For necessary expenses of the Food and Drug Administration, including hire and purchase of passenger motor vehicles; for payment of space rental and related costs pursuant to Public Law 92–313 for programs and activities of the Food and Drug Administration which are included in this Act; for rental of special purpose space in the District of Columbia or elsewhere; in addition to amounts appropriated to the FDA Innovation Account, for carrying out the activities described in section 1002(b)(4) of the 21st Century Cures Act (Public Law 114–255); 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; $5,897,299,000: Provided, That of the amount provided under this heading, $1,119,188,000 shall be derived from prescription drug user fees authorized by 21 U.S.C. 379h, and shall be credited to this account and remain available until expended; $238,595,000 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; $526,039,000 shall be derived from human generic drug user fees authorized by 21 U.S.C. 379j-42, and shall be credited to this account and remain available until expended; $42,998,000 shall be derived from biosimilar biological product user fees authorized by 21 U.S.C. 379j-52, and shall be credited to this account and remain available until expended; $31,306,000 shall be derived from animal drug user fees authorized by 21 U.S.C. 379j-12, and shall be credited to this account and remain available until expended; $20,609,000 shall be derived from generic new animal drug user fees authorized by 21 U.S.C. 379j-21, and shall be credited to this account and remain available until expended; $712,000,000 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: Provided further, That in addition to and notwithstanding any other provision under this heading, amounts collected for prescription drug user fees, medical device user fees, human generic drug user fees, biosimilar biological product user fees, animal drug user fees, and generic new animal drug user fees that exceed the respective fiscal year 2021 limitations are appropriated and shall be credited to this account and remain available until expended: Provided further, That fees derived from prescription drug, medical device, human generic drug, biosimilar biological product, animal drug, and generic new animal drug assessments for fiscal year 2021, including any such fees collected prior to fiscal year 2021 but credited for fiscal year 2021, shall be subject to the fiscal year 2021 limitations: Provided further, That the Secretary may accept payment during fiscal year 2021 of user fees specified under this heading and authorized for fiscal year 2022, prior to the due date for such fees, and that amounts of such fees assessed for fiscal year 2022 for which the Secretary accepts payment in fiscal year 2021 shall not be included in amounts under this heading: Provided further, That none of these funds shall be used to develop, establish, or operate any program of user fees authorized by 31 U.S.C. 9701: Provided further, That 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: Provided further, That any transfer of funds pursuant to section 770(n) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379dd(n)) shall only be from amounts made available under this heading for other activities: Provided further, That funds may be transferred from one specified activity to another with the prior notice to the Committees on Appropriations of both Houses of Congress.
In addition, mammography user fees authorized by 42 U.S.C. 263b, export certification user fees authorized by 21 U.S.C. 381, priority review user fees authorized by 21 U.S.C. 360n and 360ff, food and feed recall fees, food reinspection fees, and voluntary qualified importer program fees authorized by 21 U.S.C. 379j-31, outsourcing facility fees authorized by 21 U.S.C. 379j-62, prescription drug wholesale distributor licensing and inspection fees authorized by 21 U.S.C. 353(e)(3), third-party logistics provider licensing and inspection fees authorized by 21 U.S.C. 360eee-3(c)(1), third-party auditor fees authorized by 21 U.S.C. 384d(c)(8), and medical countermeasure priority review voucher user fees authorized by 21 U.S.C. 360bbb-4a, and, contingent upon the enactment of the Over-the-Counter Monograph User Fee Act of 2020, fees relating to over-the-counter monograph drugs authorized by part 10 of subchapter C of Chapter VII of the Federal Food, Drug and Cosmetic Act shall be credited to this account, to remain available until expended.
(Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2020.)
For plans, construction, repair, improvement, extension, alteration, demolition, and purchase of fixed equipment or facilities of or used by the Food and Drug Administration, where not otherwise provided, $13,788,000, to remain available until expended.
(Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2020.)
Special and Trust Fund Receipts (in millions of dollars)
|
||||
Identification code 075–9911–0–1–554 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
0100 | Balance, start of year | 1 | 1 | 2 |
Receipts: | ||||
Current law: | ||||
1130 | Cooperative Research and Development Agreements, FDA | 1 | 3 | 3 |
|
|
|
||
2000 | Total: Balances and receipts | 2 | 4 | 5 |
Appropriations: | ||||
Current law: | ||||
2101 | Salaries and Expenses | –1 | –2 | –2 |
|
|
|
||
5099 | Balance, end of year | 1 | 2 | 3 |
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–9911–0–1–554 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Foods | 1,060 | 1,089 | 1,091 |
0002 | Human Drugs | 663 | 683 | 683 |
0003 | Devices and Radiological Health | 387 | 395 | 416 |
0004 | National Center for Toxicological Research | 67 | 67 | 66 |
0005 | FDA Other Activities (FDA Headquaters) | 186 | 185 | 187 |
0006 | FDA Other Rent and Rent Related Activities (Including White Oak Consolidation) | 115 | 126 | 154 |
0007 | FDA GSA Rental Payments | 170 | 171 | 167 |
0008 | FDA Buildings and Facilities | 12 | 32 | 14 |
0009 | Cooperative Research and Development (CRADA) | 1 | 2 | 2 |
0010 | Animal Drugs and Feed | 179 | 191 | 190 |
0011 | Biologics | 240 | 252 | 252 |
0015 | CURES Activities | 75 | 70 | |
0016 | Emerging Health Threats | 5 | ||
0017 | Opioids - IMF | 65 | ||
0018 | FDA HCFAC Wedge Fund | 6 | ||
|
|
|
||
0799 | Total direct obligations | 3,156 | 3,268 | 3,292 |
0801 | FDA Reimbursable program (User fees) | 2,447 | 2,664 | 2,744 |
0802 | FDA Reimbursable program (Federal sources) | 32 | ||
|
|
|
||
0899 | Total reimbursable obligations | 2,479 | 2,664 | 2,744 |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 5,635 | 5,932 | 6,036 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 927 | 1,022 | 1,017 |
1001 | Discretionary unobligated balance brought fwd, Oct 1 | 926 | 1,000 | |
1021 | Recoveries of prior year unpaid obligations | 57 | ||
|
|
|
||
1050 | Unobligated balance (total) | 984 | 1,022 | 1,017 |
Budget authority: | ||||
Appropriations, discretionary: | ||||
1100 | Appropriation | 3,080 | 3,192 | 3,220 |
1120 | Appropriations transferred to other accts [075–0128] | –2 | –2 | |
1121 | Appropriations transferred from other acct [075–5629] | 75 | 70 | |
|
|
|
||
1160 | Appropriation, discretionary (total) | 3,078 | 3,265 | 3,290 |
Appropriations, mandatory: | ||||
1201 | Appropriation (special or trust fund) | 1 | 2 | 2 |
Spending authority from offsetting collections, discretionary: | ||||
1700 | Collected | 2,557 | 2,660 | 2,743 |
1700 | Collected | 10 | 22 | |
1701 | Change in uncollected payments, Federal sources | 22 | –22 | |
1702 | Offsetting collections (previously unavailable) | 772 | ||
1725 | Spending authority from offsetting collections precluded from obligation (limitation on obligations) | –774 | ||
|
|
|
||
1750 | Spending auth from offsetting collections, disc (total) | 2,587 | 2,660 | 2,743 |
Spending authority from offsetting collections, mandatory: | ||||
1800 | Collected | 1 | ||
1801 | Change in uncollected payments, Federal sources | 6 | ||
|
|
|
||
1850 | Spending auth from offsetting collections, mand (total) | 7 | ||
1900 | Budget authority (total) | 5,673 | 5,927 | 6,035 |
1930 | Total budgetary resources available | 6,657 | 6,949 | 7,052 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 1,022 | 1,017 | 1,016 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 2,978 | 2,867 | 2,993 |
3010 | New obligations, unexpired accounts | 5,635 | 5,932 | 6,036 |
3011 | Obligations ("upward adjustments"), expired accounts | 26 | ||
3020 | Outlays (gross) | –5,615 | –5,806 | –6,294 |
3040 | Recoveries of prior year unpaid obligations, unexpired | –57 | ||
3041 | Recoveries of prior year unpaid obligations, expired | –100 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 2,867 | 2,993 | 2,735 |
Uncollected payments: | ||||
3060 | Uncollected pymts, Fed sources, brought forward, Oct 1 | –70 | –66 | –44 |
3070 | Change in uncollected pymts, Fed sources, unexpired | –28 | 22 | |
3071 | Change in uncollected pymts, Fed sources, expired | 32 | ||
|
|
|
||
3090 | Uncollected pymts, Fed sources, end of year | –66 | –44 | –44 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 2,908 | 2,801 | 2,949 |
3200 | Obligated balance, end of year | 2,801 | 2,949 | 2,691 |
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
4000 | Budget authority, gross | 5,665 | 5,925 | 6,033 |
Outlays, gross: | ||||
4010 | Outlays from new discretionary authority | 3,323 | 4,735 | 4,832 |
4011 | Outlays from discretionary balances | 2,284 | 1,063 | 1,460 |
|
|
|
||
4020 | Outlays, gross (total) | 5,607 | 5,798 | 6,292 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4030 | Federal sources: | –35 | –22 | |
4033 | Non-Federal sources: | –2,557 | –2,660 | –2,743 |
|
|
|
||
4040 | Offsets against gross budget authority and outlays (total) | –2,592 | –2,682 | –2,743 |
Additional offsets against gross budget authority only: | ||||
4050 | Change in uncollected pymts, Fed sources, unexpired | –22 | 22 | |
4052 | Offsetting collections credited to expired accounts | 25 | ||
|
|
|
||
4060 | Additional offsets against budget authority only (total) | 3 | 22 | |
|
|
|
||
4070 | Budget authority, net (discretionary) | 3,076 | 3,265 | 3,290 |
4080 | Outlays, net (discretionary) | 3,015 | 3,116 | 3,549 |
Mandatory: | ||||
4090 | Budget authority, gross | 8 | 2 | 2 |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 6 | 2 | 2 |
4101 | Outlays from mandatory balances | 2 | 6 | |
|
|
|
||
4110 | Outlays, gross (total) | 8 | 8 | 2 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4120 | Federal sources: | –6 | ||
4123 | Non-Federal sources: | –1 | ||
|
|
|
||
4130 | Offsets against gross budget authority and outlays (total) | –1 | –6 | |
Additional offsets against gross budget authority only: | ||||
4140 | Change in uncollected pymts, Fed sources, unexpired | –6 | ||
4142 | Offsetting collections credited to expired accounts | 6 | ||
|
|
|
||
4150 | Additional offsets against budget authority only (total) | –6 | 6 | |
|
|
|
||
4160 | Budget authority, net (mandatory) | 1 | 2 | 2 |
4170 | Outlays, net (mandatory) | 7 | 2 | 2 |
4180 | Budget authority, net (total) | 3,077 | 3,267 | 3,292 |
4190 | Outlays, net (total) | 3,022 | 3,118 | 3,551 |
|
||||
Memorandum (non-add) entries: | ||||
5090 | Unexpired unavailable balance, SOY: Offsetting collections | 804 | 806 | 806 |
5092 | Unexpired unavailable balance, EOY: Offsetting collections | 806 | 806 | 806 |
|
The Food and Drug Administration (FDA) promotes and protects public health by overseeing the safety, efficacy, quality, and security of human and veterinary drugs, biological products, medical devices, foods, cosmetics, and products that emit radiation. FDA also has responsibility for regulating the manufacturing, marketing, and distribution of tobacco products to protect public health and to reduce tobacco use by minors. FDA advances public health by helping to advance innovations that make medicines more effective, safe, and affordable and by helping the public get the accurate, science-based information they need to use medicines and foods to maintain and improve their health. FDA supports the Nation's counterterrorism capability by ensuring the security of the food supply and by fostering the development of medical products and countermeasures to respond to deliberate and naturally emerging public health threats. The FY 2021 Budget includes $6.2 billion in total resources for FDA. The Budget invests in priority activities such as artificial intelligence, regulation of cannabis and cannabis derivatives, modernizing influenza vaccines, food safety track and trace, and infrastructure.
Object Classification (in millions of dollars)
|
||||
Identification code 075–9911–0–1–554 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
Personnel compensation: | ||||
11.1 | Full-time permanent | 880 | 971 | 977 |
11.3 | Other than full-time permanent | 88 | 99 | 100 |
11.5 | Other personnel compensation | 39 | 45 | 45 |
11.7 | Military personnel | 59 | 61 | 62 |
11.8 | Special personal services payments | 1 | 1 | 1 |
|
|
|
||
11.9 | Total personnel compensation | 1,067 | 1,177 | 1,185 |
12.1 | Civilian personnel benefits | 332 | 367 | 369 |
12.2 | Military personnel benefits | 32 | 33 | 34 |
21.0 | Travel and transportation of persons | 50 | 47 | 48 |
22.0 | Transportation of things | 3 | 3 | 3 |
23.1 | Rental payments to GSA | 173 | 171 | 167 |
23.2 | Rental payments to others | 1 | 1 | 1 |
23.3 | Communications, utilities, and miscellaneous charges | 18 | 17 | 17 |
24.0 | Printing and reproduction | 2 | 2 | 2 |
25.1 | Advisory and assistance services | 44 | 42 | 43 |
25.2 | Other services from non-Federal sources | 412 | 412 | 416 |
25.3 | Other goods and services from Federal sources | 506 | 484 | 489 |
25.4 | Operation and maintenance of facilities | 139 | 133 | 135 |
25.5 | Research and development contracts | 20 | 19 | 20 |
25.7 | Operation and maintenance of equipment | 35 | 33 | 34 |
26.0 | Supplies and materials | 39 | 38 | 38 |
31.0 | Equipment | 63 | 60 | 61 |
32.0 | Land and structures | 3 | 3 | 3 |
41.0 | Grants, subsidies, and contributions | 215 | 223 | 225 |
42.0 | Insurance claims and indemnities | 2 | 2 | 2 |
|
|
|
||
99.0 | Direct obligations | 3,156 | 3,267 | 3,292 |
99.0 | Reimbursable obligations | 2,479 | 2,665 | 2,744 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 5,635 | 5,932 | 6,036 |
|
Employment Summary
|
||||
Identification code 075–9911–0–1–554 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 8,439 | 8,576 | 8,637 |
1101 | Direct military average strength employment | 658 | 658 | 658 |
2001 | Reimbursable civilian full-time equivalent employment | 6,269 | 6,811 | 6,974 |
2101 | Reimbursable military average strength employment | 488 | 488 | 488 |
3001 | Allocation account civilian full-time equivalent employment | 25 | 25 | 25 |
3101 | Allocation account military average strength employment | 1 | 1 | 1 |
|
Contingent upon the enactment of authorizing legislation, the Secretary shall charge a fee for innovative food products activities and over-the-counter monograph drug activities: Provided, That fees of $28,000,000 for innovative food products shall be credited to this account and remain available until expended; $28,400,000 for over-the-counter monograph drug activities shall be credited to this account and remain available until expended: Provided further, That, in addition to and notwithstanding any other provision under this heading, amounts collected for innovative food products and over-the-counter monograph drug user fees that exceed the respective fiscal year 2021 limitations are appropriated and shall be credited to this account and remain available until expended: Provided further, That fees derived from innovative food products and over-the-counter monograph drug reviews for fiscal year 2021 received during fiscal year 2021, including any such fees assessed prior to fiscal year 2021 but credited for fiscal year 2021, shall be subject to the fiscal year 2021 limitations: Provided further, That the Secretary may accept payment during fiscal year 2021 of user fees specified in this paragraph and authorized for fiscal year 2022, prior to the due date for such fees, and that amounts of such fees assessed for fiscal year 2022 for which the Secretary accepts payment in fiscal year 2021 shall not be included in amounts in this paragraph.
In addition, contingent upon the enactment of authorizing legislation establishing fees under 21 U.S.C. 387s with respect to products deemed under 21 U.S.C. 387a(b) but not specified in 21 U.S.C. 387s(b)(2)(B), the Secretary shall assess and collect such fees: Provided, That $100,000,000 shall be derived from such fees, which shall be credited to this account and remain available until expended, in addition to amounts otherwise derived from fees authorized under 21 U.S.C. 387s.
Program and Financing (in millions of dollars)
|
||||
Identification code 075–9911–2–1–554 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0801 | FDA Reimbursable program (Tobacco, OTC and Food innovation) | 156 | ||
|
||||
Budgetary resources: | ||||
Budget authority: | ||||
Spending authority from offsetting collections, discretionary: | ||||
1700 | Collected | 156 | ||
1900 | Budget authority (total) | 156 | ||
1930 | Total budgetary resources available | 156 | ||
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3010 | New obligations, unexpired accounts | 156 | ||
3020 | Outlays (gross) | –156 | ||
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
4000 | Budget authority, gross | 156 | ||
Outlays, gross: | ||||
4010 | Outlays from new discretionary authority | 156 | ||
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4033 | Non-Federal sources: | –156 | ||
|
|
|
||
4040 | Offsets against gross budget authority and outlays (total) | –156 | ||
4180 | Budget authority, net (total) | |||
4190 | Outlays, net (total) | |||
|
The FY 2021 Budget proposes reforms to the Over-the-Counter Monograph program and includes a total of $28 million in new over-the-counter drug fees. The Budget proposes a new user fee program to support innovative food activities totaling $28 million. The Budget also includes a legislative proposal to increase the user fee collected in support of the tobacco program by $100 million and adds electronic nicotine delivery system manufacturers and importers as entities subject to the user fees.
Object Classification (in millions of dollars)
|
||||
Identification code 075–9911–2–1–554 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Reimbursable obligations: | ||||
Personnel compensation: | ||||
11.1 | Full-time permanent | 5 | ||
11.3 | Other than full-time permanent | 1 | ||
11.5 | Other personnel compensation | 1 | ||
|
|
|
||
11.9 | Total personnel compensation | 7 | ||
12.1 | Civilian personnel benefits | 2 | ||
21.0 | Travel and transportation of persons | 3 | ||
25.1 | Advisory and assistance services | 12 | ||
25.2 | Other services from non-Federal sources | 91 | ||
25.3 | Other goods and services from Federal sources | 41 | ||
|
|
|
||
99.0 | Reimbursable obligations | 156 | ||
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 156 | ||
|
Employment Summary
|
||||
Identification code 075–9911–2–1–554 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
2001 | Reimbursable civilian full-time equivalent employment | 52 | ||
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–4613–0–4–554 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Direct program activity | 324 | 324 | 324 |
0801 | Reimbursable program activity | 257 | 295 | 295 |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 581 | 619 | 619 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 5 | 33 | 33 |
Budget authority: | ||||
Spending authority from offsetting collections, discretionary: | ||||
1700 | Collected | 609 | 619 | 619 |
1900 | Budget authority (total) | 609 | 619 | 619 |
1930 | Total budgetary resources available | 614 | 652 | 652 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 33 | 33 | 33 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 205 | ||
3010 | New obligations, unexpired accounts | 581 | 619 | 619 |
3020 | Outlays (gross) | –376 | –824 | –619 |
|
|
|
||
3050 | Unpaid obligations, end of year | 205 | ||
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 205 | ||
3200 | Obligated balance, end of year | 205 | ||
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
4000 | Budget authority, gross | 609 | 619 | 619 |
Outlays, gross: | ||||
4010 | Outlays from new discretionary authority | 376 | 619 | 619 |
4011 | Outlays from discretionary balances | 205 | ||
|
|
|
||
4020 | Outlays, gross (total) | 376 | 824 | 619 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4030 | Federal sources | –609 | –619 | –619 |
4180 | Budget authority, net (total) | |||
4190 | Outlays, net (total) | –233 | 205 | |
|
Object Classification (in millions of dollars)
|
||||
Identification code 075–4613–0–4–554 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
Personnel compensation: | ||||
11.1 | Full-time permanent | 73 | 73 | 73 |
11.3 | Other than full-time permanent | 1 | 1 | 1 |
11.5 | Other personnel compensation | 2 | 2 | 2 |
11.7 | Military personnel | 1 | 1 | 1 |
|
|
|
||
11.9 | Total personnel compensation | 77 | 77 | 77 |
12.1 | Civilian personnel benefits | 26 | 26 | 26 |
12.2 | Military personnel benefits | 1 | 1 | 1 |
21.0 | Travel and transportation of persons | 1 | 1 | 1 |
23.3 | Communications, utilities, and miscellaneous charges | 6 | 6 | 6 |
24.0 | Printing and reproduction | 1 | 1 | 1 |
25.1 | Advisory and assistance services | 15 | 15 | 15 |
25.2 | Other services from non-Federal sources | 77 | 77 | 77 |
25.3 | Other goods and services from Federal sources | 54 | 54 | 54 |
25.4 | Operation and maintenance of facilities | 3 | 3 | 3 |
25.7 | Operation and maintenance of equipment | 56 | 56 | 56 |
26.0 | Supplies and materials | 4 | 4 | 4 |
31.0 | Equipment | 1 | 1 | 1 |
41.0 | Grants, subsidies, and contributions | 1 | 1 | 1 |
42.0 | Insurance claims and indemnities | 1 | 1 | 1 |
|
|
|
||
99.0 | Direct obligations | 324 | 324 | 324 |
Reimbursable obligations: | ||||
Personnel compensation: | ||||
11.1 | Full-time permanent | 58 | 58 | 58 |
11.3 | Other than full-time permanent | 1 | 1 | 1 |
11.5 | Other personnel compensation | 1 | 1 | 1 |
11.7 | Military personnel | 1 | 1 | 1 |
|
|
|
||
11.9 | Total personnel compensation | 61 | 61 | 61 |
12.1 | Civilian personnel benefits | 20 | 20 | 20 |
21.0 | Travel and transportation of persons | 1 | 1 | 1 |
23.3 | Communications, utilities, and miscellaneous charges | 5 | 5 | 5 |
24.0 | Printing and reproduction | 1 | 1 | 1 |
25.1 | Advisory and assistance services | 12 | 12 | 12 |
25.2 | Other services from non-Federal sources | 63 | 63 | 63 |
25.3 | Other goods and services from Federal sources | 43 | 81 | 81 |
25.4 | Operation and maintenance of facilities | 2 | 2 | 2 |
25.7 | Operation and maintenance of equipment | 44 | 44 | 44 |
26.0 | Supplies and materials | 3 | 3 | 3 |
41.0 | Grants, subsidies, and contributions | 1 | 1 | 1 |
43.0 | Interest and dividends | 1 | 1 | 1 |
|
|
|
||
99.0 | Reimbursable obligations | 257 | 295 | 295 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 581 | 619 | 619 |
|
Employment Summary
|
||||
Identification code 075–4613–0–4–554 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 697 | 697 | 697 |
1101 | Direct military average strength employment | 8 | 8 | 8 |
2001 | Reimbursable civilian full-time equivalent employment | 480 | 480 | 480 |
2101 | Reimbursable military average strength employment | 6 | 6 | 6 |
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0148–0–1–554 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Direct program activity | 70 | 75 | 70 |
|
|
|
||
0900 | Total new obligations, unexpired accounts (object class 94.0) | 70 | 75 | 70 |
|
||||
Budgetary resources: | ||||
Budget authority: | ||||
Appropriations, mandatory: | ||||
1200 | Appropriation | 70 | 75 | 70 |
1930 | Total budgetary resources available | 70 | 75 | 70 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3010 | New obligations, unexpired accounts | 70 | 75 | 70 |
3020 | Outlays (gross) | –70 | –75 | –70 |
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 70 | 75 | 70 |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 70 | 75 | 70 |
4180 | Budget authority, net (total) | 70 | 75 | 70 |
4190 | Outlays, net (total) | 70 | 75 | 70 |
|
This account, and a related special receipt account, were established to support the execution structure necessary to implement the 21st Century Cures Act.
For necessary expenses to carry out the purposes described under section 1002(b)(4) of the 21st Century Cures Act, in addition to amounts available for such purposes under the heading "Salaries and Expenses", $70,000,000, to remain available until expended: Provided, That amounts appropriated in this paragraph are appropriated pursuant to section 1002(b)(3) of the 21st Century Cures Act, are to be derived from amounts transferred under section 1002(b)(2)(A) of such Act, and may be transferred by the Commissioner of Food and Drugs to the appropriation for "Department of Health and Human Services Food and Drug Administration Salaries and Expenses" solely for the purposes provided in such Act: Provided further, That upon a determination by the Commissioner that funds transferred pursuant to the previous proviso are not necessary for the purposes provided, such amounts may be transferred back to the account: Provided further, That such transfer authority is in addition to any other transfer authority provided by law.
(Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2020.)
Special and Trust Fund Receipts (in millions of dollars)
|
||||
Identification code 075–5629–0–2–554 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
0100 | Balance, start of year | |||
Receipts: | ||||
Current law: | ||||
1140 | General Fund Payment, FDA Innovation, CURES Act | 70 | 75 | 70 |
|
|
|
||
2000 | Total: Balances and receipts | 70 | 75 | 70 |
Appropriations: | ||||
Current law: | ||||
2101 | FDA Innovation, Cures Act | –70 | –75 | –70 |
|
|
|
||
5099 | Balance, end of year | |||
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–5629–0–2–554 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | New Obligations for CURES Activities | 58 | ||
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 26 | 38 | 38 |
Budget authority: | ||||
Appropriations, discretionary: | ||||
1101 | Appropriation (special or trust) | 70 | 75 | 70 |
1120 | Appropriations transferred to other acct [075–9911] | –75 | –70 | |
|
|
|
||
1160 | Appropriation, discretionary (total) | 70 | ||
1930 | Total budgetary resources available | 96 | 38 | 38 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 38 | 38 | 38 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 27 | 42 | 2 |
3010 | New obligations, unexpired accounts | 58 | ||
3020 | Outlays (gross) | –43 | –40 | |
|
|
|
||
3050 | Unpaid obligations, end of year | 42 | 2 | 2 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 27 | 42 | 2 |
3200 | Obligated balance, end of year | 42 | 2 | 2 |
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
4000 | Budget authority, gross | 70 | ||
Outlays, gross: | ||||
4010 | Outlays from new discretionary authority | 17 | ||
4011 | Outlays from discretionary balances | 26 | 40 | |
|
|
|
||
4020 | Outlays, gross (total) | 43 | 40 | |
4180 | Budget authority, net (total) | 70 | ||
4190 | Outlays, net (total) | 43 | 40 | |
|
The 21st Century Cures Act was enacted into law on December 13, 2016. The Act includes authorities FDA can use to help modernize drug, biological product, and device product development and review and to create greater efficiencies and predictability in product development and review.
Object Classification (in millions of dollars)
|
||||
Identification code 075–5629–0–2–554 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
Personnel compensation: | ||||
11.1 | Full-time permanent | 13 | ||
11.3 | Other than full-time permanent | 3 | ||
11.5 | Other personnel compensation | 2 | ||
|
|
|
||
11.9 | Total personnel compensation | 18 | ||
12.1 | Civilian personnel benefits | 6 | ||
25.2 | Other services from non-Federal sources | 15 | ||
26.0 | Supplies and materials | 1 | ||
41.0 | Grants, subsidies, and contributions | 18 | ||
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 58 | ||
|
Employment Summary
|
||||
Identification code 075–5629–0–2–554 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 136 | ||
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–4309–0–3–554 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0801 | Revolving Fund for Certification and Other Services (Reimbursable) | 9 | 10 | 11 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 3 | 3 | 3 |
Budget authority: | ||||
Spending authority from offsetting collections, mandatory: | ||||
1800 | Collected | 9 | 10 | 10 |
1802 | Offsetting collections (previously unavailable) | 1 | 1 | 1 |
1823 | New and/or unobligated balance of spending authority from offsetting collections temporarily reduced | –1 | –1 | |
|
|
|
||
1850 | Spending auth from offsetting collections, mand (total) | 9 | 10 | 11 |
1900 | Budget authority (total) | 9 | 10 | 11 |
1930 | Total budgetary resources available | 12 | 13 | 14 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 3 | 3 | 3 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 4 | 5 | 2 |
3010 | New obligations, unexpired accounts | 9 | 10 | 11 |
3020 | Outlays (gross) | –8 | –13 | –11 |
|
|
|
||
3050 | Unpaid obligations, end of year | 5 | 2 | 2 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 4 | 5 | 2 |
3200 | Obligated balance, end of year | 5 | 2 | 2 |
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 9 | 10 | 11 |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 5 | 10 | 11 |
4101 | Outlays from mandatory balances | 3 | 3 | |
|
|
|
||
4110 | Outlays, gross (total) | 8 | 13 | 11 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4123 | Non-Federal sources | –9 | –10 | –10 |
4180 | Budget authority, net (total) | 1 | ||
4190 | Outlays, net (total) | –1 | 3 | 1 |
|
||||
Memorandum (non-add) entries: | ||||
5090 | Unexpired unavailable balance, SOY: Offsetting collections | 1 | 1 | 1 |
5092 | Unexpired unavailable balance, EOY: Offsetting collections | 1 | 1 | |
|
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. These services are financed wholly by fees paid by the industries affected.
Object Classification (in millions of dollars)
|
||||
Identification code 075–4309–0–3–554 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Reimbursable obligations: | ||||
Personnel compensation: | ||||
11.1 | Full-time permanent | 3 | 3 | 3 |
11.3 | Other than full-time permanent | 1 | 1 | 1 |
|
|
|
||
11.9 | Total personnel compensation | 4 | 4 | 4 |
12.1 | Civilian personnel benefits | 1 | 1 | 1 |
23.1 | Rental payments to GSA | 1 | 2 | 2 |
25.3 | Other goods and services from Federal sources | 1 | 1 | 1 |
25.4 | Operation and maintenance of facilities | 1 | 1 | 1 |
26.0 | Supplies and materials | 1 | 1 | 2 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 9 | 10 | 11 |
|
Employment Summary
|
||||
Identification code 075–4309–0–3–554 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
2001 | Reimbursable civilian full-time equivalent employment | 33 | 37 | 37 |
|
For carrying out titles II and III of the Public Health Service Act (referred to in this Act as the "PHS Act") with respect to primary health care and the Native Hawaiian Health Care Act of 1988, $1,728,522,000: Provided, That no more than $1,000,000 shall be available until expended for carrying out the provisions of section 224(o) of the PHS Act: Provided further, That no more than $120,000,000 shall be available until expended for carrying out subsections (g) through (n) and (q) of section 224 of the PHS Act, and for expenses incurred by the Department of Health and Human Services (referred to in this Act as "HHS") pertaining to administrative claims made under such law.
For carrying out titles III, VII, and VIII of the PHS Act with respect to the health workforce, sections 1128E and 1921 of the Social Security Act, and the Health Care Quality Improvement Act of 1986, $370,425,000: Provided, That sections 751 and 762(k) of the PHS Act and the proportional funding amounts in paragraphs (1) through (4) of section 756(f) of the PHS Act shall not apply to funds made available under this heading: Provided further, That fees collected for the disclosure of information under section 427(b) of the Health Care Quality Improvement Act of 1986 and sections 1128E(d)(2) and 1921 of the Social Security Act shall be sufficient to recover the full costs of operating the programs authorized by such sections and shall remain available until expended for the National Practitioner Data Bank: Provided further, That funds transferred to this account to carry out 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 such section and subpart: Provided further, That $120,000,000 shall remain available until expended for the purposes of providing primary health services, assigning National Health Service Corps ("NHSC") members to expand the delivery of substance use disorder treatment services, notwithstanding the assignment priorities and limitations under sections 333(a)(1)(D), 333(b), and 333A(a)(1)(B)(ii) of the PHS Act, and making payments under the NHSC Loan Repayment Program under section 338B of such Act: Provided further, That for purposes of the previous proviso, section 331(a)(3)(D) of the PHS Act shall be applied as if the term "primary health services" includes clinical substance use disorder treatment services, including those provided by masters level, licensed substance use disorder treatment counselors.
For carrying out titles III, XI, XII, and XIX of the PHS Act with respect to maternal and child health and title V of the Social Security Act, $919,018,000: Provided, That notwithstanding sections 502(a)(1) and 502(b)(1) of the Social Security Act, not more than $132,593,000 shall be available for carrying out special projects of regional and national significance pursuant to section 501(a)(2) of such Act and $10,276,000 shall be available for projects described in subparagraphs (A) through (F) of section 501(a)(3) of such Act.
For carrying out title XXVI of the PHS Act with respect to the Ryan White HIV/AIDS program, $2,483,781,000, of which $1,970,881,000 shall remain available to the Secretary through September 30, 2023, for parts A and B of title XXVI of the PHS Act, and of which not less than $900,313,000 shall be for State AIDS Drug Assistance Programs under the authority of section 2616 or 311(c) of such Act; and of which $165,000,000, to remain available until expended, shall be available to the Secretary for carrying out a program of grants and contracts under title XXVI or section 311(c) of such Act focused on ending the nationwide HIV/AIDS epidemic, with any grants issued under such section 311(c) administered in conjunction with title XXVI of the PHS Act, including the limitation on administrative expenses.
For carrying out titles III and XII of the PHS Act with respect to health care systems, and the Stem Cell Therapeutic and Research Act of 2005, $102,033,000: Provided, That in addition to amounts provided herein, $13,385,000 shall be from funds available under section 241 of the PHS Act to supplement funding for organ transplantation activities: 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 the Secretary based on sales data that shall be submitted by drug manufacturers and shall be credited to this account to remain available until expended.
For carrying out titles III and IV of the PHS Act with respect to rural health, section 427(a) of the Federal Coal Mine Health and Safety Act of 1969, and sections 711 and 1820 of the Social Security Act, $246,834,000.
For carrying out the program under title X of the PHS Act to provide for voluntary family planning projects, $286,479,000: Provided, 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.
For program support in the Health Resources and Services Administration, $151,993,000: Provided, That funds made available under this heading may be used to supplement program support funding provided under the headings "Primary Health Care", "Health Workforce", "Maternal and Child Health", "Ryan White HIV/AIDS Program", "Health Care Systems", and "Rural Health".
(Department of Health and Human Services Appropriations Act, 2020.)
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0350–0–1–550 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0005 | Primary Health Care (Health Centers, Free Clinics) | 1,644 | 1,707 | 1,729 |
0010 | Primary Health Care (Mandatory) | 4,047 | 2,576 | |
0015 | Health Workforce | 1,091 | 1,324 | 370 |
0020 | Health Workforce (Mandatory) | 439 | 281 | |
0025 | Maternal and Child Health | 923 | 944 | 919 |
0030 | Maternal and Child Health (Mandatory) | 6 | 6 | 6 |
0035 | Ryan White HIV/AIDS | 2,332 | 2,390 | 2,484 |
0040 | Health Care Systems | 114 | 124 | 102 |
0045 | Rural Health | 352 | 361 | 247 |
0050 | Family Planning | 285 | 286 | 286 |
0055 | HRSA Program Management | 155 | 155 | 152 |
|
|
|
||
0091 | Direct program activities, subtotal | 11,388 | 10,154 | 6,295 |
|
|
|
||
0300 | Total direct programs | 11,388 | 10,154 | 6,295 |
Credit program obligations: | ||||
0702 | Loan guarantee subsidy | 1 | 2 | |
|
|
|
||
0799 | Total direct obligations | 11,388 | 10,155 | 6,297 |
0801 | Health Resources and Services (Reimbursable) | 68 | 51 | 75 |
0802 | HRSA Reimbursable program: PHS evaluation | 13 | ||
|
|
|
||
0899 | Total reimbursable obligations | 68 | 51 | 88 |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 11,456 | 10,206 | 6,385 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 454 | 460 | 201 |
1001 | Discretionary unobligated balance brought fwd, Oct 1 | 336 | 345 | |
1010 | Unobligated balance transfer to other accts [075–0116] | –8 | ||
1010 | Unobligated balance transfer to other accts [015–5606] | –5 | –5 | –5 |
1021 | Recoveries of prior year unpaid obligations | 72 | ||
|
|
|
||
1050 | Unobligated balance (total) | 513 | 455 | 196 |
Budget authority: | ||||
Appropriations, discretionary: | ||||
1100 | Appropriation | 6,844 | 7,037 | 6,289 |
1120 | Appropriations transferred to other acct [075–1503] | –21 | ||
1121 | Appropriations transferred from other acct [075–0140] | 80 | ||
|
|
|
||
1160 | Appropriation, discretionary (total) | 6,903 | 7,037 | 6,289 |
Appropriations, mandatory: | ||||
1200 | Appropriation | 4,443 | 2,863 | 6 |
Spending authority from offsetting collections, discretionary: | ||||
1700 | Collected | 22 | 31 | 68 |
1701 | Change in uncollected payments, Federal sources | 10 | ||
|
|
|
||
1750 | Spending auth from offsetting collections, disc (total) | 32 | 31 | 68 |
Spending authority from offsetting collections, mandatory: | ||||
1800 | Offsetting collections (cash)(HPSL&NSL) | 27 | 20 | 20 |
1802 | Offsetting collections (previously unavailable) | 2 | 2 | 1 |
1823 | New and/or unobligated balance of spending authority from offsetting collections temporarily reduced | –2 | –1 | |
|
|
|
||
1850 | Spending auth from offsetting collections, mand (total) | 27 | 21 | 21 |
1900 | Budget authority (total) | 11,405 | 9,952 | 6,384 |
1930 | Total budgetary resources available | 11,918 | 10,407 | 6,580 |
Memorandum (non-add) entries: | ||||
1940 | Unobligated balance expiring | –2 | ||
1941 | Unexpired unobligated balance, end of year | 460 | 201 | 195 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 7,969 | 8,278 | 8,025 |
3010 | New obligations, unexpired accounts | 11,456 | 10,206 | 6,385 |
3011 | Obligations ("upward adjustments"), expired accounts | 34 | ||
3020 | Outlays (gross) | –11,002 | –10,459 | –8,565 |
3040 | Recoveries of prior year unpaid obligations, unexpired | –72 | ||
3041 | Recoveries of prior year unpaid obligations, expired | –107 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 8,278 | 8,025 | 5,845 |
Uncollected payments: | ||||
3060 | Uncollected pymts, Fed sources, brought forward, Oct 1 | –16 | –16 | –16 |
3070 | Change in uncollected pymts, Fed sources, unexpired | –10 | ||
3071 | Change in uncollected pymts, Fed sources, expired | 10 | ||
|
|
|
||
3090 | Uncollected pymts, Fed sources, end of year | –16 | –16 | –16 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 7,953 | 8,262 | 8,009 |
3200 | Obligated balance, end of year | 8,262 | 8,009 | 5,829 |
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
4000 | Budget authority, gross | 6,935 | 7,068 | 6,357 |
Outlays, gross: | ||||
4010 | Outlays from new discretionary authority | 2,247 | 2,297 | 2,040 |
4011 | Outlays from discretionary balances | 4,388 | 4,476 | 4,822 |
|
|
|
||
4020 | Outlays, gross (total) | 6,635 | 6,773 | 6,862 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4030 | Federal sources | –12 | –12 | –25 |
4033 | Non-Federal sources | –23 | –19 | –43 |
|
|
|
||
4040 | Offsets against gross budget authority and outlays (total) | –35 | –31 | –68 |
Additional offsets against gross budget authority only: | ||||
4050 | Change in uncollected pymts, Fed sources, unexpired | –10 | ||
4052 | Offsetting collections credited to expired accounts | 13 | ||
|
|
|
||
4060 | Additional offsets against budget authority only (total) | 3 | ||
|
|
|
||
4070 | Budget authority, net (discretionary) | 6,903 | 7,037 | 6,289 |
4080 | Outlays, net (discretionary) | 6,600 | 6,742 | 6,794 |
Mandatory: | ||||
4090 | Budget authority, gross | 4,470 | 2,884 | 27 |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 1,904 | 1,269 | 23 |
4101 | Outlays from mandatory balances | 2,463 | 2,417 | 1,680 |
|
|
|
||
4110 | Outlays, gross (total) | 4,367 | 3,686 | 1,703 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4123 | Non-Federal sources | –27 | –20 | –20 |
4180 | Budget authority, net (total) | 11,346 | 9,901 | 6,296 |
4190 | Outlays, net (total) | 10,940 | 10,408 | 8,477 |
|
||||
Memorandum (non-add) entries: | ||||
5090 | Unexpired unavailable balance, SOY: Offsetting collections | 2 | 2 | 1 |
5092 | Unexpired unavailable balance, EOY: Offsetting collections | 2 | 1 | |
5103 | Unexpired unavailable balance, SOY: Fulfilled purpose | 1 | 1 | |
5104 | Unexpired unavailable balance, EOY: Fulfilled purpose | 1 | ||
|
Summary of Budget Authority and Outlays (in millions of dollars)
|
||||
2019 actual | 2020 est. | 2021 est. | ||
|
||||
Enacted/requested: | ||||
Budget Authority | 11,346 | 9,901 | 6,296 | |
Outlays | 10,940 | 10,408 | 8,477 | |
Legislative proposal, subject to PAYGO: | ||||
Budget Authority | 1,580 | 4,437 | ||
Outlays | 689 | 2,771 | ||
Total: | ||||
Budget Authority | 11,346 | 11,481 | 10,733 | |
Outlays | 10,940 | 11,097 | 11,248 | |
|
Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in millions of dollars)
|
||||
Identification code 075–0350–0–1–550 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Guaranteed loan levels supportable by subsidy budget authority: | ||||
215001 | Health centers: Facilities renovation loan guarantee levels | 60 | 66 | |
|
|
|
||
215999 | Total loan guarantee levels | 60 | 66 | |
Guaranteed loan subsidy (in percent): | ||||
232001 | Health centers: Facilities renovation loan guarantee levels | 0.00 | 2.57 | 2.78 |
|
|
|
||
232999 | Weighted average subsidy rate | 0.00 | 2.57 | 2.78 |
Guaranteed loan subsidy budget authority: | ||||
233001 | Health centers: Facilities renovation loan guarantee levels | 2 | 2 | |
|
|
|
||
233999 | Total subsidy budget authority | 2 | 2 | |
Guaranteed loan reestimates: | ||||
235001 | Health centers: Facilities renovation loan guarantee levels | –1 | ||
|
|
|
||
235999 | Total guaranteed loan reestimates | –1 | ||
|
Resources displayed here support grants and contracts managed by Health Resources and Services Administration (HRSA). These activities include support for Health Centers, treatment and care for those living with HIV/AIDS, health workforce training, maternal and child health care services, promotion of organ and bone marrow donation, rural health activities, 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.
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 program's revolving account gets replenished, and the collected funds are then used to give out new loans in the following academic years. If the program's 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 2018–2019 data reported in the Annual Operating Report.
Health Professions Revolving Loan Programs Federal Capital Contribution
|
|
Program | Account Balance |
|
|
HPSL | 436,419,789 |
NSL | 201,922,803 |
PCL | 216,454,324 |
LDS | 187,255,691 |
|
|
Total | 1,042,052,607 |
|
|
|
Object Classification (in millions of dollars)
|
||||
Identification code 075–0350–0–1–550 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
Personnel compensation: | ||||
11.1 | Full-time permanent | 205 | 199 | 161 |
11.3 | Other than full-time permanent | 7 | 7 | 6 |
11.5 | Other personnel compensation | 5 | 5 | 4 |
11.7 | Military personnel | 20 | 18 | 14 |
|
|
|
||
11.9 | Total personnel compensation | 237 | 229 | 185 |
12.1 | Civilian personnel benefits | 67 | 64 | 52 |
12.2 | Military personnel benefits | 11 | 10 | 8 |
13.0 | Benefits for former personnel | 2 | 2 | 2 |
21.0 | Travel and transportation of persons | 4 | 4 | 3 |
23.1 | Rental payments to GSA | 20 | 20 | 16 |
23.2 | Rental payments to others | 1 | 1 | 1 |
23.3 | Communications, utilities, and miscellaneous charges | 5 | 4 | 2 |
25.1 | Advisory and assistance services | 12 | 12 | 9 |
25.2 | Other services from non-Federal sources | 266 | 268 | 210 |
25.3 | Other goods and services from Federal sources | 303 | 293 | 146 |
25.4 | Operation and maintenance of facilities | 1 | 1 | 1 |
25.6 | Medical care | 2 | 2 | 2 |
25.7 | Operation and maintenance of equipment | 5 | 5 | 4 |
26.0 | Supplies and materials | 1 | 1 | 1 |
31.0 | Equipment | 8 | 6 | 5 |
32.0 | Land and structures | 4 | 4 | 4 |
41.0 | Grants, subsidies, and contributions | 10,304 | 9,122 | 5,538 |
42.0 | Insurance claims and indemnities | 135 | 107 | 108 |
|
|
|
||
99.0 | Direct obligations | 11,388 | 10,155 | 6,297 |
99.0 | Reimbursable obligations | 68 | 51 | 88 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 11,456 | 10,206 | 6,385 |
|
Employment Summary
|
||||
Identification code 075–0350–0–1–550 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 1,808 | 1,735 | 1,426 |
1101 | Direct military average strength employment | 191 | 178 | 144 |
2001 | Reimbursable civilian full-time equivalent employment | 52 | 52 | 68 |
2101 | Reimbursable military average strength employment | 1 | 1 | 1 |
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0350–4–1–550 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0010 | Primary Health Care (Mandatory) | 1,425 | 4,000 | |
0020 | Health Workforce (Mandatory) | 155 | 437 | |
|
|
|
||
0091 | Direct program activities, subtotal | 1,580 | 4,437 | |
|
|
|
||
0300 | Total direct programs | 1,580 | 4,437 | |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 1,580 | 4,437 | |
|
||||
Budgetary resources: | ||||
Budget authority: | ||||
Appropriations, mandatory: | ||||
1200 | Appropriation | 1,580 | 4,437 | |
1900 | Budget authority (total) | 1,580 | 4,437 | |
1930 | Total budgetary resources available | 1,580 | 4,437 | |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 891 | ||
3010 | New obligations, unexpired accounts | 1,580 | 4,437 | |
3020 | Outlays (gross) | –689 | –2,771 | |
|
|
|
||
3050 | Unpaid obligations, end of year | 891 | 2,557 | |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 891 | ||
3200 | Obligated balance, end of year | 891 | 2,557 | |
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 1,580 | 4,437 | |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 689 | 1,935 | |
4101 | Outlays from mandatory balances | 836 | ||
|
|
|
||
4110 | Outlays, gross (total) | 689 | 2,771 | |
4180 | Budget authority, net (total) | 1,580 | 4,437 | |
4190 | Outlays, net (total) | 689 | 2,771 | |
|
Resources displayed here support grants and contracts managed by Health Resources and Services Administration (HRSA). These activities include support for Health Centers and health workforce programs.
Object Classification (in millions of dollars)
|
||||
Identification code 075–0350–4–1–550 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
Personnel compensation: | ||||
11.1 | Full-time permanent | 17 | 48 | |
11.3 | Other than full-time permanent | 1 | ||
11.5 | Other personnel compensation | 1 | ||
11.7 | Military personnel | 2 | 6 | |
|
|
|
||
11.9 | Total personnel compensation | 19 | 56 | |
12.1 | Civilian personnel benefits | 6 | 16 | |
12.2 | Military personnel benefits | 1 | 3 | |
23.1 | Rental payments to GSA | 4 | ||
23.3 | Communications, utilities, and miscellaneous charges | 2 | 2 | |
25.2 | Other services from non-Federal sources | 37 | 42 | |
25.3 | Other goods and services from Federal sources | 112 | 122 | |
25.7 | Operation and maintenance of equipment | 1 | ||
31.0 | Equipment | 3 | ||
41.0 | Grants, subsidies, and contributions | 1,403 | 4,188 | |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 1,580 | 4,437 | |
|
Employment Summary
|
||||
Identification code 075–0350–4–1–550 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 130 | 365 | |
1101 | Direct military average strength employment | 13 | 36 | |
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0320–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 33 | 35 | 35 |
1033 | Recoveries of prior year paid obligations | 2 | ||
|
|
|
||
1050 | Unobligated balance (total) | 35 | 35 | 35 |
1930 | Total budgetary resources available | 35 | 35 | 35 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 35 | 35 | 35 |
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4123 | Non-Federal sources | –2 | ||
Additional offsets against gross budget authority only: | ||||
4143 | Recoveries of prior year paid obligations, unexpired accounts | 2 | ||
4170 | Outlays, net (mandatory) | –2 | ||
4180 | Budget authority, net (total) | |||
4190 | Outlays, net (total) | –2 | ||
|
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 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 075–0343–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Claims | 1 | 1 | |
0103 | Admin Expense | 2 | 2 | 2 |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 2 | 3 | 3 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 1 | 1 | 1 |
1011 | Unobligated balance transfer from other acct [075–0140] | 2 | 3 | 3 |
|
|
|
||
1050 | Unobligated balance (total) | 3 | 4 | 4 |
1930 | Total budgetary resources available | 3 | 4 | 4 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 1 | 1 | 1 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 1 | 1 | 1 |
3010 | New obligations, unexpired accounts | 2 | 3 | 3 |
3020 | Outlays (gross) | –2 | –3 | |
|
|
|
||
3050 | Unpaid obligations, end of year | 1 | 1 | 4 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 1 | 1 | 1 |
3200 | Obligated balance, end of year | 1 | 1 | 4 |
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
Outlays, gross: | ||||
4011 | Outlays from discretionary balances | 2 | 3 | |
4180 | Budget authority, net (total) | |||
4190 | Outlays, net (total) | 2 | 3 | |
|
The Covered Countermeasure Process Fund is established pursuant to the Public Health Service (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 PHS Act. Additionally, authority is provided to address any unexpected claims that may arise under the Smallpox Emergency Personnel Protection Act of 2003 (P.L. 108–20).
Object Classification (in millions of dollars)
|
||||
Identification code 075–0343–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
25.2 | Other services from non-Federal sources | 1 | 1 | 1 |
42.0 | Insurance claims and indemnities | 1 | 1 | |
|
|
|
||
99.0 | Direct obligations | 1 | 2 | 2 |
99.5 | Adjustment for rounding | 1 | 1 | 1 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 2 | 3 | 3 |
|
Employment Summary
|
||||
Identification code 075–0343–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 3 | 3 | 3 |
1101 | Direct military average strength employment | 2 | 2 | 2 |
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0321–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0010 | Maternal, Infant, and Early Childhood Home Visiting Programs | 402 | 376 | 400 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 20 | 26 | 26 |
1021 | Recoveries of prior year unpaid obligations | 8 | ||
|
|
|
||
1050 | Unobligated balance (total) | 28 | 26 | 26 |
Budget authority: | ||||
Appropriations, mandatory: | ||||
1200 | Appropriation | 400 | 400 | 400 |
1230 | Appropriations and/or unobligated balance of appropriations permanently reduced | –24 | ||
|
|
|
||
1260 | Appropriations, mandatory (total) | 400 | 376 | 400 |
1930 | Total budgetary resources available | 428 | 402 | 426 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 26 | 26 | 26 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 748 | 758 | 748 |
3010 | New obligations, unexpired accounts | 402 | 376 | 400 |
3020 | Outlays (gross) | –384 | –386 | –392 |
3040 | Recoveries of prior year unpaid obligations, unexpired | –8 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 758 | 748 | 756 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 748 | 758 | 748 |
3200 | Obligated balance, end of year | 758 | 748 | 756 |
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 400 | 376 | 400 |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 11 | 15 | 16 |
4101 | Outlays from mandatory balances | 373 | 371 | 376 |
|
|
|
||
4110 | Outlays, gross (total) | 384 | 386 | 392 |
4180 | Budget authority, net (total) | 400 | 376 | 400 |
4190 | Outlays, net (total) | 384 | 386 | 392 |
|
The Maternal, Infant and Early Childhood Home Visiting Program provides comprehensive services for at risk communities. These activities are administered by HRSA.
Object Classification (in millions of dollars)
|
||||
Identification code 075–0321–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
11.1 | Direct obligations: Personnel compensation: Full-time permanent | 5 | 5 | 5 |
|
|
|
||
11.9 | Total personnel compensation | 5 | 5 | 5 |
12.1 | Civilian personnel benefits | 2 | 2 | 2 |
25.1 | Advisory and assistance services | 14 | 13 | 13 |
41.0 | Grants, subsidies, and contributions | 381 | 356 | 380 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 402 | 376 | 400 |
|
Employment Summary
|
||||
Identification code 075–0321–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 36 | 36 | 36 |
1101 | Direct military average strength employment | 2 | 2 | 2 |
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–4442–0–3–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 1 | 1 | 1 |
1930 | Total budgetary resources available | 1 | 1 | 1 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 1 | 1 | 1 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 1 | ||
3020 | Outlays (gross) | –1 | ||
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 1 | ||
|
||||
Financing authority and disbursements, net: | ||||
Mandatory: | ||||
Financing disbursements: | ||||
4110 | Outlays, gross (total) | 1 | ||
4180 | Budget authority, net (total) | |||
4190 | Outlays, net (total) | 1 | ||
|
Status of Guaranteed Loans (in millions of dollars)
|
||||
Identification code 075–4442–0–3–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Position with respect to appropriations act limitation on commitments: | ||||
2111 | Guaranteed loan commitments from current-year authority | |||
2121 | Limitation available from carry-forward | 888 | 888 | 828 |
2143 | Uncommitted limitation carried forward | –888 | –828 | –762 |
|
|
|
||
2150 | Total guaranteed loan commitments | 60 | 66 | |
2199 | Guaranteed amount of guaranteed loan commitments | 48 | 53 | |
|
||||
Cumulative balance of guaranteed loans outstanding: | ||||
2210 | Outstanding, start of year | 60 | 34 | 83 |
2231 | Disbursements of new guaranteed loans | 60 | 66 | |
2251 | Repayments and prepayments | –26 | –10 | –10 |
Adjustments: | ||||
2263 | Terminations for default that result in claim payments | –1 | –1 | |
2264 | Other adjustments, net | |||
|
|
|
||
2290 | Outstanding, end of year | 34 | 83 | 138 |
|
||||
Memorandum: | ||||
2299 | Guaranteed amount of guaranteed loans outstanding, end of year | 25 | 64 | 108 |
|
Public Law 104–299, Public Law 104–208, and Public Law 115–141 authorize Health Resources and Services Administration (HRSA) to guarantee up to $1 billion 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. The program account for this activity is displayed in the Health Resources and Services account (75–0350) as a line in the program and financing schedule.
Balance Sheet (in millions of dollars)
|
|||
Identification code 075–4442–0–3–551 | 2018 actual | 2019 actual | |
|
|||
ASSETS: | |||
1101 | Federal assets: Fund balances with Treasury | 1 | 1 |
|
|
||
1999 | Total assets | 1 | 1 |
LIABILITIES: | |||
2204 | Non-Federal liabilities: Liabilities for loan guarantees | 1 | 1 |
NET POSITION: | |||
3300 | Cumulative results of operations | ||
|
|
||
4999 | Total liabilities and net position | 1 | 1 |
|
Status of Direct Loans (in millions of dollars)
|
||||
Identification code 075–9931–0–3–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Cumulative balance of direct loans outstanding: | ||||
1210 | Outstanding, start of year | 5 | 5 | 5 |
|
|
|
||
1290 | Outstanding, end of year | 5 | 5 | 5 |
|
Titles VI and XVI of the PHS 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 the event of default, $30 million as a revolving fund for direct loans, and an amount for interest subsidy payments on guaranteed loans.
Balance Sheet (in millions of dollars)
|
|||
Identification code 075–9931–0–3–551 | 2018 actual | 2019 actual | |
|
|||
ASSETS: | |||
1601 | Direct loans, gross | 5 | 5 |
|
|
||
1999 | Total assets | 5 | 5 |
LIABILITIES: | |||
2201 | Non-Federal liabilities: Accounts payable | 5 | 5 |
NET POSITION: | |||
3100 | Unexpended appropriations | ||
3300 | Cumulative results of operations | ||
|
|
||
3999 | Total net position | ||
|
|
||
4999 | Total liabilities and net position | 5 | 5 |
|
For payments from the Vaccine Injury Compensation Program Trust Fund (the "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 PHS Act, to remain available until expended: Provided, That for necessary administrative expenses, not to exceed $16,200,000 shall be available from the Trust Fund to the Secretary.
(Department of Health and Human Services Appropriations Act, 2020.)
Special and Trust Fund Receipts (in millions of dollars)
|
||||
Identification code 075–8175–0–7–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
0100 | Balance, start of year | 3,684 | 3,818 | 3,921 |
0198 | Adjustment to reconcile to budgetary accounting | 4 | ||
|
|
|
||
0199 | Balance, start of year | 3,688 | 3,818 | 3,921 |
Receipts: | ||||
Current law: | ||||
1110 | Deposits, Vaccine Injury Compensation Trust Fund | 280 | 303 | 309 |
1140 | Interest and Profits on Investments, Vaccine Injury Compensation Trust Fund | 94 | 92 | 101 |
|
|
|
||
1199 | Total current law receipts | 374 | 395 | 410 |
|
|
|
||
1999 | Total receipts | 374 | 395 | 410 |
|
|
|
||
2000 | Total: Balances and receipts | 4,062 | 4,213 | 4,331 |
Appropriations: | ||||
Current law: | ||||
2101 | Vaccine Injury Compensation Program Trust Fund | –28 | –32 | –45 |
2101 | Vaccine Injury Compensation Program Trust Fund | –346 | –260 | –266 |
2135 | Vaccine Injury Compensation Program Trust Fund | 120 | ||
|
|
|
||
2199 | Total current law appropriations | –254 | –292 | –311 |
|
|
|
||
2999 | Total appropriations | –254 | –292 | –311 |
4030 | Vaccine Injury Compensation Program Trust Fund | 9 | ||
5098 | Adjustment to reconcile to budgetary accounting | 1 | ||
|
|
|
||
5099 | Balance, end of year | 3,818 | 3,921 | 4,020 |
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–8175–0–7–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Compensation: Claims for post - FY 1989 injuries | 226 | 260 | 266 |
0103 | Claims processing (Claims Court) | 9 | 9 | 10 |
0104 | Claims processing (HRSA) | 9 | 10 | 16 |
0105 | Claims processing (Dept. of Justice) | 10 | 13 | 19 |
|
|
|
||
0191 | Direct program activities, subtotal | 28 | 32 | 45 |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 254 | 292 | 311 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1033 | Recoveries of prior year paid obligations | 9 | ||
1035 | Unobligated balance of appropriations withdrawn | –9 | ||
Budget authority: | ||||
Appropriations, discretionary: | ||||
1101 | Appropriation (special or trust) | 28 | 32 | 45 |
Appropriations, mandatory: | ||||
1201 | Appropriation (special or trust fund) | 346 | 260 | 266 |
1235 | Appropriations precluded from obligation (special or trust) | –120 | ||
|
|
|
||
1260 | Appropriations, mandatory (total) | 226 | 260 | 266 |
1900 | Budget authority (total) | 254 | 292 | 311 |
1930 | Total budgetary resources available | 254 | 292 | 311 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 19 | 13 | |
3010 | New obligations, unexpired accounts | 254 | 292 | 311 |
3020 | Outlays (gross) | –260 | –305 | –311 |
|
|
|
||
3050 | Unpaid obligations, end of year | 13 | ||
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 19 | 13 | |
3200 | Obligated balance, end of year | 13 | ||
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
4000 | Budget authority, gross | 28 | 32 | 45 |
Outlays, gross: | ||||
4010 | Outlays from new discretionary authority | 21 | 32 | 45 |
4011 | Outlays from discretionary balances | 13 | ||
|
|
|
||
4020 | Outlays, gross (total) | 34 | 32 | 45 |
Mandatory: | ||||
4090 | Budget authority, gross | 226 | 260 | 266 |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 226 | 260 | 266 |
4101 | Outlays from mandatory balances | 13 | ||
|
|
|
||
4110 | Outlays, gross (total) | 226 | 273 | 266 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4123 | Non-Federal sources | –9 | ||
Additional offsets against gross budget authority only: | ||||
4143 | Recoveries of prior year paid obligations, unexpired accounts | 9 | ||
|
|
|
||
4160 | Budget authority, net (mandatory) | 226 | 260 | 266 |
4170 | Outlays, net (mandatory) | 217 | 273 | 266 |
4180 | Budget authority, net (total) | 254 | 292 | 311 |
4190 | Outlays, net (total) | 251 | 305 | 311 |
|
||||
Memorandum (non-add) entries: | ||||
5000 | Total investments, SOY: Federal securities: Par value | 3,750 | 3,849 | 3,984 |
5001 | Total investments, EOY: Federal securities: Par value | 3,849 | 3,984 | 4,128 |
|
The Vaccine Injury Compensation Program was established pursuant to Public Law 99–660 and Public Law 100–203 and serves as a source of funds to pay claims for compensation for vaccine-related injury or death. This account reflects payments for claims for vaccine-related injury or death occurring after October 1, 1988.
Object Classification (in millions of dollars)
|
||||
Identification code 075–8175–0–7–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
11.1 | Personnel compensation: Full-time permanent | 2 | 2 | 3 |
12.1 | Civilian personnel benefits | 1 | 1 | 1 |
25.3 | Other goods and services from Federal sources | 5 | 5 | 5 |
42.0 | Insurance claims and indemnities | 246 | 284 | 302 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 254 | 292 | 311 |
|
Employment Summary
|
||||
Identification code 075–8175–0–7–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 14 | 16 | 23 |
1101 | Direct military average strength employment | 5 | 5 | 5 |
|
For expenses necessary to carry out the Act of August 5, 1954 (68 Stat. 674), the Indian Self-Determination and Education Assistance 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, $4,507,113,000 to remain available until September 30, 2022, except as otherwise provided herein, together with payments received during the fiscal year pursuant to sections 231(b) and 233 of the Public Health Service Act (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 $964,783,000 for Purchased/Referred Care, including $53,000,000 for the Indian Catastrophic Health Emergency Fund, shall remain available until expended: Provided further, That of the funds provided, up to $44,000,000 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 of the funds provided, $58,000,000 shall be for costs related to or resulting from accreditation emergencies, including supplementing activities funded under the heading "Indian Health Facilities," of which up to $4,000,000 may be used to supplement amounts otherwise available for Purchased/Referred Care: 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 in the Fund authorized by section 108A of that Act (25 U.S.C. 1616a-1) and shall remain available until expended and, notwithstanding section 108A(c) of that 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 that Act (25 U.S.C. 1613a and 1616a): Provided further, That the amounts made available within this account for the Substance Abuse and Suicide Prevention Program, for Opioid Prevention, Treatment and Recovery Services, for the Domestic Violence Prevention Program, for the Zero Suicide Initiative, for recruitment and retention, including a housing subsidy authority for civilian employees, for Aftercare Pilot Programs at Youth Regional Treatment Centers, for transformation and modernization costs of the Indian Health Service Electronic Health Record system, for national quality and oversight activities,to improve collections from public and private insurance at Indian Health Service and tribally operated facilities, for an initiative to treat or reduce the transmission of HIV and HCV, for the Telebehaviorial Health Center of Excellence, for a maternal health initiative, for Community Health, and for accreditation emergencies shall be allocated at the discretion of the Director of the Indian Health Service and shall remain available until expended: Provided further, That funds provided in this Act may be used for annual contracts and grants that fall within 2 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 (25 U.S.C. 1613) 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 the Bureau of Indian Affairs may collect from the Indian Health Service, and from 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 of the funds provided, $72,280,000 is for the Indian Health Care Improvement Fund and may be used, as needed, to carry out activities typically funded under the Indian Health Facilities account.
(Department of the Interior, Environment, and Related Agencies Appropriations Act, 2020.)
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0390–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Clinical services | 3,753 | 3,935 | 4,178 |
0002 | Preventive health | 165 | 178 | 142 |
0003 | Urban health | 49 | 58 | 49 |
0004 | Indian health professions | 60 | 65 | 52 |
0005 | Tribal management | 2 | 2 | |
0006 | Direct operations | 70 | 72 | 81 |
0007 | Self-governance | 4 | 6 | 5 |
0009 | Diabetes funds | 150 | 97 | |
|
|
|
||
0799 | Total direct obligations | 4,253 | 4,413 | 4,507 |
0801 | Indian Health Services (Reimbursable) | 1,641 | 1,704 | 1,771 |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 5,894 | 6,117 | 6,278 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 1,219 | 1,510 | 1,606 |
1001 | Discretionary unobligated balance brought fwd, Oct 1 | 1,192 | 1,504 | |
1021 | Recoveries of prior year unpaid obligations | 192 | ||
|
|
|
||
1050 | Unobligated balance (total) | 1,411 | 1,510 | 1,606 |
Budget authority: | ||||
Appropriations, discretionary: | ||||
1100 | Appropriation | 4,103 | 4,315 | 4,507 |
Appropriations, mandatory: | ||||
1200 | Appropriation | 150 | 97 | |
Spending authority from offsetting collections, discretionary: | ||||
1700 | Collected | 1,738 | 1,801 | 1,868 |
1701 | Change in uncollected payments, Federal sources | 4 | ||
|
|
|
||
1750 | Spending auth from offsetting collections, disc (total) | 1,742 | 1,801 | 1,868 |
1900 | Budget authority (total) | 5,995 | 6,213 | 6,375 |
1930 | Total budgetary resources available | 7,406 | 7,723 | 7,981 |
Memorandum (non-add) entries: | ||||
1940 | Unobligated balance expiring | –2 | ||
1941 | Unexpired unobligated balance, end of year | 1,510 | 1,606 | 1,703 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 1,139 | 1,199 | 767 |
3010 | New obligations, unexpired accounts | 5,894 | 6,117 | 6,278 |
3011 | Obligations ("upward adjustments"), expired accounts | 43 | ||
3020 | Outlays (gross) | –5,670 | –6,549 | –6,341 |
3040 | Recoveries of prior year unpaid obligations, unexpired | –192 | ||
3041 | Recoveries of prior year unpaid obligations, expired | –15 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 1,199 | 767 | 704 |
Uncollected payments: | ||||
3060 | Uncollected pymts, Fed sources, brought forward, Oct 1 | –106 | –109 | –109 |
3070 | Change in uncollected pymts, Fed sources, unexpired | –4 | ||
3071 | Change in uncollected pymts, Fed sources, expired | 1 | ||
|
|
|
||
3090 | Uncollected pymts, Fed sources, end of year | –109 | –109 | –109 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 1,033 | 1,090 | 658 |
3200 | Obligated balance, end of year | 1,090 | 658 | 595 |
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
4000 | Budget authority, gross | 5,845 | 6,116 | 6,375 |
Outlays, gross: | ||||
4010 | Outlays from new discretionary authority | 4,504 | 5,339 | 5,564 |
4011 | Outlays from discretionary balances | 1,018 | 1,111 | 773 |
|
|
|
||
4020 | Outlays, gross (total) | 5,522 | 6,450 | 6,337 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4030 | Federal sources | –437 | –436 | –436 |
4033 | Non-Federal sources | –1,302 | –1,365 | –1,432 |
|
|
|
||
4040 | Offsets against gross budget authority and outlays (total) | –1,739 | –1,801 | –1,868 |
Additional offsets against gross budget authority only: | ||||
4050 | Change in uncollected pymts, Fed sources, unexpired | –4 | ||
4052 | Offsetting collections credited to expired accounts | 1 | ||
|
|
|
||
4060 | Additional offsets against budget authority only (total) | –3 | ||
|
|
|
||
4070 | Budget authority, net (discretionary) | 4,103 | 4,315 | 4,507 |
4080 | Outlays, net (discretionary) | 3,783 | 4,649 | 4,469 |
Mandatory: | ||||
4090 | Budget authority, gross | 150 | 97 | |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 52 | 93 | |
4101 | Outlays from mandatory balances | 96 | 6 | 4 |
|
|
|
||
4110 | Outlays, gross (total) | 148 | 99 | 4 |
4180 | Budget authority, net (total) | 4,253 | 4,412 | 4,507 |
4190 | Outlays, net (total) | 3,931 | 4,748 | 4,473 |
|
Summary of Budget Authority and Outlays (in millions of dollars)
|
||||
2019 actual | 2020 est. | 2021 est. | ||
|
||||
Enacted/requested: | ||||
Budget Authority | 4,253 | 4,412 | 4,507 | |
Outlays | 3,931 | 4,748 | 4,473 | |
Legislative proposal, subject to PAYGO: | ||||
Budget Authority | 53 | 150 | ||
Outlays | 51 | 146 | ||
Total: | ||||
Budget Authority | 4,253 | 4,465 | 4,657 | |
Outlays | 3,931 | 4,799 | 4,619 | |
|
The Indian Health Services account provides medical care, public health services, and health professions training opportunities to American Indians and Alaska Natives. More than $2.7 billion, primarily through self-determination contracts and compacts, will be administered by tribal governments in 2021.
Object Classification (in millions of dollars)
|
||||
Identification code 075–0390–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
Personnel compensation: | ||||
11.1 | Full-time permanent | 416 | 440 | 445 |
11.3 | Other than full-time permanent | 18 | 19 | 18 |
11.5 | Other personnel compensation | 66 | 68 | 68 |
11.7 | Military personnel | 56 | 58 | 57 |
|
|
|
||
11.9 | Total personnel compensation | 556 | 585 | 588 |
12.1 | Civilian personnel benefits | 166 | 175 | 174 |
12.2 | Military personnel benefits | 29 | 30 | 30 |
13.0 | Benefits for former personnel | 1 | 1 | 1 |
21.0 | Travel and transportation of persons | 8 | 8 | 14 |
21.0 | Patient travel | 20 | 21 | 20 |
22.0 | Transportation of things | 6 | 6 | 6 |
23.1 | Rental payments to GSA | 14 | 14 | 14 |
23.2 | Rental payments to others | 1 | 1 | 1 |
23.3 | Communications, utilities, and miscellaneous charges | 10 | 10 | 10 |
25.1 | Advisory and assistance services | 5 | 5 | 5 |
25.2 | Other services from non-Federal sources | 291 | 301 | 384 |
25.3 | Other goods and services from Federal sources | 111 | 114 | 112 |
25.4 | Operation and maintenance of facilities | 2 | 2 | 2 |
25.6 | Medical care | 390 | 401 | 396 |
25.7 | Operation and maintenance of equipment | 9 | 9 | 9 |
25.8 | Subsistence and support of persons | 7 | 7 | 7 |
26.0 | Supplies and materials | 109 | 112 | 131 |
31.0 | Equipment | 8 | 8 | 45 |
41.0 | Grants, subsidies, and contributions | 2,495 | 2,588 | 2,543 |
42.0 | Insurance claims and indemnities | 15 | 15 | 15 |
|
|
|
||
99.0 | Direct obligations | 4,253 | 4,413 | 4,507 |
99.0 | Reimbursable obligations | 1,641 | 1,704 | 1,771 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 5,894 | 6,117 | 6,278 |
|
Employment Summary
|
||||
Identification code 075–0390–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 6,449 | 6,449 | 6,468 |
1101 | Direct military average strength employment | 1,530 | 1,530 | 1,531 |
2001 | Reimbursable civilian full-time equivalent employment | 6,102 | 6,102 | 6,102 |
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0390–4–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0009 | Diabetes funds | 53 | 150 | |
|
|
|
||
0799 | Total direct obligations | 53 | 150 | |
|
||||
Budgetary resources: | ||||
Budget authority: | ||||
Appropriations, mandatory: | ||||
1200 | Appropriation | 53 | 150 | |
1930 | Total budgetary resources available | 53 | 150 | |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 2 | ||
3010 | New obligations, unexpired accounts | 53 | 150 | |
3020 | Outlays (gross) | –51 | –146 | |
|
|
|
||
3050 | Unpaid obligations, end of year | 2 | 6 | |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 2 | ||
3200 | Obligated balance, end of year | 2 | 6 | |
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 53 | 150 | |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 51 | 144 | |
4101 | Outlays from mandatory balances | 2 | ||
|
|
|
||
4110 | Outlays, gross (total) | 51 | 146 | |
4180 | Budget authority, net (total) | 53 | 150 | |
4190 | Outlays, net (total) | 51 | 146 | |
|
The Budget proposes to extend the Special Diabetes Program for Indians through fiscal year 2021.
Object Classification (in millions of dollars)
|
||||
Identification code 075–0390–4–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
11.1 | Direct obligations: Personnel compensation: Full-time permanent | 2 | ||
|
|
|
||
11.9 | Total personnel compensation | 2 | ||
12.1 | Civilian personnel benefits | 1 | ||
25.6 | Medical care | 10 | ||
31.0 | Equipment | 1 | ||
41.0 | Grants, subsidies, and contributions | 53 | 136 | |
|
|
|
||
99.0 | Direct obligations | 53 | 150 | |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 53 | 150 | |
|
Employment Summary
|
||||
Identification code 075–0390–4–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 23 | ||
|
For payments to tribes and tribal organizations for contract support costs associated with Indian Self-Determination and Education Assistance Act agreements with the Indian Health Service for fiscal year 2021, such sums as may be necessary: Provided, That notwithstanding any other provision of law, no amounts made available under this heading shall be available for transfer to another budget account: Provided further, That amounts obligated but not expended by a tribe or tribal organization for contract support costs for such agreements for the current fiscal year shall be applied to contract support costs due for such agreements for subsequent fiscal years.
(Department of the Interior, Environment, and Related Agencies Appropriations Act, 2020.)
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0344–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Contract Support Costs | 799 | 855 | 855 |
|
||||
Budgetary resources: | ||||
Budget authority: | ||||
Appropriations, discretionary: | ||||
1100 | Appropriation | 799 | 855 | 855 |
1930 | Total budgetary resources available | 799 | 855 | 855 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 62 | 59 | 37 |
3010 | New obligations, unexpired accounts | 799 | 855 | 855 |
3011 | Obligations ("upward adjustments"), expired accounts | 38 | ||
3020 | Outlays (gross) | –830 | –877 | –892 |
3041 | Recoveries of prior year unpaid obligations, expired | –10 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 59 | 37 | |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 62 | 59 | 37 |
3200 | Obligated balance, end of year | 59 | 37 | |
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
4000 | Budget authority, gross | 799 | 855 | 855 |
Outlays, gross: | ||||
4010 | Outlays from new discretionary authority | 777 | 855 | 855 |
4011 | Outlays from discretionary balances | 53 | 22 | 37 |
|
|
|
||
4020 | Outlays, gross (total) | 830 | 877 | 892 |
4180 | Budget authority, net (total) | 799 | 855 | 855 |
4190 | Outlays, net (total) | 830 | 877 | 892 |
|
The Contract Support Costs account provides for the reasonable and allowable costs for direct program expenses for the operation of, and any additional administrative or other expense related to, the overhead incurred by tribes and tribal organizations who operate health programs through self-determination contracts and compacts. An estimated $855 million in contract support costs funds will be provided to tribal governments and tribal organizations in 2021.
Object Classification (in millions of dollars)
|
||||
Identification code 075–0344–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
25.3 | Other goods and services from Federal sources | 799 | ||
41.0 | Grants, subsidies, and contributions | 855 | 855 | |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 799 | 855 | 855 |
|
For payments to tribes and tribal organizations for leases pursuant to section 105(l) of the Indian Self-Determination and Education Assistance Act (25 U.S.C. 5324(l)) for fiscal year 2021, such sums as may be necessary: Provided, That notwithstanding any other provision of law, no amounts made available under this heading shall be available for transfer to another budget account.
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0200–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Payments for Tribal Leases | 101 | ||
|
|
|
||
0900 | Total new obligations, unexpired accounts (object class 41.0) | 101 | ||
|
||||
Budgetary resources: | ||||
Budget authority: | ||||
Appropriations, discretionary: | ||||
1100 | Appropriation | 101 | ||
1930 | Total budgetary resources available | 101 | ||
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3010 | New obligations, unexpired accounts | 101 | ||
3020 | Outlays (gross) | –101 | ||
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
4000 | Budget authority, gross | 101 | ||
Outlays, gross: | ||||
4010 | Outlays from new discretionary authority | 101 | ||
4180 | Budget authority, net (total) | 101 | ||
4190 | Outlays, net (total) | 101 | ||
|
The Payments for Tribal Leases account provides for the reasonable and allowable costs for leases with a Tribe or tribal organization for a building owned or leased by the tribe or tribal organization that is used for administration or delivery of services under the Indian Self-Determination and Education Assistance Act. An estimated $101 million in lease funds will be provided to tribal governments and tribal organizations in 2021.
For construction, repair, maintenance, demolition, 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, $769,455,000 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 an 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 may 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.
(Department of the Interior, Environment, and Related Agencies Appropriations Act, 2020.)
Special and Trust Fund Receipts (in millions of dollars)
|
||||
Identification code 075–0391–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
0100 | Balance, start of year | |||
Receipts: | ||||
Current law: | ||||
1130 | Rent and Charges for Quarters, Indian Health Service | 8 | 9 | 9 |
|
|
|
||
2000 | Total: Balances and receipts | 8 | 9 | 9 |
Appropriations: | ||||
Current law: | ||||
2101 | Indian Health Facilities | –8 | –9 | –9 |
|
|
|
||
5099 | Balance, end of year | |||
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0391–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Maintenance | 135 | 170 | 168 |
0002 | Sanitation Facilities Construction | 208 | 214 | 193 |
0003 | Facilities and environmental health | 244 | 261 | 259 |
0004 | Equipment | 24 | 28 | 24 |
0005 | Health Care Facilities Construction | 304 | 359 | 125 |
|
|
|
||
0100 | Total direct program | 915 | 1,032 | 769 |
|
|
|
||
0799 | Total direct obligations | 915 | 1,032 | 769 |
0801 | Indian Health Facilities (Reimbursable) | 8 | 9 | 9 |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 923 | 1,041 | 778 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 621 | 630 | 569 |
1001 | Discretionary unobligated balance brought fwd, Oct 1 | 617 | 614 | |
1021 | Recoveries of prior year unpaid obligations | 14 | ||
|
|
|
||
1050 | Unobligated balance (total) | 635 | 630 | 569 |
Budget authority: | ||||
Appropriations, discretionary: | ||||
1100 | Appropriation | 879 | 912 | 769 |
Appropriations, mandatory: | ||||
1201 | Appropriation (special or trust fund) | 8 | 9 | 9 |
Spending authority from offsetting collections, discretionary: | ||||
1700 | Collected | 31 | 59 | 59 |
1900 | Budget authority (total) | 918 | 980 | 837 |
1930 | Total budgetary resources available | 1,553 | 1,610 | 1,406 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 630 | 569 | 628 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 678 | 862 | 990 |
3010 | New obligations, unexpired accounts | 923 | 1,041 | 778 |
3020 | Outlays (gross) | –725 | –913 | –926 |
3040 | Recoveries of prior year unpaid obligations, unexpired | –14 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 862 | 990 | 842 |
Uncollected payments: | ||||
3060 | Uncollected pymts, Fed sources, brought forward, Oct 1 | –18 | –18 | –18 |
|
|
|
||
3090 | Uncollected pymts, Fed sources, end of year | –18 | –18 | –18 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 660 | 844 | 972 |
3200 | Obligated balance, end of year | 844 | 972 | 824 |
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
4000 | Budget authority, gross | 910 | 971 | 828 |
Outlays, gross: | ||||
4010 | Outlays from new discretionary authority | 349 | 333 | 290 |
4011 | Outlays from discretionary balances | 370 | 564 | 627 |
|
|
|
||
4020 | Outlays, gross (total) | 719 | 897 | 917 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4030 | Federal sources | –31 | –59 | –59 |
|
|
|
||
4040 | Offsets against gross budget authority and outlays (total) | –31 | –59 | –59 |
Mandatory: | ||||
4090 | Budget authority, gross | 8 | 9 | 9 |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 2 | 9 | 9 |
4101 | Outlays from mandatory balances | 4 | 7 | |
|
|
|
||
4110 | Outlays, gross (total) | 6 | 16 | 9 |
4180 | Budget authority, net (total) | 887 | 921 | 778 |
4190 | Outlays, net (total) | 694 | 854 | 867 |
|
The Indian Health Facilities account supports construction, repair and improvement, equipment, and environmental health and facilities support for the Indian Health Service. More than $340 million, primarily through self-determination contracts and compacts, will be administered by tribal governments in 2021.
Object Classification (in millions of dollars)
|
||||
Identification code 075–0391–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
Personnel compensation: | ||||
11.1 | Full-time permanent | 45 | 47 | 48 |
11.3 | Other than full-time permanent | 1 | 1 | 1 |
11.5 | Other personnel compensation | 2 | 2 | 2 |
11.7 | Military personnel | 20 | 21 | 22 |
|
|
|
||
11.9 | Total personnel compensation | 68 | 71 | 73 |
12.1 | Civilian personnel benefits | 16 | 17 | 17 |
12.2 | Military personnel benefits | 7 | 7 | 7 |
21.0 | Travel and transportation of persons | 1 | 1 | 1 |
22.0 | Transportation of things | 1 | 1 | 1 |
23.3 | Communications, utilities, and miscellaneous charges | 5 | 5 | 5 |
25.1 | Advisory and assistance services | 1 | 1 | 1 |
25.2 | Other services from non-Federal sources | 301 | 349 | 330 |
25.3 | Other goods and services from Federal sources | 4 | 3 | 4 |
25.4 | Operation and maintenance of facilities | 3 | 3 | 3 |
25.7 | Operation and maintenance of equipment | 1 | 1 | 1 |
26.0 | Supplies and materials | 3 | 3 | 3 |
31.0 | Equipment | 2 | 2 | 2 |
32.0 | Land and structures | 110 | 128 | 60 |
41.0 | Grants, subsidies, and contributions | 383 | 432 | 253 |
42.0 | Insurance claims and indemnities | 8 | 8 | 8 |
|
|
|
||
99.0 | Direct obligations | 914 | 1,032 | 769 |
99.0 | Reimbursable obligations | 9 | 9 | 9 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 923 | 1,041 | 778 |
|
Employment Summary
|
||||
Identification code 075–0391–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 946 | 946 | 946 |
1101 | Direct military average strength employment | 151 | 151 | 151 |
2001 | Reimbursable civilian full-time equivalent employment | 40 | 40 | 40 |
|
Appropriations 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 of Health and Human Services; 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: Provided, That in accordance with the provisions of the Indian Health Care Improvement Act, non-Indian patients may be extended health care at all tribally administered or Indian Health Service facilities, subject to charges, and the proceeds along with funds recovered under the Federal Medical Care Recovery Act (42 U.S.C. 2651–2653) shall be credited to the account of the facility providing the service and shall be available without fiscal year limitation: Provided further, That notwithstanding any other law or regulation, funds transferred from the Department of Housing and Urban Development to the Indian Health Service shall be administered under Public Law 86–121, the Indian Sanitation Facilities Act and Public Law 93–638: Provided further, That funds appropriated to the Indian Health Service in this Act, except those used for administrative and program direction purposes, shall not be subject to limitations directed at curtailing Federal travel and transportation: Provided further, That none of the funds made available to the Indian Health Service in this Act shall be used for any assessments or charges by the Department of Health and Human Services unless identified in the budget justification and provided in this Act: Provided further, That notwithstanding any other provision of law, funds previously or herein made available to a tribe or tribal organization through a contract, grant, or agreement authorized by title I or title V of the Indian Self-Determination and Education Assistance Act of 1975 (25 U.S.C. 450 et seq.), 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: Provided further, That none of the funds made available to the Indian Health Service in this Act shall be used to implement the final rule published in the Federal Register on September 16, 1987, by the Department of Health and Human Services, relating to the eligibility for the health care services of the Indian Health Service until the Indian Health Service has submitted a budget request reflecting the increased costs associated with the proposed final rule, and such request has been included in an appropriations Act and enacted into law: Provided further, That 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, and the reimbursements received therefrom, along with the funds received from those entities pursuant to the Indian Self-Determination Act, may be credited to the same or subsequent appropriation account from which the funds were originally derived, with such amounts to remain available until expended: Provided further, That reimbursements for training, technical assistance, or services provided by the Indian Health Service will contain total costs, including direct, administrative, and overhead costs associated with the provision of goods, services, or technical assistance: Provided further, That the Indian Health Service may provide to civilian medical personnel serving in hospitals operated by the Indian Health Service housing allowances equivalent to those that would be provided to members of the Commissioned Corps of the United States Public Health Service serving in similar positions at such hospitals: Provided further, That none of the funds made available in this Act may be used to compensate an Indian tribe or tribal organization for any lease under section 105(l) of the Indian Self-Determination and Education Assistance Act relating to a facility exceeding 40,000 square feet unless funds for the lease are specifically appropriated in advance for such purpose.
(Department of the Interior, Environment, and Related Agencies Appropriations Act, 2020.)
For carrying out titles II, III, XVII, and XXI, and section 2821 of the PHS Act, titles II and IV of the Immigration and Nationality Act, and section 501 of the Refugee Education Assistance Act, with respect to immunization and respiratory diseases, $527,160,000.
For carrying out titles II, III, XVII, and XXIII of the PHS Act with respect to HIV/AIDS, viral hepatitis, sexually transmitted diseases, and tuberculosis prevention, $1,552,556,000.
For carrying out titles II, III, and XVII, and section 2821 of the PHS Act, titles II and IV of the Immigration and Nationality Act, and section 501 of the Refugee Education Assistance Act, with respect to emerging and zoonotic infectious diseases, $413,464,000: Provided, That of the amounts made available under this heading, up to $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 law.
For carrying out titles II, III, XI, XV, XVII, and XIX of the PHS Act with respect to chronic disease prevention and health promotion, $359,145,000: Provided, That such amounts and any amounts transferred to this appropriation shall be available for the Director of the Centers for Disease Control and Prevention (CDC) to administer a program, to be known as The America's Health State Block Grant, to provide increased flexibility for States, territories, tribes, and tribal organizations to improve public health: Provided further, That for the purposes of carrying out such program, the Director may award grants to States, territories, tribes, and tribal organizations through a formula, as determined by the Director, that takes into account the population and disease burden of the grantee: Provided further, That the Director may set aside not more than 15 percent of the amounts awarded for grants described in the previous proviso for such purposes, to make grant awards on a competitive basis, to cities, Federally-recognized tribes, and public health entities serving rural and frontier areas or other entities: Provided further, That funds made available under this heading may be available for making grants under section 1509 of the PHS Act for not less than 21 States, tribes, or tribal organizations: Provided further, That the proportional funding requirements under section 1503(a) of the PHS Act shall not apply to funds made available under this heading.
For carrying out titles II, III, XI, and XVII of the PHS Act with respect to birth defects, developmental disabilities, disabilities and health, $112,250,000.
For carrying out titles II, III, and XVII of the PHS Act with respect to health statistics, surveillance, health informatics, and workforce development, $58,000,000: Provided, That, in addition to amounts provided under this heading, $463,000,000 is available to this appropriation, for the purposes under this heading, from amounts provided pursuant to section 241 of the PHS Act.
For carrying out titles II, III, and XVII of the PHS Act with respect to environmental health, $182,000,000.
For carrying out titles II, III, and XVII of the PHS Act with respect to injury prevention and control and for carrying out the Drug-Free Communities Support Program (the Program) authorized by chapter 2 of subtitle A of title I of the National Narcotics Leadership Act of 1988 (chapter 2), $730,159,000: Provided, That the Secretary shall have the same authorities as those delegated by chapter 2 to the Office of National Drug Control Policy (ONDCP), the Director of ONDCP, and the Administrator of the Program: Provided further, That the Secretary may make grants to, or enter into cooperative agreements with, states, territories and Indian tribes for such entities to make subgrants under the Program to eligible coalitions, as defined in section 1023 of chapter 2: Provided further, That for such purpose, the Secretary may delegate to such entities those of the Secretary's authorities under subchapter I of chapter 2 and the previous proviso that the Secretary considers necessary or appropriate for efficient and effective management of the Program: Provided further, That the limitation on administrative costs in section 1024(b) of chapter 2 shall not apply to amounts made available under this heading.
For carrying out titles II, III, and XVII of the PHS Act, sections 101, 102, 103, 201, 202, 203, 301, and 501 of the Federal Mine Safety and Health Act, section 13 of the Mine Improvement and New Emergency Response Act, and sections 20, 21, and 22 of the Occupational Safety and Health Act, with respect to occupational safety and health, $111,362,000: Provided, That, in addition to amounts provided herein, $78,638,000 shall be available to this appropriation, for the purposes under this heading, from amounts provided pursuant to section 241 of the PHS Act.
For necessary expenses to administer the Energy Employees Occupational Illness Compensation Program Act, $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.
For carrying out titles II, III, and XVII of the PHS Act with respect to global health, $532,222,000, of which: (1) $69,547,000 shall remain available through September 30, 2022, for international HIV/AIDS; and (2) $225,000,000 shall be available for global public health protection: Provided, That funds may be used for purchase and insurance of official motor vehicles in foreign countries.
For carrying out titles II, III, and XVII of the PHS Act with respect to public health preparedness and response, and for expenses necessary to support activities related to countering potential biological, nuclear, radiological, and chemical threats to civilian populations, $802,000,000: Provided, That the Director of the Centers for Disease Control and Prevention (referred to in this title as "CDC") or the Administrator of the Agency for Toxic Substances and Disease Registry may detail staff without reimbursement for up to 180 days to support an activation of the CDC Emergency Operations Center.
For carrying out titles II, III, XVII and XIX, and section 2821 of the PHS Act and for cross-cutting activities and program support for activities funded in other appropriations included in this Act for the Centers for Disease Control and Prevention, $155,000,000, of which up to $5,000,000 may be transferred to the reserve of the Working Capital Fund authorized under this heading in division F of Public Law 112–74: Provided, That paragraphs (1) through (3) of subsection (b) of section 2821 of the PHS Act shall not apply to funds appropriated under this heading and in all other accounts of the CDC: Provided further, That of the amounts made available under this heading, $50,000,000 shall be transferred to and merged with the Infectious Diseases Rapid Response Reserve Fund established by section 231 of division B of Public Law 115–245: Provided further, That any amounts made available by this Act to the Centers for Disease Control and Prevention may be used to support the purchase, hire, maintenance, and operation of an aircraft for use and support of the activities of CDC: Provided further, That employees of CDC 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 HHS during the period of detail or assignment: Provided further, That CDC may use up to $10,000 from amounts appropriated to CDC in this Act for official reception and representation expenses when specifically approved by the Director of CDC: Provided further, That in addition, such sums as may be derived from authorized user fees, which shall be credited to the appropriation charged with the cost thereof: Provided further, That with respect to the previous proviso, authorized user fees from the Vessel Sanitation Program and the Respirator Certification Program shall be available through September 30, 2022.
(Department of Health and Human Services Appropriations Act, 2020.)
Special and Trust Fund Receipts (in millions of dollars)
|
||||
Identification code 075–0943–0–1–999 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
0100 | Balance, start of year | 1 | ||
Receipts: | ||||
Current law: | ||||
1130 | Cooperative Research and Development Agreements, Centers for Disease Control | 1 | 2 | 2 |
|
|
|
||
2000 | Total: Balances and receipts | 1 | 2 | 3 |
Appropriations: | ||||
Current law: | ||||
2101 | CDC-wide Activities and Program Support | –1 | –1 | –1 |
|
|
|
||
5099 | Balance, end of year | 1 | 2 | |
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0943–0–1–999 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Birth Defects, Developmental Disabilities, Disability and Health (0958) | 155 | 161 | 112 |
0002 | CDC-Wide Activities and Program Support (0943) | 483 | 359 | 155 |
0004 | Chronic Disease Prevention and Health Promotion (0948) | 1,196 | 1,240 | 813 |
0005 | Emerging and Zoonotic Infectious Diseases (0949) | 619 | 636 | 550 |
0006 | Energy Employee Illness Occupational Compensation Program Act (EEOICPA) (0954) | 52 | 55 | 55 |
0007 | Environmental Health (0947) | 213 | 214 | 182 |
0008 | Global Health (0955) | 480 | 571 | 532 |
0012 | HIV/AIDS, Viral Hepatitis, STD and TB Prevention (0950) | 1,130 | 1,274 | 1,553 |
0013 | Immunization and Respiratory Diseases (0951) | 838 | 790 | 830 |
0015 | Injury Prevention and Control (0952) | 702 | 677 | 730 |
0016 | Occupational Safety and Health (0953) | 335 | 343 | 111 |
0019 | Public Health Preparedness and Response (0956) | 860 | 827 | 802 |
0020 | Public Health Scientific Services (0959) | 494 | 578 | 58 |
0021 | Cooperative Research and Development Agreements (CRADA) (5146) | 1 | 1 | 1 |
|
|
|
||
0799 | Total direct obligations | 7,558 | 7,726 | 6,484 |
0802 | CDC-Wide Activities and Program Support (Reimbursable) | 158 | 366 | 399 |
|
|
|
||
0809 | Reimbursable program activities, subtotal | 158 | 366 | 399 |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 7,716 | 8,092 | 6,883 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 934 | 307 | 224 |
1001 | Discretionary unobligated balance brought fwd, Oct 1 | 439 | 174 | |
1010 | Unobligated balance transfer to other accts [075–0960] | –7 | ||
1010 | Unobligated balance transfer to other accts [075–0140] | –425 | ||
1010 | Unobligated balance transfer to other accts [075–0140] | –50 | ||
1011 | Unobligated balance transfer from other acct [075–0140] | 10 | ||
1012 | Unobligated balance transfers between expired and unexpired accounts | 36 | ||
1021 | Recoveries of prior year unpaid obligations | 111 | ||
1033 | Recoveries of prior year paid obligations | 1 | ||
|
|
|
||
1050 | Unobligated balance (total) | 610 | 307 | 224 |
Budget authority: | ||||
Appropriations, discretionary: | ||||
1100 | Appropriation | 7,058 | 6,815 | 5,535 |
1120 | Appropriations transferred to other acct [075–1503] | –14 | ||
1120 | Appropriations transferred to other acct [075–0140] | –604 | ||
1120 | Appropriations transferred to other acct [075–4553] | –9 | ||
1120 | Appropriations transferred to other acct [075–0945] | –50 | –85 | –50 |
1121 | Appropriations transferred from other acct [075–0140] | 20 | ||
|
|
|
||
1160 | Appropriation, discretionary (total) | 6,401 | 6,730 | 5,485 |
Appropriations, mandatory: | ||||
1200 | Appropriation (075–0954 - EEOICPA) | 55 | 55 | 55 |
1201 | Appropriation (075–5146 CRADA) | 1 | 1 | 1 |
1221 | Appropriations transferred from other acct PPHF [075–0116] | 805 | 854 | 894 |
1230 | Appropriations and/or unobligated balance of appropriations permanently reduced | –5 | ||
|
|
|
||
1260 | Appropriations, mandatory (total) | 856 | 910 | 950 |
Spending authority from offsetting collections, discretionary: | ||||
1700 | Collected | 137 | 366 | 399 |
1701 | Change in uncollected payments, Federal sources | 24 | ||
|
|
|
||
1750 | Spending auth from offsetting collections, disc (total) | 161 | 366 | 399 |
Spending authority from offsetting collections, mandatory: | ||||
1800 | Collected | 4 | 3 | 3 |
1900 | Budget authority (total) | 7,422 | 8,009 | 6,837 |
1930 | Total budgetary resources available | 8,032 | 8,316 | 7,061 |
Memorandum (non-add) entries: | ||||
1940 | Unobligated balance expiring | –9 | ||
1941 | Unexpired unobligated balance, end of year | 307 | 224 | 178 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 6,934 | 6,671 | 7,189 |
3010 | New obligations, unexpired accounts | 7,716 | 8,092 | 6,883 |
3011 | Obligations ("upward adjustments"), expired accounts | 38 | ||
3020 | Outlays (gross) | –7,395 | –7,574 | –7,879 |
3030 | Unpaid obligations transferred to other accts [075–0140] | –242 | ||
3040 | Recoveries of prior year unpaid obligations, unexpired | –111 | ||
3041 | Recoveries of prior year unpaid obligations, expired | –269 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 6,671 | 7,189 | 6,193 |
Uncollected payments: | ||||
3060 | Uncollected pymts, Fed sources, brought forward, Oct 1 | –127 | –108 | –108 |
3070 | Change in uncollected pymts, Fed sources, unexpired | –24 | ||
3071 | Change in uncollected pymts, Fed sources, expired | 43 | ||
|
|
|
||
3090 | Uncollected pymts, Fed sources, end of year | –108 | –108 | –108 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 6,807 | 6,563 | 7,081 |
3200 | Obligated balance, end of year | 6,563 | 7,081 | 6,085 |
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
4000 | Budget authority, gross | 6,562 | 7,096 | 5,884 |
Outlays, gross: | ||||
4010 | Outlays from new discretionary authority | 2,454 | 3,050 | 2,558 |
4011 | Outlays from discretionary balances | 4,121 | 3,658 | 4,401 |
|
|
|
||
4020 | Outlays, gross (total) | 6,575 | 6,708 | 6,959 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4030 | Federal sources | –167 | –366 | –399 |
4033 | Non-Federal sources | –12 | ||
|
|
|
||
4040 | Offsets against gross budget authority and outlays (total) | –179 | –366 | –399 |
Additional offsets against gross budget authority only: | ||||
4050 | Change in uncollected pymts, Fed sources, unexpired | –24 | ||
4052 | Offsetting collections credited to expired accounts | 41 | ||
4053 | Recoveries of prior year paid obligations, unexpired accounts | 1 | ||
|
|
|
||
4060 | Additional offsets against budget authority only (total) | 18 | ||
|
|
|
||
4070 | Budget authority, net (discretionary) | 6,401 | 6,730 | 5,485 |
4080 | Outlays, net (discretionary) | 6,396 | 6,342 | 6,560 |
Mandatory: | ||||
4090 | Budget authority, gross | 860 | 913 | 953 |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 146 | 218 | 226 |
4101 | Outlays from mandatory balances | 674 | 648 | 694 |
|
|
|
||
4110 | Outlays, gross (total) | 820 | 866 | 920 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4123 | Non-Federal sources | –4 | –3 | –3 |
4180 | Budget authority, net (total) | 7,257 | 7,640 | 6,435 |
4190 | Outlays, net (total) | 7,212 | 7,205 | 7,477 |
|
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 and respiratory diseases, HIV/AIDS, Hepatitis, STDs, and Tuberculosis prevention, emerging and zoonotic infectious diseases, chronic disease prevention and health promotion, public health and scientific services, injury prevention and control, environmental health, global health, programs that reduce the occurrence of birth defects and developmental disabilities, public health preparedness and emergency response, and CDC-wide activities and program support. The FY 2021 Budget provides $371 million for CDC to undertake the second year of the Ending the HIV Epidemic initative. The FY 2021 Budget maintains the proposal to establish a new block grant, proposed at $350 million, to increase flexibility for States to address their population's unique public health needs. The FY 2021 Budget provides $175 million for global health security activities to protect Americans through partnerships and other activities that support public health capacity improvements in countries at risk for uncontrolled outbreaks of infectious diseases.
Object Classification (in millions of dollars)
|
||||
Identification code 075–0943–0–1–999 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
Personnel compensation: | ||||
11.1 | Full-time permanent | 766 | 744 | 761 |
11.3 | Other than full-time permanent | 112 | 99 | 101 |
11.5 | Other personnel compensation | 39 | 38 | 38 |
11.7 | Military personnel | 70 | 65 | 68 |
11.8 | Special personal services payments | 6 | 5 | 5 |
|
|
|
||
11.9 | Total personnel compensation | 993 | 951 | 973 |
12.1 | Civilian personnel benefits | 305 | 291 | 291 |
12.2 | Military personnel benefits | 55 | 53 | 54 |
13.0 | Benefits for former personnel | 2 | 2 | 2 |
21.0 | Travel and transportation of persons | 59 | 42 | 42 |
22.0 | Transportation of things | 9 | 7 | 7 |
23.1 | Rental payments to GSA | 6 | 4 | 4 |
23.2 | Rental payments to others | 1 | 1 | 1 |
23.3 | Communications, utilities, and miscellaneous charges | 9 | 5 | 5 |
24.0 | Printing and reproduction | 3 | 3 | 3 |
25.1 | Advisory and assistance services | 811 | 784 | 607 |
25.2 | Other services from non-Federal sources | 105 | 107 | 78 |
25.3 | Other goods and services from Federal sources | 890 | 899 | 662 |
25.4 | Operation and maintenance of facilities | 14 | 11 | 8 |
25.5 | Research and development contracts | 41 | 38 | 27 |
25.6 | Medical care | 31 | 33 | 24 |
25.7 | Operation and maintenance of equipment | 33 | 30 | 22 |
26.0 | Supplies and materials | 129 | 125 | 127 |
31.0 | Equipment | 70 | 63 | 63 |
32.0 | Land and structures | 1 | ||
41.0 | Grants, subsidies, and contributions | 3,984 | 4,269 | 3,476 |
42.0 | Insurance claims and indemnities | 7 | 8 | 8 |
|
|
|
||
99.0 | Direct obligations | 7,558 | 7,726 | 6,484 |
99.0 | Reimbursable obligations | 158 | 366 | 399 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 7,716 | 8,092 | 6,883 |
|
Employment Summary
|
||||
Identification code 075–0943–0–1–999 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 8,486 | 8,477 | 8,630 |
1101 | Direct military average strength employment | 807 | 812 | 812 |
2001 | Reimbursable civilian full-time equivalent employment | 198 | 197 | 197 |
2101 | Reimbursable military average strength employment | 27 | 27 | 27 |
|
For any cost related to the acquisition of real property, equipment, construction, installation, demolition, and renovation of facilities, $30,000,000, which shall remain available until September 30, 2025.
(Department of Health and Human Services Appropriations Act, 2020.)
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0960–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | CDC Buildings and Facilities (0960) | 153 | 25 | 30 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 500 | 384 | 384 |
1011 | Unobligated balance transfer from other acct [075–0943] | 7 | ||
|
|
|
||
1050 | Unobligated balance (total) | 507 | 384 | 384 |
Budget authority: | ||||
Appropriations, discretionary: | ||||
1100 | Appropriation | 30 | 25 | 30 |
1930 | Total budgetary resources available | 537 | 409 | 414 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 384 | 384 | 384 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 26 | 144 | 109 |
3010 | New obligations, unexpired accounts | 153 | 25 | 30 |
3020 | Outlays (gross) | –35 | –60 | –49 |
|
|
|
||
3050 | Unpaid obligations, end of year | 144 | 109 | 90 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 26 | 144 | 109 |
3200 | Obligated balance, end of year | 144 | 109 | 90 |
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
4000 | Budget authority, gross | 30 | 25 | 30 |
Outlays, gross: | ||||
4010 | Outlays from new discretionary authority | 2 | 10 | 12 |
4011 | Outlays from discretionary balances | 33 | 50 | 37 |
|
|
|
||
4020 | Outlays, gross (total) | 35 | 60 | 49 |
4180 | Budget authority, net (total) | 30 | 25 | 30 |
4190 | Outlays, net (total) | 35 | 60 | 49 |
|
Object Classification (in millions of dollars)
|
||||
Identification code 075–0960–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
25.1 | Advisory and assistance services | 1 | 1 | 1 |
25.4 | Operation and maintenance of facilities | 8 | 8 | 8 |
32.0 | Land and structures | 144 | 16 | 21 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 153 | 25 | 30 |
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–4553–0–4–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0801 | CDC Working Capital Fund (Reimbursable) | 591 | 569 | 569 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 50 | 54 | 73 |
1021 | Recoveries of prior year unpaid obligations | 12 | ||
|
|
|
||
1050 | Unobligated balance (total) | 62 | 54 | 73 |
Budget authority: | ||||
Appropriations, discretionary: | ||||
1121 | Appropriations transferred from other acct [075–0943] | 9 | ||
Spending authority from offsetting collections, discretionary: | ||||
1700 | Collected | 573 | 588 | 532 |
1701 | Change in uncollected payments, Federal sources | 1 | ||
|
|
|
||
1750 | Spending auth from offsetting collections, disc (total) | 574 | 588 | 532 |
1900 | Budget authority (total) | 583 | 588 | 532 |
1930 | Total budgetary resources available | 645 | 642 | 605 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 54 | 73 | 36 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 198 | 210 | 197 |
3010 | New obligations, unexpired accounts | 591 | 569 | 569 |
3020 | Outlays (gross) | –567 | –582 | –550 |
3040 | Recoveries of prior year unpaid obligations, unexpired | –12 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 210 | 197 | 216 |
Uncollected payments: | ||||
3060 | Uncollected pymts, Fed sources, brought forward, Oct 1 | –2 | –3 | –3 |
3070 | Change in uncollected pymts, Fed sources, unexpired | –1 | ||
|
|
|
||
3090 | Uncollected pymts, Fed sources, end of year | –3 | –3 | –3 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 196 | 207 | 194 |
3200 | Obligated balance, end of year | 207 | 194 | 213 |
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
4000 | Budget authority, gross | 583 | 588 | 532 |
Outlays, gross: | ||||
4010 | Outlays from new discretionary authority | 396 | 388 | 351 |
4011 | Outlays from discretionary balances | 171 | 194 | 199 |
|
|
|
||
4020 | Outlays, gross (total) | 567 | 582 | 550 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4030 | Federal sources | –573 | –588 | –532 |
Additional offsets against gross budget authority only: | ||||
4050 | Change in uncollected pymts, Fed sources, unexpired | –1 | ||
|
|
|
||
4070 | Budget authority, net (discretionary) | 9 | ||
4080 | Outlays, net (discretionary) | –6 | –6 | 18 |
4180 | Budget authority, net (total) | 9 | ||
4190 | Outlays, net (total) | –6 | –6 | 18 |
|
Implemented in fiscal year 2014, CDC's Working Capital Fund has extended availability and serves as the funding mechanism to finance centralized business services support across CDC. Services rendered under the fund are performed at pre-established rates that are used to cover the full cost of operations and future investments. Contributions are collected for services, thereby creating market-like incentives to maximize efficiency and quality.
Object Classification (in millions of dollars)
|
||||
Identification code 075–4553–0–4–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Reimbursable obligations: | ||||
Personnel compensation: | ||||
11.1 | Full-time permanent | 148 | 148 | 148 |
11.3 | Other than full-time permanent | 3 | 4 | 4 |
11.5 | Other personnel compensation | 3 | 4 | 4 |
11.7 | Military personnel | 4 | 3 | 3 |
|
|
|
||
11.9 | Total personnel compensation | 158 | 159 | 159 |
12.1 | Civilian personnel benefits | 50 | 50 | 50 |
12.2 | Military personnel benefits | 2 | 2 | 2 |
21.0 | Travel and transportation of persons | 1 | 1 | 1 |
22.0 | Transportation of things | 2 | 2 | 2 |
23.1 | Rental payments to GSA | 33 | 32 | 32 |
23.3 | Communications, utilities, and miscellaneous charges | 17 | 22 | 22 |
25.1 | Advisory and assistance services | 34 | 31 | 31 |
25.2 | Other services from non-Federal sources | 86 | 77 | 77 |
25.3 | Other goods and services from Federal sources | 82 | 68 | 68 |
25.4 | Operation and maintenance of facilities | 53 | 10 | 10 |
25.7 | Operation and maintenance of equipment | 53 | 52 | 52 |
26.0 | Supplies and materials | 1 | 1 | 1 |
31.0 | Equipment | 10 | 12 | 12 |
32.0 | Land and structures | 9 | 50 | 50 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 591 | 569 | 569 |
|
Employment Summary
|
||||
Identification code 075–4553–0–4–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
2001 | Reimbursable civilian full-time equivalent employment | 1,484 | 1,484 | 1,484 |
2101 | Reimbursable military average strength employment | 34 | 34 | 34 |
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0945–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Direct program activity | 85 | 50 | |
|
|
|
||
0900 | Total new obligations, unexpired accounts (object class 41.0) | 85 | 50 | |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 50 | 50 | |
Budget authority: | ||||
Appropriations, discretionary: | ||||
1121 | Appropriations transferred from other acct [075–0943] | 50 | 85 | 50 |
1930 | Total budgetary resources available | 50 | 135 | 100 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 50 | 50 | 50 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 35 | ||
3010 | New obligations, unexpired accounts | 85 | 50 | |
3020 | Outlays (gross) | –50 | –85 | |
|
|
|
||
3050 | Unpaid obligations, end of year | 35 | ||
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 35 | ||
3200 | Obligated balance, end of year | 35 | ||
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
4000 | Budget authority, gross | 50 | 85 | 50 |
Outlays, gross: | ||||
4011 | Outlays from discretionary balances | 50 | 85 | |
4180 | Budget authority, net (total) | 50 | 85 | 50 |
4190 | Outlays, net (total) | 50 | 85 | |
|
The FY 2021 Budget provides $50 million for the Infectious Diseases Rapid Response Reserve Fund within the Centers for Disease Control and Prevention. This Fund will provide the ability to respond efficiently and rapidly to emerging infectious disease threats or outbreaks.
For 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) and section 3019 of the Solid Waste Disposal Act, $62,000,000: 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 healthcare 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 2021, and existing profiles may be updated as necessary.
(Department of the Interior, Environment, and Related Agencies Appropriations Act, 2020.)
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0944–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Agency for Toxic Substances and Disease Registry, Toxic Substance (Direct) | 87 | 62 | 62 |
0801 | Agency for Toxic Substances and Disease Registry, Toxic Substance (Reimbursable) | 3 | ||
|
|
|
||
0900 | Total new obligations, unexpired accounts | 90 | 62 | 62 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 20 | 18 | 36 |
Budget authority: | ||||
Appropriations, discretionary: | ||||
1100 | Appropriation | 75 | 77 | 62 |
1121 | Appropriations transferred from other acct [097–0100] | 10 | ||
|
|
|
||
1160 | Appropriation, discretionary (total) | 85 | 77 | 62 |
Spending authority from offsetting collections, discretionary: | ||||
1700 | Collected | 1 | 3 | 3 |
1701 | Change in uncollected payments, Federal sources | 2 | ||
|
|
|
||
1750 | Spending auth from offsetting collections, disc (total) | 3 | 3 | 3 |
1900 | Budget authority (total) | 88 | 80 | 65 |
1930 | Total budgetary resources available | 108 | 98 | 101 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 18 | 36 | 39 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 64 | 70 | 48 |
3010 | New obligations, unexpired accounts | 90 | 62 | 62 |
3020 | Outlays (gross) | –81 | –84 | –69 |
3041 | Recoveries of prior year unpaid obligations, expired | –3 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 70 | 48 | 41 |
Uncollected payments: | ||||
3060 | Uncollected pymts, Fed sources, brought forward, Oct 1 | –15 | –12 | –12 |
3070 | Change in uncollected pymts, Fed sources, unexpired | –2 | ||
3071 | Change in uncollected pymts, Fed sources, expired | 5 | ||
|
|
|
||
3090 | Uncollected pymts, Fed sources, end of year | –12 | –12 | –12 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 49 | 58 | 36 |
3200 | Obligated balance, end of year | 58 | 36 | 29 |
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
4000 | Budget authority, gross | 88 | 80 | 65 |
Outlays, gross: | ||||
4010 | Outlays from new discretionary authority | 49 | 52 | 42 |
4011 | Outlays from discretionary balances | 30 | 32 | 27 |
|
|
|
||
4020 | Outlays, gross (total) | 79 | 84 | 69 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4030 | Federal sources | –6 | –3 | –3 |
|
|
|
||
4040 | Offsets against gross budget authority and outlays (total) | –6 | –3 | –3 |
Additional offsets against gross budget authority only: | ||||
4050 | Change in uncollected pymts, Fed sources, unexpired | –2 | ||
4052 | Offsetting collections credited to expired accounts | 5 | ||
|
|
|
||
4060 | Additional offsets against budget authority only (total) | 3 | ||
|
|
|
||
4070 | Budget authority, net (discretionary) | 85 | 77 | 62 |
4080 | Outlays, net (discretionary) | 73 | 81 | 66 |
Mandatory: | ||||
Outlays, gross: | ||||
4101 | Outlays from mandatory balances | 2 | ||
4180 | Budget authority, net (total) | 85 | 77 | 62 |
4190 | Outlays, net (total) | 75 | 81 | 66 |
|
Object Classification (in millions of dollars)
|
||||
Identification code 075–0944–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
Personnel compensation: | ||||
11.1 | Full-time permanent | 22 | 14 | 14 |
11.3 | Other than full-time permanent | 2 | 1 | 1 |
11.5 | Other personnel compensation | 1 | ||
11.7 | Military personnel | 3 | 3 | 3 |
|
|
|
||
11.9 | Total personnel compensation | 28 | 18 | 18 |
12.1 | Civilian personnel benefits | 8 | 5 | 5 |
12.2 | Military personnel benefits | 1 | 1 | 1 |
21.0 | Travel and transportation of persons | 1 | 1 | 1 |
25.1 | Advisory and assistance services | 5 | 9 | 9 |
25.2 | Other services from non-Federal sources | 5 | 3 | 3 |
25.3 | Other goods and services from Federal sources | 16 | 15 | 15 |
25.7 | Operation and maintenance of equipment | 1 | ||
31.0 | Equipment | 1 | 1 | 1 |
41.0 | Grants, subsidies, and contributions | 21 | 9 | 9 |
|
|
|
||
99.0 | Direct obligations | 87 | 62 | 62 |
99.0 | Reimbursable obligations | 3 | ||
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 90 | 62 | 62 |
|
Employment Summary
|
||||
Identification code 075–0944–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 198 | 198 | 198 |
1101 | Direct military average strength employment | 28 | 28 | 28 |
2001 | Reimbursable civilian full-time equivalent employment | 2 | 2 | 2 |
2101 | Reimbursable military average strength employment | 1 | 1 | 1 |
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0946–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | World Trade Center Health Program—Federal Share (CDC/NIOSH) | 530 | 541 | 540 |
0002 | World Trade Center Health Program—NYC | 59 | 60 | 60 |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 589 | 601 | 600 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 873 | 797 | 735 |
1012 | Unobligated balance transfers between expired and unexpired accounts | 7 | ||
1021 | Recoveries of prior year unpaid obligations | 3 | ||
1033 | Recoveries of prior year paid obligations | 14 | ||
|
|
|
||
1050 | Unobligated balance (total) | 897 | 797 | 735 |
Budget authority: | ||||
Appropriations, mandatory: | ||||
1200 | Appropriation (WTC (CDC Direct)) | 402 | 485 | 501 |
1200 | Appropriation (WTC—NYC DHSS—CDC) | 45 | 54 | 56 |
|
|
|
||
1260 | Appropriations, mandatory (total) | 447 | 539 | 557 |
Spending authority from offsetting collections, mandatory: | ||||
1800 | Collected | 42 | ||
1900 | Budget authority (total) | 489 | 539 | 557 |
1930 | Total budgetary resources available | 1,386 | 1,336 | 1,292 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 797 | 735 | 692 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 224 | 327 | 528 |
3010 | New obligations, unexpired accounts | 589 | 601 | 600 |
3020 | Outlays (gross) | –483 | –400 | –479 |
3040 | Recoveries of prior year unpaid obligations, unexpired | –3 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 327 | 528 | 649 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 224 | 327 | 528 |
3200 | Obligated balance, end of year | 327 | 528 | 649 |
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 489 | 539 | 557 |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 248 | 256 | |
4101 | Outlays from mandatory balances | 483 | 152 | 223 |
|
|
|
||
4110 | Outlays, gross (total) | 483 | 400 | 479 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4123 | Non-Federal sources | –63 | ||
Additional offsets against gross budget authority only: | ||||
4142 | Offsetting collections credited to expired accounts | 7 | ||
4143 | Recoveries of prior year paid obligations, unexpired accounts | 14 | ||
|
|
|
||
4150 | Additional offsets against budget authority only (total) | 21 | ||
|
|
|
||
4160 | Budget authority, net (mandatory) | 447 | 539 | 557 |
4170 | Outlays, net (mandatory) | 420 | 400 | 479 |
4180 | Budget authority, net (total) | 447 | 539 | 557 |
4190 | Outlays, net (total) | 420 | 400 | 479 |
|
HHS, along with CDC, began implementing provisions of the James Zadroga 9/11 Health and Compensation Act of 2010 (P.L. 111–347) on July 1, 2011, to provide monitoring and treatment benefits to eligible responders and survivors. CDC serves as the Program Administrator for the World Trade Center (WTC) Health Program. The WTC Health Program provides quality care for WTC-related health conditions, conducts WTC research, and maintains a health registry to collect data on victims of the September 11, 2001, terrorist attacks. The WTC Health Program has been extended through FY 2090 under the James Zadroga 9/11 Health and Compensation Reauthorization Act of 2015 (P.L. 114–113, Division O, Title III). The amounts included for 2020 and 2021 in the Budget reflect estimated Federal obligations for the WTC Health Program.
Object Classification (in millions of dollars)
|
||||
Identification code 075–0946–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
Personnel compensation: | ||||
11.1 | Full-time permanent | 4 | 4 | 4 |
11.7 | Military personnel | 1 | 1 | 1 |
|
|
|
||
11.9 | Total personnel compensation | 5 | 5 | 5 |
12.1 | Civilian personnel benefits | 2 | 2 | 2 |
12.2 | Military personnel benefits | 1 | 1 | 1 |
25.1 | Advisory and assistance services | 39 | 39 | 39 |
25.2 | Other services from non-Federal sources | 105 | 105 | 105 |
25.3 | Other goods and services from Federal sources | 12 | 12 | 12 |
31.0 | Equipment | 2 | 2 | 2 |
41.0 | Grants, subsidies, and contributions | 24 | 24 | 24 |
42.0 | Insurance claims and indemnities | 399 | 411 | 410 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 589 | 601 | 600 |
|
Employment Summary
|
||||
Identification code 075–0946–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 38 | 43 | 43 |
1101 | Direct military average strength employment | 7 | 7 | 7 |
|
For carrying out section 301 and title IV of the PHS Act with respect to cancer, $5,686,173,000, of which up to $30,000,000 may be used for facilities repairs and improvements at the National Cancer Institute-Frederick Federally Funded Research and Development Center in Frederick, Maryland.
For carrying out section 301 and title IV of the PHS Act with respect to cardiovascular, lung, and blood diseases, and blood and blood products, $3,298,004,000.
For carrying out section 301 and title IV of the PHS Act with respect to dental and craniofacial diseases, $434,559,000.
For carrying out section 301 and title IV of the PHS Act with respect to diabetes and digestive and kidney disease, $1,924,211,000.
For carrying out section 301 and title IV of the PHS Act with respect to neurological disorders and stroke, $2,195,110,000.
For carrying out section 301 and title IV of the PHS Act with respect to allergy and infectious diseases, $5,445,886,000.
For carrying out section 301 and title IV of the PHS Act with respect to general medical sciences, $2,672,074,000, of which $741,000,000 shall be from funds available under section 241 of the PHS Act: Provided, That not less than $351,781,000 is provided for the Institutional Development Awards program.
For carrying out section 301 and title IV of the PHS Act with respect to child health and human development, $1,416,366,000.
For carrying out section 301 and title IV of the PHS Act with respect to eye diseases and visual disorders, $749,003,000.
For carrying out section 301 and title IV of the PHS Act with respect to environmental health sciences, $730,147,000.
(Department of Health and Human Services Appropriations Act, 2020.)
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 (42 U.S.C. 9660(a)) and section 126(g) of the Superfund Amendments and Reauthorization Act of 1986, $73,688,000.
(Department of the Interior, Environment, and Related Agencies Appropriations Act, 2020.)
For carrying out section 301 and title IV of the PHS Act with respect to aging, $3,225,782,000.
For carrying out section 301 and title IV of the PHS Act with respect to arthritis and musculoskeletal and skin diseases, $568,480,000.
For carrying out section 301 and title IV of the PHS Act with respect to deafness and other communication disorders, $446,397,000.
For carrying out section 301 and title IV of the PHS Act with respect to nursing research, $156,804,000.
For carrying out section 301 and title IV of the PHS Act with respect to alcohol abuse and alcoholism, $497,346,000.
For carrying out section 301 and title IV of the PHS Act with respect to drug abuse, $1,431,770,000.
For carrying out section 301 and title IV of the PHS Act with respect to mental health, $1,794,865,000.
For carrying out section 301 and title IV of the PHS Act with respect to human genome research, $550,116,000.
For carrying out section 301 and title IV of the PHS Act with respect to biomedical imaging and bioengineering research, $368,111,000.
For carrying out section 301 and title IV of the PHS Act with respect to complementary and integrative health, $138,167,000.
For carrying out section 301 and title IV of the PHS Act with respect to minority health and health disparities research, $305,498,000: Provided, That funds may be used to implement a reorganization that is presented to an advisory council in a public meeting and for which the Committees on Appropriations of the House of Representatives and the Senate have been notified 30 days in advance.
For carrying out the activities of the John E. Fogarty International Center (described in subpart 2 of part E of title IV of the PHS Act), $73,531,000.
For carrying out section 301 and title IV of the PHS Act with respect to health information communications, $415,665,000: Provided, That of the amounts available for improvement of information systems, $4,000,000 shall be available until September 30, 2022: Provided further, That in fiscal year 2021, 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 (referred to in this title as "NIH").
For carrying out section 301 and title IV of the PHS Act with respect to translational sciences, $787,703,000: Provided, That up to 10 percent of the amounts made available under this heading shall be available to implement section 480 of the PHS Act, relating to the Cures Acceleration Network.
For carrying out the responsibilities of the Office of the Director, NIH, $2,086,463,000: Provided, That funding shall be available for the purchase of not to exceed 29 passenger motor vehicles for replacement only: Provided further, That all funds credited to the NIH Management Fund shall remain available for one fiscal year after the fiscal year in which they are deposited: Provided further, That $168,763,500 shall be for the Environmental Influences on Child Health Outcomes study: Provided further, That $583,867,000 shall be available for the Common Fund established under section 402A(c)(1) of the 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 amounts available under this heading are also available to establish, operate, and support the Research Policy Board authorized by section 2034(f) of the 21st Century Cures Act.
In addition to other funds appropriated for the Common Fund established under section 402A(c) of the PHS Act, $12,600,000 is appropriated to the Common Fund from the 10-year Pediatric Research Initiative Fund described in section 9008 of title 26, United States Code, for the purpose of carrying out section 402(b)(7)(B)(ii) of the PHS Act (relating to pediatric research), as authorized in the Gabriella Miller Kids First Research Act.
For the study of, construction of, demolition of, renovation of, and acquisition of equipment for, facilities of or used by NIH, including the acquisition of real property, $300,000,000, to remain available through September 30, 2025.
For carrying out titles III and IX of the 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, $256,660,000: Provided, That section 947(c) of the PHS Act shall not apply in fiscal year 2021: Provided further, 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.
(Department of Health and Human Services Appropriations Act, 2020.)
Special and Trust Fund Receipts (in millions of dollars)
|
||||
Identification code 075–9915–0–1–552 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
0100 | Balance, start of year | |||
Receipts: | ||||
Current law: | ||||
1130 | Cooperative Research and Development Agreements, NIH | 51 | 68 | 51 |
|
|
|
||
2000 | Total: Balances and receipts | 51 | 68 | 51 |
Appropriations: | ||||
Current law: | ||||
2101 | National Institutes of Health | –51 | –68 | –51 |
|
|
|
||
5099 | Balance, end of year | |||
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–9915–0–1–552 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | National Cancer Institute (0849) | 5,994 | 6,606 | 5,881 |
0002 | National Heart, Lung, and Blood Institute (0872) | 3,482 | 3,625 | 3,298 |
0003 | National Institute of Dental and Craniofacial Research (0873) | 461 | 478 | 435 |
0004 | National Institute of Diabetes and Digestive and Kidney Disease (0884) | 2,025 | 2,115 | 1,924 |
0005 | National Institute of Neurological Disorders and Stroke (0886) | 2,414 | 2,449 | 2,245 |
0006 | National Institute of Allergy and Infectious Diseases (0885) | 5,567 | 5,897 | 5,446 |
0007 | National Institute of General Medical Sciences (0851) | 1,675 | 1,706 | 1,931 |
0008 | National Institute of Child Health and Human Development (0844) | 1,509 | 1,557 | 1,416 |
0009 | National Eye Institute (0887) | 794 | 823 | 749 |
0010 | National Institute of Environmental Health Sciences (0862) | 851 | 884 | 804 |
0011 | National Institute on Aging (0843) | 3,080 | 3,546 | 3,226 |
0012 | National Institute of Arthritis and Musculoskeletal and Skin Disease (0888) | 603 | 625 | 568 |
0013 | National Institute on Deafness and Other Communication Disorder (0890) | 473 | 491 | 446 |
0014 | National Institute of Mental Health (0892) | 1,870 | 2,045 | 1,845 |
0015 | National Institute on Drug Abuse (0893) | 1,621 | 1,458 | 1,432 |
0016 | National Institute on Alcohol Abuse and Alcoholism (0894) | 525 | 547 | 497 |
0017 | National Institute of Nursing Research (0889) | 163 | 172 | 157 |
0018 | National Human Genome Research Institute (0891) | 575 | 604 | 550 |
0019 | National Institute of Biomedical Imaging and Bioengineering (0898) | 388 | 405 | 368 |
0021 | National Center for Complementary and Integrative Health (0896) | 146 | 152 | 138 |
0022 | National Institute on Minority Health and Health Disparities (0897) | 313 | 336 | 305 |
0023 | John E. Fogarty International Center (0819) | 78 | 81 | 74 |
0024 | National Library of Medicine (0807) | 442 | 457 | 416 |
0025 | NIH Office of the Director (0846) | 1,926 | 2,247 | 2,099 |
0026 | NIH Buildings and facilities (0838) | 211 | 200 | 300 |
0027 | NIH Cooperative Research and Development Agreements | 47 | 68 | 51 |
0028 | National Center for Advancing Translational Sciences (0875) | 847 | 833 | 788 |
0029 | National Institute for Research on Safety and Quality | 257 | ||
0031 | Type 1 Diabetes | 74 | 297 | |
|
|
|
||
0799 | Total direct obligations | 38,154 | 40,704 | 37,646 |
0801 | NIH Reimbursable - Other | 4,360 | 4,520 | 3,909 |
0802 | NIH Royalties | 130 | 129 | 129 |
|
|
|
||
0809 | Reimbursable program activities, subtotal | 4,490 | 4,649 | 4,038 |
|
|
|
||
0899 | Total reimbursable obligations | 4,490 | 4,649 | 4,038 |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 42,644 | 45,353 | 41,684 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 1,475 | 1,145 | 754 |
1001 | Discretionary unobligated balance brought fwd, Oct 1 | 1,226 | 862 | |
1011 | Unobligated balance transfer from other acct [075–0140] | 15 | ||
1011 | Unobligated balance transfer from other acct [075–1700] | 16 | ||
1021 | Recoveries of prior year unpaid obligations | 94 | ||
1033 | Recoveries of prior year paid obligations | 2 | ||
|
|
|
||
1050 | Unobligated balance (total) | 1,586 | 1,145 | 770 |
Budget authority: | ||||
Appropriations, discretionary: | ||||
1100 | Appropriation | 37,294 | 39,805 | 37,287 |
1120 | Appropriations transferred to other acct [075–1503] | –124 | ||
1120 | Appropriations transferred to other acct [075–0128] | –5 | –5 | |
1121 | Appropriations transferred from other acct [075–5628] | 515 | 335 | 295 |
1121 | Appropriations transferred from other acct [075–5736] | 13 | 13 | 13 |
|
|
|
||
1160 | Appropriation, discretionary (total) | 37,693 | 40,148 | 37,595 |
Appropriations, mandatory: | ||||
1200 | Appropriation | 150 | 97 | |
1201 | Appropriation (special or trust fund) | 51 | 68 | 51 |
|
|
|
||
1260 | Appropriations, mandatory (total) | 201 | 165 | 51 |
Spending authority from offsetting collections, discretionary: | ||||
1700 | Collected | 3,999 | 4,649 | 4,038 |
1701 | Change in uncollected payments, Federal sources | 317 | ||
|
|
|
||
1750 | Spending auth from offsetting collections, disc (total) | 4,316 | 4,649 | 4,038 |
Spending authority from offsetting collections, mandatory: | ||||
1800 | Collected | 3 | ||
1900 | Budget authority (total) | 42,213 | 44,962 | 41,684 |
1930 | Total budgetary resources available | 43,799 | 46,107 | 42,454 |
Memorandum (non-add) entries: | ||||
1940 | Unobligated balance expiring | –10 | ||
1941 | Unexpired unobligated balance, end of year | 1,145 | 754 | 770 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 37,409 | 40,480 | 43,800 |
3010 | New obligations, unexpired accounts | 42,644 | 45,353 | 41,684 |
3011 | Obligations ("upward adjustments"), expired accounts | 389 | ||
3020 | Outlays (gross) | –39,069 | –42,033 | –43,642 |
3040 | Recoveries of prior year unpaid obligations, unexpired | –94 | ||
3041 | Recoveries of prior year unpaid obligations, expired | –799 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 40,480 | 43,800 | 41,842 |
Uncollected payments: | ||||
3060 | Uncollected pymts, Fed sources, brought forward, Oct 1 | –564 | –650 | –650 |
3070 | Change in uncollected pymts, Fed sources, unexpired | –317 | ||
3071 | Change in uncollected pymts, Fed sources, expired | 231 | ||
|
|
|
||
3090 | Uncollected pymts, Fed sources, end of year | –650 | –650 | –650 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 36,845 | 39,830 | 43,150 |
3200 | Obligated balance, end of year | 39,830 | 43,150 | 41,192 |
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
4000 | Budget authority, gross | 42,009 | 44,797 | 41,633 |
Outlays, gross: | ||||
4010 | Outlays from new discretionary authority | 12,483 | 14,636 | 13,864 |
4011 | Outlays from discretionary balances | 26,382 | 27,270 | 29,620 |
|
|
|
||
4020 | Outlays, gross (total) | 38,865 | 41,906 | 43,484 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4030 | Federal sources | –3,906 | –4,649 | –4,038 |
4033 | Non-Federal sources | –298 | ||
|
|
|
||
4040 | Offsets against gross budget authority and outlays (total) | –4,204 | –4,649 | –4,038 |
Additional offsets against gross budget authority only: | ||||
4050 | Change in uncollected pymts, Fed sources, unexpired | –317 | ||
4052 | Offsetting collections credited to expired accounts | 203 | ||
4053 | Recoveries of prior year paid obligations, unexpired accounts | 2 | ||
|
|
|
||
4060 | Additional offsets against budget authority only (total) | –112 | ||
|
|
|
||
4070 | Budget authority, net (discretionary) | 37,693 | 40,148 | 37,595 |
4080 | Outlays, net (discretionary) | 34,661 | 37,257 | 39,446 |
Mandatory: | ||||
4090 | Budget authority, gross | 204 | 165 | 51 |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 24 | 22 | 13 |
4101 | Outlays from mandatory balances | 180 | 105 | 145 |
|
|
|
||
4110 | Outlays, gross (total) | 204 | 127 | 158 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4123 | Non-Federal sources | –3 | ||
4180 | Budget authority, net (total) | 37,894 | 40,313 | 37,646 |
4190 | Outlays, net (total) | 34,862 | 37,384 | 39,604 |
|
Summary of Budget Authority and Outlays (in millions of dollars)
|
||||
2019 actual | 2020 est. | 2021 est. | ||
|
||||
Enacted/requested: | ||||
Budget Authority | 37,894 | 40,313 | 37,646 | |
Outlays | 34,862 | 37,384 | 39,604 | |
Legislative proposal, subject to PAYGO: | ||||
Budget Authority | 53 | 150 | ||
Outlays | 3 | 23 | ||
Total: | ||||
Budget Authority | 37,894 | 40,366 | 37,796 | |
Outlays | 34,862 | 37,387 | 39,627 | |
|
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. The FY 2021 Budget consolidates the activities of the Agency for Healthcare Research and Quality within the National Institutes of Health as the National Institute for Research on Safety and Quality. Detailed information is available through the Department of Health and Human Services.
Object Classification (in millions of dollars)
|
||||
Identification code 075–9915–0–1–552 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
Personnel compensation: | ||||
11.1 | Full-time permanent | 1,008 | 1,091 | 1,131 |
11.3 | Other than full-time permanent | 527 | 562 | 571 |
11.5 | Other personnel compensation | 49 | 52 | 54 |
11.7 | Military personnel | 18 | 19 | 20 |
11.8 | Special personal services payments | 199 | 210 | 210 |
|
|
|
||
11.9 | Total personnel compensation | 1,801 | 1,934 | 1,986 |
12.1 | Civilian personnel benefits | 528 | 600 | 632 |
12.2 | Military personnel benefits | 14 | 15 | 15 |
21.0 | Travel and transportation of persons | 61 | 64 | 54 |
22.0 | Transportation of things | 5 | 5 | 5 |
23.1 | Rental payments to GSA | 24 | 25 | 23 |
23.2 | Rental payments to others | 1 | 1 | 1 |
23.3 | Communications, utilities, and miscellaneous charges | 20 | 20 | 15 |
25.1 | Advisory and assistance services | 229 | 307 | 236 |
25.2 | Other services from non-Federal sources | 1,502 | 1,567 | 1,216 |
25.3 | Other goods and services from Federal sources | 3,496 | 3,763 | 3,549 |
25.4 | Operation and maintenance of facilities | 232 | 241 | 328 |
25.5 | Research and development contracts | 1,577 | 1,739 | 1,544 |
25.6 | Medical care | 44 | 38 | 34 |
25.7 | Operation and maintenance of equipment | 173 | 174 | 153 |
26.0 | Supplies and materials | 258 | 273 | 230 |
31.0 | Equipment | 188 | 200 | 164 |
32.0 | Land and structures | 41 | 25 | |
41.0 | Grants, subsidies, and contributions | 28,002 | 29,697 | 27,436 |
|
|
|
||
99.0 | Direct obligations | 38,155 | 40,704 | 37,646 |
99.0 | Reimbursable obligations | 4,489 | 4,649 | 4,038 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 42,644 | 45,353 | 41,684 |
|
Employment Summary
|
||||
Identification code 075–9915–0–1–552 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 12,540 | 13,258 | 13,467 |
1101 | Direct military average strength employment | 172 | 173 | 177 |
2001 | Reimbursable civilian full-time equivalent employment | 4,371 | 4,507 | 4,507 |
2101 | Reimbursable military average strength employment | 98 | 98 | 98 |
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–9915–4–1–552 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Type 1 Diabetes | 53 | 150 | |
|
|
|
||
0900 | Total new obligations, unexpired accounts (object class 41.0) | 53 | 150 | |
|
||||
Budgetary resources: | ||||
Budget authority: | ||||
Appropriations, mandatory: | ||||
1200 | Appropriation | 53 | 150 | |
1930 | Total budgetary resources available | 53 | 150 | |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 50 | ||
3010 | New obligations, unexpired accounts | 53 | 150 | |
3020 | Outlays (gross) | –3 | –23 | |
|
|
|
||
3050 | Unpaid obligations, end of year | 50 | 177 | |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 50 | ||
3200 | Obligated balance, end of year | 50 | 177 | |
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 53 | 150 | |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 3 | 12 | |
4101 | Outlays from mandatory balances | 11 | ||
|
|
|
||
4110 | Outlays, gross (total) | 3 | 23 | |
4180 | Budget authority, net (total) | 53 | 150 | |
4190 | Outlays, net (total) | 3 | 23 | |
|
The Budget proposes to extend the Special Diabetes Program for Type 1 Diabetes through FY 2021.
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0147–0–1–552 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Payment to NIH Innovation (object class 94.0) | 711 | 492 | 404 |
|
|
|
||
0900 | Total new obligations, unexpired accounts (object class 94.0) | 711 | 492 | 404 |
|
||||
Budgetary resources: | ||||
Budget authority: | ||||
Appropriations, mandatory: | ||||
1200 | Appropriation | 711 | 492 | 404 |
1930 | Total budgetary resources available | 711 | 492 | 404 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3010 | New obligations, unexpired accounts | 711 | 492 | 404 |
3020 | Outlays (gross) | –711 | –492 | –404 |
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 711 | 492 | 404 |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 711 | 492 | 404 |
4180 | Budget authority, net (total) | 711 | 492 | 404 |
4190 | Outlays, net (total) | 711 | 492 | 404 |
|
This account, and a related special fund receipt account, were established to support the execution structure necessary to implement the 21st Century Cures Act.
For necessary expenses to carry out the purposes described in section 1001(b)(4) of the 21st Century Cures Act, in addition to amounts available for such purposes in the appropriations provided to the NIH in this Act, $404,000,000, to remain available until expended: Provided, That such amounts are appropriated pursuant to section 1001(b)(3) of such Act, are to be derived from amounts transferred under section 1001(b)(2)(A) of such Act, and may be transferred by the Director of the National Institutes of Health to other accounts of the National Institutes of Health solely for the purposes provided in such Act: Provided further, That upon a determination by the Director that funds transferred pursuant to the previous proviso are not necessary for the purposes provided, such amounts may be transferred back to the Account: Provided further, That the transfer authority provided under this heading is in addition to any other transfer authority provided by law.
(Department of Health and Human Services Appropriations Act, 2020.)
Special and Trust Fund Receipts (in millions of dollars)
|
||||
Identification code 075–5628–0–2–552 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
0100 | Balance, start of year | |||
Receipts: | ||||
Current law: | ||||
1140 | General Fund Payment, NIH Innovation, CURES Act | 711 | 492 | 404 |
|
|
|
||
2000 | Total: Balances and receipts | 711 | 492 | 404 |
Appropriations: | ||||
Current law: | ||||
2101 | NIH Innovation, Cures Act | –711 | –492 | –404 |
|
|
|
||
5099 | Balance, end of year | |||
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–5628–0–2–552 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | CURES obligations | 185 | 216 | 109 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 48 | 59 | |
Budget authority: | ||||
Appropriations, discretionary: | ||||
1101 | Appropriation (special or trust) | 711 | 492 | 404 |
1120 | Appropriations transferred to other acct [075–9915] | –515 | –335 | –295 |
|
|
|
||
1160 | Appropriation, discretionary (total) | 196 | 157 | 109 |
1930 | Total budgetary resources available | 244 | 216 | 109 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 59 | ||
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 95 | 228 | 264 |
3010 | New obligations, unexpired accounts | 185 | 216 | 109 |
3020 | Outlays (gross) | –52 | –180 | –180 |
|
|
|
||
3050 | Unpaid obligations, end of year | 228 | 264 | 193 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 95 | 228 | 264 |
3200 | Obligated balance, end of year | 228 | 264 | 193 |
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
4000 | Budget authority, gross | 196 | 157 | 109 |
Outlays, gross: | ||||
4010 | Outlays from new discretionary authority | 17 | 31 | 23 |
4011 | Outlays from discretionary balances | 35 | 149 | 157 |
|
|
|
||
4020 | Outlays, gross (total) | 52 | 180 | 180 |
4180 | Budget authority, net (total) | 196 | 157 | 109 |
4190 | Outlays, net (total) | 52 | 180 | 180 |
|
The 21st Century Cures Act was enacted into law on December 13, 2016. The 21st Century Cures Act authorizes $4.8 billion over 10 years for four NIH Innovation Projects and includes amendments to the Public Health Service Act to advance Precision Medicine and other high-priority NIH activities. Amounts appropriated into the NIH Innovation Account are either transferred to the individual institutes and centers or obligated directly in the NIH Innovation Account.
Object Classification (in millions of dollars)
|
||||
Identification code 075–5628–0–2–552 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
Personnel compensation: | ||||
11.1 | Full-time permanent | 5 | 6 | 10 |
11.3 | Other than full-time permanent | 1 | 1 | 1 |
|
|
|
||
11.9 | Total personnel compensation | 6 | 7 | 11 |
12.1 | Civilian personnel benefits | 2 | 3 | 4 |
25.3 | Other goods and services from Federal sources | 6 | 1 | |
25.5 | Research and development contracts | 3 | ||
41.0 | Grants, subsidies, and contributions | 174 | 200 | 93 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 185 | 216 | 109 |
|
Employment Summary
|
||||
Identification code 075–5628–0–2–552 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 45 | 64 | 89 |
1101 | Direct military average strength employment | 1 | 1 | 1 |
|
Special and Trust Fund Receipts (in millions of dollars)
|
||||
Identification code 075–5736–0–2–552 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
0100 | Balance, start of year | 28 | 28 | |
Receipts: | ||||
Current law: | ||||
1140 | Transfers from Presidential Election Campaign Fund | 41 | 13 | |
|
|
|
||
2000 | Total: Balances and receipts | 41 | 41 | 28 |
Appropriations: | ||||
Current law: | ||||
2101 | 10-Year Pediatric Research Initiative Fund | –13 | –13 | –13 |
|
|
|
||
5099 | Balance, end of year | 28 | 28 | 15 |
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–5736–0–2–552 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Budgetary resources: | ||||
Budget authority: | ||||
Appropriations, discretionary: | ||||
1101 | Appropriation (special or trust) | 13 | 13 | 13 |
1120 | Appropriations transferred to other accts [075–9915] | –13 | –13 | –13 |
4180 | Budget authority, net (total) | |||
4190 | Outlays, net (total) | |||
|
This special fund was created by the Gabriella Miller Kids First Research Act, enacted on April 3, 2014. This fund receives transfers from the Presidential Election Campaign Fund, which are then appropriated to the NIH Common Fund to support pediatric research.
For carrying out titles III, V, and XIX of the PHS Act with respect to mental health, and the Protection and Advocacy for Individuals with Mental Illness Act, $1,675,106,000: Provided, That notwithstanding section 520A(f)(2) of the PHS Act, no funds appropriated for carrying out section 520A shall be available for carrying out section 1971 of the PHS Act: Provided further, That in addition to amounts provided herein, $21,039,000 shall be available under section 241 of the PHS Act to supplement funds otherwise available for mental health activities and 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: Provided further, That $35,000,000 of the amounts appropriated for subpart I of part B shall be available to support evidence-based crisis systems: Provided further, That up to 10 percent of the amounts made available to carry out the Children's Mental Health Services program may be used to carry out demonstration grants or contracts for early interventions with persons not more than 25 years of age at clinical high risk of developing a first episode of psychosis: Provided further, That $225,000,000 shall be available until September 30, 2023 for grants to communities and community organizations who meet criteria for Certified Community Behavioral Health Clinics pursuant to section 223(a) of Public Law 113–93: Provided further, That none of the funds provided for section 1911 of the PHS Act shall be subject to section 241 of such Act: Provided further, That of the funds made available under this heading, $25,000,000 shall be to carry out section 224 of the Protecting Access to Medicare Act of 2014 (Public Law 113–93; 42 U.S.C. 290aa 22 note).
For carrying out titles III and V of the PHS Act with respect to substance abuse treatment and title XIX of such Act with respect to substance abuse treatment and prevention, and the SUPPORT for Patients and Communities Act, $3,728,556,000: Provided, That $1,585,000,000 shall be for State Opioid Response Grants for carrying out activities pertaining to opioids and stimulants undertaken by the State agency responsible for administering the substance abuse prevention and treatment block grant under subpart II of part B of title XIX of the PHS Act (42 U.S.C. 300x-21 et seq.): Provided further, That of such amount $50,000,000 shall be made available to Indian Tribes or tribal organizations: Provided further, That 15 percent of the remaining amount shall be for the States with the highest mortality rate related to opioid use disorders: Provided further, That of the amounts provided for State Opioid Response Grants not more than 2 percent shall be available for Federal administrative expenses, training, technical assistance, and evaluation: Provided further, That of the amount not reserved by the previous three provisos, the Secretary shall make allocations to States, territories, and the District of Columbia according to a formula using national survey results that the Secretary determines are the most objective and reliable measure of drug use and drug-related deaths: Provided further, That prevention and treatment activities funded through such grants may include education, treatment (including the provision of medication), behavioral health services for individuals in treatment programs, referral to treatment services, recovery support, and medical screening associated with such treatment: Provided further, That each State, as well as the District of Columbia, shall receive not less than $4,000,000: Provided further, That in addition to amounts provided herein, $79,200,000 shall be available under section 241 of the PHS Act to supplement funds otherwise available for substance abuse treatment activities and 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: Provided further, That none of the funds provided for section 1921 of the PHS Act or State Opioid Response Grants shall be subject to section 241 of such Act.
For carrying out titles III and V of the PHS Act with respect to substance abuse prevention, $96,985,000.
For program support and cross-cutting activities that supplement activities funded under the headings "Mental Health", "Substance Abuse Treatment", and "Substance Abuse Prevention" in carrying out titles III, V, and XIX of the PHS Act and the Protection and Advocacy for Individuals with Mental Illness Act in the Substance Abuse and Mental Health Services Administration, $97,004,000: Provided, That in addition to amounts provided herein, $42,453,000 shall be available under section 241 of the PHS Act to supplement funds available to carry out national surveys on drug abuse and mental health, to collect and analyze program data, and to conduct public awareness and technical assistance activities: Provided further, That, in addition, fees may be collected for the costs of publications, data, data tabulations, and data analysis completed under title V of the PHS Act and provided to a public or private entity upon request, which shall be credited to this appropriation and shall remain available until expended for such purposes: Provided further, That amounts made available in this Act for carrying out section 501(o) of the PHS Act shall remain available through September 30, 2022: Provided further, That funds made available under this heading may be used to supplement program support funding provided under the headings "Mental Health", "Substance Abuse Treatment", and "Substance Abuse Prevention".
(Department of Health and Human Services Appropriations Act, 2020.)
Program and Financing (in millions of dollars)
|
||||
Identification code 075–1362–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0006 | Mental Health | 1,493 | 1,633 | 1,675 |
0007 | Substance Abuse Treatment | 3,738 | 3,757 | 3,729 |
0008 | Substance Abuse Prevention | 205 | 206 | 97 |
0009 | Health Surveillance and Program Support | 132 | 129 | 97 |
0011 | SAMHSA Prevention Fund | 12 | 12 | |
|
|
|
||
0100 | Total, direct program | 5,580 | 5,737 | 5,598 |
|
|
|
||
0799 | Total direct obligations | 5,580 | 5,737 | 5,598 |
0802 | SAMHSA Reimbursables | 121 | 2 | 2 |
0810 | SAMHSA Reimbursable: PHS Evaluation | 134 | 134 | 143 |
|
|
|
||
0899 | Total reimbursable obligations | 255 | 136 | 145 |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 5,835 | 5,873 | 5,743 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 20 | 130 | 178 |
1001 | Discretionary unobligated balance brought fwd, Oct 1 | 20 | 130 | |
1010 | Unobligated balance transfer to other accts [075–0116] | –8 | ||
1021 | Recoveries of prior year unpaid obligations | 2 | ||
|
|
|
||
1050 | Unobligated balance (total) | 14 | 130 | 178 |
Budget authority: | ||||
Appropriations, discretionary: | ||||
1100 | Appropriation | 5,597 | 5,736 | 5,598 |
1120 | Appropriations transferred to other acct [075–1503] | –9 | ||
1121 | Appropriations transferred from other acct [075–0140] | 100 | ||
|
|
|
||
1160 | Appropriation, discretionary (total) | 5,688 | 5,736 | 5,598 |
Appropriations, mandatory: | ||||
1221 | Appropriations transferred from the Prevention and Public Health Fund [075–0116] | 12 | 12 | |
Spending authority from offsetting collections, discretionary: | ||||
1700 | Collected | 135 | 173 | 173 |
1701 | Change in uncollected payments, Federal sources | 121 | ||
|
|
|
||
1750 | Spending auth from offsetting collections, disc (total) | 256 | 173 | 173 |
1900 | Budget authority (total) | 5,956 | 5,921 | 5,771 |
1930 | Total budgetary resources available | 5,970 | 6,051 | 5,949 |
Memorandum (non-add) entries: | ||||
1940 | Unobligated balance expiring | –5 | ||
1941 | Unexpired unobligated balance, end of year | 130 | 178 | 206 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 6,125 | 7,309 | 6,618 |
3010 | New obligations, unexpired accounts | 5,835 | 5,873 | 5,743 |
3011 | Obligations ("upward adjustments"), expired accounts | 49 | ||
3020 | Outlays (gross) | –4,557 | –6,564 | –6,157 |
3040 | Recoveries of prior year unpaid obligations, unexpired | –2 | ||
3041 | Recoveries of prior year unpaid obligations, expired | –141 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 7,309 | 6,618 | 6,204 |
Uncollected payments: | ||||
3060 | Uncollected pymts, Fed sources, brought forward, Oct 1 | –164 | –187 | –187 |
3070 | Change in uncollected pymts, Fed sources, unexpired | –121 | ||
3071 | Change in uncollected pymts, Fed sources, expired | 98 | ||
|
|
|
||
3090 | Uncollected pymts, Fed sources, end of year | –187 | –187 | –187 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 5,961 | 7,122 | 6,431 |
3200 | Obligated balance, end of year | 7,122 | 6,431 | 6,017 |
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
4000 | Budget authority, gross | 5,944 | 5,909 | 5,771 |
Outlays, gross: | ||||
4010 | Outlays from new discretionary authority | 976 | 1,649 | 1,610 |
4011 | Outlays from discretionary balances | 3,570 | 4,906 | 4,539 |
|
|
|
||
4020 | Outlays, gross (total) | 4,546 | 6,555 | 6,149 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4030 | Federal sources | –229 | –171 | –171 |
4033 | Non-Federal sources | –2 | –2 | |
|
|
|
||
4040 | Offsets against gross budget authority and outlays (total) | –229 | –173 | –173 |
Additional offsets against gross budget authority only: | ||||
4050 | Change in uncollected pymts, Fed sources, unexpired | –121 | ||
4052 | Offsetting collections credited to expired accounts | 94 | ||
|
|
|
||
4060 | Additional offsets against budget authority only (total) | –27 | ||
|
|
|
||
4070 | Budget authority, net (discretionary) | 5,688 | 5,736 | 5,598 |
4080 | Outlays, net (discretionary) | 4,317 | 6,382 | 5,976 |
Mandatory: | ||||
4090 | Budget authority, gross | 12 | 12 | |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 4 | ||
4101 | Outlays from mandatory balances | 11 | 5 | 8 |
|
|
|
||
4110 | Outlays, gross (total) | 11 | 9 | 8 |
4180 | Budget authority, net (total) | 5,700 | 5,748 | 5,598 |
4190 | Outlays, net (total) | 4,328 | 6,391 | 5,984 |
|
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 organizations, and private not-for-profit organizations to enhance health and reduce the adverse impact of substance abuse and mental illness on America's communities.
Object Classification (in millions of dollars)
|
||||
Identification code 075–1362–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
Personnel compensation: | ||||
11.1 | Full-time permanent | 43 | 48 | 49 |
11.3 | Other than full-time permanent | 2 | 2 | 2 |
11.5 | Other personnel compensation | 2 | 1 | 1 |
11.7 | Military personnel | 3 | 3 | 4 |
|
|
|
||
11.9 | Total personnel compensation | 50 | 54 | 56 |
12.1 | Civilian personnel benefits | 14 | 15 | 15 |
12.2 | Military personnel benefits | 2 | 2 | 2 |
21.0 | Travel and transportation of persons | 1 | 1 | 1 |
23.1 | Rental payments to GSA | 5 | 5 | 5 |
23.3 | Communications, utilities, and miscellaneous charges | 1 | 1 | 1 |
24.0 | Printing and reproduction | 1 | 1 | 1 |
25.1 | Advisory and assistance services | 37 | 34 | 35 |
25.2 | Other services from non-Federal sources | 101 | 95 | 63 |
25.3 | Other goods and services from Federal sources | 39 | 36 | 37 |
25.4 | Operation and maintenance of facilities | 1 | 1 | 1 |
26.0 | Supplies and materials | 1 | 1 | 1 |
41.0 | Grants, subsidies, and contributions | 5,327 | 5,491 | 5,381 |
|
|
|
||
99.0 | Direct obligations | 5,580 | 5,737 | 5,599 |
99.0 | Reimbursable obligations | 255 | 136 | 144 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 5,835 | 5,873 | 5,743 |
|
Employment Summary
|
||||
Identification code 075–1362–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 452 | 463 | 467 |
1101 | Direct military average strength employment | 30 | 31 | 32 |
2001 | Reimbursable civilian full-time equivalent employment | 9 | 104 | 108 |
2101 | Reimbursable military average strength employment | 8 | 8 | |
|
(Department of Health and Human Services Appropriations Act, 2020.)
Program and Financing (in millions of dollars)
|
||||
Identification code 075–1700–0–1–552 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Research on Health Costs, Quality and Outcomes | 196 | 190 | |
0002 | Medical Expenditure Panel Survey | 70 | 70 | |
0003 | AHRQ Program Support | 71 | 71 | |
|
|
|
||
0799 | Total direct obligations | 337 | 331 | |
0803 | Research on Health Costs, Quality and Outcomes (Reimbursable) | 31 | 31 | |
|
|
|
||
0899 | Total reimbursable obligations | 31 | 31 | |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 368 | 362 | |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 23 | 16 | 16 |
1001 | Discretionary unobligated balance brought fwd, Oct 1 | 1 | 1 | |
1010 | Unobligated balance transfer to other accts [075–9915] | –16 | ||
|
|
|
||
1050 | Unobligated balance (total) | 23 | 16 | |
Budget authority: | ||||
Appropriations, discretionary: | ||||
1100 | Appropriation | 338 | 338 | |
1120 | Appropriations transferred to other acct [075–1503] | –1 | ||
|
|
|
||
1160 | Appropriation, discretionary (total) | 337 | 338 | |
Spending authority from offsetting collections, discretionary: | ||||
1700 | Collected | 2 | 2 | |
1701 | Change in uncollected payments, Federal sources | 14 | 14 | |
|
|
|
||
1750 | Spending auth from offsetting collections, disc (total) | 16 | 16 | |
Spending authority from offsetting collections, mandatory: | ||||
1800 | Collected | 8 | 8 | |
1900 | Budget authority (total) | 361 | 362 | |
1930 | Total budgetary resources available | 384 | 378 | |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 16 | 16 | |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 335 | 344 | 438 |
3010 | New obligations, unexpired accounts | 368 | 362 | |
3011 | Obligations ("upward adjustments"), expired accounts | 3 | ||
3020 | Outlays (gross) | –350 | –268 | –303 |
3041 | Recoveries of prior year unpaid obligations, expired | –12 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 344 | 438 | 135 |
Uncollected payments: | ||||
3060 | Uncollected pymts, Fed sources, brought forward, Oct 1 | –35 | –28 | –21 |
3070 | Change in uncollected pymts, Fed sources, unexpired | –14 | –14 | |
3071 | Change in uncollected pymts, Fed sources, expired | 21 | 21 | |
|
|
|
||
3090 | Uncollected pymts, Fed sources, end of year | –28 | –21 | –21 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 300 | 316 | 417 |
3200 | Obligated balance, end of year | 316 | 417 | 114 |
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
4000 | Budget authority, gross | 353 | 354 | |
Outlays, gross: | ||||
4010 | Outlays from new discretionary authority | 127 | 134 | |
4011 | Outlays from discretionary balances | 217 | 118 | 303 |
|
|
|
||
4020 | Outlays, gross (total) | 344 | 252 | 303 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4030 | Federal sources | –20 | –20 | |
|
|
|
||
4040 | Offsets against gross budget authority and outlays (total) | –20 | –20 | |
Additional offsets against gross budget authority only: | ||||
4050 | Change in uncollected pymts, Fed sources, unexpired | –14 | –14 | |
4052 | Offsetting collections credited to expired accounts | 18 | 18 | |
|
|
|
||
4060 | Additional offsets against budget authority only (total) | 4 | 4 | |
|
|
|
||
4070 | Budget authority, net (discretionary) | 337 | 338 | |
4080 | Outlays, net (discretionary) | 324 | 232 | 303 |
Mandatory: | ||||
4090 | Budget authority, gross | 8 | 8 | |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 8 | ||
4101 | Outlays from mandatory balances | 6 | 8 | |
|
|
|
||
4110 | Outlays, gross (total) | 6 | 16 | |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4123 | Non-Federal sources | –8 | –8 | |
4180 | Budget authority, net (total) | 337 | 338 | |
4190 | Outlays, net (total) | 322 | 240 | 303 |
|
The FY 2021 Budget consolidates the activities of the Agency for Healthcare Research and Quality within the National Institutes of Health as the National Institute for Research on Safety and Quality.
Object Classification (in millions of dollars)
|
||||
Identification code 075–1700–0–1–552 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
Personnel compensation: | ||||
11.1 | Full-time permanent | 30 | 32 | |
11.3 | Other than full-time permanent | 4 | 4 | |
11.5 | Other personnel compensation | 1 | ||
11.7 | Military personnel | 1 | 1 | |
|
|
|
||
11.9 | Total personnel compensation | 36 | 37 | |
12.1 | Civilian personnel benefits | 11 | 11 | |
12.2 | Military personnel benefits | 1 | ||
23.1 | Rental payments to GSA | 3 | 3 | |
25.2 | Other services from non-Federal sources | 10 | 10 | |
25.3 | Other goods and services from Federal sources | 22 | 18 | |
25.5 | Research and development contracts | 141 | 133 | |
31.0 | Equipment | 1 | 1 | |
41.0 | Grants, subsidies, and contributions | 113 | 117 | |
|
|
|
||
99.0 | Direct obligations | 337 | 331 | |
99.0 | Reimbursable obligations | 31 | 31 | |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 368 | 362 | |
|
Employment Summary
|
||||
Identification code 075–1700–0–1–552 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 251 | 267 | |
1101 | Direct military average strength employment | 5 | 5 | |
2001 | Reimbursable civilian full-time equivalent employment | 1 | 1 | |
3001 | Allocation account civilian full-time equivalent employment | 7 | 7 | |
|
For carrying out, except as otherwise provided, titles XI and XIX of the Social Security Act, $313,904,098,000, to remain available until expended.
In addition, for carrying out such titles after May 31, 2021, for the last quarter of fiscal year 2021 for unanticipated costs incurred for the current fiscal year, such sums as may be necessary, to remain available until expended.
In addition, for carrying out such titles for the first quarter of fiscal year 2022, $148,732,315,000, to remain available until expended.
Payment under such title XIX may be made for any quarter with respect to a State plan or plan amendment in effect during such quarter, if submitted in or prior to such quarter and approved in that or any subsequent quarter.
(Department of Health and Human Services Appropriations Act, 2020.)
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0512–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Medicaid Vendor Payments | 430,962 | 448,384 | 465,149 |
0002 | State and local administration | 23,090 | 22,340 | 23,169 |
0003 | Vaccines for Children | 4,161 | 4,418 | 4,951 |
|
|
|
||
0799 | Total direct obligations | 458,213 | 475,142 | 493,269 |
|
|
|
||
0900 | Total new obligations, unexpired accounts (object class 41.0) | 458,213 | 475,142 | 493,269 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 15,403 | 14,678 | |
1021 | Recoveries of prior year unpaid obligations | 34,290 | 37,147 | 38,208 |
1033 | Recoveries of prior year paid obligations | 10,932 | ||
|
|
|
||
1050 | Unobligated balance (total) | 60,625 | 51,825 | 38,208 |
Budget authority: | ||||
Appropriations, mandatory: | ||||
1200 | Appropriation | 276,236 | 284,243 | 313,904 |
Advance appropriations, mandatory: | ||||
1270 | Advance appropriation | 134,848 | 137,932 | 139,903 |
Spending authority from offsetting collections, mandatory: | ||||
1800 | Collected | 1,053 | 1,142 | 1,254 |
1801 | Change in uncollected payments, Federal sources | 129 | ||
|
|
|
||
1850 | Spending auth from offsetting collections, mand (total) | 1,182 | 1,142 | 1,254 |
1900 | Budget authority (total) | 412,266 | 423,317 | 455,061 |
1930 | Total budgetary resources available | 472,891 | 475,142 | 493,269 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 14,678 | ||
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 46,079 | 48,596 | 38,208 |
3010 | New obligations, unexpired accounts | 458,213 | 475,142 | 493,269 |
3020 | Outlays (gross) | –421,406 | –448,383 | –453,032 |
3040 | Recoveries of prior year unpaid obligations, unexpired | –34,290 | –37,147 | –38,208 |
|
|
|
||
3050 | Unpaid obligations, end of year | 48,596 | 38,208 | 40,237 |
Uncollected payments: | ||||
3060 | Uncollected pymts, Fed sources, brought forward, Oct 1 | –724 | –853 | –853 |
3070 | Change in uncollected pymts, Fed sources, unexpired | –129 | ||
|
|
|
||
3090 | Uncollected pymts, Fed sources, end of year | –853 | –853 | –853 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 45,355 | 47,743 | 37,355 |
3200 | Obligated balance, end of year | 47,743 | 37,355 | 39,384 |
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 412,266 | 423,317 | 455,061 |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 379,389 | 414,441 | 448,147 |
4101 | Outlays from mandatory balances | 42,017 | 33,942 | 4,885 |
|
|
|
||
4110 | Outlays, gross (total) | 421,406 | 448,383 | 453,032 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4120 | Federal sources | –1,053 | –1,142 | –1,254 |
4123 | Non-Federal sources | –10,932 | ||
|
|
|
||
4130 | Offsets against gross budget authority and outlays (total) | –11,985 | –1,142 | –1,254 |
Additional offsets against gross budget authority only: | ||||
4140 | Change in uncollected pymts, Fed sources, unexpired | –129 | ||
4143 | Recoveries of prior year paid obligations, unexpired accounts | 10,932 | ||
|
|
|
||
4150 | Additional offsets against budget authority only (total) | 10,803 | ||
|
|
|
||
4160 | Budget authority, net (mandatory) | 411,084 | 422,175 | 453,807 |
4170 | Outlays, net (mandatory) | 409,421 | 447,241 | 451,778 |
4180 | Budget authority, net (total) | 411,084 | 422,175 | 453,807 |
4190 | Outlays, net (total) | 409,421 | 447,241 | 451,778 |
|
Summary of Budget Authority and Outlays (in millions of dollars)
|
||||
2019 actual | 2020 est. | 2021 est. | ||
|
||||
Enacted/requested: | ||||
Budget Authority | 411,084 | 422,175 | 453,807 | |
Outlays | 409,421 | 447,241 | 451,778 | |
Legislative proposal, subject to PAYGO: | ||||
Budget Authority | –3,633 | |||
Outlays | –3,633 | |||
Total: | ||||
Budget Authority | 411,084 | 422,175 | 450,174 | |
Outlays | 409,421 | 447,241 | 448,145 | |
|
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)
|
|||
Obligations | 2019 | 2020 | 2021 |
|
|||
Vaccine Purchase | 3,960 | 4,206 | 4,642 |
Vaccine Stockpile | 25 | 10 | 98 |
Ordering, Distribution, and Operations | 176 | 202 | 212 |
|
|
|
|
Total Obligations | 4,161 | 4,418 | 4,951 |
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0512–4–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Medicaid Vendor Payments | –3,633 | ||
|
|
|
||
0799 | Total direct obligations | –3,633 | ||
|
|
|
||
0900 | Total new obligations, unexpired accounts (object class 41.0) | –3,633 | ||
|
||||
Budgetary resources: | ||||
Budget authority: | ||||
Appropriations, mandatory: | ||||
1200 | Appropriation | –3,633 | ||
1900 | Budget authority (total) | –3,633 | ||
1930 | Total budgetary resources available | –3,633 | ||
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3010 | New obligations, unexpired accounts | –3,633 | ||
3020 | Outlays (gross) | 3,633 | ||
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | –3,633 | ||
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | –3,633 | ||
4180 | Budget authority, net (total) | –3,633 | ||
4190 | Outlays, net (total) | –3,633 | ||
|
This schedule reflects the Administration's Medicaid proposals.
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0516–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0012 | Medicaid integrity program | 84 | 111 | 91 |
0018 | Money follows the person (MFP) demonstration | 32 | 215 | 261 |
0023 | Grants to improve outreach and enrollment | 21 | 38 | 3 |
0028 | Demo to increase substance use provider under the Medicaid Program | 48 | 4 | 1 |
|
|
|
||
0799 | Total direct obligations | 185 | 368 | 356 |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 185 | 368 | 356 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 368 | 663 | 555 |
1012 | Unobligated balance transfers between expired and unexpired accounts | 77 | ||
1021 | Recoveries of prior year unpaid obligations | 11 | ||
|
|
|
||
1050 | Unobligated balance (total) | 456 | 663 | 555 |
Budget authority: | ||||
Appropriations, mandatory: | ||||
1200 | Appropriation | 397 | 265 | 91 |
1230 | Appropriations and/or unobligated balance of appropriations permanently reduced | –5 | –5 | |
|
|
|
||
1260 | Appropriations, mandatory (total) | 392 | 260 | 91 |
1900 | Budget authority (total) | 392 | 260 | 91 |
1930 | Total budgetary resources available | 848 | 923 | 646 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 663 | 555 | 290 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 901 | 695 | 626 |
3010 | New obligations, unexpired accounts | 185 | 368 | 356 |
3020 | Outlays (gross) | –378 | –437 | –429 |
3040 | Recoveries of prior year unpaid obligations, unexpired | –11 | ||
3041 | Recoveries of prior year unpaid obligations, expired | –2 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 695 | 626 | 553 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 901 | 695 | 626 |
3200 | Obligated balance, end of year | 695 | 626 | 553 |
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 392 | 260 | 91 |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 30 | 27 | 23 |
4101 | Outlays from mandatory balances | 348 | 410 | 406 |
|
|
|
||
4110 | Outlays, gross (total) | 378 | 437 | 429 |
4180 | Budget authority, net (total) | 392 | 260 | 91 |
4190 | Outlays, net (total) | 378 | 437 | 429 |
|
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), the Health Care and Education Reconciliation Act of 2010 (P.L. 111–152), the Protecting Access to Medicare Act of 2014 (P.L. 113–93), and the Medicare Access and CHIP Reauthorization Act of 2015 (P.L. 114–10). The account also includes funding for grant programs enacted in the HEALTHY KIDS Act (P.L. 115–120), the Advancing Chronic Care, Extenders, and Social Services Act (P.L. 115–123), the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (P.L. 115–271), the Medicaid Extenders Act of 2019 (P.L. 116–3), the Medicaid Services Investment and Accountability Act of 2019 (P.L. 116–16), the Sustaining Excellence in Medicaid Act of 2019 (P.L. 116–39), the Continuing Appropriations Act, 2020, the Health Extenders Act of 2019 (P.L. 116–59), and the Further Consolidated Appropriation Act, 2020 (P.L. 116–94).
Object Classification (in millions of dollars)
|
||||
Identification code 075–0516–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
11.1 | Direct obligations: Personnel compensation: Full-time permanent - Medicaid Integrity Program | 20 | 20 | 20 |
|
|
|
||
11.9 | Total personnel compensation | 20 | 20 | 20 |
12.1 | Civilian personnel benefits - Medicaid Integrity Program | 9 | 9 | 9 |
41.0 | Grants, subsidies, and contributions - Medicaid Integrity Program | 55 | 82 | 62 |
41.0 | Grants, subsidies, and contributions - Money follows the person (MFP) demonstrations | 32 | 215 | 261 |
41.0 | Grants, subsidies, and contributions - Grants to improve outreach and enrollment | 21 | 38 | 3 |
41.0 | Grants, subsidies, and contributions - Demo to increase substance use provider capacity under Medicaid | 48 | 4 | 1 |
|
|
|
||
99.0 | Direct obligations | 185 | 368 | 356 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 185 | 368 | 356 |
|
Employment Summary
|
||||
Identification code 075–0516–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 184 | 201 | 201 |
1101 | Direct military average strength employment | 5 | 5 | 5 |
|
For 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)(3) of Public Law 97–248, and for administrative expenses incurred pursuant to section 201(g) of the Social Security Act, $439,514,000,000.
In addition, for making matching payments under section 1844 and benefit payments under section 1860D-16 of the Social Security Act that were not anticipated in budget estimates, such sums as may be necessary.
(Department of Health and Human Services Appropriations Act, 2020.)
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0580–0–1–571 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Federal contribution to match premiums (SMI) | 271,628 | 304,045 | 325,500 |
0002 | Part D benefits (Rx Drug) | 75,418 | 104,539 | 111,800 |
0003 | Part D Federal administration (Rx Drug) | 642 | 861 | 882 |
0004 | General Fund Transfers to HI | 1,308 | 1,346 | 1,327 |
0006 | Federal Bureau of Investigation (HCFAC) | 138 | 135 | 138 |
0007 | Federal payments from taxation of OASDI benefits (HI) | 23,781 | 26,941 | 29,300 |
0008 | Criminal fines (HCFAC) | 15 | 88 | 36 |
0009 | Civil penalties and damages (HCFAC—DOJ and CMS administration) | 37 | 51 | 52 |
0010 | Asset Forfeiture | 64 | 31 | 32 |
0011 | State Low Income Determinations | 4 | 5 | 5 |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 373,035 | 438,042 | 469,072 |
|
||||
Budgetary resources: | ||||
Budget authority: | ||||
Appropriations, mandatory: | ||||
1200 | Appropriation (definite, annual) | 378,344 | 410,796 | 439,514 |
1200 | Appropriation (indefinite, permanent) | 23,781 | 26,941 | 29,300 |
1200 | Appropriation (HCFAC for FBI) | 138 | 135 | 138 |
1200 | Appropriation (indefinite for HCFAC) | 84 | 170 | 120 |
|
|
|
||
1260 | Appropriations, mandatory (total) | 402,347 | 438,042 | 469,072 |
1930 | Total budgetary resources available | 402,347 | 438,042 | 469,072 |
Memorandum (non-add) entries: | ||||
1940 | Unobligated balance expiring | –29,312 | ||
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 10,525 | 12,667 | 63,114 |
3010 | New obligations, unexpired accounts | 373,035 | 438,042 | 469,072 |
3011 | Obligations ("upward adjustments"), expired accounts | 16 | ||
3020 | Outlays (gross) | –364,706 | –387,595 | –415,989 |
3041 | Recoveries of prior year unpaid obligations, expired | –6,203 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 12,667 | 63,114 | 116,197 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 10,525 | 12,667 | 63,114 |
3200 | Obligated balance, end of year | 12,667 | 63,114 | 116,197 |
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 402,347 | 438,042 | 469,072 |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 364,039 | 375,230 | 367,777 |
4101 | Outlays from mandatory balances | 667 | 12,365 | 48,212 |
|
|
|
||
4110 | Outlays, gross (total) | 364,706 | 387,595 | 415,989 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4120 | Federal sources | –4,289 | ||
4123 | Non-Federal sources | –1,537 | ||
|
|
|
||
4130 | Offsets against gross budget authority and outlays (total) | –5,826 | ||
Additional offsets against gross budget authority only: | ||||
4142 | Offsetting collections credited to expired accounts | 5,826 | ||
|
|
|
||
4160 | Budget authority, net (mandatory) | 402,347 | 438,042 | 469,072 |
4170 | Outlays, net (mandatory) | 358,880 | 387,595 | 415,989 |
4180 | Budget authority, net (total) | 402,347 | 438,042 | 469,072 |
4190 | Outlays, net (total) | 358,880 | 387,595 | 415,989 |
|
Summary of Budget Authority and Outlays (in millions of dollars)
|
||||
2019 actual | 2020 est. | 2021 est. | ||
|
||||
Enacted/requested: | ||||
Budget Authority | 402,347 | 438,042 | 469,072 | |
Outlays | 358,880 | 387,595 | 415,989 | |
Legislative proposal, not subject to PAYGO: | ||||
Budget Authority | –7,383 | |||
Outlays | –7,383 | |||
Total: | ||||
Budget Authority | 402,347 | 438,042 | 461,689 | |
Outlays | 358,880 | 387,595 | 408,606 | |
|
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 administrative expenses that are properly chargeable to the general fund.
Object Classification (in millions of dollars)
|
||||
Identification code 075–0580–0–1–571 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
41.0 | Grants, subsidies, and contributions | 371,053 | 435,726 | 466,859 |
42.0 | Insurance claims and indemnities (HI Uninsured Federal) | 127 | 109 | 95 |
94.0 | Financial transfers (Federal admin) | 1,855 | 2,207 | 2,118 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 373,035 | 438,042 | 469,072 |
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0580–2–1–571 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Federal contribution to match premiums (SMI) | –7,383 | ||
|
|
|
||
0900 | Total new obligations, unexpired accounts (object class 41.0) | –7,383 | ||
|
||||
Budgetary resources: | ||||
Budget authority: | ||||
Appropriations, mandatory: | ||||
1200 | Appropriation (definite, annual) | –7,383 | ||
1930 | Total budgetary resources available | –7,383 | ||
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3010 | New obligations, unexpired accounts | –7,383 | ||
3020 | Outlays (gross) | 7,383 | ||
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | –7,383 | ||
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | –7,383 | ||
4180 | Budget authority, net (total) | –7,383 | ||
4190 | Outlays, net (total) | –7,383 | ||
|
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 administrative expenses that are properly chargeable to the general fund.
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0519–0–1–571 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | QIO Clinical Quality Improvement | 38 | 486 | |
0002 | QIO Beneficiary and Family Centered Care | 438 | ||
0003 | QIO Support Contracts | 421 | 462 | 354 |
0004 | QIO Administration | 62 | 74 | 76 |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 959 | 1,022 | 430 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 1 | 1 | |
Budget authority: | ||||
Spending authority from offsetting collections, mandatory: | ||||
1800 | Collected | 240 | 202 | 36 |
1801 | Change in uncollected payments, Federal sources | 1,184 | 820 | 393 |
|
|
|
||
1850 | Spending auth from offsetting collections, mand (total) | 1,424 | 1,022 | 429 |
1930 | Total budgetary resources available | 1,424 | 1,023 | 430 |
Memorandum (non-add) entries: | ||||
1940 | Unobligated balance expiring | –464 | ||
1941 | Unexpired unobligated balance, end of year | 1 | 1 | |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 867 | 886 | 886 |
3010 | New obligations, unexpired accounts | 959 | 1,022 | 430 |
3011 | Obligations ("upward adjustments"), expired accounts | 2 | ||
3020 | Outlays (gross) | –911 | –1,022 | –429 |
3041 | Recoveries of prior year unpaid obligations, expired | –31 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 886 | 886 | 887 |
Uncollected payments: | ||||
3060 | Uncollected pymts, Fed sources, brought forward, Oct 1 | –1,617 | –1,799 | –2,619 |
3070 | Change in uncollected pymts, Fed sources, unexpired | –1,184 | –820 | –393 |
3071 | Change in uncollected pymts, Fed sources, expired | 1,002 | ||
|
|
|
||
3090 | Uncollected pymts, Fed sources, end of year | –1,799 | –2,619 | –3,012 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | –750 | –913 | –1,733 |
3200 | Obligated balance, end of year | –913 | –1,733 | –2,125 |
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 1,424 | 1,022 | 429 |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 221 | 411 | 100 |
4101 | Outlays from mandatory balances | 690 | 611 | 329 |
|
|
|
||
4110 | Outlays, gross (total) | 911 | 1,022 | 429 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4120 | Federal sources | –933 | –1,022 | –429 |
Additional offsets against gross budget authority only: | ||||
4140 | Change in uncollected pymts, Fed sources, unexpired | –1,184 | –820 | –393 |
4142 | Offsetting collections credited to expired accounts | 693 | 820 | 393 |
|
|
|
||
4150 | Additional offsets against budget authority only (total) | –491 | ||
4170 | Outlays, net (mandatory) | –22 | ||
4180 | Budget authority, net (total) | |||
4190 | Outlays, net (total) | –22 | ||
|
||||
Memorandum (non-add) entries: | ||||
5093 | Expired unavailable balance, SOY: Offsetting collections | 50 | 50 | 50 |
5095 | Expired unavailable balance, EOY: Offsetting collections | 50 | 50 | |
|
Part B of title XI of the Social Security Act, as amended by the Peer Review Improvement Act of 1982 (P.L. 97–248), provides the statutory authority for the Medicare Quality Improvement Organization (QIO) Program. The mission of the program is to promote the effectiveness, efficiency, economy, and quality of services delivered to Medicare beneficiaries and to ensure that those services are reasonable and necessary. The program is funded through transfers from the Medicare Hospital Insurance Trust Fund and the Medicare Supplementary Medical Insurance Trust Fund. In FY 2012, a Treasury account specific to the QIO Program was established to improve budgetary operations.
Object Classification (in millions of dollars)
|
||||
Identification code 075–0519–0–1–571 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
Personnel compensation: | ||||
11.1 | Full-time permanent | 25 | 37 | 38 |
11.7 | Military personnel | 1 | 1 | 1 |
|
|
|
||
11.9 | Total personnel compensation | 26 | 38 | 39 |
12.1 | Civilian personnel benefits | 12 | 21 | 22 |
12.2 | Military personnel benefits | 1 | 1 | |
23.3 | Communications, utilities, and miscellaneous charges | 1 | 4 | 4 |
25.2 | Other services from non-Federal sources | 920 | 958 | 364 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 959 | 1,022 | 430 |
|
Employment Summary
|
||||
Identification code 075–0519–0–1–571 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 237 | 252 | 257 |
1101 | Direct military average strength employment | 10 | 10 | 10 |
|
For carrying out, except as otherwise provided, titles XI, XVIII, XIX, and XXI of the Social Security Act, titles XIII and XXVII of the PHS Act, the Clinical Laboratory Improvement Amendments of 1988, and other responsibilities of the Centers for Medicare & Medicaid Services, not to exceed $3,693,548,000, 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 pursuant to section 1893(h) of the Social Security 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 the Secretary is directed to collect fees in fiscal year 2021 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: Provided further, That of the funds made available under this heading, $442,192,000 shall remain available until September 30, 2022, and shall be available for the Survey and Certification Program.
(Department of Health and Human Services Appropriations Act, 2020.)
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0511–0–1–550 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Program operations | 3,050 | 2,825 | 2,479 |
0002 | Federal administration | 749 | 733 | 773 |
0003 | State survey and certification | 401 | 397 | 442 |
0004 | Research, demonstrations, and evaluation projects | 20 | 20 | |
0007 | ARRA Medicare/Medicaid HIT | 27 | 32 | 25 |
|
|
|
||
0100 | Total direct program | 4,247 | 4,007 | 3,719 |
|
|
|
||
0799 | Total direct obligations | 4,247 | 4,007 | 3,719 |
0801 | Clinical laboratory improvement amendments | 64 | 69 | 69 |
0802 | Sale of data | 24 | 27 | 27 |
0803 | Coordination of benefits | 32 | 70 | 70 |
0804 | Medicare advantage/Prescription drug plan | 76 | 85 | 85 |
0805 | Provider enrollment | 5 | 5 | 5 |
0806 | Recovery audit contractors | 87 | 111 | 119 |
0808 | Marketplace User Fees | 1,364 | 1,341 | 1,120 |
0810 | Risk Adjustment Administrative Expenses | 48 | 58 | 52 |
0813 | Other reimbursable program activity | 24 | 24 | |
|
|
|
||
0899 | Total reimbursable obligations | 1,700 | 1,790 | 1,571 |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 5,947 | 5,797 | 5,290 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 3,123 | 4,475 | 5,069 |
1020 | Adjustment of unobligated bal brought forward, Oct 1 | 464 | ||
1021 | Recoveries of prior year unpaid obligations | 27 | ||
1033 | Recoveries of prior year paid obligations | 5 | ||
|
|
|
||
1050 | Unobligated balance (total) | 3,619 | 4,475 | 5,069 |
Budget authority: | ||||
Appropriations, mandatory: | ||||
1200 | Appropriation | 3 | 3 | 3 |
Spending authority from offsetting collections, discretionary: | ||||
1700 | Collected | 1,819 | 3,995 | 3,714 |
1701 | Change in uncollected payments, Federal sources | 2,212 | ||
1710 | Spending authority from offsetting collections transferred to other accounts [075–1503] | –4 | ||
1710 | Spending authority from offsetting collections transferred to other accounts [075–9912] | –5 | ||
|
|
|
||
1750 | Spending auth from offsetting collections, disc (total) | 4,022 | 3,995 | 3,714 |
Spending authority from offsetting collections, mandatory: | ||||
1800 | Collected | 2,333 | 2,412 | 2,294 |
1801 | Change in uncollected payments, Federal sources | 607 | ||
1802 | Offsetting collections (previously unavailable) | 116 | 122 | 109 |
1823 | New and/or unobligated balance of spending authority from offsetting collections temporarily reduced | –159 | –141 | |
|
|
|
||
1850 | Spending auth from offsetting collections, mand (total) | 2,897 | 2,393 | 2,403 |
1900 | Budget authority (total) | 6,922 | 6,391 | 6,120 |
1930 | Total budgetary resources available | 10,541 | 10,866 | 11,189 |
Memorandum (non-add) entries: | ||||
1940 | Unobligated balance expiring | –119 | ||
1941 | Unexpired unobligated balance, end of year | 4,475 | 5,069 | 5,899 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 4,599 | 4,767 | 4,722 |
3010 | New obligations, unexpired accounts | 5,947 | 5,797 | 5,290 |
3011 | Obligations ("upward adjustments"), expired accounts | 46 | ||
3020 | Outlays (gross) | –5,569 | –5,842 | –6,919 |
3040 | Recoveries of prior year unpaid obligations, unexpired | –27 | ||
3041 | Recoveries of prior year unpaid obligations, expired | –229 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 4,767 | 4,722 | 3,093 |
Uncollected payments: | ||||
3060 | Uncollected pymts, Fed sources, brought forward, Oct 1 | –5,838 | –6,882 | –6,882 |
3061 | Adjustments to uncollected pymts, Fed sources, brought forward, Oct 1 | –500 | ||
3070 | Change in uncollected pymts, Fed sources, unexpired | –2,819 | ||
3071 | Change in uncollected pymts, Fed sources, expired | 2,275 | ||
|
|
|
||
3090 | Uncollected pymts, Fed sources, end of year | –6,882 | –6,882 | –6,882 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | –1,739 | –2,115 | –2,160 |
3200 | Obligated balance, end of year | –2,115 | –2,160 | –3,789 |
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
4000 | Budget authority, gross | 4,022 | 3,995 | 3,714 |
Outlays, gross: | ||||
4010 | Outlays from new discretionary authority | 1,718 | 2,008 | 1,867 |
4011 | Outlays from discretionary balances | 2,065 | 1,193 | 1,986 |
|
|
|
||
4020 | Outlays, gross (total) | 3,783 | 3,201 | 3,853 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4030 | Federal sources | –3,806 | –3,975 | –3,694 |
4033 | Non-Federal sources | –31 | –20 | –20 |
|
|
|
||
4040 | Offsets against gross budget authority and outlays (total) | –3,837 | –3,995 | –3,714 |
Additional offsets against gross budget authority only: | ||||
4050 | Change in uncollected pymts, Fed sources, unexpired | –2,212 | ||
4052 | Offsetting collections credited to expired accounts | 2,018 | ||
|
|
|
||
4060 | Additional offsets against budget authority only (total) | –194 | ||
|
|
|
||
4070 | Budget authority, net (discretionary) | –9 | ||
4080 | Outlays, net (discretionary) | –54 | –794 | 139 |
Mandatory: | ||||
4090 | Budget authority, gross | 2,900 | 2,396 | 2,406 |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 36 | 1,337 | 1,266 |
4101 | Outlays from mandatory balances | 1,750 | 1,304 | 1,800 |
|
|
|
||
4110 | Outlays, gross (total) | 1,786 | 2,641 | 3,066 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4120 | Federal sources | –356 | –54 | –31 |
4123 | Non-Federal sources | –2,049 | –2,358 | –2,263 |
|
|
|
||
4130 | Offsets against gross budget authority and outlays (total) | –2,405 | –2,412 | –2,294 |
Additional offsets against gross budget authority only: | ||||
4140 | Change in uncollected pymts, Fed sources, unexpired | –607 | ||
4142 | Offsetting collections credited to expired accounts | 67 | ||
4143 | Recoveries of prior year paid obligations, unexpired accounts | 5 | ||
|
|
|
||
4150 | Additional offsets against budget authority only (total) | –535 | ||
|
|
|
||
4160 | Budget authority, net (mandatory) | –40 | –16 | 112 |
4170 | Outlays, net (mandatory) | –619 | 229 | 772 |
4180 | Budget authority, net (total) | –49 | –16 | 112 |
4190 | Outlays, net (total) | –673 | –565 | 911 |
|
||||
Memorandum (non-add) entries: | ||||
5090 | Unexpired unavailable balance, SOY: Offsetting collections | 552 | 531 | 550 |
5091 | Expiring unavailable balance: Offsetting collections | –64 | ||
5092 | Unexpired unavailable balance, EOY: Offsetting collections | 531 | 550 | 441 |
5093 | Expired unavailable balance, SOY: Offsetting collections | 5 | 69 | 69 |
5095 | Expired unavailable balance, EOY: Offsetting collections | 5 | 69 | 69 |
|
Summary of Budget Authority and Outlays (in millions of dollars)
|
||||
2019 actual | 2020 est. | 2021 est. | ||
|
||||
Enacted/requested: | ||||
Budget Authority | –49 | –16 | 112 | |
Outlays | –673 | –565 | 911 | |
Legislative proposal, subject to PAYGO: | ||||
Budget Authority | 12 | |||
Outlays | –4 | –28 | ||
Total: | ||||
Budget Authority | –49 | –16 | 124 | |
Outlays | –673 | –569 | 883 | |
|
Program management activities include funding for program operations, survey and certification, the Clinical Laboratory Improvement Amendments (CLIA), Medicare Advantage, Medicare Part D coordination of benefits, recovery audit contracts, and other administrative costs.
Object Classification (in millions of dollars)
|
||||
Identification code 075–0511–0–1–550 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
Personnel compensation: | ||||
11.1 | Full-time permanent | 425 | 401 | 372 |
11.3 | Other than full-time permanent | 12 | 11 | 11 |
11.5 | Other personnel compensation | 6 | 6 | 5 |
11.7 | Military personnel | 15 | 14 | 13 |
|
|
|
||
11.9 | Total personnel compensation | 458 | 432 | 401 |
12.1 | Civilian personnel benefits | 162 | 153 | 142 |
12.2 | Military personnel benefits | 9 | 8 | 8 |
21.0 | Travel and transportation of persons | 5 | 5 | 4 |
23.1 | Rental payments to GSA | 16 | 15 | 14 |
23.3 | Communications, utilities, and miscellaneous charges | 8 | 8 | 7 |
24.0 | Printing and reproduction | 46 | 43 | 40 |
25.2 | Other services from non-Federal sources | 3,014 | 2,843 | 2,640 |
25.3 | Other goods and services from Federal sources | 97 | 92 | 85 |
25.6 | Medical care | 366 | 345 | 320 |
25.7 | Operation and maintenance of equipment | 40 | 38 | 35 |
26.0 | Supplies and materials | 1 | 1 | 1 |
31.0 | Equipment | 2 | 2 | 2 |
41.0 | Grants, subsidies, and contributions | 23 | 22 | 20 |
|
|
|
||
99.0 | Direct obligations | 4,247 | 4,007 | 3,719 |
99.0 | Reimbursable obligations | 1,700 | 1,790 | 1,571 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 5,947 | 5,797 | 5,290 |
|
Employment Summary
|
||||
Identification code 075–0511–0–1–550 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 4,226 | 4,088 | 4,152 |
1001 | Direct civilian full-time equivalent employment | 141 | 116 | 64 |
1101 | Direct military average strength employment | 144 | 144 | 144 |
2001 | Reimbursable civilian full-time equivalent employment | 257 | 293 | 293 |
2101 | Reimbursable military average strength employment | 16 | 16 | 16 |
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0511–4–1–550 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Program operations | 12 | ||
|
|
|
||
0100 | Total direct program | 12 | ||
|
|
|
||
0799 | Total direct obligations | 12 | ||
0801 | ACL SHIPs | 5 | 13 | |
|
|
|
||
0899 | Total reimbursable obligations | 5 | 13 | |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 5 | 25 | |
|
||||
Budgetary resources: | ||||
Budget authority: | ||||
Appropriations, mandatory: | ||||
1200 | Appropriation | 12 | ||
Spending authority from offsetting collections, mandatory: | ||||
1800 | Collected | 5 | 53 | |
1900 | Budget authority (total) | 5 | 65 | |
1930 | Total budgetary resources available | 5 | 65 | |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 40 | ||
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 4 | ||
3010 | New obligations, unexpired accounts | 5 | 25 | |
3020 | Outlays (gross) | –1 | –25 | |
|
|
|
||
3050 | Unpaid obligations, end of year | 4 | 4 | |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 4 | ||
3200 | Obligated balance, end of year | 4 | 4 | |
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 5 | 65 | |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 1 | 23 | |
4101 | Outlays from mandatory balances | 2 | ||
|
|
|
||
4110 | Outlays, gross (total) | 1 | 25 | |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4120 | Federal sources | –5 | –53 | |
4180 | Budget authority, net (total) | 12 | ||
4190 | Outlays, net (total) | –4 | –28 | |
|
This display includes the effects of proposals related to mandatory funding for the State Health Insurance Assistance Program, resources to implement HHS's legislative proposals in the FY 2021 Budget, a revisit fee for long term care facilities, and the National Medicare and You Education Program user fee increase.
Object Classification (in millions of dollars)
|
||||
Identification code 075–0511–4–1–550 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
25.3 | Direct obligations: Other goods and services from Federal sources | 12 | ||
|
|
|
||
99.0 | Direct obligations | 12 | ||
99.0 | Reimbursable obligations | 5 | 13 | |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 5 | 25 | |
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0514–4–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Direct program activity | 17,500 | ||
|
|
|
||
0900 | Total new obligations, unexpired accounts (object class 41.0) | 17,500 | ||
|
||||
Budgetary resources: | ||||
Budget authority: | ||||
Appropriations, mandatory: | ||||
1200 | Appropriation | 17,500 | ||
1930 | Total budgetary resources available | 17,500 | ||
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3010 | New obligations, unexpired accounts | 17,500 | ||
3020 | Outlays (gross) | –17,500 | ||
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 17,500 | ||
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 17,500 | ||
4180 | Budget authority, net (total) | 17,500 | ||
4190 | Outlays, net (total) | 17,500 | ||
|
This account reflects the Budget's proposals to modify payments to hospitals for uncompensated care and consolidate graduate medical education spending.
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0515–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Grants to states and US territories | 17,416 | 18,708 | 18,030 |
0002 | CHIP Redistribution Funds | 179 | ||
0003 | Child health quality | 10 | 31 | 34 |
|
|
|
||
0900 | Total new obligations, unexpired accounts (object class 41.0) | 17,605 | 18,739 | 18,064 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 8,251 | 8,237 | 14,065 |
1011 | Unobligated balance transfer from other acct [075–5551] | 4,037 | 4,914 | |
1021 | Recoveries of prior year unpaid obligations | 29 | ||
1033 | Recoveries of prior year paid obligations | 146 | ||
|
|
|
||
1050 | Unobligated balance (total) | 8,426 | 12,274 | 18,979 |
Budget authority: | ||||
Appropriations, discretionary: | ||||
1130 | Appropriations permanently reduced | –8,790 | ||
Appropriations, mandatory: | ||||
1200 | Appropriation | 22,600 | 23,700 | 24,800 |
1221 | Appropriations transferred from other acct [075–5551] | 6,093 | ||
1230 | Appropriations and/or unobligated balance of appropriations permanently reduced | –2,061 | –3,170 | |
|
|
|
||
1260 | Appropriations, mandatory (total) | 20,539 | 20,530 | 30,893 |
1900 | Budget authority (total) | 20,539 | 20,530 | 22,103 |
1930 | Total budgetary resources available | 28,965 | 32,804 | 41,082 |
Memorandum (non-add) entries: | ||||
1940 | Unobligated balance expiring | –3,123 | ||
1941 | Unexpired unobligated balance, end of year | 8,237 | 14,065 | 23,018 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 5,789 | 5,530 | 6,615 |
3010 | New obligations, unexpired accounts | 17,605 | 18,739 | 18,064 |
3020 | Outlays (gross) | –17,835 | –17,654 | –15,778 |
3040 | Recoveries of prior year unpaid obligations, unexpired | –29 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 5,530 | 6,615 | 8,901 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 5,789 | 5,530 | 6,615 |
3200 | Obligated balance, end of year | 5,530 | 6,615 | 8,901 |
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
4000 | Budget authority, gross | –8,790 | ||
Mandatory: | ||||
4090 | Budget authority, gross | 20,539 | 20,530 | 30,893 |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 12,531 | 10,831 | 9,263 |
4101 | Outlays from mandatory balances | 5,304 | 6,823 | 6,515 |
|
|
|
||
4110 | Outlays, gross (total) | 17,835 | 17,654 | 15,778 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4123 | Non-Federal sources: | –146 | ||
Additional offsets against gross budget authority only: | ||||
4143 | Recoveries of prior year paid obligations, unexpired accounts | 146 | ||
|
|
|
||
4160 | Budget authority, net (mandatory) | 20,539 | 20,530 | 30,893 |
4170 | Outlays, net (mandatory) | 17,689 | 17,654 | 15,778 |
4180 | Budget authority, net (total) | 20,539 | 20,530 | 22,103 |
4190 | Outlays, net (total) | 17,689 | 17,654 | 15,778 |
|
The Balanced Budget Act of 1997 (P.L. 105–33) 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, CHIPRA) reauthorized the CHIP program and appropriated funding for CHIP through fiscal year 2013. CHIPRA made some modifications to the program, including increased funding for States and territories, and support for child health quality and outreach activities. CHIPRA also created a contingency fund in a separate account to assist States who project spending above their available allocated CHIP funds. The Patient Protection and Affordable Care Act of 2010 (P.L. 111–148) and the Medicare Access and CHIP Reauthorization Act of 2015 (P.L. 114–10) extended CHIP funding through fiscal year 2015 and 2017, respectively. The HEALTHY KIDS Act (P.L. 115–120) and the Advancing Chronic Care, Extenders, and Social Services Act (P.L. 115–123) extended CHIP funding through fiscal year 2023 and 2027, respectively.
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0522–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Administration | 349 | 411 | 433 |
0002 | Innovation Activities | 459 | 1,003 | 810 |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 808 | 1,414 | 1,243 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 2,619 | 1,856 | 10,442 |
1021 | Recoveries of prior year unpaid obligations | 45 | ||
|
|
|
||
1050 | Unobligated balance (total) | 2,664 | 1,856 | 10,442 |
Budget authority: | ||||
Appropriations, mandatory: | ||||
1200 | Appropriation | 10,000 | ||
1930 | Total budgetary resources available | 2,664 | 11,856 | 10,442 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 1,856 | 10,442 | 9,199 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 1,228 | 1,013 | 1,217 |
3010 | New obligations, unexpired accounts | 808 | 1,414 | 1,243 |
3020 | Outlays (gross) | –978 | –1,210 | –1,203 |
3040 | Recoveries of prior year unpaid obligations, unexpired | –45 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 1,013 | 1,217 | 1,257 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 1,228 | 1,013 | 1,217 |
3200 | Obligated balance, end of year | 1,013 | 1,217 | 1,257 |
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 10,000 | ||
Outlays, gross: | ||||
4101 | Outlays from mandatory balances | 978 | 1,210 | 1,203 |
4180 | Budget authority, net (total) | 10,000 | ||
4190 | Outlays, net (total) | 978 | 1,210 | 1,203 |
|
The Center for Medicare and Medicaid Innovation ("Innovation Center") was established by section 1115A of the Social Security Act (as added by section 3021 of the Patient Protection and Affordable Care Act). The Innovation Center is tasked with testing innovative payment and service delivery models to reduce program expenditures while preserving or enhancing the quality of care provided to individuals under Medicare, Medicaid, or the Children's Health Insurance Program (CHIP). The statute provides $10 billion in mandatory funding for these purposes for fiscal years 2011 through 2019 and each subsequent 10-year fiscal period (beginning with the 10-year fiscal period beginning with fiscal year 2020).
Object Classification (in millions of dollars)
|
||||
Identification code 075–0522–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
Personnel compensation: | ||||
11.1 | Full-time permanent | 81 | 61 | 67 |
11.7 | Military personnel | 2 | 3 | 4 |
|
|
|
||
11.9 | Total personnel compensation | 83 | 64 | 71 |
12.1 | Civilian personnel benefits | 20 | 20 | 21 |
12.2 | Military personnel benefits | 1 | 1 | 1 |
23.3 | Communications, utilities, and miscellaneous charges | 3 | 3 | 3 |
25.2 | Other services from non-Federal sources | 567 | 860 | 686 |
41.0 | Grants, subsidies, and contributions | 123 | 405 | 401 |
42.0 | Insurance claims and indemnities | 11 | 61 | 60 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 808 | 1,414 | 1,243 |
|
Employment Summary
|
||||
Identification code 075–0522–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 516 | 557 | 557 |
1101 | Direct military average strength employment | 17 | 17 | 17 |
|
Special and Trust Fund Receipts (in millions of dollars)
|
||||
Identification code 075–5551–0–2–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
0100 | Balance, start of year | 3,132 | 5,609 | 6,093 |
0198 | Earnings on investment adjustment | –4 | ||
|
|
|
||
0199 | Balance, start of year | 3,128 | 5,609 | 6,093 |
Receipts: | ||||
Current law: | ||||
1140 | Interest, Child Enrollment Contingency Fund | 254 | 173 | 75 |
|
|
|
||
2000 | Total: Balances and receipts | 3,382 | 5,782 | 6,168 |
Appropriations: | ||||
Current law: | ||||
2101 | Child Enrollment Contingency Fund | –254 | –173 | –168 |
2103 | Child Enrollment Contingency Fund | –3,128 | –5,609 | –6,093 |
2135 | Child Enrollment Contingency Fund | 3,267 | 6,093 | |
|
|
|
||
2199 | Total current law appropriations | –115 | 311 | –6,261 |
|
|
|
||
2999 | Total appropriations | –115 | 311 | –6,261 |
4030 | Child Enrollment Contingency Fund | 2,342 | ||
|
|
|
||
5099 | Balance, end of year | 5,609 | 6,093 | –93 |
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–5551–0–2–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Grants to States and US Territories | 113 | ||
|
|
|
||
0900 | Total new obligations, unexpired accounts (object class 41.0) | 113 | ||
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 2,338 | 4,522 | 4,914 |
1010 | Unobligated balance transfer to other accts [075–0515] | –4,037 | –4,914 | |
1020 | Adjustment of unobligated bal brought forward, Oct 1 | 4 | ||
1035 | Unobligated balance precluded from obligation (limitation on obligations)(special and trust) | –2,342 | ||
|
|
|
||
1050 | Unobligated balance (total) | 485 | ||
Budget authority: | ||||
Appropriations, mandatory: | ||||
1200 | Appropriation | 4,520 | 4,740 | 4,960 |
1201 | Appropriation (special or trust fund) | 254 | 173 | 168 |
1203 | Appropriation (previously unavailable)(special or trust) | 3,128 | 5,609 | 6,093 |
1220 | Appropriations transferred to other acct [075–0515] | –6,093 | ||
1235 | Appropriations precluded from obligation (special or trust) | –3,267 | –6,093 | |
|
|
|
||
1260 | Appropriations, mandatory (total) | 4,635 | 4,429 | 5,128 |
1900 | Budget authority (total) | 4,635 | 4,429 | 5,128 |
1930 | Total budgetary resources available | 4,635 | 4,914 | 5,128 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 4,522 | 4,914 | 5,128 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 200 | 310 | |
3010 | New obligations, unexpired accounts | 113 | ||
3020 | Outlays (gross) | –3 | –310 | |
|
|
|
||
3050 | Unpaid obligations, end of year | 310 | ||
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 200 | 310 | |
3200 | Obligated balance, end of year | 310 | ||
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 4,635 | 4,429 | 5,128 |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 3 | ||
4101 | Outlays from mandatory balances | 310 | ||
|
|
|
||
4110 | Outlays, gross (total) | 3 | 310 | |
4180 | Budget authority, net (total) | 4,635 | 4,429 | 5,128 |
4190 | Outlays, net (total) | 3 | 310 | |
|
||||
Memorandum (non-add) entries: | ||||
5000 | Total investments, SOY: Federal securities: Par value | 15,044 | ||
5001 | Total investments, EOY: Federal securities: Par value | 15,044 | 10,042 | |
|
The Children's Health Insurance Program Reauthorization Act of 2009 (P.L. 111–3) established the Child Enrollment Contingency Fund under title XXI of the Social Security Act. Beginning in 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 (P.L. 111–148) and the Medicare Access and CHIP Reauthorization Act of 2015 (P.L. 114–10) extended the Contingency Fund through fiscal years 2015 and 2017, respectively. The HEALTHY KIDS Act (P.L. 115–120) and the Advancing Chronic Care, Extenders, and Social Services Act (P.L. 115–123) extended the Contingency Fund through FY 2023 and FY 2027, respectively.
The Fund receives an appropriation equal to 20 percent of the CHIP national allotment appropriation under section 2104(a) of the Social Security Act. The Contingency Fund is invested in interest bearing securities of the United States, and the income derived from these investments constitutes a part of the fund.
The Budget proposes to repeal the Child Enrollment Contingency Fund and instead fund a restructured Shortfall Fund that will be a more accessible safety net for states. Currently, few states can meet the restrictive eligibility criteria to qualify for a Contingency Fund payment. When States do qualify, they do not need to spend the funds on children's health. This proposal has no budget impact.
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0508–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0801 | Incentive payments to hospitals | 37 | 15 | 10 |
0802 | Incentive payments to eligible professionals | 9 | ||
|
|
|
||
0900 | Total new obligations, unexpired accounts (object class 42.0) | 46 | 15 | 10 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1033 | Recoveries of prior year paid obligations | 12 | ||
Budget authority: | ||||
Spending authority from offsetting collections, mandatory: | ||||
1800 | Collected from the HI Trust Fund | 53 | 15 | 10 |
1801 | Change in uncollected payments, Federal sources | –16 | ||
1823 | New and/or unobligated balance of spending authority from offsetting collections temporarily reduced | –3 | ||
|
|
|
||
1850 | Spending auth from offsetting collections, mand (total) | 34 | 15 | 10 |
1930 | Total budgetary resources available | 46 | 15 | 10 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 24 | 15 | 15 |
3010 | New obligations, unexpired accounts | 46 | 15 | 10 |
3020 | Outlays (gross) | –55 | –15 | –10 |
|
|
|
||
3050 | Unpaid obligations, end of year | 15 | 15 | 15 |
Uncollected payments: | ||||
3060 | Uncollected pymts, Fed sources, brought forward, Oct 1 | –161 | –145 | –145 |
3070 | Change in uncollected pymts, Fed sources, unexpired | 16 | ||
|
|
|
||
3090 | Uncollected pymts, Fed sources, end of year | –145 | –145 | –145 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | –137 | –130 | –130 |
3200 | Obligated balance, end of year | –130 | –130 | –130 |
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 34 | 15 | 10 |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 31 | 1 | 10 |
4101 | Outlays from mandatory balances | 24 | 14 | |
|
|
|
||
4110 | Outlays, gross (total) | 55 | 15 | 10 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4120 | Federal sources | –53 | –15 | –10 |
4123 | Non-Federal sources | –12 | ||
|
|
|
||
4130 | Offsets against gross budget authority and outlays (total) | –65 | –15 | –10 |
Additional offsets against gross budget authority only: | ||||
4140 | Change in uncollected pymts, Fed sources, unexpired | 16 | ||
4143 | Recoveries of prior year paid obligations, unexpired accounts | 12 | ||
|
|
|
||
4150 | Additional offsets against budget authority only (total) | 28 | ||
|
|
|
||
4160 | Budget authority, net (mandatory) | –3 | ||
4170 | Outlays, net (mandatory) | –10 | ||
4180 | Budget authority, net (total) | –3 | ||
4190 | Outlays, net (total) | –10 | ||
|
||||
Memorandum (non-add) entries: | ||||
5090 | Unexpired unavailable balance, SOY: Offsetting collections | 141 | 144 | 144 |
5092 | Unexpired unavailable balance, EOY: Offsetting collections | 144 | 144 | 144 |
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0112–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Premium rate review grants | 26 | ||
|
|
|
||
0900 | Total new obligations, unexpired accounts (object class 41.0) | 26 | ||
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 5 | 5 | 26 |
1012 | Unobligated balance transfers between expired and unexpired accounts | 16 | ||
1021 | Recoveries of prior year unpaid obligations | 5 | ||
|
|
|
||
1050 | Unobligated balance (total) | 5 | 26 | 26 |
1930 | Total budgetary resources available | 5 | 26 | 26 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 5 | 26 | |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 52 | 18 | |
3010 | New obligations, unexpired accounts | 26 | ||
3020 | Outlays (gross) | –17 | –13 | –5 |
3040 | Recoveries of prior year unpaid obligations, unexpired | –5 | ||
3041 | Recoveries of prior year unpaid obligations, expired | –17 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 18 | 21 | |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 52 | 18 | |
3200 | Obligated balance, end of year | 18 | 21 | |
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
Outlays, gross: | ||||
4101 | Outlays from mandatory balances | 17 | 13 | 5 |
4180 | Budget authority, net (total) | |||
4190 | Outlays, net (total) | 17 | 13 | 5 |
|
The Patient Protection and Affordable Care Act (P.L. 111–148) added section 2794 to the Public Health Service Act and provided that the Secretary carry out a program to award grants to States for a five-year period beginning in fiscal year 2010. The program provided $250 million in grants to help States develop or enhance their current rate review activities from 2010 through 2014, with remaining unobligated balances subsequently available for state implementation of consumer protections and other insurance reform activities consistent with section 2794(c)(2)(B).
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0113–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Pre-Existing Condition Insurance Plan Program (Direct) | 55 | ||
0002 | Administration | 75 | 75 | |
|
|
|
||
0799 | Total direct obligations | 55 | 75 | 75 |
|
|
|
||
0900 | Total new obligations, unexpired accounts (object class 25.2) | 55 | 75 | 75 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 246 | 195 | 120 |
1021 | Recoveries of prior year unpaid obligations | 4 | ||
|
|
|
||
1050 | Unobligated balance (total) | 250 | 195 | 120 |
1930 | Total budgetary resources available | 250 | 195 | 120 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 195 | 120 | 45 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 69 | 68 | 71 |
3010 | New obligations, unexpired accounts | 55 | 75 | 75 |
3020 | Outlays (gross) | –52 | –72 | –90 |
3040 | Recoveries of prior year unpaid obligations, unexpired | –4 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 68 | 71 | 56 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 69 | 68 | 71 |
3200 | Obligated balance, end of year | 68 | 71 | 56 |
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
Outlays, gross: | ||||
4101 | Outlays from mandatory balances | 52 | 72 | 90 |
4180 | Budget authority, net (total) | |||
4190 | Outlays, net (total) | 52 | 72 | 90 |
|
This account funded the Pre-Existing Condition Insurance Plan program (PCIP), which made health insurance available to people who had been unable to purchase insurance due to a pre-existing condition. Enrollees paid monthly premiums similar to those charged in the commercial individual market, and the Federal government paid for remaining costs that exceeded enrollee contributions. The funding for this program, including operating costs, was provided in the Patient Protection and Affordable Care Act (P.L. 111–148). The PCIP program ended in fiscal year 2014, and outlays in subsequent fiscal years reflect program close out and claims run out costs, as well as allowable administrative costs in the current year.
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0114–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 26 | 26 | 36 |
1021 | Recoveries of prior year unpaid obligations | 10 | ||
|
|
|
||
1050 | Unobligated balance (total) | 26 | 36 | 36 |
1930 | Total budgetary resources available | 26 | 36 | 36 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 26 | 36 | 36 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 10 | 10 | |
3040 | Recoveries of prior year unpaid obligations, unexpired | –10 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 10 | ||
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 10 | 10 | |
3200 | Obligated balance, end of year | 10 | ||
4180 | Budget authority, net (total) | |||
4190 | Outlays, net (total) | |||
|
The Patient Protection and Affordable Care Act (P.L. 111–148) authorized and appropriated $5 billion for the Early Retiree Reinsurance Program (ERRP). By statute, ERRP sunset on January 1, 2014, and is no longer providing reimbursements to plan sponsors.
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0115–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 7 | ||
3020 | Outlays (gross) | –5 | ||
3041 | Recoveries of prior year unpaid obligations, expired | –2 | ||
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 7 | ||
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
Outlays, gross: | ||||
4101 | Outlays from mandatory balances | 5 | ||
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4123 | Non-Federal sources | –1 | ||
Additional offsets against gross budget authority only: | ||||
4142 | Offsetting collections credited to expired accounts | 1 | ||
4170 | Outlays, net (mandatory) | 4 | ||
4180 | Budget authority, net (total) | |||
4190 | Outlays, net (total) | 4 | ||
|
This program provided funding for Planning and Establishment Grants to States for their activities to implement Health Insurance Exchanges. The Exchanges facilitated the purchase of qualified health plans in the individual market and allowed small businesses to offer qualified health plans to their employees through the Small Business Health Options Program (SHOP). Section 1311 of the Patient Protection and Affordable Care Act (P.L. 111–148) provided amounts necessary to enable the Secretary to award grants to States beginning no later than March 23, 2011, and allowed for renewal of grants through January 1, 2015. The final round of grants was awarded to States in December 2014.
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0126–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Cost Sharing Reductions | 6,734 | 6,624 | |
0002 | Basic Health Program | 1,266 | 1,307 | |
|
|
|
||
0900 | Total new obligations, unexpired accounts (object class 41.0) | 8,000 | 7,931 | |
|
||||
Budgetary resources: | ||||
Budget authority: | ||||
Appropriations, mandatory: | ||||
1200 | Appropriation | 8,000 | 7,931 | |
1930 | Total budgetary resources available | 8,000 | 7,931 | |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3010 | New obligations, unexpired accounts | 8,000 | 7,931 | |
3020 | Outlays (gross) | –8,000 | –7,931 | |
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 8,000 | 7,931 | |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 8,000 | 7,931 | |
4180 | Budget authority, net (total) | 8,000 | 7,931 | |
4190 | Outlays, net (total) | 8,000 | 7,931 | |
|
Under current law, insurers are required to offer reduced cost-sharing to eligible, low-income consumers. The classification of CSRs as an entitlement pursuant to BBEDCA does not determine legal entitlement to a payment or benefit or availability of funding.
Special and Trust Fund Receipts (in millions of dollars)
|
||||
Identification code 075–5733–0–2–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
0100 | Balance, start of year | 311 | 371 | 328 |
Receipts: | ||||
Current law: | ||||
1110 | Receipts, Risk Adjustment Program | 5,978 | 5,541 | 5,627 |
|
|
|
||
2000 | Total: Balances and receipts | 6,289 | 5,912 | 5,955 |
Appropriations: | ||||
Current law: | ||||
2101 | Risk Adjustment Program Payments | –5,978 | –5,540 | –5,627 |
2103 | Risk Adjustment Program Payments | –311 | –371 | –327 |
2132 | Risk Adjustment Program Payments | 371 | 327 | |
|
|
|
||
2199 | Total current law appropriations | –5,918 | –5,584 | –5,954 |
|
|
|
||
2999 | Total appropriations | –5,918 | –5,584 | –5,954 |
|
|
|
||
5099 | Balance, end of year | 371 | 328 | 1 |
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–5733–0–2–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Risk Adjustment Program Payments (Direct) | 7,397 | 5,584 | 5,954 |
|
|
|
||
0900 | Total new obligations, unexpired accounts (object class 41.0) | 7,397 | 5,584 | 5,954 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 2,225 | 746 | 746 |
Budget authority: | ||||
Appropriations, mandatory: | ||||
1201 | Appropriation (special or trust fund) | 5,978 | 5,540 | 5,627 |
1203 | Appropriation (previously unavailable)(special or trust) | 311 | 371 | 327 |
1232 | Appropriations and/or unobligated balance of appropriations temporarily reduced | –371 | –327 | |
|
|
|
||
1260 | Appropriations, mandatory (total) | 5,918 | 5,584 | 5,954 |
1930 | Total budgetary resources available | 8,143 | 6,330 | 6,700 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 746 | 746 | 746 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 2,192 | 2,678 | |
3010 | New obligations, unexpired accounts | 7,397 | 5,584 | 5,954 |
3020 | Outlays (gross) | –6,911 | –8,262 | –5,954 |
|
|
|
||
3050 | Unpaid obligations, end of year | 2,678 | ||
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 2,192 | 2,678 | |
3200 | Obligated balance, end of year | 2,678 | ||
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 5,918 | 5,584 | 5,954 |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 2,494 | 5,584 | 5,954 |
4101 | Outlays from mandatory balances | 4,417 | 2,678 | |
|
|
|
||
4110 | Outlays, gross (total) | 6,911 | 8,262 | 5,954 |
4180 | Budget authority, net (total) | 5,918 | 5,584 | 5,954 |
4190 | Outlays, net (total) | 6,911 | 8,262 | 5,954 |
|
Section 1343 of the Patient Protection and Affordable Care Act (P.L. 111–148) established a permanent risk adjustment program for non-grandfathered plans in the individual and small group markets. Risk adjustment is budget neutral within each state and market, such that charges collected from plans with lower than average actuarial risk are used to make payments to plans with higher than average actuarial risk. Risk adjustment may be operated by a State, or by the Federal government in the event a State chooses not to operate risk adjustment. Payments and charges are made in the year following the plan year for which they are calculated.
Special and Trust Fund Receipts (in millions of dollars)
|
||||
Identification code 075–5735–0–2–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
0100 | Balance, start of year | 25 | ||
Receipts: | ||||
Current law: | ||||
1110 | Contributions, Transitional Reinsurance Program | 1 | ||
|
|
|
||
2000 | Total: Balances and receipts | 26 | ||
Appropriations: | ||||
Current law: | ||||
2101 | Transitional Reinsurance Program | –1 | ||
2103 | Transitional Reinsurance Program | –25 | ||
|
|
|
||
2199 | Total current law appropriations | –26 | ||
|
|
|
||
2999 | Total appropriations | –26 | ||
|
|
|
||
5099 | Balance, end of year | |||
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–5735–0–2–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Transitional reinsurance payments | 237 | ||
|
|
|
||
0900 | Total new obligations, unexpired accounts (object class 41.0) | 237 | ||
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 216 | 5 | 5 |
Budget authority: | ||||
Appropriations, mandatory: | ||||
1201 | Appropriation (special or trust fund) | 1 | ||
1203 | Appropriation (previously unavailable)(special or trust) | 25 | ||
|
|
|
||
1260 | Appropriations, mandatory (total) | 26 | ||
1930 | Total budgetary resources available | 242 | 5 | 5 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 5 | 5 | 5 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 10 | 212 | |
3010 | New obligations, unexpired accounts | 237 | ||
3020 | Outlays (gross) | –35 | –212 | |
|
|
|
||
3050 | Unpaid obligations, end of year | 212 | ||
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 10 | 212 | |
3200 | Obligated balance, end of year | 212 | ||
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 26 | ||
Outlays, gross: | ||||
4101 | Outlays from mandatory balances | 35 | 212 | |
4180 | Budget authority, net (total) | 26 | ||
4190 | Outlays, net (total) | 35 | 212 | |
|
Section 1341 of the Patient Protection and Affordable Care Act (P.L. 111–148) established a transitional three-year reinsurance program to minimize the impact of high-cost enrollees in plans in the individual market for plan years 2014, 2015, and 2016. The Centers for Medicare & Medicaid Services assessed contributing entities a per enrollee fee to fund the reinsurance program and made payments to issuers in the individual market for enrollees whose medical costs exceed a certain threshold, up to a reinsurance cap. Reinsurance collections and payments were made in the year following the plan year for which they were applicable. Reinsurance collections ended in FY 2019 and outlays in subsequent fiscal years reflect remaining payments, refunds, and allowable administrative activities.
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0524–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
Credit program obligations: | ||||
0705 | Reestimates of direct loan subsidy | 4 | ||
0709 | Administrative expenses | 1 | ||
|
|
|
||
0900 | Total new obligations, unexpired accounts (object class 41.0) | 5 | ||
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 1 | 2 | 2 |
1021 | Recoveries of prior year unpaid obligations | 1 | ||
|
|
|
||
1050 | Unobligated balance (total) | 2 | 2 | 2 |
Budget authority: | ||||
Appropriations, mandatory: | ||||
1200 | Appropriation | 5 | ||
1930 | Total budgetary resources available | 7 | 2 | 2 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 2 | 2 | 2 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 2 | 1 | 1 |
3010 | New obligations, unexpired accounts | 5 | ||
3020 | Outlays (gross) | –5 | ||
3040 | Recoveries of prior year unpaid obligations, unexpired | –1 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 1 | 1 | 1 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 2 | 1 | 1 |
3200 | Obligated balance, end of year | 1 | 1 | 1 |
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 5 | ||
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 5 | ||
4180 | Budget authority, net (total) | 5 | ||
4190 | Outlays, net (total) | 5 | ||
|
Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in millions of dollars)
|
||||
Identification code 075–0524–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct loan reestimates: | ||||
135001 | Startup Loans | 5 | ||
|
|
|
||
135999 | Total direct loan reestimates | 5 | ||
|
The Consumer Operated and Oriented Plan Contingency Fund was established by the American Taxpayer Relief Act of 2012 (P.L. 112–240). This fund provides assistance and oversight to qualified nonprofit health insurance issuers that have been awarded loans or grants under section 1322 of the Patient Protection and Affordable Care Act (P.L. 111–148).
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0118–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
Credit program obligations: | ||||
0705 | Reestimates of direct loan subsidy | 231 | 2 | |
0706 | Interest on reestimates of direct loan subsidy | 28 | ||
0709 | Administrative expenses | 1 | 1 | |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 260 | 3 | |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 1 | 1 | |
1021 | Recoveries of prior year unpaid obligations | 1 | ||
|
|
|
||
1050 | Unobligated balance (total) | 2 | 1 | |
Budget authority: | ||||
Appropriations, mandatory: | ||||
1200 | Appropriation | 259 | 2 | |
1900 | Budget authority (total) | 259 | 2 | |
1930 | Total budgetary resources available | 261 | 3 | |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 1 | ||
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 2 | 2 | 3 |
3010 | New obligations, unexpired accounts | 260 | 3 | |
3020 | Outlays (gross) | –259 | –2 | |
3040 | Recoveries of prior year unpaid obligations, unexpired | –1 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 2 | 3 | 3 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 2 | 2 | 3 |
3200 | Obligated balance, end of year | 2 | 3 | 3 |
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 259 | 2 | |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 259 | 2 | |
4180 | Budget authority, net (total) | 259 | 2 | |
4190 | Outlays, net (total) | 259 | 2 | |
|
Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in millions of dollars)
|
||||
Identification code 075–0118–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct loan reestimates: | ||||
135002 | Startup Loans | 116 | ||
135003 | Solvency Loans | 143 | 2 | |
|
|
|
||
135999 | Total direct loan reestimates | 259 | 2 | |
|
Section 1322 of the Patient Protection and Affordable Care Act (P.L. 111–148) authorized and appropriated funding for the Consumer Operated and Oriented Plan (CO-OP) Program. 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 awarded loans to qualified nonprofit issuers to fund start-up costs and reserves, which enabled qualified issuers to meet state solvency requirements. The Secretary issued the final round of loans in December 2014.
Object Classification (in millions of dollars)
|
||||
Identification code 075–0118–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
25.3 | Other goods and services from Federal sources | 1 | 1 | |
33.0 | Investments and loans | 2 | ||
41.0 | Grants, subsidies, and contributions | 259 | ||
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 260 | 3 | |
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–4418–0–3–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
Credit program obligations: | ||||
0713 | Payment of interest to Treasury | 7 | 3 | 3 |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 7 | 3 | 3 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 22 | 18 | 20 |
1020 | Adjustment of unobligated bal brought forward, Oct 1 | –13 | ||
|
|
|
||
1050 | Unobligated balance (total) | 9 | 18 | 20 |
Financing authority: | ||||
Borrowing authority, mandatory: | ||||
1400 | Borrowing authority | 3 | 2 | 2 |
Spending authority from offsetting collections, mandatory: | ||||
1800 | Collected | 272 | 41 | |
1825 | Spending authority from offsetting collections applied to repay debt | –259 | –38 | |
|
|
|
||
1850 | Spending auth from offsetting collections, mand (total) | 13 | 3 | |
1900 | Budget authority (total) | 16 | 5 | 2 |
1930 | Total budgetary resources available | 25 | 23 | 22 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 18 | 20 | 19 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 3 | ||
3010 | New obligations, unexpired accounts | 7 | 3 | 3 |
3020 | Outlays (gross) | –7 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 3 | 6 | |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 3 | ||
3200 | Obligated balance, end of year | 3 | 6 | |
|
||||
Financing authority and disbursements, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 16 | 5 | 2 |
Financing disbursements: | ||||
4110 | Outlays, gross (total) | 7 | ||
Offsets against gross financing authority and disbursements: | ||||
Offsetting collections (collected) from: | ||||
4120 | Federal sources | –259 | –2 | |
4122 | Interest on uninvested funds | –5 | –1 | |
4123 | Non-Federal sources | –8 | –38 | |
|
|
|
||
4130 | Offsets against gross budget authority and outlays (total) | –272 | –41 | |
|
|
|
||
4160 | Budget authority, net (mandatory) | –256 | –36 | 2 |
4170 | Outlays, net (mandatory) | –265 | –41 | |
4180 | Budget authority, net (total) | –256 | –36 | 2 |
4190 | Outlays, net (total) | –265 | –41 | |
|
Status of Direct Loans (in millions of dollars)
|
||||
Identification code 075–4418–0–3–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Cumulative balance of direct loans outstanding: | ||||
1210 | Outstanding, start of year | 1,893 | 1,893 | 1,893 |
1263 | Write-offs for default: Direct loans | –582 | ||
|
|
|
||
1290 | Outstanding, end of year | 1,893 | 1,893 | 1,311 |
|
Balance Sheet (in millions of dollars)
|
|||
Identification code 075–4418–0–3–551 | 2018 actual | 2019 actual | |
|
|||
Group heading | |||
ASSETS: | |||
Federal assets: | |||
1101 | Fund balances with Treasury | 9 | 9 |
Investments in U.S. securities: | |||
1106 | Receivables, net | 259 | 259 |
Net value of assets related to post-1991 direct loans receivable: | |||
1401 | Direct loans receivable, gross | 1,893 | 1,893 |
1402 | Interest receivable | 25 | 25 |
1405 | Allowance for subsidy cost (-) | –1,778 | –1,778 |
|
|
||
1499 | Net present value of assets related to direct loans | 140 | 140 |
|
|
||
1999 | Total assets | 408 | 408 |
LIABILITIES: | |||
2103 | Federal liabilities: Debt | 408 | 408 |
NET POSITION: | |||
3300 | Cumulative results of operations | ||
|
|
||
4999 | Total liabilities and net position | 408 | 408 |
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–4482–0–3–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
Credit program obligations: | ||||
0713 | Payment of interest to Treasury | 2 | 1 | 1 |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 2 | 1 | 1 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 8 | 5 | 6 |
1020 | Adjustment of unobligated bal brought forward, Oct 1 | –3 | ||
1023 | Unobligated balances applied to repay debt | –2 | ||
|
|
|
||
1050 | Unobligated balance (total) | 3 | 5 | 6 |
Financing authority: | ||||
Borrowing authority, mandatory: | ||||
1400 | Borrowing authority | 3 | 1 | 1 |
Spending authority from offsetting collections, mandatory: | ||||
1800 | Collected | 6 | 1 | |
1825 | Spending authority from offsetting collections applied to repay debt | –5 | ||
|
|
|
||
1850 | Spending auth from offsetting collections, mand (total) | 1 | 1 | |
1900 | Budget authority (total) | 4 | 2 | 1 |
1930 | Total budgetary resources available | 7 | 7 | 7 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 5 | 6 | 6 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 1 | ||
3010 | New obligations, unexpired accounts | 2 | 1 | 1 |
3020 | Outlays (gross) | –2 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 1 | 2 | |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 1 | ||
3200 | Obligated balance, end of year | 1 | 2 | |
|
||||
Financing authority and disbursements, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 4 | 2 | 1 |
Financing disbursements: | ||||
4110 | Outlays, gross (total) | 2 | ||
Offsets against gross financing authority and disbursements: | ||||
Offsetting collections (collected) from: | ||||
4120 | Federal sources | –5 | ||
4123 | Non-Federal sources | –1 | –1 | |
|
|
|
||
4130 | Offsets against gross budget authority and outlays (total) | –6 | –1 | |
|
|
|
||
4160 | Budget authority, net (mandatory) | –2 | 1 | 1 |
4170 | Outlays, net (mandatory) | –4 | –1 | |
4180 | Budget authority, net (total) | –2 | 1 | 1 |
4190 | Outlays, net (total) | –4 | –1 | |
|
Status of Direct Loans (in millions of dollars)
|
||||
Identification code 075–4482–0–3–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Cumulative balance of direct loans outstanding: | ||||
1210 | Outstanding, start of year | 480 | 480 | 480 |
1263 | Write-offs for default: Direct loans | –139 | ||
|
|
|
||
1290 | Outstanding, end of year | 480 | 480 | 341 |
|
Balance Sheet (in millions of dollars)
|
|||
Identification code 075–4482–0–3–551 | 2018 actual | 2019 actual | |
|
|||
ASSETS: | |||
Federal assets: | |||
1101 | Fund balances with Treasury | 5 | 5 |
Investments in U.S. securities: | |||
1106 | Receivables, net | 5 | 5 |
1206 | Non-Federal assets: Receivables, net | ||
Net value of assets related to post-1991 direct loans receivable: | |||
1401 | Direct loans receivable, gross | 480 | 480 |
1402 | Interest receivable | 5 | 5 |
1405 | Allowance for subsidy cost (-) | –429 | –429 |
|
|
||
1499 | Net present value of assets related to direct loans | 56 | 56 |
|
|
||
1999 | Total assets | 66 | 66 |
LIABILITIES: | |||
Federal liabilities: | |||
2103 | Debt | 65 | 65 |
2104 | Resources payable to Treasury | ||
2207 | Non-Federal liabilities: Other | ||
|
|
||
2999 | Total liabilities | 65 | 65 |
NET POSITION: | |||
3300 | Cumulative results of operations | 1 | 1 |
|
|
||
4999 | Total liabilities and net position | 66 | 66 |
|
Special and Trust Fund Receipts (in millions of dollars)
|
||||
Identification code 075–8005–0–7–571 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
0100 | Balance, start of year | 164,161 | 156,175 | 146,288 |
Receipts: | ||||
Current law: | ||||
1110 | FHI Trust Fund, Transfers from General Fund (FICA Taxes) | 258,083 | 271,553 | 286,235 |
1110 | FHI Trust Fund, Receipts from Railroad Retirement Board | 610 | 586 | 619 |
1110 | FHI Trust Fund, Transfers from General Fund (SECA Taxes) | 18,879 | 20,005 | 21,268 |
1110 | FHI Trust Fund, Civil Penalties and Damages | 815 | 614 | 575 |
1130 | FHI Trust Fund, Other Proprietary Interest from the Public | 2 | 2 | |
1130 | FHI Trust Fund, Basic Premium, Medicare Advantage | 387 | 511 | 573 |
1130 | FHI Trust Fund, Medicare Refunds | 6,231 | 6,100 | 6,150 |
1130 | Affordable Care Act Medicare Shared Savings Models (HI) | 79 | 48 | 48 |
1130 | FHI Trust Fund, Premiums Collected for Uninsured Individuals not Otherwise Eligible | 3,823 | 4,207 | 4,511 |
1140 | FHI Trust Fund, Federal Employer Contributions (FICA) | 3,817 | 4,060 | 4,219 |
1140 | FHI Trust Fund, Postal Service Employer Contributions (FICA) | 662 | 661 | 660 |
1140 | FHI Trust Fund, Interest Received by Trust Funds | 6,927 | 6,129 | 5,688 |
1140 | FHI Trust Fund, Taxation on OASDI Benefits | 23,781 | 26,941 | 29,300 |
1140 | FHI Trust Fund, Payment from the General Fund for Health Care Fraud and Abuse Control Account | 138 | 135 | 138 |
1140 | FHI Trust Fund, Transfers from General Fund (criminal Fines) | 15 | 88 | 36 |
1140 | FHI Trust Fund, Transfers from General Fund (civil Monetary Penalties) | 64 | 52 | 52 |
1140 | FHI Trust Fund, Transfers from General Fund (asset Forfeitures) | 37 | 31 | 32 |
1140 | FHI Trust Fund, Interest Payments by Railroad Retirement Board | 24 | 23 | 22 |
1140 | FHI Trust Fund, Payments from the General Fund (uninsured and Program Management) | 1,177 | 1,293 | 1,306 |
|
|
|
||
1199 | Total current law receipts | 325,549 | 343,039 | 361,434 |
Proposed: | ||||
1210 | FHI Trust Fund, Transfers from General Fund (FICA Taxes) | –83 | ||
1230 | FHI Trust Fund, Premiums Collected for Uninsured Individuals not Otherwise Eligible | –235 | ||
1240 | FHI Trust Fund, Interest Received by Trust Funds | 247 | ||
1240 | FHI Trust Fund, Transfers from General Fund (civil Monetary Penalties) | 2 | ||
|
|
|
||
1299 | Total proposed receipts | –69 | ||
|
|
|
||
1999 | Total receipts | 325,549 | 343,039 | 361,365 |
|
|
|
||
2000 | Total: Balances and receipts | 489,710 | 499,214 | 507,653 |
Appropriations: | ||||
Current law: | ||||
2101 | Federal Hospital Insurance Trust Fund | –3,039 | –2,689 | –2,789 |
2101 | Federal Hospital Insurance Trust Fund | –320,420 | –338,930 | –357,148 |
2101 | Health Care Fraud and Abuse Control Account | –765 | –786 | –813 |
2101 | Health Care Fraud and Abuse Control Account | –1,380 | –1,406 | –1,427 |
2103 | Federal Hospital Insurance Trust Fund | –14,649 | –9,153 | –15,814 |
2132 | Federal Hospital Insurance Trust Fund | 6,636 | ||
2132 | Health Care Fraud and Abuse Control Account | 49 | 49 | |
|
|
|
||
2199 | Total current law appropriations | –333,568 | –352,915 | –377,991 |
Proposed: | ||||
2201 | Federal Hospital Insurance Trust Fund | –247 | ||
2201 | Federal Hospital Insurance Trust Fund | 235 | ||
2203 | Federal Hospital Insurance Trust Fund | –11 | ||
2234 | Federal Hospital Insurance Trust Fund | 16,932 | ||
|
|
|
||
2299 | Total proposed appropriations | –11 | 16,920 | |
|
|
|
||
2999 | Total appropriations | –333,568 | –352,926 | –361,071 |
3098 | Federal Hospital Insurance Trust Fund | 33 | ||
|
|
|
||
5099 | Balance, end of year | 156,175 | 146,288 | 146,582 |
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–8005–0–7–571 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Benefit payments, HI | 326,346 | 346,980 | 372,418 |
0002 | HIT Incentive Payments | 44 | 15 | 10 |
0003 | Administration, HI | 4,456 | 2,871 | 2,983 |
0004 | Quality improvement organizations, HI | 636 | 907 | 340 |
|
|
|
||
0799 | Total direct obligations | 331,482 | 350,773 | 375,751 |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 331,482 | 350,773 | 375,751 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 1 | ||
1001 | Discretionary unobligated balance brought fwd, Oct 1 | 1 | ||
1021 | Recoveries of prior year unpaid obligations | 39 | ||
1026 | Adjustment for change in allocation of trust fund limitation or foreign exchange valuation | –33 | ||
1033 | Recoveries of prior year paid obligations | 5 | ||
|
|
|
||
1050 | Unobligated balance (total) | 11 | 1 | |
Budget authority: | ||||
Appropriations, discretionary: | ||||
1101 | Appropriation (special or trust) | 3,039 | 2,689 | 2,789 |
Appropriations, mandatory: | ||||
1201 | Appropriation (special or trust fund) | 320,420 | 338,930 | 357,148 |
1203 | Appropriation (previously unavailable)(special or trust) | 14,649 | 9,153 | 15,814 |
1232 | Appropriations and/or unobligated balance of appropriations temporarily reduced (Sequester) | –6,636 | ||
|
|
|
||
1260 | Appropriations, mandatory (total) | 328,433 | 348,083 | 372,962 |
1900 | Budget authority (total) | 331,472 | 350,772 | 375,751 |
1930 | Total budgetary resources available | 331,483 | 350,773 | 375,751 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 1 | ||
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 36,686 | 40,274 | 40,867 |
3001 | Adjustments to unpaid obligations, brought forward, Oct 1 | 5 | ||
3010 | New obligations, unexpired accounts | 331,482 | 350,773 | 375,751 |
3020 | Outlays (gross) | –327,860 | –350,180 | –375,341 |
3040 | Recoveries of prior year unpaid obligations, unexpired | –39 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 40,274 | 40,867 | 41,277 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 36,691 | 40,274 | 40,867 |
3200 | Obligated balance, end of year | 40,274 | 40,867 | 41,277 |
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
4000 | Budget authority, gross | 3,039 | 2,689 | 2,789 |
Outlays, gross: | ||||
4010 | Outlays from new discretionary authority | 1,883 | 1,469 | 1,551 |
4011 | Outlays from discretionary balances | 1,062 | 494 | 697 |
|
|
|
||
4020 | Outlays, gross (total) | 2,945 | 1,963 | 2,248 |
Mandatory: | ||||
4090 | Budget authority, gross | 328,433 | 348,083 | 372,962 |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 292,819 | 311,142 | 339,784 |
4101 | Outlays from mandatory balances | 32,096 | 37,075 | 33,309 |
|
|
|
||
4110 | Outlays, gross (total) | 324,915 | 348,217 | 373,093 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4123 | Non-Federal sources | –5 | ||
Additional offsets against gross budget authority only: | ||||
4143 | Recoveries of prior year paid obligations, unexpired accounts | 5 | ||
|
|
|
||
4160 | Budget authority, net (mandatory) | 328,433 | 348,083 | 372,962 |
4170 | Outlays, net (mandatory) | 324,910 | 348,217 | 373,093 |
4180 | Budget authority, net (total) | 331,472 | 350,772 | 375,751 |
4190 | Outlays, net (total) | 327,855 | 350,180 | 375,341 |
|
||||
Memorandum (non-add) entries: | ||||
5000 | Total investments, SOY: Federal securities: Par value | 202,805 | 198,625 | 189,516 |
5001 | Total investments, EOY: Federal securities: Par value | 198,625 | 189,516 | 189,717 |
|
Summary of Budget Authority and Outlays (in millions of dollars)
|
||||
2019 actual | 2020 est. | 2021 est. | ||
|
||||
Enacted/requested: | ||||
Budget Authority | 331,472 | 350,772 | 375,751 | |
Outlays | 327,855 | 350,180 | 375,341 | |
Legislative proposal, subject to PAYGO: | ||||
Budget Authority | 11 | –17,167 | ||
Outlays | 11 | –17,167 | ||
Total: | ||||
Budget Authority | 331,472 | 350,783 | 358,584 | |
Outlays | 327,855 | 350,191 | 358,174 | |
|
The Hospital Insurance (HI) program funds the costs of hospital and related care for individuals age 65 or older and for eligible disabled persons.
Status of Funds (in millions of dollars)
|
||||
Identification code 075–8005–0–7–571 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Unexpended balance, start of year: | ||||
0100 | Balance, start of year | 203,227 | 198,894 | 189,672 |
0298 | Adjustment to reconcile to proprietary accounting | 1 | ||
|
|
|
||
0999 | Total balance, start of year | 203,228 | 198,894 | 189,672 |
Cash income during the year: | ||||
Current law: | ||||
Receipts: | ||||
1110 | FHI Trust Fund, Transfers from General Fund (FICA Taxes) | 258,083 | 271,553 | 286,235 |
1110 | FHI Trust Fund, Receipts from Railroad Retirement Board | 610 | 586 | 619 |
1110 | FHI Trust Fund, Transfers from General Fund (SECA Taxes) | 18,879 | 20,005 | 21,268 |
1110 | FHI Trust Fund, Civil Penalties and Damages | 815 | 614 | 575 |
1130 | FHI Trust Fund, Basic Premium, Medicare Advantage | 387 | 511 | 573 |
1130 | FHI Trust Fund, Medicare Refunds | 6,231 | 6,100 | 6,150 |
1130 | Affordable Care Act Medicare Shared Savings Models (HI) | 79 | 48 | 48 |
1130 | FHI Trust Fund, Premiums Collected for Uninsured Individuals not Otherwise Eligible | 3,823 | 4,207 | 4,511 |
1130 | Federal Hospital Insurance Trust Fund | 5 | ||
1150 | FHI Trust Fund, Interest Received by Trust Funds | 6,927 | 6,129 | 5,688 |
1150 | FHI Trust Fund, Other Proprietary Interest from the Public | 2 | 2 | |
1150 | FHI Trust Fund, Interest Payments by Railroad Retirement Board | 24 | 23 | 22 |
1160 | FHI Trust Fund, Federal Employer Contributions (FICA) | 3,817 | 4,060 | 4,219 |
1160 | FHI Trust Fund, Postal Service Employer Contributions (FICA) | 662 | 661 | 660 |
1160 | FHI Trust Fund, Taxation on OASDI Benefits | 23,781 | 26,941 | 29,300 |
1160 | FHI Trust Fund, Payment from the General Fund for Health Care Fraud and Abuse Control Account | 138 | 135 | 138 |
1160 | FHI Trust Fund, Transfers from General Fund (criminal Fines) | 15 | 88 | 36 |
1160 | FHI Trust Fund, Transfers from General Fund (civil Monetary Penalties) | 64 | 52 | 52 |
1160 | FHI Trust Fund, Transfers from General Fund (asset Forfeitures) | 37 | 31 | 32 |
1160 | FHI Trust Fund, Payments from the General Fund (uninsured and Program Management) | 1,177 | 1,293 | 1,306 |
|
|
|
||
1199 | Income under present law | 325,554 | 343,039 | 361,434 |
Proposed: | ||||
1210 | FHI Trust Fund, Transfers from General Fund (FICA Taxes) | |||
1210 | FHI Trust Fund, Transfers from General Fund (FICA Taxes) | –83 | ||
Offsetting receipts (proprietary): | ||||
1230 | FHI Trust Fund, Premiums Collected for Uninsured Individuals not Otherwise Eligible | –235 | ||
1250 | FHI Trust Fund, Interest Received by Trust Funds | 247 | ||
Offsetting governmental receipts: | ||||
1260 | FHI Trust Fund, Transfers from General Fund (civil Monetary Penalties) | 2 | ||
|
|
|
||
1299 | Income proposed | –69 | ||
|
|
|
||
1999 | Total cash income | 325,554 | 343,039 | 361,365 |
Cash outgo during year: | ||||
Current law: | ||||
2100 | Federal Hospital Insurance Trust Fund [Budget Acct] | –327,860 | –350,180 | –375,341 |
2100 | Health Care Fraud and Abuse Control Account [Budget Acct] | –1,965 | –2,070 | –2,156 |
|
|
|
||
2199 | Outgo under current law | –329,825 | –352,250 | –377,497 |
Proposed: | ||||
2200 | Federal Hospital Insurance Trust Fund | –11 | 17,167 | |
|
|
|
||
2299 | Outgo under proposed legislation | –11 | 17,167 | |
|
|
|
||
2999 | Total cash outgo (-) | –329,825 | –352,261 | –360,330 |
Surplus or deficit: | ||||
3110 | Excluding interest | –11,222 | –15,376 | –4,924 |
3120 | Interest | 6,951 | 6,154 | 5,959 |
|
|
|
||
3199 | Subtotal, surplus or deficit | –4,271 | –9,222 | 1,035 |
3298 | Adjustment to reconcile to proprietary accounting | –63 | ||
|
|
|
||
3299 | Total adjustments | –63 | ||
|
|
|
||
3999 | Total change in fund balance | –4,334 | –9,222 | 1,035 |
Unexpended balance, end of year: | ||||
4100 | Uninvested balance (net), end of year | 269 | 156 | 990 |
4200 | Federal Hospital Insurance Trust Fund | 198,625 | 189,516 | 189,717 |
|
|
|
||
4999 | Total balance, end of year | 198,894 | 189,672 | 190,707 |
|
Object Classification (in millions of dollars)
|
||||
Identification code 075–8005–0–7–571 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
41.0 | Payment for Quality Improvement Organization (QIO) activities | 636 | 907 | 340 |
42.0 | Insurance claims and indemnities (benefits) | 326,390 | 346,995 | 372,428 |
94.0 | Financial transfers | 4,456 | 2,871 | 2,983 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 331,482 | 350,773 | 375,751 |
|
Employment Summary
|
||||
Identification code 075–8005–0–7–571 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 1 | 1 | 1 |
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–8005–2–7–571 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Budgetary resources: | ||||
Budget authority: | ||||
Appropriations, mandatory: | ||||
1201 | Appropriation (special or trust fund) | 247 | ||
1235 | Appropriations precluded from obligation (special or trust) | –247 | ||
4180 | Budget authority, net (total) | |||
4190 | Outlays, net (total) | |||
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–8005–4–7–571 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Benefit payments, HI | –17,185 | ||
0003 | Administration, HI | 11 | 18 | |
|
|
|
||
0799 | Total direct obligations | 11 | –17,167 | |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 11 | –17,167 | |
|
||||
Budgetary resources: | ||||
Budget authority: | ||||
Appropriations, mandatory: | ||||
1201 | Appropriation (special or trust fund) | –235 | ||
1203 | Appropriation (previously unavailable)(special or trust) | 11 | ||
1234 | Appropriations precluded from obligation | –16,932 | ||
|
|
|
||
1260 | Appropriations, mandatory (total) | 11 | –17,167 | |
1900 | Budget authority (total) | 11 | –17,167 | |
1930 | Total budgetary resources available | 11 | –17,167 | |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3010 | New obligations, unexpired accounts | 11 | –17,167 | |
3020 | Outlays (gross) | –11 | 17,167 | |
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 11 | –17,167 | |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 11 | –17,167 | |
4180 | Budget authority, net (total) | 11 | –17,167 | |
4190 | Outlays, net (total) | 11 | –17,167 | |
|
The Budget includes a package of Medicare proposals designed to eliminate wasteful spending, preserve and expand beneficiary access to care, enhance choice and competition, and strengthen Medicare's fiscal sustainability, consistent with the President's Executive Order on Protecting and Improving Medicare for Our Nation's Seniors.
Object Classification (in millions of dollars)
|
||||
Identification code 075–8005–4–7–571 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
42.0 | Insurance claims and indemnities (benefits) | –17,185 | ||
94.0 | Financial transfers | 11 | 18 | |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 11 | –17,167 | |
|
In addition to amounts otherwise available for program integrity and program management, $813,000,000, to remain available through September 30, 2022, 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 $628,356,426 shall be for the Centers for Medicare & Medicaid Services program integrity activities, of which $101,643,574 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 $83,000,000 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 2021 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: Provided further, That of the amount provided under this heading, $311,000,000 is provided to meet the terms of section 251(b)(2)(C)(ii) of the Balanced Budget and Emergency Deficit Control Act of 1985, as amended, and $496,000,000 is additional new budget authority specified for purposes of section 251(b)(2)(C) of such Act: Provided further, That amounts made available under this heading and amounts made available for fiscal year 2021 in section 1817(k)(3)(A) of the Social Security Act shall also be available for the Senior Medicare Patrol Program to combat health care fraud and abuse.
(Department of Health and Human Services Appropriations Act, 2020.)
Program and Financing (in millions of dollars)
|
||||
Identification code 075–8393–0–7–571 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Medicare integrity program | 887 | 915 | 949 |
0002 | FBI fraud and abuse control | 138 | 141 | 154 |
0003 | Other fraud and abuse control | 285 | 301 | 324 |
0005 | Undistributed Savings, HCFAC and SSA | –31 | –210 | |
|
|
|
||
0091 | Total Mandatory | 1,310 | 1,326 | 1,217 |
0101 | CMS discretionary | 554 | 610 | 628 |
0102 | Other discretionary | 166 | 176 | 185 |
|
|
|
||
0191 | Total Discretionary | 720 | 786 | 813 |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 2,030 | 2,112 | 2,030 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 471 | 574 | 605 |
1001 | Discretionary unobligated balance brought fwd, Oct 1 | 201 | 574 | |
1021 | Recoveries of prior year unpaid obligations | 41 | ||
|
|
|
||
1050 | Unobligated balance (total) | 512 | 574 | 605 |
Budget authority: | ||||
Appropriations, discretionary: | ||||
1101 | Appropriation (special or trust) | 765 | 786 | 813 |
Appropriations, mandatory: | ||||
1201 | Appropriation (special or trust fund) | 1,380 | 1,406 | 1,427 |
1232 | Appropriations and/or unobligated balance of appropriations temporarily reduced | –49 | –49 | |
|
|
|
||
1260 | Appropriations, mandatory (total) | 1,331 | 1,357 | 1,427 |
1900 | Budget authority (total) | 2,096 | 2,143 | 2,240 |
1930 | Total budgetary resources available | 2,608 | 2,717 | 2,845 |
Memorandum (non-add) entries: | ||||
1940 | Unobligated balance expiring | –4 | ||
1941 | Unexpired unobligated balance, end of year | 574 | 605 | 815 |
Special and non-revolving trust funds: | ||||
1951 | Unobligated balance expiring | 4 | ||
1952 | Expired unobligated balance, start of year | 31 | 36 | 36 |
1953 | Expired unobligated balance, end of year | 32 | 36 | 36 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 1,970 | 1,977 | 2,019 |
3010 | New obligations, unexpired accounts | 2,030 | 2,112 | 2,030 |
3020 | Outlays (gross) | –1,965 | –2,070 | –2,156 |
3040 | Recoveries of prior year unpaid obligations, unexpired | –41 | ||
3041 | Recoveries of prior year unpaid obligations, expired | –17 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 1,977 | 2,019 | 1,893 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 1,970 | 1,977 | 2,019 |
3200 | Obligated balance, end of year | 1,977 | 2,019 | 1,893 |
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
4000 | Budget authority, gross | 765 | 786 | 813 |
Outlays, gross: | ||||
4010 | Outlays from new discretionary authority | 107 | 314 | 325 |
4011 | Outlays from discretionary balances | 601 | 109 | 353 |
|
|
|
||
4020 | Outlays, gross (total) | 708 | 423 | 678 |
Mandatory: | ||||
4090 | Budget authority, gross | 1,331 | 1,357 | 1,427 |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 415 | 689 | 608 |
4101 | Outlays from mandatory balances | 842 | 958 | 870 |
|
|
|
||
4110 | Outlays, gross (total) | 1,257 | 1,647 | 1,478 |
4180 | Budget authority, net (total) | 2,096 | 2,143 | 2,240 |
4190 | Outlays, net (total) | 1,965 | 2,070 | 2,156 |
|
The Health Insurance Portability and Accountability Act of 1996 (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.
The Budget includes a discretionary request for efforts to safeguard Centers for Medicare and Medicaid Services (CMS) program integrity that will supplement other CMS program integrity funds. See additional discussion in the Budget Process chapter in the Analytical Perspectives volume.
Object Classification (in millions of dollars)
|
||||
Identification code 075–8393–0–7–571 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
Personnel compensation: | ||||
11.1 | Full-time permanent (CMS) | 42 | 46 | 46 |
11.7 | Military personnel | 2 | 2 | 2 |
|
|
|
||
11.9 | Total personnel compensation | 44 | 48 | 48 |
12.1 | Civilian personnel benefits (CMS) | 10 | 11 | 11 |
12.2 | Military personnel benefits | 1 | 2 | 1 |
23.3 | Communications, utilities, and miscellaneous charges | 11 | 13 | 13 |
25.2 | Other services (CMS/Medicaid/Private Insurance) | 109 | ||
25.3 | Other purchases of goods and services from Government accounts (HHS/DOJ) | 140 | 145 | 150 |
25.3 | Other purchases of goods and services from Government accounts (HHS/OIG) | 298 | 303 | 327 |
25.3 | Other purchases of goods and services from Government accounts (HHS/OGC) | 7 | 7 | 7 |
25.3 | Other goods and services from Federal sources (HHS/CMS) | 15 | 18 | |
25.3 | Other goods and services from Government accounts (HHS/FDA) | 6 | 6 | 6 |
25.6 | Medical care (CMS) | 1,266 | 1,452 | 1,505 |
92.0 | Undistributed | –31 | –210 | |
94.0 | Financial transfers (FBI) | 138 | 141 | 154 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 2,030 | 2,112 | 2,030 |
|
Employment Summary
|
||||
Identification code 075–8393–0–7–571 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 410 | 430 | 430 |
1101 | Direct military average strength employment | 16 | 16 | 16 |
|
Special and Trust Fund Receipts (in millions of dollars)
|
||||
Identification code 075–8004–0–7–571 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
0100 | Balance, start of year | 67,416 | 67,661 | 67,581 |
0198 | Adjustment to reconcile to budgetary accounting | –580 | ||
|
|
|
||
0199 | Balance, start of year | 66,836 | 67,661 | 67,581 |
Receipts: | ||||
Current law: | ||||
1110 | Fee on Branded Prescription Pharmaceutical Manufacturers and Importers, SMI | 2,437 | 2,800 | 2,800 |
1130 | Other Proprietary Interest from the Public, FSMI Fund | 3 | 3 | |
1130 | Premiums Collected for Medicare Prescription Drug Account, FSMI | 5,542 | 5,780 | 6,338 |
1130 | Payments from States, Medicare Prescription Drug Account, FSMI | 12,154 | 12,478 | 13,255 |
1130 | Basic Premium, Medicare Advantage, FSMI Trust Fund | 486 | 639 | 725 |
1130 | Medicare Refunds, SMI | 4,961 | 5,011 | 5,061 |
1130 | Affordable Care Act Medicare Shared Savings Models, SMI | 72 | 45 | 45 |
1130 | Premiums Collected for the Aged, FSMI Fund | 84,468 | 95,004 | 101,235 |
1130 | Premiums Collected for the Disabled, FSMI Fund | 13,290 | 13,409 | 13,683 |
1140 | Federal Contributions, FSMI Fund | 265,819 | 287,016 | 300,234 |
1140 | Interest Received by Trust Fund, FSMI Fund | 2,657 | 1,182 | 1,333 |
1140 | Federal Contribution, State Low-income Determinations, Prescription Drug Account, FSMI | 5 | 5 | |
1140 | Interest, Medicare Prescription Drug Account, FSMI | 65 | 48 | 51 |
1140 | Federal Contribution for Admin. Contribution for Admin. Costs, Prescription Drug Account, FSMI | 1,196 | 861 | 882 |
1140 | Federal Contributions for Benefits, Prescription Drug Account, SMI | 66,687 | 71,172 | 84,003 |
1140 | Miscellaneous Federal Payments, Federal Supplementary Medical Insurance Trust Fund | 1 | 1 | 1 |
|
|
|
||
1199 | Total current law receipts | 459,835 | 495,454 | 529,654 |
Proposed: | ||||
1230 | Premiums Collected for the Aged, FSMI Fund | –2,186 | ||
1230 | Premiums Collected for the Disabled, FSMI Fund | –295 | ||
1240 | Federal Contributions, FSMI Fund | –7,383 | ||
|
|
|
||
1299 | Total proposed receipts | –9,864 | ||
|
|
|
||
1999 | Total receipts | 459,835 | 495,454 | 519,790 |
|
|
|
||
2000 | Total: Balances and receipts | 526,671 | 563,115 | 587,371 |
Appropriations: | ||||
Current law: | ||||
2101 | Federal Supplementary Medical Insurance Trust Fund | –2,998 | –3,141 | –3,101 |
2101 | Federal Supplementary Medical Insurance Trust Fund | –371,197 | –399,303 | –422,011 |
2101 | Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund | –641 | –861 | –882 |
2101 | Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund | –84,998 | –89,915 | –102,850 |
2103 | Federal Supplementary Medical Insurance Trust Fund | –5,987 | –2,301 | –5,492 |
2132 | Federal Supplementary Medical Insurance Trust Fund | 7,317 | ||
|
|
|
||
2199 | Total current law appropriations | –458,504 | –495,521 | –534,336 |
Proposed: | ||||
2201 | Federal Supplementary Medical Insurance Trust Fund | 7,383 | ||
2201 | Federal Supplementary Medical Insurance Trust Fund | 2,481 | ||
2203 | Federal Supplementary Medical Insurance Trust Fund | –7,383 | ||
2203 | Federal Supplementary Medical Insurance Trust Fund | –13 | –20 | |
2234 | Federal Supplementary Medical Insurance Trust Fund | 7,384 | ||
|
|
|
||
2299 | Total proposed appropriations | –13 | 9,845 | |
|
|
|
||
2999 | Total appropriations | –458,504 | –495,534 | –524,491 |
3098 | Federal Supplementary Medical Insurance Trust Fund | –41 | ||
5098 | Adjustment to reconcile to budgetary accounting | –465 | ||
|
|
|
||
5099 | Balance, end of year | 67,661 | 67,581 | 62,880 |
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–8004–0–7–571 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Benefit payments, SMI | 371,048 | 398,010 | 425,125 |
0002 | Transfer to Medicaid for payment of SMI premiums | 1,142 | 1,249 | |
0004 | Administration, SMI | 3,133 | 3,101 | |
0005 | Quality Improvement Organizations, SMI | 436 | 163 | |
|
|
|
||
0799 | Total direct obligations | 371,048 | 402,721 | 429,638 |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 371,048 | 402,721 | 429,638 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 34 | ||
1021 | Recoveries of prior year unpaid obligations | 9 | ||
1026 | Adjustment for change in allocation of trust fund limitation or foreign exchange valuation | 41 | ||
1033 | Recoveries of prior year paid obligations | 5 | ||
|
|
|
||
1050 | Unobligated balance (total) | 55 | 34 | |
Budget authority: | ||||
Appropriations, discretionary: | ||||
1101 | Appropriation (special or trust) | 2,998 | 3,141 | 3,101 |
Appropriations, mandatory: | ||||
1201 | Appropriation (special or trust fund) | 371,197 | 399,303 | 422,011 |
1203 | Appropriation (previously unavailable)(special or trust) | 5,987 | 2,301 | 5,492 |
1232 | Appropriations and/or unobligated balance of appropriations temporarily reduced | –7,317 | ||
1236 | Appropriations applied to repay debt | –1,872 | –1,990 | –1,000 |
|
|
|
||
1260 | Appropriations, mandatory (total) | 367,995 | 399,614 | 426,503 |
1900 | Budget authority (total) | 370,993 | 402,755 | 429,604 |
1930 | Total budgetary resources available | 371,048 | 402,755 | 429,638 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 34 | ||
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 27,919 | 31,871 | 32,154 |
3001 | Adjustments to unpaid obligations, brought forward, Oct 1 | 505 | ||
3010 | New obligations, unexpired accounts | 371,048 | 402,721 | 429,638 |
3020 | Outlays (gross) | –367,592 | –402,438 | –429,533 |
3040 | Recoveries of prior year unpaid obligations, unexpired | –9 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 31,871 | 32,154 | 32,259 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 28,424 | 31,871 | 32,154 |
3200 | Obligated balance, end of year | 31,871 | 32,154 | 32,259 |
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
4000 | Budget authority, gross | 2,998 | 3,141 | 3,101 |
Outlays, gross: | ||||
4010 | Outlays from new discretionary authority | 1,691 | 2,074 | 2,118 |
4011 | Outlays from discretionary balances | 1,317 | 442 | 691 |
|
|
|
||
4020 | Outlays, gross (total) | 3,008 | 2,516 | 2,809 |
Mandatory: | ||||
4090 | Budget authority, gross | 367,995 | 399,614 | 426,503 |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 339,640 | 369,426 | 395,419 |
4101 | Outlays from mandatory balances | 24,944 | 30,496 | 31,305 |
|
|
|
||
4110 | Outlays, gross (total) | 364,584 | 399,922 | 426,724 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4123 | Non-Federal sources | –5 | ||
Additional offsets against gross budget authority only: | ||||
4143 | Recoveries of prior year paid obligations, unexpired accounts | 5 | ||
|
|
|
||
4160 | Budget authority, net (mandatory) | 367,995 | 399,614 | 426,503 |
4170 | Outlays, net (mandatory) | 364,579 | 399,922 | 426,724 |
4180 | Budget authority, net (total) | 370,993 | 402,755 | 429,604 |
4190 | Outlays, net (total) | 367,587 | 402,438 | 429,533 |
|
||||
Memorandum (non-add) entries: | ||||
5000 | Total investments, SOY: Federal securities: Par value | 98,197 | 104,716 | 105,611 |
5001 | Total investments, EOY: Federal securities: Par value | 104,716 | 105,611 | 102,161 |
5080 | Outstanding debt, SOY | –5,024 | –3,152 | –1,162 |
5081 | Outstanding debt, EOY | –3,152 | –1,162 | –162 |
|
Summary of Budget Authority and Outlays (in millions of dollars)
|
||||
2019 actual | 2020 est. | 2021 est. | ||
|
||||
Enacted/requested: | ||||
Budget Authority | 370,993 | 402,755 | 429,604 | |
Outlays | 367,587 | 402,438 | 429,533 | |
Legislative proposal, subject to PAYGO: | ||||
Budget Authority | 13 | –9,845 | ||
Outlays | 13 | –9,845 | ||
Total: | ||||
Budget Authority | 370,993 | 402,768 | 419,759 | |
Outlays | 367,587 | 402,451 | 419,688 | |
|
The Supplementary Medical Insurance (SMI) program is a voluntary program that affords protection against the costs of physician care 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.
Status of Funds (in millions of dollars)
|
||||
Identification code 075–8004–0–7–571 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Unexpended balance, start of year: | ||||
0100 | Balance, start of year | 96,946 | 104,053 | 109,261 |
|
|
|
||
0999 | Total balance, start of year | 96,946 | 104,053 | 109,261 |
Cash income during the year: | ||||
Current law: | ||||
Receipts: | ||||
1110 | Fee on Branded Prescription Pharmaceutical Manufacturers and Importers, SMI | 2,437 | 2,800 | 2,800 |
1130 | Premiums Collected for Medicare Prescription Drug Account, FSMI | 5,542 | 5,780 | 6,338 |
1130 | Payments from States, Medicare Prescription Drug Account, FSMI | 12,154 | 12,478 | 13,255 |
1130 | Basic Premium, Medicare Advantage, FSMI Trust Fund | 486 | 639 | 725 |
1130 | Medicare Refunds, SMI | 4,961 | 5,011 | 5,061 |
1130 | Affordable Care Act Medicare Shared Savings Models, SMI | 72 | 45 | 45 |
1130 | Premiums Collected for the Aged, FSMI Fund | 84,468 | 95,004 | 101,235 |
1130 | Premiums Collected for the Disabled, FSMI Fund | 13,290 | 13,409 | 13,683 |
1130 | Federal Supplementary Medical Insurance Trust Fund | 5 | ||
1150 | Interest Received by Trust Fund, FSMI Fund | 2,657 | 1,182 | 1,333 |
1150 | Other Proprietary Interest from the Public, FSMI Fund | 3 | 3 | |
1150 | Interest, Medicare Prescription Drug Account, FSMI | 65 | 48 | 51 |
1160 | Federal Contributions, FSMI Fund | 265,819 | 287,016 | 300,234 |
1160 | Federal Contribution, State Low-income Determinations, Prescription Drug Account, FSMI | 5 | 5 | |
1160 | Federal Contribution for Admin. Contribution for Admin. Costs, Prescription Drug Account, FSMI | 1,196 | 861 | 882 |
1160 | Federal Contributions for Benefits, Prescription Drug Account, SMI | 66,687 | 71,172 | 84,003 |
1160 | Miscellaneous Federal Payments, Federal Supplementary Medical Insurance Trust Fund | 1 | 1 | 1 |
1160 | Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund | 2,564 | ||
|
|
|
||
1199 | Income under present law | 459,840 | 498,018 | 529,654 |
Proposed: | ||||
Offsetting receipts (proprietary): | ||||
1230 | Premiums Collected for Medicare Prescription Drug Account, FSMI | |||
1230 | Premiums Collected for the Aged, FSMI Fund | –2,186 | ||
1230 | Premiums Collected for the Disabled, FSMI Fund | –295 | ||
Offsetting governmental receipts: | ||||
1260 | Federal Contributions, FSMI Fund | –7,383 | ||
1260 | Federal Contributions for Benefits, Prescription Drug Account, SMI | |||
|
|
|
||
1299 | Income proposed | –9,864 | ||
|
|
|
||
1999 | Total cash income | 459,840 | 498,018 | 519,790 |
Cash outgo during year: | ||||
Current law: | ||||
2100 | Federal Supplementary Medical Insurance Trust Fund [Budget Acct] | –367,592 | –402,438 | –429,533 |
2100 | Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund [Budget Acct] | –85,140 | –90,359 | –103,451 |
|
|
|
||
2199 | Outgo under current law | –452,732 | –492,797 | –532,984 |
Proposed: | ||||
2200 | Federal Supplementary Medical Insurance Trust Fund | –13 | 9,845 | |
|
|
|
||
2299 | Outgo under proposed legislation | –13 | 9,845 | |
|
|
|
||
2999 | Total cash outgo (-) | –452,732 | –492,810 | –523,139 |
Surplus or deficit: | ||||
3110 | Excluding interest | 4,386 | 3,975 | –4,736 |
3120 | Interest | 2,722 | 1,233 | 1,387 |
|
|
|
||
3199 | Subtotal, surplus or deficit | 7,108 | 5,208 | –3,349 |
3298 | Adjustment to reconcile to proprietary accounting | –1 | ||
|
|
|
||
3299 | Total adjustments | –1 | ||
|
|
|
||
3999 | Total change in fund balance | 7,107 | 5,208 | –3,349 |
Unexpended balance, end of year: | ||||
4100 | Uninvested balance (net), end of year | –663 | 3,650 | 3,751 |
4200 | Federal Supplementary Medical Insurance Trust Fund | 104,716 | 105,611 | 102,161 |
|
|
|
||
4999 | Total balance, end of year | 104,053 | 109,261 | 105,912 |
|
Object Classification (in millions of dollars)
|
||||
Identification code 075–8004–0–7–571 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
11.1 | Personnel compensation: Full-time permanent | 1 | 1 | |
41.0 | Payment for Quality Improvement Organization (QIO) activity | 429 | 436 | 163 |
42.0 | Insurance claims and indemnities | 366,367 | 402,284 | 429,474 |
94.0 | Financial transfers | 4,252 | ||
|
|
|
||
99.0 | Direct obligations | 371,048 | 402,721 | 429,638 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 371,048 | 402,721 | 429,638 |
|
Employment Summary
|
||||
Identification code 075–8004–0–7–571 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 6 | 6 | 6 |
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–8004–2–7–571 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Budgetary resources: | ||||
Budget authority: | ||||
Appropriations, mandatory: | ||||
1201 | Appropriation (special or trust fund) | –7,383 | ||
1203 | Appropriation (previously unavailable)(special or trust) | 7,383 | ||
4180 | Budget authority, net (total) | |||
4190 | Outlays, net (total) | |||
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–8004–4–7–571 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Benefit payments, SMI | 13 | –9,845 | |
|
|
|
||
0799 | Total direct obligations | 13 | –9,845 | |
|
|
|
||
0900 | Total new obligations, unexpired accounts (object class 42.0) | 13 | –9,845 | |
|
||||
Budgetary resources: | ||||
Budget authority: | ||||
Appropriations, mandatory: | ||||
1201 | Appropriation (special or trust fund) | –2,481 | ||
1203 | Appropriation (previously unavailable)(special or trust) | 13 | 20 | |
1234 | Appropriations precluded from obligation | –7,384 | ||
|
|
|
||
1260 | Appropriations, mandatory (total) | 13 | –9,845 | |
1900 | Budget authority (total) | 13 | –9,845 | |
1930 | Total budgetary resources available | 13 | –9,845 | |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3010 | New obligations, unexpired accounts | 13 | –9,845 | |
3020 | Outlays (gross) | –13 | 9,845 | |
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 13 | –9,845 | |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 13 | –9,845 | |
4180 | Budget authority, net (total) | 13 | –9,845 | |
4190 | Outlays, net (total) | 13 | –9,845 | |
|
The Budget includes a package of Medicare proposals designed to eliminate wasteful spending, preserve and expand beneficiary access to care, enhance choice and competition, and strengthen Medicare's fiscal sustainability, consistent with the President's Executive Order on Protecting and Improving Medicare for Our Nation's Seniors.
Program and Financing (in millions of dollars)
|
||||
Identification code 075–8308–0–7–571 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Prescription Drug Benefits | 87,561 | 89,915 | 102,850 |
0002 | Administrative Costs | 642 | 861 | 882 |
|
|
|
||
0799 | Total direct obligations | 88,203 | 90,776 | 103,732 |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 88,203 | 90,776 | 103,732 |
|
||||
Budgetary resources: | ||||
Budget authority: | ||||
Appropriations, discretionary: | ||||
1101 | Appropriation (special or trust) | 641 | 861 | 882 |
Appropriations, mandatory: | ||||
1201 | Appropriation (special or trust fund) | 84,998 | 89,915 | 102,850 |
Spending authority from offsetting collections, mandatory: | ||||
1800 | Collected | 2,564 | ||
1801 | Change in uncollected payments, Federal sources | 2,564 | –2,564 | |
|
|
|
||
1850 | Spending auth from offsetting collections, mand (total) | 2,564 | ||
1900 | Budget authority (total) | 88,203 | 90,776 | 103,732 |
1930 | Total budgetary resources available | 88,203 | 90,776 | 103,732 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 7,440 | 10,503 | 10,920 |
3010 | New obligations, unexpired accounts | 88,203 | 90,776 | 103,732 |
3020 | Outlays (gross) | –85,140 | –90,359 | –103,451 |
|
|
|
||
3050 | Unpaid obligations, end of year | 10,503 | 10,920 | 11,201 |
Uncollected payments: | ||||
3060 | Uncollected pymts, Fed sources, brought forward, Oct 1 | –225 | –2,789 | –225 |
3070 | Change in uncollected pymts, Fed sources, unexpired | –2,564 | 2,564 | |
|
|
|
||
3090 | Uncollected pymts, Fed sources, end of year | –2,789 | –225 | –225 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 7,215 | 7,714 | 10,695 |
3200 | Obligated balance, end of year | 7,714 | 10,695 | 10,976 |
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
4000 | Budget authority, gross | 641 | 861 | 882 |
Outlays, gross: | ||||
4010 | Outlays from new discretionary authority | 313 | 295 | 321 |
4011 | Outlays from discretionary balances | 147 | 141 | 273 |
|
|
|
||
4020 | Outlays, gross (total) | 460 | 436 | 594 |
Mandatory: | ||||
4090 | Budget authority, gross | 87,562 | 89,915 | 102,850 |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 77,992 | 79,914 | 91,850 |
4101 | Outlays from mandatory balances | 6,688 | 10,009 | 11,007 |
|
|
|
||
4110 | Outlays, gross (total) | 84,680 | 89,923 | 102,857 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4120 | Federal sources: | –2,564 | ||
Additional offsets against gross budget authority only: | ||||
4140 | Change in uncollected pymts, Fed sources, unexpired | –2,564 | 2,564 | |
|
|
|
||
4160 | Budget authority, net (mandatory) | 84,998 | 89,915 | 102,850 |
4170 | Outlays, net (mandatory) | 84,680 | 87,359 | 102,857 |
4180 | Budget authority, net (total) | 85,639 | 90,776 | 103,732 |
4190 | Outlays, net (total) | 85,140 | 87,795 | 103,451 |
|
Since January 2006, Medicare beneficiaries have had the opportunity to enroll in a comprehensive voluntary prescription drug benefit.
Object Classification (in millions of dollars)
|
||||
Identification code 075–8308–0–7–571 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
25.2 | Other services from non-Federal sources | 642 | 861 | 882 |
42.0 | Insurance claims and indemnities | 87,561 | 89,915 | 102,850 |
|
|
|
||
99.0 | Direct obligations | 88,203 | 90,776 | 103,732 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 88,203 | 90,776 | 103,732 |
|
Employment Summary
|
||||
Identification code 075–8308–0–7–571 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 4 | 4 | 4 |
|
The Budget supports comprehensive drug pricing reform legislation including modernization of the Part D benefit.
Program and Financing (in millions of dollars)
|
||||
Identification code 075–1552–0–1–609 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | State family assistance grant | 16,433 | 16,433 | 16,433 |
0002 | Territories - family assistance grants | 78 | 78 | 78 |
0006 | Tribal work programs | 7 | 8 | 8 |
0009 | Healthy marriage and responsible fatherhood grants | 139 | 149 | 150 |
0010 | Evaluation Funding and What Works Clearinghouse | 44 | 45 | 45 |
0011 | Census Bureau Research | 8 | 10 | 10 |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 16,709 | 16,723 | 16,724 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 1 | ||
Budget authority: | ||||
Appropriations, mandatory: | ||||
1200 | Appropriation | 16,739 | 16,739 | 16,739 |
1230 | Appropriations and/or unobligated balance of appropriations permanently reduced | –2 | ||
|
|
|
||
1260 | Appropriations, mandatory (total) | 16,737 | 16,739 | 16,739 |
1900 | Budget authority (total) | 16,737 | 16,739 | 16,739 |
1930 | Total budgetary resources available | 16,737 | 16,739 | 16,740 |
Memorandum (non-add) entries: | ||||
1940 | Unobligated balance expiring | –28 | –15 | –15 |
1941 | Unexpired unobligated balance, end of year | 1 | 1 | |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 8,070 | 9,283 | 9,900 |
3010 | New obligations, unexpired accounts | 16,709 | 16,723 | 16,724 |
3011 | Obligations ("upward adjustments"), expired accounts | 4 | ||
3020 | Outlays (gross) | –15,497 | –16,106 | –16,788 |
3041 | Recoveries of prior year unpaid obligations, expired | –3 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 9,283 | 9,900 | 9,836 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 8,070 | 9,283 | 9,900 |
3200 | Obligated balance, end of year | 9,283 | 9,900 | 9,836 |
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 16,737 | 16,739 | 16,739 |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 10,210 | 10,546 | 10,546 |
4101 | Outlays from mandatory balances | 5,287 | 5,560 | 6,242 |
|
|
|
||
4110 | Outlays, gross (total) | 15,497 | 16,106 | 16,788 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4123 | Non-Federal sources | –1 | ||
Additional offsets against gross budget authority only: | ||||
4142 | Offsetting collections credited to expired accounts | 1 | ||
|
|
|
||
4160 | Budget authority, net (mandatory) | 16,737 | 16,739 | 16,739 |
4170 | Outlays, net (mandatory) | 15,496 | 16,106 | 16,788 |
4180 | Budget authority, net (total) | 16,737 | 16,739 | 16,739 |
4190 | Outlays, net (total) | 15,496 | 16,106 | 16,788 |
|
Summary of Budget Authority and Outlays (in millions of dollars)
|
||||
2019 actual | 2020 est. | 2021 est. | ||
|
||||
Enacted/requested: | ||||
Budget Authority | 16,737 | 16,739 | 16,739 | |
Outlays | 15,496 | 16,106 | 16,788 | |
Legislative proposal, subject to PAYGO: | ||||
Budget Authority | –1,494 | |||
Outlays | –1,073 | |||
Total: | ||||
Budget Authority | 16,737 | 16,739 | 15,245 | |
Outlays | 15,496 | 16,106 | 15,715 | |
|
This account provides funding for the Temporary Assistance for Needy Families (TANF) block grant and related 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). TANF's authorization was most recently extended in theFurther Consolidated Appropriations Act, 2020 (P. L. 116–94).
Object Classification (in millions of dollars)
|
||||
Identification code 075–1552–0–1–609 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
Personnel compensation: | ||||
11.1 | Full-time permanent | 9 | 9 | 9 |
11.3 | Other than full-time permanent | 1 | 1 | 1 |
|
|
|
||
11.9 | Total personnel compensation | 10 | 10 | 10 |
12.1 | Civilian personnel benefits | 1 | 1 | 1 |
21.0 | Travel and transportation of persons | 1 | 1 | 1 |
23.1 | Rental payments to GSA | 1 | 1 | 1 |
25.1 | Advisory and assistance services | 72 | 72 | 72 |
25.2 | Other services from non-Federal sources | 17 | 17 | 17 |
25.3 | Other goods and services from Federal sources | 3 | 3 | 3 |
41.0 | Grants, subsidies, and contributions | 16,604 | 16,618 | 16,619 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 16,709 | 16,723 | 16,724 |
|
Employment Summary
|
||||
Identification code 075–1552–0–1–609 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 98 | 97 | 100 |
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–1552–4–1–609 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | State family assistance grant | –1,594 | ||
0002 | Territories - family assistance grants | –8 | ||
0010 | Evaluation Funding and What Works Clearinghouse | 8 | ||
0012 | Opportunity and Economic Mobility Demonstrations | 100 | ||
|
|
|
||
0900 | Total new obligations, unexpired accounts (object class 41.0) | –1,494 | ||
|
||||
Budgetary resources: | ||||
Budget authority: | ||||
Appropriations, mandatory: | ||||
1200 | Appropriation | –1,494 | ||
1900 | Budget authority (total) | –1,494 | ||
1930 | Total budgetary resources available | –1,494 | ||
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3010 | New obligations, unexpired accounts | –1,494 | ||
3020 | Outlays (gross) | 1,073 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | –421 | ||
Memorandum (non-add) entries: | ||||
3200 | Obligated balance, end of year | –421 | ||
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | –1,494 | ||
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | –1,073 | ||
4180 | Budget authority, net (total) | –1,494 | ||
4190 | Outlays, net (total) | –1,073 | ||
|
The Budget proposes comprehensive reforms to TANF, including phasing out the work participation rate and transitioning to employment outcome and engagement measures, and modifying spending rules to refocus the program on core activities. The Budget also continues the proposal to reduce funding for TANF Family Assistance Grants to States, territories, and tribes by 10 percent. In addition, the Budget creates a demonstration opportunity for states to grow capacity across public safety net benefit programs to reduce dependency.
Program and Financing (in millions of dollars)
|
||||
Identification code 075–1522–0–1–609 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Contingency Fund for State Welfare Programs | 608 | 608 | 608 |
|
|
|
||
0900 | Total new obligations, unexpired accounts (object class 41.0) | 608 | 608 | 608 |
|
||||
Budgetary resources: | ||||
Budget authority: | ||||
Appropriations, mandatory: | ||||
1200 | Appropriation | 608 | 608 | 608 |
1930 | Total budgetary resources available | 608 | 608 | 608 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 55 | 45 | 45 |
3010 | New obligations, unexpired accounts | 608 | 608 | 608 |
3020 | Outlays (gross) | –600 | –608 | –608 |
3041 | Recoveries of prior year unpaid obligations, expired | –18 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 45 | 45 | 45 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 55 | 45 | 45 |
3200 | Obligated balance, end of year | 45 | 45 | 45 |
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 608 | 608 | 608 |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 574 | 563 | 545 |
4101 | Outlays from mandatory balances | 26 | 45 | 63 |
|
|
|
||
4110 | Outlays, gross (total) | 600 | 608 | 608 |
4180 | Budget authority, net (total) | 608 | 608 | 608 |
4190 | Outlays, net (total) | 600 | 608 | 608 |
|
Summary of Budget Authority and Outlays (in millions of dollars)
|
||||
2019 actual | 2020 est. | 2021 est. | ||
|
||||
Enacted/requested: | ||||
Budget Authority | 608 | 608 | 608 | |
Outlays | 600 | 608 | 608 | |
Legislative proposal, subject to PAYGO: | ||||
Budget Authority | –608 | |||
Outlays | –608 | |||
Total: | ||||
Budget Authority | 608 | 608 | ||
Outlays | 600 | 608 | ||
|
The TANF Contingency Fund provides a funding reserve of $608 million to assist states that meet certain criteria related to the state's unemployment rate and Supplemental Nutrition Assistance Program (SNAP) caseload. In order to qualify for contingency funds, States must also meet a higher maintenance-of-effort requirement of 100 percent of historical expenditures. The authorization for the Contingency Fund was most recently extended in the Further Consolidated Appropriations Act, 2020 (P.L. 116–94).
Program and Financing (in millions of dollars)
|
||||
Identification code 075–1522–4–1–609 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Contingency Fund for State Welfare Programs | –608 | ||
|
|
|
||
0900 | Total new obligations, unexpired accounts (object class 41.0) | –608 | ||
|
||||
Budgetary resources: | ||||
Budget authority: | ||||
Appropriations, mandatory: | ||||
1200 | Appropriation | –608 | ||
1930 | Total budgetary resources available | –608 | ||
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3010 | New obligations, unexpired accounts | –608 | ||
3020 | Outlays (gross) | 608 | ||
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | –608 | ||
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | –545 | ||
4101 | Outlays from mandatory balances | –63 | ||
|
|
|
||
4110 | Outlays, gross (total) | –608 | ||
4180 | Budget authority, net (total) | –608 | ||
4190 | Outlays, net (total) | –608 | ||
|
The Budget proposes to eliminate funding for the Contingency Fund.
For carrying out, except as otherwise provided, titles I, IV-D, X, XI, XIV, and XVI of the Social Security Act and the Act of July 5, 1960, $3,039,000,000, to remain available until expended; and for such purposes for the first quarter of fiscal year 2022, $1,400,000,000, to remain available until expended.
For carrying out, after May 31 of the current fiscal year, except as otherwise provided, 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.
(Department of Health and Human Services Appropriations Act, 2020.)
Program and Financing (in millions of dollars)
|
||||
Identification code 075–1501–0–1–609 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | State child support administrative costs | 3,979 | 4,032 | 3,988 |
0002 | Child support incentive payments | 571 | 581 | 607 |
0003 | Access and visitation grants | 10 | 10 | 10 |
|
|
|
||
0091 | Subtotal, child support enforcement | 4,560 | 4,623 | 4,605 |
0102 | Payments to territories | 33 | 33 | 33 |
0103 | Repatriation | 1 | 1 | 1 |
|
|
|
||
0191 | Subtotal, other payments | 34 | 34 | 34 |
|
|
|
||
0799 | Total direct obligations | 4,594 | 4,657 | 4,639 |
0801 | Offset obligations (CSE grants to States) | 13 | 1 | |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 4,607 | 4,658 | 4,639 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 141 | 55 | |
1021 | Recoveries of prior year unpaid obligations | 251 | 200 | 200 |
1037 | Unobligated balance of appropriations withdrawn | –52 | ||
|
|
|
||
1050 | Unobligated balance (total) | 340 | 255 | 200 |
Budget authority: | ||||
Appropriations, mandatory: | ||||
1200 | Appropriation | 2,922 | 3,002 | 3,039 |
Advance appropriations, mandatory: | ||||
1270 | Advance appropriation | 1,400 | 1,400 | 1,400 |
Spending authority from offsetting collections, mandatory: | ||||
1800 | Collected | 1 | ||
1900 | Budget authority (total) | 4,322 | 4,403 | 4,439 |
1930 | Total budgetary resources available | 4,662 | 4,658 | 4,639 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 55 | ||
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 1,383 | 1,622 | 1,755 |
3010 | New obligations, unexpired accounts | 4,607 | 4,658 | 4,639 |
3020 | Outlays (gross) | –4,117 | –4,325 | –4,351 |
3040 | Recoveries of prior year unpaid obligations, unexpired | –251 | –200 | –200 |
|
|
|
||
3050 | Unpaid obligations, end of year | 1,622 | 1,755 | 1,843 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 1,383 | 1,622 | 1,755 |
3200 | Obligated balance, end of year | 1,622 | 1,755 | 1,843 |
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 4,322 | 4,403 | 4,439 |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 3,474 | 3,762 | 3,742 |
4101 | Outlays from mandatory balances | 643 | 563 | 609 |
|
|
|
||
4110 | Outlays, gross (total) | 4,117 | 4,325 | 4,351 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4123 | Non-Federal sources | –1 | ||
4180 | Budget authority, net (total) | 4,322 | 4,402 | 4,439 |
4190 | Outlays, net (total) | 4,117 | 4,324 | 4,351 |
|
Summary of Budget Authority and Outlays (in millions of dollars)
|
||||
2019 actual | 2020 est. | 2021 est. | ||
|
||||
Enacted/requested: | ||||
Budget Authority | 4,322 | 4,402 | 4,439 | |
Outlays | 4,117 | 4,324 | 4,351 | |
Legislative proposal, subject to PAYGO: | ||||
Budget Authority | 19 | |||
Outlays | 19 | |||
Total: | ||||
Budget Authority | 4,322 | 4,402 | 4,458 | |
Outlays | 4,117 | 4,324 | 4,370 | |
|
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.
Object Classification (in millions of dollars)
|
||||
Identification code 075–1501–0–1–609 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
41.0 | Direct obligations: Grants, subsidies, and contributions | 4,594 | 4,658 | 4,639 |
99.0 | Reimbursable obligations | 13 | ||
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 4,607 | 4,658 | 4,639 |
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–1501–4–1–609 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | State child support administrative costs | 18 | ||
|
|
|
||
0091 | Subtotal, child support enforcement | 18 | ||
0103 | Repatriation | 1 | ||
|
|
|
||
0191 | Subtotal, other payments | 1 | ||
|
|
|
||
0799 | Total direct obligations | 19 | ||
|
|
|
||
0900 | Total new obligations, unexpired accounts (object class 41.0) | 19 | ||
|
||||
Budgetary resources: | ||||
Budget authority: | ||||
Appropriations, mandatory: | ||||
1200 | Appropriation | 19 | ||
1900 | Budget authority (total) | 19 | ||
1930 | Total budgetary resources available | 19 | ||
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3010 | New obligations, unexpired accounts | 19 | ||
3020 | Outlays (gross) | –19 | ||
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 19 | ||
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 19 | ||
4180 | Budget authority, net (total) | 19 | ||
4190 | Outlays, net (total) | 19 | ||
|
The Budget improves establishment and enforcement procedures by closing loopholes and improving Federal processes. Proposals promote work programs, increase collections, enhance distribution, and improve program efficiency.
(Department of Health and Human Services Appropriations Act, 2020.)
Program and Financing (in millions of dollars)
|
||||
Identification code 075–1502–0–1–609 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | LIHEAP Block Grant | 3,653 | 3,740 | |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 1 | 3 | 3 |
1012 | Unobligated balance transfers between expired and unexpired accounts | 2 | ||
|
|
|
||
1050 | Unobligated balance (total) | 3 | 3 | 3 |
Budget authority: | ||||
Appropriations, discretionary: | ||||
1100 | Appropriation | 3,690 | 3,740 | |
1120 | Appropriations transferred to other acct [075–1503] | –37 | ||
|
|
|
||
1160 | Appropriation, discretionary (total) | 3,653 | 3,740 | |
1930 | Total budgetary resources available | 3,656 | 3,743 | 3 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 3 | 3 | 3 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 1,630 | 1,570 | 1,553 |
3010 | New obligations, unexpired accounts | 3,653 | 3,740 | |
3011 | Obligations ("upward adjustments"), expired accounts | 1 | ||
3020 | Outlays (gross) | –3,696 | –3,757 | –1,296 |
3041 | Recoveries of prior year unpaid obligations, expired | –18 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 1,570 | 1,553 | 257 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 1,630 | 1,570 | 1,553 |
3200 | Obligated balance, end of year | 1,570 | 1,553 | 257 |
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
4000 | Budget authority, gross | 3,653 | 3,740 | |
Outlays, gross: | ||||
4010 | Outlays from new discretionary authority | 2,308 | 2,308 | |
4011 | Outlays from discretionary balances | 1,388 | 1,449 | 1,296 |
|
|
|
||
4020 | Outlays, gross (total) | 3,696 | 3,757 | 1,296 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4033 | Non-Federal sources | –1 | ||
Additional offsets against gross budget authority only: | ||||
4052 | Offsetting collections credited to expired accounts | 1 | ||
|
|
|
||
4070 | Budget authority, net (discretionary) | 3,653 | 3,740 | |
4080 | Outlays, net (discretionary) | 3,695 | 3,757 | 1,296 |
4180 | Budget authority, net (total) | 3,653 | 3,740 | |
4190 | Outlays, net (total) | 3,695 | 3,757 | 1,296 |
|
The Budget proposes to eliminate funding for the Low Income Home Energy Assistance Program.
Object Classification (in millions of dollars)
|
||||
Identification code 075–1502–0–1–609 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
25.1 | Advisory and assistance services | 3 | 2 | |
25.3 | Other goods and services from Federal sources | 1 | ||
41.0 | Grants, subsidies, and contributions | 3,650 | 3,737 | |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 3,653 | 3,740 | |
|
For 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, and 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, the Trafficking Victims Protection Act of 2000 ("TVPA"), and the Torture Victims Relief Act of 1998, $2,456,380,000, of which $2,412,625,000 shall remain available until expended for carrying out such sections 414, 501, 462, and 235: Provided, That amounts available under this heading to carry out the TVPA shall also be available for research and evaluation with respect to activities under such Act: Provided further, That funds made available in this or any prior Act for the Unaccompanied Alien Children program that are available for the acquisition of real property or for construction or improvement of facilities shall be available to make improvements on non-federally owned property that is adjacent to facilities utilized by such program, provided that the primary benefit of such improvements accrues to such program: Provided further, That the limitation in section 204 of this Act regarding transfers increasing any appropriation shall apply to transfers to appropriations under this heading by substituting "20 percent" for "3 percent": Provided further, That funds made available under this heading shall be available to pay or reimburse other Federal agencies for the costs of construction, improvements to property, and other activities, including structure removal, if such activities are necessary for the purpose of carrying out such sections 462 and 235: Provided further, That other Federal agencies may retain and use such payments and reimbursements to cover costs described in the preceding proviso.
(Department of Health and Human Services Appropriations Act, 2020.)
Program and Financing (in millions of dollars)
|
||||
Identification code 075–1503–0–1–609 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Refugee Support Services (RSS) and Transitional & Medical Services (TAMS) | 513 | 561 | 429 |
0002 | Assistance for treatment of torture victims | 14 | 16 | 16 |
0003 | Unaccompanied Children | 2,617 | 1,303 | 1,983 |
0005 | Trafficking Victims program | 26 | 28 | 28 |
|
|
|
||
0799 | Total direct obligations | 3,170 | 1,908 | 2,456 |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 3,170 | 1,908 | 2,456 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 41 | 2,096 | 2,096 |
1021 | Recoveries of prior year unpaid obligations | 159 | ||
|
|
|
||
1050 | Unobligated balance (total) | 200 | 2,096 | 2,096 |
Budget authority: | ||||
Appropriations, discretionary: | ||||
1100 | Base Appropriation | 4,787 | 1,908 | 2,456 |
1120 | Appropriations transferred to other acct [075–0128] | –5 | ||
1121 | Appropriations transferred from other acct [075–1502] | 37 | ||
1121 | Appropriations transferred from other acct [075–1536] | 48 | ||
1121 | Appropriations transferred from other acct [075–1515] | 18 | ||
1121 | Appropriations transferred from other acct [075–0142] | 7 | ||
1121 | Appropriations transferred from other acct [075–1700] | 1 | ||
1121 | Appropriations transferred from other acct [075–0943] | 14 | ||
1121 | Appropriations transferred from other acct [075–0350] | 21 | ||
1121 | Appropriations transferred from other acct [075–9915] | 124 | ||
1121 | Appropriations transferred from other acct [075–9912] | 1 | ||
1121 | Appropriations transferred from other acct [075–1362] | 9 | ||
|
|
|
||
1160 | Appropriation, discretionary (total) | 5,062 | 1,908 | 2,456 |
Spending authority from offsetting collections, discretionary: | ||||
1711 | Spending authority from offsetting collections transferred from other accounts [075–0511] | 4 | ||
1900 | Budget authority (total) | 5,066 | 1,908 | 2,456 |
1930 | Total budgetary resources available | 5,266 | 4,004 | 4,552 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 2,096 | 2,096 | 2,096 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 1,722 | 2,191 | 1,522 |
3010 | New obligations, unexpired accounts | 3,170 | 1,908 | 2,456 |
3011 | Obligations ("upward adjustments"), expired accounts | 1 | ||
3020 | Outlays (gross) | –2,529 | –2,577 | –2,614 |
3040 | Recoveries of prior year unpaid obligations, unexpired | –159 | ||
3041 | Recoveries of prior year unpaid obligations, expired | –14 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 2,191 | 1,522 | 1,364 |
Uncollected payments: | ||||
3060 | Uncollected pymts, Fed sources, brought forward, Oct 1 | –180 | –180 | –180 |
|
|
|
||
3090 | Uncollected pymts, Fed sources, end of year | –180 | –180 | –180 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 1,542 | 2,011 | 1,342 |
3200 | Obligated balance, end of year | 2,011 | 1,342 | 1,184 |
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
4000 | Budget authority, gross | 5,066 | 1,908 | 2,456 |
Outlays, gross: | ||||
4010 | Outlays from new discretionary authority | 1,406 | 766 | 860 |
4011 | Outlays from discretionary balances | 1,123 | 1,811 | 1,754 |
|
|
|
||
4020 | Outlays, gross (total) | 2,529 | 2,577 | 2,614 |
4180 | Budget authority, net (total) | 5,066 | 1,908 | 2,456 |
4190 | Outlays, net (total) | 2,529 | 2,577 | 2,614 |
|
Summary of Budget Authority and Outlays (in millions of dollars)
|
||||
2019 actual | 2020 est. | 2021 est. | ||
|
||||
Enacted/requested: | ||||
Budget Authority | 5,066 | 1,908 | 2,456 | |
Outlays | 2,529 | 2,577 | 2,614 | |
Legislative proposal, subject to PAYGO: | ||||
Budget Authority | 200 | |||
Outlays | 130 | |||
Total: | ||||
Budget Authority | 5,066 | 1,908 | 2,656 | |
Outlays | 2,529 | 2,577 | 2,744 | |
|
This account provides funds to States and non-governmental organizations to administer the refugee and entrant assistance programs. Funds support cash and medical assistance and social services for refugees, asylees, and other arrivals eligible for refugee benefits. The account also includes funding for the care and placement of unaccompanied alien children, and for the rehabilitation of victims of torture and human trafficking .
Object Classification (in millions of dollars)
|
||||
Identification code 075–1503–0–1–609 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
Personnel compensation: | ||||
11.1 | Full-time permanent | 9 | 15 | 15 |
11.7 | Military personnel | 1 | 2 | 2 |
|
|
|
||
11.9 | Total personnel compensation | 10 | 17 | 17 |
12.1 | Civilian personnel benefits | 3 | 5 | 5 |
12.2 | Military personnel benefits | 1 | 2 | 2 |
23.1 | Rental payments to GSA | 7 | 7 | 7 |
25.1 | Advisory and assistance services | 16 | 16 | 16 |
25.2 | Other services from non-Federal sources | 621 | 621 | 621 |
25.3 | Other goods and services from Federal sources | 123 | 123 | 123 |
25.4 | Operation and maintenance of facilities | 1 | 1 | 1 |
41.0 | Grants, subsidies, and contributions | 2,388 | 1,116 | 1,664 |
|
|
|
||
99.0 | Direct obligations | 3,170 | 1,908 | 2,456 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 3,170 | 1,908 | 2,456 |
|
Employment Summary
|
||||
Identification code 075–1503–0–1–609 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 97 | 153 | 157 |
1101 | Direct military average strength employment | 13 | 12 | 12 |
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–1503–4–1–609 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0009 | UAC Contingency Fund, mandatory | 200 | ||
|
|
|
||
0900 | Total new obligations, unexpired accounts (object class 41.0) | 200 | ||
|
||||
Budgetary resources: | ||||
Budget authority: | ||||
Appropriations, mandatory: | ||||
1200 | Appropriation | 200 | ||
1930 | Total budgetary resources available | 200 | ||
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3010 | New obligations, unexpired accounts | 200 | ||
3020 | Outlays (gross) | –130 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 70 | ||
Memorandum (non-add) entries: | ||||
3200 | Obligated balance, end of year | 70 | ||
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 200 | ||
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 130 | ||
4180 | Budget authority, net (total) | 200 | ||
4190 | Outlays, net (total) | 130 | ||
|
The Budget requests a mandatory UAC contingency fund capped at $2 billion over a three-year period.
For carrying out, except as otherwise provided, section 436 of the Social Security Act, $345,000,000 and, for carrying out, except as otherwise provided, section 437 of such Act, $59,765,000.
(Department of Health and Human Services Appropriations Act, 2020.)
Program and Financing (in millions of dollars)
|
||||
Identification code 075–1512–0–1–506 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Grants to States and Tribes | 385 | 384 | 370 |
0002 | Research, training and technical assistance | 8 | 10 | 10 |
0003 | State court improvement activities | 30 | 30 | 31 |
0004 | Family Connection Grants | 2 | 2 | |
0005 | Personal Responsibility Education (PREP) | 73 | 91 | 1 |
0006 | Sexual Risk Abstinence Education (SRAE) | 69 | 75 | |
0007 | Family Rec. & Reunification | 4 | 3 | 3 |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 569 | 595 | 417 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 39 | 53 | 546 |
1001 | Discretionary unobligated balance brought fwd, Oct 1 | 6 | ||
1021 | Recoveries of prior year unpaid obligations | 1 | ||
|
|
|
||
1050 | Unobligated balance (total) | 40 | 53 | 546 |
Budget authority: | ||||
Appropriations, discretionary: | ||||
1100 | Appropriation | 100 | 93 | 60 |
Appropriations, mandatory: | ||||
1200 | Appropriation | 510 | 995 | 345 |
1230 | Appropriations and/or unobligated balance of appropriations permanently reduced | –21 | ||
|
|
|
||
1260 | Appropriations, mandatory (total) | 489 | 995 | 345 |
1900 | Budget authority (total) | 589 | 1,088 | 405 |
1930 | Total budgetary resources available | 629 | 1,141 | 951 |
Memorandum (non-add) entries: | ||||
1940 | Unobligated balance expiring | –7 | ||
1941 | Unexpired unobligated balance, end of year | 53 | 546 | 534 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 658 | 739 | 635 |
3010 | New obligations, unexpired accounts | 569 | 595 | 417 |
3011 | Obligations ("upward adjustments"), expired accounts | 6 | ||
3020 | Outlays (gross) | –482 | –699 | –856 |
3040 | Recoveries of prior year unpaid obligations, unexpired | –1 | ||
3041 | Recoveries of prior year unpaid obligations, expired | –11 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 739 | 635 | 196 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 658 | 739 | 635 |
3200 | Obligated balance, end of year | 739 | 635 | 196 |
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
4000 | Budget authority, gross | 100 | 93 | 60 |
Outlays, gross: | ||||
4010 | Outlays from new discretionary authority | 15 | 22 | 14 |
4011 | Outlays from discretionary balances | 46 | 70 | 63 |
|
|
|
||
4020 | Outlays, gross (total) | 61 | 92 | 77 |
Mandatory: | ||||
4090 | Budget authority, gross | 489 | 995 | 345 |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 88 | 221 | 89 |
4101 | Outlays from mandatory balances | 333 | 386 | 690 |
|
|
|
||
4110 | Outlays, gross (total) | 421 | 607 | 779 |
4180 | Budget authority, net (total) | 589 | 1,088 | 405 |
4190 | Outlays, net (total) | 482 | 699 | 856 |
|
Summary of Budget Authority and Outlays (in millions of dollars)
|
||||
2019 actual | 2020 est. | 2021 est. | ||
|
||||
Enacted/requested: | ||||
Budget Authority | 589 | 1,088 | 405 | |
Outlays | 482 | 699 | 856 | |
Legislative proposal, subject to PAYGO: | ||||
Budget Authority | 220 | |||
Outlays | 22 | |||
Total: | ||||
Budget Authority | 589 | 1,088 | 625 | |
Outlays | 482 | 699 | 878 | |
|
This account provides funds for a broad range of child welfare services, including family preservation and support services and grants to increase the well-being of and improve the permanency outcomes for children affected by substance abuse, through Promoting Safe and Stable Families. It also includes the Sexual Risk Avoidance Education program and the Personal Responsibility Education Program (PREP).
Object Classification (in millions of dollars)
|
||||
Identification code 075–1512–0–1–506 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
11.1 | Personnel compensation: Full-time permanent | 1 | 1 | 2 |
25.1 | Advisory and assistance services | 27 | 28 | 27 |
25.3 | Other goods and services from Federal sources | 4 | 4 | 4 |
41.0 | Grants, subsidies, and contributions | 537 | 562 | 384 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 569 | 595 | 417 |
|
Employment Summary
|
||||
Identification code 075–1512–0–1–506 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 14 | 21 | 22 |
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–1512–4–1–506 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Grants to States and Tribes | 40 | ||
0003 | State court improvement activities | 30 | ||
0005 | Personal Responsibility Education (PREP) | 75 | ||
0006 | Sexual Risk Abstinence Education (SRAE) | 75 | ||
|
|
|
||
0900 | Total new obligations, unexpired accounts | 220 | ||
|
||||
Budgetary resources: | ||||
Budget authority: | ||||
Appropriations, mandatory: | ||||
1200 | Appropriation | 220 | ||
1930 | Total budgetary resources available | 220 | ||
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3010 | New obligations, unexpired accounts | 220 | ||
3020 | Outlays (gross) | –22 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 198 | ||
Memorandum (non-add) entries: | ||||
3200 | Obligated balance, end of year | 198 | ||
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 220 | ||
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 22 | ||
4180 | Budget authority, net (total) | 220 | ||
4190 | Outlays, net (total) | 22 | ||
|
The Budget includes a proposal to expand the Regional Partnership Grants program, to increase funding for the Court Improvement Program, and a two-year reauthorization of Sexual Risk Avoidance Education and the Personal Responsibility Education Program (PREP).
Object Classification (in millions of dollars)
|
||||
Identification code 075–1512–4–1–506 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
25.1 | Advisory and assistance services | 23 | ||
25.3 | Other goods and services from Federal sources | 3 | ||
41.0 | Grants, subsidies, and contributions | 194 | ||
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 220 | ||
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–1550–0–1–609 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Mandatory child care | 1,178 | 1,178 | 1,178 |
0002 | Matching child care | 1,708 | 1,651 | 1,651 |
0003 | Child Care Training and technical assistance | 15 | 15 | 15 |
0004 | Child care tribal grants | 43 | 58 | 58 |
0005 | Child Care Research | 15 | 15 | 15 |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 2,959 | 2,917 | 2,917 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1012 | Unobligated balance transfers between expired and unexpired accounts | 42 | ||
Budget authority: | ||||
Appropriations, mandatory: | ||||
1200 | Appropriation | 2,917 | 2,917 | 2,917 |
1930 | Total budgetary resources available | 2,959 | 2,917 | 2,917 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 1,614 | 1,268 | 1,224 |
3010 | New obligations, unexpired accounts | 2,959 | 2,917 | 2,917 |
3011 | Obligations ("upward adjustments"), expired accounts | 23 | ||
3020 | Outlays (gross) | –3,267 | –2,961 | –2,960 |
3041 | Recoveries of prior year unpaid obligations, expired | –61 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 1,268 | 1,224 | 1,181 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 1,614 | 1,268 | 1,224 |
3200 | Obligated balance, end of year | 1,268 | 1,224 | 1,181 |
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 2,917 | 2,917 | 2,917 |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 2,137 | 2,139 | 2,139 |
4101 | Outlays from mandatory balances | 1,130 | 822 | 821 |
|
|
|
||
4110 | Outlays, gross (total) | 3,267 | 2,961 | 2,960 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4123 | Non-Federal sources | –23 | ||
Additional offsets against gross budget authority only: | ||||
4142 | Offsetting collections credited to expired accounts | 23 | ||
|
|
|
||
4160 | Budget authority, net (mandatory) | 2,917 | 2,917 | 2,917 |
4170 | Outlays, net (mandatory) | 3,244 | 2,961 | 2,960 |
4180 | Budget authority, net (total) | 2,917 | 2,917 | 2,917 |
4190 | Outlays, net (total) | 3,244 | 2,961 | 2,960 |
|
Summary of Budget Authority and Outlays (in millions of dollars)
|
||||
2019 actual | 2020 est. | 2021 est. | ||
|
||||
Enacted/requested: | ||||
Budget Authority | 2,917 | 2,917 | 2,917 | |
Outlays | 3,244 | 2,961 | 2,960 | |
Legislative proposal, subject to PAYGO: | ||||
Budget Authority | 1,295 | |||
Outlays | 271 | |||
Total: | ||||
Budget Authority | 2,917 | 2,917 | 4,212 | |
Outlays | 3,244 | 2,961 | 3,231 | |
|
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). Since 2010, this account has been temporarily reauthorized by a series of Acts, most recently in the Further Consolidated Appropriations Act, 2020 (P.L. 116–94).
Object Classification (in millions of dollars)
|
||||
Identification code 075–1550–0–1–609 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
25.1 | Advisory and assistance services | 19 | 19 | 19 |
25.3 | Other goods and services from Federal sources | 1 | 1 | 1 |
41.0 | Grants, subsidies, and contributions | 2,939 | 2,897 | 2,897 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 2,959 | 2,917 | 2,917 |
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–1550–4–1–609 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Mandatory child care | 1,000 | ||
0002 | Matching child care | 295 | ||
|
|
|
||
0900 | Total new obligations, unexpired accounts (object class 41.0) | 1,295 | ||
|
||||
Budgetary resources: | ||||
Budget authority: | ||||
Appropriations, mandatory: | ||||
1200 | Appropriation | 1,295 | ||
1930 | Total budgetary resources available | 1,295 | ||
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3010 | New obligations, unexpired accounts | 1,295 | ||
3020 | Outlays (gross) | –271 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 1,024 | ||
Memorandum (non-add) entries: | ||||
3200 | Obligated balance, end of year | 1,024 | ||
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 1,295 | ||
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 271 | ||
4180 | Budget authority, net (total) | 1,295 | ||
4190 | Outlays, net (total) | 271 | ||
|
The Budget increases funding for this account to ensure federal funding for key child care programs is maintained, given the effects of other Budget proposals on child care spending. The Budget also proposes a $1 billion one-time fund to build the supply of child care for underserved populations and to stimulate employer investment.
For carrying out the Child Care and Development Block Grant Act of 1990 ("CCDBG Act"), $5,826,000,000 shall be used to supplement, not supplant State general revenue funds for child care assistance for low-income families: Provided, That technical assistance under section 658I(a)(3) of such Act may be provided directly, or through the use of contracts, grants, cooperative agreements, or interagency agreements: Provided further, That all funds made available to carry out section 418 of the Social Security Act (42 U.S.C. 618), including funds appropriated for that purpose in such section 418 or any other provision of law, shall be subject to the reservation of funds authority in paragraphs (4) and (5) of section 658O(a) of the CCDBG Act: Provided further, That in addition to the amounts required to be reserved by the Secretary under section 658O(a)(2)(A) of such Act, $174,780,000 shall be for Indian tribes and tribal organizations.
(Department of Health and Human Services Appropriations Act, 2020.)
Program and Financing (in millions of dollars)
|
||||
Identification code 075–1515–0–1–609 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Child Care Block grant payments to States | 5,234 | 5,800 | 5,800 |
0004 | Child Care Research and evaluation fund | 26 | 26 | 26 |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 5,260 | 5,826 | 5,826 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 28 | 28 | |
1012 | Unobligated balance transfers between expired and unexpired accounts | 4 | ||
|
|
|
||
1050 | Unobligated balance (total) | 4 | 28 | 28 |
Budget authority: | ||||
Appropriations, discretionary: | ||||
1100 | Appropriation | 5,306 | 5,826 | 5,826 |
1120 | Appropriations transferred to other acct [075–1503] | –18 | ||
|
|
|
||
1160 | Appropriation, discretionary (total) | 5,288 | 5,826 | 5,826 |
1930 | Total budgetary resources available | 5,292 | 5,854 | 5,854 |
Memorandum (non-add) entries: | ||||
1940 | Unobligated balance expiring | –4 | ||
1941 | Unexpired unobligated balance, end of year | 28 | 28 | 28 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 2,791 | 4,115 | 4,646 |
3010 | New obligations, unexpired accounts | 5,260 | 5,826 | 5,826 |
3020 | Outlays (gross) | –3,918 | –5,295 | –6,360 |
3041 | Recoveries of prior year unpaid obligations, expired | –18 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 4,115 | 4,646 | 4,112 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 2,791 | 4,115 | 4,646 |
3200 | Obligated balance, end of year | 4,115 | 4,646 | 4,112 |
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
4000 | Budget authority, gross | 5,288 | 5,826 | 5,826 |
Outlays, gross: | ||||
4010 | Outlays from new discretionary authority | 1,981 | 3,204 | 3,612 |
4011 | Outlays from discretionary balances | 1,937 | 2,091 | 2,748 |
|
|
|
||
4020 | Outlays, gross (total) | 3,918 | 5,295 | 6,360 |
4180 | Budget authority, net (total) | 5,288 | 5,826 | 5,826 |
4190 | Outlays, net (total) | 3,918 | 5,295 | 6,360 |
|
This program provides grants to States for child care subsidies for low-income working families and activities to improve child care quality.
Object Classification (in millions of dollars)
|
||||
Identification code 075–1515–0–1–609 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
11.1 | Personnel compensation: Full-time permanent | 2 | 2 | 2 |
12.1 | Civilian personnel benefits | 1 | 1 | 1 |
25.1 | Advisory and assistance services | 46 | 45 | 45 |
25.3 | Other goods and services from Federal sources | 1 | 3 | 3 |
41.0 | Grants, subsidies, and contributions | 5,210 | 5,775 | 5,775 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 5,260 | 5,826 | 5,826 |
|
Employment Summary
|
||||
Identification code 075–1515–0–1–609 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 16 | 16 | 16 |
|
(Department of Health and Human Services Appropriations Act, 2020.)
Program and Financing (in millions of dollars)
|
||||
Identification code 075–1534–0–1–506 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Social Services Block Grant | 1,594 | 1,600 | 1,700 |
0002 | Health Profession Opportunity Grants | 83 | 85 | |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 1,677 | 1,685 | 1,700 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 30 | 31 | 31 |
Budget authority: | ||||
Appropriations, mandatory: | ||||
1200 | Appropriation | 1,785 | 1,785 | 1,700 |
1230 | Appropriations and/or unobligated balance of appropriations permanently reduced | –105 | –100 | |
|
|
|
||
1260 | Appropriations, mandatory (total) | 1,680 | 1,685 | 1,700 |
1930 | Total budgetary resources available | 1,710 | 1,716 | 1,731 |
Memorandum (non-add) entries: | ||||
1940 | Unobligated balance expiring | –2 | ||
1941 | Unexpired unobligated balance, end of year | 31 | 31 | 31 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 545 | 566 | 536 |
3010 | New obligations, unexpired accounts | 1,677 | 1,685 | 1,700 |
3020 | Outlays (gross) | –1,646 | –1,715 | –1,712 |
3041 | Recoveries of prior year unpaid obligations, expired | –10 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 566 | 536 | 524 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 545 | 566 | 536 |
3200 | Obligated balance, end of year | 566 | 536 | 524 |
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 1,680 | 1,685 | 1,700 |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 1,212 | 1,331 | 1,360 |
4101 | Outlays from mandatory balances | 434 | 384 | 352 |
|
|
|
||
4110 | Outlays, gross (total) | 1,646 | 1,715 | 1,712 |
4180 | Budget authority, net (total) | 1,680 | 1,685 | 1,700 |
4190 | Outlays, net (total) | 1,646 | 1,715 | 1,712 |
|
Summary of Budget Authority and Outlays (in millions of dollars)
|
||||
2019 actual | 2020 est. | 2021 est. | ||
|
||||
Enacted/requested: | ||||
Budget Authority | 1,680 | 1,685 | 1,700 | |
Outlays | 1,646 | 1,715 | 1,712 | |
Legislative proposal, subject to PAYGO: | ||||
Budget Authority | –1,700 | |||
Outlays | –1,360 | |||
Total: | ||||
Budget Authority | 1,680 | 1,685 | ||
Outlays | 1,646 | 1,715 | 352 | |
|
The Social Services Block Grant (SSBG) account includes funding for SSBG and the Health Profession Opportunity Grants (HPOG) programs. SSBG funds a broad array of social services for children and adults. The account also provides funding for the HPOG demonstration to provide education and training to Temporary Assistance for Needy Families recipients and other low-income individuals for health care occupations that pay well and are expected to either experience labor shortages or be in high demand.
Object Classification (in millions of dollars)
|
||||
Identification code 075–1534–0–1–506 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
11.1 | Personnel compensation: Full-time permanent | 1 | 1 | |
21.0 | Travel and transportation of persons | 1 | 1 | 1 |
25.1 | Advisory and assistance services | 10 | 10 | 10 |
41.0 | Grants, subsidies, and contributions | 1,665 | 1,673 | 1,689 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 1,677 | 1,685 | 1,700 |
|
Employment Summary
|
||||
Identification code 075–1534–0–1–506 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 8 | 8 | |
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–1534–4–1–506 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Social Services Block Grant | –1,700 | ||
|
||||
Budgetary resources: | ||||
Budget authority: | ||||
Appropriations, mandatory: | ||||
1200 | Appropriation | –1,700 | ||
1930 | Total budgetary resources available | –1,700 | ||
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3010 | New obligations, unexpired accounts | –1,700 | ||
3020 | Outlays (gross) | 1,360 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | –340 | ||
Memorandum (non-add) entries: | ||||
3200 | Obligated balance, end of year | –340 | ||
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | –1,700 | ||
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | –1,360 | ||
4180 | Budget authority, net (total) | –1,700 | ||
4190 | Outlays, net (total) | –1,360 | ||
|
The Budget proposes to discontinue funding for the Social Services Block Grant. The Budget does not propose reauthorizing the Health Profession Opportunity Grants (HPOG).
Object Classification (in millions of dollars)
|
||||
Identification code 075–1534–4–1–506 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
11.1 | Personnel compensation: Full-time permanent | –1 | ||
21.0 | Travel and transportation of persons | –1 | ||
25.1 | Advisory and assistance services | –10 | ||
41.0 | Grants, subsidies, and contributions | –1,688 | ||
|
|
|
||
99.9 | Total new obligations, unexpired accounts | –1,700 | ||
|
For carrying out, except as otherwise provided, the Runaway and Homeless Youth Act, the Head Start Act, the Child Abuse Prevention and Treatment Act, sections 303 and 313 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), and part B-1 of title IV and sections 429, 473A, 477(i), 1110, 1114A, and 1115 of the Social Security Act ; and for necessary administrative expenses to carry out titles I, IV, V, X, XI, XIV, XVI, and XX-A of the Social Security Act, the Act of July 5, 1960, the Child Care and Development Block Grant Act of 1990, title IV of the Immigration and Nationality Act, and section 501 of the Refugee Education Assistance Act of 1980, $11,856,130,000, of which $75,000,000, to remain available through September 30, 2022, shall be for grants to States for adoption and legal guardianship incentive payments, as defined by section 473A of the Social Security Act and may be made for adoptions and legal guardianships completed before September 30, 2021: Provided, That $10,613,095,000 shall be for making payments under the Head Start Act, including for Early Head Start-Child Care Partnerships, and, of which, notwithstanding section 640 of such Act:
(1) $25,000,000 shall be available for allocation by the Secretary to supplement activities described in paragraphs (7)(B) and (9) of section 641(c) of the Head Start Act under the Designation Renewal System, established under the authority of sections 641(c)(7), 645A(b)(12), and 645A(d) of such Act, and such funds shall not be included in the calculation of "base grant" in subsequent fiscal years, as such term is used in section 640(a)(7)(A) of such Act; and
(2) $19,000,000 shall be available to supplement funding otherwise available for research, evaluation, and Federal administrative costs:
Provided further, That the Secretary may reduce the reservation of funds under section 640(a)(2)(C) of such Act in lieu of reducing the reservation of funds under sections 640(a)(2)(B), 640(a)(2)(D), and 640(a)(2)(E) of such Act: Provided further, That $175,000,000 shall be for carrying out section 303(a) of the Family Violence Prevention and Services Act, of which $7,000,000 shall be allocated notwithstanding section 303(a)(2) of such Act for carrying out section 309 of such Act: Provided further, That the percentages specified in section 112(a)(2) of the Child Abuse Prevention and Treatment Act shall not apply to funds appropriated under this heading: Provided further, That $4,000,000 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 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.
(Department of Health and Human Services Appropriations Act, 2020.)
Program and Financing (in millions of dollars)
|
||||
Identification code 075–1536–0–1–506 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0101 | Head Start | 10,438 | 10,671 | 10,613 |
0102 | Preschool Development Grants | 249 | 515 | |
0103 | Runaway and homeless youth (basic centers) | 54 | 63 | 63 |
0104 | Transitional living | 56 | 51 | 51 |
0106 | Education grants to reduce sexual abuse of runaway youth | 17 | 19 | 19 |
0109 | Child abuse State grants | 85 | 90 | 90 |
0110 | Child abuse discretionary activities | 33 | 35 | 51 |
0111 | Community-based child abuse prevention | 40 | 56 | 56 |
0112 | Child welfare services | 268 | 269 | 269 |
0113 | Child welfare training, research, or demonstration projects | 18 | 18 | 21 |
0114 | Adoption opportunities | 39 | 42 | 42 |
0116 | Adoption and Legal Guardianship Incentives | 75 | 75 | 75 |
0117 | Independent living education and training vouchers | 46 | 43 | 43 |
0124 | Native American programs | 54 | 56 | 57 |
0125 | Social services and income maintenance research | 6 | 7 | 6 |
0128 | ACF Federal administration | 202 | 206 | 209 |
0131 | Disaster human services case management | 2 | 2 | 4 |
|
|
|
||
0191 | Direct program activities, subtotal | 11,682 | 12,218 | 11,669 |
0301 | Community services block grant | 717 | 740 | |
0303 | Rural community facilities | 9 | 10 | |
0304 | Community economic development | 20 | 20 | |
0308 | Domestic violence hotline | 10 | 12 | 12 |
0309 | Family violence prevention and services | 164 | 175 | 175 |
|
|
|
||
0391 | Direct program activities, subtotal | 920 | 957 | 187 |
|
|
|
||
0400 | Total, direct program | 12,602 | 13,175 | 11,856 |
|
|
|
||
0799 | Total direct obligations | 12,602 | 13,175 | 11,856 |
0801 | Children and Families Services Programs (Reimbursable) | 31 | 22 | 22 |
|
|
|
||
0809 | Reimbursable program activities, subtotal | 31 | 22 | 22 |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 12,633 | 13,197 | 11,878 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 1,251 | 933 | 685 |
1001 | Discretionary unobligated balance brought fwd, Oct 1 | 1,251 | 933 | |
1012 | Unobligated balance transfers between expired and unexpired accounts | 3 | ||
1021 | Recoveries of prior year unpaid obligations | 3 | ||
|
|
|
||
1050 | Unobligated balance (total) | 1,257 | 933 | 685 |
Budget authority: | ||||
Appropriations, discretionary: | ||||
1100 | Appropriation | 12,329 | 12,877 | 11,856 |
1120 | Appropriations transferred to other accts [075–1503] | –48 | ||
|
|
|
||
1160 | Appropriation, discretionary (total) | 12,281 | 12,877 | 11,856 |
Spending authority from offsetting collections, discretionary: | ||||
1700 | Collected | 26 | 70 | 70 |
1701 | Change in uncollected payments, Federal sources | 2 | ||
|
|
|
||
1750 | Spending auth from offsetting collections, disc (total) | 28 | 70 | 70 |
Spending authority from offsetting collections, mandatory: | ||||
1800 | Collected | 2 | 1 | 1 |
1801 | Change in uncollected payments, Federal sources | 1 | 1 | |
|
|
|
||
1850 | Spending auth from offsetting collections, mand (total) | 2 | 2 | 2 |
1900 | Budget authority (total) | 12,311 | 12,949 | 11,928 |
1930 | Total budgetary resources available | 13,568 | 13,882 | 12,613 |
Memorandum (non-add) entries: | ||||
1940 | Unobligated balance expiring | –2 | ||
1941 | Unexpired unobligated balance, end of year | 933 | 685 | 735 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 8,884 | 9,739 | 10,767 |
3010 | New obligations, unexpired accounts | 12,633 | 13,197 | 11,878 |
3011 | Obligations ("upward adjustments"), expired accounts | 21 | ||
3020 | Outlays (gross) | –11,639 | –12,169 | –12,622 |
3040 | Recoveries of prior year unpaid obligations, unexpired | –3 | ||
3041 | Recoveries of prior year unpaid obligations, expired | –157 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 9,739 | 10,767 | 10,023 |
Uncollected payments: | ||||
3060 | Uncollected pymts, Fed sources, brought forward, Oct 1 | –20 | –17 | –18 |
3070 | Change in uncollected pymts, Fed sources, unexpired | –2 | –1 | –1 |
3071 | Change in uncollected pymts, Fed sources, expired | 5 | ||
|
|
|
||
3090 | Uncollected pymts, Fed sources, end of year | –17 | –18 | –19 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 8,864 | 9,722 | 10,749 |
3200 | Obligated balance, end of year | 9,722 | 10,749 | 10,004 |
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
4000 | Budget authority, gross | 12,309 | 12,947 | 11,926 |
Outlays, gross: | ||||
4010 | Outlays from new discretionary authority | 4,283 | 4,240 | 3,833 |
4011 | Outlays from discretionary balances | 7,353 | 7,929 | 8,789 |
|
|
|
||
4020 | Outlays, gross (total) | 11,636 | 12,169 | 12,622 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4030 | Federal sources | –27 | –70 | –70 |
4033 | Non-Federal sources | –2 | ||
|
|
|
||
4040 | Offsets against gross budget authority and outlays (total) | –29 | –70 | –70 |
Additional offsets against gross budget authority only: | ||||
4050 | Change in uncollected pymts, Fed sources, unexpired | –2 | ||
4052 | Offsetting collections credited to expired accounts | 3 | ||
|
|
|
||
4060 | Additional offsets against budget authority only (total) | 1 | ||
|
|
|
||
4070 | Budget authority, net (discretionary) | 12,281 | 12,877 | 11,856 |
4080 | Outlays, net (discretionary) | 11,607 | 12,099 | 12,552 |
Mandatory: | ||||
4090 | Budget authority, gross | 2 | 2 | 2 |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 2 | ||
4101 | Outlays from mandatory balances | 1 | ||
|
|
|
||
4110 | Outlays, gross (total) | 3 | ||
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4120 | Federal sources | –3 | –2 | –2 |
Additional offsets against gross budget authority only: | ||||
4140 | Change in uncollected pymts, Fed sources, unexpired | –1 | –1 | |
4142 | Offsetting collections credited to expired accounts | 1 | 1 | 1 |
|
|
|
||
4150 | Additional offsets against budget authority only (total) | 1 | ||
4170 | Outlays, net (mandatory) | –2 | –2 | |
4180 | Budget authority, net (total) | 12,281 | 12,877 | 11,856 |
4190 | Outlays, net (total) | 11,607 | 12,097 | 12,550 |
|
The request totals $11.86 billion, including more than $10.6 billion for Head Start. This request discontinues funding for the Community Services Block Grant, Rural Community Facilities, Community Economic Development, and Preschool Development Grants.
Object Classification (in millions of dollars)
|
||||
Identification code 075–1536–0–1–506 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
Personnel compensation: | ||||
11.1 | Full-time permanent | 108 | 115 | 114 |
11.3 | Other than full-time permanent | 4 | 4 | 4 |
11.5 | Other personnel compensation | 1 | 1 | 1 |
11.7 | Military personnel | 1 | 1 | 1 |
|
|
|
||
11.9 | Total personnel compensation | 114 | 121 | 120 |
12.1 | Civilian personnel benefits | 36 | 38 | 38 |
21.0 | Travel and transportation of persons | 3 | 4 | 3 |
23.1 | Rental payments to GSA | 5 | 16 | 16 |
23.3 | Communications, utilities, and miscellaneous charges | 1 | 1 | 1 |
25.1 | Advisory and assistance services | 244 | 255 | 244 |
25.2 | Other services from non-Federal sources | 19 | 20 | 20 |
25.3 | Other goods and services from Federal sources | 59 | 51 | 53 |
25.4 | Operation and maintenance of facilities | 1 | 2 | 2 |
26.0 | Supplies and materials | 1 | 1 | 1 |
41.0 | Grants, subsidies, and contributions | 12,119 | 12,666 | 11,358 |
|
|
|
||
99.0 | Direct obligations | 12,602 | 13,175 | 11,856 |
99.0 | Reimbursable obligations | 31 | 22 | 22 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 12,633 | 13,197 | 11,878 |
|
Employment Summary
|
||||
Identification code 075–1536–0–1–506 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 1,032 | 1,114 | 1,113 |
1101 | Direct military average strength employment | 5 | 6 | 6 |
2001 | Reimbursable civilian full-time equivalent employment | 10 | 10 | 10 |
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–1553–0–1–609 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Training and technical assistance | 13 | 17 | 12 |
0002 | Federal parent locator service | 25 | 28 | 25 |
|
|
|
||
0799 | Total direct obligations | 38 | 45 | 37 |
0801 | Federal Parent Locator Service reimbursable | 26 | 30 | 29 |
|
|
|
||
0899 | Total reimbursable obligations | 26 | 30 | 29 |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 64 | 75 | 66 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 11 | 11 | |
1021 | Recoveries of prior year unpaid obligations | 3 | ||
|
|
|
||
1050 | Unobligated balance (total) | 14 | 11 | |
Budget authority: | ||||
Appropriations, mandatory: | ||||
1200 | Appropriation | 37 | 37 | 37 |
1230 | Appropriations and/or unobligated balance of appropriations permanently reduced | –2 | –2 | |
|
|
|
||
1260 | Appropriations, mandatory (total) | 35 | 35 | 37 |
Spending authority from offsetting collections, mandatory: | ||||
1800 | Collected | 26 | 29 | 29 |
1802 | Offsetting collections (previously unavailable) | 1 | 1 | 1 |
1823 | New and/or unobligated balance of spending authority from offsetting collections temporarily reduced | –1 | –1 | |
|
|
|
||
1850 | Spending auth from offsetting collections, mand (total) | 26 | 29 | 30 |
1900 | Budget authority (total) | 61 | 64 | 67 |
1930 | Total budgetary resources available | 75 | 75 | 67 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 11 | 1 | |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 24 | 23 | 36 |
3010 | New obligations, unexpired accounts | 64 | 75 | 66 |
3020 | Outlays (gross) | –62 | –62 | –67 |
3040 | Recoveries of prior year unpaid obligations, unexpired | –3 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 23 | 36 | 35 |
Uncollected payments: | ||||
3060 | Uncollected pymts, Fed sources, brought forward, Oct 1 | –6 | –6 | –6 |
|
|
|
||
3090 | Uncollected pymts, Fed sources, end of year | –6 | –6 | –6 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 18 | 17 | 30 |
3200 | Obligated balance, end of year | 17 | 30 | 29 |
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 61 | 64 | 67 |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 41 | 45 | 45 |
4101 | Outlays from mandatory balances | 21 | 17 | 22 |
|
|
|
||
4110 | Outlays, gross (total) | 62 | 62 | 67 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4120 | Federal sources | –8 | –9 | –9 |
4123 | Non-Federal sources | –18 | –20 | –20 |
|
|
|
||
4130 | Offsets against gross budget authority and outlays (total) | –26 | –29 | –29 |
|
|
|
||
4160 | Budget authority, net (mandatory) | 35 | 35 | 38 |
4170 | Outlays, net (mandatory) | 36 | 33 | 38 |
4180 | Budget authority, net (total) | 35 | 35 | 38 |
4190 | Outlays, net (total) | 36 | 33 | 38 |
|
||||
Memorandum (non-add) entries: | ||||
5090 | Unexpired unavailable balance, SOY: Offsetting collections | 1 | 1 | 1 |
5092 | Unexpired unavailable balance, EOY: Offsetting collections | 1 | 1 | |
|
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).
Object Classification (in millions of dollars)
|
||||
Identification code 075–1553–0–1–609 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
11.1 | Personnel compensation: Full-time permanent | 8 | 9 | 9 |
12.1 | Civilian personnel benefits | 2 | 2 | 3 |
21.0 | Travel and transportation of persons | 1 | 1 | 1 |
23.1 | Rental payments to GSA | 3 | 3 | 3 |
25.2 | Other services from non-Federal sources | 10 | 13 | 9 |
25.3 | Other goods and services from Federal sources | 6 | 7 | 5 |
25.4 | Operation and maintenance of facilities | 1 | 1 | 1 |
25.7 | Operation and maintenance of equipment | 7 | 9 | 6 |
|
|
|
||
99.0 | Direct obligations | 38 | 45 | 37 |
99.0 | Reimbursable obligations | 26 | 30 | 29 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 64 | 75 | 66 |
|
Employment Summary
|
||||
Identification code 075–1553–0–1–609 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 61 | 68 | 71 |
|
The Budget includes a set of proposals that would require changes to statute to provide additional access to the National Directory of New Hires for evidence building and program integrity purposes, while ensuring privacy and security safeguards.
For carrying out, except as otherwise provided, title IV-E of the Social Security Act, $7,012,000,000.
For carrying out, except as otherwise provided, title IV-E of the Social Security Act, for the first quarter of fiscal year 2022, $3,000,000,000.
For carrying out, after May 31 of the current fiscal year, except as otherwise provided, 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.
(Department of Health and Human Services Appropriations Act, 2020.)
Program and Financing (in millions of dollars)
|
||||
Identification code 075–1545–0–1–609 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Foster care | 5,231 | 5,569 | 5,796 |
0002 | Independent living | 142 | 143 | 143 |
0004 | Adoption assistance | 2,993 | 3,430 | 3,802 |
0005 | Guardianship | 189 | 242 | 271 |
0006 | Technical Assistance and Implementation Services for Tribal Programs | 3 | 3 | 3 |
0007 | Prevention Services Technical Assistance | 1 | 1 | 1 |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 8,559 | 9,388 | 10,016 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 2 | 2 | |
1012 | Unobligated balance transfers between expired and unexpired accounts | 2 | ||
|
|
|
||
1050 | Unobligated balance (total) | 2 | 2 | 2 |
Budget authority: | ||||
Appropriations, mandatory: | ||||
1200 | Appropriation | 5,860 | 6,589 | 7,015 |
1230 | Appropriations and/or unobligated balance of appropriations permanently reduced | –1 | –1 | |
|
|
|
||
1260 | Appropriations, mandatory (total) | 5,859 | 6,588 | 7,015 |
Advance appropriations, mandatory: | ||||
1270 | Advance appropriation | 2,700 | 2,800 | 3,000 |
1900 | Budget authority (total) | 8,559 | 9,388 | 10,015 |
1930 | Total budgetary resources available | 8,561 | 9,390 | 10,017 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 2 | 2 | 1 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 1,214 | 1,410 | 1,409 |
3010 | New obligations, unexpired accounts | 8,559 | 9,388 | 10,016 |
3011 | Obligations ("upward adjustments"), expired accounts | 359 | ||
3020 | Outlays (gross) | –8,619 | –9,389 | –9,910 |
3041 | Recoveries of prior year unpaid obligations, expired | –103 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 1,410 | 1,409 | 1,515 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 1,214 | 1,410 | 1,409 |
3200 | Obligated balance, end of year | 1,410 | 1,409 | 1,515 |
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 8,559 | 9,388 | 10,015 |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 7,513 | 8,259 | 8,816 |
4101 | Outlays from mandatory balances | 1,106 | 1,130 | 1,094 |
|
|
|
||
4110 | Outlays, gross (total) | 8,619 | 9,389 | 9,910 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4123 | Non-Federal sources | –20 | ||
Additional offsets against gross budget authority only: | ||||
4142 | Offsetting collections credited to expired accounts | 20 | ||
|
|
|
||
4160 | Budget authority, net (mandatory) | 8,559 | 9,388 | 10,015 |
4170 | Outlays, net (mandatory) | 8,599 | 9,389 | 9,910 |
4180 | Budget authority, net (total) | 8,559 | 9,388 | 10,015 |
4190 | Outlays, net (total) | 8,599 | 9,389 | 9,910 |
|
Summary of Budget Authority and Outlays (in millions of dollars)
|
||||
2019 actual | 2020 est. | 2021 est. | ||
|
||||
Enacted/requested: | ||||
Budget Authority | 8,559 | 9,388 | 10,015 | |
Outlays | 8,599 | 9,389 | 9,910 | |
Legislative proposal, subject to PAYGO: | ||||
Budget Authority | 45 | |||
Outlays | 45 | |||
Total: | ||||
Budget Authority | 8,559 | 9,388 | 10,060 | |
Outlays | 8,599 | 9,389 | 9,955 | |
|
This account provides formula grants for Foster Care, Adoption Assistance, Guardianship Assistance Program, Foster Care Prevention Services, and the Chafee Program for Successful Transition to Adulthood, as well as technical assistance and implementation services for tribal programs.
Foster Care—The proposed level will support eligible low-income children who must be placed outside the home. An average of 171,500 children per month are estimated to be served in FY 2021.
Adoption Assistance—The proposed funding level will support subsidies for families adopting eligible low-income children with special needs. An average of 649,400 children per month are estimated to be served in FY 2021.
Guardianship Assistance Program—The proposed funding level will provide payments for relatives taking legal guardianship of eligible children who have been in foster care. An average of 46,300 children per month are estimated to be served in FY 2021.
Object Classification (in millions of dollars)
|
||||
Identification code 075–1545–0–1–609 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
21.0 | Travel and transportation of persons | 1 | 1 | 1 |
23.1 | Rental payments to GSA | 1 | 1 | 1 |
25.1 | Advisory and assistance services | 30 | 32 | 34 |
25.2 | Other services from non-Federal sources | 1 | 1 | 1 |
41.0 | Grants, subsidies, and contributions | 8,526 | 9,353 | 9,979 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 8,559 | 9,388 | 10,016 |
|
Employment Summary
|
||||
Identification code 075–1545–0–1–609 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 3 | 3 | 3 |
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–1545–4–1–609 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Foster care | 19 | ||
0002 | Independent living | 12 | ||
0004 | Adoption assistance | 13 | ||
0005 | Guardianship | 1 | ||
|
|
|
||
0900 | Total new obligations, unexpired accounts (object class 41.0) | 45 | ||
|
||||
Budgetary resources: | ||||
Budget authority: | ||||
Appropriations, mandatory: | ||||
1200 | Appropriation | 45 | ||
1900 | Budget authority (total) | 45 | ||
1930 | Total budgetary resources available | 45 | ||
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3010 | New obligations, unexpired accounts | 45 | ||
3020 | Outlays (gross) | –45 | ||
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 45 | ||
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 45 | ||
4180 | Budget authority, net (total) | 45 | ||
4190 | Outlays, net (total) | 45 | ||
|
The Budget includes proposals to create the Child Welfare Flexible Funding Option for title IV-E agencies, to create a performance incentive for improving Child and Family Services Reviews outcomes, and to allow states to pay salaries to foster parents who can care for children with complex needs. The Budget provides new flexibilities and support in the Chafee program for youth transitioning out of foster care. The Family First Improvements proposal streamlines approval of title IV-E prevention services and kinship navigator programs and provides additional flexibility to title IV-E tribal agencies in operating the title IV-E program. Additionally, the Budget includes the interaction effects from the proposal to eliminate SSBG funding, which increases costs in the Foster Care and Permanency account due to State agencies shifting eligible expenses previously funded by SSBG to Foster Care and Permanency.
For carrying out, to the extent not otherwise provided, the Older Americans Act of 1965 ("OAA"), the RAISE Family Caregivers Act, the Supporting Grandparents Raising Grandchildren Act, titles III and XXIX of the PHS Act, sections 1252 and 1253 of the PHS Act, section 119 of the Medicare Improvements for Patients and Providers Act of 2008, title XX-B of the Social Security Act, the Developmental Disabilities Assistance and Bill of Rights Act, parts 2 and 5 of subtitle D of title II of the Help America Vote Act of 2002, the Assistive Technology Act of 1998, titles II and VII (and section 14 with respect to such titles) of the Rehabilitation Act of 1973, and for Department-wide coordination of policy and program activities that assist individuals with disabilities, $2,072,092,000, together with $36,115,000 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: Provided, 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 which have been demonstrated through rigorous evaluation to be evidence-based and effective: Provided further, That of amounts made available under this heading to carry out section 321 of the OAA, up to one percent of such amounts shall be available for developing and implementing evidence-based practices for enhancing home and community-based supportive services: Provided further, That of amounts made available under this heading to carry out sections 311, 331, and 336 of the OAA, up to one percent of such amounts shall be available for developing and implementing evidence-based practices for enhancing senior nutrition, including medically-tailored meals: Provided further, That notwithstanding any other provision of this Act, funds made available under this heading to carry out section 311 of the OAA may be transferred to the Secretary of Agriculture in accordance with such section: Provided further, That of the amount made available under this heading, $5,000,000 shall be available for a program under which the Secretary may make competitive grants to centers for independent living that have received grants under part C of chapter 1 of title VII of the Rehabilitation Act of 1973, to develop evidence-based interventions to increase employment of individuals with disabilities: Provided further, That none of the funds made available under this heading may be used by an eligible system (as defined in section 102 of the Protection and Advocacy for Individuals with Mental Illness Act (42 U.S.C. 10802)) to continue to pursue any legal action in a Federal or State court on behalf of an individual or group of individuals with a developmental disability (as defined in section 102(8)(A) of the Developmental Disabilities and Assistance and Bill of Rights Act of 2000 (20 U.S.C. 15002(8)(A)) that is attributable to a mental impairment (or a combination of mental and physical impairments), that has as the requested remedy the closure of State operated intermediate care facilities for people with intellectual or developmental disabilities, unless reasonable public notice of the action has been provided to such individuals (or, in the case of mental incapacitation, the legal guardians who have been specifically awarded authority by the courts to make healthcare and residential decisions on behalf of such individuals) who are affected by such action, within 90 days of instituting such legal action, which informs such individuals (or such legal guardians) of their legal rights and how to exercise such rights consistent with current Federal Rules of Civil Procedure: Provided further, That the limitations in the immediately preceding proviso shall not apply in the case of an individual who is neither competent to consent nor has a legal guardian, nor shall the proviso apply in the case of individuals who are a ward of the State or subject to public guardianship.
(Department of Health and Human Services Appropriations Act, 2020.)
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0142–0–1–506 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0101 | Aging Services Programs | 1,629 | 1,651 | 1,627 |
0102 | ACL Program Administration | 40 | 41 | 42 |
0103 | Integrated Aging and Disability Services Programs | 44 | 53 | 46 |
0104 | Disability Services Programs | 321 | 314 | 267 |
0105 | National Institute on Disability, Independent Living & Rehab Research | 109 | 112 | 90 |
|
|
|
||
0300 | Total, direct program | 2,143 | 2,171 | 2,072 |
|
|
|
||
0799 | Total direct obligations | 2,143 | 2,171 | 2,072 |
0801 | ACL Reimbursable Programs | 94 | 85 | 54 |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 2,237 | 2,256 | 2,126 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 7 | 6 | 28 |
1001 | Discretionary unobligated balance brought fwd, Oct 1 | 7 | 6 | |
1021 | Recoveries of prior year unpaid obligations | 4 | ||
|
|
|
||
1050 | Unobligated balance (total) | 11 | 6 | 28 |
Budget authority: | ||||
Appropriations, discretionary: | ||||
1100 | Appropriation | 2,120 | 2,171 | 2,072 |
1120 | Appropriations transferred to other accts [012–3507] | –2 | ||
1120 | Appropriations transferred to other acct [075–1503] | –7 | ||
|
|
|
||
1160 | Appropriation, discretionary (total) | 2,111 | 2,171 | 2,072 |
Appropriations, mandatory: | ||||
1221 | PPHF Appropriations transferred from other accounts [075–0116] | 28 | 28 | |
Spending authority from offsetting collections, discretionary: | ||||
1700 | Collected | 11 | 14 | 11 |
1701 | Change in uncollected payments, Federal sources | 58 | 57 | 44 |
|
|
|
||
1750 | Spending auth from offsetting collections, disc (total) | 69 | 71 | 55 |
Spending authority from offsetting collections, mandatory: | ||||
1800 | Collected | 17 | ||
1801 | Change in uncollected payments, Federal sources | 8 | 8 | |
|
|
|
||
1850 | Spending auth from offsetting collections, mand (total) | 25 | 8 | |
1900 | Budget authority (total) | 2,233 | 2,278 | 2,127 |
1930 | Total budgetary resources available | 2,244 | 2,284 | 2,155 |
Memorandum (non-add) entries: | ||||
1940 | Unobligated balance expiring | –1 | ||
1941 | Unexpired unobligated balance, end of year | 6 | 28 | 29 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 1,470 | 1,516 | 1,202 |
3010 | New obligations, unexpired accounts | 2,237 | 2,256 | 2,126 |
3011 | Obligations ("upward adjustments"), expired accounts | 4 | ||
3020 | Outlays (gross) | –2,177 | –2,570 | –2,193 |
3040 | Recoveries of prior year unpaid obligations, unexpired | –4 | ||
3041 | Recoveries of prior year unpaid obligations, expired | –14 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 1,516 | 1,202 | 1,135 |
Uncollected payments: | ||||
3060 | Uncollected pymts, Fed sources, brought forward, Oct 1 | –190 | –129 | –194 |
3070 | Change in uncollected pymts, Fed sources, unexpired | –66 | –65 | –44 |
3071 | Change in uncollected pymts, Fed sources, expired | 127 | ||
|
|
|
||
3090 | Uncollected pymts, Fed sources, end of year | –129 | –194 | –238 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 1,280 | 1,387 | 1,008 |
3200 | Obligated balance, end of year | 1,387 | 1,008 | 897 |
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
4000 | Budget authority, gross | 2,180 | 2,242 | 2,127 |
Outlays, gross: | ||||
4010 | Outlays from new discretionary authority | 1,019 | 1,338 | 1,275 |
4011 | Outlays from discretionary balances | 1,110 | 1,182 | 882 |
|
|
|
||
4020 | Outlays, gross (total) | 2,129 | 2,520 | 2,157 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4030 | Federal sources | –136 | –55 | –55 |
Additional offsets against gross budget authority only: | ||||
4050 | Change in uncollected pymts, Fed sources, unexpired | –58 | –57 | –44 |
4052 | Offsetting collections credited to expired accounts | 125 | 41 | 44 |
|
|
|
||
4060 | Additional offsets against budget authority only (total) | 67 | –16 | |
|
|
|
||
4070 | Budget authority, net (discretionary) | 2,111 | 2,171 | 2,072 |
4080 | Outlays, net (discretionary) | 1,993 | 2,465 | 2,102 |
Mandatory: | ||||
4090 | Budget authority, gross | 53 | 36 | |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 2 | 3 | |
4101 | Outlays from mandatory balances | 46 | 47 | 36 |
|
|
|
||
4110 | Outlays, gross (total) | 48 | 50 | 36 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4120 | Federal sources | –18 | –8 | |
Additional offsets against gross budget authority only: | ||||
4140 | Change in uncollected pymts, Fed sources, unexpired | –8 | –8 | |
4142 | Offsetting collections credited to expired accounts | 1 | 8 | |
|
|
|
||
4150 | Additional offsets against budget authority only (total) | –7 | ||
|
|
|
||
4160 | Budget authority, net (mandatory) | 28 | 28 | |
4170 | Outlays, net (mandatory) | 30 | 42 | 36 |
4180 | Budget authority, net (total) | 2,139 | 2,199 | 2,072 |
4190 | Outlays, net (total) | 2,023 | 2,507 | 2,138 |
|
Summary of Budget Authority and Outlays (in millions of dollars)
|
||||
2019 actual | 2020 est. | 2021 est. | ||
|
||||
Enacted/requested: | ||||
Budget Authority | 2,139 | 2,199 | 2,072 | |
Outlays | 2,023 | 2,507 | 2,138 | |
Legislative proposal, subject to PAYGO: | ||||
Budget Authority | 19 | 25 | ||
Outlays | 4 | 15 | ||
Total: | ||||
Budget Authority | 2,139 | 2,218 | 2,097 | |
Outlays | 2,023 | 2,511 | 2,153 | |
|
This account funds formula and discretionary grants that provide home and community-based services and supports to assist older adults and people of all ages with disabilities to live independently and to fully participate in their communities. ACL works with states, localities, tribal organizations, nonprofit organizations, businesses and families, and through networks of aging and disability organizations, to provide these services and supports which include nutrition, supportive, caregiver, independent living, and protection and advocacy services.
Object Classification (in millions of dollars)
|
||||
Identification code 075–0142–0–1–506 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
11.1 | Personnel compensation: Full-time permanent | 22 | 22 | 22 |
12.1 | Civilian personnel benefits | 7 | 7 | 7 |
23.1 | Rental payments to GSA | 3 | 3 | 3 |
25.1 | Advisory and assistance services | 44 | 44 | 44 |
41.0 | Grants, subsidies, and contributions | 2,067 | 2,096 | 1,996 |
|
|
|
||
99.0 | Direct obligations | 2,143 | 2,172 | 2,072 |
99.0 | Reimbursable obligations | 94 | 84 | 54 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 2,237 | 2,256 | 2,126 |
|
Employment Summary
|
||||
Identification code 075–0142–0–1–506 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 168 | 177 | 180 |
2001 | Reimbursable civilian full-time equivalent employment | 12 | 11 | 11 |
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0142–4–1–506 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0801 | ACL Reimbursable Programs | 29 | 51 | |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | –10 | ||
Budget authority: | ||||
Spending authority from offsetting collections, mandatory: | ||||
1800 | Collected | 19 | 25 | |
1900 | Budget authority (total) | 19 | 25 | |
1930 | Total budgetary resources available | 19 | 15 | |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | –10 | –36 | |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 25 | ||
3010 | New obligations, unexpired accounts | 29 | 51 | |
3020 | Outlays (gross) | –4 | –15 | |
|
|
|
||
3050 | Unpaid obligations, end of year | 25 | 61 | |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 25 | ||
3200 | Obligated balance, end of year | 25 | 61 | |
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 19 | 25 | |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 4 | 5 | |
4101 | Outlays from mandatory balances | 10 | ||
|
|
|
||
4110 | Outlays, gross (total) | 4 | 15 | |
4180 | Budget authority, net (total) | 19 | 25 | |
4190 | Outlays, net (total) | 4 | 15 | |
|
This legislative proposal extends funding for Medicare enrollment assistance programs through 2021.
Object Classification (in millions of dollars)
|
||||
Identification code 075–0142–4–1–506 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Reimbursable obligations: | ||||
25.1 | Advisory and assistance services | 1 | 3 | |
41.0 | Grants, subsidies, and contributions | 28 | 48 | |
|
|
|
||
99.0 | Reimbursable obligations | 29 | 51 | |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 29 | 51 | |
|
Employment Summary
|
||||
Identification code 075–0142–4–1–506 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
2001 | Reimbursable civilian full-time equivalent employment | 1 | 4 | |
|
For necessary expenses, not otherwise provided, for general departmental management, including hire of six passenger motor vehicles, and for carrying out titles III, XVII, XXI, and section 229 of the PHS Act, the United States-Mexico Border Health Commission Act, and to carry out health or human services research and evaluation activities, including such activities that are similar to activities carried out by other components of the Department, $347,105,000, together with $73,840,000 from the amounts available under section 241 of the PHS Act : Provided, That of this amount, $53,900,000 shall be for minority AIDS prevention and treatment activities: Provided further, That of the funds made available under this heading, $2,000,000 shall be for carrying out prize competitions sponsored by the Office of the Secretary to accelerate innovation in the prevention, diagnosis, and treatment of kidney diseases (as authorized by section 24 of the Stevenson-Wydler Technology Innovation Act of 1980 (15 U.S.C. 3719)).
(Department of Health and Human Services Appropriations Act, 2020.)
Program and Financing (in millions of dollars)
|
||||
Identification code 075–9912–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | GDM Direct | 481 | 480 | 347 |
|
|
|
||
0100 | Direct, subtotal | 481 | 480 | 347 |
0802 | GDM Reimbursable (collected) | 169 | 191 | 182 |
0803 | PHS Evaluation Reimbursable (Collected) | 65 | 65 | 74 |
|
|
|
||
0809 | Reimbursable program activities, subtotal | 234 | 256 | 256 |
0811 | HCFAC Mandatory (R) | 7 | 7 | 10 |
0812 | MACRA Mandatory (R) | 5 | 5 | 5 |
|
|
|
||
0819 | Reimbursable program activities, subtotal | 12 | 12 | 15 |
|
|
|
||
0899 | Total reimbursable obligations | 246 | 268 | 271 |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 727 | 748 | 618 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 11 | 13 | 13 |
Budget authority: | ||||
Appropriations, discretionary: | ||||
1100 | Appropriation [GDM Direct] | 481 | 480 | 347 |
1120 | Appropriations transferred — other accts [075–1503] | –1 | ||
|
|
|
||
1160 | Appropriation, discretionary (total) | 480 | 480 | 347 |
Spending authority from offsetting collections, discretionary: | ||||
1700 | Collected | 106 | 256 | 260 |
1701 | Change in uncollected payments, Federal sources | 127 | ||
1711 | Spending authority transferred other accounts [075–0511] | 5 | ||
|
|
|
||
1750 | Spending auth from offsetting collections, disc (total) | 238 | 256 | 260 |
Spending authority from offsetting collections, mandatory: | ||||
1800 | Collected | 11 | 12 | 15 |
1801 | Change in uncollected payments, Federal sources | 1 | ||
|
|
|
||
1850 | Spending auth from offsetting collections, mand (total) | 12 | 12 | 15 |
1900 | Budget authority (total) | 730 | 748 | 622 |
1930 | Total budgetary resources available | 741 | 761 | 635 |
Memorandum (non-add) entries: | ||||
1940 | Unobligated balance expiring | –1 | ||
1941 | Unexpired unobligated balance, end of year | 13 | 13 | 17 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 493 | 525 | 527 |
3010 | New obligations, unexpired accounts | 727 | 748 | 618 |
3011 | Obligations ("upward adjustments"), expired accounts | 8 | ||
3020 | Outlays (gross) | –684 | –746 | –694 |
3041 | Recoveries of prior year unpaid obligations, expired | –19 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 525 | 527 | 451 |
Uncollected payments: | ||||
3060 | Uncollected pymts, Fed sources, brought forward, Oct 1 | –318 | –248 | –248 |
3070 | Change in uncollected pymts, Fed sources, unexpired | –128 | ||
3071 | Change in uncollected pymts, Fed sources, expired | 198 | ||
|
|
|
||
3090 | Uncollected pymts, Fed sources, end of year | –248 | –248 | –248 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 175 | 277 | 279 |
3200 | Obligated balance, end of year | 277 | 279 | 203 |
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
4000 | Budget authority, gross | 718 | 736 | 607 |
Outlays, gross: | ||||
4010 | Outlays from new discretionary authority | 357 | 352 | 296 |
4011 | Outlays from discretionary balances | 315 | 382 | 383 |
|
|
|
||
4020 | Outlays, gross (total) | 672 | 734 | 679 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4030 | Federal sources: | –298 | –256 | –260 |
4033 | Non-Federal sources: | –1 | ||
|
|
|
||
4040 | Offsets against gross budget authority and outlays (total) | –299 | –256 | –260 |
Additional offsets against gross budget authority only: | ||||
4050 | Change in uncollected pymts, Fed sources, unexpired | –127 | ||
4052 | Offsetting collections credited to expired accounts | 193 | ||
|
|
|
||
4060 | Additional offsets against budget authority only (total) | 66 | ||
|
|
|
||
4070 | Budget authority, net (discretionary) | 485 | 480 | 347 |
4080 | Outlays, net (discretionary) | 373 | 478 | 419 |
Mandatory: | ||||
4090 | Budget authority, gross | 12 | 12 | 15 |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 8 | 12 | 15 |
4101 | Outlays from mandatory balances | 4 | ||
|
|
|
||
4110 | Outlays, gross (total) | 12 | 12 | 15 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4120 | Federal sources: | –14 | –12 | –15 |
Additional offsets against gross budget authority only: | ||||
4140 | Change in uncollected pymts, Fed sources, unexpired | –1 | ||
4142 | Offsetting collections credited to expired accounts | 3 | ||
|
|
|
||
4150 | Additional offsets against budget authority only (total) | 2 | ||
4170 | Outlays, net (mandatory) | –2 | ||
4180 | Budget authority, net (total) | 485 | 480 | 347 |
4190 | Outlays, net (total) | 371 | 478 | 419 |
|
Note.—The reimbursable program (HCFAC) in the General Department Management (GDM) account reflects estimates of the allocation for 2021 . The actual allocation is determined annually.
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.
Object Classification (in millions of dollars)
|
||||
Identification code 075–9912–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
Personnel compensation: | ||||
11.1 | Full-time permanent | 83 | 90 | 87 |
11.3 | Other than full-time permanent | 4 | 4 | 4 |
11.5 | Other personnel compensation | 2 | 2 | 2 |
11.7 | Military personnel | 3 | 2 | 2 |
|
|
|
||
11.9 | Total personnel compensation | 92 | 98 | 95 |
12.1 | Civilian personnel benefits | 25 | 31 | 30 |
12.2 | Military personnel benefits | 1 | 1 | 1 |
21.0 | Travel and transportation of persons | 5 | 4 | 4 |
23.1 | Rental payments to GSA | 20 | 21 | 22 |
23.3 | Communications, utilities, and miscellaneous charges | 2 | 2 | 2 |
24.0 | Printing and reproduction | 1 | 1 | 1 |
25.1 | Advisory and assistance services | 22 | 21 | 17 |
25.2 | Other services from non-Federal sources | 35 | 26 | 28 |
25.3 | Other goods and services from Federal sources | 125 | 124 | 88 |
25.4 | Operation and maintenance of facilities | 5 | 5 | 6 |
25.7 | Operation and maintenance of equipment | 3 | 3 | 3 |
26.0 | Supplies and materials | 1 | 1 | 1 |
31.0 | Equipment | 1 | 1 | 1 |
41.0 | Grants, subsidies, and contributions | 143 | 141 | 48 |
|
|
|
||
99.0 | Direct obligations | 481 | 480 | 347 |
99.0 | Reimbursable obligations | 246 | 268 | 271 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 727 | 748 | 618 |
|
Employment Summary
|
||||
Identification code 075–9912–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 836 | 868 | 833 |
1101 | Direct military average strength employment | 25 | 22 | 24 |
2001 | Reimbursable civilian full-time equivalent employment | 491 | 486 | 507 |
2101 | Reimbursable military average strength employment | 15 | 15 | 13 |
|
This account, and a related special receipt account, were established to support the execution structure necessary to implement the 21st Century Cures Act.
The 21st Century Cures Act authorized in 2017 and 2018 grants to states, the District of Columbia, and territories to develop and provide opioid abuse prevention, treatment, and recovery support services.
For expenses necessary for the Office for Civil Rights, $30,286,000.
(Department of Health and Human Services Appropriations Act, 2020.)
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0135–0–1–751 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Office for Civil Rights (Direct) | 39 | 39 | 30 |
0801 | Office for Civil Rights (Reimbursable) | 7 | 14 | 27 |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 46 | 53 | 57 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 34 | 53 | 49 |
1021 | Recoveries of prior year unpaid obligations | 3 | ||
|
|
|
||
1050 | Unobligated balance (total) | 37 | 53 | 49 |
Budget authority: | ||||
Appropriations, discretionary: | ||||
1100 | Appropriation | 39 | 39 | 30 |
Spending authority from offsetting collections, mandatory: | ||||
1800 | Collected | 23 | 10 | 10 |
1802 | Offsetting collections (previously unavailable) | 1 | ||
1823 | New and/or unobligated balance of spending authority from offsetting collections temporarily reduced | –1 | ||
|
|
|
||
1850 | Spending auth from offsetting collections, mand (total) | 23 | 10 | 10 |
1900 | Budget authority (total) | 62 | 49 | 40 |
1930 | Total budgetary resources available | 99 | 102 | 89 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 53 | 49 | 32 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 23 | 15 | 4 |
3010 | New obligations, unexpired accounts | 46 | 53 | 57 |
3020 | Outlays (gross) | –51 | –64 | –48 |
3040 | Recoveries of prior year unpaid obligations, unexpired | –3 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 15 | 4 | 13 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 23 | 15 | 4 |
3200 | Obligated balance, end of year | 15 | 4 | 13 |
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
4000 | Budget authority, gross | 39 | 39 | 30 |
Outlays, gross: | ||||
4010 | Outlays from new discretionary authority | 34 | 31 | 24 |
4011 | Outlays from discretionary balances | 6 | 8 | 8 |
|
|
|
||
4020 | Outlays, gross (total) | 40 | 39 | 32 |
Mandatory: | ||||
4090 | Budget authority, gross | 23 | 10 | 10 |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 1 | 1 | |
4101 | Outlays from mandatory balances | 11 | 24 | 15 |
|
|
|
||
4110 | Outlays, gross (total) | 11 | 25 | 16 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4123 | Non-Federal sources | –23 | –10 | –10 |
4180 | Budget authority, net (total) | 39 | 39 | 30 |
4190 | Outlays, net (total) | 28 | 54 | 38 |
|
The Office for Civil Rights funds activities that carry out the Department's civil rights, nondiscrimination, health information privacy, and security compliance programs.
Object Classification (in millions of dollars)
|
||||
Identification code 075–0135–0–1–751 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
Personnel compensation: | ||||
11.1 | Full-time permanent | 16 | 17 | 15 |
11.3 | Other than full-time permanent | 1 | 1 | 1 |
|
|
|
||
11.9 | Total personnel compensation | 17 | 18 | 16 |
12.1 | Civilian personnel benefits | 6 | 6 | 6 |
21.0 | Travel and transportation of persons | 1 | 1 | 1 |
23.1 | Rental payments to GSA | 4 | 4 | 1 |
25.2 | Other services from non-Federal sources | 1 | 2 | 1 |
25.3 | Other goods and services from Federal sources | 9 | 8 | 5 |
31.0 | Equipment | 1 | ||
|
|
|
||
99.0 | Direct obligations | 39 | 39 | 30 |
99.0 | Reimbursable obligations | 7 | 14 | 27 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 46 | 53 | 57 |
|
Employment Summary
|
||||
Identification code 075–0135–0–1–751 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 138 | 150 | 140 |
1101 | Direct military average strength employment | 1 | 1 | 1 |
2001 | Reimbursable civilian full-time equivalent employment | 1 | 2 | 1 |
|
For expenses necessary for the Office of the National Coordinator for Health Information Technology, including grants, contracts, and cooperative agreements for the development and advancement of interoperable health information technology, $50,717,000.
(Department of Health and Human Services Appropriations Act, 2020.)
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0130–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Health information technology (IT) | 60 | 60 | 51 |
|
|
|
||
0799 | Total direct obligations | 60 | 60 | 51 |
0801 | Office of the National Coordinator for Health IT (ONC): Reimbursable | 6 | 6 | 6 |
|
|
|
||
0899 | Total reimbursable obligations | 6 | 6 | 6 |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 66 | 66 | 57 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 2 | 10 | 19 |
1021 | Recoveries of prior year unpaid obligations | 9 | ||
|
|
|
||
1050 | Unobligated balance (total) | 11 | 10 | 19 |
Budget authority: | ||||
Appropriations, discretionary: | ||||
1100 | Appropriation | 60 | 60 | 51 |
Spending authority from offsetting collections, discretionary: | ||||
1700 | Collected | 15 | 15 | |
1701 | Change in uncollected payments, Federal sources | 5 | ||
|
|
|
||
1750 | Spending auth from offsetting collections, disc (total) | 5 | 15 | 15 |
1900 | Budget authority (total) | 65 | 75 | 66 |
1930 | Total budgetary resources available | 76 | 85 | 85 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 10 | 19 | 28 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 68 | 54 | 13 |
3010 | New obligations, unexpired accounts | 66 | 66 | 57 |
3011 | Obligations ("upward adjustments"), expired accounts | 2 | ||
3020 | Outlays (gross) | –69 | –107 | –68 |
3040 | Recoveries of prior year unpaid obligations, unexpired | –9 | ||
3041 | Recoveries of prior year unpaid obligations, expired | –4 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 54 | 13 | 2 |
Uncollected payments: | ||||
3060 | Uncollected pymts, Fed sources, brought forward, Oct 1 | –20 | –10 | –10 |
3070 | Change in uncollected pymts, Fed sources, unexpired | –5 | ||
3071 | Change in uncollected pymts, Fed sources, expired | 15 | ||
|
|
|
||
3090 | Uncollected pymts, Fed sources, end of year | –10 | –10 | –10 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 48 | 44 | 3 |
3200 | Obligated balance, end of year | 44 | 3 | –8 |
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
4000 | Budget authority, gross | 65 | 75 | 66 |
Outlays, gross: | ||||
4010 | Outlays from new discretionary authority | 41 | 64 | 56 |
4011 | Outlays from discretionary balances | 28 | 43 | 12 |
|
|
|
||
4020 | Outlays, gross (total) | 69 | 107 | 68 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4030 | Federal sources: | –14 | –15 | –15 |
|
|
|
||
4040 | Offsets against gross budget authority and outlays (total) | –14 | –15 | –15 |
Additional offsets against gross budget authority only: | ||||
4050 | Change in uncollected pymts, Fed sources, unexpired | –5 | ||
4052 | Offsetting collections credited to expired accounts | 14 | ||
|
|
|
||
4060 | Additional offsets against budget authority only (total) | 9 | ||
|
|
|
||
4070 | Budget authority, net (discretionary) | 60 | 60 | 51 |
4080 | Outlays, net (discretionary) | 55 | 92 | 53 |
4180 | Budget authority, net (total) | 60 | 60 | 51 |
4190 | Outlays, net (total) | 55 | 92 | 53 |
|
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 authorized in title XXX of the PHS Act as added by the Health Information Technology for Economic and Clinical Health (HITECH) Act (P.L. 111–5, Title XIII) and the 21st Century Cures Act (P.L. 114–255), 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.
Object Classification (in millions of dollars)
|
||||
Identification code 075–0130–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
Personnel compensation: | ||||
11.1 | Full-time permanent | 19 | 19 | 19 |
11.3 | Other than full-time permanent | 1 | 1 | 1 |
11.5 | Other personnel compensation | 1 | 1 | 1 |
|
|
|
||
11.9 | Total personnel compensation | 21 | 21 | 21 |
12.1 | Civilian personnel benefits | 6 | 6 | 6 |
23.1 | Rental payments to GSA | 2 | 2 | 2 |
25.2 | Other services from non-Federal sources | 13 | 13 | 11 |
25.3 | Other goods and services from Federal sources | 11 | 11 | 9 |
41.0 | Grants, subsidies, and contributions | 6 | 6 | |
|
|
|
||
99.0 | Direct obligations | 59 | 59 | 49 |
99.0 | Reimbursable obligations | 5 | 5 | 5 |
99.5 | Adjustment for rounding | 2 | 2 | 3 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 66 | 66 | 57 |
|
Employment Summary
|
||||
Identification code 075–0130–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 156 | 162 | 162 |
1101 | Direct military average strength employment | 2 | 2 | 2 |
|
For expenses necessary for Medicare hearings and appeals in the Office of the Secretary, $196,381,000 shall remain available until September 30, 2022, to be transferred in appropriate part from the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund.
(Department of Health and Human Services Appropriations Act, 2020.)
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0139–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Office of Medicare Hearings and Appeals (Direct) | 164 | 192 | 196 |
0002 | Proposed User Fees | 2 | ||
|
|
|
||
0799 | Total direct obligations | 164 | 192 | 198 |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 164 | 192 | 198 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 37 | 56 | 56 |
1021 | Recoveries of prior year unpaid obligations | 3 | ||
|
|
|
||
1050 | Unobligated balance (total) | 40 | 56 | 56 |
Budget authority: | ||||
Spending authority from offsetting collections, discretionary: | ||||
1700 | Collected | 127 | 192 | 196 |
1701 | Change in uncollected payments, Federal sources | 55 | ||
|
|
|
||
1750 | Spending auth from offsetting collections, disc (total) | 182 | 192 | 196 |
1900 | Budget authority (total) | 182 | 192 | 196 |
1930 | Total budgetary resources available | 222 | 248 | 252 |
Memorandum (non-add) entries: | ||||
1940 | Unobligated balance expiring | –2 | ||
1941 | Unexpired unobligated balance, end of year | 56 | 56 | 54 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 55 | 57 | 1 |
3010 | New obligations, unexpired accounts | 164 | 192 | 198 |
3020 | Outlays (gross) | –158 | –248 | –196 |
3040 | Recoveries of prior year unpaid obligations, unexpired | –3 | ||
3041 | Recoveries of prior year unpaid obligations, expired | –1 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 57 | 1 | 3 |
Uncollected payments: | ||||
3060 | Uncollected pymts, Fed sources, brought forward, Oct 1 | –106 | –156 | –156 |
3070 | Change in uncollected pymts, Fed sources, unexpired | –55 | ||
3071 | Change in uncollected pymts, Fed sources, expired | 5 | ||
|
|
|
||
3090 | Uncollected pymts, Fed sources, end of year | –156 | –156 | –156 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | –51 | –99 | –155 |
3200 | Obligated balance, end of year | –99 | –155 | –153 |
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
4000 | Budget authority, gross | 182 | 192 | 196 |
Outlays, gross: | ||||
4010 | Outlays from new discretionary authority | 98 | 192 | 196 |
4011 | Outlays from discretionary balances | 60 | ||
|
|
|
||
4020 | Outlays, gross (total) | 158 | 192 | 196 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4030 | Federal sources | –130 | –192 | –196 |
Additional offsets against gross budget authority only: | ||||
4050 | Change in uncollected pymts, Fed sources, unexpired | –55 | ||
4052 | Offsetting collections credited to expired accounts | 3 | ||
|
|
|
||
4060 | Additional offsets against budget authority only (total) | –52 | ||
4080 | Outlays, net (discretionary) | 28 | ||
Mandatory: | ||||
Outlays, gross: | ||||
4101 | Outlays from mandatory balances | 56 | ||
4180 | Budget authority, net (total) | |||
4190 | Outlays, net (total) | 28 | 56 | |
|
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, and the Medicare appeals related operations of the Departmental Appeals Board (DAB). OMHA provides an independent and impartial forum for the adjudication of claims brought by or on behalf of Medicare beneficiaries related to their benefits and care. The Departmental Appeals Board for Medicare provides final HHS administrative review of claims for Medicare entitlement, payment, and coverage.
Object Classification (in millions of dollars)
|
||||
Identification code 075–0139–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
Personnel compensation: | ||||
11.1 | Full-time permanent | 77 | 107 | 119 |
11.5 | Other personnel compensation | 2 | 2 | |
|
|
|
||
11.9 | Total personnel compensation | 77 | 109 | 121 |
12.1 | Civilian personnel benefits | 27 | 35 | 36 |
21.0 | Travel and transportation of persons | 1 | ||
22.0 | Transportation of things | 1 | ||
23.1 | Rental payments to GSA | 5 | 11 | 11 |
23.3 | Communications, utilities, and miscellaneous charges | 4 | 8 | 8 |
25.2 | Other services from non-Federal sources | 13 | 13 | 2 |
25.3 | Other goods and services from Federal sources | 19 | 10 | 12 |
25.4 | Operation and maintenance of facilities | 5 | 2 | 1 |
25.7 | Operation and maintenance of equipment | 1 | 2 | 3 |
26.0 | Supplies and materials | 3 | 1 | 1 |
31.0 | Equipment | 8 | 1 | 3 |
|
|
|
||
99.0 | Direct obligations | 164 | 192 | 198 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 164 | 192 | 198 |
|
Employment Summary
|
||||
Identification code 075–0139–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 853 | 1,376 | 1,339 |
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0139–4–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0801 | Reimbursable program activity | 2 | ||
|
|
|
||
0900 | Total new obligations, unexpired accounts (object class 25.2) | 2 | ||
|
||||
Budgetary resources: | ||||
Budget authority: | ||||
Spending authority from offsetting collections, mandatory: | ||||
1800 | Collected | 2 | ||
1930 | Total budgetary resources available | 2 | ||
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3010 | New obligations, unexpired accounts | 2 | ||
3020 | Outlays (gross) | –2 | ||
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 2 | ||
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 2 | ||
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4120 | Federal sources | –2 | ||
4180 | Budget authority, net (total) | |||
4190 | Outlays, net (total) | |||
|
This legislative proposal provides the Office of Medicare Hearings and Appeals (OMHA) and the Departmental Appeals Board (DAB) mandatory resources to address the Medicare appeals backlog. The proposal would establish a post-adjudication user fee for Medicare Parts A and B claim appeals filed by a provider or supplier, or a State Medicaid Agency, with respect to appeals that are unfavorable to the appellant and for appeals that are dismissed.
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, $1,081,465,000, of which $561,700,000 shall remain available through September 30, 2022, for expenses necessary to support advanced research and development pursuant to section 319L of the PHS Act and other administrative expenses of the Biomedical Advanced Research and Development Authority: Provided, That funds provided under this heading for the purpose of acquisition of security countermeasures shall be in addition to any other funds available for such purpose: Provided further, That products purchased with funds provided under this heading may, at the discretion of the Secretary, be deposited in the Strategic National Stockpile pursuant to section 319F-2 of the PHS Act: Provided further, That $5,000,000 of the amounts made available to support emergency operations shall remain available through September 30, 2023: Provided further, That $20,000,000 of the amounts made available to the National Disaster Medical System shall remain available through September 30, 2022, for activities related to the Pediatric Disaster Care Program: Provided further, That $5,000,000 of the amounts made available for policy and planning shall remain available until expended for implementation activities related to the National Biodefense Strategy.
For expenses necessary for procuring security countermeasures (as defined in section 319F-2(c)(1)(B) of the PHS Act), $535,000,000, to remain available until expended.
For expenses necessary to carry out section 319F-2(a) of the PHS Act, $705,000,000, to remain available until expended.
For an additional amount for expenses necessary to prepare for or respond to an influenza pandemic, $310,000,000; of which $275,000,000 shall be available until expended, for activities including the development and purchase of vaccine, antivirals, necessary medical supplies, diagnostics, and other surveillance tools: Provided, That notwithstanding section 496(b) of the PHS Act, funds may be used for the construction or renovation of privately owned facilities for the production of pandemic influenza vaccines and other biologics, if the Secretary finds such construction or renovation necessary to secure sufficient supplies of such vaccines or biologics.
For an additional amount to supplement amounts otherwise available for programs in the Department to provide authorized assistance or services to individuals who are homeless or who have experienced homelessness, $10,000,000: Provided, That such funds may be transferred to other accounts in the Department for such purposes: Provided further, That the transfer authority provided in the previous proviso is in addition to any other transfer authority available to the Department.
(Department of Health and Human Services Appropriations Act, 2020.)
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0140–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Public Health and Social Services Emergency Fund | 2,916 | 2,737 | 2,641 |
|
|
|
||
0100 | Direct program activities, subtotal | 2,916 | 2,737 | 2,641 |
0801 | Reimbursable program (FEMA) | 91 | 98 | 98 |
0802 | Reimbursable program activity (OPP) | 2 | 2 | 2 |
|
|
|
||
0899 | Total reimbursable obligations | 93 | 100 | 100 |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 3,009 | 2,837 | 2,741 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 437 | 694 | 1,126 |
1010 | Unobligated balance transfer to other accts [075–0343] | –2 | –3 | –3 |
1010 | Unobligated balance transfer to other accts [075–9915] | –15 | ||
1010 | Unobligated balance transfer to other accts [075–0943] | –10 | ||
1011 | Unobligated balance transfer from other acct [075–0943] | 50 | ||
1011 | Unobligated balance transfer from other acct [075–0943] | 425 | ||
1011 | Unobligated balance transfer from other acct [075–0116] | 16 | ||
1021 | Recoveries of prior year unpaid obligations | 88 | ||
|
|
|
||
1050 | Unobligated balance (total) | 989 | 691 | 1,123 |
Budget authority: | ||||
Appropriations, discretionary: | ||||
1100 | Appropriation | 2,222 | 3,272 | 2,641 |
1120 | Appropriations transferred to other acct [075–0350] | –80 | ||
1120 | Appropriations transferred to other acct [075–0128] | –1 | ||
1120 | Appropriations transferred to other acct [075–1362] | –100 | ||
1120 | Appropriations transferred to other acct [075–0943] | –20 | ||
1121 | Appropriations transferred from other acct [075–0943] | 604 | ||
|
|
|
||
1160 | Appropriation, discretionary (total) | 2,625 | 3,272 | 2,641 |
Spending authority from offsetting collections, discretionary: | ||||
1700 | Collected | 4 | ||
1701 | Change in uncollected payments, Federal sources | 87 | ||
|
|
|
||
1750 | Spending auth from offsetting collections, disc (total) | 91 | ||
1900 | Budget authority (total) | 2,716 | 3,272 | 2,641 |
1930 | Total budgetary resources available | 3,705 | 3,963 | 3,764 |
Memorandum (non-add) entries: | ||||
1940 | Unobligated balance expiring | –2 | ||
1941 | Unexpired unobligated balance, end of year | 694 | 1,126 | 1,023 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 4,480 | 4,967 | 4,746 |
3010 | New obligations, unexpired accounts | 3,009 | 2,837 | 2,741 |
3011 | Obligations ("upward adjustments"), expired accounts | 19 | ||
3020 | Outlays (gross) | –2,658 | –3,058 | –3,332 |
3031 | Unpaid obligations transferred from other accts [075–0943] | 242 | ||
3040 | Recoveries of prior year unpaid obligations, unexpired | –88 | ||
3041 | Recoveries of prior year unpaid obligations, expired | –37 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 4,967 | 4,746 | 4,155 |
Uncollected payments: | ||||
3060 | Uncollected pymts, Fed sources, brought forward, Oct 1 | –198 | –203 | –203 |
3070 | Change in uncollected pymts, Fed sources, unexpired | –87 | ||
3071 | Change in uncollected pymts, Fed sources, expired | 82 | ||
|
|
|
||
3090 | Uncollected pymts, Fed sources, end of year | –203 | –203 | –203 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 4,282 | 4,764 | 4,543 |
3200 | Obligated balance, end of year | 4,764 | 4,543 | 3,952 |
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
4000 | Budget authority, gross | 2,716 | 3,272 | 2,641 |
Outlays, gross: | ||||
4010 | Outlays from new discretionary authority | 431 | 617 | 581 |
4011 | Outlays from discretionary balances | 2,227 | 2,441 | 2,751 |
|
|
|
||
4020 | Outlays, gross (total) | 2,658 | 3,058 | 3,332 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4030 | Federal sources | –86 | ||
4033 | Non-Federal sources: | –1 | ||
|
|
|
||
4040 | Offsets against gross budget authority and outlays (total) | –87 | ||
Additional offsets against gross budget authority only: | ||||
4050 | Change in uncollected pymts, Fed sources, unexpired | –87 | ||
4052 | Offsetting collections credited to expired accounts | 83 | ||
|
|
|
||
4060 | Additional offsets against budget authority only (total) | –4 | ||
|
|
|
||
4070 | Budget authority, net (discretionary) | 2,625 | 3,272 | 2,641 |
4080 | Outlays, net (discretionary) | 2,571 | 3,058 | 3,332 |
4180 | Budget authority, net (total) | 2,625 | 3,272 | 2,641 |
4190 | Outlays, net (total) | 2,571 | 3,058 | 3,332 |
|
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 and Advancing Innovation Act of 2019. Funds will be used for hospital preparedness and other emergency preparedness activities including the National Disaster Medical System and National Biodefense Strategy implementation. The PHSSEF continues to support the advanced development, procurement, and stockpiling of biodefense and pandemic influenza countermeasures.
The PHSSEF also supports the HHS Cybersecurity program, National Security and Strategic Information programs, the U.S. Public Health Service Commissioned Corps, and the Medical Reserve Corps.
Object Classification (in millions of dollars)
|
||||
Identification code 075–0140–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
Personnel compensation: | ||||
11.1 | Full-time permanent | 96 | 110 | 115 |
11.3 | Other than full-time permanent | 14 | ||
11.7 | Military personnel | 9 | 10 | 11 |
|
|
|
||
11.9 | Total personnel compensation | 119 | 120 | 126 |
12.1 | Civilian personnel benefits | 32 | 31 | 33 |
12.2 | Military personnel benefits | 4 | 5 | 5 |
21.0 | Travel and transportation of persons | 13 | 9 | 16 |
22.0 | Transportation of things | 3 | 6 | 8 |
23.1 | Rental payments to GSA | 6 | 6 | 7 |
23.2 | Rental payments to others | 9 | 10 | 11 |
23.3 | Communications, utilities, and miscellaneous charges | 5 | 3 | 3 |
25.1 | Advisory and assistance services | 900 | 1,057 | 967 |
25.2 | Other services from non-Federal sources | 183 | 150 | 150 |
25.3 | Other goods and services from Federal sources | 157 | 106 | 107 |
25.4 | Operation and maintenance of facilities | 14 | 25 | 25 |
25.5 | Research and development contracts | 45 | 40 | 40 |
25.7 | Operation and maintenance of equipment | 31 | 31 | 33 |
26.0 | Supplies and materials | 1,092 | 801 | 752 |
31.0 | Equipment | 6 | 2 | 3 |
32.0 | Land and structures | 35 | 35 | |
41.0 | Grants, subsidies, and contributions | 297 | 300 | 320 |
|
|
|
||
99.0 | Direct obligations | 2,916 | 2,737 | 2,641 |
99.0 | Reimbursable obligations | 93 | 100 | 100 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 3,009 | 2,837 | 2,741 |
|
Employment Summary
|
||||
Identification code 075–0140–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 821 | 935 | 963 |
1101 | Direct military average strength employment | 80 | 77 | 81 |
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0145–0–1–552 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | AHRQ | 52 | 106 | |
0002 | Office of the Secretary | 26 | 27 | 25 |
0003 | NIRSQ | 98 | ||
|
|
|
||
0900 | Total new obligations, unexpired accounts | 78 | 133 | 123 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 127 | 195 | 195 |
1021 | Recoveries of prior year unpaid obligations | 1 | ||
|
|
|
||
1050 | Unobligated balance (total) | 128 | 195 | 195 |
Budget authority: | ||||
Spending authority from offsetting collections, mandatory: | ||||
1800 | Collected | 145 | 133 | 123 |
1930 | Total budgetary resources available | 273 | 328 | 318 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 195 | 195 | 195 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 118 | 116 | 168 |
3010 | New obligations, unexpired accounts | 78 | 133 | 123 |
3020 | Outlays (gross) | –79 | –81 | –152 |
3040 | Recoveries of prior year unpaid obligations, unexpired | –1 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 116 | 168 | 139 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 118 | 116 | 168 |
3200 | Obligated balance, end of year | 116 | 168 | 139 |
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 145 | 133 | 123 |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 4 | 4 | |
4101 | Outlays from mandatory balances | 79 | 77 | 148 |
|
|
|
||
4110 | Outlays, gross (total) | 79 | 81 | 152 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4120 | Federal sources | –145 | –133 | –123 |
4180 | Budget authority, net (total) | |||
4190 | Outlays, net (total) | –66 | –52 | 29 |
|
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 was transferred each year to the Department of Health and Human Services (HHS). In FY 2020, PCORTF was extended through FY 2029. 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 coordinate Federal health programs to build research and data capacity for comparative clinical effectiveness research. Transferred funds were distributed to the Secretary of HHS and the Agency for Healthcare Research and Quality to carry out these activities. The FY 2021 Budget consolidates the Agency for Healthcare Research and Quality within the National Institutes of Health as the National Institute for Research on Safety and Quality.
Object Classification (in millions of dollars)
|
||||
Identification code 075–0145–0–1–552 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
25.3 | Other goods and services from Federal sources | 54 | 27 | 25 |
41.0 | Grants, subsidies, and contributions | 24 | 106 | 98 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 78 | 133 | 123 |
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0125–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Nonrecurring Expenses Fund Projects | 505 | 665 | 105 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 1,116 | 1,024 | 609 |
1012 | Unobligated balance transfers between expired and unexpired accounts | 792 | 600 | 600 |
1021 | Recoveries of prior year unpaid obligations | 21 | ||
|
|
|
||
1050 | Unobligated balance (total) | 1,929 | 1,624 | 1,209 |
Budget authority: | ||||
Appropriations, discretionary: | ||||
1131 | Unobligated balance of appropriations permanently reduced | –400 | –350 | –500 |
1930 | Total budgetary resources available | 1,529 | 1,274 | 709 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 1,024 | 609 | 604 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 543 | 792 | 796 |
3010 | New obligations, unexpired accounts | 505 | 665 | 105 |
3020 | Outlays (gross) | –235 | –661 | 185 |
3040 | Recoveries of prior year unpaid obligations, unexpired | –21 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 792 | 796 | 1,086 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 543 | 792 | 796 |
3200 | Obligated balance, end of year | 792 | 796 | 1,086 |
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
4000 | Budget authority, gross | –400 | –350 | –500 |
Outlays, gross: | ||||
4010 | Outlays from new discretionary authority | –52 | –75 | |
4011 | Outlays from discretionary balances | 235 | 713 | –110 |
|
|
|
||
4020 | Outlays, gross (total) | 235 | 661 | –185 |
4180 | Budget authority, net (total) | –400 | –350 | –500 |
4190 | Outlays, net (total) | 235 | 661 | –185 |
|
The Nonrecurring Expenses Fund is a no-year account that receives transfers of expired unobligated balances from discretionary accounts prior to cancellation. The Fund is used for capital acquisition, including facilities infrastructure and information technology infrastructure.
Object Classification (in millions of dollars)
|
||||
Identification code 075–0125–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
25.1 | Advisory and assistance services | 8 | 11 | |
25.2 | Other services from non-Federal sources | 144 | 90 | |
25.3 | Other goods and services from Federal sources | 90 | 119 | |
25.4 | Operation and maintenance of facilities | 121 | 160 | |
25.5 | Research and development contracts | 3 | 4 | |
25.7 | Operation and maintenance of equipment | 51 | 67 | |
31.0 | Equipment | 14 | 18 | |
32.0 | Land and structures | 73 | 196 | 105 |
|
|
|
||
99.0 | Direct obligations | 504 | 665 | 105 |
99.5 | Adjustment for rounding | 1 | ||
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 505 | 665 | 105 |
|
Employment Summary
|
||||
Identification code 075–0125–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 4 | 4 | 4 |
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0119–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 1 | 3 | 3 |
1021 | Recoveries of prior year unpaid obligations | 2 | ||
|
|
|
||
1050 | Unobligated balance (total) | 3 | 3 | 3 |
1930 | Total budgetary resources available | 3 | 3 | 3 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 3 | 3 | 3 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 22 | 15 | 13 |
3020 | Outlays (gross) | –5 | –2 | –2 |
3040 | Recoveries of prior year unpaid obligations, unexpired | –2 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 15 | 13 | 11 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 22 | 15 | 13 |
3200 | Obligated balance, end of year | 15 | 13 | 11 |
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
Outlays, gross: | ||||
4101 | Outlays from mandatory balances | 5 | 2 | 2 |
4180 | Budget authority, net (total) | |||
4190 | Outlays, net (total) | 5 | 2 | 2 |
|
Section 1005 of the Health Care and Education Reconciliation Act of 2010 (P.L. 111–152) appropriated $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 075–0116–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 6 | 6 | 6 |
1010 | Unobligated balance transfer to other accts [075–0140] | –16 | ||
1011 | Unobligated balance transfer from other acct [075–0350] | 8 | ||
1011 | Unobligated balance transfer from other acct [075–1362] | 8 | ||
|
|
|
||
1050 | Unobligated balance (total) | 6 | 6 | 6 |
Budget authority: | ||||
Appropriations, mandatory: | ||||
1200 | Appropriation | 900 | 950 | 950 |
1220 | Appropriations transferred to other accts [075–0142] | –28 | –28 | |
1220 | Appropriations transferred to other accts [075–0943] | –805 | –854 | –894 |
1220 | Appropriations transferred to other accts [075–1362] | –12 | –12 | |
1230 | Appropriations and/or unobligated balance of appropriations permanently reduced [SEQ] | –55 | –56 | –56 |
1930 | Total budgetary resources available | 6 | 6 | 6 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 6 | 6 | 6 |
4180 | Budget authority, net (total) | |||
4190 | Outlays, net (total) | |||
|
The Prevention and Public Health Fund supports prevention and public health activities. In FY 2021, $894 million is available to support a range of public health efforts intended to prevent disease and reduce health care costs. The Secretary has authority to transfer to accounts within HHS.
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0117–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Pregnancy Assistance Fund (Direct) | 23 | ||
|
||||
Budgetary resources: | ||||
Budget authority: | ||||
Appropriations, mandatory: | ||||
1200 | Appropriation | 25 | ||
1230 | Appropriations and/or unobligated balance of appropriations permanently reduced | –2 | ||
|
|
|
||
1260 | Appropriations, mandatory (total) | 23 | ||
1930 | Total budgetary resources available | 23 | ||
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 29 | 26 | 1 |
3010 | New obligations, unexpired accounts | 23 | ||
3020 | Outlays (gross) | –21 | –25 | –1 |
3041 | Recoveries of prior year unpaid obligations, expired | –5 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 26 | 1 | |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 29 | 26 | 1 |
3200 | Obligated balance, end of year | 26 | 1 | |
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 23 | ||
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 1 | ||
4101 | Outlays from mandatory balances | 20 | 25 | 1 |
|
|
|
||
4110 | Outlays, gross (total) | 21 | 25 | 1 |
4180 | Budget authority, net (total) | 23 | ||
4190 | Outlays, net (total) | 21 | 25 | 1 |
|
This appropriation funds competitive grants to States to assist pregnant and parenting teens and women. Annual funding for this program expired at the end of FY 2019. The Budget does request an extension of this program.
Object Classification (in millions of dollars)
|
||||
Identification code 075–0117–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
25.3 | Other goods and services from Federal sources | 1 | ||
41.0 | Grants, subsidies, and contributions | 22 | ||
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 23 | ||
|
Employment Summary
|
||||
Identification code 075–0117–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 2 | ||
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–3902–0–1–552 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0801 | Section 241 Evaluation Transactions Account (Reimbursable) | 516 | 584 | 667 |
|
|
|
||
0809 | Reimbursable program activities, subtotal | 516 | 584 | 667 |
|
|
|
||
0900 | Total new obligations, unexpired accounts (object class 25.3) | 516 | 584 | 667 |
|
||||
Budgetary resources: | ||||
Budget authority: | ||||
Spending authority from offsetting collections, discretionary: | ||||
1700 | Collected | 84 | 584 | 667 |
1701 | Change in uncollected payments, Federal sources | 432 | ||
|
|
|
||
1750 | Spending auth from offsetting collections, disc (total) | 516 | 584 | 667 |
1930 | Total budgetary resources available | 516 | 584 | 667 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 633 | 790 | 324 |
3010 | New obligations, unexpired accounts | 516 | 584 | 667 |
3011 | Obligations ("upward adjustments"), expired accounts | 3 | ||
3020 | Outlays (gross) | –321 | –1,050 | –861 |
3041 | Recoveries of prior year unpaid obligations, expired | –41 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 790 | 324 | 130 |
Uncollected payments: | ||||
3060 | Uncollected pymts, Fed sources, brought forward, Oct 1 | –629 | –787 | –787 |
3070 | Change in uncollected pymts, Fed sources, unexpired | –432 | ||
3071 | Change in uncollected pymts, Fed sources, expired | 274 | ||
|
|
|
||
3090 | Uncollected pymts, Fed sources, end of year | –787 | –787 | –787 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 4 | 3 | –463 |
3200 | Obligated balance, end of year | 3 | –463 | –657 |
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
4000 | Budget authority, gross | 516 | 584 | 667 |
Outlays, gross: | ||||
4010 | Outlays from new discretionary authority | 84 | 584 | 667 |
4011 | Outlays from discretionary balances | 237 | 466 | 194 |
|
|
|
||
4020 | Outlays, gross (total) | 321 | 1,050 | 861 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4030 | Federal sources | –317 | –584 | –667 |
4033 | Non-Federal sources | –3 | ||
|
|
|
||
4040 | Offsets against gross budget authority and outlays (total) | –320 | –584 | –667 |
Additional offsets against gross budget authority only: | ||||
4050 | Change in uncollected pymts, Fed sources, unexpired | –432 | ||
4052 | Offsetting collections credited to expired accounts | 236 | ||
|
|
|
||
4060 | Additional offsets against budget authority only (total) | –196 | ||
4080 | Outlays, net (discretionary) | 1 | 466 | 194 |
4180 | Budget authority, net (total) | |||
4190 | Outlays, net (total) | 1 | 466 | 194 |
|
The Public Health Service (PHS) Act Evaluation Transactions account supports the execution of section 241 of the PHS Act.
For retirement pay and medical benefits of Public Health Service Commissioned Officers as authorized by law, for payments under the Retired Serviceman's Family Protection Plan and Survivor Benefit Plan, and for medical care of dependents and retired personnel under the Dependents' Medical Care Act, such amounts as may be required during the current fiscal year.
(Department of Health and Human Services Appropriations Act, 2020.)
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0379–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Retirement payments | 488 | 506 | 525 |
0002 | Survivors' benefits | 31 | 31 | 32 |
0003 | Medical care | 104 | 100 | 96 |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 623 | 637 | 653 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 1 | 1 | |
Budget authority: | ||||
Appropriations, mandatory: | ||||
1200 | Appropriation | 624 | 637 | 653 |
1930 | Total budgetary resources available | 624 | 638 | 654 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 1 | 1 | 1 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 102 | 93 | 30 |
3010 | New obligations, unexpired accounts | 623 | 637 | 653 |
3011 | Obligations ("upward adjustments"), expired accounts | 12 | ||
3020 | Outlays (gross) | –618 | –700 | –652 |
3041 | Recoveries of prior year unpaid obligations, expired | –26 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 93 | 30 | 31 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 102 | 93 | 30 |
3200 | Obligated balance, end of year | 93 | 30 | 31 |
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 624 | 637 | 653 |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 558 | 605 | 620 |
4101 | Outlays from mandatory balances | 60 | 95 | 32 |
|
|
|
||
4110 | Outlays, gross (total) | 618 | 700 | 652 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4123 | Non-Federal sources | –1 | ||
Additional offsets against gross budget authority only: | ||||
4142 | Offsetting collections credited to expired accounts | 1 | ||
|
|
|
||
4160 | Budget authority, net (mandatory) | 624 | 637 | 653 |
4170 | Outlays, net (mandatory) | 617 | 700 | 652 |
4180 | Budget authority, net (total) | 624 | 637 | 653 |
4190 | Outlays, net (total) | 617 | 700 | 652 |
|
The number of beneficiaries using the Commissioned Corps system is estimated as follows:
Retirement Pay, Survivor Benefits, and Medical Benefits
|
|||
2019 | 2020 | 2021 | |
|
|||
Active Duty: | |||
HHS | 4,876 | 4,859 | 4,676 |
DOJ, BOP | 787 | 787 | 754 |
Homeland Security | 400 | 400 | 492 |
EPA | 55 | 55 | 53 |
All Other | 294 | 312 | 326 |
|
|
|
|
Total Active Duty | 6,412 | 6,411 | 6,301 |
Retirees & Survivors: | |||
Retirees | 6,150 | 6,300 | 6,380 |
Retiree family members and survivors | 1,125 | 1,100 | 1,120 |
|
|
|
|
Total Retirement Pay | 7,275 | 7,400 | 7,500 |
Total Beneficiaries (active duty, retirees, survivors) | 13,687 | 13,811 | 13,801 |
|
|
|
|
|
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.
Object Classification (in millions of dollars)
|
||||
Identification code 075–0379–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
13.0 | Benefits for former personnel | 519 | 537 | 557 |
25.6 | Medical care | 104 | 100 | 96 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 623 | 637 | 653 |
|
The Budget includes a mandatory proposal, effective FY 2022, which shifts the U.S. Public Health Service Commissioned Corps retirement pay and survivor benefit costs from mandatory to discretionary.
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0170–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Medicare eligible accruals | 29 | 29 | 31 |
|
|
|
||
0900 | Total new obligations, unexpired accounts (object class 12.2) | 29 | 29 | 31 |
|
||||
Budgetary resources: | ||||
Budget authority: | ||||
Appropriations, discretionary: | ||||
1100 | Appropriation | 29 | 29 | 31 |
1900 | Budget authority (total) | 29 | 29 | 31 |
1930 | Total budgetary resources available | 29 | 29 | 31 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3010 | New obligations, unexpired accounts | 29 | 29 | 31 |
3020 | Outlays (gross) | –29 | –29 | –31 |
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
4000 | Budget authority, gross | 29 | 29 | 31 |
Outlays, gross: | ||||
4010 | Outlays from new discretionary authority | 29 | 29 | 31 |
4180 | Budget authority, net (total) | 29 | 29 | 31 |
4190 | Outlays, net (total) | 29 | 29 | 31 |
|
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).
Beginning FY 2022, this account would support the unfunded liability of U.S. Public Health Service Commissioned Corps retirement pay and survivor benefits costs.
Program and Financing (in millions of dollars)
|
||||
Identification code 075–9913–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 1 | 1 | 1 |
1930 | Total budgetary resources available | 1 | 1 | 1 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 1 | 1 | 1 |
4180 | Budget authority, net (total) | |||
4190 | Outlays, net (total) | |||
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–9941–0–4–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0801 | Program Support Center | 1,025 | 1,280 | 880 |
0802 | OS activities | 477 | 505 | 505 |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 1,502 | 1,785 | 1,385 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 204 | 216 | 629 |
1021 | Recoveries of prior year unpaid obligations | 35 | 250 | 250 |
|
|
|
||
1050 | Unobligated balance (total) | 239 | 466 | 879 |
Budget authority: | ||||
Spending authority from offsetting collections, discretionary: | ||||
1700 | Collected | 1,621 | 1,948 | 1,948 |
1701 | Change in uncollected payments, Federal sources | –142 | ||
|
|
|
||
1750 | Spending auth from offsetting collections, disc (total) | 1,479 | 1,948 | 1,948 |
1930 | Total budgetary resources available | 1,718 | 2,414 | 2,827 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 216 | 629 | 1,442 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 1,265 | 1,012 | 1,081 |
3010 | New obligations, unexpired accounts | 1,502 | 1,785 | 1,385 |
3020 | Outlays (gross) | –1,720 | –1,466 | –1,464 |
3040 | Recoveries of prior year unpaid obligations, unexpired | –35 | –250 | –250 |
|
|
|
||
3050 | Unpaid obligations, end of year | 1,012 | 1,081 | 752 |
Uncollected payments: | ||||
3060 | Uncollected pymts, Fed sources, brought forward, Oct 1 | –673 | –531 | –531 |
3070 | Change in uncollected pymts, Fed sources, unexpired | 142 | ||
|
|
|
||
3090 | Uncollected pymts, Fed sources, end of year | –531 | –531 | –531 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 592 | 481 | 550 |
3200 | Obligated balance, end of year | 481 | 550 | 221 |
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
4000 | Budget authority, gross | 1,479 | 1,948 | 1,948 |
Outlays, gross: | ||||
4010 | Outlays from new discretionary authority | 885 | 980 | 980 |
4011 | Outlays from discretionary balances | 835 | 486 | 484 |
|
|
|
||
4020 | Outlays, gross (total) | 1,720 | 1,466 | 1,464 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4030 | Federal sources | –1,618 | –1,948 | –1,948 |
4033 | Non-Federal sources | –3 | ||
|
|
|
||
4040 | Offsets against gross budget authority and outlays (total) | –1,621 | –1,948 | –1,948 |
Additional offsets against gross budget authority only: | ||||
4050 | Change in uncollected pymts, Fed sources, unexpired | 142 | ||
4080 | Outlays, net (discretionary) | 99 | –482 | –484 |
4180 | Budget authority, net (total) | |||
4190 | Outlays, net (total) | 99 | –482 | –484 |
|
The 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 the Secretary activities include the Service and Supply Fund Manager's Office, departmental contracts, audit resolutions, Commissioned Corps force management, web management, claims, acquisition integration and modernization, acquisition reform, small business consolidation, grants tracking, the physical security component 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.
Object Classification (in millions of dollars)
|
||||
Identification code 075–9941–0–4–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Reimbursable obligations: | ||||
Personnel compensation: | ||||
11.1 | Full-time permanent | 103 | 117 | 123 |
11.3 | Other than full-time permanent | 3 | 3 | 3 |
11.5 | Other personnel compensation | 4 | 3 | 3 |
11.7 | Military personnel | 5 | 8 | 8 |
11.8 | Special personal services payments | 10 | 10 | 12 |
|
|
|
||
11.9 | Total personnel compensation | 125 | 141 | 149 |
12.1 | Civilian personnel benefits | 34 | 38 | 42 |
12.2 | Military personnel benefits | 2 | 3 | 3 |
21.0 | Travel and transportation of persons | 2 | 2 | 2 |
22.0 | Transportation of things | 2 | 3 | 3 |
23.1 | Rental payments to GSA | 21 | 18 | 18 |
23.3 | Communications, utilities, and miscellaneous charges | 9 | 9 | 9 |
24.0 | Printing and reproduction | 5 | 6 | 6 |
25.1 | Advisory and assistance services | 136 | 197 | 197 |
25.2 | Other services from non-Federal sources | 933 | 1,194 | 782 |
25.3 | Other goods and services from Federal sources | 65 | 21 | 21 |
25.4 | Operation and maintenance of facilities | 22 | 14 | 14 |
25.6 | Medical care | 20 | 32 | 32 |
25.7 | Operation and maintenance of equipment | 71 | 51 | 51 |
26.0 | Supplies and materials | 54 | 50 | 50 |
31.0 | Equipment | 1 | 6 | 6 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 1,502 | 1,785 | 1,385 |
|
Employment Summary
|
||||
Identification code 075–9941–0–4–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
2001 | Reimbursable civilian full-time equivalent employment | 934 | 1,191 | 1,191 |
2101 | Reimbursable military average strength employment | 55 | 71 | 71 |
3101 | Allocation account military average strength employment | 1,455 | 1,472 | 1,572 |
|
Beginning FY 2022, this account would fund the U.S. Public Health Service Commissioned Corps retirement pay and survivor benefit payments.
Beginning FY 2022, this account would fund the U.S. Public Health Service Commissioned Corps retirement pay and survivor benefit payments.
Special and Trust Fund Receipts (in millions of dollars)
|
||||
Identification code 075–9971–0–7–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
0100 | Balance, start of year | 2 | ||
Receipts: | ||||
Current law: | ||||
1130 | Contributions, Indian Health Facilities | 3 | 3 | 3 |
1130 | Contributions, N.I.H., Unconditional Gift Fund | 2 | 3 | 3 |
1130 | Centers for Disease Control, Gifts and Donations | 26 | 26 | 26 |
1130 | Contributions, N.I.H., Conditional Gift Fund | 40 | 40 | 40 |
1130 | Contributions to the Indian Health Service Gift Fund | 1 | 1 | |
1140 | Interest, Miscellaneous Trust Funds | 1 | 1 | 1 |
|
|
|
||
1199 | Total current law receipts | 72 | 74 | 74 |
|
|
|
||
1999 | Total receipts | 72 | 74 | 74 |
|
|
|
||
2000 | Total: Balances and receipts | 72 | 74 | 76 |
Appropriations: | ||||
Current law: | ||||
2101 | Miscellaneous Trust Funds | –72 | –72 | –72 |
|
|
|
||
5099 | Balance, end of year | 2 | 4 | |
|
Program and Financing (in millions of dollars)
|
||||
Identification code 075–9971–0–7–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0002 | Gifts | 97 | 62 | 62 |
0003 | Contributions, Indian Health Facilities | 36 | 36 | |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 97 | 98 | 98 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 188 | 172 | 154 |
1021 | Recoveries of prior year unpaid obligations | 9 | 8 | 8 |
|
|
|
||
1050 | Unobligated balance (total) | 197 | 180 | 162 |
Budget authority: | ||||
Appropriations, mandatory: | ||||
1201 | Appropriation (special or trust fund) | 72 | 72 | 72 |
1930 | Total budgetary resources available | 269 | 252 | 234 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 172 | 154 | 136 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 100 | 110 | 40 |
3010 | New obligations, unexpired accounts | 97 | 98 | 98 |
3020 | Outlays (gross) | –78 | –160 | –85 |
3040 | Recoveries of prior year unpaid obligations, unexpired | –9 | –8 | –8 |
|
|
|
||
3050 | Unpaid obligations, end of year | 110 | 40 | 45 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | 100 | 110 | 40 |
3200 | Obligated balance, end of year | 110 | 40 | 45 |
|
||||
Budget authority and outlays, net: | ||||
Mandatory: | ||||
4090 | Budget authority, gross | 72 | 72 | 72 |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 20 | 26 | 26 |
4101 | Outlays from mandatory balances | 58 | 134 | 59 |
|
|
|
||
4110 | Outlays, gross (total) | 78 | 160 | 85 |
4180 | Budget authority, net (total) | 72 | 72 | 72 |
4190 | Outlays, net (total) | 78 | 160 | 85 |
|
||||
Memorandum (non-add) entries: | ||||
5000 | Total investments, SOY: Federal securities: Par value | 37 | 35 | 35 |
5001 | Total investments, EOY: Federal securities: Par value | 35 | 35 | 35 |
|
Gifts to the Public Health Service are for the benefit of patients and for research. Contributions are made for the construction, improvement, extension, and provision of sanitation facilities.
Object Classification (in millions of dollars)
|
||||
Identification code 075–9971–0–7–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
Personnel compensation: | ||||
11.1 | Full-time permanent | 3 | 3 | 3 |
11.3 | Other than full-time permanent | 1 | 1 | 1 |
11.8 | Special personal services payments | 3 | 3 | 3 |
|
|
|
||
11.9 | Total personnel compensation | 7 | 7 | 7 |
12.1 | Civilian personnel benefits | 2 | 2 | 2 |
21.0 | Travel and transportation of persons | 3 | 3 | 3 |
25.1 | Advisory and assistance services | 5 | 5 | 5 |
25.2 | Other services from non-Federal sources | 12 | 12 | 12 |
25.3 | Other goods and services from Federal sources | 1 | 1 | 1 |
25.5 | Research and development contracts | 3 | 3 | 3 |
25.6 | Medical care | 1 | 1 | 1 |
25.8 | Subsistence and support of persons | 1 | 1 | 1 |
26.0 | Supplies and materials | 6 | 6 | 6 |
31.0 | Equipment | 3 | 3 | 3 |
41.0 | Grants, subsidies, and contributions | 53 | 54 | 54 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 97 | 98 | 98 |
|
Employment Summary
|
||||
Identification code 075–9971–0–7–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 33 | 33 | 33 |
|
For 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, $90,000,000: Provided, That of such amount, necessary sums shall be available for providing protective services to the Secretary and investigating non-payment of child support cases for which non-payment is a Federal offense under 18 U.S.C. 228: Provided further, That of the amount appropriated under this heading, $5,300,000 shall be available through September 30, 2022, for activities authorized under section 3022 of the Public Health Service Act relating to information blocking.
(Department of Health and Human Services Appropriations Act, 2020.)
Program and Financing (in millions of dollars)
|
||||
Identification code 075–0128–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Obligations by program activity: | ||||
0001 | Office of Inspector General (Direct) | 86 | 86 | 90 |
0801 | Office of Inspector General HCFAC Trust Fund | 240 | 212 | 228 |
0802 | Office of Inspector General (Direct Reimbursable) | 14 | 21 | 21 |
0803 | Office of Inspector General HCFAC Discretionary | 87 | 93 | 101 |
|
|
|
||
0899 | Total reimbursable obligations | 341 | 326 | 350 |
|
|
|
||
0900 | Total new obligations, unexpired accounts | 427 | 412 | 440 |
|
||||
Budgetary resources: | ||||
Unobligated balance: | ||||
1000 | Unobligated balance brought forward, Oct 1 | 41 | 30 | 31 |
1001 | Discretionary unobligated balance brought fwd, Oct 1 | 37 | 30 | |
1021 | Recoveries of prior year unpaid obligations | 4 | 2 | |
|
|
|
||
1050 | Unobligated balance (total) | 45 | 32 | 31 |
Budget authority: | ||||
Appropriations, discretionary: | ||||
1100 | Appropriation | 80 | 80 | 90 |
1121 | Appropriations transferred from other acct [075–9911] | 2 | 2 | |
1121 | Appropriations transferred from other acct [075–0140] | 1 | ||
1121 | Appropriations transferred from other acct [075–9915] | 5 | 5 | |
1121 | Appropriations transferred from other acct [075–1503] | 5 | ||
|
|
|
||
1160 | Appropriation, discretionary (total) | 93 | 87 | 90 |
Spending authority from offsetting collections, discretionary: | ||||
1700 | Collected | 96 | 111 | 111 |
1701 | Change in uncollected payments, Federal sources | 3 | ||
|
|
|
||
1750 | Spending auth from offsetting collections, disc (total) | 99 | 111 | 111 |
Spending authority from offsetting collections, mandatory: | ||||
1800 | Collected | 221 | 213 | 228 |
1801 | Change in uncollected payments, Federal sources | –1 | ||
1802 | Offsetting collections (previously unavailable) | 1 | 1 | 1 |
1823 | New and/or unobligated balance of spending authority from offsetting collections temporarily reduced | –1 | –1 | |
|
|
|
||
1850 | Spending auth from offsetting collections, mand (total) | 220 | 213 | 229 |
1900 | Budget authority (total) | 412 | 411 | 430 |
1930 | Total budgetary resources available | 457 | 443 | 461 |
Memorandum (non-add) entries: | ||||
1941 | Unexpired unobligated balance, end of year | 30 | 31 | 21 |
|
||||
Change in obligated balance: | ||||
Unpaid obligations: | ||||
3000 | Unpaid obligations, brought forward, Oct 1 | 97 | 101 | 56 |
3010 | New obligations, unexpired accounts | 427 | 412 | 440 |
3011 | Obligations ("upward adjustments"), expired accounts | 2 | ||
3020 | Outlays (gross) | –418 | –455 | –430 |
3040 | Recoveries of prior year unpaid obligations, unexpired | –4 | –2 | |
3041 | Recoveries of prior year unpaid obligations, expired | –3 | ||
|
|
|
||
3050 | Unpaid obligations, end of year | 101 | 56 | 66 |
Uncollected payments: | ||||
3060 | Uncollected pymts, Fed sources, brought forward, Oct 1 | –135 | –128 | –128 |
3070 | Change in uncollected pymts, Fed sources, unexpired | –2 | ||
3071 | Change in uncollected pymts, Fed sources, expired | 9 | ||
|
|
|
||
3090 | Uncollected pymts, Fed sources, end of year | –128 | –128 | –128 |
Memorandum (non-add) entries: | ||||
3100 | Obligated balance, start of year | –38 | –27 | –72 |
3200 | Obligated balance, end of year | –27 | –72 | –62 |
|
||||
Budget authority and outlays, net: | ||||
Discretionary: | ||||
4000 | Budget authority, gross | 192 | 198 | 201 |
Outlays, gross: | ||||
4010 | Outlays from new discretionary authority | 156 | 179 | 183 |
4011 | Outlays from discretionary balances | 26 | 19 | 18 |
|
|
|
||
4020 | Outlays, gross (total) | 182 | 198 | 201 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4030 | Federal sources | –105 | –111 | –111 |
Additional offsets against gross budget authority only: | ||||
4050 | Change in uncollected pymts, Fed sources, unexpired | –3 | ||
4052 | Offsetting collections credited to expired accounts | 9 | ||
|
|
|
||
4060 | Additional offsets against budget authority only (total) | 6 | ||
|
|
|
||
4070 | Budget authority, net (discretionary) | 93 | 87 | 90 |
4080 | Outlays, net (discretionary) | 77 | 87 | 90 |
Mandatory: | ||||
4090 | Budget authority, gross | 220 | 213 | 229 |
Outlays, gross: | ||||
4100 | Outlays from new mandatory authority | 160 | 194 | 208 |
4101 | Outlays from mandatory balances | 76 | 63 | 21 |
|
|
|
||
4110 | Outlays, gross (total) | 236 | 257 | 229 |
Offsets against gross budget authority and outlays: | ||||
Offsetting collections (collected) from: | ||||
4120 | Federal sources | –211 | –213 | –216 |
4123 | Non-Federal sources | –10 | –12 | –12 |
|
|
|
||
4130 | Offsets against gross budget authority and outlays (total) | –221 | –225 | –228 |
Additional offsets against gross budget authority only: | ||||
4140 | Change in uncollected pymts, Fed sources, unexpired | 1 | ||
4142 | Offsetting collections credited to expired accounts | 12 | ||
|
|
|
||
4150 | Additional offsets against budget authority only (total) | 1 | 12 | |
|
|
|
||
4160 | Budget authority, net (mandatory) | 1 | ||
4170 | Outlays, net (mandatory) | 15 | 32 | 1 |
4180 | Budget authority, net (total) | 93 | 87 | 91 |
4190 | Outlays, net (total) | 92 | 119 | 91 |
|
||||
Memorandum (non-add) entries: | ||||
5090 | Unexpired unavailable balance, SOY: Offsetting collections | 1 | 1 | 1 |
5092 | Unexpired unavailable balance, EOY: Offsetting collections | 1 | 1 | |
|
The mission of the Office of Inspector General (OIG) is to protect the integrity of the U.S. Department of Health and Human Services (HHS) programs and the health and welfare of the people they serve. As established by the Inspector General Act of 1978, OIG is an independent and objective organization that fights fraud, waste, and abuse and promotes efficiency, economy, and effectiveness in HHS programs and operations. OIG works to ensure that Federal dollars are used appropriately and that HHS programs well serve the people that use them. OIG fulfills its mission through a broad range of audits, evaluations, investigations, and enforcement and compliance activities. In addition to discretionary 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.
Object Classification (in millions of dollars)
|
||||
Identification code 075–0128–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
Direct obligations: | ||||
Personnel compensation: | ||||
11.1 | Full-time permanent | 40 | 40 | 43 |
11.3 | Other than full-time permanent | 1 | 1 | 1 |
11.5 | Other personnel compensation | 1 | 1 | 1 |
|
|
|
||
11.9 | Total personnel compensation | 42 | 42 | 45 |
12.1 | Civilian personnel benefits | 16 | 16 | 17 |
21.0 | Travel and transportation of persons | 2 | 2 | 2 |
22.0 | Transportation of things | 1 | 1 | 1 |
23.1 | Rental payments to GSA | 5 | 5 | 5 |
23.3 | Communications, utilities, and miscellaneous charges | 1 | 1 | 1 |
25.2 | Other services from non-Federal sources | 12 | 12 | 12 |
25.3 | Other goods and services from Federal sources | 2 | 2 | 2 |
25.4 | Operation and maintenance of facilities | 1 | 1 | 1 |
31.0 | Equipment | 4 | 4 | 4 |
|
|
|
||
99.0 | Direct obligations | 86 | 86 | 90 |
99.0 | Reimbursable obligations | 341 | 326 | 350 |
|
|
|
||
99.9 | Total new obligations, unexpired accounts | 427 | 412 | 440 |
|
Employment Summary
|
||||
Identification code 075–0128–0–1–551 | 2019 actual | 2020 est. | 2021 est. | |
|
||||
1001 | Direct civilian full-time equivalent employment | 1,624 | 1,640 | 1,666 |
2001 | Reimbursable civilian full-time equivalent employment | 7 | 10 | 10 |
|
(in millions of dollars)
|
||||
2019 actual | 2020 est. | 2021 est. | ||
|
||||
Offsetting receipts from the public: | ||||
075–143500 | General Fund Proprietary Interest Receipts, not Otherwise Classified | 120 | 90 | 90 |
075–275830 | Downward Reestimates of Subsidies, Health Centers | 1 | ||
075–310700 | Federal Share of Child Support Collections | 526 | 634 | 562 |
075–310700 | Federal Share of Child Support Collections: Legislative proposal, subject to PAYGO | 4 | ||
075–322000 | All Other General Fund Proprietary Receipts Including Budget Clearing Accounts | 511 | 34 | 34 |
|
|
|
||
General Fund Offsetting receipts from the public | 1,158 | 758 | 690 | |
|
(transfer of funds)
SEC. 204. 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 HHS 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 the transfer authority granted by this section shall not be used to create any new program or to fund any project or activity for which no funds are provided in this Act: 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.SEC. 205. In lieu of the timeframe specified in section 338E(c)(2) of the PHS Act, terminations described in such section may occur up to 60 days after the effective date of a contract awarded in fiscal year 2021 under section 338B of such Act, or at any time if the individual who has been awarded such contract has not received funds due under the contract.SEC. 206. None of the funds appropriated in this Act may be made available to any entity under title X of the PHS Act unless the applicant for the award certifies to the Secretary that it encourages family participation in the decision of minors to seek family planning services and that it provides counseling to minors on how to resist attempts to coerce minors into engaging in sexual activities.SEC. 207. Notwithstanding any other provision of law, no provider of services under title X of the PHS Act shall be exempt from any State law requiring notification or the reporting of child abuse, child molestation, sexual abuse, rape, or incest.SEC. 208. None of the funds appropriated by this Act (including funds appropriated to any trust fund) may be used to carry out the Medicare Advantage program if the Secretary denies participation in such program to an otherwise eligible entity (including a Provider Sponsored Organization) because the entity informs the Secretary that it will not provide, pay for, provide coverage of, or provide referrals for abortions: Provided, That the Secretary shall make appropriate prospective adjustments to the capitation payment to such an entity (based on an actuarially sound estimate of the expected costs of providing the service to such entity's enrollees): Provided further, That nothing in this section shall be construed to change the Medicare program's coverage for such services and a Medicare Advantage organization described in this section shall be responsible for informing enrollees where to obtain information about all Medicare covered services.SEC. 209. None of the funds made available in this title may be used, in whole or in part, to advocate or promote gun control.SEC. 210. In order for HHS 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 2021:(1) The Secretary 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 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 is authorized to provide such funds by advance or reimbursement to the Secretary of State as may be necessary to pay the costs of acquisition, lease, alteration, renovation, and management of facilities outside of the United States for the use of HHS. The Department of State shall cooperate fully with the Secretary to ensure that HHS 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 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 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.
'(transfer of funds)
SEC. 211. The Director of the NIH, 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.'(transfer of funds)
SEC. 212. Of the amounts made available in this Act for NIH, the amount for research related to the human immunodeficiency virus, as jointly determined by the Director of NIH and the Director of the Office of AIDS Research, shall be made available to the "Office of AIDS Research" account. The Director of the Office of AIDS Research shall transfer from such account amounts necessary to carry out section 2353(d)(3) of the PHS Act.SEC. 213.(a) Authority.—Notwithstanding any other provision of law, the Director of NIH ("Director") may use funds authorized under section 402(b)(12) of the PHS Act to enter into transactions (other than contracts, cooperative agreements, or grants) to carry out research identified pursuant to or research and activities described in such section 402(b)(12).
(b) Peer 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 PHS Act.
'(transfer of funds)
SEC. 214. Not to exceed 1 percent of funds appropriated by this Act to the offices, institutes, and centers of the National Institutes of Health may be transferred to and merged with funds appropriated under the heading "National Institutes of Health-Buildings and Facilities": Provided, That the use of such transferred funds shall be subject to a centralized prioritization and governance process: Provided further, That the Director of the National Institutes of Health shall notify the Committees on Appropriations of the House of Representatives and the Senate at least 15 days in advance of any such transfer: Provided further, That this transfer authority is in addition to any other transfer authority provided by law.'(transfer of funds)
SEC. 215. Of the amounts made available for NIH, 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 736, 739, or 747 of the PHS Act, and 1 percent of the amount made available for NRSA shall be made available to the Director of the National Institute for Research on Safety and Quality to make NRSA awards for health service research.SEC. 216.(a) The Biomedical Advanced Research and Development Authority ("BARDA") may enter into a contract, for more than one but no more than 10 program years, for purchase of research services or of security countermeasures, as that term is defined in section 319F-2(c)(1)(B) of the PHS Act (42 U.S.C. 247d-6b(c)(1)(B)), if—
(1) funds are available and obligated—
(A) for the full period of the contract or for the first fiscal year in which the contract is in effect; and
(B) for the estimated costs associated with a necessary termination of the contract; and
(2) the Secretary determines that a multi-year contract will serve the best interests of the Federal Government by encouraging full and open competition or promoting economy in administration, performance, and operation of BARDA's programs.
(b) A contract entered into under this section—
(1) shall include a termination clause as described by subsection (c) of section 3903 of title 41, United States Code; and
(2) shall be subject to the congressional notice requirement stated in subsection (d) of such section.
SEC. 217. Effective during the period beginning on November 1, 2015 and ending January 1, 2022, any provision of law that refers (including through cross-reference to another provision of law) to the current recommendations of the United States Preventive Services Task Force with respect to breast cancer screening, mammography, and prevention shall be administered by the Secretary involved as if—(1) such reference to such current recommendations were a reference to the recommendations of such Task Force with respect to breast cancer screening, mammography, and prevention last issued before 2009; and
(2) such recommendations last issued before 2009 applied to any screening mammography modality under section 1861(jj) of the Social Security Act (42 U.S.C. 1395x(jj)).
'(transfer of funds)
SEC. 218. The NIH Director may transfer discretionary amounts identified by the Director as funding for opioid addiction, opioid alternatives, pain management, and addiction treatment among Institutes and Centers of the NIH to be used for the same purpose 15 days after notifying the Committees on Appropriations of the House of Representatives and the Senate: Provided, That the transfer authority provided in the previous proviso is in addition to any other transfer authority provided by law.SEC. 219. Funds appropriated in this Act that are available for salaries and expenses of employees of the Department of Health and Human Services shall also be available to pay travel and related expenses of such an employee or of a member of his or her family, when such employee is assigned to duty, in the United States or in a U.S. territory, during a period and in a location that are the subject of a determination of a public health emergency under section 319 of the Public Health Service Act and such travel is necessary to obtain medical care for an illness, injury, or medical condition that cannot be adequately addressed in that location at that time. For purposes of this section, the term "U.S. territory" means Guam, the Commonwealth of Puerto Rico, the Northern Mariana Islands, the Virgin Islands, American Samoa, or the Trust Territory of the Pacific Islands.SEC. 220. The Department of Health and Human Services may accept donations from the private sector, nongovernmental organizations, and other groups independent of the Federal Government for the care of unaccompanied alien children (as defined in section 462(g)(2) of the Homeland Security Act of 2002 (6 U.S.C. 279(g)(2))) in the care of the Office of Refugee Resettlement of the Administration for Children and Families, including monetary donations and medical goods and services, which may include early childhood developmental screenings, school supplies, toys, clothing, and any other items and services intended to promote the wellbeing of such children.SEC. 221. Funds appropriated in this Act that are available for salaries and expenses of employees of the Centers for Disease Control and Prevention shall also be available for the primary and secondary schooling of eligible dependents of personnel stationed in a U.S. territory as defined in section 229 of this Act at costs not in excess of those paid for or reimbursed by the Department of Defense.SEC. 222. Amounts made available in section 238 of division A of Public Law 116–94 shall remain available until September 30, 2024 for installation expenses, including moving expenses, related to the Centers for Disease Control and Prevention's Chamblee Campus. SEC. 223. Of the funds provided under the heading "CDC-Wide Activities and Program Support", $50,000,000, to remain available until expended, shall be available to the Director of the CDC for deposit in the Infectious Diseases Rapid Response Reserve Fund established by section 231 of division B of Public Law 115–245: Provided, That such amount may be available for Ebola preparedness and response activities without regard to the limitations in the third proviso in such section 231.'(cancellation)
SEC. 224. Of the unobligated balances available in the "Nonrecurring Expenses Fund" established in section 223 of division G of Public Law 110–161, $500,000,000 are hereby permanently cancelled.SEC. 225.(a) IN GENERAL. Under the conditions listed in subsection (b), the Secretary or the head of a major organizational unit within the Department may in this fiscal year enter into a reimbursable agreement with the head of another major organizational unit within the Department or of another agency under which —
(1) the head of the ordering agency or unit delegates to the head of the servicing agency or unit the authority to issue a grant or cooperative agreement on behalf of the ordering agency or unit;
(2) the servicing agency or unit will execute or manage a grant or cooperative agreement on behalf of the ordering agency or unit; and
(3) the ordering agency or unit will reimburse the servicing unit or agency for the amount of the grant or cooperative agreement and for the service of executing or managing the grant or cooperative agreement.
(b) CONDITIONS. The conditions for making an agreement described in subsection (a) are that —
(1) amounts are available;
(2) the head of the ordering agency or unit decides the agreement is in the best interest of the United States Government; and
(3) the agency or unit to execute or manage the grant or cooperative agreement is able to provide that service.
(c) PAYMENT. Payment shall be made promptly through the Intra-governmental Payment and Collection system at the request of the agency or unit providing the service. Payment may be in advance or on providing all or part of the service, and shall be for any part of the estimated or actual cost as determined by the agency or unit providing the service. A bill submitted or a request for payment is not subject to audit or certification in advance of payment. Proper adjustment of amounts paid in advance shall be made as agreed to by the heads of the agencies or units on the basis of the amount of the grant or cooperative agreement and the actual cost of service provided.
(d) LIMITATIONS ON FUNDS. A condition or limitation applicable to amounts for grant or cooperative agreements of the ordering agency or unit applies to an agreement made under this section and to a grant or cooperative agreement made under such agreement.
(e) OBLIGATION OF APPROPRIATIONS. An agreement made under this section obligates an appropriation of the ordering agency or unit. The amount obligated is deobligated to the extent that the agency or unit providing the service has not incurred obligations, before the end of the period of availability of the appropriation, in—
(1) awarding the grant or cooperative agreement; or
(2) providing the agreed-on services.
(f) NO EFFECT ON OTHER LAWS. This section does not affect other laws about reimbursable agreements.
SEC. 226.(a) IN GENERAL. A State or tribal organization which receives grant funds attributable to appropriations under the heading "Department of Health and Human Services, Administration for Community Living, Aging and Disability Services Programs" to carry out programs under parts B, C, D, or E of title III (with respect to States) or under title VI (with respect to tribal organizations) of the Older Americans Act of 1965 (OAA) may elect to transfer up to 100 percent of such received funds among such title III or title VI programs (respectively), subject to OAA sections 306(a)(9) and 307(a)(9) but notwithstanding any otherwise-applicable limitations on such transfers under the OAA or such heading.
(b) NOTIFICATION OF PROPOSED TRANSFER; SECRETARIAL APPROVAL. A State or tribal organization which elects to make a transfer under subsection (a) shall notify the Secretary of Health and Human Services of such proposed transfer, including a description of the amount to be transferred, the purposes of the transfer, the need for the transfer, and the impact of the transfer on the provision of services from which the funding would be transferred. The Secretary shall approve any such transfer unless the Secretary determines that such transfer is not consistent with the objectives of the OAA.
(c) RULES OF CONSTRUCTION. No transfer of grant funds by a State or tribal organization under this section shall be construed—
(1) as inconsistent with the authorized use of such funds under the OAA, including for purposes of OAA administration and oversight by the Secretary; or
(2) to relieve the State or tribal organization from applicable reporting requirements under the OAA regarding the use of such funds.
SEC. 227. Funds appropriated in this Act to accounts that received appropriations in title II of division A of Public Law 116–94 for the administrative expenses of programs or activities for which appropriations are not provided in this Act shall be available for necessary expenses to carry out the closure of such programs or activities. SEC. 228. Section 340B of the Public Health Service Act (42 U.S.C. 256b) is amended —(a) in subsection (a)(5)(C) —
(1) by striking "A covered entity shall permit" and inserting "(i) DUPLICATE DISCOUNTS AND DRUG RESALE. A covered entity shall permit"; and
(2) by inserting at the end the following:
"(ii) USE OF SAVINGS. — A covered entity shall permit the Secretary to audit, at the Secretary's expense, the records of the entity to determine how net income from purchases under this section are used by the covered entity.
"(iii) RECORDS RETENTION. — Covered entities shall retain such records and provide such records and reports as deemed necessary by the Secretary for carrying out this subparagraph.".
(b) by adding at the end the following new subsection:
"(f) REGULATIONS. — The Secretary may promulgate such regulations as the Secretary determines appropriate to carry out the provisions of this section.".
SEC. 229. For fiscal year 2021, the notification requirements described in sections 1804(a) and 1851(d) of the Social Security Act may be fulfilled by the Secretary in a manner similar to that described in paragraphs (1) and (2) of section 1806(c) of such Act. SEC. 230. Any assessment or user fee charged pursuant to section 1311(d)(5)(A) of the Patient Protection and Affordable Care Act credited to the "Centers for Medicare and Medicaid Services, Program Management" account shall be available for any other Federal administrative expenses the Secretary incurs for activities related to the Exchange program, in addition to any other purposes authorized by law, and shall remain available until expended for the purposes described in this section. '(including transfer of funds)
SEC. 231. There is hereby established in the Treasury a fund to be known as the "Federal Emergency Response Fund" (the "Fund"). Amounts in the Fund shall be available, in addition to any other amount appropriated for such purposes, to carry out titles II, III, and XVII of the PHS Act, and domestic preparedness activities and global health; to prevent, prepare for, or respond to a chemical, biological, radiological, or nuclear defense threat; or to prevent, prepare for, or respond to an emerging infectious disease; and may be used to purchase or lease, and provide for the insurance of, passenger motor vehicles for official use in foreign countries. Amounts in the Fund may only be used for such threats or emergencies that the Secretary determines have significant potential to occur and potential, on occurrence, to affect national security or the health and security of United States citizens, domestically or internationally. The Secretary may transfer to the Fund such amounts as are necessary from any discretionary amounts (pursuant to the Balanced Budget and Emergency Deficit Control Act of 1985) appropriated in this Act, provided that no such appropriation is reduced by more than 1 percent. Such transferred amounts shall remain available until expended. When implementing response activities, amounts in the Fund may be transferred to other accounts of the Department of Health and Human Services for the purposes provided in this section. The Committees on Appropriations of the House of Representatives and the Senate shall be notified promptly of the initiation of response activities under this authority, and of any transfer made under the authority provided in this subsection. The Committees on Appropriations of the House of Representatives and the Senate shall receive a report not later than 45 days after the end of each quarter in the fiscal year on the unobligated balances in the Fund and all actual obligations incurred for the fiscal year, including obligations by program, project, or activity. The transfer authorities in this section are in addition to any other transfer authority otherwise available to the Department of Health and Human Services. Products purchased using amounts in the Fund may, at the discretion of the Secretary of Health and Human Services, be deposited in the Strategic National Stockpile under section 319F-2 of the PHS Act. '(including transfer of funds)
SEC. 232.(a) The Secretary may reserve not more than 0.25 percent from each appropriation made available in this Act to the accounts of the Administration for Children and Families identified in subsection (b) in order to carry out evaluations of any of the programs or activities that are funded under such accounts. Any such funds reserved under this section may be transferred to "Children and Families Services Programs" for use by the Assistant Secretary for the Administration for Children and Families and shall remain available until expended: Provided, That such funds shall only be available if such Assistant Secretary submits a plan to the Committees on Appropriations of the House of Representatives and the Senate describing the evaluations to be carried out 15 days in advance of any such transfer.
(b) The accounts referred to in subsection (a) are: "Low Income Home Energy Assistance", "Refugee and Entrant Assistance", "Payments to States for the Child Care and Development Block Grant", and "Children and Families Services Programs".
SEC. 233. Section 2813 of the Public Health Service Act (42 U.S.C. 300hh-15) is amended —(1) by redesignating subsection (i) as subsection (j); and
(2) by inserting after subsection (h) the following new subsection:
"(i) TORT CLAIMS AND WORK INJURY COMPENSATION COVERAGE FOR CORPS VOLUNTEERS. —
"(1) IN GENERAL — If under section 223 and regulations pursuant to such section, and through an agreement entered into in accordance with such regulations, the Secretary accepts, from an individual in the Corps, services for a specified period that are volunteer and without compensation other than reasonable reimbursement or allowance for expenses actually incurred, such individual shall, during such period, have the coverages described in paragraphs (2) and (3).
"(2) FEDERAL TORT CLAIMS ACT COVERAGE. — Such individual shall, while performing such services during such period —
"(A) be deemed to be an employee of the Department of Health and Human Services, for purposes of claims under sections 1346(b) and 2672 of title 28, United States Code, for money damages for personal injury, including death, resulting from the performance of functions under such agreement; and
"(B) be deemed to be an employee of the Public Health Service performing medical, surgical, dental, or related functions, for purposes of having the remedy provided by such sections of title 28 be exclusive of any other civil action or proceeding by reason of the same subject matter against such individual or against the estate of such individual.
"(3) COMPENSATION FOR WORK INJURIES. Such individual shall, while performing such services during such period, be deemed to be an employee of the Department of Health and Human Services, and an injury sustained by such an individual shall be deemed 'in the performance of duty' for purposes of chapter 81 of title 5, United States Code, pertaining to compensation for work injuries.".
SEC. 234. Funds made available to the Secretary of Health and Human Services (HHS) in this or any other or prior Acts that are available for acquisition of real property or for construction or improvement of facilities shall also be available to make improvements on non-federally owned property located directly adjacent to property owned by HHS or a component thereof, provided that the primary benefit of such improvements accrues to HHS or the component thereof funding the improvements.(Department of Health and Human Services Appropriations Act, 2020.)