A Guide to Fiscal Year 1991 Federal Funding for HIV Disease: How Dollars are Spent How to Access Them

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Each year the President submits a budget to the
United States Congress which ultimately allows the
Federal Government to spend money, once the
budget is approved by the Congress and signed into
law by the President. Because the Government is so
large, and because it deals with such vast amounts
of money, the process is somewhat complicated. This
explanation will give a broad overview of how that
process works specifically regarding AIDS/HIV
spending in any fiscal year (FY), which runs from
October 1 to September 30.
The Federal Budget Process
In 1974 the Congress passed a bill (known appropriately as the 1974 Budget Act) which directs the
President of the United States to submit the next
fiscal year's proposed spending requests to Congress
at the first of each calendar year. These spending
requests are known as the budget, and they originate
in the White House from the Office of Management
and Budget (OMB). They take into consideration past
spending, laws passed by Congress in the preceding
year which affect spending, and recommendations
made by the President and his Cabinet.
The actual process of developing a budget is a long
and involved one, including all levels of Government
agencies-from the top to the bottom. As each
operating level decides its future needs (and already
much of FY '93 has been totally planned), funding
decisions are made. An appeal process is built into
every level so critical programs are not lost and new
needs not ignored. All budgets are made based on
anticipated revenues. Table 2.A gives an overview
of the Federal budget process time frame.
The budget is sent to Congress, first arriving at the
respective budget committees in the House of
Representatives and the Senate. Because the budget
is so big (literally-you may recall President Reagan
in one State of the Union address lifting up stacks of

sheets of paper several feet high showing the nation
the budget Congress had sent back to him), it may
be divided into as many as 13 separate documents.
The budget committees then decide if the requests
conform to their wishes or not. If they do, they pass
a budget resolution. If they don't, it is at this point
that the first Congressional changes are made before
the budget resolution is passed.
The budget resolution puts an overall stamp of
approval on spending projects and amounts, and lays
the framework for various committees dealing with
the many and diverse areas of government spending
and involvement. These instructions for committees
allow for budget reconciliation to take place (meeting
total spending limits by adjusting funding amounts
within specific areas of concern, such as health or
defense spending). This then allows the members of
Congress to vote on a final bill, which conforms with
the Omnibus Budget Reconciliation Act (OBRA),
requiring Congress to match spending and funding
needs.
The proposed Federal Budget is usually available
to the public through the Government Printing Office
by late spring.
Throughout this process Congress may vote on
specific measures authorizing money to be spent.
However, authorization of money does not always
mean that Congress will appropriate all those monies.
A good example of this in the area of AIDS/HIV is
the much publicized Ryan White Bill (also known as
the CARE Act) passed early in 1990. It authorized
$855,000,000 to be spent for care of people with
AIDS/HIV (PWAs) and specified programs for the
cities hardest hit by the epidemic. Ultimately, Congress appropriated $323,000,000 for the initiative;
and a significant amount of that would have been
spent anyway from monies already allocated to
similar purposes.

~1991 ASAP

Reproduction By Permission Only

~1991 ASAP Reproduction By Permission Only