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DEPARTMENT OF HEALTH AND HUMAN SERVICES 00.07 00.08 00.09 09.01 FOOD AND DRUG ADMINISTRATION Federal Funds SALARIES AND Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. AND Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. Special and Trust Fund Receipts (in millions of dollars) Identification code 75–9911–0–1–554 2006 actual 2007 est. 2008 est. Balance, start of year .................................................... ................... ................... ................... Receipts: 02.00 User fees, FDA—legislative proposal subject to PAYGO ................... ................... 23 02.01 User fees, FDA—legislative proposal subject to PAYGO ................... ................... 4 02.20 Cooperative research and development agreements, FDA ............................................................................ 1 1 1 Total receipts and collections ................................... 1 1 28 Total: Balances and collections .................................... Appropriations: 05.00 Salaries and expenses ................................................... 1 1 28 ¥1 ¥1 ¥1 05.99 ¥1 ¥1 ¥1 Balance, end of year ..................................................... ................... ................... 27 04.00 07.99 132 5 1 62 10.00 Total new obligations ................................................ 1,905 1,861 1,703 21.40 22.00 Budgetary resources available for obligation: Unobligated balance carried forward, start of year New budget authority (gross) ........................................ 99 1,922 116 1,861 116 1,704 23.90 23.95 Total budgetary resources available for obligation Total new obligations .................................................... 2,021 ¥1,905 1,977 ¥1,861 1,820 ¥1,703 24.40 Unobligated balance carried forward, end of year 116 116 117 New budget authority (gross), detail: Discretionary: 40.00 Appropriation ............................................................. 40.35 Appropriation permanently reduced .......................... 1,510 1,490 1,641 ¥15 ................... ................... 43.00 1,495 1,490 1,641 433 370 62 58.00 58.10 58.26 58.45 58.90 Spending authority from offsetting collections (total discretionary) .......................................... Mandatory: Appropriation (special fund) ..................................... 70.00 Total new budget authority (gross) .......................... 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) ................................................ 72.40 73.10 73.20 73.40 74.00 74.40 Total appropriations .................................................. 86.90 86.93 86.97 86.98 87.00 Obligated balance, end of year ................................ 19 ................... ................... 186 212 212 ¥212 ¥212 ¥212 426 370 62 1 1 1 1,922 1,861 1,704 491 414 518 1,905 1,861 1,703 ¥1,900 ¥1,757 ¥1,652 ¥1 ................... ................... ¥19 ................... ................... ¥62 ................... ................... 414 518 569 Program and Financing (in millions of dollars) Identification code 75–9911–0–1–554 Obligations by program activity: Foods .............................................................................. Drugs .............................................................................. Devices and radiological products ................................ National Center for Toxicological Research ................... Other activities .............................................................. Other rent and rent related activities ........................... 2006 actual 1,900 1,757 1,652 Offsets: Against gross budget authority and outlays: Offsetting collections (cash) from: 88.00 Federal sources ..................................................... 88.45 Offsetting governmental collections (from nonFederal sources) ............................................... ¥49 ¥45 ¥45 ¥402 ¥325 ¥17 88.90 ¥451 ¥370 ¥62 439 526 220 41 86 57 88.96 2007 est. 439 526 220 41 86 57 Outlays (gross), detail: Outlays from new discretionary authority ..................... 1,520 1,484 1,292 Outlays from discretionary balances ............................. 377 272 359 Outlays from new mandatory authority ......................... ................... 1 1 Outlays from mandatory balances ................................ 3 ................... ................... Total outlays (gross) ................................................. 88.95 00.01 00.02 00.03 00.04 00.05 00.06 Appropriation (total discretionary) ........................ Spending authority from offsetting collections: Offsetting collections (cash) ................................ Change in uncollected customer payments from Federal sources (unexpired) ............................. Offsetting collections (previously unavailable) .... Portion precluded from obligation (limitation on obligations) ....................................................... Balance, start of year .................................................... ................... ................... ................... 01.99 02.99 116 5 1 370 60.20 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, $4,950,000, to remain available until expended. 01.00 116 8 1 411 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 Public Law 107–188; $1,649,405,000: Provided, That of the amount provided under this heading, $13,696,000 shall be derived from animal drug 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 animal drug assessments received during fiscal year 2008, including any such fees assessed prior to the current fiscal year but credited during the current year, shall be subject to the fiscal year 2008 limitation. 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 Rental payments ............................................................ Buildings and facilities ................................................. CRADAs .......................................................................... Reimbursable program .................................................. 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 ................................................... ¥19 ................... ................... 18 ................... ................... 2008 est. 467 574 240 36 88 98 89.00 90.00 94.01 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 1,470 1,449 1,491 1,387 1,642 1,590 Memorandum (non-add) entries: Unavailable balance, start of year: Offsetting collections ........................................................................... 186 212 212 393 394 FOOD AND DRUG ADMINISTRATION—Continued Federal Funds—Continued BUILDINGS AND THE BUDGET FOR FISCAL YEAR 2008 32.0 41.0 42.0 FACILITIES—Continued Program and Financing (in millions of dollars)—Continued Identification code 75–9911–0–1–554 94.02 2006 actual Unavailable balance, end of year: Offsetting collections ........................................................................... 212 2007 est. 212 2008 est. 212 Land and structures .................................................. Grants, subsidies, and contributions ........................ Insurance claims and indemnities ........................... 6 28 2 4 28 2 4 30 2 99.0 99.0 Direct obligations .................................................. Reimbursable obligations .............................................. 1,493 412 1,491 370 1,641 62 99.9 Total new obligations ................................................ 1,905 1,861 1,703 Employment Summary [In millions of dollars] 2006 Distribution of budget authority by account: Salaries and expenses ............................................................ Buildings and facilities .......................................................... Distribution of outlays by account: Salaries and expenses ............................................................ Buildings and facilities .......................................................... 2007 2008 Identification code 75–9911–0–1–554 1,486 9 1,485 5 1,636 5 1,465 9 1,384 5 1,585 5 Summary of Budget Authority and Outlays (in millions of dollars) 2006 actual 2007 est. 2008 est. Enacted/requested: Budget Authority ..................................................................... 1,470 1,491 1,642 Outlays .................................................................................... 1,449 1,387 1,590 Legislative proposal, not subject to PAYGO: Budget Authority ..................................................................... .................... .................... .................... Outlays .................................................................................... .................... .................... .................... Total: Budget Authority ..................................................................... Outlays .................................................................................... 1,470 1,449 1,491 1,387 1,642 1,590 The Food and Drug Administration (FDA) is responsible for protecting the public health by assuring the safety, efficacy, and security of human and veterinary drugs, biological products, medical devices, our Nation’s food supply, cosmetics, and products that emit radiation. The FDA is also responsible for advancing the public health by helping to speed innovations that make medicines more effective and helping to provide the public accurate, science-based information about medicines and foods to improve their health. FDA decisions affect Americans on a daily basis. The Budget includes funding for counterterrorism activities that specifically relate to the protection of products or therapies 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. Specifically, the Budget requests funding for generic and other drug review, drug safety, food safety, medical device review and safety, and headquarters consolidation in White Oak, Maryland. SALARIES 11.1 11.3 11.5 11.7 11.9 12.1 12.2 13.0 21.0 22.0 23.1 23.2 23.3 24.0 25.1 25.2 25.3 25.4 25.5 25.7 26.0 31.0 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 ....................... 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 ................................................................. 2006 actual 2007 est. 2008 est. ..................... ..................... 7,319 573 6,965 545 7,407 580 ..................... ..................... 1,717 135 1,462 114 146 11 ..................... ..................... 28 1 28 1 28 1 AND EXPENSES (Legislative proposal, not subject to PAYGO) Contingent upon the enactment of authorizing legislation, the Secretary shall charge a fee for generic drug review activities: Provided, That such fees, in an amount not to exceed $15,701,000, shall be credited as an offsetting collection to this account, to remain available until expended for the purpose of such generic drug review activities. In addition, contingent upon the enactment of authorizing legislation, the Secretary shall charge a fee for prescription drug review activities and medical device review activities: Provided, That such fees, in an amount not to exceed $339,195,000, for prescription drug reviews, shall be credited to this account and remain available until expended for the purpose of such prescription drug reviews, and shall not include any prescription drug review fees assessed for fiscal year 2009 but collected in fiscal year 2008; and $47,500,000 for medical device reviews, shall be credited to this account, to remain available until expended for the purpose of such medical device review activities: Provided further, That fees derived from prescription drug and medical device review assessments received during fiscal year 2008, including any such fees assessed prior to the current fiscal year but credited during the current year, shall be subject to the fiscal year 2008 limitation. In addition, contingent upon the enactment of authorizing legislation, the Secretary shall charge a fee for mammography-related activities: Provided, That such fees shall be credited as an offsetting collection to this account, to remain available until expended for the purpose of ensuring mammography quality. Object Classification (in millions of dollars) Identification code 75–9911–0–1–554 2006 actual Direct: 1001 Civilian full-time equivalent employment 1101 Military full-time equivalent employment Reimbursable: 2001 Civilian full-time equivalent employment 2101 Military full-time equivalent employment Allocation account: 3001 Civilian full-time equivalent employment 3101 Military full-time equivalent employment Program and Financing (in millions of dollars) 2007 est. 2008 est. 547 73 24 44 533 71 23 42 609 81 27 48 688 172 23 5 22 4 116 4 669 167 22 5 21 3 127 21 765 191 26 6 23 4 132 4 30 3 52 97 31 3 52 96 33 3 56 104 92 50 26 21 26 26 95 48 26 21 24 26 99 52 28 23 28 28 Identification code 75–9911–2–1–554 2006 actual 2007 est. ................... ................... ................... ................... ................... ................... ................... ................... 339 48 18 16 10.00 Total new obligations ................................................ ................... ................... 421 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ ................... ................... Total new obligations .................................................... ................... ................... 421 ¥421 Obligations by program activity: 09.01 Reimbursable program—PDUFA .................................... 09.02 Reimbursable program—MDUFMA ................................ 09.03 Reimbursable program—MQSA ..................................... 09.04 Reimbursable program- Generic Drugs ......................... 24.40 2008 est. Unobligated balance carried forward, end of year ................... ................... ................... New budget authority (gross), detail: Discretionary: 58.00 Spending authority from offsetting collections: Offsetting collections (cash) ..................................... ................... ................... 421 73.10 73.20 Change in obligated balances: Total new obligations .................................................... ................... ................... Total outlays (gross) ...................................................... ................... ................... 421 ¥421 86.90 Outlays (gross), detail: Outlays from new discretionary authority ..................... ................... ................... 421 HEALTH RESOURCES AND SERVICES ADMINISTRATION Federal DEPARTMENT OF HEALTH AND HUMAN SERVICES Offsets: Against gross budget authority and outlays: 88.45 Offsetting collections (cash) from: Offsetting governmental collections (from non-Federal sources) ................... ................... 86.98 87.00 The 2008 Budget includes a number of new and current user fees. Legislation will be proposed to allow FDA to collect fees to support generic drug review activities. The additional resources, estimated at $16 million in 2008, would enable FDA to reduce review times and respond to the growing number of generic drug applications. The budget also reproposes user fees to support activities related to re-inspections of FDA-regulated facilities and issue export certificates for food and animal feeds. Lastly, the budget includes a total of $339 million in prescription drug user fees, $48 million in medical device user fees, and $18 million in mammography user fees. Authorizing language for these fees will be proposed to reauthorize the collection and spending of the fees subject to appropriations language. Object Classification (in millions of dollars) 2006 actual 2007 est. Outlays from mandatory balances ................................ ................... 2 2 Total outlays (gross) ................................................. 5 7 7 Offsets: Against gross budget authority and outlays: 88.40 Offsetting collections (cash) from: Non-Federal sources .................................................................. ¥7 ¥7 ¥7 ¥421 Net budget authority and outlays: 89.00 Budget authority ............................................................ ................... ................... ................... 90.00 Outlays ........................................................................... ................... ................... ................... Identification code 75–9911–2–1–554 395 2008 est. 89.00 90.00 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) Identification code 75–4309–0–3–554 11.1 12.1 23.1 25.2 26.0 31.0 99.9 99.0 Reimbursable obligations .......................................... ................... ................... Total new obligations ................................................ ................... ................... 2006 actual 2007 est. 2008 est. Reimbursable obligations: Personnel compensation: Full-time permanent ............. 3 3 3 Civilian personnel benefits ............................................ 1 1 1 Rental payments to GSA ................................................ 1 1 1 Other services ................................................................ ................... ................... 1 Supplies and materials ................................................. 1 1 1 Equipment ...................................................................... ................... 1 ................... Total new obligations ................................................ 421 6 7 7 421 99.9 Net budget authority and outlays: Budget authority ............................................................ ................... ................... ................... Outlays ........................................................................... ¥2 ................... ................... Employment Summary Identification code 75–9911–2–1–554 Identification code 75–4309–0–3–554 2006 actual Direct: 1001 Civilian full-time equivalent employment Reimbursable: 2001 Civilian full-time equivalent employment 2101 Military full-time equivalent employment Allocation account: 3001 Civilian full-time equivalent employment 3101 Military full-time equivalent employment 2007 est. 2008 est. ..................... ................... ................... ................... ..................... ................... ................... ..................... ................... ................... FOR 1,703 87 ..................... ................... ................... ................... ..................... ................... ................... ................... CERTIFICATION AND OTHER SERVICES 2006 actual 2007 est. 2008 est. Obligations by program activity: 09.01 Reimbursable program .................................................. 6 7 7 10.00 Total new obligations ................................................ 6 7 7 21.40 22.00 Budgetary resources available for obligation: Unobligated balance carried forward, start of year New budget authority (gross) ........................................ 1 7 2 7 2 7 23.90 23.95 Total budgetary resources available for obligation Total new obligations .................................................... 8 ¥6 9 ¥7 9 ¥7 24.40 Unobligated balance carried forward, end of year 2 2 2 New budget authority (gross), detail: Mandatory: 69.00 Spending authority from offsetting collections: Offsetting collections (cash) ..................................... 7 7 7 72.40 73.10 73.20 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... 1 6 ¥5 2 7 ¥7 2 7 ¥7 74.40 Obligated balance, end of year ................................ 2 2 2 86.97 Outlays (gross), detail: Outlays from new mandatory authority ......................... 5 5 5 33 2007 est. 31 2008 est. 34 f HEALTH RESOURCES AND SERVICES ADMINISTRATION Federal HEALTH RESOURCES Program and Financing (in millions of dollars) Identification code 75–4309–0–3–554 2006 actual Reimbursable: 2001 Civilian full-time equivalent employment ..................... f REVOLVING FUND Employment Summary AND SERVICES For carrying out titles II, III, IV, VII, VIII, X, XII, and XXVI of the Public Health Service Act (‘‘PHS Act’’), section 427(a) of the Federal Coal Mine Health and Safety Act, title V and sections 1128E, and 711 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, and section 712 of the American Jobs Creation Act of 2004, $5,795,805,000: Provided, That of the funds made available under this heading, $100,000 shall be available until expended for facilities renovations at the Gillis W. Long Hansen’s Disease Center: Provided further, That in addition to fees authorized by section 427(b) of the Health Care Quality Improvement Act of 1986, fees shall be collected for the full disclosure of information under the Act sufficient to recover the full costs of operating the National Practitioner Data Bank, and shall remain available until expended to carry out that Act: Provided further, That no more than $100,000 is available until expended for carrying out 42 U.S.C. 233(o) including administrative expenses: Provided further, That $1,966,000 is available until expended for the National Cord Blood Stem Cell Program: Provided further, That fees collected for the full disclosure of information under the ‘‘Health 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 $44,055,000 is available until expended for carrying out the provisions of Public Law 104– 73 and for expenses incurred by the Department of Health and Human Services pertaining to administrative claims made under such law: Provided further, That $26,000,000 of funding provided for health centers shall be used for high-need counties, notwithstanding section 330(r)(2)(B) of the PHS Act: Provided further, That of the funds made available under this heading, $283,103,000 shall be for the program 396 HEALTH RESOURCES AND SERVICES ADMINISTRATION—Continued Federal—Continued HEALTH RESOURCES AND THE BUDGET FOR FISCAL YEAR 2008 40.36 41.00 SERVICES—Continued under title X of the PHS 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 of the funds available under this heading, $1,819,511,000 shall remain available to the Secretary until September 30, 2010, for parts A and B of title XXVI of the PHS Act; Provided further, That $814,546,000 shall be for State AIDS Drug Assistance Programs authorized by section 2616 of the PHS Act: Provided further, That in addition to amounts provided herein, $25,000,000 shall be available from amounts available under section 241 of the PHS Act to carry out parts A, B, C, and D of title XXVI of the PHS Act to fund section 2691 Special Projects of National Significance. Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. Program and Financing (in millions of dollars) Identification code 75–0350–0–1–550 2006 actual 2007 est. Obligations by program activity: 00.07 Loan Guarantee Downward Reestimate ......................... 1 ................... 00.10 Health centers ................................................................ 1,740 1,738 00.11 National Health Service Corps ....................................... 40 40 00.12 National Health Service Corps recruitment ................... 85 85 00.13 Hansen’s Disease Center ............................................... 16 16 00.14 Payment to Hawaii for the treatment of Hansen’s disease ...................................................................... 2 2 00.15 Black lung clinics .......................................................... 6 6 00.16 Nursing education loan repayment and scholarships 31 31 00.17 Health professions ......................................................... 264 264 00.18 Maternal and child health block grant ......................... 693 693 00.19 Healthy start .................................................................. 101 102 00.20 Poison control centers ................................................... 23 23 00.21 EMS for children ............................................................ 20 20 00.22 Universal newborn hearing screening ........................... 10 10 00.23 HIV/AIDS ......................................................................... 2,036 2,038 00.24 Organ transplantation ................................................... 23 23 00.25 Bone marrow donor registry .......................................... 25 25 00.26 Rural health policy development ................................... 9 9 00.27 Rural health outreach grants ........................................ 39 39 00.28 Rural health flexibility grants ....................................... 63 64 00.29 Denali Commission ........................................................ 39 39 00.30 Telehealth ....................................................................... 7 7 00.31 Program management ................................................... 144 145 00.32 Family planning ............................................................. 283 283 00.36 Health centers tort claim fund ...................................... 27 54 00.39 Childrens’ GME .............................................................. 297 297 00.42 State offices of rural health .......................................... 8 8 00.45 Rural and community access to emergency devices 1 1 00.46 Radiogenic diseases ...................................................... 2 2 00.47 Traumatic brain injury ................................................... 9 9 00.50 Cord blood stem cell bank ............................................ ................... 23 00.51 Bioterrorism activities .................................................... 495 495 00.52 Free clinics medical malpractice .................................. 1 1 00.54 Sickle cell ....................................................................... 2 2 00.55 Drug pricing program .................................................... ................... ................... 00.56 Family to family health information centers ................. ................... 3 2008 est. ................... 1,944 31 85 16 2 6 44 71 693 101 10 ................... ................... 2,133 23 23 9 ................... ................... ................... 7 144 283 44 110 8 ................... 2 ................... 2 ................... ................... 2 3 4 03.00 09.01 09.02 Total direct programs ................................................ Reimbursable program .................................................. Reimbursable program: PHS evaluation ........................ 6,542 112 25 6,597 124 25 5,800 123 25 10.00 Total new obligations ................................................ 6,679 6,746 5,948 21.40 22.00 Budgetary resources available for obligation: Unobligated balance carried forward, start of year New budget authority (gross) ........................................ 98 6,690 109 6,678 41 5,914 23.90 23.95 Total budgetary resources available for obligation Total new obligations .................................................... 6,788 ¥6,679 6,787 ¥6,746 5,955 ¥5,948 24.40 Unobligated balance carried forward, end of year 109 41 7 New budget authority (gross), detail: Discretionary: 40.00 Appropriation ............................................................. 40.35 Appropriation permanently reduced .......................... 6,634 6,542 5,796 ¥66 ................... ................... Unobligated balance permanently reduced .............. ................... ¥16 ¥5 Transferred to other accounts ................................... ¥5 ................... ................... 43.00 Appropriation (total discretionary) ........................ 6,563 6,526 5,791 Spending authority from offsetting collections: Offsetting collections (cash) ................................ 92 120 119 Offsetting collections (HPSL/NSL Recall) ............. ................... ................... 100 Offsetting collections (cash) HPSL/NSL M-SAVER ................... ................... ¥29 Change in uncollected customer payments from Federal sources (unexpired) ............................. 30 ................... ................... Offsetting collections permanently reduced (¥) ................... ................... ¥100 58.00 58.00 58.00 58.10 58.35 58.90 60.00 60.35 62.50 69.00 70.00 Spending authority from offsetting collections (total discretionary) .......................................... 122 120 90 Mandatory: Appropriation ............................................................. ................... 3 4 Appropriation permanently reduced .......................... ¥25 ................... ................... Appropriation (total mandatory) ........................... Spending authority from offsetting collections: Offsetting collections (cash)(HPSL&NSL) .................. ¥25 3 4 30 29 29 Total new budget authority (gross) .......................... 6,690 6,678 5,914 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) ................................................ 72.40 73.10 73.20 73.40 74.00 5,617 5,349 5,590 6,679 6,746 5,948 ¥6,800 ¥6,505 ¥6,323 ¥126 ................... ................... ¥30 ................... ................... 9 ................... ................... 74.40 Obligated balance, end of year ................................ 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 ................................ 87.00 Total outlays (gross) ................................................. 6,800 6,505 6,323 Offsets: Against gross budget authority and outlays: Offsetting collections (cash) from: 88.00 Federal sources ..................................................... 88.40 Non-Federal sources ............................................. ¥80 ¥51 ¥100 ¥49 ¥100 ¥119 ¥131 ¥149 ¥219 88.90 88.95 88.96 89.00 90.00 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 ........................................................................... 5,349 5,590 5,215 2,647 2,590 2,292 4,141 3,883 3,998 1 32 33 11 ................... ................... ¥30 ................... ................... 9 ................... ................... 6,538 6,669 6,529 6,356 5,695 6,104 Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in millions of dollars) Identification code 75–0350–0–1–550 Guaranteed loan levels supportable by subsidy budget authority: 215001 Health centers: Facilities renovation loan guarantee levels ......................................................................... 215999 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 .......................................................... 232003 Health centers: Managed care plan loan guarantee levels ......................................................................... 2006 actual 2007 est. 2008 est. 2 8 ................... 2 8 ................... 3.50 4.08 0.00 8.00 8.88 0.00 8.17 8.43 0.00 232999 Weighted average subsidy rate ..................................... Guaranteed loan downward reestimates: 237001 Health centers: Facilities renovation loan guarantee levels ......................................................................... 3.50 4.08 0.00 237999 Total downward reestimate subsidy budget authority ¥1 ................... ................... ¥1 ................... ................... HEALTH RESOURCES AND SERVICES ADMINISTRATION—Continued Federal—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES 3510 3590 Administrative expense data: Budget authority ............................................................ Outlays from new authority ........................................... 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 funds, which pay malpractice claims filed against employees of federally-supported health centers. Object Classification (in millions of dollars) Identification code 75–0350–0–1–550 11.1 11.3 11.5 11.7 11.9 12.1 12.2 13.0 21.0 23.1 23.2 23.3 2006 actual Direct obligations: Personnel compensation: Full-time permanent ............................................. Other than full-time permanent ........................... Other personnel compensation ............................. Military personnel ................................................. 2007 est. 104 3 4 24 108 3 4 24 128 26 12 3 3 10 2 135 26 13 4 3 11 2 139 26 13 4 2 7 2 3 4 57 77 3 4 70 91 1 4 54 65 25.4 25.6 25.7 26.0 31.0 33.0 41.0 42.0 203 1 3 2 1 1 5 5,979 22 225 1 2 2 1 1 5 5,962 37 161 1 2 2 1 1 5 5,282 28 99.0 99.0 Direct obligations .................................................. Reimbursable obligations .............................................. 6,542 137 6,598 148 5,800 148 99.9 Total new obligations ................................................ 6,679 6,746 5,948 Outlays (gross), detail: Outlays from new mandatory authority ......................... Outlays from mandatory balances ................................ 87.00 ¥3 ................... ................... 3 ................... ................... Total outlays (gross) ................................................. ................... ................... ................... Offsets: Against gross budget authority and outlays: 88.40 Offsetting collections (cash) from: Non-Federal sources .................................................................. ¥3 ................... ................... Net budget authority and outlays: Budget authority ............................................................ ................... ................... ................... Outlays ........................................................................... ¥3 ................... ................... The Vaccine Injury Compensation Program was established pursuant to Public Law 99–660 and Public Law 100–203, and serves as a source of funds to pay claims for compensation for vaccine related injury or death. Payment of claims associated with vaccine related injury or death occurring before October 1, 1988 are financed from the General Fund and are reflected in this account. Given sufficient carry-over funds from prior years’ appropriations to pay for the balance of the pre-1988 claims yet to be adjudicated, no appropriation is requested in 2008 to cover payment of pre-1988 claims. By statute, no new claims are accepted for this account. Payment of claims associated with vaccine related injury or death occurring after October 1, 1988 are reflected in the Vaccine Injury Compensation Program trust fund account. f HEALTH CENTER GUARANTEED LOAN FINANCING ACCOUNT Program and Financing (in millions of dollars) Identification code 75–4442–0–3–551 00.01 08.02 2006 actual 2007 est. 2008 est. Obligations by program activity: Default claims ............................................................... ................... 1 ................... Downward reestimates paid to receipt accounts .......... 1 ................... ................... ..................... ..................... ..................... ..................... 1,226 259 90 221 2007 est. 2008 est. 1,255 270 99 301 Total new obligations ................................................ 1 1 ................... Budgetary resources available for obligation: Unobligated balance carried forward, start of year Total new obligations .................................................... 4 ¥1 3 2 ¥1 ................... Unobligated balance carried forward, end of year 3 73.10 73.20 Change in obligated balances: Total new obligations .................................................... Total financing disbursements (gross) ......................... 1 ¥1 1 ................... ¥1 ................... 87.00 Outlays (gross), detail: Total financing disbursements (gross) ......................... 1 1 ................... 89.00 90.00 2006 actual 10.00 24.40 Identification code 75–0350–0–1–550 Direct: Civilian full-time equivalent employment Military full-time equivalent employment Reimbursable: 2001 Civilian full-time equivalent employment 2101 Military full-time equivalent employment Allocation account: 3001 Civilian full-time equivalent employment 3101 Military full-time equivalent employment 86.97 86.98 21.40 23.95 Employment Summary 1001 1101 Change in obligated balances: Total outlays (gross) ...................................................... ................... ................... ................... 89.00 90.00 Total personnel compensation .............................. Civilian personnel benefits ....................................... Military personnel benefits ........................................ Benefits for former personnel ................................... Travel and transportation of persons ....................... 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 .................. Medical care .............................................................. Operation and maintenance of equipment ............... Supplies and materials ............................................. Equipment ................................................................. Investments and loans .............................................. Grants, subsidies, and contributions ........................ Insurance claims and indemnities ........................... 24.0 25.1 25.2 25.3 73.20 2008 est. 100 4 3 21 397 Net financing authority and financing disbursements: Financing authority ........................................................ ................... ................... ................... Financing disbursements ............................................... 1 1 ................... 1,222 259 141 339 ..................... ................... ................... ................... ..................... ................... ................... ................... f 2 2 VACCINE INJURY COMPENSATION Status of Guaranteed Loans (in millions of dollars) Program and Financing (in millions of dollars) Identification code 75–4442–0–3–551 Identification code 75–0320–0–1–551 2006 actual 2007 est. 2008 est. 21.40 22.00 Budgetary resources available for obligation: Unobligated balance carried forward, start of year New budget authority (gross) ........................................ 23.90 Total budgetary resources available for obligation 5 5 5 24.40 Unobligated balance carried forward, end of year 5 5 2006 actual 2007 est. 2008 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 ....................... 100 98 90 2142 Uncommitted loan guarantee limitation ....................... ................... ................... ¥90 2143 Uncommitted limitation carried forward ....................... ¥98 ¥90 ................... 5 New budget authority (gross), detail: Mandatory: 69.00 Spending authority from offsetting collections: Offsetting collections (cash) ..................................... 2 5 5 3 ................... ................... 2150 2199 3 ................... ................... Total guaranteed loan commitments ........................ Guaranteed amount of guaranteed loan commitments 2 2 8 ................... 8 ................... 2210 2231 Cumulative balance of guaranteed loans outstanding: Outstanding, start of year ............................................. Disbursements of new guaranteed loans ...................... 40 2 38 42 8 ................... 398 HEALTH RESOURCES AND SERVICES ADMINISTRATION—Continued Federal—Continued THE BUDGET FOR FISCAL YEAR 2008 HEALTH CENTER GUARANTEED LOAN FINANCING ACCOUNT— Continued 74.40 Obligated balance, end of year ................................ 2 2 2 Status of Guaranteed Loans (in millions of dollars)—Continued 86.90 Outlays (gross), detail: Outlays from new discretionary authority ..................... 3 3 3 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 3 3 3 3 3 3 Identification code 75–4442–0–3–551 2251 2263 2006 actual 2007 est. Repayments and prepayments ...................................... ¥4 Adjustments: Terminations for default that result in claim payments ......................................................... ................... 2008 est. ¥3 ¥3 ¥1 ................... 2290 Outstanding, end of year .......................................... 38 42 39 2299 Memorandum: Guaranteed amount of guaranteed loans outstanding, end of year ................................................................ 32 30 34 Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in millions of dollars) Identification code 75–0340–0–1–552 P.L. 104–299 and P.L. 104–208 authorize Health Resources and Services Administration (HRSA) to guarantee up to $160 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. 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. The Budget proposes to rescind the unobligated balances of the Health Center Guaranteed Loan subsidy. Balance Sheet (in millions of dollars) Identification code 75–4442–0–3–551 2005 actual 1 1 Total assets .................................................................................. LIABILITIES: 2204 Non-Federal liabilities: Liabilities for loan guarantees ............ 1 1 1 1 2999 Total liabilities ............................................................................. 1 1 4999 Negative subsidy BA total [75–0350] ....................................... 1 1 ¥31 ¥34 ................... 237999 Total downward reestimate subsidy budget authority ¥31 ¥34 ................... Administrative expense data: Budget authority ............................................................ Outlays from new authority ........................................... 3 3 3510 3590 Identification code 75–0340–0–1–552 2006 actual 2007 est. 2008 est. Direct obligations: 11.1 Personnel compensation: Full-time permanent ............. 25.3 Other purchases of goods and services from Government accounts ........................................................... 1 1 1 2 2 2 99.9 3 3 3 Total new obligations ................................................ Identification code 75–0340–0–1–552 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, $2,906,000. 2007 est. 2008 est. Obligations by program activity: 00.09 Administrative expenses ................................................ 3 3 3 10.00 3 3 3 2007 est. 2008 est. f HEALTH EDUCATION ASSISTANCE LOANS FINANCING ACCOUNT Program and Financing (in millions of dollars) Identification code 75–4304–0–3–552 Program and Financing (in millions of dollars) 2006 actual 2006 actual Direct: 1001 Civilian full-time equivalent employment ..................... 12 12 12 1101 Military full-time equivalent employment ..................... ................... ................... ................... Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. 00.01 08.02 08.04 Obligations by program activity: Default Claims ............................................................... Payment of downward reestimate to receipt account Payment of interest on downward reestimate to receipt account ............................................................. 2006 actual 2007 est. 2008 est. 13 18 20 20 20 ................... 13 14 ................... 3 ¥3 Subtotal (reestimates) ............................................... 31 34 ................... Total new obligations ................................................ 44 54 20 21.40 22.00 3 ¥3 08.91 10.00 Budgetary resources available for obligation: Unobligated balance carried forward, start of year New financing authority (gross) .................................... 171 17 144 10 100 11 23.90 23.95 Total budgetary resources available for obligation Total new obligations .................................................... 188 ¥44 154 ¥54 111 ¥20 24.40 Unobligated balance carried forward, end of year 144 100 91 3 ¥3 New budget authority (gross), detail: Discretionary: 40.00 Appropriation ............................................................. 3 3 3 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... 2 3 ¥3 2 3 ¥3 2 3 ¥3 72.40 73.10 73.20 3 3 Employment Summary HEALTH EDUCATION ASSISTANCE LOANS PROGRAM ACCOUNT Budgetary resources available for obligation: New budget authority (gross) ........................................ Total new obligations .................................................... 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. f 22.00 23.95 2008 est. Object Classification (in millions of dollars) 1999 Total new obligations ................................................ 2007 est. 2006 actual ASSETS: 1101 Federal assets: Fund balances with Treasury .......................... Identification code 75–0340–0–1–552 2006 actual Guaranteed loan downward reestimates: 237001 HEAL Loan guarantee .................................................... New financing authority (gross), detail: Mandatory: HEALTH RESOURCES AND SERVICES ADMINISTRATION—Continued Federal—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES 69.00 Spending authority from offsetting collections: Offsetting collections (cash) ..................................... 4999 17 10 Total liabilities and net position ............................................... 399 258 216 11 f Change in obligated balances: 73.10 Total new obligations .................................................... 73.20 Total financing disbursements (gross) ......................... 44 ¥44 88.90 89.00 90.00 Total, offsetting collections (cash) ....................... 20 ¥20 44 54 20 ¥6 ¥4 ¥17 ¥10 ¥11 2006 actual 2007 est. 2008 est. Total guaranteed loan commitments ........................ ................... ................... ................... Cumulative balance of guaranteed loans outstanding: Outstanding, start of year ............................................. 1,440 1,156 936 Repayments and prepayments ...................................... ¥271 ¥200 ¥200 Adjustments: 2261 Terminations for default that result in loans receivable ....................................................................... ¥10 ¥17 ¥17 2263 Terminations for default that result in claim payments .................................................................... ¥3 ¥3 ¥3 2264 Other adjustments, net ............................................. ................... ................... ................... 2210 2251 Outstanding, end of year .......................................... Memorandum: 2299 Guaranteed amount of guaranteed loans outstanding, end of year ................................................................ 1,156 1,156 936 936 716 716 Addendum: Cumulative balance of defaulted guaranteed loans that result in loans receivable: 2310 Outstanding, start of year ........................................ 635 640 656 2331 Disbursements for guaranteed loan claims ............. 13 20 20 2351 Repayments of loans receivable ............................... ¥8 ¥4 ¥5 2364 Other adjustments, net ............................................. ................... ................... ................... 2390 Outstanding, end of year ...................................... 640 656 671 This account records all cash flows to and from the Government resulting from HEAL loan guarantees committed between 1992 and 2004. No new loan guarantees will be issued after 2004. 2008 est. Identification code 75–4304–0–3–552 ASSETS: Federal assets: Fund balances with Treasury .......................... Net value of assets related to post–1991 acquired defaulted guaranteed loans receivable: 1501 Defaulted guaranteed loans receivable, gross .......................... 1505 Allowance for subsidy cost (–) .................................................. 1101 2005 actual 144 635 –548 640 –568 87 72 Total assets .................................................................................. LIABILITIES: Non-Federal liabilities: 2204 Liabilities for loan guarantees ................................................... 2207 Other, downward reestimate ....................................................... 258 216 227 31 182 34 2999 258 216 1999 Total liabilities ............................................................................. 1 Total new obligations (object class 42.0) ................ 3 4 1 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ Total new obligations .................................................... 4 ¥3 4 ¥4 1 ¥1 4 4 1 15 ¥15 15 ¥15 10 ¥10 New budget authority (gross), detail: Mandatory: 60.00 Appropriation ............................................................. Spending authority from offsetting collections: 69.00 Offsetting collections (cash) ................................ 69.27 Capital transfer to general fund .......................... 69.90 Spending authority from offsetting collections (total mandatory) ............................................. ................... ................... ................... 70.00 Total new budget authority (gross) .......................... 4 4 1 72.40 73.10 73.20 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... 4 3 ¥3 4 4 ¥4 4 1 ¥1 74.40 Obligated balance, end of year ................................ 4 4 4 86.97 Outlays (gross), detail: Outlays from new mandatory authority ......................... 3 4 1 Offsets: Against gross budget authority and outlays: 88.40 Offsetting collections (cash) from: Non-Federal sources .................................................................. ¥15 ¥15 ¥10 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... ¥11 ¥12 ¥11 ¥11 ¥9 ¥9 89.00 90.00 Status of Guaranteed Loans (in millions of dollars) Identification code 75–4305–0–3–552 2006 actual 2007 est. 2008 est. Cumulative balance of guaranteed loans outstanding: Outstanding, start of year ............................................. 268 216 154 Repayments and prepayments ...................................... ¥49 ¥58 ¥58 Adjustments: 2261 Terminations for default that result in loans receivable ....................................................................... ¥3 ¥4 ¥1 2264 Other adjustments, net ............................................. ................... ................... ................... 2210 2251 2290 Outstanding, end of year .......................................... 216 154 95 Memorandum: Guaranteed amount of guaranteed loans outstanding, end of year ................................................................ 216 154 95 2006 actual 171 Net present value of assets related to defaulted guaranteed loans ......................................................................................... 4 2299 Balance Sheet (in millions of dollars) 1599 2007 est. 3 ¥6 ¥5 Position with respect to appropriations act limitation on commitments: 2111 Limitation on guaranteed loans made by private lenders .............................................................................. ................... ................... ................... 2290 2006 actual 10.00 ¥9 ¥8 Status of Guaranteed Loans (in millions of dollars) 2150 Identification code 75–4305–0–3–552 Obligations by program activity: 00.02 Defaulted loans .............................................................. Net financing authority and financing disbursements: Financing authority ........................................................ ................... ................... ................... Financing disbursements ............................................... 28 44 9 Identification code 75–4304–0–3–552 HEALTH EDUCATION ASSISTANCE LOANS LIQUIDATING ACCOUNT Program and Financing (in millions of dollars) Outlays (gross), detail: 87.00 Total financing disbursements (gross) ......................... Offsets: Against gross financing authority and financing disbursements: Offsetting collections (cash) from: 88.25 Interest on uninvested funds ............................... 88.40 Recoveries of defaulted loans .............................. 54 ¥54 Addendum: Cumulative balance of defaulted guaranteed loans that result in loans receivable: 2310 Outstanding, start of year ........................................ 111 99 88 2331 Disbursements for guaranteed loan claims ............. 3 4 1 2351 Repayments of loans receivable ............................... ¥15 ¥15 ¥10 2364 Other adjustments, net ............................................. ................... ................... ................... 2390 Outstanding, end of year ...................................... 99 88 79 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. This account records all cash flows to and from the Government resulting from HEAL loan guarantees committed prior to 1992. 400 HEALTH RESOURCES AND SERVICES ADMINISTRATION—Continued Federal—Continued THE BUDGET FOR FISCAL YEAR 2008 HEALTH EDUCATION ASSISTANCE LOANS LIQUIDATING ACCOUNT— Continued Balance Sheet (in millions of dollars) Identification code 75–4305–0–3–552 2005 actual ASSETS: 1101 Federal assets: Fund balances with Treasury .......................... 1701 Defaulted guaranteed loans, gross ............................................ 1703 Allowance for estimated uncollectible loans and interest (–) 2006 actual vaccine-related injury or death with respect to vaccines administered after September 30, 1988, pursuant to subtitle 2 of title XXI of the Public Health Service Act, to remain available until expended: Provided, That for necessary administrative expenses, not to exceed $3,528,000 shall be available from the Trust Fund to the Secretary of Health and Human Services. 4 99 –4 4 111 –4 Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. Special and Trust Fund Receipts (in millions of dollars) 1704 Defaulted guaranteed loans and interest receivable, net ....... 107 95 1799 Value of assets related to loan guarantees ............................ 107 95 Identification code 20–8175–0–7–551 Total assets .................................................................................. LIABILITIES: 2104 Federal liabilities: Resources payable to Treasury ................... 2204 Non-Federal liabilities: Liabilities for loan guarantees ............ 111 99 01.00 109 2 99 .................... 01.99 2999 Total liabilities ............................................................................. 111 99 4999 Total liabilities and net position ............................................... 111 99 1999 2008 est. 2,371 2,587 Balance, start of year .................................................... Receipts: 02.00 Interest and profits on investments, Vaccine injury compensation trust fund ........................................... 02.60 Deposits, Vaccine injury compensation trust fund ....... 2,162 2,371 2,587 93 184 98 195 103 196 Total receipts and collections ................................... 277 293 299 Total: Balances and collections .................................... Appropriations: 05.00 Vaccine injury compensation program trust fund ........ 05.01 Vaccine injury compensation program trust fund ........ 2,439 2,664 2,886 ¥14 ¥54 ¥14 ¥63 ¥14 ¥73 05.99 Total appropriations .................................................. ¥68 ¥77 ¥87 07.99 Balance, end of year ..................................................... 2,371 2,587 2,799 04.00 AND LOAN FUND Program and Financing (in millions of dollars) Identification code 75–9931–0–3–551 2007 est. 2,162 02.99 f MEDICAL FACILITIES GUARANTEE 2006 actual Balance, start of year .................................................... 2006 actual 2007 est. 2008 est. 72.40 Change in obligated balances: Obligated balance, start of year ................................... 1 1 1 74.40 Obligated balance, end of year ................................ 1 1 1 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ ................... ................... ................... Outlays ........................................................................... ................... ................... ................... Status of Direct Loans (in millions of dollars) Identification code 75–9931–0–3–551 2006 actual 2007 est. Program and Financing (in millions of dollars) Identification code 20–8175–0–7–551 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 (HRSA) ........................................ 01.05 Claims processing (Dept. of Justice) ........................ 54 56 58 4 4 6 4 4 6 4 4 7 7 1290 7 7 Total, administrative expenses ............................. 14 14 15 10.00 Total new obligations ................................................ 68 70 73 21.40 22.00 Budgetary resources available for obligation: Unobligated balance carried forward, start of year New budget authority (gross) ........................................ 1 68 1 77 8 87 23.90 23.95 Total budgetary resources available for obligation Total new obligations .................................................... 69 ¥68 78 ¥70 95 ¥73 24.40 Unobligated balance carried forward, end of year 1 8 22 New budget authority (gross), detail: Discretionary: 40.26 Appropriation (trust fund) ......................................... Mandatory: 60.26 Appropriation (trust fund) ......................................... 14 14 14 54 63 73 70.00 7 Total new budget authority (gross) .......................... 68 77 87 72.40 73.10 73.20 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... 4 68 ¥64 8 70 ¥77 1 73 ¥87 74.40 Obligated balance, end of year ................................ 8 1 ¥13 Outlays (gross), detail: Outlays from new discretionary authority ..................... Outlays from new mandatory authority ......................... Outlays from mandatory balances ................................ 7 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. Balance Sheet (in millions of dollars) 2005 actual ASSETS: 1206 Non-Federal assets: Receivables, net ........................................ 1601 Direct loans, gross ...................................................................... 2008 est. 01.91 7 Identification code 75–9931–0–3–551 2007 est. 2008 est. Cumulative balance of direct loans outstanding: 1210 Outstanding, start of year ............................................. Outstanding, end of year .......................................... 2006 actual 2006 actual 13 .................... 12 7 Total assets .................................................................................. LIABILITIES: 2204 Non-Federal liabilities: Liabilities for loan guarantees ............ 13 19 13 19 2999 Total liabilities ............................................................................. 13 19 86.90 86.97 86.98 4999 Total liabilities and net position ............................................... 13 19 87.00 Total outlays (gross) ................................................. 64 77 87 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 68 64 77 77 87 87 Memorandum (non-add) entries: Total investments, start of year: Federal securities: Par value ................................................................... 2,165 2,380 2,303 1999 f Trust Funds 10 14 14 53 63 73 1 ................... ................... 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 92.01 INDIAN HEALTH SERVICE Federal DEPARTMENT OF HEALTH AND HUMAN SERVICES 92.02 Total investments, end of year: Federal securities: Par value ................................................................... 2,380 2,303 2,216 The Vaccine Injury Compensation Program was established pursuant to Public Law 99–660 and Public Law 100–203, and serves as a source of funds to pay claims for compensation for vaccine related injury or death. This account reflects payments for claims for vaccine related injury or death occurring after October 1, 1988. Object Classification (in millions of dollars) Identification code 20–8175–0–7–551 2006 actual 2007 est. 2008 est. Direct obligations: 25.2 Other services ................................................................ 25.3 Other purchases of goods and services from Government accounts ........................................................... 42.0 Insurance claims and indemnities ................................ 4 4 5 10 54 10 56 10 58 99.9 68 70 73 Total new obligations ................................................ f RICKY RAY HEMOPHILIA RELIEF FUND Program and Financing (in millions of dollars) Identification code 75–8074–0–7–551 2006 actual 2007 est. 2008 est. Obligations by program activity: 00.01 Funds Returned to Treasury from Original Obligations 00.02 New Collections Returned to Treasury ........................... 2 ................... ................... 3 ................... ................... 10.00 Total new obligations (object class 94.0) ................ 5 ................... ................... 21.40 22.10 Budgetary resources available for obligation: Unobligated balance carried forward, start of year Resources available from recoveries of prior year obligations ....................................................................... 23.90 23.95 24.40 72.40 73.10 73.20 73.45 74.40 86.98 Total budgetary resources available for obligation Total new obligations .................................................... 2 ................... ................... 3 ................... ................... 5 ................... ................... ¥5 ................... ................... Unobligated balance carried forward, end of year ................... ................... ................... Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Recoveries of prior year obligations .............................. 3 5 ¥5 ¥3 ................... ................... ................... ................... ................... ................... ................... ................... Obligated balance, end of year ................................ ................... ................... ................... Outlays (gross), detail: Outlays from mandatory balances ................................ 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 $551,515,000 for contract medical care shall remain available for obligation until September 30, 2009: 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 program under section 108 of the Indian Health Care Improvement Act: Provided further, That funds provided in this Act may be used for one-year contracts and grants which are to be performed in two fiscal years, so long as the total obligation is recorded in the year for which the funds are appropriated: Provided further, That the amounts collected by the Secretary of Health and Human Services under the authority of title IV of the Indian Health Care Improvement Act shall remain available until expended for the purpose of achieving compliance with the applicable conditions and requirements of titles XVIII and XIX of the Social Security Act (exclusive of planning, design, or construction of new facilities): Provided further, That funding contained herein, and in any earlier appropriations Acts for scholarship programs under the Indian Health Care Improvement Act (25 U.S.C. 1613), shall remain available 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 $271,636,000 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 2008, of which not to exceed $5,000,000 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 the Bureau of Indian Affairs may collect from the Indian Health Service and tribes and tribal organizations operating health facilities pursuant to Public Law 93–638 such individually identifiable health information relating to disabled children as may be necessary for the purpose of carrying out its functions under the Individuals with Disabilities Education Act, 20 U.S.C. 1400, et seq. Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. 5 ................... ................... Net budget authority and outlays: 89.00 Budget authority ............................................................ ................... ................... ................... 90.00 Outlays ........................................................................... 5 ................... ................... The Ricky Ray Hemophilia Relief Fund was established pursuant to Public Law 105–369 and served 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. By law the fund terminated November 12, 2003, five years after the date of enactment. All unobligated balances have been returned to the Treasury. 401 Program and Financing (in millions of dollars) Identification code 75–0390–0–1–551 2006 actual 2007 est. 2008 est. Obligations by program activity: 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 .................................................. 2,175 117 33 32 2 63 6 265 163 909 2,179 2,425 117 130 33 ................... 31 32 2 2 62 65 6 6 265 272 150 150 909 909 10.00 Total new obligations ................................................ 3,765 3,754 3,991 21.40 22.00 Budgetary resources available for obligation: Unobligated balance carried forward, start of year New budget authority (gross) ........................................ 244 3,710 183 3,733 162 3,970 23.90 23.95 23.98 Total budgetary resources available for obligation Total new obligations .................................................... Unobligated balance expiring or withdrawn ................. 24.40 Unobligated balance carried forward, end of year f INDIAN HEALTH SERVICE Federal 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, $2,931,530,000, together with payments received during the fiscal year pursuant to 42 U.S.C. New budget authority (gross), detail: Discretionary: 3,954 3,916 4,132 ¥3,765 ¥3,754 ¥3,991 ¥6 ................... ................... 183 162 141 402 INDIAN HEALTH SERVICE—Continued Federal—Continued THE BUDGET FOR FISCAL YEAR 2008 23.2 23.3 INDIAN HEALTH SERVICES—Continued 25.4 25.6 25.7 25.8 26.0 31.0 41.0 42.0 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 .................. Medical care .............................................................. Operation and maintenance of equipment ............... Subsistence and support of persons ........................ Supplies and materials ............................................. Equipment ................................................................. Grants, subsidies, and contributions ........................ Insurance claims and indemnities ........................... 99.0 99.0 99.9 Program and Financing (in millions of dollars)—Continued Identification code 75–0390–0–1–551 2006 actual 2007 est. 2008 est. 40.00 40.35 Appropriation ............................................................. Appropriation permanently reduced .......................... 2,732 2,695 2,932 ¥40 ................... ................... 43.00 Appropriation (total discretionary) ........................ Spending authority from offsetting collections: Offsetting collections (cash) ................................ Change in uncollected customer payments from Federal sources (unexpired) ............................. 2,692 2,695 2,932 885 888 888 58.00 58.10 58.90 ¥17 ................... ................... 868 888 888 60.00 Spending authority from offsetting collections (total discretionary) .......................................... Mandatory: Appropriation ............................................................. 150 150 150 70.00 Total new budget authority (gross) .......................... 3,710 3,733 3,970 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) ................................................ 72.40 73.10 73.20 73.40 74.00 74.40 24.0 25.1 25.2 25.3 2 1 1 14 1 10 83 14 1 10 81 15 1 10 89 50 4 246 6 2 95 18 1,676 1 48 4 248 6 2 91 17 1,654 1 54 5 274 6 1 101 19 1,798 1 Direct obligations .................................................. Reimbursable obligations .............................................. 2,856 909 2,845 909 3,082 909 Total new obligations ................................................ 3,765 3,754 3,991 Employment Summary 562 610 581 3,765 3,754 3,991 ¥3,744 ¥3,783 ¥3,986 8 ................... ................... 17 ................... ................... 2 ................... ................... Obligated balance, end of year ................................ 610 581 3,272 322 132 18 3,260 373 132 18 3,468 367 132 19 87.00 Total outlays (gross) ................................................. 3,744 3,783 3,986 Offsets: Against gross budget authority and outlays: Offsetting collections (cash) from: 88.00 Federal sources ..................................................... 88.40 Non-Federal sources ............................................. ¥444 ¥444 ¥444 ¥444 ¥444 ¥444 88.90 ¥888 ¥888 ¥888 88.95 88.96 89.00 90.00 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 ........................................................................... 17 ................... ................... 3 ................... ................... 2,842 2,856 2,845 2,895 3,082 3,098 The Indian health services account provides medical care, public health services, and health professions training opportunities to American Indians and Alaska Natives. An estimated $1,766 million, primarily through self determination contracts and compacts, will be administered by tribal governments in 2008. Object Classification (in millions of dollars) Identification code 75–0390–0–1–551 2006 actual 2007 est. 2008 est. 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 ................................................. 332 22 31 72 345 23 32 73 364 24 33 81 11.9 12.1 12.2 13.0 21.0 21.0 22.0 23.1 Total personnel compensation .............................. Civilian personnel benefits ....................................... Military personnel benefits ........................................ Benefits for former personnel ................................... Travel and transportation of persons ....................... Patient travel ............................................................. Transportation of things ........................................... Rental payments to GSA ........................................... 457 104 33 6 14 19 9 6 473 108 34 6 13 19 8 6 502 114 36 6 14 19 9 7 2006 actual Direct: 1001 Civilian full-time equivalent employment 1101 Military full-time equivalent employment Reimbursable: 2001 Civilian full-time equivalent employment 2101 Military full-time equivalent employment 586 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 ................................ Identification code 75–0390–0–1–551 2007 est. 2008 est. ..................... ..................... 7,189 1,147 7,220 1,135 7,326 1,153 ..................... ..................... 4,893 782 4,904 771 4,904 771 f INDIAN HEALTH FACILITIES For construction, repair, maintenance, improvement, and equipment of health and related auxiliary facilities, including quarters for personnel; preparation of plans, specifications, and drawings; acquisition of sites, purchase and erection of modular buildings, and purchases of trailers; and for provision of domestic and community sanitation facilities for Indians, as authorized by section 7 of the Act of August 5, 1954 (42 U.S.C. 2004a), the Indian Self-Determination Act, and the Indian Health Care Improvement Act, and for expenses necessary to carry out such Acts and titles II and III of the Public Health Service Act with respect to environmental health and facilities support activities of the Indian Health Service, $339,196,000, 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 a federally-recognized 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 none of the funds appropriated to the Indian Health Service may be used for sanitation facilities construction for new homes funded with grants by the housing programs of the United States Department of Housing and Urban Development: Provided further, That not to exceed $1,000,000 from this account and the ‘‘Indian Health Services’’ account 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 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. Special and Trust Fund Receipts (in millions of dollars) Identification code 75–0391–0–1–551 01.00 01.99 2006 actual 2007 est. 2008 est. Balance, start of year .................................................... ................... ................... ................... Balance, start of year .................................................... ................... ................... ................... Receipts: 02.20 Rent and charges for quarters, Indian Health Service ¥1 6 6 Adjustments: 02.90 Adjustments ............................................................... 1 ................... ................... INDIAN HEALTH SERVICE—Continued Federal—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES 02.99 Total receipts and collections ................................... ................... 6 6 Total: Balances and collections .................................... ................... Appropriations: 05.00 Indian health facilities .................................................. ................... 6 6 ¥6 ¥6 04.00 07.99 Balance, end of year ..................................................... ................... ................... ................... Program and Financing (in millions of dollars) Identification code 75–0391–0–1–551 2006 actual 2007 est. 2008 est. 00.01 00.02 00.03 00.04 Obligations by program activity: Sanitation and health facilities .................................... Maintenance ................................................................... Facilities and environmental health .............................. Equipment ...................................................................... 156 63 149 22 130 52 161 21 101 52 165 21 01.00 09.01 Total direct program ................................................. Reimbursable program .................................................. 390 4 364 7 339 7 10.00 Total new obligations ................................................ 394 371 Budgetary resources available for obligation: Unobligated balance carried forward, start of year New budget authority (gross) ........................................ 285 360 251 377 257 352 25.4 25.7 26.0 31.0 32.0 41.0 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 ................................................................. Land and structures .................................................. Grants, subsidies, and contributions ........................ 99.0 99.0 99.9 25.1 25.2 25.3 7 3 3 1 8 3 3 1 8 3 3 1 14 5 95 15 5 88 15 4 76 1 7 2 8 11 43 112 1 6 2 7 10 29 105 1 7 2 7 9 15 104 Direct obligations .................................................. Reimbursable obligations .............................................. 390 4 364 7 339 7 Total new obligations ................................................ 394 371 346 346 21.40 22.00 12.2 21.0 22.0 23.1 23.3 403 Employment Summary 23.90 23.95 Total budgetary resources available for obligation Total new obligations .................................................... 645 ¥394 628 ¥371 609 ¥346 24.40 Unobligated balance carried forward, end of year 251 257 263 New budget authority (gross), detail: Discretionary: 40.00 Appropriation ............................................................. 40.35 Appropriation permanently reduced .......................... 43.00 58.00 60.20 69.00 358 364 339 ¥5 ................... ................... Appropriation (total discretionary) ........................ 353 364 339 Spending authority from offsetting collections: Offsetting collections (cash) ..................................... 2 7 7 Mandatory: Appropriation (special fund) ..................................... ................... 6 6 Spending authority from offsetting collections: Offsetting collections (cash) ..................................... 5 ................... ................... Total new budget authority (gross) .......................... 360 377 352 72.40 73.10 73.20 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... 246 394 ¥404 236 371 ¥373 234 346 ¥389 74.40 Obligated balance, end of year ................................ 236 234 191 86.90 86.93 86.97 Outlays (gross), detail: Outlays from new discretionary authority ..................... Outlays from discretionary balances ............................. Outlays from new mandatory authority ......................... 336 63 5 116 251 6 109 274 6 87.00 Total outlays (gross) ................................................. 404 373 389 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 ........................................................................... 353 397 370 366 345 382 The Indian health facilities account supports construction, repair and improvement, equipment, and environmental health and facilities support for the Indian health services. Object Classification (in millions of dollars) Identification code 75–0391–0–1–551 2006 actual Direct: 1001 Civilian full-time equivalent employment ..................... 1101 Military full-time equivalent employment ..................... Reimbursable: 2001 Civilian full-time equivalent employment ..................... 2007 est. 2008 est. 981 238 989 236 1,008 238 46 46 46 f 70.00 89.00 90.00 Identification code 75–0391–0–1–551 2006 actual 2007 est. 2008 est. 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 ................................................. 42 4 1 19 43 5 1 19 45 5 1 20 11.9 12.1 Total personnel compensation .............................. Civilian personnel benefits ....................................... 66 12 68 13 71 13 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 V 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 V 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 author- 404 INDIAN HEALTH SERVICE—Continued Federal—Continued THE BUDGET FOR FISCAL YEAR 2008 ADMINISTRATIVE PROVISIONS, INDIAN HEALTH SERVICE—Continued ized 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. The appropriation structure for the Indian Health Service may not be altered without advance notification to the House and Senate Committees on Appropriations. Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. f CENTERS FOR DISEASE CONTROL AND PREVENTION Federal DISEASE CONTROL, RESEARCH, AND 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, section 501 of the Refugee Education Assistance Act of 1980, and for expenses necessary to support activities related to countering potential biological, disease, nuclear, radiological, and chemical threats to civilian populations; including purchase and insurance of official motor vehicles in foreign countries; and purchase, hire, maintenance, and operation of aircraft, $5,716,651,000, of which $20,000,000 shall remain available until expended for equipment, construction and renovation of facilities; of which $581,335,000 shall remain available until expended for the Strategic National Stockpile; and of which $121,224,000 for international HIV/AIDS shall remain available until September 30, 2009; and of which $30,000,000 shall remain available until expended for section 2625 of the PHS act. 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, the following amounts shall be available from amounts available under section 241 of the Public Health Service Act: (1) $12,794,000 to carry out the National Immunization Surveys; (2) $109,921,000 to carry out the National Center for Health Statistics surveys; (3) $24,751,000 to carry out information systems standards development and architecture and applications-based research used at local public health levels; (4) $463,000 for Health Marketing evaluations; (5) $31,000,000 to carry out Public Health Research; and (6) $87,071,000 to carry out research activities within the National Occupational Research Agenda: 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, in whole or in part, to advocate or promote gun control: Provided further, That up to $31,800,000 shall be made available until expended for Individual Learning Accounts for full-time equivalent employees of the Centers for Disease Control and Prevention: 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 $12,500,000 may be available for making grants under section 1509 of the Public Health Service Act to not more than 15 States, tribes, or tribal organizations: Provided further, That of the funds appropriated, $10,000 is for official reception and representation expenses when specifically approved by the Director of the Centers for Disease Control and Prevention. Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. Special and Trust Fund Receipts (in millions of dollars) Identification code 75–0943–0–1–550 01.00 2006 actual 2007 est. 2008 est. Balance, start of year .................................................... ................... ................... ................... 01.99 Balance, start of year .................................................... ................... ................... ................... Receipts: 02.20 Cooperative research and development agreements, Centers for Disease Control ...................................... 1 1 1 04.00 05.00 07.99 Total: Balances and collections .................................... Appropriations: Disease control, research, and training ........................ 1 1 1 ¥1 ¥1 ¥1 Balance, end of year ..................................................... ................... ................... ................... Program and Financing (in millions of dollars) Identification code 75–0943–0–1–550 Obligations by program activity: 00.01 Infectious diseases ........................................................ 00.02 Health promotion ........................................................... 00.03 Health information and service ..................................... 00.04 Environmental health and injury ................................... 00.05 Occupational safety and health .................................... 00.06 Global health ................................................................. 00.08 Public health improvement and leadership .................. 00.09 Prev. health and health services block grant ............... 00.10 Buildings and facilities ................................................. 00.11 Business services support ............................................. 00.12 Terrorism ........................................................................ 00.14 World Trade Center Registry .......................................... Reimbursable program: 09.01 Health statistics ........................................................ 09.02 Other reimbursable program ..................................... 09.03 Public health research .............................................. 2006 actual 2007 est. 2008 est. 1,649 1,646 1,752 962 959 959 87 85 108 286 287 288 164 166 166 311 310 380 200 189 190 99 99 ................... 136 134 20 316 318 320 1,534 1,544 1,504 6 ................... ................... 109 387 31 109 403 31 110 418 31 09.09 Subtotal, reimbursable programs ......................... 527 543 559 10.00 Total new obligations ................................................ 6,277 6,280 6,246 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 ....................................................................... 300 6,444 466 6,291 477 6,230 23.90 23.95 23.98 Total budgetary resources available for obligation Total new obligations .................................................... Unobligated balance expiring or withdrawn ................. 24.40 Unobligated balance carried forward, end of year 3 ................... ................... 6,747 6,757 6,707 ¥6,277 ¥6,280 ¥6,246 ¥4 ................... ................... 466 477 461 New budget authority (gross), detail: Discretionary: 40.00 Appropriation ............................................................. 5,978 5,737 5,717 40.35 Appropriation permanently reduced .......................... ¥59 ................... ................... 40.36 Unobligated balance permanently reduced .............. ................... ................... ¥30 41.00 Transferred to other accounts ....................................... ¥4 ................... ................... 43.00 58.00 58.10 58.90 Appropriation (total discretionary) ........................ Spending authority from offsetting collections: Offsetting collections (cash) ................................ Change in uncollected customer payments from Federal sources (unexpired) ............................. 60.20 Spending authority from offsetting collections (total discretionary) .......................................... Mandatory: Appropriation (special fund) ..................................... 70.00 Total new budget authority (gross) .......................... 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) ................................................ 72.40 73.10 73.20 73.40 73.45 74.00 74.40 Obligated balance, end of year ................................ 5,915 5,737 5,687 234 553 542 294 ................... ................... 528 553 542 1 1 1 6,444 6,291 6,230 3,633 4,694 4,817 6,277 6,280 6,246 ¥5,057 ¥6,157 ¥6,283 ¥71 ................... ................... ¥3 ................... ................... ¥294 ................... ................... 209 ................... ................... 4,694 4,817 4,780 CENTERS FOR DISEASE CONTROL AND PREVENTION—Continued Federal—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES 86.90 86.93 86.97 Outlays (gross), detail: Outlays from new discretionary authority ..................... Outlays from discretionary balances ............................. Outlays from new mandatory authority ......................... 1,986 3,070 1 2,561 3,595 1 2,531 3,751 1 87.00 Total outlays (gross) ................................................. 5,057 6,157 405 6,283 2101 Military full-time equivalent employment ..................... 57 57 57 Allocation account: 3001 Civilian full-time equivalent employment ..................... ................... ................... ................... f AGENCY Offsets: Against gross budget authority and outlays: Offsetting collections (cash) from: 88.00 Federal sources ..................................................... 88.40 Non-Federal sources ............................................. ¥186 ¥256 ¥514 ¥39 ¥503 ¥39 88.90 ¥442 ¥553 ¥542 88.95 88.96 89.00 90.00 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 ........................................................................... FOR TOXIC SUBSTANCES AND DISEASE REGISTRY TOXIC SUBSTANCES AND ENVIRONMENTAL PUBLIC HEALTH ¥294 ................... ................... 208 ................... ................... 5,916 4,615 5,738 5,604 5,688 5,741 The Centers for Disease Control and Prevention (CDC) supports a number of categorical programs designed to improve the health, safety, and protection of all Americans. These activities include immunization, 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, emergency response, and pandemic influenza preparedness activities. Object Classification (in millions of dollars) 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, $75,004,000, of which up to $1,500,000, to remain available until expended, is for Individual Learning Accounts for full-time equivalent employees of the Agency for Toxic Substances and Disease Registry: 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 2008, and existing profiles may be updated as necessary. Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. Program and Financing (in millions of dollars) Identification code 75–0943–0–1–550 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 2006 actual Direct obligations: Personnel compensation: Full-time permanent ............................................. Other than full-time permanent ........................... Other personnel compensation ............................. Military personnel ................................................. Special personal services payments .................... 2007 est. 2008 est. Identification code 75–0944–0–1–551 469 53 22 57 1 488 55 23 59 1 515 58 25 62 1 602 145 36 43 21 69 1 626 152 38 42 21 68 1 661 160 40 39 19 63 1 22 9 381 215 21 9 377 212 20 8 350 197 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 ........................ 347 77 123 19 24 529 70 105 2,912 342 76 124 19 24 523 69 102 2,891 319 71 129 17 22 486 65 92 2,928 99.0 99.0 Direct obligations .................................................. Reimbursable obligations .............................................. 5,750 527 5,737 543 5,687 559 99.9 Total new obligations ................................................ 6,277 6,280 6,246 24.0 25.1 25.2 25.3 Employment Summary Identification code 75–0943–0–1–550 Direct: 1001 Civilian full-time equivalent employment ..................... 1101 Military full-time equivalent employment ..................... Reimbursable: 2001 Civilian full-time equivalent employment ..................... 2006 actual 2007 est. 2008 est. 2006 actual 2007 est. 2008 est. Obligations by program activity: 00.01 Direct program ............................................................... 09.01 Reimbursable program .................................................. 74 6 75 6 75 6 10.00 80 81 81 Budgetary resources available for obligation: Unobligated balance carried forward, start of year ................... New budget authority (gross) ........................................ 81 1 81 1 81 21.40 22.00 Total new obligations ................................................ 23.90 23.95 Total budgetary resources available for obligation Total new obligations .................................................... 81 ¥80 82 ¥81 82 ¥81 24.40 Unobligated balance carried forward, end of year 1 1 1 New budget authority (gross), detail: Discretionary: 40.00 Appropriation ............................................................. 40.35 Appropriation permanently reduced .......................... 43.00 58.00 58.10 58.90 70.00 Appropriation (total discretionary) ........................ Spending authority from offsetting collections: Offsetting collections (cash) ................................ Change in uncollected customer payments from Federal sources (unexpired) ............................. 76 75 75 ¥1 ................... ................... 75 75 75 4 6 6 2 ................... ................... Spending authority from offsetting collections (total discretionary) .......................................... 6 6 6 Total new budget authority (gross) .......................... 81 81 81 33 80 ¥77 38 81 ¥80 45 81 ¥81 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Change in uncollected customer payments from Federal sources (unexpired) ............................................ 74.10 Change in uncollected customer payments from Federal sources (expired) ................................................ 72.40 73.10 73.20 74.00 ¥2 ................... ................... 4 6 6 6,453 773 6,761 778 7,173 783 74.40 Obligated balance, end of year ................................ 38 45 51 895 895 950 86.90 Outlays (gross), detail: Outlays from new discretionary authority ..................... 54 52 52 CENTERS FOR DISEASE CONTROL AND PREVENTION—Continued Federal—Continued 406 AGENCY FOR TOXIC SUBSTANCES AND THE BUDGET FOR FISCAL YEAR 2008 DISEASE REGISTRY—Continued TOXIC SUBSTANCES AND ENVIRONMENTAL PUBLIC HEALTH—Continued Trust Funds TOXIC SUBSTANCES AND ENVIRONMENTAL PUBLIC HEALTH, AGENCY FOR TOXIC SUBSTANCES AND DISEASE REGISTRY Program and Financing (in millions of dollars)—Continued Identification code 75–0944–0–1–551 2006 actual Program and Financing (in millions of dollars) 2007 est. 2008 est. 86.93 Outlays from discretionary balances ............................. 23 28 29 87.00 Total outlays (gross) ................................................. 77 80 81 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 ................................................... Net budget authority and outlays: 89.00 Budget authority ............................................................ 90.00 Outlays ........................................................................... ¥8 ¥6 ¥6 11.1 11.3 11.5 11.7 11.9 12.1 12.2 21.0 23.3 25.1 25.2 25.3 25.5 31.0 41.0 75 69 75 74 75 75 2007 est. 2008 est. 21 1 1 4 21 1 1 4 22 1 1 5 27 6 1 1 27 6 2 1 29 6 2 1 12 2 6 12 2 6 11 2 5 1 1 2 15 1 1 2 15 1 1 2 15 Direct obligations .................................................. Reimbursable obligations .............................................. 74 6 75 6 75 6 99.9 Total new obligations ................................................ 80 81 81 Employment Summary Direct: Civilian full-time equivalent employment Military full-time equivalent employment Reimbursable: 2001 Civilian full-time equivalent employment 2101 Military full-time equivalent employment 1001 1101 10 2 ................... ¥8 ¥2 ................... ¥1 ................... ................... 1 ................... ................... Outlays (gross), detail: Outlays from discretionary balances ............................. Offsets: Against gross budget authority and outlays: 88.00 Offsetting collections (cash) from: Federal sources Against gross budget authority only: 88.96 Portion of offsetting collections (cash) credited to expired accounts ................................................... 89.00 90.00 2 ................... ................... 300 14 2007 est. 300 14 2008 est. 300 14 ..................... 16 16 16 ..................... ................... ................... ................... 8 2 ................... ¥1 ................... ................... 1 ................... ................... Net budget authority and outlays: Budget authority ............................................................ ................... ................... ................... Outlays ........................................................................... 7 2 ................... The Agency for Toxic Substances and Disease Registry (ATSDR) received appropriations solely from the Hazardous Substance Superfund trust fund until 2004, when ATSDR received an appropriation from the general fund, depending on any available balances from the trust fund. The Budget proposes that ATSDR’s appropriation come only from the general fund in 2008, without regard to any available balances in the trust fund. f NATIONAL INSTITUTES OF HEALTH Federal NATIONAL CANCER INSTITUTE For carrying out section 301 and title IV of the Public Health Service Act with respect to cancer, $4,782,114,000, of which up to $8,000,000 may be used for facilities repairs and improvements at the NCI-Frederick Federally Funded Research and Development Center in Frederick, Maryland. Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. NATIONAL HEART, LUNG, AND BLOOD INSTITUTE For carrying out section 301 and title IV of the Public Health Service Act with respect to cardiovascular, lung, and blood diseases, and blood and blood products, $2,925,413,000. Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. NATIONAL INSTITUTE 2006 actual ..................... ..................... 2008 est. 1 ................... ................... Obligated balance, end of year ................................ 86.93 99.0 99.0 Identification code 75–0944–0–1–551 Change in obligated balances: Obligated balance, start of year ................................... Total outlays (gross) ...................................................... Adjustments in expired accounts (net) ......................... Change in uncollected customer payments from Federal sources (expired) ................................................ 74.40 2006 actual Total personnel compensation .............................. Civilian personnel benefits ....................................... Military personnel benefits ........................................ 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 ........................ 72.40 73.20 73.40 74.10 2007 est. 4 ................... ................... Object Classification (in millions of dollars) Direct obligations: Personnel compensation: Full-time permanent ............................................. Other than full-time permanent ........................... Other personnel compensation ............................. Military personnel ................................................. 2006 actual Budgetary resources available for obligation: 24.41 Special and trust fund receipts returned to Schedule N ................................................................................ ¥2 ................... ................... 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. Identification code 75–0944–0–1–551 Identification code 75–8252–0–7–551 OF DENTAL AND CRANIOFACIAL RESEARCH For carrying out section 301 and title IV of the Public Health Service Act with respect to dental disease, $389,722,000. Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE DISEASES AND KIDNEY For carrying out section 301 and title IV of the Public Health Service Act with respect to diabetes and digestive and kidney disease, $1,708,045,000. NATIONAL INSTITUTES OF HEALTH—Continued Federal—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. NATIONAL INSTITUTE 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, $1,537,019,000. Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES (INCLUDING TRANSFER OF FUNDS) For carrying out section 301 and title IV of the Public Health Service Act with respect to allergy and infectious diseases, $4,592,482,000: Provided, That $300,000,000 may be made available to International Assistance Programs ‘‘Global Fund to Fight HIV/ AIDS, Malaria, and Tuberculosis’’, to remain available until expended: Provided further, That such sums obligated in fiscal years 2003 through 2007 for extramural facilities construction projects are to remain available until expended for disbursement, with prior notification of such projects to the House of Representatives and Senate Committees on Appropriations. Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES For carrying out section 301 and title IV of the Public Health Service Act with respect to general medical sciences, $1,941,462,000. Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT For carrying out section 301 and title IV of the Public Health Service Act with respect to child health and human development, $1,264,946,000. Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. 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, $667,820,000. Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL SKIN DISEASES 407 AND For carrying out section 301 and title IV of the Public Health Service Act with respect to arthritis and musculoskeletal and skin diseases, $508,082,000. Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. 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, $393,682,000. Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. NATIONAL INSTITUTE OF NURSING RESEARCH For carrying out section 301 and title IV of the Public Health Service Act with respect to nursing research, $137,800,000. Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM For carrying out section 301 and title IV of the Public Health Service Act with respect to alcohol abuse and alcoholism, $436,505,000. Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. NATIONAL INSTITUTE ON DRUG ABUSE For carrying out section 301 and title IV of the Public Health Service Act with respect to drug abuse, $1,000,365,000. Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. NATIONAL INSTITUTE OF MENTAL HEALTH For carrying out section 301 and title IV of the Public Health Service Act with respect to mental health, $1,405,421,000. Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. NATIONAL HUMAN GENOME RESEARCH INSTITUTE For carrying out section 301 and title IV of the Public Health Service Act with respect to human genome research, $484,436,000. For carrying out sections 301 and 311 and title IV of the Public Health Service Act with respect to environmental health sciences, $637,406,000. Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. NATIONAL INSTITUTE 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, $78,434,000. Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. OF BIOMEDICAL IMAGING AND BIOENGINEERING For carrying out section 301 and title IV of the Public Health Service Act with respect to biomedical imaging and bioengineering research, $300,463,000. Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. NATIONAL CENTER FOR RESEARCH RESOURCES For carrying out section 301 and title IV of the Public Health Service Act with respect to aging, $1,047,148,000. For carrying out section 301 and title IV of the Public Health Service Act with respect to research resources and general research support grants, $1,112,498,000: 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. Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. NATIONAL INSTITUTE ON AGING 408 NATIONAL INSTITUTES OF HEALTH—Continued Federal—Continued NATIONAL CENTER THE BUDGET FOR FISCAL YEAR 2008 For carrying out section 301 and title IV of the Public Health Service Act with respect to complementary and alternative medicine, $121,699,000. BUILDINGS AND FACILITIES 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, $136,000,000, to remain available until expended. Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. NATIONAL CENTER ON FOR COMPLEMENTARY MEDICINE MINORITY HEALTH AND AND ALTERNATIVE HEALTH DISPARITIES Special and Trust Fund Receipts (in millions of dollars) For carrying out section 301 and title IV of the Public Health Service Act with respect to minority health and health disparities research, $194,495,000. Identification code 75–9915–0–1–552 Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. 01.99 JOHN E. FOGARTY INTERNATIONAL CENTER For carrying out the activities at the John E. Fogarty International Center, $66,594,000. Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. NATIONAL LIBRARY OF Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. OF THE DIRECTOR (INCLUDING TRANSFER OF FUNDS) For carrying out the responsibilities of the Office of the Director, National Institutes of Health, $517,062,000, of which up to $25,000,000 shall be used to carry out section 215 of this Act: Provided, That funding shall be available for the purchase of not to exceed 29 passenger motor vehicles for replacement only: 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 such Fund shall remain available for one fiscal year after the fiscal year in which they are deposited: Provided further, That the amounts appropriated in this Act to each Institute and Center may be transferred and utilized for the National Institutes of Health Common Fund: Provided further, That the amount utilized under the preceding proviso shall not exceed $365,000,000 without prior notification to the Committees on Appropriations of the House of Representatives and the Senate: Provided further, That amounts transferred and utilized under the preceding two provisos shall be in addition to amounts made available for the Common Fund from the Director’s Discretionary Fund and to any amounts allocated to activities related to the Common Fund through the normal research priority-setting process of individual Institutes and Centers: Provided further, That of the funds provided $10,000 shall be for official reception and representation expenses when specifically approved by the Director of NIH: Provided further, That the Office of AIDS Research within the Office of the Director, NIH may spend up to $4,000,000 to make grants for construction or renovation of facilities as provided for in section 2354(a)(5)(B) of the Public Health Service Act. Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. 2007 est. 2008 est. Balance, start of year .................................................... ................... ................... ................... Balance, start of year .................................................... ................... ................... ................... Receipts: 02.20 Cooperative research and development agreements, NIH ............................................................................. 15 16 16 04.00 Total: Balances and collections .................................... Appropriations: 05.00 National Institutes of Health ......................................... 07.99 MEDICINE For carrying out section 301 and title IV of the Public Health Service Act with respect to health information communications, $312,562,000, of which $4,000,000 shall be available until expended for improvement of information systems: Provided, That in fiscal year 2008, 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: Provided further, That in addition to amounts provided herein, $8,200,000 shall be available from amounts available under section 241 of the Public Health Service Act to carry out National Information Center on Health Services Research and Health Care Technology and related health services. OFFICE 01.00 2006 actual 15 16 16 ¥15 ¥16 ¥16 Balance, end of year ..................................................... ................... ................... ................... Program and Financing (in millions of dollars) Identification code 75–9915–0–1–552 Obligations by program activity: 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 ................................................................ 00.20 National Center for Research Resources ....................... 00.21 National Center for Complementary and Alternative Medicine .................................................................... 00.22 National Center on Minority Health and Health Disparities ...................................................................... 00.23 John E. Fogarty International Center ............................. 00.24 National Library of Medicine ......................................... 00.25 Office of the Director ..................................................... 00.26 Buildings and facilities ................................................. 00.27 Cooperative Research and Development Agreements 00.28 Royalities ........................................................................ 09.00 Reimbursable program .................................................. 10.00 Total new obligations ................................................ 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 ....................................................................... 2006 actual 2007 est. 2008 est. 4,747 2,894 386 4,793 2,922 389 4,782 2,925 390 1,839 1,520 4,224 1,917 1,855 1,535 4,365 1,936 1,858 1,537 4,592 1,941 1,253 660 710 1,037 1,265 667 720 1,047 1,265 668 716 1,047 503 508 508 390 1,390 990 432 136 481 393 1,404 1,000 436 137 486 394 1,405 1,000 437 138 484 294 1,088 297 1,099 300 1,113 120 121 122 193 66 312 725 175 20 76 2,637 195 66 315 478 171 20 76 2,758 195 67 313 517 136 16 76 2,883 31,224 31,454 31,823 434 31,180 381 31,161 88 31,825 2 ................... ................... 23.90 23.95 23.98 Total budgetary resources available for obligation Total new obligations .................................................... Unobligated balance expiring or withdrawn ................. 31,616 31,542 31,913 ¥31,224 ¥31,454 ¥31,823 ¥11 ................... ................... 24.40 Unobligated balance carried forward, end of year 381 88 90 New budget authority (gross), detail: Discretionary: 40.00 Appropriation ............................................................. 28,648 28,450 28,700 NATIONAL INSTITUTES OF HEALTH—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES 40.35 41.00 Appropriation permanently reduced .......................... Transferred to other accounts ....................................... 43.00 Appropriation (total discretionary) ........................ Spending authority from offsetting collections: Offsetting collections (cash) ................................ Change in uncollected customer payments from Federal sources (unexpired) ............................. ¥287 ................... ................... ¥119 ................... ................... 58.90 28,450 28,700 2,124 2,545 2,959 649 ................... ................... 60.00 60.20 Spending authority from offsetting collections (total discretionary) .......................................... Mandatory: Appropriation ............................................................. Appropriation (special fund) ..................................... 62.50 Appropriation (total mandatory) ........................... 165 166 Total new budget authority (gross) .......................... 31,180 31,161 486 484 294 297 300 120 193 66 312 725 175 121 195 66 315 478 171 122 195 67 313 517 136 Subtotal .......................................................................... Cooperative Research and Development Agreements ............ 28,392 15 28,600 16 28,850 16 28,407 28,616 28,866 166 70.00 481 Total Budget Authority, NIH ........................................... 58.00 58.10 28,242 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 .......................................................... 409 31,825 2,773 2,545 2,959 150 15 150 16 150 16 [Dollars in millions] 2006 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) ............................................ 74.10 Change in uncollected customer payments from Federal sources (expired) ................................................ 29,063 29,560 30,351 31,224 31,454 31,823 ¥30,362 ¥30,663 ¥31,551 ¥192 ................... ................... ¥2 ................... ................... ¥649 ................... ................... 478 ................... ................... 74.40 Obligated balance, end of year ................................ 29,560 30,351 30,623 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 ................................ 9,862 20,338 49 113 9,658 20,842 40 123 10,162 21,223 40 126 87.00 Total outlays (gross) ................................................. 30,362 30,663 31,551 Offsets: Against gross budget authority and outlays: Offsetting collections (cash) from: 88.00 Federal sources ..................................................... 88.40 Non-Federal sources ............................................. ¥2,502 ¥2,545 ¥2,959 ¥89 ................... ................... 88.90 ¥2,591 88.95 88.96 89.00 90.00 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 ........................................................................... ¥2,545 ¥2,959 ¥649 ................... ................... 467 ................... ................... 28,407 27,771 28,616 28,118 28,866 28,592 Note.—Excludes $50 million in budget authority and associated outlays in 2006 and 2007 for advanced development of bioterrorism countermeasures activities that are proposed to be financed in the Public Health and Social Services Emergency Fund in 2008. DISTRIBUTION OF BUDGET AUTHORITY AND OUTLAYS BY ACCOUNT [Dollars in millions] 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 ................................ 2006 2007 2008 4,747 2,894 386 4,793 2,922 389 1,855 1,535 4,365 1,936 1,265 667 720 1,047 1,858 1,537 4,592 1,941 1,265 668 716 1,047 503 508 508 390 136 432 990 1,390 1,088 393 137 436 1,000 1,404 1,099 394 138 437 1,000 1,405 1,113 2007 2008 4,713 2,854 379 4,660 2,817 371 4,694 2,894 385 1,808 1,536 4,007 1,907 1,235 649 728 1,029 1,721 1,506 4,314 1,855 1,252 662 693 1,033 1,837 1,504 4,362 1,906 1,252 654 712 1,036 498 496 503 387 135 424 979 1,412 1,119 463 372 135 430 976 1,331 1,080 497 390 136 432 981 1,390 1,093 477 292 286 294 114 194 64 314 479 158 (118) 118 174 66 310 706 247 0 120 188 66 308 756 212 0 Subtotal Outlays ............................................................ Cooperative Research and Development Agreements ............ 27,759 12 28,108 10 28,582 10 Total Outlays, NIH .......................................................... 27,771 28,118 28,592 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. 4,782 2,925 390 1,839 1,520 4,224 1,917 1,253 660 710 1,037 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 ......................... Object Classification (in millions of dollars) 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 23.2 23.3 24.0 Direct obligations: Personnel compensation: Full-time permanent ............................................. Other than full-time permanent ........................... Other personnel compensation ............................. Military personnel ................................................. Special personal services payments .................... Total personnel compensation .............................. Civilian personnel benefits ....................................... Military personnel benefits ........................................ Travel and transportation of persons ....................... Transportation of things ........................................... Rental payments to others ........................................ Communications, utilities, and miscellaneous charges ................................................................. Printing and reproduction ......................................... 2006 actual 2007 est. 2008 est. 800 250 33 25 169 847 264 35 26 174 891 277 36 28 178 1,277 295 17 55 5 1 1,346 312 17 55 5 1 1,410 327 18 53 5 1 29 15 30 14 30 14 410 NATIONAL INSTITUTES OF HEALTH—Continued BUILDINGS AND THE BUDGET FOR FISCAL YEAR 2008 FACILITIES Object Classification (in millions of dollars)—Continued Identification code 75–9915–0–1–552 25.1 25.2 25.3 2006 actual 2007 est. 2008 est. 131 553 132 522 129 520 25.4 25.5 25.6 25.7 26.0 31.0 41.0 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 ........................ 2,555 292 1,976 18 78 223 136 20,931 2,594 298 2,090 17 77 218 135 20,833 2,558 258 2,243 17 73 208 130 20,946 99.0 99.0 Direct obligations .................................................. Reimbursable obligations .............................................. 28,587 2,637 28,696 2,758 00.02 00.03 00.05 00.10 00.11 00.12 00.13 28,940 2,883 00.18 00.19 Direct program: Mental health block grant ........................................ Substance abuse block grant ................................... Program management ............................................... Children’s mental health ............................................... PATH homeless State grants ......................................... Protection and advocacy ................................................ Mental health programs of regional and national significance .................................................................... Prevention programs of regional and national significance ......................................................................... Treatment programs of regional and national significance ......................................................................... 407 1,678 75 104 54 34 407 1,679 76 104 54 34 407 1,679 77 104 54 34 263 263 187 192 193 156 394 395 348 31,224 31,454 31,823 Employment Summary Identification code 75–9915–0–1–552 2006 actual Direct: 1001 Civilian full-time equivalent employment 1101 Military full-time equivalent employment Reimbursable: 2001 Civilian full-time equivalent employment 2101 Military full-time equivalent employment 2007 est. 2008 est. ..................... ..................... 11,454 285 11,642 321 11,776 358 ..................... ..................... 5,020 107 5,118 121 5,177 134 3,201 281 3,205 272 3,046 272 Total new obligations ................................................ 3,482 3,477 3,318 22.00 23.95 23.98 Budgetary resources available for obligation: New budget authority (gross) ........................................ Total new obligations .................................................... Unobligated balance expiring or withdrawn ................. 3,485 3,477 3,318 ¥3,482 ¥3,477 ¥3,318 ¥2 ................... ................... New budget authority (gross), detail: Discretionary: 40.00 Appropriation ............................................................. 40.35 Appropriation permanently reduced .......................... 41.00 Transferred to other accounts ................................... 3,238 3,205 3,046 ¥32 ................... ................... ¥2 ................... ................... 43.00 Total new obligations ................................................ Total, direct program ................................................ Reimbursable program .................................................. 10.00 99.9 01.00 09.01 3,204 3,205 3,046 157 272 272 58.00 58.10 f SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION 58.90 70.00 Appropriation (total discretionary) ........................ Spending authority from offsetting collections: Offsetting collections (cash) ................................ Change in uncollected customer payments from Federal sources (unexpired) ............................. 124 ................... ................... Spending authority from offsetting collections (total discretionary) .......................................... 281 272 272 Total new budget authority (gross) .......................... 3,485 3,477 3,318 Federal SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES For carrying out titles V and XIX of the Public Health Service Act (‘‘PHS Act’’) with respect to substance abuse and mental health services, the Protection and Advocacy for Individuals with Mental Illness Act, and section 301 of the PHS Act with respect to program management, $3,046,426,000: Provided, That notwithstanding section 520A(f)(2) of the PHS Act, no funds appropriated for carrying out section 520A are available for carrying out section 1971 of the PHS Act: Provided further, That in addition to amounts provided herein, the following amounts shall be available under section 241 of the PHS Act: (1) $79,200,000 to carry out subpart II of part B of title XIX of the PHS Act to fund section 1935(b) technical assistance, national data, data collection and evaluation activities, and further that the total available under this Act for section 1935(b) activities shall not exceed 5 percent of the amounts appropriated for subpart II of part B of title XIX; (2) $21,413,000 to carry out subpart I of part B of title XIX of the PHS Act to fund section 1920(b) technical assistance, national data, data collection and evaluation activities, and further that the total available under this Act for section 1920(b) activities shall not exceed 5 percent of the amounts appropriated for subpart I of part B of title XIX; (3) $16,250,000 to carry out national surveys on drug abuse; and (4) $4,300,000 to evaluate substance abuse treatment programs. Pursuant to section 1942 of the PHS Act, a State that receives an allotment under section 1911 or 1921 of such Act for the current fiscal year shall submit data from the previous year on all developed National Outcome Measures. A State shall not receive more than 95 percent of the State’s allotment as determined under section 1933 for such year if that State does not report on National Outcome Measures under section 1921. Undistributed amounts under section 1921 shall be reallocated to States that report on such measures under section 1921 in accordance with section 1944 of the PHS Act. Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. Program and Financing (in millions of dollars) Identification code 75–1362–0–1–551 Obligations by program activity: 2006 actual 2007 est. 2008 est. 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) ................................................ 72.40 73.10 73.20 73.40 74.00 2,600 2,589 2,590 3,482 3,477 3,318 ¥3,425 ¥3,476 ¥3,416 ¥36 ................... ................... ¥124 ................... ................... 92 ................... ................... 74.40 Obligated balance, end of year ................................ 2,589 2,590 2,492 86.90 86.93 Outlays (gross), detail: Outlays from new discretionary authority ..................... Outlays from discretionary balances ............................. 1,431 1,994 1,554 1,922 1,491 1,925 87.00 Total outlays (gross) ................................................. 3,425 3,476 3,416 Offsets: Against gross budget authority and outlays: Offsetting collections (cash) from: 88.00 Federal sources ..................................................... 88.40 Non-Federal sources ............................................. ¥189 ¥272 ¥272 ¥53 ................... ................... 88.90 ¥242 88.95 88.96 89.00 90.00 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 ........................................................................... ¥272 ¥272 ¥124 ................... ................... 85 ................... ................... 3,204 3,183 3,205 3,204 3,046 3,144 This program provides Federal support to strengthen the capacity of the Nation’s health care delivery system to provide substance abuse prevention, addiction treatment, and mental health services, for people at risk for or experiencing substance abuse or mental illness. SAMHSA builds partnerships with states, communities, and private organizations to address the needs of individuals with substance abuse disorders CENTERS FOR MEDICARE AND MEDICAID SERVICES Federal DEPARTMENT OF HEALTH AND HUMAN SERVICES and/or mental illness and to identify and respond to the community risk factors that contribute to these illnesses. Object Classification (in millions of dollars) Identification code 75–1362–0–1–551 11.1 11.3 11.5 11.7 11.9 12.1 12.2 21.0 23.1 23.3 2006 actual 2007 est. 2008 est. 39 2 1 1 41 3 1 2 42 3 2 2 43 9 1 2 6 47 10 2 1 6 49 10 2 1 6 1 5 23 176 1 4 22 169 1 3 12 98 26.0 41.0 42.0 100 1 2,832 2 102 1 2,839 1 75 1 2,787 1 99.0 99.0 Direct obligations .................................................. Reimbursable obligations .............................................. 3,201 281 3,205 272 99.9 Total new obligations ................................................ 3,482 3,477 2006 actual Direct: 1001 Civilian full-time equivalent employment 1101 Military full-time equivalent employment Reimbursable: 2001 Civilian full-time equivalent employment 2101 Military full-time equivalent employment 2007 est. 17 60.00 70.00 452 28 452 28 ..................... ..................... 36 23 37 23 357 221 ................... ................... 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 ................................................... 448 17 346 ¥239 ................... ................... Total outlays (gross) ................................................. ..................... ..................... 357 44 45 45 346 346 357 ¥326 ¥346 ¥357 ¥1 ................... ................... Outlays (gross), detail: Outlays from new discretionary authority ..................... Outlays from new mandatory authority ......................... 2008 est. 346 1 ................... ................... Obligated balance, end of year ................................ 3,318 357 346 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) ................................................ 87.00 346 345 72.40 73.10 73.20 73.40 74.00 3,046 272 17 239 ................... ................... Total new budget authority (gross) .......................... 86.90 86.97 17 106 Spending authority from offsetting collections (total discretionary) .......................................... Mandatory: Appropriation ............................................................. 74.40 Employment Summary Identification code 75–1362–0–1–551 Unobligated balance carried forward, end of year New budget authority (gross), detail: Discretionary: Spending authority from offsetting collections: 58.00 Offsetting collections (cash) ................................ 58.10 Change in uncollected customer payments from Federal sources (unexpired) ............................. 58.90 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 ....................... 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 ................................................. Supplies and materials ............................................. Grants, subsidies, and contributions ........................ Insurance claims and indemnities ........................... 24.0 25.1 25.2 25.3 24.40 411 45 45 45 325 346 357 1 ................... ................... 326 346 357 ¥327 ¥346 ¥357 ¥239 ................... ................... 221 ................... ................... 37 23 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 1 ................... ................... ¥1 ................... ................... AGENCY FOR HEALTHCARE RESEARCH AND QUALITY 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. Federal Object Classification (in millions of dollars) f HEALTHCARE RESEARCH AND QUALITY Identification code 75–1700–0–1–552 2006 actual 2007 est. 2008 est. 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 made available pursuant to section 927(c) of the Public Health Service Act shall not exceed $329,564,000. 99.0 Reimbursable obligations .......................................... 346 346 357 99.9 Total new obligations ................................................ 346 346 357 Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. Reimbursable: 2001 Civilian full-time equivalent employment ..................... 2101 Military full-time equivalent employment ..................... Employment Summary Identification code 75–1700–0–1–552 Program and Financing (in millions of dollars) Identification code 75–1700–0–1–552 2006 actual 2006 actual 2007 est. 2008 est. 346 346 357 10.00 346 346 Total budgetary resources available for obligation Total new obligations .................................................... 286 13 Federal GRANTS 23.90 23.95 279 13 CENTERS FOR MEDICARE AND MEDICAID SERVICES 357 Budgetary resources available for obligation: 21.40 Unobligated balance carried forward, start of year 22.00 New budget authority (gross) ........................................ 2008 est. f Obligations by program activity: 09.00 Reimbursable program .................................................. Total new obligations ................................................ 279 13 2007 est. 17 346 17 346 17 357 363 ¥346 363 ¥346 374 ¥357 TO STATES FOR MEDICAID For carrying out, except as otherwise provided, titles XI and XIX of the Social Security Act, $141,628,056,000, to remain available until expended. For making, after May 31, 2008, payments to States under title XIX of the Social Security Act for the last quarter of fiscal year 412 CENTERS FOR MEDICARE AND MEDICAID SERVICES—Continued Federal—Continued GRANTS TO STATES FOR THE BUDGET FOR FISCAL YEAR 2008 MEDICAID—Continued 2008, 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 2009, $67,292,669,000, 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 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. Outlays .................................................................................... .................... .................... Legislative proposal, subject to PAYGO: Budget Authority ..................................................................... .................... 35 Outlays .................................................................................... .................... 35 Total: Budget Authority ..................................................................... Outlays .................................................................................... 215,471 180,625 168,290 191,876 –425 –1,517 –1,517 204,944 201,944 Medicaid assists States in providing medical care to their low-income populations by granting Federal matching payments under title XIX of the Social Security Act to States with approved plans. Medicaid estimates assume budget authority for expenses that are incurred but not reported (IBNR). Object Classification (in millions of dollars) Program and Financing (in millions of dollars) Identification code 75–0512–0–1–551 Identification code 75–0512–0–1–551 2006 actual 2007 est. 2008 est. 00.01 00.02 00.03 00.04 09.01 Obligations by program activity: Medicaid vendor payments ............................................ State and local administration ..................................... Vaccine purchases ......................................................... Incurred by providers but not yet reported ................... Medicare Part B premiums ............................................ 182,284 10,490 1,974 6,830 264 179,054 191,109 9,882 10,015 2,905 2,762 3,000 3,000 350 ................... 10.00 Total new obligations ................................................ 201,842 195,191 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 ....................................................................... 378 215,737 26,586 ................... 168,605 206,886 23.90 23.95 Total budgetary resources available for obligation Total new obligations .................................................... 24.40 Unobligated balance carried forward, end of year New budget authority (gross), detail: Mandatory: 60.00 Appropriation ............................................................. 65.00 Advance appropriation .............................................. 69.00 Spending authority from offsetting collections: Offsetting collections (cash) ..................................... 70.00 Total new budget authority (gross) .......................... 41.0 2006 actual 2007 est. 2008 est. 99.0 Direct obligations: Grants, subsidies, and contributions ........................................................................... Reimbursable obligations: reimbursable obligations 201,578 264 194,841 206,886 350 ................... 99.9 Total new obligations ................................................ 201,842 195,191 GRANTS 206,886 TO STATES FOR 206,886 MEDICAID (Legislative proposal, not subject to PAYGO) Program and Financing (in millions of dollars) 12,313 ................... ................... 228,428 ¥201,842 195,191 ¥195,191 206,886 ¥206,886 26,586 ................... ................... 156,954 58,517 266 215,737 105,471 62,784 141,628 65,258 Identification code 75–0512–2–1–551 2007 est. 2008 est. ¥425 Net budget authority and outlays: Budget authority ............................................................ ................... ................... Outlays ........................................................................... ................... ................... ¥425 ¥425 89.00 90.00 This schedule reflects the Administration’s Medicaid proposal. GRANTS 350 ................... 168,605 2006 actual Offsets: Against gross budget authority and outlays: 88.00 Offsetting collections (cash) from: Federal sources ................... ................... TO STATES FOR MEDICAID (Legislative proposal, subject to PAYGO) 206,886 Program and Financing (in millions of dollars) 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 .............................. 11,388 20,026 23,026 201,842 195,191 206,886 ¥180,891 ¥192,191 ¥203,886 ¥12,313 ................... ................... 2007 est. ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... 35 ................... ................... ¥1,225 ¥200 ¥355 ¥75 ¥70 460 ¥477 425 10.00 Total new obligations ................................................ ................... 35 ¥1,517 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ ................... Total new obligations .................................................... ................... 35 ¥35 ¥1,517 1,517 New budget authority (gross), detail: Mandatory: 60.00 Appropriation ............................................................. ................... 35 69.00 Spending authority from offsetting collections: Offsetting collections (cash) ..................................... ................... ................... ¥1,942 70.00 Total new budget authority (gross) .......................... ................... 35 ¥1,517 73.10 73.20 23,026 2006 actual Change in obligated balances: Total new obligations .................................................... ................... Total outlays (gross) ...................................................... ................... 35 ¥35 ¥1,517 1,517 206,886 203,886 86.97 Outlays (gross), detail: Outlays from new mandatory authority ......................... ................... 35 ¥1,517 –425 89.00 Net budget authority and outlays: Budget authority ............................................................ ................... 35 ¥1,517 74.40 Obligated balance, end of year ................................ 20,026 26,026 86.97 86.98 Outlays (gross), detail: Outlays from new mandatory authority ......................... Outlays from mandatory balances ................................ 180,513 378 165,605 203,886 26,586 ................... 87.00 Total outlays (gross) ................................................. 180,891 192,191 203,886 Offsets: Against gross budget authority and outlays: Offsetting collections (cash) from: 88.00 Federal sources ..................................................... 88.40 Non-Federal sources ............................................. ¥264 ¥350 ................... ¥2 ................... ................... 88.90 ¥266 Total, offsetting collections (cash) ....................... Net budget authority and outlays: 89.00 Budget authority ............................................................ 90.00 Outlays ........................................................................... 215,471 180,625 ¥350 ................... 168,255 191,841 206,886 203,886 Summary of Budget Authority and Outlays (in millions of dollars) 2006 actual 2007 est. Enacted/requested: Budget Authority ..................................................................... 215,471 168,255 Outlays .................................................................................... 180,625 191,841 Legislative proposal, not subject to PAYGO: Budget Authority ..................................................................... .................... .................... Identification code 75–0512–4–1–551 Obligations by program activity: 00.01 Administrative Services Reforms ................................... 00.02 Reimbursement Reforms ................................................ 00.03 Pharmacy Reforms ......................................................... 00.04 Program Integrity Reforms ............................................. 00.05 Long Term Care Reform ................................................. 00.06 Authorization Extensions and Modifications .................. 00.07 Other proposals .............................................................. 09.01 Medicare Part B premiums ............................................ 2008 est. 425 2008 est. CENTERS FOR MEDICARE AND MEDICAID SERVICES—Continued Federal—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES 90.00 Outlays ........................................................................... ................... 35 ¥1,517 This schedule reflects the Administration’s Medicaid proposal. 63.00 69.00 413 Reappropriation—Tax Relief and Health Care Act of 2006 ................................................................. ................... 10 ................... Spending authority from offsetting collections: Offsetting collections (cash) ..................................... 70 ................... ................... 70.00 Total new budget authority (gross) .......................... 2,636 707 764 72.40 73.10 73.20 73.45 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Recoveries of prior year obligations .............................. 74.40 Obligated balance, end of year ................................ 1,404 545 835 86.97 86.98 Outlays (gross), detail: Outlays from new mandatory authority ......................... Outlays from mandatory balances ................................ 1,124 215 378 1,302 433 63 87.00 Total outlays (gross) ................................................. 1,339 1,680 496 Object Classification (in millions of dollars) Identification code 75–0512–4–1–551 41.0 99.0 99.9 2006 actual 2007 est. 2008 est. Direct obligations: Grants, subsidies, and contributions ........................................................................... ................... 35 Reimbursable obligations: reimbursable obligations ................... ................... Total new obligations ................................................ ................... 35 ¥1,942 425 ¥1,517 f STATE GRANTS AND DEMONSTRATIONS Program and Financing (in millions of dollars) Identification code 75–0516–0–1–551 Obligations by program activity: 00.01 Ticket to Work—grants ................................................. 00.02 High-risk pools—grants ................................................ 00.03 Emergency health services for undocumented aliens 00.04 Pilot program—background checks .............................. 00.05 State pharmaceutical assistance programs ................. 00.06 Health care infrastructure improv program .................. 00.08 Medicaid Integrity Program—general ........................... 00.09 Site development grants-rural PACE ............................. 00.10 Funding for PACE outliers ............................................. 00.11 Drug surveys & reports .................................................. 00.12 Partnerships for long term care .................................... 00.13 Alternate non-emergency network providers ................. 00.14 Psychiatric residential treatment demonstration .......... 00.15 Money follows the Person (MFP) demonstration ........... 00.16 MFP evaluations & technical support ........................... 00.17 Medicaid transformation grants .................................... 00.19 Katrina relief .................................................................. 09.11 Reimbursable program-Katrina/Rita hurricane support 10.00 Total new obligations ................................................ 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 Total budgetary resources available for obligation Total new obligations .................................................... Unobligated balance expiring or withdrawn ................. 24.40 Unobligated balance carried forward, end of year New budget authority (gross), detail: Mandatory: 60.00 Appropriation—(P.L. 106–170, Sections 203 & 204) ....................................................................... 60.00 Appropriation—(P. L. 108–173)—Undocumented aliens .................................................................... 60.00 Appropriation-(P.L. 108–173)—State pharmaceutical assistance programs .............................. 60.00 Appropriation-High Risk Pools .................................. 60.00 Appropriation-Katrina Relief ...................................... 60.00 Appropriation-Site Development for Rural PACE grants .................................................................... 60.00 Appropriation-Rural PACE outlier grants .................. 60.00 Appropriation-Federal upper payment limit for multiple source drugs ................................................. 60.00 Appropriation-Expansion of Long-term Care Partnerships ..................................................................... 60.00 Appropriation-Grants to establish alternate nonemergency services ............................................... 60.00 Appropriation-Psychiatric Residential Treatment Demonstration ....................................................... 60.00 Appropriation-Money follows the Person demonstration ........................................................................ 60.00 Appropriation-Money follows the Person—evaluation ........................................................................ 60.00 Appropriation-Medicaid Transformation grants ........ 60.00 AppropriationMedicaid Integrity Program .................. Offsets: Against gross budget authority and outlays: 88.00 Offsetting collections (cash) from: Federal sources 2006 actual 2007 est. 2008 est. 104 77 170 10 63 140 3 7 ................... 5 3 ................... ................... ................... ................... ................... 1,864 69 50 ................... 200 ................... ................... 2 52 ................... 2 5 3 25 21 248 1 75 136 1 51 ................... 250 ................... ................... ................... 50 ................... 3 5 3 12 37 298 2 75 ................... ................... 2,515 821 786 381 2,636 634 707 89.00 90.00 Appropriation (total mandatory) ........................... Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... ¥70 ................... ................... 2,566 1,269 707 1,680 764 496 Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in millions of dollars) Identification code 75–0516–0–1–551 Direct loan levels supportable by subsidy budget authority: 115001 Health care infrastructure improvement ....................... 115999 Total direct loan levels .................................................. Direct loan subsidy (in percent): 132001 Health care infrastructure improvement ....................... 2006 actual 2007 est. 2008 est. 140 1 ................... 140 1 ................... 100.00 100.00 0.00 132999 Weighted average subsidy rate ..................................... Direct loan subsidy budget authority: 133001 Health care infrastructure improvement ....................... 100.00 100.00 0.00 140 1 ................... 520 764 133999 Total subsidy budget authority ...................................... Direct loan subsidy outlays: 134001 Health care infrastructure improvement ....................... 140 1 ................... 140 1 ................... 155 ................... ................... 134999 Total subsidy outlays ..................................................... 140 1 ................... 3,172 1,341 1,284 ¥2,515 ¥821 ¥786 ¥23 ................... ................... 634 520 498 82 43 44 250 250 State Grants and Demonstrations provides funding for grant programs established under several legislative authorities, including the Ticket to Work and Work Incentives Improvement Act of 1999 (P.L. 106–170), the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (P.L. 108–173), and the Deficit Reduction Act of 2005 (P.L. 109– 171). 250 63 ................... ................... 90 ................... ................... 2,000 ................... ................... 8 ................... ................... 10 ................... ................... Object Classification (in millions of dollars) Identification code 75–0516–0–1–551 11.1 12.1 41.0 5 5 5 3 3 3 41.0 41.0 50 ................... ................... 41.0 ................... 21 37 ................... 249 298 ................... ................... 5 1 75 50 2 75 50 2,566 697 764 41.0 41.0 41.0 41.0 62.50 383 1,404 545 2,515 821 786 ¥1,339 ¥1,680 ¥496 ¥155 ................... ................... 2006 actual 2007 est. 2008 est. Direct obligations: Personnel compensation: Full-time permanent-Medicaid Integrity Program ......................................... ................... 3 6 Civilian personnel benefits-Medicaid Integrity Program ...................................................................... ................... 2 2 Grants, subsidies, and contributions—Ticket to Work ...................................................................... 103 50 51 Grants, subsidies, and contributions—High-Risk Pools ...................................................................... 77 ................... ................... Grants, subsidies, and contributions—Fed’l Reimb.—Emer Svcs, Undoc. Aliens ..................... 170 200 250 Grants, subsidies, and contributions—Background Checks ................................................................... 10 ................... ................... Grants, subsidies, and contributions—State Pharmaceutical Assistance Programs ......................... 63 ................... ................... Grants, subsidies, and contributions—Health Care Infrastructure Improvement Program ................... 140 2 ................... Grants, subsidies, and contributions-Medicaid Integrity Program ..................................................... 3 47 42 Grants, subsidies, and contributions-Site Development Grants-Rural PACE ...................................... 7 ................... ................... 414 CENTERS FOR MEDICARE AND MEDICAID SERVICES—Continued Federal—Continued STATE GRANTS AND THE BUDGET FOR FISCAL YEAR 2008 1111 1131 DEMONSTRATIONS—Continued Object Classification (in millions of dollars)—Continued Identification code 75–0516–0–1–551 41.0 41.0 41.0 41.0 41.0 41.0 41.0 41.0 41.0 2006 actual Grants, subsidies, and contributions-Funding for PACE Outliers ........................................................ Grants, subsidies, and contributions-Drug Surveys & Reports .............................................................. Grants, subsidies, and contributions-Partnership for Long Term Care .................................................... Grants, subsidies, and contributions-Alternate NonEmergency Network Providers ............................... Grants, subsidies, and contributions-Psychiatric Residential Treatment Demonstration .................. Grants, subsidies, and contributions-Money follows the Person (MFP) Demonstration .......................... Grants, subsidies, and contributions-MFP Evaluations & Technical Support .................................... Grants, subsidies, and contributions-Medicaid Transformation Grants .......................................... Grants, subsidies, and contributions-Katrina/Rita Hurricane Support ................................................. Grants, subsidies, and contributions-Katrina Relief 1150 2007 est. Limitation on direct loans ............................................. ................... ................... ................... Direct loan obligations exempt from limitation ............ 140 1 ................... Total direct loan obligations ..................................... 140 1 ................... 2008 est. ................... 2 3 5 5 5 3 3 25 12 ................... 21 37 Cumulative balance of direct loans outstanding: Outstanding, start of year ............................................. ................... 140 141 Disbursements: Direct loan disbursements ................... 140 1 ................... Write-offs for default: Loan forgiveness ....................... ................... ................... ................... 3 ................... 1210 1231 1264 ................... 248 298 ................... 1 2 ................... 75 75 ................... 1,864 1 ................... 136 ................... 1290 Outstanding, end of year .......................................... 140 141 141 Balance Sheet (in millions of dollars) Identification code 75–4438–0–3–551 2005 actual ASSETS: Net value of assets related to post–1991 direct loans receivable: 1401 Direct loans receivable, gross .................................................... 1402 Interest receivable ........................................................................ 1405 Allowance for subsidy cost (–) .................................................. 140 7 –147 99.0 99.0 Direct obligations .................................................. Reimbursable obligations .............................................. 99.9 Total new obligations ................................................ 2,445 821 786 70 ................... ................... 2,515 821 786 Net present value of assets related to direct loans .............. .................... .................... Total assets .................................................................................. LIABILITIES: 2999 Total liabilities ............................................................................. NET POSITION: 3999 Total net position ........................................................................ .................... .................... .................... .................... .................... .................... 4999 41.0 1499 .................... .................... .................... 2006 actual .................... .................... 1999 Total liabilities and net position ............................................... Employment Summary Identification code 75–0516–0–1–551 1001 f 2006 actual Direct: Civilian full-time equivalent employment ..................... ................... 2007 est. 2008 est. PAYMENTS 26 53 f HEALTH CARE INFRASTRUCTURE IMPROVEMENT PROGRAM, DIRECT LOAN FINANCING ACCOUNT Program and Financing (in millions of dollars) Identification code 75–4438–0–3–551 2006 actual 2007 est. 2008 est. 00.01 Obligations by program activity: Health care infrastructure improvement program ........ 140 1 ................... 10.00 Total new obligations ................................................ 140 1 ................... 22.00 23.95 Budgetary resources available for obligation: New financing authority (gross) .................................... Total new obligations .................................................... 140 ¥140 1 ................... ¥1 ................... TO HEALTH CARE TRUST FUNDS For payment to the Federal Hospital Insurance and the Federal Supplementary Medical Insurance Trust Funds, as provided under section 1844 and 1860D–16 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, $188,628,000,000. In addition, for making matching payments under section 1844, and benefit payments under 1860D–16 of the Social Security Act, not anticipated in budget estimates, such sums as may be necessary. Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. Program and Financing (in millions of dollars) New financing authority (gross), detail: Mandatory: 69.00 Spending authority from offsetting collections: Offsetting collections (cash) ..................................... 140 1 ................... 73.10 73.20 Change in obligated balances: Total new obligations .................................................... Financing disbursements (gross) .................................. 140 ¥140 1 ................... ¥1 ................... 87.00 Outlays (gross), detail: Total financing disbursements (gross) ......................... 140 1 ................... Offsets: Against gross financing authority and financing disbursements: 88.00 Offsetting collections (cash) from: Federal sources ¥140 Identification code 75–0580–0–1–571 2006 actual 2007 est. 2008 est. Obligations by program activity: Supplementary medical insurance (SMI) ....................... 134,255 137,623 140,704 Hospital insurance for uninsured (HI) ........................... 202 239 269 Federal uninsured payment (HI) .................................... 206 229 237 Program management (HI) ............................................ 131 175 192 Fraud and abuse control, criminal fines ...................... 144 200 200 Federal payments from taxation of OASDI benefits (HI) ............................................................................. 10,319 10,810 12,245 00.07 Fraud and abuse control, FBI ........................................ 114 118 121 00.08 FHI trust fund, Transfers from general fund (civil monetary penalties) ................................................... 11 22 22 00.10 Federal contributions, Transitional assistance account 229 ................... ................... 00.11 General Revenue for Part D Benefits ............................ 27,943 37,329 46,299 00.12 General Revenue for Part D Federal Admin .................. 174 704 744 00.14 HCFAC reimbursement ................................................... ................... ................... 183 ¥1 ................... 10.00 Net financing authority and financing disbursements: 89.00 Financing authority ........................................................ ................... ................... ................... 90.00 Negative subsidy BA total [75–0516] ........................... ................... ................... ................... Status of Direct Loans (in millions of dollars) Identification code 75–4438–0–3–551 Position with respect to appropriations act limitation on obligations: 00.01 00.02 00.03 00.04 00.05 00.06 2006 actual 2007 est. 2008 est. 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 ................. New budget authority (gross), detail: Mandatory: 60.00 Appropriation (Tax on OASDI Benefits) ..................... 60.00 Appropriation (HCFAC penalties, etc.) ...................... 60.00 Appropriation (Subsidy for HI & SMI benefits, General Fund federal admin) ..................................... 60.00 Appropriation (HCFAC funding) ................................. 173,728 187,449 201,216 201,386 187,449 201,216 ¥173,728 ¥187,449 ¥201,216 ¥27,658 ................... ................... 10,319 155 10,810 222 12,245 222 136,087 114 138,970 118 142,146 304 CENTERS FOR MEDICARE AND MEDICAID SERVICES—Continued Federal—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES 60.00 60.00 60.00 Appropriation (Transitional Assistance Benefits) ..... Appropriation (Part D State Eligibility Determinations) ..................................................................... Appropriation (Part D Drug Benefits) ....................... 339 ................... ................... 62.50 Appropriation (total mandatory) ........................... 201,386 187,449 201,216 73.10 73.20 Change in obligated balances: Total new obligations .................................................... Total outlays (gross) ...................................................... 173,728 ¥173,728 187,449 ¥187,449 201,216 ¥201,216 99 ................... ................... 54,273 37,329 46,299 89.00 90.00 415 Net budget authority and outlays: Budget authority ............................................................ ................... ................... Outlays ........................................................................... ................... ................... ¥1,649 ¥1,649 The Budget proposes a package of reforms to encourage competition, recognize efficiencies and productivity in health care, enhance program integrity, and strengthen responsibility for health care choices. f Outlays (gross), detail: 86.97 Outlays from new mandatory authority ......................... 173,728 187,449 201,216 Net budget authority and outlays: 89.00 Budget authority ............................................................ 90.00 Outlays ........................................................................... 201,386 173,728 187,449 187,449 201,216 201,216 Summary of Budget Authority and Outlays (in millions of dollars) 2006 actual 2007 est. Enacted/requested: Budget Authority ..................................................................... 201,386 187,449 Outlays .................................................................................... 173,728 187,449 Legislative proposal, not subject to PAYGO: Budget Authority ..................................................................... .................... .................... Outlays .................................................................................... .................... .................... Total: Budget Authority ..................................................................... Outlays .................................................................................... 201,386 173,728 187,449 187,449 2008 est. 201,216 201,216 –1,649 –1,649 199,567 199,567 Payments are made to the Federal Hospital Insurance and Federal Supplementary Medical Insurance trust funds from the general fund of the Treasury to finance Medicare’s medical and drug benefits for beneficiaries and certain other qualified individuals. Object Classification (in millions of dollars) Identification code 75–0580–0–1–571 2006 actual 2007 est. 2008 est. Direct obligations: 41.0 Grants, subsidies, and contributions ............................ 42.0 Insurance claims and indemnities ................................ 94.0 Financial transfers (federal admin) .............................. 173,015 408 305 186,102 468 879 199,774 506 936 99.0 Direct obligations ...................................................... 173,728 187,449 201,216 99.9 Total new obligations ................................................ 173,728 187,449 201,216 PAYMENTS TO HEALTH CARE TRUST FUNDS (Legislative proposal, not subject to PAYGO) Program and Financing (in millions of dollars) Identification code 75–0580–2–1–571 2006 actual 2007 est. 2008 est. Obligations by program activity: 00.01 Supplementary medical insurance (SMI) ....................... ................... ................... 00.11 General Revenue for Part D Benefits ............................ ................... ................... ¥1,203 ¥446 10.00 Total new obligations (object class 41.0) ................ ................... ................... ¥1,649 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ ................... ................... Total new obligations .................................................... ................... ................... ¥1,649 1,649 New budget authority (gross), detail: Mandatory: 60.00 Appropriation (Subsidy for HI & SMI benefits, General Fund federal admin) ..................................... ................... ................... 60.00 Appropriation (Part D Drug Benefits) ....................... ................... ................... ¥1,203 ¥446 62.50 Appropriation (total mandatory) ........................... ................... ................... ¥1,649 73.10 73.20 Change in obligated balances: Total new obligations .................................................... ................... ................... Total outlays (gross) ...................................................... ................... ................... ¥1,649 1,649 86.97 Outlays (gross), detail: Outlays from new mandatory authority ......................... ................... ................... ¥1,649 PROGRAM MANAGEMENT For carrying out, except as otherwise provided, titles XI, XVIII, XIX, and XXI of the Social Security Act (SSA), titles XIII and XXVII of the Public Health Service Act, and the Clinical Laboratory Improvement Amendments of 1988, not to exceed $3,274,026,000, to be transferred from the Federal Hospital Insurance and the Federal Supplementary Medical Insurance Trust Funds, as authorized by section 201(g) of the SSA; together with all funds collected in accordance with section 353 of the Public Health Service Act and section 1857(e)(2) of the SSA, funds retained by the Secretary pursuant to section 302 of the Tax Relief and Health Care Act of 2006; and such sums as may be collected from authorized user fees and the sale of data, which shall remain available until expended: Provided, That all funds derived in accordance with 31 U.S.C. 9701 from organizations established under title XIII of the Public Health Service Act shall be credited to and available for carrying out the purposes of this appropriation: Provided further, That $49,869,000, to remain available until September 30, 2009, is for contract costs for the Healthcare Integrated General Ledger Accounting System: Provided further, That the Centers for Medicare and Medicaid Services will take all reasonable actions necessary to ensure that before December 15, 2008 no fewer than 15 Medicare Administrative Contractors will commence the duties of Medicare claims-processing activities and related responsibilities: Provided further, That $253,775,000, to remain available until September 30, 2009, is for CMS Medicare contracting reform activities: Provided further, That funds appropriated under this heading are available for the Healthy Start, Grow Smart program under which the Centers for Medicare and Medicaid Services may, directly or through grants, contracts, or cooperative agreements, produce and distribute informational materials including, but not limited to, pamphlets and brochures on infant and toddler health care to expectant parents enrolled in the Medicaid program and to parents and guardians enrolled in such program with infants and children: Provided further, That the Secretary of Health and Human Services is directed to collect fees in fiscal year 2008 from Medicare Advantage 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 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. Program and Financing (in millions of dollars) Identification code 75–0511–0–1–550 2006 actual 2007 est. 2008 est. Obligations by program activity: Direct program: 00.01 Medicare operations .................................................. 00.02 Federal administration .............................................. 00.03 State survey and certification ................................... 00.04 Research, demonstrations, and evaluation projects 00.05 Revitalization plan .................................................... 2,208 639 258 62 23 2,225 2,304 648 643 258 293 48 34 25 ................... 01.00 09.01 09.03 09.04 09.06 Total direct program ................................................. CLIA ................................................................................ Other reimbursements ................................................... Coordination of benefits ................................................ MA/PDP ........................................................................... 3,190 43 34 18 58 3,204 43 2 30 69 09.09 Total reimbursable program ...................................... 153 144 147 10.00 Total new obligations ................................................ 3,343 3,348 3,421 21.40 22.00 Budgetary resources available for obligation: Unobligated balance carried forward, start of year New budget authority (gross) ........................................ 103 3,354 116 3,325 93 3,421 3,274 43 2 32 70 416 CENTERS FOR MEDICARE AND MEDICAID SERVICES—Continued Federal—Continued THE BUDGET FOR FISCAL YEAR 2008 PROGRAM MANAGEMENT—Continued Program and Financing (in millions of dollars)—Continued Identification code 75–0511–0–1–550 22.10 2006 actual 2007 est. 2008 est. Resources available from recoveries of prior year obligations ....................................................................... 12 ................... ................... 23.90 23.95 23.98 Total budgetary resources available for obligation Total new obligations .................................................... Unobligated balance expiring or withdrawn ................. 3,469 3,441 3,514 ¥3,343 ¥3,348 ¥3,421 ¥10 ................... ................... 24.40 Unobligated balance carried forward, end of year Program management activities include funding for research, Medicare operations, survey and certification, Clinical Laboratory Improvement Amendments (CLIA), Medicare Advantage, and administrative costs. Program management activities also include funding for the implementation of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 and the Tax Relief and Health Care Act of 2006. 42.00 43.00 58.00 58.00 58.10 58.90 60.00 69.00 70.00 New budget authority (gross), detail: Discretionary: Transferred from other accounts .............................. Appropriation (total discretionary) ........................ Spending authority from offsetting collections: Offsetting collections (cash) ................................ Offsetting collections (cash) ................................ Change in uncollected customer payments from Federal sources (unexpired) ............................. Spending authority from offsetting collections (total discretionary) .......................................... Mandatory: Appropriation ............................................................. Spending authority from offsetting collections: Offsetting collections (cash) ..................................... Total new budget authority (gross) .......................... 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) ................................................ 72.40 73.10 73.20 73.40 73.45 74.00 74.40 Obligated balance, end of year ................................ 86.90 86.93 86.97 Outlays (gross), detail: Outlays from new discretionary authority ..................... Outlays from discretionary balances ............................. Outlays from new mandatory authority ......................... 87.00 Total outlays (gross) ................................................. 116 93 93 40 ................... ................... 40 ................... ................... 88.95 88.96 89.00 90.00 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 ........................................................................... 11.1 11.3 11.5 11.7 2007 est. 369 16 9 8 371 13 8 7 2008 est. 391 14 6 7 72 8 36 1,357 359 1 7 10 54 1,081 ................... ................... 99.0 99.0 Direct obligations .................................................. Reimbursable obligations .............................................. 3,190 153 3,204 144 3,274 147 ¥94 99.9 Total new obligations ................................................ 3,343 3,348 3,421 3,274 147 882 ................... ................... 3,240 3,220 3,421 38 ................... ................... 36 3,354 105 ................... 3,325 ¥882 ................... ................... ¥71 2,349 3,220 3,421 990 ................... ................... 68 105 ................... 3,407 3,325 ¥3,432 ¥3,325 3,421 ¥3,421 ¥882 ................... ................... 1,038 ................... ................... 78 ................... ................... ¥25 ................... ................... (in millions of dollars) 2006 actual 2007 est. Enacted/requested: Budget Authority ..................................................................... 78 .................... Outlays .................................................................................... –25 .................... Legislative proposal, not subject to PAYGO: Budget Authority ..................................................................... .................... .................... Outlays .................................................................................... .................... .................... 24.0 25.1 25.2 25.3 3,421 ¥199 ¥94 ¥71 3,343 3,348 3,421 ¥3,407 ¥3,325 ¥3,421 ¥18 ................... ................... ¥12 ................... ................... ¥71 11.9 12.1 12.2 21.0 22.0 23.1 23.3 2006 actual Direct obligations: Personnel compensation: Full-time permanent ............................................. Other than full-time permanent ........................... Other personnel compensation ............................. Military personnel ................................................. 25.4 25.5 25.6 25.7 26.0 31.0 32.0 41.0 3,076 144 Summary of Budget Authority and Outlays Total: Budget Authority ..................................................................... Outlays .................................................................................... Identification code 75–0511–0–1–550 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 .................. Research and development contracts ....................... Medical care .............................................................. Operation and maintenance of equipment ............... Supplies and materials ............................................. Equipment ................................................................. Land and structures .................................................. Grants, subsidies, and contributions ........................ 2,222 136 Offsets: Against gross budget authority and outlays: Offsetting collections (cash) from: 88.00 Federal sources ..................................................... ¥3,308 ¥3,181 ¥3,274 88.00 Federal sources ..................................................... ................... ................... ................... 88.40 Non-Federal sources ............................................. ¥124 ¥144 ¥147 88.90 Object Classification (in millions of dollars) .................... .................... 78 .................... .................... –25 .................... .................... 39 2 2 17 3 3 38 ................... ................... 660 146 90 3 3 ................... ................... 42 24 2,463 2,577 ................... ................... 1 1 ................... ................... 10 10 ................... 10 Employment Summary Identification code 75–0511–0–1–550 2006 actual Direct: 1001 Civilian full-time equivalent employment ..................... 1101 Military full-time equivalent employment ..................... Reimbursable: 2001 Civilian full-time equivalent employment ..................... 2007 est. 2008 est. 4,461 93 4,255 89 4,255 89 72 75 84 PROGRAM MANAGEMENT (Legislative proposal, not subject to PAYGO) In addition, the Secretary may, contingent upon the enactment of authorizing legislation, charge a fee for conducting revisit surveys on health care facilities cited for deficiencies during initial certification, recertification, or substantiated complaints surveys: Provided, That such fees, in an amount not to exceed $35,000,000, shall be credited to this account as offsetting collections, to remain available until expended for the purpose of conducting such revisit surveys: Provided further, That amounts transferred to this account from the Federal Health Insurance and Federal Supplementary Medical Insurance Trust Funds for fiscal year 2008 shall be reduced by the amount credited to this account under this paragraph. 2008 est. .................... .................... 402 399 418 95 96 96 3 3 3 8 9 9 1 ................... ................... 23 27 28 Program and Financing (in millions of dollars) Identification code 75–0511–2–1–550 2006 actual 2007 est. 2008 est. Obligations by program activity: Direct program: 00.03 State survey and certification ................................... ................... ................... ¥35 01.00 09.02 ¥35 35 Total direct program ................................................. ................... ................... Revisit Fees .................................................................... ................... ................... CENTERS FOR MEDICARE AND MEDICAID SERVICES—Continued Federal—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES 09.09 Total reimbursable program ...................................... ................... ................... 35 10.00 Total new obligations ................................................ ................... ................... ................... 73.10 89.00 90.00 Change in obligated balances: Total new obligations .................................................... ................... ................... ................... Offsets: Against gross budget authority and outlays: Offsetting collections (cash) from: 88.00 Federal sources ..................................................... ................... ................... 88.40 Non-Federal sources ............................................. ................... ................... Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 4,365 5,451 417 5,040 5,647 5,040 5,424 Summary of Budget Authority and Outlays (in millions of dollars) 2006 actual 35 ¥35 88.90 Total, offsetting collections (cash) ....................... ................... ................... ................... 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ ................... ................... ................... Outlays ........................................................................... ................... ................... ................... The Budget includes $35 million in new user fees to finance survey and certification activities. Centers for Medicare and Medicaid Services (CMS) would charge revisit survey fees to health care facilities cited for deficiencies during initial certification, recertification, or substantiated complaint surveys. Proposed appropriations language provides authority to collect and spend these fees. The amount appropriated from the Federal Hospital Insurance (HI) and Federal Supplementary Medical Insurance (SMI) trust funds would be reduced on a dollar-for-dollar basis with fees collected. 2007 est. 2008 est. Enacted/requested: Budget Authority ..................................................................... 4,365 5,040 5,040 Outlays .................................................................................... 5,451 5,647 5,424 Legislative proposal, subject to PAYGO: Budget Authority ..................................................................... .................... .................... .................... Outlays .................................................................................... .................... .................... 1,220 Total: Budget Authority ..................................................................... Outlays .................................................................................... 4,365 5,451 5,040 5,647 5,040 6,644 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 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. STATE CHILDREN’S HEALTH INSURANCE FUND (Legislative proposal, subject to PAYGO) Object Classification (in millions of dollars) Program and Financing (in millions of dollars) Identification code 75–0511–2–1–550 25.6 99.0 2006 actual 2007 est. Direct obligations: Medical care .................................... ................... ................... Reimbursable obligations: reimbursable obligations ................... ................... 2008 est. ¥35 35 Identification code 75–0515–4–1–551 2006 actual 2007 est. 2008 est. 1,220 10.00 99.9 Obligations by program activity: 00.01 SCHIP Reauthorization ................................................... ................... ................... Total new obligations (object class 41.0) ................ ................... ................... 1,220 Budgetary resources available for obligation: Expired unobligated balance transfer to unexpired account .......................................................................... ................... ................... 23.95 Total new obligations .................................................... ................... ................... 1,220 ¥1,220 73.10 73.20 Change in obligated balances: Total new obligations .................................................... ................... ................... Total outlays (gross) ...................................................... ................... ................... 1,220 ¥1,220 1,220 Total new obligations ................................................ ................... ................... ................... f 22.30 STATE CHILDREN’S HEALTH INSURANCE FUND Program and Financing (in millions of dollars) Identification code 75–0515–0–1–551 2006 actual 2007 est. 2008 est. Obligations by program activity: 00.01 Grants to States and U.S. territories ............................ 4,539 5,187 5,040 10.00 Total new obligations (object class 41.0) ................ 4,539 5,187 5,040 86.97 Outlays (gross), detail: Outlays from new mandatory authority ......................... ................... ................... 22.00 22.30 Budgetary resources available for obligation: New budget authority (gross) ........................................ Expired unobligated balance transfer to unexpired account .......................................................................... 4,365 5,040 5,040 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ ................... ................... ................... Outlays ........................................................................... ................... ................... 1,220 23.90 23.95 Total budgetary resources available for obligation Total new obligations .................................................... 174 4,539 ¥4,539 147 ................... 5,187 ¥5,187 5,040 ¥5,040 New budget authority (gross), detail: Mandatory: 60.00 Appropriation, BBA .................................................... 60.00 Appropriation, BBRA for territories ........................... 60.00 Appropriation, DRA 2006 ........................................... 4,365 f 4,050 5,000 5,000 32 40 40 283 ................... ................... 62.50 This schedule reflects the Administration’s SCHIP proposals. MEDICARE ADVANTAGE STABILIZATION FUND Special and Trust Fund Receipts (in millions of dollars) Identification code 75–5384–0–2–571 Appropriation (total mandatory) ........................... 5,040 5,040 2007 est. 2008 est. Obligated balance, end of year ................................ 13 Total receipts and collections ................................... ................... 13 18 Total: Balances and collections .................................... ................... 13 31 07.99 Balance, end of year ..................................................... ................... 13 31 01.99 7,275 4,539 ¥5,451 ¥1,455 4,908 4,908 4,301 5,187 5,040 ¥5,647 ¥5,424 ¥147 ................... 4,301 10 8 3,917 Outlays (gross), detail: 86.97 Outlays from new mandatory authority ......................... 86.98 Outlays from mandatory balances ................................ 1,202 4,249 2,225 3,422 2,671 2,753 87.00 5,451 5,647 5,424 Total outlays (gross) ................................................. 13 Balance, start of year .................................................... ................... ................... Receipts: 02.00 Payments from HI, Stabilization fund ........................... ................... 7 02.01 Payments from SMI, Stabilization fund ......................... ................... 6 04.00 74.40 Balance, start of year .................................................... ................... ................... 02.99 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) ......................... 01.00 2006 actual The Medicare Advantage (MA) Regional Stabilization Fund finances incentives to have MA regional plans offered in each 418 CENTERS FOR MEDICARE AND MEDICAID SERVICES—Continued Federal—Continued THE BUDGET FOR FISCAL YEAR 2008 MEDICARE ADVANTAGE STABILIZATION FUND—Continued MA region and to retain MA plans in certain regions with below national average MA market penetration. The Tax Relief and Health Care Act of 2006 amended this fund. f Budgetary resources available for obligation: New budget authority (gross) ........................................ Resources available from recoveries of prior year obligations ....................................................................... 23.33 Adjustment for changes in allocation ........................... 22.00 22.10 23.90 23.95 23.98 Trust Funds 189,151 206,696 216,418 14 ................... ................... 29 ................... ................... Total budgetary resources available for obligation Total new obligations .................................................... Unobligated balance expiring or withdrawn ................. 189,194 206,696 216,418 ¥189,180 ¥206,696 ¥216,418 ¥14 ................... ................... New budget authority (gross), detail: Discretionary: 40.26 Appropriation (trust fund) ......................................... 40.37 Appropriation temporarily reduced ............................ 1,832 1,660 1,731 ¥43 ................... ................... FEDERAL HOSPITAL INSURANCE TRUST FUND Special and Trust Fund Receipts (in millions of dollars) Identification code 20–8005–0–7–571 01.00 Balance, start of year .................................................... 2006 actual 259,707 2007 est. 2008 est. 281,754 294,939 43.00 Balance, start of year .................................................... 259,707 281,754 Receipts: 02.00 FHI trust fund, Federal employer contributions (FICA) 2,722 2,839 02.01 FHI trust fund, Postal Service employer contributions (FICA) ......................................................................... 682 694 02.02 FHI trust fund, Interest received by trust funds ........... 15,356 15,216 02.03 FHI trust fund, Interest received by trust funds— legislative proposal not subject to PAYGO ............... ................... ................... 02.04 FHI trust fund, Taxation on OASDI benefits .................. 10,319 10,810 02.05 FHI trust fund, Payment from the general fund for health care fraud and abuse control account ......... 114 118 02.06 FHI trust fund, Transfers from general fund (criminal fines) ......................................................................... 144 200 02.07 FHI trust fund, Transfers from general fund (civil monetary penalties) ................................................... 19 22 02.08 FHI trust fund, Interest payments by Railroad Retirement Board ................................................................ 32 30 02.09 FHI trust fund, Payments from the general fund (uninsured and program management) ......................... 540 644 02.20 FHI trust fund, Other proprietary receipts from the public ......................................................................... 3 1 02.21 FHI trust fund, Basic premium, Medicare advantage 20 77 02.22 FHI trust fund, medicare refunds .................................. 2,088 2,100 02.23 FHI trust fund, Premiums collected for uninsured individuals not otherwise eligible ................................... 2,632 2,782 02.60 FHI trust fund, Transfers from general fund (FICA taxes) ......................................................................... 165,160 171,199 02.61 FHI trust fund, Receipts from Railroad Retirement Board ......................................................................... 440 459 02.62 FHI trust fund, Transfers from general fund (SECA taxes) ......................................................................... 11,829 13,505 02.63 FHI trust fund, Civil penalties and damages ............... 297 297 294,939 01.99 02.99 2,965 720 15,883 109 12,245 121 200 22 29 882 1 85 2,200 1,789 1,660 1,731 60.26 60.45 Appropriation (total discretionary) ........................ Mandatory: Appropriation (trust fund) ......................................... Portion precluded from balances .............................. 209,421 ¥22,059 218,221 ¥13,185 234,329 ¥19,642 62.50 Appropriation (total mandatory) ........................... 187,362 205,036 214,687 70.00 Total new budget authority (gross) .......................... 189,151 206,696 216,418 72.40 73.10 73.20 73.45 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Recoveries of prior year obligations .............................. 74.40 Obligated balance, end of year ................................ 21,028 20,798 20,704 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 ................................ 1,429 383 167,231 16,830 1,370 313 188,923 16,320 1,430 301 197,453 17,328 87.00 Total outlays (gross) ................................................. 185,873 206,926 216,512 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 189,151 185,873 206,696 206,926 216,418 216,512 277,268 302,186 314,044 302,186 314,044 314,041 2,889 184,499 483 Memorandum (non-add) entries: Total investments, start of year: Federal securities: Par value ................................................................... 92.02 Total investments, end of year: Federal securities: Par value ................................................................... 17,735 21,028 20,798 189,180 206,696 216,418 ¥185,873 ¥206,926 ¥216,512 ¥14 ................... ................... 92.01 13,744 297 Total receipts and collections ................................... 212,397 220,993 237,374 Total: Balances and collections .................................... Appropriations: 05.00 Federal hospital insurance trust fund .......................... 05.01 Federal hospital insurance trust fund .......................... 05.02 Federal hospital insurance trust fund .......................... 05.03 Federal hospital insurance trust fund .......................... 05.04 Federal hospital insurance trust fund .......................... 05.05 Federal hospital insurance trust fund—legislative proposal not subject to PAYGO ................................. 05.06 Federal hospital insurance trust fund—legislative proposal not subject to PAYGO ................................. 05.07 Federal hospital insurance trust fund—legislative proposal not subject to PAYGO ................................. 05.08 Federal hospital insurance trust fund—legislative proposal subject to PAYGO ....................................... 05.09 Federal hospital insurance trust fund—legislative proposal subject to PAYGO ....................................... 05.10 Health care fraud and abuse control account .............. 05.11 Health care fraud and abuse control account .............. 472,104 502,747 532,313 04.00 05.99 06.10 Total appropriations .................................................. Health care fraud and abuse control account .............. 07.99 Balance, end of year ..................................................... ¥29 ................... ................... ¥1,832 ¥1,660 ¥1,731 43 ................... ................... ¥209,421 ¥218,221 ¥234,329 22,059 13,185 19,642 ................... ................... 35 ................... ................... ¥35 ................... ................... 35 ................... ................... ¥109 ................... ................... ................... ................... ¥1,187 ¥1,112 3,309 ¥183 ¥1,131 ¥190,367 ¥207,808 ¥214,497 17 ................... ................... 281,754 294,939 317,816 Summary of Budget Authority and Outlays (in millions of dollars) 2006 actual 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 .................................................................................... 189,151 185,873 2007 est. 2008 est. 206,696 206,926 216,418 216,512 .................... .................... .................... .................... –35 –35 .................... .................... .................... .................... –3,200 –3,200 189,151 185,873 206,696 206,926 213,183 213,277 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) Program and Financing (in millions of dollars) Identification code 20–8005–0–7–571 Identification code 20–8005–0–7–571 2006 actual 2007 est. 2008 est. 00.01 00.02 00.03 00.04 Obligations by program activity: Benefit payments, HI ..................................................... Administration, HI .......................................................... Quality improvement organizations, HI ......................... Research, HI ................................................................... 186,541 1,950 678 11 204,729 1,783 149 35 214,288 1,849 246 35 10.00 Total new obligations ................................................ 189,180 206,696 216,418 2006 actual 2007 est. 2008 est. Unexpended balance, start of year: 0100 Balance, start of year .................................................... 277,670 303,131 315,978 0199 277,670 303,131 315,978 2,722 2,839 2,965 Total balance, start of year ...................................... Cash income during the year: Current law: Receipts: 1200 FHI trust fund, Federal employer contributions (FICA) ................................................................ CENTERS FOR MEDICARE AND MEDICAID SERVICES—Continued Trust Funds—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES 1201 1202 1204 1205 1206 1207 1208 1209 1220 1221 1222 1223 1260 1261 1262 1263 1280 1299 2203 2299 FHI trust fund, Postal Service employer contributions (FICA) ....................................................... 682 694 FHI trust fund, Interest received by trust funds 15,356 15,216 FHI trust fund, Taxation on OASDI benefits ......... 10,319 10,810 FHI trust fund, Payment from the general fund for health care fraud and abuse control account ................................................................. 114 118 FHI trust fund, Transfers from general fund (criminal fines) ................................................. 144 200 FHI trust fund, Transfers from general fund (civil monetary penalties) ................................ 19 22 FHI trust fund, Interest payments by Railroad Retirement Board ............................................. 32 30 FHI trust fund, Payments from the general fund (uninsured and program management) ........... 540 644 Offsetting receipts (proprietary): FHI trust fund, Other proprietary receipts from the public ......................................................... 3 1 FHI trust fund, Basic premium, Medicare advantage .................................................................. 20 77 FHI trust fund, medicare refunds ......................... 2,088 2,100 FHI trust fund, Premiums collected for uninsured individuals not otherwise eligible .................... 2,632 2,782 Offsetting governmental receipts: FHI trust fund, Transfers from general fund (FICA taxes) ...................................................... 165,160 171,199 FHI trust fund, Receipts from Railroad Retirement Board ....................................................... 440 459 FHI trust fund, Transfers from general fund (SECA taxes) ..................................................... 11,829 13,505 FHI trust fund, Civil penalties and damages 297 297 Offsetting collections: Health care fraud and abuse control account 6 10 Income under present law ........................................ 212,403 221,003 Proposed legislation: Receipts: FHI trust fund, Interest received by trust funds ................... ................... Income under proposed legislation ........................... ................... ................... 3299 Total cash income ..................................................... 212,403 221,003 Cash outgo during year: Current law: 4500 Federal hospital insurance trust fund ...................... ¥185,873 ¥206,926 4501 Health care fraud and abuse control account ......... ¥1,069 ¥1,230 4599 Outgo under current law (¥) .................................. ¥186,942 ¥208,156 Proposed legislation: 5500 Federal hospital insurance trust fund ...................... ................... ................... 5501 Federal hospital insurance trust fund ...................... ................... ................... 5599 Outgo under proposed legislation (¥) .................... ................... ................... Total balance, end of year ........................................ 121 200 New budget authority (gross), detail: Discretionary: 40.26 Appropriation (trust fund) ......................................... ................... ................... Mandatory: 60.26 Appropriation (trust fund) ......................................... ................... ................... 60.45 Portion precluded from balances .............................. ................... ................... 62.50 35 ¥35 35 ¥35 Appropriation (total mandatory) ........................... ................... ................... ................... 22 70.00 Total new budget authority (gross) .......................... ................... ................... ¥35 73.10 73.20 Change in obligated balances: Total new obligations .................................................... ................... ................... Total outlays (gross) ...................................................... ................... ................... ¥35 35 85 2,200 86.90 Outlays (gross), detail: Outlays from new discretionary authority ..................... ................... ................... ¥35 2,889 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ ................... ................... Outlays ........................................................................... ................... ................... ¥35 ¥35 Memorandum (non-add) entries: Total investments, end of year: Federal securities: Par value ................................................................... ................... ................... 35 29 882 1 184,499 92.02 483 13,744 297 10 237,275 The Budget proposes a user fee to cover the costs associated with follow-up visits to health care facilities found to be out of compliance with Medicare standards. FEDERAL HOSPITAL INSURANCE TRUST FUND 109 109 (Legislative proposal, subject to PAYGO) Program and Financing (in millions of dollars) 237,384 Identification code 20–8005–4–7–571 ¥216,512 ¥1,324 ¥217,836 2006 actual 2007 est. 2008 est. 315,978 ¥3,200 10.00 Total new obligations (object class 42.0) ................ ................... ................... ¥3,200 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ ................... ................... Total new obligations .................................................... ................... ................... ¥3,200 3,200 21,376 314,041 35 3,309 New budget authority (gross), detail: Mandatory: 60.26 Appropriation (trust fund) ......................................... ................... ................... 60.45 Portion precluded from balances .............................. ................... ................... 109 ¥3,309 338,761 62.50 Appropriation (total mandatory) ........................... ................... ................... ¥3,200 Change in obligated balances: Total new obligations .................................................... ................... ................... Total outlays (gross) ...................................................... ................... ................... ¥3,200 3,200 86.97 303,131 Obligations by program activity: 00.01 Benefit payments, HI ..................................................... ................... ................... Outlays (gross), detail: Outlays from new mandatory authority ......................... ................... ................... ¥3,200 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ ................... ................... Outlays ........................................................................... ................... ................... ¥3,200 ¥3,200 35 3,200 3,235 ¥214,601 Object Classification (in millions of dollars) Identification code 20–8005–0–7–571 Total new obligations .................................................... ................... ................... 73.10 73.20 Total cash outgo (¥) ............................................... ¥186,942 ¥208,156 Unexpended balance, end of year: 8700 Uninvested balance (net), end of year .......................... 945 1,934 8701 Invested balance, end of year ....................................... 302,186 314,044 8701 Invested balance, end of year ....................................... ................... ................... 8701 Invested balance, end of year ....................................... ................... ................... 6599 8799 23.95 720 15,883 12,245 419 2006 actual 2007 est. 2008 est. Direct obligations: 41.0 Payment for Quality Improvement Organization (QIO) activities .................................................................... 42.0 Insurance claims and indemnities (benefits) ............... 94.0 Financial transfers ......................................................... 705 186,515 1,960 149 204,729 1,818 246 214,288 1,884 99.0 Direct obligations ...................................................... 189,180 206,696 216,418 99.9 Total new obligations ................................................ 189,180 206,696 216,418 FEDERAL HOSPITAL INSURANCE TRUST FUND Memorandum (non-add) entries: Total investments, start of year: Federal securities: Par value ................................................................... ................... ................... ................... 92.02 Total investments, end of year: Federal securities: Par value ................................................................... ................... ................... 3,309 92.01 (Legislative proposal, not subject to PAYGO) Program and Financing (in millions of dollars) Identification code 20–8005–2–7–571 2006 actual 2007 est. 2008 est. Obligations by program activity: 00.02 Administration, HI .......................................................... ................... ................... ¥35 10.00 ¥35 Total new obligations (object class 94.0) ................ ................... ................... Budgetary resources available for obligation: 22.00 New budget authority (gross) ........................................ ................... ................... ¥35 The Budget proposes a package of reforms to encourage competition, recognize efficiencies and productivity in health care, enhance program integrity, and strengthen responsibility for health care choices. f HEALTH CARE FRAUD AND ABUSE CONTROL ACCOUNT In addition to amounts otherwise available for program integrity and program management, $183,000,000, to be transferred from the 420 CENTERS FOR MEDICARE AND MEDICAID SERVICES—Continued Trust Funds—Continued HEALTH CARE FRAUD AND THE BUDGET FOR FISCAL YEAR 2008 ABUSE CONTROL ACCOUNT—Continued Federal Hospital Insurance and the Federal Supplementary Medical Insurance Trust Funds, as authorized by section 201(g) of the Social Security Act, of which $137,840,000 is for the Medicare Integrity Program at the Centers for Medicare and Medicaid Services to conduct oversight of activities authorized in titles I and II of Public Law 108–173, with oversight activities including those activities listed in 18 U.S.C. 1893(b); of which $17,530,000 is for the Department of Health and Human Services Office of Inspector General; of which $10,100,000 is for the Medicaid program integrity activities; and of which $17,530,000 is for the Department of Justice: Provided, That the report required by 18 U.S.C. 1817(k)(5) for FY 2008 shall include measures of the operational efficiency and impact on fraud, waste and abuse in the Medicare and Medicaid programs for the funds provided by this appropriation. Program and Financing (in millions of dollars) Identification code 75–8393–0–7–571 00.01 00.02 00.03 Obligations by program activity: Medicare integrity program ........................................... FBI fraud and abuse control ......................................... Other fraud and abuse control ...................................... 2006 actual 832 114 240 2007 est. 2008 est. 744 118 250 756 121 254 00.91 01.01 01.02 01.03 Subtotal, mandatory .................................................. 1,186 1,112 MIP—discretionary ........................................................ ................... ................... FBI—discretionary ......................................................... ................... ................... Other discretionary ......................................................... ................... ................... 1,131 138 9 36 01.91 09.01 Subtotal, discretionary .............................................. ................... ................... Reimbursable (OIG) ........................................................ 8 6 183 10 10.00 Total new obligations ................................................ 1,194 1,118 1,324 21.40 22.00 Budgetary resources available for obligation: Unobligated balance carried forward, start of year New budget authority (gross) ........................................ 7 1,193 6 1,122 10 1,324 23.90 23.95 Total budgetary resources available for obligation Total new obligations .................................................... 1,200 ¥1,194 1,128 ¥1,118 1,334 ¥1,324 24.40 24.41 Unobligated balance carried forward, end of year Special and trust fund receipts returned to Schedule N ................................................................................ 6 10 10 17 ................... ................... New budget authority (gross), detail: Discretionary: 40.26 Appropriation (trust fund) ......................................... ................... ................... Mandatory: 60.26 Appropriation (trust fund) ......................................... 1,187 1,112 69.00 Spending authority from offsetting collections: Offsetting collections (cash) ..................................... 6 10 70.00 Total new budget authority (gross) .......................... 72.40 73.10 73.20 73.40 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Adjustments in expired accounts (net) ......................... 74.40 Obligated balance, end of year ................................ 86.90 86.97 86.98 87.00 1,193 1,122 183 1,131 10 out 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 2007 and 2008. As required by statute, actual 2007 and 2008 agency distributions will be determined by the Secretary of HHS and the Attorney General consistent with the Administration’s priorities. 2006 actual 51 166 32 52 169 33 Total ............................................................................... 240 249 254 The 2008 Budget includes a discretionary request for efforts to safeguard Medicaid and the Medicare prescription drug benefit, and will supplement the mandatory funds made available by P.L. 104–191. It is important that these cost increases and new enforcement investments be fully funded. The Administration is proposing to fund them as contingent appropriations. To ensure full funding of the new enforcement investments, the Administration proposes to employ a budget enforcement mechanism that allows for an adjustment by the Budget Committees to the section 302(a) allocation to the Appropriations Committees found in the concurrent resolution on the budget. In addition, the Administration will also seek to establish statutory spending limits, as defined by section 251 of the Balanced Budget and Emergency Deficit Control Act of 1985, and to adjust them for this purpose. These adjustments would only be permissible if the use of these funds was clearly restricted to the specified purpose. The maximum allowable adjustment to the 302(a) allocation and/or the statutory spending limit would be $183 million for 2008 (see chapter 15 in Analytical Perspectives). The HCFAC entities will develop a comprehensive plan for Medicare, Medicaid and SCHIP program integrity activities. The plan will indicate how program integrity appropriations from all sources (DRA, HIPAA and the discretionary cap adjustment) will be allocated to address program integrity priorities. These priorities include the fraud, waste, and abuse vulnerabilities of these programs, and efforts to address responsibilities under the Improper Payments Improvement Act. Object Classification (in millions of dollars) Identification code 75–8393–0–7–571 Direct obligations .................................................. Reimbursable obligations .............................................. 1,186 8 1,112 6 1,314 10 99.9 Total new obligations ................................................ 1,194 1,118 1,324 25.2 25.3 1,069 1,230 25.3 1,324 25.3 Offsets: Against gross budget authority and outlays: 88.00 Offsetting collections (cash) from: Federal sources 25.3 ¥6 ¥10 ¥10 25.3 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 1,187 1,063 1,112 1,220 1,314 1,314 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 with- 2008 est. 99.0 99.0 Outlays (gross), detail: Outlays from new discretionary authority ..................... ................... ................... 183 Outlays from new mandatory authority ......................... 940 1,118 1,141 Outlays from mandatory balances ................................ 129 112 ................... Total outlays (gross) ................................................. 2007 est. 25.6 94.0 11.1 231 231 2006 actual Direct obligations: Personnel compensation: Full-time permanent (CMS 100 FTEs) .............................................................. Civilian personnel benefits (CMS) ............................ Rental payments to others ........................................ Communications, utilities, and miscellaneous charges ................................................................. Other services (CMS) ................................................. Other purchases of goods and services from Government accounts (HHS) ....................................... 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) ................................................... Financial transfers .................................................... 12.1 23.2 23.3 343 2008 est. 49 160 31 1,324 228 343 231 1,194 1,118 1,324 ¥1,069 ¥1,230 ¥1,324 ¥10 ................... ................... 2007 est. Department of Justice, DOJ ......................................................... Office of the Inspector General, HHS .......................................... Other specific HHS fraud and abuse projects ............................ 8 2 1 8 2 1 8 2 1 1 10 1 10 1 20 1 3 3 49 51 61 160 166 187 3 3 3 5 832 114 5 744 118 5 894 129 CENTERS FOR MEDICARE AND MEDICAID SERVICES—Continued Trust Funds—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES 07.99 Employment Summary Identification code 75–8393–0–7–571 2006 actual Direct: 1001 Civilian full-time equivalent employment ..................... 2007 est. 90 2008 est. 93 100 25,568 Identification code 20–8004–0–7–571 2006 actual 2007 est. 2008 est. 2008 est. Balance, start of year .................................................... ¥1,226 10,660 ¥1,226 10,660 19,259 134,255 137,623 140,704 ................... ................... 1,452 1,998 ¥1,203 2,451 ................... ................... 7 14 8 16 175,463 183,282 2,459 2,553 38 62 7 7 350 ................... 164,328 178,317 185,904 163,797 178,317 185,904 Total new obligations ................................................ 19,259 Balance, start of year .................................................... Receipts: 02.00 Federal contributions, FSMI Fund .................................. 02.01 Federal contributions, FSMI Fund—legislative proposal not subject to PAYGO ................................................ 02.02 Interest received by trust fund, FSMI Fund .................. 02.03 Interest received by trust fund, FSMI Fund—legislative proposal not subject to PAYGO .......................... 02.04 Interest, Medicare prescription drug account, FSMI 02.05 Federal contributions, Transitional assistance account, FSMI ........................................................................... 02.06 Federal contribution for admin. contribution for admin. costs, prescription drug account, FSMI ........ 02.07 Federal contributions for benefits, prescription drug account, SMI .............................................................. 02.08 Federal contributions for benefits, prescription drug account, SMI—legislative proposal not subject to PAYGO ........................................................................ 02.09 Miscellaneous Federal payments, Federal supplementary medical insurance trust fund ..................... 02.20 Premiums collected for Medicare prescription drug account, FSMI ............................................................ 02.21 Premiums collected for Medicare prescription drug account, FSMI—legislative proposal subject to PAYGO ........................................................................ 02.22 Payments from States, Medicare prescription drug account, FSMI ................................................................ 02.23 Payments from States, Medicare prescription drug account, FSMI—legislative proposal subject to PAYGO 02.24 Basic premium, Medicare advantage, FSMI trust fund 02.25 Medicare refunds, SMI ................................................... 02.26 Premiums collected for the aged, FSMI Fund ............... 02.27 Premiums collected for the aged, FSMI Fund—legislative proposal subject to PAYGO ................................ 02.28 Premiums collected for the disabled, FSMI Fund ......... 02.29 Premiums collected for the disabled, FSMI Fund— legislative proposal subject to PAYGO ...................... 160,980 2,967 106 11 264 10.00 Special and Trust Fund Receipts (in millions of dollars) 2007 est. 19,259 Obligations by program activity: 00.01 Benefit payments, SMI ................................................... 00.02 Administration, SMI ....................................................... 00.03 Quality improvement organizations, SMI ....................... 00.04 Research, SMI ................................................................ 00.06 Transfer to Medicaid for payment of SMI premiums FEDERAL SUPPLEMENTARY MEDICAL INSURANCE TRUST FUND 2006 actual 10,660 Program and Financing (in millions of dollars) f Identification code 20–8004–0–7–571 Balance, end of year ..................................................... 421 01.00 01.99 Budgetary resources available for obligation: New budget authority (gross) ........................................ Resources available from recoveries of prior year obligations ....................................................................... 23.33 Adjustment for changes in allocation ........................... 22.00 22.10 23.90 23.95 23.98 24.41 Total budgetary resources available for obligation Total new obligations .................................................... Unobligated balance expiring or withdrawn ................. Special and trust fund receipts returned to Schedule N ................................................................................ 20 ................... ................... 531 ................... ................... 164,348 178,317 185,904 ¥164,328 ¥178,317 ¥185,904 ¥20 ................... ................... 20 ................... ................... 229 ................... ................... New budget authority (gross), detail: Discretionary: 40.26 Appropriation (trust fund) ......................................... 40.37 Appropriation temporarily reduced ............................ 2,488 2,371 2,553 ¥72 ................... ................... ¥446 43.00 174 703 744 27,943 37,329 46,299 ................... ................... 1 2 2 60.26 60.45 Appropriation (total discretionary) ........................ Mandatory: Appropriation (trust fund) ......................................... Portion precluded from obligation ............................ 809 3,840 5,926 62.50 Appropriation (total mandatory) ........................... 161,381 175,946 183,351 ................... ................... 280 70.00 Total new budget authority (gross) .......................... 163,797 178,317 185,904 72.40 73.10 73.20 73.45 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Recoveries of prior year obligations .............................. 74.40 Obligated balance, end of year ................................ 19,495 19,454 19,452 Outlays (gross), detail: Outlays from new discretionary authority ..................... Outlays from discretionary balances ............................. Outlays from new mandatory authority ......................... Outlays from mandatory balances ................................ 2,037 600 143,188 16,570 1,916 484 158,905 17,053 2,063 471 166,299 17,073 3,630 8,030 7,918 ................... ................... 18 68 1,114 1,200 35,606 39,090 91 75 1,300 41,050 ................... ................... 6,023 6,928 ¥179 7,177 2,416 2,371 2,553 173,234 ¥11,853 184,545 ¥8,599 190,230 ¥6,879 17,582 19,495 19,454 164,328 178,317 185,904 ¥162,395 ¥178,358 ¥185,906 ¥20 ................... ................... Total receipts and collections ................................... 211,261 236,825 252,190 86.90 86.93 86.97 86.98 Total: Balances and collections .................................... Appropriations: 05.00 Federal supplementary medical insurance trust fund 05.01 Federal supplementary medical insurance trust fund 05.02 Federal supplementary medical insurance trust fund 05.03 Federal supplementary medical insurance trust fund 05.04 Federal supplementary medical insurance trust fund 05.05 Federal supplementary medical insurance trust fund—legislative proposal not subject to PAYGO 05.06 Federal supplementary medical insurance trust fund—legislative proposal not subject to PAYGO 05.07 Federal supplementary medical insurance trust fund—legislative proposal subject to PAYGO .......... 05.08 Federal supplementary medical insurance trust fund—legislative proposal subject to PAYGO .......... 05.09 Transitional drug assistance, Federal supplementary medical insurance trust fund ................................... 05.10 Medicare prescription drug account, Federal supplementary insurance trust fund ................................... 05.11 Medicare prescription drug account, Federal supplementary insurance trust fund ................................... 05.12 Medicare prescription drug account, Federal supplementary insurance trust fund ................................... 05.13 Medicare prescription drug account, Federal supplementary insurance trust fund—legislative proposal subject to PAYGO ...................................................... 210,035 247,485 271,449 87.00 Total outlays (gross) ................................................. 162,395 178,358 185,906 ¥531 ................... ................... ¥2,488 ¥2,371 ¥2,553 72 ................... ................... ¥173,234 ¥184,545 ¥190,230 11,853 8,599 6,879 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 163,797 162,395 178,317 178,358 185,904 185,906 ................... ................... ¥319 92.01 17,204 33,061 41,855 ................... ................... ¥106 33,061 41,855 48,750 ................... ................... 1,714 ................... ................... ¥464 02.99 04.00 05.99 06.10 06.11 Total appropriations .................................................. Federal supplementary medical insurance trust fund Transitional drug assistance, Federal supplementary medical insurance trust fund ................................... ................... ................... ¥23 ¥194 ................... ................... 457 ................... ................... ¥707 ¥726 ¥760 ¥34,626 ¥49,183 ¥60,119 ................... ................... 77 ¥199,398 ¥228,226 ¥245,881 20 ................... ................... 3 ................... ................... Memorandum (non-add) entries: Total investments, start of year: Federal securities: Par value ................................................................... 92.02 Total investments, end of year: Federal securities: Par value ................................................................... Summary of Budget Authority and Outlays (in millions of dollars) 2006 actual 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 .................................................................................... 163,797 162,395 2007 est. 2008 est. 178,317 178,358 185,904 185,906 .................... .................... .................... .................... 425 425 .................... .................... .................... .................... –1,250 –1,250 163,797 162,395 178,317 178,358 185,079 185,081 422 CENTERS FOR MEDICARE AND MEDICAID SERVICES—Continued Trust Funds—Continued THE BUDGET FOR FISCAL YEAR 2008 8701 FEDERAL SUPPLEMENTARY MEDICAL INSURANCE TRUST FUND— Continued 8799 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: Unexpended balance, start of year: Balance, start of year .................................................... Adjustments: 0190 Adjustments ............................................................... 0100 0199 Total balance, start of year ...................................... Cash income during the year: Current law: Receipts: 1200 Federal contributions, FSMI Fund ......................... 1202 Interest received by trust fund, FSMI Fund ......... 1204 Interest, Medicare prescription drug account, FSMI .................................................................. 1205 Federal contributions, Transitional assistance account, FSMI ................................................... 1206 Federal contribution for admin. contribution for admin. costs, prescription drug account, FSMI 1207 Federal contributions for benefits, prescription drug account, SMI ............................................ 1209 Miscellaneous Federal payments, Federal supplementary medical insurance trust fund ............ Offsetting receipts (proprietary): 1220 Premiums collected for Medicare prescription drug account, FSMI .......................................... 1222 Payments from States, Medicare prescription drug account, FSMI .......................................... 1224 Basic premium, Medicare advantage, FSMI trust fund .................................................................. 1225 Medicare refunds, SMI .......................................... 1226 Premiums collected for the aged, FSMI Fund 1228 Premiums collected for the disabled, FSMI Fund 1299 Income under present law ........................................ Proposed legislation: Receipts: 2201 Federal contributions, FSMI Fund ......................... 2203 Interest received by trust fund, FSMI Fund ......... 2208 Federal contributions for benefits, prescription drug account, SMI ............................................ Offsetting receipts (proprietary receipts): 2221 Premiums collected for Medicare prescription drug account, FSMI .......................................... 2223 Payments from States, Medicare prescription drug account, FSMI .......................................... 2227 Premiums collected for the aged, FSMI Fund 2229 Premiums collected for the disabled, FSMI Fund 2299 Income under proposed legislation ........................... 3299 Total cash income ..................................................... Cash outgo during year: Current law: 4500 Federal supplementary medical insurance trust fund ....................................................................... 4501 Transitional drug assistance, Federal supplementary medical insurance trust fund ................ 4502 Medicare prescription drug account, Federal supplementary insurance trust fund .......................... 4599 Outgo under current law (¥) .................................. Proposed legislation: 5500 Federal supplementary medical insurance trust fund ....................................................................... 5501 Federal supplementary medical insurance trust fund ....................................................................... 5502 Medicare prescription drug account, Federal supplementary insurance trust fund .......................... 5599 Outgo under proposed legislation (¥) .................... 33,264 41,855 48,180 Object Classification (in millions of dollars) Identification code 20–8004–0–7–571 2006 actual 2007 est. 2008 est. 16,887 2007 est. 2008 est. 33,264 Direct obligations: 41.0 Payment for Quality Improvement Organization (QIO) activity ....................................................................... 42.0 Insurance claims and indemnities ................................ 94.0 Financial transfers ......................................................... 106 161,244 2,978 38 175,813 2,466 62 183,282 2,560 Direct obligations ...................................................... 164,328 178,317 185,904 99.9 2006 actual Total new obligations ................................................ 164,328 178,317 185,904 41,855 FEDERAL SUPPLEMENTARY MEDICAL INSURANCE TRUST FUND ¥2 ................... ................... 16,885 33,264 (Legislative proposal, not subject to PAYGO) 41,855 Program and Financing (in millions of dollars) 134,255 1,452 137,623 1,998 140,704 2,451 7 14 Identification code 20–8004–2–7–571 2006 actual 2007 est. 2008 est. 16 Obligations by program activity: 00.06 Transfer to Medicaid for payment of SMI premiums ................... ................... 425 10.00 Total new obligations (object class 42.0) ................ ................... ................... 425 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ ................... ................... Total new obligations .................................................... ................... ................... 425 ¥425 New budget authority (gross), detail: Mandatory: 60.26 Appropriation (trust fund) ......................................... ................... ................... 60.28 Appropriation (previously unavailable) ..................... ................... ................... 319 106 62.50 Appropriation (total mandatory) ........................... ................... ................... 425 73.10 73.20 Change in obligated balances: Total new obligations .................................................... ................... ................... Total outlays (gross) ...................................................... ................... ................... 425 ¥425 86.97 Outlays (gross), detail: Outlays from new mandatory authority ......................... ................... ................... 425 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ ................... ................... Outlays ........................................................................... ................... ................... 425 425 Memorandum (non-add) entries: Total investments, end of year: Federal securities: Par value ................................................................... ................... ................... ¥106 229 ................... ................... 174 703 744 27,943 37,329 46,299 1 2 2 809 3,840 5,926 3,630 8,030 7,918 18 1,114 35,606 6,023 211,261 68 1,200 39,090 6,928 236,825 75 1,300 41,050 7,177 253,662 ................... ................... ................... ................... ¥1,203 8 ................... ................... ¥446 92.02 ................... ................... 280 ................... ................... ................... ................... ................... ................... ................... ................... 91 ¥179 ¥23 ¥1,472 211,261 236,825 252,190 ¥162,395 ¥178,358 ¥185,906 The Budget includes a Medicaid proposal to extend the subsidy of Medicare cost sharing for certain qualified individuals that are reimbursed by Medicare. FEDERAL SUPPLEMENTARY MEDICAL INSURANCE TRUST FUND (Legislative proposal, subject to PAYGO) ¥258 ................... ................... ¥32,229 ¥194,882 ¥49,876 ¥228,234 ¥60,861 ¥246,767 ................... ................... ................... ................... 1,250 ................... ................... ................... ................... 77 902 Program and Financing (in millions of dollars) Identification code 20–8004–4–7–571 2006 actual 2007 est. 2008 est. ¥425 Obligations by program activity: 00.01 Benefit payments, SMI ................................................... ................... ................... ¥1,250 10.00 Total cash outgo (¥) ............................................... ¥194,882 ¥228,234 ¥245,865 Unexpended balance, end of year: 8700 Uninvested balance (net), end of year .......................... 203 ................... ................... 8701 Invested balance, end of year ....................................... 33,061 41,855 48,750 8701 Invested balance, end of year ....................................... ................... ................... ¥106 6599 Total balance, end of year ........................................ ¥464 99.0 Status of Funds (in millions of dollars) Identification code 20–8004–0–7–571 Invested balance, end of year ....................................... ................... ................... Total new obligations (object class 42.0) ................ ................... ................... ¥1,250 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ ................... ................... Total new obligations .................................................... ................... ................... ¥1,250 1,250 New budget authority (gross), detail: Mandatory: 60.26 Appropriation (trust fund) ......................................... ................... ................... 60.28 Appropriation (unavailable balances) ....................... ................... ................... ¥1,714 464 62.50 ¥1,250 Appropriation (total mandatory) ........................... ................... ................... CENTERS FOR MEDICARE AND MEDICAID SERVICES—Continued Trust Funds—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES 423 Change in obligated balances: Total new obligations .................................................... ................... ................... Total outlays (gross) ...................................................... ................... ................... 00.04 Prescription Drug Benefits ............................................. 34,626 49,173 60,118 73.10 73.20 ¥1,250 1,250 10.00 Total new obligations ................................................ 34,876 49,909 60,879 86.97 Outlays (gross), detail: Outlays from new mandatory authority ......................... ................... ................... ¥1,250 22.00 23.33 Budgetary resources available for obligation: New budget authority (gross) ........................................ Adjustment for changes in allocation ........................... 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ ................... ................... Outlays ........................................................................... ................... ................... ¥1,250 ¥1,250 23.90 23.95 Total budgetary resources available for obligation Total new obligations .................................................... 34,876 ¥34,876 49,909 ¥49,909 60,879 ¥60,879 ¥464 40.26 New budget authority (gross), detail: Discretionary: Appropriation (trust fund) ......................................... Mandatory: 60.26 Appropriation (trust fund) ......................................... 707 726 760 34,626 49,183 60,119 70.00 Total new budget authority (gross) .......................... 35,333 49,909 60,879 72.40 73.10 73.20 73.40 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Adjustments in expired accounts (net) ......................... 74.40 Obligated balance, end of year ................................ 92.02 Memorandum (non-add) entries: Total investments, end of year: Federal securities: Par value ................................................................... ................... ................... The Budget proposes a package of reforms to encourage competition, recognize efficiencies and productivity in health care, enhance program integrity, and strengthen responsibility for health care choices. f TRANSITIONAL DRUG ASSISTANCE, FEDERAL SUPPLEMENTARY MEDICAL INSURANCE TRUST FUND Program and Financing (in millions of dollars) 35,333 49,909 60,879 ¥457 ................... ................... 405 3,065 3,098 34,876 49,909 60,879 ¥32,229 ¥49,876 ¥60,861 13 ................... ................... 3,065 3,098 3,116 Outlays (gross), detail: Outlays from new discretionary authority ..................... 174 589 Outlays from discretionary balances ............................. 337 106 Outlays from new mandatory authority ......................... 31,718 49,181 Outlays from mandatory balances ................................ ................... ................... 613 127 60,119 2 00.01 Obligations by program activity: Benefit payments, transitional drug assistance ........... 194 ................... ................... 86.90 86.93 86.97 86.98 10.00 Total new obligations (object class 42.0) ................ 194 ................... ................... 87.00 Total outlays (gross) ................................................. 32,229 49,876 60,861 22.00 23.95 24.41 Budgetary resources available for obligation: New budget authority (gross) ........................................ Total new obligations .................................................... Special and trust fund receipts returned to Schedule N ................................................................................ 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 35,333 32,229 49,909 49,876 60,879 60,861 Identification code 75–8307–0–7–571 2006 actual 2007 est. 2008 est. 194 ................... ................... ¥194 ................... ................... 3 ................... ................... Summary of Budget Authority and Outlays New budget authority (gross), detail: Mandatory: 60.26 Appropriation (trust fund) ......................................... 194 ................... ................... 72.40 73.10 73.20 73.40 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Adjustments in expired accounts (net) ......................... 125 58 58 194 ................... ................... ¥258 ................... ................... ¥3 ................... ................... 74.40 Obligated balance, end of year ................................ 86.93 86.97 86.98 Outlays (gross), detail: Outlays from discretionary balances ............................. Outlays from new mandatory authority ......................... Outlays from mandatory balances ................................ 29 ................... ................... 183 ................... ................... 46 ................... ................... Since January 2006, Medicare beneficiaries have had the opportunity to enroll in a comprehensive voluntary prescription drug benefit. 87.00 Total outlays (gross) ................................................. 258 ................... ................... Object Classification (in millions of dollars) 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 194 ................... ................... 258 ................... ................... (in millions of dollars) 58 58 58 Authorized under the Medicare Modernization Act as section 1860 D–31 of the Social Security Act, the Medicare Transitional Drug Assistance program provided low-income beneficiaries with $600 per year in 2004 and 2005 to help them pay for their prescription drugs and covered the cost of enrollment fees. Some benefits remained available in early 2006, until beneficiaries had the opportunity to enroll in the voluntary Medicare prescription drug benefits. 2006 actual 2007 est. Enacted/requested: Budget Authority ..................................................................... 35,333 49,909 Outlays .................................................................................... 32,229 49,876 Legislative proposal, subject to PAYGO: Budget Authority ..................................................................... .................... .................... Outlays .................................................................................... .................... .................... Total: Budget Authority ..................................................................... Outlays .................................................................................... Identification code 75–8308–0–7–571 35,333 32,229 2006 actual 49,909 49,876 2007 est. 2008 est. 60,879 60,861 –77 –77 60,802 60,784 2008 est. Direct obligations: 25.2 Other services ................................................................ 41.0 Grants, subsidies, and contributions ............................ 250 34,626 736 49,173 761 60,118 99.9 34,876 49,909 60,879 Total new obligations ................................................ MEDICARE PRESCRIPTION DRUG ACCOUNT, FEDERAL SUPPLEMENTARY MEDICAL INSURANCE TRUST FUND (Legislative proposal, subject to PAYGO) Program and Financing (in millions of dollars) f Identification code 75–8308–4–7–571 MEDICARE PRESCRIPTION DRUG ACCOUNT, FEDERAL SUPPLEMENTARY MEDICAL INSURANCE TRUST FUND Obligations by program activity: 00.01 Administrative costs ...................................................... 2007 est. 2008 est. 250 2007 est. 736 Total new obligations (object class 41.0) ................ ................... ................... ¥77 22.00 23.95 2006 actual ¥77 10.00 Program and Financing (in millions of dollars) Identification code 75–8308–0–7–571 2006 actual Obligations by program activity: 00.04 Prescription Drug Benefits ............................................. ................... ................... Budgetary resources available for obligation: New budget authority (gross) ........................................ ................... ................... Total new obligations .................................................... ................... ................... ¥77 77 2008 est. 761 424 CENTERS FOR MEDICARE AND MEDICAID SERVICES—Continued Trust Funds—Continued THE BUDGET FOR FISCAL YEAR 2008 MEDICARE PRESCRIPTION DRUG ACCOUNT, FEDERAL SUPPLEMENTARY MEDICAL INSURANCE TRUST FUND—Continued Program and Financing (in millions of dollars)—Continued Identification code 75–8308–4–7–571 2006 actual 2007 est. 2008 est. New budget authority (gross), detail: Mandatory: 60.26 Appropriation (trust fund) ......................................... ................... ................... ¥77 73.10 73.20 Change in obligated balances: Total new obligations .................................................... ................... ................... Total outlays (gross) ...................................................... ................... ................... ¥77 77 86.97 Outlays (gross), detail: Outlays from new mandatory authority ......................... ................... ................... Net budget authority and outlays: Budget authority ............................................................ ................... ................... Outlays ........................................................................... ................... ................... ¥77 ¥77 The Budget proposes changes to strengthen the financing of the Medicare prescription drug benefit. f ALLOCATION RECEIVED FROM OTHER ACCOUNTS 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.’’ Outlays ........................................................................... 16,897 17,318 17,296 The Temporary Assistance for Needy Families block grant provides funding to States for aid to low-income families with children. The Budget provides funding for activities reauthorized by the Deficit Reduction Act of 2005 (P.L. 109–171). This includes funding for a healthy marriage and fatherhood grant program. The Budget proposes to extend supplemental grants for population increases. It also proposes to eliminate the separate two-parent family work participation rate and to require twoparent families to meet the 50 percent work rate that single parent families adhere to. ¥77 89.00 90.00 90.00 Object Classification (in millions of dollars) Identification code 75–1552–0–1–609 11.1 12.1 21.0 23.1 25.1 25.2 25.3 41.0 99.9 2006 actual 2007 est. 2008 est. Direct obligations: Personnel compensation: Full-time permanent ............. 1 2 2 Civilian personnel benefits ............................................ 1 1 1 Travel and transportation of persons ............................ 1 1 1 Rental payments to GSA ................................................ ................... 1 1 Advisory and assistance services .................................. 19 22 22 Other services ................................................................ 5 ................... ................... Other purchases of goods and services from Government accounts ........................................................... 2 2 2 Grants, subsidies, and contributions ............................ 17,004 17,015 17,015 Total new obligations ................................................ 17,033 17,044 17,044 f Employment Summary ADMINISTRATION FOR CHILDREN AND FAMILIES Identification code 75–1552–0–1–609 Federal TEMPORARY ASSISTANCE FOR NEEDY FAMILIES 2006 actual 2008 est. 16,479 77 319 8 150 16,489 78 319 8 150 16,489 78 319 8 150 10.00 17,033 17,044 23.90 23.95 23.98 24.40 Total budgetary resources available for obligation Total new obligations .................................................... Unobligated balance expiring or withdrawn ................. 5,070 ................... ................... 11,988 17,059 17,059 17,058 ¥17,033 ¥25 17,059 ¥17,044 ¥15 17,059 ¥17,044 ¥15 Unobligated balance carried forward, end of year ................... ................... ................... New budget authority (gross), detail: Mandatory: 60.00 Appropriation ............................................................. 72.40 73.10 73.20 73.40 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Adjustments in expired accounts (net) ......................... 74.40 Obligated balance, end of year ................................ Identification code 75–1522–0–1–609 17,059 17,059 6,334 6,414 6,140 17,033 17,044 17,044 ¥16,897 ¥17,318 ¥17,296 ¥56 ................... ................... 6,414 6,140 5,888 Outlays (gross), detail: 86.97 Outlays from new mandatory authority ......................... 86.98 Outlays from mandatory balances ................................ 11,988 4,909 12,826 4,492 12,992 4,304 87.00 Total outlays (gross) ................................................. 16,897 17,318 17,296 89.00 Net budget authority and outlays: Budget authority ............................................................ 11,988 17,059 17,059 2006 actual 2007 est. 2008 est. Obligations by program activity: 00.01 Contingency fund ........................................................... 107 90 91 10.00 Total new obligations (object class 41.0) ................ 107 90 91 21.40 23.95 Budgetary resources available for obligation: Unobligated balance carried forward, start of year Total new obligations .................................................... 1,900 ¥107 1,793 ¥90 1,703 ¥91 24.40 Unobligated balance carried forward, end of year 1,793 1,703 1,612 New budget authority (gross), detail: Mandatory: 60.36 Unobligated balance permanently reduced .............. 63.00 Reappropriation ......................................................... 70.00 11,988 24 Program and Financing (in millions of dollars) 17,044 Budgetary resources available for obligation: 21.40 Unobligated balance carried forward, start of year 22.00 New budget authority (gross) ........................................ 24 2008 est. CONTINGENCY FUND 2007 est. Obligations by program activity: 00.01 State family assistance grant ....................................... 00.02 Territories—family assistance grants ........................... 00.04 Supplemental grants for population increases ............. 00.06 Tribal work programs ..................................................... 00.09 Healthy marriage and responsible fatherhood grants Total new obligations ................................................ 11 2007 est. f Program and Financing (in millions of dollars) Identification code 75–1552–0–1–609 2006 actual Direct: 1001 Civilian full-time equivalent employment ..................... ¥1,855 ................... ................... 1,855 ................... ................... Total new budget authority (gross) .......................... ................... ................... ................... 72.40 73.10 73.20 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... 15 107 ¥77 45 90 ¥103 32 91 ¥91 74.40 Obligated balance, end of year ................................ 45 32 32 86.98 Outlays (gross), detail: Outlays from mandatory balances ................................ 77 103 91 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ ................... ................... ................... Outlays ........................................................................... 77 103 91 The Budget proposes to allow States participating in the child welfare program the option to access the TANF contingency fund if they experience increases in their foster care caseload. ADMINISTRATION FOR CHILDREN AND FAMILIES—Continued Federal—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT FAMILY SUPPORT PROGRAMS AND 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), $2,949,713,000, to remain available until expended, of which up to $5,000,000 is for repatriation of U.S. citizens returned from foreign countries pursuant to section 1113 of the Act (notwithstanding subsection (d) of such section); and for such purposes for the first quarter of fiscal year 2009, $1,000,000,000, 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 for 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. 425 Offsets: Against gross budget authority and outlays: 88.40 Offsetting collections (cash) from: Non-Federal sources .................................................................. ¥221 ¥7 ¥7 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 3,322 4,001 4,399 4,519 3,950 4,078 89.00 90.00 Summary of Budget Authority and Outlays (in millions of dollars) 2006 actual 2007 est. Enacted/requested: Budget Authority ..................................................................... 3,322 4,399 Outlays .................................................................................... 4,001 4,519 Legislative proposal, subject to PAYGO: Budget Authority ..................................................................... .................... .................... Outlays .................................................................................... .................... .................... Total: Budget Authority ..................................................................... Outlays .................................................................................... 3,322 4,001 4,399 4,519 2008 est. 3,950 4,078 7 7 3,957 4,085 Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. This account provides for payments to States for child support enforcement and other family support programs, including access and visitation programs for families. The Federal share of child support collections is returned to the Treasury in a receipt account. The text table below shows the net Federal costs of child support enforcement and assumes enactment of legislative proposals effective in 2008. Program and Financing (in millions of dollars) Net Federal Costs of Child Support Enforcement (In millions of dollars) Identification code 75–1501–0–1–609 2006 actual 2007 est. 2008 est. 2006 Obligations by program activity: 00.01 State child support administrative costs ...................... 00.02 Child support incentive payments ................................. 00.03 Access and visitation grants ......................................... 3,517 458 10 3,936 471 10 3,468 483 10 00.91 01.02 01.03 Subtotal, child support enforcement ........................ Payments to territories .................................................. Repatriation ................................................................... 3,985 59 3 4,417 38 1 Subtotal, other payments .......................................... Offset obligations (CSE grants to States) .................... 62 221 39 7 39 7 10.00 Total new obligations ................................................ 4,268 4,463 4,007 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 Total budgetary resources available for obligation Total new obligations .................................................... 24.40 Unobligated balance carried forward, end of year 2008 –1,055 458 3,739 10 –1,065 471 3,944 10 –1,049 483 3,480 12 Total .................................................................................... 3,152 3,360 2,926 3,961 38 1 01.91 09.01 2007 Gross Federal share of collections .............................................. Federal incentive payments to States ........................................ State child support administrative costs ................................... Access and visitation grants ...................................................... Object Classification (in millions of dollars) Identification code 75–1501–0–1–609 2007 est. 2008 est. 99.0 728 3,543 7 ................... 4,406 3,957 4 50 50 4,275 ¥4,268 4,463 ¥4,463 41.0 2006 actual Direct obligations: Grants, subsidies, and contributions ........................................................................... Reimbursable obligations: reimbursable obligations 4,047 221 4,456 7 4,000 7 99.9 Total new obligations ................................................ 4,268 4,463 4,007 4,007 ¥4,007 PAYMENTS 2,122 1,200 221 7 3,543 4,406 AND Program and Financing (in millions of dollars) 7 70.00 STATES FOR CHILD SUPPORT ENFORCEMENT FAMILY SUPPORT PROGRAMS (Legislative proposal, subject to PAYGO) 7 ................... ................... New budget authority (gross), detail: Mandatory: 60.00 Appropriation ............................................................. 65.00 Advance appropriation .............................................. 69.00 Spending authority from offsetting collections: Offsetting collections (cash) ..................................... TO 3,957 Identification code 75–1501–4–1–609 2006 actual 2007 est. 2008 est. 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 .............................. 74.40 Obligated balance, end of year ................................ 2,950 1,000 757 4,268 ¥4,222 ¥4 799 4,463 ¥4,526 ¥50 686 4,007 ¥4,085 ¥50 799 686 Total new obligations (object class 41.0) ................ ................... ................... 7 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ ................... ................... Total new obligations .................................................... ................... ................... 7 ¥7 New budget authority (gross), detail: Mandatory: 60.00 Appropriation ............................................................. ................... ................... 7 73.10 73.20 Change in obligated balances: Total new obligations .................................................... ................... ................... Total outlays (gross) ...................................................... ................... ................... 7 ¥7 86.97 Outlays (gross), detail: Outlays from new mandatory authority ......................... ................... ................... 7 558 Outlays (gross), detail: 86.97 Outlays from new mandatory authority ......................... 86.98 Outlays from mandatory balances ................................ 3,465 757 3,933 593 3,537 548 87.00 4,222 4,526 4,085 Total outlays (gross) ................................................. 5 2 10.00 Total new budget authority (gross) .......................... 3,199 1,200 Obligations by program activity: 00.01 State child support administrative costs ...................... ................... ................... 00.03 Access and visitation grants ......................................... ................... ................... 426 ADMINISTRATION FOR CHILDREN AND FAMILIES—Continued Federal—Continued PAYMENTS THE BUDGET FOR FISCAL YEAR 2008 TO STATES FOR CHILD SUPPORT ENFORCEMENT AND FAMILY SUPPORT PROGRAMS—Continued 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 3,159 2,637 2,161 2,635 1,782 1,874 Program and Financing (in millions of dollars)—Continued Identification code 75–1501–4–1–609 89.00 90.00 2006 actual 2007 est. 2008 est. Net budget authority and outlays: Budget authority ............................................................ ................... ................... Outlays ........................................................................... ................... ................... 7 7 The legislative proposals include tools to increase child support collections such as intercept of gaming proceeds and data match of multi-state financial institutions. It also provides an increase in resources for the Access and Visitation Program which aims to increase the non-custodial parents’ involvement in their children’s lives. Additionally, new legislative proposals will provide Tribal child support programs with access to waivers and new enforcement and collections tools. f LOW INCOME HOME ENERGY ASSISTANCE For making payments under section 2602(b) of the Low Income Home Energy Act (42 U.S.C. 8621(b)), $1,500,000,000. For making payments under section 2604(e) of the Low Income Home Energy Assistance Act of 1981 (42 U.S.C. 8623(e)), $282,000,000, notwithstanding the emergency designation requirement of section 2602(e) of such Act. Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. Program and Financing (in millions of dollars) Identification code 75–1502–0–1–609 2006 actual 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 ENTRANT ASSISTANCE For necessary expenses for refugee and entrant assistance activities and for costs associated with the care and placement of unaccompanied alien children authorized by section 414 of the Immigration and Nationality Act and section 501 of the Refugee Education Assistance Act of 1980, for carrying out section 462 of the Homeland Security Act of 2002, and for carrying out the Torture Victims Relief Act of 2003, $655,630,000, of which up to $14,816,000 shall be available to carry out the Trafficking Victims Protection Reauthorization Act of 2005: Provided, That funds appropriated under this heading pursuant to section 414(a) of the Immigration and Nationality Act and section 462 of the Homeland Security Act of 2002 for fiscal year 2008 shall be available for the costs of assistance provided and other activities to remain available through September 30, 2010 (6 U.S.C. 279; 8 U.S.C. 1522 note, 1524; 22 U.S.C. 2152 note, 7101 et seq.). Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. Program and Financing (in millions of dollars) Identification code 75–1503–0–1–609 2007 est. 2008 est. Obligations by program activity: 00.01 Direct program activity .................................................. 3,160 2,180 1,782 10.00 Total new obligations (object class 41.0) ................ 3,160 2,180 1,782 21.40 22.00 Budgetary resources available for obligation: Unobligated balance carried forward, start of year New budget authority (gross) ........................................ 20 3,159 19 ................... 2,161 1,782 23.90 23.95 Total budgetary resources available for obligation Total new obligations .................................................... 3,179 ¥3,160 24.40 Unobligated balance carried forward, end of year 2,180 ¥2,180 1,782 ¥1,782 2006 actual 2007 est. 2008 est. 00.01 00.02 00.03 Obligations by program activity: Refugee and entrant assistance ................................... Assistance for treatment of torture victims .................. Unaccompanied alien children ...................................... 466 10 77 484 10 77 511 10 135 10.00 Total new obligations ................................................ 553 571 656 21.40 22.00 22.10 Budgetary resources available for obligation: Unobligated balance carried forward, start of year ................... 18 ................... New budget authority (gross) ........................................ 570 553 656 Resources available from recoveries of prior year obligations ....................................................................... 1 ................... ................... 23.90 23.95 Total budgetary resources available for obligation Total new obligations .................................................... 24.40 19 ................... ................... 571 ¥553 571 ¥571 656 ¥656 Unobligated balance carried forward, end of year 18 ................... ................... New budget authority (gross), detail: Discretionary: 40.00 Appropriation—Block ................................................ 40.00 Appropriation—Emergency ........................................ 40.35 Appropriation permanently reduced .......................... 41.00 Transferred to other accounts ................................... 2,000 1,980 1,500 183 181 282 ¥22 ................... ................... ¥2 ................... ................... New budget authority (gross), detail: Discretionary: 40.00 Appropriation ............................................................. 40.35 Appropriation permanently reduced .......................... 576 553 656 ¥6 ................... ................... 43.00 2,159 43.00 Appropriation (total discretionary) ........................ 570 72.40 73.10 73.20 73.40 73.45 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 .............................. 74.40 Obligated balance, end of year ................................ 506 536 594 86.90 86.93 Outlays (gross), detail: Outlays from new discretionary authority ..................... Outlays from discretionary balances ............................. 235 275 232 309 276 322 60.00 60.00 Appropriation (total discretionary) ........................ Mandatory: Appropriation—Block ................................................ Appropriation—Emergency ........................................ 62.50 Appropriation (total mandatory) ........................... 70.00 Total new budget authority (gross) .......................... 3,159 72.40 73.10 73.20 73.40 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Adjustments in expired accounts (net) ......................... 549 3,160 ¥2,637 ¥3 74.40 Obligated balance, end of year ................................ 1,069 2,161 1,782 500 ................... ................... 500 ................... ................... 1,000 ................... ................... 2,161 1,782 1,069 606 2,180 1,782 ¥2,635 ¥1,874 ¥8 ................... 606 514 553 656 471 506 536 553 571 656 ¥510 ¥541 ¥598 ¥7 ................... ................... ¥1 ................... ................... 87.00 Total outlays (gross) ................................................. 510 541 598 Outlays (gross), detail: 86.90 Outlays from new discretionary authority ..................... 1,471 1,624 1,342 86.93 Outlays from discretionary balances ............................. 476 701 532 86.97 Outlays from new mandatory authority ......................... 690 ................... ................... 86.98 Outlays from mandatory balances ................................ ................... 310 ................... 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 570 510 553 541 656 598 87.00 States are subsidized for administering the refugee assistance program. Funds are also provided to assist in the reha- Total outlays (gross) ................................................. 2,637 2,635 1,874 ADMINISTRATION FOR CHILDREN AND FAMILIES—Continued Federal—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES bilitation of victims of torture, trafficking victims, and the care and placement of unaccompanied alien children. Object Classification (in millions of dollars) Identification code 75–1503–0–1–609 2006 actual 2007 est. 2008 est. 427 Object Classification (in millions of dollars) Identification code 75–1512–0–1–506 2006 actual 2007 est. 2008 est. Direct obligations: 25.1 Advisory and assistance services .................................. 25.3 Other purchases of goods and services from Government accounts ........................................................... 41.0 Grants, subsidies, and contributions ............................ 1 ................... ................... 449 451 451 99.9 454 4 3 Direct obligations: Personnel compensation: Full-time permanent ............. Rental payments to GSA ................................................ Advisory and assistance services .................................. Other services ................................................................ Other purchases of goods and services from Government accounts ........................................................... 41.0 Grants, subsidies, and contributions ............................ 3 1 14 2 3 1 15 3 3 1 15 3 10 523 10 539 14 620 CHILD CARE ENTITLEMENT 99.9 553 571 656 3 Program and Financing (in millions of dollars) 11.1 23.1 25.1 25.2 25.3 Total new obligations ................................................ 2007 est. 26 33 2008 est. 33 f PROMOTING SAFE AND TO STATES 2006 actual 2007 est. 2008 est. Obligations by program activity: 00.01 Mandatory child care ..................................................... 00.02 Matching child care ....................................................... 00.03 Training and technical assistance ................................ 00.04 Child care tribal grants ................................................. 1,178 1,677 7 58 1,178 1,674 7 58 1,178 1,674 7 58 Total new obligations ................................................ 2,920 2,917 2,917 21.40 22.00 22.30 Budgetary resources available for obligation: Unobligated balance carried forward, start of year New budget authority (gross) ........................................ Expired unobligated balance transfer to unexpired account .......................................................................... STABLE FAMILIES For carrying out section 436 of the Social Security Act, $345,000,000 and section 437, $89,100,000. Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. 23.90 23.95 Program and Financing (in millions of dollars) 24.40 Identification code 75–1512–0–1–506 454 10.00 2006 actual Direct: 1001 Civilian full-time equivalent employment ..................... 454 f Identification code 75–1550–0–1–609 Employment Summary Identification code 75–1503–0–1–609 Total new obligations ................................................ 2006 actual 2007 est. 2008 est. Obligations by program activity: 00.01 Grants to States and Tribes .......................................... 00.02 Research, training and technical assistance ............... 00.03 State court improvement activities ............................... 412 9 33 412 9 33 412 9 33 10.00 Total new obligations ................................................ 454 454 454 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ Total new obligations .................................................... 454 ¥454 454 ¥454 454 ¥454 Total budgetary resources available for obligation Total new obligations .................................................... 991 ................... ................... 1,926 2,917 2,917 3 ................... ................... 2,920 ¥2,920 2,917 ¥2,917 2,917 ¥2,917 Unobligated balance carried forward, end of year ................... ................... ................... New budget authority (gross), detail: Mandatory: 60.00 Appropriation ............................................................. 1,926 2,917 2,917 43.00 90 89 89 ¥1 ................... ................... 89 89 365 365 365 70.00 Total new budget authority (gross) .......................... 454 454 454 72.40 73.10 73.20 73.40 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Adjustments in expired accounts (net) ......................... 74.40 Obligated balance, end of year ................................ 451 454 Outlays (gross), detail: Outlays from new discretionary authority ..................... Outlays from discretionary balances ............................. Outlays from new mandatory authority ......................... Outlays from mandatory balances ................................ 23 73 82 246 20 71 84 276 20 66 84 277 87.00 Total outlays (gross) ................................................. 424 451 447 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 454 424 454 451 454 447 Obligated balance, end of year ................................ 729 818 935 86.97 86.98 Outlays (gross), detail: Outlays from new mandatory authority ......................... Outlays from mandatory balances ................................ 1,926 1,134 2,100 728 2,100 700 Total outlays (gross) ................................................. 3,060 2,828 2,800 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 1,926 3,060 2,917 2,828 2,917 2,800 461 86.90 86.93 86.97 86.98 74.40 877 729 818 2,920 2,917 2,917 ¥3,060 ¥2,828 ¥2,800 ¥8 ................... ................... 89 60.00 Appropriation (total discretionary) ........................ Mandatory: Appropriation ............................................................. Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Adjustments in expired accounts (net) ......................... 87.00 New budget authority (gross), detail: Discretionary: 40.00 Appropriation ............................................................. 40.35 Appropriation permanently reduced .......................... 72.40 73.10 73.20 73.40 429 451 454 454 454 454 ¥424 ¥451 ¥447 ¥8 ................... ................... 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). Object Classification (in millions of dollars) Identification code 75–1550–0–1–609 2006 actual 2007 est. 2008 est. Direct obligations: 25.1 Advisory and assistance services .................................. 41.0 Grants, subsidies, and contributions ............................ 7 2,913 7 2,910 7 2,910 99.9 2,920 2,917 2,917 Total new obligations ................................................ f This program provides funds for a broad range of child welfare services, including family preservation and family support services. PAYMENTS TO STATES FOR THE BLOCK CHILD CARE GRANT AND DEVELOPMENT For carrying out the Child Care and Development Block Grant Act of 1990 (42 U.S.C. 9858 et seq.), $2,062,081,000 shall be used to supplement, not supplant State general revenue funds for child ADMINISTRATION FOR CHILDREN AND FAMILIES—Continued Federal—Continued 428 PAYMENTS TO THE BUDGET FOR FISCAL YEAR 2008 STATES FOR THE CHILD CARE AND DEVELOPMENT BLOCK GRANT—Continued care assistance for low-income families: Provided, That $18,777,370 shall be available for child care resource and referral and schoolaged child care activities, of which $982,080 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, $267,785,718 shall be reserved by the States for activities authorized under section 658G, of which $98,208,000 shall be for activities that improve the quality of infant and toddler care: Provided further, That $9,821,000 shall be for use by the Secretary for child care research, demonstration, and evaluation activities. Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. 2006 actual 2007 est. 2,051 10 2,052 10 2,052 10 10.00 2,061 2,062 2,062 Budgetary resources available for obligation: 22.00 New budget authority (gross) ........................................ 23.95 Total new obligations .................................................... 2,061 ¥2,061 2,062 ¥2,062 2,062 ¥2,062 New budget authority (gross), detail: Discretionary: 40.00 Appropriation ............................................................. 40.35 Appropriation permanently reduced .......................... 41.00 Transferred to other accounts ................................... 2,083 2,062 2,062 ¥21 ................... ................... ¥1 ................... ................... 43.00 2,061 Appropriation (total discretionary) ........................ 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 ................................ 710 2,061 ¥2,192 ¥4 Identification code 75–1534–0–1–506 2006 actual 2,062 575 610 2,062 2,062 ¥2,024 ¥2,053 ¥3 ................... 00.01 Obligations by program activity: Direct program activity .................................................. 2,250 1,700 1,200 10.00 Total new obligations (object class 41.0) ................ 2,250 1,700 1,200 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 ....................................................................... 4 2,250 17 1,700 17 1,200 13 ................... ................... Total budgetary resources available for obligation Total new obligations .................................................... 2,267 ¥2,250 1,717 ¥1,700 1,217 ¥1,200 Unobligated balance carried forward, end of year 17 17 17 New budget authority (gross), detail: Discretionary: 40.00 Appropriation ............................................................. ................... ................... Mandatory: 60.00 Appropriation ............................................................. 2,250 1,700 ¥500 70.00 Total new budget authority (gross) .......................... 72.40 73.10 73.20 73.45 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Recoveries of prior year obligations .............................. 74.40 Obligated balance, end of year ................................ 2,250 1,700 1,700 1,200 442 831 376 2,250 1,700 1,200 ¥1,848 ¥2,155 ¥1,306 ¥13 ................... ................... 831 376 270 86.90 86.97 86.98 Outlays (gross), detail: Outlays from new discretionary authority ..................... ................... ................... Outlays from new mandatory authority ......................... 1,550 1,445 Outlays from mandatory balances ................................ 298 710 ¥425 1,445 286 610 87.00 Total outlays (gross) ................................................. 1,848 2,155 1,306 89.00 90.00 575 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 2,250 1,848 1,700 2,155 1,200 1,306 619 1,553 639 1,526 498 1,526 527 87.00 Total outlays (gross) ................................................. 2,192 2,024 2,053 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 2,061 2,192 2,062 2,024 2,062 2,053 This appropriation helps low-income families pay for child care and related services and supports grants to States for activities to improve child care quality. Object Classification (in millions of dollars) 2006 actual 2007 est. 2008 est. Direct obligations: 25.1 Advisory and assistance services .................................. 25.3 Other purchases of goods and services from Government accounts ........................................................... 41.0 Grants, subsidies, and contributions ............................ 5 6 6 1 2,055 1 2,055 1 2,055 99.9 2,061 2,062 2,062 Total new obligations ................................................ 2008 est. 2,062 Outlays (gross), detail: 86.90 Outlays from new discretionary authority ..................... 86.93 Outlays from discretionary balances ............................. Identification code 75–1515–0–1–609 2007 est. 24.40 2008 est. Obligations by program activity: 00.01 Block grant payments to States .................................... 00.04 Research and evaluation fund ...................................... Total new obligations ................................................ Program and Financing (in millions of dollars) 23.90 23.95 Program and Financing (in millions of dollars) Identification code 75–1515–0–1–609 Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. f SOCIAL SERVICES BLOCK GRANT For making grants to States pursuant to section 2002 of the Social Security Act (42 U.S.C. 1397a), $1,200,000,000: Provided, That notwithstanding section 2003(c) of such Act, the amount specified for allocation under such section for fiscal year 2008 shall be $1,200,000,000. 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 of 2000, the Head Start Act, the Child Abuse Prevention and Treatment Act, sections 310 and 316 of the Family Violence Prevention and Services Act, the Native American Programs Act of 1974, title II of the Child Abuse Prevention and Treatment and Adoption Reform Act of 1978 (adoption opportunities), sections 330F and 330G of the Public Health Services Act, the Abandoned Infants Assistance Act of 1988, sections 261 and 291 of the Help America Vote Act of 2002, part B(1) of title IV and sections 413, 1110, and 1115 of the Social Security Act, sections 439(i), 473(B), and 477(i) of the Social Security Act, and the Assets for Independence Act, and for necessary administrative expenses to carry out said Acts and titles I, IV, V, X, XI, XIV, XVI, and XX of the Social Security Act, the Act of July 5, 1960, the Low Income Home Energy Assistance Act of 1981, title IV of the Immigration and Nationality Act, section 501 of the Refugee Education Assistance Act of 1980, $8,239,709,000, of which $13,500,000, to remain available until September 30, 2009, shall be for grants to States for adoption incentive payments, as authorized by section 473A of the Social Security Act and may be made for adoptions completed before September 30, 2008: Provided, That $6,788,571,000 shall be for making payments under the Head Start Act, of which $1,388,800,000 shall become available October 1, 2008, and remain available through September 30, 2009: Provided further, That in addition to amounts provided herein, $5,880,000 shall be available from amounts available under section 241 of the Public Health Service Act to carry out the provisions of section 1110 of the Social Security Act: Provided further, That $75,000,000 is for ADMINISTRATION FOR CHILDREN AND FAMILIES—Continued Federal—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES 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 $15,720,000 shall be for activities authorized by the Help America Vote Act of 2002, of which $10,890,000 shall be for payments to States to promote access for voters with disabilities, and of which $4,830,000 shall be for payments to States for protection and advocacy systems for voters with disabilities: Provided further, That $136,664,000 shall be for making competitive grants to provide abstinence education (as defined by section 510(b)(2) of the Social Security Act) to adolescents, and for Federal costs of administering the grant: 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 abstinence education was provided: Provided further, That within amounts provided herein for abstinence education for adolescents, up to $10,000,000 may be available for a national abstinence education campaign: Provided further, That in addition to amounts provided herein for abstinence education for adolescents, $4,500,000 shall be available from amounts available under section 241 of the Public Health Service Act to carry out evaluations (including longitudinal evaluations) of adolescent pregnancy prevention approaches: Provided further, That up to $2,000,000 shall be for improving the Public Assistance Reporting Information System, including grants to States to support data collection for a study of the system’s effectiveness. (42 U.S.C. 254C-6, 254C-7, 604 note, 670 note, 673b, 2991a et seq., 5101 et seq., 5111 et seq., 5751 et seq., 9834 et seq., 10409, 10416, 15001 et seq., 15424, 15462; 24 U.S.C. ch. 9.) Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. Program and Financing (in millions of dollars) Identification code 75–1536–0–1–506 2006 actual 2007 est. 2008 est. Obligations by program activity: Head start ...................................................................... 6,851 6,789 6,789 Runaway and homeless youth (basic centers) ............. 48 48 48 Transitional living .......................................................... 40 40 40 Education grants to reduce sexual abuse of runaway youth .......................................................................... 15 15 15 01.07 Abstinence education (mandatory) ................................ 42 37 ................... 01.08 Mentoring children of prisoners .................................... 49 50 50 01.09 Child abuse state grants .............................................. 27 27 27 01.10 Child abuse discretionary activities .............................. 26 26 36 01.11 Community based resource centers .............................. 42 42 42 01.12 Child welfare services ................................................... 287 287 287 01.13 Child welfare training .................................................... 7 7 7 01.14 Adoption opportunities ................................................... 27 27 27 01.15 Abandoned infants assistance ...................................... 12 12 12 01.16 Adoption incentives ........................................................ 12 12 14 01.17 Independent living training vouchers ............................ 46 46 46 01.18 Children’s health act programs .................................... 13 13 13 01.19 State councils on developmental disabilities ............... 72 72 72 01.20 Protection and advocacy ................................................ 39 39 39 01.21 Projects of national significance ................................... 11 11 11 01.22 University centers for excellence ................................... 33 33 33 01.23 Voting access for individuals with disabilities ............. 16 16 16 01.24 Native american programs ............................................ 43 44 44 01.25 Social services and income maintenance research ...... 6 6 ................... 01.26 Compassion capital fund .............................................. 64 64 75 01.28 Federal administration ................................................... 183 184 197 01.29 Center for faith-based and community initiatives ....... 1 1 1 01.30 Abstinence education (discretionary) ............................ 109 109 137 01.31 Interstate home study incentives .................................. ................... ................... 10 01.01 01.03 01.04 01.06 01.91 03.01 03.03 03.04 03.06 03.08 03.09 Subtotal ..................................................................... Community services block grant ................................... Rural communtiy facilities ............................................ Community services discretionary (JOLI & CED) ........... Assets for independence ................................................ Domestic violence hotline .............................................. Family violence prevention and services ....................... 8,121 630 7 32 25 125 3 8,057 8,088 630 ................... 7 ................... 32 ................... 24 24 3 3 125 125 03.91 Subtotal ..................................................................... 822 821 152 04.00 Total, direct program ................................................ 8,943 8,878 8,240 429 09.01 Reimbursable program .................................................. 14 22 17 10.00 Total new obligations ................................................ 8,957 8,900 8,257 21.40 22.00 Budgetary resources available for obligation: Unobligated balance carried forward, start of year New budget authority (gross) ........................................ 26 8,971 9 8,895 4 8,257 23.90 23.95 23.98 Total budgetary resources available for obligation Total new obligations .................................................... Unobligated balance expiring or withdrawn ................. 24.40 Unobligated balance carried forward, end of year 8,997 8,904 8,261 ¥8,957 ¥8,900 ¥8,257 ¥31 ................... ................... 9 4 4 New budget authority (gross), detail: Discretionary: 40.00 Appropriation ............................................................. 40.35 Appropriation permanently reduced .......................... 40.36 Unobligated balance permanently reduced .............. 41.00 Transferred to other accounts ................................... 7,623 7,452 6,851 ¥75 ................... ................... ¥23 ................... ................... ¥5 ................... ................... 43.00 55.00 55.35 Appropriation (total discretionary) ........................ Advance appropriation .............................................. Advance appropriation permanently reduced ........... 7,520 7,452 6,851 1,400 1,389 1,389 ¥14 ................... ................... 55.90 Advance appropriation (total discretionary) ......... Spending authority from offsetting collections: Offsetting collections (cash) ................................ Change in uncollected customer payments from Federal sources (unexpired) ............................. 1,386 1,389 1,389 4 17 17 58.00 58.10 58.90 11 ................... ................... 60.00 Spending authority from offsetting collections (total discretionary) .......................................... Mandatory: Appropriation ............................................................. 50 70.00 Total new budget authority (gross) .......................... 8,971 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) ................................................ 72.40 73.10 73.20 73.40 74.00 15 17 17 37 ................... 8,895 8,257 4,892 4,850 4,892 8,957 8,900 8,257 ¥8,882 ¥8,858 ¥8,501 ¥118 ................... ................... ¥11 ................... ................... 12 ................... ................... 74.40 Obligated balance, end of year ................................ 4,850 4,892 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 ................................ 4,768 4,064 18 32 4,719 4,374 4,101 4,107 14 ................... 24 20 87.00 Total outlays (gross) ................................................. 8,882 8,858 8,501 ¥22 ¥17 ¥17 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 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 4,648 ¥11 ................... ................... 18 ................... ................... 8,956 8,860 8,878 8,841 8,240 8,484 Summary of Budget Authority and Outlays (in millions of dollars) 2006 actual Enacted/requested: Budget Authority ..................................................................... 8,956 Outlays .................................................................................... 8,860 Legislative proposal, subject to PAYGO: Budget Authority ..................................................................... .................... Outlays .................................................................................... .................... Total: Budget Authority ..................................................................... Outlays .................................................................................... 8,956 8,860 2007 est. 2008 est. 8,878 8,841 8,240 8,484 13 5 50 25 8,891 8,846 8,290 8,509 430 ADMINISTRATION FOR CHILDREN AND FAMILIES—Continued Federal—Continued CHILDREN AND THE BUDGET FOR FISCAL YEAR 2008 90.00 FAMILIES SERVICES PROGRAMS—Continued The 2008 Budget eliminates community services programs, including the Community Services Block Grant, Community Economic Development, Rural Community Facilities and Job Opportunities for Low-Income Individuals. This is due to poor program performance and/or duplication with other Federal programs that can achieve greater results and better focus on communities most in need of assistance. 11.1 11.3 11.5 11.9 12.1 21.0 23.1 23.3 24.0 25.1 25.2 25.3 25.4 25.5 26.0 41.0 2006 actual Direct obligations: Personnel compensation: Full-time permanent ............................................. Other than full-time permanent ........................... Other personnel compensation ............................. 2007 est. 2008 est. 98 5 2 103 5 1 110 6 1 Total personnel compensation .............................. 105 Civilian personnel benefits ....................................... 22 Travel and transportation of persons ....................... 4 Rental payments to GSA ........................................... 13 Communications, utilities, and miscellaneous charges ................................................................. 2 Printing and reproduction ......................................... 2 Advisory and assistance services ............................. 154 Other services ............................................................ 11 Other purchases of goods and services from Government accounts ................................................. 99 Operation and maintenance of facilities .................. 2 Research and development contracts ....................... ................... Supplies and materials ............................................. 1 Grants, subsidies, and contributions ........................ 8,528 109 24 4 16 117 25 4 16 3 2 142 6 5 2 148 6 70 2 1 1 8,498 72 3 1 1 7,840 99.0 99.0 Direct obligations .................................................. Reimbursable obligations .............................................. 8,943 14 8,878 22 8,240 17 99.9 Total new obligations ................................................ 8,957 8,900 CHILDREN’S RESEARCH 2006 actual AND TECHNICAL ASSISTANCE 2006 actual 2007 est. 2008 est. Obligations by program activity: 00.01 Training and technical assistance ................................ 00.02 Federal parent locator service ....................................... 00.03 Child welfare study ........................................................ 00.04 Welfare research ............................................................ 09.01 Reimbursable program .................................................. 12 25 6 15 18 14 25 6 15 23 12 25 6 15 24 10.00 Total new obligations ................................................ 76 83 82 21.40 22.00 Budgetary resources available for obligation: Unobligated balance carried forward, start of year New budget authority (gross) ........................................ 1 77 2 ................... 81 82 23.90 23.95 Total budgetary resources available for obligation Total new obligations .................................................... 78 ¥76 24.40 Unobligated balance carried forward, end of year New budget authority (gross), detail: Mandatory: 60.00 Appropriation ............................................................. Spending authority from offsetting collections: 69.00 Offsetting collections (cash) ................................ 69.10 Change in uncollected customer payments from Federal sources (unexpired) ............................. 83 ¥83 82 ¥82 2 ................... ................... 58 58 58 15 23 24 4 ................... ................... 2007 est. 1,156 Spending authority from offsetting collections (total mandatory) ............................................. 19 23 24 70.00 Employment Summary CHILDREN AND Program and Financing (in millions of dollars) 69.90 Direct: 1001 Civilian full-time equivalent employment ..................... 25 f 8,257 Identification code 75–1536–0–1–506 5 This legislative proposal provides for an extension of the Title V abstinence education program. Identification code 75–1553–0–1–609 Object Classification (in millions of dollars) Identification code 75–1536–0–1–506 Outlays ........................................................................... ................... Total new budget authority (gross) .......................... 77 81 82 72.40 73.10 73.20 73.40 74.00 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) ............................................ 2008 est. 1,157 1,196 FAMILIES SERVICES PROGRAMS (Legislative proposal, subject to PAYGO) 66 64 60 76 83 82 ¥72 ¥87 ¥82 ¥2 ................... ................... ¥4 ................... ................... 74.40 Obligated balance, end of year ................................ 64 60 60 86.97 86.98 Outlays (gross), detail: Outlays from new mandatory authority ......................... Outlays from mandatory balances ................................ 40 32 44 43 45 37 87.00 Total outlays (gross) ................................................. 72 87 82 Offsets: Against gross budget authority and outlays: Offsetting collections (cash) from: 88.00 Federal sources ..................................................... ¥15 88.40 Non-Federal sources ............................................. ................... ¥13 ¥10 ¥14 ¥10 ¥15 ¥23 ¥24 Program and Financing (in millions of dollars) Identification code 75–1536–4–1–506 2006 actual 2007 est. 2008 est. Obligations by program activity: 01.07 Abstinence education ..................................................... ................... 13 50 04.00 Total, direct program ................................................ ................... 13 50 10.00 Total new obligations (object class 41.0) ................ ................... 13 50 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ ................... Total new obligations .................................................... ................... 13 ¥13 50 ¥50 New budget authority (gross), detail: Mandatory: 60.00 Appropriation ............................................................. ................... 88.95 13 Change in obligated balances: 72.40 Obligated balance, start of year ................................... ................... ................... 73.10 Total new obligations .................................................... ................... 13 73.20 Total outlays (gross) ...................................................... ................... ¥5 74.40 86.97 86.98 87.00 Obligated balance, end of year ................................ ................... 50 8 50 ¥25 8 33 Outlays (gross), detail: Outlays from new mandatory authority ......................... ................... 5 Outlays from mandatory balances ................................ ................... ................... 19 6 Total outlays (gross) ................................................. ................... Net budget authority and outlays: 89.00 Budget authority ............................................................ ................... 88.90 5 13 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... ¥4 ................... ................... 58 57 58 64 58 58 This account provides funding for research and technical assistance activities established in P.L. 104–193. Object Classification (in millions of dollars) Identification code 75–1553–0–1–609 25 50 Total, offsetting collections (cash) ....................... Against gross budget authority only: Change in uncollected customer payments from Federal sources (unexpired) .................................. 11.1 12.1 21.0 Direct obligations: Personnel compensation: Full-time permanent ........ Civilian personnel benefits ....................................... Travel and transportation of persons ....................... 2006 actual 7 1 1 2007 est. 2008 est. 7 1 1 7 1 1 ADMINISTRATION FOR CHILDREN AND FAMILIES—Continued Federal—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES 23.1 25.1 25.2 25.3 431 3 28 6 3 32 6 3 30 6 73.10 73.20 73.40 Total new obligations .................................................... Total outlays (gross) ...................................................... Adjustments in expired accounts (net) ......................... 7 4 7 3 7 3 74.40 Obligated balance, end of year ................................ 917 1,026 1,082 41.0 Rental payments to GSA ........................................... Advisory and assistance services ............................. Other services ............................................................ Other purchases of goods and services from Government accounts ................................................. Grants, subsidies, and contributions ........................ 99.0 99.0 Direct obligations .................................................. Reimbursable obligations .............................................. 57 19 60 23 58 24 86.97 86.98 Outlays (gross), detail: Outlays from new mandatory authority ......................... Outlays from mandatory balances ................................ 5,537 816 5,795 738 6,005 816 99.9 Total new obligations ................................................ 76 83 82 87.00 Total outlays (gross) ................................................. 6,353 6,533 6,821 Employment Summary Identification code 75–1553–0–1–609 1001 2006 actual Direct: Civilian full-time equivalent employment ..................... 65 2007 est. 2008 est. 64 64 f Offsets: Against gross budget authority and outlays: 88.00 Offsetting collections (cash) from: Federal sources Against gross budget authority only: 88.96 Portion of offsetting collections (cash) credited to expired accounts ................................................... 89.00 90.00 DISABLED VOTER SERVICES 2006 actual 2006 actual 10 ¥3 74.40 Obligated balance, end of year ................................ 7 2 ................... 86.93 Outlays (gross), detail: Outlays from discretionary balances ............................. 3 5 7 ¥5 2 ¥2 2 Net budget authority and outlays: 89.00 Budget authority ............................................................ ................... ................... ................... 90.00 Outlays ........................................................................... 3 5 2 f STATES FOR FOSTER CARE AND ADOPTION ASSISTANCE For making payments to States or other non-Federal entities under title IV–E of the Social Security Act, $5,067,000,000. For making payments to States or other non-Federal entities under title IV–E of the Act, for the first quarter of fiscal year 2009, $1,776,000,000. 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 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. Program and Financing (in millions of dollars) Identification code 75–1545–0–1–609 Obligations by program activity: 00.01 Foster care ..................................................................... 00.02 Independent living ......................................................... 00.04 Adoption assistance ....................................................... 6,620 6,352 2006 actual Total: Budget Authority ..................................................................... Outlays .................................................................................... 6,877 6,821 4,475 140 2,027 6,620 6,352 6,941 6,533 6,877 6,821 15 13 6,892 6,834 Object Classification (in millions of dollars) Identification code 75–1545–0–1–609 2006 actual 2007 est. 2008 est. Direct obligations: 25.1 Advisory and assistance services .................................. 25.3 Other purchases of goods and services from Government accounts ........................................................... 41.0 Grants, subsidies, and contributions ............................ 9 11 11 1 6,247 1 6,630 1 6,865 99.9 6,257 6,642 6,877 Total new obligations ................................................ Employment Summary 2008 est. 4,581 140 2,156 2008 est. Foster care.—The proposed level will support eligible lowincome children who must be placed outside the home. An average of 211,000 children per month will be served in 2008. Adoption assistance.—The proposed funding level will support subsidies for families adopting eligible low-income children with special needs. An average of 426,900 children per month will be served in 2008. Identification code 75–1545–0–1–609 2007 est. 2007 est. Enacted/requested: Budget Authority ..................................................................... 6,620 6,941 Outlays .................................................................................... 6,352 6,533 Legislative proposal, subject to PAYGO: Budget Authority ..................................................................... .................... .................... Outlays .................................................................................... .................... .................... 1001 4,325 140 1,792 6,941 6,533 (in millions of dollars) 2008 est. Change in obligated balances: Obligated balance, start of year ................................... Total outlays (gross) ...................................................... TO 1 ................... ................... Summary of Budget Authority and Outlays 2007 est. 72.40 73.20 PAYMENTS ¥1 ................... ................... Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... Program and Financing (in millions of dollars) Identification code 75–1533–0–1–808 6,257 6,642 6,877 ¥6,353 ¥6,533 ¥6,821 10 ................... ................... 2006 actual Direct: Civilian full-time equivalent employment ..................... PAYMENTS TO STATES FOR FOSTER CARE 2007 est. 2 AND 2008 est. 2 2 ADOPTION ASSISTANCE (Legislative proposal, subject to PAYGO) 10.00 Total new obligations ................................................ 6,257 6,642 6,877 Program and Financing (in millions of dollars) Budgetary resources available for obligation: 22.00 New budget authority (gross) ........................................ 23.95 Total new obligations .................................................... 23.98 Unobligated balance expiring or withdrawn ................. 6,620 ¥6,257 ¥363 New budget authority (gross), detail: Mandatory: 60.00 Appropriation ............................................................. 65.00 Advance appropriation .............................................. 4,853 1,767 6,941 6,877 ¥6,642 ¥6,877 ¥299 ................... Identification code 75–1545–4–1–609 2006 actual 2007 est. 2008 est. 12 3 10.00 5,211 1,730 Obligations by program activity: 00.01 Foster care ..................................................................... ................... ................... 00.04 Adoption assistance ....................................................... ................... ................... Total new obligations ................................................ ................... ................... 15 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ ................... ................... Total new obligations .................................................... ................... ................... 15 ¥15 5,067 1,810 70.00 Total new budget authority (gross) .......................... 6,620 6,941 6,877 72.40 Change in obligated balances: Obligated balance, start of year ................................... 1,003 917 1,026 New budget authority (gross), detail: Mandatory: 432 ADMINISTRATION FOR CHILDREN AND FAMILIES—Continued Federal—Continued PAYMENTS TO STATES FOR FOSTER CARE ASSISTANCE—Continued THE BUDGET FOR FISCAL YEAR 2008 21.40 22.00 AND 23.90 23.95 23.98 Program and Financing (in millions of dollars)—Continued Identification code 75–1545–4–1–609 Budgetary resources available for obligation: Unobligated balance carried forward, start of year New budget authority (gross) ........................................ Total budgetary resources available for obligation Total new obligations .................................................... Unobligated balance expiring or withdrawn ................. ADOPTION 2006 actual 2007 est. 2008 est. 60.00 Appropriation ............................................................. ................... ................... 15 73.10 73.20 Change in obligated balances: Total new obligations .................................................... ................... ................... Total outlays (gross) ...................................................... ................... ................... 15 ¥13 74.40 Obligated balance, end of year ................................ ................... ................... 2 86.97 Outlays (gross), detail: Outlays from new mandatory authority ......................... ................... ................... 13 Net budget authority and outlays: 89.00 Budget authority ............................................................ ................... ................... 90.00 Outlays ........................................................................... ................... ................... 99.9 1,370 1,371 1,343 ¥1,369 ¥1,367 ¥1,339 ¥1 ................... ................... Unobligated balance carried forward, end of year ................... 4 4 New budget authority (gross), detail: Discretionary: 40.00 Appropriation ............................................................. 40.35 Appropriation permanently reduced .......................... 41.00 Transferred to other accounts ................................... 1,377 1,367 1,335 ¥14 ................... ................... ¥1 ................... ................... 1,362 1,367 1,335 1 4 4 58.00 58.10 15 13 Object Classification (in millions of dollars) 21.0 25.1 25.5 41.0 4 1,339 43.00 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 face far fewer administrative burdens and will receive funds in the form of flexible grants. The proposal also includes increasing the match rate for the District of Columbia to match that used in the Medicaid program. Identification code 75–1545–4–1–609 24.40 4 ................... 1,366 1,371 2006 actual 2007 est. ................... ................... ................... ................... ................... ................... ................... ................... 1 3 1 10 Total new obligations ................................................ ................... ................... 70.00 3 ................... ................... Spending authority from offsetting collections (total discretionary) .......................................... 4 4 4 Total new budget authority (gross) .......................... 1,366 1,371 1,339 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) ................................................ 72.40 73.10 73.20 73.40 74.00 560 541 556 1,369 1,367 1,339 ¥1,385 ¥1,352 ¥1,346 4 ................... ................... ¥3 ................... ................... ¥4 ................... ................... 74.40 Obligated balance, end of year ................................ 541 556 549 86.90 86.93 Outlays (gross), detail: Outlays from new discretionary authority ..................... Outlays from discretionary balances ............................. 902 483 888 464 867 479 87.00 Total outlays (gross) ................................................. 1,385 1,352 1,346 ¥6 ¥4 ¥4 15 Direct obligations: Travel and transportation of persons ............................ Advisory and assistance services .................................. Research and development contracts ........................... Grants, subsidies, and contributions ............................ 2008 est. 58.90 Appropriation (total discretionary) ........................ Spending authority from offsetting collections: Offsetting collections (cash) ................................ Change in uncollected customer payments from Federal sources (unexpired) ............................. 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 ................................................... f ADMINISTRATION ON AGING Federal AGING SERVICES PROGRAMS For carrying out, to the extent not otherwise provided, the Older Americans Act of 1965, as amended, $1,335,146,000. Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. Program and Financing (in millions of dollars) Identification code 75–0142–0–1–506 Obligations by program activity: 01.01 Home and community-based supportive services ......... 01.02 Preventive health services ............................................. 01.03 National family caregiver support program .................. 01.04 Native American caregiver support program ................ 01.05 Congregate nutrition services ........................................ 01.06 Home-delivered nutrition services ................................. 01.07 Nutrition services incentive program ............................ 01.08 Native American nutrition and supportive services ...... 01.09 Program innovations ...................................................... 01.10 Aging network support activities ................................... 01.11 Long-term care ombudsmen program ........................... 01.12 Prevention of elder abuse and neglect ......................... 01.13 Alzheimer’s disease demonstration grants ................... 01.14 Program administration ................................................. 01.15 White House Conference on Aging ................................ 2006 actual 2007 est. 2008 est. 350 351 351 21 21 ................... 156 156 154 6 6 6 385 385 383 182 182 181 148 148 147 26 26 26 25 25 36 13 13 13 15 15 14 5 5 5 12 12 ................... 18 18 19 3 ................... ................... 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... ¥3 ................... ................... 5 ................... ................... 1,362 1,379 1,367 1,348 1,335 1,342 Note.—The reimbursable program (HCFAC) in the Administration on Aging (AoA) reflects the estimated distribution of the allocation account for 2007 and 2008. Actual 2007 and 2008 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. These programs are part of a comprehensive system of home and community-based support for older people and their families. The Budget will fund the Choices for Independence demonstration first proposed in the 2007 Budget which aims to help older individuals and their families conserve and extend their personal resources through the use of low-cost, community-based alternatives in long-term care. Object Classification (in millions of dollars) Identification code 75–0142–0–1–506 02.00 09.01 Total, direct program ................................................ Reimbursable program .................................................. 1,365 4 1,363 4 1,335 4 11.1 11.3 Direct obligations: Personnel compensation: Full-time permanent ............................................. Other than full-time permanent ........................... 10.00 Total new obligations ................................................ 1,369 1,367 1,339 11.9 12.1 Total personnel compensation .............................. Civilian personnel benefits ....................................... 2006 actual 2007 est. 2008 est. 10 11 12 1 ................... ................... 11 2 11 2 12 2 DEPARTMENTAL MANAGEMENT Federal DEPARTMENT OF HEALTH AND HUMAN SERVICES 21.0 23.1 25.1 25.3 41.0 Travel and transportation of persons ....................... Rental payments to GSA ........................................... Advisory and assistance services ............................. Other purchases of goods and services from Government accounts ................................................. Grants, subsidies, and contributions ........................ 1 ................... ................... 2 2 2 10 8 7 7 1,332 7 1,333 7 1,305 99.0 99.0 Direct obligations .................................................. Reimbursable obligations .............................................. 1,365 4 1,363 4 99.9 Total new obligations ................................................ 1,369 1,367 2006 actual 2007 est. 24.40 Unobligated balance carried forward, end of year 2 ................... ................... 1,335 4 New budget authority (gross), detail: Discretionary: 40.00 Appropriation ............................................................. 40.35 Appropriation permanently reduced .......................... 42.00 Transferred from other accounts .............................. 384 380 420 ¥4 ................... ................... 7 ................... ................... 1,339 43.00 387 380 420 111 5 234 5 244 5 2008 est. 113 104 109 10 11 11 f SECRETARY GENERAL DEPARTMENTAL MANAGEMENT For necessary expenses, not otherwise provided, for general departmental management, including hire of six sedans, and for carrying out titles III, XVII, XX, and XXI of the Public Health Service Act, the United States-Mexico Border Health Commission Act, and research studies under section 1110 of the Social Security Act, $386,705,000, 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, and $46,756,000 from the amounts available under section 241 of the Public Health Service Act to carry out national health or human services research and evaluation activities: Provided, That of the funds made available under this heading for carrying out title XX of the Public Health Service Act, $13,120,000 shall be for activities specified under section 2003(b)(2), all of which 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, $51,891,000 shall be for minority AIDS prevention and treatment activities; $6,016,000 shall be 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; and up to $4,000,000 may be used by the Secretary of Health and Human Services to meet unanticipated needs of Departmental programs. OFFICE FOR 70.00 Spending authority from offsetting collections (total discretionary) .......................................... 225 239 249 Total new budget authority (gross) .......................... 612 619 669 326 294 314 612 621 669 ¥622 ¥601 ¥645 ¥18 ................... ................... ¥109 ................... ................... 105 ................... ................... 74.40 Obligated balance, end of year ................................ 294 314 338 86.90 86.93 Outlays (gross), detail: Outlays from new discretionary authority ..................... Outlays from discretionary balances ............................. 328 294 440 161 471 174 87.00 Total outlays (gross) ................................................. 622 601 645 ¥207 ¥239 ¥249 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 ¥109 ................... ................... 91 ................... ................... Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 387 415 380 362 420 396 Note.—The reimbursable program (HCFAC) in Departmental Management reflects the estimated distribution from the allocation account for 2007 and 2008. Actual 2007 and 2008 distributions will be determined by the Secretary of HHS and the Attorney General. Departmental Management CIVIL RIGHTS (Dollars in millions) For expenses necessary for the Office for Civil Rights, $33,748,000, 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. Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. Program and Financing (in millions of dollars) Identification code 75–9912–0–1–551 109 ................... ................... 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) ................................................ Federal OF THE 58.90 Appropriation (total discretionary) ........................ Spending authority from offsetting collections: Offsetting collections (cash) ................................ Offsetting collections (cash) ................................ Change in uncollected customer payments from Federal sources (unexpired) ............................. 72.40 73.10 73.20 73.40 74.00 DEPARTMENTAL MANAGEMENT OFFICE ¥669 Total new obligations .................................................... 58.00 58.00 58.10 Direct: 1001 Civilian full-time equivalent employment ..................... Reimbursable: 2001 Civilian full-time equivalent employment ..................... ¥621 23.95 Employment Summary Identification code 75–0142–0–1–506 ¥612 433 2006 actual 2007 est. 2008 est. Obligations by program activity: 00.01 General departmental management .............................. 00.02 Office for Civil Rights .................................................... 09.01 Reimbursable program .................................................. 09.02 Reimbursable program (HCFAC) .................................... 356 31 220 5 351 31 234 5 386 34 244 5 10.00 Total new obligations ................................................ 612 621 669 21.40 22.00 Budgetary resources available for obligation: Unobligated balance carried forward, start of year New budget authority (gross) ........................................ 2 612 2 ................... 619 669 23.90 Total budgetary resources available for obligation 614 621 2006 actual Distribution of budget authority by account: General Departmental Management ....................................... Office for Civil Rights ............................................................. Distribution of outlays by account: General Departmental Management ....................................... Office for Civil Rights ............................................................. 2007 est. 2008 est. 356 31 349 31 386 34 459 36 330 32 362 34 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 nondiscrimination and health information privacy compliance programs; and support research to develop policy initiatives and improve existing HHS programs. DM also includes the activities of the Office of Public Health and Science, including adolescent family life, disease prevention and health promotion, physical fitness and sports, minority health, research integrity, and women’s health. Object Classification (in millions of dollars) 669 Identification code 75–9912–0–1–551 Direct obligations: 2006 actual 2007 est. 2008 est. DEPARTMENTAL MANAGEMENT—Continued Federal—Continued 434 OFFICE OF THE THE BUDGET FOR FISCAL YEAR 2008 58.90 SECRETARY—Continued GENERAL DEPARTMENTAL MANAGEMENT—Continued 70.00 Object Classification (in millions of dollars)—Continued Identification code 75–9912–0–1–551 11.1 11.3 11.5 11.7 11.9 12.1 12.2 21.0 23.1 23.3 2006 actual Personnel compensation: Full-time permanent ............................................. Other than full-time permanent ........................... Other personnel compensation ............................. Military personnel ................................................. 2007 est. 2008 est. 99 10 2 4 106 4 2 4 111 4 2 20 115 29 1 3 20 116 31 1 3 24 137 32 6 3 26 4 2 19 32 4 1 18 26 4 1 20 32 25.4 25.7 26.0 31.0 41.0 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 ................................................. Operation and maintenance of facilities .................. Operation and maintenance of equipment ............... Supplies and materials ............................................. Equipment ................................................................. Grants, subsidies, and contributions ........................ 45 5 5 3 2 102 35 4 4 3 2 110 42 4 4 2 1 106 99.0 99.0 Direct obligations .................................................. Reimbursable obligations .............................................. 387 225 382 239 420 249 99.9 Total new obligations ................................................ 612 621 669 24.0 25.1 25.2 25.3 Employment Summary Identification code 75–9912–0–1–551 2006 actual Direct: 1001 Civilian full-time equivalent employment ..................... 1101 Military full-time equivalent employment ..................... Reimbursable: 2001 Civilian full-time equivalent employment ..................... 2007 est. 2008 est. 1,228 71 1,174 77 1,182 171 340 345 404 f OFFICE OF THE NATIONAL COORDINATOR TECHNOLOGY FOR HEALTH INFORMATION 72.40 73.10 73.20 74.00 74.40 86.90 86.93 87.00 Spending authority from offsetting collections (total discretionary) .......................................... 24 24 33 Total new budget authority (gross) .......................... 67 66 123 Change in obligated balances: Obligated balance, start of year ................................... ................... 27 34 Total new obligations .................................................... 66 66 123 Total outlays (gross) ...................................................... ¥17 ¥59 ¥90 Change in uncollected customer payments from Federal sources (unexpired) ............................................ ¥22 ................... ................... Obligated balance, end of year ................................ 27 34 67 Outlays (gross), detail: Outlays from new discretionary authority ..................... 17 Outlays from discretionary balances ............................. ................... 39 20 65 25 17 59 90 ¥2 ¥24 ¥33 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 ¥22 ................... ................... Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 43 15 42 35 90 57 This program supports coordination of Federal health information technology activities, and Federal initiatives for the advancement of an interoperable national health information technology infrastructure, in cooperation with participants in the health sector. The Office of the National Coordinator for Health Information Technology was created by Executive Order 13335, for the purpose of addressing strategic planning, coordination, and the analysis of key technical, economic and other issues related to the public and private adoption of health information technology. Through this program, activities related to health information technology are coordinated across several HHS organizations, as shown in the following consolidated table. Health Information Technology Funding For expenses necessary for the Office of the National Coordinator for Health Information Technology, including grants, contracts and cooperative agreements for the development and advancement of an interoperable national health information technology infrastructure, $89,872,000: Provided, That in addition to amounts provided herein, $28,000,000 shall be available from amounts available under section 241 of the Public Health Service Act to carry out health information technology network development. Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. Program and Financing (in millions of dollars) Identification code 75–0130–0–1–551 2006 actual [Program level—Dollars in millions] 2006 actual Distribution of funding by account: National Coordinator for Health Information Technology General Departmental Management .................................. Agency for Healthcare Research and Quality .................... HIT Initiative Total .............................................................. Federal Health Architecture ................................................ 61 1 50 112 5 61 4 50 115 5 2008 est. 118 2 45 165 5 Note.—Includes budget authority, Public Health Service evaluation funds and other resources. Object Classification (in millions of dollars) Identification code 75–0130–0–1–551 2007 est. 2007 est. 2006 actual 2007 est. 2008 est. 11.1 12.1 25.1 25.2 Direct obligations: Personnel compensation: Full-time permanent ........ 1 Civilian personnel benefits ....................................... ................... Advisory and assistance services ............................. 23 Other services ............................................................ 18 3 1 22 16 4 1 36 49 2008 est. Obligations by program activity: 00.01 Health information technology ....................................... 09.01 Reimbursable program .................................................. 42 24 42 24 90 33 10.00 Total new obligations ................................................ 66 66 123 99.0 99.0 Direct obligations .................................................. Reimbursable obligations .............................................. 42 24 42 24 90 33 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ Total new obligations .................................................... 67 ¥66 66 ¥66 123 ¥123 99.9 Total new obligations ................................................ 66 66 123 New budget authority (gross), detail: Discretionary: 40.00 Appropriation ............................................................. Spending authority from offsetting collections: 58.00 Offsetting collections (cash) ................................ 58.10 Change in uncollected customer payments from Federal sources (unexpired) ............................. Employment Summary 43 42 90 2 24 33 22 ................... ................... Identification code 75–0130–0–1–551 1001 1101 Direct: Civilian full-time equivalent employment ..................... Military full-time equivalent employment ..................... 2006 actual 5 1 2007 est. 27 1 2008 est. 37 1 DEPARTMENTAL MANAGEMENT—Continued Federal—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES OFFICE OF MEDICARE HEARINGS AND APPEALS Employment Summary For expenses necessary for administrative law judges responsible for hearing cases under title XVIII of the Social Security Act (and related provisions of title XI of such Act), $70,000,000, to be transferred in appropriate part from the Federal Hospital Insurance and the Federal Supplementary Medical Insurance Trust Funds. Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. Program and Financing (in millions of dollars) Identification code 75–0139–0–1–551 2006 actual 2007 est. 2008 est. Obligations by program activity: 00.01 Direct program activity .................................................. 59 59 70 10.00 Total new obligations ................................................ 59 59 70 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ Total new obligations .................................................... 59 ¥59 59 ¥59 70 ¥70 New budget authority (gross), detail: Discretionary: 58.00 Spending authority from offsetting collections: Offsetting collections (cash) ..................................... 59 59 70 Change in obligated balances: Obligated balance, start of year ................................... ................... Total new obligations .................................................... 59 Total outlays (gross) ...................................................... ¥29 30 59 ¥58 31 70 ¥83 30 31 18 Outlays (gross), detail: Outlays from new discretionary authority ..................... 29 Outlays from discretionary balances ............................. ................... 44 14 53 30 58 83 72.40 73.10 73.20 74.40 86.90 86.93 87.00 Obligated balance, end of year ................................ Total outlays (gross) ................................................. Offsets: Against gross budget authority and outlays: 88.00 Offsetting collections (cash) from: Federal sources 29 ¥59 ¥59 ¥70 This activity funds the Office of Medicare Hearings and Appeals (OMHA), as directed by Medicare Prescription Drug, Improvement, and Modernization Act of 2003. OMHA provides the basic mechanisms through which individuals and organizations who are dissatisfied with Medicare determinations affecting their rights to, or their participation in, the Medicare program may administratively appeal these determinations, in accordance with the requirements of the Administrative Procedures Act and the Social Security Act. Object Classification (in millions of dollars) 25.4 26.0 31.0 Direct obligations: Personnel compensation: Full-time permanent ............. Civilian personnel benefits ............................................ 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 ...................... Supplies and materials ................................................. Equipment ...................................................................... 99.9 Total new obligations ................................................ 11.1 12.1 23.1 23.3 25.1 25.2 25.3 Identification code 75–0139–0–1–551 2006 actual Direct: 1001 Civilian full-time equivalent employment ..................... 274 2007 est. 2008 est. 360 382 f PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND For expenses necessary to support activities related to countering potential biological, disease, nuclear, radiological and chemical threats to civilian populations, and for other public health emergencies, $780,646,000, of which not to exceed $22,338,000, to remain available until September 30, 2009, is to pay the costs described in section 319F–2(c)(7)(B) of the Public Health Service Act. For expenses necessary to prepare for and respond to an influenza pandemic, $948,091,000, of which $870,000,000 shall be available until expended, for activities including the development and purchase of vaccine, antivirals, necessary medical supplies, diagnostics, and other surveillance tools: Provided, That products purchased with these funds may, at the discretion of the Secretary, be deposited in the Strategic National Stockpile: Provided further, That notwithstanding section 496(b) of the Public Health Service Act, funds may be used for the construction or renovation of privately owned facilities for the production of pandemic influenza vaccines and other biologicals, where the Secretary finds such a contract necessary to secure sufficient supplies of such vaccines or biologicals: Provided further, That funds appropriated herein may be transferred to other appropriation accounts of the Department of Health and Human Services, as determined by the Secretary to be appropriate, to be used for the purposes specified in this sentence. For expenses to provide screening and treatment for first response emergency services personnel related to the September 11, 2001, terrorist attacks on the World Trade Center, $25,000,000 shall be available until expended. Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. Program and Financing (in millions of dollars) Net budget authority and outlays: 89.00 Budget authority ............................................................ ................... ................... ................... 90.00 Outlays ........................................................................... ¥30 ¥1 13 Identification code 75–0139–0–1–551 435 2006 actual 2007 est. 2008 est. 20 6 7 1 1 15 28 7 7 1 1 6 30 9 7 1 1 13 6 1 1 1 6 1 1 1 6 1 1 1 59 59 70 Identification code 75–0140–0–1–551 2006 actual 2007 est. 2008 est. 00.01 09.01 Obligations by program activity: Public Health and Social Services Emergency Fund Reimbursable program .................................................. 2,466 980 3,548 54 1,754 54 10.00 Total new obligations ................................................ 3,446 3,602 1,808 Budgetary resources available for obligation: Unobligated balance carried forward, start of year 52 3,278 10 New budget authority (gross) ........................................ 6,658 304 1,808 Resources available from recoveries of prior year obligations ....................................................................... 15 ................... ................... 22.22 Unobligated balance transferred from other accounts ................... 30 ................... 21.40 22.00 22.10 23.90 23.95 23.98 Total budgetary resources available for obligation Total new obligations .................................................... Unobligated balance expiring or withdrawn ................. 24.40 Unobligated balance carried forward, end of year 6,725 3,612 1,818 ¥3,446 ¥3,602 ¥1,808 ¥1 ................... ................... 3,278 10 10 New budget authority (gross), detail: Discretionary: 40.00 Appropriation ............................................................. 5,713 208 1,754 40.35 Appropriation permanently reduced .......................... ¥11 ................... ................... 40.36 Unobligated balance permanently reduced .............. ................... ¥5 ................... 41.00 Transferred to other accounts ................................... ¥30 ................... ................... 42.00 Transferred from other accounts .............................. ................... 47 ................... 43.00 58.00 58.10 58.90 70.00 Appropriation (total discretionary) ........................ Spending authority from offsetting collections: Offsetting collections (cash) ................................ Change in uncollected customer payments from Federal sources (unexpired) ............................. 5,672 250 1,754 6 54 54 980 ................... ................... Spending authority from offsetting collections (total discretionary) .......................................... 986 54 54 Total new budget authority (gross) .......................... 6,658 304 1,808 436 DEPARTMENTAL MANAGEMENT—Continued Federal—Continued PUBLIC HEALTH AND THE BUDGET FOR FISCAL YEAR 2008 25.7 26.0 31.0 41.0 SOCIAL SERVICES EMERGENCY FUND— Continued Program and Financing (in millions of dollars)—Continued Identification code 75–0140–0–1–551 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) ................................................ 72.40 73.10 73.20 73.40 73.45 74.00 2008 est. 3,342 3,386 4,192 3,446 3,602 1,808 ¥2,406 ¥2,796 ¥2,717 ¥7 ................... ................... ¥15 ................... ................... ¥980 ................... ................... 6 ................... ................... Obligated balance, end of year ................................ 3,386 4,192 3,283 86.90 86.93 Outlays (gross), detail: Outlays from new discretionary authority ..................... Outlays from discretionary balances ............................. 663 1,743 77 2,719 211 2,506 87.00 Total outlays (gross) ................................................. 2,406 2,796 2,717 ¥12 ¥54 ¥54 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 25.1 25.2 25.3 25.4 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 .................. Research and development contracts ....................... Supplies and materials ............................................. Equipment ................................................................. Grants, subsidies, and contributions ........................ 10 2 1 1 2 24 6 1 1 1 1 13 ................... ................... ................... ................... ................... ................... 1 33 9 1 21 8 1 32 17 44 1 14 688 16 395 Allocation account—direct ................................... 1,241 675 100 Total new obligations ................................................ 3,446 3,602 1,808 11.1 11.3 11.7 11.9 12.1 12.2 21.0 22.0 23.1 23.3 25.1 25.2 25.3 25.4 25.5 26.0 31.0 41.0 5 3 2 4 ................... 1 ................... 1 ................... 24 29 1 ................... 13 ................... 363 11 9 ................... 212 10 Employment Summary 5,672 2,394 250 2,742 1,754 2,663 Object Classification (in millions of dollars) 11.9 12.1 12.2 21.0 23.1 23.2 23.3 1,654 54 1,225 980 6 ................... ................... The Public Health and Social Services Emergency Fund (PHSSEF) provides resources to support a comprehensive program to prepare for the health and medical consequences of bioterrorism or other public health emergencies. The account includes funding for international activities, rapid tests, and communications to support the detection and control of pandemic influenza. In addition, PHSSEF includes funding for the Office of the Assistant Secretary for Preparedness and Response (ASPR), as authorized by the Pandemic and All-Hazards Preparedness Act. Funds will be used for the advanced development of pandemic and biodefense countermeasures, hospital preparedness and other emergency preparedness activities including the National Disaster Medical System that was transferred to HHS from the Department of Homeland Security in January 2007. 11.1 11.3 11.5 11.7 2,873 54 Direct obligations .................................................. Reimbursable obligations .............................................. Allocation Account—direct: Personnel compensation: Full-time permanent ............................................. Other than full-time permanent ........................... Military personnel ................................................. ¥980 ................... ................... Note.—Activities financed under the Office of the Director at NIH for the advanced development of medical countermeasures in 2006 and 2007 are proposed to be financed in this account in 2008 and are presented in these schedules on a three year comparable basis. Identification code 75–0140–0–1–551 4 2 19 426 99.9 2007 est. 74.40 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 ................................................... 4 2 5 26 99.0 2006 actual 99.0 99.0 Operation and maintenance of equipment ............... 3 Supplies and materials ............................................. ................... Equipment ................................................................. 3 Grants, subsidies, and contributions ........................ 27 2006 actual Direct obligations: Personnel compensation: Full-time permanent ............................................. 7 Other than full-time permanent ........................... 1 Other personnel compensation ............................. ................... Military personnel ................................................. 3 Total personnel compensation .............................. 11 Civilian personnel benefits ....................................... 2 Military personnel benefits ........................................ 1 Travel and transportation of persons ....................... 2 Rental payments to GSA ........................................... 3 Rental payments to others ........................................ ................... Communications, utilities, and miscellaneous charges ................................................................. 1 Advisory and assistance services ............................. 11 Other services ............................................................ 1,024 Other purchases of goods and services from Government accounts ................................................. 135 Operation and maintenance of facilities .................. 2 2007 est. 2008 est. Identification code 75–0140–0–1–551 Direct: 1001 Civilian full-time equivalent employment ..................... 1101 Military full-time equivalent employment ..................... 2006 actual 66 38 2007 est. 222 48 2008 est. 343 99 NONRECURRING EXPENSES FUND There is hereby established in the Treasury of the United States a fund to be known as the ‘‘Nonrecurring expenses fund’’ (the Fund): Provided, That unobligated balances of expired discretionary funds appropriated for this or any succeeding fiscal year from the General Fund of the Treasury to the Department of Health and Human Services by this or any other Act may be transferred (not later than the end of the fifth fiscal year after the last fiscal year for which such funds are available for the purposes for which appropriated) into the Fund: Provided further, That amounts deposited in the Fund shall be available until expended, and in addition to such other funds as may be available for such purposes, for capital acquisition necessary for the operation of the Department, including facilities infrastructure and information technology infrastructure; and other Department-wide higher priorities, as the Secretary of Health and Human Services considers appropriate, subject to approval by the Office of Management and Budget: Provided further, That amounts in the Fund may be obligated only after notification of the Committees on Appropriations of the House of Representatives and the Senate of the planned use of funds. Program and Financing (in millions of dollars) 15 10 2 3 31 10 1 4 30 6 1 8 8 2 46 13 1 6 8 3 2 13 2,536 3 20 810 228 2 291 2 Identification code 75–0125–0–1–551 2006 actual 2007 est. 2008 est. Budgetary resources available for obligation: 22.30 Expired unobligated balance transfer to unexpired account .......................................................................... ................... ................... ................... 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ ................... ................... ................... Outlays ........................................................................... ................... ................... ................... The Nonrecurring expenses fund is a no-year account that captures expired unobligated balances from discretionary accounts prior to cancellation. This fund will be used for nonrecurring expenses that are difficult to accommodate or arise outside of the normal budget process. Beginning with 2008 PROGRAM SUPPORT CENTER Federal—Continued DEPARTMENT OF HEALTH AND HUMAN SERVICES appropriations, transfers will occur up to five years after expiration when it is certain that original obligations have been fully paid and closed out. Advance notification of the proposed use of the Nonrecurring expenses fund is submitted to the relevant Committees on Appropriations of the House of Representatives and the Senate with justification for the areas/ projects proposed. 437 medical benefits for active duty PHS commissioned officers, retirees, and dependents of member and retirees of the PHS Commissioned Corps. Object Classification (in millions of dollars) Identification code 75–0379–0–1–551 2006 actual 2007 est. 2008 est. PROGRAM SUPPORT CENTER RETIREMENT PAY AND MEDICAL BENEFITS OFFICERS FOR 285 57 309 61 336 67 99.9 f Direct obligations: 13.0 Benefits for former personnel ........................................ 25.6 Medical care .................................................................. 342 370 403 Total new obligations ................................................ COMMISSIONED f For retirement pay and medical benefits of Public Health Service Commissioned Officers as authorized by law, for payments under the Retired Serviceman’s Family Protection Plan and Survivor Benefit Plan, for medical care of dependents and retired personnel under the Dependents’ Medical Care Act (10 U.S.C. chapter 55), such amounts as may be required during the current fiscal year. HHS ACCRUAL CONTRIBUTION TO THE UNIFORMED SERVICES RETIREE HEALTH CARE FUND Program and Financing (in millions of dollars) Identification code 75–0170–0–1–551 2006 actual 2007 est. 2008 est. 34 36 37 10.00 Total new obligations (object class 12.2) ................ 34 36 37 22.00 23.95 Budgetary resources available for obligation: New budget authority (gross) ........................................ Total new obligations .................................................... 34 ¥34 36 ¥36 37 ¥37 New budget authority (gross), detail: Discretionary: 40.00 Appropriation ............................................................. 34 36 37 73.10 73.20 Change in obligated balances: Total new obligations .................................................... Total outlays (gross) ...................................................... 34 ¥34 36 ¥36 37 ¥37 86.90 Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. Obligations by program activity: 00.01 Medicare eligible accruals ............................................. Outlays (gross), detail: Outlays from new discretionary authority ..................... 34 36 37 89.00 90.00 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... 34 34 36 36 37 37 Program and Financing (in millions of dollars) Identification code 75–0379–0–1–551 2006 actual 2007 est. 2008 est. 00.01 00.02 00.03 Obligations by program activity: Retirement payments ..................................................... Survivors’ benefits ......................................................... Medical care .................................................................. 269 16 57 292 17 61 318 18 67 10.00 Total new obligations ................................................ 342 370 403 Budgetary resources available for obligation: 22.00 New budget authority (gross) ........................................ 23.95 Total new obligations .................................................... New budget authority (gross), detail: Mandatory: 60.00 Appropriation ............................................................. 342 ¥342 342 370 ¥370 370 403 ¥403 403 72.40 73.10 73.20 73.40 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Adjustments in expired accounts (net) ......................... 74.40 Obligated balance, end of year ................................ 31 37 40 86.97 86.98 Outlays (gross), detail: Outlays from new mandatory authority ......................... Outlays from mandatory balances ................................ 314 29 333 31 363 37 87.00 Total outlays (gross) ................................................. 343 364 400 Net budget authority and outlays: 89.00 Budget authority ............................................................ 90.00 Outlays ........................................................................... 29 31 37 342 370 403 ¥343 ¥364 ¥400 3 ................... ................... The cost of medical benefits for Medicare-eligible beneficiaries is paid from the Department of Defense MedicareEligible Retiree Health Care Fund (10 U.S.C., ch. 56). Beginning in 2006, permanent indefinite authority is provided for a discretionary appropriation of the annual accrual payment into this fund (P.L. No. 108–375, section 725). f HEALTH ACTIVITIES FUNDS Program and Financing (in millions of dollars) 342 343 370 364 403 400 The number of beneficiaries using the Commissioned Corps system is estimated as follows: Identification code 75–9913–0–1–552 Active Duty: HHS ......................................................................................... DOJ, BOP ................................................................................. Homeland Security .................................................................. EPA .......................................................................................... All Other .................................................................................. Total Active Duty ......................................................................... Retirees & Survivors: Retirees ........................................................................................ Retiree family members and survivors ....................................... Total Retirement Pay ................................................................... Total Beneficiaries (active duty, retirees, survivors) .................. FY2007 FY2008 4,948 635 210 82 73 5,948 5,031 630 213 82 74 6,030 5,247 630 213 82 74 6,246 4,647 633 5,280 11,228 4,896 639 5,535 11,565 5,149 645 5,794 12,040 This activity funds annuities of retired Public Health Service (PHS) commissioned officers and survivors of retirees, and 2007 est. 2008 est. 2 2 2 74.40 2 2 2 Retirement Pay Eligible Beneficiaries FY2006 2006 actual Change in obligated balances: 72.40 Obligated balance, start of year ................................... 89.00 90.00 Obligated balance, end of year ................................ 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 HHS SERVICE AND SUPPLY FUND Program and Financing (in millions of dollars) Identification code 75–9941–0–4–551 Obligations by program activity: 2006 actual 2007 est. 2008 est. 438 PROGRAM SUPPORT CENTER—Continued Federal—Continued HHS SERVICE AND THE BUDGET FOR FISCAL YEAR 2008 SUPPLY FUND—Continued agency, either through an allocation account or by directly citing that agency’s appropriation. Program and Financing (in millions of dollars)—Continued Object Classification (in millions of dollars) Identification code 75–9941–0–4–551 2006 actual 2007 est. 2008 est. 09.01 09.02 Program support center ................................................. OS activities ................................................................... 633 64 617 74 647 73 10.00 Total new obligations ................................................ 697 691 720 63 711 98 691 98 720 Budgetary resources available for obligation: Unobligated balance carried forward, start of year New budget authority (gross) ........................................ Resources available from recoveries of prior year obligations ....................................................................... 22.22 Unobligated balance transferred from other accounts 21.40 22.00 22.10 20 ................... ................... 1 ................... ................... 23.90 23.95 Total budgetary resources available for obligation Total new obligations .................................................... 795 ¥697 789 ¥691 818 ¥720 24.40 Unobligated balance carried forward, end of year 98 98 98 New budget authority (gross), detail: Mandatory: Spending authority from offsetting collections: 69.00 Offsetting collections (cash) ................................ 69.10 Change in uncollected customer payments from Federal sources (unexpired) ............................. 69.90 72.40 73.10 73.20 73.45 74.00 74.40 Spending authority from offsetting collections (total mandatory) ............................................. 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) ............................................ Obligated balance, end of year ................................ Outlays (gross), detail: 86.97 Outlays from new mandatory authority ......................... 86.98 Outlays from mandatory balances ................................ 87.00 Total outlays (gross) ................................................. 689 691 720 22 ................... ................... 711 691 720 6 23 23 697 691 720 ¥638 ¥691 ¥720 ¥20 ................... ................... ¥22 ................... ................... 23 23 23 Identification code 75–9941–0–4–551 11.1 11.3 11.5 11.7 Reimbursable obligations: Personnel compensation: Full-time permanent .................................................. Other than full-time permanent ............................... Other personnel compensation .................................. Military personnel ...................................................... 691 2007 est. 2008 est. 92 4 2 9 100 4 2 9 106 5 3 9 107 28 4 2 3 14 46 1 39 275 115 30 5 3 3 17 43 1 38 255 123 31 5 3 4 17 45 1 39 261 25.4 25.6 25.7 26.0 31.0 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 .................................................................. Operation and maintenance of equipment ................... Supplies and materials ................................................. Equipment ...................................................................... 48 18 45 18 42 7 45 24 35 12 62 3 47 26 37 12 66 3 99.9 Total new obligations ................................................ 697 691 720 11.9 12.1 12.2 21.0 22.0 23.1 23.3 24.0 25.1 25.2 25.3 Employment Summary Identification code 75–9941–0–4–551 2006 actual Reimbursable: Civilian full-time equivalent employment Military full-time equivalent employment Allocation account: 3101 Military full-time equivalent employment 3101 Military full-time equivalent employment 2001 2101 128 691 720 510 ................... ................... 638 2006 actual 2007 est. 2008 est. ..................... ..................... 1,260 100 1,317 99 1,348 99 ..................... ..................... 635 283 630 287 630 287 f Trust Funds 720 MISCELLANEOUS TRUST 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) .................................. Special and Trust Fund Receipts (in millions of dollars) ¥689 ¥691 ¥720 Identification code 75–9971–0–7–551 ¥22 ................... ................... 01.00 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 includes activities such as personnel and payroll support, financial management operations, and administrative services, including acquisitions management, building and property management, telecommunication services, medical supplies repackaging and distribution services, and the Federal Occupational Health Service. The Office of Secretary activities include the fund manager, departmental contracts, audit resolutions, Commissioned Corps force management, information technology, web management, claims, acquisition integration and modernization, small business, grants tracking, and competitive sourcing. Most Commissioned Corps officers work for agencies in the Department of Health and Human Services and are reflected in the agencies’ personnel summaries. However, some officers are assigned to other Federal agencies. The allocation account section in the following personnel summary shows officers assigned to other agencies which are paid directly by that 2007 est. 2008 est. 32 32 32 Balance, start of year .................................................... Receipts: 02.00 Interest, Miscellaneous trust funds ............................... 02.20 Contributions, Indian health facilities .......................... 02.60 Gifts and contributions, Miscellaneous trust funds 32 32 32 1 9 41 1 9 41 1 9 41 02.99 Total receipts and collections ................................... 51 51 51 Total: Balances and collections .................................... Appropriations: 05.00 Miscellaneous trust funds ............................................. 83 83 83 ¥51 ¥51 ¥51 32 32 32 01.99 Net budget authority and outlays: 89.00 Budget authority ............................................................ ................... ................... ................... 90.00 Outlays ........................................................................... ¥51 ................... ................... 2006 actual Balance, start of year .................................................... 04.00 07.99 Balance, end of year ..................................................... Program and Financing (in millions of dollars) Identification code 75–9971–0–7–551 2006 actual 2007 est. 2008 est. Obligations by program activity: 00.02 Gifts ............................................................................... 00.03 Contributions, Indian health facilities .......................... 35 27 42 9 42 9 10.00 Total new obligations ................................................ 62 51 51 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 ....................................................................... 119 51 109 51 109 51 1 ................... ................... OFFICE OF THE INSPECTOR GENERAL DEPARTMENT OF HEALTH AND HUMAN SERVICES 23.90 23.95 Total budgetary resources available for obligation Total new obligations .................................................... 171 ¥62 160 ¥51 160 ¥51 24.40 Unobligated balance carried forward, end of year 109 109 109 New budget authority (gross), detail: Mandatory: 60.26 Appropriation (trust fund) ......................................... 51 51 51 72.40 73.10 73.20 73.45 Change in obligated balances: Obligated balance, start of year ................................... Total new obligations .................................................... Total outlays (gross) ...................................................... Recoveries of prior year obligations .............................. 135 148 122 62 51 51 ¥48 ¥77 ¥67 ¥1 ................... ................... 74.40 Obligated balance, end of year ................................ 148 122 106 86.97 86.98 Outlays (gross), detail: Outlays from new mandatory authority ......................... Outlays from mandatory balances ................................ 8 40 11 66 11 56 87.00 Total outlays (gross) ................................................. 48 77 out the provisions of the Inspector General Act of 1978, as amended, $44,687,000: 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 non-payment is a Federal offense under 18 U.S.C. 228. Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution. Program and Financing (in millions of dollars) Identification code 75–0128–0–1–551 51 67 21 32 32 32 Memorandum (non-add) entries: Total investments, start of year: Federal securities: Par value ................................................................... 92.02 Total investments, end of year: Federal securities: Par value ................................................................... 51 77 32 32 92.01 [Dollars in millions] 2006 Distribution of budget authority by account: Gifts ........................................................................................ Contributions, Indian health facilities ................................... Distribution of outlays by account: Gifts ........................................................................................ Contributions, Indian health facilities ................................... 2007 2008 42 9 42 9 42 9 41 7 63 14 55 12 81 197 16 10.00 239 267 294 Budgetary resources available for obligation: Unobligated balance carried forward, start of year ................... New budget authority (gross) ........................................ 264 24 259 16 283 Identification code 75–9971–0–7–551 2006 actual Direct obligations: Personnel compensation: 11.1 Full-time permanent .................................................. 11.3 Other than full-time permanent ............................... 11.9 12.1 21.0 25.1 25.2 25.5 25.7 26.0 31.0 41.0 Total personnel compensation .............................. Civilian personnel benefits ............................................ Travel and transportation of persons ............................ Advisory and assistance services .................................. Other services ................................................................ Research and development contracts ........................... Operation and maintenance of equipment ................... Supplies and materials ................................................. Equipment ...................................................................... Grants, subsidies, and contributions ............................ 99.9 Total new obligations ................................................ 2007 est. 2 2 2008 est. 2 2 2 2 4 4 4 1 1 1 1 1 1 2 2 2 26 23 23 10 7 7 2 2 2 2 1 1 1 ................... ................... 13 10 10 62 51 51 Employment Summary Identification code 75–9971–0–7–551 1001 2006 actual Direct: Civilian full-time equivalent employment ..................... 71 2007 est. 2008 est. 71 71 f OFFICE OF THE INSPECTOR GENERAL OFFICE OF Total new obligations ................................................ 23.90 23.95 23.98 Total budgetary resources available for obligation Total new obligations .................................................... Unobligated balance expiring or withdrawn ................. 24.40 Unobligated balance carried forward, end of year New budget authority (gross), detail: Discretionary: 40.00 Appropriation ............................................................. 40.35 Appropriation permanently reduced .......................... 43.00 58.00 69.00 69.10 69.90 70.00 Object Classification (in millions of dollars) 2008 est. 75 176 16 60.00 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. 2007 est. 39 170 30 21.40 22.00 51 48 2006 actual Obligations by program activity: 00.01 Direct program ............................................................... 09.01 HCFAC reimbursable program ....................................... 09.02 Reimbursable program .................................................. 67 Net budget authority and outlays: 89.00 Budget authority ............................................................ 90.00 Outlays ........................................................................... 439 Appropriation (total discretionary) ........................ Spending authority from offsetting collections: Offsetting collections (cash) ..................................... Mandatory: Appropriation ............................................................. Spending authority from offsetting collections: Offsetting collections (cash) ................................ Change in uncollected customer payments from Federal sources (unexpired) ............................. 264 283 299 ¥239 ¥267 ¥294 ¥1 ................... ................... 24 16 5 40 39 45 ¥1 ................... ................... 39 39 45 14 16 34 25 28 25 178 176 179 8 ................... ................... Spending authority from offsetting collections (total mandatory) ............................................. 186 176 179 Total new budget authority (gross) .......................... 264 259 283 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) ................................................ 72.40 73.10 73.20 73.40 74.00 32 37 48 239 267 294 ¥232 ¥256 ¥288 ¥2 ................... ................... ¥8 ................... ................... 8 ................... ................... 74.40 Obligated balance, end of year ................................ 37 48 54 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 ................................ 30 17 172 13 32 33 187 4 52 21 189 26 87.00 Total outlays (gross) ................................................. 232 256 288 ¥200 ¥192 ¥213 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 Net budget authority and outlays: Budget authority ............................................................ Outlays ........................................................................... ¥8 ................... ................... 8 ................... ................... 64 32 67 64 70 75 INSPECTOR GENERAL For expenses necessary for the Office of Inspector General, including the hire of passenger motor vehicles for investigations, in carrying The Office of Inspector General (OIG) identifies and recommends actions to correct fraud, waste, and abuse in HHS OFFICE OF THE INSPECTOR GENERAL—Continued 440 OFFICE OF THE BUDGET FOR FISCAL YEAR 2008 INSPECTOR GENERAL—Continued administered and assisted programs and operations through audits, evaluations, and investigations. In addition to the discretionary resources appropriated to the OIG, the Health Insurance Portability and Accountability Act of 1996 and the Deficit Reduction Act of 2005 (DRA) make 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, waste, and abuse through a coordinated Health care fraud and abuse control (HCFAC) program with the Department of Justice and to establish a Medicaid Integrity Program under DRA. The following table shows total funding resources for the OIG: (In millions of dollars) Budget Authority: 2006 actual 2007 est. 2008 est. Discretionary appropriation ..................................................... Discretionary caps proposal ................................................... Mandatory (HCFAC Account) ................................................... Medicaid Integrity Program .................................................... Audit and investigations reimburements ............................... Medicare Modernization Act .................................................... Never Events Study ................................................................. 39 0 160 25 10 14 0 39 0 166 25 10 0 3 45 18 169 25 10 0 0 Total .................................................................................... 248 243 267 Note.—The reimbursable program (HCFAC) in Office of the Inspector General reflects the estimated distribution of the allocation account for 2007 and 2008. Actual 2007 and 2008 distributions will be determined by the Secretary of HHS and the Attorney General. Object Classification (in millions of dollars) Identification code 75–0128–0–1–551 2006 actual 2007 est. 2008 est. 26.0 31.0 Direct obligations: Personnel compensation: Full-time permanent ........ 23 Civilian personnel benefits ....................................... 7 Travel and transportation of persons ....................... 2 Rental payments to GSA ........................................... 3 Communications, utilities, and miscellaneous charges ................................................................. 1 Other services ............................................................ ................... Other purchases of goods and services from Government accounts ................................................. 3 Supplies and materials ............................................. ................... Equipment ................................................................. ................... 99.0 99.0 Direct obligations .................................................. Reimbursable obligations .............................................. 39 200 75 192 81 213 99.9 Total new obligations ................................................ 239 267 294 11.1 12.1 21.0 23.1 23.3 25.2 25.3 42 13 3 5 45 14 3 5 1 1 1 1 8 1 1 9 1 2 Employment Summary Identification code 75–0128–0–1–551 2006 actual Direct: 1001 Civilian full-time equivalent employment ..................... Reimbursable: 2001 Civilian full-time equivalent employment ..................... 2007 est. 2008 est. 266 472 489 1,181 1,113 1,212 General Fund Intragovernmental payments ................................ 5 5 5 ¥120 ................... ................... ¥115 5 5 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 PROVISIONS SEC. 201. Funds appropriated in this title shall be available for not to exceed $50,000 for official reception and representation expenses when specifically approved by the Secretary. SEC. 202. The Secretary shall make available through assignment not more than 60 employees of the Public Health Service to assist in child survival activities and to work in AIDS programs through and with funds provided by the Agency for International Development, the United Nations International Children’s Emergency Fund or the World Health Organization. SEC. 203. None of the funds appropriated in this Act may be used to implement 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. None of the funds appropriated in this title for Head Start shall be used to pay the compensation of an individual, either as direct costs or any proration as an indirect cost, at a rate in excess of Executive Level II. SEC. 206. Notwithstanding section 241(a) of the Public Health Service Act, such portion as the Secretary shall determine, but not more than 2.4 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 OF FUNDS) SEC. 207. 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 Act may be transferred between appropriations, but no such appropriation shall be increased by more than 3 percent by any such transfer: Provided, That an appropriation may be increased by up to an additional 2 percent after notification of the House and Senate Committees on Appropriations: Provided further, That the Appropriations Committees of both Houses of Congress are notified at least 15 days in advance of any transfer. (TRANSFER OF FUNDS) f GENERAL FUND RECEIPT ACCOUNTS (in millions of dollars) 2006 actual 2007 est. 2008 est. Offsetting receipts from the public: 75–143500 General fund proprietary interest receipts, not otherwise classified ............................................................ 77 77 77 75–274530 Health education assistance loans, Downward reestimates of subsidies .................................................... 31 34 ................... 75–275830 Downward reestimates of subsidies, Health Centers ............................................................................... 1 ................... ................... 75–310700 Federal share of child support collections ...... 1,055 1,065 1,047 Legislative proposal, subject to PAYGO ...................................... ................... ................... 2 75–322000 All other general fund proprietary receipts including budget clearing accounts .................................. 362 107 107 General Fund Offsetting receipts from the public ..................... 1,526 1,283 1,233 Intragovernmental payments: ...................................................... 75–330500 Transfer of excess receipts to the general fund, trust fund payments ................................................. 75–388500 Undistributed intragovernmental payments and receivables from cancelled accounts ......................... SEC. 208. 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 and centers 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. (TRANSFER OF FUNDS) SEC. 209. Of the amounts made available in this Act for the National Institutes of Health, the amount for research related to the human immunodeficiency virus, as jointly determined by the Director of 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. 210. 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 DEPARTMENT OF HEALTH AND HUMAN SERVICES 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. 211. None of the funds appropriated by this Act (including funds appropriated to any trust fund) may be used to carry out the Medicare Advantage 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 Advantage organization described in this section shall be responsible for informing enrollees where to obtain information about all Medicare covered services. SEC. 212. 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. 213. (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, 2008, 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 2008 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 2007, 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 2007 State expenditures and all fiscal year 2008 obligations for tobacco prevention and compliance activities by program activity by July 31, 2008. (d) The Secretary shall exercise discretion in enforcing the timing of the State obligation of the additional funds required by the certification described in subsection (a) as late as July 31, 2008. (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. 214. 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 2008, the Secretary of Health and Human Services (HHS)— (1) may exercise authority equivalent to that available to the Secretary of State in section 2(c) of the State Department Basic Authorities Act of 1956 (22 U.S.C. 2669(c)). The Secretary of HHS shall consult with the Secretary of State and relevant Chief of Mission to ensure that the authority provided in this section is exercised in a manner consistent with section 207 of the Foreign Service Act of 1980 (22 U.S.C. 3927) and other applicable statutes administered by the Department of State, and (2) is authorized to provide such funds by advance or reimbursement to the Secretary of State as may be necessary to pay the costs of acquisition, lease, alteration, renovation, and management of facilities outside of the United States for the use of HHS. The Department of State shall cooperate fully with the Secretary of HHS to ensure that HHS has secure, safe, functional facilities that comply with applicable regulation governing location, setback, and other GENERAL PROVISIONS—Continued 441 facilities requirements and serve the purposes established by this Act. The Secretary of HHS is authorized, in consultation with the Secretary of State, through grant or cooperative agreement, to make available to public or nonprofit private institutions or agencies in participating foreign countries, funds to acquire, lease, alter, or renovate facilities in those countries as necessary to conduct programs of assistance for international health activities, including activities relating to HIV/AIDS and other infectious diseases, chronic and environmental diseases, and other health activities abroad. SEC. 215. (a) AUTHORITY.—Notwithstanding any other provision of law, the Director of the National Institutes of Health may use funds available under section 402(b)(7) and 402(b)(12) of the Public Health Service Act to enter into transactions (other than contracts, cooperative agreements, or grants) to carry out research in support of the NIH Common Fund. (b) PEER REVIEW.—In entering into transactions under subsection (a), the Director of the National Institutes of Health may utilize such peer review procedures (including consultation with appropriate scientific experts) as the Director determines to be appropriate to obtain assessments of scientific and technical merit. Such procedures shall apply to such transactions in lieu of the peer review and advisory council review procedures that would otherwise be required under sections 301(a)(3), 405(b)(1)(B), 405(b)(2), 406(a)(3)(A), 492, and 494 of the Public Health Service Act (42 U.S.C. 241, 284(b)(1)(B), 284(b)(2), 284a(a)(3)(A), 289a, and 289c). SEC. 216. Funds which are available for Individual Learning Accounts for employees of the Centers for Disease Control and Prevention and the Agency for Toxic Substances and Disease Registry may be transferred to ‘‘Disease Control, Research, and Training,’’ to be available only for Individual Learning Accounts: Provided, That such funds may be used for any individual full-time equivalent employee while such employee is employed either by CDC or ATSDR. SEC. 217. Of the unobligated balances available under the heading; Health Resources and Service Administration, the amounts made available to the Health Centers Loan Guarantee Program authorized under section 330(d) of the Public Health Service Act and Title II of P.L. 104–208 are cancelled. SEC. 218. Notwithstanding section 835 of title VIII and subpart II of title VII of the Public Health Service Act, an institution of higher education with a student loan revolving fund established under these authorities shall, no later than September 30, 2008, pay to the Secretary of Health and Human Services the Federal portion of all of the liquid assets of such fund, as determined by the Secretary on June 30, 2008: Provided, That amounts collected under the proceeding provision are cancelled: Provided further, That the institution shall not make any new loans under these authorities until the amount equal to that Federal portion determined on June 30, 2008 has been paid to the Secretary. SEC. 219. Of the unobligated balances available under the heading, ‘‘Centers for Disease Control and Prevention,’’ in Public Law 109– 149, $29,680,000 are cancelled. SEC. 220. The Director of the Centers for Disease Control and Prevention may reallocate up to one percent of any discretionary funds appropriated for the current fiscal year for the Centers for Disease Control and Prevention between the agency’s programs, projects, and activities: Provided, That the transfer should not decrease any program, project, or activity by more than three percent: Provided further, That the reallocation authority granted by this section shall be available only to meet CDC’s public health mission: Provided further, That the appropriations committees of both Houses of Congress are notified within 15 days of any reallocation. SEC. 221. Not to exceed $35,000,000 of funds appropriated by this Act to the Institutes and Centers of the National Institutes of Health may be used for alteration, repair, or improvement of facilities, as necessary for the proper and efficient conduct of the activities authorized herein, at not to exceed $2,500,000 per project. Note.—A regular 2007 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. 109–289, Division B, as amended). The amounts included for 2007 in this budget reflect the levels provided by the continuing resolution.
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