEDICAID SERVICES—Continued Trust Funds DEPARTMENT OF HEALTH AND HUMAN SERVICES Trust Funds 86.97 86.98 FEDERAL HOSPITAL INSURANCE TRUST FUND 87.00 Total outlays (gross) ................................................. 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... Unavailable Collections (in millions of dollars) 2002 actual Identification code 20–8005–0–7–571 2003 est. 2004 est. Balance, start of year .................................................... 196,791 227,932 254,489 Receipts: 02.00 Transfers from general fund (FICA taxes) ..................... 138,876 141,866 148,900 02.01 Transfers from general fund (SECA taxes) ................... 9,785 10,011 10,487 02.02 Receipts from Railroad Retirement Board .................... 388 398 397 02.03 Civil penalties and damages ........................................ 330 363 363 02.20 Premiums collected for uninsured individuals not otherwise eligible ........................................................... 1,525 1,568 1,681 02.21 Other proprietary receipts from the public ................... 1 ................... ................... 02.40 Federal employer contributions (FICA) ........................... 2,191 2,333 2,402 02.41 Postal service employer contributions (FICA) ................ 722 684 683 02.42 Payments from the general fund (uninsured and program management) ................................................... 646 566 566 02.43 Taxation on OASDI benefits ........................................... 10,946 7,780 8,348 02.44 Interest payments by Railroad Retirement Board ......... 36 31 28 02.45 Interest received by trust funds .................................... 13,738 14,006 15,331 02.47 FBI, Payment from the general fund ............................. 101 114 114 02.48 Criminal fines, transfers from the general fund .......... 431 4 4 02.49 Civil monetary penalties, transfers from the general fund ........................................................................... 7 7 7 02.50 Transfers from DOD, HI ................................................. 16 4 ................... 02.52 Transfer from general fund (in lieu of DOD payments for military service credits) ....................................... ................... ................... 150 02.81 Health care fraud and abuse control, offsetting collections ...................................................................... 7 ................... ................... Outlays from new mandatory authority ......................... 145,606 Outlays from mandatory balances ................................ ................... 425 150,155 154 159,475 275 147,050 151,875 161,322 147,198 147,050 152,128 151,875 161,113 161,322 197,137 228,908 255,896 228,908 255,896 282,960 01.99 02.99 Total receipts and collections ................................... 179,746 179,735 189,461 Total: Balances and collections .................................... 376,537 Appropriations: Appropriations: 05.00 Federal hospital insurance trust fund ...................... ¥147,198 05.00 Proposed legislation not subject to PAYGO .............. ................... 05.01 Health care fraud and abuse control account .............. ¥1,018 407,667 443,950 ¥152,128 25 ¥1,075 ¥161,113 38 ¥1,075 04.00 05.99 06.10 Total appropriations .................................................. Unobligated balance returned to receipts ..................... 07.99 Balance, end of year ..................................................... ¥148,216 ¥153,178 ¥162,150 ¥389 ................... ................... 227,932 254,489 2002 actual 2003 est. 2004 est. Obligations by program activity: 00.01 Benefit payments, HI ..................................................... 00.02 Administration, HI .......................................................... 00.03 Quality improvement organizations, HI ......................... 00.04 Research, HI ................................................................... 00.05 HI partial transfer of home health to SMI .................... 144,139 150,001 159,418 1,552 1,532 1,563 244 572 80 95 23 52 1,168 ................... ................... 10.00 Total new obligations ................................................ 147,198 152,128 161,113 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ Total new obligations .................................................... 147,198 ¥147,198 152,128 ¥152,128 161,113 ¥161,113 New budget authority (gross), detail: Discretionary: 40.26 Appropriation (trust fund) ......................................... Mandatory: 60.26 Appropriation (trust fund) ......................................... 60.45 Portion precluded from obligation ............................ 1,607 1,515 1,574 178,139 ¥32,548 178,220 ¥27,607 187,737 ¥28,198 62.50 Appropriation (total mandatory) ........................... 145,591 150,613 159,538 70.00 Total new budget authority (gross) .......................... 147,198 152,128 161,113 Change in obligated balances: 72.40 Obligated balance, start of year ................................... 73.10 Total new obligations .................................................... 73.20 Total outlays (gross) ...................................................... 73.40 Adjustments in expired accounts (net) ......................... 74.40 Obligated balance, end of year ..................................... 86.90 86.93 408 966 1,219 147,198 152,128 161,113 ¥147,050 ¥151,875 ¥161,322 410 ................... ................... 966 1,219 1,009 Outlays (gross), detail: Outlays from new discretionary authority ..................... 1,444 Outlays from discretionary balances ............................. ................... VerDate Dec 13 2002 15:09 Jan 23, 2003 Jkt 193833 PO 00000 99.00 99.01 Additional net budget authority and outlays to cover cost of fully accruing retirement: Budget authority ............................................................ 38 43 Outlays ........................................................................... 38 43 46 46 Summary of Budget Authority and Outlays (in millions of dollars) Enacted/requested: 2002 actual Budget Authority ..................................................................... 147,198 Outlays .................................................................................... 147,050 Legislative proposal, not subject to PAYGO: Budget Authority ..................................................................... .................... Outlays .................................................................................... .................... Total: Budget Authority ..................................................................... Outlays .................................................................................... 147,198 147,050 2003 est. 2004 est. 152,128 151,875 161,112 161,321 –25 –25 –38 –38 152,103 151,850 161,074 161,283 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) 2002 actual Identification code 20–8005–0–7–571 2003 est. 2004 est. Unexpended balance, start of year: 0100 Treasury balance ............................................................ 0101 Federal securities: Par value ......................................... 247 197,137 202 ................... 228,908 255,921 0199 197,385 229,111 255,921 138,876 141,866 148,900 9,785 10,011 10,487 388 330 398 363 397 363 281,800 Program and Financing (in millions of dollars) Identification code 20–8005–0–7–571 Memorandum (non-add) entries: Total investments, start of year: Federal securities: Par value ................................................................... 92.02 Total investments, end of year: Federal securities: Par value ................................................................... 92.01 1,506 60 1,556 15 Frm 00025 Fmt 3616 Total balance, start of year ...................................... Cash income during the year: Current law: Receipts: 1200 FHI trust fund, transfers from general fund (FICA taxes) ...................................................... 1201 FHI trust fund, transfers from general fund (SECA taxes) ..................................................... 1202 FHI trust fund, receipts from Railroad Retirement Board ....................................................... 1203 HCFAC: Civil penalties and damages .................. Offsetting receipts (proprietary): 1220 FHI trust fund, premiums collected for uninsured individuals not otherwise eligible .................... 1221 Other proprietary receipts ..................................... Offsetting receipts (intragovernmental): 1240 FHI trust fund, Federal employer contributions (FICA) ................................................................ 1241 FHI trust fund, Postal Service employer contributions (FICA) ....................................................... Offsetting receipts (intragovernmental): 1242 FHI trust fund, Federal payment for transitional coverage for uninsured Federal employees ......................................................... 1242 FHI trust fund, Federal payment for transitional coverage for the uninsured ............... 1242 FHI trust fund, general fund transfer, program management (HI) ............................... 1243 FHI trust fund, Federal payments for OASDI taxes ................................................................. 1244 FHI trust fund, interest payment from Railroad Retirement Board ............................................. 1245 FHI trust fund, interest on investments ............... 1247 HCFAC: FBI ............................................................ 1248 HCFAC: Criminal fines .......................................... 1249 HCFAC: Civil monetary penalties .......................... 1250 Other intragovernmental transactions .................. Offsetting collections: 1281 HCFAC user fees ................................................... 1299 Sfmt 3643 Income under present law .................................... E:\BUDGET\HHS.XXX HHS 1,525 1,568 1,681 1 ................... ................... 2,191 2,333 2,402 722 684 683 150 168 168 292 225 197 205 173 201 10,946 7,780 8,348 36 13,738 101 431 7 16 31 28 14,006 15,331 114 114 4 4 7 7 4 ................... 7 ................... ................... 179,746 179,735 189,311 426 CENTERS FOR MEDICARE AND MEDICAID SERVICES—Continued Trust Funds—Continued THE BUDGET FOR FISCAL YEAR 2004 ¥25 ¥38 Memorandum (non-add) entries: Total investments, start of year: Federal securities: Par value ................................................................... ................... ................... 92.02 Total investments, end of year: Federal securities: Par value ................................................................... ................... 25 25 90.00 FEDERAL HOSPITAL INSURANCE TRUST FUND—Continued Status of Funds (in millions of dollars)—Continued Outlays ........................................................................... ................... 92.01 2002 actual Identification code 20–8005–0–7–571 2252 Proposed legislation: Offsetting receipts (intragovernmental): Transfer from the general fund in lieu of DOD payments for military service credits .............. ................... ................... 3299 Total cash income ..................................................... Cash outgo during year: Current law: Cash outgo during the year (¥): 4500 Benefit Payments .................................................. 4500 Administration ....................................................... 4500 Quality Improvement Organizations ...................... 4500 Research ............................................................... 4500 HI Partial Transfer of Home Health to SMI .......... 4501 HCFAC ........................................................................ 4599 5500 179,746 179,735 2004 est. 150 189,461 f ¥152,950 ¥162,397 25 38 ¥148,020 ¥152,925 ¥162,359 Total cash outgo (¥) ............................................... Unexpended balance, end of year: 8700 Uninvested balance ....................................................... 8701 Federal securities: Par value ......................................... Total balance, end of year ........................................ 202 ................... ................... 228,906 255,921 283,023 229,111 255,921 2002 actual 41.0 2003 est. HEALTH CARE FRAUD (FEDERAL 2004 est. 42.0 94.0 Payment for Quality Improvement Organization (QIO) activities .................................................................... Insurance claims and indemnities (benefits) ............... Financial transfers ......................................................... 244 144,139 2,815 572 150,001 1,555 80 159,418 1,615 99.0 Direct obligations .................................................. 147,198 152,128 161,113 99.9 Total new obligations ................................................ 147,198 152,128 161,113 f FEDERAL HOSPITAL INSURANCE FUND 2002 actual Identification code 20–8005–2–7–571 2003 est. 2004 est. 00.02 Obligations by program activity: Administration, HI .......................................................... ................... ¥25 ¥38 10.00 Total new obligations (object class 94.0) ................ ................... ¥25 ¥38 Budgetary resources available for obligation: 22.00 New budget authority (gross) ........................................ ................... 23.95 Total new obligations .................................................... ................... New budget authority (gross), detail: Discretionary: 40.26 Appropriation (trust fund) ......................................... ................... Mandatory: 60.26 Appropriation (trust fund) ......................................... ................... 60.45 Portion precluded from obligation ............................ ................... 62.50 ¥25 25 ¥38 38 ¥25 ¥38 25 ¥25 38 ¥38 Appropriation (total mandatory) ........................... ................... ................... ................... Total new budget authority (gross) .......................... ................... ¥25 ¥38 Change in obligated balances: 73.10 Total new obligations .................................................... ................... 73.20 Total outlays (gross) ...................................................... ................... ¥25 25 ¥38 38 86.90 Outlays (gross), detail: Outlays from new discretionary authority ..................... ................... ¥25 ¥38 89.00 Net budget authority and outlays: Budget authority ............................................................ ................... ¥25 ¥38 Frm 00026 Fmt 3616 70.00 VerDate Dec 13 2002 15:09 Jan 23, 2003 Jkt 193833 PO 00000 ABUSE CONTROL ACCOUNT 2002 actual Identification code 75–8393–0–7–571 2003 est. 2004 est. 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 ...................................... Reimbursables ............................................................... 10.00 Total new obligations ................................................ 22.00 23.95 23.98 Budgetary resources available for obligation: New budget authority (gross) ........................................ Total new obligations .................................................... Unobligated balance expiring or withdrawn ................. 1,018 1,075 1,075 ¥1,011 ¥1,075 ¥1,075 ¥7 ................... ................... New budget authority (gross), detail: Mandatory: 60.28 Appropriation (unavailable balances) ....................... 69.00 Offsetting collections (cash) ......................................... 1,011 1,075 1,075 7 ................... ................... 70.00 Total new budget authority (gross) .......................... 1,018 72.40 73.10 73.20 73.40 74.40 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Adjustments in expired accounts (net) ......................... Obligated balance, end of year ..................................... 186 213 213 1,011 1,075 1,075 ¥970 ¥1,075 ¥1,075 ¥14 ................... ................... 213 213 213 86.97 86.98 Outlays (gross), detail: Outlays from new mandatory authority ......................... Outlays from mandatory balances ................................ 846 1,075 1,075 124 ................... ................... 87.00 Total outlays (gross) ................................................. (Legislative proposal, not subject to PAYGO) Program and Financing (in millions of dollars) AND HOSPITAL INSURANCE TRUST FUND) Program and Financing (in millions of dollars) 283,022 Object Classification (in millions of dollars) Identification code 20–8005–0–7–571 63 The budget proposes new discretionary user fees paid by providers who file a Medicare claims appeal or submit duplicate or unprocessable claims. This account reflects the reduction in payments to HI as a result of this user fee proposal. ¥144,140 ¥150,001 ¥159,418 ¥1,425 ¥1,519 ¥1,555 ¥258 ¥268 ¥291 ¥59 ¥87 ¥59 ¥1,168 ................... ................... ¥970 ¥1,075 ¥1,075 Outgo under current law (¥) .............................. ¥148,020 Proposed legislation: Administration, legislative proposal not subject to PAYGO ................................................................... ................... 6599 8799 2003 est. Offsets: Against gross budget authority and outlays: 88.00 Offsetting collections (cash) from: Federal sources 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 700 720 720 101 114 114 202 241 241 8 ................... ................... 1,011 970 1,075 1,075 1,075 1,075 1,075 1,075 ¥7 ................... ................... 1,011 963 1,075 1,075 1,075 1,075 P.L. 104–191 established the Health Care Fraud and Abuse Control (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. This schedule reflects the estimated distribution of the account for 2003 and 2004. Actual 2003 and 2004 distributions will be determined by the Secretary of HHS and the Attorney General consistent with the Administration’s priorities, including augmenting existing program integrity activities for Medicaid and the State Children’s Health Insurance Program (SCHIP). 2002 actual Department of Justice, DOJ ......................................................... Sfmt 3647 E:\BUDGET\HHS.XXX HHS 55 2003 est. 50 2004 est. 45 CENTERS FOR MEDICARE AND MEDICAID SERVICES—Continued Trust Funds—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the Inspector General, HHS .......................................... Centers for Medicare and Medicaid Services, Medicaid/SCHIP Program Integrity, HHS ........................................................... Centers for Medicare and Medicaid Services, Other HHS .......... Office of the General Counsel, HHS ............................................ Other HHS .................................................................................... 139 160 160 0 3 3 2 10 12 6 3 20 9 5 2 Total ............................................................................... 202 241 241 427 Personnel Summary 2002 actual Identification code 75–8393–0–7–571 2003 est. 2004 est. Direct: Total compensable workyears: 1001 Civilian full-time equivalent employment ................. ................... ................... 100 f FEDERAL SUPPLEMENTARY MEDICAL INSURANCE TRUST FUND Object Classification (in millions of dollars) 2002 actual Identification code 75–8393–0–7–571 11.1 12.1 25.1 25.2 25.3 25.3 25.3 25.3 25.6 41.0 94.0 99.0 99.0 Direct obligations: Personnel compensation: Full-time permanent (CMS 100 FTEs) .............................................................. Civilian personnel benefits (CMS) ............................ Advisory and assistance services (CMS) .................. Other services (CMS) ................................................. Other purchases of goods and services from Government accounts: Other purchases of goods and services from Government accounts (DoJ) .............................. Other purchases of goods and services from Government accounts (HHS/OIG) ...................... Other purchases of goods and services from Government accounts (HHS/AoA) ..................... Other purchases of goods and services from Government accounts (HHS/OGC) .................... Medical care (CMS) ................................................... Grants, subsidies, and contributions (CMS) ............. Financial transfers .................................................... 2003 est. Unavailable Collections (in millions of dollars) 2004 est. 8 2 5 9 ................... 50 45 ................... 160 160 ................... 3 2 ................... 700 ................... 101 6 720 5 114 5 720 5 114 801 1,075 1,075 8 ................... ................... 94.0 94.0 Direct obligations .................................................. Reimbursable obligations .............................................. Allocation Account: Travel and transportation of persons: Travel and transportation of persons (OIG) ......... Travel and transportation of persons (DoJ) ......... Transportation of things (OIG) .................................. Rental payments to GSA: Rental payments to GSA (OIG) ............................. Rental payments to GSA (DoJ) ............................. Rental payments to GSA (OGC) ............................ Communications, utilities, and miscellaneous charges (OIG) ........................................................ Printing and reproduction [DOJ] ............................... Advisory and assistance services: Advisory and assistance services [DOJ] ............... Advisory and assistance services (CMS) .............. Other services: Other services (DoJ) .............................................. Other services [OIG] .............................................. Other purchases of goods and services from Government accounts: Purchases of goods and services from Government accounts (DoJ) ........................................ Purchases of goods and services from Government accounts [OIG] ........................................ Operation and maintenance of equipment (OIG) Supplies and materials (OIG) ................................... Equipment: Equipment (OIG) ................................................... Equipment [DOJ] ................................................... Grants, subsidies, and contributions: Grants, subsidies, and contributions (AoA) ......... Grants, subsidies, and contributions (CMS) ........ Financial transfers: OIG full-time permanent ....................................... DoJ full-time permanent ....................................... OGC full-time permanent ..................................... AoA full-time permanent ...................................... Undistributed (DoJ other than full-time permanent) ................................................................. Undistributed (OIG other than full-time permanent) ................................................................. Undistributed (OIG other personnel compensation) .................................................................. Undistributed (DoJ special personal services payments) ......................................................... Undistributed (OIG personnel benefits) ................ Undistributed (DoJ personnel benefits) ................ 99.0 Allocation account ................................................ 202 ................... ................... 99.9 Total new obligations ................................................ 21.0 21.0 22.0 23.1 23.1 23.1 23.3 24.0 25.1 25.1 25.2 25.2 25.3 25.3 25.7 26.0 31.0 31.0 41.0 41.0 94.0 94.0 94.0 94.0 94.0 94.0 94.0 94.0 VerDate Dec 13 2002 15:09 Jan 23, 2003 Jkt 193833 2002 actual Identification code 20–8004–0–7–571 ................... ................... ................... ................... ................... 12 ................... 5 7 ................... ................... 1 ................... ................... 1 ................... ................... 9 ................... ................... 3 ................... ................... 1 ................... ................... 2 ................... ................... 1 ................... ................... 1 ................... ................... 1 ................... ................... 25 ................... ................... 2 ................... ................... 2 ................... ................... 10 ................... ................... 1 ................... ................... 2 ................... ................... 4 ................... ................... 1 ................... ................... 1 ................... ................... 2 ................... ................... 75 15 2 1 ................... ................... ................... ................... ................... ................... ................... ................... 1 ................... ................... 1 ................... ................... 2 ................... ................... 1 ................... ................... 23 ................... ................... 4 ................... ................... 1,011 PO 00000 1,075 1,075 Frm 00027 Fmt 3616 2003 est. 2004 est. 01.99 Balance, start of year .................................................... 41,663 37,744 27,608 Receipts: 02.20 Premiums collected for the aged .................................. 21,173 23,009 25,145 02.21 Premiums collected for the disabled ............................ 3,254 3,692 4,172 02.22 Other proprietary receipts from the public ................... 3 ................... ................... 02.40 Federal contributions ..................................................... 78,318 80,905 94,518 Offsetting receipts (intragovernmental): 02.41 Interest received by trust fund ................................. 2,916 2,374 1,966 02.41 Interest received by trust fund, legislative proposal not subject to PAYGO ........................................... ................... ................... ¥6 02.42 Transfers from DOD, SMI ............................................... 15 4 ................... 02.45 Miscellaneous Federal payments ................................... 1 ................... ................... 02.80 Federal supplementary medical insurance trust fund, offsetting collections ................................................. 1,168 ................... ................... 02.99 Total receipts and collections ................................... 106,848 109,984 125,795 Total: Balances and collections .................................... 148,511 Appropriations: Appropriations: 05.00 Federal supplementary medical insurance trust fund ....................................................................... ¥110,353 05.00 Legislative proposal not subject to PAYGO .............. ................... 147,728 153,403 ¥120,175 55 ¥121,599 108 04.00 05.99 06.10 Total appropriations .................................................. Unobligated balance returned to receipts ..................... 07.99 Balance, end of year ..................................................... ¥110,353 ¥120,120 ¥121,491 ¥414 ................... ................... 37,744 27,608 31,912 Program and Financing (in millions of dollars) 2002 actual Identification code 20–8004–0–7–571 2003 est. 2004 est. 00.01 00.02 00.03 00.04 00.06 09.01 Obligations by program activity: Benefit payments, SMI ................................................... Administration, SMI ....................................................... Quality improvement organizations, SMI ....................... Research, SMI ................................................................ Transfer to Medicaid for payment of SMI premiums HI partial transfer of home health ................................ 10.00 Total new obligations ................................................ 110,353 120,175 121,599 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ Total new obligations .................................................... 110,353 ¥110,353 120,175 ¥120,175 121,599 ¥121,599 106,909 117,627 119,214 2,181 2,273 2,353 71 143 20 22 5 12 2 127 ................... 1,168 ................... ................... New budget authority (gross), detail: Discretionary: 40.26 Appropriation (trust fund) ......................................... Mandatory: 60.26 Appropriation (trust fund) ......................................... 60.28 Appropriation (unavailable balances) ....................... 2,198 2,273 2,360 103,482 3,505 107,711 10,191 123,441 ¥4,202 62.50 69.00 Appropriation (total mandatory) ........................... Offsetting collections (cash) ......................................... 106,987 117,902 119,239 1,168 ................... ................... 70.00 Total new budget authority (gross) .......................... 72.40 73.10 73.20 73.40 74.40 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Adjustments in expired accounts (net) ......................... Obligated balance, end of year ..................................... 86.90 86.97 86.98 Outlays (gross), detail: Outlays from new discretionary authority ..................... Outlays from new mandatory authority ......................... Outlays from mandatory balances ................................ Sfmt 3643 E:\BUDGET\HHS.XXX HHS 110,353 120,175 121,599 142 916 1,017 110,353 120,175 121,599 ¥109,993 ¥120,074 ¥121,626 414 ................... ................... 916 1,017 990 1,712 108,155 126 2,238 117,788 48 2,328 119,223 75 428 CENTERS FOR MEDICARE AND MEDICAID SERVICES—Continued Trust Funds—Continued THE BUDGET FOR FISCAL YEAR 2004 4500 4500 4500 4500 FEDERAL SUPPLEMENTARY MEDICAL INSURANCE TRUST FUND— Continued Program and Financing (in millions of dollars)—Continued 2002 actual Identification code 20–8004–0–7–571 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 ........................................................................... Memorandum (non-add) entries: Total investments, start of year: Federal securities: Par value ................................................................... 92.02 Total investments, end of year: Federal securities: Par value ................................................................... 109,993 2003 est. 120,074 2004 est. 121,626 4599 5500 Quality Improvement Organizations ...................... Research ............................................................... HI partial transfer of home health ....................... Transfer to Medicaid for payment of SMI premiums ............................................................... 109,185 108,825 120,175 120,074 121,599 121,626 41,978 38,804 28,570 38,804 28,570 32,695 ¥121,626 55 108 ¥109,993 ¥120,019 ¥121,518 Total cash outgo (¥) ............................................... Unexpended balance, end of year: 8700 Uninvested balance ....................................................... 8701 Federal securities: Par value ......................................... 8799 Total balance, end of year ........................................ Enacted/requested: 2002 actual Budget Authority ..................................................................... 109,185 Outlays .................................................................................... 108,825 Legislative proposal, not subject to PAYGO: Budget Authority ..................................................................... .................... Outlays .................................................................................... .................... 2003 est. 2004 est. 120,175 120,074 121,599 121,626 –55 –55 –108 –108 120,120 120,019 121,491 121,518 Status of Funds (in millions of dollars) 2002 actual Total balance, start of year ...................................... Cash income during the year: Current law: Offsetting receipts (proprietary): 1220 Premiums collected for the aged, FSMI fund 1221 Premiums collected for the disabled, FSMI fund 1222 Other proprietary receipts ..................................... Offsetting receipts (intragovernmental): 1240 Federal contributions, FSMI fund ......................... 1241 Interest received by trust fund, FSMI fund .......... 1242 Intragovernmental transactions ............................ 1245 Offsetting receipts (intragovernmental) ............... Offsetting collections: 1280 HI partial transfer of home health ....................... 1299 2241 2003 est. Total cash income ..................................................... Cash outgo during year: Current law: Cash outgo during the year (¥): 4500 Benefit payments & ESRD .................................... 4500 Administration ....................................................... VerDate Dec 13 2002 15:09 Jan 23, 2003 Jkt 193833 2004 est. ¥174 41,978 ¥145 ................... 38,804 28,625 41,805 38,660 28,625 21,173 23,009 25,145 3,254 3,692 4,172 3 ................... ................... 78,318 80,905 94,518 2,916 2,374 1,966 15 4 ................... 1 ................... ................... 1,168 ................... ................... Income under present law .................................... 106,848 109,984 Proposed legislation: Offsetting receipts (intragovernmental): Interest received by trust fund, legislative proposal not subject to PAYGO ............................. ................... ................... 3299 2003 est. 2004 est. 71 106,911 2,203 99.0 99.0 Direct obligations .................................................. Reimbursable obligations .............................................. 109,185 120,175 121,599 1,168 ................... ................... 99.9 Total new obligations ................................................ 110,353 143 117,754 2,278 120,175 20 119,214 2,365 121,599 f FEDERAL SUPPLEMENTARY MEDICAL INSURANCE TRUST FUND (Legislative proposal, not subject to PAYGO) 109,185 108,825 The Supplementary Medical Insurance (SMI) program is a voluntary program that 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: 0199 32,902 42.0 94.0 Program and Financing (in millions of dollars) 2002 actual Identification code 20–8004–2–7–571 Unexpended balance, start of year: Treasury balance ............................................................ Federal securities: Par value ......................................... 28,625 Direct obligations: Payment for Quality Improvement Organization (QIO) activity ......................................................... Insurance claims and indemnities ........................... Financial transfers .................................................... 41.0 42 42 (in millions of dollars) 0100 0101 38,660 2002 actual Identification code 20–8004–0–7–571 Summary of Budget Authority and Outlays Identification code 20–8004–0–7–571 ¥145 ................... ................... 38,804 28,625 32,902 Object Classification (in millions of dollars) Additional net budget authority and outlays to cover cost of fully accruing retirement: Budget authority ............................................................ 35 38 Outlays ........................................................................... 35 38 Total: Budget Authority ..................................................................... Outlays .................................................................................... ¥127 ................... ¥120,074 92.01 99.00 99.01 ¥112 Outgo under current law (¥) .............................. ¥109,993 Proposed legislation: Administration, legislative proposal not subject to PAYGO ................................................................... ................... 6599 ¥1,168 ................... ................... ¥95 ¥77 ¥79 ¥13 ¥20 ¥13 ¥1,168 ................... ................... 106,848 109,984 125,801 ¥6 125,795 2003 est. 2004 est. 00.02 00.06 Obligations by program activity: Administration, SMI ....................................................... ................... Transfer to Medicaid for payment of SMI premiums ................... ¥105 50 ¥163 55 10.00 Total new obligations ................................................ ................... ¥55 ¥108 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ ................... Total new obligations .................................................... ................... ¥55 55 ¥108 108 ................... ¥105 ¥163 ................... ................... ................... 105 157 50 ¥102 ¥105 ................... New budget authority (gross), detail: Discretionary: 40.26 Appropriation (trust fund) ......................................... Mandatory: 60.26 Appropriation (trust fund) ......................................... 60.28 Appropriation (unavailable balances) ....................... 60.45 Portion precluded from obligation ............................ 62.50 Appropriation (total mandatory) ........................... ................... 50 55 70.00 Total new budget authority (gross) .......................... ................... ¥55 ¥108 73.10 73.20 Change in obligated balances: Total new obligations .................................................... ................... Total outlays (gross) ...................................................... ................... ¥55 55 ¥108 108 86.90 86.97 Outlays (gross), detail: Outlays from new discretionary authority ..................... ................... Outlays from new mandatory authority ......................... ................... ¥105 50 ¥163 55 87.00 Total outlays (gross) ................................................. ................... ¥55 ¥108 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ ................... Outlays ........................................................................... ................... ¥55 ¥55 ¥108 ¥108 Memorandum (non-add) entries: Total investments, start of year: Federal securities: Par value ................................................................... ................... ................... 92.02 Total investments, end of year: Federal securities: Par value ................................................................... ................... 55 55 92.01 ¥106,901 ¥1,704 PO 00000 ¥117,627 ¥2,223 ¥119,214 ¥2,320 Frm 00028 Fmt 3616 Sfmt 3643 E:\BUDGET\HHS.XXX HHS 207 ADMINISTRATION FOR CHILDREN AND FAMILIES Federal Funds DEPARTMENT OF HEALTH AND HUMAN SERVICES The budget proposes new discretionary user fees paid by providers who file a Medicare claims appeal or submit duplicate or unprocessable claims. This account reflects the reduction in payments to SMI as a result of this user fee proposal. The budget proposes to extend the subsidy of Medicare cost sharing for certain qualified individuals. Outlays .................................................................................... 18,749 Legislative proposal, subject to PAYGO: Budget Authority ..................................................................... .................... Outlays .................................................................................... .................... Total: Budget Authority ..................................................................... Outlays .................................................................................... 17,009 18,749 429 19,214 18,567 127 –5 –81 146 17,009 19,209 17,609 18,713 Object Classification (in millions of dollars) 2002 actual Identification code 20–8004–2–7–571 2003 est. 2004 est. 42.0 94.0 Insurance claims and indemnities ................................ ................... Financial transfers ......................................................... ................... 50 ¥105 55 ¥163 99.9 Total new obligations ................................................ ................... ¥55 ¥108 This account provides continued 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. f f ALLOCATION RECEIVED FROM OTHER ACCOUNTS TEMPORARY ASSISTANCE Note.—Obligations incurred under allocations from other accounts are included in the schedule of the parent appropriation as follows: Centers for Medicare and Medicaid Services ‘‘Health Care Fraud and Abuse Control Account.’’ Program and Financing (in millions of dollars) ADMINISTRATION FOR CHILDREN AND FAMILIES NEEDY FAMILIES Program and Financing (in millions of dollars) 2002 actual 2003 est. 2004 est. Obligations by program activity: 00.01 State family assistance grant ....................................... 00.03 Territories—family assistance grants ........................... 00.04 Matching grants to territories ....................................... 00.05 Bonus to reward decrease in illegitimacy ..................... 00.06 Supplemental grants for population increases ............. 00.07 Bonus to reward high performance States ................... 00.08 Tribal work programs ..................................................... 16,489 73 6 100 319 200 8 16,489 16,489 78 78 15 15 100 100 192 ................... 400 200 8 8 10.00 Total new obligations (object class 41.0) ................ 17,195 17,282 21.40 22.00 Budgetary resources available for obligation: Unobligated balance carried forward, start of year New budget authority (gross) ........................................ 600 17,009 400 ................... 16,882 17,690 23.90 23.95 23.98 24.40 Total budgetary resources available for obligation Total new obligations .................................................... Unobligated balance expiring or withdrawn ................. Unobligated balance carried forward, end of year ....... New budget authority (gross), detail: Mandatory: 60.00 Appropriation ............................................................. Change in obligated balances: 72.40 Obligated balance, start of year ................................... 73.10 Total new obligations .................................................... 73.20 Total outlays (gross) ...................................................... 73.40 Adjustments in expired accounts (net) ......................... 74.40 Obligated balance, end of year ..................................... Obligations by program activity: Promotion of healthy marriage and family formation grants ........................................................................ 00.02 Family formation, research, demonstration, and technical assistance ........................................................ 00.03 Supplemental grants for population increases ............. 00.04 Elimination of illegitimacy bonus .................................. 00.05 Redirect high performance bonus ................................. 2003 est. 2004 est. 00.01 General and special funds: Identification code 75–1552–0–1–609 2002 actual Identification code 75–1552–4–1–609 Federal Funds FOR NEEDY FAMILIES (Legislative proposal, subject to PAYGO) f TEMPORARY ASSISTANCE FOR 16,890 17,609 17,282 17,690 ¥17,195 ¥17,282 ¥16,890 ¥14 ................... ................... 400 ................... 800 17,009 16,882 17,690 10,543 8,884 6,952 17,195 17,282 16,890 ¥18,749 ¥19,214 ¥18,567 ¥105 ................... ................... 8,884 6,952 5,275 Outlays (gross), detail: 86.97 Outlays from new mandatory authority ......................... 86.98 Outlays from mandatory balances ................................ 12,442 6,307 12,816 6,398 13,028 5,539 87.00 Total outlays (gross) ................................................. 18,749 19,214 18,567 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 17,009 18,749 16,882 19,214 17,690 18,567 Summary of Budget Authority and Outlays ................... 100 100 ................... ................... ................... ................... 100 127 ¥100 ¥100 100 319 ¥100 ¥500 10.00 Total new obligations ................................................ ................... 127 ¥81 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ ................... Total new obligations .................................................... ................... 127 ¥127 ¥81 81 New budget authority (gross), detail: Mandatory: 60.00 Appropriation ............................................................. ................... 127 ¥81 72.40 73.10 73.20 74.40 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Obligated balance, end of year ..................................... ................... ................... ................... 127 ................... 5 ................... 132 132 ¥81 ¥146 ¥95 86.97 86.98 Outlays (gross), detail: Outlays from new mandatory authority ......................... ................... ¥5 Outlays from mandatory balances ................................ ................... ................... 96 50 87.00 Total outlays (gross) ................................................. ................... ¥5 146 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ ................... Outlays ........................................................................... ................... 127 ¥5 ¥81 146 This schedule reflects additional proposals to be included in the reauthorization of the Temporary Assistance for Needy Families program. These include funding for Supplemental Grants and initiatives to promote healthy marriages and family formation. Object Classification (in millions of dollars) 2002 actual Identification code 75–1552–4–1–609 25.1 41.0 Advisory and assistance services .................................. ................... Grants, subsidies, and contributions ............................ ................... 99.9 Total new obligations ................................................ ................... 2003 est. 2004 est. 20 ................... 107 ¥81 (in millions of dollars) Enacted/requested: Budget Authority ..................................................................... VerDate Dec 13 2002 15:09 Jan 23, 2003 Jkt 193833 2002 actual 17,009 PO 00000 2003 est. 2004 est. 16,882 17,690 Frm 00029 Fmt 3616 Sfmt 3643 E:\BUDGET\HHS.XXX HHS 127 ¥81 430 ADMINISTRATION FOR CHILDREN AND FAMILIES—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 2004 General and special funds—Continued This schedule reflects a proposal to authorize a more accessible Contingency Fund. CONTINGENCY FUND f Program and Financing (in millions of dollars) PAYMENTS 2002 actual Identification code 75–1522–0–1–609 2003 est. 2004 est. 00.01 Obligations by program activity: Program activity ............................................................. ................... ................... 2 10.00 Total new obligations (object class 41.0) ................ ................... ................... 2 21.40 22.00 Budgetary resources available for obligation: Unobligated balance carried forward, start of year ................... ................... 1,958 New budget authority (gross) ........................................ 1,958 1,958 ................... 23.90 23.95 23.98 24.40 Total budgetary resources available for obligation 1,958 1,958 1,958 Total new obligations .................................................... ................... ................... ¥2 Unobligated balance expiring or withdrawn ................. ¥1,958 ................... ................... Unobligated balance carried forward, end of year ....... ................... 1,958 1,956 New budget authority (gross), detail: Mandatory: 60.00 Appropriation ............................................................. ................... 1,958 ................... 63.00 Reappropriation ......................................................... 1,958 ................... ................... 70.00 73.10 73.20 Total new budget authority (gross) .......................... 1,958 1,958 ................... Change in obligated balances: Total new obligations .................................................... ................... ................... Total outlays (gross) ...................................................... ................... ................... 2 ¥1 Outlays (gross), detail: 86.98 Outlays from mandatory balances ................................ ................... ................... 89.00 90.00 1 Net budget authority and outlays: Budget authority ............................................................ 1,958 1,958 ................... Outlays ........................................................................... ................... ................... 1 Summary of Budget Authority and Outlays Note.—A regular 2003 appropriation for this account had not been enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 107–229, as amended). The amounts included for 2003 in this budget reflect the Administration’s 2003 policy proposals. Program and Financing (in millions of dollars) 2002 actual Identification code 75–1501–0–1–609 2003 est. 2004 est. 3,905 454 10 00.91 01.02 01.03 Subtotal, child support enforcement ........................ Payments to territories .................................................. Repatriation ................................................................... 3,784 23 1 4,003 23 1 4,369 23 1 01.91 24 24 24 02.01 02.03 Subtotal, other payments .......................................... Aid to families with dependent children (AFDC) payments: AFDC benefit payments ............................................. State and local welfare administration .................... 124 10 ................... 3 ................... ................... (Legislative proposal, subject to PAYGO) 02.91 09.01 Subtotal, AFDC programs ..................................... Offset obligations (cse grants to states) ...................... 127 157 Program and Financing (in millions of dollars) 10.00 Total new obligations ................................................ 4,092 21.40 22.00 Budgetary resources available for obligation: Unobligated balance carried forward, start of year New budget authority (gross) ........................................ 23.90 23.95 Total budgetary resources available for obligation Total new obligations .................................................... 4,092 ¥4,092 4,226 ¥4,226 4,572 ¥4,572 New budget authority (gross), detail: Mandatory: 60.00 Appropriation ............................................................. 65.00 Advance appropriation .............................................. 69.00 Offsetting collections (cash) ......................................... 2,846 1,000 157 2,937 1,100 189 3,293 1,100 179 70.00 Total new budget authority (gross) .......................... 4,003 4,226 4,572 72.40 73.10 73.20 74.40 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Obligated balance, end of year ..................................... 803 4,092 ¥4,155 740 740 4,226 ¥4,363 603 603 4,572 ¥4,517 658 86.97 Outlays (gross), detail: Outlays from new mandatory authority ......................... 3,641 3,817 4,102 2,000 .................... 1 2 f CONTINGENCY FUND 2002 actual Identification code 75–1522–4–1–609 2003 est. 2004 est. Budgetary resources available for obligation: 21.40 Unobligated balance carried forward, start of year ................... ................... 42 22.00 New budget authority (gross) ........................................ ................... 42 ................... Total budgetary resources available for obligation ................... Unobligated balance carried forward, end of year ....... ................... New budget authority (gross), detail: Mandatory: 60.00 Appropriation ............................................................. ................... Change in obligated balances: Total outlays (gross) ...................................................... ................... Outlays (gross), detail: 86.98 Outlays from mandatory balances ................................ ................... Net budget authority and outlays: Budget authority ............................................................ ................... Outlays ........................................................................... ................... VerDate Dec 13 2002 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), $3,292,970,000, to remain available until expended; and for such purposes for the first quarter of fiscal year 2005, $1,200,000,000, 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 3 months of the current fiscal year for unanticipated costs, incurred for the current fiscal year, such sums as may be necessary. 3,532 461 10 Total: Budget Authority ..................................................................... 1,958 Outlays .................................................................................... .................... 89.00 90.00 AND 3,324 450 10 Enacted/requested: 2002 actual 2003 est. 2004 est. Budget Authority ..................................................................... 1,958 1,958 .................... Outlays .................................................................................... .................... .................... 1 Legislative proposal, subject to PAYGO: Budget Authority ..................................................................... .................... 42 .................... Outlays .................................................................................... .................... 1 1 73.20 STATES FOR CHILD SUPPORT ENFORCEMENT FAMILY SUPPORT PROGRAMS Obligations by program activity: Child support enforcement (CSE): Benefit payments: 00.01 State child support administrative costs ............. 00.02 Child support incentive payments ........................ 00.03 Access and visitation grants ................................ (in millions of dollars) 23.90 24.40 TO 15:09 Jan 23, 2003 Jkt 193833 PO 00000 42 42 42 42 42 ................... ¥1 1 4,226 4,572 89 ................... ................... 4,003 4,226 4,572 ¥1 1 42 ................... 1 1 Frm 00030 10 ................... 189 179 Fmt 3616 Sfmt 3643 E:\BUDGET\HHS.XXX HHS ADMINISTRATION FOR CHILDREN AND FAMILIES—Continued Federal Funds—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES 86.98 Outlays from mandatory balances ................................ 514 546 415 87.00 Total outlays (gross) ................................................. 4,155 4,363 4,517 Offsets: Against gross budget authority and outlays: 88.45 Offsetting collections (cash) from: Offsetting governmental collections (from non-Federal sources) Net budget authority and outlays: 89.00 Budget authority ............................................................ 90.00 Outlays ........................................................................... ¥157 ¥189 3,846 3,998 4,037 4,174 3,846 3,998 4,037 4,174 ¥47 73.10 73.20 Change in obligated balances: Total new obligations .................................................... ................... ................... Total outlays (gross) ...................................................... ................... ................... ¥47 47 86.97 Outlays (gross), detail: Outlays from new mandatory authority ......................... ................... ................... ¥47 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ ................... ................... Outlays ........................................................................... ................... ................... ¥47 ¥47 4,393 4,338 (in millions of dollars) Total: Budget Authority ..................................................................... Outlays .................................................................................... New budget authority (gross), detail: Mandatory: 60.00 Appropriation ............................................................. ................... ................... ¥179 Summary of Budget Authority and Outlays Enacted/requested: 2002 actual 2003 est. Budget Authority ..................................................................... 3,846 4,037 Outlays .................................................................................... 3,998 4,174 Legislative proposal, subject to PAYGO: Budget Authority ..................................................................... .................... .................... Outlays .................................................................................... .................... .................... 431 2004 est. 4,393 4,338 –47 –47 4,346 4,291 This account provides for payments to States for child support enforcement and other family support programs, including access and visitation programs for families. Spending authority from the Federal share of child support collections is used to pay incentive payments. The remaining net Federal share of collections is returned to the Treasury in a receipt account. The text table below shows the net Federal costs of child support enforcement: Net Federal Costs of Child Support Enforcement This legislative package reproposes provisions in the TANF reauthorization plan, including proposals to increase child support collections and to direct more of these payments to families. Also included are provisions to streamline current and introduce new data matching efforts to more effectively seize child support payments through state, tribal, and private industry participation. f LOW INCOME HOME ENERGY ASSISTANCE For making payments under title XXVI of the Omnibus Budget Reconciliation Act of 1981, $1,700,000,000. For making payments under title XXVI of the Omnibus Budget Reconciliation Act of 1981, $300,000,000: Provided, That these funds are for the unanticipated home energy assistance needs of one or more States, as authorized by section 2604(e) of the Act, and notwithstanding the designation requirement of section 2602(e). Note.—A regular 2003 appropriation for this account had not been enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 107–229, as amended). The amounts included for 2003 in this budget reflect the Administration’s 2003 policy proposals. (In millions of dollars) 2002 2003 Gross Federal share of collections .............................................. –1,235 Federal incentive payments to States ........................................ 450 Hold harmless payments ............................................................. .................... State child support administrative costs ................................... 3,481 Access and visitation grants ...................................................... 10 Total .................................................................................... 2,706 3,065 3,348 Object Classification (in millions of dollars) 2002 actual Identification code 75–1501–0–1–609 41.0 2003 est. 2004 est. 99.0 Direct obligations: Grants, subsidies, and contributions ........................................................................... Reimbursable obligations: Reimbursable obligations ... 3,935 157 4,037 189 4,393 179 99.9 Total new obligations ................................................ 4,092 4,226 4,572 f PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT FAMILY SUPPORT PROGRAMS Program and Financing (in millions of dollars) 2004 –1,127 –1,151 461 454 10 .................... 3,711 4,035 10 10 AND 2002 actual Identification code 75–1502–0–1–609 2003 est. 2004 est. 00.01 Obligations by program activity: Direct program activity .................................................. 1,800 1,550 1,850 10.00 Total new obligations (object class 41.0) ................ 1,800 1,550 1,850 21.40 22.00 Budgetary resources available for obligation: Unobligated balance carried forward, start of year New budget authority (gross) ........................................ 300 2,000 300 1,700 300 2,000 23.90 23.95 23.98 24.40 Total budgetary resources available for obligation Total new obligations .................................................... Unobligated balance expiring or withdrawn ................. Unobligated balance carried forward, end of year ....... 2,300 ¥1,800 ¥200 300 2,000 ¥1,550 ¥150 300 2,300 ¥1,850 ¥150 300 New budget authority (gross), detail: Discretionary: Appropriation: 40.00 Appropriation [Base Program] .............................. 40.00 Appropriation [Emergency] .................................... 1,700 300 1,400 300 1,700 300 43.00 Appropriation (total discretionary) ........................ 2,000 1,700 2,000 72.40 73.10 73.20 73.40 74.40 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Adjustments in expired accounts (net) ......................... Obligated balance, end of year ..................................... 512 536 1,800 1,550 ¥1,773 ¥1,628 ¥3 ................... 536 459 459 1,850 ¥1,774 ¥5 530 (Legislative proposal, subject to PAYGO) Program and Financing (in millions of dollars) 2002 actual Identification code 75–1501–4–1–609 2003 est. 2004 est. Obligations by program activity: Child support enforcement (CSE): Benefit payments: 00.01 State child support administrative costs ............. ................... ................... 00.03 Access and visitation grants ................................ ................... ................... ¥49 2 86.90 86.93 Outlays (gross), detail: Outlays from new discretionary authority ..................... Outlays from discretionary balances ............................. 1,329 444 1,147 481 1,369 405 10.00 Total new obligations (object class 41.0) ................ ................... ................... ¥47 87.00 Total outlays (gross) ................................................. 1,773 1,628 1,774 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ ................... ................... Total new obligations .................................................... ................... ................... ¥47 47 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 2,000 1,773 1,700 1,628 2,000 1,774 VerDate Dec 13 2002 15:09 Jan 23, 2003 Jkt 193833 PO 00000 Frm 00031 Fmt 3616 Sfmt 3643 E:\BUDGET\HHS.XXX HHS 432 ADMINISTRATION FOR CHILDREN AND FAMILIES—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 2004 General and special funds—Continued LOW INCOME HOME ENERGY ASSISTANCE—Continued 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. Obligation estimates for the contingency fund are based on average historical obligation rates. f REFUGEE AND ing to the care and placement of unaccompanied alien children are estimates. Final amounts transferred will be included in a determination order issued by the Director of the Office of Management and Budget. Object Classification (in millions of dollars) 25.1 25.2 25.3 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), $417,626,000: Provided, That funds appropriated pursuant to section 414(a) of the Immigration and Nationality Act for fiscal year 2004 shall be available for the costs of assistance provided and other activities through September 30, 2006: Provided further, That up to $10,000,000 is available to carry out the Trafficking Victims Protection Act of 2000. For carrying out section 5 of the Torture Victims Relief Act of 1998 (Public Law 105–320), $10,000,000. For carrying out section 462 of the Homeland Security Act of 2002 (P.L. 107–296), $34,000,000. Note.—A regular 2003 appropriation for this account had not been enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 107–229, as amended). The amounts included for 2003 in this budget reflect the Administration’s 2003 policy proposals. 2002 actual Identification code 75–1503–0–1–609 2003 est. 2004 est. 1 2 1 2 1 2 41.0 Advisory and assistance services .................................. Other services ................................................................ Other purchases of goods and services from Government accounts ........................................................... Grants, subsidies, and contributions ............................ 2 473 2 495 2 467 99.9 Total new obligations ................................................ 478 500 472 f PROMOTING SAFE AND STABLE FAMILIES For carrying out section 436 of the Social Security Act, $305,000,000; for section 437, $199,978,000; and for section 439, $50,000,000. Note.—A regular 2003 appropriation for this account had not been enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 107–229, as amended). The amounts included for 2003 in this budget reflect the Administration’s 2003 policy proposals. Program and Financing (in millions of dollars) Program and Financing (in millions of dollars) 2002 actual Identification code 75–1512–0–1–506 2002 actual Identification code 75–1503–0–1–609 2003 est. 00.01 00.02 Obligations by program activity: Refugee and entrant assistance ................................... Assistance for treatment of torture victims .................. 468 10 490 10 462 10 10.00 Total new obligations ................................................ 478 500 472 Budgetary resources available for obligation: 21.40 Unobligated balance carried forward, start of year 22.00 New budget authority (gross) ........................................ 22.10 Resources available from recoveries of prior year obligations ....................................................................... 23.90 23.95 23.98 24.40 Total budgetary resources available for obligation Total new obligations .................................................... Unobligated balance expiring or withdrawn ................. Unobligated balance carried forward, end of year ....... 24 460 Appropriation (total discretionary) ........................ Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Adjustments in expired accounts (net) ......................... Recoveries of prior year obligations .............................. Change in uncollected customer payments from Federal sources (expired) ................................................ 74.40 Obligated balance, end of year ..................................... 72.40 73.10 73.20 73.40 73.45 74.10 10 462 19 ................... ................... 503 510 472 ¥478 ¥500 ¥472 ¥2 ................... ................... 24 10 ................... New budget authority (gross), detail: Discretionary: 40.00 Appropriation ............................................................. 460 42.00 Transferred from other accounts .............................. ................... 43.00 24 486 00.01 00.02 00.03 00.04 Obligations by program activity: Grants to States and Tribes .......................................... 353 Research, training and technical assistance ............... 9 State court assessment activities ................................. 13 Mentoring children of prisoners .................................... ................... 475 13 17 50 375 530 555 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ Total new obligations .................................................... 375 ¥375 530 ¥530 555 ¥555 New budget authority (gross), detail: Discretionary: Appropriation: 40.00 Appropriation ......................................................... 70 40.00 Appropriation ......................................................... ................... 200 25 200 50 43.00 70 225 250 60.00 Appropriation (total discretionary) ........................ Mandatory: Appropriation ............................................................. 305 305 305 462 70.00 Total new budget authority (gross) .......................... 375 530 555 570 544 559 478 500 472 ¥480 ¥483 ¥476 ¥2 ................... ................... ¥19 ................... ................... 72.40 73.10 73.20 73.40 74.40 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Adjustments in expired accounts (net) ......................... Obligated balance, end of year ..................................... Outlays (gross), detail: Outlays from new discretionary authority ..................... 12 Outlays from discretionary balances ............................. ................... Outlays from new mandatory authority ......................... 56 Outlays from mandatory balances ................................ 233 460 453 462 33 ................... 486 ¥3 ................... ................... 544 559 555 138 342 146 337 139 337 87.00 Total outlays (gross) ................................................. 480 483 476 87.00 Total outlays (gross) ................................................. 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 460 480 486 483 462 476 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... States are subsidized for administering the refugee assistance program. Funds are also provided to assist in the rehabilitation of victims of torture. The transferred amounts from the Department of Homeland Security to HHS in 2003 relatJkt 193833 475 13 17 25 Total new obligations ................................................ Outlays (gross), detail: 86.90 Outlays from new discretionary authority ..................... 86.93 Outlays from discretionary balances ............................. 15:09 Jan 23, 2003 2004 est. 10.00 86.90 86.93 86.97 86.98 VerDate Dec 13 2002 2003 est. 2004 est. PO 00000 Frm 00032 Fmt 3616 339 402 541 375 530 555 ¥301 ¥391 ¥507 ¥11 ................... ................... 402 541 591 37 45 55 254 39 150 55 263 301 391 507 375 301 530 391 555 507 This program provides funds for a broad range of child welfare services, including family preservation and family support services. It also includes funding for competitive grants to mentor the children of prisoners. Sfmt 3616 E:\BUDGET\HHS.XXX HHS ADMINISTRATION FOR CHILDREN AND FAMILIES—Continued Federal Funds—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES Object Classification (in millions of dollars) 2002 actual Identification code 75–1512–0–1–506 25.1 25.3 433 Object Classification (in millions of dollars) 2003 est. 2004 est. 2002 actual Identification code 75–1550–0–1–609 3 4 4 41.0 Advisory and assistance services .................................. Other purchases of goods and services from Government accounts ........................................................... Grants, subsidies, and contributions ............................ 2 370 2 524 2 549 99.9 Total new obligations ................................................ 375 530 555 2003 est. 2004 est. 25.1 25.2 41.0 Advisory and assistance services .................................. Other services ................................................................ Grants, subsidies, and contributions ............................ 6 1 2,751 6 1 2,710 6 1 2,710 99.9 Total new obligations ................................................ 2,758 2,717 2,717 f f PAYMENTS JOB OPPORTUNITIES AND Program and Financing (in millions of dollars) 2002 actual Identification code 75–1509–0–1–504 2003 est. 2004 est. 72.40 73.20 73.40 Change in obligated balances: Obligated balance, start of year ................................... Total outlays (gross) ...................................................... Adjustments in expired accounts (net) ......................... 8 ................... ................... ¥23 ................... ................... 15 ................... ................... 86.98 Outlays (gross), detail: Outlays from mandatory balances ................................ 23 ................... ................... 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ ................... ................... ................... Outlays ........................................................................... 23 ................... ................... This activity was replaced by Temporary Assistance for Needy Families. CHILD CARE ENTITLEMENT TO 2003 est. 2004 est. 00.01 00.02 00.03 00.04 Obligations by program activity: Mandatory child care ..................................................... Matching child care ....................................................... Training and technical assistance ................................ Child care tribal grants ................................................. 1,178 1,519 7 54 1,178 1,478 7 54 1,178 1,478 7 54 10.00 Total new obligations ................................................ 2,758 2,717 2,717 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ Total new obligations .................................................... 2,758 ¥2,758 2,717 ¥2,717 2,717 ¥2,717 New budget authority (gross), detail: Mandatory: 60.00 Appropriation ............................................................. 63.00 Reappropriation ......................................................... 2,717 2,717 2,717 41 ................... ................... 70.00 Total new budget authority (gross) .......................... 2,758 72.40 73.10 73.20 73.40 74.40 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Adjustments in expired accounts (net) ......................... Obligated balance, end of year ..................................... 86.97 86.98 Outlays (gross), detail: Outlays from new mandatory authority ......................... Outlays from mandatory balances ................................ 1,774 591 1,842 848 1,926 887 87.00 Total outlays (gross) ................................................. 2,365 2,690 2,813 Net budget authority and outlays: 89.00 Budget authority ............................................................ 90.00 Outlays ........................................................................... 2,717 2,717 814 1,144 1,171 2,758 2,717 2,717 ¥2,365 ¥2,690 ¥2,813 ¥63 ................... ................... 1,144 1,171 1,075 AND DEVELOPMENT Note.—A regular 2003 appropriation for this account had not been enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 107–229, as amended). The amounts included for 2003 in this budget reflect the Administration’s 2003 policy proposals. 2002 actual 2003 est. 2004 est. 00.01 00.04 Obligations by program activity: Block grant payments to States .................................... Research and evaluation fund ...................................... 2,090 10 2,090 10 2,090 10 10.00 Total new obligations ................................................ 2,100 2,100 2,100 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ Total new obligations .................................................... 2,100 ¥2,100 2,100 ¥2,100 2,100 ¥2,100 New budget authority (gross), detail: Discretionary: 40.00 Appropriation ............................................................. 2,100 2,100 2,100 72.40 73.10 73.20 73.40 74.40 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Adjustments in expired accounts (net) ......................... Obligated balance, end of year ..................................... 86.90 86.93 Outlays (gross), detail: Outlays from new discretionary authority ..................... Outlays from discretionary balances ............................. 1,349 825 1,344 736 1,344 749 87.00 Total outlays (gross) ................................................. 2,174 2,080 2,093 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 2,100 2,174 2,100 2,080 2,100 2,093 1,121 1,044 1,064 2,100 2,100 2,100 ¥2,174 ¥2,080 ¥2,093 ¥3 ................... ................... 1,044 1,064 1,071 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) 2,758 2,365 2,717 2,690 2,717 2,813 This account provides child care funding for welfare recipients and low-income working families and was established by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (P.L. 104–193). Jkt 193833 CHILD CARE GRANT Identification code 75–1515–0–1–609 STATES 2002 actual Identification code 75–1550–0–1–609 FOR THE BLOCK Program and Financing (in millions of dollars) Program and Financing (in millions of dollars) 15:09 Jan 23, 2003 STATES 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), $2,099,729,000 shall be used to supplement, not supplant state general revenue funds for child care assistance for low-income families: Provided, That $19,120,000 shall be available for child care resource and referral and school-aged child care activities, of which $1,000,000 shall be for the Child Care Aware toll free hotline: Provided further, That in addition to the amounts required to be reserved by the States under section 658G, $272,672,000 shall be reserved by the States for activities authorized under section 658G, of which $100,000,000 shall be for activities that improve the quality of infant and toddler care: Provided further, That $9,864,000 shall be for use by the Secretary for child care research, demonstration, and evaluation activities. f VerDate Dec 13 2002 TO BASIC SKILLS TRAINING PROGRAM PO 00000 Frm 00033 Fmt 3616 2002 actual Identification code 75–1515–0–1–609 25.1 25.3 2003 est. 2004 est. 6 6 6 41.0 Advisory and assistance services .................................. Other purchases of goods and services from Government accounts ........................................................... Grants, subsidies, and contributions ............................ 1 2,093 1 2,093 1 2,093 99.9 Total new obligations ................................................ 2,100 2,100 2,100 Sfmt 3643 E:\BUDGET\HHS.XXX HHS 434 ADMINISTRATION FOR CHILDREN AND FAMILIES—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 2004 General and special funds—Continued SOCIAL SERVICES BLOCK GRANT For making grants to States pursuant to section 2002 of the Social Security Act, $1,700,000,000. Note.—A regular 2003 appropriation for this account had not been enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 107–229, as amended). The amounts included for 2003 in this budget reflect the Administration’s 2003 policy proposals. Program and Financing (in millions of dollars) 2002 actual Identification code 75–1534–0–1–506 2003 est. 2004 est. 00.01 Obligations by program activity: Direct program activity .................................................. 1,700 1,700 1,700 10.00 Total new obligations (object class 41.0) ................ 1,700 1,700 1,700 21.40 22.00 Budgetary resources available for obligation: Unobligated balance carried forward, start of year New budget authority (gross) ........................................ 1 1,700 1 1,700 1 1,700 23.90 23.95 24.40 Total budgetary resources available for obligation Total new obligations .................................................... Unobligated balance carried forward, end of year ....... 1,701 ¥1,700 1 1,701 ¥1,700 1 1,701 ¥1,700 1 New budget authority (gross), detail: Mandatory: 60.00 Appropriation ............................................................. 1,700 1,700 1,700 Change in obligated balances: 72.40 Obligated balance, start of year ................................... 746 666 73.10 Total new obligations .................................................... 1,700 1,700 73.20 Total outlays (gross) ...................................................... ¥1,780 ¥1,792 73.40 Adjustments in expired accounts (net) ......................... ................... ................... 74.40 Obligated balance, end of year ..................................... 666 574 574 1,700 ¥1,790 ¥4 480 86.97 86.98 Outlays (gross), detail: Outlays from new mandatory authority ......................... Outlays from mandatory balances ................................ 1,452 328 1,445 347 1,445 345 87.00 Total outlays (gross) ................................................. 1,780 1,792 1,790 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 1,700 1,780 1,700 1,792 1,700 1,790 f CHILDREN AND FAMILIES SERVICES PROGRAMS For carrying out, except as otherwise provided, the Runaway and Homeless Youth Act, the Developmental Disabilities Assistance and Bill of Rights Act, the Head Start Act, the Child Abuse Prevention and Treatment Act, sections 310 and 316 of the Family Violence Prevention and Services Act, as amended, 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), sections 1201 and 1211 of the Children’s Health Act of 2000, the Abandoned Infants Assistance Act of 1988, sections 413, 429A, 1110, and 1115 of the Social Security Act, and sections 40155, 40211, and 40241 of Public Law 103–322; 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, $8,547,382,000, of which $43,000,000, to remain available until September 30, 2005, 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) and may be made for adoptions completed before September 30, 2004; of which $552,312,000 shall be for making payments under the Community Services Block Grant Act; and of which $6,815,570,000 shall be for making payments under the Head Start Act, of which $1,400,000,000 shall become available October 1, 2004 and remain available through September 30, 2005: Provided, That to the extent VerDate Dec 13 2002 15:09 Jan 23, 2003 Jkt 193833 PO 00000 Frm 00034 Fmt 3616 Community Services Block Grant funds are distributed as grant funds by a State to an eligible entity as provided under the Act, and have not been expended by such entity, they shall remain with such entity for carryover into the next fiscal year for expenditure by such entity consistent with program purposes: Provided further, That all eligible entities currently in good standing in the Community Services Block Grant program shall receive an increase in funding proportionate to the increase provided in this Act for the Community Services Block Grant: Provided further, That $100,000,000 is for a compassion capital fund to provide grants to charitable organizations to emulate model social service programs and to encourage research on the best practices of social service organizations: Provided further, That the Secretary shall establish procedures regarding the disposition of intangible property which permits grant funds, or intangible assets acquired with funds authorized under section 680 of the Community Services Block Grant Act, as amended, to become the sole property of such grantees after a period of not more than 12 years after the end of the grant for purposes and uses consistent with the original grant: Provided further, That funds appropriated for section 680(a)(2) of the Community Services Block Grant Act, as amended, shall be available for financing construction and rehabilitation and loans or investments in private business enterprises owned by community development corporations. Note.—A regular 2003 appropriation for this account had not been enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 107–229, as amended). The amounts included for 2003 in this budget reflect the Administration’s 2003 policy proposals. Program and Financing (in millions of dollars) 2002 actual Identification code 75–1536–0–1–506 Obligations by program activity: Head start ...................................................................... Runaway and homeless youth: 01.03 Runaway and homeless youth .................................. 01.04 Transitional living ..................................................... 01.05 Education grants to reduce sexual abuse of runaway youth ............................................................ Child abuse programs: 01.07 Child abuse State grants .......................................... 01.08 Child abuse discretionary grants .............................. 01.09 Community based resource centers .......................... Child welfare programs: 01.11 Child welfare services ............................................... 01.12 Child welfare training ............................................... 01.15 Abandoned infants .................................................... 01.16 Adoption incentives ................................................... 01.17 Adoption opportunities .............................................. 01.18 Children’s health act programs .................................... 01.19 Social services and income maintenance research ...... 01.20 Native American programs ............................................ 01.21 Compassion capital fund .............................................. 01.23 Early learning fund ........................................................ Developmental disabilities programs: 01.24 Protection and advocacy ........................................... 01.25 Projects of national significance .............................. 01.26 Centers for excellence ............................................... 01.27 State grants .............................................................. 01.28 Federal administration ................................................... 01.29 Faith-based center ......................................................... 00.01 2003 est. 2004 est. 6,537 6,667 6,816 48 40 48 40 62 26 15 15 15 22 26 33 22 26 33 22 26 33 292 292 292 8 8 7 12 12 13 40 43 43 27 27 27 13 13 13 31 6 6 46 45 45 30 100 100 25 ................... ................... 35 12 24 70 171 2 35 12 24 70 171 2 35 12 24 70 180 1 1,022 1,044 1,052 03.01 03.03 03.04 03.05 03.06 03.08 03.09 Subtotal ..................................................................... Community services programs: Community services block grants ............................. Community food and nutrition .................................. Community services discretionary ............................. National youth sports ................................................ Individual development accounts .................................. Domestic violence hotline .............................................. Grants for battered women’s shelters ........................... 03.91 Subtotal ..................................................................... 864 768 679 04.00 09.01 Total, direct program ................................................ Reimbursable program .................................................. 8,423 18 8,479 15 8,547 15 10.00 Total new obligations ................................................ 8,441 8,494 8,562 21.40 22.00 Budgetary resources available for obligation: Unobligated balance carried forward, start of year New budget authority (gross) ........................................ 3 8,445 4 8,494 1 8,562 23.90 23.95 Total budgetary resources available for obligation Total new obligations .................................................... 8,448 ¥8,441 8,498 ¥8,494 8,563 ¥8,562 01.91 Sfmt 3643 E:\BUDGET\HHS.XXX HHS 649 570 495 7 7 ................... 39 39 32 17 ................... ................... 25 25 25 2 2 3 125 125 124 ADMINISTRATION FOR CHILDREN AND FAMILIES—Continued Federal Funds—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES 23.98 24.40 Unobligated balance expiring or withdrawn ................. Unobligated balance carried forward, end of year ....... ¥1 4 ¥3 ................... 1 1 New budget authority (gross), detail: Discretionary: 40.00 Appropriation ............................................................. 40.71 Reduction pursuant to P.L. 107–116 ....................... 40.73 Reduction pursuant to P.L. 107–206 ....................... 7,030 7,079 7,147 ¥1 ................... ................... ¥2 ................... ................... 43.00 55.00 7,027 1,400 7,079 1,400 7,147 1,400 15 15 15 68.00 68.10 68.90 70.00 Appropriation (total discretionary) ........................ Advance appropriation .............................................. Spending authority from offsetting collections: Offsetting collections (cash) ..................................... Change in uncollected customer payments from Federal sources (unexpired) .................................. 3 ................... ................... Spending authority from offsetting collections (total discretionary) .......................................... 18 15 15 Total new budget authority (gross) .......................... 8,445 8,494 8,562 23.1 23.3 25.7 26.0 31.0 41.0 Rental payments to GSA ........................................... Communications, utilities, and miscellaneous charges ................................................................. Printing and reproduction ......................................... Advisory and assistance services ............................. Other services ............................................................ Other purchases of goods and services from Government accounts ................................................. Operation and maintenance of equipment ............... Supplies and materials ............................................. Equipment ................................................................. Grants, subsidies, and contributions ........................ 99.0 99.0 99.9 14 16 16 4 2 105 5 2 3 124 41 2 3 124 41 55 3 1 1 8,094 30 1 2 1 8,117 30 1 2 1 8,185 Direct obligations .................................................. Reimbursable obligations .............................................. 8,423 18 8,479 15 8,547 15 Total new obligations ................................................ 8,441 8,494 8,562 24.0 25.1 25.2 25.3 Personnel Summary 2002 actual Identification code 75–1536–0–1–506 Change in obligated balances: 72.40 Obligated balance, start of year ................................... 73.10 Total new obligations .................................................... 73.20 Total outlays (gross) ...................................................... 73.40 Adjustments in expired accounts (net) ......................... 74.00 Change in uncollected customer payments from Federal sources (unexpired) ............................................ 74.10 Change in uncollected customer payments from Federal sources (expired) ................................................ 74.40 Obligated balance, end of year ..................................... 4,374 4,693 4,771 8,441 8,494 8,562 ¥8,084 ¥8,416 ¥8,464 ¥35 ................... ................... 435 Direct: Total compensable workyears: 1001 Civilian full-time equivalent employment ................. 1,448 2003 est. 2004 est. 1,512 1,472 f ¥3 ................... ................... CHILDREN 1 ................... ................... 4,693 4,771 4,869 AND FAMILY SERVICES PROGRAMS (Legislative proposal, not subject to PAYGO) Program and Financing (in millions of dollars) Outlays (gross), detail: 86.90 Outlays from new discretionary authority ..................... 86.93 Outlays from discretionary balances ............................. 4,412 3,672 4,391 4,025 4,429 4,035 Identification code 75–1536–2–1–506 87.00 8,084 8,416 8,464 01.19 01.20 Obligations by program activity: Maternity group homes .................................................. ................... Strengthening fatherhood and healthy marriages ........ ................... 10 20 10 20 04.00 Total, direct program ................................................ ................... 30 30 ¥15 ¥15 ¥15 10.00 Total new obligations ................................................ ................... 30 30 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ ................... Total new obligations .................................................... ................... 30 ¥30 30 ¥30 New budget authority (gross), detail: Discretionary: 40.00 Appropriation ............................................................. ................... 30 30 Total outlays (gross) ................................................. Offsets: Against gross budget authority and outlays: 88.00 Offsetting collections (cash) from: Federal sources Against gross budget authority only: 88.95 Change in uncollected customer payments from Federal sources (unexpired) .................................. Net budget authority and outlays: 89.00 Budget authority ............................................................ 90.00 Outlays ........................................................................... 99.00 99.01 ¥3 ................... ................... 8,427 8,071 8,479 8,401 8,547 8,449 Additional net budget authority and outlays to cover cost of fully accruing retirement: Budget authority ............................................................ 11 11 Outlays ........................................................................... 11 11 13 13 Summary of Budget Authority and Outlays 2002 actual 2003 est. 2004 est. 72.40 73.10 73.20 74.40 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Obligated balance, end of year ..................................... ................... ................... ................... 30 ................... ¥5 ................... 25 25 30 ¥18 37 Outlays (gross), detail: Outlays from new discretionary authority ..................... ................... 5 Outlays from discretionary balances ............................. ................... ................... 5 13 (in millions of dollars) Enacted/requested: 2002 actual Budget Authority ..................................................................... 8,427 Outlays .................................................................................... 8,069 Legislative proposal, not subject to PAYGO: Budget Authority ..................................................................... .................... Outlays .................................................................................... .................... Total: Budget Authority ..................................................................... Outlays .................................................................................... 2003 est. 8,427 8,069 2004 est. 8,479 8,401 8,547 8,449 86.90 86.93 30 5 30 18 87.00 Total outlays (gross) ................................................. ................... 5 18 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ ................... Outlays ........................................................................... ................... 30 5 30 18 8,509 8,406 8,577 8,467 Provides funding for a Compassion Capital Fund to support public and private partnerships in funding community and faith-based charitable organizations that expand upon or emulate model social service programs. Object Classification (in millions of dollars) 2002 actual Identification code 75–1536–0–1–506 2003 est. 2004 est. Object Classification (in millions of dollars) 11.1 11.3 11.5 Direct obligations: Personnel compensation: Full-time permanent ............................................. Other than full-time permanent ........................... Other personnel compensation ............................. 111 2 1 113 1 1 113 1 1 11.9 12.1 21.0 Total personnel compensation ......................... Civilian personnel benefits ....................................... Travel and transportation of persons ....................... 114 21 4 115 22 5 115 22 5 Frm 00035 Fmt 3616 VerDate Dec 13 2002 15:09 Jan 23, 2003 Jkt 193833 This legislative proposal establishes the Responsible Fatherhood and Healthy Marriages Program. The budget provides grants to faith-based and community organizations to assist non-custodial fathers in becoming more involved in the lives of their children. In addition, the Administration includes funding for grants to provide young, pregnant and parenting women with access to maternity group homes. PO 00000 2002 actual Identification code 75–1536–2–1–506 25.3 2003 est. 2004 est. 41.0 Other purchases of goods and services from Government accounts ........................................................... ................... Grants, subsidies, and contributions ............................ ................... 7 23 7 23 99.9 Total new obligations ................................................ ................... 30 30 Sfmt 3643 E:\BUDGET\HHS.XXX HHS 436 ADMINISTRATION FOR CHILDREN AND FAMILIES—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 2004 General and special funds—Continued Temporary Assistance to Needy Families account under Illegitimacy Reduction and Family Formation activities. VIOLENT CRIME REDUCTION PROGRAMS Object Classification (in millions of dollars) Program and Financing (in millions of dollars) 2002 actual Identification code 75–8605–0–1–754 2003 est. 2002 actual Identification code 75–1553–0–1–609 2004 est. 72.40 73.20 73.40 74.40 Change in obligated balances: Obligated balance, start of year ................................... Total outlays (gross) ...................................................... Adjustments in expired accounts (net) ......................... Obligated balance, end of year ..................................... 86.93 Outlays (gross), detail: Outlays from discretionary balances ............................. 3 41.0 Direct obligations: Travel and transportation of persons ....................... Rental payments to GSA ........................................... Communications, utilities, and miscellaneous charges ................................................................. Advisory and assistance services ............................. Other services ............................................................ Other purchases of goods and services from Government accounts ................................................. Grants, subsidies, and contributions ........................ 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ ................... ................... ................... Outlays ........................................................................... 13 9 3 99.0 99.0 99.9 29 15 6 ¥13 ¥9 ¥3 ¥1 ................... ................... 15 6 3 13 9 21.0 23.1 23.3 25.1 25.2 25.3 AND 1 1 1 1 1 14 5 1 20 5 1 20 5 13 2 13 9 13 9 Direct obligations .................................................. Reimbursable obligations .............................................. 37 9 50 9 50 9 Total new obligations ................................................ 46 59 59 f TECHNICAL ASSISTANCE PAYMENTS Program and Financing (in millions of dollars) 2002 actual Identification code 75–1553–0–1–609 00.01 00.02 00.04 09.01 Obligations by program activity: Training and technical assistance ................................ 12 Federal parent locator service ....................................... 25 Welfare research ............................................................ ................... Reimbursable program .................................................. 9 2003 est. 2004 est. 12 23 15 9 12 23 15 9 59 10.00 Total new obligations ................................................ 46 59 21.40 22.00 Budgetary resources available for obligation: Unobligated balance carried forward, start of year New budget authority (gross) ........................................ 1 46 1 ................... 59 59 23.90 23.95 24.40 Total budgetary resources available for obligation Total new obligations .................................................... Unobligated balance carried forward, end of year ....... 47 60 59 ¥46 ¥59 ¥59 1 ................... ................... TO STATES FOR FOSTER CARE 58 50 50 ¥21 ................... ................... 62.50 69.00 Appropriation (total mandatory) ........................... Offsetting collections (cash) ......................................... 37 9 50 9 50 9 70.00 Total new budget authority (gross) .......................... 46 59 59 Change in obligated balances: 72.40 Obligated balance, start of year ................................... 73.10 Total new obligations .................................................... 73.20 Total outlays (gross) ...................................................... 74.40 Obligated balance, end of year ..................................... 34 46 ¥48 31 31 59 ¥47 44 44 59 ¥53 50 86.97 86.98 Outlays (gross), detail: Outlays from new mandatory authority ......................... Outlays from mandatory balances ................................ 24 24 25 22 24 29 87.00 Total outlays (gross) ................................................. 48 47 53 Offsets: Against gross budget authority and outlays: Offsetting collections (cash) from: 88.00 Federal sources ..................................................... 88.40 Non-Federal sources ............................................. ¥4 ¥5 ¥4 ¥5 ¥4 ¥5 88.90 Total, offsetting collections (cash) .................. ¥9 ¥9 ¥9 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 37 40 50 38 50 44 This account provides funding for research and technical assistance activities established in P.L. 104–193. Amounts for welfare research are in addition to research amounts in the Children and families services program account and the VerDate Dec 13 2002 15:09 Jan 23, 2003 Jkt 193833 PO 00000 Frm 00036 Fmt 3616 AND ADOPTION ASSISTANCE For making payments to States or other non-Federal entities under title IV–E of the Social Security Act, $5,043,200,000. In addition, for carrying out section 477(i), $60,000,000. For making payments to States or other non-Federal entities under title IV–E of the Act, for the first quarter of fiscal year 2005, $1,767,700,000. For making, after May 31 of the current fiscal year, payments to States or other non-Federal entities under section 474 of title IV– E, for the last 3 months of the current fiscal year for unanticipated costs, incurred for the current fiscal year, such sums as may be necessary. Note.—A regular 2003 appropriation for this account had not been enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 107–229, as amended). The amounts included for 2003 in this budget reflect the Administration’s 2003 policy proposals. Program and Financing (in millions of dollars) 2002 actual Identification code 75–1545–0–1–609 New budget authority (gross), detail: Mandatory: 60.00 Appropriation ............................................................. 60.35 Appropriation rescinded ............................................ 2004 est. 1 1 f CHILDREN’S RESEARCH 2003 est. 00.01 00.02 00.03 00.04 Obligations by program activity: Foster care ..................................................................... 4,536 Independent living ......................................................... 140 Education and training vouchers .................................. ................... Adoption assistance ....................................................... 1,393 10.00 Total new obligations ................................................ 6,069 22.00 23.95 23.98 Budgetary resources available for obligation: New budget authority (gross) ........................................ Total new obligations .................................................... Unobligated balance expiring or withdrawn ................. 6,622 ¥6,069 ¥552 2003 est. 2004 est. 4,666 140 60 1,539 4,939 140 60 1,700 6,405 6,839 6,556 6,839 ¥6,405 ¥6,839 ¥151 ................... New budget authority (gross), detail: Discretionary: 40.00 Appropriation ............................................................. ................... Mandatory: 60.00 Appropriation ............................................................. 4,886 65.00 Advance appropriation .............................................. 1,736 60 60 4,742 1,754 5,043 1,736 70.00 Total new budget authority (gross) .......................... 6,556 6,839 72.40 73.10 73.20 73.40 74.40 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Adjustments in expired accounts (net) ......................... Obligated balance, end of year ..................................... 86.90 86.93 86.97 86.98 Outlays (gross), detail: Outlays from new discretionary authority ..................... ................... 9 Outlays from discretionary balances ............................. ................... ................... Outlays from new mandatory authority ......................... 5,235 5,412 Outlays from mandatory balances ................................ 650 885 6,622 934 1,117 1,216 6,069 6,405 6,839 ¥5,885 ¥6,306 ¥6,736 ¥2 ................... ................... 1,117 1,216 1,320 9 40 5,831 856 87.00 Total outlays (gross) ................................................. 5,885 6,306 6,736 89.00 Net budget authority and outlays: Budget authority ............................................................ 6,622 6,556 6,839 Sfmt 3643 E:\BUDGET\HHS.XXX HHS ADMINISTRATION ON AGING Federal Funds DEPARTMENT OF HEALTH AND HUMAN SERVICES 90.00 Outlays ........................................................................... 5,885 6,306 6,736 ADMINISTRATION ON AGING Federal Funds Summary of Budget Authority and Outlays General and special funds: (in millions of dollars) Enacted/requested: 2002 actual 2003 est. Budget Authority ..................................................................... 6,622 6,556 Outlays .................................................................................... 5,885 6,306 Legislative proposal, subject to PAYGO: Budget Authority ..................................................................... .................... .................... Outlays .................................................................................... .................... .................... Total: Budget Authority ..................................................................... Outlays .................................................................................... 6,622 5,885 6,839 6,736 35 31 6,556 6,306 6,874 6,767 25.1 25.5 41.0 99.9 2003 est. Advisory and assistance services .................................. 9 Research and development contracts ........................... ................... Grants, subsidies, and contributions ............................ 6,060 Total new obligations ................................................ 6,069 2004 est. 12 2 6,391 17 2 6,820 6,405 6,839 TO STATES FOR FOSTER CARE ASSISTANCE AND ADOPTION (Legislative proposal, subject to PAYGO) Program and Financing (in millions of dollars) 2002 actual Identification code 75–1545–4–1–609 2003 est. Program and Financing (in millions of dollars) 2002 actual Identification code 75–0142–0–1–506 2004 est. Obligations by program activity: Foster care ..................................................................... ................... ................... 35 02.00 09.01 10.00 Total new obligations (object class 41.0) ................ ................... ................... 35 10.00 Total new obligations ................................................ 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ ................... ................... Total new obligations .................................................... ................... ................... 35 ¥35 21.40 22.00 23.90 23.95 24.40 Change in obligated balances: 73.10 Total new obligations .................................................... ................... ................... 73.20 Total outlays (gross) ...................................................... ................... ................... 74.40 Obligated balance, end of year ..................................... ................... ................... Outlays (gross), detail: 86.97 Outlays from new mandatory authority ......................... ................... ................... Net budget authority and outlays: 89.00 Budget authority ............................................................ ................... ................... 90.00 Outlays ........................................................................... ................... ................... 35 35 ¥31 5 35 31 19:03 Jan 23, 2003 Jkt 193833 PO 00000 Frm 00037 Fmt 3616 Total, Direct Program ................................................ 1,200 Reimbursable program (HCFAC) .................................... ................... 357 21 142 390 178 150 26 28 2 18 11 18 3 1,341 3 1,344 3 1,200 1,344 1,347 Budgetary resources available for obligation: Unobligated balance carried forward, start of year New budget authority (gross) ........................................ 2 1,200 1 1,344 1 1,347 Total budgetary resources available for obligation Total new obligations .................................................... Unobligated balance carried forward, end of year ....... 1,202 ¥1,200 1 1,345 ¥1,344 1 1,348 ¥1,347 1 New budget authority (gross), detail: Discretionary: 40.00 Appropriation ............................................................. 1,200 Mandatory: 69.00 Offsetting collections (cash) ..................................... ................... 1,341 1,344 3 3 70.00 Total new budget authority (gross) .......................... 1,344 1,347 72.40 73.10 73.20 73.40 74.40 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Adjustments in expired accounts (net) ......................... Obligated balance, end of year ..................................... 86.90 86.93 86.97 Outlays (gross), detail: Outlays from new discretionary authority ..................... 727 Outlays from discretionary balances ............................. 378 Outlays from new mandatory authority ......................... ................... 31 This legislative proposal includes provisions to introduce an option available to all states to participate in an alternative financing system for child welfare that will better meet the needs of each state’s foster care population. States choosing to participate will face fewer administrative burdens and will receive funds in the form of flexible grants. VerDate Jan 23 2003 2004 est. Obligations by program activity: Home and community-based supportive services ......... 357 357 Preventive health ........................................................... 21 21 National family caregiver support program .................. 142 142 Congregate meals .......................................................... 390 492 Home-delivered meals ................................................... 176 224 Nutrition services incentive program ............................ ................... ................... Grants to Indian tribes .................................................. 26 28 Program innovations ...................................................... 39 28 Aging network support activities ................................... 2 2 Federal administration ................................................... 18 18 Alzheimer’s disease demonstration grants to States 11 11 Grants to States for the protection of vulnerable older Americans ......................................................... 18 18 01.15 White House Conference on Aging ................................ ................... ................... 00.01 New budget authority (gross), detail: Mandatory: 60.00 Appropriation ............................................................. ................... ................... 2003 est. 01.01 01.02 01.03 01.05 01.06 01.07 01.08 01.09 01.10 01.11 01.13 01.14 f PAYMENTS For carrying out, to the extent not otherwise provided, the Older Americans Act of 1965, as amended, and section 398 of the Public Health Service Act, $1,343,701,000 of which $5,000,000 shall be available for activities regarding medication management, screening, and education to prevent incorrect medication and adverse drug reactions; of which $2,842,000 shall remain available until September 30, 2006 for the White House Conference on Aging; and of which $149,670,000 shall be for making payments to or on behalf of States and other eligible grantees, consistent with section 311 of the Older Americans Act of 1965: Provided, That references to the Secretary of Agriculture in section 311(b) and (d)(1) shall be deemed to be references to the Secretary of Health and Human Services: Provided further, That in those instances in which the eligible entity elects to receive its allotment, in part or in total, in the form of commodities, the Secretary of Agriculture shall supply such commodities and be reimbursed for the costs thereof from amounts provided herein. Note.—A regular 2003 appropriation for this account had not been enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 107–229, as amended). The amounts included for 2003 in this budget reflect the Administration’s 2003 policy proposals. Object Classification (in millions of dollars) 2002 actual AGING SERVICES PROGRAMS 2004 est. Foster care.—The proposed level will support eligible lowincome children who must be placed outside the home. An average of 240,600 children per month will be served in 2004. Adoption assistance.—The proposed funding level will support subsidies for families adopting eligible low-income children with special needs. An average of 348,700 children per month will be served in 2004. Identification code 75–1545–0–1–609 437 87.00 Sfmt 3643 Total outlays (gross) ................................................. E:\BUDGET\HHS.XXX HHS 1,200 456 548 601 1,200 1,344 1,347 ¥1,105 ¥1,291 ¥1,344 ¥3 ................... ................... 548 601 603 1,105 832 456 3 834 507 3 1,291 1,344 438 ADMINISTRATION ON AGING—Continued Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 2004 General and special funds—Continued DEPARTMENTAL MANAGEMENT AGING SERVICES PROGRAMS—Continued Federal Funds General and special funds: Program and Financing (in millions of dollars)—Continued 2002 actual Identification code 75–0142–0–1–506 2003 est. Offsets: Against gross budget authority and outlays: 88.00 Offsetting collections (cash) from: Federal sources ................... 89.00 90.00 99.00 99.01 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 1,200 1,105 GENERAL DEPARTMENTAL MANAGEMENT 2004 est. ¥3 ¥3 1,341 1,288 1,344 1,341 Additional net budget authority and outlays to cover cost of fully accruing retirement: Budget authority ............................................................ 1 1 Outlays ........................................................................... 1 1 1 1 Note.—The reimbursable program (HCFAC) in the Administration on Aging (AoA) reflects the estimated distribution of the allocation account for fiscal years 2003 and 2004. Actual 2003 and 2004 distributions will be determined by the Secretary of HHS and the Attorney General. Administration on Aging.—The proposed level will provide continued funding for core formula grant programs that provide nutrition, supportive services and caregiver support services through the aging network. AoA programs are part of a comprehensive system of support for older people and their families. The proposed level also includes funding for the White House Conference on Aging. In order to improve program management, the budget proposes to transfer the smaller Department of Agriculture nutrition program for the elderly to AoA, while preserving State access to commodities and ensuring that the funds continue to be dedicated exclusively to the provision of meals. Although both Departments currently fund these services, HHS is the lead agency and has greater interaction with service providers. This transfer will improve program oversight and streamline reporting requirements. Object Classification (in millions of dollars) 2002 actual Identification code 75–0142–0–1–506 2003 est. 2004 est. 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, $348,100,000 together with $5,851,000 to be transferred and expended as authorized by section 201(g)(1) of the Social Security Act from the Hospital Insurance Trust Fund and the Supplemental Medical Insurance Trust Fund: Provided, That of the funds made available under this heading for carrying out title XX of the Public Health Service Act, $11,885,000 shall be for activities specified under section 2003(b)(2), of which $10,157,000 shall be for prevention service demonstration grants under section 510(b)(2) of title V of the Social Security Act, as amended, without application of the limitation of section 2010(c) of said title XX: Provided further, That of this amount, $50,000,000 is for minority AIDS prevention and treatment activities; and $18,400,000 is for an Information Technology Security and Innovation Fund for Department-wide activities involving cybersecurity, information technology security, and related innovation projects, and $5,000,000 is to assist Afghanistan in the development of maternal and child health clinics, consistent with section 103(a)(4)(H) of the Afghanistan Freedom Support Act of 2002. OFFICE FOR CIVIL RIGHTS For expenses necessary for the Office for Civil Rights, $30,936,000, 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. POLICY RESEARCH For carrying out, to the extent not otherwise provided, research studies under section 1110 of the Social Security Act and title III of the Public Health Service Act, $2,499,000: Provided, That in addition to amounts provided herein, $21,000,000 shall be available from amounts available under section 241 of the Public Health Service Act to carry out national health or human services research and evaluation activities: Provided further, That the expenditure of any funds available under section 241 of the Public Health Service Act are subject to the requirements of section 205 of this Act. PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND 41.0 Direct obligations: Personnel compensation: Full-time permanent ........ Civilian personnel benefits ....................................... Rental payments to GSA ........................................... Advisory and assistance services ............................. Other services ............................................................ Other purchases of goods and services from Government accounts ................................................. Grants, subsidies, and contributions ........................ 6 1,176 4 1,317 6 1,317 99.0 99.0 Direct obligations .................................................. 1,200 Reimbursable obligations .............................................. ................... 1,341 3 1,344 3 1,344 1,347 11.1 12.1 23.1 25.1 25.2 25.3 99.9 Total new obligations ................................................ 9 2 1 5 1 9 2 2 6 1 10 2 2 6 1 1,200 Personnel Summary 2002 actual Identification code 75–0142–0–1–506 2003 est. 2004 est. Direct: Total compensable workyears: 1001 Civilian full-time equivalent employment ................. 112 112 112 Reimbursable: Total compensable workyears: 2001 Civilian full-time equivalent employment ................. ................... 8 8 Allocation account: Total compensable workyears: 3001 Civilian full-time equivalent employment ................. 8 ................... ................... VerDate Jan 23 2003 19:03 Jan 23, 2003 Jkt 193833 PO 00000 Frm 00038 Fmt 3616 For expenses necessary to support activities related to countering potential biological, disease and chemical threats to civilian populations, $1,896,149,000, of which $100,000,000 shall be for activities to ensure a year-round influenza vaccine production capacity and the development and implementation of rapidly expandable production technologies: Provided, That the Secretary of Health and Human Services may increase funding for such pandemic influenza activities by transfer of up to $150,000,000 from available unobligated amounts in discretionary accounts (pursuant to the Balanced Budget and Emergency Deficit Control Act of 1985, as amended) of the Department of Health and Human Services funded in this or prior appropriations Acts: Provided further, That funding for pandemic influenza activities shall remain available until expended. Note.—A regular 2003 appropriation for this account had not been enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 107–229, as amended). The amounts included for 2003 in this budget reflect the Administration’s 2003 policy proposals. Program and Financing (in millions of dollars) 2002 actual Identification code 75–9912–0–1–551 2003 est. 2004 est. Obligations by program activity: Direct activities: 00.01 General departmental management ......................... 343 00.02 Office for Civil Rights ............................................... 28 00.03 Policy research .......................................................... 2 00.04 Public health and social services emergency fund 1,625 09.01 Reimbursable program .................................................. 141 09.02 Reimbursable program (HCFAC) .................................... ................... 341 30 2 1,807 168 6 353 31 2 1,896 186 5 10.00 2,354 2,473 Sfmt 3643 Total new obligations ................................................ E:\BUDGET\HHS.XXX HHS 2,139 DEPARTMENTAL MANAGEMENT—Continued Federal Funds—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES 21.40 22.00 Budgetary resources available for obligation: Unobligated balance carried forward, start of year New budget authority (gross) ........................................ 23.90 23.95 23.98 24.40 Total budgetary resources available for obligation Total new obligations .................................................... Unobligated balance expiring or withdrawn ................. Unobligated balance carried forward, end of year ....... New budget authority (gross), detail: Discretionary: 40.00 Appropriation ............................................................. 40.73 Reduction pursuant to P.L. 107–206 ....................... 42.00 Transferred from other accounts .............................. 43.00 68.00 68.00 68.10 68.90 70.00 109 2,182 147 2,356 149 2,475 2,291 2,503 2,624 ¥2,139 ¥2,354 ¥2,473 ¥4 ................... ................... 147 149 151 2,029 2,176 2,278 ¥3 ................... ................... 9 ................... ................... Spending authority from offsetting collections (total discretionary) .......................................... 147 180 197 Total new budget authority (gross) .......................... 2,182 2,356 2,475 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Adjustments in expired accounts (net) ......................... Change in uncollected customer payments from Federal sources (unexpired) ............................................ 74.10 Change in uncollected customer payments from Federal sources (expired) ................................................ 74.40 Obligated balance, end of year ..................................... 562 1,555 1,996 2,139 2,354 2,473 ¥1,092 ¥1,913 ¥2,432 ¥17 ................... ................... ¥66 ................... ................... 28 ................... ................... 1,555 1,996 2,037 86.90 86.93 Outlays (gross), detail: Outlays from new discretionary authority ..................... Outlays from discretionary balances ............................. 760 332 806 1,107 851 1,581 87.00 Total outlays (gross) ................................................. 1,092 1,913 2,432 Offsets: Against gross budget authority and outlays: 88.00 Offsetting collections (cash) from: Federal sources Against gross budget authority only: 88.95 Change in uncollected customer payments from Federal sources (unexpired) .................................. 88.96 Portion of offsetting collections (cash) credited to expired accounts ................................................... 89.00 90.00 99.00 99.01 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 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, as well as programs to counter bioterrorist threats. Object Classification (in millions of dollars) Appropriation (total discretionary) ........................ 2,035 2,176 2,278 Spending authority from offsetting collections: Offsetting collections (cash): Offsetting collections (cash) ................................ 81 174 192 Offsetting collections (cash) HCFAC .................... ................... 6 5 Change in uncollected customer payments from Federal sources (unexpired) .................................. 66 ................... ................... 72.40 73.10 73.20 73.40 74.00 439 ¥108 ¥180 ¥197 11.1 11.3 11.5 11.7 Direct obligations: Personnel compensation: Full-time permanent ............................................. Other than full-time permanent ........................... Other personnel compensation ............................. Military personnel ................................................. 11.9 12.1 12.2 21.0 23.1 23.3 Total personnel compensation ......................... Civilian personnel benefits ....................................... Military 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 ............................................................ Other purchases of goods and services from Government accounts ................................................. Operation and maintenance of facilities .................. Operation and maintenance of equipment ............... Supplies and materials ............................................. Equipment ................................................................. Grants, subsidies, and contributions ........................ 24.0 25.1 25.2 25.3 25.4 25.7 26.0 31.0 41.0 99.0 99.0 11.1 11.3 11.5 11.8 Direct obligations .................................................. Reimbursable obligations .............................................. Allocation Account: Personnel compensation: Full-time permanent ............................................. Other than full-time permanent ........................... Other personnel compensation ............................. Special personal services payments .................... 11.9 12.1 21.0 23.1 23.3 ¥66 ................... ................... 27 ................... ................... 2,035 982 2,176 1,733 2,278 2,235 Additional net budget authority and outlays to cover cost of fully accruing retirement: Budget authority ............................................................ 10 10 Outlays ........................................................................... 10 10 12 12 Note.—The reimbursable program (HCFAC) in Departmental Management reflects the estimated distribution from the allocation account for fiscal year 2003 and 2004. Actual 2003 and 2004 distributions will be determined by the Secretary of HHS and the Attorney General. 2002 actual Identification code 75–9912–0–1–551 25.1 25.2 25.3 25.4 25.5 25.6 25.7 26.0 31.0 41.0 42.0 2003 est. 2004 est. 106 4 3 2 113 6 2 3 115 6 2 3 115 24 1 6 15 124 26 1 6 18 126 27 1 4 24 4 2 7 24 6 2 1 37 4 2 1 41 48 9 18 5 7 111 43 8 25 8 7 127 41 9 28 3 3 134 396 142 439 174 448 191 29 13 13 3 2 2 2 2 2 1 ................... ................... Total personnel compensation ......................... 35 17 17 Civilian personnel benefits ....................................... 10 9 9 Travel and transportation of persons ....................... 4 3 3 Rental payments to GSA ........................................... ................... 5 5 Communications, utilities, and miscellaneous charges ................................................................. 7 3 3 Advisory and assistance services ............................. 51 11 11 Other services ............................................................ 36 12 12 Other purchases of goods and services from Government accounts ................................................. 63 22 22 Operation and maintenance of facilities .................. 39 52 52 Research and development contracts ....................... 22 22 22 Medical care .............................................................. 6 ................... ................... Operation and maintenance of equipment ............... 1 1 1 Supplies and materials ............................................. 6 20 20 Equipment ................................................................. 20 14 14 Grants, subsidies, and contributions ........................ 1,301 1,549 1,642 Insurance claims and indemnities ........................... ................... 1 1 99.0 Allocation account ................................................ 1,601 1,741 1,834 99.9 Total new obligations ................................................ 2,139 2,354 2,473 (Dollars in millions) 2002 actual Distribution of budget authority by account: General Departmental Management ....................................... Office for Civil Rights ............................................................. Policy Research ....................................................................... Public Health and Social Services Emergency Fund .............. Distribution of outlays by account: General Departmental Management ....................................... Office for Civil Rights ............................................................. Policy research ........................................................................ Public Health and Social Services Emergency Fund .............. 2003 est. 2004 est. 334 28 2 1,671 337 30 2 1,807 349 31 2 1,896 319 25 11 627 324 30 2 1,377 341 32 2 1,860 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 and health information privacy compliance enforcement programs; and support research to develop policy initiatives and VerDate Jan 23 2003 19:03 Jan 23, 2003 Jkt 193833 PO 00000 Frm 00039 Fmt 3616 Personnel Summary 2002 actual Identification code 75–9912–0–1–551 Direct: Total compensable workyears: 1001 Civilian full-time equivalent employment ................. 1101 Military full-time equivalent employment ................. Reimbursable: Total compensable workyears: 2001 Civilian full-time equivalent employment ................. 2003 est. 2004 est. 1,300 61 1,424 61 1,419 61 257 277 278 f ALLOCATIONS RECEIVED FROM OTHER ACCOUNTS Note.—Obligations incurred under allocations from other accounts are included in the schedules of the parent appropriation as follows: Centers for Medicare and Medicaid Services ‘‘Health Care Fraud and Abuse Control Account.’’ Sfmt 3616 E:\BUDGET\HHS.XXX HHS 440 PROGRAM SUPPORT CENTER Federal Funds—Continued THE BUDGET FOR FISCAL YEAR 2004 Uniformed Services Non-Medicare Eligible Retiree Health Care Accrual Proposal Effects on Public Health Accounts in 2004 PROGRAM SUPPORT CENTER General and special funds: RETIREMENT PAY AND (Dollars in millions) 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, and for medical care of dependents and retired personnel under the Dependents’ Medical Care Act (10 U.S.C. ch. 55 and 56), such amounts as may be required during the current fiscal year. Note.—A regular 2003 appropriation for this account had not been enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 107–229, as amended). The amounts included for 2003 in this budget reflect the Administration’s 2003 policy proposals. Program and Financing (in millions of dollars) 2002 actual Identification code 75–0379–0–1–551 2003 est. 2004 est. Obligations by program activity: Retirement payments ..................................................... Survivors’ benefits ......................................................... Medical care .................................................................. 204 13 56 219 14 52 234 15 54 10.00 Total new obligations ................................................ 273 285 303 22.00 23.95 23.98 Budgetary resources available for obligation: New budget authority (gross) ........................................ Total new obligations .................................................... Unobligated balance expiring or withdrawn ................. Change in obligated balances: 72.40 Obligated balance, start of year ................................... 73.10 Total new obligations .................................................... 73.20 Total outlays (gross) ...................................................... 73.40 Adjustments in expired accounts (net) ......................... 74.40 Obligated balance, end of year ..................................... 278 285 303 20 45 49 273 285 303 ¥253 ¥281 ¥301 5 ................... ................... 45 49 51 Outlays (gross), detail: Outlays from new mandatory authority ......................... Outlays from mandatory balances ................................ 234 19 242 39 258 43 87.00 Total outlays (gross) ................................................. 253 281 301 99.00 99.01 278 253 285 281 303 301 Additional net budget authority and outlays to cover cost of fully accruing retirement: Budget authority ............................................................ ................... ................... Outlays ........................................................................... ................... ................... 27 27 Summary of Budget Authority and Outlays (in millions of dollars) Enacted/requested: 2002 actual 2003 est. Budget Authority ..................................................................... 278 285 Outlays .................................................................................... 253 281 Legislative proposal, not subject to PAYGO: Budget Authority ..................................................................... .................... .................... Outlays .................................................................................... .................... .................... Total: Budget Authority ..................................................................... Outlays .................................................................................... 278 253 285 281 2004 est. 303 301 19:03 Jan 23, 2003 Jkt 193833 ¥27 Object Classification (in millions of dollars) 2002 actual Identification code 75–0379–0–1–551 2003 est. 2004 est. 13.0 25.6 Benefits for former personnel ........................................ Medical care .................................................................. 217 56 233 52 249 54 99.9 Total new obligations ................................................ 273 285 303 RETIREMENT PAY AND MEDICAL BENEFITS OFFICERS FOR COMMISSIONED (Legislative proposal, not subject to PAYGO) PO 00000 Frm 00040 2002 actual Identification code 75–0379–2–1–551 2003 est. 2004 est. 00.03 Obligations by program activity: Medical care .................................................................. ................... ................... 13 10.00 Total new obligations (object class 12.2) ................ ................... ................... 13 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ ................... ................... Total new obligations .................................................... ................... ................... 13 ¥13 New budget authority (gross), detail: Discretionary: 40.00 Appropriation ............................................................. ................... ................... 13 73.10 73.20 Change in obligated balances: Total new obligations .................................................... ................... ................... Total outlays (gross) ...................................................... ................... ................... 13 ¥13 86.90 Outlays (gross), detail: Outlays from new discretionary authority ..................... ................... ................... 13 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ ................... ................... Outlays ........................................................................... ................... ................... 13 13 A Department of Defense legislative proposal will change the accrual amount that HHS pays into the Uniformed Services Retiree Health Care Fund for health benefits for Medicare-eligible Public Health Service Commissioned Corps officers. The new accrual rate more accurately reflects the allofficer nature of the Commissioned Corps. f 13 13 HEALTH ACTIVITIES FUNDS 316 314 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. The estimates in the following table support the President’s Budget proposal to extend accrual financing for health care provided to non-Medicare-eligible uniformed services retirees. VerDate Jan 23 2003 Change to Public Health Discretionary Appropriation ................................... ...................... Program and Financing (in millions of dollars) 278 285 303 ¥273 ¥285 ¥303 ¥5 ................... ................... 86.97 86.98 Net budget authority and outlays: 89.00 Budget authority ............................................................ 90.00 Outlays ........................................................................... Discretionary f 00.01 00.02 00.03 New budget authority (gross), detail: Mandatory: 60.00 Appropriation ............................................................. Mandatory Mandatory Offsetting Collection through the Defense Health Account from the Uniformed Services Retiree Health Care Fund for NonMedicare Eligible Retiree Health Care: Public Health Service ..................................................................................... 54 .................... Adjustments to Public Health Discretionary Appropriation Payments to the Uniformed Services Retiree Health Care Fund Ret. Pay and Med. Benefits for Commissioned Officers Account ........................................... ...................... 27 Adj. to Ret. Pay and Med. Benefits for Commissioned Officers Account ...................... ¥54 Fmt 3616 Program and Financing (in millions of dollars) 2002 actual Identification code 75–9913–0–1–552 2003 est. 2004 est. 21.40 24.40 Budgetary resources available for obligation: Unobligated balance carried forward, start of year Unobligated balance carried forward, end of year ....... 7 7 7 7 7 7 72.40 74.40 Change in obligated balances: Obligated balance, start of year ................................... Obligated balance, end of year ..................................... 2 2 2 2 2 2 Sfmt 3643 E:\BUDGET\HHS.XXX HHS PROGRAM SUPPORT CENTER—Continued Trust Funds DEPARTMENT OF HEALTH AND HUMAN SERVICES 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ ................... ................... ................... Outlays ........................................................................... ................... ................... ................... 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. f Intragovernmental funds: HHS SERVICE AND SUPPLY FUND Program and Financing (in millions of dollars) 2002 actual Identification code 75–9941–0–4–551 2003 est. 2004 est. Object Classification (in millions of dollars) 11.1 11.3 11.5 11.7 11.9 12.1 12.2 21.0 22.0 23.1 23.3 24.0 25.1 25.2 25.3 Obligations by program activity: Program support center ................................................. Federal employee occupational health .......................... OS activities ................................................................... 287 110 8 320 129 7 321 138 7 10.00 Total new obligations ................................................ 405 456 466 21.40 22.00 22.10 Budgetary resources available for obligation: Unobligated balance carried forward, start of year New budget authority (gross) ........................................ Resources available from recoveries of prior year obligations ....................................................................... 25.4 25.6 26.0 31.0 69 417 89 456 89 466 99.9 23.90 23.95 24.40 Total budgetary resources available for obligation Total new obligations .................................................... Unobligated balance carried forward, end of year ....... 494 ¥405 89 545 ¥456 89 555 ¥466 89 New budget authority (gross), detail: Mandatory: 69.00 Offsetting collections (cash) ..................................... 69.10 Change in uncollected customer payments from Federal sources (unexpired) .................................. 385 456 466 69.90 Spending authority from offsetting collections (total mandatory) ............................................. Change in obligated balances: 72.40 Obligated balance, start of year ................................... 73.10 Total new obligations .................................................... 73.20 Total outlays (gross) ...................................................... 73.45 Recoveries of prior year obligations .............................. 74.00 Change in uncollected customer payments from Federal sources (unexpired) ............................................ 74.40 Obligated balance, end of year ..................................... 86.97 Outlays (gross), detail: Outlays from new mandatory authority ......................... Offsets: Against gross budget authority and outlays: 88.00 Offsetting collections (cash) from: Federal sources Against gross budget authority only: 88.95 Change in uncollected customer payments from Federal sources (unexpired) .................................. 89.00 90.00 456 466 ¥15 ¥46 ¥46 405 456 466 ¥397 ¥456 ¥466 ¥8 ................... ................... 456 Jkt 193833 2004 est. 73 2 2 8 77 2 2 8 Total personnel compensation .............................. Civilian personnel benefits ............................................ Military 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 ................................................................ Other purchases of goods and services from Government accounts ........................................................... Operation and maintenance of facilities ...................... Medical care .................................................................. Supplies and materials ................................................. Equipment ...................................................................... 78 19 4 3 2 11 8 1 13 100 85 18 3 3 2 13 8 1 15 119 89 19 4 3 3 13 8 2 15 109 27 18 34 80 7 31 21 39 86 12 32 21 40 94 14 Total new obligations ................................................ 405 456 466 This year’s budget includes an improved display for Public Health Service Commissioned Corps Officers. Most Commissioned Corps officers work for agencies in the Department of Health and Human Services. However, some of these officers are detailed to perform work in other Federal agencies. The allocation account section in the table below shows the total number of these detailed FTE. Personnel Summary 2002 actual Reimbursable: Total compensable workyears: 2001 Civilian full-time equivalent employment ................. 2101 Military full-time equivalent employment ................. Allocation account: Total compensable workyears: 3101 Military full-time equivalent employment ................. ¥32 ................... ................... ¥46 ¥46 ¥46 397 2003 est. 67 2 2 7 Identification code 75–9941–0–4–551 417 2003 est. 2004 est. 1,122 71 1,122 71 1,122 71 1,131 1,281 1,281 f 466 Trust Funds MISCELLANEOUS TRUST FUNDS ¥385 ¥456 ¥466 ¥32 ................... ................... HHS Service and Supply Fund (SSF) provides a wide range of logistical and support services to components of the Department and other Federal agencies. The Program Support Center line includes activities such as personnel and payroll administration, financial management operations, and administrative services, including acquisitions management, building and property management, information technology and telecommunication services, and medical supplies repackaging and distribution services. The Federal Occupational Health program is also financed by the SSF, and provides clinical health services, environmental and industrial hygiene-related services, and employee assistance programs. The Office of Secretary activities line includes the fund manager, departmental contracts, audit resolutions, and the regional health administrators. 19:03 Jan 23, 2003 Personnel compensation: Full-time permanent .................................................. Other than full-time permanent ............................... Other personnel compensation .................................. Military personnel ...................................................... 32 ................... ................... Net budget authority and outlays: Budget authority ............................................................ ................... ................... ................... Outlays ........................................................................... 11 ................... ................... VerDate Jan 23 2003 2002 actual Identification code 75–9941–0–4–551 09.01 09.02 09.03 8 ................... ................... 441 PO 00000 Frm 00041 Fmt 3616 Unavailable Collections (in millions of dollars) 2002 actual Identification code 75–9971–0–7–551 2003 est. 2004 est. 01.99 Balance, start of year .................................................... ................... ................... ................... Receipts: 02.00 Gifts and contributions, miscellaneous trust funds 47 47 47 02.20 Contributions, Indian health facilities, Health Services Administration ........................................................... 60 60 60 02.40 Interest, Miscellaneous trust funds ............................... 1 1 1 02.99 Total receipts and collections ................................... Appropriations: 05.00 Miscellaneous trust funds ............................................. 07.99 108 108 108 ¥108 ¥108 ¥108 Balance, end of year ..................................................... ................... ................... ................... Program and Financing (in millions of dollars) 2002 actual Identification code 75–9971–0–7–551 2003 est. 2004 est. 00.02 00.03 Obligations by program activity: Gifts ............................................................................... Contributions, Indian health facilities .......................... 38 42 48 60 48 60 10.00 Total new obligations ................................................ 80 108 108 Sfmt 3643 E:\BUDGET\HHS.XXX HHS 442 PROGRAM SUPPORT CENTER—Continued Trust Funds—Continued THE BUDGET FOR FISCAL YEAR 2004 Personnel Summary MISCELLANEOUS TRUST FUNDS—Continued 2002 actual Identification code 75–9971–0–7–551 Program and Financing (in millions of dollars)—Continued 2002 actual Identification code 75–9971–0–7–551 Budgetary resources available for obligation: 21.40 Unobligated balance carried forward, start of year 22.00 New budget authority (gross) ........................................ 23.90 23.95 24.40 Total budgetary resources available for obligation Total new obligations .................................................... Unobligated balance carried forward, end of year ....... 2003 est. Direct: Total compensable workyears: 1001 Civilian full-time equivalent employment ................. 2004 est. 74 108 101 108 101 108 182 ¥80 101 209 ¥108 101 209 ¥108 101 22 2003 est. 2004 est. 22 22 f OFFICE OF THE INSPECTOR GENERAL General and special funds: OFFICE OF INSPECTOR GENERAL New budget authority (gross), detail: Mandatory: 60.26 Appropriation (trust fund) ......................................... 108 108 108 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Obligated balance, end of year ..................................... For expenses necessary for the Office of Inspector General in carrying out the provisions of the Inspector General Act of 1978, as amended, $39,497,000: Provided, That, of such amount, necessary sums are available for providing protective services to the Secretary and investigating non-payment of child support cases for which nonpayment is a Federal offense under 18 U.S.C. 228. 76 80 ¥57 99 99 108 ¥78 129 129 108 ¥96 141 Note.—A regular 2003 appropriation for this account had not been enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 107–229, as amended). The amounts included for 2003 in this budget reflect the Administration’s 2003 policy proposals. 72.40 73.10 73.20 74.40 Program and Financing (in millions of dollars) Outlays (gross), detail: 86.97 Outlays from new mandatory authority ......................... 86.98 Outlays from mandatory balances ................................ 24 33 32 46 32 64 Identification code 75–0128–0–1–551 87.00 Total outlays (gross) ................................................. 57 78 96 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 00.01 09.01 09.02 108 57 108 78 108 96 10.00 Total new obligations ................................................ 21.40 22.00 23.90 23.95 24.40 Memorandum (non-add) entries: 92.01 Total investments, start of year: Federal securities: Par value ................................................................... 92.02 Total investments, end of year: Federal securities: Par value ................................................................... 25 30 30 30 30 30 [Dollars in millions] 2002 Distribution of budget authority by account: Gifts ........................................................................................ Contributions, Indian health facilities ................................... Distribution of outlays by account: Gifts ........................................................................................ Contributions, Indian health facilities ................................... 2003 2004 48 60 48 60 48 60 26 31 35 43 43 53 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. 2002 actual 11.1 11.3 11.9 21.0 22.0 25.1 25.2 25.3 25.4 25.5 25.7 26.0 31.0 32.0 41.0 99.9 Personnel compensation: Full-time permanent .................................................. Other than full-time permanent ............................... 2003 est. 2004 est. 1 1 1 1 1 1 Total personnel compensation .............................. 2 Travel and transportation of persons ............................ 1 Transportation of things ................................................ ................... Advisory and assistance services .................................. 1 Other services ................................................................ 11 Other purchases of goods and services from Government accounts ........................................................... 1 Operation and maintenance of facilities ...................... ................... Research and development contracts ........................... 8 Operation and maintenance of equipment ................... 22 Supplies and materials ................................................. 1 Equipment ...................................................................... 1 Land and structures ...................................................... 5 Grants, subsidies, and contributions ............................ 27 2 1 1 1 15 2 1 1 1 15 1 1 11 30 1 1 7 36 1 1 11 30 1 1 7 36 108 108 Frm 00042 Fmt 3616 Total new obligations ................................................ VerDate Dec 13 2002 15:09 Jan 23, 2003 Jkt 193833 80 PO 00000 Obligations by program activity: Direct program ............................................................... 36 HCFAC reimbursable program ....................................... ................... Reimbursable program .................................................. 17 69.00 2004 est. 40 166 12 39 166 12 53 218 217 Budgetary resources available for obligation: Unobligated balance carried forward, start of year New budget authority (gross) ........................................ 1 52 1 218 1 217 Total budgetary resources available for obligation Total new obligations .................................................... Unobligated balance carried forward, end of year ....... 53 ¥53 1 219 ¥218 1 218 ¥217 1 36 40 39 6 12 12 New budget authority (gross), detail: Discretionary: 40.00 Appropriation ............................................................. Spending authority from offsetting collections: 68.00 Offsetting collections (cash) ..................................... 68.10 Change in uncollected customer payments from Federal sources (unexpired) .................................. 68.90 2003 est. 10 ................... ................... Spending authority from offsetting collections (total discretionary) .......................................... 16 Mandatory: Offsetting collections (cash) ..................................... ................... 70.00 Total new budget authority (gross) .......................... 52 12 12 166 166 218 217 Change in obligated balances: Obligated balance, start of year ................................... 1 ................... 4 Total new obligations .................................................... 53 218 217 Total outlays (gross) ...................................................... ¥54 ¥214 ¥217 Change in uncollected customer payments from Federal sources (unexpired) ............................................ ¥10 ................... ................... 74.10 Change in uncollected customer payments from Federal sources (expired) ................................................ 11 ................... ................... 74.40 Obligated balance, end of year ..................................... ................... 4 4 72.40 73.10 73.20 74.00 Object Classification (in millions of dollars) Identification code 75–9971–0–7–551 2002 actual 86.90 86.93 86.97 Outlays (gross), detail: Outlays from new discretionary authority ..................... 32 48 Outlays from discretionary balances ............................. 22 ................... Outlays from new mandatory authority ......................... ................... 166 87.00 Total outlays (gross) ................................................. Offsets: Against gross budget authority and outlays: 88.00 Offsetting collections (cash) from: Federal sources Against gross budget authority only: 88.95 Change in uncollected customer payments from Federal sources (unexpired) .................................. 88.96 Portion of offsetting collections (cash) credited to expired accounts ................................................... Sfmt 3643 E:\BUDGET\HHS.XXX HHS 47 4 166 54 214 217 ¥18 ¥178 ¥178 ¥10 ................... ................... 12 ................... ................... GENERAL PROVISIONS DEPARTMENT OF HEALTH AND HUMAN SERVICES 89.00 90.00 99.00 99.01 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... General Fund Offsetting receipts from the public ..................... 36 36 40 36 (In millions of dollars) 2003 est. 2004 est. Budget Authority: Discretionary appropriations ................................................... Mandatory (HCFAC Account) ................................................... 36 139 40 160 39 160 Total ............................................................................... 175 200 199 Note.—The reimbursable program (HCFAC) in Office of the Inspector General reflects the estimated distrubiton of the allocation account for fiscal years 2003 and 2004. Actual 2003 and 2004 distributions will be determined by the Secretary of HHS and the Attorney General. 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 399F(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, the Agency for Healthcare Research and Quality, 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 II. SEC. 205. Notwithstanding section 241(a) of the Public Health Service Act, such portion as the Secretary shall determine, but not more than 1.25 percent, of any amounts appropriated for programs authorized under said Act shall be made available for the evaluation (directly, or by grants or contracts) of the implementation and effectiveness of such programs. (TRANSFER Object Classification (in millions of dollars) 2002 actual 2003 est. 2004 est. 31.0 Direct obligations: Personnel compensation: Full-time permanent ........ Civilian personnel benefits ....................................... Travel and transportation of persons ....................... Rental payments to GSA ........................................... Other purchases of goods and services from Government accounts ................................................. Equipment ................................................................. 99.0 99.0 Direct obligations .................................................. Reimbursable obligations .............................................. 36 17 40 178 39 178 99.9 Total new obligations ................................................ 53 218 217 11.1 12.1 21.0 23.1 25.3 20 6 2 3 24 6 2 3 4 1 24 6 2 3 4 4 1 ................... Personnel Summary 2002 actual Identification code 75–0128–0–1–551 Direct: Total compensable workyears: 1001 Civilian full-time equivalent employment ................. Reimbursable: Total compensable workyears: 2001 Civilian full-time equivalent employment ................. Allocation account: Total compensable workyears: 3001 Civilian full-time equivalent employment ................. 2003 est. 2004 est. 296 320 307 56 1,320 1,252 1,217 ................... ................... f ALLOCATIONS RECEIVED FROM OTHER ACCOUNTS Note.—Obligations incurred under allocations from other accounts are included in the schedules of the parent appropriations as follows: Centers for Medicare and Medicaid Services ‘‘Health Care Fraud and Abuse Control Account.’’ f GENERAL FUND RECEIPT ACCOUNTS (in millions of dollars) 2002 actual 2003 est. Offsetting receipts from the public: 75–310700 Federal share of child support collections ...... 1,235 1,117 Legislative proposal, subject to PAYGO ............................. ................... ................... VerDate Dec 13 2002 15:09 Jan 23, 2003 Jkt 193833 PO 00000 Frm 00043 1,151 f 10 10 The Office of Inspector General (OIG) 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 OIG, the Health Insurance Portability and Accountability Act of 1996 makes available mandatory funding for use by the OIG. These funds are used to combat Medicare, Medicaid, and State Children’s Health Insurance Program (SCHIP) 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: Identification code 75–0128–0–1–551 1,117 39 39 Additional net budget authority and outlays to cover cost of fully accruing retirement: Budget authority ............................................................ 9 9 Outlays ........................................................................... 9 9 2002 actual 1,235 443 2004 est. 1,137 14 Fmt 3616 OF FUNDS) SEC. 206. Not to exceed 3 percent of any discretionary funds (pursuant to the Balanced Budget and Emergency Deficit Control Act of 1985, as amended) which are appropriated for the current fiscal year for the Department of Health and Human Services in this or any other Act may be transferred between appropriations, but no such appropriation shall be increased by more than 10 percent by any such transfer: Provided, That the Appropriations Committees of both Houses of Congress are notified at least 15 days in advance of any transfer. SEC. 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. SEC. 208. 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 the National Institutes of Health 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. SEC. 209. 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. SEC. 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. Sfmt 3616 E:\BUDGET\HHS.XXX HHS 444 GENERAL PROVISIONS—Continued (TRANSFER THE BUDGET FOR FISCAL YEAR 2004 OF FUNDS)—Continued SEC. 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. SEC. 212. (a) Except as provided by subsection (e) none of the funds appropriated by this Act may be used to withhold substance abuse funding from a State pursuant to section 1926 of the Public Health Service Act (42 U.S.C. 300x–26) if such State certifies to the Secretary of Health and Human Services by May 1, 2004 that the State will commit additional State funds, in accordance with subsection (b), to ensure compliance with State laws prohibiting the sale of tobacco products to individuals under 18 years of age. (b) The amount of funds to be committed by a State under subsection (a) shall be equal to 1 percent of such State’s substance abuse block grant allocation for each percentage point by which the State misses the retailer compliance rate goal established by the Secretary of Health and Human Services under section 1926 of such Act. (c) The State is to maintain State expenditures in fiscal year 2004 for tobacco prevention programs and for compliance activities at a level that is not less than the level of such expenditures maintained by the State for fiscal year 2003, and adding to that level the additional funds for tobacco compliance activities required under subsection (a). The State is to submit a report to the Secretary on all fiscal year 2003 State expenditures and all fiscal year 2004 obligations for tobacco prevention and compliance activities by program activity by July 31, 2004. (d) The Secretary shall exercise discretion in enforcing the timing of the State obligation of the additional funds required by the certification in subsection (a) as late as July 31, 2004. VerDate Dec 13 2002 15:09 Jan 23, 2003 Jkt 193833 PO 00000 Frm 00044 Fmt 3616 (e) None of the funds appropriated by this Act may be used to withhold substance abuse funding pursuant to section 1926 from a territory that receives less than $1,000,000. SEC. 213. In order for the Centers for Disease Control and Prevention to carry out international health activities, including HIV/AIDS and other infectious disease, chronic and environmental disease, and other health activities abroad during fiscal year 2004, the Secretary of Health and Human Services is authorized to— (1) utilize the authorities contained in subsection 2(c) of the State Department Basic Authorities Act of 1956, as amended; and (2) utilize the authorities contained in 22 U.S.C. 291 and 292 and directly or through contract or cooperative agreement to lease, alter or renovate facilities in foreign countries, to carry out programs supported by this appropriation notwithstanding PHS Act section 307. In exercising the authority set forth in paragraphs (1) and (2), the Secretary of Health and Human Services shall consult with the Department of State to assure that planned activities are within the legal strictures of the State Department Basic Authorities Act of 1956, as amended, and other applicable parts of title 22, United States Code. SEC. 214. The Division of Federal Occupational Health may utilize personal services contracting to employ professional management/administrative and occupational health professionals. SEC. 215. With the funds appropriated to the National Institutes of Health in this Act, NIH is authorized to obligate in fiscal year 2004 the full multi-year cost of a grant or contract that is awarded in that year, and any funds which may be deobligated subsequently shall remain available until expended for the same purposes. Sfmt 3616 E:\BUDGET\HHS.XXX HHS