/ r - e @ / @@.c -@ - - @ @ (re7 A @#r VAC-Affc@ ,c roll, Oil 'file, Ol-( 3- c, opc i-S to !.circl desi,@iledt and the clievoic)l)!,@iellt of resources in the i-@ation -t@-in.-Lstritioii of e)@.is.',i.ng stati-itor), authorities as V,,C]l a!7, ii.P.. 1,6.,.'O,l or siniilar pending legislation. l,eg.i.rlat--',,-)n b,@i.iig con@-idereti c-'Lea-rly dicta-Los the need to perform the fol-lollvInu f7lll--tiol,,s: 1. Develop, fc.,rirtat, promulgate, coordinate, aid revise is a sufficient bocly of policy, re-ulatioiis, guidelines, -tr;.d tional I)i,oceul!.irc-s to facilitate the practice of th(.- intent, 2. Provi.d(@ for t@.e cstablisti-,iient, develoDTiient, a4zsistE!j,,,,--e support c.c iie@tltj'i planning auc-i--ies in states and des-lonate@@, Z, areas, and to proiriote through them the devclo,,,t-.Icqt of systems and resources which i-)eet identified rieeiis a.-id know,) deficiencies within their zones of i.nflu@i-ice. 3. Monitor, assess, evali.tatc,, and regL,.Iate within the context oj-- existi@i- laiv the rrogrc@ss aiid practice of the established aQ@eTi.ci es. 4 Proviii-- @oi- resezi-rcti, synthesis, 'pro,iiulc--atioi-i Df matiozi Pi-id rf-lat--d st(---Is to assist and encourage healt@, T)IclTi" a-enc;@es tow@ird are c@L@f,@ctive use of liealtfi plariiiii- methodolog-. ORGA-N.T7ATIONAT. -,)IT)rSopIly: To accc)illl)jisi-, itlr Office (CO) 1)1, flat I)Y'oi.ride fc)f 'll@ @i oil and active response to regional staff needs. SLICII a devoid of ina@llige Iftel,,t layering with cjca@l, li3ics of Co;"6i-illtjrlic-Ition and well articulated delc,,ati 'Flic Ceiitr,@t-'Officl@ stl"Licl-.Llre sliculd also prc;,iot- horizontal cooperation, communication, and interdependence, and dicol,a the formation of Iltdrfli problems. Lastly, the organization should provide the capacity for its leadership to delegate authority and responsibility as completely as possible, and to as low a level in the structure as is feasible, while retaining an ability to become involved in critical issuos. Two facts dictate this philosophy: 1. The staffing of the Central Office, in terms of numbers, will be small. 2. The program scope -i.s wide and diverse. Both facts speak for an exceptionally ti-lit knit or,,a.,Ij.- zation with maximum use of every position. Much must be accomplished. through the small group intrapersonal relationship of activity and interest that in larger organizations is relegated to structural e7,itil'Icf, e.g. program coordination embodied in a "coordination staff". Tiic, biii,eaii will be strongly centralized from the standpoint of policy and program coordination, but its operations will be decentralized. 'flie Central Office will provide basic policy and programmatic goals, regulations, and guidelines. The regional staffs will translate these basics into active assistance to the agencies. The regional staffs will observe and assess the activities of the agencies and, through synthesis and structured reporting to the CO, provide the necessary information to test6@ and as necessary, bring about the revision and improvement of policies and regulations. The Central Office/Regional Office (RO) relationship, I.ike 3- of the eye and the is not I)a.@c--d oil the superiority of onc-, o,- tile, The success of that relationship is dependent on the rapid @.ii(i . ii oru'e-r to transmission of information which ser@,es the need.-; of both i attain the goals of the program.. Structure: See attached cliart-11 Basic Component Functions: 1. Office of The Bureau Director: Provides executive leadership and direction for the programs and activities of the Bureau. Specifically: (1) Coordinates the functioning of the bureau both internally and in the context of other national health programs; (2) Develops program objectives, alternatives, and policy positions consistent with broad administration guidelines; (3) Evaluates program accomplishments; (4) Develops and administers operating policies and procedures and provides assistance to bureau constituents to achieve effectiveness and economy in the management of bureau programs; (5) Provides selected management services for bureau constituents and carries out necessary coordination with respect to management services provided for the bureau by higher headquarters; (6) Serves as principal contact and advisor to the Department, the Health Resources Administration and other PHS agencies, The National Council for Health Policy, and other interested parties on matters relating to planning and development of health systems (7) Directs and coordinates bureau activities carried out in support of equal employment opportunity programs; (8) Provides guidance and assistance to DHEW regional offices in executing the Bureauls responsibilities for the efficient and effective conduct of the Bureauls programs; (9) Provides,:through appropriate channels, information about bureau programs to the general public, health profes- -4- sioiis associations, ,,iici other interested '91-otil)s and orgaiiizati-c,;-is; (10) Establishes and coordinates exterii,,il relationships; and Plans, develops and maintains a s,,,stein to ensure and management of clerical services throtighttit the Bureau. Policy Coordination Staff Serves as the focus for bureau-wide policy coordination and the management of controlled correspondence having potential policy involve- ment or impact. Functioning as one of Bureau Director's primary staff ares: (1) Coordinates, performs analyses of, and assesses the impact of diverse program policy on the mission of the bureau; (2) Brings to the attention of the Bureau Director and Executive Staff policy issues which have not found resolution at lower levels; (3) Evaluates trends and indicators of potential policy problems and issues needful of revision or lateration; (4) Negotiates and maintains a program of planned chan-e in programmatic policy; (5) Assures that bureau personnel are informed and kept aware of policy evolution on a periodic basis; (6) Serves as a focal point for communicating with other HEW components with regard to policy clearance. In support of its policy coordination functions: (1) Receives and reviews controlled correspondence and makes action assignments and follows up to assure timely and appropriate action; (2) Establishes standards for and ensures the quality of written communications and is- suances throughout the bureau; (3) Maintains for the Director a docket of pending requests and a structured device for insuring timeliness of rosponse; (4) Establishes and maintains central files for the Bureau Director; (5) Establishes and assures implementation of bureau and administration corres- pondence procedures and policies. Evaluation and Legislation Staff (1) Serves as I'he Dii-c@ctor's primary staff unit and principal sour(-,@. or advice on program evaluation and legislative affairs; (2) Oversees a-l@e,,Ior conducts communications between the Bureau and higher levels of povcrrlllc7,lt on all matters that involve evaluations of program performance; (3) Main- tains liaison with other Federal. and iioi-l-edoral health agencies on inatte,-s within its area of responsibility; (4) Prepares and directs the implementa- tion of comprehensive program evaluation strategies to obtain needed eval- uative data; (5) Monitors on-goi.ng information systems which produce evalua- tive data about the Bureauls programs; (6) Identifies problem areas in achieving bureau and program objectives and recommends actions to be taken in response to those problems; (7) Monitors, and makes recommendations for needed change in, legislation affecting the bureaus programs; a,-id (8) Provides leadership for task oriented problem resolution at the discretion of the Director. Office of Management Plans, directs, and evaluates the administrative management support activities of the bureau. Serves the bureau by providing or acquiring services and resources in the requisite management areas: (1) Plans, directs, and coordinates those personnel management and training programs which meet the particular needs of the bureau; (2) Plans, directs and coordinates property management and procurement programs required for the bureauls operation; (3) Conducts organization and management surveys and prepares necessary systems and controls to maintain and further the or- ganization and management practices of the Bureau: (4) Provides, through the Office of the Administrator, HRA, a program of financial management for the bureau, inclusive, of budget planning, formulation and execution, -6- and administration of set aside f, erves @is the fcca.1 lilids; (5) S point in the bureau for the development of ADP systems and policy, and evaluation; (6) Develops procedures for and n@aintai.iis tire) bure@.iuls reports management systems; (7) Coordinates the bureau activities in management plai,.ning and prepares, with requisite inputs', sucli Documents as the forward plan, OPS, and bureau contributions to hic,l,,er I.cvel plan- ning activities; (8) Conducts bureau management improvement programs; (9) Participates in program and legislative planning to assure recogni- tion of management and resource problems; and (10) Maintains necessary extra-bureau liaison to acquire clearances and support of its activities. Office of Operations Monitoring Provides a bureau focal point for coordination of operations activities: (1) Plans, directs, and coordinates the bureau monitoring and assessment programs; (2) Participates in bureau Executive policy formulation by advisin- on the operational implications of the bureauls plans and programs; (3) Devises, controls, and operates the necessary systems of management control and information; (4) Through the operation of MIS and monitoring activities, provides the bureau with an effective source for the transmission of routine information; (5) Collaborates with the program divisions to establish criteria, parameters, and content of information required for the effective monitoring of program operations; (6) Maintains close liaison with the Office of Regional Operations (ORO) HRA; and (7) Provides analytical and advisory capacities where operational matters involve interprogram conflicts. Division of Planning Methods and Teclinolocy Provides a bureau and National focal. point for the development and dissemination of technical materials, planning approaches, methodologies, -7- policies, standards, and gui.deli es for the appropriate pl@iniiiiiG og n @ I health resources aid services. The sii)jcct of such activities include, but are not limited to: (1) The provision of primary care services for medically uncierserved populations; (2) The Oevelol.)iRent of Tillilti- institutional systents for coordination oy consoli-cl@iti-cii of institutional health services; (3) The development of medical group practice whose services are appropriately coordinated or integrated with institutional health services; (4) The training and increased utilization of physician assistants; (5) The development of multi-institutioiial arrangements for thez,shating of support services; (6) Improvements in the quality of health services; (7) The;@(levelopment ofiliealth service institutional capacity to provide various levels of care on a geographically integrated basis; (8) The adoption of uniform cost accounting, reimbursement, and utilization reporting systems; and (9) Effective methods for educating the general public on basic personal health care and use of available health care resources. The division will produce guidelines for the conduct of planning processes and also will specify the minimum data needs for determining the health status of residents of health service areas, for determining the status of health resources and services, and for describing the use of such resources and services. The Division is responsible for the establishment, coordination, and consultative direction of the National Center for Health Planning Information and the Centers for Health Planning and provides technical assistance and technical materials to the Health Systems Agencies and state agencies for use in health planning. -8- Division of Agency Development Provides a Bureau focus for the management and operational develop- ment of health systems agencies and state.agencies: (1) Provides a central referent and problem resolving source of comlyaritive information on agency management and operational development; (2) Prepares prototype plans of organization and operation of agencies; (3) Provides determinants, alterations, and interpretations of guides to meet the needs of a broad variety of agency situations and levels of development; (4) Participates in the development and maintenance of agency performance standards and assessment criteria; (5) Provides assistance, information, guides and interpretation including, but not limited to; guides to incorporation, revision of by-laws, staffing patterns, personnel policies, organization models, administration manuals, salary determination, position descriptions, and agency policy and procedures; (6) Serves as a consultative resource on agency development matters as they relate to other programmatic,divisional activities; (7) Coordinates activities closely with other program divi- sions to assure that agency development activities are properly inclusive of emphases which benefit and further all programmatic activity; and (8) Participates in establishing MIS reporting that is conducive to agency development and problem determination and resolution. -9- DIVISION OF FACILITIES DEVELOPNIENT Serves as the bureau focal point for guidance, assistance, and standard setting for the construction, modernization and expansion of health care facilities. (1) Participates, with the Division of Planning Methods and Technology, in the development and maintenance of crit@ria, standards and guidelines to be used by state health planning and development agencies and health systems agencies in preparing and administering facilities plans; (2) Coordinates the financial feasibility reviews and project approval requirements for Section 242 of the National Housing Act and carries comparable responsibilities for direct loans and loan guarantees administered by DHEW; (3) Maintains liaison with Treasury, the Federal Financing Bank, HUD, FNMA, GNMA, and other agencies regarding development of policies and other guide- lines; (4) Serves as the Bureau focal point in providing technological assistance in the operation of health care facilities bv providing leader- ship in the architectural, engineering, and equipment aspects of the health facility construction program; providing consultative assistance to repre- sentatives of fore ign governments to federal, state, and local officials and to the public; conducting studies on the design and construction re- quirements of health care facilities; and maintaining liaison with State hospital associations, and professional and technical organizations con- cerned with the design, construction, and equipping of health care facilities'in order to be aware of technological developments and needs in order that they may be provided for in minimum construction requirements; (5) Participates in the analysis of data on the Nation's health care facility needs and resources, the evaluation of programs in relation to health care facility needs, the development of measures of adequacy for -10- the health care facility system, the developmental analyses in support of legislative program proposals and appropriation requests for the Office of Management and Budget and congressional presentations, the pre- paration and testing of allocation formulae for use in the administration of the grant, loan, and loan guarantee programs, evaluative studies developed in the annual evaluation plan; and the conduct of miscellaneous studies attendant to program development; (6) Collaborates with the Office of Operations Monitoring in providing guidance for the effective monitoring of facilities grants and loan programs; and (7) Coordinates its activities .with programs within the Bureau, the Department and other agencies and groups concerned with health care facilities. Division of Regulatory Activities Functions as the focal point for all regulatory activities of supported agencies: (1) Creates and maintains standards for certificate of need and 1122 agreements; (2) Prepares, and modifies as needed, criteria and guidelines for review and approval activities; (3) Serves as a consultative resource regarding rate review practices, standards and utilization; (4) Through analysis of review and approval activities, identifies trends and developments which, through cooperation with Planning Methods and Technology Division, will assist in priority setting or development of needed planning reserach; (5) Participates in the development of and/or reviews programmatic guides, performance standards, and criteria to provide comment on, or reaction to, regulatory impact; (6) Establishes minimum standards for adherence to Federal regulations; and creates models for optimum performance of regulatory intent; (7) Prepares and revises monitoring criteria for inclusion in the MIS which will provide requisite information for regulatory assessment and evaluation; (8) Participates in Executive Staff consideration of policy changes or programmatic alterations which impact on regulatory activities and (9) Suggests legislative considerations which will further attainment of regulatory goals. 0 t', 0 4-1 4-J L" 0 cl@ @ C, 4i V) 4i 4J 4-) 0 rt) r-i 0 Q) > C.) > CZ 0 4J Lt -P 4-4 4-4 0 0 CA @o 0 @ r- -H r- 0 -H Cd 4-J > E- ?A 0 0 -H Cd 0 4-J 0 4-i -H o 0 0 U cd 44 -H LH 0-0 4-J 0 k 0 0 0 .,i r, 0 L'i ID -4