DEPARTMENT OF HEALTH AND HUMAN SERVICES DEPARTMENT OF HEALTH AND HUMAN SERVICES Department of Health and Human Services General Fund Proprietary Interest Receipts, not Otherwise Classified Health Education Assistance Loans, Downward Reestimates of Subsidies Downward Reestimates of Subsidies, Health Centers Federal Share of Child Support Collections Legislative proposal, subject to PAYGO All Other General Fund Proprietary Receipts Including Budget Clearing Accounts Undistributed Intragovernmental Payments and Receivables from Cancelled Accounts Rent and Charges for Quarters, Indian Health Service Cooperative Research and Development Agreements, NIH Cooperative Research and Development Agreements, Centers for Disease Control Cooperative Research and Development Agreements, FDA Interest, Child Enrollment Contingency Fund Reinsurance and Risk Adjustment Program Collections Deltas between the Annualized CR Amounts and the FY 2011 Budget Request Adjustment to reach the 2011 Budget Fee on Branded Prescription Pharmaceutical Manufacturers and Importers, SMI Federal Contributions, FSMI Fund Legislative proposal, not subject to PAYGO Interest Received by Trust Fund, FSMI Fund Legislative proposal, not subject to PAYGO Other Proprietary Interest from the Public, FSMI Fund Federal Contribution, State Low-income Determinations, Prescription Drug Account, FSMI Premiums Collected for Medicare Prescription Drug Account, FSMI Legislative proposal, subject to PAYGO Payments from States, Medicare Prescription Drug Account, FSMI Legislative proposal, subject to PAYGO Interest, Medicare Prescription Drug Account, FSMI Legislative proposal, not subject to PAYGO Basic Premium, Medicare Advantage, FSMI Trust Fund Federal Contribution for Admin. Contribution for Admin. Costs, Prescription Drug Account, FSMI Federal Contributions for Benefits, Prescription Drug Account, SMI Legislative proposal, not subject to PAYGO Premiums Collected for the Aged, FSMI Fund Legislative proposal, subject to PAYGO Miscellaneous Federal Payments, Federal Supplementary Medical Insurance Trust Fund Premiums Collected for the Disabled, FSMI Fund Legislative proposal, subject to PAYGO FHI Trust Fund, Transfers from General Fund (FICA Taxes) Amounts included in baseline projection of current policy Legislative proposal, not subject to PAYGO Legislative proposal, subject to PAYGO FHI Trust Fund, Receipts from Railroad Retirement Board FHI Trust Fund, Transfers from General Fund (SECA Taxes) FHI Trust Fund, Federal Employer Contributions (FICA) FHI Trust Fund, Postal Service Employer Contributions (FICA) FHI Trust Fund, Interest Received by Trust Funds Legislative proposal, not subject to PAYGO FHI Trust Fund, Other Proprietary Interest from the Public FHI Trust Fund, Taxation on OASDI Benefits FHI Trust Fund, Basic Premium, Medicare Advantage FHI Trust Fund, Payment from the General Fund for Health Care Fraud and Abuse Control Account FHI Trust Fund, Transfers from General Fund (criminal Fines) FHI Trust Fund, Transfers from General Fund (civil Monetary Penalties) FHI Trust Fund, Civil Penalties and Damages FHI Trust Fund, Interest Payments by Railroad Retirement Board FHI Trust Fund, Medicare Refunds FHI Trust Fund, Payments from the General Fund (uninsured and Program Management) FHI Trust Fund, Premiums Collected for Uninsured Individuals not Otherwise Eligible Legislative proposal, subject to PAYGO Contributions, Indian Health Facilities CLASS Independence Fund, Premiums CLASS Independence Fund, Interest Received by Trust Fund Deposits, Vaccine Injury Compensation Trust Fund Interest and Profits on Investments, Vaccine Injury Compensation Trust Fund Contributions, N.I.H., Unconditional Gift Fund Centers for Disease Control, Gifts and Donations Contributions, N.I.H., Conditional Gift Fund Contributions, PHS Conditional Gift Fund Contributions to the Indian Health Service Gift Fund Deposits, Patients benefit fund, N.I.H. Deposits, Patients Benefits Fund, PHS Hospitals Gifts and Contributions, Miscellaneous Trust Funds Interest, Miscellaneous Trust Funds Food and Drug Administration salaries and expensesFor 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; $3,699,611,000 $4,256,673,000: Provided, That of the amount provided under this heading, $667,057,000 $856,041,000 shall be derived from prescription drug user fees authorized by 21 U.S.C. 379h, shall be credited to this account and remain available until expended, and shall not include any fees pursuant to 21 U.S.C. 379h(a)(2) and (a)(3) assessed for fiscal year 2012 2013 but collected in fiscal year 2011 2012; $61,860,000 $67,118,000 shall be derived from medical device user fees authorized by 21 U.S.C. 379j, and shall be credited to this account and remain available until expended; $19,448,000 $21,768,000 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; $5,397,000$5,706,000 shall be derived from animal generic drug user fees authorized by 21 U.S.C. 379f, and shall be credited to this account and shall remain available until expended; and $450,000,000 $477,000,000 shall be derived from tobacco product user fees authorized by 21 U.S.C. 387s and shall be credited to this account and remain available until expended:; $12,364,000 shall be derived from food and feed recall fees authorized by section 743 of the Federal Food, Drug, and Cosmetic Act (Public Law 75–717), as added by the FDA Food Safety Modernization Act (Public Law 111–353), and shall be credited to this account and remain available until expended; $14,700,000 shall be derived from food reinspection fees authorized by section 743 of the Federal Food, Drug, and Cosmetic Act, as added by the FDA Food Safety Modernization Act, and shall be credited to this account and remain available until expended; and $71,066,000 shall be derived from voluntary qualified importer program fees authorized by section 743 of the Federal Food, Drug, and Cosmetic Act, as added by the FDA Food Safety Modernization Act, and shall be credited to this account and remain available until expended: Provided further, That in addition and notwithstanding any other provision under this heading, amounts collected for prescription drug user fees that exceed the fiscal year 2011 2012 limitation are appropriated and shall be credited to this account and remain available until expended: Provided further, That fees derived from prescription drug, medical device, animal drug, animal generic drug, and tobacco product assessments for fiscal year 2011 2012 received during fiscal year 2011 2012, including any such fees assessed prior to fiscal year 2011 2012 but credited for fiscal year 2011 2012, shall be subject to the fiscal year 2011 2012 limitations: Provided further, That not to exceed $25,000 of this amount shall be for official reception and representation expenses, not otherwise provided for, as determined by the Commissioner.In addition, mammography user fees authorized by 42 U.S.C. 263b, export certification user fees authorized by 21 U.S.C. 381, and priority review user fees authorized by 21 U.S.C. 360n may be credited to this account, to remain available until expended. 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, $12,433,000 $13,055,000, to remain available until expended. Note.—A full-year 2011 appropriation for this account was not enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 111–242, as amended). The amounts included for 2011 reflect the annualized level provided by the continuing resolution.[In millions of dollars]201020112012
Distribution of discretionary budget authority by account:
Salaries and expenses234823462731
Buildings and facilities161613
Distribution of discretionary outlays by account:
Salaries and expenses208223222592
Buildings and facilities111413
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, safer, and more affordable; 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 food protection, drug safety, medical device review and safety, developing medical countermeasures, and headquarters consolidation in White Oak, Maryland.The Budget includes a number of new and current user fees. The Budget proposes user fees to support activities related to generic human drug reviews and inspection-related activities at domestic courier facilities. Additionally, the Budget includes fees related to food recall and reinspection activities, export certification, and the voluntary qualified importer program, all of which were authorized in the newly enacted Food Safety Modernization Act. Special and Trust Fund Receipts(in millions of dollars)Identification code 75–9911–0–1–5542010 actualCR2012 est.
0100Balance, start of year1
Receipts:
0220Cooperative Research and Development Agreements, FDA233
0299Total receipts and collections233
0400Total: Balances and collections234
Appropriations:
0500Salaries and Expenses–2–2–2
0599Total appropriations–2–2–2
0799Balance, end of year12
Program and Financing(in millions of dollars)Identification code 75–9911–0–1–5542010 actualCR2012 est.
Obligations by program activity:
0001Foods783781955
0002Drugs801802872
0003Devices and radiological products313314329
0004National Center for Toxicological Research595960
0005Other activities141141198
0006Other rent and rent related activities104104150
0007Rental payments145145167
0008Buildings and facilities221613
0009CRADAs333
0091Direct program activities, subtotal2,3712,3652,747
0801Reimbursable program8161,0111,556
0900Total new obligations3,1873,3764,303
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 1258587293
1020Adjustment of unobligated bal brought forward, Oct 1–293
1050Unobligated balance (total)258294293
Budget authority:
Appropriations, discretionary:
1100Appropriation2,3642,3622,744
Appropriations, mandatory:
1201Appropriation (special fund)222
Spending authority from offsetting collections, discretionary:
1700Collected8901,0111,554
1701Change in uncollected payments, Federal sources25
1702Offsetting collections (previously unavailable)270333333
1725Spending authority from offsetting collections precluded from obligation (limitation on obligations)–35–333–333
1750Spending auth from offsetting collections, disc (total)1,1501,0111,554
1900Budget authority (total)3,5163,3754,300
1930Total budgetary resources available3,7743,6694,593
Memorandum (non-add) entries:
1941Unexpired unobligated balance, end of year587293290
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)1,2261,3641,391
3010Uncollected pymts, Fed sources, brought forward, Oct 1–109–51–51
3020Obligated balance, start of year (net)1,1171,3131,340
3030Obligations incurred, unexpired accounts3,1873,3764,303
3040Outlays (gross)–3,021–3,349–4,161
3050Change in uncollected pymts, Fed sources, unexpired–25
3051Change in uncollected pymts, Fed sources, expired83
3081Recoveries of prior year unpaid obligations, expired–28
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)1,3641,3911,533
3091Uncollected pymts, Fed sources, end of year–51–51–51
3100Obligated balance, end of year (net)1,3131,3401,482
Budget authority and outlays, net:
Discretionary:
4000Budget authority, gross3,5143,3734,298
Outlays, gross:
4010Outlays from new discretionary authority2,1922,6183,420
4011Outlays from discretionary balances804729739
4020Outlays, gross (total)2,9963,3474,159
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030Federal sources–34–67
4033Non-Federal sources–869
4034Offsetting governmental collections–1,011–1,487
4040Offsets against gross budget authority and outlays (total)–903–1,011–1,554
Additional offsets against gross budget authority only:
4050Change in uncollected pymts, Fed sources, unexpired–25
4052Offsetting collections credited to expired accounts13
4060Additional offsets against budget authority only (total)–12
4070Budget authority, net (discretionary)2,5992,3622,744
4080Outlays, net (discretionary)2,0932,3362,605
Mandatory:
4090Budget authority, gross222
Outlays, gross:
4100Outlays from new mandatory authority2522
4180Budget authority, net (total)2,6012,3642,746
4190Outlays, net (total)2,1182,3382,607
Memorandum (non-add) entries:
5090Unavailable balance, SOY: Offsetting collections3016666
5091Unavailable balance, EOY: Offsetting collections666666
Summary of Budget Authority and Outlays(in millions of dollars)2010 actualCR2012 est.
Enacted/requested:
Budget Authority2,6012,3642,746
Outlays2,1182,3382,607
Legislative proposal, not subject to PAYGO:
Budget Authority
Outlays
Total:
Budget Authority2,6012,3642,746
Outlays2,1182,3382,607
Object Classification(in millions of dollars)Identification code 75–9911–0–1–5542010 actualCR2012 est.
Direct obligations:
Personnel compensation:
11.1Full-time permanent700743797
11.3Other than full-time permanent107113122
11.5Other personnel compensation555862
11.7Military personnel566065
11.8Special personal services payments111
11.9Total personnel compensation9199751,047
12.1Civilian personnel benefits238253271
12.2Military personnel benefits303234
21.0Travel and transportation of persons494151
22.0Transportation of things556
23.1Rental payments to GSA145146168
23.2Rental payments to others55373
23.3Communications, utilities, and miscellaneous charges707184
24.0Printing and reproduction333
25.1Advisory and assistance services546981
25.2Other services from non-federal sources321244379
25.3Other goods and services from federal sources158129136
25.4Operation and maintenance of facilities9395120
25.5Research and development contracts463640
25.7Operation and maintenance of equipment151519
26.0Supplies and materials464656
31.0Equipment9888110
32.0Land and structures1477
41.0Grants, subsidies, and contributions605260
42.0Insurance claims and indemnities222
99.0Direct obligations2,3712,3622,747
99.0Reimbursable obligations8161,0141,556
99.9Total new obligations3,1873,3764,303
Employment SummaryIdentification code 75–9911–0–1–5542010 actualCR2012 est.
1001Direct civilian full-time equivalent employment8,6868,6869,074
1101Direct military average strength employment682682682
2001Reimbursable civilian full-time equivalent employment2,8372,8374,351
2101Reimbursable military average strength employment224224224
3001Allocation account civilian full-time equivalent employment565656
3101Allocation account military average strength employment666
Legislative proposal, not subject to PAYGO Salaries and ExpensesContingent upon the enactment of authorizing legislation, the Secretary shall charge fees for generic drug review activities: Provided, That such fees, in an amount not to exceed $38,015,000 $40,122,000, shall be credited to this account, to remain available until expended, for generic drug review activities. In addition, contingent upon the enactment of authorizing legislation, the Secretary shall charge fees for reinspection: Provided, That such fees, in an amount not to exceed $27,296,000 shall be credited to this account, to remain available until expended, for reinspections. In addition, contingent upon the enactment of authorizing legislation to charge reinspection fees for products other than food, the Secretary shall charge fees for such reinspections: Provided, That such fees, in an amount not to exceed $14,108,000, shall be credited to this account, to remain available until expended, for reinspections. In addition, contingent upon the enactment of authorizing legislation, the Secretary shall charge fees for export certification: Provided, That such fees, in an amount not to exceed $4,385,000 shall be credited to this account, to remain available until expended, for the issuance of export certifications. In addition, contingent upon the enactment of authorizing legislation, the Secretary shall charge fees for food inspections and food facility registrations: Provided, That such fees, in an amount not to exceed $220,200,000 shall be credited to this account, and shall remain available until expended. In addition, contingent upon the enactment of authorizing legislation, the Secretary shall charge fees for international express courier import activities: Provided, That such fees, in an amount not to exceed $5,338,000, shall be credited to this account, to remain available until expended for international express couriers import activities. Program and Financing(in millions of dollars)Identification code 75–9911–2–1–5542010 actualCR2012 est.
Obligations by program activity:
0810Generic Drug User Fee40
0811Reinspection User Fee (Medical)14
0812International Courier User Fee6
0900Total new obligations60
Budgetary Resources:
Budget authority:
Spending authority from offsetting collections, discretionary:
1700Collected60
1930Total budgetary resources available60
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)
3030Obligations incurred, unexpired accounts60
3040Outlays (gross)–60
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)
Budget authority and outlays, net:
Discretionary:
4000Budget authority, gross60
Outlays, gross:
4010Outlays from new discretionary authority60
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4033Non-Federal sources–60
4070Budget authority, net (discretionary)
4080Outlays, net (discretionary)
4180Budget authority, net (total)
4190Outlays, net (total)
Object Classification(in millions of dollars)Identification code 75–9911–2–1–5542010 actualCR2012 est.
99.0Reimbursable obligations60
99.9Total new obligations60
Employment SummaryIdentification code 75–9911–2–1–5542010 actualCR2012 est.
2001Reimbursable civilian full-time equivalent employment150
Revolving Fund for Certification and Other Services 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.Program and Financing(in millions of dollars)Identification code 75–4309–0–3–5542010 actualCR2012 est.
Obligations by program activity:
0801Reimbursable program788
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 1122
Budget authority:
Spending authority from offsetting collections, mandatory:
1800Collected888
1930Total budgetary resources available91010
Memorandum (non-add) entries:
1941Unexpired unobligated balance, end of year222
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)332
3030Obligations incurred, unexpired accounts788
3040Outlays (gross)–7–9–9
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)321
Budget authority and outlays, net:
Mandatory:
4090Budget authority, gross888
Outlays, gross:
4100Outlays from new mandatory authority688
4101Outlays from mandatory balances111
4110Outlays, gross (total)799
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123Non-Federal sources–8–8–8
4160Budget authority, net (mandatory)
4170Outlays, net (mandatory)–111
4180Budget authority, net (total)
4190Outlays, net (total)–111
Object Classification(in millions of dollars)Identification code 75–4309–0–3–5542010 actualCR2012 est.
Reimbursable obligations:
11.1Personnel compensation: Full-time permanent444
12.1Civilian personnel benefits111
23.1Rental payments to GSA111
25.2Other services from non-federal sources111
26.0Supplies and materials11
99.0Reimbursable obligations788
99.9Total new obligations788
Employment SummaryIdentification code 75–4309–0–3–5542010 actualCR2012 est.
2001Reimbursable civilian full-time equivalent employment383838
Health Resources and Services Administration Health Resources and Services health resources and servicesFor carrying out titles II, III, IV, VII, VIII, X, XI, XII, XIX, 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 711, 1128E, and 1820 of the Social Security Act, the Health Care Quality Improvement Act of 1986, the Native Hawaiian Health Care Act of 1988, the Cardiac Arrest Survival Act of 2000, section 712 of the American Jobs Creation Act of 2004, and the Stem Cell Therapeutic and Research Act of 2005, and the Patient Protection and Affordable Care Act, $7,501,658,000 $6,801,262,000, of which $41,200,000$26,200,000 from general revenues, notwithstanding section 1820(j) of the Social Security Act, shall be available for carrying out the Medicare rural hospital flexibility grants program under such section: Provided, That of the funds made available under this heading for Medicare rural hospital flexibility grants, $1,000,000$1,000,000 shall be to carry out section 1820(g)(6) of the Social Security Act, with funds provided for such grants available for the purchase and implementation of telehealth services, including pilots and demonstrations on the use of electronic health records to coordinate rural veterans care between rural providers and the Department of Veterans Affairs through the use of the VISTA-Electronic Health Record: Provided further, That sections 340G-1(d)(1) and (d)(2), 747(c)(2), 751(j)(2), and the proportional funding amounts in paragraphs (1) through (4) of section 756(e) of the PHS Act shall not apply to funds made available in this paragraph: Provided further, That of the funds made available under this heading, $129,000$129,000 shall be available until expended for facilities renovations at the Gillis W. Long Hansen's Disease Center: Provided further, That in addition to fees authorized by section 427(b) of the Health Care Quality Improvement Act of 1986, fees shall be collected for the full disclosure of information under the Act sufficient to recover the full costs of operating the National Practitioner Data Bank, and shall remain available until expended to carry out that Act: Provided further, That fees collected for the full disclosure of information under the "Health 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 $40,000$40,000 shall be available until expended for carrying out the provisions of section 224(o) of the PHS Act including associated administrative expenses and relevant evaluations: Provided further, That no more than $44,055,000$96,077,000 shall be 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 ("HHS'') pertaining to administrative claims made under such law: Provided further, That of the funds made available under this heading, $327,356,000$327,356,000 shall be for the program 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, $1,962,865,000$2,037,865,000 shall remain available to the Secretary of HHS through September 30, 20132014, for parts A and B of title XXVI of the PHS Act, of which not less than $880,000,000 shall be for State AIDS Drug Assistance Programs under section 2616 of such Act: Provided further, That within the amounts designated in the previous proviso to carry out Parts A and B of title XXVI of the PHS Act, $60,000,000 shall be available for allocation to State AIDS Drug Assistance Programs under section 2620 or section 311(c) of the PHS Act: Provided further, That within the amounts provided for part A of title XXVI of the PHS Act, $6,021,000$6,021,000 shall be available to the Secretary through September 30, 2013,2014, and shall be available to qualifying jurisdictions, within 30 days of enactment, for increasing supplemental grants for fiscal year 20112012 to metropolitan and transitional areas that received grant funding in fiscal year 2010 2011 under subparts I and II of part A of title XXVI of the PHS Act to ensure that an area's total funding under subparts I and II of part A for fiscal year 20102011, together with the amount of this additional funding, is not less than 92.492.4 percent of the amount of such area's total funding under part A for fiscal year 2006: Provided further, That notwithstanding section 2603(c)(1) of the PHS Act, the additional funding to areas under the immediately preceding proviso, which may be used for costs incurred during fiscal year 20102011, shall be available to the area for obligation from the date of the award through the end of the grant year for the award: Provided further, That $855,000,000 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, (1) $25,000,000$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, and (2) $255,423,000 to carry out titles VII and VIII and section 340G of the PHS Act: Provided further, That notwithstanding sections 502(a)(1) and 502(b)(1) of the Social Security Act, not to exceed $93,999,263$74,712,263 shall be available for carrying out special projects of regional and national significance pursuant to section 501(a)(2) of such Act and $11,810,915$11,810,915 shall be available for projects described in paragraphs (A) through (F) of section 501(a)(3) of such Act: Provided further, That dentistry faculty loan repayments shall be made using the same terms and conditions as the Nursing Faculty Loan Repayment program authorized under section 738 of the PHS Act unless otherwise authorized: Provided further, That, for any program operating under section 751 of the PHS Act on or before January 1, 2009, the Secretary of HHS may waive any of the requirements contained in sections 751(d)(2)(A) and 751(d)(2)(B) of such Act: Provided further, That funds provided under section 846 and subpart 3 of part D of title III of the PHS Act may be used to make prior year adjustments to awards made under these sections: Provided further, That notwithstanding section 399BB(g) of the PHS Act, funds made available under this heading for section 399BB of the PHS Act are for carrying out the program as authorized under section 399BB(a)-(f) of such Act: Provided further, That notwithstanding subsection (d)(3)(B) of section 340A the Public Health Service Act, $5,000,000 shall be available for activities under such section: Provided further, That notwithstanding section 338J(k) of the PHS Act, $10,075,000$10,075,000 shall be available for State Offices of Rural Health: Provided further, That of the funds provided, $15,000,000 shall be available for the Small Rural Hospital Improvement Grant Program for quality improvement and adoption of health information technology: Provided further, That $75,000,000 shall be available for State Health Access Grants to expand access to affordable health care coverage for the uninsured populations in such States, Provided further, That the Secretary may collect a fee of 0.1 percent of each purchase of 340B drugs from entities participating in the Drug Pricing Program pursuant to section 340B of the PHS Act to pay for the operating costs of such program: Provided further, That fees pursuant to the 340B Drug Pricing Program shall be collected by manufacturers at the time of sale, and shall be credited to this account, to remain available until expended. Note.—A full-year 2011 appropriation for this account was not enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 111–242, as amended). The amounts included for 2011 reflect the annualized level provided by the continuing resolution. Resources displayed here support categorical grants and contracts managed by Health Resources and Services Administration (HRSA). These activities include support for Federally Qualified Health Centers, treatment and care for those living with HIV/AIDS, health professions training, maternal and child health care services, promotion of organ and bone marrow donation, and the medical malpractice claims funds, which pay malpractice claims filed against employees of federally-supported health centers and free clinics. HRSA is also responsible for oversight of the 340B Drug Discount Program. The FY 2012 Budget proposes a new user fee for this program to improve administration and oversight of this activity.HRSA administers the following revolving loan programs: Health Professions Student Loans (HPSL), Nursing Student Loans (NSL), Primary Care Loans (PCL) and Loans for Disadvantaged Students (LDS). These programs are financed through revolving accounts (Federal Capital Contribution) and do not receive annual appropriations. Through these revolving fund accounts, funds are awarded to institutions that in turn provide loans to individual students. As borrowers pay back loans the programs revolving account gets replenished, and the collected funds are then used to give out new loans in the following academic years. If the programs revolving account has excess funds that will not be used to provide new loans, these excess funds are returned to HRSA. Funds returned to HRSA are then awarded to programs that are in need of additional funds. The information below reflects Academic Year 2009–2010 data reported in the Annual Operating Report.Health Professions Revolving Loan ProgramsFederal Capital Contribution ProgramAccount Balance
HPSL$362,160,100
NSL$165,315,300
PCL$253,049,300
LDS$111,847,000
Total$892,371,700
Program and Financing(in millions of dollars)Identification code 75–0350–0–1–5502010 actualCR2012 est.
Obligations by program activity:
0010Health centers2,1412,1462,022
0011National Health Service Corps414125
0012National Health Service Corps Recruitment10010199
0013Hansen's Disease Center161616
0014Payment to Hawaii for the Treatment of Hansen's Disease222
0015Black Lung Clinics777
0016Nursing Education Loan Repayment and Scholarships949494
0017Health Professions406408468
0018Maternal and Child Health Block Grant661662654
0019Healthy Start105105105
0020Poison Control Centers292929
0021EMS for Children222222
0022Universal Newborn Hearing Screening191919
0023HIV/AIDS2,2862,2662,375
0024Organ Transplantation262626
0025Bone Marrow Donor Registry242427
0026Rural Health Policy Development101010
0027Rural Health Outreach Grants565657
0028Rural Health Flexibility Grants414126
0029Denali Commission1010
0030Telehealth121212
0031Program Management147147171
0032Family Planning316317327
0033Loan Repayment/Faculty Fellowship111
0034Public Health Improvement (Facilities & Other Projects)337338
0035Health Centers Tort Claim Fund584496
0036Heritable Disorders101010
0037Congenital Disabilities11
0038Childrens' GME317317
0039State Health Access Grants7575
0040Delta Health Initiative3535
0041State Offices of Rural Health101010
0042Rural and Community Access to Emergency Devices33
0043Radiogenic Diseases222
0044Traumatic Brain Injury101010
0045Autism and Other Developmental Disorders484855
0046Cord Blood Stem Cell Bank121214
0047Free Clinics Medical Malpractice1
0048Sickle Cell555
0049Drug Pricing Program225
0050Family to Family Health Information Centers555
0062Primary Care Training and Enhancement Prevention Fund198
0063Healthy Weight Collaborative Prevention Fund55
0064Nurse Managed Health Centers Prevention Fund15
0065Advanced Education Nursing Prevention Fund32
0066State Health Care Workforce Dev. Grants Prev. Fund6
0067Public Health/Preventive Medicine Prevention Fund1515
0069GME Payments Teaching Health Centers722
0071ARRA90874
0072Infrastructure to Expand Access to Care100
0091Direct program activities, subtotal8,6817,6606,849
0300Total direct programs8,6817,6606,849
0801Reimbursable program777585
0802Reimbursable program: PHS evaluation2525280
0899Total reimbursable obligations102100365
0900Total new obligations8,7837,7607,214
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 11,049223271
1021Recoveries of prior year unpaid obligations1
1050Unobligated balance (total)1,050223271
Budget authority:
Appropriations, discretionary:
1100Appropriation7,4747,4746,801
1121Appropriations transferred from other accounts9
1160Appropriation, discretionary (total)7,4837,4746,801
Appropriations, mandatory:
1200Appropriation1052355
1221Appropriations transferred from other accounts27120
1260Appropriations, mandatory (total)37623525
Spending authority from offsetting collections, discretionary:
1700Collected6182100
1701Change in uncollected payments, Federal sources21
1750Spending auth from offsetting collections, disc (total)8282100
Spending authority from offsetting collections, mandatory:
1800Offsetting collections (cash)(HPSL&NSL)171717
1900Budget authority (total)7,9587,8086,943
1930Total budgetary resources available9,0088,0317,214
Memorandum (non-add) entries:
1940Unobligated balance expiring–2
1941Unexpired unobligated balance, end of year223271
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)6,4576,8636,180
3010Uncollected pymts, Fed sources, brought forward, Oct 1–37–50–50
3020Obligated balance, start of year (net)6,4206,8136,130
3030Obligations incurred, unexpired accounts8,7837,7607,214
3031Obligations incurred, expired accounts1
3040Outlays (gross)–8,265–8,443–7,834
3050Change in uncollected pymts, Fed sources, unexpired–21
3051Change in uncollected pymts, Fed sources, expired8
3080Recoveries of prior year unpaid obligations, unexpired–1
3081Recoveries of prior year unpaid obligations, expired–112
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)6,8636,1805,560
3091Uncollected pymts, Fed sources, end of year–50–50–50
3100Obligated balance, end of year (net)6,8136,1305,510
Budget authority and outlays, net:
Discretionary:
4000Budget authority, gross7,5657,5566,901
Outlays, gross:
4010Outlays from new discretionary authority3,2113,2212,957
4011Outlays from discretionary balances5,0315,0234,636
4020Outlays, gross (total)8,2428,2447,593
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030Federal sources–28–54–67
4033Non-Federal sources–40–28–33
4040Offsets against gross budget authority and outlays (total)–68–82–100
Additional offsets against gross budget authority only:
4050Change in uncollected pymts, Fed sources, unexpired–21
4052Offsetting collections credited to expired accounts7
4060Additional offsets against budget authority only (total)–14
4070Budget authority, net (discretionary)7,4837,4746,801
4080Outlays, net (discretionary)8,1748,1627,493
Mandatory:
4090Budget authority, gross39325242
Outlays, gross:
4100Outlays from new mandatory authority42627
4101Outlays from mandatory balances19173214
4110Outlays, gross (total)23199241
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123Non-Federal sources–17–17–17
Additional offsets against gross budget authority only:
4142Offsetting collections credited to expired accounts
4160Budget authority, net (mandatory)37623525
4170Outlays, net (mandatory)6182224
4180Budget authority, net (total)7,8597,7096,826
4190Outlays, net (total)8,1808,3447,717
Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program(in millions of dollars)Identification code 75–0350–0–1–5502010 actualCR2012 est.
Guaranteed loan levels supportable by subsidy budget authority:
215001Health centers: Facilities renovation loan guarantee levels1010
215002Health centers: Managed care network development loan guarantee22
215003Health centers: Managed care plan loan guarantee levels55
215999Total loan guarantee levels1717
Guaranteed loan subsidy (in percent):
232001Health centers: Facilities renovation loan guarantee levels0.002.722.67
232002Health centers: Managed care network development loan guarantee0.009.139.62
232003Health centers: Managed care plan loan guarantee levels0.005.695.76
232999Weighted average subsidy rate0.004.354.40
233999Total subsidy budget authority11
Guaranteed loan subsidy outlays:
234001Health centers: Facilities renovation loan guarantee levels1
234999Total subsidy outlays1
Object Classification(in millions of dollars)Identification code 75–0350–0–1–5502010 actualCR2012 est.
Direct obligations:
Personnel compensation:
11.1Full-time permanent120133126
11.3Other than full-time permanent955
11.5Other personnel compensation555
11.7Military personnel191818
11.9Total personnel compensation153161154
12.1Civilian personnel benefits343735
12.2Military personnel benefits101010
13.0Benefits for former personnel222
21.0Travel and transportation of persons443
23.1Rental payments to GSA141746
23.2Rental payments to others222
23.3Communications, utilities, and miscellaneous charges111
24.0Printing and reproduction111
25.1Advisory and assistance services384841
25.2Other services from non-federal sources148123113
25.3Other goods and services from federal sources225222188
25.4Operation and maintenance of facilities332
25.6Medical care444
25.7Operation and maintenance of equipment765
26.0Supplies and materials111
31.0Equipment544
41.0Grants, subsidies, and contributions7,9766,9766,147
42.0Insurance claims and indemnities533890
99.0Direct obligations8,6817,6606,849
99.0Reimbursable obligations102100365
99.9Total new obligations8,7837,7607,214
Employment SummaryIdentification code 75–0350–0–1–5502010 actualCR2012 est.
1001Direct civilian full-time equivalent employment1,2991,2991,181
1101Direct military average strength employment193196199
2001Reimbursable civilian full-time equivalent employment869096
2101Reimbursable military average strength employment777
Primary Health Care Access P.L. 111–148 provides resources to the Community Health Center and National Health Service Corps Fund through FY 2015 and to School Based Health Centers through FY 2013. These activities are administered by HRSA.Program and Financing(in millions of dollars)Identification code 75–0352–0–1–5512010 actualCR2012 est.
Obligations by program activity:
0010Health Center1,0001,200
0011Health Centers Construction1,4914
0012National Health Service Corps290295
0013School-Based Health Centers10050
0900Total new obligations2,8811,549
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 1509
Budget authority:
Appropriations, mandatory:
1200Appropriation502,8401,545
1930Total budgetary resources available502,8901,554
Memorandum (non-add) entries:
1941Unexpired unobligated balance, end of year5095
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)2,272
3030Obligations incurred, unexpired accounts2,8811,549
3040Outlays (gross)–609–1,928
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)2,2721,893
Budget authority and outlays, net:
Mandatory:
4090Budget authority, gross502,8401,545
Outlays, gross:
4100Outlays from new mandatory authority606570
4101Outlays from mandatory balances31,358
4110Outlays, gross (total)6091,928
4180Budget authority, net (total)502,8401,545
4190Outlays, net (total)6091,928
Object Classification(in millions of dollars)Identification code 75–0352–0–1–5512010 actualCR2012 est.
Direct obligations:
Personnel compensation:
11.1Full-time permanent1115
11.7Military personnel1
11.9Total personnel compensation1116
12.1Civilian personnel benefits33
21.0Travel and transportation of persons33
25.2Other services from non-federal sources11379
41.0Grants, subsidies, and contributions2,7511,448
99.9Total new obligations2,8811,549
Employment SummaryIdentification code 75–0352–0–1–5512010 actualCR2012 est.
1001Direct civilian full-time equivalent employment113162
1101Direct military average strength employment314
Vaccine Injury Compensation 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 2012 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.Program and Financing(in millions of dollars)Identification code 75–0320–0–1–5512010 actualCR2012 est.
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 1121212
1930Total budgetary resources available121212
Memorandum (non-add) entries:
1941Unexpired unobligated balance, end of year121212
4180Budget authority, net (total)
4190Outlays, net (total)
Covered Countermeasure Process Fund The Covered Countermeasure Process Fund is established pursuant to the PHS Act, as amended by Division C of Public Law 109–148, to serve as a source of funds to pay for compensation for injuries, illnesses or death, or losses resulting from the administration to or use by an individual of a covered countermeasure for which a Secretarial Declaration has been issued, pursuant to section 319F-3(b) of the Public Health Service Act. Additionally, authority is provided to address any unexpected claims that may arise under the Smallpox Emergency Personal Protection Act of 2003.Program and Financing(in millions of dollars)Identification code 75–0343–0–1–5512010 actualCR2012 est.
Obligations by program activity:
0001Claims11
0103Admin Expense44
0900Total new obligations55
Budgetary Resources:
Unobligated balance:
1011Unobligated balance transferred from other accounts55
1930Total budgetary resources available55
Memorandum (non-add) entries:
1941Unexpired unobligated balance, end of year
Change in obligated balance:
3030Obligations incurred, unexpired accounts55
4180Budget authority, net (total)
4190Outlays, net (total)
Object Classification(in millions of dollars)Identification code 75–0343–0–1–5512010 actualCR2012 est.
Direct obligations:
11.1Personnel compensation: Full-time permanent11
25.3Other goods and services from federal sources32
42.0Insurance claims and indemnities12
99.9Total new obligations55
Employment SummaryIdentification code 75–0343–0–1–5512010 actualCR2012 est.
1001Direct civilian full-time equivalent employment47
1101Direct military average strength employment11
Maternal, Infant, and Early Childhood Home Visiting Programs P.L. 111–148 provides resources to Maternal, infant and early childhood home visiting program through FY 2014 to provide comprehensive services for at risk communities. These activities are administered by HRSA.Program and Financing(in millions of dollars)Identification code 75–0321–0–1–5512010 actualCR2012 est.
Obligations by program activity:
0010Maternal, Infant, and Early Childhood Home Visiting Programs100250350
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200Appropriation100250350
1930Total budgetary resources available100250350
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)99202
3030Obligations incurred, unexpired accounts100250350
3040Outlays (gross)–1–147–322
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)99202230
Budget authority and outlays, net:
Mandatory:
4090Budget authority, gross100250350
Outlays, gross:
4100Outlays from new mandatory authority1105147
4101Outlays from mandatory balances42175
4110Outlays, gross (total)1147322
4180Budget authority, net (total)100250350
4190Outlays, net (total)1147322
Object Classification(in millions of dollars)Identification code 75–0321–0–1–5512010 actualCR2012 est.
Direct obligations:
11.1Personnel compensation: Full-time permanent23
12.1Civilian personnel benefits11
25.1Advisory and assistance services2225
41.0Grants, subsidies, and contributions100225321
99.0Direct obligations100250350
99.9Total new obligations100250350
Employment SummaryIdentification code 75–0321–0–1–5512010 actualCR2012 est.
1001Direct civilian full-time equivalent employment32227
1101Direct military average strength employment11
Health Center Guaranteed Loan Financing Account 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. Program and Financing(in millions of dollars)Identification code 75–4442–0–3–5512010 actualCR2012 est.
Obligations by program activity:
Credit program obligations:
0711Default claim payments on principal11
0900Total new obligations11
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 1221
1930Total budgetary resources available221
Memorandum (non-add) entries:
1941Unexpired unobligated balance, end of year21
Change in obligated balance:
3030Obligations incurred, unexpired accounts11
4180Financing authority, net (total)
4190Financing disbursements, net (total)
Status of Guaranteed Loans(in millions of dollars)Identification code 75–4442–0–3–5512010 actualCR2012 est.
Position with respect to appropriations act limitation on commitments:
2121Limitation available from carry-forward707053
2143Uncommitted limitation carried forward–70–53–36
2150Total guaranteed loan commitments1717
2199Guaranteed amount of guaranteed loan commitments1414
Cumulative balance of guaranteed loans outstanding:
2210Outstanding, start of year656571
2231Disbursements of new guaranteed loans1717
2251Repayments and prepayments–10–10
2263Adjustments: Terminations for default that result in claim payments–1–1
2290Outstanding, end of year657177
Memorandum:
2299Guaranteed amount of guaranteed loans outstanding, end of year595762
Balance Sheet(in millions of dollars)Identification code 75–4442–0–3–5512009 actual2010 actual
ASSETS:
1101Federal assets: Fund balances with Treasury44
1999Total assets44
LIABILITIES:
Non-Federal liabilities:
2204Liabilities for loan guarantees24
2207Downward Reestimate2
2999Total liabilities44
4999Total liabilities and net position44
Health Education Assistance Loans Program Account health education assistance loans program account Note.—A full-year 2011 appropriation for this account was not enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 111–242, as amended). The amounts included for 2011 reflect the annualized level provided by the continuing resolution.Consistent with the FY 2011 President's Budget, in FY 2012 the Department of Education will assume responsibility for the program. The authority to administer, service, collect, and enforce the program as well as the functions, assets, and liabilities of the Secretary of Health and Human Services will be permanently transferred to the Secretary of Education.Program and Financing(in millions of dollars)Identification code 75–0340–0–1–5522010 actualCR2012 est.
Obligations by program activity:
Credit program obligations:
0707Reestimates of loan guarantee subsidy13
0708Interest on reestimates of loan guarantee subsidy14
0709Administrative expenses33
0900Total new obligations330
Budgetary Resources:
Budget authority:
Appropriations, discretionary:
1100Appropriation33
Appropriations, mandatory:
1200Appropriation27
1900Budget authority (total)330
1930Total budgetary resources available330
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)222
3030Obligations incurred, unexpired accounts330
3040Outlays (gross)–3–30
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)222
Budget authority and outlays, net:
Discretionary:
4000Budget authority, gross33
Outlays, gross:
4010Outlays from new discretionary authority23
4011Outlays from discretionary balances1
4020Outlays, gross (total)33
Mandatory:
4090Budget authority, gross27
Outlays, gross:
4100Outlays from new mandatory authority27
4180Budget authority, net (total)330
4190Outlays, net (total)330
Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program(in millions of dollars)Identification code 75–0340–0–1–5522010 actualCR2012 est.
Guaranteed loan upward reestimates:
235001HEAL Loan guarantee26
235999Total upward reestimate budget authority26
Guaranteed loan downward reestimates:
237001HEAL Loan guarantee–10
237999Total downward reestimate subsidy budget authority–10
Administrative expense data:
3510Budget authority33
3590Outlays from new authority33
Object Classification(in millions of dollars)Identification code 75–0340–0–1–5522010 actualCR2012 est.
Direct obligations:
11.1Personnel compensation: Full-time permanent11
25.3Other goods and services from federal sources229
99.9Total new obligations330
Employment SummaryIdentification code 75–0340–0–1–5522010 actualCR2012 est.
1001Direct civilian full-time equivalent employment1414
Health Education Assistance Loans Financing Account Program and Financing(in millions of dollars)Identification code 75–4304–0–3–5522010 actualCR2012 est.
Obligations by program activity:
Credit program obligations:
0711Default claim payments on principal1013
0712Default claim payments on interest23
0742Downward reestimate paid to receipt account5
0743Interest on downward reestimates5
0900Total new obligations2216
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 1614967
1010Unobligated balance transferred to other accounts–67
1050Unobligated balance (total)6149
Financing authority:
Borrowing authority, mandatory:
1400Borrowing authority1
Spending authority from offsetting collections, mandatory:
1800Collected934
1900Financing authority(total)1034
1930Total budgetary resources available7183
Memorandum (non-add) entries:
1941Unexpired unobligated balance, end of year4967
Change in obligated balance:
3030Obligations incurred, unexpired accounts2216
3040Financing disbursements (gross)–23–16
Financing authority and disbursements, net:
Mandatory:
4090Financing authority, gross1034
Financing disbursements:
4110Financing disbursements, gross2316
Offsets against gross financing authority and disbursements:
Offsetting collections (collected) from:
4120Federal sources - upward reestimates and interest–27
4122Interest on uninvested funds–3–3
4123Recoveries of defaulted loans–6–4
4130Offsets against gross financing auth and disbursements (total)–9–34
4160Financing authority, net (mandatory)1
4170Financing disbursements, net (mandatory)14–18
4180Financing authority, net (total)1
4190Financing disbursements, net (total)14–18
Status of Guaranteed Loans(in millions of dollars)Identification code 75–4304–0–3–5522010 actualCR2012 est.
Position with respect to appropriations act limitation on commitments:
2150Total guaranteed loan commitments
Cumulative balance of guaranteed loans outstanding:
2210Outstanding, start of year729627597
2251Repayments and prepayments–90–14
Adjustments:
2261Terminations for default that result in loans receivable–11–11
2263Terminations for default that result in claim payments–1–5
2264Other adjustments, net–597
2290Outstanding, end of year627597
Memorandum:
2299Guaranteed amount of guaranteed loans outstanding, end of year627597
Addendum:
Cumulative balance of defaulted guaranteed loans that result in loans receivable:
2310Outstanding, start of year170171177
2331Disbursements for guaranteed loan claims1111
2351Repayments of loans receivable–6–4
2361Write-offs of loans receivable–4–1
2364Other adjustments, net–177
2390Outstanding, end of year171177
Balance Sheet(in millions of dollars)Identification code 75–4304–0–3–5522009 actual2010 actual
ASSETS:
1101Federal assets: Fund balances with Treasury6149
Net value of assets related to post-1991 acquired defaulted guaranteed loans receivable:
1501Defaulted guaranteed loans receivable, gross170171
1505Allowance for subsidy cost (-)–121–126
1599Net present value of assets related to defaulted guaranteed loans4945
1999Total assets11094
LIABILITIES:
Non-Federal liabilities:
2204Liabilities for loan guarantees10094
2207Other, downward reestimate10
2999Total liabilities11094
4999Total liabilities and net position11094
Health Education Assistance Loans Liquidating Account Program and Financing(in millions of dollars)Identification code 75–4305–0–3–5522010 actualCR2012 est.
Obligations by program activity:
Credit program obligations:
0710Direct loan obligations33
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200Appropriation11
Spending authority from offsetting collections, mandatory:
1800Collected910
1820Capital transfer of spending authority from offsetting collections to general fund–7–8
1850Spending auth from offsetting collections, mand (total)22
1900Budget authority (total)33
1930Total budgetary resources available33
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)
3030Obligations incurred, unexpired accounts33
3040Outlays (gross)–3–3
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)
Budget authority and outlays, net:
Mandatory:
4090Budget authority, gross33
Outlays, gross:
4100Outlays from new mandatory authority33
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123Non-Federal sources–9–10
4160Budget authority, net (mandatory)–6–7
4170Outlays, net (mandatory)–6–7
4180Budget authority, net (total)–6–7
4190Outlays, net (total)–6–7
Status of Guaranteed Loans(in millions of dollars)Identification code 75–4305–0–3–5522010 actualCR2012 est.
Cumulative balance of guaranteed loans outstanding:
2210Outstanding, start of year12410385
2251Repayments and prepayments–18–15
Adjustments:
2261Terminations for default that result in loans receivable–2–2
2263Terminations for default that result in claim payments–1–1
2264Other adjustments, net–85
2290Outstanding, end of year10385
Memorandum:
2299Guaranteed amount of guaranteed loans outstanding, end of year10385
Addendum:
Cumulative balance of defaulted guaranteed loans that result in loans receivable:
2310Outstanding, start of year421379371
2331Disbursements for guaranteed loan claims22
2351Repayments of loans receivable–10–10
2361Write-offs of loans receivable–15
2364Other adjustments, net–19–371
2390Outstanding, end of year379371
Balance Sheet(in millions of dollars)Identification code 75–4305–0–3–5522009 actual2010 actual
ASSETS:
1101Federal assets: Fund balances with Treasury11
1701Defaulted guaranteed loans, gross421379
1703Allowance for estimated uncollectible loans and interest (-)–1–1
1704Defaulted guaranteed loans and interest receivable, net420378
1799Value of assets related to loan guarantees420378
1999Total assets421379
LIABILITIES:
2104Federal liabilities: Resources payable to Treasury421379
2999Total liabilities421379
4999Total liabilities and net position421379
Object Classification(in millions of dollars)Identification code 75–4305–0–3–5522010 actualCR2012 est.
Direct obligations:
33.0Investments and loans22
42.0Insurance claims and indemnities11
99.9Total new obligations33
Medical Facilities Guarantee and Loan Fund Titles VI and 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. Program and Financing(in millions of dollars)Identification code 75–9931–0–3–5512010 actualCR2012 est.
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)111
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)111
4180Budget authority, net (total)
4190Outlays, net (total)
Status of Direct Loans(in millions of dollars)Identification code 75–9931–0–3–5512010 actualCR2012 est.
Cumulative balance of direct loans outstanding:
1210Outstanding, start of year777
1251Repayments: Repayments and prepayments
1290Outstanding, end of year777
Balance Sheet(in millions of dollars)Identification code 75–9931–0–3–5512009 actual2010 actual
ASSETS:
1601Direct loans, gross97
1999Total assets97
LIABILITIES:
2201Non-Federal liabilities: Accounts payable97
2999Total liabilities97
4999Total liabilities and net position97
Vaccine Injury Compensation Program Trust Fund vaccine injury compensation program trust fundFor payments from the Vaccine Injury Compensation Program Trust Fund ("Trust Fund''), such sums as may be necessary for claims associated with vaccine-related injury or death with respect to vaccines administered after September 30, 1988, pursuant to subtitle 2 of title XXI of the Public Health Service Act, to remain available until expended: Provided, That for necessary administrative expenses, not to exceed $6,502,000 $6,502,000 shall be available from the Trust Fund to the Secretary of Health and Human Services. Note.—A full-year 2011 appropriation for this account was not enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 111–242, as amended). The amounts included for 2011 reflect the annualized level provided by the continuing resolution.The Vaccine Injury Compensation Program was established pursuant to P.L. 99–660 and P.L. 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.Special and Trust Fund Receipts(in millions of dollars)Identification code 75–8175–0–7–5512010 actualCR2012 est.
0100Balance, start of year2,8932,9603,019
Adjustments:
0191Rounding adjustment–8
0199Balance, start of year2,8852,9603,019
Receipts:
0200Deposits, Vaccine Injury Compensation Trust Fund218228237
0240Interest and Profits on Investments, Vaccine Injury Compensation Trust Fund647197
0299Total receipts and collections282299334
0400Total: Balances and collections3,1673,2593,353
Appropriations:
0500Vaccine Injury Compensation Program Trust Fund–20–20–20
0501Vaccine Injury Compensation Program Trust Fund–187–220–235
0599Total appropriations–207–240–255
0799Balance, end of year2,9603,0193,098
Program and Financing(in millions of dollars)Identification code 75–8175–0–7–5512010 actualCR2012 est.
Obligations by program activity:
0001Compensation: Claims for post - FY 1989 injuries188220235
0103Claims processing (Claims Court)555
0104Claims processing (HRSA)777
0105Claims processing (Dept. of Justice)888
0191Total, administrative expenses202020
0801Reimbursable program activity5
0900Total new obligations213240255
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 11
Budget authority:
Appropriations, discretionary:
1102Appropriation (trust fund)202020
Appropriations, mandatory:
1202Appropriation (Vaccine Injury Trust fund)187220235
Spending authority from offsetting collections, mandatory:
1800Collected5
1900Budget authority (total)212240255
1930Total budgetary resources available213240255
Memorandum (non-add) entries:
1941Unexpired unobligated balance, end of year
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)12166
3030Obligations incurred, unexpired accounts213240255
3040Outlays (gross)–209–250–261
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)166
Budget authority and outlays, net:
Discretionary:
4000Budget authority, gross202020
Outlays, gross:
4010Outlays from new discretionary authority102020
4011Outlays from discretionary balances7106
4020Outlays, gross (total)173026
Mandatory:
4090Budget authority, gross192220235
Outlays, gross:
4100Outlays from new mandatory authority192220235
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120Federal sources–5
4160Budget authority, net (mandatory)187220235
4170Outlays, net (mandatory)187220235
4180Budget authority, net (total)207240255
4190Outlays, net (total)204250261
Memorandum (non-add) entries:
5000Total investments, SOY: Federal securities: Par value2,8842,9392,990
5001Total investments, EOY: Federal securities: Par value2,9392,9903,062
Object Classification(in millions of dollars)Identification code 75–8175–0–7–5512010 actualCR2012 est.
Direct obligations:
25.2Other services from non-federal sources9
25.3Other goods and services from federal sources122020
42.0Insurance claims and indemnities187220235
99.0Direct obligations208240255
99.0Reimbursable obligations5
99.9Total new obligations213240255
indian health servicesFor 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, $3,961,187,000 $4,166,139,000 together with payments received during the fiscal year pursuant to 42 U.S.C. 238(b) and 238b 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 $862,765,000 $948,646,000 for contract medical care, including $53,000,000 $58,000,000 for the Indian Catastrophic Health Emergency Fund, shall remain available until expended: Provided further, That of the funding provided for information technology activities and, notwithstanding any other provision of law, $4,000,000 $4,000,000 shall be allocated at the discretion of the Director of the Indian Health Service: Provided further, That of the funds provided, up to $36,000,000 $36,000,000 shall remain available until expended for implementation of the loan repayment program under section 108 of the Indian Health Care Improvement Act: Provided further, That the amounts collected by the Federal Government as authorized by sections 104 and 108 of the Indian Health Care Improvement Act (25 U.S.C. 1613a and 1616a) during the preceding fiscal year for breach of contracts shall be deposited to the Fund authorized by section 108A of the Act (25 U.S.C. 1616a-1) and shall remain available until expended and, notwithstanding section 108A(c) of the Act (25 U.S.C. 1616a-1(c)), funds shall be available to make new awards under the loan repayment and scholarship programs under sections 104 and 108 of the Act (25 U.S.C. 1613a and 1616a): Provided further, That $16,391,000 $16,391,000 is provided for the methamphetamine and suicide prevention and treatment initiative and $10,000,000 $10,000,000 is provided for the domestic violence prevention initiative and, notwithstanding any other provision of law, the amounts available under this proviso shall be allocated at the discretion of the Director of the Indian Health Service and shall remain available until expended: Provided further, That $4,000,000 $4,000,000 is provided for a substance abuse treatment grant program and, notwithstanding any other provision of law, the amounts available under this proviso shall be allocated at the discretion of the Director of the Indian Health Service and shall remain available until September 30, 2012 2013: Provided further, That funds provided in this Act may be used for annual contracts and grants that fall within two fiscal years, provided the total obligation is recorded in the year 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, except for those related to the planning, design, or construction of new facilities: Provided further, That funding contained herein 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 $444,332,000 $461,837,000 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 2011 2012, of which not to exceed $10,000,000 $10,000,000 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, 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.): Provided further, That the Indian Health Care Improvement Fund may be used, as needed, to carry out activities typically funded under the Indian Health Facilities account. Note.—A full-year 2011 appropriation for this account was not enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 111–242, as amended). The amounts included for 2011 reflect the annualized level provided by the continuing resolution.The Indian Health Services account provides medical care, public health services, and health professions training opportunities to American Indians and Alaska Natives. An estimated $2.634 billion primarily through self determination contracts and compacts, will be administered by tribal governments in 2012.Program and Financing(in millions of dollars)Identification code 75–0390–0–1–5512010 actualCR2012 est.
Obligations by program activity:
0001Clinical services2,9842,9543,376
0002Preventive health144144157
0003Urban health434347
0004Indian health professions464142
0005Tribal management333
0006Direct operations696974
0007Self-governance666
0008Contract support costs398398462
0009Diabetes funds166166166
0091Direct program activities, subtotal3,8593,8244,333
0801Reimbursable program1,1661,1821,182
0900Total new obligations5,0255,0065,515
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 1392433372
1021Recoveries of prior year unpaid obligations189
1050Unobligated balance (total)581433372
Budget authority:
Appropriations, discretionary:
1100Appropriation3,6583,6584,166
1120Appropriations transferred to other accounts–43
1121Appropriations transferred from other accounts43
1160Appropriation, discretionary (total)3,6583,6584,166
Appropriations, mandatory:
1200Appropriation150150150
Spending authority from offsetting collections, discretionary:
1700Collected1,1211,1371,137
1701Change in uncollected payments, Federal sources–44
1750Spending auth from offsetting collections, disc (total)1,0771,1371,137
1900Budget authority (total)4,8854,9455,453
1930Total budgetary resources available5,4665,3785,825
Memorandum (non-add) entries:
1940Unobligated balance expiring–8
1941Unexpired unobligated balance, end of year433372310
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)1,0351,076913
3010Uncollected pymts, Fed sources, brought forward, Oct 1–295–232–232
3020Obligated balance, start of year (net)740844681
3030Obligations incurred, unexpired accounts5,0255,0065,515
3031Obligations incurred, expired accounts57
3040Outlays (gross)–4,815–5,169–5,439
3050Change in uncollected pymts, Fed sources, unexpired44
3051Change in uncollected pymts, Fed sources, expired19
3080Recoveries of prior year unpaid obligations, unexpired–189
3081Recoveries of prior year unpaid obligations, expired–37
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)1,076913989
3091Uncollected pymts, Fed sources, end of year–232–232–232
3100Obligated balance, end of year (net)844681757
Budget authority and outlays, net:
Discretionary:
4000Budget authority, gross4,7354,7955,303
Outlays, gross:
4010Outlays from new discretionary authority4,0504,1374,553
4011Outlays from discretionary balances621882733
4020Outlays, gross (total)4,6715,0195,286
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030Federal sources–365–370–370
4033Non-Federal sources–756–767–767
4040Offsets against gross budget authority and outlays (total)–1,121–1,137–1,137
Additional offsets against gross budget authority only:
4050Change in uncollected pymts, Fed sources, unexpired44
4052Offsetting collections credited to expired accounts
4060Additional offsets against budget authority only (total)44
4070Budget authority, net (discretionary)3,6583,6584,166
4080Outlays, net (discretionary)3,5503,8824,149
Mandatory:
4090Budget authority, gross150150150
Outlays, gross:
4100Outlays from new mandatory authority144144144
4101Outlays from mandatory balances69
4110Outlays, gross (total)144150153
4180Budget authority, net (total)3,8083,8084,316
4190Outlays, net (total)3,6944,0324,302
Object Classification(in millions of dollars)Identification code 75–0390–0–1–5512010 actualCR2012 est.
Direct obligations:
Personnel compensation:
11.1Full-time permanent394394394
11.3Other than full-time permanent242424
11.5Other personnel compensation585858
11.7Military personnel808080
11.9Total personnel compensation556556556
12.1Civilian personnel benefits130130130
12.2Military personnel benefits373737
13.0Benefits for former personnel226
21.0Travel and transportation of persons151516
21.0Patient travel303030
22.0Transportation of things8810
23.1Rental payments to GSA9914
23.2Rental payments to others222
23.3Communications, utilities, and miscellaneous charges141418
24.0Printing and reproduction111
25.1Advisory and assistance services232310
25.2Other services from non-federal sources11996163
25.3Other goods and services from federal sources525274
25.4Operation and maintenance of facilities445
25.6Medical care292292600
25.7Operation and maintenance of equipment12127
25.8Subsistence and support of persons333
26.0Supplies and materials120120153
31.0Equipment504050
41.0Grants, subsidies, and contributions2,3792,3772,447
42.0Insurance claims and indemnities111
99.0Direct obligations3,8593,8244,333
99.0Reimbursable obligations1,1661,1821,182
99.9Total new obligations5,0255,0065,515
Employment SummaryIdentification code 75–0390–0–1–5512010 actualCR2012 est.
1001Direct civilian full-time equivalent employment7,1737,2747,374
1101Direct military average strength employment1,0971,1151,130
2001Reimbursable civilian full-time equivalent employment5,4815,4815,481
2101Reimbursable military average strength employment839839839
indian health facilitiesFor 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, $445,242,000 $457,699,000, to remain available until expended: Provided, That notwithstanding any other provision of law, funds appropriated for the planning, design, construction, renovation or expansion of health facilities for the benefit of a federally-recognized Indian tribe or tribes may be used to purchase land on which such facilities will be located: Provided further, That not to exceed $500,000 $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 $2,700,000 $2,700,000 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 $500,000 shall be placed in a Demolition Fund, to remain available until expended, and be used by the Indian Health Service for the demolition of Federal buildings. Note.—A full-year 2011 appropriation for this account was not enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 111–242, as amended). The amounts included for 2011 reflect the annualized level provided by the continuing resolution.The Indian Health Facilities account supports construction, repair and improvement, equipment, and environmental health and facilities support for the Indian Health Service.Special and Trust Fund Receipts(in millions of dollars)Identification code 75–0391–0–1–5512010 actualCR2012 est.
0100Balance, start of year
Receipts:
0220Rent and Charges for Quarters, Indian Health Service888
0400Total: Balances and collections888
Appropriations:
0500Indian Health Facilities–8–8–8
0799Balance, end of year
Program and Financing(in millions of dollars)Identification code 75–0391–0–1–5512010 actualCR2012 est.
Obligations by program activity:
0001Sanitation and health facilities329125165
0002Maintenance1005457
0003Facilities and environmental health174193211
0004Equipment322325
0091Direct program activities, subtotal635395458
0100Total direct program635395458
0801Reimbursable program888
0900Total new obligations643403466
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 1346180186
1021Recoveries of prior year unpaid obligations67
1050Unobligated balance (total)413180186
Budget authority:
Appropriations, discretionary:
1100Appropriation395395458
Appropriations, mandatory:
1201Appropriation (special fund)888
Spending authority from offsetting collections, discretionary:
1700Collected566
1701Change in uncollected payments, Federal sources7
1750Spending auth from offsetting collections, disc (total)1266
Spending authority from offsetting collections, mandatory:
1801Change in uncollected payments, Federal sources–5
1900Budget authority (total)410409472
1930Total budgetary resources available823589658
Memorandum (non-add) entries:
1941Unexpired unobligated balance, end of year180186192
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)645551529
3010Uncollected pymts, Fed sources, brought forward, Oct 1–6–8–8
3020Obligated balance, start of year (net)639543521
3030Obligations incurred, unexpired accounts643403466
3040Outlays (gross)–670–425–575
3050Change in uncollected pymts, Fed sources, unexpired–2
3080Recoveries of prior year unpaid obligations, unexpired–67
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)551529420
3091Uncollected pymts, Fed sources, end of year–8–8–8
3100Obligated balance, end of year (net)543521412
Budget authority and outlays, net:
Discretionary:
4000Budget authority, gross407401464
Outlays, gross:
4010Outlays from new discretionary authority225125143
4011Outlays from discretionary balances436292424
4020Outlays, gross (total)661417567
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030Federal sources–4–6–6
4033Non-Federal sources–1
4040Offsets against gross budget authority and outlays (total)–5–6–6
Additional offsets against gross budget authority only:
4050Change in uncollected pymts, Fed sources, unexpired–7
4070Budget authority, net (discretionary)395395458
4080Outlays, net (discretionary)656411561
Mandatory:
4090Budget authority, gross388
Outlays, gross:
4100Outlays from new mandatory authority388
4101Outlays from mandatory balances6
4110Outlays, gross (total)988
Additional offsets against gross budget authority only:
4140Change in uncollected pymts, Fed sources, unexpired5
4160Budget authority, net (mandatory)888
4170Outlays, net (mandatory)988
4180Budget authority, net (total)403403466
4190Outlays, net (total)665419569
Object Classification(in millions of dollars)Identification code 75–0391–0–1–5512010 actualCR2012 est.
Direct obligations:
Personnel compensation:
11.1Full-time permanent555544
11.3Other than full-time permanent663
11.5Other personnel compensation332
11.7Military personnel262622
11.9Total personnel compensation909071
12.1Civilian personnel benefits171712
12.2Military personnel benefits999
21.0Travel and transportation of persons444
22.0Transportation of things443
23.1Rental payments to GSA332
23.2Rental payments to others11
23.3Communications, utilities, and miscellaneous charges131322
25.1Advisory and assistance services1
25.2Other services from non-federal sources484056
25.3Other goods and services from federal sources442
25.4Operation and maintenance of facilities17144
25.7Operation and maintenance of equipment221
25.8Subsistence and support of persons65
26.0Supplies and materials884
31.0Equipment21218
32.0Land and structures1451524
41.0Grants, subsidies, and contributions249150170
99.0Direct obligations635395458
99.0Reimbursable obligations888
99.9Total new obligations643403466
Employment SummaryIdentification code 75–0391–0–1–5512010 actualCR2012 est.
1001Direct civilian full-time equivalent employment9661,0161,023
1101Direct military average strength employment239241244
2001Reimbursable civilian full-time equivalent employment292929
ADMINISTRATIVE PROVISIONS administrative provisions, indian health serviceAppropriations provided in this Act to the Indian Health Service shall be available for services as authorized by 5 U.S.C. 3109 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; uniforms or allowances therefor as authorized by 5 U.S.C. 5901–5902; and for expenses of attendance at meetings that relate to the functions or activities of the Indian Health Service.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 authorized to provide goods and services to those entities on a reimbursable basis, including payments 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 from which the funds were originally derived, with such amounts to 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. Centers for Disease Control and Prevention Disease Control, Research, and Training disease control, research, and trainingTo carry out titles II, III, VII, XI, XV, XVII, XIX, XXI, XXIII, and XXVI of the Public Health Service Act ("PHS Act''), sections 101, 102, 103, 201, 202, 203, 301, 501, and 514 of the Federal Mine Safety and Health Act of 1977, section 13 of the Mine Improvement and New Emergency Response Act of 2006, sections 20, 21, and 22 of the Occupational Safety and Health Act of 1970, titles II and IV of the Immigration and Nationality Act, section 501 of the Refugee Education Assistance Act of 1980, sections 4001, 4004, and 4201 of the Patient Protection and Affordable Care Act, section 103(a)(4)(H) of the Afghanistan Freedom Support Act of 2002, and for expenses necessary to support activities related to countering potential biological, 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, $6,265,806,000$5,817,412,000, of which $0$30,000,000 shall remain available until expended for acquisition of real property, equipment, construction and renovation of facilities; of which $523,533,000$625,000,000 shall remain available until expended for the Strategic National Stockpile under section 319F-2 of the PHS Act; ; of which $118,092,000$118,023,000 for international HIV/AIDS shall remain available through September 30, 20132; of which $1,000,000 shall remain available until expended to pay for the transportation, medical care, treatment, and other related costs of persons quarantined or isolated under Federal or State quarantine laws: and of which $150,137,000 shall be available until expended to provide screening and treatment for first response emergency services personnel, residents, students, and others related to the September 11, 2001 terrorist attacks on the World Trade Center: Provided, That in addition, such sums as may be derived from authorized user fees, which shall be credited to this account and : Provided further, That with respect to the previous proviso, authorized user fees from the Vessel Sanitation Program shall be available through September 30, 2011until expended: Provided further, That in addition to amounts provided herein, the following amounts shall be available from amounts available under section 241 of the PHS Act: (1) $12,864,000$12,864,000 to carry out the National Immunization Surveys; (2) $161,883,000$161,883,000 to carry out the National Center for Health Statistics surveys; (3) $30,880,000 for Public Health Informatics$55,791,000 to carry out Public Health Scientific Services; and (4) $17,151,000 for Health Marketing; (5) $31,170,000 to carry out Public Health Research; and (6) $91,724,000 $259,934,000 to carry out research activities within the National Institute for Occupational Research AgendaSafety and Health: Provided further, That Centers for Disease Control and Prevention and State grant recipients may transfer up to 5 percent of funds appropriated for Centers for Disease Control and Prevention HIV/AIDS, sexually transmitted disease, hepatitis, and tuberculosis activities to address the overlapping epidemics of these diseases by improving program collaboration and providing integrated services in accordance with priorities identified by the Centers for Disease Control and Prevention: Provided further, That, with respect to the previous proviso, grantees shall submit a plan in writing to the Centers for Disease Control and Prevention and obtain the approval of the Centers for Disease Control and Prevention to transfer such funds: 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 of the funds made available under this heading, up to $1,000 per eligible employee of the Centers for Disease Control and Prevention shall be made available until expended for Individual Learning Accounts: 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 Committees on Appropriations of the House of Representatives and the Senate are to be notified promptly of any such redirection: Provided further, That not to exceed $20,787,000funds appropriated to the Centers for Disease Control and Prevention may be available for making grants under section 1509 of the PHS Act for to up tonot less than 21 States, tribes, or tribal organizations: Provided further, That the solicitation and contract shall contain the clause "availability of funds'' found at 48 CFR 52.232–18: Provided further, That of this amount, $5,789,000$5,789,000 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: Provided further, That of the funds appropriated, $10,000 shall be for official reception and representation expenses when specifically approved by the Director of the Centers for Disease Control and Prevention: Provided further, That employees of the Centers for Disease Control and Prevention or the Public Health Service, both civilian and Commissioned Officers, detailed to States, municipalities, or other organizations under authority of section 214 of the PHS Act, or in overseas assignments, shall be treated as non-Federal employees for reporting purposes only and shall not be included within any personnel ceiling applicable to the Agency, Service, or the Department of Health and Human Services during the period of detail or assignment.In addition, for necessary expenses to administer the Energy Employees Occupational Illness Compensation Program Act, $55,358,000$55,358,000, to remain available until expended: Provided, That this amount shall be available consistent with the provision regarding administrative expenses in section 151(b) of division B, title I of Public Law 106–554: Provided further, That with respect to grants to States authorized under Sections 301, 307, 310, 311, 304, and 317 of the PHS Act, any State may redirect up to 10 percent of any fiscal year 2011 grant program allocation to supplement other grants the State receives from funds provided under this heading to address one or more of the top five leading causes of death within such State: Provided further, That each State choosing to redirect funds under the preceding proviso shall submit a detailed plan to the Secretary not less than 30 days prior to such redirection, and, not later than 30 days after the close of the fiscal year, provide a final report in the format specified by the Secretary on the amounts so redirected and how such amounts were used to improve the performance of State public health programs: Provided further, That such redirections may not be used to supplant State funds for such activities. Provided further, That funds made available for the Epidemiology-Laboratory Capacity Grants program shall be available notwithstanding paragraphs (1)-(3) of subsection (b) of section 2821 of the PHS Act. Note.—A full-year 2011 appropriation for this account was not enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 111–242, as amended). The amounts included for 2011 reflect the annualized level provided by the continuing resolution.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. The CDC Stockpile activities include resources directed at enhancing preparedness. The Budget will finance a portion of these ongoing activities through unobligated balances available from P.L. 111–32, the Supplemental Appropriations Act of 2009. P.L. 111–32 appropriated $7.65 billion to the Public Health and Social Servcies Emergency Fund for pandemic influenza preparedness and response activities. Special and Trust Fund Receipts(in millions of dollars)Identification code 75–0943–0–1–9992010 actualCR2012 est.
0100Balance, start of year
Receipts:
0220Cooperative Research and Development Agreements, Centers for Disease Control222
0400Total: Balances and collections222
Appropriations:
0500Disease Control, Research, and Training–2–2–2
0799Balance, end of year
Program and Financing(in millions of dollars)Identification code 75–0943–0–1–9992010 actualCR2012 est.
Obligations by program activity:
0001Infectious Diseases1,9941,996
0002Health Promotion1,0731,075
0003Health Information and Service7172
0004Environmental Health and Injury Prevention335336
0005Occupational Safety and Health209211
0006Global Health325328381
0007Public Health Improvement and Leadership209211
0008Business Services Support367370418
0009Terrorism952953
0010Prev. Health and Health Services Block Grant102102
0011Buildings and Facilities1066930
0012Individual Learning Accounts (ILAs)8
0013Strategic National Stockpile (SNS)593596625
00149/11 Follow-up Activities (World Trade Center)12071
0015Energy Employee Occupational Comp.545555
0016Pandemic Influenza Supplemental (H1N1)82
0017Recovery Act - Section 317 Immunization146
0018Recovery Act CPPW650
0019Health Reform Prevent. & Public Health Fund192752
0020Immunization and Resp Diseases647
0021HIV/AIDS, V Hepatitis, STD and TB1,157
0022Emerging & Zoonotic Infectious Diseases289
0023Chronic Disease & Hlth Promotion725
0024Birth Defects, Dev Disabilities, Disability & Hlth144
0025Environmental Hlth129
0026Injury Prevention and Control148
0027Public Health Scientific Services206
0028Public Hlth Leadership & Support121
0029Public Hlth Preparedness & Response798
0091Direct program activities, subtotal7,5886,4456,625
0801Recovery Act - Section 317 Receivable2
0802Other Reimbursable Programs563575712
0809Reimbursable program activities, subtotal565575712
0899Total reimbursable obligations565575712
0900Total new obligations8,1537,0207,337
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 1560284286
1011Unobligated balance transferred from other accounts650
1021Recoveries of prior year unpaid obligations8
1050Unobligated balance (total)1,218284286
Budget authority:
Appropriations, discretionary:
1100Appropriation6,3906,3905,817
1120Appropriations transferred to other accounts–1
1121Appropriations transferred from other accounts1
1160Appropriation, discretionary (total)6,3906,3905,817
Appropriations, mandatory:
1200Appropriation805555
1201Appropriation (special fund)222
1221Appropriations transferred from other accounts192752
1260Appropriations, mandatory (total)27457809
Spending authority from offsetting collections, discretionary:
1700Collected282575712
1701Change in uncollected payments, Federal sources283
1750Spending auth from offsetting collections, disc (total)565575712
1900Budget authority (total)7,2297,0227,338
1930Total budgetary resources available8,4477,3067,624
Memorandum (non-add) entries:
1940Unobligated balance expiring–10
1941Unexpired unobligated balance, end of year284286287
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)6,2146,8506,786
3010Uncollected pymts, Fed sources, brought forward, Oct 1–483–486–486
3020Obligated balance, start of year (net)5,7316,3646,300
3030Obligations incurred, unexpired accounts8,1537,0207,337
3031Obligations incurred, expired accounts74
3040Outlays (gross)–7,424–7,084–7,246
3050Change in uncollected pymts, Fed sources, unexpired–283
3051Change in uncollected pymts, Fed sources, expired280
3080Recoveries of prior year unpaid obligations, unexpired–8
3081Recoveries of prior year unpaid obligations, expired–159
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)6,8506,7866,877
3091Uncollected pymts, Fed sources, end of year–486–486–486
3100Obligated balance, end of year (net)6,3646,3006,391
Budget authority and outlays, net:
Discretionary:
4000Budget authority, gross6,9556,9656,529
Outlays, gross:
4010Outlays from new discretionary authority2,7552,6622,411
4011Outlays from discretionary balances4,6094,2904,415
4020Outlays, gross (total)7,3646,9526,826
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030Federal sources–536–565–703
4033Non-Federal sources–8–10–9
4040Offsets against gross budget authority and outlays (total)–544–575–712
Additional offsets against gross budget authority only:
4050Change in uncollected pymts, Fed sources, unexpired–283
4052Offsetting collections credited to expired accounts262
4060Additional offsets against budget authority only (total)–21
4070Budget authority, net (discretionary)6,3906,3905,817
4080Outlays, net (discretionary)6,8206,3776,114
Mandatory:
4090Budget authority, gross27457809
Outlays, gross:
4100Outlays from new mandatory authority4346302
4101Outlays from mandatory balances1786118
4110Outlays, gross (total)60132420
4180Budget authority, net (total)6,6646,4476,626
4190Outlays, net (total)6,8806,5096,534
Object Classification(in millions of dollars)Identification code 75–0943–0–1–9992010 actualCR2012 est.
Direct obligations:
Personnel compensation:
11.1Full-time permanent651668624
11.3Other than full-time permanent788074
11.5Other personnel compensation373835
11.7Military personnel666963
11.8Special personal services payments213
11.9Total personnel compensation834856799
12.1Civilian personnel benefits216222208
12.2Military personnel benefits505249
21.0Travel and transportation of persons625756
22.0Transportation of things151413
23.1Rental payments to GSA274551
23.2Rental payments to others21010
23.3Communications, utilities, and miscellaneous charges444143
24.0Printing and reproduction767
25.1Advisory and assistance services578462543
25.2Other services from non-federal sources243215345
25.3Other goods and services from federal sources396337289
25.4Operation and maintenance of facilities895863
25.5Research and development contracts474341
25.6Medical care151411
25.7Operation and maintenance of equipment444140
25.8Subsistence and support of persons (Includes 1259)222020
26.0Supplies and materials822674672
31.0Equipment666251
32.0Land and structures918520
41.0Grants, subsidies, and contributions3,9193,1313,294
99.0Direct obligations7,5896,4456,625
99.0Reimbursable obligations564575712
99.9Total new obligations8,1537,0207,337
Employment SummaryIdentification code 75–0943–0–1–9992010 actualCR2012 est.
1001Direct civilian full-time equivalent employment8,0098,1187,815
1101Direct military average strength employment760793793
2001Reimbursable civilian full-time equivalent employment1,0241,0281,381
2101Reimbursable military average strength employment828686
Toxic Substances and Environmental Public Health, Agency for Toxic Substances and Disease Registry Agency for Toxic Substances and Disease Registrytoxic substances and environmental public healthFor necessary expenses for the Agency for Toxic Substances and Disease Registry (ATSDR) in carrying out activities set forth in sections 104(i) and 111(c)(4) 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, $76,337,000$76,337,000, of which up to $1,000 per eligible employee of the Agency for Toxic Substance and Disease Registry shall remain available until expended for Individual Learning Accounts: 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 20122011, and existing profiles may be updated as necessary. Note.—A full-year 2011 appropriation for this account was not enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 111–242, as amended). The amounts included for 2011 reflect the annualized level provided by the continuing resolution.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.Program and Financing(in millions of dollars)Identification code 75–0944–0–1–5512010 actualCR2012 est.
Obligations by program activity:
0001Agncy for Toxic Substances & Disease Registry767776
0801Reimbursable program1666
0900Total new obligations928382
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 12424
Budget authority:
Appropriations, discretionary:
1100Appropriation777776
Appropriations, mandatory:
1200Appropriation23
Spending authority from offsetting collections, discretionary:
1700Collected466
1701Change in uncollected payments, Federal sources12
1750Spending auth from offsetting collections, disc (total)1666
1900Budget authority (total)1168382
1930Total budgetary resources available116107106
Memorandum (non-add) entries:
1941Unexpired unobligated balance, end of year242424
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)344317
3010Uncollected pymts, Fed sources, brought forward, Oct 1–4–14–14
3020Obligated balance, start of year (net)30293
3030Obligations incurred, unexpired accounts928382
3031Obligations incurred, expired accounts1
3040Outlays (gross)–82–109–96
3050Change in uncollected pymts, Fed sources, unexpired–12
3051Change in uncollected pymts, Fed sources, expired2
3081Recoveries of prior year unpaid obligations, expired–2
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)43173
3091Uncollected pymts, Fed sources, end of year–14–14–14
3100Obligated balance, end of year (net)293–11
Budget authority and outlays, net:
Discretionary:
4000Budget authority, gross938382
Outlays, gross:
4010Outlays from new discretionary authority578180
4011Outlays from discretionary balances25257
4020Outlays, gross (total)8210687
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030Federal sources–5–6–6
Additional offsets against gross budget authority only:
4050Change in uncollected pymts, Fed sources, unexpired–12
4052Offsetting collections credited to expired accounts1
4060Additional offsets against budget authority only (total)–11
4070Budget authority, net (discretionary)777776
4080Outlays, net (discretionary)7710081
Mandatory:
4090Budget authority, gross23
Outlays, gross:
4101Outlays from mandatory balances39
4180Budget authority, net (total)1007776
4190Outlays, net (total)7710390
Object Classification(in millions of dollars)Identification code 75–0944–0–1–5512010 actualCR2012 est.
Direct obligations:
Personnel compensation:
11.1Full-time permanent232321
11.3Other than full-time permanent111
11.5Other personnel compensation111
11.7Military personnel444
11.9Total personnel compensation292927
12.1Civilian personnel benefits776
12.2Military personnel benefits221
21.0Travel and transportation of persons111
23.3Communications, utilities, and miscellaneous charges121211
25.1Advisory and assistance services222
25.2Other services from non-federal sources5510
25.3Other goods and services from federal sources341
25.5Research and development contracts2
26.0Supplies and materials11
31.0Equipment111
41.0Grants, subsidies, and contributions131314
99.0Direct obligations767776
99.0Reimbursable obligations1666
99.9Total new obligations928382
Employment SummaryIdentification code 75–0944–0–1–5512010 actualCR2012 est.
1001Direct civilian full-time equivalent employment247247247
1101Direct military average strength employment434343
2001Reimbursable civilian full-time equivalent employment201919
2101Reimbursable military average strength employment122
National Institutes of Health National Institutes of Health national cancer instituteFor carrying out section 301 and title IV of the Public Health Service Act with respect to cancer, $5,264,643,000 $5,196,136,000, of which up to $8,000,000 may be used for facilities repairs and improvements at the National Cancer Institute-Frederick Federally Funded Research and Development Center in Frederick, Maryland.national heart, lung, and blood instituteFor 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, $3,187,516,000 $3,147,992,000. national institute of dental and craniofacial researchFor carrying out section 301 and title IV of the Public Health Service Act with respect to dental disease, $423,511,000 $420,369,000. national institute of diabetes and digestive and kidney diseasesFor carrying out section 301 and title IV of the Public Health Service Act with respect to diabetes and digestive and kidney disease, $1,857,589,000 $1,837,957,000. national institute of neurological disorders and strokeFor carrying out section 301 and title IV of the Public Health Service Act with respect to neurological disorders and stroke, $1,681,333,000 $1,664,253,000. 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, $4,977,070,000 $4,915,970,000: 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. national institute of general medical sciencesFor carrying out section 301 and title IV of the Public Health Service Act with respect to general medical sciences, $2,125,090,000 $2,102,300,000. eunice kennedy shriver national institute of child health and human developmentFor carrying out section 301 and title IV of the Public Health Service Act with respect to child health and human development, $1,368,894,000 $1,352,189,000. national eye instituteFor carrying out section 301 and title IV of the Public Health Service Act with respect to eye diseases and visual disorders, $724,360,000 $719,059,000. national institute of environmental health sciencesFor carrying out section 301 and title IV of the Public Health Service Act with respect to environmental health sciences, $707,339,000 $700,537,000. 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, $81,763,000 $81,085,000. national institute on agingFor carrying out section 301 and title IV of the Public Health Service Act with respect to aging, $1,142,337,000 $1,129,987,000. national institute of arthritis and musculoskeletal and skin diseasesFor carrying out section 301 and title IV of the Public Health Service Act with respect to arthritis and musculoskeletal and skin diseases, $555,715,000 $547,891,000. national institute on deafness and other communication disordersFor carrying out section 301 and title IV of the Public Health Service Act with respect to deafness and other communication disorders, $429,007,000 $426,043,000. national institute of nursing researchFor carrying out section 301 and title IV of the Public Health Service Act with respect to nursing research, $150,198,000 $148,114,000. national institute on alcohol abuse and alcoholismFor carrying out section 301 and title IV of the Public Health Service Act with respect to alcohol abuse and alcoholism, $474,649,000 $469,197,000. national institute on drug abuseFor carrying out section 301 and title IV of the Public Health Service Act with respect to drug abuse, $1,094,078,000 $1,080,018,000. national institute of mental healthFor carrying out section 301 and title IV of the Public Health Service Act with respect to mental health, $1,540,345,000 $1,517,006,000. national human genome research instituteFor carrying out section 301 and title IV of the Public Health Service Act with respect to human genome research, $533,959,000 $524,807,000. national institute of biomedical imaging and bioengineeringFor carrying out section 301 and title IV of the Public Health Service Act with respect to biomedical imaging and bioengineering research, $325,925,000 $322,106,000. national center for research resourcesFor carrying out section 301 and title IV of the Public Health Service Act with respect to research resources and general research support grants, $1,308,741,000 $1,297,900,000. national center for complementary and alternative medicineFor carrying out section 301 and title IV of the Public Health Service Act with respect to complementary and alternative medicine, $132,004,000 $131,002,000. national institute center on minority health and health disparitiesFor carrying out section 301 and title IV of the Public Health Service Act with respect to minority health and health disparities research, $219,046,000 $214,608,000. john e. fogarty international centerFor carrying out the activities of the John E. Fogarty International Center (described in subpart 2 of part E of title IV of the Public Health Service Act), $73,027,000 $71,328,000. national library of medicineFor carrying out section 301 and title IV of the Public Health Service Act ("PHS Act'') with respect to health information communications, $364,802,000 $387,153,000, of which $4,000,000 shall be available until expended for improvement of information systems: Provided, That in fiscal year 20112012, the National Library of Medicine 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 PHS Act to carry out the purposes of the National Information Center on Health Services Research and Health Care Technology established under section 478A of the PHS Act and related health services. office of the directorFor carrying out the responsibilities of the Office of the Director, National Institutes of Health ("NIH''), $1,220,478,000 $1,298,412,000, of which up to $25,000,000 shall be used to carry out section 212 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 NIH is authorized to collect third party payments for the cost of clinical services that are incurred in NIH research facilities and that such payments shall be credited to the NIH 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 up to $194,400,000 $193,880,000 shall be available for continuation of the National Children's Study: Provided further, That $561,629,000 $556,890,000 shall be available for the Common Fund established under section 402A(1) of the Public Health Service Act ("PHS Act''): Provided further, That of the funds provided $10,000 shall be for official reception and representation expenses when specifically approved by the Director of the NIH: Provided further, That the Office of AIDS Research within the Office of the Director of the NIH may spend up to $8,000,000 to make grants for construction or renovation of facilities as provided for in section 2354(a)(5)(B) of the PHS Act: Provided further, That up to $100,000,000 shall be available to implement section 402C of the PHS Act, relating to the Cures Acceleration Network. buildings and facilitiesFor 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, $125,581,000 $125,581,000, to remain available until expended. Note.—A full-year 2011 appropriation for this account was not enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 111–242, as amended). The amounts included for 2011 reflect the annualized level provided by the continuing resolution.DISTRIBUTION OF BUDGET AUTHORITY AND OUTLAYS BY ACCOUNT(in millions of dollars)201020112012
Distribution of budget authority by account:
National Cancer Institute5,1035,1035,196
National Heart, Lung, and Blood Institute3,0973,0973,148
National Institute of Dental and Craniofacial Research413413420
National Institute of Diabetes and Digestive and Kidney Diseases1,9581,9581,988
National Institute of Neurological Disorder and Stroke1,6361,6361,664
National Institute of Allergy and Infectious Diseases4,8184,51414,916
National Institute of General Medical Sciences2,0522,0522,102
Eunice Kennedy Shriver National Institute of Child Health and Human Development1,3301,3301,352
National Eye Institute707707719
National Institute of Environmental Health Sciences769769782
National Institute on Aging1,1101,1101,130
National Institute of Arthritis and Musculoskeletal and Skin Diseases539539548
National Institute on Deafness and Other Communication Disorders419419426
National Institute of Nursing Research146146148
National Institute on Alcohol Abuse and Alcoholism462462469
National Institute on Drug Abuse1,0601,0601,080
National Institute of Mental Health1,4891,4891,517
National Center for Research Resources1,2691,2691,298
National Human Genome Research Institute516516525
National Institute of Biomedical Imaging and Bioengineering317317322
National Center for Complementary and Alternative Medicine129129131
National Institute on Minority Health and Health Disparities212212215
John E. Fogarty International Center707071
National Library of Medicine340340387
Office of the Director1,1771,1771,298
Buildings and Facilities100100126
ARRA Funds000
Subtotal31,23830,93431,978
Cooperative Research and Development Agreements161616
Total Budget Authority, NIH31,25430,95031,994
1 The 2010 Labor, HHS, and Education Appropriations Act included a total of $4,818,275,000 for NIAID, of which $304,000,000 was transferred from the Biodefense Countermeasures account in the Department of Homeland Security. Since there are no funds remaining in that account in 2011, under the current law continuing resolution (P.L. 111–242, as amended), there can be no transfer to NIAID. The Administration supports replacing this transfer with budget authority for NIAID in 2011.
(in millions of dollars)201020112012
Distribution of outlays by account:
National Cancer Institute5,0124,8355,074
National Heart, Lung, and Blood Institute2,9913,0573,071
National Institute of Dental and Craniofacial Research385428415
National Institute of Diabetes and Digestive and Kidney Diseases1,8521,9321,960
National Institute of Neurological Disorders and Stroke1,5371,6451,641
National Institute of Allergy and Infectious Diseases4,3794,1654,526
National Institute of General Medical Sciences1,9792,0262,060
Eunice Kennedy Shriver National Institute of Child Health and Human Development1,2751,3161,335
National Eye Institute686678709
National Institute of Environmental Health Sciences754737773
National Institute on Aging1,0721,0551,135
National Institute of Arthritis and Musculoskeletal and Skin Diseases532516540
National Institute on Deafness and Other Communication Disorders399419420
National Institute of Nursing Research143134146
National Institute on Alcohol Abuse and Alcoholism447526463
National Institute on Drug Abuse1,0461,0151,054
National Institute of Mental Health1,43814841,496
National Center for Research Resources1,2649711,268
National Human Genome Research Institute523492520
National Institute of Biomedical Imaging and Bioengineering311303320
National Center for Complementary and Alternative Medicine124105133
National Institute on Minority Health and Health Disparities212197216
John E. Fogarty International Center677171
National Library of Medicine349308363
Office of the Director1,0501,4231,193
Buildings and Facilities11565113
ARRA Funds3,0703,2632,703
Subtotal Outlays33,01233,16633,718
Cooperative Research and Development Agreements161616
Total Outlays, NIH33,02833,18233,734
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.Special and Trust Fund Receipts(in millions of dollars)Identification code 75–9915–0–1–5522010 actualCR2012 est.
0100Balance, start of year
Receipts:
0220Cooperative Research and Development Agreements, NIH161616
0299Total receipts and collections161616
0400Total: Balances and collections161616
Appropriations:
0500National Institutes of Health–16–16–16
0599Total appropriations–16–16–16
0799Balance, end of year
Program and Financing(in millions of dollars)Identification code 75–9915–0–1–5522010 actualCR2012 est.
Obligations by program activity:
0001National Cancer Institute5,0985,1035,196
0002National Heart, Lung, and Blood Institute3,0943,0973,148
0003National Institute of Dental and Craniofacial Research412413420
0004National Institute of Diabetes and Digestive and Kidney Disease1,9581,8081,838
0005National Institute of Neurological Disorders and Stroke1,6341,6361,664
0006National Institute of Allergy and Infectious Diseases4,5154,5144,916
0007National Institute of General Medical Sciences2,0482,0522,102
0008National Institute of Child Health and Human Development1,3271,3301,352
0009National Eye Institute706707719
0010National Institute of Environmental Health Sciences773769782
0011National Institute on Aging1,1081,1101,129
0012National Institute of Arthritis and Musculoskeletal and Skin Disease538539548
0013National Institute on Deafness and Other Communication Disorder418419426
0014National Institute of Mental Health1,4941,4891,517
0015National Institute on Drug Abuse1,0661,0601,080
0016Natinal Institute on Alcohol Abuse and Alcoholism462462469
0017National Institute of Nursing Research145146148
0018National Human Genome Research Institute524516525
0019National Institute of Biomedical Imaging and Bioengineering316317322
0020National Center for Research Resources1,2671,2691,298
0021National Center for Complementary and Alternative Medicine128129131
0022National Institute on Minority Health and Health Disparities211212215
0023John E. Fogarty International Center717071
0024National Library of Medicine340340387
0025Office of the Director1,1761,1771,298
0026Buildings and facilities203100126
0027Cooperative Research and Development Agreements161616
0028ARRA Funds5,601
0029Royalties888
0031Type 1 Diabetes150150
0091Direct program activities, subtotal36,65730,95832,001
0801Reimbursable program activity3,3063,3383,624
0809Reimbursable program activities, subtotal3,3063,3383,624
0900Total new obligations39,96334,29635,625
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 15,922344347
1021Recoveries of prior year unpaid obligations177915
1029Other balances withdrawn–1
1050Unobligated balance (total)6,098353362
Budget authority:
Appropriations, discretionary:
1100Appropriation30,78430,78531,829
1120Appropriations transferred to other accounts–305
1121Appropriations transferred from other accounts3051
1160Appropriation, discretionary (total)30,78430,78631,829
Appropriations, mandatory:
1200Appropriation150150150
1201Appropriation (special fund)161616
1260Appropriations, mandatory (total)166166166
Spending authority from offsetting collections, discretionary:
1700Collected2,7433,3383,624
1701Change in uncollected payments, Federal sources518
1750Spending auth from offsetting collections, disc (total)3,2613,3383,624
1900Budget authority (total)34,21134,29035,619
1930Total budgetary resources available40,30934,64335,981
Memorandum (non-add) entries:
1940Unobligated balance expiring–2
1941Unexpired unobligated balance, end of year344347356
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)36,37539,71337,445
3010Uncollected pymts, Fed sources, brought forward, Oct 1–1,235–1,248–1,248
3020Obligated balance, start of year (net)35,14038,46536,197
3030Obligations incurred, unexpired accounts39,96334,29635,625
3031Obligations incurred, expired accounts118
3040Outlays (gross)–36,284–36,555–37,442
3050Change in uncollected pymts, Fed sources, unexpired–518
3051Change in uncollected pymts, Fed sources, expired505
3080Recoveries of prior year unpaid obligations, unexpired–177–9–15
3081Recoveries of prior year unpaid obligations, expired–282
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)39,71337,44535,613
3091Uncollected pymts, Fed sources, end of year–1,248–1,248–1,248
3100Obligated balance, end of year (net)38,46536,19734,365
Budget authority and outlays, net:
Discretionary:
4000Budget authority, gross34,04534,12435,453
Outlays, gross:
4010Outlays from new discretionary authority9,39711,21911,772
4011Outlays from discretionary balances26,69625,14225,488
4020Outlays, gross (total)36,09336,36137,260
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030Federal sources–3,122–3,338–3,624
4033Non-Federal sources–94
4040Offsets against gross budget authority and outlays (total)–3,216–3,338–3,624
Additional offsets against gross budget authority only:
4050Change in uncollected pymts, Fed sources, unexpired–518
4052Offsetting collections credited to expired accounts473
4060Additional offsets against budget authority only (total)–45
4070Budget authority, net (discretionary)30,78430,78631,829
4080Outlays, net (discretionary)32,87733,02333,636
Mandatory:
4090Budget authority, gross166166166
Outlays, gross:
4100Outlays from new mandatory authority45252
4101Outlays from mandatory balances187142130
4110Outlays, gross (total)191194182
4180Budget authority, net (total)30,95030,95231,995
4190Outlays, net (total)33,06833,21733,818
Object Classification(in millions of dollars)Identification code 75–9915–0–1–5522010 actualCR2012 est.
Direct obligations:
Personnel compensation:
11.1Full-time permanent862872872
11.3Other than full-time permanent472476476
11.5Other personnel compensation464646
11.7Military personnel232424
11.8Special personal services payments183188187
11.9Total personnel compensation1,5861,6061,605
12.1Civilian personnel benefits386391391
12.2Military personnel benefits161717
21.0Travel and transportation of persons595859
22.0Transportation of things666
23.2Rental payments to others111
23.3Communications, utilities, and miscellaneous charges272425
24.0Printing and reproduction889
25.1Advisory and assistance services10998103
25.2Other services from non-federal sources995720746
25.3Other goods and services from federal sources3,1003,0463,333
25.4Operation and maintenance of facilities595178195
25.5Research and development contracts2,4842,2492,323
25.6Medical care201819
25.7Operation and maintenance of equipment827375
26.0Supplies and materials270216220
31.0Equipment186141145
41.0Grants, subsidies, and contributions26,72322,10722,728
42.0Insurance claims and indemnities4
99.0Direct obligations36,65730,95732,000
99.0Reimbursable obligations3,3063,3393,625
99.9Total new obligations39,96334,29635,625
Employment SummaryIdentification code 75–9915–0–1–5522010 actualCR2012 est.
1001Direct civilian full-time equivalent employment12,55012,57312,573
1101Direct military average strength employment220235235
2001Reimbursable civilian full-time equivalent employment5,4635,4675,467
2101Reimbursable military average strength employment125133133
Substance Abuse and Mental Health Services Administration Substance Abuse and Mental Health Services substance abuse and mental health servicesFor carrying out titles III, V, and XIX of the Public Health Service Act ("PHS Act'') with respect to substance abuse and mental health services and the Protection and Advocacy for Individuals with Mental Illness Act, $3,541,362,000$3,386,903,000: 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$74,711,000 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) $21,039,000$21,039,000 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) $23,399,000$45,428,000 to carry out national surveys on drug abuse and mental health; and (4) $8,596,000$28,567,000 to collect and analyze data, conduct public awareness and technical assistance activites, and evaluate substance abuse treatment programs: Provided further, That section 520E(b)(2) of the PHS Act shall not apply to funds appropriated under this Act for fiscal year 20112012: Provided further, That section 1922(a)(1) of the PHS Act shall not apply to amounts provided herein. Note.—A full-year 2011 appropriation for this account was not enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 111–242, as amended). The amounts included for 2011 reflect the annualized level provided by the continuing resolution.This program provides Federal support to strengthen the capacity of the Nation's health care delivery system to provide effective 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, tribal and private not-for-profit organizations to enhance health and reduce the adverse impact of substance abuse and mental illness on America's communities.Program and Financing(in millions of dollars)Identification code 75–1362–0–1–5512010 actualCR2012 est.
Obligations by program activity:
0002Mental Health Block Grant400400414
0003Substance Abuse Block Grant1,3761,3761,420
0004State Prevention Grants480481485
0005Program Management797982
0006St. Elizabeths Hospital11
0010Children's Mental Health121121121
0011PATH Homeless State Grants656565
0012Protection and Advocacy373736
0013Innovation and Emerging Issues829809745
0014Public Education and Support1414
0020Prescription Drug Monitoring (NASPER)222
0022Performance and Quality Information Systems3131
0023Regulatory and Oversight Functions161617
0091Direct program activities, subtotal3,4513,4323,387
0100Total, direct program3,4513,4323,387
0802Reimbursable program: PHS Evaluation242242285
0900Total new obligations3,6933,6743,672
Budgetary Resources:
Budget authority:
Appropriations, discretionary:
1100Appropriation3,4313,4323,387
Appropriations, mandatory:
1221Appropriations transferred from other accounts2093
Spending authority from offsetting collections, discretionary:
1700Collected227242285
1701Change in uncollected payments, Federal sources15
1750Spending auth from offsetting collections, disc (total)242242285
1900Budget authority (total)3,6933,6743,765
1930Total budgetary resources available3,6933,6743,765
Memorandum (non-add) entries:
1941Unexpired unobligated balance, end of year93
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)2,8032,8282,828
3010Uncollected pymts, Fed sources, brought forward, Oct 1–198–152–137
3020Obligated balance, start of year (net)2,6052,6762,691
3030Obligations incurred, unexpired accounts3,6933,6743,672
3031Obligations incurred, expired accounts1
3040Outlays (gross)–3,614–3,674–3,698
3050Change in uncollected pymts, Fed sources, unexpired–15
3051Change in uncollected pymts, Fed sources, expired6115
3081Recoveries of prior year unpaid obligations, expired–55
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)2,8282,8282,802
3091Uncollected pymts, Fed sources, end of year–152–137–137
3100Obligated balance, end of year (net)2,6762,6912,665
Budget authority and outlays, net:
Discretionary:
4000Budget authority, gross3,6733,6743,672
Outlays, gross:
4010Outlays from new discretionary authority1,5841,6151,640
4011Outlays from discretionary balances2,0302,0592,058
4020Outlays, gross (total)3,6143,6743,698
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030Federal sources–158–242–285
4033Non-Federal sources–131
4040Offsets against gross budget authority and outlays (total)–289–242–285
Additional offsets against gross budget authority only:
4050Change in uncollected pymts, Fed sources, unexpired–15
4052Offsetting collections credited to expired accounts62
4060Additional offsets against budget authority only (total)47
4070Budget authority, net (discretionary)3,4313,4323,387
4080Outlays, net (discretionary)3,3253,4323,413
Mandatory:
4090Budget authority, gross2093
4180Budget authority, net (total)3,4513,4323,480
4190Outlays, net (total)3,3253,4323,413
Object Classification(in millions of dollars)Identification code 75–1362–0–1–5512010 actualCR2012 est.
Direct obligations:
Personnel compensation:
11.1Full-time permanent454546
11.3Other than full-time permanent222
11.5Other personnel compensation111
11.7Military personnel444
11.9Total personnel compensation525253
12.1Civilian personnel benefits121212
12.2Military personnel benefits222
21.0Travel and transportation of persons222
23.1Rental payments to GSA777
23.3Communications, utilities, and miscellaneous charges111
24.0Printing and reproduction333
25.1Advisory and assistance services292927
25.2Other services from non-federal sources230230211
25.3Other goods and services from federal sources10410497
25.7Operation and maintenance of equipment111
41.0Grants, subsidies, and contributions3,0072,9882,970
42.0Insurance claims and indemnities111
99.0Direct obligations3,4513,4323,387
99.0Reimbursable obligations242242285
99.9Total new obligations3,6933,6743,672
Employment SummaryIdentification code 75–1362–0–1–5512010 actualCR2012 est.
1001Direct civilian full-time equivalent employment435436436
1101Direct military average strength employment475151
2001Reimbursable civilian full-time equivalent employment383845
2101Reimbursable military average strength employment171212
Agency for Healthcare Research and Quality Healthcare Research and Quality healthcare research and qualityFor carrying out titles III and IX of the Public Health Service Act ("PHS Act''), part A of title XI of the Social Security Act, and section 1013 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, $366,397,000 shall be available from amounts available under section 241 of the PHS Act, notwithstanding subsection 947(c) of such Act: Provided, That, in addition, 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 937(c) of the PHS Act shall not exceed $610,912,000. Note.—A full-year 2011 appropriation for this account was not enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 111–242, as amended). The amounts included for 2011 reflect the annualized level provided by the continuing resolution.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. Program and Financing(in millions of dollars)Identification code 75–1700–0–1–5522010 actualCR2012 est.
Obligations by program activity:
0001Recovery Act693
0002Mandatory Appropriations: MIPPA2
0003Prevention and Public Health Fund5
0091Direct program activities, subtotal700
0801Reimbursable program212121
0802Reimbursable program: PHS evaluation397397366
0899Total reimbursable obligations418418387
0900Total new obligations1,118418387
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 170355
Budget authority:
Appropriations, mandatory:
1221Appropriations transferred from other accounts5
Spending authority from offsetting collections, discretionary:
1700Collected146418387
1701Change in uncollected payments, Federal sources269
1750Spending auth from offsetting collections, disc (total)415418387
1900Budget authority (total)420418387
1930Total budgetary resources available1,123423392
Memorandum (non-add) entries:
1941Unexpired unobligated balance, end of year555
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)4651,1651,063
3010Uncollected pymts, Fed sources, brought forward, Oct 1–370–451–451
3020Obligated balance, start of year (net)95714612
3030Obligations incurred, unexpired accounts1,118418387
3031Obligations incurred, expired accounts16
3040Outlays (gross)–428–520–676
3050Change in uncollected pymts, Fed sources, unexpired–269
3051Change in uncollected pymts, Fed sources, expired188
3081Recoveries of prior year unpaid obligations, expired–6
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)1,1651,063774
3091Uncollected pymts, Fed sources, end of year–451–451–451
3100Obligated balance, end of year (net)714612323
Budget authority and outlays, net:
Discretionary:
4000Budget authority, gross415418387
Outlays, gross:
4010Outlays from new discretionary authority127418387
4011Outlays from discretionary balances301100287
4020Outlays, gross (total)428518674
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030Federal sources–348–418–387
Additional offsets against gross budget authority only:
4050Change in uncollected pymts, Fed sources, unexpired–269
4052Offsetting collections credited to expired accounts202
4060Additional offsets against budget authority only (total)–67
4070Budget authority, net (discretionary)
4080Outlays, net (discretionary)80100287
Mandatory:
4090Budget authority, gross5
Outlays, gross:
4101Outlays from mandatory balances22
4180Budget authority, net (total)5
4190Outlays, net (total)80102289
Object Classification(in millions of dollars)Identification code 75–1700–0–1–5522010 actualCR2012 est.
Direct obligations:
Personnel compensation:
11.3Other than full-time permanent1
11.3Other than full-time permanent1
11.9Total personnel compensation2
12.1Civilian personnel benefits1
25.5Research and development contracts293
41.0Grants, subsidies, and contributions404
99.0Direct obligations700
99.0Reimbursable obligations418418387
99.9Total new obligations1,118418387
Employment SummaryIdentification code 75–1700–0–1–5522010 actualCR2012 est.
1001Direct civilian full-time equivalent employment12
2001Reimbursable civilian full-time equivalent employment286286290
2101Reimbursable military average strength employment141414
Centers for Medicare and Medicaid Services Grants to States for Medicaid grants to states for medicaidFor carrying out, except as otherwise provided, titles XI and XIX of the Social Security Act, $173,143,799,000$184,279,110,000, to remain available until expended.For making, after May 31, 20112012, payments to States or in the case of section 1928 on behalf of States under title XIX of the Social Security Act for the last quarter of fiscal year 20112012 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 20122013, $86,445,289,000$90,614,082,000, 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 full-year 2011 appropriation for this account was not enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 111–242, as amended). The amounts included for 2011 reflect the annualized level provided by the continuing resolution.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).Authorized as part of Title XIX, Vaccines for Children (VFC) finances the purchase of vaccines for low-income, eligible children. VFC is administered by the Centers for Disease Control and Prevention and is funded entirely by the Federal Government.Vaccines for Children(in millions of dollars)Obligations201020112012
Vaccine Purchase3,4583,6153,726
Vaccine Stockpile135138137
Ordering, Distribution, and Operations123109125
Vaccine Management Contract Support542
Evaluation Activities394041
Total Obligations3,7613,9064,031
Program and Financing(in millions of dollars)Identification code 75–0512–0–1–5512010 actualCR2012 est.
Obligations by program activity:
0001Medicaid vendor payments274,214262,368252,525
0002State and local administration11,97112,85612,808
0003Vaccines for Children3,7613,9064,031
0004Incurred by providers but not yet reported1,5391,360
0091Direct program activities, subtotal289,946280,669270,724
0801Medicare Part B premiums515630165
0900Total new obligations290,461281,299270,889
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 18,17917,006
1020Adjustment of unobligated bal brought forward, Oct 1–8,163
1021Recoveries of prior year unpaid obligations14,0172,880
1050Unobligated balance (total)14,03319,886
Budget authority:
Appropriations, mandatory:
1200Appropriation Medicaid220,962173,144184,280
1200Appropriation Medicaid, Indefinite850
1260Appropriations, mandatory (total)220,962173,994184,280
Advance appropriations, mandatory:
1270Advance appropriation71,70086,78986,445
Spending authority from offsetting collections, mandatory:
1800Collected772480165
1800Collected150
1850Spending auth from offsetting collections, mand (total)772630165
1900Budget authority (total)293,434261,413270,890
1930Total budgetary resources available307,467281,299270,890
Memorandum (non-add) entries:
1941Unexpired unobligated balance, end of year17,0061
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)25,49028,39129,931
3030Obligations incurred, unexpired accounts290,461281,299270,889
3040Outlays (gross)–273,543–276,879–269,530
3080Recoveries of prior year unpaid obligations, unexpired–14,017–2,880
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)28,39129,93131,290
Budget authority and outlays, net:
Mandatory:
4090Budget authority, gross293,434261,413270,890
Outlays, gross:
4100Outlays from new mandatory authority273,062259,873269,530
4101Outlays from mandatory balances48117,006
4110Outlays, gross (total)273,543276,879269,530
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120Federal sources–515–630–165
4123Non-Federal sources–257
4130Offsets against gross budget authority and outlays (total)–772–630–165
4160Budget authority, net (mandatory)292,662260,783270,725
4170Outlays, net (mandatory)272,771276,249269,365
4180Budget authority, net (total)292,662260,783270,725
4190Outlays, net (total)272,771276,249269,365
Summary of Budget Authority and Outlays(in millions of dollars)2010 actualCR2012 est.
Enacted/requested:
Budget Authority292,662260,783270,725
Outlays272,771276,249269,365
Legislative proposal, not subject to PAYGO:
Budget Authority–602
Outlays–602
Legislative proposal, subject to PAYGO:
Budget Authority305
Outlays305
Total:
Budget Authority292,662260,783270,428
Outlays272,771276,249269,068
Object Classification(in millions of dollars)Identification code 75–0512–0–1–5512010 actualCR2012 est.
41.0Direct obligations: Grants, subsidies, and contributions289,946280,669270,724
99.0Reimbursable obligations: reimbursable obligations515630165
99.9Total new obligations290,461281,299270,889
Legislative proposal, not subject to PAYGO Please see the narratives in the Limitation on Administrative Expenses and Health Care Fraud and Abuse Control accounts for a description of the program integrity proposals reflected here. Program and Financing(in millions of dollars)Identification code 75–0512–2–1–5512010 actualCR2012 est.
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200Appropriation Medicaid–107
1900Budget authority (total)–107
1930Total budgetary resources available–107
Change in obligated balance:
3040Outlays (gross)107
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)107
Budget authority and outlays, net:
Mandatory:
4090Budget authority, gross–107
Outlays, gross:
4100Outlays from new mandatory authority–107
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120Federal sources–495
4160Budget authority, net (mandatory)–602
4170Outlays, net (mandatory)–602
4180Budget authority, net (total)–602
4190Outlays, net (total)–602
Legislative proposal, subject to PAYGO This schedule reflects the Administration's Medicaid proposals.Program and Financing(in millions of dollars)Identification code 75–0512–4–1–5512010 actualCR2012 est.
Obligations by program activity:
0001Program Integrity–155
0003Other Proposals–35
0091Direct program activities, subtotal–190
0801Medicare Part B premiums495
0900Total new obligations305
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200Appropriation Medicaid–190
Spending authority from offsetting collections, mandatory:
1800Collected495
1900Budget authority (total)305
1930Total budgetary resources available305
Change in obligated balance:
3030Obligations incurred, unexpired accounts305
3040Outlays (gross)–305
Budget authority and outlays, net:
Mandatory:
4090Budget authority, gross305
Outlays, gross:
4100Outlays from new mandatory authority305
4180Budget authority, net (total)305
4190Outlays, net (total)305
Object Classification(in millions of dollars)Identification code 75–0512–4–1–5512010 actualCR2012 est.
41.0Direct obligations: Grants, subsidies, and contributions–190
99.0Reimbursable obligations: reimbursable obligations495
99.9Total new obligations305
State Grants and Demonstrations State Grants and Demonstrations includes funding for grant programs enacted in 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), the Deficit Reduction Act of 2005 (P.L. 109–171), the Children's Health Insurance Program Reauthorization Act of 2009 (P.L. 111–3), the Patient Protection and Affordable Care Act (P.L. 111–148), and the Health Care and Education Reconciliation Act of 2010 (P.L. 111–152).Program and Financing(in millions of dollars)Identification code 75–0516–0–1–5512010 actualCR2012 est.
Obligations by program activity:
0010Ticket to Work grants8270
0011Emergency health services for undocumented aliens1008053
0012Medicaid integrity program719277
0015Partnerships for long-term care333
0017Psychiatric residential treatment demonstration2860
0018Money follows the person (MFP) demonstration118175250
0019MFP evaluations and technical support211
0023Grants to improve outreach and enrollment124937
0024PPS for FQHCs and rural health clinics23
0025Medicaid Emergency Psychiatric Demo1515
0026Incentives for Prevention of Chronic Diseases in Medicaid2020
0900Total new obligations418568456
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 19821,2071,261
1021Recoveries of prior year unpaid obligations36
1029Other balances withdrawn–92
1050Unobligated balance (total)1,0181,1151,261
Budget authority:
Appropriations, mandatory:
1200Appropriation (Ticket to Work)4647
1200Appropriation (Drug surveys and reports)5
1200Appropriation (Expansion of long-term care partnerships)333
1200Appropriation (Psychiatric residential treatment demonstration)5357
1200Appropriation (Money follows the person (MFP) demonstration)399449449
1200Appropriation (MFP research & evaluation)111
1200Appropriation (Medicaid integrity program)757677
1200Appropriation (Grants to improve outreach and enrollment)40
1200Appropriation (Medicaid Emergency Psychiatric Demo)75
1200Appropriation (Incentives for Prevention of Chronic Diseases in Medicaid)100
1260Appropriations, mandatory (total)622808530
1900Budget authority (total)622808530
1930Total budgetary resources available1,6401,9231,791
Memorandum (non-add) entries:
1940Unobligated balance expiring–15–94
1941Unexpired unobligated balance, end of year1,2071,2611,335
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)892738691
3030Obligations incurred, unexpired accounts418568456
3040Outlays (gross)–531–615–518
3080Recoveries of prior year unpaid obligations, unexpired–36
3081Recoveries of prior year unpaid obligations, expired–5
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)738691629
Budget authority and outlays, net:
Mandatory:
4090Budget authority, gross622808530
Outlays, gross:
4100Outlays from new mandatory authority97128
4101Outlays from mandatory balances531518390
4110Outlays, gross (total)531615518
4180Budget authority, net (total)622808530
4190Outlays, net (total)531615518
Summary of Budget Authority and Outlays(in millions of dollars)2010 actualCR2012 est.
Enacted/requested:
Budget Authority622808530
Outlays531615518
Legislative proposal, subject to PAYGO:
Budget Authority20
Outlays20
Total:
Budget Authority622808550
Outlays531615538
Object Classification(in millions of dollars)Identification code 75–0516–0–1–5512010 actualCR2012 est.
Direct obligations:
11.1Personnel compensation: Full-time permanent-Medicaid Integrity Program899
12.1Civilian personnel benefits-Medicaid Integrity Program266
41.0Grants, subsidies, and contributions - Ticket to Work8270
41.0Grants, subsidies, and contributions - Fed'l Reimb. - Emer Svcs, Undoc. Aliens1008053
41.0Grants, subsidies, and contributions-Medicaid Integrity Program617762
41.0Grants, subsidies, and contributions-Partnership for long-term care33
41.0Grants, subsidies, and contributions-Psychiatric Residential Treatment Demonstration360
41.0Grants, subsidies, and contributions-Money follows the Person (MFP) Demonstration175250
41.0Grants, subsidies, and contributions-MFP Evaluations & Technical Support2811
41.0Grants, subsidies, and contributions-Grants to improve outreach and enrollment1304937
41.0Grants, subsidies, and contributions-Application of prospective payment system43
41.0Grants, subsidies, and contributions-Medicaid Emergency Psychiatric Demo1515
41.0Grants, subsidies, and contributions-Incentives for Prevention of Chronic Diseases in Medicaid2020
99.9Total new obligations418568456
Employment SummaryIdentification code 75–0516–0–1–5512010 actualCR2012 est.
1001Direct civilian full-time equivalent employment8694105
Legislative proposal, subject to PAYGO The President's Wireless Innovation and Infrastructure Initiative (WI3) proposes to reallocate a total of 500 megahertz of Federal agency and commercial spectrum bands over the next 10 years in order to increase Americans' access to wireless broadband. The auctions of reallocated spectrum licenses are expected to raise more than $27 billion by 2021. Repurposing spectrum will greatly facilitate access for smart phones, portable computers, and innovative technologies that are on the horizon. This effort will also enhance America's public safety, infrastructure, and competitiveness by investing some of the expected receipts in the creation of a broadband network for public safety, expanding access to wireless broadband in rural America, and a Wireless Innovation (WIN) Fund to help develop cutting edge wireless technologies. As part of this initiative, the Centers for Medicare & Medicaid Services will participate in the WIN Fund by providing $100 million in grants that increase and improve use of wireless technologies in health care, for example, for health software applications and telemedicine, with special emphasis on technologies used in conjunction with innovative delivery systems.Program and Financing(in millions of dollars)Identification code 75–0516–4–1–5512010 actualCR2012 est.
Obligations by program activity:
0027Wireless Innovation Fund20
0900Total new obligations (object class 41.0)20
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200Wireless Innovation Fund20
1930Total budgetary resources available20
Change in obligated balance:
3030Obligations incurred, unexpired accounts20
3040Outlays (gross)–20
Budget authority and outlays, net:
Mandatory:
4090Budget authority, gross20
Outlays, gross:
4100Outlays from new mandatory authority20
4180Budget authority, net (total)20
4190Outlays, net (total)20
Payments to Health Care Trust Funds payments to health care trust fundsFor payment to the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund, as provided under sections 217(g), 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, $229,664,000,000$231,012,000,000.In addition, for making matching payments under section 1844, and benefit payments under section 1860D-16 of the Social Security Act, not anticipated in budget estimates, such sums as may be necessary.Note.—A full-year 2011 appropriation for this account was not enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 111–242, as amended). The amounts included for 2011 reflect the annualized level provided by the continuing resolution.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. Program and Financing(in millions of dollars)Identification code 75–0580–0–1–5712010 actualCR2012 est.
Obligations by program activity:
0001Federal contribution to match premiums (SMI)161,109165,338178,041
0002Part D benefits (Rx Drug)52,34155,54851,431
0003Part D Federal administration (Rx Drug)300404475
0004General Fund Transfers to HI598151,065
0006Federal Bureau of Investigation (HCFAC)126128130
0007Federal payments from taxation of OASDI benefits (HI)13,76014,87415,303
0008Criminal fines (HCFAC)1,206217221
0009Civil monetary penalties and damages (HCFAC - DOJ and CMS administration)191616
0900Total new obligations228,920237,340246,682
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200Appropriation (definite, annual)207,286222,105231,012
1200Appropriation (indefinite, annual)8,100
1200Appropriation (indefinite, permanent)13,76115,10715,540
1200Appropriation (HCFAC for FBI)126128130
1200Appropriation (indefinite for HCFAC)1,224
1260Appropriations, mandatory (total)230,497237,340246,682
1930Total budgetary resources available230,497237,340246,682
Memorandum (non-add) entries:
1940Unobligated balance expiring–1,577
Change in obligated balance:
3030Obligations incurred, unexpired accounts228,920237,340246,682
3040Outlays (gross)–228,920–237,340–246,682
Budget authority and outlays, net:
Mandatory:
4090Budget authority, gross230,497237,340246,682
Outlays, gross:
4100Outlays from new mandatory authority228,920237,340246,682
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120Federal sources–42
Additional offsets against gross budget authority only:
4142Offsetting collections credited to expired accounts42
4160Budget authority, net (mandatory)230,497237,340246,682
4170Outlays, net (mandatory)228,878237,340246,682
4180Budget authority, net (total)230,497237,340246,682
4190Outlays, net (total)228,878237,340246,682
Summary of Budget Authority and Outlays(in millions of dollars)2010 actualCR2012 est.
Enacted/requested:
Budget Authority230,497237,340246,682
Outlays228,878237,340246,682
Legislative proposal, not subject to PAYGO:
Budget Authority–417
Outlays–417
Total:
Budget Authority230,497237,340246,265
Outlays228,878237,340246,265
Object Classification(in millions of dollars)Identification code 75–0580–0–1–5712010 actualCR2012 est.
Direct obligations:
41.0Grants, subsidies, and contributions228,419236,432245,723
42.0Insurance claims and indemnities275262
94.0Financial transfers (Federal admin)501633697
99.0Direct obligations228,920237,340246,682
99.9Total new obligations228,920237,340246,682
Legislative proposal, not subject to PAYGO Program and Financing(in millions of dollars)Identification code 75–0580–2–1–5712010 actualCR2012 est.
Obligations by program activity:
0001Federal contribution to match premiums (SMI)–32
0002Part D benefits (Rx Drug)–385
0900Total new obligations (object class 41.0)–417
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200Appropriation (definite, annual)–417
1930Total budgetary resources available–417
Change in obligated balance:
3030Obligations incurred, unexpired accounts–417
3040Outlays (gross)417
Budget authority and outlays, net:
Mandatory:
4090Budget authority, gross–417
Outlays, gross:
4100Outlays from new mandatory authority–417
4180Budget authority, net (total)–417
4190Outlays, net (total)–417
Quality Improvements Organizations program managementFor carrying out, except as otherwise provided, titles XI, XVIII, XIX, and XXI of the Social Security Act,; titles XIII and XXVII of the Public Health Service Act ("PHS Act''),; the Patient Protection and Affordable Care Act; and the Clinical Laboratory Improvement Amendments of 1988, not to exceed $3,601,147,000$4,396,973,000, to be transferred from the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund, as authorized by section 201(g) of the Social Security Act; together with all funds collected in accordance with section 353 of the PHS Act and section 1857(e)(2) of the Social Security Act, funds retained by the Secretary of Health and Human Services pursuant to section 302 of the Tax Relief and Health Care Act of 2006, funds retained by the Secretary pursuant to the Patient Protection and Affordable Care Act;, and such sums as may be collected from authorized user fees and the sale of data, which shall be credited to this account and remain available until expended: Provided, That all funds derived in accordance with 31 U.S.C. 9701 from organizations established under title XIII of the PHS Act shall be credited to and available for carrying out the purposes of this appropriation: Provided further, That $37,687,000$34,000,000, to remain available through September 30, 2012 2013, shall be for contract costs for the Healthcare Integrated General Ledger Accounting System: the Centers for Medicare and Medicaid Service's Health Care Data Improvement Initiative: Provided further, That the Secretary is directed to collect fees in fiscal year 20112012 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 full-year 2011 appropriation for this account was not enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 111–242, as amended). The amounts included for 2011 reflect the annualized level provided by the continuing resolution. Note.—A full-year 2011 appropriation for this account was not enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 111–242, as amended). The amounts included for 2011 reflect the annualized level provided by the continuing resolution.Program management activities include funding for research, program operations, survey and certification, Clinical Laboratory Improvement Amendments (CLIA), Medicare Advantage, Medicare Part D coordination of benefits, recovery audit contracts and administrative costs, and include costs attributable to the Affordable Care Act.Program and Financing(in millions of dollars)Identification code 75–0511–0–1–5502010 actualCR2012 est.
Obligations by program activity:
0001Program operations2,4042,6893,245
0002Federal administration697767925
0003State survey and certification366469417
0004Research, demonstrations, and evaluation projects3960290
0006High-risk pool grants555544
0007ARRA Medicare/Medicaid HIT88191201
0008Consumer Assistance Grants129
0091Direct program activities, subtotal3,6504,8024,922
0100Total direct program3,6504,8024,922
0801Clinical laboratory improvement amendments544343
0802Sale of data822
0803Coordination of benefits425259
0804Medicare advantage/Prescription drug plan717372
0805Recovery audit contractors26259500
0806Other reimbursables29
0809Reimbursable program activities, subtotal230429676
0899Total reimbursable obligations230429676
0900Total new obligations3,8805,2315,598
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 1492849483
1021Recoveries of prior year unpaid obligations19
1050Unobligated balance (total)511849483
Budget authority:
Appropriations, mandatory:
1200Appropriation392403253
Spending authority from offsetting collections, discretionary:
1700Collected2,0703,8995,073
1701Change in uncollected payments, Federal sources1,587
1750Spending auth from offsetting collections, disc (total)3,6573,8995,073
Spending authority from offsetting collections, mandatory:
1800Collected856364
1801Change in uncollected payments, Federal sources177
1850Spending auth from offsetting collections, mand (total)18556364
1900Budget authority (total)4,2344,8655,390
1930Total budgetary resources available4,7455,7145,873
Memorandum (non-add) entries:
1940Unobligated balance expiring–16
1941Unexpired unobligated balance, end of year849483275
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)2,1822,4812,346
3010Uncollected pymts, Fed sources, brought forward, Oct 1–2,449–2,866–2,866
3020Obligated balance, start of year (net)–267–385–520
3030Obligations incurred, unexpired accounts3,8805,2315,598
3031Obligations incurred, expired accounts93
3040Outlays (gross)–3,430–5,366–5,617
3050Change in uncollected pymts, Fed sources, unexpired–1,764
3051Change in uncollected pymts, Fed sources, expired1,347
3080Recoveries of prior year unpaid obligations, unexpired–19
3081Recoveries of prior year unpaid obligations, expired–225
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)2,4812,3462,327
3091Uncollected pymts, Fed sources, end of year–2,866–2,866–2,866
3100Obligated balance, end of year (net)–385–520–539
Budget authority and outlays, net:
Discretionary:
4000Budget authority, gross3,6573,8995,073
Outlays, gross:
4010Outlays from new discretionary authority1,8863,8995,073
4011Outlays from discretionary balances1,3772
4020Outlays, gross (total)3,2633,9015,073
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030Federal sources–3,148–3,470–4,397
4033Non-Federal sources–189–429–676
4040Offsets against gross budget authority and outlays (total)–3,337–3,899–5,073
Additional offsets against gross budget authority only:
4050Change in uncollected pymts, Fed sources, unexpired–1,587
4052Offsetting collections credited to expired accounts1,267
4060Additional offsets against budget authority only (total)–320
4070Budget authority, net (discretionary)
4080Outlays, net (discretionary)–742
Mandatory:
4090Budget authority, gross577966317
Outlays, gross:
4100Outlays from new mandatory authority3649191
4101Outlays from mandatory balances164816353
4110Outlays, gross (total)1671,465544
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120Federal sources–18–563–64
Additional offsets against gross budget authority only:
4140Change in uncollected pymts, Fed sources, unexpired–177
4142Offsetting collections credited to expired accounts10
4150Additional offsets against budget authority only (total)–167
4160Budget authority, net (mandatory)392403253
4170Outlays, net (mandatory)149902480
4180Budget authority, net (total)392403253
4190Outlays, net (total)75904480
Object Classification(in millions of dollars)Identification code 75–0511–0–1–5502010 actualCR2012 est.
Direct obligations:
Personnel compensation:
11.1Full-time permanent407429515
11.3Other than full-time permanent141414
11.5Other personnel compensation91011
11.7Military personnel91012
11.9Total personnel compensation439463552
12.1Civilian personnel benefits112114141
12.2Military personnel benefits556
21.0Travel and transportation of persons91013
22.0Transportation of things1
23.1Rental payments to GSA172535
23.3Communications, utilities, and miscellaneous charges615
24.0Printing and reproduction2733
25.1Advisory and assistance services24694210
25.2Other services from non-federal sources1,7031,9341,985
25.3Other goods and services from federal sources8567
25.5Research and development contracts41
25.6Medical care6101,4501,562
25.7Operation and maintenance of equipment14426
26.0Supplies and materials211
31.0Equipment14275
32.0Land and structures1111
41.0Grants, subsidies, and contributions13368690
99.0Direct obligations3,6494,8024,922
99.0Reimbursable obligations230429676
99.5Below reporting threshold1
99.9Total new obligations3,8805,2315,598
Employment SummaryIdentification code 75–0511–0–1–5502010 actualCR2012 est.
1001Direct civilian full-time equivalent employment4,0814,3024,985
1101Direct military average strength employment103109129
2001Reimbursable civilian full-time equivalent employment106115118
Children's Health Insurance Fund The Balanced Budget Act of 1997 established the Children's Health Insurance Program (CHIP) under Title XXI of the Social Security Act. Title XXI provides Federal matching funds to States to enable them to extend coverage to uninsured children from low-income families. States are able to use Title XXI funds for obtaining health benefit coverage for uninsured children through a separate CHIP program, a CHIP Medicaid expansion program, or a combination of both. The Children's Health Insurance Program Reauthorization Act of 2009 (P.L. 111–3) reauthorized the CHIP program through FY 2013 and made some modifications to the program including increased funding for States and territories, bonus payments for States that exceed enrollment targets, and support for child health quality and outreach activities. A contingency fund to assist States who project spending above their available allocated CHIP funds was also created by CHIPRA and funding is included in a separate account. The Patient Protection and Affordable Care Act of 2010 (P.L. 111–148) extended funding for CHIP, providing appropriations through FY 2015.Program and Financing(in millions of dollars)Identification code 75–0515–0–1–5512010 actualCR2012 est.
Obligations by program activity:
0001Grants to States and U.S. Territories10,6018,4768,476
0002Performance Bonus Payment75206130
0003Child Health Quality Improvement414851
0900Total new obligations (object class 41.0)10,7178,7308,657
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 13,3904,3309,104
1012Expired unobligated bal transferred to unexpired accts1,092
1050Unobligated balance (total)4,4824,3309,104
Budget authority:
Appropriations, mandatory:
1200Appropriation12,52013,45914,982
1200Appropriation454545
1220Appropriations transferred to other accounts–2
1260Appropriations, mandatory (total)12,56313,50415,027
1930Total budgetary resources available17,04517,83424,131
Memorandum (non-add) entries:
1940Unobligated balance expiring–1,998
1941Unexpired unobligated balance, end of year4,3309,10415,474
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)5,4458,1957,856
3030Obligations incurred, unexpired accounts10,7178,7308,657
3031Obligations incurred, expired accounts4
3040Outlays (gross)–7,887–9,069–9,781
3081Recoveries of prior year unpaid obligations, expired–84
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)8,1957,8566,732
Budget authority and outlays, net:
Mandatory:
4090Budget authority, gross12,56313,50415,027
Outlays, gross:
4100Outlays from new mandatory authority3,7134,2414,445
4101Outlays from mandatory balances4,1744,8285,336
4110Outlays, gross (total)7,8879,0699,781
4180Budget authority, net (total)12,56313,50415,027
4190Outlays, net (total)7,8879,0699,781
Center for Medicare and Medicaid Innovation Program and Financing(in millions of dollars)Identification code 75–0522–0–1–5512010 actualCR2012 est.
Obligations by program activity:
0001Administration3347
0002Innovation Activities780965
0900Total new obligations8131,012
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 159,192
Budget authority:
Appropriations, mandatory:
1200Appropriation510,000
1930Total budgetary resources available510,0059,192
Memorandum (non-add) entries:
1941Unexpired unobligated balance, end of year59,1928,180
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)267
3030Obligations incurred, unexpired accounts8131,012
3040Outlays (gross)–546–801
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)267478
Budget authority and outlays, net:
Mandatory:
4090Budget authority, gross510,000
Outlays, gross:
4100Outlays from new mandatory authority543
4101Outlays from mandatory balances3801
4110Outlays, gross (total)546801
4180Budget authority, net (total)510,000
4190Outlays, net (total)546801
Object Classification(in millions of dollars)Identification code 75–0522–0–1–5512010 actualCR2012 est.
Direct obligations:
11.1Personnel compensation: Full-time permanent911
12.1Civilian personnel benefits23
42.0Insurance claims and indemnities769951
94.0Financial transfers3347
99.9Total new obligations8131,012
Employment SummaryIdentification code 75–0522–0–1–5512010 actualCR2012 est.
1001Direct civilian full-time equivalent employment481100
Child Enrollment Contingency Fund The Children's Health Insurance Program Reauthorization Act (CHIPRA) of 2009 established the Child Enrollment Contingency Fund under Title XXI. Beginning in FY 2009, a State may qualify for a contingency fund payment if it projects a funding shortfall for the fiscal year and if its average monthly child enrollment exceeds its target average number of enrollees for the fiscal year. The Patient Protection and Affordable Care Act of 2010 extended the contingency fund through FY 2015.The fund received an initial appropriation equal to 20 percent of the FY 2009 national allotment ($2.1 billion). In fiscal years 2010 through 2015, the statute appropriates the amount necessary to make payments to eligible States, but not to exceed 20 percent of the total annual appropriation for CHIP allotments to States. Any amounts in excess of this aggregate cap will be made available for CHIP performance bonus payments. The contingency fund will be invested in interest bearing securities of the United States, and the income derived from these investments constitutes a part of the fund. Special and Trust Fund Receipts(in millions of dollars)Identification code 75–5551–0–2–5512010 actualCR2012 est.
0100Balance, start of year
Receipts:
0240Interest, Child Enrollment Contingency Fund1416
0400Total: Balances and collections1416
Appropriations:
0500Child Enrollment Contingency Fund–1–4–16
0799Balance, end of year
Program and Financing(in millions of dollars)Identification code 75–5551–0–2–5512010 actualCR2012 est.
Obligations by program activity:
0001Grants to States and US Territories100200
0900Total new obligations (object class 41.0)100200
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 12,1132,1142,018
Budget authority:
Appropriations, mandatory:
1201Appropriation (special fund)1416
1930Total budgetary resources available2,1142,1182,034
Memorandum (non-add) entries:
1941Unexpired unobligated balance, end of year2,1142,0181,834
Change in obligated balance:
3030Obligations incurred, unexpired accounts100200
3040Outlays (gross)–100–200
Budget authority and outlays, net:
Mandatory:
4090Budget authority, gross1416
Outlays, gross:
4101Outlays from mandatory balances100200
4180Budget authority, net (total)1416
4190Outlays, net (total)100200
Memorandum (non-add) entries:
5000Total investments, SOY: Federal securities: Par value2,1142,1192,018
5001Total investments, EOY: Federal securities: Par value2,1192,0181,834
Medicare Advantage Stabilization Fund The Medicare Advantage (MA) Regional Stabilization Fund was repealed under the Affordable Care Act.Program and Financing(in millions of dollars)Identification code 75–0520–0–1–5712010 actualCR2012 est.
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 1108
Budget authority:
Spending authority from offsetting collections, mandatory:
1801Change in uncollected payments, Federal sources–108
1930Total budgetary resources available
Memorandum (non-add) entries:
1941Unexpired unobligated balance, end of year
Change in obligated balance:
Obligated balance, start of year (net):
3010Uncollected pymts, Fed sources, brought forward, Oct 1–108
3050Change in uncollected pymts, Fed sources, unexpired108
Budget authority and outlays, net:
Mandatory:
4090Budget authority, gross–108
Additional offsets against gross budget authority only:
4140Change in uncollected pymts, Fed sources, unexpired108
4160Budget authority, net (mandatory)
4180Budget authority, net (total)
4190Outlays, net (total)
Medicare Health Information Technology Incentive Payments, Recovery Act Program and Financing(in millions of dollars)Identification code 75–0508–0–1–5512010 actualCR2012 est.
Obligations by program activity:
0801Reimbursable program activity (Incentive Payments to Hospitals)4501,860
0802Reimbursable program activity Incentive Payments to Eligible Providers)190970
0900Total new obligations (object class 42.0)6402,830
Budgetary Resources:
Budget authority:
Spending authority from offsetting collections, mandatory:
1800Collected4501,860
1800Collected190970
1850Spending auth from offsetting collections, mand (total)6402,830
1930Total budgetary resources available6402,830
Change in obligated balance:
3030Obligations incurred, unexpired accounts6402,830
3040Outlays (gross)–640–2,830
Budget authority and outlays, net:
Mandatory:
4090Budget authority, gross6402,830
Outlays, gross:
4100Outlays from new mandatory authority6402,830
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120Federal sources–640–2,830
4160Budget authority, net (mandatory)
4170Outlays, net (mandatory)
4180Budget authority, net (total)
4190Outlays, net (total)
Grants to States for Premium Review The Affordable Care Act (P.L. 111–148) amends Section 2794 of the Public Health Service Act and provides that the Secretary shall carry out a program to award grants to States for a five year period beginning in fiscal year 2010. The Grants to States for Health Insurance Premium Review program will allow States to improve the oversight of proposed health insurance premium increases and provide the Secretary with trend information about premium increases in health insurance coverage. The program provides $250,000,000 over the five year period beginning with fiscal year 2010, and States may receive no less than $1,000,000 and no more than $5,000,000 in any one grant year.Program and Financing(in millions of dollars)Identification code 75–0112–0–1–5512010 actualCR2012 est.
Obligations by program activity:
0001Direct program activity465651
0900Total new obligations (object class 41.0)465651
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 1204148
Budget authority:
Appropriations, mandatory:
1200Appropriation250
1930Total budgetary resources available250204148
Memorandum (non-add) entries:
1941Unexpired unobligated balance, end of year20414897
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)4631
3030Obligations incurred, unexpired accounts465651
3040Outlays (gross)–71–66
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)463116
Budget authority and outlays, net:
Mandatory:
4090Budget authority, gross250
Outlays, gross:
4101Outlays from mandatory balances7166
4180Budget authority, net (total)250
4190Outlays, net (total)7166
Temporary High Risk Health Insurance Pool Program This account funds the Pre-Existing Condition Insurance Plan Program (PCIP), which makes health insurance available to people who have been unable to get insurance due to a pre-existing condition. Enrollees pay cost-sharing and monthly premiums similar to those charged in the commercial individual market, and the Federal government pays for remaining costs that exceed enrollee contributions. The budget authority for this program, including operating costs, is provided by the Affordable Care Act (P.L. 111–148).Program and Financing(in millions of dollars)Identification code 75–0113–0–1–5512010 actualCR2012 est.
Obligations by program activity:
0001Direct program activity2221,4301,561
0801Reimbursable program activity41122
0900Total new obligations2221,4711,683
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 14,7783,348
Budget authority:
Appropriations, mandatory:
1200Appropriation5,000
Spending authority from offsetting collections, mandatory:
1800Collected41122
1900Budget authority (total)5,00041122
1930Total budgetary resources available5,0004,8193,470
Memorandum (non-add) entries:
1941Unexpired unobligated balance, end of year4,7783,3481,787
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)218218
3030Obligations incurred, unexpired accounts2221,4711,683
3040Outlays (gross)–4–1,471–1,684
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)218218217
Budget authority and outlays, net:
Mandatory:
4090Budget authority, gross5,00041122
Outlays, gross:
4100Outlays from new mandatory authority441122
4101Outlays from mandatory balances1,4301,562
4110Outlays, gross (total)41,4711,684
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123Non-Federal sources–41–122
4160Budget authority, net (mandatory)5,000
4170Outlays, net (mandatory)41,4301,562
4180Budget authority, net (total)5,000
4190Outlays, net (total)41,4301,562
Object Classification(in millions of dollars)Identification code 75–0113–0–1–5512010 actualCR2012 est.
Direct obligations:
11.1Personnel compensation: Full-time permanent33
12.1Civilian personnel benefits11
25.2Other services from non-federal sources2225046
25.3Other goods and services from federal sources5353
41.0Grants, subsidies, and contributions1,3221,457
99.0Direct obligations2221,4291,560
99.0Reimbursable obligations41122
99.5Below reporting threshold11
99.9Total new obligations2221,4711,683
Employment SummaryIdentification code 75–0113–0–1–5512010 actualCR2012 est.
1001Direct civilian full-time equivalent employment12933
Temporary Reinsurance Program The Affordable Care Act (P.L. 111–148) authorized and appropritated $5 billion for the Early Retiree Reinsurance Program (ERRP). ERRP provides reimbursement to participating sponsors of certified plans that provide health benefits to early retirees (ages 55–64), their spouses, and surviving spouses and dependents. Reimbursement is equal to 80 percent of the actual cost of health expenses paid for an individual between a cost threshold of $15,000 and cost limit of $90,000 beginning in 2010. The cost threshold and cost limit will be adjusted for inflation in future years by the consumer price index. Savings to sponsors shall be used to reduce employer health care costs, provide premium and cost sharing relief to workers and families, or both. Program and Financing(in millions of dollars)Identification code 75–0114–0–1–5512010 actualCR2012 est.
Obligations by program activity:
0001Direct program activity363,5681,376
0002Direct program activity590
0900Total new obligations6263,5681,376
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 14,3741,396
1020Adjustment of unobligated bal brought forward, Oct 1590
1050Unobligated balance (total)4,9641,396
Budget authority:
Appropriations, mandatory:
1200Appropriation5,000
1930Total budgetary resources available5,0004,9641,396
Memorandum (non-add) entries:
1941Unexpired unobligated balance, end of year4,3741,39620
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)62519
3001Adjustments to unpaid obligations, brought forward, Oct 1–590
3020Obligated balance, start of year (net)3519
3030Obligations incurred, unexpired accounts6263,5681,376
3040Outlays (gross)–1–3,584–1,386
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)625199
Budget authority and outlays, net:
Mandatory:
4090Budget authority, gross5,000
Outlays, gross:
4100Outlays from new mandatory authority1
4101Outlays from mandatory balances3,5841,386
4110Outlays, gross (total)13,5841,386
4180Budget authority, net (total)5,000
4190Outlays, net (total)13,5841,386
Object Classification(in millions of dollars)Identification code 75–0114–0–1–5512010 actualCR2012 est.
Direct obligations:
11.1Personnel compensation: Full-time permanent11
25.2Other services from non-federal sources363732
42.0Insurance claims and indemnities5903,5301,342
99.0Direct obligations6263,5681,375
99.5Below reporting threshold1
99.9Total new obligations6263,5681,376
Employment SummaryIdentification code 75–0114–0–1–5512010 actualCR2012 est.
1001Direct civilian full-time equivalent employment811
American Health Benefit Exchange Program The American Health Benefit Exchange Program, commonly known as the Health Insurance Exchanges, provides funding for Planning and Establishment Grants to implement State Exchanges. The Exchanges will facilitate the purchase of qualified health plans in the individual market and provide for the establishment of a Small Business Health Options Program to allow small businesses to offer qualified health plans to their employees. Section 1311 of the Affordable Care Act (P.L. 111–148) provides amounts necessary to enable the Secretary to award grants to States beginning no later than March 23, 2011, and funds grants through January 1, 2015, at which time the Exchanges are to be self-sustaining.Program and Financing(in millions of dollars)Identification code 75–0115–0–1–5512010 actualCR2012 est.
Obligations by program activity:
0001Direct program activity49201400
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200Appropriation49201400
1930Total budgetary resources available49201400
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)48
3030Obligations incurred, unexpired accounts49201400
3040Outlays (gross)–1–249–400
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)48
Budget authority and outlays, net:
Mandatory:
4090Budget authority, gross49201400
Outlays, gross:
4100Outlays from new mandatory authority1201400
4101Outlays from mandatory balances48
4110Outlays, gross (total)1249400
4180Budget authority, net (total)49201400
4190Outlays, net (total)1249400
Object Classification(in millions of dollars)Identification code 75–0115–0–1–5512010 actualCR2012 est.
Direct obligations:
11.1Personnel compensation: Full-time permanent67
12.1Civilian personnel benefits22
41.0Grants, subsidies, and contributions49190388
99.0Direct obligations49198397
99.5Below reporting threshold33
99.9Total new obligations49201400
Employment SummaryIdentification code 75–0115–0–1–5512010 actualCR2012 est.
1001Direct civilian full-time equivalent employment16570
Reduced Cost Sharing for Individuals Enrolling in Qualified Health Plans Reinsurance and Risk Adjustment Program Payments Consumer Operated and Oriented Plan Program Account The Consumer Operated and Oriented Plan (CO-OP) Program was authorized in Section 1322 of the Affordable Care Act (P.L. 111–148). The CO-OP Program fosters the creation of qualified nonprofit health insurance issuers that operate with a strong consumer focus to offer qualified health plans in the individual and small group markets in the States. The Secretary shall award to qualified nonprofit issuers loans for start-up costs and grants to enable qualified issuers to meet state solvency requirements. The Secretary may also award grants for the purposes of encouraging the establishment of CO-OPs in states where no issuer applies to be a qualified nonprofit issuer under Section 1322. $6 billion has been appropriated to carry out Section 1322 of the Affordable Care Act. As required by the Federal Credit Reform Act of 1990, this account records, for this program, the subsidy costs associated with CO-OP Program grants and loans, as well as administrative expenses of this program. The subsidy amounts are estimated on a present value basis; the administrative expenses are estimated on a cash basis. Program and Financing(in millions of dollars)Identification code 75–0118–0–1–5512010 actualCR2012 est.
Obligations by program activity:
Credit program obligations:
0701Direct loan subsidy376
0709Administrative expenses1012
0900Total new obligations10388
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 16,0005,990
Budget authority:
Appropriations, mandatory:
1200Appropriation6,000
1930Total budgetary resources available6,0006,0005,990
Memorandum (non-add) entries:
1941Unexpired unobligated balance, end of year6,0005,9905,602
Change in obligated balance:
3030Obligations incurred, unexpired accounts10388
3040Outlays (gross)–10–388
Budget authority and outlays, net:
Mandatory:
4090Budget authority, gross6,000
Outlays, gross:
4101Outlays from mandatory balances10388
4180Budget authority, net (total)6,000
4190Outlays, net (total)10388
Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program(in millions of dollars)Identification code 75–0118–0–1–5512010 actualCR2012 est.
Direct loan levels supportable by subsidy budget authority:
115002Startup Loans208
115003Solvency Grants382
115004Planning Grants3
115999Total direct loan levels593
Direct loan subsidy (in percent):
132002Startup Loans0.000.0060.00
132003Solvency Grants0.000.0065.00
132004Planning Grants0.000.00100.00
132999Weighted average subsidy rate0.000.0063.42
Direct loan subsidy budget authority:
133002Startup Loans125
133003Solvency Grants248
133004Planning Grants3
133999Total subsidy budget authority376
Direct loan subsidy outlays:
134002Startup Loans125
134003Solvency Grants248
134004Planning Grants3
134999Total subsidy outlays376
Administrative expense data:
3510Budget authority1012
3580Outlays from balances1012
Object Classification(in millions of dollars)Identification code 75–0118–0–1–5512010 actualCR2012 est.
Direct obligations:
11.1Personnel compensation: Full-time permanent1
25.2Other services from non-federal sources1011
41.0Grants, subsidies, and contributions376
99.0Direct obligations10388
99.9Total new obligations10388
Employment SummaryIdentification code 75–0118–0–1–5512010 actualCR2012 est.
1001Direct civilian full-time equivalent employment59
Consumer Operated and Oriented Plan Financing Account As required by the Federal Credit Reform Act of 1990, this non-budgetary account records all cash flows to and from the Government resulting from direct loans obligated in 1992 and beyond (including modifications of direct loans that resulted from obligations in any year). The amounts in this account are a means of financing and are not included in the budget totals.Program and Financing(in millions of dollars)Identification code 75–4418–0–3–5512010 actualCR2012 est.
Obligations by program activity:
Credit program obligations:
0710Direct loan obligations593
0713Payment of interest to Treasury4
0900Total new obligations597
Budgetary Resources:
Financing authority:
Borrowing authority, mandatory:
1400Borrowing authority221
Spending authority from offsetting collections, mandatory:
1800Collected376
1900Financing authority(total)597
1930Total budgetary resources available597
Change in obligated balance:
3030Obligations incurred, unexpired accounts597
3040Financing disbursements (gross)–597
Financing authority and disbursements, net:
Mandatory:
4090Financing authority, gross597
Financing disbursements:
4110Financing disbursements, gross597
Offsets against gross financing authority and disbursements:
Offsetting collections (collected) from:
4120Federal sources–376
4160Financing authority, net (mandatory)221
4170Financing disbursements, net (mandatory)221
4180Financing authority, net (total)221
4190Financing disbursements, net (total)221
Status of Direct Loans(in millions of dollars)Identification code 75–4418–0–3–5512010 actualCR2012 est.
Position with respect to appropriations act limitation on obligations:
1131Direct loan obligations exempt from limitation593
1150Total direct loan obligations593
Cumulative balance of direct loans outstanding:
1210Outstanding, start of year
1231Disbursements: Direct loan disbursements593
1251Repayments: Repayments and prepayments
1290Outstanding, end of year593
Federal Hospital Insurance Trust Fund 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. Special and Trust Fund Receipts(in millions of dollars)Identification code 75–8005–0–7–5712010 actualCR2012 est.
0100Balance, start of year285,374255,722215,933
Adjustments:
0191Adjustment - Treasury reconciliation19
0199Balance, start of year285,393255,722215,933
Receipts:
0200FHI Trust Fund, Transfers from General Fund (FICA Taxes)165,547173,902186,855
0201FHI Trust Fund, Transfers from General Fund (FICA Taxes) - legislative proposal subject to PAYGO2–308
0202FHI Trust Fund, Transfers from General Fund (FICA Taxes)1
0203FHI Trust Fund, Receipts from Railroad Retirement Board507480498
0204FHI Trust Fund, Transfers from General Fund (SECA Taxes)14,01412,81914,185
0205FHI Trust Fund, Civil Penalties and Damages612329336
0220FHI Trust Fund, Other Proprietary Interest from the Public22
0221FHI Trust Fund, Basic Premium, Medicare Advantage189204204
0222FHI Trust Fund, Medicare Refunds4,6385,5505,700
0223FHI Trust Fund, Premiums Collected for Uninsured Individuals not Otherwise Eligible3,3143,3523,448
0224FHI Trust Fund, Premiums Collected for Uninsured Individuals not Otherwise Eligible - legislative proposal subject to PAYGO–6
0240FHI Trust Fund, Federal Employer Contributions (FICA)3,2923,3873,361
0241FHI Trust Fund, Postal Service Employer Contributions (FICA)750646626
0242FHI Trust Fund, Interest Received by Trust Funds14,57613,01611,288
0243FHI Trust Fund, Interest Received by Trust Funds - legislative proposal not subject to PAYGO7
0244FHI Trust Fund, Taxation on OASDI Benefits13,76014,87415,303
0245FHI Trust Fund, Payment from the General Fund for Health Care Fraud and Abuse Control Account126128130
0246FHI Trust Fund, Transfers from General Fund (criminal Fines)1,206217221
0247FHI Trust Fund, Transfers from General Fund (civil Monetary Penalties)221617
0248FHI Trust Fund, Interest Payments by Railroad Retirement Board282525
0249FHI Trust Fund, Payments from the General Fund (uninsured and Program Management)608161,066
0299Total receipts and collections222,641229,765242,959
0400Total: Balances and collections508,034485,487458,892
Appropriations:
0500Federal Hospital Insurance Trust Fund–2,354–2,348–2,737
0501Federal Hospital Insurance Trust Fund–218,848–225,706–238,681
0502Federal Hospital Insurance Trust Fund–30,917–39,791–29,432
0503Federal Hospital Insurance Trust Fund - legislative proposal not subject to PAYGO–7
0504Federal Hospital Insurance Trust Fund - legislative proposal not subject to PAYGO7
0505Federal Hospital Insurance Trust Fund - legislative proposal subject to PAYGO6
0506Federal Hospital Insurance Trust Fund - legislative proposal subject to PAYGO314
0507Health Care Fraud and Abuse Control Account–311–311–581
0508Health Care Fraud and Abuse Control Account–1,173–1,398–1,272
0509Health Care Fraud and Abuse Control Account - legislative proposal not subject to PAYGO788
0599Total appropriations–253,603–269,554–271,595
0610Federal Hospital Insurance Trust Fund–4
0611Health Care Fraud and Abuse Control Account19
0620Federal Hospital Insurance Trust Fund22
0795Adjustment for outstanding reconciliation1,254
0799Balance, end of year255,722215,933187,297
Program and Financing(in millions of dollars)Identification code 75–8005–0–7–5712010 actualCR2012 est.
Obligations by program activity:
0001Benefit payments, HI250,084264,285265,616
0002HIT Incentive Payments4501,860
0003Administration, HI2,6402,7982,920
0004Quality improvement organizations, HI132312454
0091Direct program activities, subtotal252,856267,845270,850
0812Reimbursable program activity256
0900Total new obligations253,112267,845270,850
Budgetary Resources:
Unobligated balance:
1021Recoveries of prior year unpaid obligations755
1026Adjustment in unobligated balances for change in allocation–22
1029Other balances withdrawn4
1050Unobligated balance (total)737
Budget authority:
Appropriations, discretionary:
1102Appropriation (trust fund)2,3542,3482,737
Appropriations, mandatory:
1202Appropriation (trust fund)218,848225,706238,681
1203Appropriation (previously unavailable)30,91739,79129,432
1260Appropriations, mandatory (total)249,765265,497268,113
Spending authority from offsetting collections, mandatory:
1800Collected256
1900Budget authority (total)252,375267,845270,850
1930Total budgetary resources available253,112267,845270,850
Memorandum (non-add) entries:
1941Unexpired unobligated balance, end of year
Special and non-revolving trust funds:
1950Other balances withdrawn–4
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)23,76323,42323,689
3010Uncollected pymts, Fed sources, brought forward, Oct 1–1–1–1
3020Obligated balance, start of year (net)23,76223,42223,688
3030Obligations incurred, unexpired accounts253,112267,845270,850
3040Outlays (gross)–252,697–267,579–270,669
3080Recoveries of prior year unpaid obligations, unexpired–755
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)23,42323,68923,870
3091Uncollected pymts, Fed sources, end of year–1–1–1
3100Obligated balance, end of year (net)23,42223,68823,869
Budget authority and outlays, net:
Discretionary:
4000Budget authority, gross2,3542,3482,737
Outlays, gross:
4010Outlays from new discretionary authority1,4981,8442,127
4011Outlays from discretionary balances499462502
4020Outlays, gross (total)1,9972,3062,629
Mandatory:
4090Budget authority, gross250,021265,497268,113
Outlays, gross:
4100Outlays from new mandatory authority228,347242,753243,768
4101Outlays from mandatory balances22,35322,52024,272
4110Outlays, gross (total)250,700265,273268,040
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120Federal sources–256
4160Budget authority, net (mandatory)249,765265,497268,113
4170Outlays, net (mandatory)250,444265,273268,040
4180Budget authority, net (total)252,119267,845270,850
4190Outlays, net (total)252,441267,579270,669
Memorandum (non-add) entries:
5000Total investments, SOY: Federal securities: Par value309,702279,475239,694
5001Total investments, EOY: Federal securities: Par value279,475239,694209,819
Summary of Budget Authority and Outlays(in millions of dollars)2010 actualCR2012 est.
Enacted/requested:
Budget Authority252,119267,845270,850
Outlays252,441267,579270,669
Legislative proposal, subject to PAYGO:
Budget Authority–320
Outlays–320
Total:
Budget Authority252,119267,845270,530
Outlays252,441267,579270,349
Status of Funds(in millions of dollars)Identification code 75–8005–0–7–5712010 actualCR2012 est.
Unexpended balance, start of year:
0100Balance, start of year309,836280,119240,665
Adjustments:
0190To TCS22
0199Total balance, start of year309,858280,119240,665
Cash income during the year:
Current law:
Receipts:
1200FHI Trust Fund, Transfers from General Fund (FICA Taxes)165,547173,902186,855
1203FHI Trust Fund, Receipts from Railroad Retirement Board507480498
1204FHI Trust Fund, Transfers from General Fund (SECA Taxes)14,01412,81914,185
1205FHI Trust Fund, Civil Penalties and Damages612329336
Offsetting receipts (proprietary):
1220FHI Trust Fund, Other Proprietary Interest from the Public22
1221FHI Trust Fund, Basic Premium, Medicare Advantage189204204
1222FHI Trust Fund, Medicare Refunds4,6385,5505,700
1223FHI Trust Fund, Premiums Collected for Uninsured Individuals not3,3143,3523,448
Offsetting receipts (intragovernmental):
1240FHI Trust Fund, Federal Employer Contributions (FICA)3,2923,3873,361
1241FHI Trust Fund, Postal Service Employer Contributions (FICA)750646626
1242FHI Trust Fund, Interest Received by Trust Funds14,57613,01611,288
1244FHI Trust Fund, Taxation on OASDI Benefits13,76014,87415,303
1245FHI Trust Fund, Payment from the General Fund for Health Care Fr126128130
1246FHI Trust Fund, Transfers from General Fund (criminal Fines)1,206217221
1247FHI Trust Fund, Transfers from General Fund (civil Monetary Pena221617
1248FHI Trust Fund, Interest Payments by Railroad Retirement Board282525
1249FHI Trust Fund, Payments from the General Fund (uninsured and Pr608161,066
Offsetting collections:
1280Federal Hospital Insurance Trust Fund256
1299Income under present law222,897229,763243,265
Proposed legislation:
Receipts:
2201FHI Trust Fund, Transfers from General Fund (FICA Taxes)2–308
2202FHI Trust Fund, Transfers from General Fund (FICA Taxes)1
Offsetting receipts (proprietary receipts):
2224FHI Trust Fund, Premiums Collected for Uninsured Individuals not–6
Offsetting receipts (intragovernmental):
2243FHI Trust Fund, Interest Received by Trust Funds7
2299Income under proposed legislation2–306
3299Total cash income222,897229,765242,959
Cash outgo during year:
Current law:
4500Federal Hospital Insurance Trust Fund–252,697–267,579–270,669
4500Health Care Fraud and Abuse Control Account–1,193–1,640–1,875
4599Outgo under current law (-)–253,890–269,219–272,544
Proposed legislation:
5500Federal Hospital Insurance Trust Fund320
5500Health Care Fraud and Abuse Control Account788
5599Outgo under proposed legislation (-)1,108
6599Total cash outgo (-)–253,890–269,219–271,436
Manual Adjustments:
7690Manual Adjustments1,254
7699Total adjustments1,254
Unexpended balance, end of year:
8700Uninvested balance (net), end of year6449712,042
8701Federal Hospital Insurance Trust Fund279,475239,694209,819
8701Federal Hospital Insurance Trust Fund7
8701Federal Hospital Insurance Trust Fund320
8799Total balance, end of year280,119240,665212,188
Commitments against unexpended balance, end of year:
9899Total commitments (-)
Object Classification(in millions of dollars)Identification code 75–8005–0–7–5712010 actualCR2012 est.
Direct obligations:
41.0Payment for Quality Improvement Organization (QIO) activities132312454
42.0Insurance claims and indemnities (benefits)250,084264,735267,476
94.0Financial transfers2,6402,7982,920
99.0Direct obligations252,856267,845270,850
Allocation Account - reimbursable:
42.0Insurance claims and indemnities256
99.0Allocation account - reimbursable256
99.9Total new obligations253,112267,845270,850
Legislative proposal, not subject to PAYGO Program and Financing(in millions of dollars)Identification code 75–8005–2–7–5712010 actualCR2012 est.
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1202Appropriation (trust fund)7
1203Appropriation (previously unavailable)–7
1260Appropriations, mandatory (total)
1930Total budgetary resources available
Budget authority and outlays, net:
Mandatory:
4090Budget authority, gross
4180Budget authority, net (total)
4190Outlays, net (total)
Memorandum (non-add) entries:
5000Total investments, SOY: Federal securities: Par value
5001Total investments, EOY: Federal securities: Par value7
Legislative proposal, subject to PAYGO Program and Financing(in millions of dollars)Identification code 75–8005–4–7–5712010 actualCR2012 est.
Obligations by program activity:
0001Benefit payments, HI–320
0900Total new obligations (object class 42.0)–320
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1202Appropriation (trust fund)–6
1203Appropriation (previously unavailable)–314
1260Appropriations, mandatory (total)–320
1930Total budgetary resources available–320
Change in obligated balance:
3030Obligations incurred, unexpired accounts–320
3040Outlays (gross)320
Budget authority and outlays, net:
Mandatory:
4090Budget authority, gross–320
Outlays, gross:
4100Outlays from new mandatory authority–320
4180Budget authority, net (total)–320
4190Outlays, net (total)–320
Memorandum (non-add) entries:
5000Total investments, SOY: Federal securities: Par value
5001Total investments, EOY: Federal securities: Par value320
Health Care Fraud and Abuse Control Account Health Care Fraud and Abuse Control AccountIn addition to amounts otherwise available for program integrity and program management, $561,000,000$580,580,000, to remain available through September 30, 20122013, to be transferred from the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund, as authorized by section 201(g) of the Social Security Act, of which $376,167,000$389,938,260 shall be for Centers for Medicare and Medicaid Services Program Integrity Activities, including administrative costs, to conduct oversight activities for Medicare Advantage and the Medicare Prescription Drug Program authorized in title XVIII of the Social Security Act , for activities listed in section 1893 of such Act and for Medicaid and Children's Health Insurance Program ("CHIP") program integrity activities; of which $94,830,000$97,556,404 shall be for the Department of Health and Human Services Office of Inspector General to carry out fraud and abuse activities authorized by section 1817(k)(3) of such Act; and of which $90,003,000$93,085,336 shall be for the Department of Justice to carry out fraud and abuse activities authorized by section 1817(k)(3) of such Act: Provided, That the report required by section 1817(k)(5) of the Social Security Act for fiscal year 20112012 shall include measures of the operational efficiency and impact on fraud, waste, and abuse in the Medicare, Medicaid, and CHIP programs for the funds provided by this appropriation. Note.—A full-year 2011 appropriation for this account was not enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 111–242, as amended). The amounts included for 2011 reflect the annualized level provided by the continuing resolution.P.L. 104–191 established the Health Care Fraud and Abuse Control (HCFAC) account within the Federal Hospital Insurance Trust Fund and appropriated funds, 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 2012. As required by statute, actual 2012 agency distributions will be determined by the Secretary of HHS and the Attorney General consistent with the Administration's priorities.2010 actual2011 actual2012 est.
Department of Justice, DOJ556260
Office of the Inspector General, HHS177198194
Other specific HHS fraud and abuse projects343837
Total266298291
* Numbers may not add due to rounding.
The Budget includes a discretionary request for efforts to safeguard Medicare, Medicaid, and CHIP that will supplement the mandatory funds made available by P.L. 104–191. The 2012 discretionary investment is a part of a multi-year fraud and abuse proposal in the Budget; similar funding has been enacted for the past three years.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. 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 would be $581 million for 2012. See additional discussion in the Budget Process chapter in the Analytical Perspectives volume.The HCFAC entities will develop a comprehensive plan for Medicare, Medicaid and CHIP program integrity activities. The plan will indicate how program integrity appropriations from all sources will be allocated to address program integrity priorities. These priorities include reducing the improper payment rate, identifying and recouping excessive payments, pinpointing potential weaknesses in program integrity oversight, and establishing new processes and safeguards to correct programmatic vulnerabilities. Program and Financing(in millions of dollars)Identification code 75–8393–0–7–5712010 actualCR2012 est.
Obligations by program activity:
0001Medicare integrity program756872851
0002FBI fraud and abuse control133128130
0003Other fraud and abuse control275297291
0004Predictive Modeling4122
0091Total Mandatory1,1641,3381,294
0101CMS - Discretionary199251390
0102Other Discretionary6060191
0191Total Discretionary259311581
0900Total new obligations1,4231,6491,875
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 11065160
1021Recoveries of prior year unpaid obligations183525
1050Unobligated balance (total)28100185
Budget authority:
Appropriations, discretionary:
1102Appropriation (trust fund)311311581
Appropriations, mandatory:
1202Appropriation (trust fund)1,1731,3981,272
1900Budget authority (total)1,4841,7091,853
1930Total budgetary resources available1,5121,8092,038
Memorandum (non-add) entries:
1940Unobligated balance expiring–24
1941Unexpired unobligated balance, end of year65160163
Special and non-revolving trust funds:
1951Unobligated balance expiring24
1952Expired unobligated balance, start of year143636
1953Expired unobligated balance, end of year123636
1954Unobligated balance canceling19
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)679873847
3030Obligations incurred, unexpired accounts1,4231,6491,875
3031Obligations incurred, expired accounts9
3040Outlays (gross)–1,193–1,640–1,875
3080Recoveries of prior year unpaid obligations, unexpired–18–35–25
3081Recoveries of prior year unpaid obligations, expired–27
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)873847822
Budget authority and outlays, net:
Discretionary:
4000Budget authority, gross311311581
Outlays, gross:
4010Outlays from new discretionary authority37311581
4011Outlays from discretionary balances142
4020Outlays, gross (total)179311581
Mandatory:
4090Budget authority, gross1,1731,3981,272
Outlays, gross:
4100Outlays from new mandatory authority751956884
4101Outlays from mandatory balances263373410
4110Outlays, gross (total)1,0141,3291,294
4180Budget authority, net (total)1,4841,7091,853
4190Outlays, net (total)1,1931,6401,875
Summary of Budget Authority and Outlays(in millions of dollars)2010 actualCR2012 est.
Enacted/requested:
Budget Authority1,4841,7091,853
Outlays1,1931,6401,875
Legislative proposal, not subject to PAYGO:
Budget Authority–788
Outlays–788
Total:
Budget Authority1,4841,7091,065
Outlays1,1931,6401,087
Object Classification(in millions of dollars)Identification code 75–8393–0–7–5712010 actualCR2012 est.
Direct obligations:
11.1Personnel compensation: Full-time permanent (CMS)111114
12.1Civilian personnel benefits (CMS)222
23.3Communications, utilities, and miscellaneous charges222
25.1Advisory and assistance services(Predictive Modeling)4122
25.2Other services (CMS)131314
25.3Other purchases of goods and services from Government accounts (HHS/DOJ)8885154
25.3Other purchases of goods and services from Government accounts (HHS/OIG)217207291
25.3Other purchases of goods and services from Government accounts (HHS/AoA)4413
25.3Other purchases of goods and services from Government accounts (HHS/OGC)999
25.3Other goods and services from federal sources (Other HHS)3
25.3Other goods and services from Government accounts (HHS/FDA)22
25.3Other goods and services from Government accounts (HHS/ASPA)11
25.3Other goods and services from Government accounts (HHS/ASPE)11
25.6Medical care (CMS)9411,1431,220
94.0Financial transfers (FBI)133128130
99.9Total new obligations1,4231,6491,875
Employment SummaryIdentification code 75–8393–0–7–5712010 actualCR2012 est.
1001Direct civilian full-time equivalent employment106150175
Legislative proposal, not subject to PAYGO Program and Financing(in millions of dollars)Identification code 75–8393–2–7–5712010 actualCR2012 est.
Obligations by program activity:
0001Medicare integrity program–788
0900Total new obligations (object class 25.6)–788
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1202Appropriation (trust fund)–788
1930Total budgetary resources available–788
Change in obligated balance:
3030Obligations incurred, unexpired accounts–788
3040Outlays (gross)788
Budget authority and outlays, net:
Discretionary:
4000Budget authority, gross
Mandatory:
4090Budget authority, gross–788
Outlays, gross:
4100Outlays from new mandatory authority–788
4180Budget authority, net (total)–788
4190Outlays, net (total)–788
Federal Supplementary Medical Insurance Trust Fund 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 generally financed by premium payments from enrollees and contributions from the general revenues. The status of the trust fund is as follows. Special and Trust Fund Receipts(in millions of dollars)Identification code 75–8004–0–7–5712010 actualCR2012 est.
0100Balance, start of year34,24145,63038,055
Adjustments:
0191Adjustment - Treasury reconciliation28
0199Balance, start of year34,26945,63038,055
Receipts:
0200Fee on Branded Prescription Pharmaceutical Manufacturers and Importers, SMI2,2502,770
0220Other Proprietary Interest from the Public, FSMI Fund133
0221Premiums Collected for Medicare Prescription Drug Account, FSMI2,3632,8963,539
0222Premiums Collected for Medicare Prescription Drug Account, FSMI - legislative proposal subject to PAYGO–32
0223Payments from States, Medicare Prescription Drug Account, FSMI4,4936,8258,315
0224Payments from States, Medicare Prescription Drug Account, FSMI - legislative proposal subject to PAYGO–74
0225Basic Premium, Medicare Advantage, FSMI Trust Fund168200210
0226Medicare Refunds, SMI4,0634,1504,300
0227Premiums Collected for the Aged, FSMI Fund45,83247,29951,409
0228Premiums Collected for the Aged, FSMI Fund - legislative proposal subject to PAYGO–18
0229Premiums Collected for the Disabled, FSMI Fund8,9488,9799,940
0230Premiums Collected for the Disabled, FSMI Fund - legislative proposal subject to PAYGO–4
0240Federal Contributions, FSMI Fund161,110165,338178,041
0241Federal Contributions, FSMI Fund - legislative proposal not subject to PAYGO–32
0242Interest Received by Trust Fund, FSMI Fund2,9893,2773,683
0243Interest Received by Trust Fund, FSMI Fund - legislative proposal not subject to PAYGO–66–410
0244Interest, Medicare Prescription Drug Account, FSMI9711
0245Federal Contribution for Admin. Contribution for Admin. Costs, Prescription Drug Account, FSMI258404475
0246Federal Contributions for Benefits, Prescription Drug Account, SMI52,34155,54851,431
0247Federal Contributions for Benefits, Prescription Drug Account, SMI - legislative proposal not subject to PAYGO–385
0248Miscellaneous Federal Payments, Federal Supplementary Medical Insurance Trust Fund111
0299Total receipts and collections282,576297,111313,173
0400Total: Balances and collections316,845342,741351,228
Appropriations:
0500Federal Supplementary Medical Insurance Trust Fund–3,099–2,890–3,530
0501Federal Supplementary Medical Insurance Trust Fund–221,586–227,820–247,553
0502Federal Supplementary Medical Insurance Trust Fund–7,509
0503Federal Supplementary Medical Insurance Trust Fund11,24824,374
0504Federal Supplementary Medical Insurance Trust Fund - legislative proposal not subject to PAYGO4421,254
0505Federal Supplementary Medical Insurance Trust Fund - legislative proposal not subject to PAYGO–442–1,749
0506Federal Supplementary Medical Insurance Trust Fund - legislative proposal subject to PAYGO22
0507Federal Supplementary Medical Insurance Trust Fund - legislative proposal subject to PAYGO–18,272
0508Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund–482–385–476
0509Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund–57,491–66,082–62,569
0510Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund - legislative proposal subject to PAYGO489
0599Total appropriations–271,410–304,686–308,010
0610Federal Supplementary Medical Insurance Trust Fund–7
0611Transitional Drug Assistance, Federal Supplementary Medical Insurance Trust Fund30
0612Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund58
0620Federal Supplementary Medical Insurance Trust Fund73
0795Adjustment for outstanding reconciliation41
0799Balance, end of year45,63038,05543,218
Program and Financing(in millions of dollars)Identification code 75–8004–0–7–5712010 actualCR2012 est.
Obligations by program activity:
0001Benefit payments, SMI209,761234,229221,873
0002Transfer to Medicaid for payment of SMI premiums515630165
0003HIT Incentive Payments190970
0004Administration, SMI3,2223,0923,588
0005Quality Improvement Organizations, SMI3278113
0091Direct program activities, subtotal213,530238,219226,709
0801Reimbursable program activity23
0900Total new obligations213,553238,219226,709
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 1
1021Recoveries of prior year unpaid obligations159
1026Adjustment in unobligated balances for change in allocation–73
1029Other balances withdrawn7
1050Unobligated balance (total)93
Budget authority:
Appropriations, discretionary:
1102Appropriation (trust fund)3,0992,8903,530
Appropriations, mandatory:
1202Appropriation (trust fund)221,586227,820247,553
1203Appropriation (previously unavailable)7,509
1235Appropriations precluded from obligation–11,248–24,374
1260Appropriations, mandatory (total)210,338235,329223,179
Spending authority from offsetting collections, mandatory:
1800Collected23
1900Budget authority (total)213,460238,219226,709
1930Total budgetary resources available213,553238,219226,709
Memorandum (non-add) entries:
1941Unexpired unobligated balance, end of year
Special and non-revolving trust funds:
1950Other balances withdrawn–7
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)21,25622,18422,223
3030Obligations incurred, unexpired accounts213,553238,219226,709
3040Outlays (gross)–212,466–238,180–226,515
3080Recoveries of prior year unpaid obligations, unexpired–159
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)22,18422,22322,417
Budget authority and outlays, net:
Discretionary:
4000Budget authority, gross3,0992,8903,530
Outlays, gross:
4010Outlays from new discretionary authority1,7522,1622,555
4011Outlays from discretionary balances975754766
4020Outlays, gross (total)2,7272,9163,321
Mandatory:
4090Budget authority, gross210,361235,329223,179
Outlays, gross:
4100Outlays from new mandatory authority190,305214,571201,076
4101Outlays from mandatory balances19,43420,69322,118
4110Outlays, gross (total)209,739235,264223,194
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120Federal sources–23
4160Budget authority, net (mandatory)210,338235,329223,179
4170Outlays, net (mandatory)209,716235,264223,194
4180Budget authority, net (total)213,437238,219226,709
4190Outlays, net (total)212,443238,180226,515
Memorandum (non-add) entries:
5000Total investments, SOY: Federal securities: Par value61,76470,98263,581
5001Total investments, EOY: Federal securities: Par value70,98263,58169,306
Summary of Budget Authority and Outlays(in millions of dollars)2010 actualCR2012 est.
Enacted/requested:
Budget Authority213,437238,219226,709
Outlays212,443238,180226,515
Legislative proposal, not subject to PAYGO:
Budget Authority495
Outlays495
Legislative proposal, subject to PAYGO:
Budget Authority18,250
Outlays18,250
Total:
Budget Authority213,437238,219245,454
Outlays212,443238,180245,260
Status of Funds(in millions of dollars)Identification code 75–8004–0–7–5712010 actualCR2012 est.
Unexpended balance, start of year:
0100Balance, start of year61,40771,97764,512
0199Total balance, start of year61,40771,97764,512
Cash income during the year:
Current law:
Receipts:
1200Fee on Branded Prescription Pharmaceutical Manufacturers and Imp2,2502,770
Offsetting receipts (proprietary):
1220Other Proprietary Interest from the Public, FSMI Fund133
1221Premiums Collected for Medicare Prescription Drug Account, FSMI2,3632,8963,539
1223Payments from States, Medicare Prescription Drug Account, FSMI4,4936,8258,315
1225Basic Premium, Medicare Advantage, FSMI Trust Fund168200210
1226Medicare Refunds, SMI4,0634,1504,300
1227Premiums Collected for the Aged, FSMI Fund45,83247,29951,409
1229Premiums Collected for the Disabled, FSMI Fund8,9488,9799,940
Offsetting receipts (intragovernmental):
1240Federal Contributions, FSMI Fund161,110165,338178,041
1242Interest Received by Trust Fund, FSMI Fund2,9893,2773,683
1244Interest, Medicare Prescription Drug Account, FSMI9711
1245Federal Contribution for Admin. Contribution for Admin. Costs, P258404475
1246Federal Contributions for Benefits, Prescription Drug Account, S52,34155,54851,431
1248Miscellaneous Federal Payments, Federal Supplementary Medical in111
Offsetting collections:
1280Federal Supplementary Medical Insurance Trust Fund23
1281Medicare Prescription Drug Account, Federal Supplementary Insura468
1299Income under present law283,067297,177314,128
Proposed legislation:
Offsetting receipts (proprietary receipts):
2222Premiums Collected for Medicare Prescription Drug Account, FSMI–32
2224Payments from States, Medicare Prescription Drug Account, FSMI–74
2228Premiums Collected for the Aged, FSMI Fund–18
2230Premiums Collected for the Disabled, FSMI Fund–4
Offsetting receipts (intragovernmental):
2241Federal Contributions, FSMI Fund–32
2243Interest Received by Trust Fund, FSMI Fund–66–410
2247Federal Contributions for Benefits, Prescription Drug Account, S–385
2299Income under proposed legislation–66–955
3299Total cash income283,067297,111313,173
Cash outgo during year:
Current law:
4500Federal Supplementary Medical Insurance Trust Fund–212,466–238,180–226,515
4500Medicare Prescription Drug Account, Federal Supplementary Insura–60,031–66,396–63,038
4599Outgo under current law (-)–272,497–304,576–289,553
Proposed legislation:
5500Federal Supplementary Medical Insurance Trust Fund–495
5500Federal Supplementary Medical Insurance Trust Fund–18,250
5500Medicare Prescription Drug Account, Federal Supplementary Insura489
5599Outgo under proposed legislation (-)–18,256
6599Total cash outgo (-)–272,497–304,576–307,809
7699Total adjustments
Unexpended balance, end of year:
8700Uninvested balance (net), end of year99593119,315
8701Federal Supplementary Medical Insurance Trust Fund70,98263,58169,306
8701Federal Supplementary Medical Insurance Trust Fund–495
8701Federal Supplementary Medical Insurance Trust Fund–18,250
8799Total balance, end of year71,97764,51269,876
Commitments against unexpended balance, end of year:
9899Total commitments (-)
Object Classification(in millions of dollars)Identification code 75–8004–0–7–5712010 actualCR2012 est.
Direct obligations:
41.0Payment for Quality Improvement Organization (QIO) activity3278113
42.0Insurance claims and indemnities210,276235,049223,008
94.0Financial transfers3,2223,0923,588
99.0Direct obligations213,530238,219226,709
Allocation Account - reimbursable:
42.0Insurance claims and indemnities23
99.0Allocation account - reimbursable23
99.9Total new obligations213,553238,219226,709
Legislative proposal, not subject to PAYGO Program and Financing(in millions of dollars)Identification code 75–8004–2–7–5712010 actualCR2012 est.
Obligations by program activity:
0002Transfer to Medicaid for payment of SMI premiums495
0900Total new obligations (object class 42.0)495
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1202Appropriation (trust fund)–442–1,254
1235Appropriations precluded from obligation4421,749
1260Appropriations, mandatory (total)495
1930Total budgetary resources available495
Change in obligated balance:
3030Obligations incurred, unexpired accounts495
3040Outlays (gross)–495
Budget authority and outlays, net:
Mandatory:
4090Budget authority, gross495
Outlays, gross:
4100Outlays from new mandatory authority495
4180Budget authority, net (total)495
4190Outlays, net (total)495
Memorandum (non-add) entries:
5000Total investments, SOY: Federal securities: Par value
5001Total investments, EOY: Federal securities: Par value–495
Legislative proposal, subject to PAYGO Program and Financing(in millions of dollars)Identification code 75–8004–4–7–5712010 actualCR2012 est.
Obligations by program activity:
0001Benefit payments, SMI18,250
0900Total new obligations (object class 42.0)18,250
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1202Appropriation (trust fund)–22
1235Appropriations precluded from obligation18,272
1260Appropriations, mandatory (total)18,250
1930Total budgetary resources available18,250
Change in obligated balance:
3030Obligations incurred, unexpired accounts18,250
3040Outlays (gross)–18,250
Budget authority and outlays, net:
Mandatory:
4090Budget authority, gross18,250
Outlays, gross:
4100Outlays from new mandatory authority18,250
4180Budget authority, net (total)18,250
4190Outlays, net (total)18,250
Memorandum (non-add) entries:
5000Total investments, SOY: Federal securities: Par value
5001Total investments, EOY: Federal securities: Par value–18,250
Transitional Drug Assistance, Federal Supplementary Medical Insurance Trust Fund Program and Financing(in millions of dollars)Identification code 75–8307–0–7–5712010 actualCR2012 est.
Memorandum (non-add) entries:
Special and non-revolving trust funds:
1954Unobligated balance canceling30
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)30
3081Recoveries of prior year unpaid obligations, expired–30
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)
4180Budget authority, net (total)
4190Outlays, net (total)
Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund Since January 2006, Medicare beneficiaries have had the opportunity to enroll in a comprehensive voluntary prescription drug benefit. Program and Financing(in millions of dollars)Identification code 75–8308–0–7–5712010 actualCR2012 est.
Obligations by program activity:
0001Prescription Drug Benefits57,53165,99262,564
0002Administrative Costs264475481
0091Direct program activities, subtotal57,79566,46763,045
0801Reimbursable program (Prescription Drug Benefits)468
0900Total new obligations58,26366,46763,045
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 1
1021Recoveries of prior year unpaid obligations42
1050Unobligated balance (total)42
Budget authority:
Appropriations, discretionary:
1102Appropriation (trust fund)482385476
Appropriations, mandatory:
1202Appropriation (trust fund)57,49166,08262,569
Spending authority from offsetting collections, mandatory:
1800Collected468
1900Budget authority (total)58,44166,46763,045
1930Total budgetary resources available58,48366,46763,045
Memorandum (non-add) entries:
1940Unobligated balance expiring–220
1941Unexpired unobligated balance, end of year
Special and non-revolving trust funds:
1951Unobligated balance expiring220
1952Expired unobligated balance, start of year342536536
1953Expired unobligated balance, end of year316536536
1954Unobligated balance canceling58
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)5,5083,6263,697
3030Obligations incurred, unexpired accounts58,26366,46763,045
3031Obligations incurred, expired accounts110
3040Outlays (gross)–60,031–66,396–63,038
3080Recoveries of prior year unpaid obligations, unexpired–42
3081Recoveries of prior year unpaid obligations, expired–182
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)3,6263,6973,704
Budget authority and outlays, net:
Discretionary:
4000Budget authority, gross482385476
Outlays, gross:
4010Outlays from new discretionary authority240307375
4011Outlays from discretionary balances168181
4020Outlays, gross (total)256388456
Mandatory:
4090Budget authority, gross57,95966,08262,569
Outlays, gross:
4100Outlays from new mandatory authority57,95962,54559,069
4101Outlays from mandatory balances1,8163,4633,513
4110Outlays, gross (total)59,77566,00862,582
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120Federal sources–468
Additional offsets against gross budget authority only:
4142Offsetting collections credited to expired accounts
4160Budget authority, net (mandatory)57,49166,08262,569
4170Outlays, net (mandatory)59,30766,00862,582
4180Budget authority, net (total)57,97366,46763,045
4190Outlays, net (total)59,56366,39663,038
Summary of Budget Authority and Outlays(in millions of dollars)2010 actualCR2012 est.
Enacted/requested:
Budget Authority57,97366,46763,045
Outlays59,56366,39663,038
Legislative proposal, subject to PAYGO:
Budget Authority–489
Outlays–489
Total:
Budget Authority57,97366,46762,556
Outlays59,56366,39662,549
Object Classification(in millions of dollars)Identification code 75–8308–0–7–5712010 actualCR2012 est.
Direct obligations:
25.2Other services from non-federal sources264475481
42.0Insurance claims and indemnities57,53165,99262,564
99.0Direct obligations57,79566,46763,045
Allocation Account - reimbursable:
42.0Insurance claims and indemnities468
99.0Allocation account - reimbursable468
99.9Total new obligations58,26366,46763,045
Legislative proposal, subject to PAYGO Program and Financing(in millions of dollars)Identification code 75–8308–4–7–5712010 actualCR2012 est.
Obligations by program activity:
0001Prescription Drug Benefits–489
0900Total new obligations (object class 42.0)–489
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1202Appropriation (trust fund)–489
1930Total budgetary resources available–489
Change in obligated balance:
3030Obligations incurred, unexpired accounts–489
3040Outlays (gross)489
Budget authority and outlays, net:
Mandatory:
4090Budget authority, gross–489
Outlays, gross:
4100Outlays from new mandatory authority–489
4180Budget authority, net (total)–489
4190Outlays, net (total)–489
Allocations 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."Administration for Children and Families Temporary Assistance for Needy Families This account provides funding for activities authorized by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (P.L. 104–193), as amended by the Deficit Reduction Act of 2005 (P.L. 109–171) and the Claims Resolution Act of 2010 (P.L. 111–291), including the Temporary Assistance for Needy Families block grant.Program and Financing(in millions of dollars)Identification code 75–1552–0–1–6092010 actualCR2012 est.
Obligations by program activity:
0001State family assistance grant16,48716,48716,485
0002Territories - family assistance grants787878
0004Supplemental Grants 2011211
0005ARRA - Supplemental grants for population increases319
0006Tribal work programs888
0009Healthy marriage and responsible fatherhood grants149150150
0900Total new obligations17,04116,93416,721
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200Appropriation17,05916,95116,740
1930Total budgetary resources available17,05916,95116,740
Memorandum (non-add) entries:
1940Unobligated balance expiring–18–17–19
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)5,2504,7774,685
3030Obligations incurred, unexpired accounts17,04116,93416,721
3040Outlays (gross)–17,513–17,026–16,863
3081Recoveries of prior year unpaid obligations, expired–1
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)4,7774,6854,543
Budget authority and outlays, net:
Mandatory:
4090Budget authority, gross17,05916,95116,740
Outlays, gross:
4100Outlays from new mandatory authority13,67913,37613,378
4101Outlays from mandatory balances3,8343,6503,485
4110Outlays, gross (total)17,51317,02616,863
4180Budget authority, net (total)17,05916,95116,740
4190Outlays, net (total)17,51317,02616,863
Summary of Budget Authority and Outlays(in millions of dollars)2010 actualCR2012 est.
Enacted/requested:
Budget Authority17,05916,95116,740
Outlays17,51317,02616,863
Legislative proposal, subject to PAYGO:
Budget Authority108319
Outlays22342
Total:
Budget Authority17,05917,05917,059
Outlays17,51317,04817,205
Object Classification(in millions of dollars)Identification code 75–1552–0–1–6092010 actualCR2012 est.
Direct obligations:
11.1Personnel compensation: Full-time permanent222
12.1Civilian personnel benefits111
21.0Travel and transportation of persons111
23.1Rental payments to GSA111
25.1Advisory and assistance services212121
25.3Other goods and services from federal sources333
41.0Grants, subsidies, and contributions17,01216,90516,692
99.9Total new obligations17,04116,93416,721
Employment SummaryIdentification code 75–1552–0–1–6092010 actualCR2012 est.
1001Direct civilian full-time equivalent employment212424
Legislative proposal, subject to PAYGO Program and Financing(in millions of dollars)Identification code 75–1552–4–1–6092010 actualCR2012 est.
Obligations by program activity:
0004Supplemental Grants 2011108319
0900Total new obligations (object class 41.0)108319
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200Appropriation108319
1930Total budgetary resources available108319
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)86
3030Obligations incurred, unexpired accounts108319
3040Outlays (gross)–22–342
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)8663
Budget authority and outlays, net:
Mandatory:
4090Budget authority, gross108319
Outlays, gross:
4100Outlays from new mandatory authority22256
4101Outlays from mandatory balances86
4110Outlays, gross (total)22342
4180Budget authority, net (total)108319
4190Outlays, net (total)22342
This account provides funding for the TANF Contingency Fund authorized by section 403(b) of the Social Security Act that currently provides money to qualifying States (but not Territories or Tribes) during an economic downturn.Program and Financing(in millions of dollars)Identification code 75–1522–0–1–6092010 actualCR2012 est.
Obligations by program activity:
0001Contingency fund212334612
0002ARRA- Emergency Contingency Fund for State TANF Programs4,383
0900Total new obligations (object class 41.0)4,595334612
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 14,59611
Budget authority:
Appropriations, mandatory:
1200Appropriation506612
1231Appropriations permanently reduced–172
1260Appropriations, mandatory (total)334612
1930Total budgetary resources available4,596335613
Memorandum (non-add) entries:
1941Unexpired unobligated balance, end of year111
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)7652,453358
3030Obligations incurred, unexpired accounts4,595334612
3040Outlays (gross)–2,907–2,429–844
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)2,453358126
Budget authority and outlays, net:
Mandatory:
4090Budget authority, gross334612
Outlays, gross:
4100Outlays from new mandatory authority322600
4101Outlays from mandatory balances2,9072,107244
4110Outlays, gross (total)2,9072,429844
4180Budget authority, net (total)334612
4190Outlays, net (total)2,9072,429844
Payments to States for Child Support Enforcement and Family Support Programs payments to states for child support enforcement and family support programsFor 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, $2,482,814,000$2,305,035,000, to remain available until expended; and for such purposes for the first quarter of fiscal year 20122013, $1,200,000,000$1,100,000,000, 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 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, 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 full-year 2011 appropriation for this account was not enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 111–242, as amended). The amounts included for 2011 reflect the annualized level 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. Program and Financing(in millions of dollars)Identification code 75–1501–0–1–6092010 actualCR2012 est.
Obligations by program activity:
0001State child support administrative costs4,4803,9083,142
0002Child support incentive payments504513519
0003Access and visitation grants101010
0091Subtotal, child support enforcement4,9944,4313,671
0102Payments to territories333333
0103Repatriation811
0191Subtotal, other payments413434
0799Total direct obligations5,0354,4653,705
0801Offset obligations (CSE grants to States)91011
0900Total new obligations5,0444,4753,716
Budgetary Resources:
Unobligated balance:
1021Recoveries of prior year unpaid obligations369400200
Budget authority:
Appropriations, mandatory:
1200Appropriation3,6662,9652,305
Advance appropriations, mandatory:
1270Advance appropriation1,0001,1001,200
Spending authority from offsetting collections, mandatory:
1800Collected91011
1900Budget authority (total)4,6754,0753,516
1930Total budgetary resources available5,0444,4753,716
Memorandum (non-add) entries:
1941Unexpired unobligated balance, end of year
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)8871,1301,576
3030Obligations incurred, unexpired accounts5,0444,4753,716
3040Outlays (gross)–4,432–3,629–3,547
3080Recoveries of prior year unpaid obligations, unexpired–369–400–200
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)1,1301,5761,545
Budget authority and outlays, net:
Mandatory:
4090Budget authority, gross4,6754,0753,516
Outlays, gross:
4100Outlays from new mandatory authority3,7373,0882,769
4101Outlays from mandatory balances695541778
4110Outlays, gross (total)4,4323,6293,547
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123Non-Federal sources–9–10–11
4160Budget authority, net (mandatory)4,6664,0653,505
4170Outlays, net (mandatory)4,4233,6193,536
4180Budget authority, net (total)4,6664,0653,505
4190Outlays, net (total)4,4233,6193,536
Summary of Budget Authority and Outlays(in millions of dollars)2010 actualCR2012 est.
Enacted/requested:
Budget Authority4,6664,0653,505
Outlays4,4233,6193,536
Legislative proposal, subject to PAYGO:
Budget Authority305
Outlays244
Total:
Budget Authority4,6664,0653,810
Outlays4,4233,6193,780
Object Classification(in millions of dollars)Identification code 75–1501–0–1–6092010 actualCR2012 est.
41.0Direct obligations: Grants, subsidies, and contributions5,0354,4653,705
99.0Reimbursable obligations: reimbursable obligations91011
99.9Total new obligations5,0444,4753,716
Legislative proposal, subject to PAYGO Program and Financing(in millions of dollars)Identification code 75–1501–4–1–6092010 actualCR2012 est.
Obligations by program activity:
0001State child support administrative costs5
0002Child support incentive payments300
0900Total new obligations (object class 41.0)305
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200Appropriation305
1900Budget authority (total)305
1930Total budgetary resources available305
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)
3030Obligations incurred, unexpired accounts305
3040Outlays (gross)–244
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)61
Budget authority and outlays, net:
Mandatory:
4090Budget authority, gross305
Outlays, gross:
4100Outlays from new mandatory authority244
4180Budget authority, net (total)305
4190Outlays, net (total)244
Low Income Home Energy Assistance low income home energy assistanceFor making payments under subsections (b), (d), and (e) of section 2602 of the Low Income Home Energy Assistance Act of 1981, $3,300,000,000$2,569,551,000, of which $2,510,000,000$1,980,000,000 shall be for payments under subsections (b) and (d) of such section; and of which $790,000,000$589,551,000, to remain available until expended, shall be for payments under subsection (e) of such section, to be made notwithstanding the designation requirements of such subsection: Provided, That notwithstanding section 2605(b)(2)(B)(ii) of such Act, a State may use any amount of an allotment from prior appropriations Acts that is available to that State for providing assistance in fiscal year 2011, and any allotment from funds appropriated in this Act or any other appropriations Act for fiscal year 2011, to provide assistance to households whose income does not exceed 75 percent of the State median incomenotwithstanding section 2609(A)(a), of the amounts appropriated under section 2602(b), not more than $3,000,000 of such amounts may be reserved by the Secretary of Health and Human Services for technical assistance, training, and monitoring of program activities for compliance with internal controls, policies and procedures. Note.—A full-year 2011 appropriation for this account was not enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 111–242, as amended). The amounts included for 2011 reflect the annualized level provided by the continuing resolution.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.Program and Financing(in millions of dollars)Identification code 75–1502–0–1–6092010 actualCR2012 est.
Obligations by program activity:
0001LIHEAP5,1005,1002,570
0900Total new obligations (object class 41.0)5,1005,1002,570
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 11
Budget authority:
Appropriations, discretionary:
1100Appropriation5,1005,1002,570
1120Appropriations transferred to other accounts–1
1160Appropriation, discretionary (total)5,0995,1002,570
1930Total budgetary resources available5,1005,1002,570
Memorandum (non-add) entries:
1941Unexpired unobligated balance, end of year
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)1,2141,7141,680
3030Obligations incurred, unexpired accounts5,1005,1002,570
3040Outlays (gross)–4,598–5,134–3,257
3081Recoveries of prior year unpaid obligations, expired–2
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)1,7141,680993
Budget authority and outlays, net:
Discretionary:
4000Budget authority, gross5,0995,1002,570
Outlays, gross:
4010Outlays from new discretionary authority3,5273,5881,817
4011Outlays from discretionary balances1,0711,5461,440
4020Outlays, gross (total)4,5985,1343,257
4180Budget authority, net (total)5,0995,1002,570
4190Outlays, net (total)4,5985,1343,257
Refugee and Entrant Assistance refugee and entrant assistanceFor necessary expenses for refugee and entrant assistance activities 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, section 235 of the William Wilberforce Trafficking Victims Protection Reauthorization Act of 2008, and the Trafficking Victims Protection Act of 2000, for costs associated with the care and placement of unaccompanied alien children, and for carrying out the Torture Victims Relief Act of 1998, $877,602,000$824,694,000, of which up to $9,814,000 shall be available to carry out the Trafficking Victims Protection Act of 2000: Provided, That funds appropriated under this heading pursuant to section 414(a) of the Immigration and Nationality Act, section 462 of the Homeland Security Act of 2002, section 235 of the William Wilberforce Trafficking Victims Protection Reauthorization Act of 2008, and the Trafficking Victims Protection Act of 2000 for fiscal year 20112012 shall be available for the costs of assistance provided and other activities to remain available through September 30, 20132014:. Provided further, That of the amounts provided herein, $25,000,000 shall be available until expended for the costs of furnishing transitional and medical services under title IV of the Immigration and Nationality Act. Note.—A full-year 2011 appropriation for this account was not enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 111–242, as amended). The amounts included for 2011 reflect the annualized level provided by the continuing resolution.This program provides funds to States and non-governmental organizations for administering the refugee and entrant assistance program. Funds also are provided to assist in the rehabilitation of victims of torture, trafficking victims, and the care and placement of unaccompanied alien children. Program and Financing(in millions of dollars)Identification code 75–1503–0–1–6092010 actualCR2012 est.
Obligations by program activity:
0001Refugee and entrant assistance563609637
0002Assistance for treatment of torture victims111111
0003Unaccompanied alien children163188177
0900Total new obligations737808825
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 18477
Budget authority:
Appropriations, discretionary:
1100Appropriation731731825
1930Total budgetary resources available815808825
Memorandum (non-add) entries:
1940Unobligated balance expiring–1
1941Unexpired unobligated balance, end of year77
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)591575743
3030Obligations incurred, unexpired accounts737808825
3040Outlays (gross)–749–640–867
3081Recoveries of prior year unpaid obligations, expired–4
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)575743701
Budget authority and outlays, net:
Discretionary:
4000Budget authority, gross731731825
Outlays, gross:
4010Outlays from new discretionary authority295292330
4011Outlays from discretionary balances454348537
4020Outlays, gross (total)749640867
4180Budget authority, net (total)731731825
4190Outlays, net (total)749640867
Object Classification(in millions of dollars)Identification code 75–1503–0–1–6092010 actualCR2012 est.
Direct obligations:
11.1Personnel compensation: Full-time permanent444
12.1Civilian personnel benefits111
21.0Travel and transportation of persons111
21.0Travel and transportation of persons1
23.1Rental payments to GSA222
25.1Advisory and assistance services293131
25.3Other goods and services from federal sources141515
41.0Grants, subsidies, and contributions685754771
99.9Total new obligations737808825
Employment SummaryIdentification code 75–1503–0–1–6092010 actualCR2012 est.
1001Direct civilian full-time equivalent employment333232
1101Direct military average strength employment111
Supporting Healthy Families and Adolescent Development promoting safe and stable familiesSupporting Healthy Families and Adolescent DevelopmentFor carrying out section 436 of the Social Security Act, $345,000,000$365,000,000, and, in addition, for carrying out section 437 of such Act, $63,311,000. Note.—A full-year 2011 appropriation for this account was not enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 111–242, as amended). The amounts included for 2011 reflect the annualized level provided by the continuing resolution.This program provides funds for a broad range of child welfare services, including family preservation and family support services. Additionally, this account includes funding for the Personal Responsibility Education Program (PREP) and Abstinence Education which were made available by the Patient Protection and Affordable Care Act (P.L. 111–148).Program and Financing(in millions of dollars)Identification code 75–1512–0–1–5062010 actualCR2012 est.
Obligations by program activity:
0001Grants to States and Tribes408408388
0002Research, training and technical assistance888
0003State court improvement activities121232
0004Family Connection Grants151515
0005PREP569375
0006Abstinence Education355050
0900Total new obligations534586568
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 118
Budget authority:
Appropriations, discretionary:
1100Appropriation636363
Appropriations, mandatory:
1200Appropriation505505505
1900Budget authority (total)568568568
1930Total budgetary resources available568586568
Memorandum (non-add) entries:
1940Unobligated balance expiring–16
1941Unexpired unobligated balance, end of year18
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)428552598
3030Obligations incurred, unexpired accounts534586568
3040Outlays (gross)–406–540–558
3081Recoveries of prior year unpaid obligations, expired–4
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)552598608
Budget authority and outlays, net:
Discretionary:
4000Budget authority, gross636363
Outlays, gross:
4010Outlays from new discretionary authority191919
4011Outlays from discretionary balances364345
4020Outlays, gross (total)556264
Mandatory:
4090Budget authority, gross505505505
Outlays, gross:
4100Outlays from new mandatory authority106135135
4101Outlays from mandatory balances245343359
4110Outlays, gross (total)351478494
4180Budget authority, net (total)568568568
4190Outlays, net (total)406540558
Object Classification(in millions of dollars)Identification code 75–1512–0–1–5062010 actualCR2012 est.
Direct obligations:
25.1Advisory and assistance services111212
25.3Other goods and services from federal sources222
41.0Grants, subsidies, and contributions521572554
99.0Direct obligations534586568
99.9Total new obligations534586568
Employment SummaryIdentification code 75–1512–0–1–5062010 actualCR2012 est.
1001Direct civilian full-time equivalent employment366
Child Care Entitlement to States This account provides child care subsidies for low-income working families and was established by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (P.L. 104–193), as amended by the Deficit Reduction Act of 2005 (P.L. 109–171) and the Claims Resolution Act of 2010 (P.L. 111–291).Program and Financing(in millions of dollars)Identification code 75–1550–0–1–6092010 actualCR2012 est.
Obligations by program activity:
0001Mandatory child care1,1781,1781,178
0002Matching child care1,7031,6741,674
0003Training and technical assistance777
0004Child care tribal grants585858
0900Total new obligations2,9462,9172,917
Budgetary Resources:
Unobligated balance:
1012Expired unobligated bal transferred to unexpired accts29
Budget authority:
Appropriations, mandatory:
1200Appropriation2,9172,9172,917
1900Budget authority (total)2,9172,9172,917
1930Total budgetary resources available2,9462,9172,917
Memorandum (non-add) entries:
1941Unexpired unobligated balance, end of year
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)615806982
3030Obligations incurred, unexpired accounts2,9462,9172,917
3040Outlays (gross)–2,723–2,741–3,096
3081Recoveries of prior year unpaid obligations, expired–32
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)806982803
Budget authority and outlays, net:
Discretionary:
4000Budget authority, gross
Mandatory:
4090Budget authority, gross2,9172,9172,917
Outlays, gross:
4100Outlays from new mandatory authority2,2352,2582,258
4101Outlays from mandatory balances488483838
4110Outlays, gross (total)2,7232,7413,096
4180Budget authority, net (total)2,9172,9172,917
4190Outlays, net (total)2,7232,7413,096
Summary of Budget Authority and Outlays(in millions of dollars)2010 actualCR2012 est.
Enacted/requested:
Budget Authority2,9172,9172,917
Outlays2,7232,7413,096
Legislative proposal, subject to PAYGO:
Budget Authority500
Outlays381
Total:
Budget Authority2,9172,9173,417
Outlays2,7232,7413,477
Object Classification(in millions of dollars)Identification code 75–1550–0–1–6092010 actualCR2012 est.
Direct obligations:
25.1Advisory and assistance services111
25.2Other services from non-federal sources666
41.0Grants, subsidies, and contributions2,9392,9102,910
99.9Total new obligations2,9462,9172,917
Legislative proposal, subject to PAYGO Program and Financing(in millions of dollars)Identification code 75–1550–4–1–6092010 actualCR2012 est.
Obligations by program activity:
0002Matching child care480
0003Training and technical assistance10
0004Child care tribal grants10
0900Total new obligations500
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200Appropriation500
1900Budget authority (total)500
1930Total budgetary resources available500
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)
3030Obligations incurred, unexpired accounts500
3040Outlays (gross)–381
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)119
Budget authority and outlays, net:
Discretionary:
4000Budget authority, gross
Mandatory:
4090Budget authority, gross500
Outlays, gross:
4100Outlays from new mandatory authority381
4180Budget authority, net (total)500
4190Outlays, net (total)381
Object Classification(in millions of dollars)Identification code 75–1550–4–1–6092010 actualCR2012 est.
Direct obligations:
25.1Advisory and assistance services9
25.2Other services from non-federal sources1
41.0Grants, subsidies, and contributions490
99.9Total new obligations500
Payments to States for the Child Care and Development Block Grant payments to states for the child care and development block grantFor carrying out the Child Care and Development Block Grant Act of 1990, $2,927,081,000$2,926,757,000 shall be used to supplement, not supplant State general revenue funds for child care assistance for low-income families: Provided, That $26,090,899$25,712,061 shall be available for child care resource and referral and school-aged child care activities, of which $1,000,000 shall be for the Child Care Aware toll-free hotline: Provided further, That, in addition to the amounts required to be reserved by the States under section 658G, $373,475,533$373,434,193 shall be reserved by the States for activities authorized under section 658G, of which $136,968,964$136,953,802 shall be for activities that improve the quality of infant and toddler care: Provided further, That $9,910,000 shall be for use by the Secretary of Health and Human Services for child care research, demonstration, and evaluation activities. Note.—A full-year 2011 appropriation for this account was not enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 111–242, as amended). The amounts included for 2011 reflect the annualized level provided by the continuing resolution.This program provides grants to States for child care subsidies for low-income working families and activities to improve child care quality. Program and Financing(in millions of dollars)Identification code 75–1515–0–1–6092010 actualCR2012 est.
Obligations by program activity:
0001Block grant payments to States2,1172,1172,917
0004Research and evaluation fund101010
0005Block grant payments to States, Recovery Act10
0900Total new obligations2,1372,1272,927
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 110
Budget authority:
Appropriations, discretionary:
1100Appropriation2,1272,1272,927
1930Total budgetary resources available2,1372,1272,927
Memorandum (non-add) entries:
1941Unexpired unobligated balance, end of year
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)2,2421,240663
3030Obligations incurred, unexpired accounts2,1372,1272,927
3040Outlays (gross)–3,136–2,704–2,822
3081Recoveries of prior year unpaid obligations, expired–3
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)1,240663768
Budget authority and outlays, net:
Discretionary:
4000Budget authority, gross2,1272,1272,927
Outlays, gross:
4010Outlays from new discretionary authority1,6141,6702,257
4011Outlays from discretionary balances1,5221,034565
4020Outlays, gross (total)3,1362,7042,822
4180Budget authority, net (total)2,1272,1272,927
4190Outlays, net (total)3,1362,7042,822
Object Classification(in millions of dollars)Identification code 75–1515–0–1–6092010 actualCR2012 est.
Direct obligations:
11.1Personnel compensation: Full-time permanent1
25.1Advisory and assistance services101112
25.3Other goods and services from federal sources111
41.0Grants, subsidies, and contributions2,1262,1152,912
99.0Direct obligations2,1372,1272,926
99.5Below reporting threshold1
99.9Total new obligations2,1372,1272,927
Employment SummaryIdentification code 75–1515–0–1–6092010 actualCR2012 est.
1001Direct civilian full-time equivalent employment10
Social Services Block Grant social services block grantFor making grants to States pursuant to section 2002 of the Social Security Act, $1,700,000,000: Provided, That notwithstanding subparagraph (B) of section 404(d)(2) of such Act, the applicable percent specified under such subparagraph for a State to carry out State programs pursuant to title XX of such Act shall be 10 percent. Note.—A full-year 2011 appropriation for this account was not enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 111–242, as amended). The amounts included for 2011 reflect the annualized level provided by the continuing resolution.Program and Financing(in millions of dollars)Identification code 75–1534–0–1–5062010 actualCR2012 est.
Obligations by program activity:
0001Social Services Block Grant1,7001,7001,700
0002Healthcare Workforce Demonstration Projects848585
0900Total new obligations1,7841,7851,785
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 12929
1021Recoveries of prior year unpaid obligations29
1050Unobligated balance (total)292929
Budget authority:
Appropriations, mandatory:
1200Appropriation1,7851,7851,785
1930Total budgetary resources available1,8141,8141,814
Memorandum (non-add) entries:
1940Unobligated balance expiring–1
1941Unexpired unobligated balance, end of year292929
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)891611385
3030Obligations incurred, unexpired accounts1,7841,7851,785
3040Outlays (gross)–2,035–2,011–1,802
3080Recoveries of prior year unpaid obligations, unexpired–29
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)611385368
Budget authority and outlays, net:
Mandatory:
4090Budget authority, gross1,7851,7851,785
Outlays, gross:
4100Outlays from new mandatory authority1,4321,4831,483
4101Outlays from mandatory balances603528319
4110Outlays, gross (total)2,0352,0111,802
4180Budget authority, net (total)1,7851,7851,785
4190Outlays, net (total)2,0352,0111,802
Object Classification(in millions of dollars)Identification code 75–1534–0–1–5062010 actualCR2012 est.
Direct obligations:
11.1Personnel compensation: Full-time permanent11
25.1Advisory and assistance services131716
41.0Grants, subsidies, and contributions1,7711,7671,768
99.9Total new obligations1,7841,7851,785
Employment SummaryIdentification code 75–1534–0–1–5062010 actualCR2012 est.
1001Direct civilian full-time equivalent employment77
Children and Families Services Programs children and families services programs(including transfer of funds)For carrying out, except as otherwise provided, the Runaway and Homeless Youth Act, the Developmental Disabilities Assistance and Bill of Rights Act, the Head Start Act, the Child Abuse Prevention and Treatment Act, sections 310 and 316 of the Family Violence Prevention and Services Act, the Native American Programs Act of 1974, title II of the Child Abuse Prevention and Treatment and Adoption Reform Act of 1978 (adoption opportunities), 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; for making payments under the Community Services Block Grant Act ("CSBG Act''), sections 439(i), 473B, and 477(i) of the Social Security Act, and the Assets for Independence Act; and for necessary administrative expenses to carry out such 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, and section 501 of the Refugee Education Assistance Act of 1980, $10,312,070,000$9,794,598,000, of which $42,000,000$49,875,000, to remain available through September 30, 20132012, 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, 2012: 2011Provided, That $8,223,958,000$8,099,783,000 shall be for making payments under the Head Start Act: Provided further, That for purposes of allocating funds described by the immediately preceding proviso, the following provisions shall apply: (1) the term "base grant" as used in section 640(a)(7)(A) of such Act with respect to funding provided to a Head Start agency (including each Early Head Start agency) for fiscal year 2010 shall be deemed to include funds appropriated in the American Recovery and Reinvestment Act of 2009 (Public Law 111–5) and provided to such agency for carrying out expansion of Head Start programs, as that phrase is used in subsection (a)(4)(D) of such section 640(a), and provided to such agency as the ongoing funding level for operations in the 12 month budget period beginning in fiscal year 2010; (2) the amount reserved under subsection (a)(1)(C) of such section shall be less than the amount that would be reserved under such subparagraph absent this proviso by a sum of $5,131,935; and (3) the text of paragraph (4)(B)(i) of such section shall be applied by substituting the following language: "Under the circumstances described in clause (ii), from the balance, the Secretary shall reserve remaining amounts, to be allotted to each Head Start agency (including each Early Head Start agency) in an amount that bears the same ratio to such remaining amounts as the funds appropriated in the American Recovery and Reinvestment Act of 2009 and provided to such agency for carrying out quality improvement of Head Start programs, as that phrase is used in paragraph (5) of this section (which funds shall be referred to in this proviso as such agency's "ARRA quality improvement funds") bear to the total of all such agencies' ARRA quality improvement funds, to carry out such quality improvement activities.": Provided further, That $736,000,000 $370,000,000 shall be for making payments under the CSBG Act, of which $20,000,000 shall be for section 680(a)(2) of the CSBG Act: Provided further, That in addition to amounts provided herein, $5,762,000 $5,762,000 shall be available from amounts available under section 241 of the PHS Act to carry out the provisions of section 1110 of the Social Security Act: Provided further, That to the extent Community Services Block Grant funds are distributed as grant funds by a State to an eligible entity as provided under the CSBG Act, and have not been expended by such entity, they shall remain with such entity for carryover into the next fiscal year for expenditure by such entity consistent with program purposes: Provided further, That the Secretary of Health and Human Services shall establish procedures regarding the disposition of intangible assets and program income that permit such assets acquired with, and program income derived from, grant funds authorized under section 680 of the CSBG Act to become the sole property of such grantees after a period of not more than 12 years after the end of the grant period for any activity consistent with section 680(a)(2)(A) of the CSBG Act: Provided further, That intangible assets in the form of loans, equity investments and other debt instruments, and program income may be used by grantees for any eligible purpose consistent with section 680(a)(2)(A) of the CSBG Act: Provided further, That these procedures shall apply to such grant funds made available after November 29, 1999: Provided further, That funds appropriated for section 680(a)(2) of the CSBG Act shall be available for financing construction and rehabilitation and loans or investments in private business enterprises owned by community development corporations: Provided further, That $17,410,000 shall be for activities authorized by the Help America Vote Act of 2002, of which $12,154,000 shall be for payments to States to promote access for voters with disabilities, and of which $5,256,000 shall be for payments to States for protection and advocacy systems for voters with disabilities: Provided further, That $2,000,000$2,000,000 shall be for a human services case management system for federally declared disasters, to include a comprehensive national case management contract and Federal costs of administering the system: Provided further, That up to $2,000,000$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: Provided further, That section 303(a)(2)(A)(i) of the Family Violence Prevention and Services Act shall not apply to amounts provided herein. Note.—A full-year 2011 appropriation for this account was not enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 111–242, as amended). The amounts included for 2011 reflect the annualized level provided by the continuing resolution. The request prioritizes investments in early learning to improve outcomes for children. A total of $8.099 billion is requested to maintain the number of children served in Head Start. This Budget also requests additional funds for runaway and homeless youth, family violence prevention, to improve the capacity of non-profits to serve their neighborhoods, and bonus payments to states that increase the number of children adopted from their public foster care systems. The Budget redirects funding for Children's Health Act programs to the Adoption Opportunities program.Program and Financing(in millions of dollars)Identification code 75–1536–0–1–5062010 actualCR2012 est.
Obligations by program activity:
0101Head start7,2347,2358,100
0103Runaway and homeless youth (basic centers)545459
0104Transitional living444444
0106Education grants to reduce sexual abuse of runaway youth181818
0108Mentoring children of prisoners494925
0109Child abuse State grants272727
0110Child abuse discretionary activities292929
0111Community-based child abuse prevention414141
0112Child welfare services282282282
0113Child welfare training, research, or demonstration projects272727
0114Adoption opportunities262639
0115Abandoned infants assistance121212
0116Adoption incentives404050
0117Independent living training vouchers454545
0118Children's health act programs1313
0119State councils on developmental disabilities757575
0120Protection and advocacy414141
0121Projects of national significance14148
0122University centers for excellence393939
0123Voting access for individuals with disabilities1717
0124Native American programs494949
0125Social services and income maintenance research20203
0128Federal administration208209225
0129Center for faith-based and community initiatives111
0131Disaster human services case management222
0132Regular Head Start ARRA funding431
0133Early Head Start ARRA funding1,092
0134CSBG ARRA funding8
0135Strengthening Communities Fund (ARRA)2
0191Subtotal9,9408,4099,241
0301Community services block grant700700350
0303Rural communtiy facilities1010
0304Community services discretionary (JOLI & CED)383920
0306Assets for independence242424
0308Domestic violence hotline335
0309Family violence prevention and services130130135
0310Strengthening Communities Fund20
0391Subtotal905906554
0400Total, direct program10,8459,3159,795
0799Total direct obligations10,8459,3159,795
0801Reimbursable program283030
0900Total new obligations10,8739,3459,825
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 11,53633
Budget authority:
Appropriations, discretionary:
1100Appropriation9,3159,3159,795
1120Appropriations transferred to other accounts–1
1160Appropriation, discretionary (total)9,3149,3159,795
Spending authority from offsetting collections, discretionary:
1700Collected183030
1701Change in uncollected payments, Federal sources10
1750Spending auth from offsetting collections, disc (total)283030
1900Budget authority (total)9,3429,3459,825
1930Total budgetary resources available10,8789,3489,828
Memorandum (non-add) entries:
1940Unobligated balance expiring–2
1941Unexpired unobligated balance, end of year333
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)7,9097,8095,754
3010Uncollected pymts, Fed sources, brought forward, Oct 1–19–15–15
3020Obligated balance, start of year (net)7,8907,7945,739
3030Obligations incurred, unexpired accounts10,8739,3459,825
3040Outlays (gross)–10,885–11,400–9,379
3050Change in uncollected pymts, Fed sources, unexpired–10
3051Change in uncollected pymts, Fed sources, expired14
3081Recoveries of prior year unpaid obligations, expired–88
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)7,8095,7546,200
3091Uncollected pymts, Fed sources, end of year–15–15–15
3100Obligated balance, end of year (net)7,7945,7396,185
Budget authority and outlays, net:
Discretionary:
4000Budget authority, gross9,3429,3459,825
Outlays, gross:
4010Outlays from new discretionary authority3,8754,3584,615
4011Outlays from discretionary balances7,0097,0294,763
4020Outlays, gross (total)10,88411,3879,378
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030Federal sources–14–30–30
4033Non-Federal sources–18
4040Offsets against gross budget authority and outlays (total)–32–30–30
Additional offsets against gross budget authority only:
4050Change in uncollected pymts, Fed sources, unexpired–10
4052Offsetting collections credited to expired accounts14
4060Additional offsets against budget authority only (total)4
4070Budget authority, net (discretionary)9,3149,3159,795
4080Outlays, net (discretionary)10,85211,3579,348
Mandatory:
4090Budget authority, gross
Outlays, gross:
4101Outlays from mandatory balances1131
4180Budget authority, net (total)9,3149,3159,795
4190Outlays, net (total)10,85311,3709,349
Object Classification(in millions of dollars)Identification code 75–1536–0–1–5062010 actualCR2012 est.
Direct obligations:
Personnel compensation:
11.1Full-time permanent111116129
11.3Other than full-time permanent567
11.5Other personnel compensation333
11.9Total personnel compensation119125139
12.1Civilian personnel benefits283131
21.0Travel and transportation of persons554
23.1Rental payments to GSA152020
23.2Rental payments to others111
23.3Communications, utilities, and miscellaneous charges455
24.0Printing and reproduction122
25.1Advisory and assistance services263248251
25.2Other services from non-federal sources21515
25.3Other goods and services from federal sources714949
25.4Operation and maintenance of facilities333
25.5Research and development contracts111
26.0Supplies and materials111
31.0Equipment1
41.0Grants, subsidies, and contributions10,3308,8099,273
99.0Direct obligations10,8459,3159,795
99.0Reimbursable obligations283030
99.9Total new obligations10,8739,3459,825
Employment SummaryIdentification code 75–1536–0–1–5062010 actualCR2012 est.
1001Direct civilian full-time equivalent employment1,1971,2281,242
1101Direct military average strength employment555
Children's Research and Technical Assistance This account provides funding for research and technical assistance activities established by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (P.L. 104–193), as amended by the Deficit Reduction Act of 2005 (P.L. 109–171) and the Claims Resolution Act of 2010 (P.L. 111–291). Program and Financing(in millions of dollars)Identification code 75–1553–0–1–6092010 actualCR2012 est.
Obligations by program activity:
0001Training and technical assistance131412
0002Federal parent locator service242725
0003Child welfare study66
0004Welfare research151515
0091Direct program activities, subtotal586252
0801Reimbursable program232626
0900Total new obligations818878
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 155
Budget authority:
Appropriations, mandatory:
1200Appropriation585852
Spending authority from offsetting collections, mandatory:
1800Collected222526
1801Change in uncollected payments, Federal sources1
1850Spending auth from offsetting collections, mand (total)232526
1900Budget authority (total)818378
1930Total budgetary resources available868878
Memorandum (non-add) entries:
1941Unexpired unobligated balance, end of year5
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)555861
3010Uncollected pymts, Fed sources, brought forward, Oct 1–5–6–6
3020Obligated balance, start of year (net)505255
3030Obligations incurred, unexpired accounts818878
3040Outlays (gross)–77–85–79
3050Change in uncollected pymts, Fed sources, unexpired–1
3081Recoveries of prior year unpaid obligations, expired–1
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)586160
3091Uncollected pymts, Fed sources, end of year–6–6–6
3100Obligated balance, end of year (net)525554
Budget authority and outlays, net:
Mandatory:
4090Budget authority, gross818378
Outlays, gross:
4100Outlays from new mandatory authority354849
4101Outlays from mandatory balances423730
4110Outlays, gross (total)778579
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120Federal sources–3–4–5
4123Non-Federal sources–19–21–21
4130Offsets against gross budget authority and outlays (total)–22–25–26
Additional offsets against gross budget authority only:
4140Change in uncollected pymts, Fed sources, unexpired–1
4160Budget authority, net (mandatory)585852
4170Outlays, net (mandatory)556053
4180Budget authority, net (total)585852
4190Outlays, net (total)556053
Summary of Budget Authority and Outlays(in millions of dollars)2010 actualCR2012 est.
Enacted/requested:
Budget Authority585852
Outlays556053
Legislative proposal, subject to PAYGO:
Budget Authority6
Outlays2
Total:
Budget Authority585858
Outlays556055
Object Classification(in millions of dollars)Identification code 75–1553–0–1–6092010 actualCR2012 est.
Direct obligations:
11.1Personnel compensation: Full-time permanent887
12.1Civilian personnel benefits222
21.0Travel and transportation of persons111
23.1Rental payments to GSA333
25.1Advisory and assistance services232519
25.2Other services from non-federal sources12135
25.3Other goods and services from federal sources676
25.7Operation and maintenance of equipment117
41.0Grants, subsidies, and contributions222
99.0Direct obligations586252
99.0Reimbursable obligations232626
99.9Total new obligations818878
Employment SummaryIdentification code 75–1553–0–1–6092010 actualCR2012 est.
1001Direct civilian full-time equivalent employment676767
Legislative proposal, subject to PAYGO Program and Financing(in millions of dollars)Identification code 75–1553–4–1–6092010 actualCR2012 est.
Obligations by program activity:
0003Child welfare study6
0900Total new obligations (object class 41.0)6
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200Appropriation6
1900Budget authority (total)6
1930Total budgetary resources available6
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)
3030Obligations incurred, unexpired accounts6
3040Outlays (gross)–2
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)4
Budget authority and outlays, net:
Mandatory:
4090Budget authority, gross6
Outlays, gross:
4100Outlays from new mandatory authority2
4180Budget authority, net (total)6
4190Outlays, net (total)2
Payments to States for Foster Care and Adoption Assistance payments for foster care and permanencyFor making payments to States or other non-Federal entities under title IV-E of the Social Security Act, $5,366,000,000$5,153,000,000.For making payments to States or other non-Federal entities under title IV-E of the Social Security Act, for the first quarter of fiscal year 20122013, $1,850,000,000$2,100,000,000. 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 of the Social Security Act, 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 full-year 2011 appropriation for this account was not enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 111–242, as amended). The amounts included for 2011 reflect the annualized level provided by the continuing resolution.The Budget includes a proposal designed to reward States that achieve improved outcomes for children in foster care and those at risk of entering or re-entering foster care; and encourage efficient and effective use of Federal foster care resources that lead to savings.The proposed level will support eligible low-income children who must be placed outside the home. An average of 166,800 children per month are estimated to be served in FY 2012.The proposed funding level will support subsidies for families adopting eligible low-income children with special needs. An average of 470,400 children per month are estimated to be served in FY 2012.The proposed funding level will provide payments for relatives taking legal guardianship of eligible children who have been in foster care. An average of 13,900 children per month are estimated to be served in FY 2012.Program and Financing(in millions of dollars)Identification code 75–1545–0–1–6092010 actualCR2012 est.
Obligations by program activity:
0001Foster care4,6033,9674,288
0002Independent living140140140
0004Adoption assistance2,4382,4802,495
0005Kinship guardianship113280
0006Tribal T&TA333
0900Total new obligations7,1956,6227,006
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200Appropriation5,5324,7725,156
Advance appropriations, mandatory:
1270Advance appropriation1,8031,8501,850
1900Budget authority (total)7,3356,6227,006
1930Total budgetary resources available7,3356,6227,006
Memorandum (non-add) entries:
1940Unobligated balance expiring–140
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)1,1281,216946
3030Obligations incurred, unexpired accounts7,1956,6227,006
3031Obligations incurred, expired accounts22
3040Outlays (gross)–6,972–6,892–7,016
3081Recoveries of prior year unpaid obligations, expired–157
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)1,216946936
Budget authority and outlays, net:
Discretionary:
4000Budget authority, gross
Mandatory:
4090Budget authority, gross7,3356,6227,006
Outlays, gross:
4100Outlays from new mandatory authority6,2645,8526,207
4101Outlays from mandatory balances7081,040809
4110Outlays, gross (total)6,9726,8927,016
4180Budget authority, net (total)7,3356,6227,006
4190Outlays, net (total)6,9726,8927,016
Summary of Budget Authority and Outlays(in millions of dollars)2010 actualCR2012 est.
Enacted/requested:
Budget Authority7,3356,6227,006
Outlays6,9726,8927,016
Legislative proposal, subject to PAYGO:
Budget Authority250
Outlays220
Total:
Budget Authority7,3356,6227,256
Outlays6,9726,8927,236
Object Classification(in millions of dollars)Identification code 75–1545–0–1–6092010 actualCR2012 est.
Direct obligations:
25.1Advisory and assistance services202020
25.3Other goods and services from federal sources111
41.0Grants, subsidies, and contributions7,1746,6016,985
99.9Total new obligations7,1956,6227,006
Employment SummaryIdentification code 75–1545–0–1–6092010 actualCR2012 est.
1001Direct civilian full-time equivalent employment444
Legislative proposal, subject to PAYGO Program and Financing(in millions of dollars)Identification code 75–1545–4–1–6092010 actualCR2012 est.
Obligations by program activity:
0001Foster care250
0900Total new obligations (object class 41.0)250
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200Appropriation250
1900Budget authority (total)250
1930Total budgetary resources available250
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)
3030Obligations incurred, unexpired accounts250
3040Outlays (gross)–220
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)30
Budget authority and outlays, net:
Discretionary:
4000Budget authority, gross
Mandatory:
4090Budget authority, gross250
Outlays, gross:
4100Outlays from new mandatory authority220
4180Budget authority, net (total)250
4190Outlays, net (total)220
aging services programsFor carrying out, to the extent not otherwise provided, the Older Americans Act of 1965 ("OAA"), as amended, section 398 and title XXIX of the Public Health Service Act, and section 119 of the Medicare Improvements for Patients and Providers Act of 2008, subtitle B of title XX of the Social Security Act, and for necessary administrative expenses to carry out titles XVII and XXXII of the Public Health Service Act, $1,624,733,000$2,190,984,000, together with $46,960,000 to be transferred from the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund to carry out section 4360 of the Omnibus Budget Reconciliation Act of 1990: of which $202,220,000Provided, That, of the amount appropriated under this heading, $192,220,000 shall be for carrying out part E of title IIIsections 371 through 374 of the Older Americans Act of 1965OAA and $8,389,000$8,388,000 shall be for carrying out section 631 of such Act: Provided further, That amounts appropriated under this heading may be used for grants to States under section 361 of the OAA only for disease prevention and health promotion programs and activities that have been demonstrated to the satisfaction of the Secretary of Health and Human Services to be evidence-based and effective: Provided further, That, notwithstanding section 206(g) of the OAA, up to 1 percent of amounts appropriated to carry out programs authorized under title III of such Act shall be available for conducting evaluations, training and technical assistance: Provided further, That amounts available under this heading for the cost of administering the program under title XXXII of the Public Health Service Act shall be in addition to any amounts available under such title for such purposes: Provided further, That, of the amount under this heading, $450,000,000 shall be available for carrying out title V of the OAA: Provided further, That, with respect to the previous proviso, such funds shall be available through June 30, 2013, and may be recaptured and reobligated in accordance with section 517(c) of the OAA. Note.—A full-year 2011 appropriation for this account was not enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 111–242, as amended). The amounts included for 2011 reflect the annualized level provided by the continuing resolution.Note.—The reimbursable program (HCFAC) in the Administration on Aging (AoA) reflects the estimated distribution of the allocation account for 2011. Actual 2011 distributions will be determined by the Secretary of HHS and the Attorney General.This account provides funding to help predominantly older Americans, with the assistance of their caregivers, maintain their dignity and independence in their homes and communities. The Senior Community Service Employment Program (SCSEP), authorized by Title V of the Older Americans Act, is a federally-sponsored community service employment and training program for unemployed low-income individuals, ages 55 and older. The program offers participants work-based community service training so that they can gain on-the-job experience and prepare to enter or re-enter the workforce. The 2012 Budget proposes transferring SCSEP from the Department of Labor to improve coordination between SCSEP and other senior-serving programs and to help the program better fulfill its dual goals of fostering individual economic self-sufficiency and promoting useful opportunities in community service. Further, this account provides for the carrying out of a voluntary program to provide a self-directed resource for participants to purchase community living assistance services and supports. Program and Financing(in millions of dollars)Identification code 75–0142–0–1–5062010 actualCR2012 est.
Obligations by program activity:
0101Home and community-based supportive services368368416
0102Preventive health services212121
0103National family caregiver support program154154192
0104Native American caregiver support program668
0105Congregate nutrition services441441441
0106Home-delivered nutrition services218218218
0107Nutrition services incentive program158161161
0108Native American nutrition and supportive services282828
0109Program innovations191912
0110Aging network support activities44448
0111Long-term care ombudsmen program171722
0112Prevention of elder abuse and neglect555
0113Alzheimer's disease demonstration grants111111
0114Program administration202024
0115Lifespan respite care program3310
0117Aging and Disability Resource Centers (ADRC)101013
0118Chronic Disease Self-Management Program10
0120Adult Protective Services17
0121Senior Medicare Patrol program10
0122Elder Rights Support Activities4
0123CLASS Program Administration120
0125Community Service Employment for Older Americans450
0126State Health Insurance Assistance Program (SHIPs)47
0191Subtotal, annual appropriations1,5231,5262,248
0300Total, direct program1,5231,5262,248
0801Reimbursable program433
0803MIPPA30
0899Total reimbursable obligations3433
0900Total new obligations1,5571,5292,251
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 111
Budget authority:
Appropriations, discretionary:
1100Appropriation1,5161,5162,237
1120Appropriations transferred to other accounts–3
1160Appropriation, discretionary (total)1,5131,5162,237
Appropriations, mandatory:
1200Appropriation101010
Spending authority from offsetting collections, discretionary:
1700Collected33
1701Change in uncollected payments, Federal sources1
1750Spending auth from offsetting collections, disc (total)133
Spending authority from offsetting collections, mandatory:
1800Collected826
1801Change in uncollected payments, Federal sources26–26
1850Spending auth from offsetting collections, mand (total)34
1900Budget authority (total)1,5581,5292,250
1930Total budgetary resources available1,5581,5302,251
Memorandum (non-add) entries:
1941Unexpired unobligated balance, end of year11
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)715746758
3010Uncollected pymts, Fed sources, brought forward, Oct 1–25–49–23
3020Obligated balance, start of year (net)690697735
3030Obligations incurred, unexpired accounts1,5571,5292,251
3040Outlays (gross)–1,521–1,517–1,969
3050Change in uncollected pymts, Fed sources, unexpired–2726
3051Change in uncollected pymts, Fed sources, expired3
3081Recoveries of prior year unpaid obligations, expired–5
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)7467581,040
3091Uncollected pymts, Fed sources, end of year–49–23–23
3100Obligated balance, end of year (net)6977351,017
Budget authority and outlays, net:
Discretionary:
4000Budget authority, gross1,5141,5192,240
Outlays, gross:
4010Outlays from new discretionary authority9169281,368
4011Outlays from discretionary balances597588591
4020Outlays, gross (total)1,5131,5161,959
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030Federal sources–1–3–3
Additional offsets against gross budget authority only:
4050Change in uncollected pymts, Fed sources, unexpired–1
4052Offsetting collections credited to expired accounts1
4060Additional offsets against budget authority only (total)
4070Budget authority, net (discretionary)1,5131,5162,237
4080Outlays, net (discretionary)1,5121,5131,956
Mandatory:
4090Budget authority, gross441010
Outlays, gross:
4100Outlays from new mandatory authority111
4101Outlays from mandatory balances79
4110Outlays, gross (total)8110
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120Federal sources–8–26
Additional offsets against gross budget authority only:
4140Change in uncollected pymts, Fed sources, unexpired–2626
4160Budget authority, net (mandatory)101010
4170Outlays, net (mandatory)–2510
4180Budget authority, net (total)1,5231,5262,247
4190Outlays, net (total)1,5121,4881,966
Object Classification(in millions of dollars)Identification code 75–0142–0–1–5062010 actualCR2012 est.
Direct obligations:
Personnel compensation:
11.1Full-time permanent111115
11.3Other than full-time permanent111
11.9Total personnel compensation121216
12.1Civilian personnel benefits336
23.1Rental payments to GSA223
25.1Advisory and assistance services99134
25.3Other goods and services from federal sources7718
41.0Grants, subsidies, and contributions1,4901,4932,071
99.0Direct obligations1,5231,5262,248
99.0Reimbursable obligations3433
99.9Total new obligations1,5571,5292,251
Employment SummaryIdentification code 75–0142–0–1–5062010 actualCR2012 est.
1001Direct civilian full-time equivalent employment93103168
2001Reimbursable civilian full-time equivalent employment788
This account provides for administrative expenses related to the management of the CLASS program from the CLASS Independence Fund. The account is funded by premiums collected from individuals who voluntarily enroll in the CLASS Independence Benefit Plan. Their premiums are deposited into the CLASS Independence Fund, a trust fund held by the CLASS Independence Fund Board of Trustees. This program provides a self-directed resource for eligible participants to purchase community living assistance services and supports. This account also accrues interest earned on investment of the CLASS Independence Fund.2010CR2012
Start of Year Fund Balance........................
Premiums................5,500
Interest................90
Appropriations................(200)
End of Year Fund Balance................5,390
Program and Financing(in millions of dollars)Identification code 75–8160–0–7–5512010 actualCR2012 est.
Obligations by program activity:
0001Direct program activity200
0900Total new obligations200
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200Appropriation200
1930Total budgetary resources available200
Change in obligated balance:
3030Obligations incurred, unexpired accounts200
3040Outlays (gross)–200
Budget authority and outlays, net:
Mandatory:
4090Budget authority, gross200
Outlays, gross:
4100Outlays from new mandatory authority200
4180Budget authority, net (total)200
4190Outlays, net (total)200
General Departmental Management general departmental management(including transfer of funds)For necessary expenses, not otherwise provided, for general departmental management, including hire of six sedans, and for carrying out titles III, IV, XVII, XX, and XXI, and XXVII of the Public Health Service Act ("PHS Act''), the United States-Mexico Border Health Commission Act, and research studies under section 1110 of the Social Security Act, $537,149,000 $363,644,000, and $65,211,000$126,702,000 from the amounts available under section 241 of the PHS Act to carry out national health or human services research and evaluation activities: Provided, That of this amount, $53,891,000 shall be for minority AIDS prevention and treatment activities: Provided further, That none of the funds made available under this heading shall be available for carrying out activities specified under section 2003(b) (2) or (3) of Title XX of the PHS Act: Provided further, That of the funds made available under this heading, $129,218,000 shall be for making competitive contracts and grants to public and private entities to fund medically accurate and age appropriate programs that reduce teen pregnancy and for the Federal costs associated with administering and evaluating such contracts and grants, of which not less than $85,000,000 shall be for replicating programs that have been proven effective through rigorous evaluation to reduce teenage pregnancy, behavioral risk factors underlying teenage pregnancy, or other associated risk factors, of which not less than $28,000,000 shall be available for research and demonstration grants to develop, replicate, refine, and test additional models and innovative strategies for preventing teenage pregnancy, and of which any remaining amounts shall be available for training and technical assistance, evaluation, outreach, and additional program support activities: Provided, furtherThat of the amounts provided under this heading from amounts available under section 241 of the PHS Act, $4,455,000$8,455,000 shall be available to carry out evaluations (including longitudinal evaluations) of teenage pregnancy prevention approaches, and $53,891,000 shall be available for minority AIDS prevention and treatment activities: Provided further, That of the funds made available under this heading, $7,000,000 is for strengthening the Department's acquisition workforce capacity and capabilities: Provided further, That, with respect to the previous proviso, such funds shall be available for training, recruitment, retention, and hiring members of the acquisition workforce as defined by the Office of Federal Procurement Policy Act, as amended (41 U.S.C. 401 et seq.): Provided further, That, with respect to the second proviso, such funds shall be available for information technology in support of acquisition workforce effectiveness or for management solutions to improve acquisition management: Provided further, That funds provided in this Act for embryo adoption activities may be used to provide, to individuals adopting embryos, through grants and other mechanisms, medical and administrative services deemed necessary for such adoptions: Provided further, That such services shall be provided consistent with 42 CFR 59.5(a)(4): Provided further, That $10,000,000 of the funds made available under this heading shall be available for health and wellness pilot initiatives for Federal employees, of which up to $5,000,000 may be transferred to other agencies, with the approval of the Director of the Office of Management and Budget, to assist those agencies in the implementation of such initiatives. Note.—A full-year 2011 appropriation for this account was not enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 111–242, as amended). The amounts included for 2011 reflect the annualized level provided by the continuing resolution.Note.—The reimbursable HCFAC program in General Departmental Management reflects the estimated distribution from the allocation account for 2011 and 2012. General Departmental Management (GDM) funds activities that provide leadership, policy, legal, and administrative guidance to HHS components, and support research to develop policy initiatives and improve existing HHS programs. GDM also funds the activities of the Office of the Assistant Secretary for Health, including adolescent health, disease prevention and health promotion, physical fitness and sports, minority health, research integrity, women's health, and programs funded through the Prevention and Public Health Fund. This includes funding the continuation of grants for medically accurate and age appropriate programs to reduce teen pregnancy, including funds for research, demonstration grants, and replication of programs that have been proven effective through rigorous evaluation to reduce teen pregnancy. Program and Financing(in millions of dollars)Identification code 75–9912–0–1–5512010 actualCR2012 est.
Obligations by program activity:
0001General departmental management559493364
0003CHIPRA evaluation3
0004Prevention and Public Health Fund135
0091Direct program activities, subtotal562493499
0801General departmental management919191
0802HCFAC999
0803PHS evaluation6565127
0899Total reimbursable obligations165165227
0900Total new obligations727658726
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 1101474
Budget authority:
Appropriations, discretionary:
1100Appropriation493493364
1120Appropriations transferred to other accounts–1–1
1160Appropriation, discretionary (total)492492364
Appropriations, mandatory:
1200Appropriation10
1221Appropriations transferred from other accounts12135
1260Appropriations, mandatory (total)22135
Spending authority from offsetting collections, discretionary:
1700Collected96217226
1701Change in uncollected payments, Federal sources119
1750Spending auth from offsetting collections, disc (total)215217226
Spending authority from offsetting collections, mandatory:
1800Collected9
1801Change in uncollected payments, Federal sources9
1850Spending auth from offsetting collections, mand (total)99
1900Budget authority (total)738718725
1930Total budgetary resources available748732799
Memorandum (non-add) entries:
1940Unobligated balance expiring–7
1941Unexpired unobligated balance, end of year147473
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)443542537
3010Uncollected pymts, Fed sources, brought forward, Oct 1–247–346–346
3020Obligated balance, start of year (net)196196191
3030Obligations incurred, unexpired accounts727658726
3031Obligations incurred, expired accounts4
3040Outlays (gross)–622–663–772
3050Change in uncollected pymts, Fed sources, unexpired–128
3051Change in uncollected pymts, Fed sources, expired29
3081Recoveries of prior year unpaid obligations, expired–10
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)542537491
3091Uncollected pymts, Fed sources, end of year–346–346–346
3100Obligated balance, end of year (net)196191145
Budget authority and outlays, net:
Discretionary:
4000Budget authority, gross707709590
Outlays, gross:
4010Outlays from new discretionary authority319512444
4011Outlays from discretionary balances291130193
4020Outlays, gross (total)610642637
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030Federal sources–128–217–226
Additional offsets against gross budget authority only:
4050Change in uncollected pymts, Fed sources, unexpired–119
4052Offsetting collections credited to expired accounts32
4060Additional offsets against budget authority only (total)–87
4070Budget authority, net (discretionary)492492364
4080Outlays, net (discretionary)482425411
Mandatory:
4090Budget authority, gross319135
Outlays, gross:
4100Outlays from new mandatory authority99135
4101Outlays from mandatory balances312
4110Outlays, gross (total)1221135
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120Federal sources–9
Additional offsets against gross budget authority only:
4140Change in uncollected pymts, Fed sources, unexpired–9
4160Budget authority, net (mandatory)22135
4170Outlays, net (mandatory)1212135
4180Budget authority, net (total)514492499
4190Outlays, net (total)494437546
Object Classification(in millions of dollars)Identification code 75–9912–0–1–5512010 actualCR2012 est.
Direct obligations:
Personnel compensation:
11.1Full-time permanent828294
11.3Other than full-time permanent988
11.5Other personnel compensation399
11.7Military personnel497
11.8Special personal services payments1
11.9Total personnel compensation99108118
12.1Civilian personnel benefits232627
12.2Military personnel benefits354
21.0Travel and transportation of persons577
22.0Transportation of things1
23.1Rental payments to GSA2524
23.3Communications, utilities, and miscellaneous charges2461
24.0Printing and reproduction255
25.1Advisory and assistance services495844
25.2Other services from non-federal sources315042
25.3Other goods and services from federal sources515834
25.4Operation and maintenance of facilities41011
25.5Research and development contracts1
25.7Operation and maintenance of equipment134
26.0Supplies and materials238
31.0Equipment366
41.0Grants, subsidies, and contributions263123164
99.0Direct obligations562493499
99.0Reimbursable obligations165165227
99.9Total new obligations727658726
Employment SummaryIdentification code 75–9912–0–1–5512010 actualCR2012 est.
1001Direct civilian full-time equivalent employment890897980
1101Direct military average strength employment664748
2001Reimbursable civilian full-time equivalent employment363400386
2101Reimbursable military average strength employment182625
office for civil rightsFor expenses necessary for the Office for Civil Rights, $44,382,000$46,717,000. Note.—A full-year 2011 appropriation for this account was not enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 111–242, as amended). The amounts included for 2011 reflect the annualized level provided by the continuing resolution.The Office for Civil Rights funds activities that carry out the Department's civil rights nondiscrimination and health information privacy and security compliance programs.Program and Financing(in millions of dollars)Identification code 75–0135–0–1–7512010 actualCR2012 est.
Obligations by program activity:
0001Direct program activity383847
0801Reimbursable program33
0900Total new obligations414147
Budgetary Resources:
Budget authority:
Appropriations, discretionary:
1100Appropriation383847
Spending authority from offsetting collections, discretionary:
1700Collected33
1900Budget authority (total)414147
1930Total budgetary resources available414147
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)121212
3010Uncollected pymts, Fed sources, brought forward, Oct 1–1–1–1
3020Obligated balance, start of year (net)111111
3030Obligations incurred, unexpired accounts414147
3040Outlays (gross)–40–41–46
3081Recoveries of prior year unpaid obligations, expired–1
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)121213
3091Uncollected pymts, Fed sources, end of year–1–1–1
3100Obligated balance, end of year (net)111112
Budget authority and outlays, net:
Discretionary:
4000Budget authority, gross414147
Outlays, gross:
4010Outlays from new discretionary authority323338
4011Outlays from discretionary balances888
4020Outlays, gross (total)404146
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030Federal sources–3–3
Additional offsets against gross budget authority only:
4052Offsetting collections credited to expired accounts
4070Budget authority, net (discretionary)383847
4080Outlays, net (discretionary)373846
4180Budget authority, net (total)383847
4190Outlays, net (total)373846
Object Classification(in millions of dollars)Identification code 75–0135–0–1–7512010 actualCR2012 est.
Direct obligations:
11.1Personnel compensation: Full-time permanent232328
12.1Civilian personnel benefits667
21.0Travel and transportation of persons1
23.1Rental payments to GSA333
25.2Other services from non-federal sources668
99.0Direct obligations383847
99.0Reimbursable obligations33
99.9Total new obligations414147
Employment SummaryIdentification code 75–0135–0–1–7512010 actualCR2012 est.
1001Direct civilian full-time equivalent employment226262276
1101Direct military average strength employment111
2001Reimbursable civilian full-time equivalent employment333
Office of the National Coordinator for Health Information Technology office of the national coordinator for health information technologyFor 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 interoperable health information technology, $78,334,000.$57,013,000: Provided, That in addition to amounts provided herein, $21,400,000 shall be available from amounts available under section 241 of the Public Health Service Act. Note.—A full-year 2011 appropriation for this account was not enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 111–242, as amended). The amounts included for 2011 reflect the annualized level provided by the continuing resolution.This program supports coordination, leadership, and development of Federal health information technology activities and Federal initiatives for the nationwide advancement of private and secure interoperable health information technology, in cooperation with participants in the health sector. The Office of the National Coordinator for Health Information Technology was established in the Health Information Technology for Economic and Clinical Health Act (P.L. 111–5, Title XIII), 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 and supporting the President's Health Information Technology Initiative are coordinated across several HHS organizations, as shown in the following consolidated table. Health Information Technology Funding(Program level - in millions of dollars)2010 actual2011 est.2012 est.
Distribution of funding by account:
National Coordinator for Health Information Technology616178
General Departmental Management211
Agency for Healthcare Research and Quality282828
HIT Initiative Total9190107
Federal Health Architecture81312
Program and Financing(in millions of dollars)Identification code 75–0130–0–1–5512010 actualCR2012 est.
Obligations by program activity:
0001Health information technology424257
0002Recovery Act activities1,820158
0091Direct program activities, subtotal1,86220057
0801Reimbursable program171312
0802Reimbursable program: PHS evaluation191921
0899Total reimbursable obligations363233
0900Total new obligations1,89823290
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 11,979158
Budget authority:
Appropriations, discretionary:
1100Appropriation424257
Spending authority from offsetting collections, discretionary:
1700Collected193233
1701Change in uncollected payments, Federal sources17
1750Spending auth from offsetting collections, disc (total)363233
1900Budget authority (total)787490
1930Total budgetary resources available2,05723290
Memorandum (non-add) entries:
1940Unobligated balance expiring–1
1941Unexpired unobligated balance, end of year158
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)701,8131,473
3010Uncollected pymts, Fed sources, brought forward, Oct 1–37–34–34
3020Obligated balance, start of year (net)331,7791,439
3030Obligations incurred, unexpired accounts1,89823290
3040Outlays (gross)–153–572–433
3050Change in uncollected pymts, Fed sources, unexpired–17
3051Change in uncollected pymts, Fed sources, expired20
3081Recoveries of prior year unpaid obligations, expired–2
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)1,8131,4731,130
3091Uncollected pymts, Fed sources, end of year–34–34–34
3100Obligated balance, end of year (net)1,7791,4391,096
Budget authority and outlays, net:
Discretionary:
4000Budget authority, gross787490
Outlays, gross:
4010Outlays from new discretionary authority485362
4011Outlays from discretionary balances105519371
4020Outlays, gross (total)153572433
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030Federal sources–27–32–33
4033Non-Federal sources–11
4040Offsets against gross budget authority and outlays (total)–38–32–33
Additional offsets against gross budget authority only:
4050Change in uncollected pymts, Fed sources, unexpired–17
4052Offsetting collections credited to expired accounts19
4060Additional offsets against budget authority only (total)2
4070Budget authority, net (discretionary)424257
4080Outlays, net (discretionary)115540400
4180Budget authority, net (total)424257
4190Outlays, net (total)115540400
Object Classification(in millions of dollars)Identification code 75–0130–0–1–5512010 actualCR2012 est.
Direct obligations:
11.1Personnel compensation: Full-time permanent8914
12.1Civilian personnel benefits224
23.1Rental payments to GSA223
25.1Advisory and assistance services292427
25.2Other services from non-federal sources1151002
25.3Other goods and services from federal sources1026
31.0Equipment111
41.0Grants, subsidies, and contributions1,69560
99.0Direct obligations1,86220057
99.0Reimbursable obligations363233
99.9Total new obligations1,89823290
Employment SummaryIdentification code 75–0130–0–1–5512010 actualCR2012 est.
1001Direct civilian full-time equivalent employment71148188
1101Direct military average strength employment111
Office of Medicare Hearings and Appeals office of medicare hearings and appealsFor 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), $77,798,000 $81,019,000, to be transferred in appropriate part from the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund. Note.—A full-year 2011 appropriation for this account was not enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 111–242, as amended). The amounts included for 2011 reflect the annualized level provided by the continuing resolution.This appropriation funds the operations of the Office of Medicare Hearings and Appeals (OMHA), as authorized by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. OMHA provides the forum 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 those determinations, in accordance with the requirements of the Administrative Procedures Act and the Social Security Act.Program and Financing(in millions of dollars)Identification code 75–0139–0–1–5512010 actualCR2012 est.
Obligations by program activity:
0001Direct program activity707181
Budgetary Resources:
Budget authority:
Spending authority from offsetting collections, discretionary:
1700Collected717181
1930Total budgetary resources available717181
Memorandum (non-add) entries:
1940Unobligated balance expiring–1
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)142020
3030Obligations incurred, unexpired accounts707181
3040Outlays (gross)–64–71–81
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)202020
Budget authority and outlays, net:
Discretionary:
4000Budget authority, gross717181
Outlays, gross:
4010Outlays from new discretionary authority587181
4011Outlays from discretionary balances6
4020Outlays, gross (total)647181
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030Federal sources–71–71–81
4070Budget authority, net (discretionary)
4080Outlays, net (discretionary)–7
4180Budget authority, net (total)
4190Outlays, net (total)–7
Object Classification(in millions of dollars)Identification code 75–0139–0–1–5512010 actualCR2012 est.
Direct obligations:
Personnel compensation:
11.1Full-time permanent343441
11.5Other personnel compensation11
11.9Total personnel compensation343542
12.1Civilian personnel benefits9912
23.1Rental payments to GSA877
23.3Communications, utilities, and miscellaneous charges112
25.1Advisory and assistance services986
25.2Other services from non-federal sources434
25.3Other goods and services from federal sources487
26.0Supplies and materials11
99.0Direct obligations707181
99.9Total new obligations707181
Employment SummaryIdentification code 75–0139–0–1–5512010 actualCR2012 est.
1001Direct civilian full-time equivalent employment368395424
Public Health and Social Services Emergency Fund public health and social services emergency fund(including transfer of funds)For expenses necessary to support activities related to countering potential biological, nuclear, radiological, chemical, and cybersecurity threats to civilian populations, and for other public health emergencies, $623,734,000$585,023,000; of which $44,153,000$15,000,000 shall remain available until expended to support emergency operationsshall be to support preparedness and emergency operations, of which $15,000,000, to support expenses due to response efforts, shall remain available until expended; and of which $10,000,000$5,000,000, to remain available through September 30, 20122013, shall be to support the delivery of medical countermeasures: Provided, That of the amount made available herein for the delivery of medical countermeasures, up to $8,000,000$4,000,000 may be transferred made available to the U.S. Postal Service to support delivery of medical countermeasures. From funds transferred to this account pursuant to the fourth paragraph under this heading in Public Law 111–117, up to $476,194,000$665,000,000 shall be available for expenses necessary to support advanced research and development pursuant to section 319L of the Public Health Service Act ("PHS Act''), Actand other administrative expenses of the Biomedical Advanced Research and Development Authority: Provided, That the Secretary may increase this limitation 15 days after notifying the Committees on Appropriations of the House of Representatives and the Senate of the intent to do so to support additional advanced research and development pursuant to section 319L of the PHS Act.For expenses necessary to prepare for and respond to an influenza pandemic, $65,578,000.For expenses necessary for fit-out and other costs related to a competitive lease procurement to renovate or replace the existing headquarters building for Public Health Service agencies and other components of the Department of Health and Human Services, $35,000,000, to remain available until expended; and, in addition, for fit-out and other costs related to the consolidation of office space for the Office of the Assistant Secretary for Preparedness and Response, $10,000,000$10,000,000, to remain available until expended. Of the remaining balances of funds transferred to this account pursuant to the fourth paragraph under this heading in Public Law 111–117, up to $100,000,000 shall be available for the purpose of funding a strategic investment corporation established to further the purposes of section 319L of the PHS Act (42 U.S.C. 247d-7e) to foster innovation in the development of medical countermeasures.Note.—A full-year 2011 appropriation for this account was not enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 111–242, as amended). The amounts included for 2011 reflect the annualized level provided by the continuing resolution.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. This account 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 hospital preparedness and other emergency preparedness activities including the National Disaster Medical System. The PHSSEF also supports the HHS Cyber Security program, the Medical Reserve Corps, and the Office of Security and Strategic Information. The PHSSEF also continues to support the advanced development of biodefense countermeasures. These resources will be derived from available funds appropriated for the BioShield Special Reserve Fund. Included will be all administrative expenses of the Biomedical Advanced Research and Development Authority (BARDA).Resources are also being provided to consolidate the offices of the Assistant Secretary for Preparedness and Response. A Strategic Investor corporation will be created to make investments in the private sector with specific focus on disruptive technologies including novel antimicrobials and multi-use platform technologies for diagnostics and medical countermeasures, which will be funded from available resources appropriated for the BioShield Special Reserve Fund. Program and Financing(in millions of dollars)Identification code 75–0140–0–1–5512010 actualCR2012 est.
Obligations by program activity:
0001Public Health and Social Services Emergency Fund1,7722,9521,859
0002Recovery Act, PHSSEF46
0091Direct program activities, subtotal1,8182,9521,859
0801Reimbursable program446060
0900Total new obligations1,8623,0121,919
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 14,5616,6174,700
1010Unobligated balance transferred to other accounts–242–5–5
1021Recoveries of prior year unpaid obligations146
1050Unobligated balance (total)4,4656,6124,695
Budget authority:
Appropriations, discretionary:
1100Appropriation1,2621,040595
1120Appropriations transferred to other accounts–2
1121Appropriations transferred from other accounts2,729
1131Unobligated balance of appropriations permanently reduced–7
1160Appropriation, discretionary (total)3,9821,040595
Spending authority from offsetting collections, discretionary:
1700Collected136060
1701Change in uncollected payments, Federal sources23
1750Spending auth from offsetting collections, disc (total)366060
1900Budget authority (total)4,0181,100655
1930Total budgetary resources available8,4837,7125,350
Memorandum (non-add) entries:
1940Unobligated balance expiring–4
1941Unexpired unobligated balance, end of year6,6174,7003,431
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)7,0873,8352,420
3010Uncollected pymts, Fed sources, brought forward, Oct 1–520–461–461
3020Obligated balance, start of year (net)6,5673,3741,959
3030Obligations incurred, unexpired accounts1,8623,0121,919
3031Obligations incurred, expired accounts24
3040Outlays (gross)–4,981–4,427–2,815
3050Change in uncollected pymts, Fed sources, unexpired–23
3051Change in uncollected pymts, Fed sources, expired82
3080Recoveries of prior year unpaid obligations, unexpired–146
3081Recoveries of prior year unpaid obligations, expired–11
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)3,8352,4201,524
3091Uncollected pymts, Fed sources, end of year–461–461–461
3100Obligated balance, end of year (net)3,3741,9591,063
Budget authority and outlays, net:
Discretionary:
4000Budget authority, gross4,0181,100655
Outlays, gross:
4010Outlays from new discretionary authority219220158
4011Outlays from discretionary balances4,7624,2072,657
4020Outlays, gross (total)4,9814,4272,815
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030Federal sources–91–60–60
Additional offsets against gross budget authority only:
4050Change in uncollected pymts, Fed sources, unexpired–23
4052Offsetting collections credited to expired accounts78
4060Additional offsets against budget authority only (total)55
4070Budget authority, net (discretionary)3,9821,040595
4080Outlays, net (discretionary)4,8904,3672,755
4180Budget authority, net (total)3,9821,040595
4190Outlays, net (total)4,8904,3672,755
Object Classification(in millions of dollars)Identification code 75–0140–0–1–5512010 actualCR2012 est.
Direct obligations:
Personnel compensation:
11.1Full-time permanent515565
11.3Other than full-time permanent91414
11.7Military personnel798
11.9Total personnel compensation677887
12.1Civilian personnel benefits141417
12.2Military personnel benefits444
21.0Travel and transportation of persons121414
22.0Transportation of things411
23.1Rental payments to GSA101313
23.3Communications, utilities, and miscellaneous charges1964
25.1Advisory and assistance services354163332
25.2Other services from non-federal sources4264129
25.3Other goods and services from federal sources415235343
25.4Operation and maintenance of facilities213
25.5Research and development contracts561,289260
25.6Medical care3
25.7Operation and maintenance of equipment82436
26.0Supplies and materials320113249
31.0Equipment336
32.0Land and structures70518
41.0Grants, subsidies, and contributions415412361
99.0Direct obligations1,8182,9521,859
99.0Reimbursable obligations446060
99.9Total new obligations1,8623,0121,919
Employment SummaryIdentification code 75–0140–0–1–5512010 actualCR2012 est.
1001Direct civilian full-time equivalent employment643643643
1101Direct military average strength employment737373
Transfers from the Patient-Centered Outcomes Research Trust Fund Public Law 111–148 established the Patient-Centered Outcomes Research Trust Fund (PCORTF). Beginning in FY 2011, a total of 20 percent of the funds appropriated or credited to the PCORTF will be transferred each year to the Department of Health and Human Services (HHS). As authorized in section 937 of the Public Health Service Act, HHS will disseminate research findings from the Patient-Centered Outcomes Research Institute and other government-funded comparative clinical effectiveness research and build research and data capacity for comparative clinical effectiveness research. Transferred funds will be distributed to the Secretary of HHS and the Agency for Healthcare Research and Quality to carry out these activities. Program and Financing(in millions of dollars)Identification code 75–0145–0–1–5522010 actualCR2012 est.
Obligations by program activity:
0801AHRQ824
0802Office of the Secretary26
0900Total new obligations1030
Budgetary Resources:
Budget authority:
Spending authority from offsetting collections, mandatory:
1800Collected1030
1930Total budgetary resources available1030
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)9
3030Obligations incurred, unexpired accounts1030
3040Outlays (gross)–1–9
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)930
Budget authority and outlays, net:
Mandatory:
4090Budget authority, gross1030
Outlays, gross:
4100Outlays from new mandatory authority15
4101Outlays from mandatory balances4
4110Outlays, gross (total)19
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120Federal sources–10–30
4160Budget authority, net (mandatory)
4170Outlays, net (mandatory)–9–21
4180Budget authority, net (total)
4190Outlays, net (total)–9–21
Object Classification(in millions of dollars)Identification code 75–0145–0–1–5522010 actualCR2012 est.
99.0Reimbursable obligations: reimbursable obligations26
Allocation Account - reimbursable:
25.5Research and development contracts824
99.0Allocation account - reimbursable824
99.9Total new obligations1030
Prevention and Wellness Fund, Recovery Act The Prevention and Wellness Fund is authorized under the American Recovery and Reinvestment Act (ARRA), (P.L. 111–5). The Prevention and Wellness Fund administers evidence-based clinical and community-based prevention and wellness strategies. Program and Financing(in millions of dollars)Identification code 75–0144–0–1–5512010 actualCR2012 est.
Obligations by program activity:
0001Direct program activity9
0900Total new obligations (object class 41.0)9
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 1659
1010Unobligated balance transferred to other accounts–650
1050Unobligated balance (total)9
1930Total budgetary resources available9
Memorandum (non-add) entries:
1941Unexpired unobligated balance, end of year
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)403931
3030Obligations incurred, unexpired accounts9
3040Outlays (gross)–10–8–31
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)3931
Budget authority and outlays, net:
Discretionary:
Outlays, gross:
4011Outlays from discretionary balances10831
4180Budget authority, net (total)
4190Outlays, net (total)10831
Nonrecurring Expenses Fund The Nonrecurring Expenses Fund is a no-year account that captures expired unobligated balances from discretionary accounts prior to cancellation. The Fund will be used for nonrecurring expenses that are difficult to accomodate or arise outside of the normal budget process. Beginning with 2008 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 a proposed use of the Fund will be submitted to the relevant Committees on Appropriations of the House of Representatives and the Senate, with justification for the proposed areas/projects. Health Insurance Reform Implementation Fund Section 1005 of the Health Care and Education Reconciliation Act of 2010 (P.L. 111–152) appropriates $1,000,000,000 to the Health Insurance Reform Implementation Fund within the Department of Health and Human Services. The Fund shall be used for Federal administrative expenses necessary to carry out the requirements of the Patient Protection and Affordable Care Act of 2010 (P.L. 111–148) and the Health Care and Education Reconciliation Act of 2010.Program and Financing(in millions of dollars)Identification code 75–0119–0–1–5512010 actualCR2012 est.
Obligations by program activity:
0001Direct program activity12879082
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 187282
Budget authority:
Appropriations, mandatory:
1200Appropriation1,000
1930Total budgetary resources available1,00087282
Memorandum (non-add) entries:
1941Unexpired unobligated balance, end of year87282
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)107447
3030Obligations incurred, unexpired accounts12879082
3040Outlays (gross)–21–450–420
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)107447109
Budget authority and outlays, net:
Mandatory:
4090Budget authority, gross1,000
Outlays, gross:
4100Outlays from new mandatory authority21
4101Outlays from mandatory balances450420
4110Outlays, gross (total)21450420
4180Budget authority, net (total)1,000
4190Outlays, net (total)21450420
Object Classification(in millions of dollars)Identification code 75–0119–0–1–5512010 actualCR2012 est.
Direct obligations:
Personnel compensation:
11.1Full-time permanent485
11.7Military personnel3
11.9Total personnel compensation488
12.1Civilian personnel benefits130
12.2Military personnel benefits1
21.0Travel and transportation of persons14
22.0Transportation of things11
23.1Rental payments to GSA11
24.0Printing and reproduction12
25.1Advisory and assistance services64356
25.2Other services from non-federal sources69
25.3Other goods and services from federal sources1421
25.4Operation and maintenance of facilities12
25.7Operation and maintenance of equipment47
25.8Subsistence and support of persons610
26.0Supplies and materials12
31.0Equipment13
33.0Investments and loans11
99.0Direct obligations107538
Allocation Account - direct:
11.1Personnel compensation: Full-time permanent47152
12.1Civilian personnel benefits12615
21.0Travel and transportation of persons16
23.1Rental payments to GSA1
23.3Communications, utilities, and miscellaneous charges14
24.0Printing and reproduction5
25.1Advisory and assistance services48310
25.2Other services from non-federal sources109
25.3Other goods and services from federal sources3
25.4Operation and maintenance of facilities1
26.0Supplies and materials1
31.0Equipment405
32.0Land and structures2
99.0Allocation account - direct2125282
99.9Total new obligations12879082
Employment SummaryIdentification code 75–0119–0–1–5512010 actualCR2012 est.
1001Direct civilian full-time equivalent employment87703
1101Direct military average strength employment20
Prevention and Public Health Fund The Patient Protection and Affordable Care Act, (P.L. 111–148) establishes the Prevention and Public Health Fund as a mandatory appropriation for prevention and public health activities. For FY 2012, the law appropriates $1 billion into the Fund, which the Secretary then has authority to transfer to accounts within HHS. The Prevention and Public Health Fund increases and sustains investments in a range of public health efforts intended to prevent disease and reduce health care costs. Program and Financing(in millions of dollars)Identification code 75–0116–0–1–5512010 actualCR2012 est.
Obligations by program activity:
0001Direct program activity750
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200Appropriation5007501,000
1220Appropriations transferred to other accounts–500–1,000
1260Appropriations, mandatory (total)750
1930Total budgetary resources available750
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)682
3030Obligations incurred, unexpired accounts750
3040Outlays (gross)–68–600
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)68282
Budget authority and outlays, net:
Mandatory:
4090Budget authority, gross750
Outlays, gross:
4100Outlays from new mandatory authority68
4101Outlays from mandatory balances600
4110Outlays, gross (total)68600
4180Budget authority, net (total)750
4190Outlays, net (total)68600
Object Classification(in millions of dollars)Identification code 75–0116–0–1–5512010 actualCR2012 est.
Direct obligations:
25.5Research and development contracts150
41.0Grants, subsidies, and contributions600
99.9Total new obligations750
Pregnancy Assistance Fund For awarding competitive grants to States to assist pregnant and parenting teens and women.Program and Financing(in millions of dollars)Identification code 75–0117–0–1–5512010 actualCR2012 est.
Obligations by program activity:
0001Direct program activity252525
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200Appropriation252525
1930Total budgetary resources available252525
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)2227
3030Obligations incurred, unexpired accounts252525
3040Outlays (gross)–3–20–25
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)222727
Budget authority and outlays, net:
Mandatory:
4090Budget authority, gross252525
Outlays, gross:
4100Outlays from new mandatory authority111
4101Outlays from mandatory balances21924
4110Outlays, gross (total)32025
4180Budget authority, net (total)252525
4190Outlays, net (total)32025
Object Classification(in millions of dollars)Identification code 75–0117–0–1–5512010 actualCR2012 est.
Direct obligations:
25.3Other goods and services from federal sources111
41.0Grants, subsidies, and contributions242424
99.9Total new obligations252525
World Trade Center Health Program Fund The World Trade Center Program is authorized under P.L. 111 347, the James Zadroga 9/11 Health and Compensation Act of 2010. The Department of Health and Human Services, including NIOSH, will administer the program. The program will provide medical monitoring and treatment services to response workers who responded to the September 11, 2001, Word Trade Center Emergency in New York and to individuals who lived or worked in the vicinity of the World Trade Center during that time. Program and Financing(in millions of dollars)Identification code 75–0146–0–1–5512010 actualCR2012 est.
Obligations by program activity:
0001WTC70313
0840WTC Reimbursables731
0900Total new obligations77344
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200Appropriation70313
Spending authority from offsetting collections, mandatory:
1800Collected731
1900Budget authority (total)77344
1930Total budgetary resources available77344
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)7
3030Obligations incurred, unexpired accounts77344
3040Outlays (gross)–70–332
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)719
Budget authority and outlays, net:
Discretionary:
4000Budget authority, gross
Mandatory:
4090Budget authority, gross77344
Outlays, gross:
4100Outlays from new mandatory authority70325
4101Outlays from mandatory balances7
4110Outlays, gross (total)70332
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4123Non-Federal sources–7–31
4160Budget authority, net (mandatory)70313
4170Outlays, net (mandatory)63301
4180Budget authority, net (total)70313
4190Outlays, net (total)63301
Object Classification(in millions of dollars)Identification code 75–0146–0–1–5512010 actualCR2012 est.
Direct obligations:
11.1Personnel compensation: Full-time permanent13
12.1Civilian personnel benefits1
25.1Advisory and assistance services5
25.6Medical care63280
41.0Grants, subsidies, and contributions624
99.0Direct obligations70313
99.0Reimbursable obligations731
99.9Total new obligations77344
Employment SummaryIdentification code 75–0146–0–1–5512010 actualCR2012 est.
1001Direct civilian full-time equivalent employment1025
Retirement Pay and Medical Benefits for Commissioned Officers retirement pay and medical benefits for commissioned officersFor retirement pay and medical benefits of Public Health Service Commissioned Officers as authorized by law, for payments under the Retired Serviceman's Family Protection Plan and Survivor Benefit Plan, and for medical care of dependents and retired personnel under the Dependents' Medical Care Act, such amounts as may be required during the current fiscal year. Note.—A full-year 2011 appropriation for this account was not enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 111–242, as amended). The amounts included for 2011 reflect the annualized level provided by the continuing resolution.The number of beneficiaries using the Commissioned Corps system is estimated as follows:Retirement Pay, Survivor Benefits, and Medical Benefits201020112012
Active Duty:
HHS498250865118
DOJ, BOP782800820
Homeland Security492471471
EPA767676
All Other292389435
Total Active Duty658468226920
|
Retirees & Survivors:
Retirees531754765495
Retiree family members and survivors945950985
Total Retirement Pay626264266480
Total Beneficiaries (active duty, retirees, survivors)128461324813400
This activity funds annuities of retired Public Health Service (PHS) commissioned officers and survivors of retirees, and medical benefits for active duty PHS commissioned officers, retirees, and dependents of members and retirees of the PHS Commissioned Corps.Program and Financing(in millions of dollars)Identification code 75–0379–0–1–5512010 actualCR2012 est.
Obligations by program activity:
0001Retirement payments344386418
0002Survivors' benefits242832
0003Medical care73104115
0900Total new obligations441518565
Budgetary Resources:
Budget authority:
Appropriations, mandatory:
1200Appropriation461518565
1930Total budgetary resources available461518565
Memorandum (non-add) entries:
1940Unobligated balance expiring–20
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)494267
3001Adjustments to unpaid obligations, brought forward, Oct 120
3020Obligated balance, start of year (net)496267
3030Obligations incurred, unexpired accounts441518565
3040Outlays (gross)–447–513–561
3081Recoveries of prior year unpaid obligations, expired–1
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)426771
Budget authority and outlays, net:
Mandatory:
4090Budget authority, gross461518565
Outlays, gross:
4100Outlays from new mandatory authority406471514
4101Outlays from mandatory balances414247
4110Outlays, gross (total)447513561
4180Budget authority, net (total)461518565
4190Outlays, net (total)447513561
Object Classification(in millions of dollars)Identification code 75–0379–0–1–5512010 actualCR2012 est.
Direct obligations:
13.0Benefits for former personnel368414450
25.6Medical care73104115
99.9Total new obligations441518565
HHS Accrual Contribution to the Uniformed Services Retiree Health Care Fund The cost of medical benefits for Medicare-eligible beneficiaries is paid from the Department of Defense Medicare-Eligible 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).Program and Financing(in millions of dollars)Identification code 75–0170–0–1–5512010 actualCR2012 est.
Obligations by program activity:
0001Medicare eligible accruals363839
0900Total new obligations (object class 12.2)363839
Budgetary Resources:
Budget authority:
Appropriations, discretionary:
1100Appropriation363839
1930Total budgetary resources available363839
Change in obligated balance:
3030Obligations incurred, unexpired accounts363839
3040Outlays (gross)–36–38–39
Budget authority and outlays, net:
Discretionary:
4000Budget authority, gross363839
Outlays, gross:
4010Outlays from new discretionary authority363839
4180Budget authority, net (total)363839
4190Outlays, net (total)363839
Legislative proposal, not subject to PAYGO This display shows activities in support of St. Elizabeths Hospital and scientific activities overseas that were supported by foreign currencies by the United States abroad.Program and Financing(in millions of dollars)Identification code 75–9913–0–1–5522010 actualCR2012 est.
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)111
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)111
4180Budget authority, net (total)
4190Outlays, net (total)
HHS Service and Supply Fund 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, information technology, 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, web management, claims, acquisition integration and modernization, small business, grants tracking, the physical access aspects of the Department's implementation of Homeland Security Presidential Directive 12, and commercial services management. 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 agency, either through an allocation account or by directly citing that agency's appropriation.Program and Financing(in millions of dollars)Identification code 75–9941–0–4–5512010 actualCR2012 est.
Obligations by program activity:
0801Program support center8841,0991,044
0802OS activities536865
0900Total new obligations9371,1671,109
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 1191180180
1021Recoveries of prior year unpaid obligations32
1050Unobligated balance (total)223180180
Budget authority:
Spending authority from offsetting collections, discretionary:
1700Collected8501,1671,109
1701Change in uncollected payments, Federal sources44
1750Spending auth from offsetting collections, disc (total)8941,1671,109
1930Total budgetary resources available1,1171,3471,289
Memorandum (non-add) entries:
1941Unexpired unobligated balance, end of year180180180
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)307384384
3010Uncollected pymts, Fed sources, brought forward, Oct 1–396–440–440
3020Obligated balance, start of year (net)–89–56–56
3030Obligations incurred, unexpired accounts9371,1671,109
3040Outlays (gross)–828–1,167–1,109
3050Change in uncollected pymts, Fed sources, unexpired–44
3080Recoveries of prior year unpaid obligations, unexpired–32
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)384384384
3091Uncollected pymts, Fed sources, end of year–440–440–440
3100Obligated balance, end of year (net)–56–56–56
Budget authority and outlays, net:
Discretionary:
4000Budget authority, gross8941,1671,109
Outlays, gross:
4010Outlays from new discretionary authority6421,1671,109
4011Outlays from discretionary balances186
4020Outlays, gross (total)8281,1671,109
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030Federal sources–844–1,167–1,109
4033Non-Federal sources–6
4040Offsets against gross budget authority and outlays (total)–850–1,167–1,109
Additional offsets against gross budget authority only:
4050Change in uncollected pymts, Fed sources, unexpired–44
4070Budget authority, net (discretionary)
4080Outlays, net (discretionary)–22
4180Budget authority, net (total)
4190Outlays, net (total)–22
Object Classification(in millions of dollars)Identification code 75–9941–0–4–5512010 actualCR2012 est.
Reimbursable obligations:
Personnel compensation:
11.1Full-time permanent106120124
11.3Other than full-time permanent455
11.5Other personnel compensation334
11.7Military personnel91011
11.8Special personal services payments101111
11.9Total personnel compensation132149155
12.1Civilian personnel benefits303738
12.2Military personnel benefits586
21.0Travel and transportation of persons254
22.0Transportation of things444
23.1Rental payments to GSA171920
23.3Communications, utilities, and miscellaneous charges394646
24.0Printing and reproduction211
25.1Advisory and assistance services324434
25.2Other services from non-federal sources477599572
25.3Other goods and services from federal sources528655
25.4Operation and maintenance of facilities566
25.6Medical care192424
25.7Operation and maintenance of equipment698889
25.8Subsistence and support of persons6
26.0Supplies and materials343841
31.0Equipment101011
41.0Grants, subsidies, and contributions233
99.0Reimbursable obligations9371,1671,109
99.9Total new obligations9371,1671,109
Employment SummaryIdentification code 75–9941–0–4–5512010 actualCR2012 est.
2001Reimbursable civilian full-time equivalent employment1,2431,2671,267
2101Reimbursable military average strength employment117117117
3101Allocation account military average strength employment782800820
3101Allocation account military average strength employment744860906
Miscellaneous Trust Funds (in millions of dollars)201020112012
Distribution of budget authority by account:
Gifts444949
Contributions, Indian Health Facilities1053333
Distribution of outlays by account:
Gifts344549
Contributions, Indian Health Facilities803133
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.Special and Trust Fund Receipts(in millions of dollars)Identification code 75–9971–0–7–5512010 actualCR2012 est.
0100Balance, start of year45
Adjustments:
0191Adjustment - correction of prior budget entries–45
0199Balance, start of year
Receipts:
0220Contributions, Indian Health Facilities723333
0221Contributions, N.I.H., Unconditional Gift Fund177
0222Centers for Disease Control, Gifts and Donations1366
0223Contributions, N.I.H., Conditional Gift Fund513434
0224Gifts and Contributions, Miscellaneous Trust Funds10
0240Interest, Miscellaneous Trust Funds22
0299Total receipts and collections1478282
0400Total: Balances and collections1478282
Appropriations:
0500Miscellaneous Trust Funds–149–82–82
0599Total appropriations–149–82–82
0795Rounding adjustment2
0799Balance, end of year
Program and Financing(in millions of dollars)Identification code 75–9971–0–7–5512010 actualCR2012 est.
Obligations by program activity:
0002Gifts444949
0003Contributions, Indian Health Facilities823333
0091Direct program activities, subtotal1268282
0801Reimbursable program activity64
0900Total new obligations1908282
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 1116149149
1021Recoveries of prior year unpaid obligations10
1050Unobligated balance (total)126149149
Budget authority:
Appropriations, mandatory:
1202Appropriation (trust fund)1498282
Spending authority from offsetting collections, mandatory:
1800Collected586
1801Change in uncollected payments, Federal sources6–6
1850Spending auth from offsetting collections, mand (total)64
1900Budget authority (total)2138282
1930Total budgetary resources available339231231
Memorandum (non-add) entries:
1941Unexpired unobligated balance, end of year149149149
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)163171171
3010Uncollected pymts, Fed sources, brought forward, Oct 1–6
3020Obligated balance, start of year (net)163165171
3030Obligations incurred, unexpired accounts1908282
3040Outlays (gross)–172–82–82
3050Change in uncollected pymts, Fed sources, unexpired–66
3080Recoveries of prior year unpaid obligations, unexpired–10
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)171171171
3091Uncollected pymts, Fed sources, end of year–6
3100Obligated balance, end of year (net)165171171
Budget authority and outlays, net:
Mandatory:
4090Budget authority, gross2138282
Outlays, gross:
4100Outlays from new mandatory authority588
4101Outlays from mandatory balances1677474
4110Outlays, gross (total)1728282
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120Federal sources–58–6
Additional offsets against gross budget authority only:
4140Change in uncollected pymts, Fed sources, unexpired–66
4142Offsetting collections credited to expired accounts
4150Additional offsets against budget authority only (total)–66
4160Budget authority, net (mandatory)1498282
4170Outlays, net (mandatory)1147682
4180Budget authority, net (total)1498282
4190Outlays, net (total)1147682
Memorandum (non-add) entries:
5000Total investments, SOY: Federal securities: Par value493941
5001Total investments, EOY: Federal securities: Par value394141
Object Classification(in millions of dollars)Identification code 75–9971–0–7–5512010 actualCR2012 est.
Direct obligations:
Personnel compensation:
11.1Full-time permanent222
11.3Other than full-time permanent111
11.8Special personal services payments111
11.9Total personnel compensation444
12.1Civilian personnel benefits111
21.0Travel and transportation of persons211
25.1Advisory and assistance services344
25.2Other services from non-federal sources541919
25.3Other goods and services from federal sources122
25.4Operation and maintenance of facilities22
25.5Research and development contracts51212
25.6Medical care111
26.0Supplies and materials644
31.0Equipment122
32.0Land and structures11
41.0Grants, subsidies, and contributions482929
99.0Direct obligations1268282
99.0Reimbursable obligations64
99.9Total new obligations1908282
Employment SummaryIdentification code 75–9971–0–7–5512010 actualCR2012 est.
1001Direct civilian full-time equivalent employment282828
Office of the Inspector General Office of the Inspector General office of inspector generalFor expenses necessary for the Office of Inspector General, including the hire of passenger motor vehicles for investigations, in carrying out the provisions of the Inspector General Act of 1978, $51,754,000 $53,329,000: Provided, That of such amount, necessary sums shall be available for providing protective services to the Secretary of Health and Human Services and investigating non-payment of child support cases for which non-payment is a Federal offense under 18 U.S.C. 228: Provided further, That, in addition to amounts provided herein, $10,000,000 shall be available from amounts available under section 241 of the Public Health Services Act to, consistent with the independence accorded by the Inspector General Act of 1978 (5 U.S.C. App.), carry out the responsibilities of the Inspector General to prevent and detect fraud and abuse and promote economy and efficiency in the Department of Health and Human Services programs and operations. Note.—A full-year 2011 appropriation for this account was not enacted at the time the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 111–242, as amended). The amounts included for 2011 reflect the annualized level provided by the continuing resolution. The Office of Inspector General (OIG) is an independent oversight organization within the U.S. Department of Health and Human Services (HHS) that promotes economy, efficiency, and effectiveness through the elimination of fraud, waste, and abuse in the Department's programs and operations. OIG fulfills its mission through a broad range of audits, evaluations, investigations, and enforcement and compliance activities. In addition to discretionary and supplemental appropriations, OIG receives funds through the Health Care Fraud and Abuse Control (HCFAC) account created by the Health Insurance Portability and Accountability Act of 1996. The following table shows total appropriated funding for OIG:(in millions of dollars)2010 actual2011 est.2012 est.
Discretionary Appropriation505053
PHS Evaluation Funds0010
HCFAC - Mandatory177198193
HCFAC - Discretionary Allocation Adjustment303098
DRA - Medicaid Integrity Program12500
Total282278354
1Deficit Reduction Act of 2005 (P.L. 109–171)
Program and Financing(in millions of dollars)Identification code 75–0128–0–1–5512010 actualCR2012 est.
Obligations by program activity:
0001Direct program888769
0801HCFAC Reimbursable program189207208
0802Direct Reimbursable program172130
0803HCFAC Discretionary allocation adjustment183098
0899Total reimbursable obligations224258336
0900Total new obligations312345405
Budgetary Resources:
Unobligated balance:
1000Unobligated balance brought forward, Oct 1826840
1012Expired unobligated bal transferred to unexpired accts397
1050Unobligated balance (total)857747
Budget authority:
Appropriations, discretionary:
1100Appropriation505053
Appropriations, mandatory:
1200Appropriation25
Spending authority from offsetting collections, discretionary:
1700Collected1451128
1701Change in uncollected payments, Federal sources21
1750Spending auth from offsetting collections, disc (total)3551128
Spending authority from offsetting collections, mandatory:
1800Collected176207208
1801Change in uncollected payments, Federal sources10
1850Spending auth from offsetting collections, mand (total)186207208
1900Budget authority (total)296308389
1930Total budgetary resources available381385436
Memorandum (non-add) entries:
1940Unobligated balance expiring–1
1941Unexpired unobligated balance, end of year684031
Change in obligated balance:
Obligated balance, start of year (net):
3000Unpaid obligations, brought forward, Oct 1 (gross)757656
3010Uncollected pymts, Fed sources, brought forward, Oct 1–32–40–40
3020Obligated balance, start of year (net)433616
3030Obligations incurred, unexpired accounts312345405
3031Obligations incurred, expired accounts1
3040Outlays (gross)–304–365–398
3050Change in uncollected pymts, Fed sources, unexpired–31
3051Change in uncollected pymts, Fed sources, expired23
3081Recoveries of prior year unpaid obligations, expired–8
Obligated balance, end of year (net):
3090Unpaid obligations, end of year (gross)765663
3091Uncollected pymts, Fed sources, end of year–40–40–40
3100Obligated balance, end of year (net)361623
Budget authority and outlays, net:
Discretionary:
4000Budget authority, gross85101181
Outlays, gross:
4010Outlays from new discretionary authority6394173
4011Outlays from discretionary balances192912
4020Outlays, gross (total)82123185
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4030Federal sources–17–51–128
4033Non-Federal sources–10
4040Offsets against gross budget authority and outlays (total)–27–51–128
Additional offsets against gross budget authority only:
4050Change in uncollected pymts, Fed sources, unexpired–21
4052Offsetting collections credited to expired accounts13
4060Additional offsets against budget authority only (total)–8
4070Budget authority, net (discretionary)505053
4080Outlays, net (discretionary)557257
Mandatory:
4090Budget authority, gross211207208
Outlays, gross:
4100Outlays from new mandatory authority164207208
4101Outlays from mandatory balances58355
4110Outlays, gross (total)222242213
Offsets against gross budget authority and outlays:
Offsetting collections (collected) from:
4120Federal sources–155–195–196
4123Non-Federal sources–31–12–12
4130Offsets against gross budget authority and outlays (total)–186–207–208
Additional offsets against gross budget authority only:
4140Change in uncollected pymts, Fed sources, unexpired–10
4142Offsetting collections credited to expired accounts10
4160Budget authority, net (mandatory)25
4170Outlays, net (mandatory)36355
4180Budget authority, net (total)755053
4190Outlays, net (total)9110762
Object Classification(in millions of dollars)Identification code 75–0128–0–1–5512010 actualCR2012 est.
Direct obligations:
Personnel compensation:
11.1Full-time permanent454631
11.3Other than full-time permanent121
11.5Other personnel compensation111
11.9Total personnel compensation474933
12.1Civilian personnel benefits151510
21.0Travel and transportation of persons433
23.1Rental payments to GSA555
23.3Communications, utilities, and miscellaneous charges112
25.2Other services from non-federal sources222
25.3Other goods and services from federal sources767
25.4Operation and maintenance of facilities111
26.0Supplies and materials111
31.0Equipment545
99.0Direct obligations888769
99.0Reimbursable obligations224258336
99.9Total new obligations312345405
Employment SummaryIdentification code 75–0128–0–1–5512010 actualCR2012 est.
1001Direct civilian full-time equivalent employment515477334
1101Direct military average strength employment111
2001Reimbursable civilian full-time equivalent employment1,0661,2331,640
2101Reimbursable military average strength employment11
Pandemic Flu Preparedness GENERAL FUND RECEIPT ACCOUNTS (in millions of dollars)2010 actualCR2012 est.
Offsetting receipts from the public:
75–143500General Fund Proprietary Interest Receipts, not Otherwise Classified1139090
75–274530Health Education Assistance Loans, Downward Reestimates of Subsidies10
75–310700Federal Share of Child Support Collections806846835
75–322000All Other General Fund Proprietary Receipts Including Budget Clearing Accounts445656
General Fund Offsetting receipts from the public973992981
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Intragovernmental payments:
75–388500Undistributed Intragovernmental Payments and Receivables from Cancelled Accounts86
General Fund Intragovernmental payments86
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." 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 of Health and Human Services.202 The Secretary of Health and Human Services 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.203 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.204 Notwithstanding section 241(a) of the Public Health Service Act, such portion as the Secretary of Health and Human Services shall determine, but not more than 2.9 3.2 percent, of any amounts appropriated for programs authorized under such Act shall be made available for the evaluation (directly, or by grants or contracts) of the implementation and effectiveness of such programs.205 Not to exceed 1 percent of any discretionary funds (pursuant to the Balanced Budget and Emergency Deficit Control Act of 1985) 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 Committees on Appropriations of the House of Representatives and the Senate are notified at least 15 days in advance of any transfer.206 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 Committees on Appropriations of the House of Representatives and the Senate are notified at least 15 days in advance of any transfer. 207 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.208 None of the funds appropriated in this Act may be made available to any entity under title X of the Public Health Service Act unless the applicant for the award certifies to the Secretary of Health and Human Services that it encourages family participation in the decision of minors to seek family planning services and that it provides counseling to minors on how to resist attempts to coerce minors into engaging in sexual activities.209 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.210 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 of Health and Human Services 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.211 In order for the Department of Health and Human Services 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 2011 2012:1 The Secretary of Health and Human Services 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. The Secretary of Health and Human Services 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 and other applicable statutes administered by the Department of State.2 The Secretary of Health and Human Services 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 the Department of Health and Human Services. The Department of State shall cooperate fully with the Secretary of Health and Human Services to ensure that the Department of Health and Human Services has secure, safe, functional facilities that comply with applicable regulation governing location, setback, and other facilities requirements and serve the purposes established by this Act. The Secretary of Health and Human Services 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.3 The Secretary of Health and Human Services is authorized to provide to personnel appointed or assigned by the Secretary to serve abroad, allowances and benefits similar to those provided under chapter 9 of title I of the Foreign Service Act of 1980, and 22 U.S.C. 4081 through 4086 and subject to such regulations prescribed by the Secretary. The Secretary is further authorized to provide locality-based comparability payments (stated as a percentage) up to the amount of the locality-based comparability payment (stated as a percentage) that would be payable to such personnel under section 5304 of title 5, United States Code if such personnel's official duty station were in the District of Columbia. Leaves of absence for personnel under this subsection shall be on the same basis as that provided under subchapter I of chapter 63 of title 5, United States Code, or section 903 of the Foreign Service Act of 1980, to individuals serving in the Foreign Service. 212a Authority.—Notwithstanding any other provision of law, the Director of the National Institutes of Health ("Director'') may use funds available under section 402(b)(7) or 402(b)(12) of the Public Health Service Act ("PHS Act'') to enter into transactions (other than contracts, cooperative agreements, or grants) to carry out research identified pursuant to such section 402(b)(7) (pertaining to the Common Fund) or research and activities described in such section 402(b)(12).bPeer Review.—In entering into transactions under subsection (a), the Director 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.213 Funds which are available for Individual Learning Accounts for employees of the Centers for Disease Control and Prevention ("CDC'') and the Agency for Toxic Substances and Disease Registry ("ATSDR'') 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.214 Notwithstanding any other provisions of law, funds made available in this Act may be used to continue operating the Council on Graduate Medical Education established by section 301 of Public Law 102–408.215 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.216 Of the amounts made available for the National Institutes of Health, 1 percent of the amount made available for National Research Service Awards ("NRSA'') shall be made available to the Administrator of the Health Resources and Services Administration to make NRSA awards for research in primary medical care to individuals affiliated with entities who have received grants or contracts under sections 747 and 748 of the Public Health Service Act, and 1 percent of the amount made available for NRSA shall be made available to the Director of the Agency for Healthcare Research and Quality to make NRSA awards for health service research.217aIN GENERAL. The Health Education Assistance Loan (HEAL) program under title VII, part A, subpart I of the Public Health Service Act (42 U.S.C. 292–292p), and the authority to administer such program, including servicing, collecting, and enforcing any loans that were made under such program that remain outstanding, shall be permanently transferred from the Secretary of Health and Human Services to the Secretary of Education;bTRANSFER OF FUNCTIONS, ASSETS, AND LIABILITIES. The functions, assets, and liabilities of the Secretary of Health and Human Services relating to such program shall be transferred to the Secretary of Education;cUSE OF AUTHORITIES UNDER HIGHER EDUCATION ACT OF 1965—In servicing, collecting, and enforcing the loans described in subsection (a), the Secretary of Education shall have available any and all authorities available to such Secretary in servicing, collecting, or enforcing a loan made, insured, or guaranteed under part B of title IV of the Higher Education Act of 1965;(d) CONFORMING AMENDMENTS. Effective as of the date on which the transfer of the HEAL program under subsection (a) takes effect, section 719 of the Public Health Service Act (42 U.S.C. 292) is amended by adding at the end the following new paragraph: "(6) The term "Secretary" means the Secretary of Education.".218 For an additional amount for the "General Departmental Management" account, $7,000,000, to increase the Department's acquisition workforce capacity and capabilities: Provided, That such funds may be transferred by the Secretary to any other account in the Department to carry out the purposes provided herein: Provided further, That such transfer authority is in addition to any other transfer authority provided in this Act: Provided further, That such funds shall be available only to supplement and not to supplant existing acquisition workforce activities: Provided further, That such funds shall be available for training, recruitment, retention, and hiring additional members of the acquisition workforce as defined by the Office of Federal Procurement Policy Act, as amended (41 U.S.C. 401 et seq.): Provided further, That such funds shall be available for information technology in support of acquisition workforce effectiveness or for management solutions to improve acquisition management. 218Hereafter, no funds appropriated in this or any other act, in this or any subsequent fiscal year, shall be available for transfer under section 274 of the Public Health Service Act. 219Hereafter, no funds appropriated in this or any other act, in this or any subsequent fiscal year, shall be subject to the allocation requirements of section 1707A(e) of the Public Health Service Act. 220Such portion as the Secretary shall determine, but not more than 1 percent, of any discretionary funds which are appropriated in this Act for the current fiscal year for domestic HIV/AIDS activities in any program, project, or activity carried out by the Department of Health and Human Services shall be made available to the Office of the Assistant Secretary of Health to support the National HIV/AIDS Strategy: Provided, That such support may be provided directly, or by grants or contracts, on a reimbursable basis. 221Of discretionary funds appropriated for the current fiscal year for the Department of Health and Human Services, not to exceed $5,000,000 may be transferred to the Department of Housing and Urban Development to support an interagency neighborhood revitalization program.