HHS Performance and Accountability Report Report: FY2004 -- Section V

Appendix B – Net Costs of Key HHS Programs For the Fiscal Years Ended September 30, 2004 and 2003 (in millions)
The following table presents the net costs of HHS’ 50 largest programs (based on their FY 2004 net cost) for FY 2004 and FY 2003. This listing includes programs aggregated from the several hundred total HHS programs. The net cost information is extracted from HHS Agencies’ consolidated statements of net cost for FY 2004 and FY 2003, and supplements the program identified in the Department’s consolidated statement of net cost. The shaded programs below relate to the programs discussed in the “Performance Overview” section of the Management Discussion and Analysis and in the Program Performance Report section of this report.
HHS Program	HHS Net Cost ($)		Rank by ($)		Budget Function	HHS Component Responsible for Program
HHS Program	FY 2004	FY 2003	FY 2004	FY 2003	Budget Function	HHS Component Responsible for Program
Medicare	269,748	250,074	1	1	Medicare	Centers for Medicare & Medicaid Services
Medicaid	177,060	161,721	2	2	Health	Centers for Medicare & Medicaid Services
Research Program	25,748	23,057	3	3	Health	National Institutes of Health
Temporary Assistance to Needy Families	17,798	19,348	4	4	Education, Training & Social Services / Income Security	Administration for Children and Families
Child Welfare	7,193	6,952	5	5	Education, Training & Social Services / Income Security	Administration for Children and Families
Head Start	6,750	6,780	6	6	Education, Training & Social Services / Income Security	Administration for Children and Families
Child Care	4,863	5,089	7	7	Education, Training & Social Services / Income Security	Administration for Children and Families
SCHIP	4,611	4,360	8	8	Health	Centers for Medicare & Medicaid Services
Child Support Enforcement	3,971	4,060	9	9	Education, Training & Social Services / Income Security	Administration for Children and Families
HIV/AIDS Programs	2,130	1,981	10	11	Health	Health Resources and Services Administration
Primary Care (Note 1)	2,115	1,862	11	12	Health	Health Resources and Services Administration
Low-Income Home Energy Assistance	1,895	2,030	12	10	Education, Training & Social Services / Income Security	Administration for Children and Families
Social Services Block Grant	1,753	1,741	13	13	Education, Training & Social Services / Income Security	Administration for Children and Families
Clinical Services	1,681	1,591	14	16	Health	Indian Health Service
Public Health and Social Services [Note 2]	1,662	1,483	15	17	Health	Office of the Secretary
Substance Abuse Prevention & Treatment Block Grant	1,662	1,733	16	15	Health	Substance Abuse and Mental Health Services Administration
Immunization	1,570	1,734	17	14	Health	Centers for Disease Control & Prevention
HIV/AIDS, STD &TB Prevention	1,309	1,093	18	19	Health	Centers for Disease Control & Prevention
Community Based Services	1,239	1,225	19	18	Education, Training & Social Services	Administration on Aging
Maternal and Child Health	1,025	971	20	21	Health	Health Resources and Services Administration
Health Professions	906	1,066	21	20	Health	Health Resources and Services Administration
Chronic Disease Prevention	878	771	22	22	Health	Centers for Disease Control & Prevention
Community Services	761	727	23	23	Education, Training & Social Services / Income Security	Administration for Children and Families
PHS Commissioned Corps	627	558	24	24	Health	Program Support Center
Foods and Cosmetics	566	491	25	25	Health	Food and Drug Administration
Refugee Resettlement	508	449	26	28	Education, Training & Social Services / Income Security	Administration for Children and Families
Contract Health Care	485	467	27	26	Health	Indian Health Service
Community Mental Health Services Block Grant	451	413	28	31	Health	Substance Abuse and Mental Health Services Administration
Program of Regional National Significances/Targeted Capacity Expansion (new)	423	313	29	33	Health	Substance Abuse and Mental Health Services Administration
General Departmental Management	402	435	30	29	Health	Office of the Secretary
Infectious Diseases	397	458	31	27	Health	Centers for Disease Control & Prevention
RNS Best Practices (Note 2)	367	367	32	32	Health	Substance Abuse and Mental Health Services Administration
Human Drugs	352	297	33	34	Health	Food and Drug Administration
Office of Special Programs	323	419	34	30	Health	Health Resources and Services Administration
Family Planning	283	261	35	36	Health	Health Resources and Services Administration
Tribal Activities: Contract Support	282	283	36	35	Health	Indian Health Service
Environmental Health	267	234	37	39	Health	Centers for Disease Control & Prevention
Medical Devices & Radiological Health	253	247	38	37	Health	Food and Drug Administration
Occupational Safety and Health	245	246	39	38	Health	Centers for Disease Control & Prevention
Hospitals-Facilities Support	219	198	40	41	Health	Indian Health Service
Sanitation Facilities	175	109	41	51	Health	Indian Health Service
Injury Prevention and Control	163	130	42	45	Health	Centers for Disease Control & Prevention
Developmental Disabilities	154	150	43	44	Education, Training & Social Services / Income Security	Administration for Children and Families
Public Health Improvement	140	120	44	50	Health	Centers for Disease Control & Prevention
Contributions, Indian Health Facilities	140	97	45	55	Health	Indian Health Service
Biologics	131	202	46	40	Health	Food and Drug Administration
Domestic Violence	120	125	47	48	Education, Training & Social Services / Income Security	Administration for Children and Families
Preventive Health & Health Services Block Grant	120	126	48	47	Health	Centers for Disease Control & Prevention
Animal Drugs and Feeds	120	124	49	49	Health	Food and Drug Administration
Youth	119	106	50	52	Education, Training & Social Services / Income Security / Admin of Justice	Administration for Children and Families
All Other HHS Programs	1,390	1,634			Various Components	Various Components
Total Net Costs (Note 3)	$ 547,550	$ 510,508
Note 1. Includes the Foster Care/Adoptions program discussed in the Management Discussion and Analysis (Section I) and HHS Program Performance Report (Section II) of this report. Note 2. Name of this program changed in FY 2004; was "Knowledge, Development and Application" in FY 2003. Note 3. Total net costs agrees with Agency combined totals in the consolidating statement of net cost by budget function located in other accompanying information.

The shaded programs above relate to the programs discussed in the “Performance Overview” section of the Management Discussion and Analysis and in the HHS Program Performance Report section of this report.
Highlighted Programs (#)	16	16
Highlighted Programs ($)	$ 523,255	$ 486,220
Highlighted Programs (%)	95.56%	95.24%

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Appendix B – Net Costs of Key HHS Programs

For the Fiscal Years Ended September 30, 2004 and 2003

(in millions)