Department of Health and Human Services
	Research, Demonstration, and Evaluation Activities FY 2003 Plan and Budget February 2002

---

RESEARCH AND DEMONSTRATIONS

(by HHS Strategic Plan Objective)

CROSS-CUTTING RESEARCH, DEMONSTRATION, AND EVALUATION ACTIVITIES

FY 2003 Priorities

A number of centrally managed research, demonstration, and evaluation activities support a range of projects that address virtually all of the Department’s strategic goals and objectives. They also support the analysis and development of public policy options for the Secretary and Congress. For purposes of this presentation, these activities have not been separated into specific strategic goals and objectives. Rather, they are displayed as discrete activities in this section. This was done because many of these RD&E activities support projects that cut across numerous goals, making judgements with respect to where activities fall unclear. They address RD&E priorities not addressed by other Agencies and priorities that cut across Department programs and Agencies. These activities include:

• program evaluations (usually called inspections) conducted by the Office of the Inspector General (OIG).
• policy research conducted by the Office of the Assistant Secretary for Planning and Evaluation (ASPE).
• the use of the PHS 1% Evaluation Set-Aside Program by ASPE and the Office of Public Health and Science (OPHS).

EVALUATIONS (OIG)

Evaluation: The OIG's Office of Evaluations and Inspections (OEI) conducts short-term progrram evaluations (called inspections) that focus on issues of concern to the Department, Congress, and the public, such as Medicare services, device and drug approvals/removals, child support enforcement programs, and Medicare client satisfaction. The results of this work generate rapid and reliable information on how well HHS progras are operating and offer recommendations to improve their efficiency and effectiveness. A more detailed description of OIG evaluation activities is available in the annual OIG work plan.

RESEARCH (ASPE)

The purposes of the Policy Research program are to provide policy-relevant information on national trends in public and private health and human services activities; to analyze the potential costs and benefits of proposed public sector policy changes; and to identify emerging policy issues and potential ways to address the issues. Research priorities for FY 2003 include the following:

State Innovation

Funds will be used to demonstrate and evaluate new models for delivering health and human services at the community level, including models that:

• facilitate access to health services for the uninsured.
• expand gateways to all services (e.g., through faith-based entities).
• promote family formation, responsible fatherhood, and responsible child-rearing.
• provide longitudinaldata to assess changes in teen attitudes and behaviors concerning abstinence from sexual activity.

Health Policy

• The research emphasis in FY 2003 will be to more comprehensively understand private sector systems and their interactions with changes in public programs, including an understanding of:
• health insurance markets, especially the individual market, health care workforce, and health delivery issues.
• changes in major Departmental programs such as Medicare and Medicaid, as well as new efforts to prevent disease and keep people healthy.
• implementation and effectiveness of SCHIP in enhancing insurance coverage and improving health quality for various populations.
• the impact of the Balanced Budget Act (BBA) on Medicare and Medicaid.

Human Services Policy

The research emphasis in FY 2003 will be to examine human services program policies, and delivery of services to low income families and children, to understand the effectiveness of these programs, including:

• the impact of welfare reform and changing labor markets on employment, poverty, family composition and the well-being of low income families and children.
• the socio-demographic characteristics and service needs of low income families and children.
• the demographic and poverty dynamics of those who are unemployed and not receiving cash assistance.
• how to measure proverty.
• effective strategies for job retention and advancement for persons moving from welfare to work and self-sufficiency, including the role of critical support services.
• effective ways to strengthen families and prevent out-of-wedlock pregnancies.
• successful approaches for promoting social capacity, emotional health, cognitive development, physical health, and school readiness of children.
• how to improve child support enforcement activities such as father involvement and paternity establishment.

Disability, Aging, and Long-Term Care Policy

In FY 2003, priority will be given to research that supports the development of new programs and practices that provide people with disabilities and their families a broader array of community-based long-term care services. Research will focus on:

• projecting the future need for long-term care workers and strategies for workforce development.
• developing new models for financing long-term care services.
• understanding the role and dynamics of family care-giving in the long-term care system and the impact of workplace policies on the availability and persistence of informal care.
• understanding the impact of health care availability and long-term support services on employability and job retention of working age persons with disabilities.
• assessing the impact of rehabilitation services and assistive technologies on functioning, quality of life, and costs.
• understanding the impact of private long-term care insurance and other private approaches to increasing long-term care coverage.
• developing and testing effective methods (surveys, enforcement instruments) to improve the quality of care in nursing homes.
• understanding the organizational and financial complexities of integrating supportive housing and community based long-term care in a way that is affordable and responsive to consumer preferences.

Science Policy

Research in this area will:

• formulate strategies to foster development and responsible applications of genetic testing and xenotransplantation.
• develop strategic approaches to addressing children’s environmental health, especially health problems such as asthma.
• continue to participate in developing responses to bioterrorism.
• support efforts to address bioethical issues.

EVALUATIONS (ASPE PHS EVALUATION SET-ASIDE FUNDS)

In FY 2003, ASPE evaluation priorities will focus on the following areas:

• assessing how new insurance coverage (SCHIP, VCF) affects the use of safety net providers by the newly insured.
• studying how well scientific information is translated to promote effective health care practices.
• evaluating the impact of selected crosscutting public health activities including those designed to prevent risky behavior and promote healthy youth development (e.g., children’s health, teenage pregnancy prevention, domestic violence prevention, mental health, and substance abuse treatment and prevention).
• developing indicators of child and youth health and well-being.
• assessment of the effects of changes in safety net programs on individuals and families served by public health programs.
• evaluations of recent changes in the way health care services are financed, managed, and delivered (e.g., managed care innovations, Health Insurance Portability and Accountability Act, Balanced Budget Act, and State Children’s Health Insurance Program, welfare reform), and how these changes affect the health and health care of populations served by public safety-net health programs.
• development of data and analytical tools used to evaluate public health programs and provide other technical support necessary for the conduct of evaluations of public health programs and policies.
• examining community health services for adult and child special populations (e.g., domestic violence, mental health, substance abuse, child-only cases, families with incarcerated adults), including supportive services; location-based barriers; and culture, language, and eligibility issues for particular populations (e.g., immigrants, rural, Native Americans).

PHS ONE PERCENT EVALUATION SET-ASIDE (OPHS)

Evaluations: In FY 2003, OPHS will carry out evaluations in the following areas:

• conduct activities to develop and evaluate communication and implementation strategies for the Healthy People 2010 Leading Health Indicators.
• assess the use of the Internet and emerging wireless communications to promote health related behavior change and the use of healthfinder.gov to reach selected populations through these technologies.
• assess the nature and extent of health disparities among minorities and monitor progress toward elimination of such disparities, including an assessment of data collection infrastructure needs among community-based organizations (CBO) and grantees serving minority communities.
• evaluate the activity on Elimination of Racial and Ethnic Disparities in Health, with particular emphasis on evaluating projects that seek to identify and examine root causes of, and effective strategies to address, such disparities.
• evaluate the National Centers of Excellence in Women’s Health and the National Communities Centers of Excellence in Women’s Health.
• assess efforts being made by institutions and research labs to prevent research misconduct, the oversight and technical assistance provided by the Office of Research Integrity in misconduct cases, compliance with the regulatory requirements, and evaluation of the Responsible Conduct of Research Education Program.

4 — FY 2002 and FY 2003: includes $18 million transfer from PHS 1 percent evaluation set-aside account.