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Office of the Assistant Secretary for Planning and Evaluation |
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Policy Information Center |
MISSION: To provide advice on public health and science to the Secretary of Health and Human Services, to provide executive direction to program offices within the Office of Public Health and Science (OPHS), and, at the direction of the Secretary, to coordinate crosscutting public health and science initiatives in the Department.
Evaluation Program
The Office of Public Health and Science (OPHS) provides advice, policy and program coordination, and leadership in the implementation, management, and development of activities related to public health and science, as directed by the Secretary. OPHS helps HHS conduct broad-based public health assessments to better define public health problems and solutions. It assists other components of HHS in anticipating future public health issues and problems and helps ensure that HHS designs and implements appropriate approaches, interventions, and evaluations that will maintain, sustain, and improve the health of the Nation. OPHS provides leadership and policy recommendations on population-based public health and science and, at the Secretary's direction, leads or coordinates initiatives that cut across agencies and operating divisions. In addition, OPHS communicates and interacts, on behalf of the Secretary, with national and international professional and constituency organizations on matters of public health and science. Finally, OPHS's unique role allows it to use its resources to link important HHS programs or fill gaps in areas needing better policy formulation and coordination.
The FY 1999 OPHS evaluation strategy focuses on public health and science issues that cut across multiple interests of the operating divisions and requires a coordinated approach to achieve the most effective results. OPHS evaluations support the Surgeon General and the Assistant Secretary for Health in the respective roles as the Nations top doctor and senior advisor for public health and science to the Secretary. OPHS also conducts evaluations specific to the needs of the programs operated from the offices located within OPHS, such as Womens Health, Minority Health, Disease Prevention and Health Promotion, Research Integrity, and Emergency Preparedness. Some evaluation funds are made available to the ten HHS Regional Health Administrators. In keeping with its role within the Department, OPHS does not undertake evaluations more appropriately and effectively undertaken by operating divisions of HHS or by the Assistant Secretary for Planning and Evaluation (ASPE).
The purpose of this study was to 1) assess the nature and extent of the minority health infrastructure and capacity to address issues of health disparity, especially by race and ethnicity, in nine States, and 2) identify those factors that contribute to, or detract from, the establishment and sustained support for minority health entities at the State level. Site visits and in-depth interviews with key informants (including State legislators, health administrators, program directors, and community based organizations) were conducted in eight States and one territory. OMHs crosscutting and priority health issue areas were used as the basis for investigating the kinds of activities underway to address health disparities and to facilitate discussions regarding the factors that promote or hinder attention to such disparities. Findings showed that: 1) data on the health status of all racial and ethnic minorities are lacking; 2) membership in OMHs national Minority Health Network and participation in OMH conferences afford opportunities to learn about strategies to eliminate health disparities; 3) technical assistance on effective or promising strategies for eliminating health disparities would be beneficial; 4) minority health concerns often cross state boundaries and are regional in nature; 5) while primary responsibility for providing health care to members of Federally-recognized tribes rests with the Indian Health Service (IHS), with services administered by the tribes themselves, State health departments, nonprofit groups, and others also provide some health care to these and other AI/AN populations in their jurisdictions; and 6) the availability of resources devoted to addressing racial and ethnic health disparities is critical to the capacity to provide services for racial and ethnic minorities and to meeting the Healthy People 2010 goal of eliminating health disparities. Recommended strategies for addressing racial and ethnic health disparities at the State level included: launching an initiative to assist States in collecting, tracking, and disseminating health data by race/ethnicity; improving intra-and inter-organizational collaborations related to minority health; providing technical assistance to improve state health infrastructures related to policies, programs, and practices on health disparities; sponsoring a forum to ensure that efforts to provide health care to AI/AN populations is coordinated and complementary; and increasing funding for minority health initiatives at the state and local levels.
AGENCY SPONSOR:Office of Minority Health
FEDERAL CONTACT:Gerrie Maccannon, 301-443-5084
PIC ID:7013
PERFORMER: Office of Minority Health, Rockville, MD
Recommended Dietary Allowances (RDAs) are recognized as the most authoritative source of information on nutrient levels for healthy people. This new series of references extends the scope and application of previous nutrient guidelines. For each nutrient the book presents what is known about how the nutrient functions in the human body, what the best method is to determine its requirements, which factors (caffeine or exercise, for example) may affect how it works, and how the nutrient may be related to chronic disease. This volume presents information about thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, pantothenic acid, biotin, and choline. Based on analysis of nutrient metabolism in humans and data on intakes in the U.S. population, the Standing Committee on Dietary Reference Intakes recommends intakes for each age group--from the first days of life through childhood, sexual maturity, midlife, and the later years. This volume also makes recommendations for pregnant and lactating women and identifies when intake of a nutrient may be too much.
AGENCY SPONSOR: Office of Public Health and Science
FEDERAL CONTACT: Kathryn McMurry, 202-401-0751
PIC ID: 6323.1
PERFORMER: National Academy of Sciences, Institute of Medicine, Washington, DC
This paper examines the changing role of local health departments in environmental health protection and prevention, highlighting innovative programs in select health departments around the country. This paper is based on work performed under the study, Assessing Changes in Public Health Functions and Policy Issues. As part of this study, Mathematica Policy Research (MPR) conducted two rounds of site visits to 12 local health departments in communities throughout the country. Information was collected on the extent to which health departments were providing the 10 essential services of public health in various programmatic areas. In addition the environmental health director at each health department was interviewed to determine the extent to which each environmental health programs provides the 10 essential services. The results indicate the majority of the environmental health programs concentrate their resources in 2 of the 10 essential services: enforcement of environmental regulations and monitoring and surveillance. There are, however, three areas in which local health departments have been able to offer additional essential services by integrating traditional environmental services into a broader public health context. The first is through the expansion of community education and outreach and the second area is the community-based aspect of diagnosis and assessment of health hazards.
AGENCY SPONSOR: Office of Disease Prevention and Health Promotion
FEDERAL CONTACT: Matthew Guidry, 202-401-7780
PIC ID: 6325.1
PERFORMER: Mathematica Policy Research, Inc., Washington, DC
In 1997, the OMH undertook the development of national standards to provide a much-needed alternative to the current patchwork of independently developed definitions, practices, and requirements concerning culturally and linguistically appropriate services (CLAS). The purpose was to develop national CLAS standards that would support a more consistent and comprehensive approach to cultural and linguistic competence in health care. The first stage of the project involved a review and analysis of existing cultural and linguistic competence standards and measures, the development of draft standards, and revisions based on a review by a national advisory committee. The second stage focused on obtaining and incorporating input from organizations, agencies, and individuals that have a vital stake in the establishment of CLAS standards. Publication of standards in the Federal Register on December 15, 1999, announced a 4-month public comment period, which provided three regional meetings and a Web site as well as traditional avenues (mail and fax) for submitting feedback on the CLAS standards.
AGENCY SPONSOR: Office of Minority Health,
FEDERAL CONTACT: Guadalupe Pacheco, 301-443-5084
PIC ID: 7260
PERFORMER: IQ Solutions, Inc., Rockville, MD
The purpose of this project was to implement a Customer Satisfaction Survey that was designed to evaluate the extent to which the Office of Minority Health Resource Center (OMHRC) is reaching objectives that were established by the Office of Minority Health when the Center was formalized. Objectives for the OMHRC were to: 1) Collect and maintain information on minority health resources available from Federal, State, and local organizations; 2) foster relationships and form partnerships with health professionals, health organizations, and others interested in minority health, and 3) facilitate the exchange of minority health information with emphasis on health promotion, disease prevention, and health education. It was found that an overwhelming majority (more than 96%) appreciated materials and referrals from the Resource Center. Westerners were less likely to find expert referrals useful, use the toll- free telephone service, find requested information being delivered timely, and use the Resource Center again. The study also found that Westerners expected less, and received less, from the Resource Center than did Easterners. The source of this difference was traced to the Resource Center being placed and operated on East Coast time. Westerners were limited to five hours of personal contact, during the OMHRC business day. OMH will use these findings to establish a set of recommended improvements that target Westerners and populations that comprise the smaller percentage of its user base (e.g., Asians/Pacific Islanders, American Indians, and health care professionals). Budget increases and re- evaluation of programmatic activities will be pursued accordingly.
AGENCY SPONSOR: Office of Minority Health,
FEDERAL CONTACT: Howard L. Kelley, 301-443-5224
PIC ID: 6244
PERFORMER: Research Triangle Institute, Research Triangle Park, NC
The expanding HIV/AIDS epidemic has shed light on a persistent public healthchallenge: vulnerable individuals with one health or social condition often are simultaneously faced with other conditions or problems. For eample, a person with serious and persistent mental illness may be at risk of HIV transmission and become exposed to multi-drug resistant tuberculosis. The public health challenge is to address the needs of the person--whatever they might be--using multiple, but not always fully linked or coordinated, categorical public health programs and resources. This report proposes a shift in the paradigm from a categorical disease intervention model to an integrated services approach, and offers some practical approaches for pursuing such a shift. The target audiences are local, state, and federal public health officials and elected leaders, and other public health and social service decisionmakers.
AGENCY SPONSOR: Office of HIV/AIDS Policy
FEDERAL CONTACT: Deborah von Zinkernagel, 202-690-5560
PIC ID: 6321
PERFORMER: John Snow, Inc., Boston MA
In 1994, Baker and colleagues presented a framework for examining how the health of the public can be improved during a period of substantial change in the health system. This article reviews Baker's framework for refocusing and reinvigorating public health in an era of change and provides observations of the local changes. The observations are based on 12 site visits to health departments in randomly selected communities that are representative of the U.S. population. Data for this study were collected as part of the Public Health Tracking Study, a collateral study to the Community Tracking Study that is funded by the Robert Wood Johnson Foundation. It was found that many of Baker and colleague's predictions were on target, but others fall short. Most health departments have divested direct service delivery and instead are focusing on population-based activities. The local health department, however, is a leader in providing health information and planning and mobilizing the community around health issues. It was also found that health departments are having difficulty assuring the quality and availability of services for those in need. Lack of enforcement abilities, especially with regard to managed care organizations, limits health departments' ability to influence the quality of care. Assuring services to low-income residents may become even more difficult as questions remain over the stability and commitment of managed care organizations to provide services to the Medicaid population.
AGENCY SPONSOR: Office of Disease Prevention and Health Promotion
FEDERAL CONTACT: Matthew Guidry, 202-401-7780
PIC ID: 6325
PERFORMER: Mathematica Policy Research, Inc., Plainsboro, NJ
This project will conduct a survey of a national random sample of managed care organizations (MCOs) serving racially/ethnically diverse communities. The survey will identify the nature and extent of culturally and linguistically appropriate services (CLAS) being provided by these health plans. It is intended to inform and educate health service executives and managers about the nature and importance of CLAS, encourage policies and practices in support of CLAS for all Americans, and establish meaningful national baseline data on the nature and extent of CLAS being provided across the country. This is especially important in communities where language and cultural differences create access barriers and barriers to quality of care. It is expected that the end products will include an analysis and report of the range of such services, an identification of best practices and model approaches, and an explication of the community and organizational factors conducive to the provision or inhibition of CLAS.
EXPECTED DATE OF COMPLETION:09/30/2002
AGENCY SPONSOR: Office of Minority Health
FEDERAL CONTACT: Betty Hawks, 301-443-5084
PIC ID: 6674
PERFORMER: Cosmos Corporation, Bethesda, MD
Not having racial and ethnic (r/e) data collected by health insurers and managed care organizations (MCOs) has led to a dearth of r/e data to assess the health status, access to and quality of health services for minorities, as well as the inability to monitor progress towards eliminating racial and ethnic disparities. This project includes a comprehensive review of: (1) the extent to which MCOs and health insurers can collect and report information on the applicants and enrolled members by race and ethnicity; (2) existing interpretation of state laws and regulations governing these entities; (3) parameters and overlap of civil rights versus insurance and managed care laws; and (4) practices of the state officials and these entities at the state level. A database search will be conducted in all 50 states and the District of Columbia to search for state laws and regulations which allow, require and/or prohibit the collection of r/e data. The findings developed in this project will clarify needed steps to develop a system to monitor progress towards the elimination of health disparities, one of the Nation's health promotion and disease prevention goals for the next decade.
EXPECTED DATE OF COMPLETION:05/31/2002
AGENCY SPONSOR: Office of Minority Health
FEDERAL CONTACT: Violet Ryo-Hwa Woo, 301-443-9923
PIC ID: 7479
PERFORMER: National Health Law Program, Washington, D.C.
The President's Advisory Board on Race submitted a report of its deliberations to the President in the Summer of 1998. A "chart book" on the state of race relations formed the introductory chapter(s) of the Advisory Board's report. In addition, the White House commissioned the National Academy of Sciences to prepare detailed summaries of the research literature related to race and health. To support the Department's Initiative to Eliminate Racial and Ethnic Disparities in Health community demonstration grant program, the project will identify relevant departmental data systems and perform preliminary analyses to support the grant program.
EXPECTED DATE OF COMPLETION:09/30/2001
AGENCY SPONSOR: Office of Minority Health
FEDERAL CONTACT: Olivia Carter-Pokras, 301-443-9923
PIC ID: 7014
PERFORMER: Office of Minority Health, Rockville, MD
The contractor will conduct a comprehensive analysis of past and current Office of Minority Health (OMH) funded activities including OMH grant programs, cooperative agreements, and personal services contracts to determine the current types of information/data collected and available from them. The contractor will then develop a uniform set of information/data elements that OMH grantees/partners could be encouraged to collect for OPHS and OMH GPRA performance measurement purposes. A project advisory group of Federal and non-Federal individuals will be utilized. This project will identify a uniform set of information/data that should be provided by the recipients of OMH funding in order for OMH to be able to demonstrate the "returns for the public's investment." The project is to include, but is not limited to, examinations of the findings of the recently completed evaluation of OMH's Bilingual/Bicultural Services Demonstration Program, work being done within OMH to develop a statistical data progress report, and the related experiences and successes of other DHHS entities--building upon these efforts rather than "reinventing the wheel." OMH anticipates that as a result of this contract, it will be able to implement a process for obtaining the information/data necessary to demonstrate that the various grant/funded programs supported by OMH make a difference that matters to and resonates with policy and budget decision makers. Collateral technical assistance documents related to the uniform data/information set will also be developed.
EXPECTED DATE OF COMPLETION:09/30/2001
AGENCY SPONSOR: Office of Minority Health
FEDERAL CONTACT: Violet Ryo-Hwa Woo, 301-443-9923
PIC ID: 7097
PERFORMER: Development Services Group, Inc., Bethesda MD
This project would revise and promote an agenda of cost, quality, and outcome-related research on language and cultural competency, including research that would explore issues related to cost- effectiveness, clinical efficiency, and the validation of different methods and models of linguistic and culturally competent interventions, including medical interpretation, translation, and cross cultural provider and program assessment, training, and programming. Drawing on the expertise of researchers, policymakers, and providers already interested in linguistically and culturally competent care (complemented by experts in cost, quality, outcomes research), it would produce not just a onetime report, but sponsor and maintain an online research clearinghouse/networking site for regularly updated and synergistically developed information.
EXPECTED DATE OF COMPLETION:09/30/2002
AGENCY SPONSOR: Office of Minority Health
FEDERAL CONTACT: Guadalupe Pacheco, 301-443-5084
PIC ID: 7260.1
PERFORMER: Center for the Advancement of Health, Washington, DC
The purposes of this project are to identify the potential for health plans' participation in community-level health improvement activities, and to examine the incentives and barriers that will affect their decisions to take part in community-based health efforts.
EXPECTED DATE OF COMPLETION:09/30/2001
AGENCY SPONSOR: Office of Disease Prevention and Health Promotion
FEDERAL CONTACT: Matthew Guidry, 202-401-7780
PIC ID: 6492
PERFORMER: Partnership For Prevention, Washington, DC
The National Academy of Sciences, Institute of Medicine, Food and Nutrition Board is conducting a multi- phase scientific evaluation of human nutrient requirements that: (1) evaluates requirements and dietary and supplement intake data for nutrients and non-nutrient food components, (2) develops Dietary references intakes where data are available, (3) provides guidance for how these values should be used in various applications of clinical and public health importance, and (4) identifies research needs. Multi- agency participation is facilitated by an OS/OPHS requirements contract and interagency steering committee. OPHS evaluation funds have supported completed reports on folate and other B vitamins (9/96 to 3/98); dietary antioxidants and related compounds (9/97 to 12/99); micronutrients (9/98 to 12/00) on macronutrients (fat, carbohydrate, protein (9/99 to 6/02).
EXPECTED DATE OF COMPLETION:09/30/2001
AGENCY SPONSOR: Office of Disease Prevention and Health Promotion
FEDERAL CONTACT: Kathryn McMurry, 202-401-0751
PIC ID: 6323
PERFORMER: National Academy of Sciences, Institute of Medicine, Washington, DC