USA Department of Health and Human Services (HHS) Secretary Kathleen Sebelius.

USA Department of Health and Human Services (HHS) Secretary Kathleen Sebelius.

> USA Department of Health and Human Services (HHS). About Secretary Kathleen Sebelius.

Kathleen Sebelius was sworn in as the 21st Secretary of the Department of Health and Human Services (HHS) on April 28, 2009. As Secretary, she leads the principal agency charged with keeping Americans healthy, ensuring they get the health care they need, and providing children, families, and seniors with the essential human services they depend on.

> USA Department of Health and Human Services (HHS) Secretary Kathleen Sebelius. Biography.

“When we talk about health care, we always keep in mind that we are not just talking about saving money or increasing efficiency.  We are also talking about providing a higher quality of life.  When people are healthy, they miss fewer days of work and get more done.  They spend more time at home and less time in doctors’ offices.  They can take care of their grandkids.  They can play softball…They can get a good night of sleep. ” – Kathleen Sebelius, The Commonwealth Fund’s 12th Annual Symposium on Health Care Policy

Kathleen Sebelius was sworn in as the 21st Secretary of the Department of Health and Human Services (HHS) on April 28, 2009. As Secretary, she leads the principal agency charged with keeping Americans healthy, ensuring they get the health care they need, and providing children, families, and seniors with the essential human services they depend on. She also oversees one of the largest civilian departments in the federal government, with nearly 80,000 employees.

Since taking office, Secretary Sebelius has been a leader on some of the Obama administration’s top priorities. As the country’s highest-ranking health official, she is guiding the implementation of the historic Affordable Care Act.  She has also been at the forefront of efforts to build a 21st century health care system, from putting a new focus on prevention and wellness to promoting electronic medical records to expanding the primary care workforce.  In 2010, Modern Healthcare named her America’s second most powerful person in health care.

Under Secretary Sebelius’s leadership, HHS has played a key role in the Administration’s aggressive response to the economic downturn, helping families stay on their feet by providing health care, job training, child care, and energy assistance.  In addition, she has been a leader during public health crises, coordinating the government response to the 2009 H1N1 virus and helping to provide rapid medical assistance following the oil spill in the Gulf of Mexico and the devastating earthquake in Haiti.

Secretary Sebelius has also answered President Obama’s call to break down walls in government to serve the American people more effectively. She has worked with Secretary Vilsack to build a 21st century food safety system. With Attorney General Holder, she is leading a new effort to stamp out health care fraud.  She has teamed up with Secretary Duncan to raise the quality of early childhood education programs. And she has joined Housing and Urban Development Secretary Donovan in an effort to improve the lives of seniors and people with disabilities who wish to live at home.

Secretary Sebelius has been a leader on health care, family, and senior issues for over 20 years. As Governor of Kansas from 2003 to 2009, she fought to create jobs, improve access to affordable health care, and give every Kansas child a quality education. In 2005, Time Magazine recognized her achievements by naming her one of America’s Top Five Governors.

Before being elected Governor, she was the first Democrat to be elected Kansas Insurance Commissioner, earning a reputation from 1995 to 2003 as a strong advocate for consumers and effective budget manager. For her efforts, Governing Magazine selected her as their Public Official of the Year for 2000. Prior to her service as Insurance Commissioner, she was a member of the Kansas House of Representatives from 1987 to 1995.

Secretary Sebelius is the first daughter of a governor to be elected governor in American history. She holds a Master of Public Administration degree from the University of Kansas and a Bachelor of Arts degree from Trinity Washington University. She is married to Gary Sebelius, a federal magistrate judge. They have two sons, John and Ned, and a daughter-in-law, Lisa.

> USA Department of Health and Human Services (HHS) Secretary Kathleen Sebelius. Organization.

The Office of the Secretary is directly supported by the Deputy Secretary, and a number of Assistant Secretaries and Offices.
– Immediate Office of the Secretary (IOS). The Immediate Office of the Secretary includes:
— Office of the Deputy Secretary (DS) The Deputy Secretary is responsible for the operations of the largest civilian department in the federal government.
— Office of the Chief of Staff (COS)
— The Executive Secretariat (ES)
— Office of Intergovernmental Affairs (IGA) IGA’s mission is to facilitate communication regarding HHS initiatives as they relate to state, local, and tribal governments.
— Office of the Secretary’s Regional Directors Regional Directors are provided by Region and States within the region.
— Office on Disability (OD)The OD serves as an advisor on HHS activities relating to disability.

– Assistant Secretary for Administration (ASA)
ASA provides leadership for HHS departmental management, including human resource policy and departmental operations.

– Assistant Secretary for Financial Resources (ASFR)
ASFR provides advice and guidance to the Secretary on budget, financial management, acquisition policy and support, grants management, and the small business programs and to provide for the direction and coordination of these activities throughout the Department.

– Assistant Secretary for Health (ASH)
ASH serves as the Secretary’s primary advisor on matters involving the nation’s public health and oversees HHS’ U.S. Public Service (PHS) for the Secretary.

– Assistant Secretary for Legislation (ASL)
ASL Serves as the primary link between the Department of Health & Human Services (HHS) and Congress.

– Assistant Secretary for Planning and Evaluation (ASPE)
ASPE in the principal advisor on policy development, and is responsible for major activities in policy coordination, legislation development, strategic planning, policy research, evaluation, and economic analysis.

– Assistant Secretary for Public Affairs (ASPA)
ASPA serves as the principle counsel on public affairs matters, conducts a national public affairs program, provides centralized leadership and guidance for public affairs activities within HHS’ staff and operation divisions and regional offices, and administers the Freedom of Information and Privacy Act.

– Assistant Secretary for Preparedness and Response (ASPR)
ASPR serves as the principal advisory staff on matters related to bioterrorism and other public health emergencies.

– Departmental Appeals Board (DAB)
DAB provides prompt, fair, and impartial dispute resolution services to parties in many different kinds of disputes involving components of HHS.

– Office for Civil Rights (OCR)
OCR enforces Federal laws that prohibit discrimination by health care and human services providers that receive funds from HHS.

– Office of Consumer Information and Insurance Oversight (OCIIO)
OCIIO is responsible for ensuring compliance with new insurance market rules, providing guidance and oversight for the state-based insurance exchanges, administering the temporary high-risk pool program and the early retiree reinsurance program, and compiling and maintaining data for an internet portal providing information on insurance options.

– Office of Global Health Affairs (OGHA)
OGHA represents the Department to the governments, other Federal Departments and agencies, international organizations and the private sector on international and refugee health issues.

– Office of Inspector General (OIG)
OIG protects the integrity of HHS programs, as well as the health and welfare of the beneficiaries of those programs.

– Office of Medicare Hearings and Appeals (OMHA)
OMHA administers nationwide hearings for the Medicare program.

– Office of the National Coordinator for Health Information Technology (ONC)
ONC provides counsel to the Secretary of HHS and Departmental leadership for the development and nationwide implementation of an interoperable health information technology infrastructure.

– Office of the General Counsel (OGC)
OGC is the legal team for HHS, providing quality representation and legal advice on a wide range of highly visible national issues.

– Center for Faith Based and Community Initiatives (CFBCI)
CFBCI provides information and technical assistance for faith-based and community organizations to compete more effectively for Federal funds.

> USA Department of Health and Human Services (HHS) Secretary Kathleen Sebelius. Strategic Plan and Priorities

– Strategic Plan 2010 – 2015

Every three years, HHS updates its strategic plan, which describes its work to address complex, multifaceted, and ever-evolving health and human service issues. An agency strategic plan is one of three main elements required by the Government Performance and Results Act (GPRA) of 1993 (Public Law 103-62). An agency’s strategic plan defines its missions, goals, and the means by which it will measure its progress in addressing specific national problems, needs, or challenges related to its mission over the course of at least five years.

For the period FY 2010—2015, HHS is publishing its Strategic Plan as a Web document, which will be updated periodically to reflect the Department’s strategies, actions, and progress toward its goals. The Web version of the Strategic Plan, rather than focusing on a static set of performance measures, provides priorities, accomplishments, and next steps that are tracked and updated frequently, reinforcing the Strategic Plan’s function as a living, vital document that serves a genuine management purpose.

– HHS Strategic Plan FY 2010-2015 Secretary’s Message

This is an exciting time for the U.S. Department of Health and Human Services.  Whether it’s providing millions of children, families, and seniors with access to high-quality health care, helping people find jobs and parents find quality child care, keeping the food on Americans’ shelves safe and infectious diseases at bay, or exploring new frontiers of biomedical research, we are working every day to give Americans the building blocks they need to live healthy, successful lives.

To achieve these goals, we must always keep an eye on the future—to prepare for the next public health emergency, to pursue the next lifesaving cure, and to support the development of the next generation of Americans.  But we must also frequently look closer at old programs and existing services and ask:  What needs to be changed?  How can we serve Americans better?  What can be done faster, less expensively, and with higher quality and greater transparency?

It was with these questions in mind that we developed this Strategic Plan for Fiscal Years 2010–2015.  It reflects the contributions of every operating and staff division, and it sets forth the Department’s overarching goals for the next 5 years:

• Transform Health Care
• Advance Scientific Knowledge and Innovation
• Advance the Health, Safety, and Well-Being of the American People
• Increase Efficiency, Transparency, and Accountability of HHS Programs
• Strengthen the Nation’s Health and Human Services Infrastructure and Workforce

Together, these goals form our vision for how our Department can contribute to an even stronger, healthier, and more prosperous America in the years to come. 

Achieving this vision will not be easy. But with these goals in hand, we have a clear direction.  And we look forward to the challenge of building on our successes to serve Americans even better.

That work begins now.

Kathleen Sebelius
Secretary
Health and Human Services

– HHS Strategic Plan FY 2010-2015 Introduction

Mission

The mission of the U.S. Department of Health and Human Services (HHS) is to enhance the health and well-being of Americans by providing for effective health and human services and by fostering sound, sustained advances in the sciences underlying medicine, public health, and social services.

HHS accomplishes its mission through several hundred programs and initiatives that cover a wide spectrum of activities, serving the American public at every stage of life.

Organization

The Department of Health and Human Services (HHS) is the United States government’s principal agency for protecting the health of all Americans and providing essential human services, especially for those who are least able to help themselves.  HHS is responsible for almost a quarter of all Federal expenditures and administers more grant dollars than all other Federal agencies combined.[1]

Eleven operating divisions, including eight agencies in the United States Public Health Service (USPHS) and three human service agencies, administer HHS’s programs.  In addition, staff divisions provide leadership, direction, and policy and management guidance to the Department. Appendix A of the HHS Strategic Plan for Fiscal Years 2010–15 (Strategic Plan) describes HHS operating and staff divisions and their primary functions. Since the publication of the last Strategic Plan, HHS has created several new offices, including the Office of Consumer Information and Insurance Oversight (OCIIO), the Office of Recovery Act Coordination (ORAC) within the Office of the Assistant Secretary for Financial Resources (ASFR), and the Office of Health Reform (OHR).  Appendix A also provides descriptions of these offices as well as an organizational chart.

Working with Other Governmental, Nongovernmental, and Private Partners

Through its programming and other activities, HHS works closely with State, local, and U.S. territorial governments.  The Federal Government has a unique legal and political government-to-government relationship with tribal governments and a special obligation to provide services for American Indians and Alaska Natives (AI/ANs) based on these individuals’ relationship to tribal governments. HHS works with tribal governments and with urban Indian and other organizations to facilitate greater consultation and coordination between State and tribal governments on health and human services.

HHS also has strong partnerships with the private sector and nongovernmental organizations.  The Department works with partners in the private sector, such as regulated industries, academic institutions, trade organizations, and advocacy groups. The Department recognizes that leveraging resources from organizations and individuals with shared interests allows HHS to accomplish its mission in ways that are the least burdensome and most beneficial to the American public. Grantees in the private sector, such as academic institutions and faith-based and neighborhood partnerships, provide many HHS-funded services at the local level. HHS also works closely with other Federal departments and international partners to coordinate its efforts to ensure the maximum impact for the public.

Strategic Plan Development

Every 3 years, HHS updates its strategic plan, which describes its work to address complex, multifaceted, and ever-evolving health and human service issues. An agency strategic plan is one of three main elements required by the Government Performance and Results Act (GPRA) of 1993 (Public Law 103–62).  An agency strategic plan defines its missions, goals, and the means by which it will measure its progress in addressing specific national problems, needs, or mission-related challenges over at least 5 years.

Each of the Department’s operating and staff divisions contributed to the development of the Strategic Plan, as reflected in goals, objectives, strategies, evaluations, and performance indicators. The process emphasized creating alignment between the long-range Strategic Plan and annual GPRA reporting in the Department’s Congressional Budget Justifications and the Summary of Performance and Financial Information, which together, fulfill HHS’s GPRA annual performance reporting requirements. This Strategic Plan also aligns goals and objectives with priorities of the Administration and the HHS Secretary, Kathleen Sebelius as well as with departmental and agency priorities.

In developing and selecting performance measures, HHS included broad health and human service impact measures as well as more intermediate processes and outcomes that have contributed to the achievement of long-term outcomes. As part of this process, HHS has developed an array of meaningful measures to track the new priorities and activities of the groundbreaking the Patient Protection and Affordable Care Act (Affordable Care Act) (Public Law 111-148). This historic legislation provides an exciting performance management opportunity for HHS, and HHS is committed to using these measures to monitor our progress and to ensure that the promise of the Affordable Care Act is fulfilled for the American people.

HHS personnel regularly monitor more than a thousand performance measures to examine effectiveness and to improve program processes. This Strategic Plan includes a selection of important milestones and broad outcomes and provides links to full sets of performance measures to demonstrate progress.

Among the performance measures monitored by the Department are several measures that support the Department’s High Priority Performance Goals. These goals, established with the President’s FY 2010 budget request, are a set of ambitious, but realistic, performance objectives that the Department will accomplish by the end of FY 2012. The HHS High Priority Performance Goals support, and are aligned with, the goals and objectives in the Strategic Plan (for more information, visit http://www.goal.performance.gov).  

Using the Web to Present and Track Progress

For the period FY 2010–15, HHS is publishing its Strategic Plan in HTML format, which will be updated periodically to reflect the Department’s strategies, actions, and progress toward its goals. This version of the Strategic Plan, rather than focusing on a static set of performance measures, will provide priorities, accomplishments, and next steps that will be tracked and updated frequently, reinforcing the Strategic Plan’s function as a living, vital document that serves a genuine management purpose.  

The Obama administration is advancing the concept of Open Government to establish a system of transparency, collaboration, and public participation. In support of that goal, the Strategic Plan will be posted on the HHS Web site and provide links to the array of programs and initiatives that HHS will undertake in the next 5 years.  As a result, HHS, its stakeholders, and the broader public will have access to the most current information possible.

Consultation with the Congress and External Parties

Under GPRA, Federal agencies are required to consult with the Congress and to solicit and consider the views of external parties. To comply with this mandate, HHS consulted widely with stakeholders to garner input on the Strategic Plan. HHS invited public comment on the Strategic Plan through the HHS Open Government Web site (http://www.hhs.gov/open). To this end, HHS published a Notice of Availability on the Strategic Plan public comment period in the Federal Register.  HHS also sought input from the Congress and the OMB.

Nearly three hundred comments were received during the public comment period—the vast majority (245) through the Open Government Web site.  The remaining comments were received by e-mail and fax. Comments came from individuals and organizations. Input ranged from editorial suggestions to more substantive comments, and in response, HHS incorporated many changes and additions into the final plan.

– HHS Strategic Plan FY 2010-2015 Goal 1

>>> Goal 1:  Transform Health Care <<<

Objective A:  Make coverage more secure for those who have insurance, and extend affordable coverage to the uninsured

Objective B:  Improve healthcare quality and patient safety

Objective C:  Emphasize primary and preventive care linked with community prevention services

Objective D:  Reduce the growth of healthcare costs while promoting high-value, effective care

Objective E:  Ensure access to quality, culturally competent care for vulnerable populations

Objective F:  Promote the adoption and meaningful use of health information technology

On March 23, 2010, the President signed the Patient Protection and Affordable Care Act (Affordable Care Act) (P.L. 111–148) into law, transforming and modernizing our healthcare system.  The Affordable Care Act makes health insurance coverage more secure and reliable for Americans who have it, make coverage more affordable for families and small business owners, and bring down skyrocketing healthcare costs that have strained our Federal budget.  Americans have waited decades for this day to come. It will be remembered long into the future as the moment when our country overcame significant obstacles to give every American access to secure, stable, and affordable health insurance.

HHS is responsible for implementing many of the health reform changes included in the Affordable Care Act. HHS is transforming and modernizing the healthcare system to improve patient outcomes, promoting efficiency and accountability, ensuring patient safety, encouraging shared responsibility, and working toward a high-value healthcare system. HHS also is improving access to culturally competent, quality health care for uninsured, underserved, vulnerable, older, and special needs populations. These reforms and the resulting improvements in the care provided on a day-to-day basis also improve our foundation for emergency preparedness.  A stronger healthcare system will enhance our Nation’s ability to provide extra medical care capacity when needed. Individuals and communities also will be more resilient in the face of emergencies if they are healthy and have access to quality care on a regular basis.

The Secretary has identified the transformation of health care as one of her Strategic Initiatives.   A critical part of HHS’s strategy is to give the American public the means to make more informed choices to ensure optimal health care by improving transparency regarding the quality and costs of health services, better coordinating care, fostering patient-centered care, and promoting consumers’ participation in their health and health care.

HHS has made extensive use of program evaluation findings to identify new, and refine existing, priorities for transforming the healthcare system. For example, findings from previously completed Medicare post–acute care evaluations have led to the refinement of HHS’s approaches to reducing costs while promoting high-value care. Evaluations of primary care services have helped to identify the need for linkages between primary care and community prevention services. Findings from evaluations of medical product clinical trials and post-market surveillance have helped to inform new medical product efficacy and patient safety activities.

HHS will continue to use evaluation information to monitor progress on its efforts to transform health care. For example, HHS plans to conduct evaluations of the Children’s Health Insurance Program (CHIP); pharmacovigilance practices at the Food and Drug Administration (FDA); early childhood home visitation programs; and newly developed nursing home tools to reduce falls, pressure ulcers, and emergency room visits.

HHS’s Administration on Aging (AoA), Agency for Healthcare Research and Quality (AHRQ), Assistant Secretary for Preparedness and Response (ASPR), Centers for Medicare & Medicaid Services (CMS), Centers for Disease Control and Prevention (CDC), Food and Drug Administration (FDA), Health Resources and Services Administration (HRSA), Indian Health Service (IHS), National Institutes of Health (NIH), and Substance Abuse and Mental Health Services Administration (SAMHSA) all have significant roles to play in transforming health care.  The Office of the Assistant Secretary for Planning and Evaluation (ASPE), Office of Consumer Information and Insurance Oversight (OCIIO), Office for Civil Rights (OCR), Office on Disability (OD), Office of Health Reform (OHR), Office of the National Coordinator for Health Information Technology (ONC), and Office of the Assistant Secretary for Health (OASH) also are critical to advancing this goal.

– HHS Strategic Plan FY 2010-2015 Goal 2

>>> Goal 2:  Advance Scientific Knowledge and Innovation <<<

Objective A: Accelerate the process of scientific discovery to improve patient care

Objective B: Foster innovation to create shared solutions

Objective C: Invest in the regulatory sciences to improve food and medical product safety

Objective D: Increase our understanding of what works in public health and human service practice

Americans are living longer, healthier lives, thanks to significant advances in health-related research. Life expectancy is at a record high of 77.7 years. Mortality rates in the United States have experienced an almost uninterrupted decline since 1960. However, rates of gain are inconsistent between the genders and across age brackets, socioeconomic status, and racial and ethnic groups.

HHS’s health and human service systems continue to face many challenges, from providing access to quality health care for all Americans, to reducing the burden of illness and disease and extending healthy life, to protecting our population from known and unknown public health threats, to maximizing the impact of the social service safety net. 

Effectively addressing these challenges requires that HHS employ innovative, knowledge-based approaches. To do so, HHS must expand its scientific understanding of how to best advance health care, public health, human services, biomedical research, and the availability of safe medical and food products. Chief among these efforts will be the identification, implementation, and rigorous evaluation of new approaches in science, health care, public health, and human services that reward efficiency, effectiveness, and sustainability. 

HHS will focus on promising strategies with the potential to yield positive results from public investments. These strategies include using technology to improve collaboration, modernizing the regulatory approval process, and expanding behavioral research. In addition, HHS will work to promote service integration and delivery, community-based approaches, and collaboration with the private sector to advance scientific knowledge.

HHS uses internal and external evaluation data to determine how best to increase the pace of science and its ultimate use in practice. For example, a previous evaluation of FDA’s capacity to support current and future regulatory needs led HHS to set priorities for investments in the regulatory sciences as a new objective. An evaluation of AHRQ’s prevention portfolio identified crucial gaps in knowledge about the safety and effectiveness of clinical preventive services.  Information from studies supported by NIH will guide the transformation of clinical and translational science programs to reduce the time needed for laboratory discoveries to become treatments for patients. HHS will also use findings from evaluations to advance patient care, for example, by determining the effectiveness of health information sites geared toward particular populations of interest and the providers who serve them.   

HHS will continue to use evaluations to monitor progress on its efforts to advance scientific knowledge and implement innovative practices. HHS plans to evaluate regulatory science, science management, and the safety risks and ethical, legal, and societal implications of new technologies. 

A number of HHS operating and staff divisions, including ACF, AHRQ, CDC, FDA, IHS, NIH, and SAMHSA work both independently and collaboratively to use research and development resources to improve health, public health, and human services. These agencies sustain and contribute to a full spectrum of scientific research and development activities.

– HHS Strategic Plan FY 2010-2015 Goal 3

>>>  Goal 3:  Advance the Health, Safety, and Well-Being of the American People <<<

Objective A: Promote the safety, well-being, resilience, and healthy development of children and youth

Objective B: Promote economic and social well-being for individuals, families, and communities

Objective C: Improve the accessibility and quality of supportive services for people with disabilities and older adults

Objective D:  Promote prevention and wellness

Objective E:  Reduce the occurrence of infectious diseases

Objective F:  Protect Americans’ health and safety during emergencies, and foster resilience in response to emergencies 

Over the past few decades, the Nation has made substantial advancements in ensuring the public health, safety, and well-being of the American people. But there is still more to be done.

Poverty, teen pregnancy, family disruptions, violence, and trauma continue to be pervasive, harmful, and costly public health problems in the United States. Trauma has been shown to be a serious, underlying risk factor for chronic physical diseases and mental and substance use disorders. Substance abuse and mental illness contribute to many of the Nation’s social and economic problems, as well as other health concerns. Naturally occurring and manmade disasters seriously threaten Americans’ health, safety, and well-being.  

As the U.S. population ages, there are increasing numbers of older adults to serve—adults who are experiencing more extended periods of frailty, affecting their ability to stay active and healthy. Economic downturns can increase the demand for services from safety net providers—at the same time that services are in short supply—in response to shrinking State and local budgets. In addition, protecting public health requires global cooperation on a host of issues, including ensuring the safety of imported products.

In response to these challenges, HHS is working to implement evidence-based strategies to strengthen families and to improve outcomes for children, adults, and communities. Underlying each objective and strategy is a focus on prevention. For example, with rare exceptions, breastfeeding provides the best nutrition for infants and is an important public health strategy for promoting the health of infants and mothers. Early childhood programs support healthy child development, foster school readiness, and support working parents struggling to make ends meet.  Youth development strategies not only prevent and reduce risky behaviors but also build skills and assets. HHS programs are addressing the unique needs of vulnerable populations through improved program coordination, policy development, evidence-based practice, and research.

Prevention is a cornerstone of our response to emergencies. Healthy, informed communities with strong social networks and robust health systems are much better equipped than communities without these advantages to withstand and recover from adversity.

Ongoing and future evaluation efforts will help HHS to understand program impacts on health, safety, and well-being. These activities include an evaluation of methods to prevent falls among older people, an extensive examination of the Recovery Act–funded Communities Putting Prevention to Work initiative that focuses on tobacco prevention and physical activity and on nutrition improvement efforts, continuing work to monitor the effectiveness of the Early Head Start Program, and an assessment of States’ progress and effectiveness in using evidence-based programs, policies, and practices to prevent substance abuse and mental illness. HHS has a number of evaluations in progress on employment retention and advancement, including welfare-to-work efforts, which will provide information to help reduce child poverty and advance family economic security.

The evidence base for public health preparedness, however, is limited. Thus, HHS will set priorities for research, evaluation, and quality improvement to improve emergency management and response.

HHS seeks to advance Americans’ health, safety, and well-being through the coordinated effort of several HHS agencies and offices, including ACF, AoA, ASPR, CDC, CMS, HRSA, IHS, NIH, OASH, and SAMHSA, as well as collaborative efforts with other Federal departments and agencies.

– HHS Strategic Plan FY 2010-2015 Goal 4

>>> Goal 4:  Increase Efficiency, Transparency, and Accountability of HHS Programs <<<

Objective A: Ensure program integrity and responsible stewardship of resources

Objective B: Fight fraud and work to eliminate improper payments

Objective C: Use HHS data to improve the health and well-being of the American people

Objective D: Improve HHS environmental, energy, and economic performance to promote sustainability 

As the largest grant-awarding agency in the Federal Government and the Nation’s largest health insurer, HHS places a high priority on ensuring the integrity of its investments. HHS manages several hundred programs in basic and applied science, public health, income support, child development, and health and social services, awarding more than 75,000 grants annually.  Its responsibilities are driven by complex scientific and technologic issues that require sophisticated analyses of exponentially growing amounts of information. Robust and secure information technology infrastructure and information management systems are required to support mission-critical activities, such as personalized medicine applicants and analysis of product marketing applications.

Promoting program integrity and increasing transparency of HHS’s efforts requires the expertise of staff across HHS, working both independently and in close collaboration. HHS provides ongoing training and guidance for staff who oversee grants and contracts, and uses established internal administrative procedures. HHS uses its grants management information system to report all grant award data across agencies, review program announcements, and review audits and resolution of grants audit findings.

HHS financial management systems work to ensure effective internal controls, timely and reliable financial and performance data for reporting, and system integration. As part of this effort, HHS maintains management systems, processes, and controls that ensure financial accountability; provide useful management information; and meet requirements of Federal laws, regulations, and guidance.

HHS also embraces the power of Open Government, recognizing that with openness comes responsibility and accountability for results. Through Open Government, HHS is promoting transparency, participation, and collaboration—vital enablers of success in the HHS mission to improve the health and well-being of all Americans.

HHS’s Open Government efforts will break new ground in enabling the public to give feedback to HHS programs. HHS can help stakeholders contribute knowledge and experience to help it do jobs better, and HHS can support new kinds of collaborative teamwork that will deliver better results for our citizens.  HHS will move forward toward new strategies, new tools, and a new culture of public participation and collaboration in its affairs.

Planned evaluations of HHS activities in this goal include program integrity reviews of States’ Medicaid programs to ensure compliance with Federal program integrity regulations, provide technical assistance to State’s program integrity operations, and identify areas to improve effectiveness and efficiency.  Further, HHS will continue to enter into contracts that support Medicaid integrity efforts and provide support and assistance to States through training and other educational programs. These evaluations will help to ensure that HHS knows how its program dollars are spent and that HHS regularly shares the findings with its partners, stakeholders, and the public.

HHS works to increase its efficiency, transparency, and accountability through the effort of every agency and office, including CMS, the Office of the Inspector General (OIG), and ASFR.

– HHS Strategic Plan FY 2010-2015 Goal 5

>>> Goal 5:  Strengthen the Nation’s Health and Human Services Infrastructure and Workforce <<<

Objective A: Invest in the HHS workforce to meet America’s health and human service needs today and tomorrow

Objective B: Ensure that the Nation’s healthcare workforce can meet increased demands

Objective C: Enhance the ability of the public health workforce to improve public health at home and abroad

Objective D: Strengthen the Nation’s human service workforce

Objective E: Improve national, State, local, and tribal surveillance and epidemiology capacity
 
Currently, areas in the Nation face shortages of critical healthcare workers, including primary care physicians, nurses, behavioral health and long-term care workers, as well as public health and human service professionals. Moreover, this problem is anticipated to increase in the coming years. More than 64 million people currently live in a primary-care health professional shortage area, and others live in smaller areas with health professional shortages. More than half of the counties in the United States have no behavioral health worker at all. With the implementation of the Affordable Care Act and the resulting expansion of health insurance coverage, demand for services of primary care professionals will increase substantially.

These concerns come at a time when demand for services is increasing—particularly with an aging population with more frail seniors in need of care—and the healthcare system is grappling with quality of care concerns. Natural and manmade disasters can strain existing health care, public health, and human service workforce capacity, and require rapid identification and deployment of skilled professionals to affected areas. In addition, all health professions will need to be responsive to new challenges and realize the potential of new technologies. Innovative approaches, including improved preparation of primary care practitioners and the enhanced use of mid-level professionals, such as nurse practitioners and physician assistants, will be required to meet the increased demand. Moreover, new approaches using peer mentors, recovery coaches, and care managers will be needed for persons with long-term care needs.

HHS is addressing many of these workforce issues. Through implementation of the Affordable Care Act, HHS will fund scholarships and loan repayment programs to increase the number of primary care physicians, nurses, physician assistants, mental health providers, and dentists in the areas of the country that need them most. With a comprehensive approach focusing on retention and enhanced educational opportunities, HHS is addressing the continuing need for a highly skilled, diverse nursing workforce. HHS is working with State, local, and tribal governments to develop health workforce training, recruitment, and retention strategies and to expand critical, timely access to care by funding the expansion, construction, and operation of Health Centers throughout the United States.

Providers, policymakers, and consumers are likely to consider a broad range of strategies to address gaps in infrastructure and workforce:  engaging students at younger ages, improving wages and benefits of direct care workers, tapping new worker pools, strengthening the skills that new workers bring at job entry, and providing more useful continuing education and training.

Findings from HHS’s analyses of health and human service workforce issues were the impetus for this goal. Reviews of nursing and nursing assistant studies; data on State, local, and tribal public health workforce shortages; and information on the impact of the health professions training programs informed the workforce development and infrastructure goal and objectives. HHS will continue to monitor national workforce issues and conduct evaluations on topics such as the HIV clinician workforce and access to specialty care for clients of HRSA’s Health Centers.

HHS is committed to helping recruit, train, develop, retain, and support a competent workforce.   Among the operating and staff divisions contributing to these efforts are ACF, AoA, the Office of the Assistant Secretary for Administration (ASA), ASPE, CMS, HRSA, IHS, OD, OASH, and SAMHSA.