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MAKING HHS MORE RESPONSIVE TO THE PEOPLE IT SERVES

Secretary Thompson is working aggressively to support the President's pledge to make the federal government more responsive to those it serves. Nowhere is this pledge more evident than in the number of waivers granted to states, helping them serve families in innovative ways. As promised, Thompson is working in close partnership with states to provide increased access to health insurance for low-income Americans. Between Jan. 20 and April 20, 2001, the Department of Health and Human Services approved 247 waivers and state plan amendments for programs like Medicaid and SCHIP. And more are in the pipeline. By speeding up and simplifying the waiver approval process, this administration is rewarding and encouraging innovation and working in partnership with states. The result is that states are able to provide more access and better healthcare to hundreds of thousands of Americans. For example:

Colorado. The Secretary approved two changes in the Colorado State Children's Health Insurance Program that will allow the state to eliminate monthly premiums in the program and substitute a nominal annual enrollment fee of $25 for one child or $35 for eligible families with two or more children whose income is between 151 percent and 185 percent of the federal poverty level (FPL). The second change streamlines the state's application and enrollment process to make it easier for families to sign up for coverage. The state expects to cover 29,743 children this year.

Louisiana. The Secretary approved Louisiana's request to extend its CommunityCARE program. CommunityCARE's physician primary care case managers coordinate health care and increase access to preventive care for approximately 46,000 people enrolled in Medicaid.

In addition, Secretary Thompson moved immediately upon his confirmation to direct the Health Care Financing Administration (HCFA) to improve accountability, responsiveness, and partnership in the federal/state Medicaid waiver and amendment process. In response to the Secretary's directive, HCFA has developed a new data system for tracking all amendments and waivers in a common format and central database. HCFA is implementing new procedures for streamlining the approval process.

IMPROVING ACCESS TO HEALTH CARE

President Bush and Secretary Thompson have already begun working to improve access to health insurance for the uninsured by:

• Including a tax credit for purchasing health insurance for low-income individuals of $1,000 for singles and $2,000 for married couples. This credit is expected to make health care accessible to 6 million more people;
• Increasing by $124 million funding for Community Health Centers in FY 2002, for a total of $1.3 billion, as part of a multi-year initiative to support 1,200 new or expanded health center sites;
• Allowing states increased flexibility in running Medicaid and the State Children's Health Insurance Programs through the waiver process.

PROTECTING PATIENTS' PRIVACY RIGHTS

At the President's request, Secretary Thompson began implementing strong patient privacy protections included in a final rule that gives patients greater access to their own medical records and more control over how their personal information is used.

This rule makes sure that private health information isn't misused in the information and technology age, when an array of data is readily available. This administration is giving patients peace of mind in knowing that their medical records are indeed confidential and their privacy is not vulnerable to intrusion.

American consumers will continue to receive high-quality health care without sacrificing the confidentiality of their private health matters. After patient privacy debates lasting the better part of a decade, President Bush acted within 100 days to resolve this matter.

LEAVING NO CHILD BEHIND

The President has put substantial resources behind his promise to leave no child behind, clearly making children a top priority of his administration. He has requested a $3 billion increase in resources ($76.8 billion total) to fund initiatives to support children and youth, including:

• After School Certificates (+$400 million),
• Promoting Safe and Stable Families (+$200 million),
• Mentoring Children of Prisoners (+$67 million),
• Independent Living Program (+$60 million),
• Promoting Responsible Fatherhood (+$64 million), and
• Maternity Group Homes initiative (+$33 million);

ORGAN DONATION

Secretary Thompson pledged that within his first 100 days he would launch an initiative to increase organ donation in this country. On his 75th day in office, the Secretary launched his five point "Donate Life" initiative including:

• Workplace Partnership for Life. A public-private partnership whereby participating corporations and companies of all sizes encourage employees to become organ donors and raise awareness about the need for donation in their workplaces.
• National Organ Donor Card that will serve as a model and legal card for those wishing to make clear that they intend to be organ donors. The card creates some uniformity and clarity in regard to the intent of the donor.
• National Forum on Donor Registries. This forum will bring together HHS agencies overseeing donation and transplantation as well as the other stakeholders in this issue to discuss the need for a national registry or state registries that can be linked.
• National Gift of Life Medal. This medal will be created and given to the surviving families of organ donation to recognize their loved one for giving the gift of life.
• Organ Donation Curriculum for Driver's Education. HHS and HRSA, in conjunction with the states, are developing a model curriculum that can be used in driver's education classes to raise awareness for organ donation and encourage young people to become donors.

The Secretary plans to build upon this foundation in addressing the issues of organ donation and transplantation in America throughout his tenure.

STRENGTHENING AND IMPROVING MEDICARE

President Bush has kept his promise to focus on strengthening and improving Medicare by committing $153 billion over 10 years to modernize Medicare, including the addition of a prescription drug benefit.

In addition, to assist seniors with limited incomes or high drug expenses, the President put forward his Immediate Helping Hand prescription drug proposal. The Immediate Helping Hand proposal will give immediate financial support to states so they can provide prescription drug coverage to beneficiaries with low incomes or high drug expenses. The HHS budget allocates $46 billion for Immediate Helping Hand, which is designed to provide drug coverage to those most in need until the Administration and Congress enact broader Medicare reforms, including the creation of a prescription drug option for all beneficiaries.

In addition, Secretary Thompson, along with his fellow Trustees, approved new technical assumptions so that the Medicare Part A Trust Fund will better estimate future Medicare resource needs. This is particularly important as the Administration creates a plan to strengthen and modernize the Medicare program to ensure its financial stability in the coming years.

Also, HCFA approved requests by managed care plans to reenter areas where plans had left or to offer new Medicare managed care options to beneficiaries in New York, Illinois, New Mexico, Texas, Massachusetts and Missouri. These Medicare+Choice organizations give Medicare beneficiaries another health plan option.

COMMITMENT TO MEDICAL RESEARCH

President Bush showed his commitment to research by meeting his campaign pledge of doubling the funding for the National Institutes of Health by 2003. In his FY 2002 budget request, the President included $2.75 billion in increased funding for NIH -- the biggest single year budget increase in NIH's history. He has been a passionate advocate for more scientific research since becoming Secretary.

ENCOURAGING HEALTHY BEHAVIOR

Surgeon General's Report on Women and Smoking. On March 27, Surgeon General David Satcher and Secretary Thompson released a major new report "Women and Smoking: A Report of the Surgeon General." This report summarizes patterns of tobacco use among women, factors associated with starting and continuing to smoke, the health consequences of smoking, tobacco marketing targeted at women, and cessation and prevention interventions.

Women now account for 39 percent of all smoking-related deaths each year in the United States, a proportion that has more than doubled since 1965, according to the report. The report concludes that the increased likelihood of lung cancer, cardiovascular disease, and reproductive health problems among female smokers makes tobacco use a serious women's health issue.

This report helped put the spotlight on the issue of women's health, which Secretary Thompson plans to make a major priority at HHS during his tenure.

National Campaign to Screen for Colorectal Cancer. HCFA and CDC are following through on the Secretary's efforts to inform the public about Medicare's coverage of screening for colorectal cancer. The two agencies, along with the National Cancer Institute, are targeting people 50 and older in the early detection and prevention of this cancer. Medicare, the program for elderly and disabled Americans, is reminding beneficiaries that four types of colorectal cancer screening tests are now covered by Medicare. In July, Medicare will also cover a fifth test, a screening colonoscopy every 10 years for people not at high risk for colorectal cancer.

Breast or Cervical Cancer Screening for Women Covered by Medicaid. The Secretary approved proposals from Maryland, New Hampshire and West Virginia to expand Medicaid benefits to uninsured women who are diagnosed with breast or cervical cancer through a federal screening program. The action allows the states to take advantage of the federal Breast and Cervical Cancer Prevention and Treatment Act (BCCPT) that was signed into law in October 2000. The law extends the full Medicaid benefit package to women who are screened and found to need treatment through the Centers for Disease Control and Prevention's (CDC) National Breast and Cervical Cancer Early Detection Program. Adoption of coverage for women under the BCCPT is optional for states. However, states that do offer the benefit receive an enhanced matching rate for women who enroll.

REACHING OUT TO ALL AMERICANS

In the first 100 days, Secretary Thompson has been reaching out to Americans, speaking several times a week. Thompson spoke to 18 national groups and organizations representing almost 3.2 million health care professionals, including doctors, dentists, hospital employees, community health care workers, and audiologists. He has also spoken to advocacy groups, scientists, lawmakers, state and local government groups, and citizens visiting HHS. He has traveled to California, Florida, Georgia, Illinois, Rhode Island, Maryland and Wisconsin.

The Secretary has also reached out to more than 1,800 HHS employees in three regional offices and more than 29,000 employees in six satellite offices including the Center for Disease Control, the Food and Drug Administration, and the National Institutes of Health. During these visits, the Secretary is learning about the agencies and encouraging more cooperation and coordination within the Department. Some HHS employees said Secretary Thompson was the first Secretary they had met in 20 years.

NEW FREEDOM INITIATIVE

On February 1, President Bush launched his New Freedom Initiative, a government-wide framework for helping provide people with disabilities with the tools they need to fully access and participate in their communities.

FAITH AND COMMUNITY BASED INITIATIVES

Within the first 100 days of this new administration, and pursuant the President Bush's Executive Order, Secretary Thompson has created a Center for Faith and Community Based Initiatives at the agency. The Secretary created the center to establish a level playing field for all faith-based and community organizations applying for federal grants.

MANAGEMENT IMPROVEMENTS

HCFA Reform. The Secretary has launched a comprehensive management review to modernize and reform the Health Care Financing Administration (HCFA), which oversees the Medicare, Medicaid and State Children's Health Insurance Program. The review will examine the agency's mission, competing demands, and resources. The Secretary expects to take appropriate steps to ensure HCFA has the structure and resources to respond to the needs of beneficiaries, states and health care providers.

As part of this effort, the Secretary will spend the week of April 30 working out of the HCFA Office in Baltimore.

Consolidated Software Purchases. Consistent with the Secretary's support for information technology standardization and centralized buying, the Department negotiated major new software contracts (with SAS Software, and Oracle). Based on historical usage using piecemeal contracts, these consolidated purchases will save over $40 million. More consolidated contracts of this type are planned.

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