AHRQ Exhibits and Narrative

Appropriation Language—Agency for Healthcare Research and Quality

For carrying out Titles III and IX of the Public Health Service Act ("PHS ACT"), part A of Title XI of the Social Security Act, and section 1013 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, amounts received from Freedom of Information Act fees, reimbursable and interagency agreements, and the sale of data shall be credited to this appropriation and shall remain available until expended. Provided, That the amount made available pursuant to section 937(c) of the Public Health Service Act shall not exceed $372,053,000.

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Amounts Available for Obligation¹

Department of Health and Human Services, Agency for Healthcare Research and Quality

Obligations		2008 Actual2	Appropriated 2009	2010 President's Budget (PB)
Appropriation:	Supplemental (P.L. 111-5)3	$0	$1,100,000,000	$0
	Transfer of Funds to NIH	$0	-$400,000,000	$0
Subtotal, adjusted appropriation		$0	$700,000,000	$0
Offsetting Collections from: Federal funds pursuant to Title IX of P.L. 102-410, (Section 937(c) PHS Act)	HCQO	$276,356,000	$314,053,000	$314,053,000
	MEPS	$55,300,000	$55,300,000	$55,300,000
	Program Support	$2,696,000	$2,700,000	$2,700,000
Subtotal, adjusted appropriation		$334,352,000	$372,053,000	$372,053,000
Unobligated Balance Lapsing		$212,000	-	-
Total obligations		$334,564,000	$1,072,053,000	$372,053,000

¹ Excludes the following amounts for reimbursements:
FY 2008: $25,529,000 ($7,820,000 for National Research Service Awards [NRSAs] and $17,709,000 for other reimbursements).
FY 2009: $25,529,000 ($7,820,0000 for NRSAs and $17,709,000 for other reimbursements).
FY 2010: $25,529,000 ($7,820,000 for NRSAs and $17,709,000 for other reimbursements).
² Reflects actual obligations.
³ In FY 2009, the American Recovery and Reinvestment Act (ARRA) provided $1,100,000,000 for Comparative Effectiveness Research. Of this total, $400,000,000 was transferred to the National Institute of Health. A total of $400,000,000 is available for Comparative Effectiveness Research to be allocated at the discretion of the Secretary of the Department of Health and Human Services. A new Federal Coordinating Council for Comparative Effectiveness Research will help set the agenda for these funds. The remaining $300,000,000 is available for the AHRQ to conduct and support comparative effectiveness research. These funds are available for obligation in FY 2009 and FY 2010.

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Summary of Changes

2009 Appropriation: $-0-
(Obligations): (372,053,000)

2010 Estimate: $-0-
(Obligations): (372,053,000)

Net change: $-0-
(Obligations): (0)

Changes			2009 Current Budget Base		Change from Base
			Full Time Equivalent (FTE)	Budget Authority	(FTE)	Budget Authority
Increases	A. Built-in	1. Annualization of 2009 pay raise	-- (--)	-- (43,037,000)	-- (--)	-- (+456,000)
		2. January 2010 Pay Raise	-- (--)	-- (43,037,000)	-- (--)	-- (+1,416,,000)
		3. Rental payments to General Services Administration (GSA)	-- (--)	-- (4,285,000)	-- (--)	-- (+106,000)
		6. Inflation Costs on Other Objects			-- (--)	-- (+500,000)
		Subtotal, Built-in			-- (--)	-- (+2,478,000)
	B. Program	Subtotal, Program			-- (--)	-- (--)
	Total Increases				-- (+1)	-- (+2,478,000)
Decreases	A. Built-in	1. HCQO: Crosscutting Activities Related to Quality, Effectiveness and Efficiency—Research Grants	-- --	- $39,602,000	-- (--)	-- (-2,478,000)
		Subtotal, Built-in			-- (--)	-- (-2,478,000)
	B. Program	Total, Decreases			(--) (--)	-- (-2,478,000)
		Net change, Budget Authority    Net change, Obligations			-- (--)	-- (--)

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Budget Authority (BA) by Activity¹

(Dollars in Thousands)

Activity	2008		2009 Omnibus		2009 Recovery Act2		2010
	FTE	Amount	FTE	Amount	FTE	Amount	FTE	Amount
1. Research on Health Costs, Quality, & Outcomes BA	-	0	-	0	-	700,000	38	0
PHS Evaluation	[278]	[276,564]	[278]	[314,053]	[--]	[0]	[278]	[314,053]
Total Operational Level	278	276,564	278	314,053		700,000	316	314,053
2. Medical Expenditure Panel Surveys BA	-	-	-	-	-	-	-	-
PHS Evaluation	-	[55,300]	-	[55,300]	-	[0]	-	[55,300]
Total Operational Level	-	55,300	-	55,300	-	0		55,300
3. Program Support BA	-	-	-	-	-	-	-	-
PHS Evaluation	[22]	[2,700]	[22]	[2,700]	[--]	[0]	[22]	[2,700]
Total Operational Level	22	2,700	22	2,700	-	0	22	2,700
Total, Budget Authority	0	0	0	0	-	700,000	38	0
Total PHS Evaluation	[300]	[334,564]	[300]	[372,053]	[--]	[0]	[300]	[372,053]
Total Operations	300	334,564	300	372,053		700,000	338	372,053

¹ Excludes the following amounts for reimbursements:
FY 2008: $25,529,000 ($7,820,000 for National Research Service Awards [NRSAs] and $17,709,000 for other reimbursements).
FY 2009: $25,529,000 ($7,820,0000 for NRSAs and $17,709,000 for other reimbursements).
FY 2010: $25,529,000 ($7,820,000 for NRSAs and $17,709,000 for other reimbursements).
²In FY 2009, the American Recovery and Reinvestment Act (ARRA) provided $1,100,000,000 for Comparative Effectiveness Research. Of this total, $400,000,000 was transferred to the National Institute of Health. A total of $400,000,000 is available for Comparative Effectiveness Research to be allocated at the discretion of the Secretary of the Department of Health and Human Services. A new Federal Coordinating Council for Comparative Effectiveness Research will help set the agenda for these funds. The remaining $300,000,000 is available for the AHRQ to conduct and support comparative effectiveness research. These funds are available for obligation in FY 2009 and FY 2010. The number of FTE in FY 2010 includes an estimated 38 non-permanent FTEs to be compensated using Recovery Act funds.

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Authorizing Language¹

Legislation	2009 Amount Authorized	2009 Omnibus	2010 Amount Authorized	FY 2010 President's Budget
Research on Health Costs, Quality, and Outcomes: Secs. 301 & 926(a) Public Health Service Act (PHSA)	SSAN	$0	SSAN	$0
Research on Health Costs, Quality, and Outcomes: Part A of Title XI of the Social Security Act (SSA) Section 1142(i)2,3 Budget Authority (BA)______ Medicare Trust Funds (MTF)4,3 Subtotal BA & MTF______	Expired5		Expired5
Program Support: Section 301 PHSA	Indefinite	$0	Indefinite	$0
Evaluation Funds: Section 937(c) PHSA	Indefinite	$372,053,000	Indefinite	$372,053,000
Total appropriations		$372,053,000		$372,053,000
Total appropriation against definite authorizations	-	-	-	-

Note: SSAN = Such Sums As Necessary.

1. Section 487(d)(3)(B) PHSA makes one percent of the funds appropriated to the National Institutes of Health (NIH) for National Research Service Awards (NRSA) available to AHRQ. Because these reimbursable funds are not included in AHRQ's appropriation language, they have been excluded from this table.
2. Pursuant to Section 1142 of the Social Security Act, FY 1997 funds for the medical treatment effectiveness activity are to be appropriated against the total authorization level in the following manner: 70% of the funds are to be appropriated from Medicare Trust Funds (MTF); 30% of the funds are to be appropriated from general budget authority.
3. No specific amounts are authorized for years following FY 1994.
4. Funds appropriated against Title XI of the Social Security Act authorization are from the Federal Hospital Insurance Trust Funds (60%) and the Federal Supplementary Medical Insurance Trust Funds (40%).
5. Expired September 30, 1994.

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Appropriations History Table

Year		Budget Estimates to Congress	House Allowance	Senate Allowance	Appropriation
2001	Budget Authority	$-0-	$123,669,000	$-0-	$104,963,000
	PHS Evaluation Funds	249,943,000	99,980,000	269,943,000	164,980,000
	Total	$249,943,000	$223,649,000	$269,943,000	$269,943,000
Rescission	Budget Authority	$-0-	$123,669,000	$-0-	$104,816,000
	PHS Evaluation Funds	249,943,000	99,980,000	269,943,000	164,980,000
	Total	$249,943,000	$223,649,000	$269,943,000	$269,796,000
2002	Budget Authority	$-0-	$168,445,000	$291,245,000	$2,600,000
	PHS Evaluation Funds	306,245,000	137,800,000	-0-	296,145,000
	Total	$306,245,000	$306,245,000	$291,245,000	$298,745,000
2003	Budget Authority	$-0-		$202,645,000	$-0-
	PHS Evaluation Funds	250,000,000		106,000,000	303,695,000
	Bioterrorism	-0-		5,000,000	5,000,000
	Total	$250,000,000	$0	$313,645,000	$308,695,000
2004	Budget Authority	$-0-	$-0-	$-0-	$-0-
	PHS Evaluation Funds	279,000,000	303,695,000	303,695,000	318,695,000
	Total	$279,000,000	$303,695,000	$303,695,000	$318,695,000
2005	Budget Authority	$-0-	$-0-	$-0-	$-0-
	PHS Evaluation Funds	303,695,000	303,695,000	318,695,000	318,695,000
	Total	$303,695,000	$303,695,000	$318,695,000	$318,695,000
2006	Budget Authority	$-0-	$318,695,000	$	$
	PHS Evaluation Funds	$318,695,000	$-0-	$323,695,000	$318,692,000
	Total	$318,695,000	$318,695,000	$323,695,000	$318,692,000
2007	Budget Authority	$-0-	$-0-	$-0-	$-0-
	PHS Evaluation Funds	$318,692,000	$-0-	$-0-	$318,692,000
	Total	$318,692,000	$-0-	$-0-	$318,692,000
2008	Budget Authority	$-0-	$329,564,000	$329,564,000	$-0-
	PHS Evaluation Funds	$329,564,000	$-0-	$-0-	$334,564,000
	Total	$329,564,000	$329,564,000	$329,564,000	$334,564,000
2009	Budget Authority	$-0-	$323,087,000	$90,598,000	$-0-
	PHS Evaluation Funds	$325,664,000	51.913,000	243,966,000	$372,053,000
	ARRA Funding P.L. 111-5	$-0-	$-0-	$-0-	$1,100,000,0001
	Total	$325,664,000	$375,000,000	$334,564,000	$1,472,053,000
2010	Budget Authority	$-0-
	PHS Evaluation Funds	$372,053,000
	Total	$372,053,000

¹ In FY 2009, the American Recovery and Reinvestment Act (ARRA) provided $1,100,000,000 for Comparative Effectiveness Research. Of this total, $400,000,000 was transferred to the National Institute of Health. A total of $400,000,000 is available for Comparative Effectiveness Research to be allocated at the discretion of the Secretary of the Department of Health and Human Services. A new Federal Coordinating Council for Comparative Effectiveness Research will help set the agenda for these funds. The remaining $300,000,000 is available for the AHRQ to conduct and support comparative effectiveness research. These funds are available for obligation in FY 2009 and FY 2010.

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