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The following HTML text is provided to enhance online readability. Many aspects of typography translate only awkwardly to HTML. Please use the page image as the authoritative form to ensure accuracy. TABLE 5–2 Annual Awards and Expenditures of Section 317 Direct Assistance (DA) Vaccine Purchase Funds (in millions of dollars)
were not protected within the general health budget at all (Freed et al., 1999). An additional finance issue involves differences in federal and state fiscal years. Legislatures in many states appropriate federal funds, so that expenditures cannot be made until the legislature has approved them. State legislatures do not meet every year in every state. State purchasing and hiring procedures are legal controls of major importance that can delay action in response to federal initiatives. The processes for the preparation and approval of capital budgets and general expenditure budget processes are often separate in many states and involve lengthy and detailed procedures. States also differ in the extent to which they respond to unmet needs; CDC has reported more than a five-fold variation across states in the
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