TABLE 5–2 Annual Awards and Expenditures of Section 317 Direct Assistance (DA) Vaccine Purchase Funds (in millions of dollars)

Year

New Funds

Re-awarded Fundsa

Total Award

Expenditures

Percentage of Total Award Expendedb

1990

149.0

0.0

149.0

106.3

71%

1991

112.9

37.5

150.3

102.5

68%

1992

156.2

26.8

183.1

121.6

66%

1993

171.2

43.9

215.1

156.2

77%

1994

136.2

86.3

222.5

171.9

61%

1995c

83.1

74.3

157.4

96.3

59%

1996

133.3

11.0

144.2

111.2

77%

1997

124.0

34.7

158.7

128.4

81%

1998d

108.2

34.9

143.1

135.6

95%

1999

128.0

8.0

136.0

NA

NA

NOTE: CDC notes that 1990 was the first year in which grants were administered centrally, instead of by regional offices. There is limited background information with which to substantiate these amounts, and as a result their accuracy is questionable. In 1994, an additional $30,672,686 in appropriated vaccine purchase funds was paid directly to the Department of the Treasury for floor stock excise taxes on behalf of all the grantees when the Vaccine Compensation Act was reauthorized.

aFunds awarded in previous years but not obligated.

bBased on year-end unobligated balances for 1990–1997 reported to CDC as of April 1, 1999.

c$53 million rescinded from unobligated balances in fiscal year 1996 (comprising funds from 1993, 1994, and 1995).

dCDC estimates for expenditures and percentage of 1998 award expended.

SOURCE: Information provided by CDC.

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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