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FY 2006 Budget in BriefDepartmental ManagementOn this page: Departmental Management Overview Table
Departmental ManagementThe office of Department Management supports the Secretary in his role as chief policy officer and general manager of the Department. Departmental Management (DM) includes funding for four appropriation accounts in the Office of the Secretary: General Departmental Management (GDM); Health Information Technology; Medicare Hearings and Appeals; and Public Health and Social Services Emergency Fund (PHSSEF). The FY 2006 budget request for GDM provides a total program level of $404 million, including appropriations of $359 million, interagency transfers of $40 million in evaluation funds (including $18 million in evaluation funds from the former Policy Research account), and $5 million in health care fraud and abuse funds. The FY 2006 DM request also reflects funding for two new appropriation accounts: Health Information Technology, including appropriations of $75 million and interagency transfers of $3 million in evaluation funds; and funding of $80 million for Medicare Hearings and Appeals. The FY 2006 DM budget request also includes a total of $2.4 billion for the PHSSEF account. Health Information TechnologyThe FY 2006 budget request includes a total of $78 million for Health Information Technology (IT). The Office of the National Coordinator for Health Information Technology (ONCHIT) was created in April 2004 by Presidential Executive Order, to address strategic planning, coordination, and analysis related to key technical, economic and other issues surrounding the public and private adoption of Health IT. This request will support ONCHIT's efforts to coordinate Federal efforts across many initiatives and activities, including:
The FY 2006 budget request will enable ONCHIT to provide strategic direction for a national interoperable health care system, and to encourage clinicians to connect and collaborate within a national Health IT network. The Administration also plans to propose expansion of the Department's Health IT investment in FY 2005. The National Coordinator will work with the Agency for Healthcare Research and Quality (AHRQ) and the National Library of Medicine to develop regional collaborations for the deployment of interoperable applications, and to accelerate the development of standards and prototypes. In addition to funds requested within Departmental Management for Health IT, the FY 2006 request for AHRQ includes $50 million to advance the use of Health IT to enhance patient safety. Medicare Hearings and AppealsThe FY 2006 budget request includes $80 million in Medicare Trust Funds to support a new Office of Medicare Hearings and Appeals (OMHA), as mandated by the Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA). MMA transferred responsibility for hearing Medicare appeals at the Administrative Law Judge (ALJ) level - the third level of Medicare claims appeals - from the Social Security Administration to the Office of the Secretary at HHS by no later than October 1, 2005. The Medicare Benefits Improvement and Protection Act of 2000 (BIPA) also mandated that ALJ appeals be heard within 90 days after receipt of a request from a Medicare appellant for such a hearing. To be able to meet this timeframe, OMHA plans to invest heavily in technology and to utilize video-teleconferencing (rather than face-to-face hearings) for the majority of cases. General Departmental ManagementThe GDM account supports those activities associated with the Secretary's roles in administering and overseeing the organization, programs, and activities of the Department. These activities are carried out through 15 Staff Divisions (STAFFDIVs). The GDM budget request for FY 2006 totals $404 million, a decrease of $15 million or 4 percent below the comparable FY 2005 level. The GDM request provides funding for the following activities: Office of Population Affairs (OPA)/Adolescent Family Life: The Adolescent and Family Life (AFL) request of $31 million will continue to provide support for the AFL demonstration and research program authorized under Title XX of the Public Health Service (PHS) Act. Through the grants awarded under this program, AFL provides funding in three areas: care demonstration projects, prevention projects, and research projects. This request includes $13 million in abstinence-only prevention projects, as defined by the Welfare Reform legislation (P.L. 104-193). Further, OPA also administers the Family Planning program under Title X of the PHS Act, which is funded through the Health Resources and Services Administration (HRSA). Office of Minority Health: The Office of Minority Health request of $47 million, a $3 million decrease from FY 2005, will provide funding to continue disease prevention, health promotion, service demonstration, and educational efforts that focus on health concerns that cause the high rate of death in racial and ethnic minority communities. The reduction is attributed to FY 2005 Congressional earmarks which are not continued in FY 2006. Office on Women's Health: The Office on Women's Health request of $29 million, the same as FY 2005, will provide funding to continue the advancement of women's health programs through the promotion and coordination of research, service delivery, and education - both throughout HHS agencies and offices, with other government organizations, and with consumer and health professional groups. Minority HIV/AIDS: The FY 2006 request includes $52 million, the same level as FY 2005, to support innovative approaches to HIV/AIDS prevention and treatment in minority communities heavily impacted by this disease. These funds allow the Department to continue priority investments and public health strategies targeted to reduce the disparities and burden of HIV/AIDS in racial and ethnic minority populations. Information Technology Security and Innovation Fund: The FY 2006 budget request includes $15 million to continue funding for the IT Security and Innovation Fund. Projects funded through the IT Security and Innovation Fund focus on HHS enterprise-wide investments, notably: enterprise architecture, key E-Government projects, HHS common IT infrastructure services, and security and infrastructure to enable HHS common administrative systems. Afghanistan: Included in the FY 2006 request for the Office of Global Health Affairs is $6 million to continue support of HHS health care initiatives in Afghanistan, particularly in the areas of maternal and child health. Embryo Adoption Awareness Campaign: Included in the President's Budget request for the first time is $1 million to continue the Embryo Adoption pubic awareness campaign grant award program. The purpose of the campaign is to educate Americans about the existence of frozen embryos (resulting from in-vitro fertilization) which are available for adoption. Other General Departmental Management: The FY 2006 budget request includes $178 million to fund offices which provide leadership, policy, legal, and administrative guidance to HHS components. One of the offices included in Other GDM is the Office on Disability (OD). Established in 2002 in support of President Bush's New Freedom Initiative, OD has been charged to: lead the HHS New Freedom Initiative; oversee, coordinate, develop and implement disability programs and initiatives within HHS that affect persons with disabilities; ensure that persons of every age with disabilities have a voice within HHS; and heighten the interaction of programs within HHS and with Federal, State, community and private sector partners. Public Health and Social Services Emergency Fund and BioterrorismThe FY 2006 request funds HHS bioterrorism and other emergency preparedness activities in two ways. The Public Health and Social Services Emergency Fund (PHSSEF) provides $2.4 billion for pandemic influenza preparedness and bioterrorism efforts in the Centers for Disease Control and Prevention, the Health Resources and Services Administration, the Office of the Secretary, and targeted countermeasure research at the National Institutes of Health. Direct appropriations are also provided to NIH and the Food and Drug Administration for their bioterrorism efforts. Bioterrorism: The HHS FY 2006 request includes $4.2 billion for bioterrorism, a net increase of $154 million above FY 2005. Of the total, $2.3 billion is funded through the PHSSEF, and $1.9 billion through NIH and FDA accounts. The FY 2006 budget supports thr new Federal Mass Casualty Initiative, a model emergency response demonstration, a new chemical countermeasures research initiative, and expanded procurement funding for the Strategic National Stockpile (SNS). Mass Casualty Initiative The FY 2006 President's Budget includes $70 million within HHS for a new Federal Mass Casualty Initiative. Since FY 2002, HRSA has funded work to expand state and local hospital capacity to treat mass casualties. This new initiative reflects the concern that local medical systems will need added assistance in the case of an attack involving the use of weapons of mass destruction. The FY 2006 request includes a three-pronged effort. First, the request for the SNS includes $50 million in new funding for the purchase, maintenance, and operation of portable hospital units that can be deployed to increase hospital surge capacity in the event of a bioterrorist attack. Second, the Medical Reserve Corps (MRC) budget includes an increase of $12.5 million for a total of $22 million. The MRC is the Citizen Corps component that organizes local volunteers to assist regular medical response professionals and facilities during a large-scale local emergency. Finally, $7.5 million will finance the development and updating of systems designed to rapidly access credentialing information on healthcare providers in an emergency. These systems will be able to obtain data from federal, state, and non-government sources, including the State-based Emergency System for Advance Registration of Volunteer Healthcare Personnel. Strategic National Stockpile The FY 2006 President's Budget includes $600 million for the Strategic National Stockpile (SNS), an increase of $203 million above FY 2005. This increase includes $50 million for the purchase of portable mass casualty treatment units. In addition to housing these new units, the SNS finances the procurement of commercially available countermeasures, such as anthrax antibiotics to cover 60 million people, and the replacement of pharmaceuticals and supplies that have lost potency. This appropriation also includes funding for specialized facilities needed to store SNS and BioShield procured countermeasures, including enough smallpox vaccine for every American. Finally, funds are necessary to maintain the capacity to move SNS assets anywhere in the U.S. within 12 hours and to provide technical assistance to State and local governments participating in the Cities Readiness Initiative; this initiative seeks to upgrade their ability to provide anthrax antibiotics to all residents within 48 hours of an anthrax event. National Institutes of Health The FY 2006 request for the National Institutes of Health (NIH) biodefense activities totals $1.8 billion, a net increase of $56 million, or 3.2 percent, above FY 2005. Within this amount, research and development funding will increase $175 million, partially offset by a $119 million reduction in extramural laboratory construction funding. Of the NIH total, $97 million is budgeted in the PHSSEF to develop countermeasures against chemical, nuclear, and radiological threats. NIH will use $47 million to continue work initiated in FY 2005 on nuclear and radiological countermeasures. In FY 2006, the President's Budget includes an additional $50 million to complement this work with a new targeted research effort to expand the current range of chemical countermeasures. Of the funds directly appropriated to NIH, $1.7 billion will fund basic research addressing both naturally occurring threats and the risk of biotechnology advances leading to engineered or modified organisms that could evade current medical countermeasures or enhance their virulence. These research efforts will focus on the biology of microbial agents with bioterrorism potential, the properties of the host's response, and applied research and advanced development of new or improved diagnostics, vaccines, and therapies. A complementary investment of $30 million is requested to expand extramural laboratory capacity to conduct biodefense research. This additional funding raises the five-year NIH investment total to $1 billion for the construction of intramural and extramural biodefense facilities. Food Defense The budget for FDA includes $244 million for bioterrorism activities. This total includes $180 million for food defense, an increase of $30 million above FY 2005. This request includes $20 million to increase analytic surge testing capacity for biological, chemical, and radiological threat agents for the Food Emergency Response Network (FERN), $6 million for research, and $1 million to continue development of an Emergency Response and Operations Network. Finally, FDA will use $3 million, for a total of $5 million, to coordinate food surveillance activities within the Biosurveillance Initiative. HRSA Curriculum Development and Education The request maintains the FY 2005 level of $28 million. The Bioterrorism Training and Curriculum Development program is designed to provide bioterrorism-related continuing education and training opportunities for practicing health care providers and support for new emergency preparedness curricula in health professions schools. State and Local Preparedness CDC and HRSA continue to demonstrate a strong commitment to preparing States and local public health departments and hospitals to prepare against public health emergencies and acts of bioterrorism. A total of $6.7 billion will have been invested between FY 2002 and FY 2006. The FY 2006 request includes $1.3 billion for this work, including $25 million for one or more competitive grants for a model emergency response demonstration. This net reduction of $138 million reflects the targeting of resources to direct Federal efforts, including portable mass casualty treatment capacity that can assist any State and expanded countermeasure readiness. HHS will also re-evaluate State and local preparedness funding formulas in an attempt to assure that allocations reflect risk and performance. Upgrading CDC Capacity and Anthrax Research The FY 2006 request includes $140 million for upgrading CDC capacity. With these funds, CDC will continue to improve epidemiological expertise in the identification and control of diseases caused by terrorism, including better electronic communication, distance learning programs, and cooperative training between public health agencies and local hospitals. This request provides support for upgrading capacity at CDC, national planning efforts, oversight of inter-laboratory transfers of dangerous pathogens and toxins, and laboratory safety inspections. No funding is earmarked for research on older anthrax vaccines, as the project is nearing completion; funds were redirected into the Strategic National Stockpile. Office of the Secretary The FY 2006 request for the PHSSEF bioterrorism activities includes $81 million for the Office of the Secretary. This amount includes an increase of $20 million over FY 2005 to fund the new Mass Casualty Initiative discussed above, as well as: The President's Budget includes $41 million to support the Office for Public Health and Emergency Preparedness' (OPHEP) ongoing operations, including the Secretary's Emergency Response Team, and the International Early Warning Surveillance efforts. This appropriation also allows OPHEP to target advanced research projects and support the development of an effective risk communication and information strategy for the public. OPHEP also manages HHS's role in Project BioShield countermeasure needs analysis and is responsible for procuring these DHS-funded countermeasures for the SNS. Cybersecurity funding is maintained at $10 million in FY 2006 for cybersecurity. These funds continue to protect the Department's information technology infrastructure from cyber-terrorist attacks. These funds will provide continuous security monitoring for all HHS systems, assets, and services. Emergency PreparednessPandemic Influenza: The budget includes $120 million, an increase of $21 million, to ensure the Nation has the vaccine production capacity to respond to an influenza pandemic. It is normal for influenza strains to change slightly from year to year. When major changes occur to the influenza strain genetic structure, widespread disease and death can result. Three such global events - called pandemics - occurred in the 20th century. Such a pandemic could cause an additional 90,000 to 300,000+ deaths in the U.S., especially if adequate vaccines were not available quickly. Once a pandemic began, time would be critical in accomplishing necessary research, development, and delivery of vaccines required to mitigate the pandemic. The Department issued a draft Pandemic Influenza Response and Preparedness Plan in August, 2004. This plan lays out action steps in several areas. This appropriation is focused on expanding the year-round domestic vaccine surge production capacity that would be needed in a pandemic. It will finance contracts with vaccine manufacturers to develop and license influenza vaccines using new production techniques and establishing a domestic manufacturing capability. Second, HHS will continue to ensure a year-round supply of specialized eggs needed for domestic production of currently licensed vaccines. Moreover, manufacturers will be encouraged to license and implement new processing and other technologies to improve vaccine yields from both new cell culture vaccines and existing egg-based vaccines. In addition, HHS will sponsor development and licensing of antigen-sparing strategies that would increase the number of individuals who could be vaccinated from a given amount of bulk vaccine product. Finally, the budget maintains the flexibility to redirect these funds to initiate pandemic vaccine production at any time a pandemic appears imminent. Bioterrorism Overview Table
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Last revised: March 31, 2005
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