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DEPARTMENT OF HEALTH AND HUMAN SERVICES

FOOD AND DRUG ADMINISTRATION

Federal Funds

S

ALARIES AND

E

XPENSES

For necessary expenses of the Food and Drug Administration, including hire and

purchase of passenger motor vehicles; for payment of space rental and related costs

pursuant to Public Law 92–313 for programs and activities of the Food and Drug

Administration which are included in this Act; for rental of special purpose space

in the District of Columbia or elsewhere; for miscellaneous and emergency expenses

of enforcement activities, authorized and approved by the Secretary and to be

ac-counted for solely on the Secretary's certificate, not to exceed $25,000; and

notwith-standing section 521 of Public Law 107–188; [$4,443,356,000] $4,665,400,000:

Provided, That of the amount provided under this heading, [$798,000,000]

$826,072,000 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

expen-ded; [$128,282,000] $134,475,000 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; [$312,116,000] $320,029,000 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; [$21,014,000] $21,540,000 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;

[$22,464,000] $22,140,000 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; [$6,944,000] $7,429,000 shall be derived from animal generic drug

user fees authorized by 21 U.S.C. 379j-21, and shall be credited to this account and

remain available until expended; [$566,000,000] $599,000,000 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

addi-tion 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 animal

generic drug user fees that exceed the respective fiscal year [2015] 2016 limitations

are appropriated and shall be credited to this account and remain available until

ex-pended: Provided further, That fees derived from prescription drug, medical device,

human generic drug, biosimilar biological product, animal drug, and animal generic

drug assessments for fiscal year [2015] 2016, including any such fees collected

prior to fiscal year [2015] 2016 but credited for fiscal year [2015] 2016, shall be

subject to the fiscal year [2015] 2016 limitations: Provided further, That the

Sec-retary may accept payment during fiscal year [2015] 2016 of user fees specified

under this heading and authorized for fiscal year [2016] 2017, prior to the due date

for such fees, and that amounts of such fees assessed for fiscal year [2016] 2017

for which the Secretary accepts payment in fiscal year [2015] 2016 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 of the total amount appropriated: (1)

$903,403,000 shall be for the Center for Food Safety and Applied Nutrition and

re-lated field activities in the Office of Regulatory Affairs; (2) $1,337,948,000 shall

be for the Center for Drug Evaluation and Research and related field activities in

the Office of Regulatory Affairs; (3) $344,267,000 shall be for the Center for

Biolo-gics Evaluation and Research and for related field activities in the Office of

Regu-latory Affairs; (4) $173,976,000 shall be for the Center for Veterinary Medicine and

for related field activities in the Office of Regulatory Affairs; (5) $420,548,000 shall

be for the Center for Devices and Radiological Health and for related field activities

in the Office of Regulatory Affairs; (6) $63,331,000 shall be for the National Center

for Toxicological Research; (7) $531,527,000 shall be for the Center for Tobacco

Products and for related field activities in the Office of Regulatory Affairs; (8) not

to exceed $163,079,000 shall be for Rent and Related activities, of which $47,116,000

is for White Oak Consolidation, other than the amounts paid to the General Services

Administration for rent; (9) not to exceed $227,674,000 shall be for payments to

the General Services Administration for rent; and (10) $277,603,000 shall be for

other activities, including the Office of the Commissioner of Food and Drugs, the

Office of Foods and Veterinary Medicine, the Office of Medical and Tobacco

Products, the Office of Global and Regulatory Policy, the Office of Operations, the

Office of the Chief Scientist, and central services for these offices:] Provided further,

That not to exceed $25,000 of this amount shall be for official reception and

repres-entation 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 of the amounts that are made available under this heading for "other activities",

and that are not derived from user fees, $1,500,000 shall be transferred to and merged

with the appropriation for "Department of Health and Human Services—Office of

Inspector General" for oversight of the programs and operations of the Food and

Drug Administration and shall be in addition to funds otherwise made available for

oversight of the Food and Drug Administration:] Provided further, That funds may

be transferred from one specified activity to another with the prior [approval]

noti-fication of the Committees on Appropriations of both Houses of Congress.

In addition, mammography user fees authorized by 42 U.S.C. 263b, export

certi-fication 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,

out-sourcing 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), and

third-party logistics provider licensing and inspection fees authorized by 21 U.S.C.

360eee-3(c)(1), and third-party auditor fees authorized by 21 U.S.C. 384d(C)(8)

shall be credited to this account, to remain available until expended.

[For an additional amount for "Salaries and Expenses", to prevent, prepare for,

and respond to the Ebola virus domestically and internationally, and to develop

ne-cessary medical countermeasures and vaccines, including the review, regulations,

post market surveillance of vaccines and therapies, and administrative activities,

$25,000,000, to remain available until expended: Provided, That such amount is

designated by the Congress as an emergency requirement pursuant to section

251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985:

Provided further, That of the amounts provided, $4,800,000 is for the Center for

Biologics Evaluation and Research; $2,400,000 is for the Center for Devices and

Radiological Health; $400,000 is for the Office of the Commissioner; $1,900,000

is for the Center for Drug Evaluation and Research; $500,000 is for the Office of

Regulatory Affairs; and $15,000,000 is for the Medical Countermeasures Initiative.]

B

UILDINGS AND

F

ACILITIES

For plans, construction, repair, improvement, extension, alteration, and purchase

of fixed equipment or facilities of or used by the Food and Drug Administration,

where not otherwise provided, $8,788,000, to remain available until expended.

(Agriculture, Rural Development, Food and Drug Administration, and Related

Agencies Appropriations Act, 2015.)

Special and Trust Fund Receipts

(in millions of dollars)

2016 est. 2015 est. 2014 actual Identification code 075–9911–0–1–554 2 1 1 Balance, start of year ... 0100

Receipts:

3 3 2 Cooperative Research and Development Agreements, FDA ... 0220

5 4 3 Total: Balances and collections ... 0400

Appropriations:

–2 –2 –2 Salaries and Expenses ... 0500

3 2 1 Balance, end of year ... 0799

Program and Financing

(in millions of dollars)

2016 est. 2015 est. 2014 actual Identification code 075–9911–0–1–554

Obligations by program activity:

987 903 883 Foods ... 0001 485 482 466 Drugs ... 0002 328 321 321 Devices and Radiological Products ... 0003

59 63 62 National Center for Toxicological Research ... 0004 181 175 172 Other Activities ... 0005 137 116 133 Other Rent and Rent Related Activities ... 0006 177 169 162 Rental Payments ... 0007 9 9 8 Buildings and Facilities ... 0008 2 2 2 CRADAs ... 0009 166 148 142 Animal Drugs and Feed ... 0010 215 211 211 Biologics ... 0011 ... ... 24 Food and Drug Safety (no-year) ... 0012

2,746 2,599 2,586 Total direct obligations ... 0799

2,177 1,901 1,707 Reimbursable program (User fees) ... 0801

... ... 38 Reimbursable program (Federal sources) ... 0802

... ... 8 Reimbursable program (Refund Sequester collections - User

fee) ... 0803

2,177 1,901 1,753 Total reimbursable obligations ... 0899

(2)

S

ALARIES AND

E

XPENSES

—Continued

Program and Financing

—Continued

2016 est. 2015 est. 2014 actual Identification code 075–9911–0–1–554 4,923 4,500 4,339 Total new obligations ... 0900 Budgetary resources: Unobligated balance: 997 974 670 Unobligated balance brought forward, Oct 1 ... 1000

... ... 4 Discretionary unobligated balance brought fwd, Oct 1 ... 1001

... ... 4 Recoveries of prior year unpaid obligations ... 1021

997 974 674 Unobligated balance (total) ... 1050 Budget authority: Appropriations, discretionary: 2,744 2,597 2,561 Appropriation ... 1100 ... 25 ...

Appropriation- Emergency pursuant to 2011 BCA [EBOLA] ... 1100

... –2 ...

Appropriations transferred to other accts [075–0128] ... 1120

2,744 2,620 2,561 Appropriation, discretionary (total) ... 1160

Appropriations, mandatory:

2 2 2 Appropriation (special or trust fund) ... 1201

2 2 2 Appropriations, mandatory (total) ... 1260

Spending authority from offsetting collections, discretionary:

1,978 1,901 1,931 Collected ... 1700 ... ... 22 Change in uncollected payments, Federal sources ... 1701

333 333 605 Offsetting collections (previously unavailable) ... 1702

–333 –333 –494 Spending authority from offsetting collections precluded

from obligation (limitation on obligations) ... 1725

1,978 1,901 2,064 Spending auth from offsetting collections, disc (total) ... 1750

Spending authority from offsetting collections, mandatory:

... ... 12 Offsetting collections (previously unavailable) ... 1802

... ... 12 Spending auth from offsetting collections, mand (total) ... 1850

4,724 4,523 4,639 Budget authority (total) ... 1900

5,721 5,497 5,313 Total budgetary resources available ... 1930

Memorandum (non-add) entries:

798 997 974 Unexpired unobligated balance, end of year ... 1941

Change in obligated balance: Unpaid obligations:

2,334 2,676 2,319 Unpaid obligations, brought forward, Oct 1 ... 3000

4,923 4,500 4,339 Obligations incurred, unexpired accounts ... 3010

... ... 6 Obligations incurred, expired accounts ... 3011 –4,752 –4,842 –3,915 Outlays (gross) ... 3020 ... ... –4 Recoveries of prior year unpaid obligations, unexpired ... 3040

... ... –69 Recoveries of prior year unpaid obligations, expired ... 3041

2,505 2,334 2,676 Unpaid obligations, end of year ... 3050

Uncollected payments:

–51 –51 –51 Uncollected pymts, Fed sources, brought forward, Oct 1 ... 3060

... ... –22 Change in uncollected pymts, Fed sources, unexpired ... 3070

... ... 22 Change in uncollected pymts, Fed sources, expired ... 3071

–51 –51 –51 Uncollected pymts, Fed sources, end of year ... 3090

Memorandum (non-add) entries:

2,283 2,625 2,268 Obligated balance, start of year ... 3100

2,454 2,283 2,625 Obligated balance, end of year ... 3200

Budget authority and outlays, net: Discretionary:

4,722 4,521 4,625 Budget authority, gross ... 4000

Outlays, gross:

3,579 3,430 2,513 Outlays from new discretionary authority ... 4010

1,171 1,410 1,401 Outlays from discretionary balances ... 4011

4,750 4,840 3,914 Outlays, gross (total) ... 4020

Offsets against gross budget authority and outlays: Offsetting collections (collected) from:

–1 –1 –33 Federal sources ... 4030 –1,977 –1,900 –1,915 Non-Federal sources ... 4033 –1,978 –1,901 –1,948 Offsets against gross budget authority and outlays (total) .... 4040

Additional offsets against gross budget authority only:

... ... –22 Change in uncollected pymts, Fed sources, unexpired ... 4050

... ... 17 Offsetting collections credited to expired accounts ... 4052

... ... –5 Additional offsets against budget authority only (total) ... 4060

2,744 2,620 2,672 Budget authority, net (discretionary) ... 4070

2,772 2,939 1,966 Outlays, net (discretionary) ... 4080

Mandatory:

2 2 14 Budget authority, gross ... 4090

Outlays, gross:

2 2 1 Outlays from new mandatory authority ... 4100

2,746 2,622 2,686 Budget authority, net (total) ... 4180

2,774 2,941 1,967 Outlays, net (total) ... 4190

Memorandum (non-add) entries:

541 541 664 Unexpired unavailable balance, SOY: Offsetting collections ... 5090

541 541 541 Unexpired unavailable balance, EOY: Offsetting collections ... 5092

[In millions of dollars]

2016 2015 2014 Distribution of discretionary budget authority by account:

2,734 2,611 2,575 Salaries and expenses ...

9 9 8 Buildings and facilities ... Distribution of discretionary outlays by account:

2,763 2,930 1,726 Salaries and expenses ...

9 9 6 Buildings and facilities ...

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 speed innovations that make medicines more

effective, safer, and more affordable and by helping the public get the

ac-curate, science-based information they need to use medicines and foods to

maintain and improve their health. FDA supports the Nation's

counterter-rorism capability by ensuring the security of the food supply and by

foster-ing the development of medical products and countermeasures to respond

to deliberate and naturally emerging public health threats. The FY 2016

Budget provides funding to support food and medical product safety,

in-cluding implementation of the Food Safety Modernization Act and the

Food and Drug Administration Safety and Innovation Act, encourage

de-velopment of innovative diagnostics and theraputics, promote dede-velopment

of medical countermeasures, and maintain the integrity of operations and

infrastructure. In addition, the FY 2015 funding level for FDA includes

$25 million in one-time emergency funding for the U.S. Government

re-sponse to contain, treat, and prevent the spread of Ebola.

The President is again asking Congress to revive an authority enabling

him to submit fast-track proposals to reorganize or consolidate Federal

programs and agencies in order to reduce the size of Government or cut

costs. The Budget includes a variety of proposed reforms across government

designed to drive efficiency and accountability, prevent duplication, and

make government work better and smarter for the American people. One

of these reorganizations the President would propose with this authority is

to consolidate the USDA's Food Safety Inspection Service and the food

safety components of the Food and Drug Administration at HHS to create

a new agency at HHS. This consolidation could deliver a "one-stop" shop

for most of the issues that mean the most for consumers and industry and

provide centralized leadership to allocate resources strategically across all

food products. The Budget schedules for these agencies and programs

continue to reflect them in their current alignment.

Object Classification

(in millions of dollars)

2016 est. 2015 est. 2014 actual Identification code 075–9911–0–1–554 Direct obligations: Personnel compensation: 883 842 819 Full-time permanent ... 11.1 102 98 95 Other than full-time permanent ... 11.3

59 56 55 Other personnel compensation ... 11.5 67 66 64 Military personnel ... 11.7 1 1 1 Special personal services payments ... 11.8

1,112 1,063 1,034 Total personnel compensation ... 11.9

312 298 290 Civilian personnel benefits ... 12.1

35 35 34 Military personnel benefits ... 12.2

46 43 44 Travel and transportation of persons ... 21.0 3 3 3 Transportation of things ... 22.0 177 169 162 Rental payments to GSA ... 23.1

2 2 2 Rental payments to others ... 23.2

51 47 49 Communications, utilities, and miscellaneous charges ... 23.3

2 1 1 Printing and reproduction ... 24.0

53 49 51 Advisory and assistance services ... 25.1

417 388 399 Other services from non-Federal sources ... 25.2

THE BUDGET FOR FISCAL YEAR 2016

440

Food and Drug Administration—Continued Federal Funds—Continued

(3)

145 135 140 Other goods and services from Federal sources ... 25.3

115 107 110 Operation and maintenance of facilities ... 25.4

21 20 21 Research and development contracts ... 25.5

33 31 32 Operation and maintenance of equipment ... 25.7

43 40 41 Supplies and materials ... 26.0 68 63 66 Equipment ... 31.0 1 1 1 Land and structures ... 32.0

109 101 105 Grants, subsidies, and contributions ... 41.0

1 1 1 Insurance claims and indemnities ... 42.0 2,746 2,597 2,586 Direct obligations ... 99.0 2,177 1,903 1,753 Reimbursable obligations ... 99.0 4,923 4,500 4,339 Total new obligations ... 99.9

Employment Summary

2016 est. 2015 est. 2014 actual Identification code 075–9911–0–1–554 9,537 9,420 9,246 Direct civilian full-time equivalent employment ... 1001

712 712 696 Direct military average strength employment ... 1101

5,855 5,392 4,338 Reimbursable civilian full-time equivalent employment ... 2001

335 335 327 Reimbursable military average strength employment ... 2101

38 38 38 Allocation account civilian full-time equivalent employment ... 3001

1 1 1 Allocation account military average strength employment ... 3101

S

ALARIES AND

E

XPENSES

(Legislative proposal, not subject to PAYGO)

In addition, contingent upon the enactment of authorizing legislation, the Secretary

shall assess user fees with respect to food facility registrations and inspections, food

imports, food contact notification activities, cosmetic activities, and international

express courier import activities, and shall assess an increase in export certification

user fees otherwise appropriated under this heading, and such fees shall be credited

to this account and remain available until expended.

Program and Financing

(in millions of dollars)

2016 est. 2015 est. 2014 actual Identification code 075–9911–2–1–554

Obligations by program activity:

60 ...

... Food Facility Registration and Inspection ... 0801 103 ... ... Food Import ... 0802 6 ... ... International Courier ... 0803 5 ... ... Food Contact Substance Notification ... 0804 20 ... ... Cosmetics ... 0805 4 ... ... Export Certification fee increase ... 0806

198 ...

... Total new obligations ... 0900

Budgetary resources: Budget authority:

Spending authority from offsetting collections, discretionary:

198 ... ... Collected ... 1700 198 ... ... Spending auth from offsetting collections, disc (total) ... 1750

198 ...

... Total budgetary resources available ... 1930

Change in obligated balance: Unpaid obligations:

198 ...

... Obligations incurred, unexpired accounts ... 3010 –198 ... ... Outlays (gross) ... 3020

Budget authority and outlays, net: Discretionary:

198 ...

... Budget authority, gross ... 4000

Outlays, gross:

198 ...

... Outlays from new discretionary authority ... 4010

Offsets against gross budget authority and outlays: Offsetting collections (collected) from:

–198 ...

... Non-Federal sources ... 4033

The FY 2016 Budget includes a number of new user fees. Legislation

will be proposed to allow FDA to collect fees for food import and food

facility registration and inspection to implement the requirements of the

FDA Food Safety Modernization Act (FSMA). The additional resources,

estimated at $103 million for the food import program, would support

FDA's food safety efforts to modernize the import system. The fees

collec-ted for the food facility registration and inspection program, estimacollec-ted at

$60 million, would enable FDA to target new and improved activities

re-quired by FSMA to modernize the food safety system and support

improve-ments in safety science and risk analysis to prevent food safety outbreaks.

The Budget also proposes user fees to support activities related to cosmetics

and food contact notification activities, and fees to support

inspection-re-lated activities at domestic courier facilities. The Budget also includes a

proposal to allow FDA to increase the funding cap for the export

certifica-tion fee from $175 to $600 per certificacertifica-tion to ensure that FDA can

effi-ciently implement the export certification program.

Object Classification

(in millions of dollars)

2016 est. 2015 est. 2014 actual Identification code 075–9911–2–1–554 Reimbursable obligations: Personnel compensation: 152 ... ... Full-time permanent ... 11.1 30 ... ... Other than full-time permanent ... 11.3

8 ...

... Other personnel compensation ... 11.5

190 ...

... Total personnel compensation ... 11.9

8 ...

... Advisory and assistance services ... 25.1

198 ...

... Total new obligations ... 99.9

Employment Summary

2016 est. 2015 est. 2014 actual Identification code 075–9911–2–1–554 242 ... ... Reimbursable civilian full-time equivalent employment ... 2001

R

EVOLVING

F

UND FOR

C

ERTIFICATION AND

O

THER

S

ERVICES

Program and Financing

(in millions of dollars)

2016 est. 2015 est. 2014 actual Identification code 075–4309–0–3–554

Obligations by program activity:

10 9 8 Revolving Fund for Certification and Other Services

(Reimbursable) ... 0801 Budgetary resources: Unobligated balance: 3 4 5 Unobligated balance brought forward, Oct 1 ... 1000

Budget authority:

Spending authority from offsetting collections, mandatory:

9 8 8 Collected ... 1800 1 1 ...

Offsetting collections (previously unavailable) ... 1802

... –1 –1 New and/or unobligated balance of spending authority from

offsetting collections temporarily reduced ... 1823

10 8 7 Spending auth from offsetting collections, mand (total) ... 1850

10 8 7 Budget authority (total) ... 1900

13 12 12 Total budgetary resources available ... 1930

Memorandum (non-add) entries:

3 3 4 Unexpired unobligated balance, end of year ... 1941

Change in obligated balance: Unpaid obligations:

1 2 2 Unpaid obligations, brought forward, Oct 1 ... 3000

10 9 8 Obligations incurred, unexpired accounts ... 3010 –10 –10 –8 Outlays (gross) ... 3020 1 1 2 Unpaid obligations, end of year ... 3050

Memorandum (non-add) entries:

1 2 2 Obligated balance, start of year ... 3100

1 1 2 Obligated balance, end of year ... 3200

Budget authority and outlays, net: Mandatory:

10 8 7 Budget authority, gross ... 4090

Outlays, gross:

10 8 ...

Outlays from new mandatory authority ... 4100

... 2 8 Outlays from mandatory balances ... 4101

10 10 8 Outlays, gross (total) ... 4110

Offsets against gross budget authority and outlays: Offsetting collections (collected) from:

–9 –8 –8 Non-Federal sources ... 4123 1 ... –1 Budget authority, net (total) ... 4180

1 2 ...

Outlays, net (total) ... 4190

441

(4)

R

EVOLVING

F

UND FOR

C

ERTIFICATION AND

O

THER

S

ERVICES

—Continued

Program and Financing

—Continued

2016 est. 2015 est. 2014 actual Identification code 075–4309–0–3–554

Memorandum (non-add) entries:

1 1 ...

Unexpired unavailable balance, SOY: Offsetting collections ... 5090

... 1 1 Unexpired unavailable balance, EOY: Offsetting collections ... 5092

FDA certifies color additives for use in foods, drugs, and cosmetics. It

also lists color additives for use in foods, drugs, medical devices, and

cos-metics (21 U.S.C. 346a, 356, 357, 376). These services are financed wholly

by fees paid by the industries affected.

Object Classification

(in millions of dollars)

2016 est. 2015 est. 2014 actual Identification code 075–4309–0–3–554 Reimbursable obligations: 6 5 4 Personnel compensation: Full-time permanent ... 11.1

1 1 1 Civilian personnel benefits ... 12.1

1 1 1 Rental payments to GSA ... 23.1

1 1 1 Operation and maintenance of equipment ... 25.7 1 1 1 Equipment ... 31.0 10 9 8 Total new obligations ... 99.9

Employment Summary

2016 est. 2015 est. 2014 actual Identification code 075–4309–0–3–554 37 37 36 Reimbursable civilian full-time equivalent employment ... 2001

HEALTH RESOURCES AND SERVICES ADMINISTRATION

Federal Funds

P

RIMARY

H

EALTH

C

ARE

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, [$1,491,522,000] $1,491,522,000: Provided,

That no more than [$100,000] $100,000 shall be available until expended for

car-rying out the provisions of section 224(o) of the PHS Act [, including associated

administrative expenses and relevant evaluations]: Provided further, That no more

than [$99,893,000] $99,893,000 shall be available until expended for carrying out

the provisions of Public Law 104–73 and for expenses incurred by the Department

of Health and Human Services (referred to in this Act as "HHS") pertaining to

ad-ministrative claims made under such law [: Provided further, That of funds provided

for the Health Centers program, as defined by section 330 of the PHS Act, by this

Act or any other Act for fiscal year 2015, not less than $165,000,000 shall be

oblig-ated in fiscal year 2015 as base grant adjustments, not less than $350,000,000 shall

be obligated in fiscal year 2015 to support new access points including approved

and unfunded applications from fiscal year 2014, grants to expand medical services,

behavioral health, oral health, pharmacy, and vision services, and up to $150,000,000

shall be obligated in fiscal year 2015 for construction and capital improvement

costs].

H

EALTH

W

ORKFORCE

For carrying out titles III, VII, and VIII of the PHS Act with respect to the health

workforce, sections 1128E and 1921(b) of the Social Security Act, and the Health

Care Quality Improvement Act of 1986, [$751,600,000] $856,820,000: Provided,

That $287,370,000, to remain available until expended, shall be for the National

Health Service Corps Program: Provided further, That sections 747(c)(2) [,

751(j)(2),] and 762(k), and the proportional funding amounts in paragraphs (1)

through (4) of section 756(e) of the PHS Act shall not apply to funds made available

under this heading: [Provided further, That for any program operating under section

751 of the PHS Act on or before January 1, 2009, the Secretary may hereafter waive

any of the requirements contained in sections 751(d)(2)(A) and 751(d)(2)(B) of such

Act for the full project period of a grant under such section: Provided further, That

no funds shall be available for section 340G-1 of the PHS Act:]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 sections:

Provided further, That, of the amount appropriated under this heading, $100,000,000

shall be for payments to children's hospitals pursuant to section 340E of the PHS

Act, all of which shall be for payments for direct graduate medical education as

described in section 340E(c).

M

ATERNAL AND

C

HILD

H

EALTH

For carrying out titles III, XI, XII, and XIX of the PHS Act with respect to maternal

and child health, title V of the Social Security Act, and section 712 of the American

Jobs Creation Act of 2004, [$851,738,000] $851,738,000: Provided, That

notwith-standing sections 502(a)(1) and 502(b)(1) of the Social Security Act, not more than

[$77,093,000] $77,093,000 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] $10,276,000 shall be available for projects described in subparagraphs

(A) through (F) of section 501(a)(3) of such Act.

R

YAN

W

HITE

HIV/AIDS P

ROGRAM

For carrying out title XXVI of the PHS Act with respect to the Ryan White

HIV/AIDS program, [$2,318,781,000] $2,322,781,000, of which [$1,970,881,000]

$1,970,881,000 shall remain available to the Secretary through September 30,

[2017] 2018, for parts A and B of title XXVI of the PHS Act, and of which not

less than [$900,313,000] $900,313,000 shall be for State AIDS Drug Assistance

Programs under the authority of section 2616 or 311(c) of such Act.

H

EALTH

C

ARE

S

YSTEMS

For carrying out titles III and XII of the PHS Act with respect to health care

sys-tems, and the Stem Cell Therapeutic and Research Act of 2005, [$103,193,000]

$110,193,000, of which [$122,000] $122,000 shall be available until expended for

facilities renovations at the Gillis W. Long Hansen's Disease Center: Provided, 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.

R

URAL

H

EALTH

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, [the Cardiac Arrest

Survival Act of 2000,] and sections 711 and 1820 of the Social Security Act,

[$147,471,000] $127,562,000, of which [$41,609,000] $26,200,000 from general

revenues, notwithstanding section 1820(j) of the Social Security Act, shall be

available for carrying out the Medicare rural hospital flexibility grants program:

Provided, That of the funds made available under this heading for Medicare rural

hospital flexibility grants, [$14,942,000 shall be available for the Small Rural

Hospital Improvement Grant Program for quality improvement and adoption of

health information technology and] up to $1,000,000 shall be to carry out section

1820(g)(6) of the Social Security Act, with funds provided for grants under section

1820(g)(6) available for the purchase and implementation of telehealth services,

including pilots and demonstrations on the use of electronic health records to

co-ordinate rural veterans care between rural providers and the Department of Veterans

Affairs electronic health record system: Provided further, That notwithstanding

section 338J(k) of the PHS Act, [$9,511,000] $9,511,000 shall be available for

State Offices of Rural Health.

F

AMILY

P

LANNING

For carrying out the program under title X of the PHS Act to provide for voluntary

family planning projects, [$286,479,000] $300,000,000: 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.

P

ROGRAM

M

ANAGEMENT

For program support in the Health Resources and Services Administration,

[$154,000,000] $157,061,000: 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":

Provided further, That the Administrator may transfer funds between any of the

accounts of HRSA with notification to the Committees on Appropriations of both

Houses of Congress at least 15 days in advance of any transfer, but no such account

THE BUDGET FOR FISCAL YEAR 2016

442

Food and Drug Administration—Continued Federal Funds—Continued

(5)

shall be decreased by more than 3 percent by any such transfer. (Department of

Health and Human Services Appropriations Act, 2015.)

Program and Financing

(in millions of dollars)

2016 est. 2015 est. 2014 actual Identification code 075–0350–0–1–550

Obligations by program activity:

... ... 1 Free Clinics Medical Malpractice ... 0009 1,392 1,392 1,397 Health Centers ... 0010 287 ... ... National Health Service Corps ... 0012

15 15 15 Hansen's Disease Center ... 0013

2 2 2 Payment to Hawaii for the Treatment of Hansen's Disease ... 0014

7 7 7 Black Lung Clinics ... 0015

82 82 80 Nursing Education Loan Repayment and Scholarships ... 0016 386 403 387 Health Professions ... 0017 637 637 632 Maternal and Child Health Block Grant ... 0018 102 102 101 Healthy Start ... 0019 19 19 19 Poison Control Centers ... 0020

20 20 20 EMS for Children ... 0021

18 18 18 Universal Newborn Hearing Screening ... 0022 2,323 2,319 2,290 HIV/AIDS ... 0023 24 24 23 Organ Transplantation ... 0024 22 22 22 Bone Marrow Donor Registry ... 0025

9 9 9 Rural Health Policy Development ... 0026

59 59 57 Rural Health Outreach Grants ... 0027

26 42 40 Rural Health Flexibility Grants ... 0028 15 15 14 Telehealth ... 0030 157 154 153 Program Management ... 0031 300 286 286 Family Planning ... 0032 1 1 1 Loan Repayment/Faculty Fellowship ... 0033

100 100 81 Health Centers Tort Claim Fund ... 0035 14 14 12 Heritable Disorders ... 0036 100 265 264 Childrens' GME ... 0038 10 10 9 State Offices of Rural Health ... 0041 2 2 2 Radiogenic Diseases ... 0043 9 9 9 Traumatic Brain Injury ... 0044

47 47 47 Autism and Other Developmental Disorders ... 0045

11 11 11 Cord Blood Stem Cell Bank ... 0046 4 4 4 Sickle Cell ... 0048 17 10 10 Drug Pricing Program ... 0049

... 3 5 Family to Family Health Information Centers ACA ... 0050

178 2,968 2,152 Health Centers ACA ... 0073

... ... 38 Health Centers Construction ACA ... 0074

... 287 281 National Health Service Corps ACA ... 0075

... 3 1 School Based Health Centers ACA ... 0076

... 105 60 GME Payments THC ACA ... 0077

... 5 3 Rural Health AED ... 0079

6,395 9,471 8,563 Total direct programs ... 0300

6,395 9,471 8,563 Total direct obligations ... 0799

64 57 56 Health Resources and Services (Reimbursable) ... 0801

... ... 25 Reimbursable program: PHS evaluation ... 0802

64 57 81 Total reimbursable obligations ... 0899

6,459 9,528 8,644 Total new obligations ... 0900 Budgetary resources: Unobligated balance: 726 298 361 Unobligated balance brought forward, Oct 1 ... 1000

... ... 123 Discretionary unobligated balance brought fwd, Oct 1 ... 1001

... ... 26 Recoveries of prior year unpaid obligations ... 1021

726 298 387 Unobligated balance (total) ... 1050 Budget authority: Appropriations, discretionary: 6,218 6,105 6,054 Appropriation ... 1100 ... ... –10 Appropriations transferred to other accts [075–0511] ... 1120

... ... –5 Appropriations transferred to other accts [075–1503] ... 1120

6,218 6,105 6,039 Appropriation, discretionary (total) ... 1160 Appropriations, mandatory: ... 3,799 2,510 Appropriation ... 1200 ... ... –77 Appropriations and/or unobligated balance of

appropriations permanently reduced ... 1230

... 3,799 2,433 Appropriations, mandatory (total) ... 1260

Spending authority from offsetting collections, discretionary:

43 35 30 Collected ... 1700 ... ... 38 Change in uncollected payments, Federal sources ... 1701

... ... 1 Offsetting collections (previously unavailable) ... 1702

43 35 69 Spending auth from offsetting collections, disc (total) ... 1750

Spending authority from offsetting collections, mandatory:

17 17 17 Offsetting collections (cash)(HPSL&NSL) ... 1800

1 1 ...

Offsetting collections (previously unavailable) ... 1802

... –1 –1 New and/or unobligated balance of spending authority from

offsetting collections temporarily reduced ... 1823

18 17 16 Spending auth from offsetting collections, mand (total) ... 1850

6,279 9,956 8,557 Budget authority (total) ... 1900

7,005 10,254 8,944 Total budgetary resources available ... 1930

Memorandum (non-add) entries:

... ... –2 Unobligated balance expiring ... 1940

546 726 298 Unexpired unobligated balance, end of year ... 1941

Change in obligated balance: Unpaid obligations:

6,952 6,233 6,239 Unpaid obligations, brought forward, Oct 1 ... 3000

6,459 9,528 8,644 Obligations incurred, unexpired accounts ... 3010

... ... 1 Obligations incurred, expired accounts ... 3011 –8,215 –8,809 –8,530 Outlays (gross) ... 3020 ... ... –26 Recoveries of prior year unpaid obligations, unexpired ... 3040

... ... –95 Recoveries of prior year unpaid obligations, expired ... 3041

5,196 6,952 6,233 Unpaid obligations, end of year ... 3050

Uncollected payments:

–67 –67 –74 Uncollected pymts, Fed sources, brought forward, Oct 1 ... 3060

... ... –38 Change in uncollected pymts, Fed sources, unexpired ... 3070

... ... 45 Change in uncollected pymts, Fed sources, expired ... 3071

–67 –67 –67 Uncollected pymts, Fed sources, end of year ... 3090

Memorandum (non-add) entries:

6,885 6,166 6,165 Obligated balance, start of year ... 3100

5,129 6,885 6,166 Obligated balance, end of year ... 3200

Budget authority and outlays, net: Discretionary:

6,261 6,140 6,108 Budget authority, gross ... 4000

Outlays, gross:

2,367 2,310 2,259 Outlays from new discretionary authority ... 4010

3,816 3,492 3,642 Outlays from discretionary balances ... 4011

6,183 5,802 5,901 Outlays, gross (total) ... 4020

Offsets against gross budget authority and outlays: Offsetting collections (collected) from:

–15 –15 –43 Federal sources ... 4030 –20 –20 –28 Non-Federal sources ... 4033 –8 ... ... Non-Federal sources ... 4033 –43 –35 –71 Offsets against gross budget authority and outlays (total) .... 4040

Additional offsets against gross budget authority only:

... ... –38 Change in uncollected pymts, Fed sources, unexpired ... 4050

... ... 41 Offsetting collections credited to expired accounts ... 4052

... ... 3 Additional offsets against budget authority only (total) ... 4060

6,218 6,105 6,040 Budget authority, net (discretionary) ... 4070

6,140 5,767 5,830 Outlays, net (discretionary) ... 4080

Mandatory:

18 3,816 2,449 Budget authority, gross ... 4090

Outlays, gross:

18 1,486 1,241 Outlays from new mandatory authority ... 4100

2,014 1,521 1,388 Outlays from mandatory balances ... 4101

2,032 3,007 2,629 Outlays, gross (total) ... 4110

Offsets against gross budget authority and outlays: Offsetting collections (collected) from:

–17 –17 –17 Non-Federal sources ... 4123 6,219 9,904 8,472 Budget authority, net (total) ... 4180

8,155 8,757 8,442 Outlays, net (total) ... 4190

Memorandum (non-add) entries:

1 1 1 Unexpired unavailable balance, SOY: Offsetting collections ... 5090

... 1 1 Unexpired unavailable balance, EOY: Offsetting collections ... 5092

Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program

(in millions of dollars) 2016 est. 2015 est. 2014 actual Identification code 075–0350–0–1–550

Guaranteed loan levels supportable by subsidy budget authority:

4 6 3 Health centers: Facilities renovation loan guarantee levels ... 215001

4 6 3 Total loan guarantee levels ... 215999

Guaranteed loan subsidy (in percent):

2.67 2.67 2.81 Health centers: Facilities renovation loan guarantee levels ... 232001

2.67 2.67 2.81 Weighted average subsidy rate ... 232999

Resources displayed here support categorical grants and contracts

man-aged by Health Resources and Services Administration (HRSA). These

activities include support for Health Centers, treatment and care for those

living with HIV/AIDS, health professions training, maternal and child

443

(6)

H

EALTH

R

ESOURCES AND

S

ERVICES

—Continued

health care services, promotion of organ and bone marrow donation, and

the medical malpractice claims funds, which pay malpractice claims filed

against employees of federally-supported health centers and free clinics.

HRSA is also responsible for oversight of the 340B Drug Discount Program.

The 2016 Budget proposes a new user fee for this program to improve

ad-ministration and oversight of this activity.

HRSA administers the following revolving loan programs: Health

Profes-sions Student Loans (HPSL), Nursing Student Loans (NSL), Primary Care

Loans (PCL) and Loans for Disadvantaged Students (LDS). These programs

are financed through revolving accounts (Federal Capital Contribution)

and do not receive annual appropriations. Through these revolving fund

accounts, funds are awarded to institutions that in turn provide loans to

individual students. As borrowers pay back loans the programs revolving

account gets replenished, and the collected funds are then used to give out

new loans in the following academic years. If the program's revolving

ac-count 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 2012–2013 data reported in the Annual

Operating Report.

Health Professions Revolving Loan Programs

Federal Capital Contribution

Account Balance Program 389,796,286 HPSL ... 174,462,796 NSL ... 258,568,607 PCL ... 132,944,663 LDS ... 955,772,352 Total ...

Object Classification

(in millions of dollars)

2016 est. 2015 est. 2014 actual Identification code 075–0350–0–1–550 Direct obligations: Personnel compensation: 159 175 158 Full-time permanent ... 11.1 6 6 6 Other than full-time permanent ... 11.3

3 3 3 Other personnel compensation ... 11.5 13 18 18 Military personnel ... 11.7 181 202 185 Total personnel compensation ... 11.9

48 53 48 Civilian personnel benefits ... 12.1

7 10 10 Military personnel benefits ... 12.2

2 2 2 Travel and transportation of persons ... 21.0

22 26 22 Rental payments to GSA ... 23.1

1 1 1 Rental payments to others ... 23.2

5 6 7 Communications, utilities, and miscellaneous charges ... 23.3

13 13 14 Advisory and assistance services ... 25.1

125 134 136 Other services from non-Federal sources ... 25.2

170 250 254 Other goods and services from Federal sources ... 25.3

1 1 1 Operation and maintenance of facilities ... 25.4 3 3 3 Medical care ... 25.6 41 42 42 Operation and maintenance of equipment ... 25.7

1 1 1 Supplies and materials ... 26.0 3 3 3 Equipment ... 31.0 5,680 8,632 7,762 Grants, subsidies, and contributions ... 41.0

92 92 72 Insurance claims and indemnities ... 42.0 6,395 9,471 8,563 Direct obligations ... 99.0 64 57 81 Reimbursable obligations ... 99.0 6,459 9,528 8,644 Total new obligations ... 99.9

Employment Summary

2016 est. 2015 est. 2014 actual Identification code 075–0350–0–1–550 1,500 1,688 1,555 Direct civilian full-time equivalent employment ... 1001

131 182 182 Direct military average strength employment ... 1101

68 62 58 Reimbursable civilian full-time equivalent employment ... 2001

4 4 4 Reimbursable military average strength employment ... 2101

H

EALTH

R

ESOURCES AND

S

ERVICES

(Legislative proposal, subject to PAYGO)

Program and Financing

(in millions of dollars)

2016 est. 2015 est. 2014 actual Identification code 075–0350–4–1–550

Obligations by program activity:

400 ...

... Targeted Support GME ... 0001 2,700 ... ... Health Centers ... 0073 523 ... ... National Health Service Corps ... 0075

3,623 ...

... Total direct programs ... 0300

3,623 ...

... Total new obligations ... 0900 Budgetary resources: Budget authority: Appropriations, mandatory: 3,623 ... ... Appropriation ... 1200 3,623 ... ... Appropriations, mandatory (total) ... 1260

3,623 ...

... Budget authority (total) ... 1900

3,623 ...

... Total budgetary resources available ... 1930

Change in obligated balance: Unpaid obligations:

3,623 ...

... Obligations incurred, unexpired accounts ... 3010 –1,652 ... ... Outlays (gross) ... 3020 1,971 ... ... Unpaid obligations, end of year ... 3050

Memorandum (non-add) entries:

1,971 ...

... Obligated balance, end of year ... 3200

Budget authority and outlays, net: Mandatory:

3,623 ...

... Budget authority, gross ... 4090

Outlays, gross:

1,652 ...

... Outlays from new mandatory authority ... 4100

3,623 ...

... Budget authority, net (total) ... 4180

1,652 ...

... Outlays, net (total) ... 4190

Object Classification

(in millions of dollars)

2016 est. 2015 est. 2014 actual Identification code 075–0350–4–1–550 Direct obligations: Personnel compensation: 28 ... ... Full-time permanent ... 11.1 1 ... ... Other than full-time permanent ... 11.3 5 ... ... Military personnel ... 11.7 34 ... ... Total personnel compensation ... 11.9

9 ...

... Civilian personnel benefits ... 12.1

3 ...

... Military personnel benefits ... 12.2

4 ...

... Rental payments to GSA ... 23.1

1 ...

... Communications, utilities, and miscellaneous charges ... 23.3

14 ...

... Other services from non-Federal sources ... 25.2

77 ...

... Other goods and services from Federal sources ... 25.3

3,481 ...

... Grants, subsidies, and contributions ... 41.0

3,623 ...

... Total new obligations ... 99.9

Employment Summary

2016 est. 2015 est. 2014 actual Identification code 075–0350–4–1–550 264 ... ... Direct civilian full-time equivalent employment ... 1001

50 ...

... Direct military average strength employment ... 1101

V

ACCINE

I

NJURY

C

OMPENSATION

Program and Financing

(in millions of dollars)

2016 est. 2015 est. 2014 actual Identification code 075–0320–0–1–551 Budgetary resources: Unobligated balance: 23 23 19 Unobligated balance brought forward, Oct 1 ... 1000

THE BUDGET FOR FISCAL YEAR 2016

444

Health Resources and Services Administration—Continued Federal Funds—Continued

(7)

Budget authority:

Spending authority from offsetting collections, mandatory:

... ... 4 Collected ... 1800 ... ... 4 Spending auth from offsetting collections, mand (total) ... 1850

... ... 4 Budget authority (total) ... 1900

23 23 23 Total budgetary resources available ... 1930

Memorandum (non-add) entries:

23 23 23 Unexpired unobligated balance, end of year ... 1941

Budget authority and outlays, net: Mandatory:

... ... 4 Budget authority, gross ... 4090

Offsets against gross budget authority and outlays: Offsetting collections (collected) from:

... ... –4 Federal sources ... 4120 ... ... –4 Outlays, net (total) ... 4190

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'

appro-priations 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.

C

OVERED

C

OUNTERMEASURE

P

ROCESS

F

UND

Program and Financing

(in millions of dollars)

2016 est. 2015 est. 2014 actual Identification code 075–0343–0–1–551

Obligations by program activity:

2 3 5 Claims ... 0001 1 2 ... Admin Expense ... 0103 3 5 5 Total new obligations ... 0900 Budgetary resources: Unobligated balance: ... 2 2 Unobligated balance brought forward, Oct 1 ... 1000

3 3 5 Unobligated balance transfer from other acct [075–0140] .... 1011

3 5 7 Unobligated balance (total) ... 1050

3 5 7 Total budgetary resources available ... 1930

Memorandum (non-add) entries:

... ... 2 Unexpired unobligated balance, end of year ... 1941

Change in obligated balance: Unpaid obligations:

3 2 2 Unpaid obligations, brought forward, Oct 1 ... 3000

3 5 5 Obligations incurred, unexpired accounts ... 3010 –4 –4 –5 Outlays (gross) ... 3020 2 3 2 Unpaid obligations, end of year ... 3050

Memorandum (non-add) entries:

3 2 2 Obligated balance, start of year ... 3100

2 3 2 Obligated balance, end of year ... 3200

Budget authority and outlays, net: Discretionary:

Outlays, gross:

4 4 5 Outlays from discretionary balances ... 4011

4 4 5 Outlays, net (total) ... 4190

The Covered Countermeasure Process Fund is established pursuant to

the PHS Act, as amended by Division C of Public Law 109–148, to serve

as a source of funds to pay for compensation for injuries, illnesses or death,

or losses resulting from the administration to or use by an individual of a

covered countermeasure for which a Secretarial Declaration has been issued,

pursuant to section 319F-3(b) of the Public Health Service Act.

Addition-ally, authority is provided to address any unexpected claims that may arise

under the Smallpox Emergency Personal Protection Act of 2003.

Object Classification

(in millions of dollars)

2016 est. 2015 est. 2014 actual Identification code 075–0343–0–1–551 Direct obligations: ... ... 1 Personnel compensation: Full-time permanent ... 11.1

1 1 1 Other services from non-Federal sources ... 25.2

1 3 2 Insurance claims and indemnities ... 42.0 2 4 4 Direct obligations ... 99.0 1 1 1 Below reporting threshold ... 99.5

3 5 5 Total new obligations ... 99.9

Employment Summary

2016 est. 2015 est. 2014 actual Identification code 075–0343–0–1–551 6 6 4 Direct civilian full-time equivalent employment ... 1001

2 2 2 Direct military average strength employment ... 1101

M

ATERNAL

, I

NFANT

,

AND

E

ARLY

C

HILDHOOD

H

OME

V

ISITING

P

ROGRAMS

Program and Financing

(in millions of dollars)

2016 est. 2015 est. 2014 actual Identification code 075–0321–0–1–551

Obligations by program activity:

... 422 394 Maternal, Infant, and Early Childhood Home Visiting

Programs ... 0010 Budgetary resources: Unobligated balance: 5 27 25 Unobligated balance brought forward, Oct 1 ... 1000

... ... 25 Unobligated balance transfers between expired and unexpired

accounts ... 1012

5 27 50 Unobligated balance (total) ... 1050 Budget authority: Appropriations, mandatory: ... 400 400 Appropriation ... 1200 ... ... –29 Appropriations and/or unobligated balance of

appropriations permanently reduced ... 1230

... 400 371 Appropriations, mandatory (total) ... 1260

5 427 421 Total budgetary resources available ... 1930

Memorandum (non-add) entries:

5 5 27 Unexpired unobligated balance, end of year ... 1941

Change in obligated balance: Unpaid obligations:

803 703 654 Unpaid obligations, brought forward, Oct 1 ... 3000

... 422 394 Obligations incurred, unexpired accounts ... 3010 –367 –322 –320 Outlays (gross) ... 3020 ... ... –25 Recoveries of prior year unpaid obligations, expired ... 3041

436 803 703 Unpaid obligations, end of year ... 3050

Memorandum (non-add) entries:

803 703 654 Obligated balance, start of year ... 3100

436 803 703 Obligated balance, end of year ... 3200

Budget authority and outlays, net: Mandatory:

... 400 371 Budget authority, gross ... 4090

Outlays, gross:

... 16 6 Outlays from new mandatory authority ... 4100

367 306 314 Outlays from mandatory balances ... 4101

367 322 320 Outlays, gross (total) ... 4110

... 400 371 Budget authority, net (total) ... 4180

367 322 320 Outlays, net (total) ... 4190

P.L. 113–93 provides resources to Maternal, Infant and Early Childhood

Home Visiting Program through 2015 to provide comprehensive services

for at risk communities. The 2016 Budget includes $500 million for the

Maternal, Infant and Early Childhood Home Visiting Program to extend

and expand evidenced-based home visiting services for at risk communities.

These activities are administered by HRSA.

445

(8)

M

ATERNAL

, I

NFANT

,

AND

E

ARLY

C

HILDHOOD

H

OME

V

ISITING

P

ROGRAMS

—Continued

Object Classification

(in millions of dollars)

2016 est. 2015 est. 2014 actual Identification code 075–0321–0–1–551 Direct obligations: Personnel compensation: ... 2 2 Full-time permanent ... 11.1 ... 1 1 Military personnel ... 11.7 ... 3 3 Total personnel compensation ... 11.9

... 1 1 Civilian personnel benefits ... 12.1

... 19 19 Advisory and assistance services ... 25.1

... 399 371 Grants, subsidies, and contributions ... 41.0

... 422 394 Total new obligations ... 99.9

Employment Summary

2016 est. 2015 est. 2014 actual Identification code 075–0321–0–1–551 ... 18 18 Direct civilian full-time equivalent employment ... 1001

... 4 4 Direct military average strength employment ... 1101

M

ATERNAL

, I

NFANT

,

AND

E

ARLY

C

HILDHOOD

H

OME

V

ISITING

P

ROGRAMS

(Legislative proposal, subject to PAYGO)

Program and Financing

(in millions of dollars)

2016 est. 2015 est. 2014 actual Identification code 075–0321–4–1–551

Obligations by program activity:

500 ...

... Maternal, Infant, and Early Childhood Home Visiting

Programs ... 0010 Budgetary resources: Budget authority: Appropriations, mandatory: 500 ... ... Appropriation ... 1200 500 ... ... Appropriations, mandatory (total) ... 1260

500 ...

... Total budgetary resources available ... 1930

Change in obligated balance: Unpaid obligations:

500 ...

... Obligations incurred, unexpired accounts ... 3010 –20 ... ... Outlays (gross) ... 3020 480 ... ... Unpaid obligations, end of year ... 3050

Memorandum (non-add) entries:

480 ...

... Obligated balance, end of year ... 3200

Budget authority and outlays, net: Mandatory:

500 ...

... Budget authority, gross ... 4090

Outlays, gross:

20 ...

... Outlays from new mandatory authority ... 4100

500 ...

... Budget authority, net (total) ... 4180

20 ...

... Outlays, net (total) ... 4190

P.L. 113–93 provides resources to Maternal, Infant and Early Childhood

Home Visiting Program through 2015 to provide comprehensive services

for at risk communities. The 2016 Budget includes $500 million for the

Maternal, Infant and Early Childhood Home Visiting Program to extend

and expand evidenced-based home visiting services for at risk communities.

These activities are administered by HRSA.

Object Classification

(in millions of dollars)

2016 est. 2015 est. 2014 actual Identification code 075–0321–4–1–551 Direct obligations: Personnel compensation: 2 ... ... Full-time permanent ... 11.1 1 ... ... Military personnel ... 11.7 3 ... ... Total personnel compensation ... 11.9

1 ...

... Civilian personnel benefits ... 12.1

19 ...

... Advisory and assistance services ... 25.1

477 ...

... Grants, subsidies, and contributions ... 41.0

500 ...

... Total new obligations ... 99.9

Employment Summary

2016 est. 2015 est. 2014 actual Identification code 075–0321–4–1–551 18 ... ... Direct civilian full-time equivalent employment ... 1001

4 ...

... Direct military average strength employment ... 1101

H

EALTH

C

ENTER

G

UARANTEED

L

OAN

F

INANCING

A

CCOUNT

Program and Financing

(in millions of dollars)

2016 est. 2015 est. 2014 actual Identification code 075–4442–0–3–551

Obligations by program activity: Credit program obligations:

1 1 ...

Default claim payments on principal ... 0711

1 1 ...

Total new obligations ... 0900 Budgetary resources: Unobligated balance: 2 3 3 Unobligated balance brought forward, Oct 1 ... 1000

2 3 3 Total budgetary resources available ... 1930

Memorandum (non-add) entries:

1 2 3 Unexpired unobligated balance, end of year ... 1941

Change in obligated balance: Unpaid obligations:

1 ...

... Unpaid obligations, brought forward, Oct 1 ... 3000

1 1 ...

Obligations incurred, unexpired accounts ... 3010

2 1 ...

Unpaid obligations, end of year ... 3050

Memorandum (non-add) entries:

1 ...

... Obligated balance, start of year ... 3100

2 1 ...

Obligated balance, end of year ... 3200

Status of Guaranteed Loans

(in millions of dollars)

2016 est. 2015 est. 2014 actual Identification code 075–4442–0–3–551

Position with respect to appropriations act limitation on commitments:

9 15 18 Limitation available from carry-forward ... 2121

–5 –9 –15 Uncommitted limitation carried forward ... 2143

4 6 3 Total guaranteed loan commitments ... 2150

3 5 3 Guaranteed amount of guaranteed loan commitments ... 2199

Cumulative balance of guaranteed loans outstanding:

75 80 77 Outstanding, start of year ... 2210

4 6 3 Disbursements of new guaranteed loans ... 2231

–10 –10 ...

Repayments and prepayments ... 2251

–1 –1 ...

Adjustments: Terminations for default that result in claim payments ... 2263

68 75 80 Outstanding, end of year ... 2290

Memorandum:

68 75 80 Guaranteed amount of guaranteed loans outstanding, end of

year ... 2299

P.L. 104–299 and P.L. 104–208 authorize Health Resources and Services

Administration (HRSA) to guarantee up to $160 million in private loans

to health centers for the costs of developing and operating managed care

networks or plans and for the construction, renovation and modernization

of medical facilities. The program account for this activity is displayed in

the Health Resources and Services account (75–0350) as a line in the

pro-gram and financing schedule.

Balance Sheet

(in millions of dollars)

2014 actual 2013 actual Identification code 075–4442–0–3–551 ASSETS: 3 3

Federal assets: Fund balances with Treasury ... 1101 3 3 Total assets ... 1999 LIABILITIES: 3 3

Non-Federal liabilities: Liabilities for loan guarantees ... 2204

THE BUDGET FOR FISCAL YEAR 2016

446

Health Resources and Services Administration—Continued Federal Funds—Continued

(9)

3 3

Total liabilities and net position ... 4999

H

EALTH

E

DUCATION

A

SSISTANCE

L

OANS

P

ROGRAM

A

CCOUNT

Program and Financing

(in millions of dollars)

2016 est. 2015 est. 2014 actual Identification code 075–0340–0–1–552

Obligations by program activity: Credit program obligations:

... ... 2 Administrative expenses ... 0709 Budgetary resources: Budget authority: Appropriations, discretionary: ... ... 3 Appropriation ... 1100 ... ... –1 Appropriations transferred to other accts [091–0202] ... 1120

... ... 2 Appropriation, discretionary (total) ... 1160

... ... 2 Budget authority (total) ... 1900

... ... 2 Total budgetary resources available ... 1930

Change in obligated balance: Unpaid obligations:

... ... 1 Unpaid obligations, brought forward, Oct 1 ... 3000

... ... 2 Obligations incurred, unexpired accounts ... 3010 ... ... –3 Outlays (gross) ... 3020

Memorandum (non-add) entries:

... ... 1 Obligated balance, start of year ... 3100

Budget authority and outlays, net: Discretionary:

... ... 2 Budget authority, gross ... 4000

Outlays, gross:

... ... 2 Outlays from new discretionary authority ... 4010

... ... 1 Outlays from discretionary balances ... 4011

... ... 3 Outlays, gross (total) ... 4020

... ... 2 Budget authority, net (total) ... 4180

... ... 3 Outlays, net (total) ... 4190

Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program

(in millions of dollars) 2016 est. 2015 est. 2014 actual Identification code 075–0340–0–1–552

Guaranteed loan reestimates:

... ... –43 HEAL Loan guarantee ... 235001

Pursuant to P.L. 113–76, the Consolidated Appropriations Act, in 2014

the authority to administer, service, collect, and enforce the program as

wel as the functions, assets, and liabilities of the Secretary of Health and

Human Services was permanently transferred to the Secretary of Education.

Object Classification

(in millions of dollars)

2016 est. 2015 est. 2014 actual Identification code 075–0340–0–1–552 Direct obligations: ... ... 1 Personnel compensation: Full-time permanent ... 11.1

... ... 1 Other goods and services from Federal sources ... 25.3

... ... 2 Total new obligations ... 99.9

Employment Summary

2016 est. 2015 est. 2014 actual Identification code 075–0340–0–1–552 ... ... 10 Direct civilian full-time equivalent employment ... 1001

H

EALTH

E

DUCATION

A

SSISTANCE

L

OANS

F

INANCING

A

CCOUNT

Program and Financing

(in millions of dollars)

2016 est. 2015 est. 2014 actual Identification code 075–4304–0–3–552

Obligations by program activity: Credit program obligations:

... ... 2 Default claim payments on principal ... 0711

... ... 18 Downward reestimate paid to receipt account ... 0742

... ... 26 Interest on downward reestimates ... 0743

... ... 46 Total new obligations ... 0900 Budgetary resources: Unobligated balance: ... ... 108 Unobligated balance brought forward, Oct 1 ... 1000

... ... –62 Unobligated balance transfer to other accts [091–4300] ... 1010

... ... 46 Unobligated balance (total) ... 1050

Financing authority:

Spending authority from offsetting collections, mandatory:

... ... 5 Collected ... 1800 ... ... –5 Spending authority from offsetting collections transferred

to other accounts [091–4300] ... 1810

... ... 46 Total budgetary resources available ... 1930

Change in obligated balance: Unpaid obligations:

... ... 46 Obligations incurred, unexpired accounts ... 3010

... ... –46 Financing disbursements (gross) ... 3020

Financing authority and disbursements, net: Mandatory:

Financing disbursements:

... ... 46 Financing disbursements, gross ... 4110

Offsets against gross financing authority and disbursements: Offsetting collections (collected) from:

... ... –5 Recoveries of defaulted loans ... 4123

... ... –5 Financing authority, net (total) ... 4180

... ... 41 Financing disbursements, net (total) ... 4190

Status of Guaranteed Loans

(in millions of dollars)

2016 est. 2015 est. 2014 actual Identification code 075–4304–0–3–552

Cumulative balance of guaranteed loans outstanding:

... ... 350 Outstanding, start of year ... 2210

Adjustments:

... ... –2 Terminations for default that result in loans receivable ... 2261

... ... –348 Other adjustments, net ... 2264

... ... ... Outstanding, end of year ... 2290

Addendum:

Cumulative balance of defaulted guaranteed loans that result in loans receivable:

... ... 192 Outstanding, start of year ... 2310

... ... –192 Other adjustments, net ... 2364

... ... ... Outstanding, end of year ... 2390

Pursuant to P.L. 113–76, the Consolidated Appropriations Act, in 2014

this activity was transferred to the Department of Education.

Balance Sheet

(in millions of dollars)

2014 actual 2013 actual Identification code 075–4304–0–3–552 ASSETS: ... 108

Federal assets: Fund balances with Treasury ... 1101

Net value of assets related to post-1991 acquired defaulted guaranteed loans receivable:

... 192

Defaulted guaranteed loans receivable, gross ... 1501

... –144

Allowance for subsidy cost (-) ... 1505

... 48

Net present value of assets related to defaulted guaranteed loans ... 1599 ... 156 Total assets ... 1999 LIABILITIES: ... 156

Non-Federal liabilities: Liabilities for loan guarantees ... 2204

... 156

Total liabilities and net position ... 4999

447

References

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