Federal Budget and Appropriations Process Overview

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Federal Budget and Appropriations ProcessOverview
Budget Training
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Where the Money Comes From
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Where the Money Goes
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HHS Budget Authority 660 Billionof which only
10.7 is Discretionary
Discretionary Programs 10.7
Medicare53.0
Childrens Entitlement Programs 3.1
TANF 2.8
Other Mandatory Programs 0.4
Medicaid30
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Phases of the Overall Budget Process
Work on any Single Years Budget takes more than
3 Years to Complete
Formulation
Present to Congress
Execution
Planning
Sept Feb Feb Oct
Sept
For FY 2011
2008
2009
2010
2011
2012
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Levels of Review/Recommendation
IHS, Tribes, Urbans
Execution
The President
Present to Congress
Conference Committee Full House Senate Approps
Committee/Subcomm.
Formulation
OMB
DHHS
IHS, Tribes, Urbans
Planning
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IHS Tribal Consultation Policy - Budget
Formulation Process
Individual Area I/T/U Worksessions Oct-Dec
Evaluation Session August/Sept
National I/T/U Budget Worksession Feb/March
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IHS Process Step-by-Step
Evaluation Session August/Sept

• Budget workgroup evaluates how the process has
  worked and makes recommendations for improvement
• The recommendations are incorporated into the
  planning for the next fiscal year's process.

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IHS Process Step-By-Step
Individual Area I/T/U Worksessions Oct-Dec

• Each Area develops a set of health/budget
  priorities and makes budget recommendations
  within a designated amount.

• Area input regarding the GPRA performance
  measures should also occur at this time.

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IHS Process Step-by-Step

• At the National Worksession, the 12 sets of Area
  recommendations are consolidated into one set of
  national recommendations.
• Health Priorities
• Budget Priorities
• Two representatives from each Area participate.

National I/T/U Budget Worksession Feb/March
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IHS Process Step-by-Step

• The Department of Health and Human Services (HHS)
  has two annual Tribal Consultation meetings,
  which includes all HHS Operating Divisions.

• Typically the workgroup co-chairs and other
  members present the recommendations for the IHS
  budget from the National Worksession at these
  meetings.
• The Department provides the opportunity for
  anyone to participate in the planning of this
  meeting, with the Tribal leads being NIHB / NCAI.

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IHS Process Step-by-Step

• The Tribal priorities are used as the basis of
  IHS official budget submission to HHS and
  throughout the remainder of the budget cycle for
  justification and support for other initiatives
  or opportunities that arise.

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How Does IHS Determine Its Budget Request?

• I/T/U Input
• Area sessions - recommendations for designated
  funding levels (e.g., 500 mil)
• National Worksession - consolidation of
  recommendations for percent increases agreed to
  through consensus (e.g., minimum 20 increase)

• HHS Budget Guidance
• Includes
• direction on funding levels for budget request
• Secretarial budget priorities
• Technical instructions, e.g., pay raise
  assumptions

IHS Budget Request to HHS