	Introduction

The Department of Health and Human Services (HHS) has designated eight of its 11 operating divisions (agencies) as components of the U.S. Public Health Service (PHS). The PHS agencies are (1) the Agency for Healthcare Research and Quality (AHRQ), (2) the Agency for Toxic Substances and Disease Registry (ATSDR), (3) the Centers for Disease Control and Prevention (CDC), (4) the Food and Drug Administration (FDA), (5) the Health Resources and Services Administration (HRSA), (6) the Indian Health Service (IHS), (7) the National Institutes of Health (NIH), and (8) the Substance Abuse and Mental Health Services Administration (SAMHSA). Two of them are primarily research agencies. NIH conducts and supports basic, clinical, and translational medical research, and AHRQ conducts and supports research on the quality and effectiveness of health care services and systems. Three agencies—IHS, HRSA, and SAMHSA—provide health care services or support systems that do so. IHS supports a health care delivery system for American Indians and Alaska Natives. HRSA funds programs and systems to improve access to health care among low-income populations, pregnant women and children, persons living with HIV/AIDS, rural and frontier populations, and others who are medically underserved. SAMHSA funds community-based mental health and substance abuse prevention and treatment services. Report Roadmap

For each PHS agency, this report provides a brief overview of the agency's statutory authority and principal activities and includes a table summarizing its funding for FY2010 and FY2011, as well as the FY2012 budget request. Program level indicates the total amount of funding available to the agency, which includes discretionary budget authority plus additional funding from other sources. PPACA Funding

The Patient Protection and Affordable Care Act (PPACA), as amended, includes numerous mandatory appropriations that together provide billions of dollars to support new and existing grant programs and other activities within HHS. Overall, AHRQ's FY2011 program level is $11 million (3%) below the FY2010 level. CDC is the nation's principal public health agency, coordinating and supporting a variety of population-based disease and injury control activities. However, the CDC/ATSDR program level for FY2011 decreased by only $6 million (less than 1%) from the FY2010 amount. FDA's budget has two funding streams: direct appropriations (i.e., discretionary budget authority) and industry user fees. User fees, which account for 33% of FDA's total FY2011 program level, come from several programs. FY2011 Funding

The FY2011 full-year CR provides FDA with a total program level of $3.690 billion, which includes $2.457 billion in direct appropriations (discretionary budget authority) and $1.233 billion in user fees. Relative to FY2010 funding, these amounts represent a 4% increase in budget authority and a 34% increase in user fees, for an overall 12% increase in total program level. FY2011 Funding

The FY2011 full-year CR provided HRSA with a total discretionary budget authority of $6.272 billion, a decrease of $1.221 billion (16%) from FY2010. However, this reduction was more than offset by a substantial increase in PPACA funds. As a result, HRSA's total program level increased by $1.598 billion (20%), from $8.067 billion in FY2010 to $9.665 billion in FY2011 (see Table 4 ). Overall, total NIH funding in FY2011, at $30.926 billion, is $317 million (1%) lower than FY2010. 112-10 ) slightly reduced SAMHSA's funding below the FY2010 level. With the 0.2% across-the-board rescission, the agency's discretionary budget authority for FY2011 is $3.380 billion, which is $52 million (1.5%) less than the FY2010 amount. SAMHSA's total program level for FY2011 is $3.599 billion, which is $16 million (0.4%) above the FY2010 program level of $3.583 billion.
Within the Department of Health and Human Services (HHS), eight agencies are designated components of the U.S. Public Health Service (PHS): (1) the Agency for Healthcare Research and Quality (AHRQ), (2) the Agency for Toxic Substances and Disease Registry (ATSDR), (3) the Centers for Disease Control and Prevention (CDC), (4) the Food and Drug Administration (FDA), (5) the Health Resources and Services Administration (HRSA), (6) the Indian Health Service (IHS), (7) the National Institutes of Health (NIH), and (8) the Substance Abuse and Mental Health Services Administration (SAMHSA). This report gives a brief overview of each agency and summarizes its funding for FY2010 and FY2011, as well as its FY2012 budget request.
The total amount of funding available to the agency (i.e., total program level) includes discretionary budget authority provided in annual appropriations acts, plus additional funding from other sources. These include mandatory funding provided in laws other than annual appropriations acts, notably the Patient Protection and Affordable Care Act (PPACA).
AHRQ and NIH are primarily research agencies. AHRQ conducts and supports health services research to improve the quality of health care. For FY2011, AHRQ's total program level is $392 million, which is $11 million (2.7%) below the FY2010 amount. NIH conducts and supports basic, clinical, and translational biomedical and behavioral research. For FY2011, NIH's total program level is $30.926 billion, which is $317 million (1.0%) lower than FY2010.
Three PHS agencies—IHS, HRSA, and SAMHSA—provide health care services or help fund systems that do so. IHS supports a health care delivery system for American Indians and Alaska Natives. For FY2011, IHS's total program level is $5.134 billion, which is $34 million (0.7%) above the FY2010 amount. HRSA funds programs and systems to improve access to health care among the uninsured and medically underserved. For FY2011, HRSA's discretionary budget authority is $6.272 billion, and its total program level is $9.665 billion. Budget authority decreased by $1.221 billion (16.3%) from FY2010 to FY2011, but this drop was more than offset by an increase in mandatory funding from PPACA and funds from other sources. Overall, HRSA's total program level increased by $1.598 billion (19.8%) from FY2010 to FY2011. SAMHSA funds mental health and substance abuse prevention and treatment services. For FY2011, SAMHSA's discretionary budget authority is $3.380 billion, which is $52 million (1.5%) below the FY2010 level. With the slight increase in PPACA funds, however, SAMHSA's FY2011 total program level of $3.599 billion is $16 million (0.4%) above the FY2010 amount.
CDC, the federal government's lead public health agency, coordinates and supports a variety of population-based programs to prevent and control disease, injury, and disability. For FY2011, CDC's discretionary budget authority (including ATSDR) is $5.726 billion, and its total program level is $10.870 billion. Budget authority decreased by $741 million (11.5%) from FY2010 to FY2011. However, that cut was largely offset by PPACA funds and funding from other sources. Overall, CDC's program level decreased by only $6 million. FDA, which regulates drugs, medical devices, food, and tobacco products, receives a significant portion of its funding from industry user fees. For FY2011, FDA has a total program level of $3.690 billion, which includes $2.457 billion in direct appropriations and $1.233 billion in user fees. Relative to FY2010, these amounts represent a 4.0% increase in direct appropriations and a 33.7% increase in user fees, which now account for one-third of FDA's funding.