Table of contents


Vision

Mission

Value

1: Health Care

1.A: Coverage & Affordability

Strategy 1.A.1: Exchanges

Strategy 1.A.2: Subsidies

Strategy 1.A.3: Dependents

Strategy 1.A.4: Medicaid

Strategy 1.A.5: Drug Coverage

Strategy 1.A.6: Access

Strategy 1.A.7: Sick Coverage

Strategy 1.A.8: Pre-Existing Conditions

Strategy 1.A.9: Rates

Strategy 1.A.10: Website

Strategy 1.A.11: Premium Revenue

Strategy 1.A.12: Appeals

Strategy 1.A.13: Outreach, Information & Assistance

1.B: Quality & Safety

Strategy 1.B.1: Outcomes Research

Strategy 1.B.2: Payment Reforms

Strategy 1.B.3: Quality & Safety

Strategy 1.B.4: Partnership for Patients

Strategy 1.B.5: IHS System

Strategy 1.B.6: Medical Products

Strategy 1.B.7: Patient Safety

Strategy 1.B.8: Healthcare Delivery

1.C: Primary & Preventive Care

Strategy 1.C.1: Community Health Centers

Strategy 1.C.2: Financial Barriers

Strategy 1.C.3: Pregnant Women & Infants

Strategy 1.C.4: Community-Based Prevention Programs

Strategy 1.C.5: Prevention & Public Health Fund

Strategy 1.C.6: Behavioral Health Disorders

Strategy 1.C.7: Substance Abuse

Strategy 1.C.8: Emotional Health

Strategy 1.C.9: Communication & Coordination

Strategy 1.C.10: Clinical Preventive Services

Strategy 1.C.11: Medical Homes

Strategy 1.C.12: Policies

Strategy 1.C.13: Public-Private Sector Partnerships

1.D: Healthcare Costs

Strategy 1.D.1: Measures, Data, Tools & Evidence

Strategy 1.D.2: Information Tools

Strategy 1.D.3: Telehealth

Strategy 1.D.4: Incentives

Strategy 1.D.5: New Models

Strategy 1.D.6: Medicare & Medicaid Payment Systems

1.E: Vulnerable Populations

Strategy 1.E.1: Access & Quality

Strategy 1.E.2: Populations with Heath Disparities

Strategy 1.E.3: Discriminatory Actions & Practices

Strategy 1.E.4: Community Health Centers

Strategy 1.E.5: Quality Improvement

Strategy 1.E.6: Affordable Care Act

Strategy 1.E.7: Mental Health & Substance Abuse

Strategy 1.E.8: Medicare, Medicaid & CHIP

Strategy 1.E.9: Oral Healthcare

Strategy 1.E.10: Strategic Plan

Strategy 1.E.11: Active Duty, Guard, Reserve, & Veterans & Families

1.F: Health Information Technology

Strategy 1.F.1: Incentives, Grants & Technical Assistance

Strategy 1.F.2: Participation & Engagement

Strategy 1.F.3: Confidence & Trust

Strategy 1.F.4: Innovation, Pilots, Policies, Standards & Services

Strategy 1.F.5: Telehealth

Strategy 1.F.6: Mobile Technology

Strategy 1.F.7: Communication & Public Awareness

2: Scientific Knowledge & Innovation

2.A: Patient Care

Strategy 2.A.1: Biomedical & Behavioral Sciences

Strategy 2.A.2: Biomedical & Prevention Research

Strategy 2.A.3: Efficacy

Strategy 2.A.4: Research Capacity

Strategy 2.A.5: Evidence-Based Health Care

Strategy 2.A.6: Collaboration & Practice

Strategy 2.A.7: Public/Private Collaboration

Strategy 2.A.8: Practice Improvement

Strategy 2.A.9: New Medical Treatments

Strategy 2.A.10: Reponsiveness & Integrity

2.B: Shared Solutions

Strategy 2.B.1: Geography-Based Inventories

Strategy 2.B.2: Participation & Collaboration CoP

Strategy 2.B.3: Personal Health Records

Strategy 2.B.4: Alerts & Safety Information

Strategy 2.B.5: Surveillance, Monitoring, Analysis & Reporting

Strategy 2.B.6: Insights & Experiences

Strategy 2.B.7: Solution Sharing

Strategy 2.B.8: Center for Medicare and Medicaid Innovation

2.C: Food & Medical Product Safety

Strategy 2.C.1: Medical Technologies

Strategy 2.C.2: Medical Products

Strategy 2.C.3: Transparency & Scientific Integrity

Strategy 2.C.4: Food Safety

Strategy 2.C.5: Foodborne Contaminants

Strategy 2.C.6: Preventive Controls

Strategy 2.C.7: Product Development

Strategy 2.C.8: Emerging Technologies

2.D: Health & Human Service Practice

Strategy 2.D.1: Program Evaluation

Strategy 2.D.2: Training & Support

Strategy 2.D.3: Oral Health

Strategy 2.D.4: National Prevention Strategy

Strategy 2.D.5: Findings & Recommendations

Strategy 2.D.6: Replication, Assistance, Funding & Testing

3: Health, Safety, and Well-Being

3.A: Children & Youth

Strategy 3.A.1: Early Childhoon Care & Education

Strategy 3.A.2: Early Childhood Education

Strategy 3.A.3: Teen Pregnancy, Sexually Transmitted Infections, Underage Drinking & Drug Use

Strategy 3.A.4: Safe & Stable Homes

Strategy 3.A.5: Safety, Well-Being & Healthy Development

Strategy 3.A.6: Permanent Families

Strategy 3.A.7: Prevention & Intervention

Strategy 3.A.8: Violence & Trauma

3.B: Economic & Social Well-Being

Strategy 3.B.1: Economic Security

Strategy 3.B.2: Jobs & Wages

Strategy 3.B.3: Supportive Services

Strategy 3.B.4: Substance Abuse, Mental Illness & Trauma

Strategy 3.B.5: Economically Distressed Communities

Strategy 3.B.6: Vulnerable Populations

Strategy 3.B.7: Fathers, Parents & Families

Strategy 3.B.8: Community Partnerships

3.C: People with Disabilities & Older Adults

Strategy 3.C.1: Service Access

Strategy 3.C.2: Home- & Community-Based Services

Strategy 3.C.3: Medicaid

Strategy 3.C.4: Community-Based Support Systems

Strategy 3.C.5: Family Caregivers

Strategy 3.C.6: Long-Term Care Services

Strategy 3.C.7: Law Enforcement

Strategy 3.C.8: Individuals with Chronic Conditions & Functional Impairments

Strategy 3.C.9: Community Living Services

Strategy 3.C.10: Olmstead Coordination

Strategy 3.C.11: Housing & Service Options

Strategy 3.C.12: Homeless Individuals & Families with Special Needs

3.D: Prevention & Wellness

3.E: Infectious Diseases

Strategy 3.E.1: HIV/AIDS

Strategy 3.E.2: Outreach

Strategy 3.E.3: Food Safety

Strategy 3.E.4: Capacity-Building

Strategy 3.E.5: Information & Best Practices

Strategy 3.E.6: Immunizations

Strategy 3.E.7: U.S. Global Health Initiative

3.F: Emergencies

Strategy 3.F.1: Hospitals & Healthcare Systems

Strategy 3.F.2: Human Service Systems

Strategy 3.F.3: Medical Countermeasures

Strategy 3.F.4: Response & Recovery

Strategy 3.F.5: Preparedness, Response & Recovery

Strategy 3.F.6: Evaluation & Learning

Strategy 3.F.7: Research, Evaluation & Quality Improvement

Strategy 3.F.8: Communication Strategies

Strategy 3.F.9: Vulnerable Populations

4: Efficiency, Transparency & Accountability

4.A: Integrity & Stewardship

Strategy 4.A.1: Financial Integrity

Strategy 4.A.2: Payment Methodologies

Strategy 4.A.3: Compliance

Strategy 4.A.4: Internal Controls

Strategy 4.A.5: Accountability

Strategy 4.A.6: Feedback & Continuous Improvement

4.B: Fraud & Improper Payments

Strategy 4.B.1: Fraud & Program Vulnerabilities

Strategy 4.B.2: Performance Risks

Strategy 4.B.3: Screening & Compliance Programs

Strategy 4.B.4: Predictive Indicators, Automated Edits & Medical Record Review

Strategy 4.B.5: Coordination & Data Sharing

Strategy 4.B.6: Controls & Results

Strategy 4.B.7: Improper Payments

4.C: Data

Strategy 4.C.1: Data Collection & Analysis

Strategy 4.C.2: Data.gov

Strategy 4.C.3: Strategic Initiatives & Cross-Departmental Priorities

Strategy 4.C.4: Smaller Populations

Strategy 4.C.5: Dialogue

Strategy 4.C.6: Data Analysis & Information Sharing

Strategy 4.C.7: Proactive Publishing

Strategy 4.C.8: Community Health Data Initiative

Strategy 4.C.9: Data 2020

4.D:

Strategy 4.D.1: Energy Consumption & Greenhouse Gas

Strategy 4.D.2: Conservation

Strategy 4.D.3: Human & Environmental Health

Strategy 4.D.4: Leadership, Communication & Engagement

Strategy 4.D.5: Research

5: Infrastructure & Workforce

5.A: Workforce

Strategy 5.A.1: Recruitment, Hiring & Retention

Strategy 5.A.2: Innovation, Opportunity & Success

Strategy 5.A.3: Wellness

Strategy 5.A.4: Resources & Accountability

Strategy 5.A.5: Commissioned Corps

5.B: Healthcare Workforce Demands

Strategy 5.B.1: Monitoring & Assessment

Strategy 5.B.2: Workforce Needs

Strategy 5.B.3: Underserved Communities

Strategy 5.B.4: Oral Healthcare

Strategy 5.B.5: Training & Practice

Strategy 5.B.6: Cultural & Linguistic Needs

Strategy 5.B.7: Primary Care & Behavioral Health Capacity

Strategy 5.B.8: Training & Collaboration

Strategy 5.B.9: Geriatrics Education & Training

5.C: Public Health

Strategy 5.C.1: Surveillance & Laboratory Capacity

Strategy 5.C.2: States, Tribes, Urban Indians, Localities & Territories

Strategy 5.C.3: Health Incidents

Strategy 5.C.4: Health Threats

5.D: Human Service Workforce

Strategy 5.D.1: Recruitment & Retention

Strategy 5.D.2: Training & Professional Development

Strategy 5.D.3: Head Start / Early Head Start

Strategy 5.D.4: Training, Education & Technical Assistance

Strategy 5.D.5: Cultural Competence

Strategy 5.D.6: Evidence-Based Practices

Strategy 5.D.7: Data & Evaluation

5.E: Surveillance & Epidemiology Capacity

Strategy 5.E.1: Outpatient Clinical Settings

Strategy 5.E.2: Information Technology

Strategy 5.E.3: Laboratory Capacity

Strategy 5.E.4: Chemical Laboratory Capacity

Strategy 5.E.5: Laboratory Technology

Strategy 5.E.6: Data Access & Sharing

Strategy 5.E.7: HIV



StrategicPlan

Strategic Plan 2010 - 2015

Every four 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. The Strategic Plan was last updated September 30, 2011.

Source:
http://www.hhs.gov/secretary/about/priorities/priorities.html

Start: 2009-10-01 End: 2015-09-30 Publication Date: 2013-07-18

Submitter:

First name: Owen

Last name: Ambur

Email Address: Owen.Ambur@verizon.net

Organization:

Name: U.S. Department of Health and Human Services

Acronym: HHS

Description: 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. 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. Appendix A also provides descriptions of these offices as well as an organizational chart.

Stakeholder(s):

Kathleen Sebelius: Secretary

HHS Partners: 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.

Vision

Mission

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.


Goal 1: Health Care

Strengthen Health Care

Stakeholder(s):

Children’s Health Insurance Program (CHIP): HHS is continuing to use evaluation information to monitor progress on its efforts to strengthen health care. For example, HHS is conducting numerous evaluations, including those 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.

Food and Drug Administration (FDA)

Administration on Aging (AoA): 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 strengthening health care. The Office of the Assistant Secretary for Planning and Evaluation (ASPE), 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.

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)

Health Resources and Services Administration (HRSA)

Indian Health Service (IHS)

National Institutes of Health (NIH)

Substance Abuse and Mental Health Services Administration (SAMHSA)

Office of the Assistant Secretary for Planning and Evaluation (ASPE)

Office for Civil Rights (OCR)

Office on Disability (OD)

Office of Health Reform (OHR)

Office of the National Coordinator for Health Information Technology (ONC)

Office of the Assistant Secretary for Health (OASH)

Objective(s):

1.A: Coverage & Affordability

Strategy 1.A.1: Exchanges

Strategy 1.A.2: Subsidies

Strategy 1.A.3: Dependents

Strategy 1.A.4: Medicaid

Strategy 1.A.5: Drug Coverage

Strategy 1.A.6: Access

Strategy 1.A.7: Sick Coverage

Strategy 1.A.8: Pre-Existing Conditions

Strategy 1.A.9: Rates

Strategy 1.A.10: Website

Strategy 1.A.11: Premium Revenue

Strategy 1.A.12: Appeals

Strategy 1.A.13: Outreach, Information & Assistance

1.B: Quality & Safety

Strategy 1.B.1: Outcomes Research

Strategy 1.B.2: Payment Reforms

Strategy 1.B.3: Quality & Safety

Strategy 1.B.4: Partnership for Patients

Strategy 1.B.5: IHS System

Strategy 1.B.6: Medical Products

Strategy 1.B.7: Patient Safety

Strategy 1.B.8: Healthcare Delivery

1.C: Primary & Preventive Care

Strategy 1.C.1: Community Health Centers

Strategy 1.C.2: Financial Barriers

Strategy 1.C.3: Pregnant Women & Infants

Strategy 1.C.4: Community-Based Prevention Programs

Strategy 1.C.5: Prevention & Public Health Fund

Strategy 1.C.6: Behavioral Health Disorders

Strategy 1.C.7: Substance Abuse

Strategy 1.C.8: Emotional Health

Strategy 1.C.9: Communication & Coordination

Strategy 1.C.10: Clinical Preventive Services

Strategy 1.C.11: Medical Homes

Strategy 1.C.12: Policies

Strategy 1.C.13: Public-Private Sector Partnerships

1.D: Healthcare Costs

Strategy 1.D.1: Measures, Data, Tools & Evidence

Strategy 1.D.2: Information Tools

Strategy 1.D.3: Telehealth

Strategy 1.D.4: Incentives

Strategy 1.D.5: New Models

Strategy 1.D.6: Medicare & Medicaid Payment Systems

1.E: Vulnerable Populations

Strategy 1.E.1: Access & Quality

Strategy 1.E.2: Populations with Heath Disparities

Strategy 1.E.3: Discriminatory Actions & Practices

Strategy 1.E.4: Community Health Centers

Strategy 1.E.5: Quality Improvement

Strategy 1.E.6: Affordable Care Act

Strategy 1.E.7: Mental Health & Substance Abuse

Strategy 1.E.8: Medicare, Medicaid & CHIP

Strategy 1.E.9: Oral Healthcare

Strategy 1.E.10: Strategic Plan

Strategy 1.E.11: Active Duty, Guard, Reserve, & Veterans & Families

1.F: Health Information Technology

Strategy 1.F.1: Incentives, Grants & Technical Assistance

Strategy 1.F.2: Participation & Engagement

Strategy 1.F.3: Confidence & Trust

Strategy 1.F.4: Innovation, Pilots, Policies, Standards & Services

Strategy 1.F.5: Telehealth

Strategy 1.F.6: Mobile Technology

Strategy 1.F.7: Communication & Public Awareness


Other Information:

On March 23, 2010, the President signed the Patient Protection and Affordable Care Act (Affordable Care Act) (P.L. 111–148) into law, strengthening and modernizing health care. The Affordable Care Act makes health insurance coverage more secure and reliable for Americans who have it, makes coverage more affordable for families and small business owners, and brings down skyrocketing healthcare costs that have put a strain on individuals, families, employers, and our Federal budget. HHS is responsible for implementing many of the health reform changes included in the Affordable Care Act. HHS is strengthening and modernizing health care to improve patient outcomes, promoting efficiency and accountability, ensuring patient safety, encouraging shared responsibility, and working toward high-value health care. 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 will improve our foundation for emergency preparedness. Stronger health care 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 several Strategic Initiatives related to strengthening health care, including promoting high-value, safe, and effective health care; securing and expanding health insurance coverage; and eliminating health disparities. 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 strengthening health care. 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.

Objective 1.A: Coverage & Affordability

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

Stakeholder(s):

CMS: Within HHS, agencies and offices such as CMS, IHS, OCR, and OHR are working together to implement the reforms prescribed in the law to make affordable coverage more accessible.

IHS

OCR

OHR

Other Information:

Today, more than 45 million Americans lack access to affordable health insurance. Additionally, many individuals who do have health insurance have incomplete coverage that may include exclusions for pre-existing conditions, or they may be one step away from losing coverage because of a change in employment. Individuals with health insurance face increasingly high premiums and medical costs that drive some to bankruptcy or force choices between maintaining health insurance coverage and paying for other household essentials. The Affordable Care Act is providing relief from skyrocketing health insurance costs and is ensuring Americans have secure, stable, and affordable health insurance. In 2010 HHS began implementing new regulations affecting the health insurance market aimed at increasing consumer protections and at creating a more competitive insurance market. This increased oversight is making health care more responsive to the needs of its patients, healthcare providers, and other stakeholders. Health insurance reform is creating health insurance Exchanges that pool together millions of individuals and small businesses and their employees to increase purchasing power and competition in the insurance market, a luxury that only large employers currently enjoy. Increased purchasing power and competition, in turn, will make premiums more affordable. The Exchanges will also reduce administrative costs for individuals and small businesses and their employees by enabling them to make more straightforward comparisons of the prices, benefits, and quality of health plans. HHS created a new website, www.healthcare.gov, which provides consumers with easily comparable health insurance options specific to their life situation and local community. Healthcare.gov improves coverage transparency by providing consumers with meaningful information about what health insurance covers and how it works. Healthcare.gov is the first central database of health coverage options, combining information about public programs, from Medicare to the new Pre-Existing Conditions Insurance Plan, with information from more than 1,000 private insurance plans. The insurance options finder automatically sorts through a catalogue of options to help consumers identify the ones that may be right for them. Other highlights of the site include extensive information about consumer rights, how to navigate the health insurance marketplace, and quality rankings for local healthcare providers... HHS is using the following key strategies to make coverage more secure for those who have insurance and to extend affordable coverage to the uninsured.

Objective Strategy 1.A.1: Exchanges

Help create State-based health insurance Exchanges that will increase purchasing power, reduce administrative expenses, and increase competition to make premiums more affordable

Objective Strategy 1.A.2: Subsidies

Provide subsidized coverage through health insurance Exchanges to people who cannot afford to purchase insurance on their own

Objective Strategy 1.A.3: Dependents

Increase the number of young adults under age 26 who are covered as a dependent on their parent’s employer-sponsored insurance policy

Stakeholder(s):

Young Adults

Objective Strategy 1.A.4: Medicaid

Expand Medicaid coverage to more low-income Americans

Stakeholder(s):

Low-Income Americans

Objective Strategy 1.A.5: Drug Coverage

Reduce the prescription drug coverage gap (“donut hole”) for those receiving the Medicare Part D Prescription Drug Benefit

Objective Strategy 1.A.6: Access

Ensure access to health insurance by prohibiting insurers from placing lifetime limits on medical care, prohibiting insurers from denying coverage based on pre-existing conditions, and prohibiting discriminatory premium rates based on health status

Objective Strategy 1.A.7: Sick Coverage

Prohibit insurance companies from dropping people from coverage when they get sick

Stakeholder(s):

Sick People

Objective Strategy 1.A.8: Pre-Existing Conditions

Establish the Pre-Existing Condition Insurance Plan Program to provide affordable insurance for Americans who are uninsured, have a pre-existing condition; and have been without coverage for at least six months

Objective Strategy 1.A.9: Rates

Work with States to establish a rate review process that identifies and remedies unreasonable rate increases by health insurance plans

Objective Strategy 1.A.10: Website

Operate a fully-accessible health insurance website, HealthCare.gov, that empowers consumers by increasing informed choice and promoting market competition

Objective Strategy 1.A.11: Premium Revenue

Require insurance companies to spend the majority of health insurance premiums on medical care, not on profits and overhead

Objective Strategy 1.A.12: Appeals

Require new health plans to implement an appeals process for coverage determination

Objective Strategy 1.A.13: Outreach, Information & Assistance

Work with tribes, HHS tribal advisory bodies, and other tribal and urban Indian groups and programs to provide outreach, information, and assistance to assure that AI/ANs, and the entities that serve them, are aware of and able to use the benefits available under the Indian Health Care Improvement Act and other Indian-specific and generally applicable provisions of the Affordable Care Act.

Stakeholder(s):

Tribal Advisory Bodies

Tribal Groups

Urban Indian Groups

Objective 1.B: Quality & Safety

Improve healthcare quality and patient safety

Stakeholder(s):

Patients

FDA: HHS is committed to improving health care quality and patient safety for all Americans through its operating and staff divisions. FDA is protecting the Nation’s health by ensuring the safety, effectiveness, and security of human and veterinary drugs, vaccines, and other biological products and medical devices... HHS is also ensuring quality of care and patient safety through surveillance activities at FDA and CDC.

SAMHSA: SAMHSA is regulating the safe use of methadone for addiction treatment.

CDC

AHRQ: AHRQ is developing strategies to strengthen quality measurement and improvement and is overseeing the operations of a task force focused on patient safety.

OASH: OASH is coordinating the efforts of agencies to improve healthcare quality and public health quality with a special emphasis on reducing the burden of healthcare-associated infections, and is serving as the focal point for implementation of a national strategy to prevent health care-associated infections.

IHS : IHS is improving the quality of care in the clinical, public health, and preventive services it provides to AI/ANs in a number of ways. Strategies include providing training and support for innovative uses of paraprofessionals — enabling members of American Indian and Alaska Native communities to have access to a wider range of culturally and linguistically appropriate services. IHS’s Improving Patient Care Initiative is supporting tribal, IHS, and urban Indian health programs to improve quality and access to care through the development of an American Indian and Alaska Native health system medical home.

American Indian Communities

Alaska Native Communities

CMS: CMS is expanding its role beyond being simply a payer of claims, and becoming an agency that positively promotes the quality of care for its beneficiaries. Examples include developing physician- and hospital-quality reporting systems that link payments to the quality and efficiency of care; implementing nursing home initiatives that reduce the incidence of bed sores and dehydration among residents; employing initiatives to eliminate payment for certain medical errors (“never-events”); and applying payment incentives to avoid healthcare-acquired conditions and readmissions; and initiating a bundled-payment system that will align payments for services delivered across an episode of care, such as a heart bypass or hip replacement, rather than paying for services separately. Bundled payments will give doctors and hospitals new incentives to coordinate care, improve the quality of care, and save money for Medicare.

ASPR : In addition, ASPR is working to expand equitable access to safe, quality care when an emergency requires the rapid expansion of healthcare delivery.

OCR : OCR is enforcing civil rights laws to prevent discrimination in the delivery of health care on the basis of race, color, national origin, disability, age, and in many instances, gender and religion.

Other Information:

Innovative therapies and cutting-edge technologies are fundamental to medical care in the United States. However, there are numerous opportunities for improvement that could significantly impact the health of the American people. The gap between the best possible care and the care that is routinely delivered is considerable. Despite modest improvements in the quality of care, the pace is slow, especially for preventive services and chronic disease management. Of particular concern is the continued slow progress in the area of patient safety and healthcare-associated infections as well as the persistent geographic variation in quality of care delivered. Disparities in care remain prominent; uninsured patients receive considerably lower quality care than insured patients on several dimensions... Within HHS, AHRQ, CDC, CMS, FDA, HRSA, IHS, OCR, OASH, and SAMHSA are working to improve healthcare quality and patient safety for all Americans, using the following key strategies.

Objective Strategy 1.B.1: Outcomes Research

Increase the availability of patient-centered outcomes research to give patients and practitioners evidence on the most effective medical options

Objective Strategy 1.B.2: Payment Reforms

Implement payment reforms, such as bundled payments, that reward quality care and work with physicians and practitioners, and across the public and private sectors, in quality improvement efforts

Objective Strategy 1.B.3: Quality & Safety

Reduce healthcare-associated infections, adverse drug events, and other complications of healthcare delivery through quality and safety promotion efforts

Objective Strategy 1.B.4: Partnership for Patients

Establish the Partnership for Patients, a new public-private partnership that will help improve the quality, safety, and affordability of health care for all Americans.

Objective Strategy 1.B.5: IHS System

Improve the quality of, and access to, care in the IHS system as well as patient safety by approaches such as implementing the Improving Patient Care initiative, which focuses on creating a medical home for patients

Stakeholder(s):

IHS

Objective Strategy 1.B.6: Medical Products

Improve medical products to enhance patient safety

Objective Strategy 1.B.7: Patient Safety

Improve patient safety through the surveillance of adverse events, errors, or near misses in blood, organ, and tissue procedures

Stakeholder(s):

Patients

Objective Strategy 1.B.8: Healthcare Delivery

Improve the quality and safety of healthcare delivery through Patient Safety Organizations.

Stakeholder(s):

Patient Safety Organizations

Objective 1.C: Primary & Preventive Care

Emphasize primary and preventive care linked with community prevention services

Other Information:

Both improved access to primary care services and more effective public health measures are critical to ensuring that individuals have access to high-quality services at the place and time that best meets their needs. It is important that individuals be informed of existing community services that support health promotion, such as exercise programs, educational classes, self-management training, and nutrition counseling. If diagnosed with diseases or adverse health conditions, they can be linked to these same community services to enable them to take a holistic approach to improving their health. The Affordable Care Act is expanding insurance coverage for Americans, supporting improvements in primary care, and makings new investments in community-based prevention. As part of this effort, HHS is focusing on creating key linkages between health care and effective community prevention services that support healthy living and disease management.

Objective Strategy 1.C.1: Community Health Centers

Increase the emphasis of Community Health Centers on providing preventive services and linking with the public health community

Stakeholder(s):

Community Health Centers

Public Health Community

Objective Strategy 1.C.2: Financial Barriers

Remove financial barriers to accessing recommended preventive health services by providing health insurance that includes coverage of these services at no cost to the patient

Objective Strategy 1.C.3: Pregnant Women & Infants

Promote early entry into primary care, education, and coordinated services for pregnant women and infants

Stakeholder(s):

Pregnant Women

Infants

Objective Strategy 1.C.4: Community-Based Prevention Programs

Expand community-based prevention programs to help improve the health and quality of life of individuals with, and at risk for, chronic diseases and conditions

Stakeholder(s):

Community-Based Prevention Programs

Individuals with Chronic Diseases

Objective Strategy 1.C.5: Prevention & Public Health Fund

Support implementation of the Prevention and Public Health Fund to assist state and community efforts to prevent disease, detect it early, manage conditions before they become severe, and provide states and communities the resources they need to promote healthy living

Stakeholder(s):

States

Communities

Objective Strategy 1.C.6: Behavioral Health Disorders

Build community and individual resilience and skills to cope with risk factors for behavioral health disorders

Stakeholder(s):

Communities

Individuals with Behavioral Health Disorders

Objective Strategy 1.C.7: Substance Abuse

Disseminate best practices for use of substance abuse screening and intervention in acute healthcare settings

Stakeholder(s):

Acute Healthcare Facilities

Substance Abusers

Objective Strategy 1.C.8: Emotional Health

Promote emotional health by creating prevention-prepared communities that take coordinated action to prevent and reduce mental illness and substance abuse

Objective Strategy 1.C.9: Communication & Coordination

Support rapid communication and coordination between public health practitioners and clinicians to increase use of evidence-based prevention strategies to address risk factors and conditions

Stakeholder(s):

Public Health Practitioners

Clinicians

Objective Strategy 1.C.10: Clinical Preventive Services

Build and operate programs to identify, evaluate, disseminate, and promote effective clinical preventive services

Objective Strategy 1.C.11: Medical Homes

Increase access to comprehensive primary, preventive, and specialty services by expanding the number of medical homes for children, youth, and adults

Stakeholder(s):

Children

Youth

Adults

Objective Strategy 1.C.12: Policies

Establish Medicare and Medicaid payment and delivery system policies (including accountable care organizations, medical homes, and bundled payments) that value primary care and promote prevention and wellness in a fiscally responsible way

Objective Strategy 1.C.13: Public-Private Sector Partnerships

Develop public-private sector partnerships to improve care and empower people to make healthier choices.

Objective 1.D: Healthcare Costs

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

Other Information:

Healthcare costs consume an ever-increasing amount of our Nation’s resources, straining family, business, and Government budgets. Rising premiums hurt the competitiveness of American businesses and erode workers’ take-home pay. Healthcare costs take up a growing share of federal and state budgets and imperil the Government’s long-term fiscal outlook. In the United States, one of the sources of inefficiency that is leading to rising healthcare costs is payment systems that reward medical inputs rather than outcomes, contain high administrative costs, and lack focus on disease prevention. The Affordable Care Act is bringing down costs for families, businesses, and government with the broadest package of healthcare cost-cutting measures that has ever been enacted. As part of health reform implementation, HHS is lowering costs for American families and individuals through insurance market reforms that ensure access to preventive care. HHS is changing Medicare from a system that rewards volume of service to one that rewards efficient, effective care; reduces delivery system fragmentation; and better aligns reimbursement rates with provider costs. Efforts to strengthen program integrity in Medicare and Medicaid, and to encourage widespread adoption and meaningful use of health information technology also help reduce the growth of healthcare costs. Within HHS, AHRQ, ASPE, CDC, CMS, FDA, HRSA, IHS, and SAMHSA have significant roles to play in realizing this objective. HHS will use the following key strategies to reduce the growth of healthcare costs while promoting high-value, effective care.

Objective Strategy 1.D.1: Measures, Data, Tools & Evidence

Produce the measures, data, tools, and evidence that healthcare providers, insurers, purchasers, and policymakers need to improve the value and affordability of health care and to reduce disparities in costs and quality between population groups and regions

Stakeholder(s):

Healthcare Providers

Healthcare Insurers

Healthcare Purchasers

Healthcare Policymakers

Objective Strategy 1.D.2: Information Tools

Develop and disseminate data and evidence-based information tools needed to inform policy and practice and to improve the efficiency and quality of health care (i.e., evidence-based, high-value services recommended by the Community Guide and Guide to Clinical Preventive Services)

Objective Strategy 1.D.3: Telehealth

Increase the use of cost-effective telehealth mechanisms to make specialized care more available to AI/AN and other underserved populations

Stakeholder(s):

Underserved Populations

Specialized Care Providers

Objective Strategy 1.D.4: Incentives

Design, implement, and evaluate healthcare provider incentives that encourage the delivery of effective, efficient healthcare services

Stakeholder(s):

Healthcare Providers

Objective Strategy 1.D.5: New Models

Create new models of care including health delivery mechanisms, payment methods, or insurance Exchanges that align provider incentives with quality and efficiency goals

Objective Strategy 1.D.6: Medicare & Medicaid Payment Systems

Reform the Medicare and Medicaid payment systems, through value-based purchasing and other programs, to reward high-value services instead of high-volume services.

Objective 1.E: Vulnerable Populations

Ensure access to quality, culturally competent care for vulnerable populations

Stakeholder(s):

Vulnerable Populations

Office of Minority Health: A number of HHS programs help make health care more available to people whose circumstances call for special attention, including older adults; children; people with disabilities; uninsured populations; and persons with Limited English Proficiency. For instance, to help healthcare professionals provide the highest quality of care to every patient regardless of race, ethnicity, cultural background, or the ability to speak English, the Office of Minority Health has developed a free interactive Web-based training course, A Physician’s Practical Guide to Culturally Competent Care, for physicians, nurses, nurse practitioners, and other healthcare providers.

Medicaid Beneficiaries: While Medicare generally does not reimburse language services (except in the case of outpatient psychotherapy), some Medicare Advantage plans make translators available to their enrollees. Moreover, the Federal Government gives each state the option of receiving matching funds for the provision of language assistance services to Medicaid and CHIP beneficiaries.

CHIP Beneficiaries

Low Income People: In other instances, people also may have difficulty accessing high-quality care because they have low incomes or live in remote areas. For example, IHS, tribal, and urban Indian organization providers face challenges in addressing the needs of AI/ANs who experience health disparities and lack access to various kinds of care.

People Living in Remote Areas

IHS

Tribal Organizations

Urban Indian Organizations

American Indians: Given our Government’s unique legal and political relationship with tribal governments, it has a special obligation to provide health services for American Indians and Alaska Natives (AI/ANs). HHS follows the President’s 2009 tribal consultation policy to partner with tribes to ensure access to quality health care for AI/ANs. In addition, the Affordable Care Act contains the permanent reauthorization of the Indian Health Care Improvement Act, which modernizes and updates a range of authorities for programs and functions operated by IHS, tribes, tribal organizations, and urban Indian organizations. The Affordable Care Act also includes other provisions that address the unique circumstances and needs of tribes and AI/AN individuals. As HHS is implementing the provisions of the new law, HHS is partnering with tribes and tribal organizations through tribally operated health programs, urban Indian organizations, and healthcare providers on how to ensure access to a broader array of health care for AI/ANs.

Alaska Natives

Military Families: Military families may experience difficulty in accessing the needed and appropriate care.

LGBT Individuals: Lesbian, gay, bisexual, and transgender individuals may face problems in seeking and receiving care that meets their needs.

AHRQ: The AHRQ-issued 2009 National Healthcare Disparities Report finds that, for many measures, racial and ethnic minorities have more limited access to care and receive lower quality care. Data from some Community Health Centers indicates that disparity gaps exist for racial and ethnic minorities regardless of economic status... AHRQ regularly monitors healthcare quality and disparities, and through its grants and contracts, focuses on improving how care is delivered.

Racial Minorities

Ethnic Minorities

Community Health Centers

CMS: CMS programs open the door to health services for older adults, people with disabilities, and many low-income adults and children. CMS sets requirements for providers that help ensure a common level of healthcare quality. Through demonstration projects and other innovations, CMS seeks to find better ways to deliver high-quality care.

HRSA: Service delivery programs in HRSA, IHS, and SAMHSA help enhance the availability of care in areas of high need. These agencies strive to improve the quality of care their programs deliver. When fully implemented, the Affordable Care Act will provide for expanded access to insurance coverage, making care more accessible for vulnerable populations that are currently uninsured. For example, CMS’s Pre-Existing Condition Insurance Plan Program is providing healthcare coverage to many individuals with pre-existing conditions who are uninsured, while the establishment of health insurance Exchanges will provide access to subsidized health insurance coverage. As stated earlier, the Affordable Care Act also contains many provisions directed at improving healthcare quality in existing HHS programs and in health care generally. One provision of particular significance is the requirement within the Affordable Care Act to establish a program for measuring and reporting on the quality of care adults receive under Medicaid. This effort parallels a similar program addressing the quality of care children receive under the Medicaid and CHIP Programs that was enacted in the Children’s Health Insurance Program Reauthorization Act (CHIPRA) of 2009 (P.L. 111–3). Expanded funding for Community Health Centers, which serve large numbers of ethnic and racial minorities, makes primary care more accessible across the Nation in inner cities, underserved suburbs, and rural areas. Civil rights protections in the Affordable Care Act ensures equal access to healthcare programs and activities for individuals regardless of race, color, national origin, disability, gender, and age. The Affordable Care Act contains many provisions to help patients receive help in managing their care and in successfully navigating a complex array of health supports.

IHS

SAMHSA

Minority Health Offices: The Affordable Care Act highlights minority health by formally establishing minority health offices in the Department’s agencies, and contains provisions to improve data collected, analyzed, and reported (by the Department’s programs) on race, ethnicity, gender, age, primary language, and disability status -- provisions that will help the Department better target its efforts in the years to come by providing data on subpopulation groups, whose health status issues were masked by their inclusion in general groupings. Similarly, a wide variety of health data will be available on the LBGT population, data that is generally not available today.

Other Information:

With the growing diversity of the U.S. population, healthcare providers are increasingly called on to address their patient’s unique social and cultural experience and language needs. Provision of culturally competent care can increase quality and effectiveness, increase patient satisfaction, improve patient compliance, and reduce racial and ethnic health disparities... Through its Departmental Oral Health Initiative, HHS is promoting the incorporation of oral healthcare services and oral disease prevention into primary healthcare delivery sites. Good oral health is essential to good overall health; conversely, poor oral health negatively impacts the quality of life, including pain, lost productivity at school and work, and implications for future disease patterns. HHS is promoting policies to integrate oral health into primary care, including prevention and improved health literacy. Improved availability of oral health services, including disease prevention, treatment, and health promotion and education are being promoted for poor and underserved populations as well as for the population at large... Within HHS, ACF, AHRQ, AoA, CDC, CMS, HRSA, IHS, OCR, OD, OASH, and SAMHSA have significant roles to play in realizing this objective. HHS will use the following key strategies to ensure access to quality, culturally competent care for elderly and vulnerable populations.

Objective Strategy 1.E.1: Access & Quality

Monitor access to and quality of care across population groups, and work with federal, state, local, tribal, urban Indian, and nongovernmental actors to address observed disparities and to encourage and facilitate consultation and collaboration among them

Stakeholder(s):

Federal Actors

State Actors

Local Actors

Tribal Actors

Urban Indian Actors

Nongovernmental Actors

Objective Strategy 1.E.2: Populations with Heath Disparities

Promote expanded access to quality and culturally competent healthcare services to populations that have experienced health disparities, including African Americans, Latinos, AI/AN; individuals with disabilities; refugees as well as to populations with Limited English Proficiency

Stakeholder(s):

Populations with Heath Disparities

African Americans

Latinos

AI/AN

Individuals with Disabilities

Refugees

Populations with Limited English Proficiency

Objective Strategy 1.E.3: Discriminatory Actions & Practices

Improve access to quality care through the prevention and correction of discriminatory actions and practices

Objective Strategy 1.E.4: Community Health Centers

Increase access to comprehensive primary and preventive services to historically underserved areas by expanding the number of Community Health Centers and the range of services offered by these centers

Stakeholder(s):

Community Health Centers

Historically Underserved Areas

Objective Strategy 1.E.5: Quality Improvement

Support concentrated approaches to quality improvement in service delivery programs, and build a comparable focus on improvement in the quality of behavioral health services

Objective Strategy 1.E.6: Affordable Care Act

Implement quality improvement provisions of the Affordable Care Act and evaluate their impact

Objective Strategy 1.E.7: Mental Health & Substance Abuse

Improve access to mental health and substance abuse treatment through the implementation of the Wellstone and Domenici Mental Health Parity and Addiction Equity Act of 2008 and the development of the essential and benchmark packages under the Affordable Care Act

Objective Strategy 1.E.8: Medicare, Medicaid & CHIP

Expand quality improvement efforts in Medicare, Medicaid, and CHIP and continue to utilize Quality Improvement Organizations, as well as public reporting and payment changes, to foster reduction of hospital-acquired infections and other healthcare-acquired conditions

Stakeholder(s):

Quality Improvement Organizations

Objective Strategy 1.E.9: Oral Healthcare

Increase access to primary oral healthcare services and to oral disease preventive services by expanding access to Community Health Centers, school-based health centers, and Indian Health Service-funded health programs that have comprehensive primary oral healthcare services, and state and community-based programs that improve oral health, especially for children and pregnant women

Stakeholder(s):

Community Health Centers

School-Based Health Centers

Indian Health Service-Funded Health Programs

Children

Pregnant Women

Objective Strategy 1.E.10: Strategic Plan

Implement the Strategic Plan in a manner that complies with the President’s Memorandum for the Heads of Executive Departments and Agencies of November 5, 2009, on tribal consultation; renews and strengthens our partnership with tribes; in the context of national health reform, brings reform to IHS; improves the quality of and access to care for AI/AN individuals; and is accountable, transparent, fair, and inclusive

Stakeholder(s):

Tribes

AI/AN Individuals

Objective Strategy 1.E.11: Active Duty, Guard, Reserve, & Veterans & Families

Work with the Departments of Defense and Veterans Affairs, the National Guard, and the states to improve access to needed behavioral health and supportive services for active duty, guard, reserve, and veterans and their families.

Stakeholder(s):

Department of Defense

Department of Veterans Affairs

National Guard

Active Duty Service Members

National Guard Members

Reservists

Veterans

Families of Veterans

Objective 1.F: Health Information Technology

Promote the adoption and meaningful use of health information technology

Stakeholder(s):

Office of the National Coordinator for Health Information Technology (ONC) : The Office of the National Coordinator for Health Information Technology (ONC) serves as the Secretary’s principal advisor charged with coordinating nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information.

Other Information:

At the heart of HHS’s strategy to strengthen and modernize healthcare is the use of data to improve healthcare quality, reduce unnecessary healthcare costs, decrease paperwork, expand access to affordable care, improve population health, and support reformed payment structures. The nation’s health information technology infrastructure enables the flow of information to power these critical efforts -- making possible the types of fundamental changes in access and healthcare delivery proposed in the Affordable Care Act. HHS is taking a leading role in realizing health information technology’s potential benefits. The Health Information Technology for Economic and Clinical Health (HITECH) provisions of the Recovery Act committed billions to promote adoption and use of health information technology. This unprecedented investment in health information technology propelled a range of initiatives, including regulations on the meaningful use of health information technology and standards as well as the funding of regional extension centers, state health information exchanges, and Beacon communities. The rapid “wiring” of American health care, which is taking place under the law, is doing more than simply digitizing paper-based work. It is facilitating new means of improving the quality, efficiency, and patient-centeredness of care. Augmenting this investment are a range of programs across the Department, including the electronic prescribing and personal health record programs at CMS, IHS’s continued expansion and deployment of its electronic health records system, and HHS’s healthcare workforce programs. Expanded telehealth programs at HRSA and at IHS use video and telecommunication technologies to help healthcare professionals diagnose, treat, and monitor patients, thus bringing services to people who live in tribal, rural, or other areas where necessary medical expertise is not available. HHS has identified the adoption and meaningful use of health information technology nationwide as a top priority for changing health care and for making health care more accessible, affordable, and safe for all Americans... In addition to ONC, many HHS agencies and offices play a significant part in the advancement of health information technology for improving healthcare quality and efficiency and for reducing costs. These agencies and offices, including AHRQ, AoA, ASPE, CDC, CMS, FDA, HRSA, IHS, NIH, OCR, OMHA and SAMHSA, are contributing to this objective through the following key strategies.

Objective Strategy 1.F.1: Incentives, Grants & Technical Assistance

Encourage widespread adoption and meaningful use of health information technology through incentives, grants, and technical assistance

Objective Strategy 1.F.2: Participation & Engagement

Endorse the active participation of consumers in accessing and engaging with their health information

Stakeholder(s):

Consumers

Health Care Consumers

Objective Strategy 1.F.3: Confidence & Trust

Inspire confidence and trust in health information technology by ensuring the privacy and security of electronic health information

Objective Strategy 1.F.4: Innovation, Pilots, Policies, Standards & Services

Encourage innovation; support pilots that demonstrate health IT-enabled reform; and develop policies, standards, and services that will enable the appropriate re-use of information to support quality, public health, and research

Objective Strategy 1.F.5: Telehealth

Support and promote use of telehealth to provide access to modern technology and healthcare specialty resources for tribal, rural, and other underserved communities

Stakeholder(s):

Tribal Communities

Rural Communities

Underserved Communities

Objective Strategy 1.F.6: Mobile Technology

Explore the use of mobile technology to provide timely and culturally appropriate health information to vulnerable and hard-to-reach populations

Stakeholder(s):

Vulnerable Populations

Hard-to-Reach Populations

Objective Strategy 1.F.7: Communication & Public Awareness

Enhance communication and support a public awareness campaign about the value of health information technology for outreach to all healthcare stakeholders, including providers, payers, and consumers of care.

Stakeholder(s):

Health Care Providers

Health Care Payers

Health Care Consumers

Health Care Professionals

Patients

Families

Other Information:

Develop and implement a public awareness campaign public about the basics, benefits, and privacy implications of health information technology for multiple audiences, including healthcare providers, other professionals, and patients and families.


Goal 2: Scientific Knowledge & Innovation

Advance Scientific Knowledge and Innovation

Objective(s):

2.A: Patient Care

Strategy 2.A.1: Biomedical & Behavioral Sciences

Strategy 2.A.2: Biomedical & Prevention Research

Strategy 2.A.3: Efficacy

Strategy 2.A.4: Research Capacity

Strategy 2.A.5: Evidence-Based Health Care

Strategy 2.A.6: Collaboration & Practice

Strategy 2.A.7: Public/Private Collaboration

Strategy 2.A.8: Practice Improvement

Strategy 2.A.9: New Medical Treatments

Strategy 2.A.10: Reponsiveness & Integrity

2.B: Shared Solutions

Strategy 2.B.1: Geography-Based Inventories

Strategy 2.B.2: Participation & Collaboration CoP

Strategy 2.B.3: Personal Health Records

Strategy 2.B.4: Alerts & Safety Information

Strategy 2.B.5: Surveillance, Monitoring, Analysis & Reporting

Strategy 2.B.6: Insights & Experiences

Strategy 2.B.7: Solution Sharing

Strategy 2.B.8: Center for Medicare and Medicaid Innovation

2.C: Food & Medical Product Safety

Strategy 2.C.1: Medical Technologies

Strategy 2.C.2: Medical Products

Strategy 2.C.3: Transparency & Scientific Integrity

Strategy 2.C.4: Food Safety

Strategy 2.C.5: Foodborne Contaminants

Strategy 2.C.6: Preventive Controls

Strategy 2.C.7: Product Development

Strategy 2.C.8: Emerging Technologies

2.D: Health & Human Service Practice

Strategy 2.D.1: Program Evaluation

Strategy 2.D.2: Training & Support

Strategy 2.D.3: Oral Health

Strategy 2.D.4: National Prevention Strategy

Strategy 2.D.5: Findings & Recommendations

Strategy 2.D.6: Replication, Assistance, Funding & Testing


Other Information:

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 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.

Objective 2.A: Patient Care

Accelerate the process of scientific discovery to improve patient care

Stakeholder(s):

NIH: NIH will balance support for large-scale efforts and smaller investigator-initiated projects, develop a strong scientific workforce through career training, and invest in technologies and information systems needed for comprehensive research approaches. HHS will provide researchers with access to financial and technical resources through NIH to conduct early-stage drug development for promising new therapies.

Researchers

FDA: A joint effort of FDA and NIH will improve regulatory review to facilitate the efficient approval of safe new medical products.

AHRQ: HHS also will support research that is tied to clinical practice, considering the influence of payment systems and the delivery of services. Patient-centered research activities through NIH and AHRQ will help enhance the evidence base for the best preventive, screening, diagnostic, and treatment services.

Other Information:

Medical breakthroughs, fueled by scientific discovery, have made the difference between life and death for countless Americans. Nevertheless, the need for better health interventions remains. Continuing to improve the health and well-being of Americans requires HHS investments, ranging from improving its understanding of fundamental biological processes to identifying the best modes of prevention and treatment. HHS investments have improved the health of many Americans, but currently the path from basic discovery into safe, effective patient care can be long. The Department has identified several leverage points to accelerate movement along the pipeline from scientific discovery to more effective patient care... HHS will continue to support ethical and responsible research practices, including ensuring the protection of the humans and animals participating in health research. NIH is just one of the agencies within HHS that is committed to promoting integrity in research programs and ensuring that truthful, valid research is conducted. Secretary Sebelius has identified the acceleration of scientific discovery as one of her Strategic Initiatives. Within HHS, AHRQ, ASPE, ASPR, CDC, FDA, IHS, NIH, and OASH have significant roles to play in advancing science to improve health and well-being for Americans. HHS will use the following key strategies to accelerate the process of scientific discovery to improve patient care.

Objective Strategy 2.A.1: Biomedical & Behavioral Sciences

Expand the knowledge base in biomedical and behavioral sciences by investing in fundamental and service system research, human capital development, and scientific information systems

Objective Strategy 2.A.2: Biomedical & Prevention Research

Support promising biomedical and prevention research to save lives, reduce the burden of chronic diseases, and identify new, more effective prevention and treatment strategies

Objective Strategy 2.A.3: Efficacy

Support research efforts to improve the identification of, and response to, differences in efficacy of pharmaceutical and other care and treatment for under-represented populations

Stakeholder(s):

Under-Represented Populations

Objective Strategy 2.A.4: Research Capacity

Assist in developing the research capacity of individuals and institutes from diverse backgrounds, such as the Native American Research Centers for Health; tribal, and urban Indian epidemiology programs; Historically Black Colleges and Universities; Hispanic-serving institutions; and tribal colleges and universities

Stakeholder(s):

Individuals

Institutes

Native American Research Centers for Health

Tribal Epidemiology Programs

Urban Indian Epidemiology Programs

Historically Black Colleges and Universities

Hispanic-Serving Institutions

Tribal Colleges

Tribal Universities

Objective Strategy 2.A.5: Evidence-Based Health Care

Foster evidence-based health care through research

Objective Strategy 2.A.6: Collaboration & Practice

Promote translation of research into practice, including fostering government and private sector collaboration, and adapt it to the varying needs of diverse communities in culturally and linguistically appropriate ways

Objective Strategy 2.A.7: Public/Private Collaboration

Foster and obtain the necessary collaboration of government and private sector research activity to achieve fastest possible discovery

Objective Strategy 2.A.8: Practice Improvement

Provide access to resources that facilitate the translation of basic laboratory discoveries into therapies and services research into practice improvements

Objective Strategy 2.A.9: New Medical Treatments

Support comprehensive and efficient regulatory review of new medical treatments.

Objective Strategy 2.A.10: Reponsiveness & Integrity

Expand awareness and institutional responsiveness on human research participants and research integrity.

Stakeholder(s):

Human Research Participants

Objective 2.B: Shared Solutions

Foster innovation to create shared solutions

Other Information:

HHS depends on collaboration to realize its goals. Every day, HHS agencies work collaboratively with their federal, state, local, tribal, urban Indian, nongovernmental, and private sector partners to improve the health and well-being of Americans. HHS is using technology to identify new approaches to enable citizens to contribute their ideas to the work of government that will yield innovative solutions to our most pressing health and human service challenges. HHS employs an array of innovative participation and collaboration mechanisms to improve delivery of consumer information on patient safety and health, provide medical research connections and collaborations for patient engagement, provide technology for teamwork, and find creative ideas in the workplace. These innovations include engaging Web 2.0 technologies with several functional capabilities, including blogging to rate and rank ideas and priorities, crowdsourcing to identify public opinion and preferences, group collaboration tools such as file-sharing services, idea generation tools, mobile technologies such as text messaging, and online competitions. HHS is supporting and evaluating innovative programs such as Text4baby, an innovative health education service that provides underserved pregnant women and new mothers with evidence-based health messages using mobile technology. Innovation is a key element of HHS’s intraagency Open Government initiative. Through this initiative, the Obama administration is promoting agency transparency, public participation, and public-private collaboration across Federal departments. More information on HHS’s strategies to foster Open Government can be found in Goal 4. Operating and staff divisions, including AHRQ, ASPE, CDC, CMS, FDA, IHS, SAMHSA, and ONC, are contributing to making HHS more open and innovative. HHS will use the following key strategies to foster innovation.

Objective Strategy 2.B.1: Geography-Based Inventories

Deliver computerized geography-based inventories of patient care services to help patients determine which services are available at the nearest site and determine locations and travel distances to other sites where services may be available

Objective Strategy 2.B.2: Participation & Collaboration CoP

Establish a Community of Practice for Participation and Collaboration that will enable HHS Open Government innovators to share experiences, policies, and tools, and will increase dissemination of best practices and knowledge throughout the HHS workforce

Stakeholder(s):

HHS Open Government Innovators

HHS Workforce

Objective Strategy 2.B.3: Personal Health Records

Expand the functionality of personal health records as a way to deliver personalized health and behavioral health information directly to consumers

Stakeholder(s):

Health Care Consumers

Objective Strategy 2.B.4: Alerts & Safety Information

Employ high-tech options Exit Disclaimer(i.e., text messaging and cell phone applications) to reach healthcare professionals, patients, and other members of the public to share alerts and safety information that may affect both treatment and diagnostic choices for healthcare professional and service recipient

Stakeholder(s):

Healthcare Professionals

Patients

Members of the Public

Objective Strategy 2.B.5: Surveillance, Monitoring, Analysis & Reporting

Use Web-based tools to improve surveillance, monitoring, analysis, and reporting

Objective Strategy 2.B.6: Insights & Experiences

Harness employees’ insights and experiences to help develop high-impact solutions to important public health challenges

Stakeholder(s):

Employees

Objective Strategy 2.B.7: Solution Sharing

Support community members in developing and sharing solutions to meet their own unique needs

Stakeholder(s):

Community Members

Objective Strategy 2.B.8: Center for Medicare and Medicaid Innovation

Establish a Center for Medicare and Medicaid Innovation within CMS as provided for under the Affordable Care Act.

Stakeholder(s):

Center for Medicare and Medicaid Innovation

CMS

Objective 2.C: Food & Medical Product Safety

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

Stakeholder(s):

NIH-FDA Leadership Council: Advancing regulatory science and innovation is an objective shared by a number of agencies within HHS. FDA and NIH are collaborating on an initiative to fast-track medical innovation to the public. As part of the effort, the agencies established a Joint NIH-FDA Leadership Council to spearhead collaborative work on important public health issues. The Council works together to ensure that regulatory considerations form an integral component of biomedical research planning and that the latest science is integrated into the regulatory review process.

Other Information:

Regulatory science is the development and use of the scientific tools, standards, and approaches necessary for the assessment of regulated products, such as medical products and foods, to determine safety, quality, and performance. Without advances in regulatory science, promising therapies may be discarded during the development process simply for the lack of tools to recognize their potential; moreover, outmoded review methods can delay approval of critical treatments unnecessarily. Conversely, many dollars and years may be expended assessing a novel therapy that with better tools might be shown to be unsafe or ineffective at an earlier stage. Advancements in regulatory science also will help to prevent foodborne illnesses, and when outbreaks of foodborne illness occur, to identify the source of contamination quickly and to limit the impact of the outbreak. Regulatory science innovations will allow for faster access to new medical technologies that treat serious illnesses and improve quality of life. These advances will benefit every American by increasing the accuracy and efficiency of regulatory review and by reducing adverse health events, drug development costs, and the time-to-market for new medical technologies... Other agencies promoting regulatory science and innovation include AHRQ, CDC, and HRSA. HHS will employ the following key strategies to improve food and medical product safety.

Objective Strategy 2.C.1: Medical Technologies

Ensure that HHS personnel have the scientific expertise to address new challenges presented by cutting-edge medical technologies, such as nanotechnologies

Objective Strategy 2.C.2: Medical Products

Update medical product review standards and provide new regulatory pathways for new medical technologies

Objective Strategy 2.C.3: Transparency & Scientific Integrity

Adhere to high standards of transparency and scientific integrity in medical product innovation, development, and regulatory review

Objective Strategy 2.C.4: Food Safety

Implement a new, public health-focused approach to food safety that sets priorities for prevention, strengthens surveillance and enforcement, and improves response and recovery

Objective Strategy 2.C.5: Foodborne Contaminants

Develop improved methods for rapidly detecting foodborne contaminants

Objective Strategy 2.C.6: Preventive Controls

Develop science-based standards for preventive controls for food safety across the “farm to table” continuum

Objective Strategy 2.C.7: Product Development

Develop tools to modernize product development through enhanced support of partnerships

Objective Strategy 2.C.8: Emerging Technologies

Create structural supports to strengthen FDA’s leadership and coordination for cross-cutting efforts in emerging technologies.

Objective 2.D: Health & Human Service Practice

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

Stakeholder(s):

CDC: CDC’s Guide to Community Preventive Services and SAMHSA’s National Registry of Evidence-based Programs and Practices are ever-expanding resources of expert recommendations on evidence-based interventions to improve public health. Recommendations are based on systematic reviews of the evidence related to the benefits and potential harms of services.

AoA: AoA is working with its national Aging Services Network to implement evidence-based prevention programs, at the community level, that have proven effective in reducing the risk of disease, disability, and injury among the elderly.

Aging Services Network

IHS: IHS is disseminating information on best or promising practices, including 19 practice models for diabetes and other models on health promotion, disease prevention, and injury prevention.

Administration for Children and Families (ACF): The Administration for Children and Families (ACF) and SAMHSA use rigorous evaluations of social service programs for children and families to design program improvement strategies.

SAMHSA: SAMHSA has developed Web-based toolkits on implementing evidence-based practices with fidelity. By prioritizing funding for evidence-based programs, directories of evidence-based programs, implementation toolkits, and other resources, HHS promotes the adoption of these strategies and provides the information the public needs to implement these programs and practices successfully. Some human service programs, such as teen pregnancy prevention and home visitation programs, incorporate requirements for the use of evidence-based programs for grantees.

Other Information:

Working together with its public and private partners, HHS is committed to improving the quality of public health and human service practice by conducting applied, translational, and operations research and evaluations. HHS uses research and evaluation evidence to inform policy and program implementation efforts as well. HHS has identified and refined approaches that help people make healthy choices, assist communities as they work to improve the health and well-being of their residents, support safety and stability of individuals and families, and help children reach their full potential. HHS also monitors and evaluates programs to assess efficiency and responsiveness and to ensure the effective use of information in strategic planning, program or policy decision making, and program improvement... HHS investments in public health and human service research have yielded many important findings about what works. HHS will work to identify promising, effective approaches that are culturally competent and effective for populations with varying circumstances and needs. A number of HHS agencies are involved in advancing this objective, including ACF, AHRQ, AoA, ASH, CDC, HRSA, IHS, NIH, OASH, and SAMHSA. HHS will implement the following strategies to increase its understanding of what works in public health and human service practice.

Objective Strategy 2.D.1: Program Evaluation

Promote and support evaluation of existing programs and services research, and incorporate program evaluation efforts into program implementation and future policy direction

Objective Strategy 2.D.2: Training & Support

Support and train researchers, including those from diverse backgrounds, and provide communities with tools to adapt research and evaluation techniques to their own circumstances, to evaluate programs and practices, and to conduct systematic reviews more effectively

Stakeholder(s):

Researchers

Objective Strategy 2.D.3: Oral Health

Strengthen oral health research and use evidence-based oral health promotion and disease prevention to clarify the interrelationships between oral disease and other medical diseases

Objective Strategy 2.D.4: National Prevention Strategy

Implement the National Prevention Strategy using evidence-based strategies and actions

Objective Strategy 2.D.5: Findings & Recommendations

Build user-friendly mechanisms for disseminating evaluation findings and recommendations to the public, including those who may lack Internet access

Objective Strategy 2.D.6: Replication, Assistance, Funding & Testing

Promote the replication of evidence-based programs and practices, and assist public health and human service programs to implement evidence-based strategies while continuing to fund and test innovative approaches in order to expand the evidence base, as done in the teen pregnancy prevention and home visiting initiatives.


Goal 3: Health, Safety, and Well-Being

Advance the Health, Safety, and Well-Being of the American People

Stakeholder(s):

American People

Objective(s):

3.A: Children & Youth

Strategy 3.A.1: Early Childhoon Care & Education

Strategy 3.A.2: Early Childhood Education

Strategy 3.A.3: Teen Pregnancy, Sexually Transmitted Infections, Underage Drinking & Drug Use

Strategy 3.A.4: Safe & Stable Homes

Strategy 3.A.5: Safety, Well-Being & Healthy Development

Strategy 3.A.6: Permanent Families

Strategy 3.A.7: Prevention & Intervention

Strategy 3.A.8: Violence & Trauma

3.B: Economic & Social Well-Being

Strategy 3.B.1: Economic Security

Strategy 3.B.2: Jobs & Wages

Strategy 3.B.3: Supportive Services

Strategy 3.B.4: Substance Abuse, Mental Illness & Trauma

Strategy 3.B.5: Economically Distressed Communities

Strategy 3.B.6: Vulnerable Populations

Strategy 3.B.7: Fathers, Parents & Families

Strategy 3.B.8: Community Partnerships

3.C: People with Disabilities & Older Adults

Strategy 3.C.1: Service Access

Strategy 3.C.2: Home- & Community-Based Services

Strategy 3.C.3: Medicaid

Strategy 3.C.4: Community-Based Support Systems

Strategy 3.C.5: Family Caregivers

Strategy 3.C.6: Long-Term Care Services

Strategy 3.C.7: Law Enforcement

Strategy 3.C.8: Individuals with Chronic Conditions & Functional Impairments

Strategy 3.C.9: Community Living Services

Strategy 3.C.10: Olmstead Coordination

Strategy 3.C.11: Housing & Service Options

Strategy 3.C.12: Homeless Individuals & Families with Special Needs

3.D: Prevention & Wellness

3.E: Infectious Diseases

Strategy 3.E.1: HIV/AIDS

Strategy 3.E.2: Outreach

Strategy 3.E.3: Food Safety

Strategy 3.E.4: Capacity-Building

Strategy 3.E.5: Information & Best Practices

Strategy 3.E.6: Immunizations

Strategy 3.E.7: U.S. Global Health Initiative

3.F: Emergencies

Strategy 3.F.1: Hospitals & Healthcare Systems

Strategy 3.F.2: Human Service Systems

Strategy 3.F.3: Medical Countermeasures

Strategy 3.F.4: Response & Recovery

Strategy 3.F.5: Preparedness, Response & Recovery

Strategy 3.F.6: Evaluation & Learning

Strategy 3.F.7: Research, Evaluation & Quality Improvement

Strategy 3.F.8: Communication Strategies

Strategy 3.F.9: Vulnerable Populations


Other Information:

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, limited health literacy, 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 due 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, FDA, HRSA, IHS, NIH, OASH, and SAMHSA, as well as collaborative efforts with other federal departments and agencies.

Objective 3.A: Children & Youth

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

Stakeholder(s):

Children: Child welfare services, including child abuse prevention activities, foster care, adoption, and new assisted guardianship programs, target those families in which there are safety or neglect concerns. Services for mental and substance use disorders provide support for those with behavioral healthcare needs. In each of these service sectors, incorporation of trauma-informed care is essential in order to achieve positive outcomes for these children and families. Several programs across agencies also promote positive youth development and seek to prevent risky behaviors in youth.

Youth: Several agencies concerned with youth have collaborated on a review of the evidence base on teen pregnancy prevention. These agencies have identified a range of curriculum-based and youth development program models that reduce teen pregnancy or associated behavioral risk factors. HHS is working with the Departments of Education and Agriculture to foster effective government coordination that will support children’s health, nutrition, and safety in schools.

Department Agriculture

State Service Providers: HHS partners with state, local, tribal, urban Indian, and other service providers to sustain an essential safety net of services that protect children and youth, promote their emotional health and resilience in the face of adversity, and ensure their healthy development from birth through the transition to adulthood. Health and early intervention services ensure children get off to a good start from infancy. Early childhood programs, including Head Start, enhance the school readiness of preschool children.

Local Service Providers

Tribal Service Providers

Urban Indian Service Providers

Department of Education: Race to the Top – Early Learning Challenge, a historic partnership with the Department of Education, will enable more children from low-income or disadvantaged families to have access to high-quality early learning programs and services.

CDC: Vital research funded by agencies across HHS seeks to understand the risks to children’s safety, health, and well-being and to build evidence about effective interventions to mitigate these risks. CDC tracks data on injuries and violent deaths among children and youth. This agency has recently conducted a meta-analysis of the current research literature on parent training programs to identify components associated with effective models.

ACF: Four agencies -- ACF, CDC, NIH, and SAMHSA -- have collaborated to fund efficacy and effectiveness trials of child abuse and neglect interventions.

NIH

SAMHSA

Other Information:

Children and youth depend on the adults in their lives to keep them safe and to help them achieve their full potential. Yet too many of our young people—our Nation’s future workforce, parents, and civic leaders—are at risk of poor outcomes, including low educational attainment, teen pregnancy, ill health, violence, lack of labor market success, and premature death... The Secretary has identified early childhood development as a Strategic Initiative. A wide range of HHS agencies support these activities, including ACF, CDC, CMS, HRSA, IHS, NIH, OASH, and SAMHSA. HHS agencies will employ the following key strategies to ensure the safety, well-being, and healthy development of children and youth.

Objective Strategy 3.A.1: Early Childhoon Care & Education

Enhance young children’s healthy growth, development, and identity formation through high-quality early care and education and through evidence-based home visitation programs

Objective Strategy 3.A.2: Early Childhood Education

Promote school readiness and healthy child development through high-quality early education programs that utilize the best evidence-based practice and workforce development strategies.

Other Information:

Encourage healthy behaviors and reduce risky behaviors among children and youth

Objective Strategy 3.A.3: Teen Pregnancy, Sexually Transmitted Infections, Underage Drinking & Drug Use

Implement evidence-based strategies and test innovative approaches to reduce teen pregnancy, decrease rates of sexually transmitted infections, reduce underage drinking and drug use, and impact sexual risk behaviors

Stakeholder(s):

Teenagers

Objective Strategy 3.A.4: Safe & Stable Homes

Support parents, extended families, and communities to provide children with safe and stable homes

Stakeholder(s):

Parents

Extended Families

Communities

Objective Strategy 3.A.5: Safety, Well-Being & Healthy Development

Ensure the safety, well-being, and healthy development of children and youth, including children with disabilities, children experiencing homelessness, and children who have been maltreated

Stakeholder(s):

Children

Youth

Children with Disabilities

Children Experiencing Homelessness

Children Who Have Been Maltreated

Objective Strategy 3.A.6: Permanent Families

Help find permanent families for children whose birth parents cannot care for them safely

Objective Strategy 3.A.7: Prevention & Intervention

Advance the science and continue to build an evidence base for effective prevention and intervention strategies with children and youth through the innovation and evaluation of innovative, promising strategies

Stakeholder(s):

Children

Youth

Objective Strategy 3.A.8: Violence & Trauma

Implement evidence-based strategies to reduce the exposure to, build resilience to, and lessen the negative impact of violence and trauma on children, families, and communities.

Stakeholder(s):

Children

Families

Communities

Objective 3.B: Economic & Social Well-Being

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

Stakeholder(s):

Individuals

Families

Communities

ACF : ACF is the principal agency responsible for promoting the economic and social well-being of families, children, and youth through income support, financial education and asset-based strategies, job training and work activities, child support and paternity establishment, relationship skill-building for couples and co-parents, and assistance in paying for child care.

State Temporary Assistance for Needy Families (TANF) Programs: State Temporary Assistance for Needy Families (TANF) programs provide critical income assistance to some of the Nation’s poorest families, while helping mothers and fathers prepare for and secure employment. Child support programs ensure that non-custodial parents meet their financial obligations to their children, and provide a substantial share of resources for families that receive it.

OCR : OCR works to ensure that each state program is accessible to all, regardless of race, color, national origin, or disability.

SAMHSA: SAMHSA and HRSA also provide essential supportive services to particularly vulnerable individuals and families.

HRSA

Vulnerable Individuals

Vulnerable Families

Department of Housing and Urban Development (HUD): HHS collaborates with other Federal departments to support the economic and social well-being of individuals, families, and communities. HHS is involved in several White House–led interdepartmental efforts, including workgroups on urban policy and youth violence. In addition, HHS is working closely with the U.S. Department of Housing and Urban Development (HUD) to integrate the Nation’s housing, health, and human service delivery system, with particular emphasis on homelessness, community living, and livable homes and communities.

Department of Labor: HHS is collaborating with HUD and the U.S. Departments of Veterans Affairs and Labor in efforts to end homelessness among veterans... HHS and the U.S. Department of Labor are developing strategies to integrate and enhance skills development opportunities to help low-income individuals enter and succeed in the workforce.

Department of Veterans Affairs: HHS is coordinating efforts with the U.S. Departments of Veterans Affairs and Justice to improve outcomes for ex-offenders and their families, including specialized approaches for fathers and veterans. About 7.4 million children have a parent in prison, in jail, or under correctional supervision.

Department of Justice

Department of Agriculture: HHS is collaborating with the U.S. Department of Agriculture to expand access to nutritional supports for low-income youth and families.

Interagency Working Group on Youth Programs: HHS also chairs the Interagency Working Group on Youth Programs, which brings together twelve Federal departments and agencies to improve the coordination, effectiveness, and efficiency of youth-serving programs and to promote effective community-based efforts to reduce the factors that put youth at risk.

Other Information:

Strong individuals, families, and communities are the building blocks for a strong America. Unfortunately, many face challenges that affect their economic and social well-being. Vulnerable families need a path of opportunity to help them enter the middle class, and communities need to be revitalized to become engines for economic growth and opportunity. Many vulnerable Americans live in poverty, lack the skills needed to obtain good jobs, need supportive services to get or retain jobs, experience unstable family situations, or live in unsafe, unhealthy communities. Distressed communities and poverty can reduce the social ties of residents and can lead to a lack of accountability of, and trust in, public institutions like those dedicated to public safety and education. Lack of employment opportunities and low levels of academic achievement can lead to juvenile delinquency, substance abuse, and criminal activity that are major drivers of community violence and family disruption. Unstable couple relationships, lack of involvement by fathers, and disconnection from strong supportive social networks increase the vulnerability of both adults and children and weaken communities. Promoting economic and social well-being requires attention to a complex set of factors, through the collaborative efforts of agencies, policymakers, researchers, and providers. HHS agencies work together and collaborate across Federal departments to maximize the potential benefits of various programs, services, and policies designed to improve the well-being of individuals, families, and communities. Many HHS agencies fund essential human services to those who are least able to help themselves, often through the Department’s state, local, and tribal partners... Within HHS, agencies including ACF, HRSA, IHS, and SAMHSA will employ the following key strategies to promote economic and social well-being for individuals, families, and communities.

Objective Strategy 3.B.1: Economic Security

Advance individual and family economic security to reduce poverty

Stakeholder(s):

Individuals

Families

Objective Strategy 3.B.2: Jobs & Wages

Promote access to quality jobs that provide a livable wage for all individuals and families, and to training and educational opportunities that promote success in those jobs

Stakeholder(s):

Individuals

Families

Objective Strategy 3.B.3: Supportive Services

Provide supportive services, such as health and behavioral health, and wraparound services like employment, housing, and peer recovery supports, to reduce and eliminate barriers for vulnerable populations, including individuals with disabilities and individuals at risk for homelessness

Stakeholder(s):

Vulnerable Populations

Individuals with Disabilities

Individuals at Risk for Homelessness

Objective Strategy 3.B.4: Substance Abuse, Mental Illness & Trauma

Identify and address substance abuse, mental illness, and trauma history early to reduce the likelihood of more severe future problems

Objective Strategy 3.B.5: Economically Distressed Communities

Help economically distressed communities to access Federal programs and resources to address behavioral health needs

Stakeholder(s):

Economically Distressed Communities

Objective Strategy 3.B.6: Vulnerable Populations

Build and strengthen partnerships with federal, state, local, tribal, urban Indian organizations and other nongovernmental stakeholders to promote culturally appropriate individual, family, and community well-being for vulnerable populations

Stakeholder(s):

Vulnerable Populations

Federal Organizations

State Organizations

Local Organizations

Tribal Organizations

Urban Indian Organizations

Nongovernmental Organizations

Objective Strategy 3.B.7: Fathers, Parents & Families

Encourage responsible fatherhood, healthy relationships, parental responsibility, and family stability

Stakeholder(s):

Fathers

Parents

Families

Objective Strategy 3.B.8: Community Partnerships

Foster community partnerships to improve opportunities and delivery of services.

Stakeholder(s):

Communities

Objective 3.C: People with Disabilities & Older Adults

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

Stakeholder(s):

People with Disabilities

Older Adults

Home & Community-Based Services (HCBS): Over the past decade, a number of policy reforms and initiatives have improved the effectiveness of efforts to promote home and community-based services (HCBS) and to decrease unnecessary reliance on institutional care. The Supreme Court’s landmark 1999 Olmstead ruling requires states to place qualified individuals with disabilities in community settings -- whenever such placements are appropriate, the person does not oppose such placement, and the state can reasonably accommodate the placement.

CMS: CMS’ Real Choice Systems Change grants assist states and tribal grantees in improving community-based support systems that enable people with disabilities to participate fully in community life.

States

Tribal Grantees

AoA: AoA provides a number of services to older adults and persons with disabilities, including supportive services, nutrition services, preventive health services, supportive services to family caregivers, senior rights protection services, nutrition and supportive services to American Indians and Alaska Natives, and a national toll-free telephone service that helps callers find senior services in their communities throughout the country. AoA also funds aging and disability resource centers -- a single point- of- entry into the array of services available in the long- term care system -- to improve access to long-term care services and nursing home diversion programs to give consumers a greater role in determining the types of services and the manner in which they receive them.

IHS : IHS works with tribes to meet the elder care needs of American Indians and Alaska Natives as well as services to people with disabilities through grants, contracts, compacts, technical assistance, and shared services. The agency also provides competitive grants for tribes and tribal organizations to conduct long- term care planning for their communities and to develop community-based services, using innovative types of personnel such as the Community Health Representative.

American Indians

Alaska Natives

CMS: CMS supports American Indians and Alaska Natives long- term care data and policy analysis projects.

CDC : IHS and CDC collaborate on community approaches to elder fall prevention.

Administration on Developmental Disabilities (ADD): Through grants, technical assistance, and information-sharing, the Administration on Developmental Disabilities (ADD) within ACF works with the ADD network of state entities (State Developmental Disabilities Councils, Protection and Advocacy Systems, University Centers on Excellence in Developmental Disabilities) to ensure that individuals with developmental disabilities and their families have access to culturally competent services and supports that promote independence, productivity, integration, and inclusion in the community. These supports include child care, education, transitional services, health care, employment, transportation, and housing. ADD also funds various programs and projects to help individuals with disabilities live self-determined lives and to assist family caregivers.

State Developmental Disabilities Councils

Protection and Advocacy Systems

University Centers on Excellence in Developmental Disabilities

OCR : OCR investigates and resolves complaints alleging violations of the Americans with Disabilities Act’s (ADA) “integration regulation,” which requires that individuals with disabilities receive services in the most integrated setting appropriate to their needs, consistent with the Supreme Court’s decision in Olmstead. OCR also collaborates with the Department of Justice to advance civil rights enforcement of the ADA and the Olmstead decision.

HCBS: Other recent developments include providing consumers who receive publicly funded long-term services and supports with the option to manage those services for themselves at home. Authorization of the Money Follows the Person Grant Program contributes federal funds to states to transition Medicaid-covered nursing home residents to the community. Another promising new development integrates acute and long-term care services to enable HCBS to be more effective at preventing and delaying the need for institutionalization.

HUD: Housing is consistently ranked as the primary barrier to community living for those with declining health and limited mobility. The most frequently cited problems are lack of affordable, accessible, integrated housing; rental subsidies; and ways to link these to individuals who need them in a timely fashion. HHS and HUD are working together to reduce barriers to affordable and accessible housing.

Other Information:

HHS programs and initiatives have special significance for older adults and people of all ages who experience disabilities. Older adults and individuals with disabilities may need services and supports to assist them in performing routine activities of daily living such as eating and dressing. Improving access to, and the quality of, supports and services for older adults and people with disabilities is an HHS policy priority... An efficient long-term care system cannot exist without a workforce to care for the population in need. There is significant demand for a direct care labor force that is well-trained to address the needs of older adults and persons with disabilities. Under the Affordable Care Act, HHS is improving direct care worker training and competencies and encouraging career pathways for the existing workers. The Affordable Care Act also provides numerous opportunities for direct care workers to access more affordable health care. Residential care (services and supports provided outside nursing homes or an individual’s home) is an important and growing option. Understanding how residential care fits into the range of long-term care options is important because the aging of the population is likely to increase the demand for these services. HHS is systematically examining residential care models to understand the changing dynamics of publicly financed long-term care... Among the agencies and offices contributing to the achievement of this objective are ACF, AHRQ, AoA, ASPE, CMS, CDC, HRSA, IHS, OCR, OD, and SAMHSA. HHS will employ the following key strategies to improve supportive services for individuals with disabilities.

Objective Strategy 3.C.1: Service Access

Across the life span, collaborate across systems to streamline access for individuals with disabilities to a full complement of inclusive, integrated services and supports (early education, child care, education, transitional services, health care, employment, transportation, and housing)

Stakeholder(s):

Individuals with Disabilities

Objective Strategy 3.C.2: Home- & Community-Based Services

Build partnerships that leverage public and private resources to enhance home- and community-based services and supports for older individuals, and for persons with disabilities and their caregivers, as well as supports for elder justice systems for the protection of vulnerable individuals’ rights

Stakeholder(s):

Older Individuals

Persons with Disabilities

Caregivers

Objective Strategy 3.C.3: Medicaid

Work closely with states, territories, tribes, tribal organizations, urban Indian organizations, and other programs to achieve more flexibility in the Medicaid program through the Money Follows the Person Grant Program and in Medicaid through the Medicaid Home & Community First Choice Option, Medicaid Home & Community-Based Services State Plan Option, State Balancing Incentive Payments Program, other grant programs, other Medicaid programmatic and funding mechanisms and policy changes

Stakeholder(s):

States

Territories

Tribes

Tribal Organizations

Urban Indian Organizations

Objective Strategy 3.C.4: Community-Based Support Systems

Assist State, tribal, and local programs in designing and implementing improvements to community-based support systems that enable people with disabilities and long-term illnesses to live and participate in the community

Stakeholder(s):

State Programs

Tribal Programs

Local Programs

Objective Strategy 3.C.5: Family Caregivers

Expand access to supports for family caregivers to maximize the health and well-being of the caregivers and the people for whom they provide care

Stakeholder(s):

Family Caregivers

Objective Strategy 3.C.6: Long-Term Care Services

Improve the coordination of long-term care services with physical and behavioral health services by fostering innovative approaches to delivering integrated care

Objective Strategy 3.C.7: Law Enforcement

Enforce Federal laws prohibiting discrimination on the basis of disability that require individuals with disabilities to receive services in the most integrated setting appropriate to their needs, consistent with the Supreme Court’s decision in Olmstead

Stakeholder(s):

Individuals with Disabilities

Objective Strategy 3.C.8: Individuals with Chronic Conditions & Functional Impairments

Improve services for individuals with chronic conditions and functional impairments by enhancing coordination of Medicare and Medicaid, because many of these individuals are dually eligible

Stakeholder(s):

Individuals with Chronic Conditions & Functional Impairments

Objective Strategy 3.C.9: Community Living Services

Improve the delivery of community living services in a more uniform, efficient way by increasing the number of single-entry point and “no wrong door” systems and the quality and scope of existing systems that serve people with disabilities and older adults

Stakeholder(s):

People with Disabilities

Older Adults

Objective Strategy 3.C.10: Olmstead Coordination

Improve coordination between HHS and HUD regarding Olmstead matters

Stakeholder(s):

HUD

Objective Strategy 3.C.11: Housing & Service Options

Develop options for housing combined with services to enhance aging in place for older adults

Stakeholder(s):

Older Adults

Objective Strategy 3.C.12: Homeless Individuals & Families with Special Needs

Promote the coordination of housing assistance, health care, and supportive services to assist chronically homeless individuals and families with special needs

Stakeholder(s):

Homeless Individuals

Families with Special Needs

Objective 3.D: Prevention & Wellness

Promote prevention and wellness

Objective 3.E: Infectious Diseases

Reduce the occurrence of infectious diseases

Stakeholder(s):

CDC: HHS coordinates and ensures collaboration among the many federal agencies involved in vaccine and immunization activities. CDC has primary responsibility for reducing the occurrence and spread of infectious diseases in the U.S. population. CDC provides significant support to state and local governments; works to strengthen infectious disease surveillance, diagnosis, and treatment; and collaborates with federal and international partners to reduce the burden of infectious diseases throughout the world. The National Vaccine Plan provides a framework for pursuing the prevention of infectious diseases through immunizations.

FDA: FDA and CDC work together to prevent and control foodborne illness outbreaks, and FDA works with international drug regulatory authorities to expedite the review of generic antiretroviral drugs under the President’s Emergency Plan for AIDS Relief (PEPFAR).

NIH : NIH conducts basic and applied research that enables understanding and development of control measures against a wide array of infectious agents.

SAMHSA : SAMHSA and IHS support programs to reduce HIV, hepatitis, and other infectious diseases associated with injection drug use.

IHS

ASPR: ASPR’s Biomedical Advanced Research and Development Authority (BARDA) coordinates interagency efforts to define and rank requirements for public health medical emergency countermeasures, research, and product development and procurement related to infectious disease threats.

Biomedical Advanced Research and Development Authority (BARDA)

Other Information:

Because microbes continually evolve, adapt, and develop resistance to drugs over time, infectious diseases continue to be a significant health threat in the United States and around the world. Rapid global travel, importation of foods, and changing demographics have increased the ability of these infectious agents to spread quickly. The 2009 H1N1 influenza pandemic exemplifies the speed at which an infectious agent can spread from one location to nearly every corner of the globe. Addressing infectious diseases is a priority for HHS. Infectious diseases include vaccine-preventable diseases, foodborne illnesses; HIV and AIDS and associated STIs; hepatitis A and B; tuberculosis; infections acquired in healthcare settings, such as methicillin-resistant staphylococcus aureus (MRSA); novel influenza viruses; and infections transmitted by animals and insects... Healthcare-associated infections (HAIs), infections that patients acquire while receiving treatment for medical or surgical conditions, exact a significant toll on human life. The prevention and reduction of HAIs is a top priority for HHS; together, AHRQ, CDC, CMS, FDA, OASH, and other HHS experts are collaborating to implement strategies to prevent and reduce HAIs. The Secretary has identified food safety and support for the national HIV/AIDS strategy as Strategic Initiatives. Within HHS, agencies such as CDC, FDA, and NIH have primary responsibility for reducing the occurrence of infectious diseases. Other HHS agencies and offices that contribute to efforts to combat infectious diseases include ASPR, CMS, HRSA, IHS, OASH, and SAMHSA. HHS will implement the following key strategies to realize this objective.

Objective Strategy 3.E.1: HIV/AIDS

Aligning with the National HIV/AIDS Strategy for the United States, prevent the spread of HIV infection, and increase efforts to make people aware of their status and to enable them to access HIV care and treatment, using innovative, culturally appropriate means

Objective Strategy 3.E.2: Outreach

Conduct an outreach campaign, accessible to all populations, to prevent the spread of infectious diseases

Objective Strategy 3.E.3: Food Safety

Modernize and implement a twenty-first century food safety system that is flexible and responsive to current and emerging threats

Objective Strategy 3.E.4: Capacity-Building

Support state and tribal infectious disease and epidemiology capacity-building programs to prevent, investigate, and control healthcare-associated infections, disease outbreaks, and other healthcare threats

Stakeholder(s):

States

Tribes

Objective Strategy 3.E.5: Information & Best Practices

Identify, disseminate information, and encourage utilization of best practices to prevent healthcare-associated infections

Objective Strategy 3.E.6: Immunizations

Remove financial and other barriers to routine immunizations for children, adolescents, and adults

Stakeholder(s):

Children

Adolescents

Adults

Objective Strategy 3.E.7: U.S. Global Health Initiative

Work with federal and global partners to reduce the spread of HIV, hepatitis A and B, tuberculosis, malaria, and other infectious diseases in developing nations, under the U.S. Global Health Initiative.

Stakeholder(s):

Developing Nations

Objective 3.F: Emergencies

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

Stakeholder(s):

Americans

ASPR: Within HHS, improving health security is a shared responsibility. ASPR serves as the Secretary’s principal advisor on matters related to bioterrorism and other public health emergencies. ASPR also coordinates interagency activities between HHS, other federal partners, and state, local, and tribal officials responsible for emergency preparedness and the protection of the civilian population in emergencies.

State Officials

Local Officials

Tribal Officials

Department of Homeland Security: Working toward this objective, ASPR, in collaboration with the Department of Homeland Security, the Federal Emergency Management Agency, and other federal departments and agencies, is addressing the requirements of Presidential Policy Directive 8 (PPD 8) - National Preparedness. The goal of PPD 8 is to strengthen the security and resilience of the U.S. through systematic preparation for threats at all levels of government, the private and nonprofit sectors, and individual citizens so that everyone can contribute to safeguarding the Nation from harm.

Federal Emergency Management Agency

Private Sector

Nonprofit Sector

Individual Citizens

OCR : OCR plays a key role in protecting the civil rights of persons with Limited English Proficiency, individuals with disabilities, and individuals from diverse cultural origins in emergency preparedness, response, and recovery efforts.

Other Information:

Over the past decade, our Nation has renewed its efforts to address large-scale incidents that have threatened human health, such as natural disasters, disease outbreaks, and terrorism. Working with its federal, state, local, tribal, and international partners, HHS has supported capacity-building efforts and strengthened linkages between government, nongovernmental organizations, and the private sector. HHS has improved and exercised response capabilities and developed plans for medical countermeasures. HHS has also made ensuring the safety and well-being of the nation’s children in the wake of disasters and public health emergencies a priority. However, HHS must do more to ensure the health and safety of Americans in the face of unexpected and emerging threats. To guide its work, HHS developed the first National Health Security Strategy, a comprehensive framework for how the entire Nation must work together to protect people’s health in the case of an emergency. The strategy lays out current challenges and gaps, and articulates a systems approach for preparedness and response, including identifying responsibilities for all levels of government, communities, families, and individuals. HHS will use this strategy as a guide for determining what should be done at the Federal level to improve Federal efforts and best integrate with and support state, local, and tribal efforts. Over the next 5 years, HHS will work with its federal, state, local, tribal, and international partners to achieve two goals of the National Health Security Strategy—that is, building community resilience and strengthening and sustaining health and emergency response systems. This includes strengthening the federal medical and public health response capability. Resilient communities and robust systems are important not just for emergencies but for daily use. This objective is intricately linked with other objectives to modernize and improve the access, safety, and quality of health care. Similarly, strategies that focus on prevention, integrated systems, and equitable practices will support both preparedness and routine use objectives. The Secretary has identified protecting the health and safety of Americans in emergencies and fostering resilience as one of her Strategic Initiatives... Agencies and offices across HHS, including ACF, CDC, FDA, NIH, and OASH, will employ an array of key strategies to advance this objective.

Objective Strategy 3.F.1: Hospitals & Healthcare Systems

Strengthen the capability of hospitals and healthcare systems to plan for, respond to, and recover from natural and man-made emergency events

Stakeholder(s):

Hospitals

Healthcare Systems

Objective Strategy 3.F.2: Human Service Systems

Strengthen the capability of human service systems to plan for, respond to, and recover from natural and manmade emergency events

Stakeholder(s):

Human Service Systems

Objective Strategy 3.F.3: Medical Countermeasures

Modernize the medical countermeasure enterprise with more promising discoveries, advanced development, robust manufacturing, better stockpiling, and advanced distribution practices in the United States and abroad

Objective Strategy 3.F.4: Response & Recovery

Strengthen the federal medical and public health response and recovery capability and to improve integration with health and emergency response systems

Stakeholder(s):

Emergency Response Systems

Objective Strategy 3.F.5: Preparedness, Response & Recovery

Upgrade state, local, and tribal human services and public health preparedness, response, and recovery capacity

Stakeholder(s):

State Human Services

Local Human Services

Tribal Human Services

Objective Strategy 3.F.6: Evaluation & Learning

Develop systems to evaluate progress and learn from experiences

Objective Strategy 3.F.7: Research, Evaluation & Quality Improvement

Develop a research agenda, evaluation framework, and quality improvement methods for systematically ensuring that exemplary practices are used efficiently and effectively

Objective Strategy 3.F.8: Communication Strategies

Enhance accessible communication strategies to ensure that appropriate messages are received by, and from, the public to facilitate community resilience in response to emergencies

Objective Strategy 3.F.9: Vulnerable Populations

Ensure that the needs of vulnerable populations, including children, individuals with Limited English Proficiency, individuals with disabilities, and individuals with diverse cultural origins, are met in emergencies, through their effective integration into planning, response, and recovery efforts.

Stakeholder(s):

Vulnerable Populations

Children

Individuals with Limited English Proficiency

Individuals with Disabilities

Individuals with Diverse Cultural Origins


Goal 4: Efficiency, Transparency & Accountability

Increase Efficiency, Transparency, and Accountability of HHS Programs

Stakeholder(s):

Office of the Inspector General (OIG): 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.

CMS

ASFR

Objective(s):

4.A: Integrity & Stewardship

Strategy 4.A.1: Financial Integrity

Strategy 4.A.2: Payment Methodologies

Strategy 4.A.3: Compliance

Strategy 4.A.4: Internal Controls

Strategy 4.A.5: Accountability

Strategy 4.A.6: Feedback & Continuous Improvement

4.B: Fraud & Improper Payments

Strategy 4.B.1: Fraud & Program Vulnerabilities

Strategy 4.B.2: Performance Risks

Strategy 4.B.3: Screening & Compliance Programs

Strategy 4.B.4: Predictive Indicators, Automated Edits & Medical Record Review

Strategy 4.B.5: Coordination & Data Sharing

Strategy 4.B.6: Controls & Results

Strategy 4.B.7: Improper Payments

4.C: Data

Strategy 4.C.1: Data Collection & Analysis

Strategy 4.C.2: Data.gov

Strategy 4.C.3: Strategic Initiatives & Cross-Departmental Priorities

Strategy 4.C.4: Smaller Populations

Strategy 4.C.5: Dialogue

Strategy 4.C.6: Data Analysis & Information Sharing

Strategy 4.C.7: Proactive Publishing

Strategy 4.C.8: Community Health Data Initiative

Strategy 4.C.9: Data 2020

4.D:

Strategy 4.D.1: Energy Consumption & Greenhouse Gas

Strategy 4.D.2: Conservation

Strategy 4.D.3: Human & Environmental Health

Strategy 4.D.4: Leadership, Communication & Engagement

Strategy 4.D.5: Research


Other Information:

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 approximately 90,000 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.

Objective 4.A: Integrity & Stewardship

Ensure program integrity and responsible stewardship of resources

Other Information:

Managing more than $900 billion in public investments is an enormous responsibility—and an opportunity. Stewardship of Federal funds is more than just ensuring that resources are allocated and expended responsibly. If Federal investments are managed with integrity and vigilance, the benefit to the public is improved health and enhanced well-being. Responsible stewardship of new resources involves allocating these resources in an effective way—and for activities that generate the highest benefits. HHS has placed a strong emphasis on protecting program integrity and the well-being of program beneficiaries by identifying opportunities to improve program efficiency and effectiveness. HHS is making every effort to ensure that when it makes payments to individuals and businesses as program beneficiaries, grantees, or contractors, or on behalf of program beneficiaries, that the right recipient is receiving the right payment for the right reason at the right time. Internal controls and risk assessment activities are evolving and being strengthened across programs, including Medicare, Medicaid, Head Start, TANF, Low Income Home Energy Assistance Program (LIHEAP), foster care, and child care, to strengthen the integrity and accountability of payments. The Secretary has identified program integrity, transparency, and accountability as key Strategic Initiatives. All agencies and offices in HHS, including ACF, ASFR, CMS, HRSA, OMHA, and OIG are focused on ensuring the integrity of HHS programs, and is employing the following key strategies.

Objective Strategy 4.A.1: Financial Integrity

Ensure that individuals and entities that seek to participate as providers and suppliers in federal healthcare programs understand, and agree to comply with, financial integrity standards before enrolling in those healthcare programs

Stakeholder(s):

Healthcare Providers

Healthcare Suppliers

Objective Strategy 4.A.2: Payment Methodologies

Establish payment methodologies that are reasonable and responsive to changes in the marketplace

Objective Strategy 4.A.3: Compliance

Assist healthcare providers and suppliers in adopting practices that promote compliance with program requirements, including quality and safety standards

Stakeholder(s):

Healthcare Providers

Healthcare Suppliers

Objective Strategy 4.A.4: Internal Controls

Increase the identification and dissemination of best practices in internal controls to ensure that funds disbursed for health and human service programs are used for their intended purposes

Objective Strategy 4.A.5: Accountability

Work with states, localities, and grantees to strengthen the integrity and accountability of payments to health care and human service programs

Stakeholder(s):

States

Localities

Grantees

Objective Strategy 4.A.6: Feedback & Continuous Improvement

Ensure continuous improvement through the collection and evaluation of public/stakeholder feedback.

Objective 4.B: Fraud & Improper Payments

Fight fraud and work to eliminate improper payments

Stakeholder(s):

Department of Justice: HHS efforts to combat healthcare fraud, waste, and abuse include provider education, data analysis, audits, investigations, and enforcement. In addition, HHS is working in collaboration with the Department of Justice through the establishment and operation of the Health Care Fraud Prevention and Enforcement Action Team (HEAT) task force. CMS works with OIG and the U.S. Department of Justice on this joint effort. To date, the HEAT task force has conducted concentrated investigations in Baton Rouge, Brooklyn, Detroit, Houston, Los Angeles, Tampa, and Miami.

Health Care Fraud Prevention and Enforcement Action Team (HEAT)

CMS

OIG

Baton Rouge

Brooklyn

Detroit

Houston

Los Angeles

Tampa

Miami

TANF: HHS is monitoring and assisting the efforts of states, territories, and tribes to prevent and control error and improper payments in Head Start, TANF, LIHEAP, foster care, and child care. For example, TANF agencies use employment data from the National Directory of New Hires (NDNH) to identify unreported and underreported income, thereby reducing improper assistance payments.

ACF: In addition, ACF uses Title IV-E Foster Care Eligibility Reviews to ensure that children for whom Federal foster care payments are claimed are program eligible and are placed with eligible foster care providers.

Other Information:

HHS strives to allocate resources in the most efficient manner possible by minimizing inappropriate payments, targeting emerging fraud schemes by provider and type of service, and establishing safeguards to correct programmatic vulnerabilities. Reducing fraud, waste, and abuse in HHS program spending for health care, social services, and scientific research is a top priority for the Department. These activities are not one-time efforts to reduce fraud and improper payments; rather, the activities reflect our long-term commitment to continuously reduce system waste and inefficiencies. HHS is strengthening efforts to identify and eliminate improper payments. Internal controls and other risk assessment activities are focused on identifying and eliminating systemic weaknesses that lead to erroneous payments. HHS investments in cutting-edge technology and data mining technologies will allow for the analysis of potential fraud with unprecedented speed and efficiency. HHS will receive snapshots of fraudulent claims activity in real time, and complete in a matter of days analyses that previously took months or years... In addition to CMS and ACF, every agency and office in the Department is focused on fighting fraud and eliminating abuse and improper payments through a number of key strategies described below.

Objective Strategy 4.B.1: Fraud & Program Vulnerabilities

Monitor programs vigilantly, pursue prosecution and punishment for those who commit fraud, and remedy program vulnerabilities

Objective Strategy 4.B.2: Performance Risks

Monitor grantees and contractors vigilantly, using existing flexibilities to remedy performance risk, ensuring federal funds are awarded only to responsible entities and taking action to exclude those known to commit fraud

Stakeholder(s):

Grantees

Contractors

Objective Strategy 4.B.3: Screening & Compliance Programs

Require designated providers and suppliers to implement compliance programs and to undergo screening, including advanced screening for certain types of high-risk providers and suppliers

Stakeholder(s):

Providers

Suppliers

Objective Strategy 4.B.4: Predictive Indicators, Automated Edits & Medical Record Review

Use data to develop better predictive indicators, restructure automated edits, and enhance medical record review efforts in Medicare to help stop known schemes before payment is made

Objective Strategy 4.B.5: Coordination & Data Sharing

Increase coordination among federal departments, including increased health-related data sharing among agencies

Stakeholder(s):

Federal Departments

Objective Strategy 4.B.6: Controls & Results

Hold states accountable for producing results and implementing controls to address risks and errors, and help and enable states to become more effective in ensuring the integrity of their programs

Stakeholder(s):

States

Objective Strategy 4.B.7: Improper Payments

Disseminate best practices in preventing, measuring, or reducing improper payments.

Objective 4.C: Data

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

Stakeholder(s):

HHS Data Council: The HHS Data Council coordinates all health and human services data collection and analysis activities, including an integrated data collection strategy, coordination of health data standards and health and human services and privacy policy activities. The HHS Data Council and agencies and offices, including ACF, AHRQ, AoA, ASPE, CDC, CMS, FDA, HRSA, IHS, NIH, ONC, OASH, and SAMHSA, will use the following key strategies to achieve this objective.

Other Information:

Transparency and data sharing are of fundamental importance to HHS and its ability to achieve its mission. HHS’s vast stores of data are a remarkable national resource that can be used to help citizens better understand what the Department does and hold the public and private sectors accountable. HHS data and information is used to increase awareness of health and human service issues and generate insights into how to improve health and well-being. By making data and information more useful and more available, HHS promotes public and private sector innovation and action and provides the basis for new products and services that can benefit the Americans. Several core principles guide HHS’s plan for leveraging its data, including publishing more Government information online in ways that are easily accessible and usable; developing and disseminating accurate, high-quality, and timely information; fostering the public’s use of the information HHS provides; and advancing a culture of data sharing at HHS. HHS is strongly committed to data security and the protection of personal privacy and confidentiality as a fundamental principle governing the collection and use of data. HHS protects the confidentiality of individually identifiable information in all public data releases, including publication of datasets on the Web. As new approaches evolve, HHS will incorporate them into its data release policies. By employing these processes for data prioritization, release, and monitoring, HHS intends to increase the value derived from its information resources in several ways. Consumers will be able to access information and benefit directly from using it personally. Public administrators may use information resources to inform service delivery and improve customer satisfaction. Information resources also will bring new transparency to health care to help spark action to improve performance; help those discovering and applying scientific knowledge to locate, combine, and share potentially relevant information across disciplines to accelerate progress; and enhance entrepreneurial value, catalyzing the development of innovative products and services that benefit the public and, in the process of doing so, fuel the private sector’s economic growth. One particularly innovative project, launched by HHS in 2010, is the Community Health Data Initiative. The project will develop an integrated Web-based, user-friendly, relational database and a query system of national-, state-, and local-level health indicators, including health outcomes and health determinants, along with evidence-based public health or policy interventions. Database users will be able to compare their indicators, as data permit, with those of other groups of interest, either by geography or by population characteristics, such as age, income, sex, race, and ethnicity. Users will access multiple options for selecting and viewing data. Moreover, the database will grant the public open access with feature sets designed and optimized for distinct user populations.

Objective Strategy 4.C.1: Data Collection & Analysis

Coordinate HHS data collection and analysis activities, and ensure effective long-range planning for surveys and other investments in major data collection

Objective Strategy 4.C.2: Data.gov

Proactively identify opportunities for transparency, data sharing, and dissemination through electronic posting of datasets on http://www.data.gov

Objective Strategy 4.C.3: Strategic Initiatives & Cross-Departmental Priorities

Include staff with data expertise on Strategic Initiatives and cross-departmental priorities to provide knowledge of HHS data; assess data needs, gaps, and opportunities; improve data quality; develop plans and recommendations for evaluation and performance information; and identify ways to share existing and new data with the public and key audiences in ways that adhere to transparency principles and advance the initiative

Objective Strategy 4.C.4: Smaller Populations

Explore effective ways to gather, share, and analyze data from numerically smaller populations, such as American Indian and Alaska Native(AI/AN), Asian and Pacific Islander groups, and others, while maintaining the highest standards of data confidentiality

Stakeholder(s):

American Indian and Alaska Native(AI/AN)

Asian Groups

Pacific Islanders

Objective Strategy 4.C.5: Dialogue

Engage in a proactive new program of monitoring, stimulating, and incorporating innovative and beneficial uses of HHS data through systematic dialogue with key stakeholder groups

Objective Strategy 4.C.6: Data Analysis & Information Sharing

Expand the focus of CMS’s data environment from claims processing to state-of-the-art data analysis and information sharing

Stakeholder(s):

CMS

Objective Strategy 4.C.7: Proactive Publishing

Establish governance within Freedom of Information Act (FOIA) operations to promote the proactive publishing of information and include FOIA officers across the Department in transparency and data-sharing planning activities

Stakeholder(s):

HHS FOIA Officers

Objective Strategy 4.C.8: Community Health Data Initiative

Implement the Community Health Data Initiative to provide multiple methods for selecting and viewing data and to allow open, fully accessible public access

Objective Strategy 4.C.9: Data 2020

Use Data 2020 to track progress toward achieving the Nation’s health objectives contained in Healthy People 2020.

Objective 4.D:

Improve HHS environmental, energy, and economic performance to promote sustainability

Stakeholder(s):

HHS Senior Sustainability Officer: The Senior Sustainability Officer in the Office of the Secretary helps ensure that HHS operations promote sustainability and comply with Executive Order 13514. However, meeting our sustainability goals is a shared responsibility, underpinning the functions of agencies and offices throughout HHS. It is also the responsibility of the individuals directly employed by HHS as well as its grantees and contractors.

HHS Employees

HHS Grantees

HHS Contractors

Other Information:

Executive Order 13514, “Federal Leadership in Environmental, Energy, and Economic Performance,” promotes sustainability in the Federal Government and sets priorities for the reduction of greenhouse gas emissions. Sustainability is integral to the HHS mission. Conducting our activities in a sustainable manner will benefit Americans today as well as secure the health and well-being of future generations of Americans. In carrying out the Executive Order, HHS will be a leader in promoting the co-benefits of sustainability to health and well-being. HHS efforts to reduce greenhouse gas emissions will protect our environment and the public’s health. Our operations produce greenhouse gases that are associated with negative health impacts resulting from alterations of our climate, ecosystems, food and water supplies, and other aspects of the physical environment. These gases and other air, water, and land contaminants are generated from energy production and use, employee travel and commuting, facility construction and maintenance, and mission activities, such as patient care and laboratory research. By helping to control greenhouse gas emissions, HHS will reduce other releases that directly impact health. For example, mercury released with greenhouse gases from the combustion of fossil fuels in power plants may contribute to the reduced cognitive ability of children in surrounding areas. Research findings have also shown that air pollution is associated with higher rates of asthma and other allergic responses, morbidity from cardiopulmonary and respiratory disease, and other adverse health outcomes. By conserving resources through sustainable purchasing operations, management of real property and recapitalization of building infrastructure and waste management positions, HHS can meet its mission while managing costs. Operational efficiencies, such as reductions in paper, water, and energy use, allow more resources to be devoted to mission-specific purposes. Managing waste reduces the level of toxins that enter water sources and food chains. Reuse and recycling efforts can reduce the amount of land devoted to landfills and raw material extraction. Protecting plant and animal species ensures biodiversity, maintains delicate ecosystems, and offers the potential to use these as sources of new medical treatments. Sustainable facilities improve the health of our staff, patients, and other building occupants. Worker absenteeism, acute disease, and chronic diseases are associated with stressors and pollutants in the indoor environment. Ventilation improvements and green cleaning and pest management practices can reduce the adverse health effects of toxic chemicals in the environment... To integrate sustainability into the HHS mission and to implement Executive Order 13514, HHS agencies and offices will employ the following key strategies.

Objective Strategy 4.D.1: Energy Consumption & Greenhouse Gas

Reduce energy consumption and greenhouse gas emissions through sustainable management of energy use and other activities

Objective Strategy 4.D.2: Conservation

Conserve resources through sustainable purchasing, operations, and waste management

Objective Strategy 4.D.3: Human & Environmental Health

Promote and protect human and environmental health through sustainability planning and operations

Objective Strategy 4.D.4: Leadership, Communication & Engagement

Lead, communicate, and engage the community on the benefits of sustainability in all policies and actions

Objective Strategy 4.D.5: Research

Support research on the relationship between sustainability and human health and well-being.


Goal 5: Infrastructure & Workforce

Strengthen the Nation’s Health and Human Service Infrastructure and Workforce

Stakeholder(s):

Physicians

Nurses

Behavioral Health Workers

Long-Term Care Workers

Public Health Professionals

Human Service Professionals

Peer Mentors

Recovery Coaches

Care Managers

Primary Care Physicians

Physician Assistants

Mental Health Providers

Dentists

State Governments

Local Governments

Tribal Governments

Health Centers

Healthcare Providers

Policymakers

Healthcare Consumers

Objective(s):

5.A: Workforce

Strategy 5.A.1: Recruitment, Hiring & Retention

Strategy 5.A.2: Innovation, Opportunity & Success

Strategy 5.A.3: Wellness

Strategy 5.A.4: Resources & Accountability

Strategy 5.A.5: Commissioned Corps

5.B: Healthcare Workforce Demands

Strategy 5.B.1: Monitoring & Assessment

Strategy 5.B.2: Workforce Needs

Strategy 5.B.3: Underserved Communities

Strategy 5.B.4: Oral Healthcare

Strategy 5.B.5: Training & Practice

Strategy 5.B.6: Cultural & Linguistic Needs

Strategy 5.B.7: Primary Care & Behavioral Health Capacity

Strategy 5.B.8: Training & Collaboration

Strategy 5.B.9: Geriatrics Education & Training

5.C: Public Health

Strategy 5.C.1: Surveillance & Laboratory Capacity

Strategy 5.C.2: States, Tribes, Urban Indians, Localities & Territories

Strategy 5.C.3: Health Incidents

Strategy 5.C.4: Health Threats

5.D: Human Service Workforce

Strategy 5.D.1: Recruitment & Retention

Strategy 5.D.2: Training & Professional Development

Strategy 5.D.3: Head Start / Early Head Start

Strategy 5.D.4: Training, Education & Technical Assistance

Strategy 5.D.5: Cultural Competence

Strategy 5.D.6: Evidence-Based Practices

Strategy 5.D.7: Data & Evaluation

5.E: Surveillance & Epidemiology Capacity

Strategy 5.E.1: Outpatient Clinical Settings

Strategy 5.E.2: Information Technology

Strategy 5.E.3: Laboratory Capacity

Strategy 5.E.4: Chemical Laboratory Capacity

Strategy 5.E.5: Laboratory Technology

Strategy 5.E.6: Data Access & Sharing

Strategy 5.E.7: HIV


Other Information:

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.

Objective 5.A: Workforce

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

Stakeholder(s):

HHS Workforce

USPHS Commissioned Corps: As one of the seven Uniformed Services of the United States, the USPHS Commissioned Corps is a specialized career system designed to attract, develop, and retain health professionals who may be assigned to federal, state, local, tribal, and urban Indian organization agencies or international organizations. The mission of the Commissioned Corps is to protect, promote, and advance the health and safety of our Nation. The Commissioned Corps achieves its mission through rapid, effective response to public health needs, leadership and excellence in public health practices, and the advancement of public health science, including onsite support and services during natural and manmade disasters. HHS will continue to invest in the Commissioned Corps to improve healthcare services to medically underserved populations; prevent and control disease and identify and correct health hazards in the environment; promote healthy lifestyles for the Nation's citizens; improve the Nation's mental health; ensure that drugs and medical devices are safe and effective; conduct biomedical, behavioral, and health services research; and work with other nations on global health problems and their solutions.

Federal Agencies

State Agencies

Local Agencies

Tribal Agencies

Urban Indian Organization Agencies

International Organizations

IHS: Other health and human service agencies, including IHS, are also working diligently to improve capacity to meet America’s health and human services needs now and in the future.

Other Information:

The United States has overcome challenges in our history because men and women of good will, keen minds, and strong hearts have always stepped forward to aid their Nation through service, both in civilian government and in our Uniformed Services. The Civil Service of today carries forward that proud American tradition. Whether it is defending our homeland, restoring confidence in our financial system and administering a historic economic recovery effort, ensuring adequate health care for our veterans and fellow citizens, or searching for cures to the most vexing diseases, we are fortunate to have our best and our brightest engaged in these efforts. People are our most important resource for facing any challenge. HHS is engaging in a variety of activities to strengthen its human capital and to address challenges in recruitment and retention with a specific emphasis on workforce diversity and succession planning. HHS is focusing on human capital development to inspire innovative approaches to training, recruitment, retention, and ongoing development of Federal workers. Combined with a focus on opportunities to align multiple training programs supported by HHS, the Department will enhance its capacity to address current and emerging challenges. HHS also is developing a culture of wellness among its employees. HHS has launched an enhanced, comprehensive and integrated health and wellness program, modeled after best practices in private industry; this program seeks to reduce health risks and improve productivity among its employees... All HHS agencies and offices are committed to investing in its workforce through the following key strategies.

Objective Strategy 5.A.1: Recruitment, Hiring & Retention

Recruit, hire, and retain a talented and diverse HHS workforce that is representative of the American people HHS serves, by promoting innovative and coordinated approaches to recruiting, hiring, training, and retaining students, mid-career professionals, and retirees to meet agency talent needs, and helping veterans and individuals with targeted disabilities identify skills that match Federal opportunities

Objective Strategy 5.A.2: Innovation, Opportunity & Success

Create a climate of innovation, opportunity, and success within HHS that capitalizes on the cultural, professional, ethnic, and personal diversity of our workforce and strengthen all segments of the multigenerational workforce

Objective Strategy 5.A.3: Wellness

Create a culture of wellness across HHS by assessing existing onsite health and wellness programs, and develop plans to expand and enhance programs across HHS that meet established Healthy People 2020 objectives for comprehensive worksite wellness programs and best practices in the industry

Objective Strategy 5.A.4: Resources & Accountability

Ensure the HHS workforce and its leaders are fully accountable, fairly appraised, and have the tools, systems, and resources to perform at the highest levels to achieve superior results

Objective Strategy 5.A.5: Commissioned Corps

Recruit and retain Commissioned Corps officers and other emergency response personnel to provide ongoing health care, and train and equip them to respond to emerging public health threats so that they can improve response operations to medical emergencies and urgent public health needs.

Stakeholder(s):

Commissioned Corps Officers

Emergency Response Personnel

Objective 5.B: Healthcare Workforce Demands

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

Stakeholder(s):

CMS: HHS supports health workforce training efforts across the educational spectrum. CMS now makes the largest financial investment in the health professions workforce through supporting the graduate medical education of physicians. CMS also uses various payment incentives to help encourage providers to practice in underserved areas.

HRSA : HRSA and IHS offer programs that provide scholarships and loan repayment in exchange for employment in underserved areas. HRSA also provides support to medical, nursing, and other health professional schools to improve specialty and geographic distribution and to encourage innovation in the education and training of the health professions workforce.

IHS : IHS also supports programs to increase the numbers of AI/AN health professionals through its scholarship program and grants to educational institutions for the Indians into Medicine, Indians into Nursing, and Indians into Psychology programs and through the operation of extern programs to allow IHS scholarship recipients and other AI/AN health professional students to obtain real-world clinical experience with IHS and tribal health professionals in their chosen disciplines.

AI/AN Health Professional Students

Health Care Workforce Commission: The Affordable Care Act authorizes many new activities and modifications to existing activities related to the Nation’s current workforce challenges. Its provisions affect agencies and offices across the Department. The Affordable Care Act authorized the creation of the independent Health Care Workforce Commission, to guide the identification and resolution of workforce issues across the Federal Government. Through its interactions with the Commission, the Department’s workforce programs and issues have new public prominence. Another requirement of the Affordable Care Act is the opportunity to develop demonstration projects to address the needs of the healthcare profession. ACF is funding projects that provide TANF recipients and other low-income individuals with training that will prepare them to enter and advance in the healthcare sector. These training programs will prepare participants for employment within the healthcare sector in positions that pay well, and will provide employment in areas that are expected either to experience labor shortages or to be in high demand or in remote or isolated rural communities.

Other Information:

The factors placing demands on our healthcare workforce include the aging of the Nation’s population, accompanied by a greater burden of chronic disease; an increasingly diverse population; the need to incorporate scientific advances into standard medical practice; and the challenge of translating healthcare reform into effective access to care, particularly for the newly insured. In addition, while the movement toward electronic health records holds the promise of improving both the quality and the efficiency of care over the long term, transitions will require support for successful implementation. These challenges play out against a backdrop of persisting problems. Our health professions workforce is not well-distributed geographically. Too many areas find themselves without needed physician, dentists, and behavioral health and other healthcare professionals. Rural and remote areas face the difficulties of low population density and long distances to care, which are especially problematic in Indian Country. Despite the need for greater primary care capacity, physicians are apt to choose other specialties—in part, because educational debt levels have grown and primary care and behavioral health practitioners have lower incomes compared with most specialists. The composition of our health professions workforce does not reflect that of the Nation racially or ethnically. There are chronic shortages in some health professions and intermittent shortages in others. Direct care and personal care workers are in short supply, and have demanding jobs, low wages, and limited opportunities for professional growth. Finally, data on the health professions workforce are limited and scattered as are analytic tools for workforce modeling, planning, and policy development... Within HHS, ACF, CMS, HRSA, IHS, SAMHSA, and others are working on this objective. The following key strategies will be implemented to ensure that the Nation’s healthcare workforce can meet increased demands.

Objective Strategy 5.B.1: Monitoring & Assessment

Improve HHS’s ability to monitor and assess the adequacy of the Nation’s health professions workforce in shortage areas and in those smaller communities likely to experience health professional shortages

Stakeholder(s):

Smaller Communities

Objective Strategy 5.B.2: Workforce Needs

Implement strategies to address the Nation’s workforce needs following health reform and the reauthorization of the Indian Health Care Improvement Act and to evaluate their effectiveness

Objective Strategy 5.B.3: Underserved Communities

Explore ways to meet expanding health and human service needs in underserved communities by training and making full use of all health professionals and telelink technologies, expanding the primary care teams, and promoting models that incorporate new providers and interagency collaborations

Stakeholder(s):

Underserved Communities

Objective Strategy 5.B.4: Oral Healthcare

Expand the primary oral healthcare team and promote models that incorporate new providers, expanded scope of existing providers, and utilization of medical providers to provide evidence-based oral health preventive services, where appropriate

Objective Strategy 5.B.5: Training & Practice

Promote interprofessional training and team-based practice to assure quality care

Objective Strategy 5.B.6: Cultural & Linguistic Needs

Address persisting problems of workforce shortages, lack of diversity, maldistribution, and lack of access to care that meets cultural and linguistic need

Objective Strategy 5.B.7: Primary Care & Behavioral Health Capacity

Build primary care and behavioral health capacity, especially in underserved areas, remote and isolated rural areas, and among groups underrepresented in the health professions, through the focused use of scholarship and loan repayment programs as well as extern, intern, fellow, and other training and experiential opportunities.

Stakeholder(s):

Underserved Areas

Remote Areas

Rural Areas

Externs

Interns

Fellows

Objective Strategy 5.B.8: Training & Collaboration

Expand community-based, interprofessional/interdisciplinary training opportunities; and increase collaboration of health career pipeline outreach activities, with special emphasis to reach underrepresented minority students and economically or educationally disadvantaged students

Stakeholder(s):

Underrepresented Minority Students

Economically Disadvantaged Students

Educationally Disadvantaged Students

Objective Strategy 5.B.9: Geriatrics Education & Training

Ensure that all health professions students, faculty, and practitioners, direct services workers, and lay and family caregivers receive high quality interprofessional education and training in geriatrics to meet the needs of an aging population and promote access to quality geriatric health care and services.

Stakeholder(s):

Health Professions Students

Health Professions Faculty

Healthcare Practitioners

Healthcare Services Workers

Lay Caregivers

Family Caregivers

Objective 5.C: Public Health

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

Stakeholder(s):

Public Health Workforce

ASPR: Within HHS, ASPR is working to support the PAHPA mandate to examine gaps in an effective and prepared public health workforce, identify ways to develop a sustainable workforce, and keep them protected during emergencies.

CDC: The Affordable Care Act establishes new programs to support training of entry-level and mid-career public health professionals in Government service at the federal, state, local, and tribal levels. The Affordable Care Act also authorizes expansion of existing CDC workforce programs that contribute to the public health ranks in the areas of epidemiology, laboratory science, and informatics.

National Health Service Corps: And the Affordable Care Act provides substantial new funding for the National Health Service Corps.

Other Information:

For at least a decade, the United States has experienced worsening workforce shortages in the public health professions. Predicted personnel shortages in research, information sciences, health promotion, preparedness, epidemiology, and the laboratory sciences will affect critical core public health capacities. The current public health workforce is inadequate to meet the needs of the U.S. population and shortages are predicted to reach 250,000 by 2020. Differences in the training requirements, goals, and objectives of varied public health programs reduce the flexibility of the public health workforce and its ability to serve in different settings. As a result, a need exists for greater standardization in curricula and more clearly defined objectives. Workforce issues also are critical to improve global public health capacity and to minimize global health threats that may affect Americans here at home. With the global nature of disease and illness, greater public health capacity is needed to support health diplomacy activities, detect and contain emerging health threats, and respond rapidly to outbreaks and other health incidents. The emergence of new and more virulent virus strains, inadequate sanitation, and global migration are among the factors stretching our public health workforce... ASPR, CDC, HRSA, IHS, NIH, OASH, and SAMHSA are working to achieve this objective through the following key strategies.

Objective Strategy 5.C.1: Surveillance & Laboratory Capacity

Build public health capacity to detect threats and improve health through improved public health surveillance and laboratory capacity

Objective Strategy 5.C.2: States, Tribes, Urban Indians, Localities & Territories

Support public health at the state, tribal, urban Indian, local, and territorial levels to increase the public health workforce

Stakeholder(s):

States

Tribes

Urban Indians

Localities

Territories

Objective Strategy 5.C.3: Health Incidents

Promote efforts to ensure the health workforce is ready to respond to major health incidents

Stakeholder(s):

Health Workforce

Objective Strategy 5.C.4: Health Threats

Act in concert with other U.S. Government agencies and global partners to address common public health threats throughout the world, enhance capacities to detect and respond to these threats, and learn from each other’s experiences.

Stakeholder(s):

U.S. Government Agencies

Global Health Partners

Objective 5.D: Human Service Workforce

Strengthen the Nation’s human service workforce

Stakeholder(s):

Human Service Workforce

Child Care Administrators: HHS is working to strengthen the human service workforce and improve the quality of human services through training and technical assistance; strategic use of data, monitoring, and evaluation efforts; collaboration with other agencies; and the promotion of evidence-based practices. For example, child care administrators are using expanded Child Care and Development Fund (CCDF) resources to provide professional development opportunities for child care teachers to enhance the quality of child care.

ACF: ACF and HRSA are dedicated to strengthening the Nation’s human service workforce through the following key strategies.

HRSA

Other Information:

The Nation’s human service workforce serves some of the most vulnerable populations in the United States. These workers can be found in early childhood and afterschool programs; domestic violence and child protection services; programs for individuals, youth, and families experiencing homelessness; teen pregnancy prevention programs; care for older adults; programs addressing behavioral health issues, including mental illness and substance abuse; and a range of other community-based services. Human service workers promote economic and social self-sufficiency and the healthy development of children and youth. In addition to the difficulty of addressing the complex issues of individuals, families, and communities, the human service workforce faces a number of challenges: high staff turnover rates, poorly developed or undefined core competencies and professional development guidelines, and unclear compensation expectations and career trajectories. Both demographic changes and the recent economic recession are impacting efforts to improve the well-being of Americans. As our population ages, the percentage of people ages 18 to 64 is expected to decline, shrinking the potential supply of human service workers. The population is growing more racially and ethnically diverse, reinforcing the need to equip the human service workforce with the necessary cultural and linguistic skills to be responsive to all Americans’ needs. And finally, as the Nation recovers from the economic recession, we face challenges of securing economic and housing stability for large numbers of families while also strengthening the capacity of the human service safety net.

Objective Strategy 5.D.1: Recruitment & Retention

Promote recruitment and retention strategies that attract qualified, competent, and diverse professionals to the human service workforce

Stakeholder(s):

Human Service Workforce

Objective Strategy 5.D.2: Training & Professional Development

Work with states to develop systems for the training and ongoing professional development of early childhood educators through the Race to the Top -- Early Learning Challenge and through enhanced professional development opportunities for child care professionals in states

Stakeholder(s):

Early Childhood Educators

Child Care Professionals

Objective Strategy 5.D.3: Head Start / Early Head Start

Build the capacity of staff in local Head Start / Early Head Start programs to deliver high-quality, evidence-based services to children and families through the redesigned Training and Technical Assistance system

Stakeholder(s):

Head Start Staff

Early Head Start Staff

Children

Families

Objective Strategy 5.D.4: Training, Education & Technical Assistance

Promote training, cross-system training, continuing education, and technical assistance for human service personnel to help them develop core competencies

Stakeholder(s):

Human Service Personnel

Objective Strategy 5.D.5: Cultural Competence

Improve the cultural competence of the Nation’s human service workforce

Stakeholder(s):

Human Service Workforce

Objective Strategy 5.D.6: Evidence-Based Practices

Foster the use of evidence-based practices in human services to professionalize the field

Objective Strategy 5.D.7: Data & Evaluation

Use data and evaluation in human service programming to inform professional development and future practice.

Objective 5.E: Surveillance & Epidemiology Capacity

Improve national, state, local, and tribal surveillance and epidemiology capacity

Stakeholder(s):

CDC : Responsibility for these activities rests with several HHS agencies. CDC is the lead agency for HHS that provides funding and technical assistance to states and localities, and provides capacity at the national level to ensure that links across entities work effectively together.

States

Localities

ASPR: Other HHS agencies and offices, including ASPR, FDA, IHS, NIH, and SAMHSA, are working to realize this objective through the following key strategies.

FDA

IHS

NIH

SAMHSA

Other Information:

Three critical elements underpin public health practice: surveillance, epidemiology, and laboratory services. Carrying out these activities requires quality data and specimen collection, evidence-based epidemiology, and adequate laboratory services across the national, state, local, and tribal departments and organizations that make up the Nation’s public health infrastructure. These services enable the public health field to detect emerging threats, monitor ongoing health issues and their risk factors, and identify and evaluate the impact of strategies to prevent disease and promote health. To achieve this objective, HHS is working to strengthen surveillance systems at the national, state, local, and tribal levels, including the monitoring of healthcare quality to ensure that best practices are used to prevent and treat the leading causes of death and disability. HHS is working toward a robust data system that provides data, feedback, and tools directly to national, state, local, and tribal health agencies, urban Indian organizations, and healthcare facilities to improve practices— and thus, health. A data system for public reporting and using electronic data sources for data collection and prevention will enhance the ability of the United States to monitor trends in critical health measures among priority populations; monitor health status, health care, and health policy concerns at the national, state, local, and tribal levels; and conduct in-depth studies of population health at the community level and for specific subpopulations.

Objective Strategy 5.E.1: Outpatient Clinical Settings

Improve surveillance in outpatient clinical settings to identify sources and control of healthcare-associated infections

Stakeholder(s):

Outpatients

Objective Strategy 5.E.2: Information Technology

Implement cutting-edge information technology solutions that support rapid, secure, and accurate information exchange; diverse types of information; and linking of information among local, state, tribal and urban Indian, and federal public health agencies, healthcare facilities, and laboratories

Stakeholder(s):

Local Health Agencies

State Health Agencies

Tribal Health Agencies

Urban Indian Health Agencies

Federal Public Health Agencies

Healthcare Facilities

Laboratories

Objective Strategy 5.E.3: Laboratory Capacity

Enhance and sustain nationwide and international laboratory capacity to gather, ship, screen, and test specimen samples for public health threats and to conduct research and development that lead to interventions for such threats

Stakeholder(s):

Laboratories

Health Laboratories

Objective Strategy 5.E.4: Chemical Laboratory Capacity

Work with public health laboratories in states, territories, tribal and urban Indian organizations, cities, and counties to assist them in expanding their chemical laboratory capacity to prepare and respond to chemical terrorism incidents or other emergencies involving chemicals

Stakeholder(s):

Health Laboratories: in states, territories, tribal and urban Indian organizations, cities, and counties

Objective Strategy 5.E.5: Laboratory Technology

Build and enhance state and local laboratory capacity by providing funding to purchase and maintain state-of-the-art laboratory technology

Stakeholder(s):

State Laboratories

Local Laboratories

Objective Strategy 5.E.6: Data Access & Sharing

Increase access to and sharing of data, and support for epidemiology programs at the state, local, and tribal government levels and by urban Indian organizations and other partners

Stakeholder(s):

Epidemiology Programs: at the state, local, and tribal government levels and by urban Indian organizations and other partners

Objective Strategy 5.E.7: HIV

Build epidemiology, surveillance, and laboratory capacity, and support monitoring and evaluation systems that measure HIV prevalence and incidence, behavior change, and population health status.

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