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Performance and Accountability Report
Fiscal Year 2003
MESSAGE FROM THE SECRETARY
In 2003, the U.S. Department of Health and Human Services (HHS) marked its 50th anniversary as a cabinet-level agency. The change and growth we have experienced in those 50 years is enormous. In terms of budget and programs, we have become the largest department in the Federal Government, with almost a quarter of total federal outlays. We administer more grant dollars than all other federal agencies combined. Our Medicare program processes more than 1 billion claims per year. Our Food and Drug Administration alone regulates products that represent 25 cents of every dollar in U.S. consumer spending. In so many ways, HHS is the federal agency that most affects Americans in their everyday lives.
In the 21st century, the pace of change seems sure to grow even faster and with it, the Department's responsibilities. We are at the vanguard of a revolution in biomedical research and development. We havespecial new responsibilities in protecting Americans from terrorism. Globalization demands new approaches in many health and social programs. And at the same time, we are at the dawn of an unprecedented growth in the number and proportion of our older population as the baby boomers age. All of these trends, and more, are creating new and urgent demands.
This annual report is a snapshot of the Department in motion. It shows how HHS is responding to our special missions in public health as well as service to those in need. It also reflects our longer-range efforts to meet the great scientific, fiscal, and management challenges that lie ahead.
In fiscal year 2003, HHS was responsible for $505 billion in net outlays. In the area of financial management, we achieved our fifth consecutive unqualified or "clean" audit opinion on the Department's consolidated financial statements. We continued vigorous efforts to ensure that America is prepared for any terrorist attack, especially the possibility of bioterrorism. These efforts also helped strengthen our public health system for coping with natural disease outbreaks, as we saw in the strong response to Severe Acute Respiratory Syndrome (SARS) in 2003. Moreover, we increased support for disease prevention, especially to help Americans understand the steps they can take to improve their own health. We took new steps in improving the quality of health care and patient safety, and we pursued new avenues for modernizing and strengthening Medicare. We also continued the build-up of our nation's community health centers, providing care especially to those without adequate health insurance.
It is my assertion that the financial information contained in this report is complete and reliable, based upon data contained in the Department's and Medicare contractors' financial information systems, and is reported in conformance with U.S. generally accepted accounting principles. Further, the financial statements have been deemed to "fairly represent" the financial condition and results of operations of the Department by our Office of Inspector General. It is also my assertion that the program performance information contained in this report is complete and reliable, based on information from the HHS component organizations.
This report includes information that satisfies the reporting requirements for the Federal Managers' Financial Integrity Act (FMFIA) of 1982. HHS's management controls are in compliance with FMFIA and provide reasonable assurance that the Department's resources are protected from fraud, abuse, and mismanagement. Our financial management information systems and reporting processes, as well as our Medicare contractor systems, are not in conformance with FMFIA. Our systems implementation projects discussed in this report - including a new Medicare financial system - provide for long-term achievement of compliance with FMFIA. In Appendix D of this report, we present the complete FMFIA report.
Given our broad and diverse missions, we have a special responsibility to be accountable for the funds we manage and for achieving results. We have established long-term strategic goals to help steer our efforts on behalf of Americans. The report is structured in accordance with our strategic goals allowing our customers and stakeholders to track our performance more clearly.
I welcome your interest in this report. As HHS embarks on its next 50 years, we must be prepared for rapid change and difficult demands. With all of the 65,000 employees of this Department, I pledge our continued dedication, hard work, high standards and measurable results.
/s/
Tommy G. Thompson
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