WPC  e@V#/ܠb}XRPW{nERm>WJ[N7?$/2z}_QU-=՟e1r5U=a(vc$Γ߿P}:sUsxu(9tcM=ԕ|8gx.rld:ְui{z) q]iUhs.X W{*$pE W C %{p0ai[)Z zt`b%n 2K"5Fի%_<" M/sRôU/OT>RhĿ1ֈwx*&)-(sk7{myX)'0.6VOa{A!( y&{Wx7^;aӺztX2l/*5'˩ 8V}=il#!U N  %W 0(]^ w@4 m 0 2= *o 0, 0.% &S &y & & & & 7NHNJ 0DLUON 1uSN 0c 0w~ 0 0 0 0 0 0 Au 0 0KHT! 0h! a" 17r" 1 "z#UN$ 1KL%UP>% &'U;NU))U B*N* 0N* 1E+ 1+ 0lS, 0D,'- 1 *.N..XZ/&/ 10 _1 C&; 1< C!<N<z<a$> 1 8> 1>NL?N?f@@fBaB'BfC A/.QC(D 0^DD 0D2E 0DvEfE D3E B[ Ef FaFf"Fa$Ff8Fa:FfNFaPFadFfxFazFfFaFFU<$Hf`HabHfvHaxHfHaHaHfHaHHfZJa\J>pJfKaKfKaKfKaKNK 1KLMOf Qa"Qf6Qa8QfLQaNQfbQadQNxQ>zQRfTaT 1TfZUa\UNpUMrUMvU 0<zUEUeUMUUUVEXYCZ\ D?]o]-[_`: b9Dcf}ddaeyef(gh*gahh9j{Vk}lPNnfoaoofDqTFqra(t5UNsUNT'əl' :ȧzUN^EUNC?UNoЭUN?-UN:UNB9UNɳ3UNѶhUNոUNh{UN1PUNϽUNUNytUN;UNPUN.T|UNUNUN{UN]oUNhUNpUN UNpUN_pUN6kUNUN>UN)wUNtUNHUNFUNydUN}+UNUN UNUNUNfaHP LaserJet IIID,,,,,,0(hH  Z6Times New Roman RegularX($ճq(b vUwUxUy z{V|v0r\((:i+003|xU W:\GPRA\INTROD~1.WPDW:\GPRA\Introduction.wpdW:\GPRA\SectionI.wpdW:\GPRA\SECTIO~1.WPDW:\GPRA\SectionII.wpdW:\GPRA\SECTIO~2.WPDW:\GPRA\SectionIII.wpdW:\GPRA\1sumv2.wpdW:\GPRA\2sumv2.wpdW:\GPRA\3sumv2.wpdW:\GPRA\4sumv2.wpdW:\GPRA\5sumv2.wpdW:\GPRA\6sumv2.wpd')*(3$ !  (  Z 6Times New Roman Regular3#37=CIQYag1.a.i.(1)(a)(i)1)a)Level 1Level 2Level 3Level 4Level 5(;3$2#  0  .3  0  (O;$0  2#  a  .3  0` (#(#(b$0  0` (#(#2#   .3  0 ` (#` (#(xir$0  0` (#(#0 ` (#` (#2#(  0  )3  0 (# (#($0  0` (#(#0 ` (#` (#0 (# (#2#(  a  )3  0h(#(#(F$0  0` (#(#0 ` (#` (#0 (# (#0h(#(#2#(   )3  0h(#h(#($0  0` (#(#0 ` (#` (#0 (# (#0h(#(#0h(#h(#2#  0  )3  0(#(#(Vm$0   ({$0  0` (#(#0 ` (#` (#0 (# (#0h(#(#0h(#h(#0(#(#2#  a  )3  0p(#(#(,!$0  0` (#(#  (@$0  0` (#(#0 ` (#` (# ` ')* !"#$%&(xdCcgkosw{TrianglesTriangle Bullet !"#$%&(h@G_cgkosw{Bullet ListBullet List p W"  _YXX *XXX*  HHSGoal1:#XVJXY+# 5!XXVJ0  REDUCETHEMAJORTHREATSTOTHEHEALTH  ANDPRODUCTIVITYOFALLAMERICANS#XVJX! 5# w(hH  Z6Times New Roman Regular !"#$%&(x?[_cgkoswSquaresSquare Bullet\  `&Times New Roman  W"  _YXX -Xe` XX-  HHSGoal2:#XVJXY+#0 e  5!XXVJIMPROVETHEECONOMICANDSOCIALWELL  BEINGOFINDIVIDUALS,FAMILIESANDCOMMUNITIESINTHEUNITEDSTATES z#XVJX! 5#   W"  _YXX *XXX*  HHSGoal3:#XVJXY+#0  kXXVJIMPROVEACCESSTOHEALTHSERVICESAND  ENSURETHEINTEGRITYOFTHENATIONSHEALTHENTITLEMENTANDSAFETYNETPROGRAMS#XVJXk# w (hH  Z 6Times New Roman Regular  )  _A\) xdExA  2/7/00(#_HHS_ԀFY2001PerformancePlanandReportSummary!  1  \  `*Times New RomanTT(O$ !"#$%&(hFCEIMQUY]aAutoList2""""""""i)1)a) !"#$%&(hYEGKOSW[_cAutoList10"""""""")1)a)((3$ !      0  (#$  0    )  _A\) xdExA  "US //  3/17/00!  (#HHSFY2001PerformancePlanandReportSummary!  40   !"#$%&(h٘CEIMQUY]aAutoList1""""""""i)1)a) ;$    1    _ԀGAO/GGD99139VerificationandValidationofPerformanceData,p.14.<http://aspe.os.dhhs.gov/PIC/gate2pic.htm>.  )  _A\) xdExA  "US //  3/17/00!  (#HHSFY2001PerformancePlanandReportSummary!  5   !"#$%&(hjG_cgkosw{Oh My StarsOh My StarsHHHHHHHH W"  _ HHSStrategicGoals   L - !"#$%&(@hx, !"#$%&(LL C !"#$%&(jhh- !"#$%&(L*,w` XX*  3    3"2jH3  0 ,   0w, , Reducethemajorthreatstothehealth  andproductivityofallAmericans. 3"M݌ w w  Ќ    3    3@2jH3  0 ,   0w, , Improvetheeconomicandsocialwell  beingofcommunities,families,andindividualsintheUnitedStates. 3@k݌ w w  Ќ    3    32jH3  0 ,   0w, , Improveaccesstohealthservicesand LL  assuretheintegrityofthenationshealthentitlementandsafetynetprograms. 3݌ w w  Ќ    3    32jH3  0 ,   0w, , Improvethequalityofhealthcareand   humanservices. 3݌ w w  Ќ    3    32jH3  0 ,   0w, , Improvepublichealthsystems. 3݌w w  Ќ  0 ,  , ,    3    32jH3  0 ,   0w, , Strengthenthenationshealthsciences  researchenterpriseandenhanceitsproductivity. 3 ݌\\w w  Ќ  P - !"#$%&(@hhC !"#$%&(PL !"#$%&(Ehh- !"#$%&(L  3   0 ,  32E`3  0` , ,   Strengthenthe  nationshealthsciencesresearchenterpriseandenhanceitsproductivity. 3݌ ` `  Ќ  P - !"#$%&(@hh !"#$%&(jPL C !"#$%&(jih- !"#$%&(L d !"#$%&(p?AEIOW_gmsummaryi.(1)(a)(i)1)a))d p W"  _YXX *XXX*  HHSGoal1:#XVJXY+# 5!XXVJ0  REDUCETHEMAJORTHREATSTOTHEHEALTH  ANDPRODUCTIVITYOFALLAMERICANS#XVJX! 5# wTable_0 !"#$%&(h Ieimquy}Square BulleSquare Bullet(hCEKQW]cioAutoList61.1.1.1.1.1.1.1.  W"  _YXX *XXX*  HHSGoal3:#XVJXY+#0  kXXVJIMPROVEACCESSTOHEALTHSERVICESAND  ENSURETHEINTEGRITYOFTHENATIONSHEALTHENTITLEMENTANDSAFETYNETPROGRAMS#XVJXk# w   W"  _YXX -Xe` XX-  HHSGoal2:#XVJXY+#0 e  5!XXVJIMPROVETHEECONOMICANDSOCIALWELL  BEINGOFINDIVIDUALS,FAMILIESANDCOMMUNITIESINTHEUNITEDSTATES z#XVJX! 5# Table_0  )  _A\) xdExA  "US //  3/17/00!  (#HHSFY2000PerformancePlanandReportSummary!  63  VWXY[C<<CLevel 1Level 2Level 3Level 4Level 5(3$ !  (3$ !  ($$   1  \\\\'dxd dTable_0Table_0Table_0Table_0Table_0Table_0Table_0 v W"  _YXX *XXX*  HHS2.5:#XVJXY+#0   5!XXVJIncreaseOpportunitiesforSeniorstoHaveanActiveand  HealthyAgingExperience w#XVJX! 5# \ `$Times NewRomanTable_0Table_0Table_0Table_0Table_0  W"  _YXX *XXX*  HHS3.3:#XVJXY+#0   5!XXVJImproveAccesstoandtheEffectivenessofHealthCare  ServicesforPersonswithSpecificNeeds w#XVJX! 5# Table_0 4 W"  _YXX -Xe` XX-  HHSGoal5:#XVJXY+#0 e  5!XXVJIMPROVEPUBLICHEALTHSYSTEMS z#XVJX! 5# Table_0Table_0Table_0 !"#$%&(hIimquy}Triangle BulTriangle Bullet  )  _A\) xdExA  "US //  3/17/00!  !(#HHSFY2001PerformancePlanSummary!  164    W"  _YXX *XXX*  HHSGoal4:#XVJXY+#0  4XVJXXXVJ4 5!X4XVJIMPROVETHEQUALITYOFHEALTHCAREAND  HUMANSERVICES#4XVJX!4 5#4lX4XVJ#4XVJX4lh# w#XVJXX4XVJ#   W"  _YXX *XXX*  HHS4.1:#XVJXY+#0   5!XXVJPromotetheAppropriateUseofEffective#XVJX! 5# 5!XXVJԀHealthServices w#XVJX! 5%# Table_0Table_0Table_0Table_0 4 W"  _YXX -Xe` XX-  HHSGoal5:#XVJXY+#0 e  5!XXVJIMPROVEPUBLICHEALTHSYSTEMS z#XVJX! 5#   W"  _YXX *XXX*  HHS5.1:#XVJXY+#0   5!XXVJImprovethePublicHealthSystemsCapacitytoMonitor#XVJX! 5# 5!XXVJ  TheHealthStatusandIdentifyThreatstotheHealthoftheNationsPopulation w#XVJX! 56# Table_0 !"#$%&(hEIgkosw{Diamond Bu04Diamond Bullet````````Table_0<:Default Para     )  _A\) xdExA  "US //  3/17/00!  88"(#HHSFY2001PerformancePlanSummary!  70    W"  _YXX*XXX*  HHSGoal6:#XVJXY+#0   5!XXVJSTRENGTHENTHENATIONSHEALTHSCIENCES  RESEARCHENTERPRISEANDENHANCEITSPRODUCTIVITY w#XVJX! 5#  ; W"  _YXX *XXX*  HHS1.1:#XVJXY+#0   5!XXVJReduceTobaccoUse,EspeciallyAmongYouth w#XVJX! 5#   )  _A\) xdExA  2/7/00(#_HHS_ԀFY2001PerformancePlanandReportSummary!  4   9 W"  _YXX *XXX*  HHS1.2:#XVJXY+#0   5!XXVJReducetheNumberandImpactofInjuries w#XVJX! 5#   W"  _YXX*XXX*  HHSGoal6:#XVJXY+#0   5!XXVJSTRENGTHENTHENATIONSHEALTHSCIENCES  RESEARCHENTERPRISEANDENHANCEITSPRODUCTIVITY w#XVJX! 5# \\\\3 ShadowdZd e W"  _YXX *XXX*  HHS1.3:#XVJXY+#0   5!XXVJImprovetheDietandtheLevelofPhysicalActivityof  Americans w#XVJX! 5#  # W"  _YXX *XXX*  HHS1.4:#XVJXY+#0   5!XXVJCurbAlcoholAbuse w#XVJX! 5#  x W"  _YXX *XXX*  HHS6.1:#XVJXY+#0   5!XXVJImprovetheUnderstandingofNormalandAbnormal  BiologicalProcessesandBehaviors w #XVJX! 5# 0 W"  _YXX *XXX*  HHS1.5:#XVJXY+#0   5!XXVJReducetheIllicitUseofDrugs w#XVJX! 5#  / W"  _YXX *XXX*  HHS1.6:#XVJXY+#0   5!XXVJReduceUnsafeSexualBehaviors w#XVJX! 5#   )  _A\) xdExA  "US //  3/17/00!  88"(#HHSFY2001PerformancePlanSummary!  98  Table_0 o W"  _YXX *XXX*  HHS6.2:#XVJXY+#0   5!XXVJImprovethePrevention,Diagnosis,andTreatmentof  DiseaseandDisability w#XVJX! 5#  ^ W"  _YXX *XXX*  HHS2.1:#XVJXY+#0   5!XXVJIncreasetheEconomicIndependenceofFamilieson  Welfare w#XVJX! 5# Table_0  W"  _YXX *XXX*  HHS2.2:#XVJXY+#0   5!XXVJIncreasetheFinancialandEmotionalResourcesAvailable  toChildrenFromTheirNoncustodialParents w#XVJX! 5#   )  _A\) xdExA  "US //  3/17/00!  (#HHSFY2001PerformancePlanSummary!  128   q W"  _YXX *XXX*  HHS2.3:#XVJXY+#0   5!XXVJImprovetheHealthyDevelopmentandLearningReadiness  ofPreschoolChildren w#XVJX! 5#  s W"  _YXX *XXX*  HHS6.3:#XVJXY+#0   5!XXVJImprovethePublicHealthPreventionEffortsThrough  PopulationBasedResearch w#XVJX! 5#  F W"  _YXX *XXX*  HHS2.4:#XVJXY+#0   5!XXVJImprovetheSafetyandSecurityofChildrenandYouth w#XVJX! 5# Table_0  W"  _YXX*XXX*  HHS3.1:#XVJXY+#0   5!XXVJIncreasethePercentageoftheNationsChildrenand  AdultsWhoHaveHealthInsuranceCoverage w#XVJX! 5#  J W"  _YXX *XXX*  HHS3.2:#XVJXY+#0   5!XXVJIncreasetheAvailabilityofPrimaryHealthCareServices w#XVJX! 5#   W"  _YXX *XXX*  HHS2.6:#XVJXY+#0   5!XXVJExpandAccesstoConsumerDirected,Homeand  CommunityBasedLongTermCareandHealthServices w#XVJX! 5# Table_0  W"  _YXX *XXX*  HHS6.5:#XVJXY+#0   5!XXVJAcceleratePrivateSectorDevelopmentofNewDrugs,  BiologicTherapies,andMedicalTechnology w#XVJX! 5#  j W"  _YXX *XXX*  HHS2.7:#XVJXY+#0   5!XXVJImprovetheEconomicandSocialDevelopmentof  DistressedCommunities w#XVJX! 5#  w W"  _YXX *XXX*  HHS3.4:#XVJXY+#0   5!XXVJProtectandImproveBeneficiaryHealthandSatisfaction  withMedicareandMedicaid w#XVJX! 5#   W"  _YXX *XXX*  HHS3.5:#XVJXY+#0   5!XXVJEnhancetheFiscalIntegrityofHCFAProgramsand  EnsuretheBestValueHealthCareforBeneficiaries w #XVJX! 5# e W"  _YXX *XXX*  HHS3.6:#XVJXY+#0   5!XXVJImprovetheHealthStatusofAmericanIndiansandAlaska  Natives w#XVJX! 5#   )  _A\) xdExA  "US //  3/17/00!  (#HHSFY2001PerformancePlanSummary!  194    W"  _YXX *XXX*  HHSGoal4:#XVJXY+#0  4XVJXXXVJ4 5!X4XVJIMPROVETHEQUALITYOFHEALTHCAREAND  HUMANSERVICES#4XVJX!4 5#4lX4XVJ#4XVJX4lh# w#XVJXX4XVJ# Table_0  W"  _YXX *XXX*  HHS6.6:#XVJXY+#0   5!XXVJImprovetheQualityofMedicalandHealthScience  ResearchbyStrengtheningtheBaseofHighlyQualifiedScientificInvestigators w#XVJX! 5#  f W"  _YXX *XXX*  HHS4.2:#XVJXY+#0   5!XXVJReduceDisparitiesintheReceiptofQualityHealthCare  Services w#XVJX! 5#  f W"  _YXX *XXX*  HHS4.3:#XVJXY+#0   5!XXVJIncreaseConsumersUnderstandingofTheirHealthCare  Options w#XVJX! 5#  , W"  _YXX *XXX*  HHS4.4:#XVJXY+#0   5!XXVJImproveConsumerProtection w#XVJX! 5#   W"  _YXX *XXX*  HHS4.5:#XVJXY+#0   5!XXVJPromoteResearchThatImprovesQualityandDevelops  KnowledgeofEffectiveHumanServicesPractice w#XVJX! 5# Table_0 | W"  _YXX *XXX*  HHS5.2:#XVJXY+#0   5!XXVJEnsureFoodandDrugSafetybyIncreasingthe  EffectivenessofScienceBasedRegulation w#XVJX! 5#   )  _A\) xdExA  "US //  3/17/00!  !(#HHSFY2001PerformancePlanSummary!  209  Table_0  )  _A\) xdExA  2/7/00(#_HHS_ԀFY2001PerformancePlanandReportSummary!  1    )  _A\) xdExA  "US //  3/17/00!  (#HHSFY2001PerformancePlanandReportSummary!  5   p W"  _YXX *XXX*  HHSGoal1:#XVJXY+# 5!XXVJ0  REDUCETHEMAJORTHREATSTOTHEHEALTH  ANDPRODUCTIVITYOFALLAMERICANS#XVJX! 5# w(hH  Z6Times New Roman Regular  W"  _YXX -Xe` XX-  HHSGoal2:#XVJXY+#0 e  5!XXVJIMPROVETHEECONOMICANDSOCIALWELL  BEINGOFINDIVIDUALS,FAMILIESANDCOMMUNITIESINTHEUNITEDSTATES z#XVJX! 5# (hH  Z6Times New Roman Regular  W"  _YXX *XXX*  HHSGoal3:#XVJXY+#0  kXXVJIMPROVEACCESSTOHEALTHSERVICESAND  ENSURETHEINTEGRITYOFTHENATIONSHEALTHENTITLEMENTANDSAFETYNETPROGRAMS#XVJXk# w (hH  Z6Times New Roman Regular  W"  _YXX *XXX*  HHS6.4:#XVJXY+#0   5!XXVJIncreasetheUnderstandingofandResponsetotheMajor  IssuesRelatedtotheQuality,Financing,Cost,andCostEffectivenessofHealthCareServices wԀ#XVJX! 5#   W"  _YXX *XXX*  HHSGoal4:#XVJXY+#0  XVJXXXVJ 5!X4XVJIMPROVETHEQUALITYOFHEALTHCAREAND  HUMANSERVICES#XVJX!4 5#lX4XVJ#XVJX4lh# w#XVJXX4XVJ# (hH  Z6Times New Roman Regular(hH  Z 6Times New Roman Regular 4 W"  _YXX -Xe` XX-  HHSGoal5:#XVJXY+#0 e  5!XXVJIMPROVEPUBLICHEALTHSYSTEMS z#XVJX! 5# (hH  Z6Times New Roman Regular  W"  _YXX*XXX*  HHSGoal6:#XVJXY+#0   5!XXVJSTRENGTHENTHENATIONSHEALTHSCIENCES  RESEARCHENTERPRISEANDENHANCEITSPRODUCTIVITY w#XVJX! 5# (hH  Z6Times New Roman Regular  )  _A\) xdExA  "US //  3/17/00!  (#HHSFY2001PerformancePlanandReportSummary!  40    W"  _YXX *XXX*  HHS6.7:#XVJXY+#0   5!XXVJEnsureThatResearchResultsAreEffectively  CommunicatedtothePublic,Practitioners,andtheScientificCommunity w#XVJX! 5#  ;$    1    _ԀGAO/GGD99139VerificationandValidationofPerformanceData,p.14.  )  _A\) xdExA  "US //  3/17/00!  (#HHSFY2000PerformancePlanandReportSummary!  63   W"  _ HHSStrategicGoals   L - !"#$%&(@hx, !"#$%&(LL C !"#$%&(jhh- !"#$%&(L*,w` XX*  3    3"2jH3  0 ,   0w, , Reducethemajorthreatstothehealth  andproductivityofallAmericans. 3"M݌ w w  Ќ    3    3@2jH3  0 ,   0w, , Improvetheeconomicandsocialwell  beingofcommunities,families,andindividualsintheUnitedStates. 3@k݌ w w  Ќ    3    32jH3  0 ,   0w, , Improveaccesstohealthservicesand LL  assuretheintegrityofthenationshealthentitlementandsafetynetprograms. 3݌ w w  Ќ    3    32jH3  0 ,   0w, , Improvethequalityofhealthcareand   humanservices. 3݌ w w  Ќ    3    32jH3  0 ,   0w, , Improvepublichealthsystems. 3݌w w  Ќ  0 ,  , ,    3    32jH3  0 ,   0w, , Strengthenthenationshealthsciences  researchenterpriseandenhanceitsproductivity. 3 ݌\\w w  Ќ  P - !"#$%&(@hhC !"#$%&(PL !"#$%&(Ehh- !"#$%&(L  3   0 ,  32E`3  0` , ,   Strengthenthe  nationshealthsciencesresearchenterpriseandenhanceitsproductivity. 3݌ ` `  Ќ  P - !"#$%&(@hh !"#$%&(jPL C !"#$%&(jih- !"#$%&(L  )  _A\) xdExA  "US //  3/17/00!  88"(#HHSFY2001PerformancePlanSummary!  70   p W"  _YXX *XXX*  HHSGoal1:#XVJXY+# 5!XXVJ0  REDUCETHEMAJORTHREATSTOTHEHEALTH  ANDPRODUCTIVITYOFALLAMERICANS#XVJX! 5# w(hH  Z6Times New Roman Regular ; W"  _YXX *XXX*  HHS1.1:#XVJXY+#0   5!XXVJReduceTobaccoUse,EspeciallyAmongYouth w#XVJX! 5# (hH  Z6Times New Roman Regular 9 W"  _YXX *XXX*  HHS1.2:#XVJXY+#0   5!XXVJReducetheNumberandImpactofInjuries w#XVJX! 5# (hH  Z6Times New Roman Regular e W"  _YXX *XXX*  HHS1.3:#XVJXY+#0   5!XXVJImprovetheDietandtheLevelofPhysicalActivityof  Americans w#XVJX! 5# (hH  Z6Times New Roman Regular # W"  _YXX *XXX*  HHS1.4:#XVJXY+#0   5!XXVJCurbAlcoholAbuse w#XVJX! 5# (hH  Z6Times New Roman Regular 0 W"  _YXX *XXX*  HHS1.5:#XVJXY+#0   5!XXVJReducetheIllicitUseofDrugs w#XVJX! 5# (hH  Z6Times New Roman Regular / W"  _YXX *XXX*  HHS1.6:#XVJXY+#0   5!XXVJReduceUnsafeSexualBehaviors w#XVJX! 5# (hH  Z6Times New Roman Regular  )  _A\) xdExA  "US //  3/17/00!  88"(#HHSFY2001PerformancePlanSummary!  98    W"  _YXX -Xe` XX-  HHSGoal2:#XVJXY+#0 e  5!XXVJIMPROVETHEECONOMICANDSOCIALWELL  BEINGOFINDIVIDUALS,FAMILIESANDCOMMUNITIESINTHEUNITEDSTATES z#XVJX! 5# (hH  Z6Times New Roman Regular ^ W"  _YXX *XXX*  HHS2.1:#XVJXY+#0   5!XXVJIncreasetheEconomicIndependenceofFamilieson  Welfare w#XVJX! 5# (hH  Z6Times New Roman Regular  W"  _YXX *XXX*  HHS2.2:#XVJXY+#0   5!XXVJIncreasetheFinancialandEmotionalResourcesAvailable  toChildrenFromTheirNoncustodialParents w#XVJX! 5# (hH  Z6Times New Roman Regular q W"  _YXX *XXX*  HHS2.3:#XVJXY+#0   5!XXVJImprovetheHealthyDevelopmentandLearningReadiness  ofPreschoolChildren w#XVJX! 5# (hH  Z6Times New Roman Regular F W"  _YXX *XXX*  HHS2.4:#XVJXY+#0   5!XXVJImprovetheSafetyandSecurityofChildrenandYouth w#XVJX! 5# (hH  Z6Times New Roman Regular v W"  _YXX *XXX*  HHS2.5:#XVJXY+#0   5!XXVJIncreaseOpportunitiesforSeniorstoHaveanActiveand  HealthyAgingExperience w#XVJX! 5# (hH  Z6Times New Roman Regular  W"  _YXX *XXX*  HHS2.6:#XVJXY+#0   5!XXVJExpandAccesstoConsumerDirected,Homeand  CommunityBasedLongTermCareandHealthServices w#XVJX! 5# (hH  Z6Times New Roman Regular j W"  _YXX *XXX*  HHS2.7:#XVJXY+#0   5!XXVJImprovetheEconomicandSocialDevelopmentof  DistressedCommunities w#XVJX! 5# (hH  Z6Times New Roman Regular  )  _A\) xdExA  "US //  3/17/00!  !(#HHSFY2001PerformancePlanSummary!  128    W"  _YXX *XXX*  HHSGoal3:#XVJXY+#0  kXXVJIMPROVEACCESSTOHEALTHSERVICESAND  ENSURETHEINTEGRITYOFTHENATIONSHEALTHENTITLEMENTANDSAFETYNETPROGRAMS#XVJXk# w (hH  Z6Times New Roman Regular  W"  _YXX*XXX*  HHS3.1:#XVJXY+#0   5!XXVJIncreasethePercentageoftheNationsChildrenand  AdultsWhoHaveHealthInsuranceCoverage w#XVJX! 5# (hH  Z6Times New Roman Regular J W"  _ YXX *XXX*  HHS3.2:# XVJXY+#0    5!XXVJIncreasetheAvailabilityofPrimaryHealthCareServices w# XVJX! 5# (hH  Z6Times New Roman Regular  W"  _ YXX *XXX*  HHS3.3:# XVJXY+#0    5!XXVJImproveAccesstoandtheEffectivenessofHealthCare  ServicesforPersonswithSpecificNeeds w# XVJX! 5# (hH  Z6Times New Roman Regular w W"  _YXX *XXX*  HHS3.4:#XVJXY+#0   5!XXVJProtectandImproveBeneficiaryHealthandSatisfaction  withMedicareandMedicaid w#XVJX! 5# (hH  Z6Times New Roman Regular  W"  _YXX *XXX*  HHS3.5:#XVJXY+#0   5!XXVJEnhancetheFiscalIntegrityofHCFAProgramsand  EnsuretheBestValueHealthCareforBeneficiaries w #XVJX! 5#(hH  Z6Times New Roman Regular e W"  _YXX *XXX*  HHS3.6:#XVJXY+#0   5!XXVJImprovetheHealthStatusofAmericanIndiansandAlaska  Natives w#XVJX! 5# (hH  Z6Times New Roman Regular  )  _A\) xdExA  "US //  3/17/00!  !(#HHSFY2001PerformancePlanSummary!  164    W"  _YXX *XXX*  HHSGoal4:#XVJXY+#0  XVJXXXVJ 5!X4XVJIMPROVETHEQUALITYOFHEALTHCAREAND  HUMANSERVICES#XVJX!4 5#lX4XVJ#XVJX4lh# w#XVJXX4XVJ# (hH  Z6Times New Roman Regular(hH  Z 6Times New Roman Regular  W"  _YXX *XXX*  HHS4.1:#XVJXY+#0   5!XXVJPromotetheAppropriateUseofEffective#XVJX! 5# 5!XXVJԀHealthServices w#XVJX! 5%# (hH  Z6Times New Roman Regular f W"  _YXX *XXX*  HHS4.2:#XVJXY+#0   5!XXVJReduceDisparitiesintheReceiptofQualityHealthCare  Services w#XVJX! 5# (hH  Z6Times New Roman Regular f W"  _YXX *XXX*  HHS4.3:#XVJXY+#0   5!XXVJIncreaseConsumersUnderstandingofTheirHealthCare  Options w#XVJX! 5# (hH  Z6Times New Roman Regular , W"  _YXX *XXX*  HHS4.4:#XVJXY+#0   5!XXVJImproveConsumerProtection w#XVJX! 5# (hH  Z6Times New Roman Regular  W"  _ YXX *XXX*  HHS4.5:# XVJXY+#0    5!XXVJPromoteResearchThatImprovesQualityandDevelops  KnowledgeofEffectiveHumanServicesPractice w# XVJX! 5# (hH  Z6Times New Roman Regular  )  _A\) xdExA  "US //  3/17/00!  !(#HHSFY2001PerformancePlanSummary!  194   4 W"  _#YXX -Xe` XX-  HHSGoal5:##XVJXY+#0 e # 5!XXVJIMPROVEPUBLICHEALTHSYSTEMS z##XVJX! 5# (hH  Z6Times New Roman Regular  W"  _%YXX *XXX*  HHS5.1:#%XVJXY+#0  % 5!XXVJImprovethePublicHealthSystemsCapacitytoMonitor#%XVJX! 5#% 5!XXVJ  TheHealthStatusandIdentifyThreatstotheHealthoftheNationsPopulation w#%XVJX! 56# (hH  Z6Times New Roman Regular | W"  _'YXX *XXX*  HHS5.2:#'XVJXY+#0  ' 5!XXVJEnsureFoodandDrugSafetybyIncreasingthe  EffectivenessofScienceBasedRegulation w#'XVJX! 5# (hH  Z6Times New Roman Regular  )  _A\) xdExA  "US //  3/17/00!  !(#HHSFY2001PerformancePlanSummary!  209    W"  _*YXX*XXX*  HHSGoal6:#*XVJXY+#0  * 5!XXVJSTRENGTHENTHENATIONSHEALTHSCIENCES  RESEARCHENTERPRISEANDENHANCEITSPRODUCTIVITY w#*XVJX! 5# (hH  Z6Times New Roman Regular x W"  _,YXX *XXX*  HHS6.1:#,XVJXY+#0  , 5!XXVJImprovetheUnderstandingofNormalandAbnormal  BiologicalProcessesandBehaviors w #,XVJX! 5#(hH  Z6Times New Roman Regular o W"  _.YXX *XXX*  HHS6.2:#.XVJXY+#0  . 5!XXVJImprovethePrevention,Diagnosis,andTreatmentof  DiseaseandDisability w#.XVJX! 5# (hH  Z6Times New Roman Regular s W"  _0YXX *XXX*  HHS6.3:#0XVJXY+#0  0 5!XXVJImprovethePublicHealthPreventionEffortsThrough  PopulationBasedResearch w#0XVJX! 5# (hH  Z6Times New Roman Regular  W"  _2YXX *XXX*  HHS6.4:#2XVJXY+#0  2 5!XXVJIncreasetheUnderstandingofandResponsetotheMajor  IssuesRelatedtotheQuality,Financing,Cost,andCostEffectivenessofHealthCareServices wԀ#2XVJX! 5# (hH  Z6Times New Roman Regular  W"  _4YXX *XXX*  HHS6.5:#4XVJXY+#0  4 5!XXVJAcceleratePrivateSectorDevelopmentofNewDrugs,  BiologicTherapies,andMedicalTechnology w#4XVJX! 5# (hH  Z6Times New Roman Regular  W"  _6YXX *XXX*  HHS6.6:#6XVJXY+#0  6 5!XXVJImprovetheQualityofMedicalandHealthScience  ResearchbyStrengtheningtheBaseofHighlyQualifiedScientificInvestigators w#6XVJX! 5# (hH  Z6Times New Roman Regular  W"  _8YXX *XXX*  HHS6.7:#8XVJXY+#0  8 5!XXVJEnsureThatResearchResultsAreEffectively  CommunicatedtothePublic,Practitioners,andtheScientificCommunity w#8XVJX! 5# (hH  Z6Times New Roman Regular  )  _A\) xdExA  "US //  3/17/00!  (#HHSFY2001PerformancePlanSummary!  194  Table_0 !  _Xz  lXXTABLEOFCONTENTS #XVJXlM#  >3 ,XS XX3+s.  'Vm  'Vm0     INTRODUCTION#""J(#.` ` (#(##1'Vm4݌  Ќ  'Vm  'Vm0     SECTIONI:SUMMARYPERFORMANCEREPORT#""J(#.0(#(##4'Vm݌ t  Ќ  )!  )!0  0S(#(#    HHSGoal1:0 S(#S(#REDUCETHEMAJORTHREATSTOTHEHEALTHAND L  PRODUCTIVITYOFALLAMERICANS#""J(#.3 (# (##7)!݌ 8  Ќ  )!  )!0  0S(#(#    HHSGoal2:0 S(#S(#IMPROVETHEECONOMICANDSOCIALWELLBEINGOF $ t  INDIVIDUALS,FAMILIESANDCOMMUNITIESINTHEUNITEDSTATES#`"`"I(#.l l  (# (##13)!݌ L  Ќ  )!  )!T0  0S(#(#    HHSGoal3:0 S(#S(#IMPROVEACCESSTOHEALTHSERVICESANDENSURETHE 8  INTEGRITYOFTHENATIONSHEALTHENTITLEMENTAND)!To݌  (# (# Ќ  )!  )!0  0S(#(#    0SS(#S(#0 S(#S(#SAFETYNETPROGRAMS#`"`"I(#.) (# (##17)!݌   Ќ  )!  )!0  0S(#(#    HHSGoal4:0 S(#S(#IMPROVETHEQUALITYOFHEALTHCAREAND)!݌  (# (# Ќ  )!  )!y0  0S(#(#    0SS(#S(#0 S(#S(#HUMANSERVICES#`"`"I(#.``$ (# (##23)!y݌  Ќ  )!  )!s 0  0S(#(#    HHSGoal5:0 S(#S(#IMPROVEPUBLICHEALTHSYSTEMS#`"`"I(#.3 (# (##30)!s ݌  Ќ  )!  )!s 0  0S(#(#    HHSGoal6:0 S(#S(#STRENGTHENTHENATIONSHEALTHSCIENCESRESEARCH p ENTERPRISEANDENHANCEITSPRODUCTIVITY#`"`"I(#.dd= (# (##33)!s ݌ \ Ќ  'Vm  'Vm 0     SECTIONII:KEYHHSMEASUREMENTISSUES#`"`"I(#.1(#(##38'Vm ݌ 4 Ќ  )!  )! 0  0S(#(#    APPROACHTOPERFORMANCEMEASUREMENT#`"`"I(#.PP/S(#S(##39)! ݌  \ Ќ  )!  )! 0  0S(#(#    DEPARTMENTALCOMMITMENTTOMANAGEMENTIMPROVEMENT#`"`"I(#.=S(#S(##41)! ݌ H Ќ  )!  )!0  0S(#(#    DATACHALLENGES#`"`"I(#.L L S(#S(##55)!݌ 4 Ќ  )!  )!S0  0S(#(#    PROGRAMEVALUATIONANDPERFORMANCEMEASUREMENT#`"`"I(#.:S(#S(##59)!Sn݌   Ќ  'Vm  'VmE0     SECTIONIII:FY2001PERFORMANCEGOALSUMMARY#`"`"I(#.8(#(##61'VmEa݌  Ќ  )!  )!+0  0S(#(#    FY2001DEPARTMENTALINITIATIVESANDREPRESENTATIVE)!+F݌ S(#S(# Ќ  )!  )!0  0S(#(#    0SS(#S(#PERFORMANCEGOALS#`"`"I(#. S(#S(##62)!݌ l! Ќ  )!  )!0  0S(#(#    FY2001PROGRAMS,INITIATIVES,STRATEGIES,ANDPERFORMANCE)!݌ S(#S(# Ќ  )!  )!0  0S(#(#    0SS(#S(#GOALSTHATSUPPORTTHEHHSSTRATEGICPLAN#`"`"I(#.  8S(#S(##68)!݌ D#! Ќ  )!  )!0  0S(#(#    HHSGoal1:0 S(#S(#REDUCETHEMAJORTHREATSTOTHEHEALTHAND %l # PRODUCTIVITYOFALLAMERICANS#`"`"I(#.3 (# (##69)!݌ &X!$ Ќ  *  *0  0S(#(#0 S(#S(# S   HHS1.1:0 (# (#ReduceTobaccoUse,EspeciallyAmongYouth#`"`"I(#.dd@ (# (##70* ݌ &D"% Ќ  *  *#0  0S(#(#0 S(#S(# S   HHS1.2:0 (# (#ReducetheNumberandImpactofInjuries#`"`"I(#.> (# (##74*#>݌ '0#& Ќ  *  *?0  0S(#(#0 S(#S(# S   HHS1.3:0 (# (#ImprovetheDietandtheLevelofPhysicalActivityofAmericans#`"`"I(#.V (# (##81*?Z݌ ($' Ќ  *  *s0  0S(#(#0 S(#S(# S   HHS1.4:0 (# (#CurbAlcoholAbuse#`"`"I(#.( (# (##85*s݌ )%( Ќ  *  *y0  0S(#(#0 S(#S(# S   HHS1.5:0 (# (#ReducetheIllicitUseofDrugs#`"`"I(#.005 (# (##89*y݌ *%) Ќ  *  *0  0S(#(#0 S(#S(# S   HHS1.6:0 (# (#ReduceUnsafeSexualBehaviors#`"`"I(#.4 (# (##93*݌ +&* Ќ  )!  )!0  0S(#(#    HHSGoal2:0 S(#S(#IMPROVETHEECONOMICANDSOCIALWELLBEINGOF h-(, INDIVIDUALS,FAMILIESANDCOMMUNITIESINTHEUNITEDSTATES#`"`"I(#.l l  (# (##97)!݌ @/*. Ќ  *  *0  0S(#(#0 S(#S(# S   HHS2.1:0 (# (#IncreasetheEconomicIndependenceofFamiliesonWelfare#`"`"I(#.PPO (# (##99*݌ ,0|+/ Ќ  _*  *;0  0S(#(#0 S(#S(# S   HHS2.2:0 (# (#IncreasetheFinancialandEmotionalResourcesAvailabletoChildren*;V݌ (# (# Ќ  *  *X 0  0S(#(#0 S(#S(# S   0 (# (#FromTheir_Noncustodial_ԀParents#!!H(#.5 (# (##102*X s ݌  Ќ  *  *!0  0S(#(#0 S(#S(# S   HHS2.3:0 (# (#ImprovetheHealthyDevelopmentandLearningReadinessofPreschool  Children#!!H(#.0 0  (# (##104*!!݌ t Ќ  *  *"0  0S(#(#0 S(#S(# S   HHS2.4:0 (# (#ImprovetheSafetyandSecurityofChildrenandYouth#!!H(#.K (# (##111*""݌ ` Ќ  *  *$0  0S(#(#0 S(#S(# S   HHS2.5:0 (# (#IncreaseOpportunitiesforSeniorstoHaveanActiveandHealthyAging L  Experience#!!H(#. (# (##115*$$݌ 8  Ќ  *  *]%0  0S(#(#0 S(#S(# S   HHS2.6:0 (# (#ExpandAccesstoConsumerDirected,HomeandCommunityBased*]%x%݌$ t (# (# Ќ  *  *r&0  0S(#(#0 S(#S(# S   0 (# (#LongTermCareandHealthServices#!!H(#.((8 (# (##120*r&&݌  ` Ќ  *  *'0  0S(#(#0 S(#S(# S   HHS2.7:0 (# (#ImprovetheEconomicandSocialDevelopmentofDistressed*''݌ L  (# (# Ќ  *  *(0  0S(#(#0 S(#S(# S   0 (# (#Communities#!!H(#.! (# (##123*((݌  8  Ќ  )!  )!)0  0S(#(#    HHSGoal3:0 S(#S(#IMPROVEACCESSTOHEALTHSERVICESANDENSURETHE   INTEGRITYOFTHENATIONSHEALTHENTITLEMENTAND)!))݌  (# (# Ќ  )!  )!*0  0S(#(#    0SS(#S(#0 S(#S(#SAFETYNETPROGRAMS#!!H(#.) (# (##126)!**݌   Ќ  *  *+0  0S(#(#0 S(#S(# S   HHS3.1:0 (# (#IncreasethePercentageoftheNationsChildrenandAdultsWho*++݌  (# (# Ќ  *  *,0  0S(#(#0 S(#S(# S   0 (# (#HaveHealthInsuranceCoverage#!!H(#.4 (# (##128*,,݌ p Ќ  *  *-0  0S(#(#0 S(#S(# S   HHS3.2:0 (# (#IncreasetheAvailabilityofPrimaryHealthCareServices#!!H(#.44O (# (##131*-.݌ \ Ќ  *  */0  0S(#(#0 S(#S(# S   HHS3.3:0 (# (#ImproveAccesstoandtheEffectivenessofHealthCareServicesfor*/3/݌H (# (# Ќ  *  *400  0S(#(#0 S(#S(# S   0 (# (#PersonswithSpecificNeeds#!!H(#.XX1 (# (##141*40O0݌ 4 Ќ  *  *<10  0S(#(#0 S(#S(# S   HHS3.4:0 (# (#ProtectandImproveBeneficiaryHealthandSatisfactionwith*<1W1݌ p (# (# Ќ  *  *Q20  0S(#(#0 S(#S(# S   0 (# (#MedicareandMedicaid#!!H(#.+ (# (##149*Q2l2݌  \ Ќ  *  *S30  0S(#(#0 S(#S(# S   HHS3.5:0 (# (#EnhancetheFiscalIntegrityofHCFAProgramsandEnsurethe*S3n3݌H (# (# Ќ  *  *h40  0S(#(#0 S(#S(# S   0 (# (#BestValueHealthCareforBeneficiaries#!!H(#.,,> (# (##154*h44݌ 4 Ќ  *  *}50  0S(#(#0 S(#S(# S   HHS3.6:0 (# (#ImprovetheHealthStatusofAmericanIndiansandAlaskaNatives#!!H(#.\\V (# (##157*}55݌   Ќ  )!  )!60  0S(#(#    HHSGoal4:0 S(#S(#IMPROVETHEQUALITYOFHEALTHCAREAND)!66݌ (# (# Ќ  )!  )!70  0S(#(#    0SS(#S(#0 S(#S(#HUMANSERVICES#!!H(#.``$ (# (##162)!77݌  Ќ  *  *80  0S(#(#0 S(#S(# S   HHS4.1:0 (# (#PromotetheAppropriateUseofEffectiveHealthServices#!!H(#.N (# (##165*88݌  Ќ  *  *90  0S(#(#0 S(#S(# S   HHS4.2:0 (# (#ReduceDisparitiesintheReceiptofQualityHealthCareServices#!!H(#.W (# (##172*99݌ l Ќ  *  *:0  0S(#(#0 S(#S(# S   HHS4.3:0 (# (#IncreaseConsumersUnderstandingofTheirHealthCareOptions#!!H(#.T (# (##181*:;݌ X  Ќ  *  *5<0  0S(#(#0 S(#S(# S   HHS4.4:0 (# (#ImproveConsumerProtection#!!H(#.1 (# (##184*5<P<݌ D! Ќ  *  *E=0  0S(#(#0 S(#S(# S   HHS4.5:0 (# (#PromoteResearchThatImprovesQualityandDevelopsKnowledgeof 0"  EffectiveHumanServicesPractice#!!H(#.HH7 (# (##190*E=`=݌ #l! Ќ  )!  )!>0  0S(#(#    HHSGoal5:0 S(#S(#IMPROVEPUBLICHEALTHSYSTEMS#!!H(#.3 (# (##192)!>>݌ $D # Ќ  *  *?0  0S(#(#0 S(#S(# S   HHS5.1:0 (# (#ImprovethePublicHealthSystemsCapacitytoMonitorTheHealth*??݌%0!$ (# (# Ќ  *  *@0  0S(#(#0 S(#S(# S   0 (# (#StatusandIdentifyThreatstotheHealthoftheNationsPopulation#!!H(#.Z (# (##194*@@݌ &"% Ќ  *  *B0  0S(#(#0 S(#S(# S   HHS5.2:0 (# (#EnsureFoodandDrugSafetybyIncreasingtheEffectiveness*BB݌'#& (# (# Ќ  *  *C0  0S(#(#0 S(#S(# S   0 (# (#ofScienceBasedRegulation#!!H(#.1 (# (##203*C2C݌ (#' Ќ  )!  )! D0  0S(#(#    HHSGoal6:0 S(#S(#STRENGTHENTHENATIONSHEALTHSCIENCESRESEARCH |*%) ENTERPRISEANDENHANCEITSPRODUCTIVITY#!!H(#.dd= (# (##207)! D;D݌ h+&* Ќ  *  *sE0  0S(#(#0 S(#S(# S   HHS6.1:0 (# (#ImprovetheUnderstandingofNormalandAbnormalBiological*sEE݌T,'+ (# (# Ќ  *  *F0  0S(#(#0 S(#S(# S   0 (# (#ProcessesandBehaviors#!!H(#.44- (# (##209*FF݌ @-(, Ќ  *  *G0  0S(#(#0 S(#S(# S   HHS6.2:0 (# (#ImprovethePrevention,Diagnosis,andTreatmentofDisease*GG݌,.|)- (# (# Ќ  *  *H0  0S(#(#0 S(#S(# S   0 (# (#andDisability#!!H(#.$ (# (##213*HH݌ /h*. Ќ  *  *I0  0S(#(#0 S(#S(# S   HHS6.3:0 (# (#ImprovethePublicHealthPreventionEffortsThroughPopulationBased 0T+/ Research#!!H(#.` `  (# (##222*II݌  Ќ  *  *J0  0S(#(#0 S(#S(# S   HHS6.4:0 (# (#IncreasetheUnderstandingofandResponsetotheMajorIssues*J K݌ (# (# Ќ  *  *L0  0S(#(#0 S(#S(# S   0 (# (#RelatedtotheQuality,Financing,Cost,andCostEffectiveness*L#L݌  (# (# Ќ  *  *M0  0S(#(#0 S(#S(# S   0 (# (#ofHealthCareServices#!!H(#.- (# (##226*M+M݌ t Ќ  *  *N0  0S(#(#0 S(#S(# S   HHS6.5:0 (# (#AcceleratePrivateSectorDevelopmentofNewDrugs,Biologic*N/N݌` (# (# Ќ  *  *)O0  0S(#(#0 S(#S(# S   0 (# (#Therapies,andMedicalTechnology#!!H(#.7 (# (##229*)ODO݌ L  Ќ  *  *7P0  0S(#(#0 S(#S(# S   HHS6.6:0 (# (#ImprovetheQualityofMedicalandHealthScienceResearchby*7PRP݌8  (# (# Ќ  *  *MQ0  0S(#(#0 S(#S(# S   0 (# (#StrengtheningtheBaseofHighlyQualifiedScientificInvestigators#!!H(#.,,Y (# (##234*MQhQ݌ $ t Ќ  *  *}R0  0S(#(#0 S(#S(# S   HHS6.7:0 (# (#EnsureThatResearchResultsAreEffectivelyCommunicatedto*}RR݌ ` (# (# Ќ  *  *S0  0S(#(#0 S(#S(# S   0 (# (#thePublic,Practitioners,andtheScientificCommunity#!!H(#.M (# (##239*SS݌  L  Ќ   z{   8  {8VJXXdXXd8 <  |5||| LmMXXVJ  HHSPERFORMANCEPLAN  ANDPERFORMANCEREPORTSUMMARYMLm ` U    INTRODUCTION V  p V XVJX   uuuuu h   W  THISISASUMMARYDOCUMENT.nWHHSisalarge,decentralizedAgencythatadministersapproximately300programactivities,withover750annualperformancegoals.Tobestaccommodatethelinkageoftheseperformancegoalstothebudgetrequestsfortheseprogramactivities,HHShasincorporatedtheperformancegoalsintothebudgetsubmissionsfortheHHScomponentsthatadministertheprograms.ToviewallperformancegoalsforallHHSprogramactivities,includingthelatestperformanceresultsandotherrequiredinformation,readersarereferredtotheperformanceplansandreportsincludedinthebudgetjustificationfortheindividualHHScomponents.      uuuuu #XXVJV# x BZXVJXTheDepartmentofHealthandHumanServicesseekstoenhancethewellbeingofAmericansby  providingforeffectivehealthandhumanservicesandbyfosteringstrong,sustainedadvancesinthesciencesunderlyingmedicine,publichealth,andsocialservices.WeaccomplishthismissionthroughtheseparateandcollaborativeeffortsofouroperatingdivisionsandstaffofficeswithintheOfficeoftheSecretary:0   AdministrationonAging (AoA)servesastheprimaryfederalfocalpointandadvocacyagent 8! forolderAmericans.Throughanetworkofstateandareaagenciesonaging,AoAfundedprogramsdelivercomprehensiveinhomeandcommunityservices;andmakelegalservices,counseling,andombudsmenprogramsavailabletoelderlyAmericans (#(# 0   AdministrationonChildrenandFamilies (ACF)leadsthenationinimprovingtheeconomic %(!  andsocialwellbeingoffamilies,children,andcommunitiesthoughfederalgrantprogramslikeHeadStart,ChildSupportEnforcement,ChildWelfareServices,ChildCareandDevelopment,andTemporaryAssistancetoNeedyFamilies. (#(# 0   AgencyforHealthCareResearchandQuality (_AHQR_)enhancesthequality, x*%% appropriateness,andeffectivenessofhealthservicesandaccesstosuchservices,throughthepromotionofimprovementsinclinicalandhealthsystempractices,includingthepreventionofdiseasesandotherhealthconditions. (#(#    ,.|)) 0   CentersforDiseaseControlandPrevention (CDC)monitorshealth;identifiesand  investigatespublichealthproblems;promoteshealthybehaviors;anddevelopsandadvocatessoundpublichealthpoliciestopreventandcontroldisease,injury,anddisability. (#(# 0   FoodandDrugAdministration (FDA)promotesimprovementinthehealthoftheAmerican d publicbyensuringtheeffectivenessand/orsafetyofdrugs,medicaldevices,biologicalproducts,food,andcosmetics;andbyencouragingtheactiveparticipationofbusinessandthepublicinmanagingthehealthhazardsassociatedwiththeseproducts. (#(# 0   HealthCareFinancingAdministration (HCFA)paysMedicarebenefits;providesstateswith  T  matchingfundsforMedicaidbenefits;conductsresearch,demonstrations,andoversighttoensurethesafetyandqualityofmedicalservicesandfacilitiesprovidedtoMedicarebeneficiaries;andestablishesrulesforeligibilityandbenefitpayments. (#(# 0   HealthResourcesandServicesAdministration (HRSA)promotesequitableaccessto   comprehensive,qualityhealthcareforall,withaparticularfocuson_underserved_Ԁandvulnerablepopulations. (#(# 0   IndianHealthService (IHS)providescomprehensivehealthservicesforAmericanIndianand X AlaskaNativepeople,withopportunityformaximumtribalinvolvementindevelopingandmanagingprogramstoimprovehealthstatusandoverallqualityoflife. (#(# 0   NationalInstitutesofHealth (NIH),throughits25institutes,centers,anddivisions,supports  \ andconductsmedicalresearch,domesticallyandabroad,intothecausesandpreventionofdiseasesandpromotestheacquisitionanddisseminationofmedicalknowledgetohealthprofessionalsandthepublic. (#(# 0   ProgramSupportCenter (PSC)providesabroadrangeofadministrativeservicestoHHS  componentsandotherFederalagenciesonacompetitive,fee-for-servicebasis.PSCservicesareprovidedinthreebusinessareas:humanresources,financialmanagement,andadministrativeoperations. (#(# 0   SubstanceAbuseandMentalHealthServicesAdministration ,(SAMHSA)throughitsthree L"  centers,workstoimprovequalityandavailabilityofprevention,earlyintervention,treatment,andrehabilitationservicesforsubstanceabuseandmentalillness,includingcooccurringdisorders,inordertoimprovehealthandreduceillness,death,disability,andcosttosociety. (#(# 0   AssistantSecretaryforManagementandBudget (ASMB)advisestheSecretaryonall &<"% aspectsofadministrationandfinancialmanagement,andprovidesgeneraloversightanddirectionoftheadministrativeandfinancialorganizationsandactivitiesoftheDepartment. (#(# 0   AssistantSecretaryforPlanningandEvaluation (ASPE)providespolicyanalysisand *%) advice;guidestheformulationoflegislation;coordinatesstrategicandimplementationplanning;conductsregulatoryanalysisandreviewsregulations;overseestheplanningof evaluation,nonbiomedicalresearch,andmajorstatisticalactivities;andadministers h-(, evaluation,datacollection,andresearchprojectsthatprovideinformationneededforHHSpolicydevelopment. (#(#  0  XVJXXXVJ OfficeforCivilRights (OCR)promotesandensuresthatpeoplehaveequalaccesstoand t opportunitytoparticipateinandreceiveservicesinallHHSprogramswithoutfacingunlawfuldiscrimination.Throughpreventionandeliminationofunlawfuldiscrimination,theOfficeforCivilRightshelpsHHScarryoutitsoverallmissionofimprovingthehealthandwellbeingofallpeopleaffectedbyitsmanyprograms. (#(# #XVJXXXVJ_p#0   OfficeofInspectorGeneral (OIG)improvesHHSprogramsandoperationsandprotects  P  themagainstfraud,waste,andabuse.Byconductingindependentandobjectiveaudits,evaluations,andinvestigationsOIGprovidestimely,useful,andreliableinformationandadvicetoDepartmentofficials,theAdministration,theCongress,andthepublic. (#(# 0   OfficeofPublicHealthandScience (_OPHS_)providesseniorprofessionalleadershipacross   HHSonpopulation-basedpublichealthandclinicalpreventiveservicesbyprovidingscientificallysoundadviceonhealthandhealthpolicytotheSecretary,DepartmentalofficialsandothergovernmentalentitiesandcommunicatingonhealthissuesdirectlytotheAmericanpublic;conductingessentialpublichealthactivitiesthroughelevenprogramoffices,andprovidingprofessionalleadershiponcross-cuttingDepartmentalpublichealthandscienceinitiatives.#XXVJZ#XVJX ,|(#(#   _ <=U <_?,X,hX,XS X?̀  `    LmMXXVJSECTIONI: L  SUMMARYPERFORMANCEREPORT#XVJXMLmw# w   XXVJPROGRESSTOWARDS  p  ACHIEVINGDEPARTMENTALINITIATIVES#XVJX{x# (   w  4 _B55  lXXVJSUMMARYPERFORMANCEREPORT!PROGRESSTOWARDS  ACHIEVINGDEPARTMENTALINITIATIVES#XVJXly# yTheGovernmentPerformanceandResultsAct(GPRA)isavaluabletoolthatwillenhanceHHSeffortstoimproveprogramsthatservetheAmericanpeople.Withthecontinueddevelopmentofperformancegoalsandmeasuresforapproximately300programs,HHSiscompilinganextensivebodyofinformationthatisinformativeacrossprogramsandagencies.SuchdatawillbecomeincreasinglyimportanttoHHSsleadershipandprogramcoordinationefforts.AlthoughtheDepartmentconsistsoflargeagencieswithmanyanddisparatefunctions,HHScoordinatesthefocusanddirectionofitsprogramactivitiesthroughDepartmentalinitiativesdevelopedintheannualHHSbudgetdecisionmakingprocesses.PerformancemeasurementwillincreasinglystrengthentheseprocessesasdataonprogramperformancetrendsbecomeavailableandserveasindicatorstosupporttheidentificationofstrategiesandobjectivestocontinuouslyimproveprogramsacrosstheDepartment.AlthoughtheGPRAinformationprocessesarestilldeveloping,weareconfidentthattheGPRAmeasuresforHHSprogramswillsupporttheassessmentoftheDepartmentalinitiativesthatSecretaryShalalahaspursuedoverthelastfouryears,andwillcontributetothedevelopmentofDepartmentalinitiativesandperformancegoalsinthefuture.DetailedinformationonGPRAresultsforallHHSprogramactivitiesispresentedintheperformancereportsandplansforHHSprogramcomponents,whicharecontainedintheindividualagencychaptersoftheCongressionalJustificationoftheFY2001budgetforHHS.ThoseperformancereportsincludeFY1999resultsdataforoverhalfoftheapproximately750performancemeasuresincludedinthefinalperformanceplanssubmittedtoCongressinFebruary1999.ThepredominantportionofthemeasuresforwhichFY1999dataarenotyetavailableisforprogramsforwhichHHSmustrelyonStatesandotheroutsideentitiesforperformancedata.AsrequiredbyOMBguidance,HHSwillreporttheresultsofallsuchFY1999performancemeasuresinfutureperformancereportssubmittedtoCongress.BudgetdecisionmakinginHHShasbeenkeytoDepartmentalcoordinationofprogramactivityandperformancemeasurementinHHS.Inrecentyears,HHSmodifieditsDepartmentalbudgetformulationprocessesspecificallytobetterbringtogetherinformationandleadersfromthroughouttheDepartmenttodefinetheprograminitiativesthatwillmoveHHStowardthecontinuedaccomplishmentofitsmissionandtowardcoordinatedprogramimprovement.AnticipatingthatGPRAinformationwillincreasinglyenhancethisdecisionmakingprocess,HHSincorporatedGPRAannualplanningandreportingintothebudgetformulationprocessandintotheHHSbudgetdocuments.Whileemphasizingourbeliefthatperformanceinformationwillbecomeincreasinglyusefulasmeasuresmatureandperformancetrendsemerge,theFY1999performancereportsofHHScomponentstakenasawhole,aswellasadditionalprograminformationfrompreviousyears,indicate:1)thatHHSperformanceplansareemployingmeasuresthataddressthenationalneedsthatgenerateourbudgetinitiatives,and2)thatimprovedresults,strategies,performancegoals,andcoordinationarealreadyinevidenceforareascoveredbythebudgetinitiativesoftheDepartment. -), Inthepagesthatfollow,wesummarizeperformanceconditionsandprogressrelatedtobothDepartmentalbudgetinitiativesandtotheDepartmentsGPRAstrategicgoals,asreflectedinreportedGPRAperformancedataforHHS.TheinformationthatisprovidedforFY1999andpreviousyearssignifiesthatthepursuitofprogramcoordinationandimprovementareDepartmentaltraits,andmarksHHSasanentitythatisfocusedonconcertedprogresstowardtheachievementofthemission,goalsandobjectivesoftheFY1997HHSStrategicPlanthroughitsDepartmentalinitiatives.AsGPRAimplementationcontinuestomature,programexecutivesandmanagersthroughoutHHSexpecttousetrenddataonperformanceresultstoseekthecoordinatedimprovementofHHSprogramsonanongoingbasis,specificallyby:1)assessingperformanceactivityandresults,2)engaginginprogramevaluationactivitywheredeeperassessmentisrequired,3)redefiningprogramstrategiestoproduceimprovedresults,and4)modifyingfutureperformancetargetstobeconsistentwithavailableresourcesanduptodateprioritiesandpolicydecisions.    ? ,X X,X,hX?iU.5%!`z3 `E`ttx [i (#(#     (#(#iU5%!`z3 `E`ttx [i lXXVJS#XVJXlڍ#UMMARYlXXVJP#XVJXl$#ERFORMANCElXXVJR#XVJXlr#EPORT  L  HHScrosscuttingbudgetinitiativessinceFY1998havereflectedextensiveDepartmentalemphasisonreducingthreatstothehealthandproductivityofAmericans.Mostinitiativeshavefocusedonasetofthreatsthatrequireemphasisandpriorityovermultiplefiscalyears,particularlytobaccouse,substanceabuse,domesticviolenceandinjury,andunhealthysexualbehaviors.L - !"#$%&(@h3L ?,X,hX,X X?YouthTobaccoUse    ReducingtobaccousebychildrenandyouthremainsahighpriorityinitiativethroughoutHHSandtheAdministration.CDCsHeartDiseaseandHealthPromotionprogramseekstopreventtobaccouse.SAMHSAadministerstheSynarAmendmenttosupportprogramsforcompliancetoreducethesaleoftobaccotominorsandmeasureschangesinyouthsmoking.FDAeffortsemphasizeitsregulatoryroleandaimtoincreasethenumberofcompliancechecksperformedatretailshopstoenforcetherequirementthatminorsdonotpurchasetobaccoproducts.L 0 !"#$%&(xh- !"#$%&(L  3    323  0    ReducingTobaccoUse: Between1991and1997,tobaccouseamongyouthincreasedfrom  \ 27.5percentto36.4percent.Inresponsetothisdisturbingtrend,theDepartmentestablishedaninitiativetoreducetobaccouseamongminors,ledbyCDC,FDA,SAMHSA,andOPHS.TheDepartmentwillmeasuretheimpactofitsactivitiesthroughthesharedCDCandOPHSFY1999goaltostoptheincreaseinyouthsmokingattheFY1997levelof36.4percent.Whiledatathatindicatethelevelofachievementforthiscrosscuttinggoalwillnotbeavailableuntil2000,CDCexpectsthattobaccocontrolprogramsshouldstartproducingannualratesofdeclineinyouthtobaccousebyFY2001.Forthatreason,CDCandOPHSsFY2001targetstoreduceyouthtobaccouseto35.9willbethefirsttoreflectananticipatedreductioninyouthsmoking. 3݌ (#(# Ќ    3    323  0    EnforcementatRetailEstablishments: TheFDAsenforcementeffortssupportsthe 4$" Departmentalinitiativebyreducingthenumberofretailerswhoselltobaccoproductstominors.SinceFY1997,FDAhasenteredintocontractswithall50statestoconductcompliancechecksatretailestablishmentsthatselltobaccoproducts.Byexpandingitscoveragefrom10statesinFY1997to43statesandterritoriesinFY1999,FDAhasbeenabletoincreasethenumberofcompliancechecksfrom6,464inFY1997toapproximately106,000inFY1999.FDAexpectsthenumberofcompliancecheckstoincreaseinFY20000@d"3.0@d" 0 asaresultofcontractssignedinFY1999thatexpandedcoveragetoall50statesand3territories. 3݌ (#(# Ќ        3    3^23  0    ImplementingtheSynarAmendment: SAMHSAsignificantlyexceededitsFY1999 p-(, performancetargetofdoublingfrom4to8thenumberofStateswhoserateoftobaccosales `.)- tominorsviolationsisatorbelow20percent.Theagencyreportedthat21StatesachievedthislevelofperformanceinFY1999.SAMHSA,inturn,madeitsFY2001targetmorerigorous,projectingthat36Stateswouldachievethislevelofcompliance.  3^݌(#(# Ќ  P - !"#$%&(@hx0 !"#$%&(=P YouthSubstanceAbuse  L  HHScontinuestoworkcloselywiththeONDCPtowardtheachievementofmeasurablereductionsindrugandalcoholabuse,particularlyamongyoungpeople.dHHSprograminitiativeshavefocusedonbothpreventionandtreatmentactivitiesinSAMHSA.IHSyouthsubstanceabuseprogramsfortheAI/ANpopulationsalsofocusonpreventionandtreatment.dOPHShassupportedeffortstoworkwithcommunitycoalitionsandothers.Researchactivities,particularlytheprogramsoftheNationalInstituteonDrugAbuseofNIH,arealsoanimportantaspectofthisHHSinitiative.L 0 !"#$%&(xh- !"#$%&(L  3    3-23  0    EffectivenessofTreatment: Inits1996NationalTreatmentImprovementEvaluationStudy   (NTIES),SAMHSAfoundaclearlinkagebetweentheprovisionofsubstanceabusetreatmentservicesandimprovedlifeoutcomesforbothchildrenandadults.ThefollowingareexamplesofNTIESfindingsontreatmenteffectiveness:78percentreductioninthepercentageofindividualsengaginginboththesaleofillicitdrugsandviolentcrimes; 3-[݌ (#(# Ќ  0  19percentincreaseintherateofemployment;42percentdecreaseinthepercentageofindividualswhowerehomeless;53percentdecreaseinalcoholandotherdrugrelatedmedicalvisits;28percentdecreaseininpatientmentalhealthvisits;and3456percentdecreasein highrisksexualbehaviorsassociatedwiththetransmissionofHIV. (#(# 9,X,hX,X,hX9L 0 !"#$%&(yx0 !"#$%&(L  3    3ʥ23  0    AssessingOutcomesofTreatment: TheNTIESfindingshaveledSAMHSAandState  substanceabuseprogramstopursuethedevelopmentofoutcomemeasuresonawiderscale.Since1997,throughtheTreatmentOutcomesandPerformancePilotStudies(TOPPS)initiative,SAMHSAandtheStateshaveidentifiedasetofoutcomeindicatorsforchildrenandadultsthatcanbeusedacrossStatestoassesssubstanceabuseprogramperformance.WiththeexperienceofNTIESandTOPPS,SAMHSAhasestablishedFY2001outcomeperformancetargetsforthe19StatesthatwillparticipateinTOPPSII.Althoughthiseffortwillnotprovidenationalperformanceoutcomeestimates,itwillprovidesignificantlybetterinformationontreatmentimpactsforthoseStates,andwillprovideaknowledgebasetoallowforexpansiontomoreStatesinfutureyears. 3ʥ݌ (#(# Ќ    3    3ש23  0    CoordinationonReductionofDrugUse: SAMHSAandHHShavealsoadoptedthe %8!$ followingONDCPlongtermprevalencetargetsasagencyandDepartmentalgoals:dBy2002,reducetheprevalenceofpastmonthuseofillegaldrugsandalcoholbyyouthby20percentasmeasuredagainstthe1996baseyear.By2007,reducethisprevalenceby50percent.d 3ש݌ (#(# Ќ    3    323  0    dPublicInformationd: SAMHSAsNationalClearinghouseforAlcoholandDrugInformation *%) (NCADI)experiencedtremendousgrowthinthenumberofrequestsitreceivedforinformation.In1999,SAMHSAdramaticallyexceededitstargetofafivepercentincreasefromits1997baseline;NCADIhada129percentincrease,foranaverageof40,285requestsforinformationpermonth.Basedonits1999performance,SAMHSAhassetmoreambitious <.)- futuretargets.In2001,SAMHSAprojectsthatitwillreach260percentofits1997baseline./XVJXXXVJNCADIisrespondingtothedemandgeneratedbytheONDCPNationalYouthAntiDrug  MediaCampaign.NCADIhasimplementedcallcenteroperations24hoursaday,7daysaweek,toservetheONDCPmediacampaignaswellasvariouspubliceducationcampaigns,andhasalsotakenonresponsibilityforSAMHSAsNationalTreatmentHelpline.#XVJXX/XVJŮ#Ԁ 31݌`(#(# Ќ    3    323  0    EffectiveUseofPreventionFunds: SAMHSAalsostrivestoimprovehowstatesspend 8  theirsubstanceabusepreventiondollarsbyencouragingthemtopromotesixpreventionstrategies:informationdissemination,education,alternativeactivities,problemidentificationandreferral,communitymobilization,andenvironmentalactivities.SAMHSAexceededits1999goalof80percentbyhaving90percentofStatesspendingpreventionfundsineachofthesixstrategyareas. 3݌ (#(# Ќ    3    3S23  0    SubstanceAbuseamongTribalYouth: 1XVJXXXVJԀBecausestudiesindicatethatthelongerindividuals   areengagedintreatment(includingaftercare/continuingcare)thebettertheprognosis,#XVJXX1XVJ#1XVJXXXVJIHS   hasdevelopedagoalfocusedonassuringadequatefollowupcareforadolescentsdischargedfromIHSsupportedRegionalTreatmentCenters(RTCs)#XVJXX1XVJӴ#1XVJXXXVJ.#XVJXX1XVJ#1XVJXXXVJԀIHSmetits#XVJXX1XVJ#FY1999targetto x determinebaselinesfortheratesandintensityoffollowupcare.Thefollowupratewithinthecriticalfirst30dayswas64.5percent1XVJXXXVJforthe815youthsdischargedfromthe12RTCin P FY1999.Thisratedropsto55.2percentforthosewhoreceivefollowupat30daysandatleastasecondfollowupby6months,anddownto40.9percentforthosewhoreceivefollowupcontactsat30days,atleastasecondfollowupby6months,andatleastathirdat12monthsafterdischarge.  #XVJXX1XVJ#1XVJXXXVJIHShassetatargettoincreasethefollowuprateby10percentin P FY2000.Inaddition,IHSwillestablishabaselineforameasuretoassesscontinuedabstinence(sixmonthsoflessalcoholanddrugusethanbeforetreatment)inFY2000#XVJXX1XVJ#1XVJXXXVJ.#XVJXX1XVJ# 3S~݌((#(# Ќ   DomesticViolenceandInjuries   Initsbudgetinitiatives,HHShasintroducedcrosscuttingstrategiestoreducethethreatoffamilyanddomesticviolence,particularlyagainstwomenandchildren,andtoreduceinjuryforallAmericans.TheHHSinitiativesreflecteffortstoprovidemoreresponsiveservicestoindividuals L! whosufferviolence,todevelopresearchaboutriskfactorsforperpetuatingviolence,andtochangethewaysthatsocietythinksaboutandtoleratesviolence.L 0 !"#$%&(yy0 !"#$%&(L  3    3"23  0    Surveillance: Muchisunknownaboutthefactorsthatcontributetointimatepartnerviolence $L # orviolenceagainstwomen.Since1994,CDChasfundedanumberofprojectstoincreasetheunderstandingoftheriskfactorsassociatedwithviolenceagainstwomen,themethodsofviolenceandtheeffectivenessofspecificinterventionorpreventionprograms.Onesuchprojectisabiannualsurveytodeterminetheincidenceandprevalenceofviolenceagainstwomen,whichwillbedevelopedinFY2000. 3"P݌ (#(# Ќ    3    3ؿ23  0    RecognizingDomesticViolence: 1XVJXXXVJRecognizingthatfamilyviolencevictims(child,spouseor t+&* elder#XVJXX1XVJn#1XVJXXXVJ)cometothehealthcaresystemwithavarietyofphysicalinjuries,illnessesormedical d,'+ conditionsdirectlyrelatedtoabuse,#XVJXX1XVJ#1XVJXXXVJԀIHSdevelopedagoaltoassurethatprovidersconsistently P-(, screenforindicationsofviolence,abuseorneglect andmakeappropriatereferrals.#XVJXX1XVJ#1XVJXXXVJԀA#XVJXX1XVJ#1XVJXXXVJԀwritten <.)- protocolmakesthismorelikelybecausetheseeffortsbecomepartofthelocalqualityassuranceprocess.#XVJXX1XVJ #1XVJXXXVJIHSexceededits#XVJXX1XVJ#FY1999goaltoassurethatatleast50percentofIHS,  Tribal,andUrbanfacilitieswithurgentcareoremergencydepartmentswouldhavewrittenpoliciesandproceduresforroutinelyidentifying,treatingand/orreferringvictimsoffamilyviolence,abuseorneglect.Asurveyof223clinicsandhospitalsthatshowedthat64percenthadwrittenpoliciesandproceduresinplace.Inaddition,thesurveydemonstratedthathavingpoliciesandproceduresinplaceactuallyraisedthelikelihoodthatpatientsareregularlyscreenedforviolenceabuseandneglect.  3ؿ݌$ t(#(# Ќ  9,X,hX,X,hX9  3    323  0    AddressingDomesticViolence: ACFplanstoincreasethenumberofFederallyrecognized  L  IndianTribesthathavefamilyviolencepreventionprograms.AlthoughACFsetatargetof162TribeshavingsuchprogramsinFY1999,itsurpasseditsgoalwith174Tribeshavingtheseprogramsinplace.InFY2001,ACFsgoalistohave189Tribeswithfamilyviolencepreventionprograms.Inaddition,EtFXXVJԀACFoperatestheNationalDomesticViolenceHotlinein   ordertoprovidereferralsandcounselingtothoseexperiencingabuse.Initsfirstyearofoperation,theHotlineanswered73,540phonecallsandthenumberofincomingcallsisdprojectedtoincreasetoanaverageof10,000phonecallspermonthinFY2001.d#XVJXFEt #EtFXXVJ   @  3"݌l(#(# Ќ  #XVJXFEt#  3    3N23  0    BicycleRelatedInjuries: InFY1996,anestimated352,000childrensoughtemergency < roomcareforabicyclerelatedinjury,30percentofwhichwerehead,facialandearinjuries.Studiesindicatethatbicyclehelmetsprevent6988percentofseriousheadorbraininjuries.AspartoftheDepartmentseffortstoreducebicyclerelatedinjuries,CDChasestablishedademonstrationprojecttoincreasetheuseofbicyclehelmetsbychildbicyclistsinCDCffundedprojectareas.AlthoughfinaldataforthismeasurewillnotbeavailableuntilApril2000,preliminarydatafromFY1998indicatethathelmetusageincreasedinallfiveprojectareas. 3N|݌ (#(# Ќ    3    323  0    ReducingInjuries: Becauseinjuriesarealeadingcauseofhospitalizationanddeathfor  AmericanIndianandAlaskanNativepeople,IHSsetaFY1999goaltoassurethattheinjurydeathratewasnogreaterthan93per100,000deaths.WhileFY1999datawillnotbeavailableuntilXX,therateforFY19941996hasdroppedto92.6per100,000,from95per100,000inFY19921994.Infact,injurieshavedroppedfromtheleadingcauseofdeathintheearlypartofthedecadetothesecondleadingcauseofdeathcurrently.Andwhileseven ,"|  IHSAreasstillhaveratesthatareabovetheFY1999target,mostoftheseareasareintheruralwestwheretraveldistancesarelongandresidentsareathighriskformotorvehiclerelatedinjury.However,theseArearateshavebeentrendingdownward,duetoeffortstoreduceimpaireddriving,thetribespassingtougherdrunkdrivingandoccupantrestraintlaws,andstricterenforcementoftheselaws. 3݌ (#(# Ќ  ##P 0 !"#$%&(xy0 !"#$%&(ּP ReducingSexuallyTransmittedDiseases  )$( SexuallyTransmittedDiseases(STDs)areoneofthemostcriticalchallengesinthenationtodaybecauseoftheirsevere,costlyconsequencesforwomenandinfants;theirtremendousimpactonthehealthofadolescentsandyoungadults(especiallyamongminoritypopulations);andtheintegralroletheyplayinthetransmissionofHIVinfection.HHScrosscuttingbudgetinitiatives (.x)- havegivenemphasistobothpreventionandtreatmentstrategies.HHSconsistentlyseekstopromotehealthybehaviorsanddiscourageriskyones.Forexample,westrivetoextendHIVcounseling,testing,andreferralserviceswhereyoung,lowincome,andminoritychildrenareathighriskofinfection.SurveillanceofriskybehavioralfactorspredisposingchildrenandyouthtosexuallytransmitteddiseasehasbeenasignificantchallengefortheDepartmentaswepursueinformationthatisrelevanttopreventionpoliciesandapproachesfordecisionmakers.L 0 !"#$%&(xx0 !"#$%&(L  3    323  0    HIV/AIDSPreventioninYouth :CDCsHIV/AIDSprogrammonitorsstudents'exposure $ t toHIV/AIDSpreventioneducationinschools,whichhasbeendemonstratedtoreduceriskbehaviorsamongyouth,andyouthbehaviorsthataffecttheirriskofbecominginfectedwithHIV.InFY2000,theprogramwillreportonitsFY1999goaltomaintainthepercentageofhighschoolstudentswhohavebeentaughtaboutHIV/AIDSpreventioninschoolat90percentorgreater.TheFY1997rateis92percent,upfrom86percentin95.Inaddition,CDChassetFY2000targetstoreducethepercentageofhighschoolstudentswhohaveeverengagedinsexualintercourseto45percentfrom48percentinFY1997andtoreducethepercentageofcurrentlysexuallyactivehighschoolstudentswhoengageinsexualintercoursewithoutacondomto38percentfrom43percentinFY1997. 3A݌ (#(# Ќ  L 0 !"#$%&(xx0 !"#$%&(L  3    323  0    GonorrheaandChlamydia :CDCandOPHSperformancegoalsfocusonwomenaged L 15-44seenatpubliclyfundedfamilyplanningandSTDclinicsforseveralreasons:womenofchild-bearingageexperiencehighincidenceratesofgonorrheaandchlamydia;womeninfectedwithNeisseriagonorrheaorChlamydiatrachomatiscandeveloppelvicinflammatorydiseasewhichmay,inturn,leadtoadversereproductiveconsequences(e.g.ectopicpregnancy,tubalfactorinfertility;)familyplanningandSTDclinicsrepresentclinicsettingswiththehighestprevalenceratesforthesediseases;andCDCresourcessupportfamilyplanningandSTDclinics,therefore,performancemeasuresatthesesitesaregoodindicatorsforprogrameffectiveness. 3݌ (#(# Ќ  ݀L 0 !"#$%&(xx0 !"#$%&(LL , !"#$%&(dxx0 !"#$%&(L  3   0   32d3  0(#(#  Gonorrhea:In1998,355,642casesofgonorrheawerereportedtoCDC,foranoverall  rateof132.9casesper100,000population.Thiswasan8.9percentincreaseincasescomparedwith1997,andthefirstincreasesince1985.Theincreasein1998wasseeninalldemographicgroupsdefinedbyage,sex,andrace/ethnicity,andoccurredinallmajorgeographicregionsexcepttheNortheast.Possiblereasonsfortheincreaseingonorrheaincludeexpansionofscreeningprograms(motivatedby  theavailabilityofsimultaneous  $#t!  testingforgenitalchlamydialinfections),increaseduseofnewdiagnostictestswith $d" improvedsensitivity,improvementsinsurveillancesystems,and,insomesegmentsofthepopulation(includingmenwhohavesexwithmen),trueincreasesinmorbidity.ThisisalsoreflectedinthemostrecentdataforthejointCDC/OPHSgoaltoreducetheincidenceofgonorrheainwomenaged1544inpubliclyfundedfamilyplanningandSTDclinicstolessthan250per100,000byFY1999.FY1998datashowarateof292per100,000,risingfrom261inFY1997and259inFY1996. 3>݌ (#(# Ќ  0   (#(#   3   0   32d3  0(#(#  Chlamydia:In1998,CDCreportedagenitalchlamydiainfectionrateof233.7casesper t+&* 100,000population,thehighestratereportedsincecaseswerefirstreportedinthemid1980s.Theincreaseinreportedinfectionsreflectsthecontinuedexpansionofchlamydiascreeningprogramsandtheincreaseduseofmoresensitivediagnostictestsforthis 8.)- condition.Overthesameperiod,dataonchlamydiaprevalenceobtainedbymonitoringpositivityratesofpersonsscreenedinavarietyofclinicsettingshaveconsistentlydocumenteddeclininglevelsofinfectioninmanypartsoftheU.S.InFY1998,CDCreportsaprevalencerateof5.4percentamongwomenundertheageof25inpubliclyfundedfamilyplanningandSTDclinics,alreadysurpassingtheFY1999targetoflessthansixpercent.However,amonghighriskwomenunder25,theprevalenceratewas11.7 L  percent,wellabovetheFY1999targettolowertheprevalencerateto8percent. 3݌ (#(# Ќ  P 0 !"#$%&(xx, !"#$%&(P  3    323  0    PrimaryandSecondarySyphilis .From1990to1998,theprimaryandsecondarysyphilis  ` ratedeclinedby86percent,from20.3to2.6per100,000,thelowestlevelsincereportingbeganin1941.SyphilishasdeclinedinallregionsoftheUnitedStatesandinallracial/ethnicgroups,howeverratesremaindisproportionatelyhighamongnonHispanicblacksandintheSouth,andfocaloutbreakscontinuetooccur.Toaddresstheseregionaldifferences,CDCsetagoaltoreducetheincidenceofprimaryandsecondarysyphilisthroughthedevelopmentofsyphiliseliminationactionplansforeachstatewitharateofgreaterthanorequalto4per100,000population.InFY1998,CDCachieveditsFY1999targettoincreasethepercentofU.S.countiesthathaveanincidenceofprimaryandsecondarysyphilisinthegeneralpopulationoflessthanorequalto4per100,000. 3݌ (#(# Ќ    3    323  0    CongenitalSyphilis :In1998,801casesofcongenitalsyphiliswerereportedtoCDC,fora 8 rateof20.6casesper100,000livebirths,movingtowardsCDCsFY1999targetoflessthan20per100,000.Inparallelwiththedeclineinprimaryandsecondarysyphilis,therateofcongenitalsyphilishasdeclineddramaticallyfromapeakof107.3per100,000livebirthsin1991.Noorlatesyphilisserologictestingduringpregnancy,oftenrelatedtolackofprenatalcareorlateprenatalcare,remainsthemajorreasonthatcongenitalsyphilispersistsintheU.S.Congenitalsyphilisisahighpriorityforprogrammaticactivityandeachpositivetestinachildisconsideredamedicalemergencywithimmediatehealthservicesfollowup.Effectiveprenatalscreeningprogramsforpatientsathighriskofsyphilisaccountforasubstantialportionofthereduction. 3݌ (#(# Ќ   t iU25%!`z  `Ett oi (#(#      (#(#iU5%!`z  `Ett oi lXXVJS#XVJXl#UMMARYlXXVJP#XVJXl#ERFORMANCElXXVJR#XVJXl`#EPORT  8  Overthelastfouryears,crosscuttingDepartmentalbudgetinitiativessupportingthisstrategicgoalhavefocusedespeciallyonimprovingtheeconomicandsocialwellbeingofthemostvulnerableinthenation:childrenandtheirfamilies,theelderly,thedisabled,andthedisadvantaged.ProminentDepartmentalinitiativestoimprovethelivesofchildrenhaveinvolvedacrosssectionofHHSprograms,including:HeadStart,ChildCare,ChildSupport,ChildrensHealth,YouthSubstanceAbuse,theStateChildrensHealthInsuranceProgram(SCHIP),Medicaid,andMaternalandChildHealth.TheHHSinitiativeshavealsosoughtcontinuousimprovementfortheelderlywitheldercare,improvementsinMedicare,increasedhealthplanchoices,andreformoflongtermcare.AsanintegratedDepartment,HHShasalsopursuedimprovedhealthforthenationasawhole,withinitiativesthatfocusonimprovementsinareasreflectedintheleadinghealthindicatorsthatwillbeestablishedundertheDepartmentsHealthy p People2010program. \ L 0 !"#$%&(yx0 !"#$%&(LEtFXXVJ ChildrensHealthandDevelopment   p #XVJXFEt{#HHSscrosscuttingbudgetinitiativesforthehealthydevelopmentofchildrenhavefocusedon 8 theavailability,access,andqualityofcareinmultiplesettings.Initiativeshavecoveredhealth,safety,emotional,economicwellbeing,andknowledgedevelopmentforpreschoolersandolderchildren.HHSeffortscutacrosscomponentagenciesandalsofostercommunicationwithandbyStateandlocalagenciesthatservechildren.Forexample,throughAdministrationandHHSinitiativesofrecentyears,HCFA,HRSA,ACFandtheStatesarereachingouttouninsuredchildrenandtheirfamiliesthroughmultipleprogrammechanismstoensurethattheyhaveaccesstohealthinsurancecoverageandservices.EtFXXVJ \! #XVJXFEt#  3    3<23  0    ChildhoodVaccinations: Datashowthatcasesofvaccinepreventablechildhooddiseases 0#! havebeenreducedby97percentfrompeaklevelsbeforethevaccineswereavailable.Similarly,vaccinationofpreschoolagechildrenisatanalltimehighforallgroups.Toensurethatpreschoolagechildrencontinuetobevaccinatedagainstpreventablediseases,CDCandHCFAhavedevelopedcomplementarygoalstoincreasethepercentageof2yearoldchildrentoreceiveallrecommendedchildhoodvaccinations.CDCseffortsfocusonmaintaininga90percentcoveragerateamongchildren1935monthsforeachrecommendedvaccine.WhileFY1999datawillnotbeavailableuntil2000,datafromFY97indicatethatCDCmetthatgoalforallbuttwovaccines.HCFAwillcontinuetodevelopitsgoaltoincreasethepercentageofMedicaidtwoyearoldchildrenwhoarefullyimmunized.Thefirstgroupof16statesbegandevelopingtheirmethodsofmeasurementandperformancebaselinesinFY1999, andwillcompletesettingtheirbaselinesbytheendofFY2000.EtFXXVJ 3<j݌X-(,(#(# Ќ    3    3R23  0    #XVJXFEt#IHSWellChildVisits :1XVJXXXVJArecognizedstandardofcare,wellchildvisitshavebeenassociated   withimprovedpostneonatalmortalityandopportunitiestoimprovefamilyhealthandsafetyinthelongerterm.Ofparticularimportanceareeducationalinterventionswithparentsconcerningdietandnutrition,injuryprevention,andpreventionoffamilyviolence.Aspartoflargereffortstoim#XVJXX1XVJ#1XVJXXXVJprovechildandfamilyhealth#XVJXX1XVJ#1XVJXXXVJ,IHSsetaFY1999goal todeterminethe d proportionoftheAmericanIndianandAlaskanNativechildrenreceivingaminimumoffourwellchildvisitsby27monthsofage.ProvisionalFY1999dataindicatethatoutof9,873children,3,799or38.5percentofthechildrenmetthiscriteria.  #XVJXX1XVJ3#1XVJXXXVJԀIHShassetaFY2000target ( x toincreasecoveragebythreepercentovertheFY1999baseline.#XVJXX1XVJ#EtFXXVJ 3R}݌ d(#(# Ќ    3    3 23  0    HealthandLearningReadinessofHeadStartChildren: dHeadStarthasbeguntoassesshow  8  programeffortsinfluencethedevelopmentofemergentliteracy,numeracy,andcognitiveskills;grossandfinemotorskills;andsocialskillsofparticipatingchildrenthroughitsFamilyandChildExperiencesSurvey(FACES).Specificmeasures/EtFFEt#/XVJXF/Etr #focusonmaintenanceof   improvementsinvocabulary,math,andsocialskillsaswellasincreasingratesofimprovementinletteridentificationandgrossandfinemotorskills.#XVJXX/XVJ #dEtFXXVJBaselinedatacollectedfrom19971999 |  indicatethatchildrenexperiencedimprovementinallofthesedimensions./EtFFEt#/XVJXF/Et #Forexample,the h datashowsthatHeadStarthelpschildrenimprovetheirvocabularyskillsduringboththeirHeadStartyearandkindergartenyearsatafasterratethantheaveragerateofimprovementforchildrenofallincomelevels.#XVJXX/XVJ #EtFXXVJԀACFisestablishingperformancegoalstoassesslearning ,| developmentusingthemeasurementscalesemployedfortheFACES.#XVJXFEt#EtFXXVJ 3  ݌h(#(# Ќ    #XVJXFEt#ԀEtFXXVJ P   3    323  0    Adoption: AspartoftheNationalPerformanceReviews HighImpactAgencyinitiativeand < consistentwiththePresentsadoptiongoalfor2001,ACFadoptedagoalofincreasingthenumberofchildrenwhoareadoptedfromthepublicfostercaresystemto51,000byFY2001.Adoptionshaveincreasedfrom28,000inFY1996to36,000inFY1998.#XVJXFEtS#EtFXXVJ 3݌(#(# Ќ   EconomicIndependenceforFamilies  ` #XVJXFEt#RecentHHSbudgetinitiativeshavereflectedtheconvictionthattheeffectivedevelopmentof ( x childrendependsheavilyonfamilysecurity,independenceandhealth.Employmentandincomearethefundamentalelementsofindependentcareforchildreninhouseholds.NewandreformedprogramactivitiesadministeredandsupportedbyHHSseektostrengthenfamiliesbyhelpingthemparticipateintheworkforce,receivefinancialsupportthatislegallytheirs,andmeettheirobligationsathome.EtFXXVJ $ #   3   d 323  0    EmploymentofFormerPublicAssistanceRecipients: ACFsgoalundertheNational &!% PerformanceReviews HighImpactAgencyinitiativewastoincreaseselfsufficiencyforlowincomefamiliesbymovingonemillionwelfarerecipientsintonewemploymentby2000.ACFachieveditsgoalearlierthananticipated,with46statesreporting1.3millionjobentriesforFY1998.ACFprojectsthatitcanincreasethepercentageofadultrecipientswhobecomenewlyemployedto43percentofalladultsreceivingcashassistanceinFY2001.dd 3݌ (#(# Ќ  d  3    323  0    ChildSupport: Atotalof1.5millionpaternitieswereestablishedandacknowledgedinFY ,D(, 1998,da12.1percentincreaseoverFY1997.dTotalchildsupportcollectionswere$15.5 -0)- billionforFY1999.ACFhassetambitiousfuturetargetsforchildsupportcollections,aimingtoincreasethecollectionrateforchildrenofIVDcasesto71percentofcurrentchildsupportduebyFY2001.#XVJXFEtn#dInordertodramaticallyimprovecollectionrates,aFederal/Statework  groupdevelopedincentivefundingrecommendationsinalignmentwithpreviouscollaborativestrategicplanningandperformancemeasurementdevelopmentefforts.Theformula,tobephasedinstartinginFY2000,willbeinstrumentalindrivingtheCSEprogramtowardachievementoftheperformancetargets.d 3݌ (#(# Ќ    3    323  0    EmploymentofRefugees: ACFassisted52,298refugeesobtainemploymentinFY1998,  X thusmeetingandsurpassingits1999goalmorethanayearaheadofschedule.1XVJXXXVJACFsOffice  H  ofRefugeeResettlementprovidesresourcesandtechnicalassistancetoStatesandothergranteesinordertohelprefugeesachieveeconomicselfsufficiencyandsocialadjustmentwithintheshortesttimepossiblefollowingtheirarrivalintheU.S.ForFY2001,ACFisrequestingincreasedfundingtoprovidecashandmedicalassistanceandemploymentservicestoanincreasednumberofrefugeeadmissionsfromKosovo,BosniaandAfrica. 3݌ (#(# Ќ  #XVJXX1XVJ# TheAgingPopulation  X Elderlyanddisabledpersonswhocancontinuetoliveandparticipateinthecommunityproducepositivebenefitsforoursociety:healthcarecostsarecontrolled,thestressleveloffamilieswhodonothavetocommittheirlovedonestoinstitutionsremainslow,andtheindividualishappierandmorelikelytocontributetohisorherenvironment.  3    3!23  0    VaccinationsforSeniorCitizens: Toreducetheincidenceofdeathsrelatedtoinfluenzaand  pneumoccoccaldisease,healthprofessionalsrecommendlifetimevaccinationforpneumoccoccaldiseaseandannualvaccinationforinfluenzaforpersonsaged65andover.CDCandHCFAsharecomplementarygoalstoincreasethenumberofannualinfluenzaandlifetimepneumoccoccalvaccinationsamongselectedpopulationsaged65andover.Forexample,CDCandHCFAshareFY1999goalstoincreasetheannualinfluenzavaccinationratestonear60percent.Althoughfinaldataforthismeasureisnotyetavailable,CDCdataindicatesthattherateofvaccinationforinfluenzaamongpersonsaged65andoverincreasedfrom33percentinFY1989to63percentinFY1997. 3!#"݌ (#(# Ќ    3    3%23  0    NutritionServices: AoAhasinitiatedanumberofactivitiestohelpseniorshaveanactive $X" andhealthyagingexperiencebyincreasingtheirabilitytoliveindependentlyandreducingtheneedforinstutionalization.Oneofthoseactivitiesisnutritionservices,whichprovidesseniorswithopportunitiesforbetternutritionandimprovedhealth.AoAmeasuresitsperformancewithtargetsdescribingthenumberofhomedeliveredandcongregatemealsitserves.Forexample,AoAestablishedanFY1999goaltomaintainthenumberofhomedeliveredmealsitservesat119million(theFY1995baseline).AoAexpectstoincreasethisnumberto166millioninFY2001. 3%%݌ (#(# Ќ    3    3)23  0    AccessServices: AoAalsofostersindependenceamongseniorsthroughtheprovisionof X,'+ transportationandinformationandassistanceservices.AoAmeasuresitsperformanceforeachserviceusingindicatorsofthenumberofcontactsorrides.Forexample,AoA 4.)- establishedagoalinFY1999tomaintainthenumberofonewayridesovertheFY1995baselineof39.5million.AlthoughdataonthismeasurewillnotbeavailableuntilFY2001,trenddataindicatesthatAoAhasincreasedthenumberofridesfrom39.5millionridesinFY1995to46.6millioninFY1997.AoAsFY2001targettoincreasethenumberofridesto50.7millionreflectsthistrend. 3)>)݌ (#(# Ќ  # #P 0 !"#$%&(xy0 !"#$%&(/P  L  iU35%!`z  `Ett ki (#(#       (#(#iU5%!`z  `Ett ki lXXVJS#XVJXl.#UMMARYlXXVJP#XVJXl/#ERFORMANCElXXVJR#XVJXlg/#EPORT  $ t HHSbudgetinitiativesforallofthelastfouryearshavepursuedimprovedaccesstohealthcarefortheapproximately44millionAmericanswhoholdnohealthinsurance,andhavesupportedeffortstoensurethatthosewhohavecoveragecanretainit.TheinitiativesarebroadbasedandinvolvemultipleHHScomponents.Theyhaveinitiatedimprovementsinprimarycareforvulnerablepopulations,andseektoovercomeinadequatecapacityinruralandinnercitylocations.Theypursuecontinuedinsurancecoverageforindividualschangingemployment,andenhancedcoverageforthoseeligibleforbothMedicareandMedicaid.Theypursuecosteffectiveoptionsandchoicestohelpindividualsretaincoverage.Evenafterseveralyearsofdemonstratedimprovements,thefinancialandmanagementintegrityoftheMedicareprogramremainsoneofthehighestprioritiesofHHS,andsimilarattentionisbeingfocusedonMedicaid. AvailabilityofPrimaryHealthCareServices  4 L , !"#$%&(dxx0 !"#$%&(LL 0 !"#$%&(yx, !"#$%&(LTheroleoftheFederalgovernmentintheprimaryhealthcareareaisnottoprovideawiderangeofservicestothegeneralpopulation,buttotargetspecificservicestoparticulargroups,focusingonthesupplyofservices,staffingavailability,andworkingwithotherstoanticipatechangesinthewaythatservicesaredelivered.#X4#P , !"#$%&(dxy0 !"#$%&( 4PL 0 !"#$%&(yx, !"#$%&(L  3    3623  0    StateChildrensHealthInsuranceProgram(SCHIP)/Medicaid :Approximately11  millionchildrenunderage19lackhealthinsurancecoverage.ThePresident,CongressandtheDepartmenthaveallcommittedtoinsuringmorechildrenthroughtheStateChildrensHealthInsuranceProgram.AscriticalplayersintheDepartmentsinitiativetoenrollmorechildreninSCHIPandMedicaid,theStateshaveimplementedseveralprocessimprovementstohelpachievethatgoal.Specifically,inFY1999eachStatedevelopedaSCHIPplanthatdescribesthestrategicobjectives,performancegoals,andperformancemeasurestheywillusetoassesstheeffectivenessoftheirplans.TheseprocessimprovementswillsupporttheachievementofHCFAsFY2001nationalgoaltoincreasethenumberofchildrenenrolledinregularMedicaidorSCHIPby1millionoverthepreviousyear. 366݌ (#(# Ќ  #6#P , !"#$%&(dxy0 !"#$%&(=6PL 0 !"#$%&(yx, !"#$%&(L#;#P , !"#$%&(dxy0 !"#$%&(N;PL 0 !"#$%&(yx, !"#$%&(L  3   1XVJXXXVJ 3y<23  0    AccessforMinority,LowIncome,andUninsuredPersons :InFY1998sHealthCenters ( $' andtheNationalHealthServiceCorpsprogramsserved10.4millionpersons,providingprimarycareandpreventiveservicestoapopulationthatwaslargelyminority(64percent)andlowincome(86percent)anddisproportionatelyuninsured(41percent)#XVJXX1XVJ<#.Insupportofits +&* roleasasafelynetprovider,HRSAwillreportonthecontinuedprovisionofpreventiveandprimarycareservicestolowincome,minority,anduninsuredindividualsforFY1999andbeyond. 3y<<݌\.)-(#(# Ќ    3    3?23  0    XVJXXXVJMaternalandChildHealth :InpartnershipwiththeStates,HRSAsMaternalandChild  HealthBureauworkstoadvancethehealthofourNationsmothers,infants,children,andadolescents.#XVJXXXVJ7@#XVJXXXVJInFY1998,theStatesbeganreportingonasetofgoalsdevelopedtomeasure  thenationalimpactoftheMaternalandChildHealth(MCH)StateBlockGrant,whichserved20.2millionchildreninFY1997.InFY1999,theprogramestablishedbaselinesforthemeasuresandsettargetsforFY2001.#XVJXXXVJSA#ԀSelectedMCHgoalsinclude: 3??݌P (#(# Ќ  L , !"#$%&(dxy0 !"#$%&(LXVJXXXVJL , !"#$%&(dxx, !"#$%&(L !;   0  !;D0(#(#2d3  04(#(#  Decreasetheinfantmortalityrate#XVJXXXVJC#ԀfromtheFY1997rateof7.1/1000to6.9/1000in ( x FY2001,anddecreasetheratiooftheblackinfantmortalityratetothewhiteinfantmortalityratefrom2.4to1inFY1996to2.1to1inFY2001.!;D?D݌ 4(#4(# Ќ   !;   0  !;E0(#(#2d3  04(#(#  Increasethepercentofinfantsborntopregnantwomenreceivingcarebeginninginthe  <  firsttrimesterfrom82.5percentinFY1997to90percentinFY2001.!;E4F݌ 4(#4(# Ќ   !;   0  !;G0(#(#2d3  04(#(#  IncreasethepercentofchildrenwithspecialhealthcareneedsintheStatewitha   medical/healthhome(asdefinedandrecommendedbytheAmericanAcademyofPediatricsXVJXXXVJ)from69percentinFY1997to80percentinFY2001.#XVJXXXVJH#!;GG݌ 4(#4(# Ќ   !;   0  !;I0(#(#2d3  04(#(#  IntheHealthyStartInitiative,dXVJXXXVJecreasethepercentageoflowbirthweightbabiesborn   toHealthyStartclientsfrom12.09percentinFY1998,to11.75percentinFY2001.#XVJXXXVJNJ#!;II݌t4(#4(# Ќ  P , !"#$%&(dxx, !"#$%&(-<PL , !"#$%&(dxx, !"#$%&(LP , !"#$%&(dxx, !"#$%&(KPL 0 !"#$%&(xx, !"#$%&(L  3    3L23  0    ImprovingAccessforAmericanIndiansandAlaskanNativesThroughFacilities L Construction : Constructionofnewhealthcarefacilitiestoreplaceold,inadequatefacilitiesis 8 thefirststepinimprovingaccessforunderservedlocations.1XVJXXXVJԀ#XVJXX1XVJ23  0    CounteringBioterrorism: TheDepartmentestablishedaCounteringBioterrorisminitiative `,'+ inresponsetothegrowingthreatofbiologicalterrorism.Theinitiativefocusesonstrengtheningthepublichealthcapacityatthefederal,stateandlocalleveltorespondtoa <.)- terroristevent.InFY1999,CDCdistributed$41millionincooperativeagreementsto48statesand3citiesforupgradingtheircapabilitiesforpreparingandrespondingtoterroristevents.Inaddition,CDCachieveditsFY1999goalofcreatinganationalpharmaceutical stockpileavailablefordeploymenttorespondtoterroristuseofpotentialbiologicalorchemicalagents,includingtheabilitytoprotect14millionciviliansfromanthraxattacks. 3>)?݌ (#(# Ќ    3    3B23  0    SurveillanceofFoodborneIllness: Improvingpublichealthagenciescapacitytomonitor 8  foodborneillnessisakeycomponentoftheFoodSafetyInitiative.CDChasadoptedandachievedgoalstoincreasesurveillanceoffoodborneillness.InFY1999,CDCestablishedagoaltoincreasetheproportionofreportedfoodborneoutbreakinvestigationsinwhichthecausativeorganismortoxinisidentifiedto45percent,from40percentinthebaselineyearofFY1998.PerformancedataindicatethatCDCexceededtheFY1999targetbyidentifying48percentofthecausativeorganismsortoxins. 3BB݌ (#(# Ќ      3    3E23  0    PublicHealthInfrastructure: CDChasplayedamajorroleinachievingthiscenturysmost   significantaccomplishmentsinpublichealth,suchastheeradicationofsmallpoxin1977.However,theemergenceofdrugresistanceinbacteria,parasites,viruses,andfungiisswiftlyreversingadvancesofthelast50years.CDCwillmeasureitsprogresstowardadaptingthepublichealthinfrastructuretorespondtothesethreatsusingseveralindicatorsofimprovementsinlaboratoryandepidemiologiccapacity.InFY1999,CDCmetitsgoalofreducingthetimeforprovidingparasiticdiseasesreferencelaboratorydiagnosticresultstostatelaboratoriesfrom24hoursto2hoursforurgentcasesandfrom2weeksto2daysforroutinecasesfor90percentofrequests.Thisisthelowestamountoftimethatcouldbeexpectedforaccurateandreliabletesting. 3EF݌ (#(# Ќ    iU5%!`z  `Ett oi (#(#      (#(#iU5%!`z  `Ett oi lXXVJS#XVJXlK#UMMARYlXXVJP#XVJXl L#ERFORMANCElXXVJR#XVJXlXL#EPORT  8  Healthresearchhasmadeenormouscontributionstoimprovinghumanhealth.Manyofthediseases,injuries,anddisabilitiesthatourparentsandgrandparentsfacedagenerationagocannowbepreventedortreated.Today,weareatthebrinkofdiscoveriesthathavethepotentialtorevolutionizetheprevention,diagnosis,andtreatmentofdiseaseaswellasthedeliveryofqualityhealthcareinAmericaandaroundtheworld.AsaDepartment,HHShasrecognizedthepotentialforhealthresearchadvancesandcontinuestopursueafocusedandbalancedapproachtofundingresearchandtheinfrastructurenecessarytotakeadvantageofresearchopportunities.HumanGenome  HHSismaintainingtheresearchinitiativesofrecentyears,seizingadditionalopportunities,and \ respondingtonewpublichealthneeds.AsHHSprogresseswiththecompletionofthehumangenomeproject,theDepartmentemphasizescrosscuttingresearchtoexploitgenomicdiscoveries.FundamentaltothesuccessofHHSsresearchobjectivesareitseffortstotrainandsupportthenewkindsofscientiststhatwillincreasinglybeabletotakeadvantageofthepowerofbiomedicalcomputing,bothtomanageandanalyzedataandtomodelbiologicalprocesses. H   3    3Q23  0    HumanGenomeProject: TheHumanGenomeProjectseekstounderstandthegenetic   instructionsthatmakeusunique.Progressincompletingthemapofthehumangenomehasalreadybeguntoyieldinformationthathasthepotentialtoimprovetheprevention,diagnosisandtreatmentofdiseaseanddisability.Scientistshavealreadyunraveledmorethan20percentofthehumangenome.TheHumanGenomeProjecthassuccessfullycompletedthepilotphaseofsequencingthehumangenome,whichtestedstrategiesanddevelopedtechnologiesforlargersequencingprojects,andhaslaunchedthefullscaleefforttosequenceall3billionbasesofhumanDNA.InFY1999,NIHexceededitstargettocomplete400millionbasepairsofthetotalhumangenomicsequenceworldwide.Finaldataindicatethat442millionbasepairswerecompletedworldwide.Itisexpectedthattheprojectwillproduceatlast90percentofthehumangenomesequencein workingdraftformbySpring2000,considerablyaheadofschedule.Theworkingdraftwillthenserveasthefoundationforfinetuningthesequenceleadingtocompletionofthepermanenthighquality,humanDNAsequenceby2003atthelatest. 3QR݌( $'(#(# Ќ   ImprovethePrevention,Diagnosis,andTreatmentofDiseaseandDisability  +&* Becausemanydiseasesanddisabilitiesaredirectlylinkedtolifestyleandunhealthybehaviors,HHSanditspartnershavebeencommittedtodiseasepreventionthrougheducationand X.)- communityinterventionsinavarietyofhealthareas,including:cardiovasculardisease,diabetes,nutrition,HIVprevention,andoralhealth.Researchfindingsaboutnormalandabnormalbiologicalfunctionsconstituteanessentialknowledgebasetosupportadvancesinpreventionandtreatmentscienceandtodeterminewhateffortsarepossibleandeffectiveacrossthepopulation.    3    3Z23  0    NormalandAbnormalBiologicalFunctionsandBehavior: Understandinghowdisease, L  geneticalterations,andenvironmentalfactorsaffectthefunctionofmolecules,cells,tissues,organsandorganismsandtheirconsequencesforhumanhealtharecriticaltoimprovingourunderstandingofdiseaseanddevelopingmethodsforpreventing,diagnosingandtreatingit.Thenonlinearnatureofbasicresearchposesuniquechallengesformeasuringresearchoutcomes.However,inFY1999,NIHdevelopedamethodforevaluatingtheagencysprogresstowardmeetingestablishedoutcomegoals,oneofwhichaddressedthequestionofhowNIHresearchaddedtothebodyofknowledgeaboutnormalandabnormalbiologicalfunctionsandbehavior.Byevaluatingadvancesinscienceandstoriesofdiscovery,anassessmentgroupconcludedthatNIHhadexceededitsgoalforFY1999.Specifically,theWorkingGroup,whichconsistedofexpertsinthefieldofbiomedicalresearch,concludedthattheoutcomesdemonstratedthatNIHhadsustainedtheexcellenceandresponsivenessoftheresearchsystemanimportantachievement!whiledemonstratingwillingnesstotakeresearchrisksnecessarytoadvancingbiomedicalknowledge,andultimatelyhumanhealth.TheWorkingGroupalsohighlightedanumberofespeciallynoteworthyoutcomesthat,inthejudgmentofthemembers,fulfilledthecriteriaforhavingsubstantiallyexceededthegoal.Theseadvancesfellintoanumberofbroadcategories:cellproliferationresearch,studiesofgenefunctionandexpression,immunology,thebiologicalbasesofcardiovasculardisease,thebrain,learningandmemory,behaviorstudies,andpopulationstudies. 3ZMZ݌ (#(# Ќ        3    3a23  0    Prevention,DiagnosisandTreatment: NIHfundedappliedresearchhasyieldedsignificant  advancesintheprevention,diagnosis,andtreatmentofdiseaseanddisability.Thisyear,NIHestablishedaformalmechanismforevaluatingtheextenttowhichthosecontributionssupportedspecificagencygoals.AspartoftheresearchoutcomesprojectthatbeganinFY1999,NIHestablishedoutcomegoalsfortheprevention,diagnosisandtreatmentofdiseaseanddisability.Again,byevaluatingscienceadvancesandstoriesofdiscovery,theassessmentgroupconcludedthatNIHexceededallthreeofthesegoalsforFY1999.Specifically,theWorkingGroupconcludedthattheFY1999researchoutcomesrepresentasignificantcontributiontoprogressindevelopingneworimprovedapproachesforpreventingordelayingtheonsetofdiseaseanddisability.TheresearchoutcomesdemonstrateNIHresponsivenesstohealthneedsandscientificopportunitiesandinnovativeusesoftechnologies.TheWorkingGroupalsohighlightedanumberofespeciallynoteworthyoutcomesthat,inthejudgmentofthemembers,fulfilledthecriteriaforhavingsubstantiallyexceededthegoal.Theseadvancesfellintoanumberofbroadcategories:longitudinalstudies;studiesrelatedtothepreventionandtreatmentofmentalillnessacrossthelifespan;therapeuticinterventionsthatalsopreventorslowdiseaseprogression;behavioralinterventions;andcommunitybasedinterventions.  3aa݌)$((#(# Ќ   HealthCareQuality,Financing,Cost,andCostEffectiveness  \,'+   H-(, Aswepursueadvancesinsciencetopreventandeliminatedisease,HHSanditspartnersseekto adjustthehealthcaresystemtoshiftitsfocusfromtreatmentofillnesstoclinicalprevention.Departmentalcrosscuttingactivityisleadingthehealthcaresystemtoaddressthechallengesofimprovingthequality,safetyandefficiencyofcare,particularlyforaselectnumberofhighprioritychallengesamongvulnerablepopulations.HHScontinuestopursuetheidentificationofresearchneedsrelatedtoquality,thecapacitytoconductresearch,andstrategiesandmethodsforintegratingqualitymeasurementandimprovementintoprofessionalcurriculaandpractice.    3    3ek23  0    AHRQResearchAgenda: ConsistentwiththeprincipaloftheAgencyforHealthcare  ` ResearchandQuality(AHRQ)thatitsresearchshouldbeginandendwithitscustomers,AHRQmetitsFY1999performancegoaltodevelopanAgencyresearchagendareflectingconsultationswithitscustomers.AHRQreceivedinputfrom:1)responsestomailingstoover100stakeholdersandcustomers;2)responsestoitsFederalRegisternotice: Request   forPlanningIdeas;3)over20 expertandusergroupmeetings;and4)consultationswithpeerreviewstudysectionmembersandtheNationalAdvisoryCouncil. 3ekk݌ (#(# Ќ    3    3n23  0    RelevanceofFindingsofAHRQResearch: InFY1999,findingsfromatleast10AHRQ t researchactivitieswerepublishedinmajorpeerreviewedprofessionalpublications.AHRQdocumentedover50citationsofresearchsponsoredbytheAgency.Conservatively,therewere3,146newspaper,tradepress,andmagazinearticlescitingtheagency.Mostimportantly,AHRQdocumentedthirteencasesofresearchfindingsbeingimplementedinthehealthcaresystem.  3nn݌d(#(# Ќ    3    3Lq23  0    DisseminationofAHRQResearch: AHRQpursuesthedisseminationofresearchprimarily < throughpartnershipsestablishedforthatpurpose.AHRQestablishedaperformancegoaltoform5disseminationpartnershipsinFY1999,andexceededthattargetbyforming30publicprivateandpublicpublicpartnershipsinFY1999. AHRQsachievementsinresearch  disseminationarealsoreflectedinitsgoalstopromotethetranslationofresearchintopractice.Forexample,inFY1999,AHRQfoundthat21purchasersand/orbusinessesusedAHRQresearchfindingstomakedecisions.InFY2001,AHRQprojectsthatitsevidencebasedpracticecenterswillproduceaminimumof12evidencereportsandtechnologyassessmentsthatcanserveasthebasisforinterventionstoenhancehealthoutcomesandquality.  3Lqwq݌<" (#(# Ќ    3    3]u23  0    DisparitiesinHealthCareResearch: AHRQplanstocontinuetoaddressracialdisparities $d" byfundingprojectsinFY2001toaddresseliminatingdisparitiesinhealthcare,particularlyforracialandethnicminorities. 3]uu݌ (#(# Ќ   ResearchCapacity  ($'   3    39w23  0    PreandPostDoctoralTrainees: InFY1999,AHRQsupportedd167dpreandpostdoctoral *%) trainees,exceedingitsFY1999goalofsupporting150suchtrainees.AHRQwillstrengthenitsinvestmentinfutureyearsbyincreasingthenumberofpreandpostdoctoraltraineesitsupports.Inaddition,AHRQplanstosupportatleastfifteenminorityinvestigatorsthroughindividualandcentergrantsinFY2001. 39wgw݌@.)-(#(# Ќ    3    3y23  0    ResearchTrainingandCareerDevelopment: ThroughitsResearchTrainingandCareer  DevelopmentProgram,NIHsupportsacriticalaspectofscientificresearch:thedevelopmentofatalentbasecapableofproducingadvancesinscience.Toevaluateitssuccessinattracting,developingandretainingadiversegroupofscientists,NIHhasestablishedseveralperformancegoalstoassesstheagencyssuccessinattractingqualifiedapplicants.Forexample,inFY1999,NIHmetitsgoaltomaintainanapplicationflowconsistentwithsuccessratesclosetohistoricallevelsof40percentforfellowships,and60percentforresearchtraininggrantsandentrylevelcareerawards. 3yy݌ (#(# Ќ    3    3}23  0    Facilities(NIH): NIHsupportsconstructionoffacilitiesontheNIHcampus,aswellas  <  grantstofundfacilityimprovementsatinstitutionsoutsideofNIH.InFY1999,NIHsetgoalstoevaluatetheprogressofintramuralconstructionprojects,aswellastoevaluatethegrantmakingprocessforextramuralassistance.Forexample,NIHestablishedagoaltocomplete65percentoftheconstructionattheLouisStokesLaboratoriesBuilding.PerformancedataindicatethatNIHfellshortofmeetingitstarget(itcompleted56.4percentoftheconstruction).However,theNIHassessmentrevealedthatthisshortfallcouldbeattributedtotheneedtomakespaceadjustmentstosupportcurrentandprojectedresearchrequirements.ConstructionisexpectedtobecompleteinDecember2000,ratherthanSeptember2000. 3}D}݌ (#(# Ќ       DisseminationofBiomedicalResearch  d   3    3{23  0    TechnologyTransfer: InFY1999,NIHsupportedthetransferofnewtechnologiesfrom < NIHresearchtotheprivatesectortofacilitatethedevelopmentofnewdrugs,productsandmethodsoftreatment.ThreeofNIHstechnologytransfertargetsdirectlyassesstheagencysprogressinpromotingtechnologytransfer.InFY1999,NIHincreasedthenumberofCooperativeResearchandDevelopmentAgreements(CRADAs)executedby10percent,whichismorethantriplethetargetedamountof3percent.Despitethissuccess,however,NIHfellshortofitsgoaltoincreasethenumberofEmployeeInventionReports(EIRs)by5percentormoreovertheFY1998levelsof287.PerformancedataindicatethattheincreaseinEIRsamountedto2.5percent,onlyhalfthetargetedamount.Similarly,NIHfellshortofitsgoaltoincreasethenumberofLicenseAgreementsexecutedby3percentoverthe215executedinFY1998.PerformancedataindicatethatthenumberoflicenseagreementsactuallydecreasedinFY1999by5percent.NIHsuspectsthatthedeclineinEIRsandLicenseAgreementscouldhavebeencausedinpartbyalevelofstabilityhavingbeen 3{݌ (#(# Ќ  0  reachedinnewintellectualpropertydevelopment.However,NIHwillcontinuetoevaluatedataoverthenext35yearstodeterminewhetherornotthishasoccurred. (#(#   3    323  0    CommunicationofResults: TheNationalLibraryofMedicine(NLM)fulfillsthecritical ($' functionofcommunicatingresearchresultstoscientists,practitionersandthepublic..InFY1999,NIHestablishedtwoperformancegoalstoevaluatetheNLMsabilitytomeettheinformationneedsofitsusers.Thesegoalswere:1)toprovideasingletollfreetelephonenumbertoreachcustomerservicestaff;and2)toimplementasystemtotrackcustomerserviceinteractions,measureresponsetimes,andrecordcustomerfeedbackonNLMproductsandservices.NIHachievedbothgoals. 3݌<.)-(#(# Ќ    3    323  0    DisseminationofPublicHealthInformation: CDCcommunicatespublichealthnewsabout  diseaseoutbreaksandtrendsinhealthandhealthbehaviorthroughtheMorbidityand  MortalityWeeklyReport.CDCmetitsFY1999targettopublish77issuesoftheMMWR, x andexpectstoincreasethatnumberto81issuesinFY2000. 3ʊ݌ d(#(# Ќ   D$<9,X,hX,X,hX9̀      LmMXXVJSECTIONII: t KEYHHSMEASUREMENTISSUES #XVJXMLm#  $   5!XXVJ#XVJX! 5:#XXVJAPPROACHTOPERFORMANCEMEASUREMENT, 8  COMMITMENTTOMANAGEMENTIMPROVEMENT,DATACHALLENGES,#XVJX₎# L  XXVJand   PROGRAMEVALUATION#XVJXH# T  v  ` =BB  lXXVJ  APPROACHTOPERFORMANCEMEASUREMENT `#XVJXlA#   2TheDepartmentofHealthandHumanServices(HHS)providesleadershipintheadministrationofprogramstoimprovethehealthandwellbeingofAmericans,andtomaintaintheUnitedStatesasaworldleaderinbiomedicalandpublichealthsciences.TheprogramsoftheDepartmentimpactallAmericans,eitherthroughdirectservices,thebenefitsofadvancesinscience,orinformationthathelpsthemchoosemedicalcare,medicine,orevenfood.ThroughMedicareandMedicaid,forexample,HHSoverseestheadministrationofthenationslargesthealthinsuranceprograms,servinganestimated72millionAmericans.Throughnumerousgrantsandotherfinancialarrangementswithpublicandprivateserviceproviders,HHSiscommittedtoimprovehealthandhumanserviceoutcomesandtheeconomicindependenceofindividualsandfamiliesthroughouttheUS.AssetforthinthelawsthatestablishedtheprogramsadministeredbyHHS,partnershipinadministrationisthecentralandfundamentalmanagementapproachforprogramimplementationandservicedelivery.Theoverwhelmingmajorityoftheapproximately$427billiondollarsthatwillbeexpendedforHHSprogramsinFY2001willbespent,notbyHHSemployees,butbyprogrampartners.TheStates,nottheAdministrationforChildrenandFamilies(ACF),spendthefundsthatsupporttheincomeassistanceprovidedunderTemporaryAssistanceforNeedyFamilies(TANF).Morethan$8outofevery$10appropriatedtotheNationalInstitutesofHealth(NIH)goestothescientificcommunityatlarge.LargefiscalagentssuchasBlueCrossandBlueShieldandAetnapaythedoctors,hospitals,andotherhealthcareprovidersthatserveMedicareandMedicaidbeneficiaries.ItisthroughcollaborationwithStates,localandtribalgovernments,andnongovernmentalpartnersthatHHSmustsetandaccomplishtheprogramgoalsandobjectives.ThediversityandscopeofHHSprogramsarealsoreflectedinthelargenumberofCongressionalappropriationsandauthorizingcommitteesandsubcommitteesinvolvedinthedeterminationofHHSresourcesandprogramstrategies.  TheHHSFY2000and2001PerformancePlansandFY1999PerformanceReportconsistofthis  summaryandtheperformanceplansandreportsofHHScomponents,whichareincorporatedintotheirFY2001budgetsubmissionstotheCongress.ThesummaryprovidestheoverallDepartmentalcontextfortheperformanceplansandreports,demonstrateshowHHS'sperformancegoalsandmeasuressupporttheHHSstrategicplan,illustrateshowGPRAperformanceinformationisbecomingincreasinglyusefultoHHSscrosscuttingbudgetinitiatives,andaddressesperformancemeasurementchallengesfortheDepartment.TheannualperformanceplansandreportsoftheHHScomponentsincludeperformancegoalsandmeasuresforallofHHS'sprogramactivitiesandthefocusonthelinkagetothebudgetthatiscriticaltotheGPRArequirementsforannualperformanceplansandperformancereports. IntegrationoftheHHSPerformancePlanandtheBudget  *%) JustasOMBCircularA11,Part2,hasstipulatedthat theprogramactivitystructureisthefoundationfordefiningandpresentingperformancegoalsandindicators,HHShasdeterminedthattheBudgetofHHS,whichdescribesHHSprogramactivitiesandnecessaryresources, T.)- providesthestructureforthedevelopmentandpresentationoftheannualperformanceplanandreportofanagencythatadministerssome300programactivities.ThedecisiontopresentperformanceinformationintheformatofthebudgetreflectsHHSsintenttoenhanceitsbudgetjustificationanddecisionmakingwithperformancemeasurementinformation,andtobeattentivetothemanyCongressionalcommitteesthatplayaroleintheDepartmentsbudget.ThereareothersignificantadvantagestoincorporatingtheannualperformanceplansandreportsintotheHHSBudget.TheBudgetroutinelydescribesprogramactivitiesandspecifiesassociatedresourceneeds,whichisinformationthatisalsorequiredbyGPRAforinclusioninannualperformanceplansandreports.CombiningtheGPRAperformancedocumentsandthebudgetensurestheconsistencyofinformationusedforbudgetandperformanceplanningpurposes.Finally,becausetheHHSBudgetroutinelycoversallHHSprogramactivities,theplacementoftheperformanceplansandreportsintheBudgetprovidestheframeworktoensurethatperformanceinformationfullycoversallofHHSsprograms.Asaresult,justastheHHSbudgetrequestispresentedinmultiplevolumesthataddresstheresourceneedsandjustificationsoftheindividualoperatingandstaffcomponentsofHHS,soalsoistheHHSannualperformanceplanpresented.ThedetailedandsubstantiveinformationthatfullyexplainsprogramlevelperformanceandthatconstitutesthefullperformanceplansandreportsfortheindividualHHScomponentsappearsnotinthisdocument,butisincludedintheseparatebudgetpresentationsandannualperformanceplansandreportsofthosecomponents.AthoroughunderstandingofHHSprogramlevelperformanceinformationrequiresthestudyoftheannualperformanceplansincludedintheCongressionalbudgetjustificationsoftheHHSOperatingDivisions.     lXXVJ  DEPARTMENTALCOMMITMENTTO  MANAGEMENTIMPROVEMENT F#XVJXl'#   TheDepartmentofHealthandHumanServicesiscommittedtoexemplarymanagementthatensuresthatprogramsaredeliveredinanefficientandeffectivemanner.Thiscommitmentisexpressedinanumberofways!throughfinancialmanagementinitiatives,throughimprovementstoinformationtechnology(IT)systems,throughimprovementsintheprocurementprocesses,andthrougheffortstodevelopandtrainourworkforce.ThissectionoftheHHSSummaryfocusesonthreedistinctwaysinwhichtheperformanceplansandreportsofHHSreflecttheimportanceofmanagementactivitytoprogramperformanceandresults.ItprovidesexamplesofperformanceinformationforeachoftheOperatingDivisionsofHHSthatillustratesHHSassessmentofthemeansthathavebeenusedwithintheprogramstoachieveprogramresults.IthighlightsasetofFY1999managementmeasuresandresultsthatreflecttheDepartmentsfocusoncriticalfinancial,technology,andadministrativemanagementfunctions.Finally,itillustratehowHHSperformanceplanshaveaddressedimportantmanagementchallengesidentifiedbytheGeneralAccountingOfficeandtheHHSOfficeofInspectorGeneral.AllthreeaspectsofmanagementassessmentreflecthowHHSseekstoimprovetheeffectivenessaswellastheefficiencyofprogramoperations./XVJXXXVJ ManagementMeasuresinthePerformancePlansofHHSOperatingDivisions  H #XVJXX/XVJ-#TheprogramlevelmanagementmeasurespresentedthroughouttheHHSperformanceplansreflectthatmanagementfunctionsandactivitiesaredeemedtoberelevanttotheassessmentofprogramresults.ThefollowingisapartiallistofmanagementfunctionsselectedfromthemoredetailedpresentationsofHHScomponentperformanceplans.L , !"#$%&(dxx0 !"#$%&(L/XVJXXXVJ  3   0   32d3  0(#(#  Informationandcommunicationmanagement 3Ү݌ (#(# Ќ    3   0   32d3  0(#(#  Accountingandfinancialmanagement 3¯݌ (#(# Ќ    3   0   3v2d3  0(#(#  Grantsandacquisitionmanagement 3v݌!(#(# Ќ    3   0   3_2d3  0(#(#  Programmanagementtrainingandtechnicalassistance 3_݌" (#(# Ќ    3   0   3[2d3  0(#(#  Programmonitoring,assessmentandevaluation 3[݌l#!(#(# Ќ    3   0   3P2d3  0(#(#  Businessprocessreengineering 3P݌X$"(#(# Ќ    3   0   372d3  0(#(#  Internalcontrols 37n݌D% #(#(# Ќ    3   0   32d3  0(#(#  Customerprotectionandsatisfaction 3G݌0&!$(#(# Ќ    3   0   32d3  0(#(#  Consumereducation 33݌'l"%(#(# Ќ    3   0   3׶2d3  0(#(#  Repairandmaintenanceoffacilities 3׶݌(X#&(#(# Ќ    3   0   3÷2d3  0(#(#  Workforcemanagement 3÷݌(D$'(#(# Ќ    3   0   32d3  0(#(#  Employeedevelopmentandsatisfaction 3ָ݌)0%((#(# Ќ  P 0 !"#$%&(xx, !"#$%&(/P  +'* #XVJXX/XVJ{#ThelistreflectsthatthecoverageofmanagementactivitiesintheperformanceplansofHHS  OPDIVsisextensive./XVJXXXVJԀThefunctionslistedaresubjecttoassessmentintheperformancemeasures  ofthe2001PerformancePlansofHHSOperatingDivisions.ThefollowingdescribesandillustrateshoweachHHSOperatingDivisionhasaddressedprogrammanagementthroughitsGPRAperformanceplanforFY2001.TheAdministrationforChildrenandFamilies 8  ACFanditspartners(whichincludeotherFederalagencies,State,localandtribalgovernments,andtheprivatesector)administer22programsthataredividedamong35budgetactivities.Theseprogramsareoperatedthroughcentralofficeheadquartersaswellasthroughthe10regionalofficesandprovidegrantfundstotaling$40billion.TheagencysperformanceplanreflectsACFscomplexpartnershipenvironmentwhererelationshipsbetweenpartners,fundingmechanismsanddegreesofautonomyvaryfromprogramtoprogram.BecauseStatesandlocalcommunityorganizationsadministermostofitsprograms,managementconcernsinACFnotonlyfocusonthefederalagencyoperationsbutalsoonimprovingStatemanagementandadministrativedatasystems.Severalofthespecificperformancemeasuresincludedinthe2001performanceplanillustratetheseareasofconcern:L > !"#$%&(٘hx0 !"#$%&(LL , !"#$%&(dxh> !"#$%&(L  3    3F2d3  0    MaketheChildSupportEnforcementprocessmoreefficientandresponsivebyincreasingthe 4 costeffectivenessratioto$5.00fromthe1996baselineof$3.93. 3Fq݌ (#(# Ќ    3    32d3  0    SurveyofStatechildsupportenforcementprogramssatisfactionwithfederalperformance. 3݌H(#(# Ќ    3    32d3  0    Increasefromanestimated94%to100%thenumberofHeadStartteacherswithadegreein   earlychildhoodeducation,achilddevelopmentassociatecredential,aStateawardedpreschoolcertificate,adegreeinafieldrelatedtoECEplusaStateawardedcertificate,orwhoareinCDAtrainingandhavebeengivena180daywaiver. 3݌ (#(# Ќ    3    32d3  0    Increaseto1500theannualnumberofsitevisitsbyTribaltrainingandtechnicalassistance l contractorstothediverseNativeAmericanpopulation,withparticularemphasisonurbanNativeorganizations,ruralandnonFederallyrecognizedTribes. 3݌ (#(# Ќ  P > !"#$%&(٘hx, !"#$%&(PTheAdministrationonAging #l! AoAhasemphasizedseveraladministrativeareasinitsperformanceplan.Theseincludeworkforceplanning,useoffederaldollarstoleveragefundsfromothersources,improvementofdatabases,anddevelopmentofpartnershipswithlocal,stateandotherfederalorganizations.SeveralofthespecificperformancemeasuresincludedintheFY2001performanceplanillustratetheseareas: L , !"#$%&(dxh> !"#$%&(L  3    32d3  0    Maintainthenincreasethelevelofprovisionofinformationandassistanceservicesthrough |*%) theOlderAmericansActandincreaseleveragedfunding. 3݌ (#(# Ќ  L , !"#$%&(dxx, !"#$%&(L  3    32d3  0    ObtainreliablebaselinedataforcaregiversupportservicesthroughsupportoftheNational T,'+ InstituteonAgingsCaregiverSupplementtotheNationalLongTermCareSurveyandfollowonsurveys. 3݌,.|)-(#(# Ќ    3    3D2d3  0    Createanddistributeculturallyappropriateeducationalmaterialsaboutmentalillnesses  commonamongolderadults. 3Do݌ (#(# Ќ  ##P , !"#$%&(dxx, !"#$%&(JPL > !"#$%&(٘hx, !"#$%&(LAgencyforHealthcareResearchandQuality ` AHRQsmissionistosupport,conductanddisseminateresearchthatimprovesaccesstocareandtheoutcomes,quality,cost,andutilizationofhealthcareservices.Theorganizationhasidentifiedthreestrategicgoalsthatframeitsactivities:supportimprovementsinhealthoutcomes,strengthenqualitymeasurementandimprovement,andidentifystrategiestoimproveaccess,fosterappropriateuse,andreduceunnecessaryexpenditures.Ithasuseditsstrategicplanningprocesstoframeitsoperations,emphasizingstaffandcustomerinput,developingoperationsplansforeachcomponents,anddevelopingindividualemployeeperformanceplans.Theemphasisonstrategicplanninghasledtoagreaterfocusonevaluation;theorganizationexpectstouseresultsofevaluationstudiesforfuturedecisionmakingprocesses.ThespecificstrategiesthathavebeendevisedfocusonAHRQsmultipleaudiences(clinicalservices,healthsystems,andpublicpolicyactors).TheagencyhasalsohighlighteditspartnershiprelationshipswithotherHHSorganizationsaswellasstateandlocalgovernmentsandprivatesectororganizations.Severalofthemanagementrelatedperformancemeasuresincludedinthe2001performanceplanareofparticularinterest:L , !"#$%&(dxh> !"#$%&(L  3    32d3  0    Maximizedisseminationofinformation,toolsandproductsdevelopmentfromresearchresults H foruseinpracticesettings. 3 ݌ (#(# Ќ    3    32d3  0    EvaluatetheimpactofAHRQsponsoredproductsinadvancingmethodstomeasureand   improvehealthcare. 3E݌ (#(# Ќ    3    3B2d3  0    ReleaseanddisseminateMEPSdataandinformationproductsintimelymannerforuseby  researchers,policymakers,purchasers,andplans. 3Bm݌ (#(# Ќ  ##P > !"#$%&(٘hx, !"#$%&(tPAHRQhasacknowledgedothermanagementmeasuresthatitwillmonitorinternallyinfutureyears,including:L , !"#$%&(dxh> !"#$%&(L  3    32d3  0    Maintainacquisitionperformancemanagementsystemtoensure(1)timelycompletionof $X" transactions,(2)vendorandcustomersatisfaction,and(3)efficientandeffectiveuseofresources. 3݌ (#(# Ќ    3    3S2d3  0    ContinuedenhancementandexpansionofAgencyIntranetsitetoensurestaffhaveimmediate '#& accesstoallcurrentinformation. 3S~݌ (#(# Ќ  #l#P > !"#$%&(٘hx, !"#$%&(P  CentersforDiseaseControlandPrevention |*%) TheframeworkthatunderliestheCDCPerformancePlanemphasizestheagencysrelationshiptothepublichealthcommunityandtothepublicingeneral.Whiletheorganizationhashighlightedspecificprogramoutcomesinitsplan(oftenbuildingontheHealthyPeople2000andHealthy ,.|)- People2010documents),itsapproachhasbeenconstructedarounditspartners!representatives  ofstateandlocalgovernments,academicinstitutions,businessandlabor,andcommunityandprofessionalorganizations.Closelyrelatedtothisstrategyistheinvestmentindatasystemsthatprovideboththeagencyanditspartnerswithinformationaboutactivitiesaswellasthedevelopmentoftrainedstaff.Severalofthespecificperformancemeasuresincludedinthe2001performanceplanillustratetheseareas:  L , !"#$%&(dxh> !"#$%&(L  3    3%2d3  0    Publichealthmicrobiologyfellowswillbetrainedandavailableforemploymentinlocal,state, $ t andfederalpublichealthlaboratories. 3%P݌ (#(# Ќ    3    3n2d3  0    SentinelsurveillancesystemsforacuteandchronicHepatitisCVirus(HCV)willbe  8  establishedinselectsites. 3n݌ (#(# Ќ    3    32d3  0    Expandaspecialprogramtoprepareacadreof60trainedpublichealthprofessionals   throughoutCDCtocompleteshorttermassignmentswithWHO. 3݌ (#(# Ќ    3    32d3  0    Developnewmonitoringtoolsneededtoaddressemergingtopics(StateandLocalArea p IntegratedTelephoneSurveySLAITS). 3݌ (#(# Ќ    3    3-2d3  0    CDCwillincreasefundingtosupportseniorstaff,andtoestablishinfrastructureand 4 collaborativeprocessesinthenationsstateeducationagenciesandstatehealthdepartmentstoreducetobaccouse,excessiveconsumptionoffatandcalories,physicalinactivity,andobesityamongyouth. 3-X݌ (#(# Ќ    3    32d3  0    CDCwilldevelopreportingmechanismsandcommunicationstrategiestoassurethatresults   fromthesestudieswillstimulatenewandimprovedinterventionstopreventdisease. 3?݌ (#(# Ќ    3    32d3  0    ResearchfindingswillbedisseminatedbyinvestigatorsreceivingPRIfunds. 3݌(#(# Ќ    3    32d3  0    Increasethenumberofprofessionalpreventioneffectivenessstaffandfellows. 3݌l(#(# Ќ    3    32d3  0    CompleteconstructionofinfectiousdiseaselabBuilding109toreplaceexistingbuildings4,6, D! 7,8and9,ChambleeCampus. 3݌ (#(# Ќ    3    32d3  0    100percentauditedfinancialstatementswithnoqualifications. 3݌$X"(#(# Ќ  L > !"#$%&(٘hx, !"#$%&(L  FoodandDrugAdministration h  %0!$ FDAhasemployedseveralstrategiesthatrelatetomanagementquestionsasitstrivestoachieveitslongtermgoalsofstrengtheningthesciencebaseforregulatorydecisionmakingandassuringthesafetyofregulatedproducts.Ithasemphasizedtheprocessofsettingstandardsforitselfaswellasothersconcernedaboutsafetyissues,recruitmentofsciencepartnerstoassessandmanagerisks,collaborativerelationshipswithitsvariousstakeholdercommunities,andbringingproductsofnewtechnologytomarket.Severalofthespecificperformancemeasuresincludedinthe2001performanceplanillustratetheseareas: ,.|)-  L , !"#$%&(dxh> !"#$%&(L  3    3S2d3  0    Increasethenumberofauditsandassessmentsofforeignfoodsafetysystems,withan  emphasisonhighvolumeexporterstotheU.S.toensurealeveloffoodsafetyprotectioncomparabletodomesticallyproducedfoods. 3S~݌ (#(# Ќ    3    32d3  0    Improvebiennialinspectioncoveragebyinspecting30percentofregisteredanimaldrugand L  feedestablishments. 3݌ (#(# Ќ    3    32d3  0    AssurethatFDAinspectionsofdomesticmedicaldevicemanufacturingestablishments,in  ` conjunctionwiththetimelycorrectionofseriousdeficienciesidentifiedintheseinspections,resultinahighrateofconformance(atleast90percent)withFDArequirements. 3J݌ (#(# Ќ    3    32d3  0    Increaseby12.5percentthenumberofcompliancechecksconductedinFY01to325,000   andconductfollowupcompliancechecksof100percentofretailersfoundtobeinviolationoftherule. 3݌ (#(# Ќ  # #P > !"#$%&(٘hx, !"#$%&(PHealthCareFinancingAdministration p HCFAsmissionistoensurethehealthcaresecurityofitsbeneficiaries.Itseekstocarryoutthismissioninthecontextofanenvironmentthatincludesrapidchangesinthehealthcareandhealthinsuranceindustriesaswellasinterdependencewithcontractors,agents,Statesandothers.Thisinterdependencecallsforpartnershipeffortsthatwillleverageresourcesandworkingwithothers(particularlytheStatesandthirdpartycontractors)toimproveperformanceInaddition,itworkscloselywithotherFederalagencies,bothwithinandoutsideHHS.Performancemeasurementhasreceivedstrongsupportwithintheagency,particularlyinvolvingthedevelopmentofperformancedatasystems.Performanceinformationincludedinthe2001performanceplanillustratetheseareas: L , !"#$%&(dxh> !"#$%&(L  3    32d3  0    Increasethepercentageofbeneficiarieswhoaresatisfiedwiththehealthcareservicesthey  receivethroughtheMedicareprogram. 3݌ (#(# Ќ    3    32d3  0    Enrollbeneficiariesintomanagedcareplansinatimelyfashion. 3݌D!(#(# Ќ    3    32d3  0    Improvethemanagementofthesurveyandcertificationbudgetdevelopmentandexecution #l! process. 3݌ (#(# Ќ    3    32d3  0    DeveloplinkedMedicareandMedicaiddatafilesonduallyeligiblebeneficiaries. 3/݌%0!$(#(# Ќ    3    3 2d3  0    ReducethepercentageofimproperpaymentsmadeundertheMedicarefeeforservice '#& program. 3 5݌ (#(# Ќ    3    3&2d3  0    IncreasetheefficiencyofmedicalreviewconductedbytheMedicarecontractorsonfeefor |*%) serviceclaimsaspartofitsProgramIntegrityComprehensivePlan. 3&Q݌ (#(# Ќ    3    32d3  0    ImprovetheeffectivenessofdisseminationofinformationtoMedicarebeneficiariesandto @-(, thoseactingontheirbehalf. 3݌,.|)-(#(# Ќ    3    32d3  0    MeetingclaimsprocessingtimelinessrequirementsforcleanMedicarebills/claimssubmitted  electronically. 3݌ (#(# Ќ    3    32d3  0    Increasetheuseofelectroniccommerce/standardsinMedicare. 3݌`(#(# Ќ    3    32d3  0    ImproveHCFAsinformationsystemssecuritypoliciesandpracticesenterprisewideinorder 8  tomeettheGAOstandardsintheFederalInformationSystemControlAuditmanual. 3݌ (#(# Ќ   L > !"#$%&(٘hx, !"#$%&(LHealthResourcesandServicesAdministration  L  HRSAisanagencywithmultipleprogramsbutasinglegoal:toassure100percentaccesstohealthcareand0percentdisparitiesforallAmericans.Theagencyworkstoestablishalliancesandpartnershipswithabroadarrayoforganizationsrangingfromstateandlocalgovernmentstofoundationsandcorporations.ThesealliancesandpartnershipsreinforceHRSAsfourstrategies:eliminatebarrierstocare,eliminatehealthdisparities,assurequalityofcare,andimprovepublichealthandhealthcaresystems.Inadditiontoutilizingitscurrentrangeofresourcesthatsupportdirectservicedeliveryandcreatetrainingopportunities,theagencyhasestablishednewcompetenciesinareassuchassurveillance,performancemeasurement,andsystemsanalysis.Severalofthespecificperformancemeasuresincludedinthe2001performanceplanillustrateHRSAsmanagementconcerns:L 9 !"#$%&(Fhh> !"#$%&(LL , !"#$%&(dxh9 !"#$%&(L  3    3$ 2d3  0    Awardnursingloanrepaymentcontracts. 3$ O ݌H(#(# Ќ    3    3 2d3  0    ImprovetotalcustomersatisfactionamongFederalagenciesserved. 3 + ݌ (#(# Ќ    3    3 2d3  0    Increasethenumberofminorityhealthcareandsocialserviceproviderswhoreceivetraining  inAETCs. 3 " ݌ (#(# Ќ    3    32d3  0    Increasethenumberoforgandonorsnationally. 3J݌l(#(# Ќ    3    32d3  0    Increasethenumberofgraduatesand/orprogramcompleterswhoenterpracticein D! underservedareas. 3.݌ (#(# Ќ    3    3'2d3  0    Annuallyproduceresultsofdatacollectionandanalysisactivitiesconductedtoinformthe $X" marketregardingissuesrelevanttohealthprofessionsandnursingworkforce. 3'R݌ (#(# Ќ    3    32d3  0    Conductanorderlyphaseoutoftheloaninsuranceauthority. 3݌&"%(#(# Ќ    3    32d3  0    Processpaymentof90percentoflumpsumawardsfortheVaccineInjuryCompensation (#' Programwithin30calendardaysofreceiptofaDOJclearanceletter. 3݌ (#(# Ќ    3    32d3  0    AllStateOfficesofRuralHealthwillimplementperformanceoutcomemeasurement h+&* indicatorsandreportedasummaryoftheiroutcomes. 3 ݌ (#(# Ќ    3    3$2d3  0    ObtainacleanauditopinionforHRSA. 3$O݌,.|)-(#(# Ќ  P 9 !"#$%&(Fhx, !"#$%&( PIndianHealthService  TheIHSPerformancePlanhighlightsasetofperformanceindicatorstoaddressthesignificanthealthproblemsoftheAmericanIndianandAlaskaNativepopulation.Theseindicatorsareconstructedaroundthemissionoftheagency:inpartnershipwithAmericanIndianandAlaskaNativepeople,toraisetheirphyscial,mental,social,andspiritualhealthtothehighestlevel.Fourstrategicobjectivesaredefinedforthispurpose:improvehealthstatus,providehealthservices,assurepartnershipsandconsultationswithitsconstituency,andperformanceofcorefunctionsandadvocacy.ApproximatelyhalfoftheIHSbudgetisprovidedbytheagencyindirectserviceswhiletheotherhalfisdeliveredbyIndiantribestotheirowncommunities.Giventhisarrangement,theperformanceplanfocusesonassuringadequatefacilitiesandequipmentfortheprovisionofhealthservicesaswellasprovidingadequatecontractsupportservicestothetribalhealthdeliverysystem.IHSalsoworkscloselywithotherHHSagenciesthatprovideservicestotheIndianpopulation.Severalofthespecificperformancemeasuresincludedinthe2001performanceplanillustratetheseareas:̀ L , !"#$%&(dxh9 !"#$%&(L  3    32d3  0    Increaseto80percentthepercentageofmedicalfacilitieswithUrgent#XVJXX/XVJ#/XVJXXXVJԀorEmergency \ departmentsorservicesthathavewrittenpoliciesandproceduresforroutinelyidentifying,treatingand/orreferringvictimsoffamilyviolence,abuseorneglect. 3݌ (#(# Ќ    3    32d3  0    ExpandthepercentageofprogramsthathaveimplementedtheuseoftheMental  \ Health/SocialServicesdatareportingsystem. 3݌ (#(# Ќ    3    32d3  0    Developthespecificationsandimplementationplanforanautomatedmutuallycompatible   informationsystemwhichcaptureshealthstatusandpatientcaredataforIndianUrbanhealthcareprogramsandimplementatfieldurbansites. 3݌ (#(# Ќ    3    3s 2d3  0    Improveconsumersatisfactionwiththeacceptabilityandaccessibilityofhealthcareas  measuredbyIHSconsumersatisfactionsurvey. 3s  ݌ (#(# Ќ    3    3!2d3  0    Developenvironmentalhealthsurveillancesystemandcompletecommunityenvironmental D! assessmentin90percentofcommunities. 3!!݌ (#(# Ќ    3    3"2d3  0    Reducethenetbacklogofmaintenance,alterationandrepair. 3"$#݌$X"(#(# Ќ    3    3#2d3  0    Improveto88percentthelevelofContractHealthServiceprocurementofinpatientand %0!$ outpatienthospitalservicesforroutinelyusedprovidersundercontractsorratequoteagreementsattheIHSwidereportinglevel. 3#$݌ (#(# Ќ    3    3%2d3  0    ContinueimplementationofManagerialCostaccountingsystemsacrossIHSsettingby )$( investinginnecessaryinformationtechnology. 3%%݌ (#(# Ќ  L > !"#$%&(٘hx, !"#$%&(LNationalInstitutesofHealth T,'+   @-(, NIHsmissiontouncovernewknowledgeabouttheprevention,detection,diagnosis,and treatmentofdiseaseanddisabilityisdirectlysupportedbyanumberofmanagementobjectives.TheNIHperformanceplanaccentuatesthreeareas:first,activitiesthatallowittoaccomplishwhatitdefinesassustainedFederalstewardship;second,thedevelopmentandtrainingofthepoolofscientifictalent;andthird,thesupport,constructionandmaintenanceoflaboratoryfacilitiesnecessaryforconductingresearch.Thestewardshiproleinvolvesestablishingresearchpriorities,theprocessofreviewingproposalsandfundingthebestprojects,disseminationofresults,andestablishingappropriatepartnershipswithotherFederalagenciesandresearchorganizationswhichshareresearchinterests.Severalofthespecificperformancemeasuresincludedinthe2001performanceplanillustratetheseareas:L , !"#$%&(dxh> !"#$%&(L  3    3r+2d3  0    IncreaseawarenessofNIHsponsoredresearchamonghealthcareprovidersandamonghigh $  risk,underserved,and/oraffectedpublics. 3r++݌ (#(# Ќ    3    3,2d3  0    ImprovetheNationalLibraryofMedicinescustomerserviceandinformationservicesfor   individualsseekingmedicalinformation. 3,,݌ (#(# Ќ    3    3-2d3  0    Enhanceoutreachtocommercialentitiesbyincreasingthenumberoflicensingagreementsin \ FY2001by3%overthenumberoflicensesinFY2000. 3-(.݌ (#(# Ќ    3    3O/2d3  0    ProgressinrespondingtotheInstituteofMedicineReportrecommendationsforimproving  p publicinputandprioritysetting. 3O/z/݌ (#(# Ќ    3    302d3  0    Improveandenhanceelectronicresearchadministrationandcommunicationwiththe 4 extramuralcommunitybyenablingincreasingnumbersofinstitutionstobeginadministeringgrantselectronically. 300݌ (#(# Ќ    3    322d3  0    ImplementtheDirectorsoverallstrategytoimproveinformationtechnologymanagementat  NIHbydevelopingastrategicvisionandformalinvestmentprocess. 32:2݌ (#(# Ќ    3    3p32d3  0    ExpandtheuseofPerformanceBasedContractingby$21.2millioninFY2001toeligible X  contracts. 3p33݌ (#(# Ќ    3    342d3  0    Increasemanagersatisfactionwithpersonnelsysteminnovationsbycompletingthe #l! developmentandbeginningthepilotimplementationofdecisionsupportsystemsforrecruitment,selection,andemployeeperformance. 344݌ (#(# Ќ    3    3*62d3  0    CompletetheFY2001milestonesinthepersonalpropertymanagementimprovementplan &"% andachievealossrateoflessthan6percentofthepropertyintheinventory. 3*6U6݌ (#(# Ќ    3    372d3  0    Expandtheroleofelectroniccapabilitiesintheadministrationofresearchtrainingandcareer )$( developmentactivitytoassurethatatleast50percentofalltrainingappointmentsarereceivedelectronically. 377݌ (#(#    T,'+   3    3A92d3  0    UtilizeasystematicprocesstomanageandaccountforNIHsRealPropertyInventoryby  providinginformationonlineatthedeskofeachstakeholderinvolvedwithrealpropertymanagement. 3A9l9݌ (#(#   P > !"#$%&(٘hx, !"#$%&(&+POfficeforCivilRights ` #XVJXX/XVJn#OCRsperformanceplanisorganizedaroundtwobroadgoals:1)toincreasenondiscriminatory 8  accessandparticipationinHHSprogramsand2)toenhanceOCRsoperationalefficiency.OCRhasidentified,inconjunctionwithitsstakeholders,sixperformanceobjectivesthataddressitshighpriorityissues!adoption,managedcare,servicesforlimitedEnglishproficientpersons,welfarereform,nondiscriminatoryqualityhealthcare,andservicesinthemostintegratedsettingpossibleforindividualswithdisabilities.Incarryingoutitsenforcementprogram,OCRprocessesandresolvesdiscriminationcomplaints,conductsreviewsandinvestigations,monitorscorrectiveactionplans,andconductsvoluntarycompliance,outreachandtechnicalassistanceactivities. Severalofthespecificperformancemeasuresincludedinthe2001performanceplanillustrate    OCRsactivities: p L , !"#$%&(dxh> !"#$%&(L  3    3?2d3  0    /XVJXXXVJIncreaseto33percentand/or297closuresfocusedonhighpriorityissues. 3??݌H(#(# Ќ    3    3@2d3  0    Decreaseto241daystheaverageageofallprioritycaseclosures.#XVJXX/XVJ?#/XVJXXXVJ 3@@݌ p(#(# Ќ    3    3A2d3  0    Increaseto30thenumberofcorrectiveactionsandnoviolationfindingsinmanagedcare H cases.#XVJXX/XVJ~A#/XVJXXXVJ 3A B݌4(#(# Ќ    3    3MC2d3  0    Increaseto29thenumberofcorrectiveactionsandnoviolationfindingsinTANFcases. 3MCxC݌ (#(# Ќ  #XVJXX/XVJB#/XVJXXXVJL : !"#$%&(Yhx, !"#$%&(LL , !"#$%&(dxh: !"#$%&(L  3    3TE2d3  0    Increaseto151thenumberofcorrectiveactionsandnoviolationfindingsincasesinvolving  accesstoservicesforpersonswithlimitedEnglishproficiency. 3TEE݌ (#(# Ќ  #D#P : !"#$%&(Yhx, !"#$%&(EP#XVJXX/XVJ}D#/XVJXXXVJProgramSupportCenter X  ThePSCwascreatedtoprovideadministrativeservicesonacompetitive,serviceforfeebasistoHHScustomersaswellasotherfederalagencies.Theagencydoesnotactuallyimplementprograms;rather,itsmajorfunctionsandoperationsareallfocusedonmanagementsupportactivities.Itsmissionistoprovidehighquality,innovativeandcosteffectiveservicestoitscustomersthroughitsthreemajorareas:humanresources,financialmanagement,andadministrativeoperations.Assuch,theperformancemeasuresincludedinitsperformanceplanareallmanagementactivities.Severalofthespecificperformancemeasuresincludedinthe2001performanceplanillustratetheseareas:L , !"#$%&(dxh: !"#$%&(L  3    3J2d3  0    Improvethetimelinessofpersonnelactionprocessingsothat90percentofactionsare |*%) completedwithinsevenworkingdays 3JJ݌ (#(# Ќ    3    3K2d3  0    Reviewandnegotiate95percentofallindirectcostrateproposalsandprocess85percentof @-(, statewidecostallocationplanswithintwelvemonthsofreceipt. 3K$L݌,.|)-(#(# Ќ    3    3`M2d3  0    Increasecustomersatisfactionwiththeindirectcostrateprocess. 3`MM݌(#(# Ќ    3    3XN2d3  0    Improvethequalityandtimelinessofpaymentmanagementsystemoperationsbyincreasing t thenumberofrecipientorganizationsto15,000andresolve100percentofassignedauditfindingswithinfivemonths. 3XNN݌ (#(# Ќ    3    3O2d3  0    Increasetheyieldofdebtmanagementservicesby10percentandrefer100percentofverified $ t delinquentdebtstotheTreasuryOffsetProgramwithin75daysaftertheendofeachquarter. 3OP݌ (#(# Ќ    3    3eQ2d3  0    Reducetheunitcostpertelecommunicationlineto$24.50. 3eQQ݌ 8 (#(# Ќ  #RJ#P : !"#$%&(Yhx, !"#$%&(qJPSubstanceAbuseandMentalHealthServicesAdministration   SAMHSAsmissionistoimprovethequalityandavailabilityofprevention,earlyintervention,treatment,andrehabilitationservicesforsubstanceabuseandmentalillnesses,includingcooccurringdisorders,inordertoimprovehealthandreduceillness,death,disability,andcosttosociety.Itsperformanceplanemphasizesthreelongtermpolicygoals:1)tosupportandcontributetotheimprovementofcommunitybasedsystemsofcareforadultsandchildrenwithseriousmentalillnessesordisturbances;2)toeducateandenableAmericasyouthtorejectillegaldrugsaswellasunderageuseofalcohol;and3)toassistStatesandcommunitiesbysupportingandhelpingtoimprovetheirsubstanceabusepreventionandtreatmentefforts.Theagencyemphasizesseveralstrategies:bridgingthegapbetweenknowledgeandpractice;promotingtheadoptionofbestpractices;assuringservicesavailabilityandmeetingtargetedneeds;andinvestingindataforqualityimprovementandaccountability.Bothmentalhealthandsubstanceabuseissuesinvolveabroadarrayofpartnersandstakeholderswhoplayanimportantroleinthedeterminationofagencypriorities.Theirroleisespeciallycriticalintheimplementationoftwooftheagencyslargestprograms:thementalhealthandsubstanceabuseblockgrantstostates.Severalofthespecificperformancemeasuresinvolvingmanagementobjectivesthatareincludedinthe2001performanceplaninclude:L , !"#$%&(dxh: !"#$%&(L  3    3PY2d3  0    Eightmonthsafterthecloseofdatacollection,datawillbeavailableintheNational D! HouseholdSurveyonDrugUse.#XVJXX/XVJHG#/XVJXXXVJ 3PY{Y݌0" (#(# Ќ    3    3Z2d3  0    Increaseto9,000thenumberofcomplaintsofabusethatwillbeaddressedbytheProtection $X" andAdvocacyprogramofCMHS.#XVJXX/XVJmZ#/XVJXXXVJ 3ZZ݌$D #(#(# Ќ    3    3U\2d3  0    Lessthan20monthsafterthecloseofdatacollection,datawillbeavailablefromtheDrug &"% AbuseServicesInformationSystem.  #XVJXX/XVJ[#/XVJXXXVJ 3U\\݌'#&(#(# Ќ  L , !"#$%&(dxx, !"#$%&(L  3    3X^2d3  0    Increaseby10percentthenumberofrequestsformaterials,connectstotheweb,and )$( telephoneinquiriesrelatedtotheKnowledgeExchangeNetworkoftheCMHS. 3X^^݌ (#(# Ќ  #XVJXX/XVJ]#/XVJXXXVJ  3    3_2d3  0    Increaseby15percentoverbaselinethenumberofinformationrequestsfromtheCSAP T,'+ ClearinghouseProgram. 3_&`݌ (#(# Ќ   ,.|)-   3    3.6'8O;ale  7lfiԀThePICprojectdatabase, < acentralizedsourceofinformationonmorethan6,000studiessponsoredbyHHS,otherFederalagenciesandprivatesectorentities,servesasaninformationsourceforindividualevaluations(eithercompletedorinprogress).ForadditionalinformationaboutusingthePICdatabaseoraccessingcopiesofevaluationreports,pleasecontactthePolicyInformationCenterat(202)6906445.  ( DWR<   LmMXXVJSECTIONIII: t FY2001PERFORMANCEGOALSUMMARY#XVJXMLm%# 5!XXVJ  $ #XVJX! 5#   5!XXVJ#XVJX! 5#XXVJLINKAGETO 8  DEPARTMENTALINITIATIVESandTHEHHSSTRATEGICPLAN #XVJXa# L     D S==  lXXVJ  FY2001DEPARTMENTALINITIATIVES  ANDREPRESENTATIVEPERFORMANCEGOALS #XVJXl#  ( t/XVJXXXVJTheFY2001HHSbudgethasbeenorganizedaroundprioritiesthatemphasizeimportantnationalneeds.TheseprioritiescutacrossprogramcomponentswithintheDepartmentandsupporttheDepartmentseffortstoachievethegoalsandobjectivesoftheHHSStrategicPlan.WhileHHSisalarge,complexorganizationthatisresponsibleforimplementationofmorethan300programs,theseprioritiesprovidetheOfficeoftheSecretarywithameansofcoordinatingeffortstoimproveHHSprograms.HHSalsoseekstousetheGPRAprocesstoenhanceprogramcoordination,andhasincorporatedannualreportingrequiredbytheGPRAintotheHHSbudgetprocesstofacilitatetheachievementofthatobjective.ThissectionoftheHHSSummaryprovidesinformationtoillustratethelinkagesoftheHHSbudgetandannualperformanceplanningprocesstotheHHSstrategicplan.qUD;+'hvFB `E2*<tt Hjq jj(#(#qU;+'hvFB `E2*<tt HjqTheHHSStrategicPlanemphasizessixoverarchinggoalsthatinformthebudgetprocess,other#XVJXX/XVJg#/XVJXXXVJԀDepartmentalplanning  activities,andprogramplanningacrosstheDepartment.ThesegoalshaveprovidedabroadframeworkforAnnualPerformancePlans,forbudgetinitiativesandnewprogramdirectionsfortheDepartment,reflectingboththePresidentsandtheSecretaryspriorities.Specificprograms,strategiesandactivitiesthatcontributetotheachievementofHHSsstrategicgoalsandobjectivesareidentifiedinthedetailedsectionsofthisSummarythatfollow.ThatpresentationalsoidentifiesnumerousperformancemeasuresforFY1999,2000and2001relatedtotheachievementofeachofthe39strategicobjectivesintheHHSStrategicPlan.AlloftheperformancegoalsandmeasuresincludedinthissummaryandintheperformanceplansofHHScomponentsareHHSperformancegoals.Althoughvastmajorityofmeasuresnecessarilyfocuson (#(#jjindividualprogramactivities,theysupportDepartmentalgoalsandthemissionofHHSasdotheveryprogramactivitiesthattheywillservetoassess.Immediatelyfollowingisasummaryofthecrosscutting,DepartmentalbudgetinitiativesincludedintheFY2001PresidentsBudgetforHHS.ToillustrateandreflectHHSscommitmentasa -), Departmenttothesuccessofitsinitiatives,wehavealsoidentifiedFY2001performancegoalsthatarerepresentativeofeffortsacrosstheDepartmenttoimproveprogramsthroughtheseinitiatives.̀ ImproveHealthCareCoverage,AccessandQuality  L  TheAdministrationproposesahealthinsuranceinitiativetoexpandaccesstoqualityhealthcareformoreAmericans.Over44millionAmericanslackhealthinsurance.Thisgenerallyresultsfromlackofinsuranceaffordabilityand/orlimitedaccesstocoverage.Theconsequencesofthelackofhealthinsuranceisdevastating.Theuninsuredarethreetimesaslikelytonotreceiveneededmedicalcare,50to70percentmorelikelytoneedhospitalizationforavoidablehospitalconditions,andfourtimesmorelikelytorelyonanemergencyroomorhavenoregularsourceofcarethantheprivatelyinsured.ThisinitiativeincludesaugmentingMedicarecoverageandbenefitsforolderanddisplacedworkers,expandinghealthinsuranceaccessandoutreachtochildrenandparentsoflowincomechildren,andmeetingtheneedsofotherunderservedpopulations,suchasNativeAmericans.TheFY2001budgetcontainsanumberofproposalsthataddresstheproblemsofhealthcareaccess,affordability,andquality.TheyincludeaproposalcalledFamilyCarethatwouldcover  p parentsofchildrencoveredbytheStateChildrensHealthInsuranceProgram(SCHIP)andMedicaid.ThisproposalwouldprovidehigherFederalmatchingpaymentsforstatecoverageofparentsofchildreneligibleforMedicaidorSCHIP.ThebudgetalsoincludesaproposaltogivestatesneededtoolstoincreaseenrollmentinSCHIP.Otherprograminitiativesarealsoincludedinthisarea.TheAdministrationproposesthatpeopleaged62through65anddisplacedworkersaged55to65beallowedtopaypremiumstobuyintoMedicare.Itincludesaproposaltogivestatestheoptionofcoveringlegalimmigrants,regardlessofwhentheycametotheUS.ItwouldexpandtheFY2000initiativethatwillimproveaccesstohealthcareforuninsuredworkers.ItproposesacomprehensivereformplantomodernizeandstrengthentheMedicareprogramintwoways:1)tomeetthehealth,demographicandfinancingchallengesofthe21stcentury,and2)tomodernizetheadministrativeinfrastructure 0"  topreventanddetecthealthcarefraudandabuse.Effortsarealsotargetedoncontinuationandexpansionofthe1998PresidentsNursingHomeInitiative,expansionoflongtermcare,andprograminitiativesthatwillprovideanationalfamilycaregiversupportsystem.  '#& HHSperformancegoalsthatarerepresentativeofHHSeffortsunderthisinitiativeare:L 0 !"#$%&(xy, !"#$%&(L  3    323  0    IncreasethenumberofchildrenwhoareenrolledinMedicaidortheStateChildrensHealth  InsuranceProgrambyonemillionchildren.HCFAPlan 3*݌t(#(# Ќ    3    3b23  0    #XVJXX/XVJ#ThroughtheMaternalandChildHealthBlockGrant,increasethepercentofpotentially L  MedicaideligiblechildrenwhohavereceivedaservicepaidbytheMedicaidprogramto80percent.HRSAPlan/XVJXXXVJ 3b݌$ t(#(# Ќ    3    3723  0    #XVJXX/XVJ#1XVJXXXVJImprovechildandfamilyhealthbyincreasingtheproportionofAmericanIndianandAlaskan  L  Nativechildrenreceivingaminimumoffourwellchildvisitsby27monthsofageby3percentovertheFY2000target(3percentovertheFY1999baselineofXX).IHSPlan#XVJXX1XVJ#/XVJXXXVJ 37b݌$ (#(# Ќ    3    323  0    ReducethepercentageofimproperpaymentsmadeundertheMedicarefeeforservice   programto6%.HCFAPlan#XVJXX/XVJ0#/XVJXXXVJ 3݌ (#(# Ќ  L 0 !"#$%&(xx0 !"#$%&(L  SupportChildrenandFamilies  \ TheFY2001HHSbudgetstrengthensthefamilybyhelpingAmericansbetterbalancethedemandsofworkandparenthood.Thiswillbeachievedbyprovidingaccesstosafe,affordablechildcare,increasingchildsupportcollections,gettingmoreresourcestofamilies,anddirectingsupporttofamilycaregivers.Thisinitiativeincludesavarietyofprogramproposals.Thechildcareinitiativeattemptstomakeaffordable,highqualitychildcareevenmoreaccessibleforworkingfamilies.Undercurrentfundinglevels,theprogramreachesonly10percentoftheeligiblepopulation.ThisisdonebyincreasingtheChildCareandDevelopmentFundaswellascreatingtheEarlyLearningFund.TheFY2001budgetincludesaproposaltobuildonthesuccessofthechildsupportenforcementprogramandincreasechildsupportcollections.Itwilldirectfundstolowincomefamiliesbygivingstatestheoptiontoadoptsimplifiedrulesthatgoverndistributionofchildsupportcollections.ItalsoproposestoprovidelimitedFederalmatchingfundsforchildsupportcollectionsthatstatespassthroughtofamiliesonassistance.Twoproposalsarefocusedonlowincomechildren:anincreaseinfundsforHeadStartandaninitiativethatwouldprovidedemonstrationgrantstoStatestotestinnovativeasthmadiseasemanagementtechniquesforchildrenenrolledinMedicaid.TheFY2001budgetalsoincludesanincreaseinthelevelofsupportfortheChildrensHospitalsGraduateMedicalEducationandanincreaseinthefundsavailabletoexpandthecapacitytotreatindividualswhouseandareaddictedtoillegaldrugs.HHSperformancegoalsforFY2001thatarerepresentativeofHHSeffortsunderthisinitiativeare:  @-(,   3    323  0    IncreasethepercentageofHeadStartchildrenwhoreceivenecessarymedicaltreatmentto92   percent.ACFPlan 3݌(#(# Ќ    3    323  0    IncreasetheChildSupportEnforcementProgramcollectionrateforcurrentsupportdueto t 71%.ACFPlan 3"݌`(#(# Ќ  #XVJXX/XVJ#L 0 !"#$%&(xx0 !"#$%&(L/XVJXXXVJ CreateaHealthierAmerica  8  TheFY2001budgetforHHSpromoteshealthylivingandprovideshealthservicesformoreAmericans.Itaddressesmanyofourgreatestpublichealthchallenges,includingensuringasafefoodsupply,andtrackingemerginginfectiousdiseasesandbioterroristthreats.ItfocusesonpreventionofHIV/AIDSandunwantedpregnancies,providestreatmentforsubstanceabuseandmentalhealth,andeliminateshealthdisparitiesamongracialandethnicminorities.ProposalsincludedinthisbudgetinvolveaHIVpreventioninitiativeandinvestmentofadditionalfundsintheRyanWhiteProgram.ItrespondstotherecentlyreleasedSurgeonGeneralsReportonMentalHealthbyincreasingfundsfortheMentalHealthBlockGrantaswellasfundsforYouthViolencePreventionactivities.Thebudgetproposesanincreaseinfundstopreventemerginginfectiousdiseasesandbioterrorism.Thesedollarswillfurtherdevelopanationaldiseasesurveillancesystemthatcanrapidlydetecttheinfectiousdiseasecasesthatsignalthebeginningofanoutbreakandtorespondtomedicalandpublichealthconsequencesofabioterroristevent.Proposalsareincludedforadditionalfundsforfamilyplanningandtomakesignificantinvestmentsinthepublichealthinfrastructure.Thelatterincludesfundsforconstructionoflaboratoryfacilities.Inaddition,theFY2001budgethighlightstheeliminationandreductionofhealthdisparitiesamongracialandethnicminoritiesandexpansionofeffortstoprovidequalitycaretoNativeAmericans.ThisinitiativeproposesanincreaseinfundsforenvironmentalhealthresearchinCDC.HHSperformancegoalsforFY2001thatarerepresentativeofHHSeffortsunderthisinitiativeare:L 0 !"#$%&(xx0 !"#$%&(L  3    3/23  0    #XVJXX/XVJ#DecreasethenumberofnewlyreportedAIDScasesinchildrenasaresultofperinatal $X" transmissionto193.CDCandHRSAPlan 3/Z݌$D #(#(# Ќ    3    323  0    /XVJXXXVJMeasuretrendsinratesofHIVtransmission.(Placeholder)CDCPlan#XVJXX/XVJ# 3݌&"%(#(# Ќ    3    323  0    /XVJXXXVJMeasuretrendsinlongtermHIV/AIDSsurvivalrates.(Placeholder)CDCPlan#XVJXX/XVJO# 3 ݌(#'(#(# Ќ    3    3&23  0    4XVJXXXVJAssureaccesstopreventiveandprimarycarethroughtheHealthCentersforminority(65%), |*%) lowincome(86%),anduninsured(45%)individuals.#XVJXX4XVJ#ԀHRSAPlan 3&Q݌h+&*(#(# Ќ    3    323  0    1XVJXXXVJDecreaseproportionofHealthCenterusers#XVJXX1XVJB #1XVJXXXVJwhoarehospitalizedforpotentiallyavoidable @-(, conditionsto13per1000.#XVJXX1XVJ #4XVJXXXVJԀHRSAPlan 3݌,.|)-(#(# Ќ    3    3!23  0    Increasethepercentageofchildrenreceivingmentalhealthservicesthroughthe  ComprehensiveCommunityMentalHealthServicesforChildrenandTheirFamiliesprogramwhoattendschoolmostofthetimeto95percent.SAMHSAPlan 3!!݌t(#(# Ќ    3    3w#23  0    #XVJXX4XVJN!#/XVJXXXVJThroughaDepartmentalinitiativeledbyCDC,FDA,SAMHSAandOPHS,reducetobacco L  useamongminorsto35.9percentinFY2001.CDCPlan#XVJXX/XVJ $#4XVJXXXVJ 3w##݌8 (#(# Ќ    3    3R%23  0    #XVJXX4XVJ$#/XVJXXXVJIncreasetobetween63and68thenumberofstateandmajorcityhealthdepartmentswith  ` expandedepidemiologyandsurveillancecapacitytoinvestigateandmitigatehealththreatsbybioterrorism.CDCPlan#XVJXX/XVJ%#4XVJXXXVJ 3R%}%݌ 8 (#(# Ќ  #XVJXX4XVJ'#/XVJXXXVJ#XVJXX/XVJ'#/XVJXXXVJ AdvanceScientificResearch    Futurescientificadvancementsdependonacommitmenttostrategicinvestmentsmadetoday.TheFY2001budgetcontinuestheAdministrationscommitmenttoprotectpublichealthandpromotescientificexpertisebyinvestinginbiomedicalscienceandhealthcarequalityresearch.ThreeprogramproposalsareincludedintheHHS2001budgetthatrelatetothisinitiativearea.ItcallsforanincreaseoffundingforresearchattheNationalInstitutesofHealthtodeveloptreatmentsandnewpreventionstrategiesforthemanydiseasesanddisabilitiesthataffecttheNationshealth.Thisproposalwillalsoplacerenewedemphasisonresearchtoaddressdomesticandinternationalhealthdisparitiesthatmaybeassociatedwithrace,ethnicity,gender,orsocioeconomicstatus.TheFY2001budgetincludesanincreaseoffundsfortheFoodandDrugAdministrationtoreducemedicalerrorsandadverseeventsandforfundsfortheAgencyforHealthcareResearchQualitytoconductresearchdirectedtowardreductionofmedicalerrors.Italsoemphasizestheimportanceofeffortstoensureasafernationalfoodsupplyandtoreducethenumberofdeathsandsicknessesfromfoodborneillnesses.TheseeffortsinvolvetheFDA,theCentersforDiseaseControlandPrevention,andtheUSDepartmentofAgriculture.HHSperformancegoalsforFY2001thatarerepresentativeofHHSeffortsunderthisinitiativeare:L 0 !"#$%&(xx0 !"#$%&(L  3    3C.23  0    Developneworimprovedapproachesforpreventingordelayingtheonsetorprogressionof %0!$ diseaseanddisability.NIHPlan 3C.n.݌&"%(#(# Ќ    3    3/23  0    Fundingaminimumof20projectsin:1)reducingmedicalerrorsandenhancingpatientsafety; (#' 2)informaticsapplicationsinhealthcare;and3)workersafetyandhealthcareforworkers.AHRQPlan#XVJXX/XVJ'#/XVJXXXVJ 3//݌|*%)(#(# Ќ    3    3d123  0    Increaseto55percenttheproportionofreportedfoodborneoutbreaksinwhichthefoodthat T,'+ causedtheoutbreakisidentified.CDCPlan#XVJXX/XVJ1#/XVJXXXVJ 3d11݌@-(,(#(# Ќ  P 0 !"#$%&(xx0 !"#$%&(-P ,.|)- #XVJXX/XVJ2#     lXXVJ  FY2001PROGRAMS,INITIATIVES,STRATEGIES,  ANDPERFORMANCEGOALSTHATSUPPORTTHEHHSSTRATEGICPLAN 3#XVJXl3#  ( 3TheHHSStrategicPlanidentifiessixlongrangestrategicgoalsthatsupportHHSmissiontoenhancethewellbeingandhealthofAmericansbyprovidingforeffectivehealthandhumanservicesandbyfosteringstrong,sustainedadvancesinthesciencesunderlyingmedicine,publichealth,andsocialservices.EachstrategicgoalissupportedbystrategicobjectivesthatfocusonthestrategiesthatHHSwillutilizetoachievethestrategicgoal.Theselongrange,strategicgoalsandobjectivesserveastheperformancemanagementframeworkoftheDepartment.9,X, X,X,hX9ThissectionoftheHHSPerformancePlanSummaryillustrateshowthestrategies,goals,andmeasuresintheFY2001PerformancePlansandBudgetsoftheHHSOperatingDivisionslinktogethertosupporttheachievementofHHSlongrangestrategicgoalsandobjectives.ForeachHHSstrategicobjective,thissectionprovideskeyperformancestrategiesforFY2001,selectedFY2001goalsandmeasuresthatwillindicateprogresstowardsachievingtheobjective,andalistofallHHSprogramsthatsupporttheobjective. Pleasenotethatthisisasummarydocument: 󀀀:,X,hX,X, X6:ӀTheHHSOperatingDivisionsFY2001  PerformancePlansandBudgets,bothofwhichareimportanttounderstandperformanceplanninginHHS,containdetailedperformanceinformationforHHSapproximately300programactivitiesasrequiredunderGPRA.ThesedocumentscontainacompletelistingofHHSgoalsandmeasures,detaileddiscussionsofprogramperformance,informationonthemeansandstrategiesthatwillbeusedtoachievethegoals,linkagetotheoperatingdivisionsbudget,dataverificationandvalidation,anddiscussionsofcrosscuttingprograms.  $t  (#(#     (#(#  D<SS? ,X X,X,hX?iUI5%!`z3 `E`ttx [iiU5%!`z3 `E`ttx [i FromtheHHSStrategicPlan,September1997. Goodhealthliesattheheartofthenations L  wellbeing.Ahealthyworkforceismoreproductive;ahealthystudentbodyisreadytolearn;andahealthypeopleisabletobuildabettersociety.Individualbehavior,education,equalityofopportunity,socialandphysicalsurroundings,theeconomy,andaccesstohealthcareareallelementscrucialtohealth,andthereforeofferopportunitiestopromotegoodhealth.Researchhasestablishedthatthemajorbehavioralfactorscontributingtoprematuredeatharetobacco,dietandactivitypatterns,alcohol,injuries,sexualbehavior,andillicitdruguse.Collectively,theseaccountfor50percentofallprematuredeathseachyearintheUnitedStates.Inaddition,unintentionalinjuries,suicides,andhomicidesaccountfor30percentofallyearsofpotentiallifelostundertheageof65.InvestmentsinprogramsthatareeffectiveinreducingoreliminatingthesebehavioralthreatspayoffheavilyinimprovedhealthandproductivityoftheAmericanpeople.Theresults"betterhealthforindividualsandlongerlifespans"arehighlyvaluedbythepublic.OfthestrategiesdevelopedbytheDepartmentofHealthandHumanServices(HHS)forreducingbehavioralthreatstohealth,mostemployacombinationofresearch,prevention,publiceducation,andregulation.AllinvolvemultiplecomponentsoftheDepartmentandrelyheavilyonpartnershipswithotherlevelsofgovernmentandtheprivatesector,includingacademicinstitutions,voluntaryassociations,andadvocacygroups.Toreflectourgrowingunderstandingoftheimportanceofsocialandenvironmentalfactorsforhealthstatus,theDepartmentstrivestocreatepartnershipswithorganizationsfromthosesectors.Specialeffortsaremadetotargetvulnerablepopulations,includingyouth,theelderly,women,minorities,andindividualswithdisabilities.Tointegrateouractivities,theDepartmenthasestablishedaconceptualmodelforthenation"Healthy  People"thatsetsanagendaforpreventionprogramsinthepublicandprivatesectorsandguides p ourselectionoftenyeartargets.Theobjectivesandstrategiesdescribedbelow,basedonresearchfindingsanddevelopedinpartnershipwithnationalhealthorganizations,willcontributetoachievingspecificHealthyPeopleobjectivesintheyear2000andwillbuildafoundationforachievinganewsetofHealthyPeopleobjectivesintheyear2010.   #p! iU5%!`z  `E$tt< i (#(#    (#(#iU5%!`z  `E$tt< iL 0 !"#$%&(xx0 !"#$%&(L?,X,hX,X X? lXXVJK#XVJXlJ#EYlXXVJFY2001P#XVJXlJ#ROGRAMS,lXXVJI#XVJXl)K#NITIATIVES,ANDlXXVJS#XVJXl|K#TRATEGIES  `   3    3K23  0    FDA!Tobacco .FDAwillincreasethenumberofcompliancechecksperformedatretail `  outletstoensurethatretailersarecomplyingwiththerulenottoallowchildrenandteenagerstopurchasecigarettesandsmokelesstobaccoproducts.FullimplementationofFDAsrulewilleliminatecertainformsofadvertisingthatareespeciallyappealingtoyoungpeople.TheoutreacheffortswillincreasethenumberofretailerswhoreceiveinformationfromFDA.ThisinformationistargetedtohelpretailersunderstandtheirresponsibilitiesunderFDAstobaccoruleandultimatelycomplywiththerequirementsthatprohibitsalestochildrenandteenagers.TheU.S.SupremeCourtisreviewingFDAsrule.TheageandidentificationprovisionsoftherulearetheonlyprovisionsineffectpendingtheSupremeCourtsfinaldecision,expectedbythesummerof2000. 3K L݌ (#(# Ќ    3    3P23  0    SAMHSA! Throughits SubstanceAbusePreventionandTreatment(SAPT)Block  Grant ,SAMHSAadministersthe SynarAmendment whichrequiresStatelegislativeand x enforcementeffortstoreducethesaleoftobaccoproductstominors.SAMHSAprovidesassistancetoStatesinenforcingtheirlawsandinspectingoutletstomeasurethelevelofretailercompliancewithtobaccosalesreduction.   3PAP݌@(#(# Ќ    3    3R23  0    HRSA!MaternalandChildHealthBlockGrant .ThroughTitleVoftheSocialSecurity h Act,thisprogramsupportsprenatalcareprogramsthatencouragehealthymaternalbehaviors,includingriskreductionbehaviors,especiallyforalcohol,tobacco,andsubstanceabuse. 3RR݌ (#(# Ќ    3    3kT23  0    HRSA!HealthCentersandtheNationalHealthServiceCorps (NHSC) .HRSAwill  reduceracialdisparityforpatientsincommunitieswiththehighestmorbidityandmortalityratesforminoritypopulations.Activitieswillfocusonpreventiveservicesandreductionofriskfactorscontributingtotheconditions,includingprovisionofsmokingcessationcounseling. 3kTT݌ (#(# Ќ    3    3V23  0    CDC ! HeartDiseaseandHealthPromotion,PreventingTobaccoUse .CDCwill X#! expanduponthecurrentinfrastructureofstatebasedtobaccocontrol,byexpandingresourcesavailabletolocalitiestopreventtobaccouse.Stateofthearttrainingandtechnicalassistancewillalsobeexpandednationwidetofurtherempowerlocalgovernments,schools,coalitions,andnationalorganizationstodevelopeffectiveinitiativesandprograms. 3VV݌ (#(# Ќ    3    3+Y23  0    /XVJXXXVJ IHS!Prevention,HealthEducation .IHSassistsitslocalpartnerstoengagein (4$' communitybasedpreventioninitiativeswhichaddressHIV/AIDSriskbehavior,violence,childabuse,physicalinactivity,nutrition,alcoholandsubstanceabuseandtobaccouseandcessation.#XVJXX/XVJY# 3+YVY݌+&*(#(# Ќ    3    3N[23  0    NIH!NicotineResearch .Nicotineaddictionistherootcauseofoneofthedeadliestand -(, mostcostlypublichealthproblems!useoftobaccoproducts.NIHwillcontinuetoprovide t.)- scientificleadershipincombatingnicotineaddiction.NIHwillsupportresearchonthetreatmentofnicotineaddictionbyfocusingonthedevelopmentofnicotineandnonnicotinereplacementmedicationsincombinationwithbehavioralstrategies.NIHwillexpanditsinitiativetodeveloptransdisciplinaryresearchcentersfocusingonprevention,developmentandtreatmentofnicotineaddictionandtobaccorelatedcancers.NIHhasalsolaunchedanAdolescentTobaccoTreatmentResearchClinic.Nicotinereplacementtherapy,usingthepatchandgum,hasbeenshowntobeeffectiveinassistingadultsmokingcessation,butonlyonestudytodatehasbeenreportedfornicotinereplacementtherapyinadolescents. 3N[y[݌ (#(# Ќ    3    3_23  0    OPHS ! XVJXXXVJԀTopreventtheabuseoftobacco,alcoholandotherdrugsbyyouth,OPHS  L  promotespartnershipswithparentsandothercaregivers,teachers,coaches,clergy,healthprofessionals,andbusinessandcommunityleaders.ThroughtheSmokeFreeKidspartnershipwithUSSoccer,OPHScoordinatesthedisseminationofanationalprogrampromotingparticipationofadolescentsinsoccerasawaytoreduceriskoftobaccouse.Also,OPHSassistsinthedevelopmentofcommunitycoalitionsandprogramsinpreventingdrugabuseandunderagealcoholandtobaccouse,supportsanddisseminatesscientificresearchanddataontheconsequencesoflegalizingdrugs,andpromotesothersimilaractivities.GirlPoweractivitiesworktoimprovetheselfesteemofgirlsandyoungwomensothattheyadopthealthierlifestylesandreducetheirrisksforsmoking,substanceabuseandteenpregnancy. 3__݌ (#(# Ќ    3    3d23  0    #XVJXXXVJ:`# OPHS 4XVJXXXVJ! In1999,theSurgeonGeneralwillissueareportonReducingTobaccoUse,which $t describeseffectivecommunitybasedtobaccocontrolprograms.AsecondreportonWomenandTobaccowillbeissuedduring2000.Thisreportwillprovideanupdateofthe1980firstSurgeonGeneralsreportonwomenandtobaccoincludingissuesrelatedtomaternalsmoking. 3dId݌ (#(# Ќ  #XVJXX4XVJd#XVJXXXVJ#XVJXXXVJf#& < lXXVJS#XVJXlg#ELECTEDlXXVJFY2001#XVJXl]g#ԀlXXVJP#XVJXlg#ERFORMANCElXXVJG#XVJXlg#OALSANDlXXVJM#XVJXlAh#EASURES   *_k ddd Xdd Xdd X(#(#,SS ,SSS ,SSS +  &\\\\G  &  PerformanceGoals 8\\\\E#! P \\\\G 8  Targets 8\\\\E#! P \\\\E 8  ActualPerformance &U"%XXVJ'<g =\\\\E(& <!   \\\\E =#XVJX"%&Unj#&U"%XXVJ&U"%"%&UReducethepercentageofteenagers(ingrades912) l"" whosmokebyconductinganeducationalcampaign,providingfundingandtechnicalassistancetostateprograms,andworkingwithnongovernmentalentities.CDCPlan#&U"%"%&Uk# 0\\\\%,!&\\\\E 0&U"%"%&UFY01:35.9% l"' FY99:36.4%#&U"%"%&Ul# 0\\\\H#(\\\\ 0FY01:FY99:2000FY97:36.4%FY95:34.8%FY93:30.5%FY91:27.5% /\\\\E&".\\\\ /Proportionofmotherswhosmokeduringpregnancy.OPHSPlan 0\\\\)T$0\\\\E 0FY01:9%FY00:10%FY99:12% 0\\\\)0%3\\\\ 0FY01:FY00:FY99:FY98:FY97:13.2% /\\\\E+&8\\\\ /Increasethenumberofcompliancechecksconductedandselectcertainsitestotargetfor intensifiedenforcementeffortstodeterminetheeffectivenessofdifferentlevelsofeffort.FDAPlan#XVJX"%&Uk#&U"%XXVJ 0\\\\ \\\\E 0FY01:228,000FY00:200,000FY99:Enterintocontractswithall50statestoconductanaverageof16,500unannouncedcompliancecheckseachmonthofretailestablishmentsthatselltobaccoproducts.#XVJX"%&Uo#&U"%XXVJ 0\\\\\\\\ 0FY01:FY00:FY99:Exceededcontractinggoalsbysigningcontractsforcompliancechecksinall50Statesand3TerritoriesinFY2000.Conductedonaverageapproximately9,000compliancecheckspermonth,approximately107,200inFY99.FY98:FDAcontractedwith43statesandterritoriesfor188,894compliancechecks.Thestatesandterritoriesconducted40,234compliancechecksinFY98.#XVJX"%&Up#&U"%XXVJ hL& FY97:Underapilotprogram,FDAcontractedwith10statesandconducted6,464compliancechecks.#XVJX"%&Ur#&U"%XXVJ /\\\\El P-\\\\ /IncreasenumberofStateswhoserateoftobaccosalestominorsviolationsisatorbelow20%.SAMHSAPlan 0\\\\#x0\\\\E 0(FY03:AllStates)FY01:30StatesFY00:12StatesFY99:8States 0\\\\p$T4\\\\ 0FY01:6/01FY00:6/00FY99:21StatesFY98:12StatesFY97:4States#XVJX"%&Us# L%09 (baseline) /\\\\E(& :\\\\ /DevelopatleastfiveregionaltobaccocontrolcenterstoassistAI/ANhealthfacilitiesandorganizationswithtobaccopreventionandcessationactivities.IHSPlan 0\\\\l*P#>\\\\E 0FY01:EstablishfivetobaccocontrolcentersFY00:establishbaselineratesfortobaccousage 0\\\\D,(%D\\\\ 0FY01:FY00:(l*P#H  \\\\ ( L.0'I  lXXVJP#XVJXl~w#ROGRAMSlXXVJS#XVJXlw#UPPORTINGlXXVJT#XVJXlx#HISlXXVJO#XVJXl]x#BJECTIVE   (X@(#(#(CDC  HeartDiseaseandHealthPromotionFDA  TobaccoHRSA `  PrimaryCareMaternalandChildHealthBlockGrantIHS $ t  Prevention 8  NIH   ResearchProgramOPHS  HealthyPeople2000OfficeonWomensHealthSAMHSA L  KnowledgeDevelopmentandApplicationTargetedCapacityExpansionHighRiskYouthNationalDataCollectionStateInfrastructureSubstanceAbuseBlockGrant 8         5@(#(#X@x5iU5%!`z  `E$tt<  i (#(#       (#(#iU5%!`z  `E$tt<  iL 0 !"#$%&(xx0 !"#$%&(L9,X,hX,X,hX9 lXXVJK#XVJXl}#EYlXXVJFY2001P#XVJXl}#ROGRAMS,lXXVJI#XVJXl8~#NITIATIVES,ANDlXXVJS#XVJXl~#TRATEGIES  `   3    3~23  0    SAMHSA 󀄀The SchoolViolencePreventionInitiative isdesignedtoincreaseopportunities `  forarangeofcommunities,andinparticularethnicandculturalminoritycommunities,toimplementcomprehensiveschoolandcommunityviolencepreventionplansandservices.Withincreasedfundingin2001,theCenterforMentalHealthServiceswillsupport1825additionalschooldistrictsthroughtheSafeSchools/HealthyStudentsprogram.Thisprogramisbasedonsixcore,mandatoryactivities:schoolsafety;preventionof,andearlyintervention,violentbehaviorandalcoholanddruguse;schoolandcommunitymentalhealthpreventiveandtreatmentinterventionservices;earlychildhoodpsychosocialandemotionaldevelopmentprograms;educationalreform;andsafeschoolpolicies.Throughthisinitiative,SAMHSAhopestodecreasetherateofviolenceintheschoolsandincreasethepercentageofmentalhealthactivitiesactuallyimplementedinschools. 3~݌ (#(# Ќ    3    3}23  0    CDC!InjuryPreventionandControl .TheNationalCenterforInjuryPreventionand t Control(NCIPC)workstopreventprematuredeathanddisabilitythrough:extramuralandintramuralresearch,developing,evaluation,andimplementingpreventionprograms,assistingStateandlocalhealthjurisdictionsintheireffortstoreduceinjuries,andconductingpreventionactivitiesinpartnershipwithotherFederalandprivatesectoragencies.EvaluationofinterventionprogramsisakeycomponentofCDCsoverallstrategytodiscoverwhatworksanddeterminehowbesttodeliverprogramstotheAmericanpeople.PriorityareasforFY2001include: 3}݌ (#(# Ќ  0  TraumaticBrainInjury(TBI).CDCwillcontinueworkingtowardeffectiveprevention  programsforTBIbydevelopingauniformreportingsystem;fundingresearch;supportingStatehealthdepartmentpreventionprojects;promotingpublicawarenessofTBI;andevaluatingtheuseofregistriestoimprovethequalityoflifeforpersonswithTBI. (#(# 0  YouthViolencePrevention.CDCfundsprojectstoevaluateeffectiveinterventionsfor `"  preventingandreducingaggressivebehavioramongyouth.Themajorityoftheprojectsemphasizeprimarypreventionandarecooperativeeffortsamongschools,healthdepartmentsandcommunitypartners.Severalprojectshavebeenfundedacrossthecountrywhichhavelookedatabroadrangeofpromisinginterventionsincludingpeermediation,conflictresolutiontraining,mentoring,roleplaying,andeffortstoimproveparentingskills.Theseinterventionswillserveastheframeworkfordevelopingperformancemeasuresaimedatreducingtheincidenceofyouthviolence. (#(# 0  IntimatePartnerViolence.CDCfundsprojectstodeterminehoweffectivespecific *%) preventionorinterventionprograms,orcombinationsoftheseprograms,areinpreventingintimatepartnerviolenceandsexualassault.Theexpansionofthisprogramwillbroadenthe populationbasereceivingtheinterventionswhichwillleadtogreaterknowledgeofmodifiable p-(, riskfactorsandconsequencesassociatedwiththedevelopmentofeffectivepreventionandinterventionstrategiesforintimatepartnerviolenceandsexualassault. (#(#  0  BicycleHelmetUsageandHeadInjuryPrevention.CDCworkstopreventtheseinjuriesand t deathsbydevelopinganddisseminatinginjurycontrolrecommendationsonbicyclehelmets;collaboratingwiththeNationalHighwayTrafficSafetyAdministration,otherfederalagencies,privateandvoluntaryagenciestopromotehelmetuseandbicyclesafety;andprovidinggrantstostatehealthdepartmentstoimplementandevaluateprogramsthatpromotehelmetuse.In1994,CDCbeganfundingprogramstopromotehelmetusewithinfundedcommunities. (#(# 0  FireRelatedInjuryPrevention.CDCworkstopreventtheseneedlessdeathsbyconducting,  8  coordinating,andfundingfireandburnpreventionresearchandinterventionsatthestate,local,andcommunitylevels,andcollaboratingwiththeConsumerProductSafetyCommission,U.S.FireAdministration,otherfederalagencies,privateandvoluntaryagenciesondevelopingrecommendationsforconductingandevaluatingsmokedetectorprograms. (#(# L F !"#$%&(px0 !"#$%&(L  3    3N23  0    /XVJXXXVJ IHS!Prevention,InjuryPrevention .IHScollaborateswithtribesandotherFederal,State, p andlocalagenciesineffortstoreducetheincidenceofsevereinjuries,withspecialemphasisonprimaryprevention,developingprogramsonsoundepidemiologicalbases,andfundingcommunitybasedpreventionprojects.IHShasdevelopedinjurypreventiontrainingprogramsspecificallyforthecommunitybasedpractitioner.IHSwillalsoassisttribesinbuildingtheircapacityandlocaltribalhealthinfrastructuretodevelopeffectiveprogramstopreventtraumaticinjuriesanddeathandincreasethenumberoftribalinjurypreventionprogramsbyasmanyas200projects.TheFY2001Budgetproposesinvestinginthedevelopmentofanenvironmentalhealthdatasurveillancesystemwhichincludesthecapacitytotracktheetiologyofinjuriessothateffectiveinterventionscanbeemployed. 3Ny݌ (#(# Ќ    3    323  0    #XVJXX/XVJ#6XVJXXXVJFDA!InjuryReportingInitiative .Reduceinjuriesandillnessesresultingfrom  consumptionanduseofFDAregulatedproducts.OneoftheFDAsprimaryobjectivesistodevelopandimplementacomprehensivesurveillancesystemtoimprovethequalityofinformationonadverseeventsandproductdefectsassociatedwithFDAregulatedproducts.Thesystemwillfocusonthreeareas:surveillanceandepidemiology;research;andeducationandoutreach.FDAbelievesthissystemwillincreasethesafetyofFDAregulatedproductsbecausemorereportsofrareandunexpectedadverseeventsandproductproblemswouldbediscoveredandcorrectiveactiontaken.Systematicfeedbackabouttheproblemcanthenbeprovidedtothehealthcarecommunityandthepublic.#XVJXX6XVJK#/XVJXXXVJ 3ߖ݌$L #(#(# Ќ  #XVJXX/XVJ#1XVJXXXVJ  3    3E23  0    #XVJXX1XVJ&# HRSA!MaternalandChildHealth,TraumaticBrainInjuryProgram (TBI).TheTBI &$"% DemonstrationGrantProgramisdesignedtoimprovehealthandotherservicesfortheassessmentandtreatmentofTBIandtoemphasizeactivitiesbyStatesthatimplementStatewidesystemsthatensureaccesstocomprehensiveandcoordinatedTBIservices. 3Ep݌ (#(# Ќ    3    323  0    HRSA!MaternalandChildHealthBlockGrant .ThroughTitleVoftheSocialSecurity t+&* Act,thisprogramsupportsinjurypreventionanddomesticviolencereductionprogramsthatreducebothaccidentalandintendedinjuries,especiallytochildren. 3݌ (#(# Ќ   <.)-   3    3U23  0    HRSA!MaternalandChildHealth,PoisonControlCenters. XVJXXXVJԀAspartofajoint  HRSA/CDCinitiative,#XVJXXXVJ #XVJXXXVJHRSAwillsupportthedevelopmentandassessmentofuniformpatient  managementguidelinestoprovideconsistent,evidencebasedprotocolsnationally.ThisbuildsonfundingallocatedinFY1999byCDC,withsupportfromHRSA,todevelopanationaltollfreetelephonenumberforpoisoncontrolandinitiateapubliceducationcampaigntoadvertisethisnumber. 3U݌ (#(# Ќ  #XVJXXXVJ#  3    323  0    ACFFamilyViolencePreventionandServices/BatteredWomensShelters. This ( x programprovidesgrantstoStatesandIndianTribestoassistinsupportingprogramsandprojectstopreventincidentsoffamilyviolence,provideimmediateshelterandrelatedassistanceforvictimsoffamilyviolenceandtheirdependents,andprovideresourcestoprogramsthatofferpreventionservicesforperpetrators.Toaddressthegrowingneedforcounselingandotherimmediateservicestoexistingandunderservedpopulationsandlocations,fundsforbatteredwomensshelterswillbeincreasedthroughtheFY2001request. 3݌ (#(# Ќ    3    323  0    ACF The DomesticViolenceHotline providescrisisinterventionbyhelpingcallersidentify   problemsandpossiblesolutions,includingmakingplansforsafetyinanemergency;informationaboutsourcesofassistanceforthosewantingtolearnmoreaboutdomesticviolenceandrelatedissues;andreferralstobatteredwomenssheltersandprograms,socialserviceagencies,legalprograms,andothergroupsandorganizationswillingtohelp.TheFY2001requestwillincreasefundsfortheNationalDomesticViolenceHotlinesothatpersonsneedingimmediateresponsecangetthehelptheyneed. 3ޥ݌ (#(# Ќ    3    3ب23  0    IHS!Prevention,HealthEducation,andTreatment .IHSscreensthetreatment @ populationforindicationforabuseorneglectandassistsitslocalpartnerstoengagein/XVJXXXVJcommunitybasedpreventioninitiativeswhichaddressHIV/AIDSriskbehavior,violence,  childabuse,physicalinactivity,nutrition,alcoholandsubstanceabuseandtobaccouseandcessation.#XVJXX/XVJ# 3ب݌(#(# Ќ    3    3g23  0    NIH!ResearchonTreatmentforTraumaticBrainandSpinalCordInjury .XVJXXXVJResearch | todevelopeffectivetreatmentsfortraumaticbrainandspinalcordinjuriesandtounderstandthelongtermconsequencesofheadinjury,especiallyinchildren,isanimportantstrategytoreducetheimpactofinjuries.Forexample,theNationalInstituteofNeurologicalDisordersandStrokeissupportingprojectsthatincludeaclinicaltrialtotestthesafetyofsystemichypothermiatoslowdownmetabolismandtherebyinhibitthecascadeofbiochemicaleventsthatimmediatelyfollowsaheadinjuryandresultsinbraincelldeathordamage.Anotherprojectwillassesstheimpactoftraumaticbraininjury(TBI)inchildrenandadolescentsontheotherfamilymembersandtheextenttowhichrecoveryfrompediatricTBIisinfluencedbythefamilyenvironment.#XVJXXXVJ*#ԀATraumaticBrainInjury(TBI)RehabilitationResearchNetworkis '#& beingdevelopedtoaddressresearchneedsrecentlyhighlightedinNIHsConsensusDevelopmentConferenceentitled RehabilitationofPersonswithTraumaticBrainInjury.Inaddition,amultidisciplinary,collaborativeprogramisbeingplannedtodevelopandassesstherapiesspecificallytargetedtothephysical,emotionalandsocialneedsofchildrenexperiencingtrauma,includingTBI. 3g݌ (#(#   1XVJXXXVJ T-(,   3    323  0    #XVJXX1XVJ# OPHS ! TheOfficeonDomesticViolence,withintheOfficeofWomensHealth,provides   HHSwidecoordinationandleadershipondomesticviolence.4XVJXXXVJInaddition,OPHSstaffsthe  AdvisoryCommitteeonViolenceAgainstWomen,ajointFederalAdvisoryCommitteethatadvisesbothHHSandtheDepartmentofJusticeontheissuesandneedstosuccessfullypreventandaddressdomesticviolence.#XVJXX4XVJB#1XVJXXXVJ 3݌d(#(# Ќ  #XVJXX1XVJ#  3    323  0    /XVJXXXVJ HRSA!PrimaryCare,HealthCenters .#XVJXX/XVJ#HRSA'sHealthCentersareimplementingaFamily <  ViolenceInitiativeandplantoaddparentingclasses,homevisitingandabusepreventionservicesinhighriskareas. 39݌ (#(# Ќ  XVJXXXVJ  3    323  0    #XVJXXXVJ# HRSA!MaternalandChildHealth,EmergencyMedicalServicesforChildren   @  (EMSC).EMSCisdesignedtoensurethatallchildrenandadolescents,nomatterwheretheyliveorwheretheytravel,canreceiveappropriatecareinahealthemergency.Itseekstoimproveallaspectsofchildrensacuteemergencymedicalcare,includingprehospitalcare,emergencydepartmentcare,hospitalcare,andrehabilitation,andtopreventsuchemergenciesfromoccurring.HRSAwillcontinuesystemsimprovementgrantstoStatesinordertofundevaluation,dataimprovement,andevidencebasedresearch. 30݌ (#(# Ќ    3    3F23  0    CDC!OccupationalSafety&Health .TheNationalInstituteforOccupationalSafetyand T Health(NIOSH),inCDC,conductsanationalprogramofbiomedicalresearchinoccupationalsafetyandhealth.NIOSHscorpsofmultidisciplinaryteamscomprisingengineers,epidemiologists,industrialhygienists,physicians,andtoxicologistsperformfivebasicpublichealthfunctionstoimprovethesafetyandhealthofworkers:(1)determinesthenatureandextentoftheoccurrenceandcausesofworkinjuriesanddiseasestotargetresearchandpreventionactivities;(2)detectsandinvestigatesworkplacehealthandsafetyproblems,identifyingtheircausesandeffects;(3)conductsstudiesanddemonstrationstoidentifyeffectiveengineeringsolutions,personalprotectiveequipment,workorganizationandpractices,andhealthcommunicationsstrategiestopreventworkinjuriesanddiseases;(4)developsanddisseminatesrecommendationsforassuringthesafetyandhealthofworkers;and(5)providesleadershipandtraininginoccupationalsafetyandhealth,establishingnationalresearchagendastoleveragetheimpactofgovernmentandprivatesectorresources,andtrainingprofessionalsandscientists. 3Fq݌ (#(# Ќ    ,#|! & h  lXXVJS#XVJXl#ELECTEDlXXVJFY2001#XVJXlP#ԀlXXVJP#XVJXl#ERFORMANCElXXVJG#XVJXl#OALSANDlXXVJM#XVJXl4#EASURES   *TJ ddSS SSS SSSS S_k(#(#,<SS ,SSS ,SS +  &\\\\G  &  PerformanceGoals 8\\\\E#!d \\\\G 8  Targets 8\\\\E#!d \\\\E 8  ActualPerformance =\\\\E(&P   \\\\E =&U"%XXVJReducethenumberofunintentionalinjuriesfor   AI/ANpeople.IHSPlan 0\\\\\ \\\\E 0 Hospitalizations     FY01:70.0/10,000FY00:71.5/10,000 Deaths   @  FY99:93/100,000      0\\\\ \\\\ 0FY01:FY00:FY99:12/00FY98:72.5/10,000FY96:74.7/10,000FY99:12/02FY9496:92.6/100,000FY9294:95.0/100,000'h  /\\\\E< \\\\ /IncreasetheuseofbicyclehelmetsbychildbicyclistsinCDCfundedprojectareas.CDC  Plan 0\\\\d\\\\E 0FY01:25%increaseFY00:25%increaseFY99:30%increase 0\\\\d\\\\ 0FY01:FY00:FY99:4/00FY98:California+83%.Colorado+16%Florida+3%Oklahoma+214%RhodeIs.+15% /\\\\E(\\\\ /Theincidenceofresidentialfirerelateddeathswillbereduced.CDCPlan 0\\\\(*\\\\E 0FY01:1.1/100,000FY00:1.1/100,000FY99:1.1/100,000 0\\\\-\\\\ 0FY01:FY00:FY99:2000FY97:1.1/100,000FY94:1.4/100,000 /\\\\El2\\\\ /RecruitadditionalhospitalsintotheMedSunSystem(MedicalDeviceSurveillanceNetwork)forinjuryreportingthatusesimproveddataformatandcollectionmethodstoenhancethevalidityandreliabilityofdataprovided,thusaffordingahigherlevelofpublichealthprotection.FDAPlan#XVJX"%&U#&U"%XXVJ 0\\\\($x8\\\\E 0FY01:Over200additionalhospitalsFY00:DevelopMedSunbasedonapproximately75to90representativeuserfacilities.FY99:N/A#XVJX"%&UI#&U"%XXVJ 0\\\\'"B\\\\ 0FY01:FY00:FY99:PilotcompletedFY98:Recruited24pilotfacilities#XVJX"%&UD#&U"%XXVJ /\\\\E+X&P\\\\ /IncreasepercentageofIHS,TribalandUrbanprogramsthathaveimplementedasuicidesurveillancesystemtomonitortheincidenceand prevalenceratesofsuicidalacts(ideation,attempts,andcompletions)whichassuresthoseatriskreceiveservices,andthatappropriatepopulationbasedpreventioninterventionsareimplemented.IHSPlan 0\\\\ h\\\\E 0FY01:50% 0\\\\d \\\\ 0FY01:FY00:FY99:FY98:25%est. /\\\\E  \\\\ /Proportionofinjurioussuicideattemptsamongyouthages1417.OPHSPlan 0\\\\\\\\E 0FY01:1.6FY00:1.8FY99:2.0 0\\\\ \\\\ 0FY01:FY00:FY99:FY98:FY97:2.6%FY94:2.8%#XVJX"%&U# /\\\\E@$ \\\\ /&U"%XXVJViolentvictimizationinflictedbyintimate   assailant.OPHSPlan p  0\\\\hL\\\\E 0 Women    FY01:FY00:7/1,000 0\\\\  \\\\ 0FY01:FY00:FY99:FY98:FY92:4.5/1000#XVJX"%&U# /\\\\E %\\\\ /&U"%XXVJIncreasethepercentageofIHS,Tribal,andUrban t& medicalfacilitieswithUrgentCareorEmergencydepartmentsorservicesthathavewrittenpoliciesandproceduresforroutinelyidentifying,treatingand/orreferringvictimsoffamilyviolence,abuseorneglect(i.e.,child,spouse,and/orelderly).IHS + Plan 0\\\\,\\\\E 0FY01:80%FY00:70%FY99:60% 0\\\\H,/\\\\ 0FY01:FY00:FY99:64%FY98:47%#XVJX"%&U#&U"%XXVJ /\\\\E$3\\\\ /#XVJX"%&U#&U"%XXVJIncreasethenumberofFederallyrecognizedIndian ( 4 Tribesthathavefamilyviolencepreventionprograms#XVJX"%&U=#&U"%XXVJ.ACFPlan 0\\\\!6\\\\E 01&U"%"%&UK+ 4 <DL!,X,hXKFY01:189 ( 7 FY00:174FY99:162#&U"%"%1&U[# !9  0\\\\":\\\\ 0?+ 4 <DL!X?FY01:FY00:dFY98:174dFY96:120#XVJX"%&U#("> \\\\ ( lXXVJP#XVJXl #ROGRAMSlXXVJS#XVJXlk#UPPORTINGlXXVJT#XVJXl#HISlXXVJO#XVJXl#BJECTIVE  %@ (X@(#(#(ACF ' B FamilyViolencePreventionandServices/BatteredWomensSheltersDomesticViolenceHotlineCDC P+4$F InjuryPreventionandControlOccupationalSafety&HealthFDA .&I FoodsHumanDrugsMedicalDevicesandRadiologicalHealthBiologicsAnimalDrugsandFeeds/XVJXXXVJHRSA <, %N PrimaryCare,HealthCenters#XVJXX/XVJ# (- &O MaternalandChildHealthBlockGrant .&P EmergencyMedicalServicesforChildrenTraumaticBrainInjuryProgramPoisonControlCentersIHS t Prevention ` NIH  ResearchProgramOPHS  OfficeonWomensHealthOfficeoftheSurgeonGeneral ` 5@(#(#X@c5  8  iU5%!`z  `E`ttx 3 i (#(#     (#(#iU5%!`z  `E`ttx 3 iL 0 !"#$%&(xpF !"#$%&(L-,X,hXX- lXXVJK#XVJXl3#EYlXXVJFY2001P#XVJXly#ROGRAMS,lXXVJI#XVJXl#NITIATIVES,ANDlXXVJS#XVJXl #TRATEGIES  L    3    323  0    /XVJXXXVJ CDC!ChronicDiseasePrevention .CDCistakingacrosscuttingapproachtoaddressthe L  burdenofheartdiseaseandotherhealthrisksintheU.S.throughthepreventionofriskfactors(e.g.,tobaccouse,physicalinactivity,andpoornutrition),surveillance,epidemiologicresearch,andhealthpromotionactivities.Cardiovasculardiseaseistheleadingcauseofdeathinallstates;CDCisimplementingthisapproachtoheartdiseaseandstrokepreventionbybuildingstatespecificcapacityforcardiovascularhealthpromotion,firstinthosestateswiththegreatestheartdiseaseandstrokeburden.Insubsequentyears,effortswillexpandtocreatecapacityinallstatesandterritoriesinordertobuildanationwidecardiovascularhealthprogram..#XVJXX/XVJ# 3݌(#(# Ќ    3    323  0    CDC!EnvironmentalDiseasePrevention .CDChaslaidafoundationforanational  campaigntoencouragefolicacidconsumptionbyallwomenofreproductiveagebyconductingcommunicationresearchneededtodevelopaneffectivecampaigntoincreasetheconsumptionofsupplementalfolicacid.Thenextstepistoencourageimplementationandevaluationofstateandlocalprogramstoconducteducationalcampaignstargetedtolocalwomenofreproductiveage,andtomakefolicacidawarenessapartofthedeliveryofpreventativehealthcareservicestowomen.Hispanicwomenwillbespecificallytargetedtoreducetheirdisparate,increasedriskfortheseseriousbirthdefects. 3݌ (#(# Ќ    3    323  0    HRSA!PrimaryCare,HealthCenters .ManyofHRSAsHealthCenterscurrently ( providenutritionandfitnesscounseling.InFY2001,HRSAwillprovideHealthCenterservicestofocusondisparityreduction,particularlyforthosecommunitieswiththehighestmorbidityandmortalityratesforminoritypopulations.Thedisparityreductionpackagewillincludecounselingofpatientsregardingtobacco,alcohol,anddruguse,oralhealth,fitness,andnutrition. 31݌ (#(# Ќ    3    323  0    AoA!CongregateandHomeDeliveredNutritionServices .AoAsupportscongregate P#! andhomedeliveredmealprogramstoincreasethenutritionalintakeofatriskseniors.Homedeliveredmealsenableolderadultstoavoidordelaycostlyinstitutionalizationandallowthemtostayintheirhomesandcommunities.Congregatenutritionservicesalsoimproveparticipantshealthsignificantlyandpreventmorecostlyinterventions.Inaddition,congregateservicesallowolderpeopletheopportunitytoengageinsocialactivitiesthatcontributetotheirwellbeing. 3݌ (#(# Ќ    3    323  0    FDA!Foods,XVJXXXVJNutritionLabeling .FDAestablishesregulations,policies,andstandardsfor *&) nutritionlabeling,dietarysupplementsandotherspecialnutritionalproductssuchasinfantformulasandmedicalfoods.Throughsciencebasednutritionpolicies,FDAprovidesinformationtoenableconsumerstomakebetterdietarychoices.Todevelopthesciencebaseforitsnutritionpolicies,theAgencywillcontinueresearchstudiesandanalysisofscientific h.)- andepidemiologicaldata,tobetterunderstandtherelationshipsbetweendietanddisease.Thefoodlabelservesasaprimarytoolforproducerstoprovideinformationtoconsumersaboutthe#XVJXXXVJ(#XVJXXXVJfoodsnutritivevalueanditsingredientsaspartofahealthydiet.TheAgencywillalso  continuetorespondtosafetyconcernsassociatedwiththerapidlyexpandinguseandmisuseofdietarysupplementproductssuchasephedra.#XVJXXXVJ# 3݌`(#(# Ќ    3    323  0    /XVJXXXVJ IHS!Prevention,HealthEducation .IHSassistsitslocalpartnerstoengagein 8  communitybasedpreventioninitiativeswhichaddressHIV/AIDSriskbehavior,violence,childabuse,physicalinactivity,nutrition,alcoholandsubstanceabuseandtobaccouseandcessation.#XVJXX/XVJ# 3݌ P (#(# Ќ    3    323  0    NIH!FiveaDayforBetterHealthProgram .Thisprogramisanationalpublic/private (  partnershipnutritioneducationprogramwhichapproachesAmericanswithasimple,positivemessage!toeat5ormoreservingsoffruitsandvegetableseveryday.TheNationalCancerInstitutetakestheleadintheprogrambyservingasthecrediblehealthsource,maintainingscientificintegrity,fundingresearchinnutritionalbehaviorchange,andorganizingandprovidingtechnicalsupporttothe55StateandterritorialhealthdepartmentsintheFiveaDayinfrastructure. 3݌ (#(# Ќ    3!    323  0    NIH!InterdisciplinaryResearchonNutrition ./XVJXXXVJNIH#XVJXX/XVJg#encouragesinterdisciplinary < interactionbetweenbasicandclinicalresearchandstressesthelinksbetweennutritionandobesity,diabetes,andotherchronicconditions/XVJXXXVJ.ThiseffortissupportedbyNIHthrough:1) h guidancefromthe#XVJXX/XVJj#/XVJXXXVJNIHNutritionCoordinatingCommitteeleadbytheNationalInstituteof T DiabetesandDigestiveandKidneyDiseases,2)aresearchportfolioofbasicinvestigationsthatseektounderstandthemolecularroleofnutrientsinhealthandinthepreventionandtreatmentofdisease,and3)eightClinicalNutritionResearchUnitsandfourObesity/NutritionResearchCenters.Thecentersprovidecoreresourcestoabroadbaseofresearchinvestigators.#XVJXX/XVJ#ԀTheNIHalsosupportsNutritionAcademicAwardstostimulatethe  developmentandenhancementofmedicalschooleducationprogramssothatphysiciansmaylearnnutritionprinciplesandclinicalpracticeskillsforthepreventionofcardiovasculardiseases,obesity,diabetes,andotherchronicdiseaserisksandimprovednutritionalmanagementoftheirpatients. 3݌ (#(# Ќ    3"    323  0    AoA!GrantstoIndianTribes .AoAsAmericanIndian,AlaskaNativeandNative (#x! HawaiianProgramawardsgrantstoprovidesupportiveandnutritionservices,includingbothcongregateandhomedeliveredmealstoolderNativeAmericans. 3݌ (#(# Ќ    3#    323  0    OPHS!XVJXXXVJ Toimprovehealthbehaviorsrelatedtophysicalactivityanddiet,#XVJXXXVJ#/XVJXXXVJOPHSworksto &,"% engageyouth,adults,andtheelderlyinprogramstoincreasephysicalactivitythroughcoordinatedactivitiesrelatedtothe#XVJXX/XVJ#XVJXXXVJPresidentialSportsAward(forages7toadult)andthe ($' PresidentsChallengePhysicalFitnessAwardsProgram(forschoolbasedachievement).#XVJXXXVJr#XVJXXXVJԀIn )$( addition,theofficeengagesinpartnershipactivitieswithprominentorganizationssuchastheNationalTaskForceonthePreventionandTreatmentonObesity,InternationalYearoftheOlderPersonsSubcommittee,PartnershipforPrevention,WomensSportsFoundation,Sears,UnitedStatesOlympicCommittee,MetropolitanLifeInsuranceCompany(MetLife),andNationalFootballLeague(NFL)/GatoradePunt,Pass&Kick. 3݌@.)-(#(# Ќ  #XVJXXXVJX#0  4XVJXXXVJAtthegrassrootslevel,OPHSenliststheactivesupportandassistanceofindividualcitizens,  civicgroups,privateenterprise,voluntaryorganizations,andothersineffortstopromoteandimprovephysicalactivityandfitnessofallAmericans.OPHSencouragesthedevelopmentofcommunityrecreation,physicalfitnessandsportsparticipationprograms.Itdevelopsanddistributesarangeofpublicationstoinformthegeneralpublicoftheimportanceofexerciseandthelinkwhichexistsbetweenregularphysicalactivityandgoodhealth. (#(# 0  OPHSworkscloselywithindustry,government,andlabororganizationstoestablishsoundphysicalactivity,fitnessinitiatives,andpartnershipsinanefforttoreducethefinancialandhumancostresultingfromphysicalinactivity.OPHShasalsoassistededucationalorganizationsatthenational,state,andlocallevelsindevelopinghighquality,innovative,comprehensivehealthandphysicaleducationprogramswhichemphasizetheimportanceofexerciseandgoodhealth.#XVJXX4XVJ# (#(# 0  GirlPoweractivitiesworktoimprovetheselfesteemofgirlsandyoungwomensothattheyadopthealthierlifestylesandreducetheirrisksforsmoking,substanceabuseandteenpregnancy./XVJXXXVJ\(#(# #XVJXX/XVJ #&  lXXVJS#XVJXl #ELECTEDlXXVJFY2001#XVJXl #ԀlXXVJP#XVJXl #ERFORMANCElXXVJG#XVJXld #OALSANDlXXVJM#XVJXl #EASURES   p *]^ d d<SS <SSS SSS TJ(#(#,SS ,SSS ,SSS +  &\\\\G  p &  PerformanceGoals 8\\\\E#! \\\\G 8  Targets 8\\\\E#! \\\\E 8  ActualPerformance =\\\\E(&p   \\\\E =&U"%XXVJ' r Percentofpeopleaged1874whoengageinlightto @ moderatephysicalactivityforatleast30minutesperday,fiveormoretimesaweek.OPHSPlan 0\\\\\\\\E 0FY01:26%FY00:30%FY99:29% 0\\\\!\\\\ 0FY01:FY00:FY99:FY98:FY95:23% /\\\\E`&\\\\ /Increasethenumberofhomedeliveredmeals.AoA  ' Plan 0\\\\!(\\\\E 0FY01:166,000,000FY00:155,000,000FY99:119,000,000 0\\\\"+\\\\ 0FY01:FY00:FY99:9/01FY98:9/00FY97:123,455,000FY96:119,110,318FY95:119,000,000 /\\\\E%H!2\\\\ /#XVJX"%&U #&U"%XXVJMaintainongoingbodymassindex(BMI) h'"3 assessmentsinAI/ANchildren35yearsoldand/or810yearsold,forbothinterventionpilotsitesandnoninterventioncomparisonsites,aspartofanoverallassessmentoftheongoingchildhoodobesitypreventionproject'seffectiveness.IHSPlan 0\\\\+'8\\\\E 0FY01:implementprogramandmonitorpilotsandcomparisonssitesFY00:developfivepilotsitesFY99:developapproachandbaselines 0\\\\l-(@\\\\ 0FY01:FY00:FY99:accomplished /\\\\E,'G\\\\ /By2000,increasethepercentofwomenof reproductiveagewhowillbeconsuming400microgramsoffolicacid.CDCPlan 0\\\\8 \\\\E 0 FY01:45% d FY00:40%FY99:35% 0\\\\8 \\\\ 0FY01:FY00:FY99:Datanotavailablefor1999(biennialsurvey)FY98:32%FY96:25%#XVJX"%&Uj#&U"%XXVJ /\\\\E  \\\\ /EstablishmodelfitnessprogramsateitherIHSAreaOfficesortheI/T/Ulevel.IHSPlan 0\\\\\\\\E 0FY01:10sites 0\\\\\\\\ 0FY01:FY00:FY99:FY98:onesite /\\\\E \\\\ /Increasetheproportionofadultswhoreportchangingtheirdecisiontobuyoruseafoodproductbecausetheyreadthefoodlabel.FDAPlan 0\\\\ \\\\E 0FY01:55%FY00:N/AFY99:Increasetoatleast77%theproportionofpeopleaged18andoverwhousefoodlabelstomakenutritiousfooddecisions. 0\\\\ \\\\ 0FY01:FY00:FY99:CollaboratedwithseveralFederalagenciestodevelopeducationalmaterialforeducatorsandconsumersonhowtousefoodlabels.()  \\\\ (#XVJX"%&U# lXXVJP#XVJXl#ROGRAMSlXXVJS#XVJXl#UPPORTINGlXXVJT#XVJXl#HISlXXVJO#XVJXlf#BJECTIVE  * (X@(#(#(AoA , CongregateMealsHomeDeliveredMealsGrantstoIndianTribes/XVJXXXVJCDC  0 ChronicDiseasePrevention#XVJXX/XVJN# !t1 EnvironmentalDiseasePreventionHRSA h#L3 PrimaryCare,HealthCentersFDA @%$5 FoodsIHS 6 PreventionNIH 8 ResearchProgramOPHS !t: OfficeonWomensHealthPresidentsCouncilonPhysicalFitnessandSportsHealthyPeople,2010 @%$> 5@(#(#X@5iU5%!`z  `E#'$tt<'  i (#(#  '>     (#(#iU5%!`z  `E#'$tt<'  iL 0 !"#$%&(xx0 !"#$%&(L9,X,hX,X,hX9 lXXVJK#XVJXl#EYlXXVJFY2001P#XVJXl#ROGRAMS,lXXVJI#XVJXl.#NITIATIVES,ANDlXXVJS#XVJXl#TRATEGIES  *#B   3$    323  0    SAMHSA! Ithasbeenestimatedthatonlyd37%dofthosewhocriticallyneedtreatmentcan ,%D beservedthroughexistingpubliclyfundedtreatmentsystems.TheFY2001requestproposes -&E increasesfortwoprogramswhichfocusspecificallyonreducingthetreatmentgap:1)theSubstanceAbusePreventionandTreatment(SAPT)BlockGrant,whichwillprovidefornationwideexpansionoftreatmentservicesandaidinthereductionoftreatmentwaitinglists;and2)theTargetedCapacityExpansionprogram,whichwillproviderapidandstrategicresponsestothedemandforalcoholanddrugabusetreatmentservicesthataremoreregionalorlocalinnature. 3 ݌ (#(# Ќ    3%    3Z#23  0    SAMHSA!StateIncentiveGrantProgram(SIG). ConsistentwiththeHHSfocuson $ t communitysolutions,theFY2001budgetrequestsupportsthetransferofpreventionknowledgefrompreventionstudiestoapplicationintheStatesandlocalcommunities.TheSIGprogramassistsGovernorstoimplementcomprehensivesciencebasedpreventionpracticesdirectedatreducingyouthsubstanceabuse(includingalcohol),improvingaccesstoneededservicesandreducingthegapinpreventionservices. 3Z##݌ (#(# Ќ    3&    3&23  0    SAMHSAEffectiveAlcoholPreventionStrategiesforYouth willreplicateproven   preventionprogrammodelsdemonstratingeffectivenessinreducingalcoholuseoritsprecursorsamongyouthages518.ExtendingSAMHSAsFY2000crosscuttinginitiativetoayoungerpopulation,thiscomponentwillaskgranteestoreplicateoneoffiveidentifiedeffectivemodelsindiversesettingsandwithdiversepopulations.Programswillleadtorefinementsinmodelsforspecificpopulations,preventionstandardsandguidelinesforbestpractices,andimplementationofeffective,sciencebasedstrategiesbyBlockGrantandotherFederal,Stateandpubliclyfundedpreventionprograms. 3&;&݌ (#(# Ќ  0  ThesecondcomponentwillbuildonSAMHSA/CSAPFY2000andpriorprogramsbysupportingtheapplication,throughcommunityprogramssupportedbyCSAPsStateIncentiveGrants,ofpreventionapproachesfoundeffectiveinitsChildrenofSubstanceAbusingParents(COSAP)programwhichendsinFY2000.Theproposedprogramwillexpandtheavailabilityofbestpracticesinpreventingunderagedrinkingproblemsamongyouthwithspecificvulnerabilitiestoalcoholrelatedproblemsinthreeagegroups:age68;age911;andage1214. (#(#   3'    3+23  0    HRSA!PrimaryCare,HealthCenters .InFY2001,HRSAwillprovideHealthCenter L! servicestofocusondisparityreduction,particularlyforthosecommunitieswiththehighestmorbidityandmortalityratesforminoritypopulations.Thedisparityreductionpackagewillincludeexpandingthecounselingofpatientsregardingtobacco,alcohol,anddruguse,oralhealth,fitness,andnutrition. 3++݌ (#(# Ќ    3(    3.23  0    /XVJXXXVJ IHS!Prevention,AntiDrugAbuseActivities .IHSwillincreasedrugrelatedactivities, &("% includingtreatment,AdolescentRegionalTreatmentCenters,CommunityRehabilitationandAftercare,Training/CommunityEducation,HealthPromotion/DiseasePrevention,NavajoRehabilitationProgramUrbanPrograms,andContractHealthServices. 3.>.݌ (#(# Ќ  0  Programimprovementswillcontinuetofocusontheneedsofalcoholandsubstanceabuserswhohaveahistoryofsexualabuseandonaredesignedcommunitymobilizationeffortthat willprovideinnovativetreatmentdnpreventionmodulestargetingcommunitiesthathavehigh P-(, ratesofalcoholismanddrubabuse.Inaddition,IHSeffortswillberesponsivetochangingdrugusepatterns,suchastheincreaseinmethamphetamineuseintheBillingsArea.#XVJXX/XVJ.#/XVJXXXVJ(#(#  #XVJXX/XVJX2#  3)    3223  0    OPHS ! XVJXXXVJTopreventtheabuseoftobacco,alcoholandotherdrugsbyyouth,OPHS t promotespartnershipswithparentsandothercaregivers,teachers,coaches,clergy,healthprofessionals,andbusinessandcommunityleaders.Also,OPHSassistsinthedevelopmentofcommunitycoalitionsandprogramsinpreventingdrugabuseandunderagealcoholandtobaccouse,supportsanddisseminatesscientificresearchanddataontheconsequencesoflegalizingdrugs,andpromotesothersimilaractivities.#XVJXXXVJL3#ԀXVJXXXVJGirlPoweractivitiesworktoimprove  d theselfesteemofgirlsandyoungwomensothattheyadopthealthierlifestylesandreducetheirrisksforsmoking,substanceabuseandteenpregnancy.#XVJXXXVJ5#XVJXXXVJ 322݌ < (#(# Ќ  #XVJXXXVJ6#  3*    3&723  0    HRSA!MaternalandChildHealthBlockGrant .ThroughTitleVoftheSocialSecurity   Act,thisprogramsupportsprenatalcareprogramsthatencouragehealthymaternalbehaviors,includingriskreductionbehaviors,especiallyforalcohol,tobacco,andsubstanceabuse. 3&7Q7݌ (#(# Ќ    3+    3823  0    NIH!AdolescentAlcoholAbuseResearch .Theprevalenceofalcoholabuseamong x adolescentshasincreasedNIHsemphasisonthedevelopmentofnewpreventionandtreatmentstrategiesagainstalcoholismandalcoholabuse.TheNIHhasidentifiedavarietyofinitiativesassociatedwithitsfocusonadolescentsandyouth.Theseinitiativesincludesolicitingstudiesthatwillprovideascientificallyinformedbasisfordevelopingeffectiveadolescenttreatmentstrategies,includingconsiderationofdifferentculturalandgenderneeds.Suchstudiesmight,forexample,contrastintegratedtreatmentregimensdesignedtoaddressthegamutofadolescentlifestyleissueswithmoretraditionaltreatmentprograms.Otherareasofspecialinterestincludeidentifyingalcoholinducedphysiologicalandbehavioralchangesuniquetoadolescents,implementingrecommendationsfromtheCollegeDrinkingSubcommittee,studyingmechanismsofyouthalcoholabuse,identifyingstrategiesforpreventingalcoholsalestounderagepersonsandpreventingalcoholuseamongyoungadolescents. 38'9݌ (#(# Ќ  &  lXXVJS#XVJXl>#ELECTEDlXXVJFY2001#XVJXl^>#ԀlXXVJP#XVJXl>#ERFORMANCElXXVJG#XVJXl>#OALSANDlXXVJM#XVJXlB?#EASURES  P! *_` ddSS SSS SSSS S]^(#(#,SS ,4SS ,SSS +  &\\\\G P#! &  PerformanceGoals 8\\\\E#!#" \\\\G 8  Targets 8\\\\E#!## \\\\E 8  ActualPerformance =\\\\E(&$%   \\\\E =&U"%XXVJProportionofyouthnotusingalcoholorany  &p!& illicitdrugsduringthepast30days.Useofalcoholoranyillicitdrugamongyouthages1220.OPHSPlan 0\\\\($)\\\\E 0FY01:78.2%FY00:FY99:FY97:77% 0\\\\($-\\\\ 0'P!>FY97:77%FY96:78%FY95:75%FY94:76%#XVJX"%&UA# /\\\\EH+&4\\\\ /&U"%XXVJMaintaintheratesandintensityoffollowupfor d adolescentsdischargedfromIHSsupported RegionalTreatmentCentersandassureabstinence.IHSPlan. 0\\\\ \\\\E 0 Abstinence  d FY01:+3%overFY00FY00:establishbaseline FollowupRates     FY01:FY00orhigherFY00:+10% overFY99    FY99:establishbaseline 0\\\\ l \\\\ 0FY01:FY00:FY01:FY00:FY99:64.5%30days̀55.2%6months̀40.9%12months#XVJX"%&UC# /\\\\E< \\\\ /&U"%XXVJ/&U"%"%&UIncreasenumberofStatesthatincorporateneeds   assessmentdataintoblockgrantapplication#&U"%"%/&UF#. l  SAMHSAPlan. 0\\\\dH \\\\E 0/&U"%"%&UFY01:38States   FY00:34StatesFY99:27States#&U"%"%/&UG# 0\\\\dH \\\\ 0/&U"%"%&UFY01:TBR6/01   FY00:TBR6/00FY99:26StatesFY94:13States#&U"%"%/&U^H##XVJX"%&U{F# /\\\\E@$ \\\\ /&U"%XXVJIncreaseinthepercentofadultsreceiving  ! serviceswho,:0 / !0[//werecurrentlyemployedorengagedin hL# productiveactivities [[ 0 / !0[//hadno/reducedinvolvementwiththe  % criminaljusticesystem#XVJX"%&UMI#&U"%XXVJ&[[ 0 / !0[//experiencedno/reducedalcoholorillegal ' drugrelatedhealth,behavior,orsocialconsequences#XVJX"%&UJ#&U"%XXVJt)[[ 0 / !0[//hadnopastmonthsubstanceabuse#XVJX"%&UK#&U"%XXVJlP*[[ 0 / 0[//(developmental).SAMHSAPlanH,+[[ L , !"#$%&(dxx0 !"#$%&(L#XVJX"%&UL#&U"%XXVJ 0\\\\$,\\\\E 0FY01:TBDFY00:Newin2001#XVJX"%&UM#&U"%XXVJ D(0 FY99:Newin2001#XVJX"%&U:N#&U"%XXVJ 0\\\\ 1\\\\ 0FY01:FY00:Baseline11/01#XVJX"%&UN#&U"%XXVJ D(5 #XVJX"%&U4O#&U"%XXVJFY99:#XVJX"%&UO#&U"%XXVJ /\\\\E 6\\\\ /#XVJX"%&UO#&U"%XXVJIncreaseinthepercentofchildrenunder17 x7 receivingserviceswho:0 / !0[//<,X, X,X,hX<wereattendingschoolL!09[[ 0 / !0[//wereresidinginastableliving (" : environment#XVJX"%&UDP#&U"%XXVJ#;[[ 0 / !0[//hadno/reducedinvolvementinthe #< juvenilejusticesystem#XVJX"%&UQ#&U"%XXVJ$=[[ 0 / !0[//hadnopastmonthuseofalcoholor %|> illegaldrugs#XVJX"%&UR#&U"%XXVJt&X?[[ 0 / !0[//experiencedno/reducedsubstanceabuse P'4 @ relatedhealth,behavior,orsocialconsequences#XVJX"%&UsS#&U"%XXVJ)!B[[ Ѐ(developmental)=,X,hX,X, XP=.SAMHSAPlan#XVJX"%&UdT#&U"%XXVJ 0\\\\)"C\\\\E 0FY01:#XVJX"%&U&U#&U"%XXVJ xD FY00:Newin2001#XVJX"%&UU#&U"%XXVJ p TE #XVJX"%&UV#&U"%XXVJFY99:#XVJX"%&U^V#&U"%XXVJԀNewin2001 0\\\\L!0F\\\\ 0FY01:FY00:Baseline11/01#XVJX"%&UV#&U"%XXVJ p TH #XVJX"%&U@W#&U"%XXVJFY99:#XVJX"%&UW#&U"%XXVJԀN/A(L!0I  \\\\ (#XVJX"%&UW# lXXVJP#XVJXlRX#ROGRAMSlXXVJS#XVJXlX#UPPORTINGlXXVJT#XVJXlX#HISlXXVJO#XVJXl1Y#BJECTIVE  ,%K  -&L (X@(#(#(HRSA  PrimaryCare,HealthCentersMaternalandChildHealthBlockGrantIHS t TreatmentPreventionNIH 8  ResearchProgramOPHS  ` HealthyPeople2000  L  GirlPowerOfficeonWomensHealthSAMHSA   KnowledgeDevelopmentandApplicationTargetedCapacityExpansionHighRiskYouthNationalDataCollectionStateInfrastructureSubstanceAbusePreventionandTreatmentBlockGrant  ` 5@(#(#X@Y5  $  iU5%!`z  `E$tt<  i (#(#    (#(#iU5%!`z  `E$tt<  iL 0 !"#$%&(xx, !"#$%&(L9,X,hX,X,hX9 lXXVJK#XVJXl1^#EYlXXVJFY2001P#XVJXlw^#ROGRAMS,lXXVJI#XVJXl^#NITIATIVES,ANDlXXVJS#XVJXl_#TRATEGIES  `   3    3_23  0    SAMHSA!4XVJXXXVJTheTargetedCapacityExpansionprogram .TheTCEprogramsupportsa `  twoprongstrategytoreduce/eliminatesubstanceabuseanditsrelatedproblems.First,theStateIncentiveGrant(SIG)ProgramextendsabilityoftheCenterforSubstanceAbusePrevention(CSAP)tohelpStatesimprovetheirpreventionservicecapacity.FundingenablesStatestoexaminetheirstatepreventionsystems,andcreateStatewidenetworksofpublicandprivateorganizationstoextendthereachoftheprimarypreventionportionoftheSAPTBlockGrantandoptimizingtheapplicationofStateandFederalsubstanceabusefundingstreams.#XVJXX4XVJ`#4XVJXXXVJԀEightyfivepercentofSIGfundsaredirectedtowardimplementingbestpractices (  withinlocalprogrammingtotargetpreventionserviceneedswithintheirstatesand#XVJXX4XVJb#reducethe   gapinpreventionservices.Inthisway,SIGfundsnotonlyhelpimproveaccesstoneededservices,theyalsoimprovethequalityofthepreventionservicesprovidedd.Second,thefiveCentersfortheApplicationofPreventionTechnologies(CAPTS) andtheU.S.Mexico  BorderCAPTsupporttheSIGs,otherStatesandtheircommunitiesbytransferringresearchbasedknowledgeanddeliveringtailoredtechnicalassistance,training,andsupportivematerialstomeettheuniqueneedsofcommunitiesandStatesintheirrespectivegeographicalareas.d 3__݌ (#(# Ќ    3    3gf23  0    HRSA!PrimaryCare,HealthCenters .InFY2001,HRSAwillprovideHealthCenter d servicestofocusondisparityreduction,particularlyforthosecommunitieswiththehighestmorbidityandmortalityratesforminoritypopulations.Thedisparityreductionpackagewillincludecounselingofpatientsregardingtobacco,alcohol,anddruguse,oralhealth,fitness,andnutrition. 3gff݌ (#(# Ќ    3    3h23  0    /XVJXXXVJ IHS!Prevention,AntiDrugAbuseActivities .IHSwillincreasedrugrelatedactivities,  includingtreatment,AdolescentRegionalTreatmentCenters,CommunityRehabilitationandAftercare,Training/CommunityEducation,HealthPromotion/DiseasePrevention,NavajoRehabilitationProgramUrbanPrograms,andContractHealthServices. 3hh݌ (#(# Ќ  0  Programimprovementswillcontinuetofocusontheneedsofalcoholandsubstanceabuserswhohaveahistoryofsexualabuseandonaredesignedcommunitymobilizationeffortthatwillprovideinnovativetreatmentdnpreventionmodulestargetingcommunitiesthathavehighratesofalcoholismanddrubabuse.Inaddition,IHSeffortswillberesponsivetochangingdrugusepatterns,suchastheincreaseinmethamphetamineuseintheBillingsArea.#XVJXX/XVJi#/XVJXXXVJ'@#&(#(# L F !"#$%&(px0 !"#$%&(L  3    3^m23  0    NIH!MultidisciplinaryResearchonPreventionandTreatmentofDrugAbuse .NIHs )%( multidisciplinaryresearchprogramcoversallaspectsofdrugabusepreventionandtreatment.ResearchisthelynchpinofeffortstoeducateandenableAmericasyouthtorejectdrugsandtodecreasethehealthandsocialcostofdrugstotheAmericanpublic.Althoughwenowunderstandclearlythatdrugaddictionisatreatablebraindisease,therestillexistsatremendousgapbetweenwhatsciencetellsusaboutthenatureofaddictionandthe h.)- applicationofthesefindingsbypeopleinawidevarietyofcommunities.Toclosethisgap,wemustcapitalizeonthevarietyofeffectiveaddictiontreatmentsthathavebeendevelopedaspartofNIHsponsoredresearch.NIHsFY2001initiativesrelatedtodrugabuseaddressesthefollowingareas:prevention,nicotine,methamphetamineandfetalmethamphetamine,geneticsofaddiction,medicationandbehavioraltherapies,neurochemistryofaddiction,neuroimaging,andunderstandingandpreventingrelapse.Inaddition,NIDAwillcontinuetoexpanditsTreatmentClinicalTrialsNetwork,whichimprovesdrugaddictiontreatmentbyrapidlyandefficientlytestingtheeffectivenessofbehavioralandpharmacologicaltreatmentsinreallifesettings. 3^mm݌ (#(# Ќ  #XVJXX/XVJl#  3    3ws23  0    OPHS ! 򀀀 Topreventtheabuseoftobacco,alcoholandotherdrugsbyyouth,OPHS  8  promotespartnershipswithparentsandothercaregivers,teachers,coaches,clergy,healthprofessionals,andbusinessandcommunityleaders.Also,OPHSassistsinthedevelopmentofcommunitycoalitionsandprogramsinpreventingdrugabuseandunderagealcoholandtobaccouse,supportsanddisseminatesscientificresearchanddataontheconsequencesoflegalizingdrugs,andpromotesothersimilaractivities.GirlPoweractivitiesworktoimprovetheselfesteemofgirlsandyoungwomensothattheyadopthealthierlifestylesandreducetheirrisksforsmoking,substanceabuseandteenpregnancy. 3wss݌ (#(# Ќ    3    3v23  0    HRSA!MaternalandChildHealthBlockGrant .ThroughTitleVoftheSocialSecurity 8 Act,thisprogramsupportsprenatalcareprogramsthatencouragehealthymaternalbehaviors,includingriskreductionbehaviors,especiallyforalcohol,tobacco,andsubstanceabuse. 3v#w݌ (#(# Ќ    3    3x23  0    /XVJXXXVJ CDC!HIV/AIDSPrevention. CDCprovidesHIVpreventionfundingtostateandlocal < healthdepartmentsandeducationagencies,communitybasedorganizations,minoritybasedorganizations,nationalorganizations,universities,andhospitalstargetedtopopulationsathighriskforHIV,includinginjectingdrugusers.InFY2000,CDCwillbeembarkingonanaggressiveefforttoensurethatallpersonsinfectedwithHIVknowtheirserostatus.#XVJXX/XVJ?y# 3xx݌(#(# Ќ    3    3{23  0    HCFA!MedicareandMedicaid .Variousformsofdrugabusetreatmentareprovidedfor x bothMedicaidandMedicarebeneficiaries.UnderMedicaid,Statesmustpayfortheinpatient,outpatient,andphysicianservicesforeligiblepersons,and(attheStatesoption),clinicandrehabilitativeservices.Medicareeligibleindividualsrequiringdrugabusetreatmentcanreceiveallcoveredhospitalandsomenonhospitalservicesnecessarytotreattheircondition.Medicareprimarilycoversinpatienthospitaltreatmentofepisodesofalcoholordrugabuse,aswellassomemedicallyreasonableandnecessaryservicesinoutpatientsettingsforthecontinuedcareofthesepatients. 3{{݌ (#(# Ќ    '#& & 8  lXXVJS#XVJXlL#ELECTEDlXXVJFY2001#XVJXl#ԀlXXVJP#XVJXl#ERFORMANCElXXVJG#XVJXl/#OALSANDlXXVJM#XVJXl{#EASURES   XVJXXXVJ&U"%XXVJ*ab ddSS 4SS 4SSS S_`(#(#,SS ,4SS ,SSS +  &\\\\G  &  PerformanceGoals 8\\\\E#!d \\\\G 8  Targets 8\\\\E#!d \\\\E 8  ActualPerformance =\\\\E(&@   \\\\E =ThenumberofAIDScasesrelatedtoinjectingdrugusewillbedecreasedfromthe1997baseof15,700casesdiagnosed.*CDCPlan  h  #XVJX"%&U#&U"%XXVJ#&U"%"%&Uހ##XVJX"%&U#P<%XXVJ*Note:Changesinbaselinedatafrom1995(inFY1999)to1997    (inFY2000)reflectsadjustmentsinAIDScasedefinitions,andavailabilityofmoreaccuratedata.#XVJX%P FY01:+3%overFY00FY00:establishbaseline FollowupRates   dB FY01:FY00orhigherFY00:+10% overFY99 !D FY99:establishbaseline 0\\\\"E\\\\ 0FY01:FY00:FY01:FY00:FY99:64.5%30days̀55.2%6months̀40.9%12months#XVJX"%&UՊ# /\\\\E#N\\\\ /&U"%XXVJIncreaseinthepercentofadultsreceiving $D O serviceswho:0 / !0[//werecurrentlyemployedorengagedin &!Q productiveactivities [[ 0 / !0[//hadno/reducedinvolvementwiththe d(#S criminaljusticesystem#XVJX"%&U#&U"%XXVJ@)$T[[ 0 / !0[//experiencedno/reducedalcoholorillegal *l%U drugrelatedhealth,behavior,orsocialconsequences#XVJX"%&UO#&U"%XXVJ+$'W[[ 0 / !0[//hadnopastmonthsubstanceabuse#XVJX"%&UG#,(X[[ 0 / 0[//(developmental).SAMHSAPlan :\\\\'"-(Y[[\\\\E :&U"%XXVJFY01: &"\ FY00:Newin2001FY99:Newin2001#XVJX"%&U#&U"%XXVJ 0\\\\(#^\\\\ 0FY01:FY00:Baseline11/01#XVJX"%&U#&U"%XXVJ '"b #XVJX"%&U#&U"%XXVJFY99:#XVJX"%&U#&U"%XXVJ /\\\\Ed(#c\\\\ /#XVJX"%&U=#&U"%XXVJIncreaseinthepercentofchildrenunder17 `d  receivingserviceswho:0 / !0[//<,X, X,X,hX<wereattendingschool [[ 0 / !0[//wereresidinginastableliving   environment#XVJX"%&U#&U"%XXVJ [[ 0 / !0[//hadno/reducedinvolvementinthe   juvenilejusticesystem#XVJX"%&UU#&U"%XXVJ [[ 0 / !0[//hadnopastmonthuseofalcoholor d h illegaldrugs#XVJX"%&U'#&U"%XXVJ@D [[ 0 / !0[//experiencedno/reducedsubstanceabuse    relatedhealth,behavior,orsocialconsequences#XVJX"%&U#&U"%XXVJ [[ Ѐ(developmental)=,X,hX,X, X^=.SAMHSAPlan#XVJX"%&U#&U"%XXVJ 0\\\\ \\\\E 0FY01:#XVJX"%&U#&U"%XXVJ `d FY00:#XVJX"%&U#&U"%XXVJԀNewin2001 <@ #XVJX"%&Uy#&U"%XXVJFY99:Newin2001#XVJX"%&Uܙ#&U"%XXVJ 0\\\\ \\\\ 0FY01:FY00:Baseline11/01#XVJX"%&U0#&U"%XXVJ <@ #XVJX"%&U#&U"%XXVJFY99:#XVJX"%&U#&U"%XXVJ(   \\\\ (#XVJX"%&U]#(X@(#(#(CDC   HIV/AIDSPreventionHRSA lp PrimaryCare,HealthCentersMaternalandChildHealthBlockGrantIHS 04 TreatmentPrevention0 4 0` 440 ` ` 0  0h  0@hp(#p(# hh NIH  ResearchProgram   OPHS   HealthyPeople2000OfficeofDiseasePreventionandHealthPromotionGirlPowerOfficeonWomensHealthSAMHSA  & KnowledgeDevelopmentandApplicationTargetedCapacityExpansionHighRiskYouthNationalDataCollectionStateInfrastructureSubstanceAbuseBlockGrant +   +    + 5@(#(#X@ɛ5iU5%!`z  `E$tt<  i (#(#       (#(#iU5%!`z  `E$tt<  i9,X,hX,X,hX9 lXXVJK#XVJXl #EYlXXVJFY2001P#XVJXlP#ROGRAMS,lXXVJI#XVJXl#NITIATIVES,ANDlXXVJS#XVJXl#TRATEGIES  `   3    3\23  0    CDC!HIV/AIDSPrevention ./XVJXXXVJԀResearchhasdemonstratedthatHIVeducationinschools `  canbeeffectiveinreducingriskbehaviorsamongyouthinschool.CDCseffortstohelpstateandlocaleducationagenciesimplementHIVpreventioneducationprogramsinschoolsnationwideincludeteachertrainingprograms,disseminationofmodelpoliciesandeffectivepreventionprograms,andevaluationtechnicalassistance.#XVJXX/XVJ# 3\݌d (#(# Ќ    3    323  0    CDC!SexuallyTransmittedDiseases(STD) .CDCprovidesnationalandinternational <  leadershipthroughresearch,policydevelopment,andsupportofeffectiveservicestopreventandcontrolthetransmissionofSTDsandtheircomplications.Specificareaswhereassistanceisprovidedare:monitoringdiseasetrends;behavioral,clinical,andhealthservicesresearch;educationandtraining;buildingpartnershipsforSTDprevention;conductingtheInfertilityPreventionandSyphilisEliminationInitiative. 3:݌ (#(# Ќ    3    3֧23  0    SAMHSA!TheTargetedCapacityExpansion programHIVgranttominoritycommunity d basedorganizationswilltargetwomen,children,adolescents,menwhohavesexwithmen,andinfectedIVdrugusers.ThegoaloftheprogramistodecreasesubstanceabuserelatedHIVinfectionbyintegratingsubstanceabusepreventionstrategiesandHIVpreventionstrategies.SpecificsubstanceabusetreatmentoutreachprogramswillprovideservicestoaddressintegratingsubstanceabuseandHIVtreatment. 3֧݌ (#(# Ќ    3    323  0    HRSA!PrimaryCare,HealthCenters .AllofHRSA'sHealthCentersprovidefamily , planningandSTDscreening;manyhavespecialprogramsinschoolsandinthecommunitytoreduceteenpregnancyandunsafesexualbehavior. 3݌ (#(# Ќ    3    3423  0    HRSA!MaternalandChildHealthBlockGrant,AbstinenceEducationProgram .This   programprovidesformulagrantstotheStatesforthepurposeofprovidingabstinenceeducation,andattheoptionoftheState,whereappropriate,mentoring,counseling,andadultsupervisiontopromoteabstinencefromsexualactivity,withafocusonthosegroupswhicharemostlikelytobearchildrenoutofwedlock. 34_݌ (#(# Ќ    3    323  0    HRSA!MaternalandChildHealthBlockGrant .ThroughTitleVoftheSocialSecurity &l!$ Act,thisprogramsupportstheGirlNeighborhoodPowerprogramtopromotethehealthandwellbeingoffemaleadolescentsbetweentheagesofnineandfourteen,andtopreventtheonsetofhealthriskbehaviorsduringtheiradolescence. 3݌ (#(# Ќ    3    323  0    HRSA!HIV/AIDS,HIVPediatricGrants(Women,Children,Youth) .HRSAwill * &) improvetheinfrastructureofcomprehensivecareservicesinordertoincreasetheaccessofHIV/AIDSaffectedwomen,infants,childrenandyouthtoacomprehensive,communitybased,familycenteredsystemofcare. 3ư݌ (#(# Ќ   p.)-   3    323  0    /XVJXXXVJOPHS/HRSA!FamilyPlanningProgram. #XVJXX/XVJ#ԀThisprogramsupportsanationwidenetwork  of4,600clinicsandprovidesreproductivehealthservicestoapproximately4.5millionpersonseachyear.Inadditiontocontraceptiveservices,TitleXalsosupportsabroadrangeofpreventionorientedreproductivehealthcareactivities,includingcounseling,routinegynecologicalcare,hypertensionscreening,reproductivecancerscreening,andtestingandtreatmentforsexuallytransmitteddiseases. 3Ʋ݌ (#(# Ќ    3    323  0    /XVJXXXVJ IHS!Prevention,HealthEducation .IHSassistsitslocalpartnerstoengagein ( x communitybasedpreventioninitiativeswhichaddressHIV/AIDSriskbehavior,violence,childabuse,physicalinactivity,nutrition,alcoholandsubstanceabuseandtobaccouseandcessation.#XVJXX/XVJ#/XVJXXXVJ 3݌ @ (#(# Ќ    3    3ַ23  0    NIH!AIDSResearchProgram .ThemagnitudeoftheAIDSpandemicisprofound.AIDS   hassignificantlyloweredthelifeexpectancyinmanynationsofAfrica,theglobalepicenterofAIDS.TherehasbeenasteepincreaseofnewinfectionsinSubSaharanAfrica,andburgeoningdiseaseratesalsothreatenthevastpopulationsofIndia,SoutheastAsia,andChina.IntheUnitedStates,newHIVinfectionsandAIDSrelateddeathscontinuetoincreaseinmanysubpopulations!amongwomen,racialandethnicminorities,heterosexuals,adolescents,drugusers,andpeopleover50yearsofage.NIHresearchinthisareacontinuestoexaminethefactorscontributingtosexualriskamongarangeofpopulationgroupsandtodevelopeffectiveandappropriateinterventionstoreducesexualrisk.#XVJXX/XVJs# 3ַ݌,|(#(# Ќ    3    323  0    OPHS !XVJXXXVJGirlPoweractivitiesworktoimprovetheselfesteemofgirlsandyoungwomenso T thattheyadopthealthierlifestylesandreducetheirrisksforsmoking,substanceabuseandteenpregnancy.#XVJXXXVJe# 3݌0(#(# Ќ    3    323  0    OPHS! TheAdolescentFamilyLifeprogramsupportsdemonstrationprojectstodevelop  modelsaimedatpromotingabstinencefromsexualintercourseasameansofpreventingadolescentpregnancyandsexuallytransmitteddiseases,includingHIV,andassistingpregnantandparentingadolescents,theirchildrenandtheirfamilies.Theprogramalsofundsresearchprojectsexaminingthecausesandconsequencesofadolescentpremaritalrelations,adolescentpregnancyandadolescentparenting. 3݌ (#(#    D"  & P  lXXVJS#XVJXl#ELECTEDlXXVJFY2001#XVJXl#ԀlXXVJP#XVJXl=#ERFORMANCElXXVJG#XVJXl#OALSANDlXXVJM#XVJXl#EASURES   XVJXXXVJ&U"%XXVJ*cd ddSS 4SS 4SSS Sab(#(#,SS , SS ,SS +  &\\\\G  &  PerformanceGoals 8\\\\E#!d \\\\G 8  Targets 8\\\\E#!d \\\\E 8  ActualPerformance =\\\\E(&@   \\\\E =#XVJX"%&UY#&U"%XXVJ#&U"%"%&U:#Reducethepercentageofhighschoolstudents `  whohaveeverengagedinsexualintercourse.CDCPlan 0\\\\ h \\\\E 0FY01:45%FY00:45% 0\\\\<  \\\\ 0FY01:FY00:FY99:06/00FY97:48%FY95:53%#XVJX"%&U#&U"%XXVJ /\\\\E \\\\ /Reducethepercentageofcurrentlysexuallyactivehighschoolstudentswhoengageinsexualintercoursewithoutacondom.CDC H  Plan 0\\\\$ \\\\E 0FY01:37%FY00: 37% 0\\\\l \\\\ 0 &U"%"%&U FY01: @  FY00:Summer/00FY95:46%#&U"%"%&U##XVJX"%&U+# /\\\\EH \\\\ /&U"%XXVJThenumberofheterosexuallyacquiredAIDS D  caseswillbedecreasedfromthe1997baseof11,500AIDScasesdiagnosed.*CDCPlan L &U"%"%&U#XVJX"%&Ub#P<%XXVJ*Note:Changesinbaselinedatafrom1995(inFY1999)to1997 ,$ (inFY2000)reflectsadjustmentsinAIDScasedefinitions,andavailabilityofmoreaccuratedata.#P<%%P<3#P<%%P<#XVJX%P\\\\ /&U"%XXVJThenumberofAIDScasesrelatedtomale 8? homosexualcontactwillbedecreasedfromthe1997baseof21,300casesdiagnosed.*CDC @A Plan B #&U"%"%&U#&U"%"%&U#XVJX"%&U#P<%XXVJ*Note:Changesinbaselinedatafrom1995(inFY1999)to $D H 1997(inFY2000)reflectsadjustmentsinAIDScasedefinitions,andavailabilityofmoreaccuratedata.#XVJX%P<&##XVJXXXVJ# 0\\\\$&t!J\\\\E 0&U"%XXVJFY01:Decrease10%from 8K theFY00targetof19,170  dL  &U"%"%&UFY00:10%decreasefromthe1997baseof21,300casesdiagnosed.FY99:20%decreasefromthe1995baseof28,600casesdiagnosed.#&U"%"%&U#&U"%"%&U 0\\\\&!V\\\\ 0FY01:FY00:5/01FY99:6/00FY97:21,300casesdiagnosed.#&U"%"%&U#&U"%"%&U#XVJX"%&Ur# /\\\\E&!b\\\\ /#XVJXXXVJt#&U"%XXVJ&U"%"%&UIncreasethenumberofenrolledfemaleclients (l#c providedcomprehensiveservicesthroughtheHIVPediatricGrantProgram,includingappropriateservicesbeforeorduringpregnancy,toreduceperinataltransmission.#&U"%"%&U'##XVJX"%&U#&U"%XXVJԀ +&g HRSAPlan 0\\\\h,'h\\\\E 0&U"%"%&UFY01:15,000 (l#i FY00:14,470FY99:13,900#&U"%"%&U##XVJX"%&Ut# )$%k  0\\\\*&l\\\\ 0&U"%XXVJFY01: (l#m FY00:FY99:1/01FY98:11,000FY97:9,469#XVJX"%&U# /\\\\E+&q\\\\ /&U"%XXVJTheprevalenceofChlamydiatrachomatis `d  amongwomenundertheageof25inpubliclyfundedfamilyplanningclinicswillbereduced.CDCandOPHSPlans 0\\\\ \\\\E 0FY01:<6%*FY00:<6%FY99:<6%*prevalencerate 0\\\\  \\\\ 0FY01:6/02FY00:6/01FY99:6/00FY98:5.4%*FY96:9%̀*medianallstates /\\\\E \\\\ /Theincidenceofgonorrheainwomenaged1544willbereduced.CDCandOPHSPlans#XVJX"%&U#&U"%XXVJ 0\\\\\\\\E 0FY01:<250/100,000FY00:<250/100,000FY99:<250/100,000 0\\\\\\\\ 0FY01:6/02FY00:6/01FY99:6/00FY98:292/100,000FY97:261/100,000#XVJX"%&U# /\\\\Ehl \\\\ /&U"%XXVJ&U"%"%&UAchieveandmaintainthepercentageofhigh   schoolstudentswhohavebeentaughtaboutHIV/AIDSpreventioninschoolat90%orgreater.#&U"%"%&U#ԀCDCPlan 0\\\\lp\\\\E 0 &U"%"%&U FY01: 90%orgreater   FY00:90%orgreaterFY99:90%orgreater#&U"%"%&U# 0\\\\ "\\\\ 0FY01:   # FY00:FY99:Summer/00FY95:86%#XVJX"%&Ud#&U"%XXVJ /\\\\Ept&\\\\ /#XVJX"%&U#&U"%XXVJIncreasethepercentageofU.S.countiesthat ' willhaveanincidenceofprimaryandsecondarysyphilisinthegeneralpopulationoflessthanorequalto4per100,000.CDC tx* Plan 0\\\\PT+\\\\E 0FY01:>90%FY00:>90%FY99: 85% 0\\\\.\\\\ 0 FY01:6/02 / FY00:6/01FY99:6/00FY98:90%FY97:87%FY96:90%FY95:81%#XVJX"%&UK#( 5 \\\\ ( lXXVJP#XVJXl#ROGRAMSlXXVJS#XVJXl#UPPORTINGlXXVJT#XVJXl&#HISlXXVJO#XVJXlm#BJECTIVE  7 (X@(#(#(CDC  9 HIV/AIDSPreventionSexuallyTransmittedDiseasesHRSA #< PrimaryCare,HealthCentersMaternalandChildHealthBlockGrantAbstinenceEducationProgramMaternalandChildHealthBlockGrantHIV/AIDS,HIVPediatricGrantsIHS 8)<"B Prevention +%E NIH  E ResearchProgramOPHS "G OfficeofDiseasePreventionandHealthPromotionOfficeonWomensHealthOfficeofPopulationAffairsHealthyPeople2000OPHS/HRSA L(P!M FamilyPlanningSAMHSA $*(#O KnowledgeDevelopmentandApplication +%Q 5@(#(#X@5  -&Q DM<<X X,X,hX<iUP5%!`z  `Ett oi (#(#      (#(#iU5%!`z  `Ett oi FromtheHHSStrategicPlan,September1997. Achievingasocietyinwhicheachperson, 8  regardlessofage,sex,physicalability,orracial/ethnicbackground,hastheopportunitytoleadaneconomicallyandsociallyproductivelifeiscentraltotheDepartmentsvisionforthefuture.Realizingthisvisionrequiresthatwesupportstrategiesthatcreateopportunitiesforindividuals,families,andcommunities"aresponsibilitythattheDepartmentofHealthandHumanServices(HHS)shareswithotherfederalagencies,state,local,andtribalgovernments,andtheprivatesector. Families,ChildrenandCommunities. TheDepartmenthasidentifiedfiveimportantareasin   whichithasdevelopedstrategiestofosterthehealthydevelopmentofchildrenandtostrengthentheabilityoffamiliestocareforthem.Theseareasareeconomicsecurity,familystability,personalresponsibility,healthydevelopmentofchildren,andstrongcommunities.Inaddressingthesefiveareas,ourguidingprincipleistomaximizeopportunitiesandreducebarrierstoindependenceandselfsufficiencyforthoseonwelfareandfortheworkingpoor.Childrenandadultswithoutadequateincomearedeniedthefullbenefitsoflivinginoursociety.Sustainedunemploymentisdiscouragingandcounterproductivetoresponsibleparentingandcitizenship.Ouremphasisisonmovingfamiliesfromwelfaretowork,shorttermfinancialaidcoupledwitheducation,training,jobservicesandchildcare;andgainfulemploymentandqualitychildcareforlowincomeworkingfamilies.Inaddition,soundgrowthanddevelopmentarebasicneedsifchildrenaretobecomeproductiveadultsandcitizens.Recentresearchhasdocumentedtheimportanceofearlybraindevelopmentandpreschoolexperiencesonlaterdevelopment.OurEarlyHeadStart,HeadStart,andquality t childcareprogramsforlowincomechildrenareessentialtohealth,earlydevelopmentandschoolreadiness;andchildcarebeforeandafterschoolandyouthdevelopmentservicesarenecessarytosustainpositiveeffects.Oureffortstopromoteeconomicindependenceandtostrengthenfamiliesandcommunitiesalsohaveabearingonchildrensdevelopment.Finally,XVJXXXVJcommunitiesprovidethecontextwithinwhichfamiliesmayfunctionwellorpoorly. $L # Communitiesareconstantlyadaptingtosocialandeconomicchallenges.Dramaticchangesinprogressrequirespecialattentionforthosewhoareeconomicallydisadvantagedandfordistressedcommunities.TheDepartment,alongwiththeDepartmentofHousingandUrbanDevelopment(HUD)andothers,iscommittedtoeconomicdevelopmentandlinkingcomprehensivecommunitydevelopment placestrategieswithcomprehensive peoplestrategiestohelpcommunitiestofunctionasapositivefactorinthelivesofcommunityresidents.#XVJXXXVJz#4XVJXXXVJ PeoplewithDisabilities. TheDepartmenthasalsoidentifiedsignificantbarrierstoindependence \,'+ facedbyworkingageadultswithdisabilities(thoseaged18!64).#XVJXX4XVJC#XVJXXXVJPeoplewithdisabilitiestypically L-(, reportthattheywanttowork,butneedpersonalassistanceservicesordevicesinordertodoso. 8.)- OtherswillnotriskworkingbecausetheycannotaffordtolosethehealthandlongtermcarecoveragetheyhaveunderMedicaidorMedicare.Thus,whilealargemajorityofworkingagepeoplewithdisabilities(90.7percentofmenand74.4percentofwomen)areinthelaborforce,thatis,theyareeitheremployedorlookingforwork,individualswithfunctionaldisabilitiesarefarlesslikelytobeinthelaborforce(67.3percentand52.3percent,respectively).#XVJXXXVJI#XVJXXXVJTheDepartment ` willworktoprovide#XVJXXXVJ#XVJXXXVJaccesstohealthcoverage#XVJXXXVJ#XVJXXXVJԀandawiderangeofsupportsfordailyliving L  activitiesneededbypeoplewithdisabilitiestofacilitatetheirparticipationintheworkforceandfullparticipationincommunitylife.Forthoseunabletowork,theDepartmentwillprovidesimilarsupportsnecessaryforindependentlivingandintegrationinthecommunity.#XVJXXXVJ#XVJXXXVJ TheAgingPopulation. Theparadigmofagingasastateofdependencydoesnotfittodays  8  elderlywhowanttoleadactiveandindependentlives.Anewparadigmisneededthatrecognizesthedesireandabilityofmanyseniorstoremainengagedineconomicallyandsociallyproductiveactivities.TheDepartmentwillsupportthis activeagingbyworkingtoeliminatebarrierspresentedbythecurrenthealthandsocialservicesystems.Doingsocallsforadequatecommunitybasedandlongtermcareservicesforagrowingnumberofelderlywhoneedsignificanthelpiftheyaretocontinuelivingindependently.TheobjectivesandstrategiesthatfollowsetforththeDepartmentsapproachtosupportingeconomicselfsufficiencyforfamilieswithchildren;fosteringsafe,stable,andprosperouscommunities;promotingsounddevelopmentalfoundationsforchildren;andprovidingneededassistancefortheelderlyandpersonswithdisabilities.#XVJXXXVJ#TheDepartmentseffortswillbecarried ` outthroughpartnershipswiththeprivatesectorandwiththestate,local,andtribalgovernmentsthatimplementmostofitsprograms.  $ iU5%!`z  `E`ttx 3i (#(#     (#(#iU5%!`z  `E`ttx 3iL 0 !"#$%&(xpF !"#$%&(L<,X,hXX X< lXXVJK#XVJXl#EYlXXVJFY2001P#XVJXl#ROGRAMS,lXXVJI#XVJXl:#NITIATIVES,ANDlXXVJS#XVJXl#TRATEGIES  L    3    323  0    ACF!TemporaryAssistanceforNeedyFamilies .TANFpromoteswork,responsibility L  andselfsufficiencyandstrengthensfamiliesthroughfundingofStatedesignedandadministeredprogramsthatprovidesupporttoneedychildrenandmovetheirparentsintowork. 3݌ (#(# Ќ    3    323  0    ACF!ChildCare. 󀀀ACFisagainrequestingfundingforthePresident'sfiveyearinitiativeto <  addressandexpandactivitiesrelatedtothreekeyissues:affordability,qualityandavailability.Thesefundswillhelpprovidesupportforworkingfamiliesintheirefforttoaccessqualitycarefortheirchildren.Thesenewfunds,combinedwiththechildcarefundsprovidedthroughwelfarereform,willenabletheprogramtoserve2.3millionchildrenby2004,anincreaseofoveronemillionsince1997. 3݌ (#(# Ќ    3    323  0    HRSA!PrimaryCare,HealthCenters .ManyofHRSAsHealthCentershireandtrain d formerwelfarerecipientsfromthecommunityasoutreachandhealthpromotionworkers. 3݌ (#(# Ќ    3    323  0    ACF!RefugeeResettlement .ACFhelpsrefugeesandCubanandHaitianentrantswhoare ,| admittedtotheUnitedStatestobecomeemployedandselfsufficientasquicklyaspossiblebyprovidingcashandmedicalassistancetorefugeehouseholdsthatarenoteligibleforTANF,MedicaidandSSIduringtheirfirstmonthsintheUnitedStatesaswellasEnglishlanguagetrainingandemploymentrelatedservices. 3+݌ (#(# Ќ    3    3a 23  0    HRSA!HealthyStart .HRSAfundscommunitiestoreducebarrierstocare,improve  perinatalsystems,andsupportprivatesectorpartnershipsthatfacilitatewelfaretoworkandcommunityjobcreation,andreduceracialdisparityinhealthstatus. 3a  ݌ (#(# Ќ    3    3! 23  0    XVJXXXVJOCR ! PreventingDiscriminationinAccesstoHHSServices .OCRwillworkin l"  partnershipwithACFandtheStatestoensurethatTANFprogramsareimplementedinanondiscriminatorymanner.Aninteragencyguidanceletterwassenttostateandlocalagencies,advocacyorganizations,andothersexplainingcivilrightsrequirementsandprovidingexamplesofpotentialdiscrimination.Astherestructuringofwelfareagenciesproceeds,itisessentialthateitherthecivilrightscompliancecomponentsand/orthemethodsdevelopedoverthepastthreedecadesforensuringthatcivilrightsissueswereaddressedinprogramdeliveryareretainedasintegralaspectsofstateandlocalprogramimplementationandoversight. 3! L ݌ (#(# Ќ   #XVJXXXVJ # +&* &   lXXVJS#XVJXl>#ELECTEDlXXVJFY2001#XVJXl#ԀlXXVJP#XVJXl#ERFORMANCElXXVJG#XVJXl!#OALSANDlXXVJM#XVJXlm#EASURES   XVJXXXVJ&U"%XXVJ*QR d dSS  SS  SS cd(#(#,SS ,SSS ,SSS +  &\\\\G  &  PerformanceGoals 8\\\\E#!d \\\\G 8  Targets 8\\\\E#!d \\\\E 8  ActualPerformance '% =\\\\E(&@   \\\\E =#XVJX"%&U#&U"%XXVJ#&U"%"%&U#AllStatesmeettheTANFworkparticipation `  targets(thetargetsarestatutory)forFY2001:ACFPlan 0\\\\ h \\\\E 0 AllFamilies #XVJX"%&UK#&U"%XXVJ `   FY01:100%FY00:100%FY99:100% Twoparentfamilies#XVJX"%&Ur#&U"%XXVJ    FY01:100%FY00:100%FY99:100% 0\\\\l \\\\ 06&U"%"%&UFY01:FY00:FY99:01/01FY98:100%(baseline)#&U"%"%6&U#   6&U"%"%&UFY01: d  FY00:FY99:01/01FY98:66%(baseline)#&U"%"%6&U# /\\\\EH \\\\ /IncreasethepercentageofadultTANFrecipientsandformerrecipientsemployedinonequarteroftheyearwhocontinuetobeemployedinthesubsequentquarter.ACFPlan 0\\\\L"\\\\E 0FY01:84%FY00:83%FY99:N/A 0\\\\ p%\\\\ 0FY01:FY00:FY99:1/01FY98:80% /\\\\EL)\\\\ /IncreasethenumberofrefugeesenteringemploymentthroughACFfundedrefugeeemploymentservicesbyatleast5%annually.ACF $t, Plan 0\\\\P-\\\\E 06&U"%"%&UFY01:56,885 l. FY00:54,176FY99:51,597#&U"%"%6&U)# 0\\\\$t0\\\\ 06&U"%"%&UFY01: l1 FY00:FY99:5/00FY98:52,298FY9746,800(baseline)#&U"%"%6&U# /\\\\E6\\\\ /IncreasethenumberofchildrenservedbyCCDFsubsidiesfromthe1998baselineaverageof1.5millionservedpermonth.ACFPlan 0\\\\09\\\\E 0FY01:2.22FY00:1.92FY99:N/A 0\\\\0<\\\\ 0FY01:FY00:FY99:5/00FY98:1.53 /\\\\E @\\\\ /Increasethenumberofrefugeefamilies(cases)thatareselfsufficient(notdependentonanycashassistance)withinthefirst4monthsafterarrivalbyatleast4%annually.ACFPlan 0\\\\#D\\\\E 0CY01:6,176CY00:5,938CY99:5,710 0\\\\"4G\\\\ 0CY01:CY00:CY99:5/00CY98:5,194CY97:5,279baseline /\\\\E$L\\\\ /IncreasecomplianceofstateandlocalTANFagenciesandserviceproviderswithTitleVI,Section504andADA.Measure:Increasednumberofcorrectiveactionsandnoviolationfindings.OCRPlan 0\\\\|)$Q\\\\E 0FY01:36FY00:29FY99:16 0\\\\(#U\\\\ 0FY01:FY00:FY99:23FY98:8#XVJX"%&U# /\\\\E(#Y\\\\ /&U"%XXVJInordertoincreaseaccesstoHHSservicesfor `d limitedEnglishproficient(LEP)persons,OCRwillincreasethenumberofHHSgranteesandprovidersfoundtobeincompliancewithTitleVIinLEPreviews/investigations.Measure:Increasednumber ofcorrectiveactionsandnoviolationfindings.OCRPlan 0\\\\ \\\\E 0FY01:153FY00:151FY99:125 0\\\\  \\\\ 0FY01:FY00:FY99:146FY98:98#XVJX"%&Us#(   \\\\ ( lXXVJP#XVJXl!#ROGRAMSlXXVJS#XVJXl+"#UPPORTINGlXXVJT#XVJXlx"#HISlXXVJO#XVJXl"#BJECTIVE  lp (X@(#(#(ACF lp  TemporaryAssistanceforNeedyFamiliesRefugeeResettlementSocialServicesBlockGrantChildCareASPE   PolicyResearch  ЇHRSA lp  HealthyStartPrimaryCare,HealthCentersOCR 04  PreventingDiscriminationinAccesstoHHSServices       5@(#(#X@&#5iU5%!`z  `E`ttx 3i (#(#        (#(#iU5%!`z  `E`ttx 3iL 0 !"#$%&(xx0 !"#$%&(L9,X,hX,X,hX9 lXXVJK#XVJXlQ'#EYlXXVJFY2001P#XVJXl'#ROGRAMS,lXXVJI#XVJXl'#NITIATIVES,ANDlXXVJS#XVJXl>(#TRATEGIES  L    3    3(23  0    ACF!ChildSupportEnforcement .ACFwillcontinuetoprovidedirection,guidance L  technicalassistance,oversight,andsomeservicestoStates'CSEProgramstoaggressivelyenforcepaymentoflegallyowedchildsupport,toestablishpaternities,andtopromotetheinvolvementofnoncustodialfathersintheirchildrenslives. 3((݌ (#(# Ќ  0  Earlyinterventionswillbesoughtthroughexpandinginhospitalbasedpaternityestablishmentprogramsandpartneringwithbirthrecordagencies,prenatalclinicsandotherentities,encouragingvoluntaryacknowledgments,inaccordancewiththerequirementsofPRWORA.Focuswillbeplacedonimprovedenforcementtechniqueswithemphasisonautomatedmechanismsforenforcement,collectionsandpaymentstofamilies. (#(# Ѐ0  ACFwillcontinueeffortstobroadenparentalresponsibility,especiallytheinvolvementoffathersinthelivesoftheirchildrenthroughseveralmeans:firstfocusingattentiononthepositiverolefathershaveinimprovingtheirchildrenswellbeing;second,ensuringthattheHHSresearchagendaspayadequateattentiontotheroleoffathersinfamiliesandtheeffectsoffatheringonchildrenswellbeing;third,usingpositivemessagesandlanguageregardingfathersandfatherhoodinpublicationsandannouncements;and,finally,ensuringthatHHSsownworkforcepoliciesencourageandenablefatherstobalanceworkandfamilyliferesponsibilities. (#(# &  lXXVJS#XVJXlW/#ELECTEDlXXVJFY2001#XVJXl/#ԀlXXVJP#XVJXl/#ERFORMANCElXXVJG#XVJXl:0#OALSANDlXXVJM#XVJXl0#EASURES   e&U"%XXVJ*Ze ddSS SSS SSSS SQRs#s#,SS ,SSS ,SSS +  &\\\\G   &  PerformanceGoals 8\\\\E#!!` \\\\G 8  Targets 8\\\\E#!!`  \\\\E 8  ActualPerformance 'H/ =\\\\E(&!<"   \\\\E =#XVJX"%&U0#&U"%XXVJIncreasethepaternityestablishmentpercentage \## amongchildrenbornoutofwedlock.ACFPlan 0\\\\8$$\\\\E 0FY01:96%FY00:96%* ,X,hX*FY99:96% 0\\\\%d '\\\\ 0FY01:FY00:FY99:3/00* /\\\\E%@!+\\\\ /IncreasethepercentageofIVDcaseshavingsupportorders.ACFPlan 0\\\\<(#-\\\\E 06&U"%"%&UFY01:76% `'". FY00:76%FY99:74%#&U"%"%6&UY5# 0\\\\)h$0\\\\ 06&U"%"%&UFY01: `'"1 FY00:FY99:3/00#&U"%"%6&U5#* )h$3  /\\\\E)D%4\\\\ /IncreasetheIVDcollectionrateforcurrentsupportdue.ACFPlan 0\\\\@,'6\\\\E 06&U"%"%&UFY01:71% d+&7 FY00:71%FY99:70%#&U"%"%6&U-7# 0\\\\-l(9\\\\ 0FY01:FY00:FY99:3/00* /\\\\E-H)=\\\\ /IncreasethepercentageofpayingcasesamongIVDarrearagecases.ACFPlan 0\\\\<@\\\\E 0FY01:50%FY00:46%FY99:46% 0\\\\ \\\\ 0FY01:FY00:FY99:3/00*(    \\\\ (#XVJX"%&US3#*ACFisrecalculatingitsbaselinebasedon1999performance. lXXVJP#XVJXl9#ROGRAMSlXXVJS#XVJXl9#UPPORTINGlXXVJT#XVJXl3:#HISlXXVJO#XVJXlz:#BJECTIVE     (X@s#s#(ACF  ChildSupportEnforcement      5@s#s#X@:5iU5%!`z  `E`ttx 3i s#s#        s#s#iU5%!`z  `E`ttx 3iL 0 !"#$%&(xx0 !"#$%&(L-,X,hXX- lXXVJK#XVJXl=#EYlXXVJFY2001P#XVJXl>#ROGRAMS,lXXVJI#XVJXlT>#NITIATIVES,ANDlXXVJS#XVJXl>#TRATEGIES  L    3    3 ?23  0    ACF!HeadStart. ACFplanstoincreaseparticipationbydapproximately70,000dpreschool L  children,infants,toddlers,andtheirfamilies,movingtowardthePresident'sgoalofserving1millionchildreninHeadStartanddoublingthesizeofEarlyHeadStartby2002. 3 ?7?݌ s#s# Ќ  0  EarlyHeadStart.ACFwillincreasethenumberofinfantsandtoddlersandtheirfamiliesin P  theEarlyHeadStartprogram,aswellasexpandingtechnicalassistance,training,andresearchtosupporttopqualityinfantandtoddlerprogramsnationwide. s#s# 0  StrengtheningFamilies.AnessentialpartofHeadStartistheinvolvementofparentsinparent  education,programplanning,andoperatingactivities.Manyparentsserveasmembersofpolicycouncilsandcommittees.Participationinclassesandworkshopsonchilddevelopmentandstaffvisitstothehomeallowparentstolearnabouttheneedsoftheirchildrenandabouteducationalactivitiesthatcantakeplaceathome. s#s# Ѐ0  Partnerships.InkeepingwiththeDepartment'sownvisionofstrongfoundationsfor 8 children'sdevelopmentthatcutacrossprogrammaticlines,ACFwillcontinuetoexpandtheabilityofHeadStartprogramstoworkwithothersincommunitiesandstatesacrossthecountryonanintegratedvisionoftopqualityearlychildhoodservices.ACFisidentifyinganddisseminatingcommunitymodelsofHeadStartchildcarecollaborations;developingnewandstrongerlinkswiththeDepartmentofEducationandlocalschooldistricts;andstrengtheningtheStateCollaborationoffices,whichsupportlinkagesbetweenHeadStartandstateearlychildhoodandrelatedofficesinall50states. s#s#   3    3F23  0    ACF!ChildCare. ACFwillcontinuetoworkwithStateadministrators,professional   groups,serviceproviders,andotherstoidentifyelementsofqualityinchildcareandappropriatemeasures;toinformStates,professionalorganizations,andparentsaboutwhatconstitutesqualityinchildcare;toinfluencethetrainingofchildcareworkersandaccreditation;toimprovelinkageswithhealthcareservices,HeadStart,andEarlyHeadStart. 3F(G݌ s#s# Ќ    3    3I23  0    IHS!TreatmentandPrevention .ThroughanInteragencyAgreementwithHeadStart,IHS &`!$ healthcareconsultantsandprovidersprioritizeHeadStartchildrenforessentialservicesandprovidetrainingandtechnicalassistancetoHeadStartstaffatthelocallevel. 3II݌ s#s# Ќ    3    3WK23  0    HRSA!PrimaryCare,HealthCenters .TheHealthCentershavemountedamajor )%( initiativetoincreasechildhoodimmunizationratesincollaborationwithCDC.Thisinitiativehasalreadyshownsignificantprogressinninestates. 3WKK݌ s#s# Ќ    3    3M23  0    CDC!Immunizations .TheNationalImmunizationProgram(NIP)focusesonseveralmajor x-(, programmaticareastoachieveitsgoals,includingchildhoodimmunization,adultd h.)- dimmunization,andglobalpolioeradication.AlthoughNIPhasassistancefrommanypartners,StateandlocalhealthagenciesplayaprimaryroleinhelpingNIPcarryoutitsmissionintheUnitedStates.StateandlocalhealthagenciesuseCDCgrantfundsforawiderangeofactivitiesincludinghiringstaff,conductingsurveillance,assessingimmunizationlevels,developingimmunizationregistries,conductingeducationandoutreach,andestablishingpartnershipswithcommunitygroupsandprivatesectororganizations. 3M1M݌ s#s# Ќ    3    3P23  0    HCFA!ChildhoodImmunization .XVJXXXVJChildhoodimmunizationisakeyelementofthehealthy $ t developmentofpreschoolchildren,andisrecognizedassuchbytheStateChildrensHealthInsuranceProgram(SCHIP)andMedicaid.UnderSCHIPlegislation,StatesthatcreateaseparateSCHIPprogrammustincludecoverageofthecompleteseriesofimmunizations.Statesalsoareprohibitedfromimposingcopaymentsordeductiblesonimmunizationservices. 3PP݌ s#s# Ќ    3    3NS23  0    #XVJXXXVJ>Q#FDA!Drugs,Vaccines .FDAhastheresponsibilityforensuringthatvaccinesandrelated   productsaresafe,effective,andadequatelylabeled.Vaccinesagainsttendiseases(HepatitisB,polio,Haemophilusinfluenzaetypeb,mumps,measles,rubella,diphtheria,tetanus,pertussis,andchickenpox)arerecommendedforallU.S.children. 3NSyS݌ s#s# Ќ  0  Forthepastdecade,thedevelopmentofanacellularpertussisvaccineforinfantimmunizationhasbeenamajornationalgoal.FDAhasplayedamajorroleindevelopingandstandardizingthesevaccines.Currently,threeacellularpertussisvaccinesarelicensedforinfants(onein1996andtwoin1997),andseveraladditionalacellularvaccinesarenowunderreview.FDAanticipatesthatthesevaccines,especiallywhencombinedwithotherroutinepediatricvaccines,willreplacewholecellpertussisvaccinesintheUnitedStates.Combinationvaccinesreducethenumberofneedlestickstochildrenandthenumberofvisitstohealthcareproviders,andareacurrentFDApriority.TheAgencyreleasedaguidancedocumentoncombinationvaccinesthisyear.XVJXXXVJ&XXVJ s#s# #&&јX##XVJX&ѷX#XVJXXXVJ   3    3aY23  0    HCFA!StateChildrensHealthInsuranceProgramandMedicaid .Estimatesofthe  insurancecoverageofchildrenintheUnitedStatessuggestthatthereareapproximately11millionchildrenundertheageof19wholackinsurance. Researchshowsthatchildrenwho d  lackinsurancecoveragehaveaccesstofewerhealthservices.Insuredchildrenaremorelikelythanuninsuredchildrentogetpreventiveandprimaryhealthcare.Insuredchildrenarealsomorelikelytohavearelationshipwithaprimarycarepractitionerandtoreceivebasicpreventiveservices,suchasimmunizationsandwellchildcheckups. MedicaidandtheState $d" ChildrensHealthInsuranceProgram(SCHIP)havethepotentialtocovermanyofthechildrenwhocurrentlylackinsurance.#XVJXXXVJ>Y#XVJXXXVJ 3aYY݌%#&U"%XXVJԀACFPlan#XVJX"%&U#&U"%XXVJ l% N Note:SeeACFPlanfordescriptionof pointscales.#XVJX"%&Uۅ#&U"%XXVJ 0\\\\(P#Q\\\\E 0dFY01:1.4dFY00:1.4FY99:#XVJX"%&Un#&U"%XXVJԀN/A#XVJX"%&U#&U"%XXVJ 0\\\\H&!T\\\\ 0FY01:FY00:FY99:#XVJX"%&UM#&U"%XXVJԀ1.4#XVJX"%&UӇ#&U"%XXVJ /\\\\EH&!W\\\\ /Maintainandthenincreasethepercentageofchildrenratedbyparentasbeinginexcellentorverygoodhealth#XVJX"%&U#&U"%XXVJ.#XVJX"%&U#&U"%XXVJԀACFPlan#XVJX"%&U<#&U"%XXVJԀ#XVJX"%&U#&U"%XXVJ 0\\\\(+x&Z\\\\E 0FY01:80%FY00:77%FY99:#XVJX"%&Uщ#&U"%XXVJԀN/A#XVJX"%&U_#&U"%XXVJ 0\\\\(+x&]\\\\ 0FY01:FY00:FY99:#XVJX"%&U#&U"%XXVJԀ77% /\\\\E(+x&`\\\\ /IncreasethepercentageofHeadStartclassroomteacherswithacertificate,adegree,orappropriatetrainingrelatedtoearlychildhood education.ACFPlan 0\\\\ \\\\E 0FY01:100%FY00:100%FY99:100% 0\\\\ \\\\ 0FY01:FY00:FY99:93%FY98:95%#XVJX"%&U+#&U"%XXVJ /\\\\E  \\\\ /#XVJX"%&U#&U"%XXVJMaintainandthenincreasethepercentageof d h  HeadStartchildrenwhoreceivenecessarymedicaltreatmentafterbeingidentifiedasneedingmedicaltreatment.ACFPlan#XVJX"%&U|#&U"%XXVJ 0\\\\ \\\\E 0FY01:92%FY00:90%FY99:88%#XVJX"%&U#&U"%XXVJ 0\\\\ \\\\ 0FY01:FY00:FY99:87%FY98:88%#XVJX"%&U# /\\\\E \\\\ /&U"%XXVJIncreasetheproportionofAI/ANchildren hl receivingaminimumoffourWellChildVisitsby27monthsofageandexpandcoverage.IHS  $  Plan 0\\\\ \\\\E 0FY01:2%overFY00FY00:2%overFY99FY99:establishbaseline 0\\\\ $ \\\\ 0FY01:FY00:FY99:4/00#XVJX"%&Uۏ#&U"%XXVJ /\\\\E $ !\\\\ /IncreasethenumberofchildrenwhoareenrolledintheStateChildrensHealthInsuranceProgram(SCHIP)andMedicaid(lessthanage19forSCHIP;lessthanage21forMedicaid).HCFAPlan 0\\\\&\\\\E 0FY01:1millionoverpreviousyearFY00:1millionoverpreviousyearFY99:#XVJX"%&U#&U"%XXVJDevelopgoal;set + baselinesandtargets#XVJX"%&UG#&U"%XXVJ , #XVJX"%&Uē#&U"%XXVJ 0\\\\-\\\\ 0FY01:FY00:FY99:#XVJX"%&U#&U"%XXVJԀGoalMet 2 FY97:22.7millionenrolledinMedicaid#XVJX"%&U#&U"%XXVJ /\\\\E4\\\\ /IncreasethenumberofuninsuredandunderservedpersonsservedbyHealthCenters,withemphasisonareaswithhighproportionsofuninsuredchildrentohelpimplementtheSCHIPprogram.HRSAPlan 0\\\\tx9\\\\E 0FY01:9.7MFY00:9.6MFY99:8.9M 0\\\\<\\\\ 0FY01:FY00:FY99:5/00(9.15)estFY98:8.7MFY97:8.3M#XVJX"%&U+#&U"%XXVJ /\\\\EtxA\\\\ /Achieveorsustainthefollowingimmunizationcoverageofatleast90%amongchildren19to35monthsofageforeachvaccine:!L Lh(x0 !"#$%&(L  3    3{2h  1  .3  0 /   4dosesofDiphtheriaTetanusPertussis   containingvaccine 3{݌ // Ќ    3    32h  2  .3  0 /   3dosesofHaemophilusinfluenzaetypeb   vaccine 3݌ // Ќ    3    32h  3  .3  0 /   1doseofMeaslesMumpsRubellavaccine* 3݌d h// Ќ    3    32h  4  .3  0 /   3dosesofHepatitisBvaccine 3݌@D // Ќ    3    3e2h  5  .3  0 /   3dosesofPoliovaccine 3e݌    //   3    3D2h  6  .3  0 /   1doseofVaricellavaccine.#XVJX"%&U8#&U"%XXVJ 3Do݌ :\\\\'" //\\\\E :Ќ  &U"%"%&UFY01:Achieveorsustain `d  immunizationcoverageofatleast90%amongchildren19to35monthsofage.FY00:Achieveorsustainimmunizationcoverageofatleast90%amongchildren19to35monthsofage.FY99:Achieveorsustainimmunizationcoverageofatleast90%amongchildren2yearsofageforeachvaccine.#&U"%"%&U##XVJX"%&U#&U"%XXVJ  $  0\\\\\\\\ 0&U"%"%&UFY01:8/02 `d FY00:8/01FY99:8/00#&U"%"%&U##XVJX"%&U>#&U"%XXVJ  * &U"%"%&UFY97:(7/976/98)̀90%vaccination coverageforeachvaccine.1.0  84%lp3 " " L : !"#$%&(Yh(LL2.93%3.92%4.87%5.91%6.43%#&U"%"%&U##XVJX"%&UH#&U"%XXVJ /\\\\E8\\\\ /IncreasethepercentageofMedicaidtwoyearoldchildrenwhoarefullyimmunized.(Tobeachievedin3phasesforStategroupings.)0 / !0[//Group1States"=[[ 0 / 0[//(baseline:2000;firstreport:2001) [[ 0 / !0[//Group2States& A[[ 0 / 0[//(baseline:20002001;firstreport:2002) [[ 0 / !0[//Group3Statesx)|"E[[ 0 / 0[//(baseline:20012002;firstreport:2003) [[ HCFAPlan 0\\\\ ,%H\\\\E 0FY01:FirstReportFY00:#XVJX"%&U#&U"%XXVJSetBaseline#XVJX"%&Ug#&U"%XXVJ t#xN FY99:#XVJX"%&U#P<%XXVJԀNotApplicable#XVJX%P<#&U"%XXVJ P$TO FY01:#XVJX"%&Uc#P<%XXVJԀ#XVJX%P<#&U"%XXVJSetBaseline & Q FY00:#XVJX"%&U#P<%XXVJNotApplicable#XVJX%P MaternalandChildHealthBlockGrantHealthyStartUniversalNewbornHearingScreeningandEarlyInterventionNIH %B ResearchProgramOPHS |' D OfficeofDiseasePreventionandHealthPromotion,HealthyPeople2010SAMHSA @*D#G KnowledgeDevelopmentandApplicationStartingEarly,StartingSmart ,%I 5@s#s#X@"5iU5%!`z  `E$tt< i s#s#       s#s#iU5%!`z  `E$tt< iL 0 !"#$%&(xh: !"#$%&(L9,X,hX,X,hX9 lXXVJK#XVJXlA#EYlXXVJFY2001P#XVJXl#ROGRAMS,lXXVJI#XVJXl۽#NITIATIVES,ANDlXXVJS#XVJXl.#TRATEGIES  `   3    323  0    ACF!AdoptionandSafeFamiliesActPrograms. ThePresidenthassetanAdoption2002 `  goalofprovidingsafety,permanencyandwellbeingforatriskchildrenbydoublingthenumberofadoptionsandpermanentplacementsfromthepublicwelfaresystem.ACFwillcontinuethejointeffortbyFederal,Stateandlocalgovernments,childwelfareandadoptionprofessionals,communityleaders,andinterestedcitizenstoachievethisgoal,therebyimprovingthelivesofchildrenwhoarebacklogged,oratriskofbeingbacklogged,inthechildwelfaresystem,bycreatingpermanenthomesforthem. 3݌ s#s# Ќ  0  Inaddition,effortstoreducebarrierstotheadoptionprocessandstrengthenACFstechnicalassistancetoenableStatestoincreasethenumbersofchildrenadopted,especiallychildrenwithspecialneedswillcontinue.Inaddition,ACFproposesaninvestmentfromtitleIVEfundsformonitoringofchildwelfareandfamilyserviceprogramsinthestates,includingfamilypreservationandsupport,timelimitedreunificationservices,adoptionsupportservices,childprotectiveservices,fostercare,adoption,andindependentliving.Thesereviewsareessentialtosafety,permanencyandchildandfamilywellbeing.Inaddition,thesefundswillbetargetedtoprovidingtechnicalassistanceandmonitoringofcriticalsystemsdevelopment,thesystemwhichprovidesACFwiththeinformationnecessarytoapproveordisapprovestateexpenditures. s#s#   3    3/23  0    ACF! IndependentLivingProgram. Thisprogramwillhelpkeepchildrenagingoutofthe 8 childwelfareprogramfrombecominghomeless,jobless,ordrugaddicted. 3/Z݌ s#s# Ќ    3    323  0    /XVJXXXVJ HRSA!PrimaryCare,HealthCenters .#XVJXX/XVJ#HRSA'sHealthCentersareimplementingaFamily  ViolenceInitiativeandplantoaddparentingclasses,homevisitingandabusepreventionservicesinhighriskareas. 3݌ s#s# Ќ    3    3x23  0    HRSA!MaternalandChildHealthBlockGrant .ThroughTitleVoftheSocialSecurity d"  Act,thisprogramsupportsinjurypreventionanddomesticviolencereductionprogramsthatreducebothaccidentalandintendedinjuries,especiallytochildren. 3x݌ s#s# Ќ    3    3823  0    SAMHSA!TheComprehensiveCommunityMentalHealthServicesforChildrenand &h!$ theirFamiliesProgram seekstoprovideintensivecommunitybasedservicesforchildren 'X"% withseriousemotionaldisturbancesandtheirfamilies.Theprogramfeaturesabroadarrayofservicestailoredtomeettheneedsofthechildthroughanindividualizedserviceplanningprocess.dInFY2001,HHSwillcontinuetosupportandevaluateapproximately50grants,allowingcontinuednationalprogressinimprovingoutcomesforalargernumberofchildrenwithseriousemotionaldisturbancesandtheirfamilies.d 38c݌ s#s# Ќ    3    3s23  0    IHS!Prevention,HealthEducation,andTreatment .IHSscreensthetreatment -(, populationforindicationforabuseorneglectandassistsitslocalpartnerstoengagein p.)- /XVJXXXVJcommunitybasedpreventioninitiativeswhichaddressHIV/AIDSriskbehavior,violence,child  abuse,physicalinactivity,nutrition,alcoholandsubstanceabuseandtobaccouseandcessation.#XVJXX/XVJ# 3s݌s#s# Ќ       4  `    h      p      x    3    323  0    OCR ! PreventingDiscriminationinAccesstoHHSServices .DuringFY2001,OCR ` anticipatescontinuingtechnicalassistancetostatesandplacementagencies,ongoingpartnershipwithACFandothers,reviewsorinvestigationsofcompliance,andfollowupmonitoringofcorrectiveactionplansassociatedwithimplementationofthestrengthenedadoptionnondiscriminationprovisionsincludedintheSmallBusinessJobProtectionActof1996(SBJPA)andinguidelinesforOCRandACFimplementation. 3݌ s#s# Ќ  & < lXXVJS#XVJXl#ELECTEDlXXVJFY2001#XVJXl#ԀlXXVJP#XVJXl##ERFORMANCElXXVJG#XVJXlq#OALSANDlXXVJM#XVJXl#EASURES    *hi ddSS 4SS 4SSS Sfgs#s#,SS ,SSS ,SSS +  &\\\\G   &  PerformanceGoals 8\\\\E#!(x  \\\\G 8  Targets 8\\\\E#!(x  \\\\E 8  ActualPerformance '< =\\\\E(&d   \\\\E =&U"%XXVJMakeprogresstowardsdoublingthenumberof  adoptionsforchildreninthepublicfostercaresystembetweenFY1997andFY2002.ACFPlan 0\\\\L\\\\E 0FY01:51,000FY00:46,000FY99:41,000̀(Originally24,000)* 0\\\\T\\\\ 0FY01:FY00:FY99:9/00FY98:36,000FY97:31,000(baseline)FY96:28,000FY95:26,000#XVJX"%&U:#&U"%XXVJ /\\\\E"\\\\ /IncreasethenumberofStateagenciesandadoptionagencies(local)foundtobeincompliancewiththenondiscriminationprovisionsoftheSmallBusinessJobProtectionAct.Measure:Increasednumberofcorrectiveactionsandnoviolationfindings.OCR x' Plan 0\\\\T (\\\\E 0FY01:24FY00:22FY99:30 0\\\\+\\\\ 0FY01:FY00:FY99:20FY98:20 /\\\\E/\\\\ /Decreasethepercentageofchildrenwithsubstantiatedreportsofmaltreatmentwhohavearepeatsubstantiatedreportofmaltreatmentwithin12months.ACFPlan 0\\\\X$3\\\\E 0CY01:10%CY00:11%CY99:21% 0\\\\|#6\\\\ 0CY01:CY00:CY99:10/01CY98:10/00CY97:12%dCY96:21%d(baseline)CY95:20% /\\\\E&<"=\\\\ /IncreasetheproportionofACF-supportedyouthprogramsthatareusingcommunitynetworkingandoutreachactivitiestostrengthenservices.ACFPlan 0\\\\*d%@\\\\E 0FY01:75%FY00:75%* ,X,hX*FY99:75% 0\\\\*d%C\\\\ 0FY01:FY00:FY99:51%FY98:79%FY97:77% /\\\\E+'H\\\\ /IncreasetheproportionofyouthlivinginsafeandappropriatesettingsafterreceivingACFfunded services.ACFPlan 0\\\\8 \\\\E 0FY01:96%FY00:95% XFY99:95% 0\\\\8 \\\\ 0FY01:FY00:FY99:86%FY98:81%FY97:82% /\\\\E  \\\\ /IncreasethenmaintaintheproportionofchildrenreceivingComprehensiveCommunityMentalHealthServiceswhoareattendingschool75%ofthetime.SAMHSAPlan.   0\\\\\\\\E 0FY01:95%FY00:80%FY99:80% 0\\\\\\\\ 0FY01:8/01FY00:8/00FY99:88.9%FY98:78.8%FY97:70%(baseline) /\\\\E\\\\ /IncreasethenmaintaintheproportionofchildrenreceivingComprehensiveCommunityMentalHealthServiceswithlawenforcementcontactsatentrywhohavenolawenforcementcontactsafter6months.SAMHSAPlan. 0\\\\ \\\\E 0FY01:57%FY00:57%FY99:57% 0\\\\ "\\\\ 0FY01:8/01FY00:8/00FY99:d43%d#XVJX"%&U#&U"%XXVJ  % FY98:54.8%FY97:47%(baseline) /\\\\E '\\\\ /ImprovethestabilityoflivingarrangementsofchildrenreceivingComprehensiveCommunityMentalHealthServicesbydecreasingthepercentageofparticipantshavingmorethanonelivingarrangementafter6monthsinservices.SAMHSAPlan 0\\\\lP-\\\\E 0FY01:11%FY00:51%FY99:56% 0\\\\1\\\\ 0FY01:8/01FY00:8/00FY99:27%FY98:23.7%FY97:76%#XVJX"%&U# t6 (baseline) /\\\\ElP7\\\\ /&U"%XXVJIncreasethepercentofIHS,Tribal,andUrban 8 medicalfacilitieswithUrgentCareorEmergencydepartmentsorservicesthathavewrittenpoliciesandproceduresforroutinelyidentifying,treatingand/orreferringvictimsoffamilyviolence,abuseorneglect(child,spouse,elderly).IHSPlan 0\\\\8 =\\\\E 0FY01:80%FY00:70%FY99:60% 0\\\\@\\\\ 0FY01:FY00:FY99:64%FY98:47%#XVJX"%&UY#(dD \\\\ (&U"%XXVJ*Theoriginalbaselinefortheadoptionmeasurewasunderestimatedat24,000.Therevisedbaselineis 0"E 41,000.#XVJX"%&U#Ԁ  #F  lXXVJP#XVJXl#ROGRAMSlXXVJS#XVJXl#UPPORTINGlXXVJT#XVJXl"#HISlXXVJO#XVJXli#BJECTIVE  %I (X@s#s#(ACF ' K ChildWelfareYouthProgramsDevelopmentalDisabilitiesSocialServicesBlockGrantHRSA ,x%P PrimaryCare,HealthCentersMaternalandChildHealthBlockGrant l.P'R IHS ' R PreventionandTreatmentOCR )"T PreventingDiscriminationinAccesstoHHSServicesSAMHSA ,x%W ComprehensiveCommunityMentalHealthServicesforChildrenandTheirFamilies l.P'Y Program    5@s#s#X@5  iUj5%!`z  `E`ttx 3i s#s#     s#s#iU5%!`z  `E`ttx 3iL 0 !"#$%&(xx0 !"#$%&(L-,X,hXX- lXXVJK#XVJXlt#EYlXXVJFY2001P#XVJXl#ROGRAMS,lXXVJI#XVJXl#NITIATIVES,ANDlXXVJS#XVJXla#TRATEGIES  L    3    323  0    AoA!SupportiveServicesandSeniorCenters .AoAssupportiveservicesprogramfunds L  transportation,informationandassistance,casemanagement,personalcareservices,andarangeofservicesprovidedinseniorcenters.Thesefundsprovideelderswithinformation,assistanceandserviceswhichenablethemtoremainactiveandinthecommunity. 3݌ s#s# Ќ    3    323  0    AoA!CongregateandHomeDeliveredNutritionServices .AoAsupportscongregateand <  homedeliveredmealprogramstoincreasethenutritionalintakeofatriskseniors.Homedeliveredmealsenableolderadultstoavoidordelaycostlyinstitutionalizationandallowthemtostayintheirhomesandcommunities.Congregatenutritionservicesalsoimproveparticipantshealthsignificantlyandpreventmorecostlyinterventions.Inaddition,congregateservicesallowolderpeopletheopportunitytoengageinsocialactivitiesthatcontributetotheirwellbeing. 3݌ s#s# Ќ    3    323  0    4XVJXXXVJ HRSA!#XVJXX4XVJ`#kXVJXXXVJPrimaryCare,HealthCenters .#XVJXXkXVJ#4XVJXXXVJHRSAsHealthCentershaveaprovenrecordof P expertiseinthemanagementofchronicconditionssuchasdiabetesandhypertensionaffectingtheelderly.HRSAisundertakinganinitiativetomeasureandimprovequalityofcarefordiabeticpatientsinover100individualcenters.Inaddition,HRSAhaslaunchedaninitiativetoincreasethenumberofMedicarebeneficiariesserved,withemphasisonmanagedcareandgeriatricexpertise.#XVJXX4XVJ# 3݌@s#s# Ќ    3    3f23  0    IHS!TreatmentandPrevention,ElderHealth .AproposedincreaseintheFY2001  BudgetwillallowIHStodevelopspecializedgeriatriccapacitywithintheIHS,Tribal,andUrbanhealthcaresystemandprovidetreatmentandmedicationmanagementuniquetotheelderpatientpopulation. 3f݌ s#s# Ќ    3    3N23  0    CDC!Immunizations .TheNationalImmunizationProgram(NIP)focusesonseveralmajor h"  programmaticareastoachieveitsgoals,includingchildhoodimmunization,adultimmunization,andglobalpolioeradication.AlthoughNIPhasassistancefrommanypartners,StateandlocalhealthagenciesplayaprimaryroleinhelpingNIPcarryoutitsmissionintheUnitedStates.StateandlocalhealthagenciesuseCDCgrantfundsforawiderangeofactivitiesincludinghiringstaff,conductingsurveillance,assessingimmunizationlevels,developingimmunizationregistries,conductingeducationandoutreach,andestablishingpartnershipswithcommunitygroupsandprivatesectororganizations. 3Ny݌ s#s# Ќ    3    323  0    CDC!InjuryPreventionandControl .CDCprovidesnationalleadershipfordesigning *&) programstopreventprematuredeathanddisabilityandreducehumansufferingandmedicalcostscausedbyinjuries.WorkintheareaofsuicidepreventionamongourNationselderlyisongoing. 3݌ s#s# Ќ   l.)-   3    323  0    HCFA!SupplementingMedicare .kXVJXXXVJOneofHCFA'scentralconcernsisthatMedicare  beneficiariesareabletogetthecaretheyneedwhentheyneedit,andthattheyarenotimpededbyfactorssuchascost,healthstatus,location,oravailabilityofprimarycarephysiciansorspecialists.Thisistruenotonlyforbeneficiariesasaclass,butmostespeciallyforvulnerablesubgroupssuchaspersonswithdisabilitiesandmembersofminorityandeconomicallydisadvantagedpopulations.AlthoughMedicareprovidesbeneficiarieswithabasicsetofhealthbenefits,theystillarerequiredtopayasignificantamountoutofpocketforpremiums,deductibles,andcoinsurance.Thiscostcanbeprohibitiveformanybeneficiaries,particularlyfortheapproximately12percentwhodonothaveprivateorpublicsupplementalinsurance.HCFAsaccesstocareperformancegoalwilltargetfinancialbarrierstocareforthesebeneficiaries.#XVJXXkXVJ^#kXVJXXXVJEmphasisintheinitialyearsofthisgoalwillbeonincreasingenrollmentforthe  <  MedicarebeneficiarieswhoareeligiblefortheQualifiedMedicareBeneficiary(QMB)ortheSpecifiedLowIncomeMedicareBeneficiary(SLMB)programs.#XVJXXkXVJC# 3݌ s#s# Ќ    3    323  0    HCFA!ManagedCare .kXVJXXXVJԀ#XVJXXkXVJW#XVJXXXVJMedicarehasprovidedaccessforbeneficiariestomainstream   healthcare.Thehealthcaresystemischangingwithgrowthinhealthmaintenanceorganizationsandotherformsofmanagedcareaswellasnewdeliveryarrangements.HCFAsgoalistoensurethatallMedicarebeneficiarieshaveachoiceofanumberofhighqualityhealthcareoptionsinbothfee-for-serviceandmanagedcare.#XVJXXXVJ#XVJXXXVJThefollowingstrategieswillcreate P greaterchoiceofhealthplansforMedicarebeneficiaries. 1)TheBalancedBudgetActof1997 < willallowcontractingwithotherthantraditionalHMOs.Itishopedthatsomeoftheapplicationsmaycomefromruralareasthathavefewornomanagedcareoptions. 2) d Utilizationofa triageapproachwillfacilitateprocessingofmanagedcareapplicationsandserviceareaexpansionsfromplansthatwillofferproductsinareasthathavelittleornomanagedcarepenetration.3)Theofferingofdifferentplanchoicesthroughdemonstrationprojects,suchasChoices,Social/HMO,andESRDcapitationdemonstration.TheseallowpromotionofmanagedcareinareasthathavenothadmuchinterestfromtraditionalHMOs.#XVJXXXVJz #kXVJXXXVJ  UndertheBalancedBudgetRefinementActof1999,aBonusPaymentProcesshasbeeninitiatedasanincentiveforamanagedcareorganizationtoenteracountywherenoothermanagedcareplansexist;eitherbecausenonhaseverbeenthereorduetoexistingplansterminatingtheirMedicarecontractswithHCFAandleavethecountywithnomanagedcareservices.#XVJXXkXVJ #kXVJXXXVJ 3݌L!s#s# Ќ  #XVJXXkXVJ#  3    3T23  0    SAMSHA ! TreatmentOutcomesStudy .Recognizingthatmostolderadultsreceivemental $#t! healthandsubstanceabuse(primarilyalcoholrelated)servicesinaprimarycaresetting,thethreeSAMHSACenters,incollaborationwithHRSA,willbeworkingtoidentifythedifferencesinoutcomesbetweentreatmentmodels.Thestudycontinuestoexaminehowthelocation,typeofprovider,andtypeofhealthcarefinancingaffectsthelevelofactualuseofsubstanceabusepreventionservices. 3T݌ s#s# Ќ    3    3 23  0    IHS!Prevention,HealthEducation,andTreatment .IHSscreensthetreatmentpopulation )$( forindicationforabuseorneglectandassistsitslocalpartnerstoengagein/XVJXXXVJcommunitybased *%) preventioninitiativeswhichaddressHIV/AIDSriskbehavior,violence,childabuse,physicalinactivity,nutrition,alcoholandsubstanceabuseandtobaccouseandcessation.#XVJXX/XVJA# 3 6݌d,'+s#s#    P-(,   3    323  0    NIH!ResearchonAppliedGerontology .TheNationalInstituteonAgingsEdwardR.   RoybalCentersofResearchonAppliedGerontologyconductresearchwiththegoalofkeepingpeopleindependent,active,andproductiveinlaterlife.Investigatorsatthesecentersfocusontranslatingpromisingsocialandbehavioralresearchfindingsintostrategiestohelpimprovethelivesofolderpeopleandtheirfamiliesinsuchareasascomputerskills,driving,exercise,caregiving,andnursinghomecare. 3݌ s#s# Ќ    3    323  0    SAMHSALinkagesamongPrimaryCare,MentalHealth,SubstanceAbuse,andHIV ( x ServicesforOlderAmericans .ThisTCEprogramwillfocusondevelopinglinkagesamong  h primarycare,mentalhealth,substanceabuseandHIVforolderAmericans,withthegoaloflearninghowbesttodeliverservicesforadiversegroupofolderAmericans(50andover)livingwithHIV/AIDSoratriskforHIV.TheprogrammodelwilladdresstheprimaryandsecondarypreventionneedsofthepopulationaswellastheimplementationofacontinuumofcareforolderAmericans.Toachievethis,approximatelytengrantswillbeawardedandacoordinatingcenterwillbeestablished. 3݌ s#s# Ќ    3    323  0    AoA!GrantstoIndianTribes .AoAsAmericanIndian,AlaskanNativeandNative | HawaiianProgramawardsgrantstoprovidesupportiveandnutritionservices,includingbothcongregateandhomedeliveredmealstoolderNativeAmericans. 3݌ s#s# Ќ    3    323  0    AoA!AlzheimersDiseaseDemonstrationGrantstoStates .Throughresearchconducted 0 byNIHandotherpartsoftheDepartment,aswellasthroughdemonstrationresultsofthisprogram,newbehavioralapproachesarerapidlyemergingthatencouragegreaterindependenceandreducedisturbingbehavior.TheAlzheimerDemonstrationGrantProgramprovidesanimportantmechanismforthesystematicapplicationoftheseresearchfindingstothedevelopmentandimplementationofmodelsofcareforpersonswithAlzheimersDisease. 3݌ s#s# Ќ    3    323  0    OPHS !Activitiesandinitiativesoncardiovasculardisease,thepreventionofosteoporosis,a  newolderwomensexerciseandfitnessinitiative,andrelatedactivitiesaretargetedathealthpromotionanddiseasepreventionforwomen. 3݌ s#s# Ќ   p  &  lXXVJS#XVJXlc!#ELECTEDlXXVJFY2001#XVJXl!#ԀlXXVJP#XVJXl!#ERFORMANCElXXVJG#XVJXlF"#OALSANDlXXVJM#XVJXl"#EASURES   XVJXXXVJ&U"%XXVJ*lm d dSS SSS SSSS Shis#s#,SS ,SSS ,SSS +  &\\\\G  &  PerformanceGoals 8\\\\E#!d \\\\G 8  Targets 8\\\\E#!d \\\\E 8  ActualPerformance 'T! =\\\\E(&@   \\\\E =#&U"%"%&U"##XVJX"%&U##&U"%XXVJ&U"%"%&UTherateofvaccinationamongpersons65years `  willbeincreasedforinfluenzaandpneumococcalpneumonia. * CDCPlan   h  * Influenzaandpneumococcalvaccinationcoverage  $  goalsforadultsaged65andolderarebasedonthe90%coveragegoals inHealthyPeople2010.Itis   expectedthatinfluenzavaccinationcoveragewillincreaseapproximately2%peryearandpneumococcal vaccinationwillincreaseabout3% (x  peryeartorealizedthe2010goals.#&U"%"%&U%##XVJX"%&U%#&U"%XXVJ 0\\\\X \\\\E 0&U"%"%&UFY01:Influenza:72%. `  Pneumococcal <  pneumonia:63%.  h FY00:Influenza:70%.   Pneumococcal   pneumonia:60%.#&U"%"%&U(##XVJX"%&UX(#&U"%XXVJ   &U"%"%&UFY99:Therateof @  vaccinationamongnoninstitutionalizedhighriskpopulations:Influenza:60%;  Pneumococcal  pneumonia:54%.#&U"%"%&U*##XVJX"%&U)#&U"%XXVJ h   0\\\\D!\\\\ 0&U"%"%&UFY01: ` " FY00:#&U"%"%&U+##XVJX"%&UI+#&U"%XXVJ&U"%"%&UFY99:6/00 @ * FY97:Influenza:65%.  p2 Pneumococcal L3 pneumonia:43% (4 (preliminarydatafromNHIS)FY95:Influenza:58%. H8 Pneumococcal $t9 pneumonia:34%.#&U"%"%&UZ,##XVJX"%&U;,#&U"%XXVJ /\\\\EP:\\\\ /MeetState/Federalnationalenrollmenttargetsforduallyeligiblebeneficiaries(MedicareandMedicaid).HCFAPlan#XVJX"%&U-#&U"%XXVJ 0\\\\(!x=\\\\E 0FY01:01/00FY00:01/00FY99:#XVJX"%&U.#*XXVJSetFY2000 (!x@ target#XVJX*a/#&U"%XXVJ 0\\\\"TA\\\\ 0FY01:FY00:FY99:#XVJX"%&U/#&U"%XXVJԀ01/00 /\\\\E(!xD\\\\ /IncreasethepercentageofMedicarebeneficiarieswhohaveatleastonemanagedcareoption/choice.HCFAPlan 0\\\\%T G\\\\E 0FY01:73%FY00:73%FY99:80% 0\\\\%T J\\\\ 0FY01:FY00:FY99:72%FY98:72%FY97:70% /\\\\E& "O\\\\ /IncreasethenmaintainthehighpercentageofMedicare+Choiceenrollmenttransactionsprocessedonatimelybasis.HCFAPlan 0\\\\)4%R\\\\E 0FY01:98%FY00:98%FY99:98% 0\\\\)4%U\\\\ 0FY01:FY00:FY99:98% /\\\\E)4%X\\\\ /Increaseoverallpneumococcalandinfluenzavaccinationlevelsamongadultsaged65yearsandolder.IHSPlan 0\\\\ \\\\E 0FY01:2%overFY00FY00:65%FY99:N/A 0\\\\ \\\\ 0FY01:FY00:FY99:3/00FY98:63% /\\\\E  \\\\ /IncreasethepercentageofIHS,Tribal,andUrbanmedicalfacilitieswithUrgentCareorEmergencydepartmentsorservicesthathavewrittenpoliciesandproceduresforroutinelyidentifying,treatingand/orreferringvictimsoffamilyviolence,abuseorneglect(child,spouse,elderly).IHSPlan 0\\\\ \\\\E 0FY01:80%FY00:70%FY99:60% 0\\\\ \\\\ 0FY01:FY00:FY99:64%FY98:47%(  \\\\ (XVJX"%&U lXXVJP#XVJXl6#ROGRAMSlXXVJS#XVJXl7#UPPORTINGlXXVJT#XVJXlb7#HISlXXVJO#XVJXl7#BJECTIVE  tx  (X@s#s#(AHRQ tx  ResearchonHealthCosts,Quality,andOutcomesAoA 8< SupportiveServices&CentersCongregateMealsHomeDeliveredMealsAlzheimersInitiativeGrantstoIndianTribes # CDC tx # ImmunizationInjuryPreventionandControlHCFA 8<& MedicarePeerReviewOrganizationsMedicare+ChoiceMedicaid * HRSA * PrimaryCare,HealthCentersIHS , TreatmentandPreventionNIH \!`. ResearchProgramOPHS 4#80 HealthyPeople2000OfficeonWomensHealth  %2 SAMHSA 2 KnowledgeDevelopmentandApplicationTargetedCapacityExpansionNationalDataCollectionStateInfrastructureProtectionandAdvocacyMentalHealthPerformancePartnershipBlockGrantSubstanceAbuseBlockGrant  $$9  &9   &9 5@s#s#X@ 85iU5%!`z  `E`ttx 3i s#s#        s#s#iU5%!`z  `E`ttx 3iL 0 !"#$%&(xx0 !"#$%&(L9,X,hX,X,hX9 lXXVJK#XVJXl>#EYlXXVJFY2001P#XVJXl>#ROGRAMS,lXXVJI#XVJXl?#NITIATIVES,ANDlXXVJS#XVJXll?#TRATEGIES  L    3    3?23  0    AoA!LongTermCareOmbudsmanProgram .TheLongTermCareOmbudsman L  Programhelpsstatestoinvestigateandresolvecomplaintsmadeby,oronbehalfof,residentsoflongtermcarefacilitiesrelatedtoaction,inaction,ordecisionsthatmayadverselyaffectthehealth,safety,welfare,orrightsofresidents.Thereare52StateLongtermCareOmbudsmanProgramswhichsupportombudsmanstaffandvolunteersin564localprograms.AoAalsosupportsanOmbudsmanResourceCenterthatofferstrainingandtechnicalassistancetoombudsmenthroughoutthecountry. 3??݌ s#s# Ќ    3    3B23  0    AoA!SupportiveServicesandSeniorCenters .AoAssupportiveservicesprogramfunds  transportation,informationandassistance,casemanagement,personalcareservices,andarangeofservicesprovidedinseniorcenters.Thesefundsprovideelderswithinformation,assistanceandserviceswhichenablethemtoremainactiveandinthecommunity. 3BB݌ s#s# Ќ    3    3D23  0    AoA!CongregateandHomeDeliveredNutritionServices .AoAsupportscongregateand P homedeliveredmealprogramstoincreasethenutritionalintakeofatriskseniors.Homedeliveredmealsenableolderadultstoavoidordelaycostlyinstitutionalizationandallowthemtostayintheirhomesandcommunities.Congregatenutritionservicesalsoimproveparticipantshealthsignificantlyandpreventmorecostlyinterventions.Inaddition,congregateservicesallowolderpeopletheopportunitytoengageinsocialactivitiesthatcontributetotheirwellbeing. 3D#E݌ s#s# Ќ    3    3G23  0    AoA!SupportforCaregivers .AoAisproposingtoprovidesupportforfamilycaregiversas  authorizedunderTitleIIIoftheOlderAmericansAct.AoAwillprovideinformation,assistanceinaccesstoservices,counselingandsupportgroups,anddirectservicestocomplementinformalcareprovidedbyfamilies.Supporttoinformalcaregiverssignificantlybenefitsthemwhiledelayingtheneedofcarerecipientsfornursinghomeservices. 3G%H݌ s#s# Ќ  L K !"#$%&( hx0 !"#$%&(L  3    3J2 3  0    AoA!AlzheimersDiseaseDemonstrationGrantstoStates .Throughresearchconducted @$" byNIHandotherpartsoftheDepartment,aswellasthroughdemonstrationresultsofthisprogram,newbehavioralapproachesarerapidlyemergingthatencouragegreaterindependenceandreducedisturbingbehavior.TheAlzheimerDemonstrationGrantProgramprovidesanimportantmechanismforthesystematicapplicationoftheseresearchfindingstothedevelopmentandimplementationofmodelsofcareforpersonswithAlzheimersDisease. 3JK݌ s#s# Ќ    3    3M2 3  0    HCFA!ProgramsforAllInclusiveCarefortheElderly .XVJXXXVJStateshavetheoptionof *&) providingMedicaidcoverageforcategoricallyrelatedgroups,suchasindividualswhowouldbeeligibleforMedicaidifinstitutionalized,butwhoarereceivingcareunderhomeandcommunitybasedserviceswaivers.TheBalancedBudgetActmadepermanenttheProgramsofAllinclusiveCarefortheElderly(PACE),foreligiblepersonsasaStateoption.PACE l.)- providesanalternativetoinstitutionalcareforpersonsaged55andoverwhorequireanursing  facilitylevelofcare.ThePACEteamoffersandmanagesallhealth,medical,andsocial  services,andmobilizesotherservicesasneededtoprovidepreventative,rehabilitative,curative,andsupportiveservices.Thiscareisprovidedindayhealthcenters,homes,hospitals,andnursinghomeswhilehelpingthepersonmaintainindependence,dignity,andqualityoflife.PACEfunctionswithintheMedicareprogramaswellasunderMedicaid.PACEprovidersmustmakeavailableallitemsandservicescoveredunderbothMedicareandMedicaidwithoutamount,duration,orscopelimitations,andwithoutapplicationofanydeductibles,copayments,orothercostsharing.#XVJXXXVJvN# 3MM݌ `s#s# Ќ    3    3S2 3  0    HCFA!NursingHomeInitiative .XVJXXXVJԀHCFAcontinuestoplayasignificantroleinthe  8  President'sNursingHomeInitiativeannouncedinJuly,1998.InFY1999,HHSbeganphasing-inkeyprovisionsoftheinitiative.ContinuedfundingwillbeprovidedprimarilyforStatesurveysofnursinghomes,Federalsurveyoroversightanddevelopinganationalcriminalabuseregistrytoscreenpotentialnursinghomeemployees.ContinuedeffortswillalsoensurelegalresourcesfortheOfficeoftheGeneralCounselandtheDepartmentalAppealsBoardtoprovidejudicialhearingsandhandleadministrativeandcourtlitigationinatimelymanner.#XVJXXXVJrT# 3ST݌ts#s# Ќ    3    3hW2 3  0    IHS!DivisionofFacilitiesandEnvironmentalEngineering .IHSprovidesaccessto L healthservicesthroughconstructionofhealthcareandsanitationfacilities. 3hWW݌ s#s# Ќ    3    3X2 3  0    SAMHSATheCenterforMentalHealthServices ,workinginpartnershipwithother d Federalagencies,Stateandlocalmentalhealthauthorities,serviceproviders,consumersofservices,andtheirfamilies,isprovidingakeyfunctioninguidingasystemofcareforcommunitybased,consumerfocusedservices.dAnexampleistherecentlyfundedknowledgedevelopmentprogramonSchoolViolenced. 3XX݌ s#s# Ќ    3    31[2 3  0    OCR ! PreventingDiscriminationinAccesstoHHSServices .Followingthedecisionby  theSupremeCourtintheOlmsteadcaseregardingthemostintegratedsettingrequirementsof  theAmericanswithDisabilitiesAct(ADA),OCRhasbeguntodeterminehowbesttoinformbeneficiariesoftheirrightsandrecipientsoftheirresponsibilitiesundertheADAwithrespecttoprovidingservicesinmostintegratedsettings.OCRexpectsasignificantincreaseincomplaintfilingsrelatedtotheOlmsteaddecisionandinrequestsfortechnicalassistancefrom @"  bothprovidersandthedisabilitycommunity.OCRwilltakeatwoprongedapproachtoresolvethesecomplaints.TherefirstwillfocusondevelopingamodelforcollaborationandcooperationamongstateMedicaidprograms,complainants,advocacyorganizations,andHCFAtoachievevoluntaryresolution.Thesecondistoconductformalinvestigations,asnecessary,todetermineiftherequirementsoftheOlmsteaddecisionarebeingfollowedbythe &,"% states. 31[\[݌ s#s# Ќ    )$( & < lXXVJS#XVJXlt`#ELECTEDlXXVJFY2001#XVJXl`#ԀlXXVJP#XVJXl a#ERFORMANCElXXVJG#XVJXlWa#OALSANDlXXVJM#XVJXla#EASURES   XVJXXXVJ   *no ddSS SSS SSSS Slms#s#,SS ,SS ,SS +  &\\\\G  &  PerformanceGoals 8\\\\E#!d \\\\G 8  Targets 8\\\\E#!d \\\\E 8  ActualPerformance '<e` =\\\\E(&P   \\\\E = &U"%XXVJDecreasethensustainthereducedprevalenceof  theuseofphysicalrestraintsinnursinghomes. \ HCFAPlan 0\\\\8 \\\\E 0#&U"%"%&Ub#FY01:10%  FY00:10%FY99:&U"%"%&UԀ14% 0\\\\8  \\\\ 0#&U"%"%&Ue#FY01:   FY00:FY99:12%&U"%"%&U 8   FY98:12%FY96:17% /\\\\E @\\\\ /Reducetheprevalenceofpressureulcers(bedsores)amongpatientsoflongtermcarefacilities.HCFAPlan 0\\\\h \\\\E 0#&U"%"%&UHf#FY01:01/01 `  FY00:#XVJX"%&Uid#&U"%XXVJSetbaselineand <  target#XVJX"%&Ug# h  FY99:YXXVJNewinFY2000#XVJXYYh#&U"%XXVJ&U"%"%&U 0\\\\D \\\\ 0#&U"%"%&Uh#FY01: `  FY00:FY99:&U"%"%&UԀN.A. /\\\\ED \\\\ /#&U"%"%&Ufi#Providesanitationfacilitiestoneworlikenew t  homesandexistingIndianhomes.IHSPlan P   0\\\\,| \\\\E 0FY01:6,350New/Likè13,080ExistingFY00:3,740New/Likè11,035ExistingFY99:5,900New/Likè9,330Existing 0\\\\#\\\\ 0FY01:FY00:FY99:3,557New/Likè13,014Existing /\\\\E)\\\\ /Improveaccesstohealthcarebyconstructionoftheapprovednewhealthcarefacilities.IHSPlan  \+  0\\\\8,\\\\E 0FY01:completescheduledphaseofconstructionofappropriatedfacilitiesFY00:completescheduledphaseofconstructionofappropriatedfacilitiesFY99:completescheduledphaseofconstructionofappropriatedfacilities 0\\\\8\\\\ 0FY01:FY00:FY99:Accomplished(`A  \\\\ (#XVJX"%&Uh# lXXVJP#XVJXln#ROGRAMSlXXVJS#XVJXlKn#UPPORTINGlXXVJT#XVJXln#HISlXXVJO#XVJXln#BJECTIVE  !B (X@s#s#(AHRQ #D ResearchonHealthCosts,Quality,andOutcomesAoA `&!G SupportiveServices&CentersCongregateMealsHomeDeliveredMealsNationalFamilyCaregiverSupportProgramAlzheimersInitiativeLongTermCareOmbudsman +8'M GrantstoIndianTribesHCFA $N MedicaidMedicareOCR L'"Q PreventingDiscriminationinAccesstoHHSServicesSAMHSA *`%T KnowledgeDevelopmentandApplication  *L&U 5@s#s#X@Co5iU5%!`z  `E`ttx 3i s#s#        s#s#iU5%!`z  `E`ttx 3iL 0 !"#$%&(xhK !"#$%&(L9,X,hX,X,hX9 lXXVJK#XVJXls#EYlXXVJFY2001P#XVJXl-t#ROGRAMS,lXXVJI#XVJXlt#NITIATIVES,ANDlXXVJS#XVJXlt#TRATEGIES  L    3    39u23  0    Comprehensive,CoordinatedCommunityServices. HHScommunityserviceprograms, L  suchasACFsFamilyViolencePreventionProgram,CommunityServicesBlockGrant,HealthyStart,SAMHSAsMentalHealthServicesforChildren,andAoAsAgingNetworkareencouragedtobuildcoordinatedservicenetworks. 39udu݌ s#s# Ќ    3    39w23  0    ACF!TheEmpowermentZone/EnterpriseCommunityInitiative. TheEZ/ECinitiative, <  incooperationwiththeDepartmentofHousingandUrbanDevelopment,providessubstantialfundingandtechnicalassistanceforcommunitydevelopmentcorporationsandotherorganizationstocreatenewbusinessandemploymentopportunities.  39wdw݌s#s# Ќ    3    3Oy23  0    SAMHSATargetedCapacityExpansion(TCE). TheCenterforSubstanceAbuse  TreatmentsTCE4XVJXXXVJwillfocusonvulnerablepopulationswhichincludeminoritycommunities, | women,andyouth.Aspartofa StrengtheningCommunitiesinitiative,serviceswillbetargetedtocertaingeographicareas,includingruralareas,smalltowns,andmetropolitanareasexperiencingparticularlyacutesubstanceabuseproblemswhereappropriatelinkageswillbemadewithEmpowermentZones.Theprogramwillcontinuetoberesponsivetoemergingdrugtrends,notablythoseidentifiedinStateleveldatawhichwillbeavailablefromtheNationalHouseholdSurveyonDrugAbuse.Programsinallareaswillbebasedonsound,scientificallybasedevidenceofeffectiveness.#XVJXX4XVJ6z#Ԁ 3Oyzy݌@s#s# Ќ    3    3n}23  0    ݀ ACF!TemporaryAssistanceforNeedyFamilies .TANFpromoteswork,responsibility  andselfsufficiencyandstrengthensfamiliesthroughfundingofStatedesignedandadministeredprogramsthatprovidesupporttoneedychildrenandmovetheirparentsintowork. 3n}}݌ s#s# Ќ    3    3@23  0    ACF!CommunityServicesBlockGrant .CSBGprovidesarangeofservicesandactivities h"  havingameasurableandpotentiallymajorimpactoncausesofpovertyinthecommunity. 3@k݌ s#s# Ќ    3    323  0    ACF!SocialServicesBlockGrant .SSBGsupportsavarietyofsocialservicestailoredto 0% # supplementStateinvestmentsintheselfsufficiencyandwellbeingoflowincomepopulationsthroughStategrants.SSBGfundsalsohelpimproveandintegrateservices,createcommunitybasedpartnerships,andstimulateinnovations. 3݌ s#s# Ќ    3    3Ȃ23  0    ACF!NativeAmericanPrograms. ACFsSocialandEconomicDevelopmentStrategies ) %( programisbasedonthepremisethatlocalcommunitieshavetheprimaryresponsibilityfordeterminingitsownneeds,planningandimplementingitsownprograms,andforuseofitsownnaturalandhumanresources.Throughadirectgrantfundingrelationship,TribesandNativecommunitieshavecreatedadministrativesystemstooperatetheirownsocialandeconomicprograms,muchinthesamewayasStateandlocalgovernments.Supportforthe p.)- unique,governmenttogovernmentrelationshipthatexistsbetweenTribalgovernmentsandtheFederalgovernmentisreflectedinthisapproach.Additionalpriorityfundingareasincludenativelanguagespreservationandenhancement,environmentalregulatoryenhancement,andenvironmentalmitigation. 3Ȃ݌ s#s# Ќ    3    323  0    HRSA!PrimaryCare,HealthCenters .HRSAsHealthCentersprovideeconomic L  developmentinthecommunitiestheyserve,providingjobsforneighborhoodresidentsandbusinessforlocalenterprises.ManyareparticipatingintheEmpowermentZone/EnterpriseCommunityprogramthroughACFandtheDepartmentofHousingandUrbanDevelopment. 3݌ s#s# Ќ    3    323  0    HRSA!HealthyStart .HRSAfundscommunitiestoreducebarrierstocare,improve  <  perinatalsystems,andsupportprivatesectorpartnershipsthatfacilitatewelfaretoworkandcommunityjobcreation,andreduceracialdisparityinhealthstatus. 31݌ s#s# Ќ    3    3Ɗ23  0    ACF!LowIncomeHomeEnergyAssistanceProgram. LIHEAPblockgrantsprovide   fundstoStates,IndianTribes/TribalorganizationsandInsularareastoassistlowincomehouseholdsinmeetingthecostsofhomeenergy. 3Ɗ݌ s#s# Ќ    3    3h23  0    /XVJXXXVJ CDC!HIV/AIDSPrevention .ThelargestportionofCDCsHIVpreventionresourcesis T awardedtostate,local,andterritorialhealthdepartments.PrioritiesfortheseresourcesaredeterminedthroughtheHIVpreventioncommunityplanningprocess.ThisprocessbringstogetherrepresentativesofaffectedcommunitiesandHIVinfectedpopulationswithhealthdepartmentofficials,scientists,andserviceproviderstoanalyzetheepidemicintheirjurisdiction,assesspreventionneeds,developresourceinventories,identifypriorityneedsintermsofpopulationsandthemosteffectiveinterventionstoreacheachpopulation,anddevelopacomprehensiveplanforHIVpreventioninthejurisdictionthatreflectstheestablishedpriorities.#XVJXX/XVJٌ# 3h݌s#s# Ќ    3    3d23  0    SAMHSA!CSAPsStateIncentiveGrant(SIG)Program willenableGovernors/Statesto  examinetheirStatePreventionSystemsandredirectresourcestocriticaltargetedpreventionserviceswithintheirstates.EightyfivepercentoftheSIGfundswillbedirectedtowardthecommunitylevelforimplementingbestpreventionpracticesandimprovingtheaccess/qualityofservices. 3d݌ s#s# Ќ       4   3    3Β23  0    OPHS !ThroughitsstaffingoftheDepartmentalMinorityInitiativesCoordinatingCommittee $l" (DMICC),OPHSwillguideandcoordinatetheformulationofactionplansfortheimplementationofthefourminorityspecificinitiatives,whichencompassBlacks/AfricanAmericans,Hispanic/Latinos,AmericanIndians/AlaskaNatives,andAsianAmericans/PacificIslanders.Whilenecessarilydiverseintheirscopeandgoals,theseinitiativessharecommonaimsatimprovinginstitutionalinfrastructureandeducationaloutcomesfordisadvantagedminorities. 3Β݌ s#s#    *%) & <  lXXVJS#XVJXl#ELECTEDlXXVJFY2001#XVJXl=#ԀlXXVJP#XVJXl#ERFORMANCElXXVJG#XVJXlՖ#OALSANDlXXVJM#XVJXl!#EASURES   XVJXXXVJ*pq ddSS SS SS nos#s#,SS ,SSS ,SSS +  &\\\\G  &  PerformanceGoals 8\\\\E#!d \\\\G 8  Targets 8\\\\E#!d \\\\E 8  ActualPerformance '<ٕ =\\\\E(&P   \\\\E =#XVJXXXVJ#Increasethenumberofvolunteerhours   contributedbyCSBGconsumersinoneormorecommunitygroupsby3percentoverthepreviousyear(expressedinmillionsofhours).ACFPlan 0\\\\0  \\\\E 0FY01:29.22 FY00:28.93 l   * ,X,hX*  6XVJXXXVJFY99:28.64 X  #XVJXX6XVJH# 0\\\\0 \\\\ 06XVJXXXVJFY01:     FY00: l    FY99: X    FY97:27(baseline) D    FY96:28.06#XVJXX6XVJܛ# /\\\\E0 \\\\ /IncreasetheamountofnonFederalresourcesbroughtintolowincomecommunitiesbytheCommunityServicesNetwork(nonFederalfundsmobilized).ACFPlan 0\\\\t \\\\E 06XVJXXXVJFY01:1.39     FY00:1.38    X  #XVJXX6XVJם#6XVJXXXVJFY99:1.36   #XVJXX6XVJ# 0\\\\t \\\\ 06XVJXXXVJFY01:     FY00:     FY99:   FY97:1.26(baseline)  FY96:1.20#XVJXX6XVJ!#(L#  \\\\ ( lXXVJP#XVJXl)#ROGRAMSlXXVJS#XVJXlu#UPPORTINGlXXVJT#XVJXl #HISlXXVJO#XVJXl #BJECTIVE  h% (X@s#s#(ACF h' CommunityServicesBlockGrantFamilyViolencePreventionProgramsLowIncomeHomeEnergyAssistanceNativeAmericanProgramsSocialServicesBlockGrantCDC @- HIV/AIDSPreventionHCFA / MedicaidMedicare !1 HRSA h1 PrimaryCare,HealthCentersHealthyStartIHS ,|4 DivisionofFacilitiesandEnvironmentalEngineeringOPHS @7 SAMHSA ,8 StateIncentiveGrantsdTargetedCapacityExpansiond  : 5@s#s#X@m5  x#: D<3 ,X XX3iUN5%!`z  `Ett ki s#s#       s#s#iU5%!`z  `Ett ki FromtheHHSStrategicPlan,September1997. Theestimated44millionAmericanswholack $ t anyhealthinsurancecoverage,andtheevenlargernumberwhoarewithoutinsuranceforbehavioralhealthcareservices,areatseriousriskofgoingwithoutessentialhealthcare.Itisamatterofgraveconcernthatthesealreadylargenumbersarerising,andthatemploymentbasedinsurance!!thebedrockofcoverageforworkingAmericans"isdeclining.Thepercentageofthenonelderlypopulationwithemploymentbasedhealthinsurancecoverageshrankfrom69.2percentin1987to63.8percentin1995.Withoutinsurance,accesstohealthservices,particularlyprimary   andpreventiveservices,isseverelycompromised.Otherbarrierstoaccessincludetheabsenceofhealthcarefacilitiesorprofessionals;discriminationongroundsofrace,nationalorigin,age,ordisability;andlanguageorculturalobstaclesthatimpedethedeliveryofcare.ThemajorfederalprogramsarethemechanismsthroughwhichtheDepartmentprovidesaccesstocare:MedicareandMedicaid,thenewStateChildrensHealthInsuranceProgram,theIndianHealthService(IHS),andthesafetynetprograms(CommunityHealthCenters,RyanWhiteCareProgram,SubstanceAbuseandMentalHealthBlockgrants,MaternalandChildHealthProgram).Allareundergoingchangesthataffectaccess.Theagentsofchangeincludetheemergenceofmanagedcare,demographictrends,changesintherelationsamongthecountryslevelsofgovernment,andtheexpandingnumbersofuninsuredindividualswhodependonthesafetynetprograms.TheDepartmentisequallycommittedtothesoundandfiscallyprudentmanagementofalloftheseprograms.Becauseoftheirsizeandscope,theMedicareandMedicaidprogramsareparticulartargetsforfraudandabuseandaccordinglyreceivethehighestpriorityattention.Acoordinatedenforcementeffort!!modeledonthehighlysuccessfulOperationRestoreTrustandinvolvingmultiplecomponentsoftheDepartmentofHealthandHumanServices(HHS),aswellastheDepartmentofJustice(DOJ)"isexpectedtocurbstrictlyandseverelyfraudandabuseintheseprograms.Areasofconcernencompassfraudperpetratedbyprovidersandbeneficiariesaswellasprogrampaymentpoliciesthatmayreimburseexcessivelyforcertaintypesofservices,andmanagementpracticesthatarewastefulorinefficient.TheDepartmentsprogramstrategytargetsallofthese.&  TheDepartmentsstrategyhasthreecomponents.First,HHSwillworkwiththeCongressandthestatestobroadenaccesstoservicesbyenlargingthepercentageof'&Ԁchildrenandadultswhohavehealthinsurancecoverage.Second,theDepartmentwillmaximizethenumberoflowincomeorspecialneedspopulationsservedthroughitsprograms,consistentwiththelevelofappropriationstothoseprograms.Emphasiswillbeonintegratingspecializedsafetynet  l+&* ЀprogramswithMedicareandMedicaid.Third,HHSwillexpanditseffortstopreventwaste,fraud,andabuseinallofitsprograms!!butparticularlyinMedicareandMedicaidbecauseoftheirsizeandtheirimpactonthetotalhealthcaresystem.  t iU5%!`z  `E`ttx 3i s#s#     s#s#iU5%!`z  `E`ttx 3iL 0 !"#$%&(xx0 !"#$%&(L?,X,hX,X X? lXXVJK#XVJXl#EYlXXVJFY2001P#XVJXl'#lXXVJROGRAMS,#XVJXlr#lXXVJI#XVJXl#lXXVJNITIATIVES,AND#XVJXl#lXXVJS#XVJXlR#lXXVJTRATEGIES  L  #XVJXl#  3    323  0    HCFA!StatesChildrensHealthInsuranceProgram .TheBalancedBudgetActof1997 t  createdtheStatesChildrensHealthInsuranceProgram(SCHIP)underTitleXXIiftheSocialSecurityAct.ForFY2001,thestatuteappropriates$4,275,000,000forallotmentstoStatesandterritoriesforthisprogram.HCFAcontinuestoworkwiththeStates,otherpartsofHHS,otherFederalagencies,andtheprivatesectoronabroadarrayofoutreachactivitiestoreachuninsuredchildren.TheseactivitiesincludeeducatingFederalworkers,Stateworkersandgranteesaboutchildrenshealthoutreach,andeducatingfamiliesabouttheirpotentialeligibilityforhealthinsurance.ItalsoincludescoordinatingeffortsacrossStates,communitybasedorganizations,advocacygroups,Governmentgrantees,suchasInformation,Counseling,andAssistanceAgencies(ICAs),andprivatesectorgroupstoidentifyorestablishnetworks,coalitionsandpartnershipsthatcanplayaninstrumentalroleinthedevelopmentandimplementationofoutreachandenrollmentstrategiesforbothMedicaidandSCHIPpopulations. 3$݌ s#s# Ќ    3    3 23  0    HCFA!TheHealthInsurancePortabilityandAccountabilityAct(HIPAA) .HIPAA ` wasenactedtopromoteaccesstohealthinsurancecoveragetopeoplewhohadlosttheirinsurance,oftenthroughjobdislocation,orwhowerepreviouslyuninsurablebecauseoftheirhealthstatus.HHS,throughHCFA,isresponsibleforensuringthatStatesenforceHIPAAprovisionswithrespecttoissuersofcoverageinthegroupandindividualmarkets.IfStatesdonothavesimilarprotectionsinplace,donotpassappropriatelaws,ordonotsubstantiallyenforcethem,HCFAisrequiredtotakeenforcementactions.SinceHCFAhasnowassumedenforcementauthorityinthreeStates,wemusttakeoncertainresponsibilitieswhichwerepreviouslyconductedbytheState.ThisreflectsasignificantnewroleforHCFA. 3 K݌ s#s# Ќ    3    3 23  0    HCFA!QualifiedMedicareBeneficiary(QMB)ortheSpecifiedLowIncomeMedicare ! Beneficiary(SLMB)programs . AcentralconcernofHCFAisthatMedicarebeneficiariesare "  abletogetthecaretheyneedwhentheyneedit,andthattheyarenotimpededbyfactorssuchascost,healthstatus,location,oravailabilityofprimarycarephysiciansorspecialists.Thisistruenotonlyforbeneficiariesasaclass,butmostespeciallyforvulnerablesubgroupssuchaspersonswithdisabilitiesandmembersofminorityandeconomicallydisadvantagedpopulations.HCFAsgoalwithregardtothisconcernsistoimproveaccesstocareforelderlyanddisabledMedicarebeneficiarieswhodonothavepublicorprivatesupplementalinsurance.Intheinitialyearsofitsendeavortowardthisgoal,HCFAwillconcentrateonenrollmentofindividualswhoareeligiblefortheQualifiedMedicareBeneficiary(QMB)ortheSpecifiedLowIncomeMedicareBeneficiary(SLMB)programs.TheseprogramswereenactedtohelplowincomeMedicarebeneficiarieswiththeirMedicarecostsharingexpenses.Statesarerequiredtopayforthepremiums,deductibles,andcostsharingforQMBs,andthePartBpremiumfor SLMBs.Despitetheexistenceoftheseprograms,ithasbeendocumentedthatasubstantial -(, proportionofindividualseligiblefortheseprogramsarenotenrolled.(Forexample,twostudiesestimatednonparticipationratesforQMBtorangefrom40to60percent.)  3 7݌s#s#     3    323  0    HCFA!Medicare/MedicaidLinkedDataFiles .Asevidentinthepreviousinitiative, t individualswhoareduallyeligibleforMedicareandMedicaidareanimportantandgrowingsegmentofbeneficiaries.ThroughcontinuedinnovationandreformintheMedicareandMedicaidprograms,HCFAfostersaservicedeliverysystemthatisbetterintegratedandmoreflexibleinmeetingtheneedsofduallyeligiblebeneficiaries.ThejointFederalandStateinterestindualeligibleshasresultedinanexaminationofthedatathatareavailabletoobtainknowledgeaboutthedemographiccharacteristics,healthstatus,diseaseepisodes,supportservices,healthservicesutilization,andexpendituresofthispopulation.HCFAisprovidingtheStateswiththeMedicareutilizationdatafordualeligiblesandenablingtheStatestodotheirownlinkingwiththeirMedicaidfiles.ThiswillrespondtoStatesneedsandprovidethemwithflexibilitytoperformStatespecificdataprojects.  3 ݌ s#s# Ќ    3    323  0    HRSA!PrimaryCare,HealthCenters .HRSA'sHealthCenterswillundertakeoutreach   incentivesandenrollmentassistancetotheuninsuredwhoareeligibleforcoverageundertheStateChildHealthInsuranceProgramorMedicaid.CentersinasignificantnumberofStatesarealreadyparticipatinginanOutstationedEligibilityDemonstrationincollaborationwithHCFA.TheseandotheroutreacheffortswillbeextendedinFY2000. 3݌ s#s# Ќ    3    323  0    HRSA!MaternalandChildHealthBlockGrant .TitleVandCSHCNprogramdirectors d workwiththeMedicaidandSCHIPprogramdirectorsintheirstatetoidentifyandenrollMedicaidandSCHIPeligiblechildren.ThishasbeenamajorpriorityandthesubjectofmanynationalmeetingsandcommunicationssincethepassageofSCHIPlegislation. 3:݌ s#s# Ќ    3    3023  0    HRSA!MaternalandChildHealth,HealthyStart .HRSA,incollaborationwithStates,  willintensifyitstechnicalassistancetotheHealthyStartprojectstofacilitatetrainingofprojectstaffandcommunityresidentsonoutreach,education,eligibilityassessment,andenrollmentactivities.Inaddition,theHealthyStartprojectswillsupportthemonitoringofqualityofservicesprovidedunderCHIPandserveasadvocatesinbreakingdownbarrierstocareforfamilies. 30[݌ s#s# Ќ    3    323  0    XVJXXXVJ OCR!#XVJXXXVJI#PreventingDiscriminationinAccesstoHHSServices .OCRwillcontinueto ,#|! providetechnicalassistanceandtrainingtoHCFAandHRSAstaffinreviewingstateCHIPplans,notingcivilrightsconcerns/problems.OCRwillfollowupwithstateagencies,providingtechnicalassistanceandoutreachastheyimplementandmodifytheirplanstoensurethattheyincorporatemethodsofprogramadministrationthatguaranteeeffectivecivilrightsprotectionforprogramparticipants. 3݌ s#s# Ќ    3    323  0    XVJXXXVJ OPHS !OPHSprovidespolicyanalysisandOPHSperspectiveonawide-varietyofissues )$( associatedwiththeimplementationoftheStateChildHealthInsuranceProgramandChildHealthInitiative.#XVJXXXVJ;# 3݌+&*s#s#    l,'+ & D  lXXVJS#XVJXl#lXXVJELECTED#XVJXl#lXXVJFY2001#XVJXlh#lXXVJԀ#XVJXl#lXXVJP#XVJXl#lXXVJERFORMANCE#XVJXl7#lXXVJG#XVJXl#lXXVJOALSAND#XVJXl#lXXVJM#XVJXl#lXXVJEASURES   ll#XVJXlU#&U"%XXVJ*Or ddSS SSS SSSS Spqs#s#,SS ,SSS ,SSS +  &\\\\G ( &  PerformanceGoals 8\\\\E#!< \\\\G 8  Targets 8\\\\E#!< \\\\E 8  ActualPerformance 'D =\\\\E(&h   \\\\E =#&U"%"%&U##XVJX"%&U#&U"%XXVJ&U"%"%&UDecreasethepercentofchildrenwithouthealth   insurance.#&U"%"%&Ut##XVJX"%&UU#&U"%XXVJԀHRSAPlan 0\\\\d \\\\E 0&U"%"%&UFY01:10%#&U"%"%&U##XVJX"%&U'#&U"%XXVJ     0\\\\d  \\\\ 0&U"%"%&UFY01:    FY00:FY99:#&U"%"%&UZ#&U"%"%&UԀ#&U"%"%&U#&U"%"%&U01/01 @   FY98:04/00FY97:14%FY96:FY95:14%#&U"%"%&U##XVJX"%&U#&U"%XXVJ /\\\\E \\\\ /&U"%"%&UIncreasethepercentofpotentiallyMedicaideligible  p  childrenwhohavereceivedaservicepaidbytheMedicaidprogram.#&U"%"%&U##XVJX"%&U#&U"%XXVJԀHRSAPlan 0\\\\( \\\\E 0&U"%"%&UFY01:80%#&U"%"%&UN##XVJX"%&U#&U"%XXVJ 0\\\\ p \\\\ 0&U"%"%&UFY01:  p  FY00:FY99:#&U"%"%&U #&U"%"%&UԀ01/01#&U"%"%&Uv#&U"%"%&U (  FY98:04/00FY97:70%#&U"%"%&U##XVJX"%&U#&U"%XXVJ /\\\\E\\\\ /&U"%"%&UIncreasethenumberofuninsuredandunderserved P personsservedbyHealthCenters,withemphasisonareaswithhigh#&U"%"%&U#&U"%"%&Uproportionsofuninsuredchildrento  helpimplementtheSCHIPprogram.#&U"%"%&Ug##XVJX"%&UO#&U"%XXVJԀHRSAPlan 0\\\\\\\\E 0&U"%"%&UFY01:9.7M P FY00:9.6MFY99:8.9M#&U"%"%&U##XVJX"%&U&#&U"%XXVJ 0\\\\"\\\\ 0&U"%"%&UFY01: P# FY00:FY99:5/00(9.15est)FY98:8.7MFY97:8.3M#&U"%"%&U##XVJX"%&U5#&U"%XXVJ /\\\\Ep'\\\\ /IncreaseenrollmentofeligibleMedicarebeneficiariesinprogramsforduallyeligiblebeneficiaries,suchastheQMBandSLMBprograms.HCFAPlan 0\\\\t+\\\\E 0&U"%"%&UFY01:Willsettarget 0, duringFY2000FY00:Increaseenrollmentby4%FY99:#XVJX"%&U9#Establisha P0 target&U"%XXVJԀ#&U"%"%&UP##XVJX"%&U#&U"%XXVJ 0\\\\<1\\\\ 0&U"%"%&UFY01: 02 FY00:FY99:#XVJX"%&U#YXXVJ&U"%YGoalMet#Y"%&Uk##YY#&U"%Y /\\\\EP6\\\\ /EnsurecompliancewithHIPAArequirementsindirectenforcementStates(California,Missouri,andRhodeIsland)byincreasingtheuseofpolicyformreviews.HCFAPlan 0\\\\P":\\\\E 0&U"%"%&UFY01:60%  ; FY00:30%FY99:#Y"%&U#P<%YNewIn2000#Y%P FY00:FY99:#Y"%&U#P<%YԀNewIn2000#Y%P<##YY6#&U"%Y(t!@  \\\\ (#Y"%&U#XVJXY lXXVJP#XVJXl#lXXVJROGRAMS#XVJXl#lXXVJS#XVJXl.#lXXVJUPPORTING#XVJXlq#lXXVJT#XVJXl#lXXVJHIS#XVJXl#lXXVJO#XVJXlF#lXXVJBJECTIVE  4% B #XVJXl#(X@s#s#(HCFA 4'"D MedicareMedicaidChildrensHealthInsuranceProgramHealthInsurancePortabilityandAccountabilityProgramMaternalandChildHealth,HealthyStart , (J CommunityHealthCentersOPHS  (p#K OfficeofDiseasePreventionandHealthPromotionOCR *4&N PreventingDiscriminationinAccesstoHHSServices  , (P 5@s#s#X@5iU5%!`z  `E$tt< i s#s#       s#s#iU 5%!`z  `E$tt< iL 0 !"#$%&(xx0 !"#$%&(L9,X,hX,X,hX9 lXXVJK#XVJXl#EYlXXVJFY2001P#XVJXl>#lXXVJROGRAMS,#XVJXl#lXXVJI#XVJXl#lXXVJNITIATIVES,AND#XVJXl#lXXVJS#XVJXli#lXXVJTRATEGIES  `   3    323  0    #XVJXl# HRSA ! /XVJXXXVJPrimaryCare,#XVJXX/XVJ#HealthCentersandtheNationalHealthServiceCorps .HRSAs   HealthCentersandtheNationalHealthServiceCorpsformacosteffective,integratedsafetynetforunderservedanduninsuredchildren,adults,migrantworkers,homelessindividuals,publichousingandU.S./Mexicoborderresidentsinapproximately4,000communitiesacrossthecountryandwillserveover11.0millionpersonsinFY2000whowouldotherwiselackaccesstoprimarycareclinicians.Thiscommunitybasednetworkdeliverspreventiveandprimarycareservicesfortheneediest,poorest,andsickestpatientsinruralandinnercityareas,throughaFederal,State,andcommunitypartnershipapproach.HealthCentersandtheNHSCcontributetodecreasesinracialandincomedisparitiesbyprovidingpreventiveservicesandriskreductiontoapopulationthatislargelyminority(64%)andlowincome(86%)anddisproportionatelyuninsured(41%). 3݌ s#s# Ќ    3    323  0    HRSA!MaternalandChildHealthBlockGrant(MCHBG). 󀀀XVJXXXVJStateTitleVprogramsuse  appropriatedformulagrantfundsforcapacityandsystemsbuilding,publicinformationandeducation,knowledgedevelopment,outreachandprogramlinkage,technicalassistance,providertraining,evaluation,supportfornewbornscreening,leadpoisoningandinjuryprevention,additionalsupportservicesforchildrenwithspecialhealthcareneeds,andpromotionofhealthandsafetyinchildcaresettings.Specialeffortsaremadetobuildcommunitycapacitytodeliversuchenablingservicesascarecoordination,transportation,homevisiting,andnutritioncounseling.Wherenoservicesareavailable,StatesalsouseTitleVtosubsidizeorprovidecategoricaldirectcare.#XVJXXXVJ# 3݌$ts#s# Ќ  0  MCHBGalsoprovidesassistanceandcareforsomeofthenewchildrenandcriticalnew needs L identifiedbySCHIPandMedicaidoutreachthatcannotbemetbyMedicaidorStateChildHealthplans,suchasadditionaltranslation,casemanagement,transportation,specialpublichealth,disability,andgapfillingservices(frequentlyreferredtoas enablingservices)neededtomakeMedicaideffectiveforlowincomechildren. s#s#   3    323  0    HRSA!MaternalandChildHealth,HealthyStart .4XVJXXXVJHealthyStartfocusesontheneedto $" strengthenandenhancecommunitysystemsofperinatalhealthbyhelpingcommunitiestofullyaddressthemedical,behavioralandpsychosocialneedsofwomenandinfants.TheFY2001programwillprovideforacontinuingopportunitytoreducefactorscontributingtoinfantmortalitybyadaptationofsuccessfulHealthyStartmodelsofinterventioninurbanandruralcommunitieswithhighratesofinfantmortality,especiallyamongracial/ethnicpopulations,andtosharethelessonslearnedwithStates,communities,andacademicandprofessionalorganizations. 3݌ s#s# Ќ    3    3G23  0    #XVJXX4XVJ#/XVJXXXVJ OPHS/HRSA!FamilyPlanningProgram. #XVJXX/XVJ#4XVJXXXVJԀThisprogramsupportsanationwidenetworkof +<'* 4,600clinicsandprovidesreproductivehealthservicestoapproximately4.5millionpersonseachyear.Inadditiontocontraceptiveservices,TitleXalsosupportsabroadrangeof -), preventionorientedreproductivehealthcareactivities,includingcounseling,routinegynecologicalcare,HIVandSTDpreventioneducation,hypertensionscreening,reproductivecancerscreening,andtestingandtreatmentforsexuallytransmitteddiseases. 3Gr݌ s#s# Ќ  #XVJXX4XVJJ#  3    3 23  0    HRSA!MaternalandChildHealth,UniversalNewbornHearingScreening .This ` partnershipwithCDC,NIH,andtheDepartmentofEducationwillpromoteuniversalnewbornhearingscreeningpriortohospitaldischargetherebygreatlyloweringtheageatwhichchildrenwithcongenitalpermanenthearinglossareidentifiedandincreasingtheabilityofthesechildrentoperformonschoolrelatedmeasures.HRSAwilladdress4XVJXXXVJԀcriticalgapsbysupportinggrants  d totheStatestodevelopandexpandstatewideuniversalnewbornhearingscreeningprograms,linkscreeningprogramstointerventionwithinthecommunityservicesystem,monitortheimpactofearlydetectionandinterventiononchild,family,andsystems,andprovidetechnicalassistance.#XVJXX4XVJ # 3  ݌ s#s# Ќ  XVJXXXVJ  3!    323  0    #XVJXXXVJ# HRSA!MaternalandChildHealth,EmergencyMedicalServicesforChildren (EMSC).   AjointeffortofHRSAandtheNationalHighwaySafetyAdministration,EMSCisdesignedtoensurethatallchildrenandadolescents,nomatterwheretheyliveorwheretheytravel,canreceiveappropriatecareinahealthemergency.Itseekstoimproveallaspectsofchildrensacuteemergencymedicalcare,includingprehospitalcare,emergencydepartmentcare,hospitalcare,andrehabilitation,andtopreventsuchemergenciesfromoccurring.XVJXXXVJԀFY2001 < fundswillenabletheStatestocontinuetopromotetheregionalizationofcareandtomakesystemimprovementstoensurethatallcomponentsofaneffectiveEMSCsystemareinplace. 33݌ s#s# Ќ  #XVJXXXVJ#  3"    3$23  0    CDC!Immunizations .TheNationalImmunizationProgram(NIP)focusesonseveralmajor < programmaticareastoachieveitsgoals,includingchildhoodimmunization,adultimmunization,andglobalpolioeradication.AlthoughNIPhasassistancefrommanypartners,stateandlocalhealthagenciesplayaprimaryroleinhelpingNIPcarryoutitsmissionintheUnitedStates.NIPensuresqualityimmunizationservicesbyawardinggrantstostatesandlargelocalhealthdepartments;offeringtechnical,epidemiologic,andscientificassistancetostateandlocalareas;monitoringimmunizationcoverage;ensuringanadequatesupplyofvaccinebyoverseeingvaccinepurchasesmadethroughCDCcontractsandmanagingtheVaccinesforChildrenprogram;developingimmunizationregistries;andconductingoperationalresearchtodevelopnewandimproveddeliverystrategies. 3$O݌ s#s# Ќ    3#    3O23  0    HCFA!ChildhoodImmunization .XVJXXXVJImmunizationinchildrenwiththecompleteseriesof $d" vaccinationsinthefirsttwoyearsoflifeisawidelyacceptedhealthcarestrategy.Itisahighlyeffectiveinterventiontopreventanumberofdiseasesinchildrenandtopreventseriousoutbreaksofillness.TheMedicaidprogramcoversvaccinesforchildrenasabasicmandatorycoveredservice.ThecentralimportanceofchildhoodimmunizationisalsorecognizedbytheStatesChildrensHealthInsuranceProgram(SCHIP).Underthelegislation,StatesthatcreateaseparateSCHIPprogrammustincludecoverageofthecompleteseriesofimmunizations.Statesalsoareprohibitedfromimposingcopaymentsordeductiblesonimmunizationservices.  3Oz݌x+&*s#s# Ќ    3$    3323  0    HCFA!PeerReviewOrganizations .#XVJXXXVJ#Appropriateuseofeffectivemedicalservicesisa P-(, criticalcomponentofHCFAsfocusonMedicarebeneficiaries.HCFAseffortstoimprove @.)- medicaltreatmentthroughitscollaborationwithPeerReviewOrganizationsisthebasisforitsperformancegoalsto:1)increaseinfluenzavaccination,2)increasetheuseofmammograms,3)increaseheartattacksurvival,and4)increasediabeticeyeexams.PROs,whichserveundercontractwithHCFA,conductcooperativeimprovementprojectsinwhichtheyusedatatoidentifyopportunitiestoimprovecare,andthenworktodevelopinterventionsthatwillbringimprovementforsubjectqualityindicators.PertinenttotheHCFAperformanceplan,HCFAandthePROsareworkingwithproviders,healthplans,andothersoninfluenzavaccinationprojects,andarenetworkingwithlocalprojectcollaboratorstoprovideeducationandreminderstoimprovemammographyrates. 33^݌ s#s# Ќ    3%    323  0    ACFHeadStart emphasizestheimportanceoftheearlyidentificationofhealthproblems.  8  Everychildisinvolvedinacomprehensivehealthprogram,whichincludesimmunizations,medical,dental,andmentalhealth,andnutritionalservices.XVJXXXVJ 3 ݌ s#s# Ќ    3&    3!23  0    #XVJXXXVJk!#/XVJXXXVJ CDC!Tuberculosis. CDChasdevelopedanationalplantoeliminateTBfromourcountry.   Toachievethisgoal,CDCworkswithlocal,state,national,andinternationalpartnerstoimprovetheprevention,diagnosis,andtreatmentofTBdisease.InadditiontopromotingthemoreeffectiveuseofexistingtoolsforcombatingTB,CDCisworkingtodevelopnewdiagnosticandtreatmenttools.#XVJXX/XVJb"#XVJXXXVJ 3!!݌Ps#s# Ќ    3'    3$23  0    #XVJXXXVJH$#/XVJXXXVJ CDC!BreastandCervicalCancerPrevention .ThroughCDCsNationalBreastand (x CervicalCancerEarlyDetectionProgram(NBCCEDP),CDCsupportsactivitiesatthestateandnationallevelintheareasofscreening,referralandfollowupservices,qualityassurance,publicandprovidereducation,surveillance,collaboration,andpartnershipdevelopment.Thescreeningprogramensuresthateligiblewomenhaveaccesstothesepreventiveservices,andthatstateprograms:informallwomenofthevalueofearlydetection,educatephysiciansaboutrecommendedscreeningguidelines,ensurethequalityofmammogramsandPaptests,monitorprogrameffectivenessthroughappropriatesurveillanceandevaluationactivities,andbuildeffectivecommunitybasedpartnershipsforearlydetectionandfollowup.#XVJXX/XVJ?%#XVJXXXVJ 3$$݌s#s# Ќ    3(    3()23  0    #XVJXXXVJ(#/XVJXXXVJ CDC!DiabetesandOtherChronicDiseases .Inordertopreventorsignificantly d  amelioratethedisablingandcostlycomplicationsofdiabetes,CDCsDiabetesControlProgramsemphasizeensuringthatpersonswithdiabeteshaveaccesstoqualitydiabetescareandservices.InFY1999,CDCprovidedsupportto16statesatthecomprehensivelevel.Comprehensiveprogramsincludecoreprogramactivitiesandemphasizeimplementationofpublichealthstrategiesthroughouttheentirestate,withanexpectedimprovementinaccesstoaffordable,highqualitydiabetescareandservices.#XVJXX/XVJ)#XVJXXXVJ 3()S)݌%@!$s#s# Ќ    3)    3,23  0    #XVJXXXVJf,#/XVJXXXVJ IHS!RestoringAccesstoHealthCareInitiative .InFY2000,IHSbegananinitiativeto '#& restoreaccesstobasichealthservices,includingassuringthatthereareadequatefacilitiesandequipmentfortheprovisionofhealthservicesandprovidingadequatesupportservicestothetribalhealthdeliverysystem. 3,,݌ s#s# Ќ  #XVJXX/XVJ]-#XVJXXXVJ  3*    3P/23  0    #XVJXXXVJ0/# HRSA!RuralHealthOutreachGrants .TheRuralHealthOutreachandRuralNetwork h,'+ DevelopmentGrantProgramssupportthedeliveryofbasichealthservicestohundredsofthousandsofAmericanslivinginunderservedruralareasofthecountry.Awiderangeof D.)- servicesincludingprimarycare,mentalhealth,dentalcare,healtheducation,specialtycare,hospicecareareprovidedthroughtheOutreachGrantProgramtosmallruralcommunitiesinalmosteverystate.AfewothercommunitiesarereceivingNetworkDevelopmentGrantstohelpthemdevelopfullyintegratedsystemsofcare.Thesesystemsusuallyinvolveeffortsbythelocalhospital,physiciansgroups,longtermfacilitiesandevenpublichealthagenciestobetterorganizeandmanagescarcehealthcareresourcesinruralcommunities. 3P/{/݌ s#s# Ќ    3+    3s323  0    HRSA!Telehealth .HRSAwillcontinueitscurrentruraltelehealthactivitiesandanticipates $ t supportingexploratoryactivitiesinurbanunderservedcommunities.HRSAwillsupportprojectstoexaminetheroleoftelecommunicationsinimprovingtheabilityofruralcommunitiestoimprovethequalityofcareservicesandeducationalopportunitiesforhealthprofessionals.HRSAwillalsoprovidesupportforanassessmentofthepracticalvalueoftelehealthtechnologiesforreachingtheunderserved,isolatedpopulationsinurbansettings.Furtherfundswillbeprovidedtosupporttworegionaltechnicalassistancecentersthatwillprovidetechnicaladvicetolocalcommunitiesandprovidersonthedevelopmentoftelehealthprograms. 3s33݌ s#s# Ќ    3,    3#723  0    HRSA!HealthProfessions !FY2001strategiesforimprovingaccesstohealthcareinclude ` increasingthenumberofhealthcareandpublichealthprovidersfromminorityanddisadvantagedbackgrounds;fosteringcommunitybasededucationandtrainingespeciallyinunderservedareas;supportingtrainingthatisdirectedatthespecialneedsofvulnerable,underservedpopulations;andenhancingservicetounderservedcommunities. 3#7N7݌ s#s# Ќ    3-    3923  0    OCR ! PreventingDiscriminationinAccesstoHHSServices .XVJXXXVJRecentstudiesbyHHS, < variousnonprofitorganizations,universitiesandotherpublicagencieshaveshedlightonseriousdisparitiesinthehealthstatusofraceandethnicminoritiesandinpractitionerreferralsofminoritiesforspecificdiagnosticandtherapeuticprocedures.OCRistakingstepstodeterminewhetherviolationsofTitleVIandotherlawsenforcedbyOCRarecontributingfactorstothesedisparities.OCRhasbeguntheprocessofstudyingtheissuebyconductingresearch,meetingwithcommunitybasedorganizations,medialproviders,publicofficials,andconcernedindividuals.Inaddition,OCRwillcontinuetoworkwithhealthcareandsocialservicesproviders,stateandlocalagenciesandHHSpartners,toensurethatpersonsoflimitedEnglishproficiencyarenotdiscriminatedagainstonthebasisofnationalorigin. 399݌ s#s# Ќ  0  OCRwillconcentrateitsresourcesonthecriticalcivilrightsissuessurroundingchangesinhealthcarecoverageandservices,includingincreaseduseofmanagedcare,thatareundertakeninthestates.#XVJXXXVJ^:#XVJXXXVJԀOCRwillfocusonassessingtheeffectsofmanagedcareonservices %T#&U"%XXVJ#&U"%"%&US#&U"%"%&U /\\\\E, |5\\\\ /AssureaccesstopreventiveandprimarycareforuninsuredindividualsintheHealthCenters.#&U"%"%&U0U#&U"%"%&U#XVJX"%&UT#&U"%XXVJԀ#XVJX"%&U@V#&U"%XXVJԀHRSAPlan#XVJX"%&UV#&U"%XXVJ#&U"%"%&UU#&U"%"%&U 0\\\\T#8\\\\E 0Ѐ HCNHSC  !9 FY01:45%4.37M1.0MFY00:43%4.10M.99MFY99:42%3.80M.88M#XVJX"%&UV#&U"%XXVJ#&U"%"%&UW#&U"%"%&U 0\\\\4$<\\\\ 0FY01:FY00:FY99:5/00FY98:41%FY97:39%(HC)#&U"%"%&UVX#&U"%"%&U#XVJX"%&UX#&U"%XXVJ /\\\\E%8!B\\\\ /DecreaseproportionofHealthCenteruserswhoarehospitalizedforpotentiallyavoidableconditions.#&U"%"%&UX#&U"%"%&U#XVJX"%&U?Y#&U"%XXVJԀHRSAPlan 0\\\\)`$E\\\\E 0FY01:13FY00:13.5FY99:14#&U"%"%&UZ#&U"%"%&U#XVJX"%&UWZ#&U"%XXVJ 0\\\\)`$H\\\\ 0FY01:FY00:FY99:FY98:5/00FY97:14.7/1000#XVJX"%&U;[#&U"%XXVJ#&U"%"%&UZ#&U"%"%&U *&M  Norm: 18.9/1000#&U"%"%&U \#&U"%"%&U#XVJX"%&U[#&U"%XXVJ /\\\\E,'O\\\\ /ThepercentageofTBpatientsthatwill completeacourseofcurativeTBtreatmentwithin12monthsofinitiationoftreatment(somepatientsrequiremorethan12months).#XVJX"%&U\#&U"%XXVJ#&U"%"%&U\#&U"%"%&U   CDCPlan 0\\\\ \\\\E 0FY01:88%FY00:85%FY99:85%#&U"%"%&UA^#&U"%"%&U#XVJX"%&U]#&U"%XXVJ 0\\\\ \\\\ 0FY01:Mid/03FY00:Mid/02FY99:Mid/01FY97:72.4%FY94:67.6%#XVJX"%&U8_#&U"%XXVJ#&U"%"%&U^#&U"%"%&U /\\\\E  \\\\ /AminimumpercentageofcontactsofinfectiouscaseswhoareplacedontherapyforlatentTBinfectionwillcompleteatreatmentregimen.#&U"%"%&U/`##XVJX"%&U_#&U"%XXVJԀCDCPlan 0\\\\\\\\E 0FY01:78%FY00:75%FY99:75%#XVJX"%&ULa#&U"%XXVJ 0\\\\ \\\\ 0FY01:Late/03FY00:Late/02FY99:Late/00FY97:71.6%FY93:68.4%#XVJX"%&Ua#&U"%XXVJ /\\\\E\\\\ /#XVJX"%&Ub#&U"%XXVJ&U"%"%&UIncreaseproportionofHealthCenterwomen  $  receivingageappropriatescreeningforcervicalandbreastcancer.HRSAPlan#&U"%"%&U6c#&U"%"%&U#XVJX"%&Uc#&U"%XXVJ   #&U"%"%&U d##XVJX"%&UMd#&U"%XXVJ 0\\\\ \\\\E 0&U"%"%&U UptodatePAPTests #&U"%"%&Ue##XVJX"%&Ud#&U"%XXVJ  $  &U"%"%&UFY01:94%   FY00:92%FY99:90% UptodateMammograms #&U"%"%&Ue#&U"%"%&U#XVJX"%&Ue#&U"%XXVJ lp# 92,B X,X,hX9FY01:70%FY00:67.5%FY99:65% UptodateClinicalBreast #&U"%"%&U]f##XVJX"%&Uf#&U"%XXVJ&U"%"%&U ( FY01:85.5%FY00:84%FY99:82.5%#&U"%"%&Ug##XVJX"%&Ug#&U"%XXVJ 0\\\\LP+\\\\ 0&U"%"%&UFY01:FY00:4/01FY99:5/00FY95:88.5%FY01:FY00:4/01FY99:5/00FY95:62.5%FY01:FY00:4/01FY99:5/00FY95:80.5%#&U"%"%&Uh##XVJX"%&U[h#&U"%XXVJ /\\\\E(,:\\\\ /&U"%"%&UExcludingbreastcancersdiagnosedonand ; initialscreenintheNBCCEDP,atleast73%ofwomenaged40andolderwillbediagnosedatlocalizedstage.CDCPlan#&U"%"%&Ui##XVJX"%&Ui#&U"%XXVJ ,!0>  0\\\\" ?\\\\E 0FY01:73%FY00:72%FY99:71%#XVJX"%&Uk#&U"%XXVJ 0\\\\P TB\\\\ 0FY01:FY00:FY99:3/00FY98:70%FY95:70%#XVJX"%&Uk#&U"%XXVJ /\\\\E" G\\\\ /&U"%"%&UExcludinginvasivecervicalcancers x#|H diagnosedonaninitialscreenintheNBCCEDP,theageadjustedrateofinvasivecervicalcancerinwomenaged20andolderisnotmorethat24per100,000Paptestsprovided.CDCPlan#&U"%"%&Ul##XVJX"%&UPl#&U"%XXVJ ' M  0\\\\(!N\\\\E 0&U"%"%&UFY01:Nomorethan22 x#|O per100,000FY00:Nomorethan22per100,000FY99:Nomorethan22per100,000#&U"%"%&U^n##XVJX"%&Um#&U"%XXVJ 0\\\\' T\\\\ 0&U"%"%&UFY01: x#|U FY00:FY99:3/00FY98:23per100,000FY95:26per100,000#&U"%"%&Uo##XVJX"%&U@o#&U"%XXVJ /\\\\E|)"\\\\\ /IncreasethepercentageofMedicareBeneficiariesage65andoverwhoreceiveamammogrameverytwoyears. HCFAPlan 0\\\\ \\\\E 0#XVJX"%&URp#&U"%XXVJFY01:51%* `d FY00:60%**FY99:59%**#XVJX"%&Uq#P<%XXVJ*Newdatasource(MedicareClaims    Data)willbeemployedforFY2001.**Datasource:NationalHealthInterviewSurvey#XVJX%P<r# 0\\\\ \\\\ 0FY01:FY00:FY99:FY98:FY97:45%*FY94:55%**&U"%XXVJ /\\\\E \\\\ /#XVJX"%&U3s#&U"%XXVJIncreasethepercentageofMedicare   beneficiariesage65yearsandolderwhoreceivevaccinations.0 / !0[//annualinfluenzavaccinationhl [[ 0 / !0[//lifetimepneumococcalvaccinationHL"[[ HCFAPlan#XVJX"%&Us#&U"%XXVJ 0\\\\&\\\\E 0#XVJX"%&U7u#&U"%XXVJFY01:72%* hl + FY00:60%**FY99:59%**#XVJX"%&Uu#&U"%XXVJFY01:55%*FY00:#XVJX"%&U,v#&U"%XXVJNewin2001 $(4 FY99:Newin2001#XVJX"%&Uv# 5 P<%XXVJ*Newdatasource(MedicareCurrent 7 BeneficiarySurvey)willbeemployedforFY2001.#XVJX%P<w#Ԁ 9 P<%XXVJ**Datasource:NationalHealth : InterviewSurvey#XVJX%P#XVJX"%&Uz#&U"%XXVJ 0\\\\<"@T\\\\ 0FY01:FY00:FY99:10/00FY98:Eye64.7%̀Foot56.5%FY96:Eye62%̀Foot52%#XVJX"%&U{#&U"%XXVJ /\\\\E&]\\\\ /&U"%"%&UIncreasepercentofHealthCenteruserswith ' ^ diabeteswithuptodatetestingofglycohemoglobin!%adultswithdiabetestestedatrecommendintervals.HRSAPlan󀀀 *#a #&U"%"%&U|##XVJX"%&Ud|#&U"%XXVJ 0\\\\h+l$b\\\\E 0&U"%"%&UFY01:90% ' c FY00:80%FY99:60%*#&U"%"%&U>~#&U"%"%&U#XVJX"%&U}#&U"%XXVJ )"e #&U"%"%&U~##XVJX"%&U~#&U"%XXVJ*DiabetesInitiativeat90%forfirst100HCs 0\\\\D,H%h\\\\ 0&U"%"%&UFY01: ' i FY00:FY99:6/00FY98:43%(97study)#&U"%"%&U##XVJX"%&Uq# &U"%XXVJ *#l  &U"%"%&UNorm :20%_#&U"%"%&UԀ##XVJX"%&U#&U"%XXVJ /\\\\ED,H%n\\\\ /&U"%"%&UIncreaseproportionofHealthCenteradults `d  withhypertensionwhoreporttheirbloodpressureisundercontrol.#&U"%"%&U##XVJX"%&Ua#&U"%XXVJԀ&U"%"%&UHRSAPlan#&U"%"%&Û##XVJX"%&U#&U"%XXVJ 0\\\\ \\\\E 0&U"%"%&UFY01:96% `d FY00:93%FY99:92%#&U"%"%&U##XVJX"%&U@#&U"%XXVJ 0\\\\ \\\\ 0&U"%"%&UFY01: `d FY00:4/01FY99:5/00FY95:90%#&U"%"%&Uw##XVJX"%&U(#&U"%XXVJ /\\\\E  \\\\ //&U"%"%&UDevelopandoperatecollaborativemodelsof d h  healthcareservicesinruralareaswhichwillserve_underserved_Ԁpopulations.#&U"%"%/&Ug#&U"%"%&U#XVJX"%&U#&U"%XXVJԀHRSAPlan    #&U"%"%&UV##XVJX"%&U#&U"%XXVJ&U"%"%&U 0\\\\ \\\\E 0#&U"%"%&UB#/&U"%"%&UFY01:854,000* d h FY00:764,000FY99:680,000FY98:616,000    #/XVJX"%/&U##/P<%X/XVJ* numberofpersonsserved peryear#/XVJX%/P#NotApplicable&U"%%P< %Z FY01:#P<%"%&U#NotApplicable&U"%%P<Ԁ Z'^ \ FY00:#P<%"%&U#NotApplicable&U"%%P< )"^ FY99:#P<%"%&U#NotApplicable&U"%%P< /\\\\E)"_\\\\ /Increase#P<%"%&U#&U"%%P<ԀthepercentageofHeadStart ^+b$` childrenwhoreceivenecessarymedicaltreatment. 0\\\\-&b\\\\E 0FY01:92%FY00:90%FY99:88% 0\\\\-&e\\\\ 0FY01:FY00:FY99:87%FY98:88% /\\\\E-&i\\\\ /Inordertoincreaseaccessforminoritiesandpersonswithdisabilitiestonondiscriminatoryservicesinmanagedcaresettings,OCRwillincrease#managedcareplansfoundtobeincompliancewithTitleVI,Section504andtheAmericanswithDisabilitiesAct.Measure:Increased#ofcorrectiveactionsandnoviolationfindings#P<%"%&U:#&U"%%P<. d h OCRPlan 0\\\\@D \\\\E 0#P<%"%&U #&U"%%P<FY01:33 `d  FY00:30FY99:40 0\\\\  \\\\ 0FY01:FY00FY99:27FY98:10 /\\\\E \\\\ /InordertoincreaseaccesstoHHSservicesforlimitedEnglishproficient(_LEP_)persons,OCRwillincrease#HHSgranteesandprovidersfoundtobeincompliancewithTitleVIin_LEP_Ԁreviews/investigations.Measure:Increased#correctiveactionsandnoviolationfindings.OCRPlan 0\\\\ \\\\E 0FY01:153FY00:151FY99:125 0\\\\hl \\\\ 0FY01:FY00:FY99:146FY98:98(DH   \\\\ (#P<%"%&U#XVJX%P<    lXXVJP#XVJXl#ROGRAMSlXXVJS#XVJXlQ#UPPORTINGlXXVJT#XVJXl#HISlXXVJO#XVJXl#BJECTIVE    lXXVJ #XVJXl #(X@s#s#(ACF ( HeadStart  <,XF4 X2,B X<ASPE  PolicyResearchCDC   Immunization/XVJXXXVJTuberculosis#XVJXX/XVJM# `  /XVJXXXVJBreastandCervicalCancerPrevention#XVJXX/XVJ# L   /XVJXXXVJDiabetesandOtherChronicDiseases#XVJXX/XVJ,# 8  HCFA $t  MedicareMedicaidChildrensHealthInsuranceProgramHealthProfessionsandNursingTrainingProgramsHRSA  PrimaryCare F HealthCenters F NationalHealthServiceCorpsMaternalandChildHealth \  F MaternalandChildHealthBlockGrant F HealthyStartInitiative0 F UniversalNewbornHearingScreening FF  F EmergencyMedicalServicesforChildren F TraumaticBrainInjuryProgramRuralHealth0 F RuralHealthOutreachGrants FF 0 F RuralHealthPolicyDevelopment FF 0 F _Telehealth_ FF WorkforceInformationandAnalysisHealthEducationandAssistanceLoans "  IHS (  Treatment  Hospitals&HealthClinics  DentalServices E   #   MentalHealth  Alcohol&SubstanceAbuse  ContractHealthServices  UrbanHealth  IndianHealthProfessionsPrevention  PublicHealthNursing  HealthEducation  CommunityHealthRepresentatives  EnvironmentalHealthSupportCapitalProgramming/Infrastructure  HealthCareFacilitiesConstructionOCR 0 PreventingDiscriminationinAccesstoHHSServices_OPHS_ \3 OfficeofMinorityHealthOfficeofWomensHealthSAMHSA  p6 KnowledgeDevelopmentandApplicationChildrensMentalHealthServicesProtectionandAdvocacySubstanceAbuseBlockGrantMentalHealthPerformancePartnershipBlockGrant != 5@s#s#X@Q5?,X4 X,XF4 X?  X$= iUu5%!`z3 `E`ttx [i s#s#     s#s#iU 5%!`z3 `E`ttx [iL 0 !"#$%&(xx0 !"#$%&(L<,X,hX,X4 X< lXXVJK#XVJXl?#EYlXXVJFY2001P#XVJXl#lXXVJROGRAMS,#XVJXlЮ#lXXVJI#XVJXl#lXXVJNITIATIVES,AND#XVJXl^#lXXVJS#XVJXl#TRATEGIES  L    30    323  0    HRSA!HIV/AIDS .HIVCare.Fundsareusedtosupportawiderangeofservices:home L  andcommunity-basedhealthcareandsupportservices;continuationofhealthinsurancecoverage,throughaHealthInsuranceContinuationProgram(_HICP_);pharmaceuticaltreatments,throughthe_ADAP_ԀProgram;HIVcareconsortiathatassessneeds,organizeanddeliverHIVservicesinconsultationwithserviceproviders,andcontractforservices;anddirecthealthandsupportservices. 3@݌ s#s# Ќ  L K !"#$%&( hx0 !"#$%&(L0  HIVEmergencyReliefGrants.Thesegrantsareusedforcommunity-basedoutpatienthealth   andsupportservicesforlow-incomepersonslivingwithAIDS/HIV,includingcomprehensivemedicalcare,prescriptiondrugs,counseling,transportation,meals-on-wheelsprograms,homecareandhospicecare.Fundsmayalsobeusedtoprovidein-patientcasemanagementforAIDS/HIVpatientstopreventunnecessaryhospitalizationortoexpeditehospitaldischarge. s#s# 0  HIVEarlyInterventionServices.ThisprogramsupportsoutpatientHIVearlyintervention L services,specificallytargetingpreviously_underserved_Ԁpopulations,whichhavehadlimitedaccesstocare,includingwomen,children,adolescents,racialandethnicminorities,andsubstanceabusers.InFY2001,HRSAplanstofundnewsites,allofwhicharecommunitiesofsignificantneedforFederalsupport. s#s# 0  HIVPediatricGrants(Women,Children,Youth).Thisprogramfocusesonincreasingthe $ accessofHIV/AIDS-affectedwomen,infants,children,andyouthtoacomprehensive,community-based,family-centeredsystemofcare.Thefocusoftheprogramhasfurtherexpandedtodevelopinnovativemodelsthatlinksystemsofcomprehensivecommunity-basedmedicalandsocialservicesfortheaffectedpopulationwiththeNationalInstitutesofHealthandotherclinicalresearchtrials.Fundssupportinnovativestrategiesandmodelstoorganize,arrangefor,anddelivercomprehensiveservicesthroughintegrationintoongoingsystemsofcare. s#s# 0  DentalServicesProgram.Throughgrants,thisprogramreimbursesaccrediteddentalschools  %p # andotherpost-doctoraldentaleducationprogramsforthedocumenteduncompensatedcoststheyhaveincurredforprovidingoralhealthtreatmenttoHIVinfectedpatients. s#s#   31    392 3  0    _OPHS_Ԁ !XVJXXXVJTheOfficeofHIV/AIDSPolicy(_OHAP_)managestheoverallHIV/AIDSactivities ( $' throughouttheDepartment._OHAP_scoordinationeffortsintegratetheDepartmentspolicies,programsandactivitiesdesignedtopreventtheoccurrenceofHIVinfectionandAIDSandpromoteeffectivemechanismstoservethoseinfectedwithHIV.ThisincludesanalyzingandcontributingtothedesignoftheDepartmentsprioritiestoensureacomprehensivenational responsetotheHIV/AIDSepidemic._OHAP_Ԁalsoprovidesadviceandguidancetothe p-(, AssistantSecretaryforHealthandSurgeonGeneral(ASH/SG),theDeputySecretaryandSecretaryoftheDepartmentonHIV/AIDSprogramsandpolicies. 39d݌ s#s#   0  ActivitiesandresponsibilitiesoftheofficeincludethemanagementoftheDepartments25memberHHSCoordinatingGrouponHIV/AIDSwhichservesastheforumforprovidingadviceandguidancetoOPDIVs,STAFFDIVsandtheSecretaryoncriticalissuesconcerningHIV/AIDSpolicyand#XVJXXXVJڻ#theSecretarysAdvisoryCommitteeonBloodSafetyandAvailability 8  andtheASH/SGsBloodSafetyCommitteeinvolvingarangeofDepartmentwideinitiativesandactivitieswithinthepurviewofthesecommittees. s#s#   32    32 3  0    _OPHS_ !AcomprehensiveSurgeonGeneral'sreportonmentalhealth(thefirsteveronthis  8  areaofhealthcare)scheduledforreleaseinFY2000willincludecuttingedgeinformationaboutthestatusofmentalhealthresearchandserviceswithintheUnitedStates.ThereportisexpectedtoserveasabasisforshapingtheFederalgovernment'sfuturementalhealthprograminitiatives,aswellasprovidingthepublicwithvaluableinformationaboutmentalhealthissuesimpactingthecountry.Asmentalhealthandmentalillnessbecomemoremainstreamandlessstigmatized,healthinsurancecoverageislikelytobecomelessrestrictive. 3݌ s#s# Ќ    33    3[2 3  0    SAMHSA!TheComprehensiveCommunityMentalHealthServicesforChildrenand L theirFamiliesProgram seekstoprovideintensivecommunitybasedservicesforchildren < withseriousemotionaldisturbancesandtheirfamilies.Theprogramfeaturesabroadarrayofservicestailoredtomeettheneedsofthechildthroughanindividualizedserviceplanningprocess.dInFY2001,HHSwillcontinuetosupportandutilizeevaluationfindingswithapproximately50grants,allowingcontinuednationalprogressinimprovingoutcomesforalargernumberofchildrenwithseriousemotionaldisturbancesandtheirfamilies.d 3[݌ s#s# Ќ    34    32 3  0    SAMHSA/XVJXXXVJThenew CenterforMentalHealthServicesTargetedCapacityExpansion   programhasbeendesignedtoimproveandenhanceexistingmentalhealthsystemsatthemunicipal,county,andtribalgovernmentlevelstogeneratenewmentalhealthsystemcapacity.Itwillconsistofthreemajorelements:1)expandinglocalpreventionandearlyinterventionservices;2)addressinggapsincommunityhealthcare;and3)engagingfederalgovernmentpartnersthroughprogramlinkages.#XVJXX/XVJ&# 3݌T!s#s# Ќ    35    32 3  0    NIH!MentalHealthResearch .NIHwillcollaboratewithSAMHSAtodevelopanew ,#|! initiativeonmentalhealthinFY2001.Theinitiativewillintegrateresearchandpreventionstrategieswithactiondesignedtoimprovethedeliveryofmentalhealthservices.Specialemphasiswillbeplacedonpublichealthissuesrelatingtothementalhealthofadolescents,minorities,andtheaged,andofindividualswithmultiplediagnoses,includingdrugandmentaldisorders. 3݌ s#s# Ќ    36    3@2 3  0    NIH!MentalHealthandHealthDisparity .Largedifferencesexistacrossethnic,racial, )$( andgendergroupsinaccesstocareformentalillness,inunderstandingofmentalhealth,intreatmentseekingbehavior,andintheprevalenceofsomeformsofmentalillness.Researchonmentalillnessandmentalhealthwillcontinuetorangefromthelaboratorybenchtothetreatmentclinic,includingtranslatingstateoftheartscientificknowledgetocommunitybasedpractice.Majorareasforstudyincludetheeffectsofcultureonmentaldisorders,the D.)- economicandsocialbarrierstodiagnosisandtreatment,howgenderdifferencesinfluencethedevelopmentandcourseofmentaldisorders,andthebehavioralandcognitiveeffectsofenvironmentalexposuresonchildren. 3;݌ s#s# Ќ    37    32 3  0    HRSA!MaternalandChildHealthBlockGrant .HRSAprovidesadditionalfundsto ` Statestoprovideservicesfortheapproximately12millionchildrenwhoarepresentlyincriticalneedofmultidisciplinaryservicesanddonothaveadequateinsurancetomeetthespecialneedsnecessarytodevelop,functionandlearn,includingoptionalbenefitsnotprovidedbysomestateCHIPplansandurgenttreatmentandpreventiveservicesforchildrenwhowillcontinuetobeuninsuredandunderinsured.Thisprogramalsosupportsthedevelopmentofcoordinatedcaredeliverysystemsandservicesforchildrenwithspecialhealthcareneeds. 3.݌ s#s# Ќ    38    3G2 3  0    SAMHSA !AmajorobjectiveoftheNationalDrugControlStrategyistoclosethetreatment   gapforsubstanceabusevictimsandreducedruguseby50percentinthenexttenyears.ToimproveprogramimpactsforthisspecialneedspopulationinFY2001,SAMHSAwillexpandeffortsintwoprogramsthatfocusonreducingthetreatmentgap:1)theSubstanceAbusePreventionandTreatmentBlockGrant,whichwillprovidefornationwideexpansionoftreatmentservicesandaidinthereductionoftreatmentwaitinglists;and,2)theTargetedCapacityExpansionProgram,whichwillproviderapidandstrategicresponsestothedemandforalcoholanddrugabusetreatmentservicesthatareregionalorlocalinnature. 3Gr݌ s#s# Ќ    39    32 3  0    ACF!DevelopmentalDisabilities(_DD_). Inordertoimprovethehealthofpeoplewith d developmentaldisabilitiesandincreasetheiraccesstoneededhealthcareservices,_DD_Ԁworkstoensurethatindividualswithdevelopmentaldisabilitiesandtheirfamilieshaveaccesstothehealthcareinformationtheyneedtomakechoices;thathealthcareisavailable,affordable,accessible,andequitable;andthathealthcarepersonnelareappropriatelyqualifiedtomeetthehealthcareneedsofpeoplewithdevelopmentaldisabilities. 3݌ s#s# Ќ    3:    32 3  0    _OPHS_/HRSA !TheNationalHispanicPrenatalHotlineProjectfundedundertheNational  CoalitionofHispanicHealthandHumanServicesOrganizationscooperativeagreementestablishesanationalhotlinetoprovideindividualized,culturally/linguisticallyappropriateinformationregardingprenatalcaretoHispanicconsumersintheUnitedStatesandPuertoRico.Throughanewlyestablisheddatabase,individualscanaccessculturallywritteninformationonprenatalcareandhealthcareprovidersareabletoaccessinformationonhowtoprovideculturallyandlinguisticallyappropriateprenatalcareservices.   x  3!݌$h"s#s# Ќ    3;    3b2 3  0    FDA!Drugs .FDAsOrphanProductsGrantProgramencouragesclinicaldevelopmentof %@!$ productsusedtotreatrarediseasesorconditions.Aproductusedtotreatadiseaseorconditionthataffectsfewerthan200,000personsintheUnitedStatesiscalledanOrphanproduct.Companiesareoftenreluctanttoinvesttimeandmoneytodeveloporphanproductsbecausethemarketissosmall.Toencourageresearchandproductdevelopmentforrarediseasesandconditions,FDAoffersgrants,specialprivilegesandmarketingincentivestocompaniesundertheOrphanDrugAct.Orphanproducts(drugs,_biologics_,medicaldevices,medicalfoods)areneededtohelpreducepainandsufferingforpersonswithdiseasessuchashemophilia,multiplesclerosis,cysticfibrosis,rarecancers,andasmanyas5,000otherknownraredisordersthataffectasmanyas20millionAmericans. 3b݌@.)-s#s# Ќ  __  3<    3>2 3  0    FDA!Drugs .FDAisdedicatedtocombatingAIDSandotherlifethreateningconditionsby  streamliningthedevelopmentandapprovalprocessfornewtherapies.FDAsbroadbased,multidisciplinaryresearchprogramshaveplayedasignificantroleinthedevelopmentofvaccines,therapeuticagents,andtestkitsforpossibleuseinAIDSandAIDSrelatedconditionsbydefiningparametersthatmustbemetregardlessofsponsor.FDAcontinuestoenlargethescopeofitsAIDSrelatedactivitiesasnewdataonHIV,AIDS,andAIDSrelateddiseasesbecomeavailableandasclinicaltrialsofnewtherapies,vaccines,anddiagnostictestsexpand. 3>i݌ s#s# Ќ    3=    32 3  0    FDA!Drugs .FDAisencouragingpatientstoplayanintegralpartinthedecisionmaking  <  processforhealthcare.FDAappointspatientrepresentativestoparticipateonAdvisoryCommitteesthatconsidernewdrugsforapproval.FDAalsoplanstoestablishapublicregistrycontaininginformationaboutclinicaltrialsforexperimentaldrugsand_biologics_Ԁthatwillbeusedtotreatseriousorlifethreateningdiseasesandconditions.Thisregistrywillprovideconsumersgreateraccesstoinformationaboutclinicaltrialsandincreasetheiropportunitytoparticipateinthesetrials. 3݌ s#s# Ќ  P 0 !"#$%&(xhK !"#$%&(P  3>    323  0    HRSA!PrimaryCare,HealthCenters .TheFY2001budgetincludesarequestforfunds P toprovidecomprehensiveprimarycareservicestomorethan50,000atriskschoolchildrenthroughschoollinkedandschoolbasedprograms,includingmentalanddentalcare,substanceabuseandviolencepreventionservices. 3=݌ s#s# Ќ    3?    323  0    6XVJXXXVJ HRSA!NationalMarrowDonorProgram .Throughtheprogram,volunteerdonorsare @ recruitedandtissuetyped,thenationalregistryofpotentialdonorsismaintained,computerizedsearchesoftheregistryareconductedforpatients,marrowiscollectedandprovidedfortransplants(1,362in1998),andascientificregistryoftransplantoutcomesispublished.Theprogramemphasizestherecruitmentofminoritydonorsinordertoequalizeaccess.Theprogramalsoprovidesinformationandsearchcasemanagementforpatientsandconductsresearchtoimprovethenumberandeffectivenessofmarrowtransplantsusingunrelateddonors.#XVJXX6XVJ# 3?݌h s#s# Ќ    3@    323  0    6XVJXXXVJ HRSA!OrganProcurementandTransportation .#XVJXX6XVJ#ԀThetotalnumberoforgantransplants @"  increased60%between1988and1998,butthenumberoftransplantcandidatesisrisingfasterthanthenumberofdonors.Physiciansandhealthcarepersonnel,aswellasthegeneralpublic,requireeducationtorecoverallorganslostbecausedonationisnotconsidered.InFY2001,HRSAplanstosustainandincreaseitseffortswithavarietyofadditionalpartnerstoincreaseorgandonationandprovideforincreasedproductionanddistributionofeducationalmaterials.HRSAwillalsosupporteffortsdirectedatabetterunderstandingoftheconsentandreferralprocessesthattakeplacebetweenhospitalandreferralpersonnelandfamilies.In1999,thereweremorethan66,000registrantswaitingfororgans. 3݌ s#s# Ќ    3A    323  0    ACFHeadStart emphasizestheimportanceoftheearlyidentificationofhealthproblems. |+&* Everychildisinvolvedinacomprehensivehealthprogram,whichincludesimmunizations,medical,dental,andmentalhealth,andnutritionalservices. 3݌ s#s# Ќ   D.)-   3B    323  0    SAMHSATheProjectsforAssistanceinTransitionfromHomelessnessProgram  (PATH) providescommunitysupportservicestoindividualswhoarehomelessoratriskof  homelessness.EligibleservicesfundedunderPATHinclude:outreach;screeninganddiagnostictreatment;habilitationandrehabilitation;communitymentalhealthservices;alcoholordrugtreatment(formentallyillindividualswithco-occurringsubstanceusedisorders);stafftraining;casemanagement;supportiveandsupervisoryservicesinresidentialsettings;andreferralsforprimaryhealthcare,jobtraining,andeducation.Inadditiontoimprovingcoordinationofservicesandhousingforthetargetpopulation,alimitedsetofhousingservicesmaybefunded. 3݌ s#s# Ќ    3C    3>23  0    OCR!PreventingDiscriminationinAccesstoHHSServices .OCRwillconcentrateits  @  resourcesonthecriticalcivilrightsissuessurroundingchangesinhealthcarecoverageandservices,includingincreaseduseofmanagedcare,thatareundertakeninthestates.OCRwillfocusonassessingtheeffectsofmanagedcareonservicestominorityanddisabilitycommunities.Itwillexpandthenumberofreviewconcentratingonensuringthat,asbothMedicareandMedicaidexpandtheuseofmanagedcare,racialandnationaloriginminorityindividualsandpersonswithdisabilitiesaretreatedinanondiscriminatorymanner.Inaddition,OCRwillcontinuetoworkwithhealthcareandsocialservicesproviders,stateandlocalagenciesandHHSpartnerstoensurethatpersonsoflimitedEnglishproficiencyarenotdiscriminatedagainstonthebasisofnationalorigin. 3>i݌ s#s# Ќ    3D    3s23  0    /XVJXXXVJ _OPHS_ !#XVJXX/XVJ#TheCenterforLinguisticandCulturalCompetenceinHealthCaredevelopsand h evaluatesmodels,conductsresearch,andprovidestechnicalassistancetoproviderstoaddresstheculturalandlinguisticbarrierstohealthcaredeliveryandincreaselimitedEnglishspeakingindividualsaccesstohealthcare.FY2000activitiesinclude:disseminatinginformationoncurrentlanguageandculturalcompetencymodelprograms,techniques,organizationalandgovernmentalpolicies;launchingaculturallycompetencesystemschangeinitiative;conductinganevaluationofselectedsitestodeterminetheeffectivenessofculturallycompetentprogramsonethnicallydiversepatients;commissioningpapersondevelopmentofculturallycompetenttrainingprogramsforhealthcareproviders; developingaresearchprojectoncultural | competencehealthdeliveryprograms,andinitiatingresearchonimpactofculturallycompetentservicesonpatienttreatmentprotocolsandoutcomes.AllproductswillbedisseminatedthroughtheOfficeofMinorityHealthResourceCenter(_OMHRC_)andthroughthe_OMHRC_website. 3s݌ s#s# Ќ  ݀/XVJXXXVJ $l" #XVJXX/XVJQ #&  lXXVJS#XVJXl #ELECTEDlXXVJFY2001#XVJXl #lXXVJԀ#XVJXlL #lXXVJP#XVJXl #ERFORMANCElXXVJG#XVJXl #OALSANDlXXVJM#XVJXl) #EASURES  %D!$ *vw ddz SS z SS SS sts#s#,SS ,SSS ,SSS +  &\\\\G 'D#& &  PerformanceGoals 8\\\\E#!X(#' \\\\G 8  Targets 8\\\\E#!X(#( \\\\E 8  ActualPerformance =\\\\E(&D)$*   \\\\E =&U"%XXVJIncreasethepercentofchildrenwithspecialhealth *&+ careneedsintheStatewithamedical/healthhome.HRSAPlan |,'-  0\\\\4.)/\\\\E 0FY01:80% 0\\\\|,'2\\\\ 0FY01:FY00:FY99:01/01FY98:04/00FY97:69%' %  /\\\\E4.)7\\\\ /Increasethenumberofvisitsforhealthrelatedcare(primarymedical,dental,mentalhealth,substanceabuse,rehabilitativeandhomehealth)inTitleIandIIprogramstoalevelthatapproximatesinclusionofnewclients.HRSAPlan 0\\\\ \\\\E 0 HIVEmergency d ReliefGrants  \@ FY01:3.00MvisitsFY00:2.92MFY99:2.88M HIVCareGrants  h  toStates  `D FY01:1.57MFY00:1.53MFY99:1.22M 0\\\\ \\\\ 0&U"%"%&UFY01:FY00:FY99:1/01FY98:2.79MFY97:2.77MFY96:2.67Mvisits#&U"%"%&U #  h &U"%"%&UFY01: <  FY00:FY99:1/01FY98:1.45MFY97:#&U"%"%&U #Ԁ1.07Mvisits /\\\\E \\\\ /&U"%"%&UIncreasethenumberofAIDSDrugAssistance   Programs#&U"%"%&U| #Ԁ(_ADAP_)clientsreceivingappropriate  ! _antiretroviral_Ԁtherapy(consistentwithclinicalguidelines)throughState_ADAPs_Ԁduringatleastonemonthoftheyear.HRSAPlan 0\\\\p$\\\\E 0FY01:74,800clientsFY00:71,900FY99:78,088 0\\\\'\\\\ 0FY01:FY00:FY99:64,500FY98:55,000clients /\\\\E+\\\\ /DecreasethenumberofnewlyreportedAIDScasesinchildrenasaresultofperinataltransmission.HRSAPlan 0\\\\.\\\\E 0FY01:193casesFY00:203FY99:214 0\\\\1\\\\ 0FY01:FY00:FY99:01/01FY98:225FY97:310FY96:502cases /\\\\EH,7\\\\ /Increaseby20%overtwoyearsthenumberoforgandonorsnationallyfromimplementationofthefinalHCFARuleonConditionsofParticipationofHospitals.(9/98) HRSAPlan 0\\\\L!0;\\\\E 0&U"%"%&UFY01:7,248donors < FY00:6,589FY99:5,990#&U"%"%&Up # 0\\\\p T>\\\\ 0FY01:FY00:FY99:5/00FY98:5,799FY97:5,477donors /\\\\E(" C\\\\ /Increaseby7.5%thenumberofunrelatedbonemarrowdonors(nationalregistryofpotentialdonors)overpreviousyeartotals.HRSAPlan 0\\\\P%4F\\\\E 0FY01:4.35MdonorsFY00:4.04MFY99:2.84M 0\\\\P%4I\\\\ 0FY01:FY00:FY99:3.76FY98:3.36FY96:2.58Mdonors /\\\\E'N\\\\ /Inordertoincreaseaccessforminoritiesandpersonswithdisabilitiestonondiscriminatoryservicesinmanagedcaresettings,OCRwillincrease#managedcareplansfoundtobeincompliancewithTitleVI,Section504andtheAmericanswithDisabilitiesAct.Measure:Increased#correctiveactionsandnoviolation findings.OCRPlan 0\\\\ h\\\\E 0FY01:33FY00:30FY99:40 0\\\\8  \\\\ 0FY01:FY00FY99:27FY98:10#XVJX"%&U# #&U"%XXVJ /\\\\E \\\\ /Increasethenumberofhealthcareproviderstrainedtomeetthehealthneedsofpeoplewithdevelopmentaldisabilitiesasaresultof_DD_programintervention.ACFPlan 0\\\\l \\\\E 06&U"%"%&UFY01:    FY00:  * ,X,hX*  #&U"%"%6&U2 #6&U"%"%&UFY99:4,000#&U"%"%6&U # 0\\\\ \\\\ 0FY01:FY00:FY99:2/01FY98:d2/00dFY97:2,922 /\\\\EdH \\\\ /Theproportionofpeople18andoverreportingdepressioninthepast12monthswhoarereceivingtreatment._OPHS_ԀPlan 0\\\\p\\\\E 0FY01:30% 0\\\\ \\\\ 0FY01:FY00:FY99:FY98:FY97:23% /\\\\ED(%\\\\ /ЀDecreasetheannualrateofsuicide._OPHS_ԀPlan 0\\\\&\\\\E 0FY01:10FY00:10.5 0\\\\H,*\\\\ 0FY01:FY00:FY99:FY98:10.8FY96:11.7#XVJX"%&U # /\\\\E$/\\\\ /&U"%XXVJInordertoincreaseaccesstoHHSservicesfor x0 limitedEnglishproficient(_LEP_)persons,OCRwillincrease#HHSgranteesandprovidersfoundtobeincompliancewithTitleVIin_LEP_reviews/investigations.Measure:Increased#correctiveactionsandnoviolationfindings.OCR !5 Plan  #XVJX"%&U # 0\\\\"6\\\\E 0&U"%XXVJFY01:153 x7 FY00:151FY99:125#XVJX"%&U # 0\\\\L09\\\\ 0&U"%XXVJFY01: x: FY00:FY99:146FY98:98#XVJX"%&U7 #(( = \\\\ ( lXXVJP#XVJXl #lXXVJROGRAMS#XVJXl! #lXXVJS#XVJXlk #lXXVJUPPORTING#XVJXl #lXXVJT#XVJXl #lXXVJHIS#XVJXl= #lXXVJO#XVJXl #lXXVJBJECTIVE  %? #XVJXl #(X@s#s#(ACF ' A DevelopmentalDisabilitiesHeadStart_AHRQ_ *p#D ResearchonHealthCosts,Quality,andOutcomesFDA P-4&G Drugs <. 'H HRSA ' H PrimaryCarèHealthCenters-,XF` XX-  NationalHansensDiseaseProgram  BlackLungClinicsHIV/AIDS  HIVCare  HIVEmergencyReliefGrants <. 'O HRSA(continued)   HIVEarlyInterventionServices F HIVPediatricGrants F EducationandTrainingCenters F DentalServicesProgramMaternalandChildHealth F MaternalandChildHealthBlockGrant0 F UniversalNewbornHearingScreeningandEarlyIntervention FF 0 F HealthyStartInitiative FF 0 F EmergencyMedicalServicesforChildren 8 FF 0 F TraumaticBrainInjuryProgram FF . X,XF` X .HealthProfessionsandNursingTrainingProgramsNationalBoneMarrowDonorProgramOrganProcurementandTransplantation   NIH  ResearchProgramOCR  PreventingDiscriminationinAccesstoHHSServices_OPHS_ L  OfficeofHIV/AIDSPolicyOfficeoftheSurgeonGeneralSAMHSA  ` TargetedCapacityExpansionChildrensMentalHealthServicesProtectionandAdvocacySubstanceAbuseBlockGrantMentalHealthPerformancePartnershipBlockGrant    \   \ 5@s#s#X@y 5iU5%!`z  `E`ttx 3i s#s#     s#s#iU 5%!`z  `E`ttx 3iL 0 !"#$%&(xx0 !"#$%&(L-,X,hXX- lXXVJK#XVJXl( #EYlXXVJFY2001P#XVJXl( #lXXVJROGRAMS,#XVJXlF) #lXXVJI#XVJXl) #lXXVJNITIATIVES,AND#XVJXl) #lXXVJS#XVJXl&* #lXXVJTRATEGIES  L  #XVJXli* #L K !"#$%&( ix0 !"#$%&(L  3E    3+ 2 3  0    HCFA!NationalMedicareEducationProgram(_NMEP_) . Theprimaryintervention L  designedtoimprovebeneficiarysatisfactionwiththehealthcareservicestheyreceiveisthe_NMEP_.The_NMEP_Ԁwillprovidebeneficiarieswithaccurate,easilyunderstandableinformationabouttheirhealthinsuranceoptionstoassisttheminbecomingmoreactiveparticipantsintheirhealthcaredecisions.Thisincludesprovidingcomparativeinformationonbenefitstructures,costsharingrequirements,andqualityandperformanceindicators.Theinformationisintendedtohelpbeneficiarieschoosewhethertheywanttobeinfeeforserviceormanagedcare;andiftheychoosemanagedcare,whichhealthplanwouldbebestforthem.The_NMEP_willalsoprovidedatawhenavailableonotherMedicare+Choiceoptions,suchasmedicalsavingsaccountsandprivatefeeforserviceplans. 3+ D+ ݌ s#s# Ќ    3F    3/ 2 3  0    HCFA!PeerReviewOrganizations . CentraltoperformancemeasurementforHCFAisthe t beneficiaryfocusthatpervadesitsgoalsandobjectives.AcriticalcomponentofthatfocusistheeffectivenessofmedicaltreatmentthatisprovidedtoMedicarebeneficiaries.HCFAseffortstoimprovemedicaltreatmentthroughitscollaborationwithPeerReviewOrganizationsisthebasisforitsperformancegoalsto:1)improveheartattacksurvivalrates,2)increaseinfluenzavaccination,3)increasetheuseof_mammograms_,and4)increasediabeticeyeexams._PROs_,whichserveundercontractwithHCFA,conductcooperativeimprovementprojectsinwhichtheyusedatatoidentifyopportunitiestoimprovecare,andthenworktodevelopinterventionsthatwillbringimprovementforsubjectqualityindicators.PertinenttotheHCFAperformanceplan,HCFAandthe_PROs_Ԁarefosteringutilizationofinterventionstotreatheartattacksandimprovesurvivalrates;areworkingwithproviders,healthplansandothersoninfluenzavaccinationprojects;andarenetworkingwithlocalprojectcollaboratorstoprovideeducationandreminderstoimprovemammographyrates. 3/ / ݌ s#s# Ќ  &XXVJ#XVJX&ъ5 #  3G    35 2 3  0    HCFA!StateChildrensHealthInsuranceProgram .Theimportanceofchildhood p"  immunizationisdemonstratedintheStateChildrensHealthInsuranceProgram(_SCHIP_).Underthelegislation,Statesthatcreateaseparate_SCHIP_Ԁprogrammustincludecoverageofthecompleteseriesofimmunizations.Statesalsoareprohibitedfromimposingcopaymentsordeductiblesonimmunizationservices.Almostallofthe_SCHIP_ԀStatePlanssubmittedtoHCFAbyApril1998indicatedtheintentiontoapplyameasureofchildhoodimmunizationtotheir_SCHIP_Ԁpopulationasabasicindicatorofqualityofcare. 35 5 ݌ s#s# Ќ  0  Moreover,highlyeffective,evidencebasedinterventionsareavailabletoraisechildhoodimmunizationcoveragelevels.Alargenumberofstudieshaveshownthatperformancemeasurementthrough_HEDIS_,registries,orotherassessmenttechniquesandtheuseofrecallandremindersystemstoidentifyandtrackchildreninneedofvaccinationwillsubstantiallyraisecoveragelevels.Amajorbarriertochildhoodimmunizationistheinformationgapthatexistsamongparentsandprovidersabouttheimmunizationstatus.Researchindicatesthat p.)- overthreefourthsofparentsofchildreninneedofimmunizationbelievetheirchildiscompletelyvaccinated.Similarly,providersalsotendtogreatlyoverestimatetheimmunizationcoveragelevelsoftheirpatients.Thisinformationgapisanimportantreasonwhybothperformancemeasurementandrecallandremindersystemsarehighlyeffective,evidencebasedinterventionstrategiesthatarerecommendedbyboththeCentersforDiseaseControlandtheAdvisoryCommitteeonImmunizationPractices. s#s#   3H    3~< 2 3  0    HCFA!NursingHomeInitiative .In1998,thePresidentandtheSecretaryofHHS $ t announcedaninitiativetotoughennursinghomeenforcementtoolsandstrengthenFederaloversightofnursinghomequalityandsafetystandards.KeycomponentsofFY2001activitiesproposedbyHCFAtowardachievingthePresidentsobjectivesincludeincreaseddirectsurveyactivitiesandemphasisonnursinghomeeffectivenessinpreventingbedsores,dehydration,andmalnutrition,investigatingcomplaintsallegingactualharmtoaresidentwithin10days,increasedsanctionsfordeficientnursinghomes,staggeringthestarttimesofannualsurveyswithatleasttenpercentbegunonweekendsorevenings,increasedsupportcontractactivities,includingreviewofnursinghomessystemstoprevent,identify,andstopphysicalorverbalabuse,neglect,andmisappropriationofresidentproperty;andmorefrequentinspectionsofnursinghomeswithrepeatedseriousviolations. 3~< < ݌ s#s# Ќ  L 0 !"#$%&(xiK !"#$%&(L  3I    3_A 23  0    _AHRQ_Ԁ!QualityofCareResearch . _AHRQ_spriorityfornewresearchismorefocused 8 thanpasteffortstoresponddirectlytothepriorityneedsofMedicareandMedicaid.ChangeandgrowthintheMedicareandMedicaidpopulationswillcontinuetoaffecthealthcarecost,which,inturn,raisesconcernsabouttheassuranceofhealthcarequality.Examplesof_AHRQ_activitiessupportingMedicareandMedicaidbeneficiariesinclude:1)providingobjective,sciencebased,timelyinformationtohealthcaredecisionmakerspatientsandclinicians,healthsystemleaders,andpolicymakers;2)healthcarecostandutilizationsurveys,suchas_CAHPS_and_MEPS_,thatprovideinformationsupportinghealthplanchoicesandcoveragedecisions;and3)trackingthenationalimpactoftheStateChildrensHealthInsuranceProgramonaccessandcostofcareforchildren. 3_A A ݌ s#s# Ќ    3J    3;F 23  0    OCR!PreventingDiscriminationinAccesstoHHSsServices .XVJXXXVJOCRwillconcentrateits `  resourcesonthecriticalcivilrightsissuessurroundingchangesinhealthcarecoverageandservices,includingincreaseduseofmanagedcare,thatareundertakeninthestates.#XVJXXXVJF #XVJXXXVJԀOCRwill <"  focusonassessingtheeffectsofmanagedcareonservicestominorityanddisabilitycommunities.Itwillexpandthenumberofreviewsconcentratingonensuringthat,asbothMedicareandMedicaidexpandthesueofmanagedcare,racialandnationalminorityindividualsandpersonswithdisabilitiesaretreatedinanondiscriminatorymanner.OCRwillworkwithitsHHSAgencypartnerstoimproveresearchanddatacollectioneffortstosupporttargetenforcementinthischangingarena.InadditionOCRwillcontinuetoworkwithhealthcareandsocialservicesproviders,stateandlocalagenciesandHHSpartners,toensurethatpersonsoflimitedEnglishproficiencyarenotdiscriminatedagainstonthebasisofnationalorigin. 3;F fF ݌ s#s# Ќ  #XVJXXXVJH #  `,'+ & D  lXXVJSELECTED#XVJXlK #lXXVJFY2001#XVJXlL #lXXVJԀ#XVJXlcL #lXXVJP#XVJXlL #lXXVJERFORMANCE#XVJXlL #lXXVJG#XVJXl6M #lXXVJOALSAND#XVJXlyM #lXXVJM#XVJXlM #lXXVJEASURES   ll#XVJXlgM #&U"%XXVJ*yz d dSS SSS SSSS Svws#s#,SS ,SSS ,SSS +  &\\\\G ( &  PerformanceGoals 8\\\\E#!< \\\\G 8  Targets 8\\\\E#!< \\\\E 8  ActualPerformance #&U"%"%&UM ##XVJX"%&UM #&U"%XXVJ'DK  =\\\\E(&h   \\\\E =#XVJX"%&UP #&U"%XXVJIncreasethepercentageofMedicarebeneficiaries   age65yearsandolderwhoreceivevaccinations.0 / !0[//annualinfluenzavaccination l [[ 0 /  // !0 / lifetime_pneumococcal_Ԁvaccination(// HCFAPlan#XVJX"%&UP #&U"%XXVJ 0\\\\H\\\\E 0#XVJX"%&UkR #&U"%XXVJFY01:72%*  H FY00:60%**FY99:59%**#XVJX"%&UR #&U"%XXVJFY01:55%*FY00:#XVJX"%&U`S #Newin2001&U"%XXVJ % FY99:#XVJX"%&US #ԀNewin2001&U"%XXVJ & *#XVJX"%&U.T #Newdatasource h( (MedicareCurrentBeneficiarySurvey)willbeemployedforFY2001.**Datasource:NationalHealthInterviewSurvey 0\\\\,/\\\\ 0&U"%XXVJFY01:FY00:FY99:FY98:FY97:63%**FY95:58%**FY94:55%**FY01:FY00:FY99:FY94:25%#XVJX"%&UPU #* /\\\\El?\\\\ /&U"%XXVJIncreasethepercentageofMedicareBeneficiaries \@ Age65andoverwhoreceivea_mammogram_Ԁeverytwoyears.#XVJX"%&U)V #ԀHCFAPlan 0\\\\!dB\\\\E 0&U"%XXVJFY01:51%* \C FY00:60%**FY99:59%**#XVJX"%&UIW #&U"%XXVJ#XVJX"%&UW #P<%XXVJ*Newdatasource(Medicare "G ClaimsData)willbeemployedforFY2001.**Datasource:NationalHealthInterviewSurvey#XVJX%P<X #&U"%XXVJ 0\\\\,%| K\\\\ 0FY01:FY00:FY99:FY98:FY97:45%*FY94:55%**#XVJX"%&UX #&U"%XXVJ /\\\\E#Q\\\\ /IncreasethepercentageofMedicaidtwoyearoldchildrenwhoarefullyimmunized.(Tobeachievedin3phasesforStategroupings.)0 / !0[//Group1States [[ 0 / 0[//(baseline:19992000;firstreport:2001) [[ 0 / !0[//Group2States@D [[ 0 / 0[//(baseline:20002001;firstreport:2002) [[  0 / !0[//Group3States [[ 0 / 0[//(baseline:20012002;firstreport:2003) [[ HCFAPlan 0\\\\hl \\\\E 0FY01:FirstreportFY00:#XVJX"%&U MedicareMedicaidMedicareIntegrityProgram  ,#0A iU5%!`z  `E`ttx 3i s#s#     s#s#iU5%!`z  `E`ttx 3iL 0 !"#$%&(xx0 !"#$%&(L9,X,hX,X,hX9 lXXVJK#XVJXl' #EYlXXVJFY2001P#XVJXlm #ROGRAMS,lXXVJI#XVJXl #NITIATIVES,ANDlXXVJS#XVJXl #TRATEGIES  L    3Q    3M 23  0    /XVJXXXVJ IHS!Treatment,HospitalsandHealthClinics .IHSHospitalsandClinicsProgram L  providesessentialservicesincludinginpatientcare,routineandemergencyambulatorycare;andsupportservicesincludinglaboratory,pharmacy,nutrition,healtheducation,medicalrecords,physicaltherapy,nursing,etc.TheprogramincludesinitiativestargetingspecialhealthconditionsthataffectAI/_ANs_Ԁsuchasspecializedprogramsfordiabetes,maternalandchildhealth,youthservices,communicablediseases(includingAIDSandtuberculosisandothers),andacontinuingemphasisonwomensandelderhealthandepidemiology. 3M x ݌ s#s# Ќ  0  Otherclinicalservices,(dentistryandcommunityservices,e.g.,publichealthnursing)alongwithanumberofhealthprogramsoperatedbythetribes(women,infants,andchildrensprogramsandbehavioralhealthservices)areoftenhousedinthesamefacilities.Thiscolocationofservicesinthehospitalandclinicincreasesaccessandfostersatrulycomprehensivecommunityorientedprogram. s#s#   3R    3 23  0    IHS!RestoringAccesstoHealthCareInitiative .InFY2000,IHSbegananinitiativeto 8 restoreaccesstobasichealthservices,includingassuringthatthereareadequatefacilitiesandequipmentfortheprovisionofhealthservicesandprovidingadequatesupportservicestothetribalhealthdeliverysystem. 3 ݌ s#s# Ќ    3S    3 23  0    IHS!ReducingtheGapinHealthDisparitiesInitiative. Thisinitiativetargetsthehealth ( problemsidentifiedashighestprioritybytheI/T/Uandresponsibleformuch_fo_ԀthedisparitynhealthstatusfortheAI/ANpopulation.Theseincludealcoholismandsubstanceabuse,diabetes,cancer,mentalhealth,elderhealth,heartdisease,injuries,dentalhealth,maternalandchildhealth,domesticviolence,infectiousdiseasesandsanitation.Supportforpublichealthinfrastructureisalsofundamentaltothisinitiative.Thisinitiativewillalsosupportsurveillance,prevention,andtreatmentservicesandarebasedon bestpracticesdefiedinthehealthliterature.IHSwillalsoaddresstheneedforwaterandsewersystemsfornewandexistinghomesatthecommunitylevel.#XVJXX/XVJ # /XVJXXXVJ 3 ݌<$"s#s# Ќ  #XVJXX/XVJw #  3T    3 23  0    /XVJXXXVJ ACF!NativeAmericanPrograms. ACFs#XVJXX/XVJn #SocialandEconomicDevelopmentStrategies &d!$ programisbasedonthepremisethatlocalcommunitieshavetheprimaryresponsibilityfordeterminingitsownneeds,planningandimplementingitsownprograms,andforuseofitsownnaturalandhumanresources.Throughadirectgrantfundingrelationship,TribesandNativecommunitieshavecreatedadministrativesystemstooperatetheirownsocialandeconomicprograms,muchinthesamewayasStateandlocalgovernments.Supportfortheunique,governmenttogovernmentrelationshipthatexistsbetweenTribalgovernmentsandtheFederalgovernmentisreflectedinthisapproach.Additionalpriorityfundingareasincludenativelanguagespreservationandenhancement,environmentalregulatoryenhancement,andenvironmentalmitigation. 3 ( ݌d.)-s#s# Ќ    3U    3Q 23  0    /XVJXXXVJ AoA!GrantstoIndianTribes .AoAsAmericanIndian,AlaskanNativeandNative  HawaiianProgramawardsgrantstoprovidesupportiveandnutritionservices,includingbothcongregateandhomedeliveredmealstoolderNativeAmericans.#XVJXX/XVJº # 3Q | ݌xs#s# Ќ    3V    3S 23  0    SAMHSA TheCenterforMentalHealthServices,incollaborationwithIHS,fundsthe P  CirclesofCareprogramwhichsupportsthedevelopmentandtestingofculturallycompetentmodelsofmentalhealthservicesforchildreninTribesandurbanAmericanIndianorganizations.Thelocalcommunitiesselecttheservicesandoutcomeswhichareimportanttothem. 3S ~ ݌ s#s# Ќ    3W    3 23  0    /XVJXXXVJ IHS!Treatment,IndianHealthProfessions .ThisprogramenablesAI/ANtoenterthe ,  healthcareprofessionsthroughacarefullydesignedsystemofpreparatory,professionalandcontinuingeducationsassistanceprograms;#XVJXX/XVJ #servesasacatalysttothedevelopmentofIndian   communitiesbyprovidingeducationalopportunitiesandenablingAI/ANhealthcareprofessionalstofurtherIndianselfdeterminationinthedeliveryofhealthcare;anddevelopsandmaintainsAmericanIndianpsychologycareerrecruitmentprogramsasameansofencouragingIndianstoenterthementalhealthfield. 3 ݌ s#s# Ќ    3X    3 23  0    /XVJXXXVJ IHS!Prevention,PublicHealthNursing(_PHN_) .Thepublichealthnursingroleis @ predominantlyoneofadvocacy,strengtheningrelationshipswithintheIndiancommunityandprovidingtheframeworkforbroadlybasedcommunityefforts.Thisincludestherapy,counseling,education,andreferralactivitiesoftencarriedoutinconjunctionwithothermembersofthehealthcareteamssuchasthecommunityhealthrepresentative.Othersignificant_PHN_Ԁactivitiesincludecoordinationandcasemanagementactivities.#XVJXX/XVJ[ # 3  ݌0s#s# Ќ    3Y    3? 23  0    /XVJXXXVJ IHS!Prevention,CommunityHealthRepresentatives(_CHR_) .The_CHR_Ԁprogram  providesaneffectivebridgebetweenthecommunityanddirecthealthcareservicestoimproveandincreaseaccesstothehealthcaredeliverysystem.AI/_ANs_Ԁmostinneedofcareareidentifiedandhomevisitsaremadetoexpectantmothers,infants,youngchildren,elderly,andthosewithchronicdiseases.Clinicalandpreventiveappointmentsaremadeandtransportationisarrangedby_CHRs_Ԁtoensurethoseneedinghealthcareservicesreceivethecareneeded.Afulltimenationalcoordinatorforcommunityhealthpromotion/diseasepreventionprovidestechnicalassistancetotribalprogramsandIHSandcoordinatesactivitiesandresourcesharingamongthegrowingnumberoftribal_CHR_Ԁprograms. 3? j ݌ s#s# Ќ    3Z    3 23  0    IHS!Prevention,HealthEducation .#XVJXX/XVJ #IHSassistsitslocalpartnerstoengagein/XVJXXXVJcommunity %D!$ basedpreventioninitiativeswhichaddressHIV/AIDSriskbehavior,violence,childabuse,physicalinactivity,nutrition,alcoholandsubstanceabuseandtobaccouseandcessation.#XVJXX/XVJ #/XVJXXXVJ 3 ݌' #&s#s# Ќ    3[    37 23  0    IHS!Prevention,AntiDrugAbuseActivities .IHSwillincreasedrugrelatedactivities, )$( includingtreatment,AdolescentRegionalTreatmentCenters,CommunityRehabilitationandAftercare,Training/CommunityEducation,HealthPromotion/DiseasePrevention,NavajoRehabilitationProgramUrbanPrograms,andContractHealthServices. 37 b ݌ s#s#    \-(, 0  Programimprovementswillcontinuetofocusontheneedsofalcoholandsubstanceabusers whohaveahistoryofsexualabuseandonaredesignedcommunitymobilizationeffortthatwillprovideinnovativetreatment_dn_Ԁpreventionmodulestargetingcommunitiesthathavehighratesofalcoholismanddrubabuse.Inaddition,IHSeffortswillberesponsivetochangingdrugusepatterns,suchastheincreaseinmethamphetamineuseintheBillingsArea.#XVJXX/XVJ #/XVJXXXVJ`s#s#   3\    3 23  0    #XVJXX/XVJ #/XVJXXXVJ IHS!Prevention,InjuryPrevention .IHScollaborateswithtribesandotherFederal,State, 8  andlocalagenciesineffortstoreducetheincidenceofsevereinjuries,withspecialemphasisonprimaryprevention,developingprogramsonsoundepidemiologicalbases,andfundingcommunitybasedpreventionprojects.IHShasdevelopedinjurypreventiontrainingprogramsspecificallyforthecommunitybasedpractitioner.IHSwillalsoassisttribesinbuildingtheircapacityandlocaltribalhealthinfrastructuretodevelopeffectiveprogramstopreventtraumaticinjuriesanddeathandincreasethenumberoftribalinjurypreventionprogramsbyasmanyas200projects.TheFY2001Budgetproposesinvestinginthedevelopmentofanenvironmentalhealthdatasurveillancesystemwhichincludesthecapacitytotracktheetiologyofinjuriessothateffectiveinterventionscanbeemployed. 3 ݌ s#s# Ќ  #XVJXX/XVJ[ #  3]    3s 23  0    _OPHS_ !ExecutiveandSecretarialOrdersandProclamations._OPHS_Ԁplanstocontinueitskey ` roleincoordination,management,andimplementationofseveralimportantExecutiveandSecretarialOrdersandProclamationstoaddressthehealthneedsofAI/_ANs_.Amongthemisthedepartmentalminorityinitiative,underExecutiveOrder13021issuedinOctober1996tosupportaccessbyTribalCollegesandUniversitiestoFederalresources._OPHS_ԀwillalsoexecuteanumberofcooperativeagreementsandotherformalarrangementswithnationalandcommunityorganizationstoaddressAI/ANhealthneeds,includingacooperativeagreementtoensurethatAI/ANneedsareappropriatelyaddressedintheNationalDiabetesEducationandPreventionPlan. 3s ݌ s#s# Ќ  lXXVJ#XVJXl # lXXVJ& < S#XVJXl #ELECTEDlXXVJFY2001#XVJXl? #ԀlXXVJP#XVJXl #ERFORMANCElXXVJG#XVJXl #OALSANDlXXVJM#XVJXl# #EASURES   lXXVJ    #XVJXl #*}~ ddSS SSS SSSS S{|s#s#,/ SS ,A SS ,SS +  &\\\\G   &  PerformanceGoals 8\\\\E#!!d \\\\G 8  Targets 8\\\\E#!!d  \\\\E 8  ActualPerformance '<  =\\\\E(&"P"   \\\\E =&U"%XXVJIncreasetheproportionofI/T/Uclients ## withdiagnoseddiabetesthathaveimprovedtheir_glycemic_Ԁcontrol.IHSPlan 0\\\\8% %\\\\E 0FY01:3yearaverageimprovedFY00:3yearaverageimprovedFY99:38% 0\\\\8% (\\\\ 0FY01:FY00:FY99:9/00FY98:35% /\\\\E&d!,\\\\ /IncreasetheproportionofI/T/Uclientswithdiagnoseddiabetesandhypertensionthathaveachieveddiabeticbloodpressurecontrolstandards.IHSPlan 0\\\\*h%0\\\\E 0FY01:3yearaverageimprovedFY00:3yearaverageimprovedFY99:30% 0\\\\<)$3\\\\ 0FY01:FY00:FY99:9/00FY98:27% /\\\\E*h%7\\\\ /IncreasetheproportionofwomanwhohaveannualPapscreening.IHSPlan 0\\\\\@\\\\E 0 PapScreening  d FY01:3%overFY00FY00:55%FY99:establishbaseline CervicalCancer    FY99:determineincidence 0\\\\  \\\\ 0FY01:FY00:FY99:04/00FY99:810/100,000basedon40%ofAN/AN /\\\\E`D\\\\ /IncreasecoverageoftheAI/ANfemalepopulation5069yearsofagewhohavehadannualscreeningmammography.IHS l  Plan 0\\\\dH \\\\E 0FY01:3%overFY00FY00:30%orgreaterFY99:establishbaseline 0\\\\l \\\\ 0FY01:FY00:FY99:04/00 /\\\\EdH \\\\ /IncreasetheproportionofAI/ANchildrenreceivingaminimumoffourWellChildVisitsby27monthsofageandexpandcoverage.IHSPlan 0\\\\hL!\\\\E 0FY01:3%overFY00FY00:3%overFY99FY99:establishbaseline 0\\\\p$\\\\ 0FY01:FY00:FY99:38.5%(provisional) /\\\\EhL(\\\\ /9ss,+(X,X,hX9IncreasethepercentageofAI/ANchildren68and1415yearswhohavereceivedprotectivedentalsealantsonpermanentmolarteeth.IHSPlan lP,  0\\\\H,-\\\\E 0 68Years  . FY01:2%overFY00FY00:23%overFY99FY99:50% 1415Years  $3 FY01:2%overFY00FY00:2%overFY99FY99:58% 0\\\\x7\\\\ 0FY01:FY00:FY99:38.8%FY91:40.1%FY01:FY00:FY99:66.8%FY91:66.5% /\\\\ExA\\\\ /:,X,hXss,+(Xk :IncreasetheproportionofAI/ANchildrenwhohavecompletedallrecommendedimmunizationsbytheagetwo.IHSPlan#XVJX"%&U* #&U"%XXVJ 0\\\\"D\\\\E 0FY01:2%overFY00FY00:2%overFY99FY99:90% 0\\\\"G\\\\ 0FY01:FY00:FY99:87%FY98:88% /\\\\E#|K\\\\ /Increaseoverall_pneumococcal_Ԁandinfluenzavaccinationlevelsamongadultsaged65yearsandolder.IHSPlan#XVJX"%&U #&U"%XXVJ 0\\\\&N\\\\E 0FY01:2%overFY00FY00:65% 0\\\\%P\\\\ 0FY01:FY00:FY99:FY98:63% /\\\\E' T\\\\ /Maintainongoingbodymassindex(_BMI_)assessmentsinAI/ANchildren35yearsoldand/or810yearsold,forbothinterventionpilotsitesandnoninterventioncomparisonsites,aspartofanoverallassessmentoftheongoingchildhoodobesitypreventionproject'seffectiveness. IHSPlan#XVJX"%&UH #&U"%XXVJ 0\\\\ h\\\\E 0FY01:implementprogramandmonitorpilotsandcomparisonssitesFY00:developfivepilotsitesFY99:developapproachandbaselines 0\\\\ \\\\ 0FY01:FY00:FY99:completed#XVJX"%&U #(  \\\\ (lXXVJ #XVJXl8 #lXXVJP#XVJXl #lXXVJROGRAMS#XVJXl #lXXVJS#XVJXl #lXXVJUPPORTING#XVJXlO #lXXVJT#XVJXl #lXXVJHIS#XVJXl #lXXVJO#XVJXl$ #lXXVJBJECTIVE    #XVJXlg #(X@s#s#(ACF   NativeAmericanProgramsAoA   GrantstoIndianTribesIHS t Treatment9,XF` X,X,hX9 F Hospitals&HealthClinics F DentalServices  T8  F MentalHealth F Alcohol&SubstanceAbuse F ContractHealthServices F UrbanHealth F IndianHealthProfessions F TribalManagement F SelfGovernance F ContractSupportCostsPrevention F PublicHealthNursing F HealthEducation F CommunityHealthRepresentatives F EnvironmentalHealthSupport F _OEHE_ԀSupport <& , CapitalProgramming/Infrastructure  SanitationFacilities  HealthCareFacilitiesConstruction  FacilitiesSupport  EnvironmentalHealthSupport  _OPHE_ԀSupport  EquipmentConsultation,Partnerships,CoreFunctions,andAdvocacy  DirectOperations  FacilitiesSupport  EnvironmentalHealthSupport  _OEHE_ԀSupport_OPHS_ 9 :,X,hX,XF` X :SAMHSA : KnowledgeDevelopmentandApplicationNationalDataCollectionStateInfrastructureSubstanceAbuseBlockGrantMentalHealthPerformancePartnershipBlockGrant P%4@ 5@s#s#X@ 5  ( @ D<? ,X X,X,hX?iU5%!`z  `E`ttx 3i s#s#     s#s#iU5%!`z  `E`ttx 3i FromtheHHSStrategicPlan,September1997. Togetherwithpartnersinstate,localandtribal L  governments,theDepartmentofHealthandHumanServices(HHS)isresponsiblefordeliveringanarrayofhealthandhumanservicesdesignedtoimprovethehealthandeconomicandsocialwellbeingofitscitizens.Attendantuponthisresponsibilityistheneedtoimprovethequalityoftheseservicescontinuallyinordertoenhancetheireffectiveness.TheDepartmentaccomplishesthisthroughsupportforawiderangeofqualityimprovementactivitiesdesignedtoprovidebetterwaysofaddressingtheconstantlychangingproblemsthatconfrontthehealthandhumanservicedeliverysystem,fromchangesinfamilystructuresanddemographicstoinnovationsinthewayhealthservicesareorganizedandfinanced. HealthCareServices. Americaisjustifiablyproudofthequalityofcareavailablefromitshealth   caresystem,whichoverthepastfiftyyearshasproduceddramaticimprovementsinthepreventionandeffectivetreatmentorcureofmanydiseasesand,inturn,longerlifespansandmoreproductivelives.Theseadvancesweresupportedinlargepartbythefeeforservicefinancingofthehealthcaresystem.However,acontinuingescalationofhealthcarecostsinthefeeforservicesystemsetthestageforthetransformationthatisnowoccurringinthefinancinganddeliveryofcare.Thedemandsofpurchasersforbettervalueinhealthcarehavefosteredavarietyofstrategiesandinterventions,nowoftendescribedintheaggregateasmanagedcare,whichhavebroughtutilizationcontrolsandcompetitiveforcestobearontheindustry.Suchchanges,alongwithpaymentreformsinMedicare,havehelpedcurbtherateofgrowthofhealthcareexpenditures.Atthesametime,concernshavearisenthatcostreductionsmightcompromisethequalityofcare.Studieshavefoundthatmanypatientsdonotreceivethemostappropriatetreatmentbecauseof_underuse_Ԁoroveruseofcertaintherapies.Assessmentsaredifficult,however,sincenationalbaselineinformationonthequalityofhealthcareisatthedevelopmentalstageandconsumersoftenerroneouslyequaterestrictionsonchoicewithdiminishedquality.Inaddition,theroleofpatientsinthehealthcaresystemischanging.Incontrasttoearlierpractice,individualsarebeingaskedtomakechoicesabouttheirhealthcareplans,healthproviders,andevenspecifictherapies.Manyhaverespondedtothischangebydemandinginformationabouthealthplans,providers,deliverysystems,andtreatmentoptionsandproducts.Yet,mostconsumershaveneverseeninformationonqualityofcare,andwhentheyhaveseenit,theywerenotsurehowtouseit.Inaddition,widedisparitiesinaccesstoqualityhealthcarepersistforcertaingroups,notablytheeconomicallydisadvantagedandracialandethnicminoritygroups,andcontributetoimportantdifferencesinhealthstatusandoutcomes.HHSinfluencesthequalityofhealthcareinthiscountryinmanyways.MedicalresearchsponsoredbytheNationalInstitutesofHealth(NIH)developstheknowledgebaseforclinicalandpopulationbasedhealthservices.FromresearchsponsoredbytheAgencyforHealthCarePolicyandResearch(_AHRQ_)havecomenewmeasuresofhealthoutcomesandqualityperformance,and 4.)- studiesoftheeffectivenessofbothmedicalservicesandofwaystoimproveandassurequalityofcare.Multipleagencies"NIH,_AHRQ_,HCFA,HRSA,IHS,andSAMHSA"developanddisseminateinformationonhowthatknowledgecanbemosteffectivelyappliedinvariousspecializedsettings.TheDepartmentisthelargestpurchaserofcareintheUnitedStatesthroughtheMedicareandMedicaidprogramsandthroughitsgrantprogramstostates,tribalgovernments,andnonprofitentitiessuchascommunityhealthcenters.TheHealthCareFinancingAdministration(HCFA)developsstandardsandcertificationofproviders,clinicallaboratories,andhealthplans,andhasbeenaleaderinthedevelopmentofperformancestandardsandqualitymeasuresforhealthplans.ThesestandardsensurethebasicqualityofcareforallAmericans.ThroughtheFoodandDrugAdministrations(FDA)regulationofdrugs,_biologics_,andmedicaldevices,andthequalityofinformationdisseminatedaboutthem,theDepartmentensuresthesafetyandefficacyofthesecriticalcomponentsofmedicalpractice.Also,theDepartmentdirectlyprovideshealthcaretoNativeAmericansthroughtheIndianHealthService(IHS).Furthermore,HHSinfluencespractitionersandconsumersthroughthedisseminationofhealthinformationtotheseaudiences. HumanServices. Humanservicesdeliverysystemsarecurrentlyundergoingenormouschanges p thatplacenewdemandsontheDepartmentsabilitytoprovidequalityservices.HHSroleincludesassistingstatesandotherpartnerstodeveloptheirdataandevaluationcapacitiesandprovidingextensivetechnicalassistancetohelpitspartnersinstateandtribalgovernmentsandincommunitiestohaveaccesstocurrentinformationonhowtoprovidehighqualityandeffectivesocialservices.TheDepartmentwillsupportbothresearchanddemonstrationstoexpandtheknowledgebase;toidentifybestpracticestohelpinformstatesofextantmodelsandapproachestoimprovethequalityofjobservices,transportation,andchildcareservices;tohelpidentifythosewhowouldnototherwisesucceedinworkwithoutancillaryhumanservices;andtohelpimprovetheintegrationandqualityoftheservicestoenableandsustainemployment.Breakingthecycleofdependencydependsbothonworkwithparentsandearlyinterventionsonbehalfofchildren.TheHeadStartprogramwasestablishedin1968toprovidecomprehensiveservicestopreschoolchildren.Inrecentyears,theprogramhasbeenexpandedtoservemorelowincomechildren.Programexpansionhasheightenedawarenessoftheimportanceofqualityservicesevenfurther.Recentresearchinrelateddisciplinesishelpingtosharpenunderstandingaboutearlyinterventionanditseffectsonearlygrowthanddevelopment.Theprogramhashadalonghistoryofmonitoringandprogramimprovement.ButevenmoreisneededtodevelopeffectivemeasuresofqualityandperformanceinHeadStart,EarlyHeadStart,andchildcareprograms.TheDepartmentwillcontinuetoworkcollaborativelywithnationalorganizations,researchers,andlocalprogramstodevelopmeasures.RigorousstudyhascommencedtomeasureEarlyHeadStartoutcomes,andchildcareresearchpartnershipswillbeexpandedtoconductfieldinitiatedstudiestoexamineissuesofquality,amongotherissues.Inrelatedefforts,theNationalInstituteofChildHealthandHumanDevelopment(_NICHD_)hasconductedanationalstudyoftheeffectsofchildcareonchilddevelopment.Theincreasingdemandforchildcareservicesforwelfareandlowincomefamilieshasbeguntobemetwithmodestincreasesinfundingforsubsidizedchildcare.However,littleisknownabouthowfarthesubsidymoniescanbeextended,thequalityofchildcarethatcanbepurchasedwiththeamountsavailable,thesupplyandnatureofchildcareavailable,utilizationpatterns,ortheextenttowhich 0.)- variationsinsubsidyandqualitychildcareaffectlaborforceattachment.TheAdministrationforChildrenandFamilies(ACF)hasinitiatedactivitiestoimprovetheDepartmentsunderstandingofthedemandsforchildcare,thechildcaremarket,andmethodsforassessingqualitytohelpinformparentsintheirchoicesofcare.Thequalityoflicenseexempt,unregulatedfamilydaycareisofparticularconcernsincethisisfrequentlythechoiceoflowincomefamilies.Additionalstudywillsooncommencetoexaminethenatureandeffectsofsuchcareonchildrenandontheirparentsabilitytoenterandsustainemployment.Throughtheseandotherinterventions,HHSplaysanimportantroleinenhancingthedevelopmentandapplicationofresearchbasedonqualitystandardsinthefieldofhumanservices.Inbothhealthcareandhumanservices,thestrategiesoutlinedforthisgoalshouldbeconsideredpartialandpreliminary.TheSecretaryhasidentifiedensuringthequalityofhealthandhumanservicesasoneoftheDepartmentshighestprioritiesforthenextfiveyears,andisleadingseveralplanningprocessestorefinetheDepartmentsstrategiesandtranslatethemintoaction.Elementsofthosestrategiesaredescribedintheobjectivesthatfollow.However,theyareexpectedtoevolvesignificantlyoverthenexttwoyearsandtobeinfluencedbytherecommendationsofgroupssuchasthePresidentsAdvisoryCommissiononConsumerProtectionandQualityintheHealthCareIndustry.  4 iU5%!`z  `E$tt< i s#s#    s#s#iU5%!`z  `E$tt< iL 0 !"#$%&(xx0 !"#$%&(L?,X,hX,X X? lXXVJK#XVJXl #EYlXXVJFY2001P#XVJXl #ROGRAMS,lXXVJI#XVJXl #NITIATIVES,ANDlXXVJS#XVJXll #TRATEGIES  `   3^    3 23  0    /XVJXXXVJ FDA !FDAisresponsibleforensuringthatdrugs,_biologics_,medicaldevicesandfoodare `  safe,effectiveandappropriatelylabeled.Inadditiontoreviewingnewdrugs,_biologics_,medicaldevicesandfoodadditiveproducts,FDAplaysakeyroleindisseminatinginformationaboutthesenewproductstohealthprofessionalsandinensuringthecorrectuseoftheseproducts. 3  ݌ s#s# Ќ  0  FDAcontinuestocollaboratewithindustrytoinformphysicians,patientsandconsumersaboutnewdrugsandfooditems.InFY2001,FDAwillcontinuetomakeinformationaboutnewlyapprovedproducts,productlabels,correctuseofmedications,andriskinformationaboutFDAregulatedproductsavailableontheInternettohealthprofessionals,consumersandotherinterestedpersons.FDAalsohasanoutreachprogramforphysicianstoinformthemofnewdrugsavailabletotheirpatients.InformationisalsoavailableonnewtherapiesapprovedbyforeigncountriesbeforetheFDAapprovesthem. s#s# L > !"#$%&(٘hx0 !"#$%&(L#XVJXX/XVJB #_L K !"#$%&( hh> !"#$%&(L  3    3$ 2 3  0    /XVJXXXVJ CDC!EpidemicServices .Epidemicservicescoveravastspectrumofactivities:preventing L andcontrollingepidemicsandprotectingtheU.S.populationfrompublichealthcrisesincludingbiologicalandchemicalemergencies;developing,operating,andmaintainingsurveillancesystems,analyzingdata,andrespondingtopublichealthproblems;trainingpublichealth_epidemiologists_;developingleadershipandmanagementskillsofpublichealthofficialsatthefederal,state,andlocallevels;carryingoutthequarantineprogramasrequiredbyregulations;andpublishingtheMorbidityandMortalityWeeklyReport,CDCsmainchannel ( forcommunicatingpublichealthnewsaboutdiseaseoutbreaksandtrendsinhealthandhealthbehavior.#XVJXX/XVJ5% # 3$ $ ݌s#s# Ќ    3    3( 2 3  0    /XVJXXXVJ FDA !AlthoughFDAregulatedproductsarerigorouslytestedduringthe_premarket_Ԁreview   period,certainrareadverseeffectsofproductsarenotrecognizeduntilafteraproductisinwidespreaduse.WhennewhealthrisksrelatedtoFDAregulatedproductsarerecognized,FDAensuresthatmanufacturers,healthprofessionals,andconsumersarealertedandcorrectiveactionsaretaken. 3( $) ݌ s#s# Ќ  0  _MedWatch_,theFDAMedicalProductsReportingProgram,isaninitiativedesignedbothtoeducateallhealthprofessionalsaboutthecriticalimportanceofbeingawareof,monitoringfor,andreportingadverseeventsandproblemstoFDAandthemanufacturer;andtoensurethatnewsafetyinformationisrapidlycommunicatedtothemedicalcommunityandthatpatientcareimprovesasaresult.FDAusesavarietyofmeanstoprovidefeedbacktothehealthcarecommunityaboutsafetyissuesinvolvingmedicalproducts,including DearHealthProfessionalletters,safetynotifications,productrecalls,andproductlabelchanges.TheseareavailableontheInternetandinprint.#XVJXX/XVJj) #,'+s#s#   t-(,   3    3. 2 3  0    HRSA!PrimaryCare,HealthCenters .HRSA'sHealthCentersprovide_psychosocial_   supportandenablingservicessuchasoutreach,homevisiting,casemanagement,transportation,translation,healtheducation,andeligibilitydetermination.Theseservices,whichmaynotbecoveredbypublicorprivateinsurance,aregearedtofacilitatetimelyentryintocareandappropriateuseofthehealthsystem. 3. . ݌ s#s# Ќ    3    3C1 2 3  0    /XVJXXXVJ CDC !Toensurethescientificfoundationofpublichealthpractices,CDCcoordinatesthe <  developmentoftheGuidetoCommunityPreventiveServices.ThisGuideprovidespublic , | healthpractitioners,theircommunitypartners,andpolicymakerswithevidencebasedrecommendationsforplanningandimplementingpopulationbasedservicesandpoliciesatthecommunityandstatelevel.#XVJXX/XVJ1 # 3C1 n1 ݌ @ s#s# Ќ    3    33 2 3  0    _AHRQ_Ԁ_Informatics_ ._AHRQ_Ԁwillundertakeathreepartinitiativein_informatics_Ԁresearchto   improvehealthcareincluding(1)thefurtherdevelopmentofwebbasedapplicationsforhealthsystemsandproviderstoimprovequality;(2)thedevelopmentandtestingof_informatics_applicationsandcomputerizedpatientrecordstoreducemedicalerrors,improvepatientsafety,andpromotequalityimprovementindiversehealthcaresettings;and(3)improvingtheefficiency,quality,privacy,andsecurityofhealthcaredata. 33 4 ݌ s#s# Ќ    3    3e7 2 3  0    _AHRQ_ԀMaximizingEmployeeHealth:theRoleofPurchasersandSystems. _AHRQ_Ԁwill @ focusonthequalityofthesystemsthroughwhichemployeesreceive,andthequalityofthehealthoutcomesandeffectivenessofthetreatmentsemployeesreceive,andthequalityofthehealthcareworkplace.Thisinitiativewilladdressunderlyinginitiativesthatareofcriticalimportancetoemployers,employees,andsocietyatlarge,suchas:interventionsorstrategiestopreventdisability;initiativestoenhancetheabilityofemployeestoreturntothesamejobonalongtermbasis(notsimplyreturntoanyjobandnotreturnonlyintheshortterm);workforceretention(giventhehighcostsofrecruitmentandtraining);productivity;andtheinterrelationshipsbetweenhealthcareoutcomes,qualityofcare,safety,andproductivity. 3e7 7 ݌ s#s# Ќ    3    3; 2 3  0    /XVJXXXVJ _AHRQ_ !Interimoutcomesofresearchcanbeevaluatedonarelativelyshorttermbasis. | However,theultimateoutcomeofhowtheresearchaffectspeoplereceivinghealthcareorpeopleinteractingwiththesystemrequireslarge,expensiveretrospectivestudies._AHRQ_ԀisimplementingagrowingportfolioofevaluationsthatwillshowovertimetheoutcomesoftheinvestmentsofAgencyfunds.TheFY2001strategyinvolvesassessingtheinterimoutcomesoffourtoolscreatedwithAgencyfundsforimprovinghealthcarequalityandevaluatingtheuseandusabilityoftheMedicalExpendituresPanelSurvey(_MEPS_)databasesfortheirintendedpurposes._AHRQ_Ԁqualityimprovementstrategiesthatwillbesubjectedtoevaluation,andsupportHHSeffortstopromoteeffectivehealthservicesinclude:1)evidencereportsandtechnologyassessmentsofevidencebasedpracticecenters;and2)productsthatadvancemethodstomeasureandimprovehealthcarequality,includingclinicalqualityimprovementsoftware(CONQUEST),theConsumerAssessmentofHealthPlansSurvey,andtheExpansionofQualityofCareMeasuresproject(QSPAN). 3; ; ݌ s#s# Ќ  #XVJXX/XVJ"< #XVJXXXVJ&XXVJ#XVJX&A #  3    3 B 2 3  0    HCFA ! ChildhoodImmunization .Thecentralimportanceofchildhoodimmunizationis x,'+ recognizedbytheStateChildrensHealthInsuranceProgram(_SCHIP_).Underthelegislation,Statesthatcreateaseparate_SCHIP_Ԁprogrammustincludecoverageofthecompleteseriesof T.)- immunizations.Statesalsoareprohibitedfromimposingcopaymentsordeductiblesonimmunizationservices. 3kA A ݌ s#s# Ќ  0  Moreover,highlyeffective,evidencebasedinterventionsareavailabletoraisechildhoodimmunizationcoveragelevels.Alargenumberofstudieshaveshownthatperformancemeasurementthrough_HEDIS_,registries,orotherassessmenttechniquesandtheuseofrecallandremindersystemstoidentifyandtrackchildreninneedofvaccinationwillsubstantiallyraisecoveragelevels.Amajorbarriertochildhoodimmunizationistheinformationgapthatexistsamongparentsandprovidersabouttheimmunizationstatus.Researchindicatesthatoverthreefourthsofparentsofchildreninneedofimmunizationbelievetheirchildiscompletelyvaccinated.Similarly,providersalsotendtogreatlyoverestimatetheimmunizationcoveragelevelsoftheirpatients.Thisinformationgapisanimportantreasonwhybothperformancemeasurementandrecallandremindersystemsarehighlyeffective,evidencebasedinterventionstrategiesthatarerecommendedbyboththeCentersforDiseaseControlandtheAdvisoryCommitteeonImmunizationPractices.&XXVJԀ s#s# #&&y? ##XVJX&љF #  /XVJXXXVJL K !"#$%&( hhK !"#$%&(L  3    3G 2 3  0    HCFA! PeerReviewOrganizations .Appropriateuseofeffectivemedicalservicesisa  criticalcomponentofHCFAsfocusonMedicarebeneficiaries.HCFAseffortstoimprovemedicaltreatmentthroughitscollaborationwithPeerReviewOrganizationsisthebasisforitsperformancegoalsto:1)improveheartattacksurvivalrates,2)increaseinfluenzavaccination,and3)increasetheuseof_mammograms_._PROs_,whichserveundercontractwithHCFA,conductcooperativeimprovementprojectsinwhichtheyusedatatoidentifyopportunitiestoimprovecare,andthenworktodevelopinterventionsthatwillbringimprovementforsubjectqualityindicators.PertinenttotheHCFAperformanceplan,HCFAandthe_PROs_Ԁarefosteringutilizationofinterventionstotreatheartattacksandimprovesurvivalrates;areworkingwithproviders,healthplansandothersoninfluenzavaccinationprojects;andarenetworkingwithlocalprojectcollaboratorstoprovideeducationandreminderstoimprovemammographyrates. 3G G ݌ s#s# Ќ  #XVJXX/XVJ*G #  3    3L 2 3  0    6XVJXXXVJ FDA !FDAiscommittedtoprovidingclear,uptodateinformationtoconsumersandpatients  thattheyneedtomakehealthcaredecisionsandtousehealthproductsappropriately.TheAgencyisawareofthegrowingdiversityofconsumerhealthneedsandinterests.FDAwillcontinuetoimplementtargetedpublicawarenesscampaignssuchastheFoodSafety H"  Programs_BAC_!,MammographyAwarenessSeminars,andOvertheCounter(OTC)Labeling 4#! Changesandwillcontinuetomakeinformationaboutnewlyapprovedproducts,productlabels  $p" andarangeofhealthissuesavailableontheInternetinlanguageconsumerscanunderstand.TheInternetisbeingusednotonlytodisseminateinformationtoconsumersbutalsotoobtaintheirinputonvariousissuesofinteresttotheAgency.TheFDAConsumerandotherprinted &4"% materials,manyofwhichareavailableinseverallanguages,areprovidedtopersonswhoarewithoutInternetcapabilities.AgeneraltelephonenumberandseveralspecialinteresthotlinesarealsoavailabletoconsumerswhohavespecificquestionsaboutFDAregulatedproducts.PublicAffairsSpecialistsinFDAsfieldofficeswillcontinueto 3L M ݌ s#s# Ќ  0  playakeyroleinfurnishinguptodateinformationaboutnewandemergingproductstointerestedconsumers.#XVJXX6XVJWM #l,'+s#s#   X-(,   3    3S 2 3  0    /XVJXXXVJ CDC !CDCfocusesonassuringthepublicshealththroughthetranslationofresearchinto   effectivecommunitybasedaction.Thisgoalisorientedtowardsdevelopingthecapacityofpublichealthdepartmentstocarryoutessentialpublichealthprogramsandservices,andinvolvecommunityinstitutionsandcommunitygroupsinhealthpromotionanddiseaseprevention. 3S GS ݌ s#s# Ќ  0  Also,whatpeopleunderstandabouttheirhealthandpotentialriskstotheirhealthisofmajorconcerninpublichealth.CDCpromoteseffectivehealthcommunication,conveyinginformationtoappropriatepopulations,andfacilitatingaccesstohealthinformation.Theagencyseekstoenhancethepublicshealthknowledgethroughcommunicationthatiscongruentwiththevaluesofdiversecommunities. s#s# 0  CDCwillalsocontinueitseffortsinthetrainingofpublichealthleadersinthescienceofpublichealthpractice.Trainingeffortsinthisareaarecriticalinaddressingfuturepublichealthissues.Forexample,theCDCsponsoredPublicHealthLeadershipInstituteisanongoingprogramthatdevelopstheleadershipskillsofpublichealthofficialsattheFederal,State,andlocallevels.#XVJXX/XVJS #ts#s#   3    3Y 2 3  0    XVJXXXVJ_OPHS_ !AcomprehensiveSurgeonGeneral'sreportonmentalhealth(thefirsteveronthis L areaofhealthcare)scheduledforreleaseinFY2000willincludecuttingedgeinformationaboutthestatusofmentalhealthresearchandserviceswithintheUnitedStates.ThereportisexpectedtoserveasabasisforshapingtheFederalgovernment'sfuturementalhealthprograminitiatives,aswellasprovidingthepublicwithvaluableinformationaboutmentalhealthissuesimpactingthecountry.Asmentalhealthandmentalillnessbecomemoremainstreamandlessstigmatized,healthinsurancecoverageislikelybebecomelessrestrictive. 3Y FY ݌ s#s# Ќ    3    3\ 2 3  0    #XVJXXXVJY #/XVJXXXVJSAMHSA !#XVJXX/XVJ;] #XVJXXXVJBridgingthegapbetweenresearchandpracticeinmentalhealthservicesand  substanceabusepreventionandtreatmentisoneofSAMHSAsgoalsforpursuitofserviceeffectiveness.KnowledgeapplicationactivitiesareintendedtofurtherdevelopandimplementresultsoriginatinginorsupportedbytheNationalInstitutesofHealth(NIH)andotherorganizations.ItistheintentofthisaspectofSAMHSAsKnowledgeDevelopmentandApplicationprograms(_KDAs_)tosynthesizeknowledge(neworexisting)intoformsthatareusefultopractitioners,effectivelycreating#XVJXXXVJ] #/XVJXXXVJ bestpracticesthatcommunitybasedorganizations <"  canuse. 3\ \ ݌ s#s# Ќ  0  InFY2001,knowledgeapplicationmechanismsareprominentthroughoutSAMHSAsprograms,asthefollowingexamplesindicate. s#s#  L !"#$%&(hhK !"#$%&(L  3   0   3b 23  0s#s#  TheCenterforMentalHealthServicesSchoolandCommunityActionGrantprogram '#& requiresorganizationstoemployanexemplarypracticetopreventyouthviolence,promotehealthychilddevelopmentandfosterresilience,andtotakeresponsibilityforfacilitatingtheadoptionofthepracticeinaspecificcommunity. 3b >b ݌ s#s# Ќ  0   s#s#   3   0   3>d 23  0s#s#  #XVJXX/XVJD` #4XVJXXXVJdTheCenterforSubstanceAbusePreventionsNationalStrengtheningtheFamilyInitiative `,'+ includesadisseminationresearchprogramthatisdeterminingcosteffectivemethodsfordisseminatinginformationandtrainingonsciencebasedfamilyfocusedprevention 8.)- strategies.TheInitiativealsoincludestheParentingisPreventionProgramtostrengthenexistingantidrugprogramsdirectedbyparents,byprovidingtraining,technicalassistanceandresourcesforparentsininitiatingyouthdrugpreventionprograms. 3c %d ݌ s#s# Ќ    3   0   35g 23  0s#s#  #XVJXX4XVJd #XVJXXXVJThePreventionEnhancementProtocolSystemcollects,synthesizes,translatesand t disseminatesresearchandpracticebasedfindingsinauseableformforapplicationincommunities.d#XVJXXXVJg #4XVJXXXVJ 35g lg ݌L s#s# Ќ    3   0   3Qi 23  0s#s#  TheNationalCenterfortheAdvancementofPrevention#XVJXX4XVJh #XVJXXXVJdevelops,synthesizes,updatesand 8  disseminatesstateoftheartpreventionknowledgeaboutwhatworksinprevention,forwhom,andunderwhatconditions.#XVJXXXVJ/j #4XVJXXXVJԀ#XVJXX4XVJ k #Ԁ 3Qi i ݌ `s#s# Ќ    3   0   3k 23  0s#s#  TheCenterforSubstanceAbuseTreatment(_CSAT_)willcontinuetopursuetheapplication  L  ofexemplarytreatmentmodels,applyingtheconceptsparticularlytowomenreceivingTemporaryAssistancetoNeedyFamilies,andindividualswithcooccurringpsychiatricandsubstanceabusedisorders. 3k k ݌ s#s# Ќ    3   0   3m 23  0s#s#  _CSAT_sPractice/ResearchCollaborativeisdesignedtobringresearchers,providers,and   othercommunityleaderstogethertoreviewavailabledataonsubstanceabuseandsubstanceabusetreatment,todevelopplansforimprovingtheservicesthatareavailable,andtoconductresearchandevaluationstudiesthatareneededtoassurethattheimprovementsaremade. 3m m ݌ s#s# Ќ       4  `    h   lXXVJS#XVJXlp #ELECTEDlXXVJFY2001#XVJXlp #ԀlXXVJP#XVJXlq #ERFORMANCElXXVJG#XVJXlmq #OALSANDlXXVJM#XVJXlq #EASURES   p * d d/ SS / A SS A SS }~s#s#,SS ,SSS ,SSS +  &\\\\G  p &  PerformanceGoals 8\\\\E#! \\\\G 8  Targets 8\\\\E#! \\\\E 8  ActualPerformance &U"%XXVJ =\\\\E(&p   \\\\E =& ( IncreasethepercentageofMedicareBeneficiariesAge65andoverwhoreceivea_mammogram_Ԁeverytwoyears.HCFAPlan <    0\\\\!D"\\\\E 0#XVJX"%&Us #&U"%XXVJFY01:51%* @# FY00:60%**FY99:59%**#XVJX"%&USu #P<%XXVJ*Newdatasource(Medicare & ClaimsData)willbeemployedforFY2001.**Datasource:NationalHealthπInterviewSurvey#XVJX%P FY95/96:31.4% /\\\\E'"?\\\\ /#Y"%&Uy #&U"%YIncreasethepercentageofMedicarebeneficiaries d age65yearsandolderwhoreceivevaccinations.0 / !0[//annualinfluenzavaccination [[  0 /  // Ѐ!lifetime_pneumococcal_ԀvaccinationHCFAPlan#Y"%&Uz # 0\\\\@$\\\\E 0&U"%YFY01:72%*FY00:60%**FY99:59%**FY01:55%*FY00:Newin2001FY99:Newin2001#Y"%&Ut| #*Newdatasource(MedicareCurrentBeneficiarySurvey)willbeemployedforFY2001.**Datasource:NationalHealthInterviewSurvey 0\\\\(\\\\ 0&U"%YFY01:FY00:FY99:FY98:FY97:63%**FY95:58%**FY94:55%**FY01:FY00:FY99:FY94:25%#Y"%&U} #* /\\\\E@$9\\\\ /&U"%YTheproportionofpeople18andoverreporting 8: depressioninthepast12monthswhoarereceivingtreatment._OPHS_ԀPlan 0\\\\<\\\\E 0FY01:30% 0\\\\>\\\\ 0FY01:FY00:FY99:FY98:FY97:23% /\\\\EC\\\\ /PercentageofCDCfundedstatediabetescontrolprogramsthatwilladopt,promote,andimplementpatientcareguidelinesforimprovingthequalityofcarereceivedbypersonswithdiabetes.CDCPlan 0\\\\"G\\\\E 0FY01:100%.FY00:100% 0\\\\ I\\\\ 0FY01:FY00:FY99:1/00FY98:60% /\\\\E"M\\\\ /&U"%"%&UBasedonestablishedcriteria,continuetopublish $N theMorbidityandMortalityWeeklyReports $O (_MMWR_)seriesofpublicationsincludingReports %P andRecommendations,SurveillanceSummaries,andtheAnnualSummarytocommunicatemajorpublichealtheventstothemedia,publicpolicymakersandhealthprofessionalsthroughmultiplemediachannelsprint,television,radio,interactiveWorldWideWeb.#&U"%"%&Uс #CDCPlan 0\\\\*#V\\\\E 0&U"%"%&UFY01:86issues $W FY00:81issuesFY99:77issues#&U"%"%&UJ # 0\\\\%Y\\\\ 0&U"%"%&UFY01: $Z FY00:FY99:77issuespublished.AlsoavailableonCDCwebsite.#&U"%"%&U ##Y"%&U~ #(h(L!_  \\\\ (XVJXY lXXVJP#XVJXl #ROGRAMSlXXVJS#XVJXl] #UPPORTINGlXXVJT#XVJXl #HISlXXVJO#XVJXl #BJECTIVE  -&a Ї(X@s#s#(_AHRQ_  MedicalExpenditurePanelSurveys̀ResearchonHealthCosts,Quality,andOutcomesCDC ` HIV/AIDSPreventionSexuallyTransmittedDiseasesTuberculosisImmunizationDiabetesandOtherChronicDiseasesHeartDiseaseandHealthPromotionBreastandCervicalCancerPreventionPreventionCentersInfectiousDiseasesLeadPoisoningHealthStatisticsPreventionResearchEpidemicServicesEnvironmentalDiseasePreventionOccupationalSafetyandHealthEliminatingRacialandEthnicDisparities  p FDA  FoodsHumanDrugsMedicalDevicesandRadiologicalHealth_Biologics_AnimalDrugsandFeedsHCFA 8  MedicaidMedicareL K !"#$%&( hh !"#$%&(LMedicare+ChoicePeerReviewOrganizationsHRSA $  PrimaryCare,HealthCentersNIH  ! ResearchProgram _OPHS_  # OfficeoftheSurgeonGeneralHealthyPeople2000SAMHSA H& KnowledgeDevelopmentandApplication 4'  H'   H' 5@s#s#X@ 5iU5%!`z  `E`ttx 3i s#s#     s#s#iU5%!`z  `E`ttx 3iL 0 !"#$%&(xhK !"#$%&(L9,X,hX,X,hX9 lXXVJK#XVJXl #EYlXXVJFY2001P#XVJXlM #ROGRAMS,lXXVJI#XVJXl #NITIATIVES,ANDlXXVJS#XVJXl #TRATEGIES  L    3    3Y 23  0    HRSA ! /XVJXXXVJPrimaryCare,#XVJXX/XVJݏ #HealthCentersandtheNationalHealthServiceCorps (_NHSC_). L  HRSAsHealthCentersandtheNationalHealthServiceCorpsformacosteffective,integratedsafetynetfor_underserved_Ԁanduninsuredchildren,adults,migrantworkers,homelessindividuals,publichousingandU.S./Mexicoborderresidentsinapproximately4,000communitiesacrossthecountryandwillserveover11millionpersonsinFY2000whowouldotherwiselackaccesstoprimarycareclinicians.Thiscommunitybasednetworkdeliverspreventiveandprimarycareservicesfortheneediest,poorest,andsickestpatientsinruralandinnercityareas,throughaFederal,State,andcommunitypartnershipapproach.HealthCentersandthe_NHSC_Ԁcontributetodecreasesinracialandincomedisparitiesbyprovidingpreventiveservicesandriskreductiontoapopulationthatislargelyminority(64%)andlowincome(86%)anddisproportionatelyuninsured(41%). 3Y ݌ s#s# Ќ    3    3 23  0    HRSA!MaternalandChildHealthBlockGrant(_MCHBG_). _MCHBG_Ԁprovides ` assistanceandcareforsomeofthenewchildrenandcriticalnew needsidentifiedbyCHIPand P MedicaidoutreachthatcannotbemetbyMedicaidorStateChildHealthplans,suchasadditionaltranslation,casemanagement,transportation,specialpublichealth,disability,andgapfillingservices(frequentlyreferredtoas enablingservices)neededtomakeMedicaideffectiveforlowincomechildren. 3 ݌ s#s# Ќ    3    3 23  0    HRSA!HealthyStart .4XVJXXXVJHealthyStartfocusesontheneedtostrengthenandenhance , communitysystemsofperinatalhealthbyhelpingcommunitiestofullyaddressthemedical,behavioraland_psychosocial_Ԁneedsofwomenandinfants.TheFY2001programwillprovideforacontinuingopportunitytoreducefactorscontributingtoinfantmortalitybyadaptationofsuccessfulHealthyStartmodelsofinterventioninurbanandruralcommunitieswithhighratesofinfantmortality,especiallyamongracial/ethnicpopulations,andtosharethelessonslearnedwithStates,communities,andacademicandprofessionalorganizations. 3 ݌ s#s# Ќ    3    3 23  0    #XVJXX4XVJ #/XVJXXXVJ CDC!EliminatingRacialandEthnicDisparitiesinHealth .CDCeffortswillfocuson @$" infantmortality,cancer,cardiovasculardiseases,diabetes,HIV/AIDS,andadultandchildimmunization.CDCwillalsoaddressotherareasofpreventablehealthdisparitiesincludingperinatalconditions,injuries,sexuallytransmitteddiseases,andotherinfectiousdiseases.Specificactivitiesincludefocusing_STD_ԀandHIV/AIDSpreventioneffortsincommunitiesofcolor.Thecurrentepidemiologyofsyphilis,combinedwithitsbasicbiologiccharacteristics,makeitpossibletoeliminatethisdiseaseintheUnitedStatesthroughenhancedsurveillance,outbreakresponsepreparedness,efficientdeliveryofeffectivebehavioralandbiomedicalinterventions,andassessmentofbothqualityandcoverageofpreventionandcontrol.ThismultisystemapproachtosyphiliseliminationwillalsobuildsustainablepreventioncapacityforpopulationsathighriskforHIVandothersexuallytransmitteddiseases.Inaddition,CDCwillcontinuetoconductappliedpreventionresearch,expandprogramsandimprovesurveillance h.)- aimedatthehealthproblemsofracialandethnicminorities,andimprovevaccinationcoveragelevelsofadolescentsandadults.#XVJXX/XVJښ #4XVJXXXVJ 3F q ݌s#s# Ќ  #XVJXX4XVJ4 #/XVJXXXVJ  3    3٠ 23  0    HCFA!Horizons . Toachieveitsperformancetargetsforinfluenzavaccinesand t _mammograms_Ԁforelderlyindividuals,HCFAmustaddressthespecialneedsofminorityindividualswhoreceivetheseservicestoalesserdegreethanthepopulationasawhole.UnderHorizons,eightPeerReviewOrganizationsareworkingwithelevenHistoricallyBlackCollegesandUniversitiestoformulatestatewideinterventionswithafocusonoutreachtotheAfricanAmericanMedicarepopulation.HCFAwillalsotargetnursinghomeresidentsforvaccinationagainstinfluenza!apopulationathighrisk.InordertoaddressthelowermammographyutilizationratesforAfricanAmericanandHispanicAmericanMedicarebeneficiaries,sixMedicarePeerReviewOrganizations,alsounderHorizons,arecarryingoutcommunitybasedprojectstoincreasemammographyratesinsixmajorcitiesforthesespecificpopulations. 3٠  ݌ s#s# Ќ  #XVJXX/XVJ #4XVJXXXVJ  3    3 23  0    NIH!CentersofExcellenceforResearchonHealthDisparities .ForNIH,theCenters     willbecomeafocalpointforenhancedsupportforresearch,researchtraining,and x infrastructurethatwillacceleratethegenerationofnewknowledgeabouthealthdisparities.Thesecenterswillencompassbasicandclinicalresearchfocusedonaddressinghealthdisparities,particularlythoseaffectingminorityanddisadvantagedsocioeconomicgroups.Majorgoalsofthesecenterswillbetoestablish,strengthen,andexpandresearchandtrainingonhealthdisparities;toenhancetheacademicperformanceofminoritystudents;toincreasethenumberandqualityofminorityapplicantsforresearchgrants;andtoimprovethecapacitytotrain,recruit,andretainminorityfaculty. 3 ݌ s#s# Ќ    3    3z 23  0    NIH!DisparityResearchTopics .NIHwillcontinuetosupportabroadrangeofresearch,  includingstudiesofhowsocioeconomicandculturalfactorscontributetothedevelopmentofhealthbeliefsandpractices,expandedeffortsinpopulationgenetics,andeffortstogainamorefundamentalunderstandingoftheeffectsoftheenvironment,culture,andeconomicstatusonhealth.Researchwillalsocontinuetoaddresshealthdisparitieswithrespecttovariousdiseases.#XVJXX4XVJp #/XVJXXXVJThemagnitudeoftheAIDSpandemicisprofound.AIDShassignificantlylowered d  thelifeexpectancyinmanynationsofAfrica,theglobalepicenterofAIDS.TherehasbeenasteepincreaseofnewinfectionsinSubSaharanAfrica,andburgeoningdiseaseratesalsothreatenthevastpopulationsofIndia,SoutheastAsia,andChina.IntheUnitedStates,newHIVinfectionsandAIDSrelateddeathscontinuetoincreaseinmanysubpopulations!amongwomen,racialandethnicminorities,heterosexuals,adolescents,drugusers,andpeopleover50yearsofage.NIHresearchinthisareawillincludeexamininggenderdifferencesin_HIH_/AIDS,disparitiesinresponsetotherapyandpreventionamongminorities,andclinicaltrialsandresearchinfrastructuredevelopmenttofacilitatetheconductofinternationalstudies.#XVJXX/XVJ #/XVJXXXVJ 3z ݌'#&s#s# Ќ    3    3 23  0    IHS!ReducingtheGapinHealthDisparitiesInitiative. Thisinitiativetargetsthehealth ($' problemsidentifiedashighestprioritybytheI/T/Uandresponsibleformuch_fo_ԀthedisparitynhealthstatusfortheAI/ANpopulation.Theseincludealcoholismandsubstanceabuse,diabetes,cancer,mentalhealth,elderhealth,heartdisease,injuries,dentalhealth,maternalandchildhealth,domesticviolence,infectiousdiseasesandsanitation.Supportforpublichealthinfrastructureisalsofundamentaltothisinitiative.Thisinitiativewillalsosupportsurveillance,prevention,andtreatmentservicesandarebasedon bestpracticesdefiedinthehealth <.)- literature.IHSwillalsoaddresstheneedforwaterandsewersystemsfornewandexistinghomesatthecommunitylevel.#XVJXX/XVJ # /XVJXXXVJ 3 C ݌s#s# Ќ  #XVJXX/XVJ #4XVJXXXVJ  3    3b 23  0    #XVJXX4XVJB #/XVJXXXVJ HRSA!HIV/AIDS,HIVCareandEmergencyReliefGrants .Recentstudieshave t demonstratedthatthebenefitsprovidedbythenewcombinationdrugs(anti_retrovirals_/proteaseinhibitors)havenotuniformlyreducedtheincidenceofAIDSbetweengendersorracialandethnicminorities.Tothisend,HRSAhasfocusedprioritiestoincludeincreasingaccesstothesevulnerablepopulations.#XVJXX/XVJ #4XVJXXXVJ 3b ݌( xs#s# Ќ    3    3Z 23  0    #XVJXX4XVJ # HRSA!RuralHealthOutreachGrants .TheRuralHealthOutreachandRuralNetwork  P  DevelopmentGrantProgramssupportthedeliveryofbasichealthservicestohundredsofthousandsofAmericanslivingin_underserved_Ԁruralareasofthecountry. 3Z ݌ s#s# Ќ    3    3Y 23  0    /XVJXXXVJ SAMHSA! #XVJXX/XVJʹ #4XVJXXXVJAspartofSAMHSAs TargetedCapacityExpansion program,anefforthas   beenmadetoinitiateorstrengthentheintegrationofHIVandsubstanceabusepreventionatthelocallevelandincreaselocalcapacitytoprovideintegratedservicestoAfricanAmericanandHispanicyouthandwomen.Inaddition,_CSAP_ԀcontinuestoidentifyspecificinterventionstailoredforyouthandwomenofcoloratriskforsubstanceabuseandHIVtodevelopstrategieswithemphasisonreducingknownriskfactors,increasingprotectivefactors,buildingresiliency,andaddressingmultiplerisksthatcrossdomains.#XVJXX4XVJ #Ԁ 3Y ݌@s#s# Ќ    3    36 23  0    OCR ! PreventingDiscriminationinAccesstoHHSServices .XVJXXXVJOCRwillconcentrateits h resourcesonthecriticalcivilrightsissuessurroundingchangesinhealthcarecoverageandservices,includingincreaseduseofmanagedcare,thatareundertakeninthestates.#XVJXXXVJ #XVJXXXVJԀOCRwill D focusonassessingtheeffectsofmanagedcareonservicestominorityanddisabilitycommunities.Itwillexpandthenumberofreviewsconcentratingonensuringthat,asbothMedicareandMedicaidexpandthesueofmanagedcare,racialandnationalminorityindividualsandpersonswithdisabilitiesaretreatedinanondiscriminatorymanner.OCRwillworkwithitsHHSAgencypartnerstoimproveresearchanddatacollectioneffortstosupporttargetenforcementinthischangingarena.InadditionOCRwillcontinuetoworkwithhealthcareandsocialservicesproviders,stateandlocalagenciesandHHSpartners,toensurethatpersonsoflimitedEnglishproficiencyarenotdiscriminatedagainstonthebasisofnationalorigin.#XVJXXXVJ #XVJXXXVJ 36 a ݌@" s#s# Ќ  #XVJXXXVJZ #  3    3 23  0    OCR!DiscriminationandRacialDisparities .RecentstudiesbyHHS,variousnonprofit $h" organizations,universitiesandotherpublicagencieshaveshedlightonseriousdisparitiesinthehealthstatusofraceandethnicminoritiesandinpractitionerreferralsofminoritiesforspecificdiagnosticandtherapeuticprocedures.Racialminoritiescontinuetofallfarbehindthegeneralpopulationinlifeexpectancy,riskofseriousillness,andaccesstoafullrangeofmedicalservicesandspecialtycare.Inaddition,ithasbeenfoundthatevenwhenallfactorsareequal,age,income,job,educationandmedicalinsurance,minoritypatientsarelesslikelytoreceivethemoreexpensiveandsophisticatedformsofcarefortheirmedicalproblems.ItisessentialthatOCRtakestepstodeterminewhetherviolationsofTitleVIandotherlawsenforcedbyOCRarecontributingfactorstothesedisparities.OCRhasbeguntheprocessofstudyingtheissuebyconductingresearch,meetingwithcommunitybasedorganizations,medicalproviders,publicofficialsandconcernedindividuals. 3 ݌@.)-s#s# Ќ  __0  /XVJXXXVJOCRwillalsocontinueitsenforcementeffortsintheeliminationofredliningofhealthservices  thatmayadverselyaffectpeopleofcolororpersonswithdisabilities.Redliningoccurswhenaserviceproviderrefusestoprovideservicesortoprovidedifferentservicestoanindividualbasedonthegeographiclocationwheretheserviceistobeprovided. s#s# #XVJXX/XVJ #  3    3y 23  0    _AHRQ_ԀEliminatingRacialandEthnicHealthDisparities .BeginninginFY2000,_AHRQ_ 8  committedtoalongterminvestmentinactivitiestomakesubstantialcontributionstotheNationsprogressinaddressingdisparities.Infiscalyear2001,_AHRQ_Ԁwillsupportprojectstotackletheissueofracialdiscriminationinhealthcarequality,providetoolsandstrategiestoimprovehealthcareforminorityAmericans,andtrainamorediversehealthresearchworkforcesothatwemayovercometheseissuesinthefuture.  3y ݌( s#s# Ќ  /XVJXXXVJ0  Forexample,_AHRQ_Ԁwillalsofocusitsresearchtodevelopandassessstrategiesfocusedon   improvingcardiaccareforminoritywomenandthepreventionoflowbirthweightinchildrenofminoritywomen.Theimpactofculturaldifferencesonoutcomesofcarewillbeconsidered,andeffectiveapproachestobettercommunicationwillbeincorporatedintomodelstested.#XVJXX/XVJ #ts#s#   3    3 23  0    _OPHS_ !TheDepartmentsInitiativetoEliminateRacialandEthnicDisparitiesinHealth L targetssixareas:infantmortality,cancerscreeningandmanagement,cardiovasculardisease,diabetes,HIV/AIDS,andchildhoodandadultimmunizations.ThefoundationfortheinitiativeisderivedfromthegoalsofHealthyPeople2000andisconsistentwiththeproposedgoaltoeliminatedisparitiesinhealthinHealthyPeople2010. 3 ݌ s#s# Ќ  0  HealthyPeople2010willbepublishedinFY2000._OPHS_ԀwillexaminewhetherandhowtheactionsadoptedinthesixareasaffectimplementationandtrackingstrategiesforHealthyPeople2010forthoseandotherfocusareas.Fundingwouldbeusedforanalysesthatwouldlookmoregloballyatprogressandlessonslearnedintheshortterminallsixfocusareas,drawingonworkdonebyresponsibleoperatingdivisionsinaspecificarea;forconveningfederalpartners,nationalorganizations,andotherStateandlocalstakeholderstoreviewthefindingsand_replicability_ԀofspecificaspectsoftheinitiativeandidentifyapplicationtoHealthyPeople2010;and,asappropriate,toengageotherinterestedpartiesthroughactiveoutreachintoincorporatingthesefindingsintoactionsaddressingotherHealthyPeoplefocusareas. s#s# 0  _OPHS_Ԁwillcontinuetoworkwith_NCHS_ԀandHHScomponentstopromotethecollectionandestablishmentofbaselineandcomparisondatabyraceandethnicityusing,ataminimum,theOMBDirective15standards. s#s#   3    3> 23  0    _OPHS_ !TheMinorityCommunityHealthCoalitionDemonstrationProgramwillcontinueto '#& support17demonstrationprojectsfocusingonthereductionofhealthriskfactorsinminoritypopulations.Emphasiswillcontinuetobeoneffortsthatcandemonstrateeffectivecoordinationofintegratedcommunitybasedscreening,outreach,andotherenablingservicestoaddresshealthproblemsandneedsofminoritycommunities. 3> i ݌ s#s# Ќ    3    3 23  0    _OPHS_ !TheOfficeofMinorityHealthResourceCenterwillcontinuetoengageinawide L-(, rangeofactivitiestoinformandeducateracial/ethnicminoritycommunitiesandthosewho <.)- servethemregardingthenatureandextentofracial/ethnicdisparitiesinhealth,policiesandprogramsunderwaytoaddresssuchdisparities,andactionstheycantaketoimprovetheirhealthcareoptions.Someoftheseactivitiesinclude:assistanceinthedevelopmentofSpanishlanguageradiobroadcastmessagestoHispaniccommunitiesonhealthpromotionandhowtousemanagedcareplansappropriately;provisionofSpanishspeakingstafftorespondtopublicinquiriesforinformationandrecommendationsfollowingsuchradiobroadcasts;andprovisionofinformationonandreferralstonationalorganizationsofminorityhealthcareprovidersandminorityhealthadvocacyorganizationsthat,inturn,providerecommendationsregardinglocalproviders. 3{ ݌ s#s# Ќ    3    3 23  0    _OPHS_ !TheBilingual/_Bicultural_ԀServiceDemonstrationGrantProgramwillcontinueto  8  supportcommunitybasedprojectstoimproveaccesstohealthcareservicesforlimitedEnglishproficient(_LEP_)populations.Allprojectsfocusonimprovingtheabilityofhealthcareprovidersandotherhealthcareprofessionalstodeliverlinguisticallyandculturallycompetenthealthcareservicesto_LEP_Ԁpopulations./XVJXXXVJ 3 @ ݌ s#s# Ќ    3    3 23  0    _OPHS_ !#XVJXX/XVJ #XVJXXXVJTheCenterforLinguisticandCulturalCompetenceinHealthdevelopsandevaluates t models,conductsresearch,andprovidestechnicalassistancetoprovidersto#XVJXXXVJ #XVJXXXVJaddressthe d culturalandlinguisticbarrierstohealthcaredeliveryandincreaselimitedEnglishspeakingindividualsaccesstohealthcare.FY2000activitiesinclude:disseminatinginformationoncurrentlanguageandculturalcompetencymodelprograms,techniques,organizationalandgovernmentalpolicies;launchingaculturallycompetencesystemschangeinitiative;conductinganevaluationofselectedsitestodeterminetheeffectivenessofculturallycompetentprogramsonethnicallydiversepatients;commissioningpapersondevelopmentofculturallycompetenttrainingprogramsforhealthcareproviders; developingaresearchprojectoncultural ( competencehealthdeliveryprograms,andinitiatingresearchonimpactofculturallycompetentservicesonpatienttreatmentprotocolsandoutcomes.AllproductswillbedisseminatedthroughtheOfficeofMinorityHealthResourceCenter(_OMHRC_)andthroughthe_OMHRC_website.#XVJXXXVJ #/XVJXXXVJ 3 I ݌s#s# Ќ  #XVJXX/XVJ3 #&  lXXVJS#XVJXl #ELECTEDlXXVJFY2001#XVJXl #ԀlXXVJP#XVJXl^ #ERFORMANCElXXVJG#XVJXl #OALSANDlXXVJM#XVJXl #EASURES  P! XVJXXXVJ&U"%XXVJ* ddSS SSS SSSS Ss#s#,SS ,SS ,SS +  &\\\\G P#! &  PerformanceGoals 8\\\\E#!#" \\\\G 8  Targets 8\\\\E#!## \\\\E 8  ActualPerformance =\\\\E(&$%   \\\\E =DecreaseproportionofHealthCenteruserswhoarehospitalizedforpotentiallyavoidableconditions.#&U"%"%&U[ #&U"%"%&U#XVJX"%&Uz #&U"%XXVJԀHRSAPlan 0\\\\'#(\\\\E 0FY01:13FY00:13.5FY99:14#&U"%"%&U( #&U"%"%&U#XVJX"%&Uj #&U"%XXVJ 0\\\\'#+\\\\ 0FY01:FY00:FY99:9/01FY98:9/00  ԍFY97:14.7/1000#XVJX"%&UN #&U"%XXVJ#&U"%"%&U #&U"%"%&U p)$0  Norm: 18.9/1000#&U"%"%&UZ #&U"%"%&U#XVJX"%&U #&U"%XXVJ' P!    /\\\\E(+x&2\\\\ /#&U"%"%&U ##XVJX"%&UK #&U"%XXVJ&U"%"%&UIncreaseproportionofHealthCenterwomen `d receivingageappropriatescreeningforcervicalandbreastcancer.HRSAPlan#&U"%"%&UO ##XVJX"%&U0 # 0\\\\ \\\\E 0XVJXXXVJ UptodatePAPTests #XVJXXXVJw #&U"%XXVJ `d FY01:94%FY00:92% FY99:90%&U"%"%&U Uptodate_Mammograms_ #&U"%"%&U4 ##XVJX"%&U #&U"%XXVJ    92,B X,X,hX9FY01:70%FY00:67.5%FY99:65%&U"%"%&U UptodateClinicalBreast #&U"%"%&Ue ##XVJX"%&U #&U"%XXVJ   FY01:85.5%FY00:84%FY99:82.5%#XVJX"%&U #&U"%XXVJ 0\\\\ \\\\ 0&U"%"%&UFY01:FY00:4/01FY99:5/00FY95:88.5%FY01:FY00:4/01FY99:5/00FY95:62.5%FY01:FY00:4/01FY99:5/00FY95:80.5%#&U"%"%&U ##XVJX"%&Uf #&U"%XXVJ /\\\\Ehl \\\\ /&U"%"%&UIncreasepercentofHealthCenteruserswith  ! diabeteswithuptodatetestingof_glycohemoglobin_Ԁ!%adultswithdiabetestestedatrecommendintervals.HRSAPlan󀀀#&U"%"%&U ##XVJX"%&U #&U"%XXVJ 0\\\\lp$\\\\E 0 &U"%"%&U FY01:90%  % FY00:80%FY99:60%*#&U"%"%&U #&U"%"%&U#XVJX"%&U> #&U"%XXVJ ' #&U"%"%&U ##XVJX"%&UL #&U"%XXVJ*DiabetesInitiativeat90%forfirst100_HCs_ 0\\\\$(*\\\\ 0&U"%"%&UFY01:  + FY00:FY99:6/00FY98:43%(97study)#&U"%"%&Uc ##XVJX"%&U # &U"%XXVJ HL/  &U"%"%&UNorm :20%#&U"%"%&UI ##XVJX"%&U #&U"%XXVJ /\\\\E1\\\\ /&U"%"%&UIncreaseproportionofHealthCenteradultswith tx2 hypertensionwhoreporttheirbloodpressureisundercontrol.#&U"%"%&U ##XVJX"%&U #&U"%XXVJԀ&U"%"%&UHRSAPlan#&U"%"%&U ##XVJX"%&U #&U"%XXVJ 0\\\\,04\\\\E 0&U"%"%&UFY01:96% tx5 FY00:93%FY99:92%#&U"%"%&U ##XVJX"%&U #&U"%XXVJ 0\\\\,07\\\\ 0&U"%"%&UFY01: tx8 FY00:4/01FY99:5/00FY95:90%#&U"%"%&U ##XVJX"%&Uy #&U"%XXVJ /\\\\E ;\\\\ /&U"%"%&UServewomenandracialandethnicminoritiesin `d TitleIandIIfundedprogramsinproportionsthatexceedtheirrepresentationinoverallAIDSprevalencebyaminimumfivepercentagepoints(i.e.,16percentofcurrentoverallAIDScasesareamongwomen,56%areminorities).#&U"%"%&Ub ##XVJX"%&U #&U"%XXVJ 0\\\\ \\\\E 0 4&U"%"%&UEmergencyReliefGrants #&U"%"%4&U@ #&U"%"%&U#XVJX"%&U #&U"%XXVJ `d #&U"%"%&U #&U"%"%&U#XVJX"%&U #&U"%XXVJFY01:32%Women <@ FY00:30%#&U"%"%&U5 #&U"%"%&U#XVJX"%&Uw #&U"%XXVJ    FY99:30%#&U"%"%&U #&U"%"%&U#XVJX"%&U* #&U"%XXVJ    FY01:66%MinoritiesFY00:64%FY99:64%#XVJX"%&U #&U"%XXVJ#&U"%"%&U #&U"%"%&U   #&U"%"%&U #4&U"%"%&UCareGrantstoStates #4XVJX"%4&UU ##XVJXX4XVJ #&U"%XXVJ&U"%"%&U DH  FY01:28%WomenFY00:27%#&U"%"%&U #&U"%"%&U#XVJX"%&Us #&U"%XXVJ   FY99:27%#&U"%"%&U #&U"%"%&U#XVJX"%&UF #&U"%XXVJ  FY01:60%MinoritiesFY00:59%FY99:59%#&U"%"%&U ##XVJX"%&U #&U"%XXVJ 0\\\\ \\\\ 0#XVJX"%&U #&U"%XXVJ&U"%"%&UFY01: <@" FY00:#&U"%"%&U0 #&U"%"%&U#XVJX"%&U #&U"%XXVJ  # FY99:#&U"%"%&U ##XVJX"%&U #&U"%XXVJ  $ &U"%"%&UFY98:30.7%#&U"%"%&U #&U"%"%&U#XVJX"%&UX #&U"%XXVJ  % FY97:30.3%#XVJX"%&U #&U"%XXVJ#&U"%"%&U #&U"%"%&U  & FY96:#&U"%"%&U ##XVJX"%&U #&U"%XXVJԀ&U"%"%&U30.7%#&U"%"%&Ua ##XVJX"%&UA #&U"%XXVJ  ' &U"%"%&UFY01: @D) FY00:#&U"%"%&U #&U"%"%&U#XVJX"%&U #&U"%XXVJ  * FY99:#&U"%"%&Ue ##XVJX"%&U #&U"%XXVJ + &U"%"%&UFY98:67.7%#&U"%"%&U\ #&U"%"%&U#XVJX"%&U( #&U"%XXVJ  , FY97:67.8%#&U"%"%&U ##XVJX"%&U #&U"%XXVJ&U"%"%&U  - FY96:#&U"%"%&U ##XVJX"%&Ur #&U"%XXVJԀ&U"%"%&U66.5%#&U"%"%&U1 ##XVJX"%&U #&U"%XXVJ  . &U"%"%&UFY01:  $1 FY00:#&U"%"%&U #&U"%"%&U#XVJX"%&U #&U"%XXVJ 2 FY99:#&U"%"%&U9 ##XVJX"%&U{ #&U"%XXVJ 3 FY98:&U"%"%&UԀ29.4%#&U"%"%&U6 ##XVJX"%&U #&U"%XXVJ 4 FY97:&U"%"%&U30.3%#&U"%"%&U ##XVJX"%&U #&U"%XXVJ 5 FY96:&U"%"%&U26.3%#&U"%"%&U ##XVJX"%&UF #&U"%XXVJԀ lp6 &U"%"%&UFY01: $(8 FY00:#&U"%"%&U! #&U"%"%&U#XVJX"%&U #&U"%XXVJ 9 FY99:FY98:64.1%#XVJX"%&U #&U"%XXVJ#&U"%"%&U #&U"%"%&U ; FY97:63.1%#&U"%"%&Ut #&U"%"%&U#XVJX"%&U2 #&U"%XXVJ < FY96:59.9%#XVJX"%&U ##XVJXXXVJ #XVJXXXVJԀ&U"%XXVJ#&U"%"%&U #&U"%"%&UԀ#&U"%"%&U ##XVJX"%&U #&U"%XXVJ 4\\\\Ept=\\\\ 4#XVJX"%&Ug #&U"%XXVJ&U"%"%&UIncreasethepercentofchildrenwithspecial  > healthcareneedsintheStatewithamedical/healthhome.HRSAPlan "@ #&U"%"%&U ##XVJX"%&U #&U"%XXVJ 0\\\\`$dB\\\\E 0&U"%"%&UFY01:80%#&U"%"%&US ##XVJX"%&U #&U"%XXVJ  C  0\\\\"E\\\\ 0&U"%"%&UFY01:  F FY00:FY99:#&U"%"%&U' #Ԁ01/01&U"%"%&U "H FY98:04/00FY97:69%#&U"%"%&U ##XVJX"%&U #&U"%XXVJ 4\\\\E`$dJ  \\\\ 4#XVJX"%&U( #&U"%XXVJ&U"%"%&UDecreasetheratiooftheblackinfantmortality %K ratetothewhiteinfantmortalityrate.#&U"%"%&U #HRSA &L Plan 0\\\\' M\\\\E 0&U"%"%&UFY01:2.1to1 %N #&U"%"%&U # 0\\\\&O\\\\ 0&U"%"%&UFY01: %P FY00:FY99:9/01FY98:FY97:FY96:2.4to1FY95:2.3to1#&U"%"%&UW # /\\\\E + $V\\\\ /&U"%"%&UIncreaseby20%overtwoyearsthenumberof `d minorityorgandonorsnationallyfromimplementationofthefinalHCFARuleon ConditionsofParticipationofHospitals(9/98).#&U"%"%&U/ #Ԁ   HRSAPlan 0\\\\ \\\\E 0&U"%"%&UFY01:1,802donors `d FY00:1,638FY99:1,500#&U"%"%&U # 0\\\\ \\\\ 0&U"%"%&UFY01: `d  FY00:FY99:5/00FY98:1,378FY97:1,342#&U"%"%&UD # /\\\\E  \\\\ /Increaseby10%thenumberofunrelatedminoritybonemarrowdonors(nationalregistryofpotentialdonors)overpreviousyeartotals.HRSAPlan 0\\\\\\\\E 0FY01:1,100,000FY00:1,000,000FY99:220,000**Newdonors:totalminoritydonorsestimatedat900,000. 0\\\\ \\\\ 0FY01:FY00:FY99:5/00FY98:800,000FY96:526,000 /\\\\E\\\\ /Collectandestablishbaselineandcomparisondataforallmeasuresfor12racialdisparitymeasures(coronaryheartdiseaseandstrokedeaths;incidenceoflowerextremityamputationsandendstagerenaldiseaseinpersonswithdiabetes),includingrelevantracialandethnicsubgroupsforwhichnodataarecurrentlyavailable._OPHS_ԀPlan 0\\\\$\\\\E 0FY01:12of12FY00:FY99:9of12 0\\\\ '\\\\ 0FY01:FY00:FY99:FY98:5of12 /\\\\E +\\\\ /ImproveAI/ANconsumersatisfactionwiththeacceptabilityandaccessibilityofhealthcareasmeasuredbyIHSconsumersatisfactionsurvey.IHSPlan 0\\\\/\\\\E 0FY01:5%overFY00FY00:establishbaselineFY99:developinstrumentandprotocol 0\\\\3\\\\ 0FY01:FY00:FY99:Completed#XVJX"%&U # /\\\\E(,6\\\\ /&U"%XXVJInordertoincreaseaccessforminoritiesand tx7 personswithdisabilitiestonondiscriminatoryservicesinmanagedcaresettings,OCRwillincrease#managedcareplansfoundtobeincompliancewithTitleVI,Section504andtheAmericanswithDisabilitiesAct.Measure:Increased#correctiveactionsandnoviolationfindings.OCRPlan 0\\\\x#|>\\\\E 0FY01:33FY00:30FY99:40 0\\\\,0A\\\\ 0FY01:FY00FY99:27FY98:10#XVJX"%&U! # /\\\\E E\\\\ /&U"%XXVJInordertoincreaseaccesstoHHSservicesfor $F limitedEnglishproficient(_LEP_)persons,OCRwillincrease#HHSgranteesandprovidersfoundtobeincompliancewithTitleVIin_LEP_reviews/investigations.Measure:Increased#correctiveactionsandnoviolationfindings.OCRPlan 0\\\\*#L\\\\E 0FY01:153FY00:151FY99:125 0\\\\&O\\\\ 0FY01:FY00:FY99:146FY98:98#XVJX"%&Ue$ #(|' S \\\\ ( lXXVJP#XVJXl& #ROGRAMSlXXVJS#XVJXl>' #UPPORTINGlXXVJT#XVJXl' #HISlXXVJO#XVJXl' #BJECTIVE  ,%U  . 'V (X@s#s#(_AHRQ_  ResearchonHealthCosts,Quality,andOutcomesMedicalExpenditurePanelSurveys  t  CDC ` HIV/AIDSPreventionSexuallyTransmittedDiseasesTuberculosisImmunizationDiabetesandOtherChronicDiseasesHeartDiseaseandHealthPromotionBreastandCervicalCancerPreventionPreventionCentersInfectiousDiseasesLeadPoisoningInjuryPreventionHealthStatisticsPreventionResearchEpidemicServicesEnvironmentalDiseasePreventionOccupationalSafetyandHealthEliminatingRacialandEthnicDisparities HCFA H ChildrensHealthInsuranceProgramMedicaidPeerReviewOrganizationsHRSA  PrimaryCare9,XF` X2,B X9 F HealthCenters F NationalHealthServiceCorps:2,B X,XF` X+ :9,XF` X2,B X9HIV/AIDS F HIVCare F HIVEmergencyReliefGrants F HIVEarlyInterventionServices F HIVPediatricGrants F EducationandTrainingCenters $D #   DentalServicesProgramMaternalandChildHealth  MaternalandChildHealthBlockGrant0  UniversalNewbornHearingScreeningandEarlyIntervention s#s# 0  HealthyStartInitiative s#s# 0  EmergencyMedicalServicesforChildren s#s# 0  TraumaticBrainInjuryProgram s#s# 0  :2,B X,XF` X+ :HealthProfessionsandNursingTrainingPrograms s#s# RuralHealth9,X` X2,B X90  RuralHealthOutreachGrants s#s# 0  RuralHealthPolicyDevelopment s#s# 0  _Telehealth_ s#s# :2,B X,X` X / :WorkforceInformationandAnalysisHealthEducationandAssistanceLoansOrganProcurementandTransplantationNationalBoneMarrowDonorProgram&  IHS H5 PreventionTreatment'H0 NIH  \8 ResearchProgramOCR 4: PreventingDiscriminationinAccesstoHHSServices_OPHS_ = OfficeofDiseasePreventionandHealthPromotionXVJXXXVJOfficeofHIV/AIDSPolicy l@ HealthPeople2000#XVJXXXVJ'2 #OfficeofMinorityHealthXVJXXXVJ D!B #XVJXXXVJ2 #4XVJXXXVJSAMHSA 0"C TargetedCapacityExpansion#XVJXX4XVJ3 #XVJXXXVJ #lD #XVJXXXVJ3 # $XE 5@s#s#X@' 5  &"E iU5%!`z  `E`ttx 3 i s#s#     s#s#iU5%!`z  `E`ttx 3 iL 0 !"#$%&(xx0 !"#$%&(L9,X,hX2,B X9 lXXVJK#XVJXl6 #EYlXXVJFY2001P#XVJXlJ6 #ROGRAMS,lXXVJI#XVJXl6 #NITIATIVES,ANDlXXVJS#XVJXl6 #TRATEGIES  L  L K !"#$%&( hx0 !"#$%&(L  3    37 2 3  0    HCFA!IncreasingHealthPlanChoices . TheBBAcreatedanarrayofnewmanagedcare L  andotherhealthplanchoicesforMedicarebeneficiariesandestablishesacoordinatedopenenrollmentprocess.ThesenewchoicesrequireHCFAtoundertakethemostextensivebeneficiaryeducationprogramintheAgencyshistory.ItalsorequiresHCFAtodevelopandimplementnewprospectivepaymentsystemsformanyMedicareservicestohelpfurtherrestraintherateofgrowthofhealthcarespendingandfosterincentivesformoreappropriateuseofscarceprogramresources.Furthermore,BBAexpandshealthinsurancetomanyuninsuredchildrenthroughtheStateChildrensHealthInsuranceProgram(_SCHIP_). 37 7 ݌ s#s# Ќ  P 0 !"#$%&(xhK !"#$%&(V7 P  3    3; 23  0    HCFA!NationalMedicareEducationProgram .InFY1999,HCFAbeganacampaignto  educateMedicarebeneficiariessotheycanmakemoreinformedhealthplandecisions.Theinitialstagesofthecampaignfocusonincreasingaccesstoinformationabouthealthplanoptions,aswellasincreasingawarenessamongbeneficiariesthattheynowhavemorehealthplanoptionsavailablethroughMedicareandthattheydonothavetochangefromtheircurrentoptioniftheydonotchoosetodoso.ThecampaignalsofocusesonincreasingunderstandingamongbeneficiariesregardingdifferencesbetweenthenewhealthplanoptionsandoriginalMedicare. 3; ; ݌ s#s# Ќ    3    3> 23  0    _AHRQ_Ԁ!TheConsumerAssessmentofHealthPlans(_CAHPS_) isatoolforsurveying < membersofhealthplansabouttheirexperiencewithandassessmentofthequalityofhealthcaretheyreceive,andforreportingtheresultstootherconsumerswhoarechoosingaplan.The_CAHPS_surveysandreportsweredevelopedinthefirstphaseoftheproject,beginninginSeptember1995andcontinuinguntilJanuary1997.Inthesecondphase,_CAHPS_willbeenhancedtocoverindividualhealthcareprovidersandinstitutionsandtoallowforcrossmarketcomparisonsofdata.Demonstrationswillbefundedtoimprovetheuseofqualityinformationbyconsumersinpublicandprivatesettingsandevaluateimpactintermsofthedecisionsmadebyconsumers,thechangesinconsumersbehaviors,andanychangesinqualityandcostsofcareasaresultofthisinformation._AHRQ_Ԁwillalsodeveloppartnershipswithappropriatehealthcareorganizationstoassurethat_CAHPS_productsarekeptuptodateandavailabletobothpublicandprivateusers.  3> "? ݌&d!$s#s# Ќ    3    3D 23  0    IHS!OfficeoftheDirector (OD).ODestablishesandcoordinatesmultipleopportunitiesfor '<#& AmericanIndianandAlaskaNativestakeholderstoparticipateinbudgetformulationandpolicydevelopmentconsistentwiththegoalofenhancingIndianselfdetermination. 3D D ݌ s#s# Ќ    3    3F 23  0    4XVJXXXVJ_OPHS_ !Through_Healthfinder_),theFederalgovernmentwideInternetgatewaytohealth +&* information,theNationalWomensHealthInformationCenter,andtheOfficeofMinority 3F F ݌ s#s# Ќ   h.)- 0  HealthResourceCenter,_OPHS_Ԁprovidesnationwideaccesstoinformationandreferralservicesforbothhealthprofessionalsandconsumers.#XVJXX4XVJF #s#s#   3    3MH 23  0    /XVJXXXVJ _OPHS_ !TheOfficeofMinorityHealthResourceCenterengagesinawiderangeofactivities t toinformandeducateracial/ethnicminoritycommunitiesandthosewhoservethemregardingthenatureandextentofracial/ethnicdisparitiesinhealth,policiesandprogramsunderwaytoaddresssuchdisparities,andactionstheycantaketoimprovetheirhealthcareoptions.Someoftheseactivitiesinclude:assistanceinthedevelopmentofSpanishlanguageradiobroadcastmessagestoHispaniccommunitiesonhealthpromotionandhowtousemanagedcareplansappropriately;provisionofSpanishspeakingstafftorespondtopublicinquiriesforinformationandrecommendationsfollowingsuchradiobroadcasts;andprovisionofinformationonandreferralstonationalorganizationsofminorityhealthcareprovidersandminorityhealthadvocacyorganizationsthat,inturn,providerecommendationsregardinglocalproviders. 3MH xH ݌ s#s# Ќ    3    3L 23  0    OCR!PreventingDiscriminationinAccesstoHHSServices .OCRwillcontinuetowork   withstateandlocalhealthagenciesandhealthcareproviderstoensuretheytakestepstoprovideservicesandinformationinlanguagesotherthanEnglishtoensurethatpersonsoflimitedEnglishproficiency(_LEP_)areeffectivelyinformedandcaneffectivelyparticipateandbenefitfromprograms. 3L M ݌ s#s# Ќ  #XVJXX/XVJH # lXXVJS#XVJXlO #ELECTEDlXXVJFY2001#XVJXlO #ԀlXXVJP#XVJXlP #ERFORMANCElXXVJG#XVJXllP #OALSANDlXXVJM#XVJXlP #EASURES  d XVJXXXVJ&U"%XXVJ* ddSS SS SS s#s#,[SS ,SSS ,SS +  &\\\\G d &#XVJX"%&U:Q #  PerformanceGoals 8\\\\E#!x \\\\G 8  Targets 8\\\\E#!x \\\\E 8  ActualPerformance &U"%XXVJ =\\\\E(&d   \\\\E =IncreaseenrollmentofeligibleMedicarebeneficiariesinprogramsforduallyeligiblebeneficiaries.HCFAPlan#XVJX"%&UFS #&U"%XXVJ 0\\\\\\\\E 0FY01:WillsettargetduringFY2000FY00:Increaseenrollmentby4%FY99:#XVJX"%&U:T #&U"%XXVJEstablisha T # target#XVJX"%&UT #&U"%XXVJ 0\\\\0!$\\\\ 0FY01:FY00:FY99:#XVJX"%&UbU #&U"%XXVJԀGoalMet /\\\\ET )\\\\ /IncreasethepercentageofMedicarebeneficiarieswhohaveatleastonemanagedcareoption/choice.HCFAPlan 0\\\\4% -\\\\E 0FY01:73%FY00:73%FY99:80% 0\\\\X$0\\\\ 0FY01:FY00:FY99:76%FY98:75%FY97:70% /\\\\E&`!5\\\\ /AchieveandmaintainthehighpercentageofMedicare+Choiceenrollmenttransactionsprocessedonatimelybasis.HCFAPlan 0\\\\8)$8\\\\E 0FY01:98%FY00:98%FY99:98% 0\\\\8)$;\\\\ 0FY01:FY00:FY99:Spring2000 /\\\\E8)$>\\\\ /#&U"%"%&UP #ImprovethelevelofI/T/Usatisfactionwiththe d processesforconsultationandparticipationprovidedbytheIHS,asmeasuredbyasurveyofIHS,Tribal,andUrbanprograms.IHSPlan 0\\\\ \\\\E 0FY01:secureOMBclearanceFY00:revisepolicyandinstrumentFY99:establishpolicy andbaseline 0\\\\  \\\\ 0FY01:FY00:FY99:policyestablishedbutbaselinedelayed /\\\\E \\\\ /InordertoincreaseaccesstoHHSservicesforlimitedEnglishproficient(_LEP_)persons,OCRwillincrease#HHSgranteesandprovidersfoundtobeincompliancewithTitleVIin_LEP_reviews/investigations.Measure:Increased#correctiveactionsandnoviolationfindings.OCRPlan  0\\\\dH \\\\E 0FY01:153FY00:151FY99:125 0\\\\\\\\ 0FY01:FY00:FY99:146FY98:98(  \\\\ ( l"%&UP#&U"%l] #XVJX"%&UROGRAMS#&U"%XXVJJ] #l"%&UԀS#&U"%l] #XVJX"%&UUPPORTING#&U"%XXVJ] #l"%&UԀT#&U"%l"^ #XVJX"%&UHIS#&U"%XXVJf^ #l"%&UԀO#&U"%l^ #XVJX"%&UBJECTIVE#&U"%XXVJ^ #l"%&U `D  #&U"%l9_ # (X@s#s#(_AHRQ_ P4" ResearchonHealthCosts,Quality,andOutcomesHCFA % MedicaidMedicareMedicare+Choice 0* IHS P4* OfficeoftheDirectorOCR , PreventingDiscriminationinAccesstoHHSServices_OPHS_ / OfficeofDiseasePreventionandHealthPromotion 02 5@s#s#X@_ 5  2 iU5%!`z  `E$tt< !i s#s#    s#s#iU5%!`z  `E$tt< !iL 0 !"#$%&(xx0 !"#$%&(L9,X,hX,X,hX9 l"%&UK#&U"%lc #EYl"%&UFY2001P#&U"%l$d #ROGRAMS,l"%&UI#&U"%lxd #NITIATIVES,ANDl"%&US#&U"%ld #TRATEGIES   p XVJX"%&U  3    3Ue 23  0    HCFA!MedicareSummaryNotice(_MSN_) .Toenhancebeneficiaryunderstandingof  ` MedicarebenefitsandreduceconfusionoverwhichservicesMedicarecovers,HCFAiscontinuingitsnationwideimplementationoftheMedicareSummaryNotice(_MSN_).The_MSN_combinesinformationsenttoMedicarebeneficiariesonbenefitsreceivedunderMedicarePartAandPartBintoeasytoreadmonthlystatements. 3Ue e ݌ s#s# Ќ    3!    3 h 23  0    HCFA! MedicareAppeals .Theappealprocessisacriticalsafeguardavailabletoall   Medicarebeneficiaries,allowingthemtochallengedenialsofpaymentorservice.TheappealprocesstakesonaddedsignificanceinmanagedcareandotherMedicarePlusChoiceplanswheretherecanbepreservicedenialsofcareand,thus,thepossibilityofrestrictedaccesstoMedicarecoveredservices.InFY1999,HCFAinitiateddevelopmentofacomprehensiveappealdatasystem.HCFAwillcollectinternalplanappealdataonseveralindicatorsofplanperformanceduringFY2000sothattheagencywillbeabletosettargetsforFY2002bytheendofFY2001./XVJXXXVJ0 s#s##XVJXX/XVJ0k #XVJXXXVJ 3 h 5h ݌d s# s# Ќ    3"    3k 23  0    HCFA!MedicareTelephoneServiceImprovement .Medicarecontractorshandleinexcess < of18milliontelephoneinquiriesannuallyfrombeneficiariesandothercallers.BeneficiarytelephonecustomerservicethereforeclearlyisacentralpartofHCFAscustomerservicefunctionanddirectlysupportsthestrategicplangoaltopromotebeneficiaryandpublicunderstandingofHCFAanditsprograms.HCFAprovidesfortelephonecustomerservicethroughavarietyofsources.AverylargepartoftheoverallvolumeofcallsishandledbyMedicarecarriers.ThisgoalfocusesonimprovingthetelephonecustomerserviceofMedicarecarriers.Athoroughassessmentofcarriertelephonecustomerservicerequiresmeasurementalongthreedimensions:accessibilityoftheservice,accuracyofresponse,andcallersatisfaction.HCFAintendstoadoptalongtermviewinmeasuringandimprovingcarriertelephonecustomerservice. 3k l ݌ s#s# Ќ  0  #XVJXXXVJk #/XVJXXXVJHCFAwillinitiateanumberofinterventionstopromoteimprovedperformance,including #P! establishinghigherstandardsthroughchangestothecontractorperformancerequirements;collectingandsharinginformationonbestpractices,throughmechanismssuchasworkshopsandregularcontractorcallcenterusergroupconferencecalls;providingfundingincreases,iffundsareavailable;and#XVJXX/XVJp #6XVJXXXVJmonitoringcontractorperformanceandusingourlegal authorityas  &"%  appropriatewhencontractorsfailtomeetHCFAstandards.#XVJXX6XVJbr #/XVJXXXVJ#'"&s#s# L K !"#$%&( hx0 !"#$%&(L  3    3s 2 3  0    HCFA!Providerand#XVJXX/XVJ@s #XVJXXXVJConsumerEducation .HCFAandothergroupshavesponsoreda x)$( largenumberofproviderandconsumereducationprojectstodemonstratewaysinwhichnursinghomesmayremoveresidentsrestraints.Theseprojectshavedemonstratedthatrestraintremovalimprovesqualityoflifeandqualityofcareandactuallydecreasestheriskofresidentinjury.HCFAhasactivelysponsoredandparticipatedineducationprogramsconsistingofseminarspresentedlocallythroughoutthecountryandviasatellitetonursing .h)- homeproviders,caregiversandresidentsfamilies;interactivevideotrainingprograms;andwrittenmanuals. 3r %s ݌ s#s# Ќ  0  OneofthemainwaysinwhichHCFAcanpromotereduceduseofphysicalrestraintsisthroughtheStateSurveyandCertificationProgram.StateandHCFAsurveyorswhoconductannualinspectionsofnursinghomespaycloseattentiontonursinghomesuseofrestraintsandcitenursinghomesfordeficientpracticeswhentheydiscoverthatresidentsarerestrainedwithoutclearmedicalreason.#XVJXXXVJs #$ ts#s#   3    3x 2 3  0    HCFA! LaboratoryProficiencyTesting .XVJXXXVJHCFAiscommittedtosustainingthecurrent  L  levelofaccuracyfordiagnosticlaboratorytestsregulatedundertheClinicalLaboratoryImprovementAmendments(_CLIA_).Specifically,HCFAcommitstosustainingtheimprovementsobtainedthusfarinlaboratoryscoresonproficiency(accuracy)testing(PT)whilemaintainingtherateofcompliancewithPTenrollmentrequirementsin_CLIA_.ItisimportanttomeasurebothenrollmentandPTscoressothatalllaboratoriessubjecttoPTunderthe_CLIA_ԀrulesarebothcontinuingtoparticipateinaPTtestingprogramandcontinuingtoperformwellonthosePTchallenges . #XVJXXXVJ1y #/XVJXXXVJ 3x x ݌ts#s# Ќ  0  Interventionsinplacefromwhichtheimprovementhasoccurredandwillcontinuetobemaintainedwithrespecttotestaccuracyinclude: s#s# L !"#$%&(hhK !"#$%&(L  3   #XVJXX/XVJU| #XVJXXXVJ? ,X, X,X,hX?   3} 23  0    laboratoriesreviewingtheirownfindingsofPTperformanceandtakingappropriateactions d intheirlaboratorytocorrecttheproblem 3} ~ ݌ s#s# Ќ    3      3 23  0    StatesurveyorsandHCFAapprovedaccreditingbodiesemployinganeducational, ( outcomeorientedsurveyapproachandongoingmonitoringoflaboratoryPTperformance 3  ݌ s#s# Ќ    3      3 23  0    recommendingtrainingandtechnicalassistanceforlaboratoriesthatfailtomeetthe  standardssetforPTperformanceinlieuofsanctionsforthefirstoccurrence 3 I ݌ s#s# Ќ    3      3 23  0    notallowinglaboratoriesrefusingtrainingandtechnicalassistancetoconductthetest(s)in `  questionuntiltheyhavemettwoPTchallengessuccessfully 3 ݌ s#s# Ќ    3      3 23  0    takingenforcementactionsorsanctionsifalaboratorysaccuracydoesnotimproveoris $#t! sopoorastoposeathreattothepublichealthandsafety 3 ! ݌ s#s# Ќ    3      3O 23  0    requestingPTproviderstobeavailabletoassistlaboratoriesthatfailPTtodeterminewhy %8!$ theyfailedandtopreventrecurrence.#XVJXXXVJ~ #XVJXXXVJ 3O ݌&$"%s#s# Ќ  #XVJXXXVJ #L 0 !"#$%&(xh !"#$%&(L  3    3X 23  0    AoA!LongTermCareOmbudsmanProgram .TheLongTermCareOmbudsman (#' Programhelpsstatestoinvestigateandresolvecomplaintsmadeby,oronbehalfof,residentsoflongtermcarefacilitiesrelatedtoaction,inaction,ordecisionsthatmayadverselyaffectthehealth,safety,welfare,orrightsofresidents.Thereare52StateLongtermCareOmbudsmanProgramswhichsupportombudsmanstaffandvolunteersin564localprograms.AoAalsosupportsanOmbudsmanResourceCenterthatofferstrainingandtechnicalassistancetoombudsmenthroughoutthecountry. 3X ݌8.)-s#s# Ќ  __  3    3 23  0    _AHRQ_ԀEnhancingPatientSafety .XVJXXXVJ_AHRQ_Ԁfurtherthenationsunderstandingofwhen,how  andunderwhatcircumstanceserrorsoccur,identifythecausesoferrors,developthetools,dataandresearchersneededtofosteranationalstrategytoimprovepatientsafety,andworkwithpublicandprivatepartnerstoapplyevidencebasedapproachestotheimprovementofpatientsafety.Theresearchandtrainingeffortsproposedwillensurethateffortsforenhancingpatientsafetywillmovebeyondjustdescribinganddefiningtheproblemtoprovidingtheknowledgeandtoolsthatwillberequiredtoaddressthepatientsafetychallenge.Thegoalofthisresearchinitiativeistoprovideanevidencebaseforthenationsapproachestoenhancingpatientsafety.#XVJXXXVJ #  3 ) ݌ P s#s# Ќ    3    3T 23  0    /XVJXXXVJHRSA!NationalPractitionerDataBank .HRSAsNationalPractitionerDataBankhelps (  protectthepublicbyassuringthatinformationaboutmedicalanddentalmalpracticepaymentsandothersanctionsisavailabletohospitalsandotherhealthcareentities,licensingauthoritiesandprofessionalsocieties. 3T  ݌ s#s# Ќ    3    3s 23  0    #XVJXX/XVJȎ #XVJXXXVJIHS#XVJXXXVJ #/XVJXXXVJ!TreatmentandPrevention .TheIHSanditsTribalandUrbanIndianProgram x partnershavecommittedtomaintainingexcellenceintheservicesprovidedtoconsumersthroughsystematicqualityassuranceprocessesand_benchmarking_Ԁwiththestandardsoftheindustry.#XVJXX/XVJP #/XVJXXXVJ 3s ݌@s#s# Ќ  #XVJXX/XVJՒ #/XVJXXXVJ  3    3z 23  0    #XVJXX/XVJZ # SAMHSAProtectionandAdvocacyforIndividualswithMentalIllness(_PAIMI_). The h goalofthisprogramisthroughadvocacyactivities,toreduceincidentofabuse,neglect,andcivilrightsviolationsofindividualswithmentalillnesswhoareplacedinresidentialtreatmentfacilities.Theprotectionandadvocacyforindividualswithmentalillness(_PAIMI_)programmakesformulagrantstoStateinstitutionsdesignatedbytheGovernor,toidentifyinstancesofabuse,neglectandrightsviolationsinStatehospitals.TheseStateinstitutionsdevelopandimplementeducation,trainingandpublicawarenessinterventions. 3z ݌ s#s# Ќ  /XVJXXXVJ  3    37 23  0    ACF!DevelopmentalDisabilities. ACFanditspartnerswillcontinuetoprotectthelegal | andhumanrightsofindividualswithdevelopmentaldisabilities.#XVJXX/XVJ #/XVJXXXVJ 37 b ݌l s#s# Ќ  #XVJXX/XVJ #  3    3 23  0    OCR ! PreventingDiscriminationinAccesstoHHSServices .XVJXXXVJOCRwillconcentrateits D"  resourcesonthecriticalcivilrightsissuessurroundingchangesinhealthcarecoverageandservices,includingincreaseduseofmanagedcare,thatareundertakeninthestates.#XVJXXXVJə #XVJXXXVJԀOCRwill  $p" focusonassessingtheeffectsofmanagedcareonservicestominorityanddisabilitycommunities.Itwillexpandthenumberofreviewsconcentratingonensuringthat,asbothMedicareandMedicaidexpandthesueofmanagedcare,racialandnationalminorityindividualsandpersonswithdisabilitiesaretreatedinanondiscriminatorymanner.OCRwillworkwithitsHHSAgencypartnerstoimproveresearchanddatacollectioneffortstosupporttargetenforcementinthischangingarena.InadditionOCRwillcontinuetoworkwithhealthcareandsocialservicesproviders,stateandlocalagenciesandHHSpartners,toensurethatpersonsoflimitedEnglishproficiencyarenotdiscriminatedagainstonthebasisofnationalorigin.#XVJXXXVJ #XVJXXXVJ 3 4 ݌l,'+s#s#   #XVJXXXVJ- # X-(,   3    3ў 23  0    _OPHS_ !_OPHS_ԀwillcontinuetobeintegrallyinvolvedintheworkoftheGoal6/Consumer   ProtectionWorkGroupundertheSecretarysHealthCareQualityImprovementInitiativeandthevariousworkgroupsundertheQualityInitiativeCoordination(_QuIC_)TaskForce._OPHS_willcontinuetosupportthedevelopmentandimplementationofDepartmentalinitiativesthatpromoteculturalcompetencyasaconsumerprotectionforincreasinglyraciallyandethnicallydiversepopulationsintheU.S.aswellasofHHSeffortstocomplywiththeConsumerBillofRightsandResponsibilities,perExecutiveOrder._OPHS_Ԁwillalsosupportstudiesthatassesstheimpactofculturallycompetenthealthcareservicesonracialandethnicminoritypopulations. 31 \ ݌ s#s# Ќ    3    3 23  0    OCR!DiscriminationandRacialDisparities .RecentstudiesbyHHS,variousnonprofit  <  organizations,universitiesandotherpublicagencieshaveshedlightonseriousdisparitiesinthehealthstatusofraceandethnicminoritiesandinpractitionerreferralsofminoritiesforspecificdiagnosticandtherapeuticprocedures.Racialminoritiescontinuetofallfarbehindthegeneralpopulationinlifeexpectancy,riskofseriousillness,andaccesstoafullrangeofmedicalservicesandspecialtycare.Inaddition,ithasbeenfoundthatevenwhenallfactorsareequal,age,income,job,educationandmedicalinsurance,minoritypatientsarelesslikelytoreceivethemoreexpensiveandsophisticatedformsofcarefortheirmedicalproblems.ItisessentialthatOCRtakestepstodeterminewhetherviolationsofTitleVIandotherlawsenforcedbyOCRarecontributingfactorstothesedisparities.OCRhasbeguntheprocessofstudyingtheissuebyconductingresearch,meetingwithcommunitybasedorganizations,medicalproviders,publicofficialsandconcernedindividuals. 3 ݌ s#s# Ќ  0  OCRwillalsocontinueitsenforcementeffortsintheeliminationofredliningofhealthservicesthatmayadverselyaffectpeopleofcolororpersonswithdisabilities.Redliningoccurswhenaserviceproviderrefusestoprovideservicesortoprovidedifferentservicestoanindividualbasedonthegeographiclocationwheretheserviceistobeprovided. s#s# ̀ lXXVJS#XVJXl1 #ELECTEDlXXVJFY2001#XVJXl| #ԀlXXVJP#XVJXlƩ #ERFORMANCElXXVJG#XVJXl #OALSANDlXXVJM#XVJXl` #EASURES  t * dd[SS [SSS SSS s#s#,SS ,SSS ,SSS +  &\\\\G t! &  &U"%XXVJPerformanceGoals 8\\\\E#!!(  \\\\G 8  Targets 8\\\\E#!!(! \\\\E 8  ActualPerformance =\\\\E(&"#   \\\\E =Decreasethensustainthereducedprevalenceoftheuseofphysicalrestraintsinnursinghomes. %P % HCFAPlan 0\\\\%,!&\\\\E 0FY01:10%FY00:10%FY99:&U"%"%&UԀ14% 0\\\\%,!)\\\\ 0#&U"%"%&U #FY01: $$t* FY00:FY99:12%&U"%"%&U %,!, FY98:12%FY96:17% /\\\\E'".\\\\ /Reducetheprevalenceofpressureulcers(bedsores)amongpatientsoflongtermcarefacilities.HCFA )0%0 Plan 0\\\\* &1\\\\E 0#&U"%"%&U^ #FY01:01/01 )T$2 FY00:SetbaselineandtargetFY99:NewinFY2000&U"%"%&U 0\\\\t,'6\\\\ 0#&U"%"%&U #FY01: )T$7 FY00:FY99:&U"%"%&UԀN.A. /\\\\E* &9\\\\ /Improveclinicallaboratorytesting: ̀!0 / Increasethensustainthepercentageof   percentageoflaboratoryscoresthatdemonstratednofailure. // ̀!0 / Increasethensustainthepercentageof_CLIA_   labsproperlyenrolledandparticipatinginproficiencytesting. // HCFAPlan 0\\\\hl \\\\E 0#&U"%"%&U #CY01:90%   CY00:90%CY99:&U"%"%&UԀ90%#&U"%"%&U #&U"%"%&U   #&U"%"%&Uٲ #CY01:95%CY00:95%CY99:&U"%"%&UԀ95%#&U"%"%&UQ #&U"%"%&U 0\\\\ \\\\ 0#&U"%"%&U #CY01:   CY00:CY99:&U"%"%&UԀ  ! CY97:88.6%CY96:87.4%CY95:69.4%0  (Baseline)#&U"%"%&U3 #&U"%"%&U@D% " " #&U"%"%&Uݴ #CY01: ' CY00:CY99:&U"%"%&UԀ  ) CY97:94.4%CY96:93.2%CY95:89.6%#&U"%"%&Uh #&U"%"%&U /\\\\EDH ,\\\\ /Maintain100%accreditationofallIHShospitalsandoutpatientclinics.IHSPlan 0\\\\.\\\\E 0FY01:100%FY00:100%FY99:100% 0\\\\lp1\\\\ 0FY01:FY00:FY99:100%FY98:100% /\\\\EHL5\\\\ /Increasethenumberofcomplaintsofabusethatareaddressedunder_PAIMI_.SAMHSAPlan 0\\\\7\\\\E 0FY01:11,100FY00:9000FY99:9000 0\\\\LP;\\\\ 0FY01:3/02FY00:3/01FY99:3/00FY98:8,687FY97:8,360(baseline) /\\\\EA\\\\ /Inordertoincreaseaccessforminoritiesandpersonswithdisabilitiestonondiscriminatoryservicesinmanagedcaresettings,OCRwillincrease#managedcareplansfoundtobeincompliancewithTitleVI,Section504andtheAmericanswithDisabilitiesAct.Measure:Increased#correctiveactionsandnoviolationfindings.OCRPlan 0\\\\x%|I\\\\E 0FY01:33FY00:30FY99:40 0\\\\,!0L\\\\ 0FY01:FY00FY99:27FY98:10 /\\\\E" P\\\\ /InordertoincreaseaccesstoHHSservicesforlimitedEnglishproficient(_LEP_)persons,OCRwillincrease#HHSgranteesandprovidersfoundtobeincompliancewithTitleVIin_LEP_reviews/investigations.Measure:Increased#correctiveactionsandnoviolationfindings.OCR 4+8$V Plan 0\\\\,%W\\\\E 0FY01:153FY00:151FY99:125 0\\\\(!Z\\\\ 0FY01:FY00:FY99:146FY98:98(|)"^  \\\\ (#XVJX"%&U( # . '_  lXXVJP#XVJXl #ROGRAMSlXXVJS#XVJXlݽ #UPPORTINGlXXVJT#XVJXl* #HISlXXVJO#XVJXlq #BJECTIVE   (X@s#s#(ACF  DevelopmentalDisabilities    AoA  LongTermCareOmbudsmanASPE `  PolicyResearchHCFA 8  MedicaidMedicareResearch L  HRSA   NationalPractitionerDataBankIHS   TreatmentandPreventionOCR `  PreventingDiscriminationinAccesstoHHSServices_OPHS_ $ t SAMHSA `  ProtectionandAdvocacy L   $    $  5@s#s#X@E 5iU5%!`z  `E`ttx 3"i s#s#     s#s#iU5%!`z  `E`ttx 3"iL 0 !"#$%&(xx0 !"#$%&(L?,X,hX,X, X? lXXVJK#XVJXl9 #EYlXXVJFY2001P#XVJXl #ROGRAMS,lXXVJI#XVJXl #NITIATIVES,ANDlXXVJS#XVJXl& #TRATEGIES  L    3    3 23  0    #XVJXXXVJ #/XVJXXXVJ ACF!#XVJXX/XVJ #1XVJXXXVJResearch .Newandcontinuingstudiesareunderwaytoevaluatetheimpactofinitial L  Stateeffortstoimplementwelfarereform,employmentsupport,andemploymentretentionandadvancementstrategiesforTemporaryAssistanceofNeedyFamilies(_TANF_)recipientsandotherlowincomefamilies.Thesestudiesexaminehow_TANF_Ԁisbeingimplementedinlocalwelfareoffices,ruralcommunitiesandintheTribal_TANF_Ԁprogramandtheimpactonthewellbeingofchildren,includingsuchissuesasschoolachievement,behavioralproblems,andhealthstatus.Thisresearchisexpectedtoinformstateandlocalprogramadministratorsaboutstrategiesformovingthosewhoarehardertoemployintoworksituationsandmethodstoimproveopportunitiesfortheworkingpoor. 3 ݌ s#s# Ќ  0  AmajorinitiativetoexaminenationaldeclinesinMedicaidandFoodStampcaseloadsthatseemtoberelatedtowelfarereformisbeingfundedbyHHSaswellasbytheDepartmentofAgricultureandtheRobertWoodJohnsonFoundation.ThisinitiativewillprovidetechnicalassistanceandgrantstostatesandlargecountiestoimprovetheirenrollmentandredeterminationprocessesforMedicaid,theStateChildrensHealthInsuranceProgram(_SCHIP_)andFoodStamps. s#s# 0  Researchandevaluationactivitiesinotherkeyareassuchaschildcare,childsupportenforcementandchildwelfarestudiesareplanned.AdditionalresearchwillfocusonthedevelopmentandtestingofnewideasfortheHeadStartprogramandthecontinuationofmultisiteandlongitudinalstudiesthatfollowthecognitive,socialemotionalandphysicaldevelopmentofchildrenovertime.#XVJXX1XVJm #s#s#   3    31 23  0    /XVJXXXVJ AoA!StateandLocalInnovationsandProjectsofNationalSignificance .AoAis   proposingforFY2001projectsrelatingto:mentalhealth,protectionoftheolderconsumer;developmentandpromotionofnewrolesforsuccessfulaging;thedemonstrationoflowcostinterventionsforsupporting_caregivers_;andeconomicsecurity.#XVJXX/XVJ # 31 \ ݌L#!s#s# Ќ    3    3 23  0    XVJXXXVJ SAMHSAKnowledgeDevelopment programsaredesignedtoexaminetheeffectiveness $%t # ofmodelsofservicedeliveryinactualsettings.Inadditiontotargetingspecificconcernssuchasemployment,housing,substanceabuse,theseprogramsexaminehowservicesaredeliveredincludingvariousintegratedservicesandconsumeroperatedmodels.Applicationofeffectivepracticesisencouragedthroughthe_SAPT_ԀandMentalHealthBlockGrantprograms#XVJXXXVJ #/XVJXXXVJ.#XVJXX/XVJX # 3 ݌(($'s#s# Ќ    3    3 23  0    /XVJXXXVJ _OPHS_Ԁ !_OPHS_Ԁsupportsseveralresearchandservicedemonstrationgrantprogramsand *&) programevaluationstoidentifywhatworks,modelstrategiesandapproaches,andbestpracticesthataddressthebarriersandhealthproblemsofracialandethnicminoritiesandidentifyeffectivediseaseanddisabilitypreventionandpublichealthapproaches.Twomajorgrantprogramswhichwillcontinuetobeadministeredby_OPHS_ԀaretheBilingual/_Bicultural_ d.)- ServiceDemonstrationGrantsProgramtoimproveaccesstohealthcarebyreducingculturalandlinguisticbarriers,andtheMinorityCommunityHealthCoalitionDemonstrationGrantsProgramtoaddressreductionofracialdisparitiesintargetedhealthareas. 3# N ݌ s#s# Ќ  #XVJXX/XVJ # lXXVJP#XVJXl6 #ROGRAMSlXXVJS#XVJXl #UPPORTINGlXXVJT#XVJXl #HISlXXVJO#XVJXl #BJECTIVE  L  (X@s#s#(ACF L  TemporaryAssistanceforNeedyFamiliesChildSupportEnforcementDevelopmentalDisabilitiesRefugeeResettlementChildCareChildWelfareYouthProgramsDevelopmentalDisabilitiesHeadStart  AoA L  Research,TrainingandDiscretionary ASPE $ t PolicyResearch  `  _OPHS_ L  SAMHSA 8  SubstanceAbusePreventionandTreatmentBlockGrantMentalHealthServicesBlockGrantKnowledgeDevelopmentandApplicationProgram  5@s#s#X@y 5  \ D\9 <9!xiU5%!`z  `E$tt< #i s#s#    s#s#iU"5%!`z  `E$tt< #i FromtheHHSStrategicPlan,September1997. 4XVJXXXVJOverthepastfiftyyears,theAmericanmedical ` caresystemhasmaderemarkablegainsinsavinglivesandamelioratingsuffering.Clinicalmedicine,however,iscreditedwithonlyfiveofthethirtyyearsthathavebeenaddedtolifeexpectancysincetheturnofthecentury.Publichealthinterventionshavehadafargreaterimpact ( x and,inconcertwithclinicalmedicine,willcontinuetoplayanimportantroleinachievingtheimprovementstheDepartmentofHealthandHumanServices(HHS)seeks.Thepublichealthsystemhasprovidedsafedrinkingwater,reducedandeveneliminatedmajorinfectiousdiseasessuchassmallpoxandpolio,anddecreasedcontaminationofthefoodsupply.#XVJXX4XVJ #XVJXXXVJStatehealthagenciesareworkingcreativelytostretchtheirresourcesandsupportlocalpartners.#XVJXXXVJ #4XVJXXXVJ   Yettoday,themajorityoflocalhealthagenciesreportthattheylacksufficientinformationsystemsandtrainedstafftomeetcurrentneeds.Thetechnologygapismostevidentamonglocalhealthdepartments,wheremanystafflackaccesstoortrainingaboutcomputersandelectronicinformation.Inaddition,publichealthagenciesarebeingaffectedasMedicaidbeneficiariespreviouslyservedinpublicclinicsareshiftedintomanagedcarenetworks.ThisshiftdepriveshealthdepartmentsoftheMedicaidsupportforoverheadcoststhathavehelpedtosustainbasicpublichealthservices.Therefore,theshifttomanagedcareheraldsachangingroleforhealthagencies,especiallytheopportunitytoconcentrateonprovidingafullrangeofessentialpublichealthservices.Doingso,however,willrequirestafftraininginpopulationbasedservicesasopposedtodirectcare.Italsopresentsachallengetohealthagenciestoaddressthelossofresourcesthatsupportbasicpublichealthservices.#XVJXX4XVJ[ #Challengesalsoexistintheareaoffoodanddrugsafety.Inthedrugarea,greatprogresshasbeenmadeunderthePrescriptionDrugUserFeeAct(_PDUFA_)inmakingnewdrugsand_biologics_availablemorequicklytotheAmericanpeople.Thishasbeendonewithoutcompromisingthescientificreviewprocess;however,moreprogresscanbemade,especiallywiththeextensionof_PDUFA_,whichisrequiredforcontinuedprogress.Ensuringthesafetyofthefoodsupplyisoneofthegovernmentsmostenduringandimportantfunctions.WhiletheUnitedStateshastheworldssafestfoodsupply,majorissuesneedtobeaddressed,includingemergingpathogens,newandnovelfoodingredients,hazardousdietarysupplements,naturallyoccurringfoodbornetoxins,andincreasingimportationoffoods.Sourcesofcontaminationaremorenumerousandmorevariedthanthepathogensthemselves,highlightingtheimportanceofadequateresearch,surveillance,andpreventionactivities.Currentlyavailablediagnosticassaysfordetectionofsomepathogenshaveseriouslimitations,diminishingtheDepartmentsabilitytoensurethesafetyofthefoodsupply.PreservingandimprovingthenationspublichealthsystemsarecriticalprioritiesfortheDepartment.Investmentsinthisareawillmaintainandimprovethefoundationforeffectiveprograms.HHSmustworkwithstateandlocalgovernmentstosecureaworkforcethatis 0.)- appropriatelytrained,informationsystemsthatareadequateandeffectivelylinked,andstructuresandresourcesthataresufficienttodelivertheessentialservicesofpublichealth.TheDepartmentalsomustworkwithindustryandconsumerstoimplementnewapproachesinsciencebasedregulationthatwillallowittoprotectthefoodanddrugsupplywhileminimizingcostsandintrusiveness.TheseactivitieswillbecoordinatedthroughtheOfficeofPublicHealthandScience(_OPHS_)withintheOfficeoftheSecretary(OS)andinvolvetheCentersforDiseaseControlandPrevention(CDC),theHealthResourcesandServicesAdministration(HRSA),theIndianHealthService(IHS),theSubstanceAbuseandMentalHealthServicesAdministration(SAMHSA),theFoodandDrugAdministration(FDA),theHealthCareFinancingAdministration(HCFA),andtheAdministrationforChildrenandFamilies(ACF).̀    iU5%!`z  `Ett o$i s#s#      s#s#iU$5%!`z  `Ett o$iL 0 !"#$%&(xx0 !"#$%&(L9,X,hX,X,hX9 lXXVJK#XVJXl1 #EYlXXVJFY2001P#XVJXlx #ROGRAMS,lXXVJI#XVJXl #NITIATIVES,ANDlXXVJS#XVJXl #TRATEGIES  L    3    3 23  0    XVJXXXVJ CDC !CDCprovidescomprehensiveinformationonhealthincludinghealthstatus,health L   risks,thehealthcaresystem,andhealthrelatedoutcomes.Bymaintainingabroadbasedmonitoringcapability,CDCcanquicklydetectandassesspublichealththreats.CDCsassessmentcapability,epidemiologicandlaboratorysurveillance,andresponsecapacityensureasystemthatidentifieshealthproblemsanddeploysteamsofexpertstohelpresolvetheproblemspromptly.Additionally,theassessmentandsurveillancecapacityensuresdataforanalysisthatcanhelpidentifycausesofdiseaseearlyandassistindecisionsaboutappropriateresearch,policy,andprogrammaticactions. 3 ݌ s#s# Ќ  0   EmphasisisonassuringthatCDCssurveillanceandhealthinformationsystemsaddress  currenthealthissuesandproblemsandthatexistingandnewCDCdatasystemsarecarefullycoordinatedandintegrated.CDCsHealthInformationandSurveillanceSystemsBoardstimulatesandsponsorsinnovationinhealthinformationandsurveillancesystemssupportiveoftheessentialpublichealthservices.Inaddition,epidemiologicandlaboratorycapacityforsurveillanceandresponsewillbestrengthened.MakinghealthinformationavailabletoawideaudienceisamajorCDCprioritythatrequiresadjustmentstoexistingdataandsurveillancesystemsandmodificationsoftheproceduresforaccessinginformation.ForFY2000,thisgoalisaccomplishedthroughmanyofCDCsprogramactivities,withemphasisonHealthStatistics,thePreventiveHealthandHealthServicesBlockGrant,EpidemicServices,EmergingInfections,InjuryPrevention,EnvironmentalandOccupationalHealth,andCancerRegistries. s#s# <,X, X,X,hX<#XVJXXXVJ #XVJXXXVJL K !"#$%&( hx0 !"#$%&(L      3    38 2 3  0    CDC!InfectiousDiseases .CDCsNationalCenterforInfectiousDiseases(_NCID_)will   focusonbuildingastrongandflexiblepublichealthinfrastructure,recognizingthatskilled_epidemiologists_,strongpublichealthlaboratories,andcoordinatedcommunicationsanddiseasereportingsystemsareessentialfordevelopingsustainablediseasepreventionstrategiesandarethebestdefenseagainstanydiseaseoutbreak.Thisapproachemphasizestheneedfordevelopingemergencypreparednessatalllevelsofgovernmentforanorganized,rapid,andeffectiveresponseintheeventof_pandemics_Ԁ(globalepidemics),suchasinfluenza,andlargescalediseaseoutbreaksornaturaldisasters. 38 c ݌ s#s# Ќ  0  Inaddition,_NCID_ԀwillexpandactivitiesoftheFY19981999NationalFoodSafetyInitiative.Activitiescarriedoutunderthisinitiativehavefocusedonbuildinganationalearlywarningsystemforhazardsinthefoodsupplybyenhancingcapacityforsurveillanceandoutbreakinvestigationsatthestateandfederallevels,andbylinkingstatehealth&  departmentsandfederalagenciestogetherwithsophisticatedcomputerandcommunicationssystemstocoordinatetheresponseto_foodborne_Ԁdisease. s#s# '+  .)-   3    3 2 3  0    #XVJXXXVJ #XVJXXXVJCDC!HealthStatistics .CDCsNationalCenterforHealthStatistics(_NCHS_)provides  statisticalinformationtoguideactionsandpoliciestoimprovehealthofAmericans.CDCwillbuildabroadbasedhealthstatisticsinfrastructureneededtomeetnewdemandsforhealthdatafrompolicymakers,healthresearchers,publichealthpractitioners,andthepublic.Toassurethatthesedataneedsaremet,CDCwillupdatecurrent endangeredsystemstoassuretheirutilitynowandinthefuture,developnewdatasystemstoaddressemergingpublichealthissues,investintechnologytoimprovetimelinessandaccessibilityofdata,fillcriticalgapsinStatelevelpolicyinformation,andfillcriticaldatagapsrelatedtoraceandethnicity.#XVJXXXVJ #XVJXXXVJ 3 - ݌( xs#s# Ќ    3    3j 2 3  0    CDC!DevelopingaPublicHealthResponsetoTerrorismInitiative .CDCwillimprove  P  publichealthpreparednessatthefederal,state,andlocallevelsofgovernmenttorespondtothethreatposedbyaterroristeventinvolvingbiological,chemicalorradiologicalweapons.CDCwillbuildpublichealthemergencyresponsecapacitybybuildingpublichealthsurveillancefordetectingunusualorsmallcovertevents;buildingepidemiologiccapacityforminimizingandcontrollingpotentialhealththreats;enhancingpublichealthlaboratorycapacityforidentifyinganddiagnosingcandidateagentsforterrorism;anddevelopingcommunicationssystemswithothergovernmentagenciesandthegeneralpublicforrapidlydisseminatinginformation.#XVJXXXVJ #XVJXXXVJ 3j  ݌ds#s# Ќ  #XVJXXXVJ #XVJXXXVJ  =,X,hX,X, XE =#XVJXXXVJ #XVJXXXVJ   4 #XVJXXXVJ #  3    3m 2 3  0    XVJXXXVJ _OPHS_Ԁ !TheOfficeofEmergencyPreparednesswillcontinueHHSsintegratedplan,begunin < FY1999,toaddressthecomplexissuesofahealthandmedicalresponsetobioterrorism,aswellasthecontinuedinfrastructureforamedicalresponsetoterrorismofanytype!nuclear,biologicalorchemical.#XVJXXXVJ #ԀThenationalresponseto_bioterrorism_ԀisledbytheASH/SG,through T surveillanceactivitiesofFDA,CDC,_ATSDR_ԀandStateandlocalhealthagencies,withtheassistanceofalltheHHSagencies.TheFY2001Budgetwillprovideincreasedsupportforteamtrainingandexercises,MetropolitanMedicalResponseTeamdevelopmentandresearchanddevelopmentrelatingtosmallpoxandanthraxvaccines. 3m ݌ s#s# Ќ    3    3 2 3  0    _OPHS_Ԁ!TheOfficeofEmergencyPreparedness(OEP) isresponsibleforcoordinatingthe  provisionofmentalhealthservicesintheimmediateresponsephaseofnaturaldisastersanddomesticterrorism.WorkingwiththeFederalEmergencyManagementAgencyandSAMHSA,OEPprovidesteamsofmentalhealthprofessionalstorespondtolargescaledeclareddisasters. 3 ݌ s#s# Ќ    3    3 2 3  0    _AHRQ_ԀReporttotheNationontheQualityofHealthCare .Thisannualseriesis $h" intendedtoprovidepolicymakerswithanationalperspectiveonthosehealthcareservicesandthekeyaspectsofthewayweorganizeanddeliverthoseservicesthatmostaffectthequalityandsafetyofpatientcare.Thisinformationwillenable_decisionmakers_Ԁtoensurethatthepopulationstheycareaboutaregettingthecaretheyneed.Itshouldhelppolicymakerstotargetresourcesandactivitiestoimprovequalitywhereitcanandneedstobeimproved.Itwillalsoprovideevidencetoinformofpurchasingdecisionsinwaysthatcanharnessmarketforcestorewardhighquality._AHRQ_Ԁwillbeginworkonenhancingdatacollectionactivitiesin *%) FY2001inordertosubmitthefirstannualreportinFY2003. 3 , ݌ s#s# Ќ    3    3i 2 3  0    _AHRQ_ 󀄀Monitorqualityofcarethroughastrengthened MedicalExpenditurePanelSurvey T-(, (_MEPS_) .Additional_MEPS_ԀinvestmentsinFY2001willcontinuetheexpansionsbeguninFY D.)- 2000toincludeinthe_MEPS_Ԁhouseholdsampleasufficientsampleofindividualswithcertainillnessesofnationalinterestintermsofqualityofcareandburdenofdisease.Thisenhancementwillnotonlypermitmorefocusedanalysesofthequalityofcarereceivedforthesevulnerablepopulations;itwillalsoenableanalysesofpatternsofuse,costs,andimpactoftheseservices.TheFY2001investmentwillalsoenablethecompletionofamoreextensivemoduleonchildren,toenableustounderstandtheimpactofchangesinhealthprograms.4XVJXXXVJ 3i  ݌L s#s# Ќ    3    3 2 3  0    _AHRQ_ԀHealthcareCostandUtilizationProject(_HCUP_). #XVJXX4XVJe #_AHRQ_Ԁwillfurtherexpand $ t _HCUP_Ԁtoprovidestateandcommunitydecisionmakersapowerfulsetoflinkeddatabasestheycanusetomonitortheimpactofmajorsystemchangesonaccess,quality,outcomesandcostintheirstatesandcommunities,andtocomparetheseagainsttheprogressofotherstatesandcommunities.Specifically,theexpansionwillincludeclinicalandfinancialrecordsfromemergencydepartmentsandotherambulatorycareaswellasrecordsfromfourmoreStates,anincreasefromanexpected26statesinFY2000,foratotalof30States.4XVJXXXVJ 3  ݌ s#s# Ќ    3    3 2 3  0    #XVJXX4XVJ` #XVJXXXVJ CDC!CancerRegistries. ThroughtheNationalProgramofCancerRegistries(_NPCR_),CDC   fundsstatesandterritoriestoenhanceexistingcancerregistries;planandimplementstatewideregistrieswheretheydonotexist;developmodellegislationandregulationsforstatestoenhanceviabilityofregistryoperations;setstandardsforcompleteness,timeliness,andquality;andprovidetraining.The_NPCR_Ԁservesasthefoundationofanational,comprehensivepreventionstrategy;itisabasictoolinsurveillanceeffortsthatwillprovidetheneededfactualbasisforappropriatepolicydecisionsandallocationsofscarceresources.InFY1999,CDCsupported45States,3territories,andtheDistrictofColumbiaforcancerregistries.#XVJXXXVJW #4XVJXXXVJ 3  ݌Ps#s# Ќ    3    3=! 2 3  0    #XVJXX4XVJ #XVJXXXVJ CDC!EnvironmentalandOccupationalHealth .CDCisworkingtodevelopcost ( effectiveenvironmentalinterventionsthat,inconjunctionwithimprovedmedicalmanagement,willreducethenumberofasthmaexacerbationsandimprovethequalityoflifeofpeoplewithasthma.#XVJXXXVJ! #4XVJXXXVJ 3=! h! ݌s#s# Ќ    3    3# 2 3  0    #XVJXX4XVJ@# #/XVJXXXVJ FDA!InjuryReportingInitiative .Reduceinjuriesandillnessesresultingfromconsumption x anduseofFDAregulatedproducts.OneoftheFDAsprimaryobjectivesistodevelopandimplementacomprehensivesurveillancesystemtoimprovethequalityofinformationonadverseeventsandproductdefectsassociatedwithFDAregulatedproducts.Thesystemwillfocusonthreeareas:surveillanceandepidemiology;research;andeducationandoutreach.FDAbelievesthissystemwillincreasethesafetyofFDAregulatedproductsbecausemorereportsofrareandunexpectedadverseeventsandproductproblemswouldbe&  discoveredandcorrectiveactiontaken.Systematicfeedbackabouttheproblemcanthenbeprovidedtothehealthcarecommunityandthepublic.#XVJXX/XVJ7$ #4XVJXXXVJ 3# # ݌&,"%s#s# Ќ  '%&   3    3( 2 3  0    #XVJXX4XVJ' #/XVJXXXVJ FDA!FoodSafetyInitiative .Surveillanceof_foodborne_Ԁillnessesprovidescritical ($' informationtodeterminetheneedforpreventiveinterventions.The_FoodNet_Ԁ_foodborne_Ԁillnessreportingsystemprovidesextensive,complete,andreliableinformationabouttheoccurrencesofoutbreaksintheU.S.Whenoutbreaksarereported,FDArespondsquicklytotracebackthroughthefooddistributionchaintoidentifythesourceoftheoutbreakandtheninitiateinterventionmeasurestolimittheoutbreak. 3( <( ݌ s#s# Ќ   @.)- 0  TheNationalAntimicrobialResistanceMonitoringSystem(_NARMS_),whichdetectspotentialhealthhazardsthroughsystematiccollection,analysisandinterpretationofantimicrobialsusceptibilitysurveillancedata,isamajorpartofthesurveillancecomponentofFDAsFoodSafetyInitiative.The_NARMS_Ԁisthebasisforregulatorydecisionmaking,foodanimaldrugpolicy,andidentifyingdiseasetrendsinhumanandanimalmedicine.The_NARMS_Ԁimpactsinternationalpolicy,federal,state,andlocalprograms. s#s# #XVJXX/XVJ( #4XVJXXXVJ#XVJXX4XVJ*. #  3    3m. 2 3  0    /XVJXXXVJ HRSA!NationalPractitionerDataBank .HRSAsNationalPractitionerDataBankhelps $ t protectthepublicbyassuringthatinformationaboutmedicalanddentalmalpracticepaymentsandothersanctionsisavailabletohospitalsandotherhealthcareentities,licensingauthoritiesandprofessionalsocieties. 3m. . ݌ s#s# Ќ    3!    30 2 3  0    HRSA!NationalCenterforWorkforceInformationandAnalysis .HRSAsNational   CenterforWorkforceInformationandAnalysisprovidesessentialdatafornational,State,andlocalhealthworkforcepolicyandanalysis.TheCenterbuildsanetworkforhealthworkforceresearch,forecastshealthworkforcesupplyandrequirements,andmaintainstheonlysourceofcountyleveldataacrossthehealthprofessions. 30 0 ݌ s#s# Ќ    3"    32 2 3  0    IHS!Treatment,IndianHealthProfessions .ThisprogramenablesAI/ANtoenterthe P healthcareprofessionsthroughacarefullydesignedsystemofpreparatory,professionalandcontinuingeducationsassistanceprograms;#XVJXX/XVJ. #servesasacatalysttothedevelopmentofIndian ,| communitiesbyprovidingeducationalopportunitiesandenablingAI/ANhealthcareprofessionalstofurtherIndianselfdeterminationinthedeliveryofhealthcare;anddevelopsandmaintainsAmericanIndianpsychologycareerrecruitmentprogramsasameansofencouragingIndianstoenterthementalhealthfield. 32 3 ݌ s#s# Ќ    3#    3?6 2 3  0    IHS!InformationandTelecommunications .ThisinitiativeisintendedtoexpandtheIHS  computingandtelecommunication/_telemedicine_Ԁcapabilitiesincludingenhancedpatientrecordsystemsandimprovedmonitoringcapabilities. 3?6 j6 ݌ s#s# Ќ    3$    3 8 2 3  0    SAMHSA!SAMHSAsdatainfrastructureinitiative supportstheNationalDrugControl h  Strategy,andconstitutesanimportantcomponentofperformancemeasurementeffortsoftheOfficeofNationalDrugControlPolicy(_ONDCP_)indeterminingtheimpactofFederal,Stateandlocaleffortstoreducedruguse.TheinfrastructureattheStateandprogramleveliscrucialtotheproductionofdatatodetermineclientoutcomesandprogrameffectiveness.Inadditiontoprovidinginformationtheinitiativemovesthesubstanceabusefieldtotheimplementationofcommontools,targetsandmeasuresforassessingprogrameffectiveness. 3 8 68 ݌ s#s# Ќ    3%    3s; 2 3  0    /XVJXXXVJSAMHSA !Throughblockgrantrelatedassistance,SAMHSAisworkingwithState '#& substanceabuseandmentalhealthagenciestostrengthentheirabilitytocollect,analyzeandreportperformanceandprogramdatatotheFederalgovernment.#XVJXX/XVJ; #Ԁ 3s; ; ݌)$(s#s# Ќ    3&    3t= 2 3  0    /XVJXXXVJ NIH!TheNationalLibraryofMedicine .TheNationalLibraryofMedicine#XVJXX/XVJ= #/XVJXXXVJԀ(_NLM_) +&* collects,organizes,andmakesavailablebiomedicalscienceinformationtoinvestigators,educators,andpractitionersandcarriesoutprogramsdesignedtostrengthenmedicallibraryservicesintheUnitedStates.NIHiscurrentlyfocusingonimprovedinformationgeneration H.)- anddisseminationbythe_NLM_Ԁthroughinitiativesinthefollowingfourareas:nextgeneration_internet_,informationservicesforconsumersandpatients,computationalmolecularbiology,basiclibraryservices,andoutreach.#XVJXX/XVJ; # 3: : ݌s#s# Ќ    3'    3> 2 3  0    _OPHS_ !HealthyPeople2010isscheduledtobereleasedinJanuary2000andwillprovidean ` agendafordiseasepreventionandhealthpromotioneffortsforthenexttenyears.Toensureadequateaccessandtomeettheneedsofstakeholdersforabroadrangeofinformationthatincludeskeycoreindicators,specificcontentareaobjectives,andanextensivedatatrackingmechanism,HealthyPeople2010willbeissuedasathree-volumeset,ratherthesinglevolumethatcomprisedHealthyPeople2000.Thefirstvolumewillbedesignedforpolicymakersandfocusonpeople,settings,andleadinghealthindicators.Itwillalsobemostunderstandabletoconsumers.Thesecondvolumewillcontainthenationalhealthobjectiveswithsupportingreferencesandjustification.Thisvolumewillbeespeciallyusefultonationalmembershiporganizations,Statesandcommunitiestouseindevelopingtheirownsetsofperformancemeasurements.Thethirdvolumewillbeastatisticalcompendiumwiththedatathatdescribespopulationgroupsbygender,raceandethnicity,and_socio_Ԅeconomicstatuscharacteristics._OPHS_ԀwillalsopostHealthyPeople2010ontheInternetwithacompletesearchabletextdatabase. 3> > ݌ s#s# Ќ    3(    3D 2 3  0    _OPHS_ !TheUS/MexicoBorderHealthCommission(_B6XVJXXXVJHC_)isauthorizedtoconductor 8 supportborderactivities,includingacomprehensiveneedsassessmentandinvestigations,research,orstudiesdesignedtoidentify,study,andmonitor,onanongoingbasis,healthproblemsaffectingtheborderpopulations. 3D D ݌ s#s# Ќ  0  TheU.S.sideoftheCommissionisexpectedtobefullyoperationalbyFY2000.Throughneedsassessments,outreachtoborderconstituencies,andotherpublicinteractions,Commissionerswillhaveidentifiedhealthprioritiesthatcouldbenefitfrom_BHC_Ԁsupportandinvolvement._BHC_Ԁwillprovidefinancial,technical,oradministrativeassistancetopublicorprivatenonprofitentitiesthatacttopreventorresolvesuchhealthpriorityproblems.The_BHC_Ԁwillalsoprogresstowardtheconductorsupportofabinational,publicprivateefforttoestablishacomprehensiveandcoordinatedsystemforcollectinghealthrelateddataandmonitoringhealthproblemsoftheU.S.Mexicoborder. s#s#   3)    3-J 2 3  0    #XVJXX6XVJvE #/XVJXXXVJ _OPHS_ !OfficeofMinorityHealth._OMH_Ԁfostersthedevelopmentofstateinfrastructuresfor $#t! addressingminorityhealthissuesthroughthedevelopmentofaminorityhealthnetworkcomprisedofFederal,national,stateandlocalorganizations._OMH_Ԁprovidedassistancethroughtheprovisionoftimelyinformation,conductingofskillsbuildingmeetingsandconferences(e.g.,theuseoftelecommunicationstechnology),andhandsontechnical assistance. 3-J XJ ݌'#&s#s# Ќ  #XVJXX/XVJJ #&   lXXVJS#XVJXlM #ELECTEDlXXVJFY2001#XVJXlM #ԀlXXVJP#XVJXl@N #ERFORMANCElXXVJG#XVJXlN #OALSANDlXXVJM#XVJXlN #EASURES  ( * ddSS SSS SSSS Ss#s#, SS , SS ,SSS +  &\\\\G ( &  PerformanceGoals 8\\\\E#!<  \\\\G 8  Targets 8\\\\E#!<  \\\\E 8  ActualPerformance =\\\\E(&( x   \\\\E =&U"%XXVJ&U"%"%&URegionalpopulationbasedEmerging    InfectionsProgramswillconductearlywarninginvestigationsofagentsofinfectiousdiseases.#&U"%"%&UcQ ##XVJX"%&UDQ #&U"%XXVJԀCDCPlan 0\\\\< \\\\E 0FY01:10FY00:9FY99:9#XVJX"%&U^R #&U"%XXVJ `   0\\\\< \\\\ 0FY01:'M FY00:FY99:9FY97:7#XVJX"%&UR #&U"%XXVJ /\\\\E< \\\\ /&U"%"%&UAtleast80%oftotalrequireddatafromall   programsfundedbythePreventiveHealthandHealthServicesBlockgrantwillbereportedtoCDCannually.#&U"%"%&UT ##XVJX"%&US #&U"%XXVJԀCDCPlan 0\\\\@ \\\\E 0FY01:Atleast85%FY00:Atleast85%FY99:Atleast80%#XVJX"%&UU #&U"%XXVJ 0\\\\d \\\\ 0FY01:FY00:FY99:3/00FY95:77%#XVJX"%&UU #&U"%XXVJ 4\\\\E@ \\\\ F4&U"%"%&UEnsuresafeandhealthfulworkingconditions   bydevelopingasystemforsurveillanceformajoroccupationalillnesses,injuries,exposures,andhealthhazards.#&U"%"%&UV ##XVJX"%&UhV #&U"%XXVJԀ D# FY01Measure:&U"%"%&UCompleteacomprehensive L% surveillanceplanningprocessandimplementrecommendationsat_NIOSH_.#&U"%"%&UX ##XVJX"%&UW #&U"%XXVJԀCDCPlan 0\\\\'\\\\E 0 &U"%"%&U FY01:Continue ( implementationofsurveillancerecommendations.FY00:Acomprehensivesurveillanceplanningprocesswillbecompletedandeffortswillbegininimplementingrecommendationsfor_NIOSH_.FY99:Undertakeacomprehensivesurveillanceplanningprocesswith_NIOSH_ԀpartnersattheStateandFederallevelstoestablishsurveillanceprioritiesanddefinerolesforvariousagencies.#&U"%"%&UpY ##XVJX"%&UY #&U"%XXVJ 0\\\\$T;\\\\ 0&U"%"%&UFY01:#&U"%"%&U\ #&U"%"%&U#XVJX"%&U[ #&U"%XXVJ < FY00:1/00 FY99:Planning ,I processcompleted;draftsurveillancestrategicplandeveloped.#&U"%"%&UL\ ##XVJX"%&U\ #&U"%XXVJ 4\\\\EL"M F \\\\ 4&U"%"%&UBy2002,anationalnetworkwillexistthat d willprovideallstateswithbetteraccesstodataondisabilitiesfortheiruseinanalyzingtheneedsofpeoplewithdisablingconditions#&U"%"%&U%[ ##XVJX"%&UZ #&U"%XXVJ.   FY01Measure:By2000,thenumberofstateswhohavebegunusingtheBehavioral RiskFactorSurveillanceSurvey(_BRFSS_)disabilitymodulewillbeincreasedto16.#XVJX"%&UU\ #&U"%XXVJ `D  CDCPlan 0\\\\<  \\\\E 0FY01:14FY00:14FY99:15#XVJX"%&U{] #&U"%XXVJ 0\\\\8  \\\\ 0FY01:FY00:FY99:16FY97:0#XVJX"%&U.^ #&U"%XXVJ /\\\\E \\\\ /&U"%"%&UIncreasethenumberofstateandmajorcity   healthdepartmentswithexpandedepidemiologyandsurveillancecapacitytoinvestigateandmitigatehealththreatsby_bioterrorism_.#&U"%"%&U_ ##XVJX"%&U^ #&U"%XXVJԀCDCPlan 0\\\\ \\\\E 0FY01:6368FY00:40FY99:40#XVJX"%&UV` #&U"%XXVJ 0\\\\dH \\\\ 0FY01:FY00:FY99:34FY98:0#XVJX"%&U` #&U"%XXVJ /\\\\E@$ \\\\ /Maintainanationalpharmaceutical stockpilefordeploymenttorespondtoterroristuseofpotentialbiologicalorchemicalagents,includingtheabilitytomedicallytreat1millionciviliansfrombiologicalagentsofanthrax,plagueandtularemiaand/ortomedicallytreat10,000civiliansfromchemicalattackusingnerveorblisteringagents.CDCPlan#XVJX"%&Ua #&U"%XXVJ 0\\\\lP&\\\\E 0 FY01: Maintainstockpile p' FY00:MaintainstockpileFY99:Createanationalpharmaceutical stockpileavailablefordeploymenttorespondtoterroristuseofpotentialbiologicalorchemicalagents,includingtheabilitytoprotect14millionciviliansfromanthraxattacks.#XVJX"%&Ukc #&U"%XXVJ 0\\\\3\\\\ 0 &U"%"%&U FY01: p4 FY00:FY99:CreatedstockpileFY98:noplan#&U"%"%&Ume ##XVJX"%&Ue #&U"%XXVJ /\\\\Et;\\\\ /NumberofMetropolitanMedicalResponseSystemswith_bioterrorism_Ԁcapabilities._OPHS_ԀPlan 0\\\\#>\\\\E 0FY01:72FY00:47 0\\\\,"@\\\\ 0FY01:FY00:FY99:27FY98:0#XVJX"%&U!f # /\\\\E#D\\\\ /&U"%XXVJRecruitadditionalhospitalsintothe_MedSun_ T%8E System(MedicalDeviceSurveillanceNetwork)forinjuryreportingthatusesimproveddataformatandcollectionmethodstoenhancethevalidityandreliabilityofdataprovided,thusaffordingahigherlevelofpublichealthprotection.FDAPlan 0\\\\|*`#K\\\\E 0FY01:Over200additionalhospitalsFY00:Develop_MedSun_Systembasedonapproximately75to90representativeuserfacilities.FY99:N/A 0\\\\|*`#R\\\\ 0FY01:FY00:FY99:PilotcompletedFY98:Recruited24pilotfacilities. /\\\\E-%\\\\\ /Expediteprocessingandevaluationofadverse d  drugeventsthroughimplementationofthe_AERS_Ԁwhichallowsforelectronicperiodicdataentryandacquisitionoffullycodedinformationfromdrugcompanies.FDAPlan 0\\\\ \\\\E 0FY01:Separatedataentryandretrievalfunctionsthroughoutnewdrugreviewdivisions.Pilottestadvancedanalyticaltechniques.Developandimplementspecialreportmodule.FY00:Implementsoftwaretomakethe_AERS_ԀmorecompatiblewithInternationalConferenceonHarmonizationrequirements.Developnextgenerationofthe_AERS_Ԁtoenhancefunctionality.FY99:Implement_AERS_Ԁfortheelectronicreceiptandreviewofvoluntaryandmandatory_ADE_Ԁreports. 0\\\\D(\\\\ 0#XVJX"%&Ueg #FY01: d  FY00:&U"%XXVJFY99:Pilottestingofelectronicindustrysubmissionsongoing!actualimplementationwithrespecttocertaintypesofperiodicindustryreportsexpectedbyendofFY99.#XVJX"%&Ufn # /\\\\E8\\\\ /&U"%XXVJDevelopthespecificationsand pT9 implementationplanforanautomatedmutuallycompatibleinformationsystemwhichcaptureshealthstatusandpatientcaredataforIndianUrbanhealthcareprogramsandimplementatfieldurbansites.IHSPlan 0\\\\">\\\\E 0FY01:implementedin30%ofurbanprogramsFY00:testatleast1siteFY99:developspecsandplan 0\\\\!C\\\\ 0FY01:FY00:FY99:accomplished 4\\\\E!H\\\\ 4Developenvironmentalhealthsurveillancesystem,andcompletecommunityenvironmentalassessmentsin90%AI/ANcommunities.IHSPlan 0\\\\&L\\\\E 0FY01:90%ofcommunitiesassessedFY00:developsurveillanceprotocolandplan 0\\\\&P\\\\ 0FY01:FY00:FY99:noreliablebaseline#XVJX"%&Uo #-#!x(\!V  \\\\ - lXXVJP#XVJXls #ROGRAMSlXXVJS#XVJXls #UPPORTINGlXXVJT#XVJXl#t #HISlXXVJO#XVJXljt #BJECTIVE  `+D$X (X@s#s#(_AHRQ_ `-D&Z ResearchonHealthCosts,Quality,and L.0'[ OutcomesMedicalExpenditurePanelSurveys L.0'\ CDC  HealthStatisticsInfectiousDiseasesHIV/AIDSPreventionChronicDiseasePreventionPreventionResearchCancerRegistriesEpidemicServicesEnvironmentalandOccupationalHealthFDA  L  FoodsHumanDrugsMedicalDevicesandRadiologicalHealth_Biologics_AnimalDrugsandFeedsHRSA   NationalPractitionerDataBank p NationalCenterforWorkforceInformationandAnalysisIHS  TreatmentCapitalProgramming/Infrastructure ` NIH L  ResearchProgram_OPHS_ $ t OfficeofDiseasePreventionandHealthPromotion,HealthyPeople2000_OPHS_(continued)  8  ЀOfficeofEmergencyPreparednessUS/MexicoBorderHealthCommission,OfficeofInternationalandRefugeeHealthSAMHSA   SubstanceAbuseandMentalHealthBlockGrants p   H    H  5@s#s#X@t 5iU5%!`z  `E`ttx 3%i s#s#     s#s#iU&5%!`z  `E`ttx 3%iL 0 !"#$%&(xhK !"#$%&(L9,X,hX,X,hX9 lXXVJK#XVJXlW| #EYlXXVJFY2001P#XVJXl| #ROGRAMS,lXXVJI#XVJXl| #NITIATIVES,ANDlXXVJS#XVJXlD} #TRATEGIES  L    3*    3} 23  0    /XVJXXXVJ CDC!InfectiousDiseases .CDCsNationalCenterforInfectiousDiseaseswillexpand L  activitiesoftheFY19981999NationalFoodSafetyInitiative.Activitiescarriedoutunderthisinitiativefocusonbuildinganationalearlywarningsystemforhazardsinthefoodsupplybyenhancingcapacityforsurveillanceandoutbreakinvestigationsatthestateandfederallevelsandbylinkingstatehealthdepartmentsandfederalagenciestogetherwithsophisticatedcomputerandcommunicationssystemstocoordinatetheresponseto_foodborne_Ԁdisease.#XVJXX/XVJ~ # 3} } ݌< s#s# Ќ    3+    3 23  0    /XVJXXXVJ FDA!ProductSafetyAssuranceInitiative .#XVJXX/XVJv #6XVJXXXVJToassurethatFDAregulatedproductsare   beingproducedandmarketedunderconditionsthatwillassuretheirsafety,qualityandefficacy.FDAintendstomeetitsdomesticstatutoryrequirementbyinspectingdomesticfirmsmoreoftenwiththeassistanceofourstateregulatorycounterparts.TheAgencywillalsousemultiplestrategiesofeducation,technicalassistance,targetinghigherriskindustrysectors,andenforcement,whennecessary,tocorrectproductriskinthemarketplace.Akeyelementofassuringqualityandsafety,particularlyinthefoodindustry,willbetostrengthentheabilityofindustrytodevelopitsownsafetyandqualitymonitoringsystems.Thiswillbeaccomplished,inpart,byexpansionoftheHazardAnalysisandCriticalControlPoint(_HACCP_)programfromseafoodtootherappropriateindustrysegments.  3 0 ݌ds#s# Ќ  0  Toimprovesafetyofimportedproducts,FDAwillcontinueitsthreecoordinatedstrategies.First,reducetheprobabilitythat_violative_ԀproductswillbeexportedtotheU.S.;second,attheU.S.border,makerapidandreliabledecisionsonproductentry;andthird,target_violative_productsandpreventtheirentryintotheU.S.#XVJXX6XVJ #s#s#   3,    3 23  0    /XVJXXXVJ FDA!FoodSafetyInitiative .#XVJXX/XVJ$ #6XVJXXXVJToincreaseconsumerconfidenceinthesafetyofthenations   foodsupply.Atthefederallevel,FDAhastheprimaryresponsibilityforensuringthatfoodsavailabletothenation'sconsumersaresafe.Foodproducts,whichfallundertheregulatorypurviewofFDA,areestimatedtorepresent70percentofthosefoundinthemarketplace.Theremainderofthefoodsupply,primarilymeatsandpoultry,isregulatedbyUSDA. 3 އ ݌ s#s# Ќ  0  TherapidgrowthinthenumberandcomplexityoffoodsafetyissuesincreasinglypresentsmajorchallengesforFDA,includingemergingpathogens,hazardousdietarysupplements,pesticidesandindustrialchemicalcontaminants.Becauseofthemagnitudeandcomplexityofthehazardsinvolvedwiththeseandotherimportantfoodsafetyissues,strategiestoaddressthemmustbeinnovative,basedonsoundscience,andeffectivelycoordinatedwiththeAgency'sfederalpartners,includingUSDA,CDCandEPA,andthestates. s#s# 0  FDAsgoalistoreduce_foodborne_Ԁillnessesbyexpandingtheuseofpreventivecontrol systems;expandingcompliancemonitoringofdomesticandimportedproducts;increasingthe t-(, _public'sunderstandinganduseofsafefoodhandlingpractices;anddevelopingmoreeffectivetechniquesfordetecting,preventingandcontrollingfoodbornehazards.#XVJXX6XVJ #s#s#     3-    3 23  0    6XVJXXXVJ FDA!InternationalHarmonizationofStandards .FDA,othergovernmentregulatory t bodies,andindustryparticipateininternationalharmonizationactivitiestohelpreducetheregulatoryburdenonindustryandtobringproductstothemarketmorequickly.AcceptanceanduseofinternationalsafetystandardsthatsatisfyU.S.consumerprotectiongoalswillimproveproductsafetyandpublichealth,reduceFDAsimportinspectionburden,andhelpfacilitatetheimportationandexportationofproducts.Byharmonizinginternationalrequirements,theindustryhopestoreducethecostsofbringingproductstomarket.FDAwillcontinuetoparticipateininternationalstandardsettingactivitiessuchasGeneralAgreementonTariffsandTrade(GATT),theNorthAmericanFreeTradeAgreement(NAFTA),andtheCodexAlimentarius,topromotedevelopmentandadoptionofsciencebasedinternationalstandardsandensureFDAsabilitytoprotecttheU.S.publichealth.#XVJXX6XVJ| # 3 6 ݌ s#s# Ќ    3.    3 23  0    6XVJXXXVJ FDA!ScienceandResearchSupportforPremarketReviews .FDAshighestpriorities   includeimprovingitssciencebaseandconductingresearch,especiallytosupportthereviewofpremarketapplications.FDAsgoalsinconductingresearcharetodevelop:1)inhousescientificexperts,especiallyinemergingtechnologies;2)scientificguidanceforproductsponsorsandreviewers;and3)sciencebasedstandards.Inhousescientificexpertsconsultwithproductreviewersonproductapplications.Scientificguidancebenefitsbothapplicantsandreviewstaffindevelopingandreviewingapplications.FDAModernizationActrequiresFDAtorecognizeandusestandardsestablishedbynationalorinternationallyrecognizedstandarddevelopmentorganizationsintheapplicationreviewprocess,especiallywithmedicaldevices.FDAsscientificeffortswillallowtheAgencytoexpanditsparticipationinstandardsdevelopmentandharmonization.Sincedatarelatingtotheaspectsofsafetyand/orefficiencycoveredbythestandardswillnotberequiredinthepremarketapplication,thereviewprocesscanbeexpedited.#XVJXX6XVJY # 3  ݌s#s# Ќ    3/    3d 23  0    /XVJXXXVJ CDC!EpidemicServices .Epidemicservicescoveravastspectrumofactivities:preventing t andcontrollingepidemicsandprotectingtheU.S.populationfrompublichealthcrisesincludingbiologicalandchemicalemergencies;developing,operating,andmaintainingsurveillancesystems,analyzingdata,andrespondingtopublichealthproblems;trainingpublichealthepidemiologists;developingleadershipandmanagementskillsofpublichealthofficialsatthefederal,state,andlocallevels;carryingoutthequarantineprogramasrequiredbyregulations;andpublishingtheMorbidityandMortalityWeeklyReport,CDCsmainchannel %P # forcommunicatingpublichealthnewsaboutdiseaseoutbreaksandtrendsinhealthandhealthbehavior.#XVJXX/XVJ՗ # 3d ݌&("%s#s#    '#& &    lXXVJS#XVJXl #ELECTEDlXXVJFY2001#XVJXl #ԀlXXVJP#XVJXlK #ERFORMANCElXXVJG#XVJXl #OALSANDlXXVJM#XVJXl #EASURES   XVJXXXVJ&U"%XXVJ* d d SS  SS  SSS Ss#s#,SS ,SSS ,SSS +  &\\\\G  &  PerformanceGoals 8\\\\E#!d \\\\G 8  Targets 8\\\\E#!d \\\\E 8  ActualPerformance #&U"%"%&UH ##XVJX"%&Ug #&U"%XXVJ =\\\\E(&@   \\\\E =&U"%"%&UTheproportionofreportedfoodborneoutbreak `  investigationsinwhichthecausativeorganismortoxinisidentified.#&U"%"%&U ##XVJX"%&U #&U"%XXVJԀCDCPlan 0\\\\ h \\\\E 0FY01:55%FY00:50%FY99:45%#XVJX"%&Uߠ #&U"%XXVJ 0\\\\ D \\\\ 0FY01:FY00:FY99:45%FY98:40%#XVJX"%&U #&U"%XXVJ'   /\\\\E D\\\\ /&U"%"%&UTherateofcentrallineassociatedbloodstream d  infectionsinadultintensivecareunitpatientswillbereducedasmeasuredthroughtheNationalNosocomialInfectionsSurveillance(NNIS)System.CDCPlan#&U"%"%&Uw ##XVJX"%&U #&U"%XXVJ 0\\\\$ \\\\E 0FY01:4.3FY00:4.4FY99:5.2#XVJX"%&Uã #&U"%XXVJ 0\\\\l \\\\ 0FY01:FY00:FY99:4.4FY98:5.3#XVJX"%&UX #&U"%XXVJ /\\\\EH \\\\ /Increasethepercentageofhighriskdomesticfoodestablishmentsinspectedonceeveryyear.FDAPlan 0\\\\ p\\\\E 0FY01:90100%onceeveryyearFY00:90100%onceeveryonetotwoyearsFY99:N/A 0\\\\$\\\\ 0FY01:FY00:FY99:N/AFY98:ThroughacombinationofFDAandstatecontractinspections,cover25%to33%ofthe6,250highriskestablishments. /\\\\E0\\\\ /Improveinspectioncoveragebyinspectingagreaterpercentageofregisteredhumandrugmanufacturers,repackers,relabelersandmedicalgasrepackers.FDAPlan 0\\\\ 4\\\\E 0FY01:26%FY00:22%FY99:22% 0\\\\07\\\\ 0FY01:FY00:FY99:26%FY98:24%FY97:26% /\\\\E <\\\\ /Improvebiennialinspectioncoveragebyinspecting30%ofregisteredanimaldrugandfeedestablishments.FDAPlan 0\\\\#?\\\\E 0FY01:30%FY00:27%FY99:27% 0\\\\#B\\\\ 0FY01:FY00:FY99:25% /\\\\E#E\\\\ /Ensurethatatleast97%ofmammographyfacilitiesmeetinspectionstandards,withlessthan3%offacilitieswithLevel1(serious)inspectionproblems.FDAPlan 0\\\\'#I\\\\E 0FY01:97%FY00:97%FY99:97% 0\\\\&8"L\\\\ 0FY01:FY00:FY99:97%FY98:97%FY97:97%FY96:95% /\\\\E|)$R\\\\ /50%ofthedomesticseafoodindustrywillbeoperatingpreventativecontrolsforsafetyasevidencedbyfunctioningHAACPsystems.FDA ,'U Plan 0\\\\-(V\\\\E 0FY01:N/AFY00:N/AFY99:50% 0\\\\,'Y\\\\ 0FY01:FY00:FY99:_3/00 /\\\\E,'\\\\\ /ImproveinspectioncoverageforClassIIandClass IIIdomesticmedicaldevicemanufacturers.FDA <@ Plan 0\\\\ \\\\E 0FY01:25%FY00:24%FY99:26% 0\\\\ \\\\ 0FY01:FY00:FY99:30%FY98:33%FY97:40%(    \\\\ (#XVJX"%&U #     4  `    h      p   lXXVJP#XVJXl #ROGRAMSlXXVJS#XVJXlT #UPPORTINGlXXVJT#XVJXl #HISlXXVJO#XVJXl #BJECTIVE     (X@s#s#(FDA  FoodsHumanDrugsMedicalDevicesandRadiologicalHealth_Biologics_AnimalDrugsandFeedsNationalCenterforToxicologicalResearch̀ (, CDC  InfectiousDiseasesEpidemicServicesHCFA x|  MedicareMedicaidResearch (, 5@s#s#X@L 5   _D= <? ,X X,X,hX?(iU5%!`z  `Ett o&i s#s#      s#s#iU)5%!`z  `Ett o&i FromtheHHSStrategicPlan,September1997. Improvementsinhealtharegroundedon 8  knowledgeacquiredthroughresearchconductedandsponsoredbytheDepartmentofHealthandHumanServices(HHS)andotherentities,bothpublicandprivate.Inthescopeandqualityofthescienceitsponsors,HHSsetsthepacefortheworldinmedical,epidemiological,behavioral,andhealthservicesresearch.Itdoessothroughstrong,sustainedpublicsupportforhealthsciencesresearch.TheNationalInstitutesofHealth(NIH)playsavitalroleinthenationsmedicalresearchenterprise.NIHsponsoredresearchgeneratesknowledgethatleadstoimprovementsinthehealthandqualityoflifeoftheAmericanpublic.Italsoprovidesacontinuallyexpandingknowledgebaseforthedevelopmentofcommercialproductsbythepharmaceutical,medicaldevice,andbiotechnologyindustriesandbyotherkeycomponentsofthenationalmedicalresearchinfrastructure.Throughitssupportofresearchtraining,theNIHprovidesthenationwithhighlytrainedscientistswhorisetoleadershipinpubliclyfundedresearchactivitiesandinthebiotechnologyandrelatedindustries.Toasignificantdegree,futureimprovementsinthehealthoftheAmericanpeopledependuponsustainingboththeresearchinfrastructurethathasbeendevelopedthroughNIHsupportandthebasicprinciplesthathaveenabledNIHresearchinvestmentstobehighlyproductive.TheCentersforDiseaseControlandPrevention(CDC)alsoconductsastrongprogramofepidemiologicalandpopulationbasedresearchtoprotectthepublichealthandpreventandcontroldisease,injury,anddisability.Finally,theDepartmentshealthservicesresearchplaysacriticalrolebyidentifyingwhatismosteffectiveandcosteffectiveindaytodaypracticeincommunitysettingsandbyidentifyingthemostefficientapproachesfordeliveringandfinancingthoseservices.ExpansioninresearchinvestmentsacrossabroadfrontofscientificdisciplinesandoperatingdivisionswithintheDepartmentwilldomorethananythingelsetoensureimprovementsinhealthstatusandinthekindsandqualityofservicessponsoredbytheDepartment.TheDepartmentalsoenhancestheproductivityofthenationsresearchenterprisethroughsuchmeansasinternationalscientificcooperationandregulatorypoliciesthatencourageinvestmentsinresearchbytheprivatesector.FourprinciplesarecentraltotheDepartmentsresearchinvestmentstrategy: BasicResearch .Firstisthehighpriorityaccordedtobasicresearchinthelifesciencesand l+&* fundamentalmethodologicalworkinhealthservicesresearch.Intheareaoflifesciences,oneneedlooknofartherthanthehistoryofthebiotechnologyindustrytoseethewisdomofthisapproach.HHSinvestmentsinbasicresearchundergirdepidemiological,clinical,andhealthservices 4.)- research.Inthecaseofthelast,theyhavelaidafoundationforbetteradministrationandreimbursementinboththepublicandtheprivatesectors. InvestigatorInitiated Research .Thesecondprincipleisthehighpriorityaccordedto t sponsorshipofinvestigatorinitiatedresearch.TheDepartmenttraditionallyhaseschewedtopdowndirectionforscienceandinsteadhasreliedprimarilyonindividualscientiststoproposeandcarryoutspecificresearchprojectswithinthecontextofbroadprogramgoalsandpolicyprioritiesenunciatedbyitsagencies.Asaresult,HHShasbeenuniquelyeffectiveinharnessingthecreativeenergiesofscientiststhroughoutthenationtowardimprovinghumanhealthandwellbeing. PeerReview .Thirdistherelianceuponpeerreviewtoassessthequalityofresearchproposals  <  andoutcomes.Determiningtherelativescientificandtechnicalmeritsofcompetingresearchideasisoneofthemostdifficulttasksfacinganyresearchagency.TheDepartmentssuccessyearafteryearindirectinginvestmentstothemostpromisingscientificopportunitiesandthemostcapableinvestigatorsstemslargelyfromitscommitmenttoseekingandheedingtheadviceofleadingexpertsdrawnfromthepertinentscientificcommunities. ResearchCapacity/Infrastructure .FourthistheDepartmentscommitmenttosponsoring d researchinawidevarietyofinstitutionalsettingsandtoencouragingahealthyresearchenterpriseintheforprofitsector.Universities,notforprofitresearchorganizations,hospitalsandotherpracticesettings,smallandlargebusinesses,andgovernmentlaboratories"eachinitsownwayhasprovidedahospitableenvironmentforimportantscientificinitiatives.Also,inviewoftheuniqueroleplayedbyacademicinstitutions,theDepartmentwillcontinueitseffortstohelpresearchintensiveuniversitiesremainstrong.Inparticular,itwillmaintainitspolicyofpayingafairshareofresearchcostsandwillcollaboratewithacademichealthcenterstofindwaystocounterthedestabilizingeffectsofmanagedcareuponclinicalresearchandtheeducationofhealthprofessionals.Finally,theDepartmentwillenhancethebaseofhighlyqualifiedscientificinvestigators.TheDepartmentreaffirmstheseprinciplesasthecoreofitsstrategytoguidenewinvestmentstoincreasethenationsknowledgebaseabouthealthscienceandmaintainitsquality.HHSintendstoapplythemevenmorebroadlyintheyearsimmediatelyahead.  P!   iU5%!`z  `E`ttx 3'i s#s#     s#s#iU+5%!`z  `E`ttx 3'iL 0 !"#$%&(xx0 !"#$%&(L?,X,hX,X X? lXXVJK#XVJXl #EYlXXVJFY2001P#XVJXl #lXXVJROGRAMS,#XVJXl& #lXXVJI#XVJXlq #lXXVJNITIATIVES,AND#XVJXl #lXXVJS#XVJXl #lXXVJTRATEGIES  L  #XVJXlI #  30    3 23  0    NIH!TheHumanGenomeProject .TheHumanGenomeProject(HGP)wasstartedin L  1990andhas,fromitsbeginning,enjoyedsignificantsuccess.AmajorgoaloftheHumanGenomeProjectistosequence,orread,eachoftheapproximately3billionbasesinthehumangeneticinstructionbook.Determiningthecompletegeneticblueprintofhumanswillgreatlyacceleratetheidentificationofthegenesembeddedinthisgeneticcodethatunderliemanyhumandiseases,includingcomplexdiseasesthatrepresentthegreatesthealthburdentotheU.S.population.Identifyingthosegenesisthefirststeptoamoreprofoundunderstandingofthebiologicalbasisofdiseaseandthis,inturn,willleadtomuchmoreeffectiveandinexpensivewaystodiagnosis,treatandpreventdisease. 3 ݌ s#s# Ќ  0  Manyoftheproject'sinitialgoalshavebeenachieved,includingbuildingmapstolocalizeandorderthepositionofgenesinboththehumanandmousegenomes,andsequencingthegenomesofmodelorganismsincludingthebacteriumE.coli,bakersyeast,andthe ` roundwormC.elegans.Inaddition,sequencingthegenomeofthefruitfly(Drosophila L melanogaster)isnearlycomplete.Theabilitytocomparethesequenceofgenesacross 8 multiplespeciesanddevelopmodelsystemsinsimplerorganismswillsignificantlyenhancetheabilityofresearcherstoidentifythefunctionalrolesoftheencodedproteinsandtherebycontributetoabetterunderstandingofthemolecularbasisforhumanhealthanddisease. s#s# 0  Basedonthesuccessofathreeyearpilotproject,inMarch1999,aninternationalconsortium,withtheU.S.takingthelead,launchedthefullscaleefforttosequencethehumangenome.OnNovember17,1999,theconsortiumdepositedtheonebillionthbasepairofthehumangenomeintothepublicdatabase,GenBank.Achievingthisimportantmilestonemarksthesuccessofthetransitionfromthepilottothefullscaleproductionsequencing.Theconsortiumexpectstoproduceatleast90percentofthehumangenomesequenceina workingdraftformbythespringof2000,yearsearlierthaninitiallyexpected,andisontracktocompletethefinal,highqualitygenomesequenceby2003orearlier. s#s# 0   s#s#   31    3 23  0    NIH!BiomedicalResearch ./XVJXXXVJMuchofhealthcaretodaystillinvolvestreatingthesymptoms  %p # ofdiseasewithoutunderstandingitsunderlyingcausesandtheprecisemechanismsbywhichdiseasedevelops(pathogenesis).Inordertoeffectivelyandsystematicallyattackthediseasesoftoday,weneedabroadbaseofknowledgeaboutlivingsystems.Weneedtounderstandhowlivingsystemsoperateatbotha microlevel!thestructureandfunctionofproteins,nucleicacids(DNAandRNA),carbohydrates,andfats!aswellasatmore macrolevels!howthesemoleculesorganizeandfunctiontogetheraslivingunits,i.e.,cells,tissues,organs,wholeorganisms,andevencommunities.Asimportant,weneedtounderstandhowdisease,geneticalterations,andenvironmentalfactorsaffectthefunctionofthesemolecules,cells,tissues,organs,andorganisms,andtheirconsequencesforhumanhealth.#XVJXX/XVJf #/XVJXXXVJ 3 ݌p-(,s#s# Ќ  L K !"#$%&( hx0 !"#$%&(L \.)- 0  Fortunately,allorganismsaremadeofthesamebasicmaterials,andmanysharesimilargeneticsandphysiologicprocesses,soresearchersseekingtounderstandbothnormalanddiseaseprocessesinhumanscanlearnagreatdealbystudyingsimilarsystemsinsimpler modelorganismslikebacteria,slimemolds,yeast,fruitflies,zebrafish,androdents.Modelsystemshaveprovenessentialtoolsforunderstandingawidearrayofhumanconditions,providingcriticalnewinsightsintomechanismsassociatedwithcardiovascular,gastrointestinal,neurological,structural,andotherdefectsthatmayhavecounterpartsinhumandisorders.Animalmodelscanbeusedforstudyingthephysiologicalcourseofadisease,determiningtheidentityandfunctionofthegenesandproteinsinvolvedinhealthandhumandisease,testingnewtreatments,anddevelopingandtestingmethodsforpreventingdiseaseanddisability. s#s# 0  Atfirstglance,thisgoalmayappeartofocusonlaboratoryresearch,butitactuallyencompassesclinicalresearchaswell.Theaimis,ofcourse,tobeabletoputallthepartstogethertounderstandnormalbiologicalactivitiesandhowtheymalfunctionindiseaseanddisability.This,inturn,willprovidethefundamentaltheoriesandconceptsformorediseaseorientedinvestigationsthatleadtonewmethodsfordiagnosing,treating,andpreventingdiseaseanddisability.Itmaytakeyears,however,afteranewdiscoveryismadeforthepotentialhealthapplicationstobecomeclear.Thus,justasnoonecanpredictwhatresearcherswilldiscoverinthefuture,neithercantheeventualclinicalapplicationsoftoday'sresultsbeknown.Asproductiveasthepasthasbeen,thefuturepromisestobestillmoreexcitingasresearchersgainanevengreaterunderstandingoflivingsystemsandapplythatunderstandingtoquestionsofhealthanddisease.#XVJXX/XVJ: #Ԁ \s#s#   32    3 2 3  0    4XVJXXXVJ OPHS contributestothestrengtheningofthehealthsciencesresearchbypromotingthe 4 responsibleconductofresearchandtheeffectivehandlingofscientificmisconduct.Inmakingandpublicizingapproximately100findingsofscientificmisconductsinceitsestablishmentin1992,theOfficeofResearchIntegrity(ORI)actionsserveasadeterrenttomisconductandeducatethescientificcommunityregardingtheimportanceofresearchintegrity.#XVJXX4XVJI #lXXVJ 3  ݌s#s# Ќ  0  ll#XVJXlg #OPHSensuresthatallapplicantandawardeeinstitutionshaveanadministrativeprocess  availableforhandlingallegationsofscientificmisconductinPHSsupportedresearchandaretakingstepstopromotearesearchenvironmentthatemphasizesintegrity.ORIhasrequestedinstitutionalpoliciesforrespondingtoscientificmisconductallegationsfrom1200institutionsforreviewtodate.Inaddition,ORIhasreceivedfundingtoconductastudyoftheguidelinesmedicalschoolshaveadoptedfortheconductofresearch. s#s# #XVJXXXVJ #   &\!$ &  lXXVJS#XVJXl #lXXVJELECTED#XVJXl #lXXVJFY2001#XVJXl) #lXXVJԀ#XVJXlr #lXXVJP#XVJXl #lXXVJERFORMANCE#XVJXl #lXXVJG#XVJXlE #lXXVJOALSAND#XVJXl #lXXVJM#XVJXl #lXXVJEASURES   #XVJXl #* d dSS SSS SSSS Ss#s#,SS ,SSS ,SSS +  &\\\\G  &  PerformanceGoals 8\\\\E#! d \\\\G 8  Targets 8\\\\E#! d \\\\E 8  ActualPerformance &U"%XXVJ =\\\\E(& P   \\\\E =#XVJX"%&UB #&U"%XXVJ &U"%"%&U Addtothebodyofknowledgeaboutnormaland    abnormalbiologicalfunctions.(CriteriadefinedinNIHPlan)NIHPlan#&U"%"%&U #/&U"%"%&UԀ#&U"%"%/&U # 0\\\\d \\\\E 0FY01:MeetorExceedFY00:MeetorExceedFY99:MeetorExceed 0\\\\8 \\\\ 0FY01:FY00:FY99:Exceeded /\\\\E8 \\\\ / &U"%"%&U Developneworimprovedinstrumentsand   technologiesforuseinresearchandmedicine.(CriteriadefinedinNIHPlan)NIHPlan#&U"%"%&U #/&U"%"%&UԀ#&U"%"%/&U # 0\\\\h \\\\E 0FY01:MeetorExceedFY00:MeetorExceedFY99:MeetorExceed 0\\\\< \\\\ 0'  FY01:FY00:FY99:Exceeded#XVJX"%&U # /\\\\E< \\\\ / XVJXXXVJ &U"%XXVJDevelopcriticalgenomicresources.  ̀!0 / U.S.annualproductionrate(basepairs)@// ̀!0 / Worldwideproduction:#// 3L !"#$%&(hhK !"#$%&(L  3   0 /  3 23  0[//  Workingdraftofhumangenomesequence: 3 ݌$[[ Ќ  0 /  //   3   0 /  3 23  0[//  Finalhumangenomesequence 3 ݌ p'[[ Ќ    3   0 /  3 23  0[//  Basepairs:annual/aggregate 3 ݌+[[ Ќ  0 / 0[//0[[0 0      ̀!0 / GenomesequenceofC.elegans0//% 2 ̀!GenomesequenceofDrosophilamelanogasterπ(excludingheterochromatin)̀!Identifyhumansinglenucleotidepolymorphisms(SNPs)̀#XVJX"%&UI ##XVJXXXVJ' #&U"%XXVJNIHPlan 0\\\\t,':\\\\E 0FY01:#XVJX"%&Um #[.XXVJNotApplicable#XVJX.[ #&U"%XXVJ @= FY00:#XVJX"%&UF # / XXVJԀ#XVJX/   #&U"%XXVJ190million l> FY99:#XVJX"%&U #&U"%XXVJ90million H? FY01:#XVJX"%&UO # / XXVJ90%complete; B   90%accurate.#XVJX/   #&U"%XXVJ hC FY01:#XVJX"%&U= #&U"%XXVJԀ1/3complete; hE 0  99.99%accurate 77 #XVJX"%&U #&U"%XXVJFY01:#XVJX"%&U5 #&U"%XXVJԀ#XVJX"%&U #[.XXVJNotApplicable#XVJX.[ #&U"%XXVJ I FY00:#XVJX"%&U #&U"%XXVJԀ275million/ d J 0  675million 77 FY99:#XVJX"%&Uo #&U"%XXVJ220million/ "lL 0  400million 77 #XVJX"%&U  #&U"%XXVJFY99:#XVJX"%&U #&U"%XXVJԀ100% % P FY01:100%#XVJX"%&U #&U"%XXVJFY01:60,000#XVJX"%&UX # )H%U  0\\\\*$&V\\\\ 0&U"%XXVJFY01#XVJX"%&U #:[.XXVJNotApplicable#XVJX.[7 # `Y &U"%XXVJFY00#XVJX"%&U #: LZ &U"%XXVJFY99#XVJX"%&U #:&U"%XXVJ173million#XVJX"%&UB # 8[ &U"%XXVJFY01:FY01:#XVJX"%&U # / XXVJ ` #XVJX/   #&U"%XXVJFY01#XVJX"%&UP #:[.XXVJNotApplicable#XVJX.[ # ,|d &U"%XXVJFY00:#XVJX"%&U #[.XXVJ  he #XVJX.[E #&U"%XXVJFY99:265million/ !0g Ѐ442millionFY99:100%FY01:#XVJX"%&U # 'X"m &U"%XXVJFY01:#XVJX"%&UJ # ) %p  /\\\\E*%q\\\\ /Numberofcollaborativeactivities(workshops, publicationsandotherresourcematerialsproduced)thatassistinstitutionsto(1)promoteintegrityinthehealthscienceresearchenterprise,and(2)developadministrativeprocessesthateffectivelyrespondtoallegationsofscientificmisconduct.OPHSPlan 0\\\\ \\\\E 0FY01:5workshopsand2publicationsFY00:4workshopsandtwopublications 0\\\\D ( \\\\ 0FY01:FY00:FY99:6workshopsandonepublication /\\\\ED (\\\\ /XVJXXXVJPercentofinstitutionalpoliciesforresponding l toallegationsofscientificmisconductthathavebeenreviewedforcompliancewiththefederalregulation42CFRPart50,SubpartA.#XVJXXXVJ5 #OPHS L0  Plan 0\\\\8 \\\\E 0FY01:65%FY00:60% 0\\\\tX\\\\ 0FY01:FY00:FY99:50%(`D   \\\\ ( lXXVJP#XVJXl #lXXVJROGRAMS#XVJXlc #lXXVJS#XVJXl #lXXVJUPPORTING#XVJXl #lXXVJT#XVJXl< #lXXVJHIS#XVJXl #lXXVJO#XVJXl #lXXVJBJECTIVE  , #XVJXl #NIH T8 ResearchProgramOPHS ,   ! iU5%!`z  `E`ttx 3(i s#s#     s#s#iU-5%!`z  `E`ttx 3(iL 0 !"#$%&(xh !"#$%&(L9,X,hX,X,hX9 lXXVJK#XVJXl #EYlXXVJFY2001P#XVJXl* #ROGRAMS,lXXVJI#XVJXl~ #lXXVJNITIATIVES,AND#XVJXl #lXXVJS#XVJXl #lXXVJTRATEGIES L  #XVJXlV #   3    3 23  0    NIH!MultiDisciplinaryResearchonDisease .XVJXXXVJԀThedevelopmentofpreventive,delaying, L  ordiseasehaltingstrategiesrequiresamultidisciplinaryapproach.Epidemiologicstudiesprovideanecessaryfoundationforanydiseasepreventionprogrambyidentifyingthemagnitude,andpossiblythevariability,ofadiseasewithinanygivenpopulation.Theepidemiologicpatternsoftargeteddiseasesmayidentifysubpopulationsthatareatriskfordevelopingspecificdiseases,aswellasprovideinformationaboutthecourseofdiseasedevelopmentindifferentenvironmentsandindifferentage,ethnicandsocioeconomicgroups.Preventionanddiseasehaltingstrategiesalsorequireasolidunderstandingofdiseasemechanisms.Forexample,itisimportanttoknowwhatcausesthedisease,howthediseaseaffectsspecificcellsororgans,ifthereisageneticbasisorpredispositionfordevelopingthedisease,andwhetherapersonsimmunesystemplaysaroleinthediseaseprocess.Asolidunderstandingofthediseasemechanismfacilitatesthedevelopmentofeffectivewaystopreventordelaythedisease.Evaluatinganynewtherapiesorbehavioralapproachesrequiresclinicalresearchandoftenclinicaltrials.Behavioralstudiesarealsoneeded.Effectivestrategiesforpreventionorcontrolofadisease#XVJXXXVJb #XVJXXXVJԀmayincludeanewmedication,oranalteration 8 inbehaviororlifestyle.#XVJXXXVJ #XVJXXXVJԀStrategiesareneededtobotheducatethepublicaswellasencourage $t thepublictotakeadvantageofthesefindings.#XVJXXXVJZ #/XVJXXXVJ  3  ݌`s#s# Ќ  #XVJXX/XVJ) #  3    3 23  0    NIH!GenomeResearchandDisease . Genomicresearchisnotlimitedtothehuman 8 organism.Studiesarealsounderwaytocharacterizethegeneticblueprintsofanumberofdiseasecausingmicrobesaswellasorganismsthatareusedextensivelyinresearchlaboratoriesasmodelsystems.Resourceswillbeusedtodevelopcoreresearchcentersandtotrainscientiststorelatemousepathologyandphysiologytothefaultygenes.Theendresultwillbenewunderstandingofmammalianbiologyaswellasneworimproved modelsystemsforlearningabouthumandiseases,genes,andproteinsandfortestingnewtreatments. 3  ݌ s#s# Ќ  0  Othergeneticresearchfocusesnotontheentiregenome,butonparticularcomplexbiologicalsystems,processes,ordiseases.TheBrainMolecularAnatomyProject,forexample,willcontinuetoadvanceourunderstandingofthegenesinvolvedinbrainandnervoussystemfunctioninnormalanddiseaseconditions.Advancesfromthiseffortwillaidindiseaseprevention,earlydetection,diagnosis,andtreatment.Othergeneticstudieswillconcentrateoncomplexchronicdiseases,suchasdiabetesandheartdisease,andneurodegenerativedisorderssuchasAlzheimersandParkinsonsdiseaseandretinaldisorders.Thesediseasesareparticularlychallengingbecausetheyresultfromtheinteractionsofanumberofgenesandenvironmentalfactors.Newunderstandingoftheidentityandinteractionsofkeygenesandenvironmentalfactorsthatcontributetodiseasewillprovidenewtargetsforthedevelopmentoftherapeuticandpreventionstrategies. s#s#   3    3! 23  0    NIH!AIDSVaccineResearch .1XVJXXXVJInsupportofthePresidentsgoalofdevelopinganAIDS \.)- vaccine,NIHissupportingvaccineresearchonthepreventionofAIDS.Avaccineworksbysensitizingthebodysimmunesystemtoaparticulardiseasecausingbacterium,virus,toxin,oracomponentofapathogenicorganism.Whentheinfectiousagentsubsequentlyinvadesthebody,theimmunesystemrecognizesitandmountsanimmediateandrobustresponsetodestroytheinvaderbeforeitcancausedisease.Themanysuccessesoftraditionalvaccinesarewellknown,butotherseriousandfataldiseasesstillhaveprovenstubbornlyresistanttovaccines,demandingnewapproaches. 3! " ݌ s#s# Ќ  0  AsafeandeffectiveAIDSvaccineisaglobalpublichealthimperative.AsofDecember1998,morethan33millionpeoplewerelivingwithHIV/AIDSworldwide,withalmost6millionnewinfectionsoccurringduring1998alone.AIDSisnowthefourthleadingcauseofdeathandistheleadingcauseofdiseaseburdeninthedevelopingworld.Withoutaneffectivevaccine,thepandemicwillcontinueunchecked.IntheU.S.,therateofnewinfections,approximately44,000peryear,remainsunacceptablyhigh. s#s# 0  TocomplementtheextramuralAIDSvaccineeffort,theNIHhasestablishedanintramuralVaccineResearchCenter(VRC)tofocusonAIDSvaccines.WhenPresidentClintonannouncedtheinitiationoftheVRCinMay1997,healsochallengedtheNIHandthescientificcommunitytoproduceanAIDSvaccinewithinthenext10years.Aspartoftheefforttomeetthischallenge,theVRCisajointventurebetweentwoNIHcomponentstheNationalCancerInstitute(NCI)andtheNationalInstituteofAllergyandInfectiousDiseases(NIAID).TheprimaryfocusfortheVRCistostimulatemultidisciplinaryresearch,frombasicandclinicalimmunologyandvirologythroughtovaccinedesignandproduction.Currently,theVRCisa laboratorywithoutwalls,includingestablishedintramurallabsfocusedonthisareaofresearch.NIHiscompletingabuildingonthecampustoeventuallyhousescientistsrecruitedfortheVRC.InFY1999,NIHhiredadirectorfortheCenter. s#s# #XVJXX1XVJy" #  3    3+ 23  0    /XVJXXXVJ NIH!DiseaseTreatment .Researchisalsopavingthewaytoimprovecurrentand,develop  new,methodsfortreatingdiseaseanddisability.TheaimofmuchofNIHresearchisthedevelopmentofnewandimprovedtherapeutics.Thispathwaytoourultimategoalofbetterhealthrequiresastrongfoundationofunderstandingdiseasemechanismsandnormalandabnormalbiologicalfunctions.Searchesfornewtherapiesdependonadvancesinchemistry,bioengineering,enzymology,structuralbiology,genetics,immunology,cellularandmolecularbiology,#XVJXX/XVJ, #XVJXXXVJԀandpharmacology.#XVJXXXVJ. #/XVJXXXVJԀ 3+ + ݌ #p!s#s# Ќ  0   s#s# 0  Newtechniquestorapidlyscreenchemicalcompoundsarenowgreatlyexpandingthepoolfromwhichpossibletherapeuticsubstancescanbedrawn.Thestudyofmolecularstructuresbyx-raycrystallographyhasyieldeddetailedunderstandingofmanymoleculescriticaltohealth,aswellastherapeuticmoleculesspecificallytailoredto"fit"thestructuresandthusaltertheirchemicalactivity.Inaddition,thescienceofsyntheticchemistryhasyieldedmanyimprovedwaystodesignnewtherapeuticsubstances.#XVJXX/XVJ. #)$(s#s#   3    31 23  0    NIH!DiagnosisofDisease ./XVJXXXVJResearchispavingthewaytoimprovecurrentand,develop l+&* new,methodsfordiagnosingdiseaseanddisability.Earlydiagnosisanddetectionofdiseaseisoftenakeyrequisiteforeffectivetreatmentandpreventionofdiseaseanddisability.Someofthemostlifethreateningdiseasesanddisabilitiescanonlybecontrolledorcurediftheyare 4.)- diagnosedandtreatedintheearlieststages.Diagnosticmethodsincludeabroadarrayofbiomedicaltechnology,e.g.,machinesthatdirectlyvisualizethebody,cells,andtissues;instrumentsthatcanmeasurespecificbodyfunctions;andteststhatdetectminutequantitiesofbiologicalandinorganicmaterials.Despitetheextremevariability,diagnostictoolsmustbeaccurateandsafe.Itisalsoadvantageousiftheyareinexpensive,noninvasive,easytouseandpainfree. 31 1 ݌ s#s# Ќ  0  Researchtocreatenewdiagnostictoolsiscloselyintertwinedwithbasicdiseaseresearch;diagnostictoolsaremostcommonlydevelopedafterthemechanismsofthespecificdiseaseprocessareunderstood.Studyingtheefficacyandaccuracyofdiagnostictoolsrequiresclinicalresearchaswellashealthservicesresearch.Itmustbeshownthatagiventestisbothreliableandeffective.#XVJXX/XVJi2 #$ s#s#   3    38 23  0    ݀ NIH!ClinicalResearch .Newnetworksforclinicalresearchandclinicaltrialswillbe   neededtoexamineinnovativetherapiesforcancer,stroke,diabetes,kidneyandurinarytractdisorders,andmentalhealthdisorders.Additionalclinicaltrialsareneededtotranslatefindingsfrombasicscienceintoimproveddiagnosticsandtherapeutics.Forexample,tohelpspeeddevelopmentofnewcancertherapeutics,theRapidAccesstoInterventionDevelopment(RAID)programmakesavailabletotheacademicresearchcommunityresources!productsandinformation!forthepreclinicaldevelopmentofdrugsandbiologics.ThegoalofRAIDisclinical proofofprinciplethatanewmoleculeorapproachisaviablecandidateforexpandedclinicalevaluation. 38 18 ݌ s#s# Ќ  0  Newtechnologiesareenablingproductionoflargenumbersofnewchemicalentitiestobeevaluatedastargetspecificcandidatetherapies.Improvedsafetyevaluationmethodsareneededtoprovidepreclinicalandclinicaltestinginanefficientandtimelyfashion.Theuseofbiologicalmarkers,orbiomarkers,definedascharacteristicsthatcanbemeasuredandevaluatedasindicatorsofnormalbiologicprocesses,pathogenicprocesses,orpharmacologicresponsestoatherapeuticintervention,isoneapproachtoenhancetestingofnewchemicalentities.Biomarkerresearchprogramsforcancer,Parkinsonsdisease,stroke,arthritis,andotherchronicdiseaseswillhelpstreamlinethedevelopmentandclinicaltestingofnewtreatments,therebyenablingpatientswiththesedisorderstobenefitmorequicklyfromlaboratorydiscoveries. s#s#   3    3D? 23  0    NIH!PandemicFluResearch .TheNIHhasdevelopedaplantofurtherresearchin  $\" pandemicflu.Inadditiontosupportingagrantsandcontractprograminbasicbiology,epidemiology,vaccinedevelopmentandevaluation,drugdiscovery,developmentandevaluation,anddiagnostics,asrelatedtoinfluenza,fundsrequestedinFY2001willallowtheinitiationoftheproductionofaninactivated,liveattenuated,and/orrecombinantvaccineagainstasingleavianinfluenzavirussubtypeofhighpandemicpotential. 3D? o? ݌ s#s# Ќ    3    3B 23  0    /XVJXXXVJ CDC !Theappliedtechniquesofepidemiology,laboratory,behavioral,andsocialsciencesare *%) theprimarytoolsthatCDCusestounderstandthecausesofpoorhealth,identifypopulationsatrisk,anddevelopinterventionsfordiseasecontrolandprevention.Asresearchprovidesmoreinformationabouttherelationshipsbetweenthephysical,mental,andsocialdimensionsofwellbeing,abroaderapproachtopublichealthhasbecomeimportantinthequestfor 8.)- answerstopreventandsolvehealthproblems.CDCiscommittedtoexpandingitsresearchagendatohelpbridgethegapbetweenresearchandpublichealthpractice.Throughtheintegrationandcommunicationofscientificinformation,themosteffectivepublichealthsolutionswillbetranslatedintopracticeintheNationscommunities. 3B \\\\ 0FY01:FY00:FY99:04/00FY97:36.4%FY95:34.8%FY93:30.5%FY91:27.5% /\\\\Ep K\\\\ /&U"%"%&UDevelopandstrengthenepidemiologicand !0L laboratorymethodsfordetecting,controlling,andpreventinginfectiousdiseases.#&U"%"%&U|x # #N Measure:&U"%"%&U22extramuralawardswillcontinuetobe P% P providedtoconductenhancedresearchinvestigationstoassistindevelopmentandimprovementofdiagnostictestsforuseinareassuchasantimicrobialresistance,sexuallytransmitteddiseases,malaria,Lymedisease,healthcareassociatedinfections,andbloodsafety.CDCPlan#&U"%"%&Uly # 0\\\\T+&W\\\\E 0FY01:45awardsFY00:22awardsFY99:22awards 0\\\\'X"^\\\\ 0FY01:FY00:FY99:22awardsFY97:17awards /\\\\E'4#f\\\\ /&U"%"%&UStrengthendomesticandglobalepidemiologicand d laboratorycapacityforsurveillanceandresponsetoinfectiousdisease.#&U"%"%&U | # 8   Measure:&U"%"%&UԀAsurveillancesystemwillbeestablished   tocollectdataonantimalarialdrugresistanceinsubSaharanAfricancountries.#&U"%"%&U} #CDCPlan 0\\\\ \\\\E 0FY01:75%countriesFY00:50%countries 0\\\\  \\\\ 0FY01:FY00:FY99:0%countries /\\\\E \\\\ /&U"%"%&UIncreaseby20%thenumberoftoxicsubstances  thatcanbemeasuredbyCDCsenvironmentalhealthlaboratorybytheyear2002fromabaselineof200in1997,sostateoftheartlaboratorymethodscanbeemployedtopreventavoidableenvironmentaldisease.#&U"%"%&U~ # dH  Measure:&U"%"%&UHumanexposuretotoxicsubstanceswill   bemeasured.#&U"%"%&UB #ԀCDCPlan 0\\\\ \\\\E 0FY01:12newsubstances.FY00:8newsubstances.FY99:8newsubstances. 0\\\\p)\\\\ 0FY01:FY00:FY99:8FY97:200toxic̀substances /\\\\Ep5\\\\ /&U"%"%&UIncreaseearlydetectionofbreastandcervical 6 cancerbybuildingnationwideprogramsinbreastandcervicalcancerprevention.#&U"%"%&U # 8 Measure:&U"%"%&UExcludingbreastcancersdiagnosedon lP: andinitialscreenintheNBCCEDP,atleast73%ofwomenaged40andolderwillbediagnosedatlocalizedstage.#&U"%"%&U # = Measure:&U"%"%&UExcludinginvasivecervicalcancers !x@ diagnosedonaninitialscreenintheNBCCEDP,theageadjustedrateofinvasivecervicalcancerinwomenaged20andolderisnotmorethat22per100,000Paptestsprovided.#&U"%"%&U #CDCPlan 0\\\\%D\\\\E 0FY01:73%FY00:72%FY99:71%FY01:Nomorethan22per100,000.FY00:Nomorethan22per100,000.FY99:Nomorethan22per100,000. 0\\\\%T\\\\ 0FY01:FY00:FY99:3/00FY98:70%FY95:70%FY01:FY00:FY99:3/00FY98:23/100,000FY95:26/100,000 /\\\\E&e\\\\ /Develop,inpartnershipwithindustry,academia,andgovernment,genechipandgenearraytechnologytoprovidehighvolumescreeningofbiomarkersforsusceptiblesubpopulationsidentifiedinmolecularepidemiology.̀!Develop riskchiptechnologytoscreenlargenumbersofpeopleforbiomarkerssimultaneously. ̀!Conductmolecularepidemiologystudiestoidentifybiomarkersofthemostfrequentlyoccurringcancersinhighlysusceptiblesubpopulations.̀!Completebiochemicalandepidemiologystudiestodefinethebasisofsusceptibilityofhumanstothetoxicityofregulatedcompounds.FDAPlan 0\\\\\\\\E 0FY01:DeveloptechnologyFY00:N/AFY99:N/AFY01:N/AFY00:ConductstudiesFY99:N/AFY01:N/AFY00:N/AFY99:Completestudies 0\\\\&\\\\ 0FY01:FY00:N/AFY99:N/AFY01:N/AFY00:FY99:N/AFY01:N/AFY00:N/AFY99:Biochemicalstudiesonpancreaticandcolorectalcancerwerecompletedandepidemiologystudiesoncancerareintheenrollmentphase.FY98:ConductedcasecontrolmolecularepidemiologystudiestoassessbreastandprostatecancerinAfricanAmericanwomen/men.FY97:Initiatedstudiestoevaluatetheuseofmolecularbiomarkersinclinicalstudiesandtoidentifysubpopulationsatincreasedrisk.  ԍ#XVJX"%&Ul #  (t,X%R \\\\ ( lXXVJP#XVJXl #lXXVJROGRAMS#XVJXl. #lXXVJS#XVJXlx #lXXVJUPPORTING#XVJXl #lXXVJT#XVJXl #lXXVJHIS#XVJXlJ #lXXVJO#XVJXl #lXXVJBJECTIVE  -t&R  .'S #XVJXlӎ #(X@s#s#(CDC  BreastandCervicalCancerPreventionResearchEpidemicServicesPreventionCentersInfectiousDiseasesEnvironmentalDiseasePreventionSexuallyTransmittedDiseaseOccupationalSafetyandHealth $  FDA   FoodsHumanDrugsMedicalDevicesandRadiologicalHealthBiologicsAnimalDrugsandFeedsNationalCenterforToxicologicalResearchTobaccoNIH  L ResearchProgramOPHS $         5@s#s#X@K 5  iU5%!`z  `E`ttx 3)i s#s#        s#s#iU/5%!`z  `E`ttx 3)iL 0 !"#$%&(xx0 !"#$%&(L9,X,hX,X,hX9 lXXVJK#XVJXl #EYlXXVJFY2001P#XVJXlE #lXXVJROGRAMS,#XVJXl #lXXVJI#XVJXl۔ #lXXVJNITIATIVES,AND#XVJXl #lXXVJS#XVJXlp #lXXVJTRATEGIES  L    3    3 23  0    /ll#/XVJX/l # CDC!PreventionResearch .Throughappliedresearch,CDCidentifiesemergingproblems, t  testssolutions,anddetermineshowtotranslateintopracticetheknowledgethathasemergedfrombiomedicalresearch.CDC'spreventionresearchprogramcanbecharacterizedasproblem-solving,population-basedresearchwhichfocusesonpreventableriskfactorsusingmultidisciplinary,community-basedapproaches.Thistypeofpublichealthresearchengagesteamsofscientists(e.g.,epidemiologists,laboratorians,economists,andbehavioralscientists)workingincooperationtoapplyscientificmethodstodevelopandevaluatepublichealthstrategiesandinterventions.Increasingly,CDCisworkingwithextramuralresearchersasapartoftheteamtoaddressthecomplexityofmanypublichealthproblems.#XVJXX/XVJe #lXXVJ 3  ݌Ls#s# Ќ    3    3p 23  0    /ll#/XVJX/l # CDC!EnvironmentalDiseasePrevention .CDCexamineshealthoutcomesthatresultfrom L interactionsbetweenpeoplesuniquebiologic,social,andlifestylefactorsandtheirphysical,chemical,anddevelopmentalenvironment.CDCsenvironmentalhealthscienceslaboratorydevelopstestsofhumanexposuretotoxicants(biomonitoring);and,whencombinedwithepidemiologicstudies,thesetestsprovidevitalinformationabouthowexposurescontributetoserioushumandisease.Inadditiontogatheringandanalyzinghumandataonenvironmentalexposuresanddisease,CDCleadseffortstotranslatescientificdataintopracticalandcosteffectivepublichealthactions.ThisworkbytheNationalCenterforEnvironmentalHealthcomplementsthatoftheNationalInstituteforOccupationalSafetyandHealth(NIOSH)atCDC,whichconductsresearchandprovidesnationalandworldleadershipinpreventingworkrelatedillness,death,anddisability.#XVJXX/XVJ #lXXVJ 3p ݌\s#s# Ќ       4  `    h   3    3ٟ 23  0    #XVJXl" # /XVJXXXVJCDC!HeartDiseaseandHealthPromotion .CDCwillconductcardiovasculardisease \  preventionresearchtotargetdisadvantagedpopulations,planinterventionsinavarietyofsettings,andmodifypoliciesandtheenvironmentfornewemergingriskfactors,(e.g.homocysteine,antioxidants,geneticfactors);secondarypreventionofcardiovasculardisease(e.g.,physicianpractices,medicalrecords,laboratory,andhospitaldischargedata;andphysicalactivityandnutrition.Insupportofitseffortstopreventtobaccouse,CDCwillconductpreventionresearchwithanemphasisonobesityprevention,improveddietaryhabits,andincreasedphysicalactivity.#XVJXX/XVJp # 3ٟ  ݌&H"$s#s# Ќ    3    3 23  0    /XVJXXXVJ CDC!InjuryPreventionandControl(IPC) .IPCisdesignedtopreventprematuredeath ( $& anddisabilityandreducehumansufferingandmedicalcostscausedbyinjuries.IPCaccomplishesitsmissionthrough:extramuralandintramuralresearch,developing,evaluation,andimplementingpreventionprograms,assistingStateandlocalhealthjurisdictionsintheireffortstoreduceinjuries,andconductingpreventionactivitiesinpartnershipwithotherFederal andprivatesectoragencies.Evaluationofinterventionprogramsisakeycomponentof p-(+ CDCsoverallstrategytodiscoverwhatworksanddeterminehowtodeliverprogramstotheAmericanpeople.#XVJXX/XVJ # 3 ң ݌s#s#     3    3u 23  0    /XVJXXXVJ IHS!TreatmentandPrevention .TheIHScontinuestoassistitspartnersindeveloping t newstrategiestopreventcommunicablediseasesthroughcollaborationwiththeCDCinvaccineresearch.TheIHSalsocollaborateswithCDCandNIHineffortstopreventandcontroldiabetesintheAmericanIndianandAlaskaNativepopulation.#XVJXX/XVJ #  3u ݌< s#s# Ќ    3    3۩ 23  0    /XVJXXXVJ OPHS !OPHSsupportsseveralresearchandservicedemonstrationgrantprogramsand  d programevaluationstoidentifywhatworks,modelstrategiesandapproaches,andbestpracticesthataddressthebarriersandhealthproblemsofracialandethnicminoritiesandidentifyeffectivediseaseanddisabilitypreventionandpublichealthapproaches.TwomajorgrantprogramswhichwillcontinuetobeadministeredbyOPHSaretheBilingual/BiculturalServiceDemonstrationGrantsProgramtoimproveaccesstohealthcarebyreducingculturalandlinguisticbarriers,andtheMinorityCommunityHealthCoalitionDemonstrationGrantsProgramtoaddressreductionofracialdisparitiesintargetedhealthareas. 3۩  ݌ s#s# Ќ    3    3 23  0    #XVJXX/XVJL # OPHS !ThenationalTitleXfamilyplanningprogramprovidesfamilyplanningandrelated d gynecologicalhealthcareservicestoover4.5millionindividualseachyeartoassisttheminplanningthetimingandspacingoftheirchildren.Theprogramalsosupportsthreeadditionalfunctions:(1)trainingforalllevelsoffamilyplanningpersonnel,(2)informationdisseminationandcommunity-basededucationandoutreachactivities,and(3)researchtoimprovethedeliveryoffamilyplanningservices. 3 ݌ s#s# Ќ  &  lXXVJS#XVJXl{ #lXXVJELECTED#XVJXl #lXXVJFY2001#XVJXl #lXXVJԀ#XVJXlR #lXXVJP#XVJXl #lXXVJERFORMANCE#XVJXlر #lXXVJG#XVJXl% #lXXVJOALSAND#XVJXlh #lXXVJM#XVJXl #lXXVJEASURES  @ #XVJXl #XVJXXXVJ* d dSS 4SS 4SS s#s#,SS ,SS ,SSS +  &\\\\G @ &  PerformanceGoals 8\\\\E#!T \\\\G 8  Targets 8\\\\E#!T \\\\E 8  ActualPerformance =\\\\E(&@   \\\\E =&U"%XXVJMaintainongoingbodymassindex(BMI)    assessmentsinAI/ANchildren35yearsoldand/or810yearsold,forbothinterventionpilotsitesandnoninterventioncomparisonsites,aspartofanoverallassessmentoftheongoingchildhoodobesitypreventionproject'seffectiveness.IHSPlan 0\\\\%8!&\\\\E 0FY01:implementprogramandmonitorpilotsandcomparisonssitesFY00:developfivepilotsitesFY99:developapproachandbaselines 0\\\\%8!-\\\\ 0FY01:'l FY00:FY99:completed /\\\\E %\ 3\\\\ /#&U"%"%&UX #&U"%"%&UStrengthenthescopeandnatureofextramural d publichealthresearchprograms.#&U"%"%&UQ # \@ Measure:&U"%"%&UCDCwillincreasethenumberof   younginvestigatorandpublichealthresearchtrainingopportunities.#&U"%"%&U #ԀCDCPlan 0\\\\ \\\\E 0FY01:5%increaseFY00:5%increase 0\\\\  \\\\ 0FY01:FY00:FY99:2extramuralprojectsand1infrastructureprojectfundedtosupport expandedtrainingactivities /\\\\E\\\\ /&U"%"%&UConductatargetedprogramofresearchto l  reducemorbidity,injuries,andmortalityamongworkersinhighpriorityareasandhighrisksectors.#&U"%"%&U #   Measure:&U"%"%&UAnnualincreasesinfundingofother  federalagencieswillbedemonstrated.#&U"%"%&U #ԀCDC  Plan 0\\\\p\\\\E 0FY01:Annualincreasesinfundingofotherfederalagencieswillbedemonstrated.FY00:Annualincreasesinfundingofotherfederalagencieswillbedemonstrated.FY99:CurrentlevelsofNIOSHandotherfederalagenciesintramuralandextramuralresearchfundinginNORAareaswillbedeterminedasabaselineandannualincreaseswillbecalculated. 0\\\\$ 0\\\\ 0FY01:FY00:FY99:Asurveyin1998showsnonNIOSHfederalagenciesspending$23.4milliononNORArelatedactivities. /\\\\EH,A\\\\ /&U"%"%&UHumanexposuretotoxicsubstanceswillbe !xB measured.CDCPlan#&U"%"%&U[ # 0\\\\p"TC\\\\E 0FY01:12newsubstancesFY00:8newsubstancesFY99:8newsubstances 0\\\\L#0F\\\\ 0FY01:FY00:FY99:8FY97:200toxic̀substances(%K  \\\\ (#XVJX"%&U~ # lXXVJP#XVJXl. #lXXVJROGRAMS#XVJXlr #lXXVJS#XVJXl #lXXVJUPPORTING#XVJXl #lXXVJT#XVJXlK #lXXVJHIS#XVJXl #lXXVJO#XVJXl #lXXVJBJECTIVE  ( M #XVJXl #(X@s#s#(CDC 8*#O PreventionResearchEpidemicServicesPreventionCentersInfectiousDiseasesEnvironmentalDiseasePrevention .'T OccupationalSafetyandHealth  8*#T  InjuryPreventionandControl $+$U HCFA ,$V MedicareIHS -&X TreatmentandPrevention .'Y OPHS     5@s#s#X@z 5iU5%!`z  `Ett o*i s#s#         s#s#iU15%!`z  `Ett o*iL 0 !"#$%&(xx0 !"#$%&(L9,X,hX,X,hX9 lXXVJK#XVJXl #EYlXXVJFY2001P#XVJXl #lXXVJROGRAMS,#XVJXla #lXXVJI#XVJXl #lXXVJNITIATIVES,AND#XVJXl #lXXVJS#XVJXlA #lXXVJTRATEGIES  8  #XVJXl #Ԁ L    3    3 23  0    AHRQReporttotheNationontheQualityofHealthCare .Thisannualseriesis 8  intendedtoprovidepolicymakerswithanationalperspectiveonthosehealthcareservicesandthekeyaspectsofthewayweorganizeanddeliverthoseservicesthatmostaffectthequalityandsafetyofpatientcare.Thisinformationwillenabledecisionmakerstoensurethatthepopulationstheycareaboutaregettingthecaretheyneed.Itshouldhelppolicymakerstotargetresourcesandactivitiestoimprovequalitywhereitcanandneedstobeimproved.Itwillalsoprovideevidencetoinformofpurchasingdecisionsinwaysthatcanharnessmarketforcestorewardhighquality.AHRQwillbeginworkonenhancingdatacollectionactivitiesin  FY2001inordertosubmitthefirstannualreportinFY2003. 3 ( ݌ s#s# Ќ    3    3 23  0    AHRQ 󀄀Monitorqualityofcarethroughastrengthened MedicalExpenditurePanelSurvey t (MEPS) .AdditionalMEPSinvestmentsinFY2001willcontinuetheexpansionsbeguninFY d 2000toincludeintheMEPShouseholdsampleasufficientsampleofindividualswithcertainillnessesofnationalinterestintermsofqualityofcareandburdenofdisease.Thisenhancementwillnotonlypermitmorefocusedanalysesofthequalityofcarereceivedforthesevulnerablepopulations;itwillalsoenableanalysesofpatternsofuse,costs,andimpactoftheseservices.TheFY2001investmentwillalsoenablethecompletionofamoreextensivemoduleonchildren,toenableustounderstandtheimpactofchangesinhealthprograms.4XVJXXXVJ 3 0 ݌@s#s# Ќ    3    3 23  0    AHRQHealthcareCostandUtilizationProject(HCUP). #XVJXX4XVJ #AHRQwillfurtherexpand  HCUPtoprovidestateandcommunitydecisionmakersapowerfulsetoflinkeddatabasestheycanusetomonitortheimpactofmajorsystemchangesonaccess,quality,outcomesandcostintheirstatesandcommunities,andtocomparetheseagainsttheprogressofotherstatesandcommunities.Specifically,theexpansionwillincludeclinicalandfinancialrecordsfromemergencydepartmentsandotherambulatorycareaswellasrecordsfromfourmoreStates,anincreasefromanexpected26statesinFY2000,foratotalof30States./XVJXXXVJ 3  ݌T#!s#s# Ќ  #XVJXX/XVJ #  3    3 23  0    /XVJXXXVJ HRSA!RuralHealthPolicyDevelopment .TheRuralHealthResearchCenterProgramis ,%| # theonlyhealthservicesresearchprogramdedicatedentirelytoproducingruralpolicyrelevantresearch.Itcurrentlysupportsfiveresearchcentersthathavemajorstudiesunderwaydealingwithsuchdiversetopicsasruralemergencyroomusebyruralelderlyresidents,theimpactofasthmaguidelinesonthecareofruralpediatricMedicaidrecipients,developinganimproveddefinitionof rural,thefinancialdependenceofruralhospitalsonMedicareoutpatientrevenuesandimplicationsforoutpatientpaymentreform,andthepotentialimpactsonruralhealthcareprovidersoftheBalancedBudgetActof1997. 3 ݌ s#s# Ќ    3    37 23  0    NIH!ImpactofQualityandCostonHealth .Researchactivitiesaresupportedacrossa |-(, broadspectrumtoincreasetheunderstandingofissuesrelatedtohealthcarequality,costand l.)- costeffectiveness.Included#XVJXX/XVJ #XVJXXXVJԀareeffortstobetterunderstandtheeffectivenessofcareprovided  invarioushealthcaresettings,theoutcomesofclinicalcarewhichinvolvespatientsintreatmentdecisions,andtheassessmentofmeasuresdesignedtoevaluatequalityoflifeaspectsofdiseasepreventionmodalities.Otherexamplesincludeconductingresearchtoexaminethecharacteristicsofdifferenthealthcarestructuresanddeliverysystemsandtheirimpactonhealthandfunctioninginoldage;theeconomicaspectsofolderpeople'saccesstoanduseofhealthcare,andrelationshiptohealth;andcomparativecrossnationalanalysesofhealthcareneedsandservices.#XVJXXXVJ #  37 b ݌$ ts#s# Ќ  &  lXXVJS#XVJXl #lXXVJELECTED#XVJXlR #lXXVJFY2001#XVJXl #lXXVJԀ#XVJXl #lXXVJP#XVJXl( #lXXVJERFORMANCE#XVJXlk #lXXVJG#XVJXl #lXXVJOALSAND#XVJXl #lXXVJM#XVJXlF #lXXVJEASURES   8  ll#XVJXl #* ddSS SS SSS Ss#s#, SS ,N SS ,SS +  &\\\\G `  &  PerformanceGoals 8\\\\E#!t  \\\\G 8  Targets 8\\\\E#!t  \\\\E 8  ActualPerformance =\\\\E(&`    \\\\E =&U"%XXVJ#&U"%"%&U #Establishfutureresearchagendabased 0 onusersneeds.AHRQPlan. 0\\\\ \\\\E 0Accomplishthefollowingbasedonconsultationwithvariousgroups:FY01:AgencyresearchagendacoveringstrategicgoalareasforFY2001priorities(errors,informatics,andworkersafety)isdocumented.FY00:Agencyresearchagendacoveringthe3strategicresearchgoalsandthenewFY2000closingthegapinitiativesaredocumented.FY99:Agencyresearchagendacoveringthe3strategicresearchgoalsisdevelopedanddocumented.#XVJX"%&U #&U"%XXVJ 0\\\\ #\\\\ 0' FY01:FY00:FY99:Completed /\\\\E82\\\\ /MakesignificantcontributionstotheeffectivefunctioningoftheU.S.healthcaresystemthroughthecreationofnewknowledge.AHRQPlan. 0\\\\ \\\\E 0FY01:Fundingaminimumof15projectstoimprovehealthcarequality,safetyandefficiency.FY00:Fundingaminimumof10projectsthataddressgapsinknowledgeaboutthepriorityproblemsfacedbyMedicareandMedicaid.Fundingofaminimumof10projectstoaddresseliminatingdisparitiesinhealthcare,particularlythoseforracialandethnicminorities.FY99:Fundingofaminimumof21 projectsinconsumersuseofinformationonquality;strengtheningvaluebasedpurchasing;measuringnationalhealthcarequality;vulnerablepopulations;andtranslatingresearchintopractice.FY99:Fundingofaminimumof17projectsinoutcomesfortheelderlyandchronicallyill;clinicalpreventiveservices;andchildrenshealth. 0\\\\ \\\\ 0#XVJX"%&U #&U"%XXVJFY01: d FY00:FY99:54FY99:52(2  \\\\ (#XVJX"%&U # lXXVJP#XVJXlF #lXXVJROGRAMS#XVJXl #lXXVJS#XVJXl #lXXVJUPPORTING#XVJXl #lXXVJT#XVJXlc #lXXVJHIS#XVJXl #lXXVJO#XVJXl #lXXVJBJECTIVE  ,4 #XVJXl/ #(X@s#s#(AHRQ T!86 ResearchonHealthCosts,Quality,andOutcomesMedicalExpenditurePanelSurveys0 h 0hh0@$9 HCFA %: MedicaidMedicareResearchandDemonstrations ' = HRSA T!8= RuralHealthPolicyDevelopmentNIH ,#? ResearchProgramSAMHSA %A KnowledgeDevelopmentandApplication &C 5@s#s#X@ 5  )"C p3iU5%!`z  `E`ttx 3+i s#s#     s#s#iU35%!`z  `E`ttx 3+iL 0 !"#$%&(xx0 !"#$%&(L9,X,hX,X,hX9 lXXVJK#XVJXl #EYlXXVJFY2001P#XVJXl_ #lXXVJROGRAMS,#XVJXl #lXXVJI#XVJXl #lXXVJNITIATIVES,AND#XVJXl8 #lXXVJS#XVJXl #TRATEGIES  L    3    3 23  0    /XVJXXXVJ FDA!PremarketApplicationReviewInitiative .#XVJXX/XVJ` #6XVJXXXVJTheresearchanddevelopmentcommunity L  continuestoproducenewandoftentechnologicallycomplexhealthcareproducts.FDAfacilitatestheavailabilityoftheseproductsandisrequiredbytheFood,DrugandCosmeticActtoreviewnewproductapplicationswithinspecifictimeframes.FDAhasdedicatedseveralstrategiestohelpreducethetimerequiredtomakeimportantnewhumandrugs,veterinarydrugs,bloodproducts,medicaldevices,vaccinesandfoodadditivesavailabletotheU.S.public.First,FDAwilldedicateadditionalreviewerstohighpriorityareas.Tousereviewerstimeefficiently,FDAhasreengineeredtoshortensomeofitsproductreviewprocesseswithoutsacrificingthequalityofthereviewandthesafetyoftheproduct.Second,initiativesareunderwaytoreducetherequirementsforpreapprovaloflowriskproductsandtoreplacetheapplicationreviewprocessfortheseproductswithanotificationprocess.Third,FDAisencouragingproductsponsorstoconsulttheAgencyearlyintheresearchanddevelopmentprocess.EarlycommunicationhelpsproductsponsorsunderstandwhatinformationisneededbyFDAandoftenleadstoahighqualityapplicationwhichcanmovethroughtheFDAapprovalprocessmorequickly.Andfinally,allofFDAsproductreviewcenterswillcontinuetoimprovetheirapplicationandreviewtrackingsystems.Improvingthesesystemsshouldresultinfasterreviewtimesforproducts,andincreasedproductivityforFDA. 3  ݌ s#s# Ќ    3    3 23  0    #XVJXX6XVJ #/XVJXXXVJ FDA!InjuryReportingInitiative .#XVJXX/XVJ #6XVJXXXVJAnestimated1.3millionAmericansareunintentionally 8 injuredeachyearasaresultofmedicalerrors.Surveillanceofmarketedproductsplaysanessentialroleinincreasingtheavailabilityofsafeandeffectivemedicalproductsfortheconsumer.OneofFDAsprimaryobjectivesistodevelopandimplementacomprehensivesurveillancesystemthatimprovesthequalityofinformationonadverseeventsandproductdefectsassociatedwithFDAregulatedproducts.Theoverallstrategycombineselementsofsurveillance,problemanalysis,education,andproblemcorrectionbyeliminatingtheconditionsthatledtothehighrisksituation. 3 F ݌ s#s# Ќ  0  FDAandtheindustrycannotlearneverythingaboutthesafetyofaproductbeforeitisapproved,andAmericanshavechosentoacceptthisriskinordertohaveproductsapprovedwithinareasonabletimeframe.ThetradeoffisthatFDAandindustrymustcontinuetoassessthesafetyofcertainproductsaftertheirusebecomeswidespread.Forexample,postmarketstudiesofamedicaldevicemayprovideadditionalinformationaboutlongtermusesorthedeviceseffectivenessinamorediversepopulation.DatathatFDArequestedforthepremarketreviewcanberequestedaftertheproductisapproved.Makingoptimaluseofpostmarketdatamayreducethepremarketdatarequirementsforsomedevices.FDAwillcontinueseekwaystominimizetheamountofpremarketdatarequestedwhenpostmarketstudiescanprovidetheappropriateconsumerprotection.#XVJXX6XVJ #,'+s#s#   p-(,   3    323  0    6XVJXXXVJ FDA!InternationalHarmonizationofStandards .FDA,othergovernmentregulatory   bodies,andindustryparticipateininternationalharmonizationactivitiestohelpreducetheregulatoryburdenonindustryandtobringproductstothemarketmorequickly.AcceptanceanduseofinternationalsafetystandardsthatsatisfyU.S.consumerprotectiongoalswillimproveproductsafetyandpublichealth,reduceFDAsimportinspectionburden,andhelpfacilitatetheimportationandexportationofproducts.Byharmonizinginternationalrequirements,theindustryhopestoreducethecostsofbringingproductstomarket.FDAwillcontinuetoparticipateininternationalstandardsettingactivitiessuchasGeneralAgreementonTariffsandTrade(GATT),theNorthAmericanFreeTradeAgreement(NAFTA),andtheCodexAlimentarius,topromotedevelopmentandadoptionofsciencebasedinternationalstandardsandensureFDAsabilitytoprotecttheU.S.publichealth.#XVJXX6XVJF# 3݌ < s#s# Ќ    3!    323  0    6XVJXXXVJ FDA!ScienceandResearchSupportforPremarketReviews .FDAshighestpriorities   includeimprovingitssciencebaseandconductingresearch,especiallytosupportthereviewofpremarketapplications.FDAsgoalsinconductingresearcharetodevelop:1)inhousescientificexperts,especiallyinemergingtechnologies;2)scientificguidanceforproductsponsorsandreviewers;and3)sciencebasedstandards.Inhousescientificexpertsconsultwithproductreviewersonproductapplications.ScientificguidancebenefitsbothapplicantsandreviewstaffindevelopingandreviewingapplicationsFDAModernizationActrequiresFDAtorecognizeandusestandardsestablishedbynationalorinternationallyrecognizedstandarddevelopmentorganizationsintheapplicationreviewprocess,especiallywithmedicaldevices.FDAsscientificeffortswillallowtheAgencytoexpanditsparticipationinstandardsdevelopmentandharmonization.Sincedatarelatingtotheaspectsofsafetyand/orefficiencycoveredbythestandardswillnotberequiredinthepremarketapplication,thereviewprocesscanbeexpedited. 3݌ s#s# Ќ  #XVJXX6XVJ-#    3"    3; 23  0    NIH!Pharmacogenetics .Genesdirecttheproductionofproteins,whichareusedas  importantstructuralcomponents,formovement,inimmunedefense,andtocarryoutchemicalreactions.Genomicdiscoveriesoftenleadtonewunderstandingofaproteinsstructureandfunction,whichcaninturnrevealnewtargetsfordrugdevelopment.Geneticinformationmayalsohelpidentifyindividualswhowillrespondwellorpoorlytoparticulardrugs.OneofNIHsnewpharmacogeneticsinitiativesisfocusedonthemechanismsunderlyingindividualvariationsindrugresponses.Theultimategoalistounderstandhowanindividualsgeneticmakeupdetermineshoweffectivelyamedicineworksintheirbody,aswellaswhatsideeffectsarelikelytooccur.Knowledgefromthisresearchwillguidedoctorsinprescribingtypesandamountsofmedicationsforaparticularpatient. 3; f ݌ s#s# Ќ    3#    3{23  0    NIH!Bioinformatics .Medicalresearchersareamassingenormousamountsofinformation &("% today!fromtheHumanGenomeproject,clinicaltrials,statisticalstudies,populationgenetics,andimagingresearch!therebycreatinglargerepositoriesofinformationthatfarsurpassalloftheinformationcollectedpreviously.Astheamountofdatagrows,thetoolstocompareandmanipulatethedatabecomemoreimportantandwillbeusedtoformbridgesbetweendatabasestoallowresearcherstolinkdisparateinformationsources.Criticaltooureffortstoanalyzethesedataistheemergingfieldofbioinformaticsthatbringstogethercrossdisciplinaryexpertiseandtechnologiesinbiology,computerscience,andmathematics.Thefocusofbioinformaticsprogramsisonmanagementofbiologicalinformationthatenableslifescience <.)- andnoveltherapeuticdiscoverytoprogressatamuchfasterpace.Forexample,theemergingfieldofpharmacogeneticswillrelyheavilyupontheuseofbioinformaticstointegrategenomicinformationaboutpopulationsandtheresponsetotherapeuticagents.Bioinformatictoolswillbedevelopedtointegratestatisticalgeneticmethods,genesequenceinformation,geneticvariationsinthepopulations,andepidemiologicdata. 3{݌ s#s# Ќ    3$    3P23  0    /XVJXXXVJ CDC!InfectiousDiseases .CDCiscommittedtostrengtheningourNationscapacityto 8  recognizeandrespondtoinfectiousdiseasethreats,andourplan,AddressingEmerging ( x DiseaseThreats:APreventionStrategyfortheUnitedStates,isbeingimplemented.Aswe  d approachthe21stcentury,manyimportantdrugchoicesforthetreatmentofcommoninfections  P  arebecomingincreasinglylimitedandexpensive,andinsomecases,nonexistent.#XVJXX/XVJ#XVJXXXVJThisyears  <  performanceplanhasbeenupdatedtoincludemajorprogrameffortsforHepatitisCVirus(HCV)infection,foodsafety,antimicrobialresistance,andbioterrorism.#XVJXXXVJ$#/XVJXXXVJ.Inaddition,each   yearCDCisinstrumentalinaccuratelytrackinginfluenzastrainsaroundtheglobe,andasaWorldHealthOrganizationCollaboratingCenter,usingsophisticatedtechniquestoprovidescientificdataessentialforvaccinedevelopment.#XVJXX/XVJ+# 3P{݌ s#s#    t p3 x   &   lXXVJS#XVJXl?#lXXVJELECTED#XVJXl#lXXVJFY2001#XVJXl#lXXVJԀ#XVJXl#lXXVJP#XVJXlX#lXXVJERFORMANCE#XVJXl#lXXVJG#XVJXl#lXXVJOALSAND#XVJXl+#lXXVJM#XVJXlv#lXXVJEASURES   ll#XVJXl#* dd SS  N SS N SS s#s#,SS ,SSS ,SS +  &\\\\G ( &  PerformanceGoals 8\\\\E#!< \\\\G 8  Targets 8\\\\E#!< \\\\E 8  ActualPerformance =\\\\E(&(x   \\\\E =&U"%XXVJReviewandacton90%ofstandardoriginalNewDrug   Application(NDA),ProductLicenseApplication(PLA)andBiologicLicenseApplication(BLA)submissionswithin12monthsofreceipt(70%within10months);andreviewandacton90%ofpriorityoriginalNDA/PLA/BLAsubmissionswithin6monthsofreceipt.̀!StandardApplicationswithin12months:̀!StandardApplicationswithin10months:̀!PriorityApplicationswithin6months:FDAPlan 0\\\\H\\\\E 0FY01:90%FY00:90%FY99:90%FY01:70%FY00:50%FY99:30%FY01:90%FY00:90%FY99:90% 0\\\\l7\\\\ 0FY01:FY00:FY99:11/00FY98:100%FY97:100%FY96:100%FY01:FY00:FY99:9/00FY98:N/AFY97:N/AFY01:FY00:FY99:5/00FY98:100%FY97:100% /\\\\E$tQ\\\\ /'&IncreasethepercentageofPremarketApprovalApplication(PMA)firstactionscompletedontime(within180days)andthepercentageofHumanitarianDeviceExemption(HDE)firstactionscompletedontime(within75days).FDAPlan 0\\\\$TV\\\\E 0FY01:90%FY00:85%FY99:65% 0\\\\$0 \\\\\ 0FY01:FY00:FY99:5/00FY98:79%FY97:65%FY96:51% /\\\\E$0 b\\\\ /Reviewandacton70%ofNADAs/AbbreviatedNewAnimalDrugApplications(ANADAs)within180daysofreceipt.FDAPlan 0\\\\(X#e\\\\E 0FY01:70%FY00:65%FY99:N/A 0\\\\(X#h\\\\ 0FY01:FY00:FY99:N/A /\\\\E(X#k\\\\ /Complete100%ofInvestigationalDeviceExemption(IDE) Agreementmeetingswithin30days.FDAPlan 0\\\\T*%m\\\\E 0FY01:100%FY00:80%FY99:N/A 0\\\\0+&p\\\\ 0FY01:FY00:FY99:23%FY98:33% /\\\\E ,\'t\\\\ /Increasethelevelofanimaldrugpresubmissionconferenceswithindustrysponsors.FDAPlan 0\\\\\@\\\\E 0FY01:80%FY00:75% FY99:N/A 0\\\\8 \\\\ 0FY01:FY00:FY99:N/A /\\\\E8 \\\\ /Enhanceoutreachtotheprivatesectorby:0 / !0[/[/[IncreasingEmployeeInventionReportseach  h  yearby5% [[[[ 0 / !0[/[/[IncreasingLicensingAgreementsoverthe  previousyearby3% [[[[ 0 / !0[/[/[IncreasingexecutedCooperativeResearchand dH  DevelopmentAgreements(CRADAs)overthepreviousyearby3% [[[[ NIHPlan 0\\\\ \\\\E 0#&U"%"%&U#FY01:5%  h FY00:5%FY99:5%&U"%"%&U#&U"%"%&U?.#FY01:3%  FY00:3%FY99:3%&U"%"%&U#&U"%"%&U.#FY01:3% dH  FY00:3%FY99:3%&U"%"%&U 0\\\\ "\\\\ 0#&U"%"%&U*/#FY01:  h$ FY00:FY99:2.5%&U"%"%&U#&U"%"%&U/#FY01: ( FY00:FY99:5%&U"%"%&U#&U"%"%&U@0#FY01: dH , FY00:FY99:10% /\\\\E0\\\\ /&U"%"%&U22extramuralawardswillcontinuetobeprovidedto D(1 conductenhancedresearchinvestigationstoassistindevelopmentandimprovementofdiagnostictestsforuseinareassuchasantimicrobialresistance,sexuallytransmitteddiseases,malaria,Lymedisease,healthcareassociatedinfections,andbloodsafety.#&U"%"%&U0#ԀCDCPlan 0\\\\t6\\\\E 0FY01:45FY00:22FY99:22 0\\\\9\\\\ 0FY01:FY00:FY99:22awardsFY97:17awards(=  \\\\ (#XVJX"%&UA"# lXXVJP#XVJXl|3#lXXVJROGRAMS#XVJXl3#lXXVJS#XVJXl 4#lXXVJUPPORTING#XVJXlL4#lXXVJT#XVJXl4#lXXVJHIS#XVJXl4#lXXVJO#XVJXl!5#lXXVJBJECTIVE  tX? #XVJXld5#(X@s#s#(CDC  A InfectiousDiseasesFDA t"XC HumanDrugsBiologics L$0E AnimalDrugsandFeedsMedicalDevicesandRadiologicalHealthNationalCenterforToxicologicalResearchNIH `#DH ResearchProgram L$0I  $&I   $&I 5@s#s#X@55iU5%!`z  `Ett o,i s#s#         s#s#iU55%!`z  `Ett o,iL 0 !"#$%&(xx0 !"#$%&(L9,X,hX,X,hX9 lXXVJK#XVJXl9#EYlXXVJFY2001P#XVJXl:#lXXVJROGRAMS,#XVJXlM:#lXXVJI#XVJXl:#lXXVJNITIATIVES,AND#XVJXl:#lXXVJS#XVJXl-;#TRATEGIES  8  Ѐ  3%    3;23  0    /XVJXXXVJ NIH!TrainingandCareerDevelopment . #XVJXX/XVJ<#Ԁ/XVJXXXVJThecontinuedsuccessandvitalityofmedical 8  researchdependsinlargeparton#XVJXX/XVJ|<#XVJXXXVJourmostimportantnationalscientificresourcethe ( x  scientist.#XVJXXXVJ"=#XVJXXXVJT#XVJXXXVJ=#XVJXXXVJheNIHsponsorsandconductsawiderangeoftrainingandcareerdevelopment d  activities#XVJXXXVJ=#XVJXXXVJԀto#XVJXXXVJ>#XVJXXXVJincreaseourabilitytoattractandretainthebestandbrightestmindsinmedical P  researchandtodevelopacorpsofhighlyskilled,welltrainedindividualsreadyto hittheroadrunningaspostdoctoralresearchersandprincipalinvestigators,andtoenhancediversity#XVJXXXVJ>#XVJXXXVJ. (  Ourresearchtrainingprogramsteachpreandpostdoctoraltraineeshowtoconductinnovative,highqualityscience,includinghowtochooseproblems,choosemodelsystems,developlogicalhypotheses,designexperiments,conductresearchwiththehighestethicalstandards,andseeconnectionsamongdifferentfieldsthatallowascientisttomakequantumleapsinunderstandingaproblem.Careerdevelopmentprogramsensurethatwecanretainandsustainthesetrainedinvestigatorswhohavethespecializedknowledge,methodologicalexpertise,andcreativityessentialtogeneratingthescientificknowledgethatwillimprovethehealthofAmericans.#XVJXXXVJ^@# 3;;݌8s#s# Ќ    3&    3C23  0    NIH!CareerDevelopmentMechanisms .1XVJXXXVJԀNIHusesanumberofdifferentaward ` mechanismstoprovideaflexibleandvariedseriesofhighqualitytrainingopportunitiestailoredtothecareerneedsofrecipients.Considerableattentionisprovidedtoensurethatexperiencessupportedarefocusedontheacquisitionofknowledgeandskillsnecessarytobecomeaproductiveresearcher.Planningtheapproximatenumberofawardstobemadeineachcategorydescribedaboveisacomplexprocessthatconsidersbothprogramcontinuityandemergingneeds.CareeroutcomeevaluationstudieshelpensurethattheNIHresearchtrainingandcareerdevelopmentprogramsareofuniformlyhighqualityandaresufficienttomeetthenationsneedsforbiomedicalandbehavioralresearchers.#XVJXX1XVJ)D# 3CC݌t!s#s# Ќ    3'    3G23  0    NIH!SupportforClinicalInvestigators .1XVJXXXVJTheNIHDirectorsPanelonClinicalResearch L#! andtheInstituteofMedicinesCommitteeonAddressingCareerPathsforClinicalResearchhaverecentlyaddressedtheneedforstrengtheningnationalresearchcapabilitiesinpatientorientedresearch.Theyidentifiedaneedtoincreasethepoolofclinicalresearcherswhocanconductpatientorientedstudies,capitalizingonthediscoveriesofbiomedicalresearchandtranslatingthemtoclinicalsettings.Amongtheirrecommendationsweretheinitiationandimprovementoftrainingprogramstoenhancetheattractivenessofcareersinclinicalresearchtomedicalstudentsandmidcareerclinicalinvestigators.Inresponse,NIHhasestablishedthreenewcareerdevelopmentmechanisms:MentoredPatientOrientedResearchCareerDevelopmentAwards(K23),MidcareerInvestigatorinPatientOrientedResearchAwards(K24),andClinicalResearchCurriculumDevelopmentAwards(K30).#XVJXX1XVJPH# 3GG݌,'+s#s#    t-(,   3(    3L23  0    AHRQ !Nurturenextgenerationofhealthservicesresearchers.AHRQwillinvestin   programsthataddresstheresearchandanalyticneedsofthechanginghealthcaresystems.Theprioritiesincludebuildingonprioreffortstomakebothcurriculaandpracticalresearchexperiencesmorerelevanttodecisionmakersconcernsabouteffectivenessofhealthcareandissuesofcost,quality,andaccess.Theyalsowillincorporateevolvinginnovationsindatasystemsandresearchtoolssothatresearchersofthefuturecanemploycuttingedgemethodologic,analytic,anddatahandlingtechniques.Additionally,AHRQwillfocusonbringingneededdiversitytothehealthservicesresearchworkforce.Thisincludesfundinggrantstodevelopand/orexpandresearchinfrastructureatminorityandminorityservinginstitutionstotrainhealthservicesresearchersandtoconductrigoroushealthservicesresearch.InordertobuildresearchcapacityinStatesthathavenottraditionallybeeninvolvedinhealthserviceresearch,theInstitutionalTrainingInnovativeIncentiveAwardProgramwillbefundedtopilottestthefeasibilityofdevelopingaprogramtobroadenthegeographicdistributionofAHRQfundingandenhancethecompetitivenessforresearchfundingofinstitutionslocatedinstatesthathavealowsuccessrateforgrantapplicationsfromAHRQ. 3LL݌ s#s# Ќ    3)    3R23  0    NIH!BiomedicalInformationScienceandTechnologyInitiative .NIHmustfindwaysto t discover,encourage,train,andsupportthenewkindsofscientistsneededfortomorrowsscience.TheBiomedicalInformationScienceandTechnologyInitiative(BISTI)willprovidethefirststepsinmeetingthisneed.ThiswillbeatransNIHinitiativeencompassingseveralmechanismsofresearchsupport:researchprojectgrantsforinterdisciplinarygrantsinbioinformatics,researchcenters,forNationalProgramsofExcellenceinBiomedicalComputingSupport,NationalResearchServiceAwardstobegintraininganewgenerationofresearcherswithcrossdisciplinaryskills,andtheLibraryofMedicine,fordevelopmentofinformaticsandmolecularcomputationalbiologyprojects,aswellasasmallprojectinIntramuralResearch. 3RS݌ s#s# Ќ    3*    3V23  0    CDC!EpidemicServices .Epidemicservicescoveravastspectrumofactivitieswhich  includethetrainingofpublichealthepidemiologistsandpreventivemedicineresidents.ThroughtheEpidemicIntelligenceService(EIS)andthePreventiveMedicineResidency(PMR),CDCprovidestrainingtopublichealthprofessionalssothattheyattainproficiencyinappliedepidemiologyandpreventivemedicine.BothparticipantsandgraduatesoftheseprogramshelpCDCcarryoutitsmissiontopreventandcontroldiseaseandinjuries,andprovideepidemiologicservicetothestateandlocalhealthdepartments. 3VW݌ s#s# Ќ  0  Inaddition,in1998,thePublicHealthInformaticsFellowshipwasimplementedtodevelopacadreofqualifiedprofessionalswhocanaddresstheincreasinglysophisticatedinformationneedsofpublichealthprogramsinareassuchasautomatedreportingofnotifiableconditions,rapiddisseminationofdatafrompublichealthsurveillanceandoutbreakinvestigations,andexpeditiousaccesstopreventionandpracticeguidelines./XVJXXXVJ p ($'s#s#   3+    3\23  0    CDC!InfectiousDiseases .CDCseffortsininfectiousdiseasepreventionfocuson *%) preventingillness,disability,anddeathcausedbyinfectiousdiseasesthroughvariousstrategies.Oneofthesestrategiesinvolvesthedeliveryoftrainingandinformationtothepublichealthworkforceusingavarietyofmethods(selfstudy,computerbasedtraining,satelliteteleconferences,audioconferences,etc.)throughthePublicHealthTrainingNetwork,aswell <.)- asthroughotherefforts.Trainingandeducationensurethatcurrentandfuturegenerationswillbepreparedtorespondtoinfectiousdiseasethreats.#XVJXX/XVJ[#lXXVJ 3\B\݌s#s# Ќ  &  #XVJXlA_#lXXVJS#XVJXl_#lXXVJELECTED#XVJXl`#lXXVJFY2001#XVJXld`#lXXVJԀ#XVJXl`#lXXVJP#XVJXl`#lXXVJERFORMANCE#XVJXl3a#lXXVJG#XVJXla#lXXVJOALSAND#XVJXla#lXXVJM#XVJXlb#lXXVJEASURES   ll#XVJXlQb#* ddSS SSS SSS s#s#,SS , SS ,rSS +  &\\\\G   &  PerformanceGoals 8\\\\E#! d \\\\G 8  Targets 8\\\\E#! d \\\\E 8  ActualPerformance =\\\\E(& P    \\\\E =#XVJXXXVJb#XVJXXXVJ&U"%XXVJStrengthenthescopeandnatureofextramural    publichealthresearchprograms.#&U"%"%&Ud# \  Measure:&U"%"%&UCDCwillincreasethenumberof d  younginvestigatorandpublichealthresearchtrainingopportunities.#&U"%"%&Ue#ԀCDCPlan 0\\\\ \\\\E 0FY01:5%increaseincareerdevelopmentawardsfundedbyPRI.FY00:5%increaseincareerdevelopmentawards' _fundedbyPRI. 0\\\\ \\\\ 0FY01:FY00:FY99: /\\\\E\\\\ /&U"%"%&UTheannualnumberofhealthservices D  providersparticipatingindistancelearningactivitieswillbeincreased.#&U"%"%&Ug#ԀCDCPlan 0\\\\"\\\\E 0FY01:115,000FY00:110,000FY99:105,000 0\\\\%\\\\ 0FY01:FY00:FY99:9/99FY97:100,000 /\\\\E)\\\\ /&U"%"%&UPublichealthmicrobiologyfellowswillbe H* trainedandavailableforemploymentinlocal,state,andfederalpublichealthlaboratories.#&U"%"%&Ui# , CDCPlan 0\\\\-\\\\E 0FY01:100fellowsFY00:70FY99:40 0\\\\0\\\\ 0FY01:FY00:FY99:40FY97:13 /\\\\E4\\\\ /Asameasureofanacceptablesupplyofwelltrainedmedicalresearchers,maintainhistoricalapplicationsuccessratesfor:0 / !0[/m/mfellowships(F32)l 9[m[m 0 / !0[/m/mresearchtraininggrants(T32)#,=[m[m 0 / !0[/m/mentrylevelcareerawards(K01,K08)L'"A[m[m NIHPlan )T$C  0\\\\)0%D\\\\E 0FY01:40%FY00:40%FY99:40%̀FY01:60%FY00:60%FY99:60%FY01:60%FY00:60%FY99:60% 0\\\\)T$S\\\\ 0FY01:FY00:FY99:44%FY01:FY00:FY99:64%FY01:FY00:FY99:37%(K01)̀52%(K08) /\\\\E)0%c\\\\ /Toincreasethepoolofclinicalresearcherswhocanconductpatientorientedresearch,increaseawardsin: 0 / !0[/m/mMentored(K23)andMidCareer   Investigator(K24),PatientOrientedResearchAwards [m[m 0 / !0[/m/mCurriculumDevelopmentAwards <   (K30) [m[m NIHPlan 0\\\\ \\\\E 0FY01:80FY00:80FY99:80FY01:NotApplicableFY00:NotApplicableFY99:20 0\\\\ \\\\ 0FY01:1/02FY00:1/01FY99:85(K23)̀81(K24)FY01:N/AFY00:N/AFY99:35 /\\\\E (\\\\ /Developandfacilitatetheuseofnewtools,talent,products,andimplementationmethodologiesstemmingfromresearchportfolio.AHRQPlan 0\\\\,\\\\E 0FY01:,L !"#$%&(hx0 !"#$%&(L  3    3r23  0 ?   Supportaminimumof165  . preandpostdoctoraltrainees. 3rr݌ ?? Ќ  L !"#$%&(hh !"#$%&(L  3    36t23  0 ?   Supportaminimumof15 p1 minorityinvestigatorsthroughindividualandcentergrants. 36tat݌ ?? Ќ  FY00:Supportafivepercentincrease,ataminimum,innumberofpreandpostdoctoraltrainees.FY99:Supportaminimumof150preandpostdoctoraltrainees. 0\\\\!=\\\\ 0FY01:FY00:FY99:167($ L  \\\\ (#XVJX"%&Ue#  #M  lXXVJP#XVJXlv#lXXVJROGRAMS#XVJXlv#lXXVJS#XVJXl7w#lXXVJUPPORTING#XVJXlzw#lXXVJT#XVJXlw#lXXVJHIS#XVJXl x#lXXVJO#XVJXlOx#lXXVJBJECTIVE   #XVJXlx#(X@s#s#(AHRQ ( ResearchonHealthCosts,Quality,andOutcomesCDC   EpidemicServicesInfectiousDiseases t  NIH ( ResearchProgramResearchTrainingandCareerDevelopmentSAMHSA    KnowledgeDevelopmentandApplication     L     L   5@s#s#X@x5iU5%!`z  `Ett o-i s#s#         s#s#iU75%!`z  `Ett o-iL 0 !"#$%&(xh !"#$%&(L9,X,hX,X,hX9 lXXVJK#XVJXl}#EYlXXVJFY2001P#XVJXld}#lXXVJROGRAMS,#XVJXl}#lXXVJI#XVJXl}#lXXVJNITIATIVES,AND#XVJXl=~#lXXVJS#XVJXl~#lXXVJTRATEGIES  8  #XVJXl~#  3    3623  0    AHRQ!TranslatingResearchIntoPractice(TRIP) . TRIPbridgesthegapbetweenthe 8  developmentofnewknowledgeanditsimplementationinthehealthcaresystem.Buildingontheprevious10yearsofresearchfindings,AHRQwillidentifyongoinggapsbetweenwhatweknownowandwhatwedoinhealthcareandwillbegintoclosethosegapsthroughresearchanddemonstrationsthatdevelopandtestimplementationstrategiesindifferentsettingsinthehealthcaresystem.Amajorfocuswithinthisisidentifyingexistingimplementationstrategiesinuseinhealthcaresettingsanddemonstratingtheirapplicabilitytowidespreaddisseminationinotherareasofthesystem. 36a݌ s#s# Ќ  0  AHRQplacesconsiderablefocusondevelopingtoolsandproductsthatfacilitatethetransferofresearchfindingsintopractice.TheAgencyhasawelldevelopeddisseminationsystemthatincludespublicationsdevelopment,thePublicationsClearinghouse,andanawardwinningWebsite.ThisemphasisiscriticaltotheAgencyssuccess.Ongoingplansincludeincorporatingregularcustomerfeedbackintoouroperationstocontinuetoimproveourefforts. s#s# 0  AHRQrecognizesthatitisunabletoundertakebridgingthisgapwithitsresourcesalone.AmajoraspectoftheAgencysapproachistoleverageitsownresourcesthroughthedevelopmentofpartnerships.Thesepartnerships,withinHHS,withotherFederalagencies,andwithprivatesectorprofessionalandconsumeradvocateorganizations,enabletheAgencytocreatedistributionmechanismsforitsinformation,products,andtools.TheAgencyalsowillcontinuetofocusonitsowndistributionmechanisms,suchastheAgencyspublicationsclearinghouse,toensurethattheyareeffectiveindisseminatingAgencyproducts. s#s#   3    3=23  0    NIH!Bioinformatics .Medicalresearchersareamassingenormousamountsofinformation p! today!fromtheHumanGenomeproject,clinicaltrials,statisticalstudies,populationgenetics,andimagingresearch!therebycreatinglargerepositoriesofinformationthatfarsurpassalloftheinformationcollectedpreviously.Astheamountofdatagrows,thetoolstocompareandmanipulatethedatabecomemoreimportantandwillbeusedtoformbridgesbetweendatabasestoallowresearcherstolinkdisparateinformationsources.Criticaltooureffortstoanalyzethesedataistheemergingfieldofbioinformaticsthatbringstogethercrossdisciplinaryexpertiseandtechnologiesinbiology,computerscience,andmathematics.Thefocusofbioinformaticsprogramsisonmanagementofbiologicalinformationthatenableslifescienceandnoveltherapeuticdiscoverytoprogressatamuchfasterpace.Forexample,theemergingfieldofpharmacogeneticswillrelyheavilyupontheuseofbioinformaticstointegrategenomicinformationaboutpopulationsandtheresponsetotherapeuticagents.Bioinformatictoolswillbedevelopedtointegratestatisticalgeneticmethods,genesequenceinformation,geneticvariationsinthepopulations,andepidemiologicdata. 3=h݌ s#s# Ќ   \.)-   3    323  0    NIH!MEDLINE .LastyeartheNationalLibraryofMedicine(NLM)reportedthatusageof  theMEDLINEbibliographicdatabasehadincreasedfrom7millionsearchesayearinFY1996to120millioninFY1998.TherateattheendofFY1999is220million,afurtherincreaseofmorethan50percentinoneyear.TheLibraryinterpretsthisasapowerfulcontinuingexpressionofthedesirenotonlyofscientistsandhealthprofessionals,butofthegeneralpublictohaveaccesstothekindofinformationservicestheLibrarycanprovide.HighontheLibraryslistofinformationimprovementsisaclinicaltrialsdatabase.ThiswillbeaneasytouseWebbasedfilecontaininginformationaboutclinicaltrials,whetherfederallyorprivatelyfunded,forexperimentaltreatmentsforseriousdiseasesandconditions.Itwillallownonscientificuserstounderstandthepurposeofaclinicaltrial,theeligibilitycriteriaforparticipating,whereitisbeingconducted,andhowtogetintouchwiththoseconductingit.Thedatabase,mandatedbytheFoodandDrugModernizationActof1997,isbeingdevelopedinstages,withNIHsponsoredtrialsasthefirstmodulebecomingavailableinFY2000.InFY2001,NLMwillexpandthedatabasetoincludedatafromotherFederalagencies,theprivatesector,andinternationalgroups. 3=݌ s#s# Ќ    3    323  0    NIH!PublicLibraryInitiative .NLMspilotPublicLibraryInitiativewasbegunlateinFY t 1998with37localpubliclibrarysystems(morethan200librariesinall).TheprojecttrainedlocallibrarianstousetheInternettofindhealthinformationpertinenttotheirpatronsneeds.Drawingonlessonslearnedinthepubliclibrarypilottest,NLMisworkingthroughtheNationalNetworkofLibrariesofMedicinetosupportoutreachprojectsthatwillinvolvehealthsciences,publicandstatelibraries,localhealthprofessionalassociations,publichealthdepartments,schools,andcommunitybasedorganizations,includingchurches,inimprovingthepublicsaccesstohighqualityhealthinformation. 3=݌ s#s# Ќ    3    323  0    NIH!NationalNetworkofLibrariesofMedicineOutreachProjects .TheNational  NetworkofLibrariesofMedicine(NNLM)areinvolvedinotherNLMsponsoredoutreachprojects.Onerecentactivityisthe TribalConnectionsProjectinthePacificNorthwestthataimstoprovideremotevillageswithInternetaccesstohealthinformation.AcontinuingsuccessstoryhasbeentheNLMsworkwithhistoricallyblackcollegesanduniversities. 3Ֆ݌ s#s# Ќ    3    3623  0    /XVJXXXVJ CDC !CDCfocusesonassuringthepublicshealththroughthetranslationofresearchinto P! effectivecommunitybasedaction.Thisgoalisorientedtowardsdevelopingthecapacityofpublichealthdepartmentstocarryoutessentialpublichealthprogramsandservices,andinvolvecommunityinstitutionsandcommunitygroupsinhealthpromotionanddiseaseprevention.AsCDCstrengthensitsongoingrelationshipswithStateandlocalhealthagencies,itisalsocommittedtobuildingpartnershipswithnongovernmentalorganizationsatthecommunityandnationallevels.Thesepartnershipsareessentialforthedesign,implementation,andevaluationofsoundpreventionprograms.Whatpeopleunderstandabouttheirhealthandpotentialriskstotheirhealthisofmajorconcerninpublichealth.CDCiscommittedtopromotingeffectivehealthcommunication,conveyinginformationtoappropriatepopulations,andfacilitatingaccesstohealthinformation.Theagencyseekstoenhancethepublicshealthknowledgethroughcommunicationthatiscongruentwiththevaluesofdiversecommunities. 36a݌ s#s# Ќ    3    3q23  0    CDC !Toensurethescientificfoundationofpublichealthpractices,CDCcoordinatesthe P-(, developmentoftheGuidetoCommunityPreventiveServices.ThisGuideprovidespublic @.)- healthpractitioners,theircommunitypartners,andpolicymakerswithevidencebasedrecommendationsforplanningandimplementingpopulationbasedservicesandpoliciesatthecommunityandstatelevel.#XVJXX/XVJ#/XVJXXXVJ 3q݌s#s# Ќ    3    3"23  0    #XVJXX/XVJ#6XVJXXXVJ FDA !FDAiscommittedtoprovidingclear,uptodateinformationtoconsumersandpatients ` thattheyneedtomakehealthcaredecisionsandtousehealthproductsappropriately.TheAgencyisawareofthegrowingdiversityofconsumerhealthneedsandinterests.FDAwillcontinuetoimplementtargetedpublicawarenesscampaignssuchastheFoodSafety ( x ProgramsBAC!,MammographyAwarenessSeminars,andOvertheCounter(OTC)Labeling  d Changesandwillcontinuetomakeinformationaboutnewlyapprovedproducts,productlabels  P  andarangeofhealthissuesavailableontheInternetinlanguageconsumerscanunderstand.TheInternetisbeingusednotonlytodisseminateinformationtoconsumersbutalsotoobtaintheirinputonvariousissuesofinteresttotheAgency.TheFDAConsumerandotherprinted   materials,manyofwhichareavailableinseverallanguages,areprovidedtopersonswhoarewithoutInternetcapabilities.AgeneraltelephonenumberandseveralspecialinteresthotlinesarealsoavailabletoconsumerswhohavespecificquestionsaboutFDAregulatedproducts.PublicAffairsSpecialistsinFDAsfieldofficeswillcontinuetoplayakeyroleinfurnishinguptodateinformationaboutnewandemergingproductstointerestedconsumers.#XVJXX6XVJ#/XVJXXXVJ 3"M݌`s#s# Ќ    3    3ا23  0    FDA !FDAisresponsibleforensuringthatdrugs,biologics,medicaldevicesandfoodare 8 safe,effectiveandappropriatelylabeled.Inadditiontoreviewingnewdrugs,biologics,medicaldevicesandfoodadditiveproducts,FDAplaysakeyroleindisseminatinginformationaboutthesenewproductstohealthprofessionalsandinensuringthecorrectuseoftheseproducts. 3ا݌ s#s# Ќ  0  FDAcontinuestocollaboratewithindustrytoinformphysicians,patientsandconsumersaboutnewdrugsandfooditems.InFY2001,FDAwillcontinuetomakeinformationaboutnewlyapprovedproducts,productlabels,correctuseofmedications,andriskinformationaboutFDAregulatedproductsavailabletohealthprofessionals,consumersandotherinterestedpersonsontheInternet.FDAalsohasanoutreachprogramforphysicianstoinformthemofnewdrugsavailabletotheirpatients.InformationisalsoavailableonnewtherapiesapprovedbyforeigncountriesbeforetheFDAapprovesthem.#XVJXX/XVJu#/XVJXXXVJL!s#s#   3    3۬23  0    FDA !AlthoughFDAregulatedproductsarerigorouslytestedduringthepremarketreview $#t! period,certainrareadverseeffectsofproductsarenotrecognizeduntilafteraproductisinwidespreaduse.WhennewhealthrisksrelatedtoFDAregulatedproductsarerecognized,FDAensuresthatmanufacturers,healthprofessionals,andconsumersarealertedandcorrectiveactionsaretaken. 3۬݌ s#s# Ќ   L K !"#$%&( hx0 !"#$%&(L0  MedWatch,theFDAMedicalProductsReportingProgram,isaninitiativedesignedbothtoeducateallhealthprofessionalsaboutthecriticalimportanceofbeingawareof,monitoringfor,andreportingadverseeventsandproblemstoFDAandthemanufacturer;andtoensurethatnewsafetyinformationisrapidlycommunicatedtothemedicalcommunityandthatpatientcareimprovesasaresult.FDAusesavarietyofmeanstoprovidefeedbacktothehealthcare communityaboutsafetyissuesinvolvingmedicalproducts,including DearHealth L-(, Professionalletters,safetynotifications,productrecalls,andproductlabelchanges.TheseareavailableontheInternetandinprint. s#s#    3    32 3  0    FDA!Communicationofresearchresultstothescientificcommunity .FDA t communicatesitsresearchfindingsinprofessionaljournalpublications,atnationalandinternationalscientificmeetings,andotherappropriateforums.FDAsponsorsaScienceForumannually,whichgovernmentandotherscientistsattend,andworkshopstoaddresscrosscuttingtopics.Inaddition,FDAholdsperiodicmeetingswithitsstakeholderstodiscussresearchfindings,gapsinscientificknowledge,andresearchandprogrampriorities;todevelopcreativeandinnovativestrategies;andtoreviewprogressmadetowardAgencygoals.#XVJXX/XVJ## &#/XVJXXXVJ 3݌ P s#s# Ќ    3    3(2 3  0    FDA!ExchangingScientificExpertise .IndustryandFDAcollaborationcreatesan (  atmospherethatencouragestheexchangeofscientificexpertise.Inaddition,FDAsponsorsworkshopsoncuttingedgetopicssuchasgenetherapyandSimianVirusandDNAvaccines.Agencyscientistsarealsoencouragedtopublishtheirresearchfindingsinprofessionaljournalssotheirnongovernmentpeerscanlearnfromtheirwork.#XVJXX/XVJŵ#/XVJXXXVJ 3(S݌ s#s# Ќ  #XVJXX/XVJy#lXXVJ     4  `     3    3f2 3  0    /ll#/XVJX/l# SAMHSA!#XVJXX/XVJ׹#XVJXXXVJTheKnowledgeExchangeNetwork programisaclearinghousedesignedto  ensurewidespreaddisseminationofinformationaboutmentalhealthresourcesandresearchresults.TheAddictionTechnologyTransferCentersprogramdisseminatesmultidisciplinary,clinicallyrelevant,researchbasedinformationaboutsubstanceabuseforpractitioners.WorkinginconjunctionwithTheOfficeofNationalDrugControlPolicy,SAMHSAsupportstheNationalClearinghouseforAlcoholandDrugInformation(NCADI)whichrespondstothousandsofrequestsforpublicinformation.#XVJXXXVJK#lXXVJ 3f݌<s#s# Ќ    3    392 3  0    #XVJXlּ# SAMHSA!ThePreventionEnhancementProtocolSystem(PEPS) collects,synthesizes, < anddisseminatesresearchandpracticebasedfindingsinuseableformforapplicationincommunities.UndertheNationalCenterforAdvancementofPrevention(NCAP),PEPSisapioneeringinitiativethatdevelopsprogramandinterventionguidelinesforthefieldusingestablished rulesofevidenceforassessingpracticeandresearchfindingsandcombiningthisevidenceintopreventionapproaches. 39d݌ s#s# Ќ    3    32 3  0    4XVJXXXVJ SAMHSA!TheNationalCenterfortheAdvancementofPreventionII (NCAPII) "(  #XVJXX4XVJ#develops,synthesizes,adaptsanddisseminatesstateoftheartpreventionknowledgeabout #! whatworksinprevention,forwhom,andunderwhatconditions.NCAPIImakesknowledgebasedtools,principlesandmodelsusefulfordevelopingpreventionplansandprogramsavailabletoStates,communities,andlocalpreventionpractitionersandpolicymakerstoimprovetheeffectivenessofpreventioneffortsacrossthenation. 3=݌ s#s# Ќ    3    3%2 3  0    4XVJXXXVJ SAMHSA!TheStateIncentiveGrant(SIG)Program extendsCSAPsabilitytohelp P)$' Statesimprovetheirpreventionservicecapacity.FundingenablesStatestoexaminetheirstatepreventionsystemsandredirectresourcestocriticaltargetedpreventionserviceneedswithintheirstates.EightyfivepercentofSIGfundsaredirectedtowardimplementingbestpracticeswithinlocalprogrammingtoreducethegapinpreventionservices.InthiswaySIGfundsnotonlyhelpimproveaccesstoneededservices,theyalsoimprovethequalityoftheprevention -@), servicesprovided.SIGStatesarealsofieldtestingtheircoremeasurestoassesstheirfeasibilityforuseinreportingonblockgrantactivities,creatingStatewidenetworksofpublicandprivateorganizationstoextendthereachoftheprimarypreventionportionoftheSAPTBlockGrantandoptimizingtheapplicationofStateandFederalsubstanceabusefundingstreams.#XVJXX4XVJ#lXXVJ 3%P݌`s#s# Ќ    3    32 3  0    #XVJXl# IHS!TreatmentandPrevention .TheIHSmaintainsaninfrastructuretosupportmission `  criticalresearchanditsdisseminationtohealthcareprovidersandthescientificcommunitywhichincludesanannualresearchconference,apeerreviewedjournalforIHShealthcareproviders,andtheIHSinstitutionalreviewboard. 3>݌ s#s# Ќ  lXXVJ  3    3b2 3  0    #XVJXlB# OPHS !ThroughHealthfinder),theFederalgovernmentwideInternetgatewaytohealth L  information,theNationalWomensHealthInformationCenter,andtheOfficeofMinorityHealthResourceCenter,OPHSprovidesnationwideaccesstoinformationandreferralservicesforbothhealthprofessionalsandconsumers. 3b݌ s#s# Ќ    3    32 3  0    /XVJXXXVJ OPHS !TheOfficeofMinorityHealthResourceCenterengagesinawiderangeofactivities ` toinformandeducateracial/ethnicminoritycommunitiesandthosewhoservethemregardingthenatureandextentofracial/ethnicdisparitiesinhealth,policiesandprogramsunderwaytoaddresssuchdisparities,andactionstheycantaketoimprovetheirhealthcareoptions.Someoftheseactivitiesinclude:assistanceinthedevelopmentofSpanishlanguageradiobroadcastmessagestoHispaniccommunitiesonhealthpromotionandhowtousemanagedcareplansappropriately;provisionofSpanishspeakingstafftorespondtopublicinquiriesforinformationandrecommendationsfollowingsuchradiobroadcasts;andprovisionofinformationonandreferralstonationalorganizationsofminorityhealthcareprovidersandminorityhealthadvocacyorganizationsthat,inturn,providerecommendationsregardinglocalproviders.#XVJXX/XVJ#lXXVJ 3݌Ls#s# Ќ  &  #XVJXl#lXXVJS#XVJXl#lXXVJELECTED#XVJXl#lXXVJFY2001#XVJXl#lXXVJԀ#XVJXle#lXXVJP#XVJXl#lXXVJERFORMANCE#XVJXl#lXXVJG#XVJXl8#lXXVJOALSAND#XVJXl{#lXXVJM#XVJXl#lXXVJEASURES ll#XVJXl # `    * ddSS  SS rSS rs#s#, SS , SS ,4SS +  &\\\\G `" &  PerformanceGoals 8\\\\E#!"  \\\\G 8  Targets 8\\\\E#!"! \\\\E 8  ActualPerformance #XVJXXXVJ2#XVJXXXVJ =\\\\E(&##   \\\\E =#XVJXXXVJ#XVJXXXVJ&U"%XXVJBasedonestablishedcriteria,continueto 0% $ publishtheMorbidityandMortality  &\!% WeeklyReports(MMWR)seriesof &8"& publicationsincludingReportsand  ԍRecommendations,SurveillanceSummaries,andtheAnnualSummarytocommunicatemajorpublichealtheventstothemedia,publicpolicymakersandhealthprofessionalsthroughmultiplemediachannelsprint,television,radio,interactiveWorldWideWeb.CDCPlan#&U"%"%&U#   0\\\\-).\\\\E 0FY01:86issuesFY00:81issuesFY99:77issues 0\\\\'#2\\\\ 0FY01:FY00:FY99:77issuespublished.Also,  ԍavailableonCDCwebsite' ` ]   /\\\\E|)$8\\\\ /&U"%"%&UMakedatamorereadilyaccessibleto d  decisionmakersandresearchersbyreleasingstatisticsinnewformatstospeedthereleaseofdataonhighprioritytopics.CDCPlan#&U"%"%&U# 0\\\\ \\\\E 0FY01:Releasetworeportsinsuchformat.FY00:Releaseonereport. 0\\\\  \\\\ 0FY01:FY00:FY99:1999Healthand   AgingChartbook   projectedpublicationSeptember1999.FY98:TeenageBirthsin  theUnitedStates:NationalandStateTrends199096was   published. 4\\\\El \\\\ 4&U"%"%&UResearchfindingswillbedisseminatedby   investigatorsreceivingPRIfunds.#&U"%"%&U#ԀCDC  Plan   0\\\\t#\\\\E 0 &U"%"%&U FY01:Implement  $ disseminationtrackingsystem.FY00:EstablishdisseminationgoalsforPRIfundedprojectsandmethodsforcollectionofdata,includingthenumberofpublishedpeerreviewedstudiesandthenumberofproductsdevelopedanddistributedto consumers.#&U"%"%&U"# 0\\\\H,0\\\\ 0FY01:FY00: 4\\\\Et;  \\\\ 4&U"%"%&UDistributeinformationonavailabilityof $< researchfindings.#&U"%"%&U#ԀCDCPlan 0\\\\%=\\\\E 0&U"%"%&UFY01 : Increaseby5%the $> numberofhitstowebsitehighlightingPRIfundedresearchprojects.FY00:EstablishwebsitewithhighlightsofselectedPRIfundedstudiesandlinkagestoCIOswebsitesonprojects,whereavailable.#&U"%"%&U# 0\\\\,%G\\\\ 0FY01:FY00: /\\\\E5)"M\\\\ /Maximizedisseminationofinformation, tools,andproductsdevelopedfromresearchresultsforuseinpracticesettings.AHRQPlan 0\\\\ \\\\E 0FY01:L !"#$%&(hhK !"#$%&(L  3    323  0    Formationofaminimum \@ of8partnershipstosupportdisseminationofAHRQproductsthroughintermediaryorganizations,suchashealthplansandprofessionalorganizations. 3݌ VV Ќ    3    3923  0    Evidencebasedpractice  centers(EPCs)willproduceaminimumof12evidencereportsandtechnologyassessmentsthatcanserveasthebasisforinterventionstoenhancehealthoutcomesandquality. 39d݌ VV Ќ  FY00:Atleast10purchasers/businessesuseAHRQfindingstomakedecisions.FY99:Atleast5purchasers/businessesuseAHRQfindingstomakedecisions. 0\\\\\\\\ 0(d   \\\\ (#XVJX"%&U'# lXXVJP#XVJXl#lXXVJROGRAMS#XVJXl#lXXVJS#XVJXle#lXXVJUPPORTING#XVJXl#lXXVJT#XVJXl#lXXVJHIS#XVJXl7#lXXVJO#XVJXl}#lXXVJBJECTIVE   " #XVJXl#(X@s#s#(AHRQ "$ ResearchonHealthCosts,Quality,andOutcomesCDC %' HIV/AIDSPreventionSexuallyTransmittedDiseasesTuberculosisDiabetesandOtherChronicDiseasesHeartDiseaseandHealthPromotionBreastandCervicalCancerPreventionPreventionCentersInfectiousDiseasesLeadPoisoning -&0 HealthStatisticsPreventionResearchEpidemicServicesEnvironmentalDiseasePreventionOccupationalSafetyandHealthEliminatingRacialandEthnicDisparitiesFDA l(P!6 FoodsHumanDrugsMedicalDevicesandRadiologicalHealthBiologicsAnimalDrugsandFeedsNationalCenterforToxicologicalResearch -&< TobaccoIHS  DirectOperationsNIH t ResearchProgramOPHS L  OfficeofDiseasePreventionandHealth 8  PromotionOfficeofMinorityHealthOfficeofWomensHealthOfficeoftheSurgeonGeneralSAMHSA `  KnowledgeExchangeNetworkStateIncentiveGrants 8   5@s#s#X@#5   `  D" y  XXTABLEOFCONTENTS #XXm{# D ^{? ,XS X,X,hX?s.  'Vm  'VmD|0     INTRODUCTION###Js#.` ` s#s##1'VmD|`|݌ < Ќ  'Vm  'Vm}0     SECTIONI:SUMMARYPERFORMANCEREPORT###Js#.~~0s#s##4'Vm}"}݌    Ќ  )!  )!}0  0Ss#s#    _HHS_ԀGoal1:0 Ss#Ss#REDUCETHEMAJORTHREATSTOTHEHEALTHAND h   PRODUCTIVITYOFALLAMERICANS###Js#.3 s# s##7)!}}݌ X  Ќ  )!  )!A0  0Ss#s#    _HHS_ԀGoal2:0 Ss#Ss#IMPROVETHEECONOMICANDSOCIALWELLBEINGOF H  INDIVIDUALS,FAMILIESANDCOMMUNITIESINTHEUNITEDSTATES#""Is#.j j  s# s##13)!A\݌ (  Ќ  )!  )!0  0Ss#s#    _HHS_ԀGoal3:0 Ss#Ss#IMPROVEACCESSTOHEALTHSERVICESANDENSURETHE   INTEGRITYOFTHENATIONSHEALTHENTITLEMENTAND)!ۀ݌  s# s# Ќ  )!  )!0  0Ss#s#    0SSs#Ss#0 Ss#Ss#SAFETYNETPROGRAMS#""Is#.) s# s##17)!3݌  Ќ  )!  )!0  0Ss#s#    _HHS_ԀGoal4:0 Ss#Ss#IMPROVETHEQUALITYOFHEALTHCAREAND)!2݌| s# s# Ќ  )!  )!%0  0Ss#s#    0SSs#Ss#0 Ss#Ss#HUMANSERVICES#""Is#.bb$ s# s##23)!%@݌ l Ќ  )!  )!0  0Ss#s#    _HHS_ԀGoal5:0 Ss#Ss#IMPROVEPUBLICHEALTHSYSTEMS#""Is#.3 s# s##30)!:݌ \ Ќ  )!  )!?0  0Ss#s#    _HHS_ԀGoal6:0 Ss#Ss#STRENGTHENTHENATIONSHEALTHSCIENCESRESEARCH L ENTERPRISEANDENHANCEITSPRODUCTIVITY#""Is#.TT= s# s##33)!?Z݌ < Ќ  'Vm  'Vm0     SECTIONII:KEY_HHS_ԀMEASUREMENTISSUES#""Is#.1s#s##38'Vm͇݌  Ќ  )!  )!0  0Ss#s#    APPROACHTOPERFORMANCEMEASUREMENT#""Is#.bb/Ss#Ss##39)!ˈ݌ h Ќ  )!  )!0  0Ss#s#    DEPARTMENTALCOMMITMENTTOMANAGEMENTIMPROVEMENT#""Is#.=Ss#Ss##41)!݌ X Ќ  )!  )!0  0Ss#s#    DATACHALLENGES#""Is#.V V Ss#Ss##55)!݌ H Ќ  )!  )!_0  0Ss#s#    PROGRAMEVALUATIONANDPERFORMANCEMEASUREMENT#""Is#.:Ss#Ss##59)!_z݌ 8 Ќ  'Vm  'VmQ0     SECTIONIII:FY2001PERFORMANCEGOALSUMMARY#""Is#.8s#s##61'VmQm݌   Ќ  )!  )!70  0Ss#s#    FY2001DEPARTMENTALINITIATIVESANDREPRESENTATIVE)!7R݌ Ss#Ss# Ќ  )!  )! 0  0Ss#s#    0SSs#Ss#PERFORMANCEGOALS#""Is#. Ss#Ss##62)! '݌ !|# Ќ  )!  )!0  0Ss#s#    FY2001PROGRAMS,INITIATIVES,STRATEGIES,ANDPERFORMANCE)!݌ Ss#Ss# Ќ  )!  )!Џ0  0Ss#s#    0SSs#Ss#GOALSTHATSUPPORTTHE_HHS_ԀSTRATEGICPLAN#""Is#.8Ss#Ss##68)!Џ݌ #\!% Ќ  )!  )!0  0Ss#s#    _HHS_ԀGoal1:0 Ss#Ss#REDUCETHEMAJORTHREATSTOTHEHEALTHAND %<#' PRODUCTIVITYOFALLAMERICANS#""Is#.3 s# s##69)! ݌ &,$( Ќ  *  *Q0  0Ss#s#0 Ss#Ss# S   _HHS_Ԁ1.1:0 s# s#ReduceTobaccoUse,EspeciallyAmongYouth#""Is#.~~@ s# s##70*Ql݌ '%) Ќ  *  *0  0Ss#s#0 Ss#Ss# S   _HHS_Ԁ1.2:0 s# s#ReducetheNumberandImpactofInjuries#""Is#.> s# s##74*݌ x( &* Ќ  *  *˔0  0Ss#s#0 Ss#Ss# S   _HHS_Ԁ1.3:0 s# s#ImprovetheDietandtheLevelofPhysicalActivityofAmericans#""Is#.,,V s# s##81*˔݌ h)&+ Ќ  *  *0  0Ss#s#0 Ss#Ss# S   _HHS_Ԁ1.4:0 s# s#CurbAlcoholAbuse#""Is#.( s# s##85*:݌ X*', Ќ  *  *E0  0Ss#s#0 Ss#Ss# S   _HHS_Ԁ1.5:0 s# s#ReducetheIllicitUseofDrugs#""Is#.FF5 s# s##89*E`݌ H+(- Ќ  *  *x0  0Ss#s#0 Ss#Ss# S   _HHS_Ԁ1.6:0 s# s#ReduceUnsafeSexualBehaviors#""Is#.4 s# s##93*x݌ 8,). Ќ   (-*/ )!  )!ə0  0Ss#s#    _HHS_ԀGoal2:0 Ss#Ss#IMPROVETHEECONOMICANDSOCIALWELLBEINGOF  INDIVIDUALS,FAMILIESANDCOMMUNITIESINTHEUNITEDSTATES#""Is#.j j  s# s##97)!ə݌  Ќ  *  *R0  0Ss#s#0 Ss#Ss# S   _HHS_Ԁ2.1:0 s# s#IncreasetheEconomicIndependenceofFamiliesonWelfare#""Is#.O s# s##99*Rm݌  Ќ  *  *0  0Ss#s#0 Ss#Ss# S   _HHS_Ԁ2.2:0 s# s#IncreasetheFinancialandEmotionalResourcesAvailabletoChildren*݌p s# s# Ќ  *  *ܝ0  0Ss#s#0 Ss#Ss# S   0 s# s#FromTheir_Noncustodial_ԀParents#G"G"Hs#.5 s# s##102*ܝ݌ `  Ќ  *  *0  0Ss#s#0 Ss#Ss# S   _HHS_Ԁ2.3:0 s# s#ImprovetheHealthyDevelopmentandLearningReadinessofPreschool P  Children#G"G"Hs#.H H  s# s##104*#݌ @  Ќ  *  *}0  0Ss#s#0 Ss#Ss# S   _HHS_Ԁ2.4:0 s# s#ImprovetheSafetyandSecurityofChildrenandYouth#G"G"Hs#.K s# s##111*}݌ 0  Ќ  *  *ǡ0  0Ss#s#0 Ss#Ss# S   _HHS_Ԁ2.5:0 s# s#IncreaseOpportunitiesforSeniorstoHaveanActiveandHealthyAging  p  Experience#G"G"Hs#.   s# s##115*ǡ݌ `  Ќ  *  *A0  0Ss#s#0 Ss#Ss# S   _HHS_Ԁ2.6:0 s# s#ExpandAccesstoConsumerDirected,HomeandCommunityBased*A\݌P  s# s# Ќ  *  *v0  0Ss#s#0 Ss#Ss# S   0 s# s#LongTermCareandHealthServices#G"G"Hs#.<<8 s# s##120*v݌ @  Ќ  *  *0  0Ss#s#0 Ss#Ss# S   _HHS_Ԁ2.7:0 s# s#ImprovetheEconomicandSocialDevelopmentofDistressed*݌0  s# s# Ќ  *  *0  0Ss#s#0 Ss#Ss# S   0 s# s#Communities#G"G"Hs#.! s# s##123*Ҧ݌   Ќ  )!  )!0  0Ss#s#    _HHS_ԀGoal3:0 Ss#Ss#IMPROVEACCESSTOHEALTHSERVICESANDENSURETHE  INTEGRITYOFTHENATIONSHEALTHENTITLEMENTAND)!˧݌  s# s# Ќ  )!  )!0  0Ss#s#    0SSs#Ss#0 Ss#Ss#SAFETYNETPROGRAMS#G"G"Hs#.) s# s##126)!#݌  Ќ  *  *0  0Ss#s#0 Ss#Ss# S   _HHS_Ԁ3.1:0 s# s#IncreasethePercentageoftheNationsChildrenandAdultsWho*#݌ s# s# Ќ  *  *C0  0Ss#s#0 Ss#Ss# S   0 s# s#HaveHealthInsuranceCoverage#G"G"Hs#.4 s# s##128*C^݌ p Ќ  *  *N0  0Ss#s#0 Ss#Ss# S   _HHS_Ԁ3.2:0 s# s#IncreasetheAvailabilityofPrimaryHealthCareServices#G"G"Hs#.O s# s##131*Ni݌ ` Ќ  *  *0  0Ss#s#0 Ss#Ss# S   _HHS_Ԁ3.3:0 s# s#ImproveAccesstoandtheEffectivenessofHealthCareServicesfor*݌P s# s# Ќ  *  *خ0  0Ss#s#0 Ss#Ss# S   0 s# s#PersonswithSpecificNeeds#G"G"Hs#.tt1 s# s##141*خ݌ @ Ќ  *  *0  0Ss#s#0 Ss#Ss# S   _HHS_Ԁ3.4:0 s# s#ProtectandImproveBeneficiaryHealthandSatisfactionwith*݌0 s# s# Ќ  *  *0  0Ss#s#0 Ss#Ss# S   0 s# s#MedicareandMedicaid#G"G"Hs#.+ s# s##149*0݌  p Ќ  *  *0  0Ss#s#0 Ss#Ss# S   _HHS_Ԁ3.5:0 s# s#EnhancetheFiscalIntegrityof_HCFA_ԀProgramsandEnsurethe*2݌` s# s# Ќ  *  *l0  0Ss#s#0 Ss#Ss# S   0 s# s#BestValueHealthCareforBeneficiaries#G"G"Hs#.VV> s# s##154*l݌ P Ќ  *  *0  0Ss#s#0 Ss#Ss# S   _HHS_Ԁ3.6:0 s# s#ImprovetheHealthStatusofAmericanIndiansandAlaskaNatives#G"G"Hs#.V s# s##157*݌ @ Ќ  )!  )!׵0  0Ss#s#    _HHS_ԀGoal4:0 Ss#Ss#IMPROVETHEQUALITYOFHEALTHCAREAND)!׵݌  s# s# Ќ  )!  )!0  0Ss#s#    0SSs#Ss#0 Ss#Ss#HUMANSERVICES#G"G"Hs#.bb$ s# s##162)!݌ ! 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