U.S. Department of Health and Human Services Strategic Plan FY 2018 - 2022Every four years, HHS updates its Strategic Plan, which describes its work to address complex, multifaceted, and evolving health and human services issues. An agency strategic plan is one of three main elements required by the Government Performance and Results Act (GPRA) of 1993 (P.L. 103-62) and the GPRA Modernization Act of 2010 (P.L. 111-352). An agency strategic plan defines its mission, goals, and the means by which it will measure its progress in addressing specific national problems over a four-year period.For the period FY 2018 - 2022, HHS is publishing its Strategic Plan as a Web document, which will be updated periodically to reflect the Department’s strategies, actions, and progress toward its goals. The Web version of the Strategic Plan, rather than focusing on a static set of performance measures, provides priorities, accomplishments, and next steps that are tracked and updated frequently, reinforcing the Strategic Plan’s function as a living, vital document that serves a genuine management purpose. The Strategic Plan was last updated February 28, 2018.U.S. Department of Health and Human Services
HHS
Organization_aaab4785-0ccf-4028-9a83-6bdbb32294fcAlex M. Azar IISecretary, Health and Human ServicesVision_faab0d7b-eeb7-412f-a271-10cb360d8badMission_faab0d7b-eeb7-412f-a271-10cb360d8badHealthcareReform, Strengthen, and Modernize the Nation's Healthcare SystemGoal_b7da4cb6-33c2-4afc-9ead-8d164b538c851For a nation to thrive, its population must be healthy. Poor health reduces one’s ability to attend school, care for one’s family, or work. Without healthcare services—including physical, behavioral, and oral healthcare—to help improve health, Americans are at greater risk of poor health and human services outcomes. To improve the health of our Nation, the Department is working with its public and private partners to make healthcare affordable, high quality, and accessible for the people it serves. The Department also is making investments to strengthen and expand the healthcare workforce. This goal seeks to improve healthcare outcomes for all people across the lifespan, including the unborn, children, youth, adults, and older adults, across healthcare settings.SAMHSAAgency for Healthcare Research and Quality (AHRQ)unnamed organisationSAMHSAFood and Drug Administration (FDA)Indian Health Service (IHS)HRSACMSONCOffice of the National Coordinator for Health Information Technology (ONC)FDAIEACMSACLIHSU.S. Census BureauAccording to the U.S. Census Bureau, 91.2 percent of people carried health insurance coverage or received medical assistance for all or part of 2016. Although most people with health insurance coverage get that coverage through private plans (67.5 percent), such as employer-sponsored insurance or direct-purchase insurance, government-sponsored plans and medical assistance such as Medicare, Medicaid, Children's Health Insurance Program (CHIP), and military healthcare pay for health services for 37.3 percent of Americans.Substance Abuse and Mental Health Services Administration (SAMHSA)AHRQHRSAOGACDCCDCFederal GovernmentYet national health spending is expected to rise between 2017 and 2026, at an average rate of 5.5 percent per year, driven by growth in medical prices. Healthcare spending by Federal, State, Tribal, local, and territorial governments will be greater than that of private businesses, households, and other private payers due to growth in Medicare enrollment and continued government funding dedicated to subsidizing premiums for lower-income enrollees of health insurance exchanges under current law.Centers for Medicare & Medicaid Services (CMS)unnamed organisationAHRQCMSOCRunnamed organisationOCRunnamed organisationHealth Resources and Services Administration (HRSA)MedicaidCenters for Disease Control and Prevention (CDC)unnamed organisationIHSSAMHSAunnamed organisationOCROffice for Civil Rights (OCR)Administration for Community Living (ACL)ACLOrganisation for Economic Co-operation and Development (OECD)unnamed organisationMedicareCMSHRSASpecialized Care Providersunnamed generic groupCommunity Health WorkersAmbulatory Surgical CentersHealthcare ProvidersAcute Care HospitalsNonprofit SectorUnderserved AreasPhysiciansunnamed generic groupChildrenThe effort to improve healthcare quality and patient safety in many ways has been an American success story. Average life expectancy at birth - PDF has increased by nearly 30 years from the turn of the last century (47.3 years in 1900) to the beginning of this century (76.8 years in 2000). A child born in 2015 will live on average 78.8 years. However, preventable medical errors potentially take 200,000 or more American lives each year and cost the United States about $19.5 billion in additional medical costs and lost productivity from missed work.Behavioral Health Providersunnamed generic groupPrivate SectorPatientsLocal GovernmentsHealthcare ConsumersIndividualsHealthcare Workforceunnamed generic groupRural CommunitiesDialysis Centersunnamed generic groupunnamed generic groupunnamed generic groupUnderserved CommunitiesPhysiciansMedicare EnrolleesPatientsunnamed generic groupHospital Emergency DepartmentsHealthcare ConsumersFaith-Based OrganizationsAlaska Nativesunnamed generic groupRecipients of Healthcare ServicesPatientsState GovernmentsDental Care Providersunnamed generic groupOlder AmericansPer-person personal healthcare spending in 2012 was $18,988 for adults older than age 65, more than five times higher than the spending per child ($3,552). Compared with other Organisation for Economic Co-operation and Development (OECD) member countries, the United States ranks the highest in healthcare spending per capita, measured as a share of Gross Domestic Product (GDP). However, health outcomes do not always reflect this.unnamed generic groupPrivate SectorUnderserved CommunitiesCommunity-Based Providersunnamed generic groupHealthcare Workforceunnamed generic groupMakers of Medical DevicesUninsured PeopleIn 2014, 86.7 percent of people younger than age 65 had health insurance, including government and private coverage, and 76.4 percent of people had a usual primary care provider. However, more than 10 percent of all people were unable to obtain or delayed obtaining necessary medical care, dental care, or prescription medicines.Physician AssistantsState Medicaid Programsunnamed generic groupAlaska NativesRural CommunitiesCommunity Health WorkersCommunity-Based OrganizationsAmerican Indiansunnamed generic groupFaith-Based Providersunnamed generic groupUnderserved CommunitiesCommunity OrganizationsPatientsPromotores de SaludPrimary Care ProvidersWomenHealthcare ProvidersPopulations at RiskConsumersHealth Care Providersunnamed generic groupTribesFaith-Based Organizationsunnamed generic groupunnamed generic groupSkilled Nursing FacilitiesPatientsTerritorial GovernmentsPatientsMakers of Medical Productsunnamed generic groupCommunity OrganizationsHealthcare OrganizationsCommunity OrganizationsSafety-Net ProvidersHealthcare WorkforceHealthy AmericansStatesUnborn ChildrenNewbornsWomenThe 2016 National Health Interview Survey reports that 4.4 percent of people failed to obtain medical care due to cost, with adult women more likely than adult men to have failed to obtain needed medical care due to cost.Payersunnamed generic groupHealth InsurersFaith-Based OrganizationsOutpatientsHealthcare ProvidersStatesunnamed generic groupHealthcare WorkforceTo improve health in the United States, the Department is working to strengthen and expand the healthcare workforce. In 2010, the U.S. primary care workforce comprised nearly 295,000 primary care professionals, including more than 208,000 physicians, more than 55,000 nurse practitioners, and more than 30,000 physician assistants. Yet the United States lags behind more than 25 other countries in the number of doctors per capita, with only 2.6 physicians per 1,000 people. While the number of physician assistants is projected to grow by almost 72 percent by 2025, the growth rate may not provide a sufficient number of providers to address the projected primary care physician shortage.Familiesunnamed generic groupunnamed generic groupLong-Term Care FacilitiesYoung AmericansHealthcare WorkforceUnderserved AreasPersons of FaithCommunity Partnersunnamed generic groupRural AreasOutpatient DepartmentsDoctorsPurchasers of Health Insuranceunnamed generic groupCaregiversPublic Health PractitionersEmployeesAccrediting OrganizationsPrimary Care PracticesFaith-Based OrganizationsConsumersTribal CommunitiesProvidersMedicare ProvidersAmbulatory Surgery LocationsAmerican IndiansSome populations, including American Indians and Alaska Natives, experience unique challenges when attempting to access care, due to factors such as inadequate supply of healthcare providers and geographic barriers.Medicare EnrolleesPersons of FaithFamiliesunnamed generic groupunnamed generic groupunnamed generic groupunnamed generic groupMedicare BeneficiariesIndividuals at RiskPublic Health WorkersHome Servicesunnamed generic groupHealthcare OrganizationsFamiliesunnamed generic groupunnamed generic groupPrimary Care ProvidersRural CommunitiesPregnant WomenHealthcare TeamsMedicare EnrolleesCommunity-Based ServicesAmerican ChildrenNurse Practitionersunnamed generic groupunnamed generic groupHealthcare Providersunnamed generic groupCliniciansunnamed generic groupHHS DivisionsWithin HHS, the following divisions are working to reform, strengthen and modernize the Nation's healthcare system:Medicaid ProvidersHealthcare ConsumersEmployersMakers of MedicationsHealthcare Consumersunnamed generic groupCommunity Organizationsunnamed generic groupunnamed generic groupTribal GovernmentsTribesunnamed generic groupRural AreasImproving access to healthcare is not just a matter of making it more affordable; services -- including specialized services -- are often not available within a person’s geographic area, or do not offer culturally responsive care, or are available only after delays. Inadequate access to healthcare can exacerbate health problems, increasing costs and preventing better health outcomes. For example, in 2014 - 2015, 17.3 percent of adults aged 18 to 64 had no usual source of healthcare. In 2016, only 84.7 percent of children age 2 to 17, and fewer than 65 percent of adults aged 18 and over, had a dental visit in the past year. And although 14 percent of Americans live in rural areas, only 9 percent of the Nation’s physicians practice there, despite the fact that rural residents are more likely than their urban counterparts to have higher rates of cigarette smoking, high blood pressure, and obesity.Rural Areasunnamed generic groupunnamed generic groupCaregiversTribal PopulationsFor Tribal populations, the Department plans and constructs healthcare facilities, youth regional treatment centers for substance abuse, small ambulatory care facilities, and other healthcare resources to eliminate geographic barriers that can prevent people from accessing care. In addition, the Department continues to be committed to implementing Executive Order 13166, Title VI of the Civil Rights Act of 1964, Sections 504 and 508 of the Rehabilitation Act of 1973, the Americans with Disabilities Act of 1990, the Age Discrimination Act of 1975, Section 1557 of the Patient Protection and Affordable Care Act to support access to care and prevent discriminatory practices, and authorities that protect religious freedom and the exercise of conscience rights.Behavioral Health ProvidersMedicaid EnrolleesPeople with Disabilitiesunnamed generic groupMedicaid Enrolleesunnamed generic groupCaregiversHealthcare Providersunnamed generic groupunnamed generic groupunnamed generic groupunnamed generic groupunnamed generic groupunnamed generic groupAffordabilityPromote affordable healthcare, while balancing spending on premiums, deductibles, and out-of-pocket costsObjective_1737663f-4cdd-4766-85c5-9a8590a5de451Performance Goals: * Reduce the average out-of-pocket share of prescription drug costs while in the Medicare Part D Prescription Drug Benefit coverage gap for non–Low-Income Subsidy Medicare beneficiaries who reach the gap and have no supplemental coverage in the gap * Increase the percentage of Medicare Fee-for-Service payments tied to alternative payment models. Affordability is a key component of accessible healthcare. For individuals and families, high costs of care create economic strain. Americans often have to choose between spending a higher proportion of wages on healthcare and paying for other household essentials. Without timely access to healthcare services, Americans risk worsening healthcare outcomes and higher costs. Yet for many, costs make healthcare out of reach. In 2016, the Federal Government accounted for 28 percent of healthcare spending; households, 28 percent; private businesses, 20 percent; and State and local governments, 17 percent. National Health Expenditure data show that growth in spending is due to expanded coverage and increased utilization of healthcare. HHS is committed to lowering healthcare costs for Americans to affordable levels and minimizing the burden of government healthcare spending. By increasing consumer information, offering lower-cost options and innovation in payment and service delivery models, and promoting preventive care and market competition, HHS is working with its partners to reduce the burden of higher healthcare costs. HHS is providing guidance, resources, and flexibility for States to enable them to construct competitive, affordable insurance options that best meet the needs of their citizens. Through the Quality Payment Program authorized by the Medicare Access and CHIP Reauthorization Act of 2015 (Pub. L. 114-10), the Department has new ways to provide incentives to pay physicians and other practitioners for providing cost-effective, high-quality care to Medicare beneficiaries, and to provide incentives for physicians to participate in alternative payment models, which reward value over volume. HHS tests and evaluates alternative payment models that bring together private payers, healthcare providers, State partners, consumer groups, beneficiaries, and others. These models aim to reduce costs and improve the quality of care for beneficiaries, including those in at-risk populations. In 2016, data on 245.4 million people, representing 84 percent of the publicly and commercially insured population in the United States, revealed that 57 percent of healthcare spending occurred within some payment structure tied to quality, including care coordination, pay-for-performance, or shared savings. Data and evidence from these innovative models are used to inform State and Federal policymakers of the methodologies that work to reduce healthcare costs and improve quality.FDAAHRQCMSOptionsPromote higher-value and lower-cost healthcare options.Objective_4bfebbaf-ab22-434d-8e1f-0f616b6e31022In 2016, the average household experienced increases in healthcare spending of 6.2 percent, primarily due to increased health insurance expenditures. Out-of-pocket spending grew 2.6 percent, physician and clinical services expenditures grew 6.3 percent, and prescription drug spending increased 9.0 percent. The Department is promoting higher-value and lower-cost healthcare options through the following strategies:unnamed organisationHealthcare ProvidersPromote the use of high-quality, lower-cost healthcare providers, such as community health workers and community organizations, where appropriateObjective_06be420e-c20c-41dc-a7a5-2b9bad944f323Healthcare ProvidersCommunity Health WorkersCommunity OrganizationsSettingsPromote better coordination and efficiency in post-acute care by discharging patients to appropriate settings, including home and community-based services and skilled nursing facilities, using site-neutral payment ratesObjective_86c69c62-0aa7-4067-bfa5-dd30a2f8b43f4Home ServicesCommunity-Based ServicesSkilled Nursing FacilitiesPrescription DrugsPromote greater affordability of prescription drugs.Objective_e83dd30c-6b79-402f-93c2-e9431be9f42a5Prescription drug spending growth is projected to grow an average of 6.3 percent per year through 2025. Spending growth is attributed to increased spending on new medicine, price growth for existing brand-name drugs, and fewer expensive drugs going off patent. The Department is working to promote greater affordability of prescription drugs through the following strategies:unnamed generic groupAccess & CompetitionExpand access to high-quality, safe, affordable generic medicines by streamlining the generic drug application review process, enhancing the development and review of complex generic drug products, and otherwise facilitating entry of lower-cost alternatives, to increase competition in the market for prescription drugsObjective_f536ade8-a4e1-4588-ac18-229ef6d817066unnamed generic groupApplication ProcessStreamline the generic drug application review process.Objective_a039a2d7-e4ba-474c-aae6-988427afb94b7unnamed generic groupComplex DrugsEnhance the development and review of complex generic drug products.Objective_ccd1c51d-fb6f-464f-ab74-8db72fb4c18a8unnamed generic groupAlternativesFacilitate entry of lower-cost alternativesObjective_afed269d-1cf7-450b-ad82-2aeec32e1a6d9unnamed generic groupGenericsPromote the use and benefits of generics through beneficiary and partner educational campaigns aimed at helping those paying for the medications to better recognize the value they presentObjective_0267e0e7-34cd-4457-be13-d78771269b4510unnamed generic groupOutpatient DrugsContinue to offer outpatient drugs to eligible healthcare organizations at reduced prices through the 340B Drug Pricing ProgramObjective_66788c55-52b4-4c0d-ae20-ae215ac424f311Healthcare OrganizationsOutpatientsDataCollect, analyze, and apply data to improve access to affordable healthcare.Objective_49fac423-f84c-476e-af9f-e8f0b5b750ab12From 2000 to 2015, national health expenditures increased from 13.3 percent to 17.8 percent of the U.S. Gross Domestic Product. Per capita expenditures rose from $4,857 to $9,990 per person. More than 16 percent of people under age 65 reported that their family spent more than 10 percent of total family income on health insurance premiums and out-of-pocket costs in 2014. The Department will continue to collect, analyze, and apply data to improve access to affordable healthcare through the following strategies:unnamed generic groupCostsProvide information on the prevalence, causes, and consequences of high healthcare financial costs, including social factors that exacerbate costsObjective_104c4913-ee52-4814-a160-aee89a223e9913unnamed generic groupEducation & InformationPartner with States, community organizations, and the private and nonprofit sectors to educate Americans about their health insurance coverage options and how they can identify the best plan for themselves, and to provide information on how Americans can access and use their benefitsObjective_309977e6-2b28-409e-a083-c08186ac86e014Private SectorStatesNonprofit SectorCommunity OrganizationsPremiums, Payments, Deductibles & MaximumsTrack trends in premiums, out-of-pocket payments, deductibles, and out-of-pocket maximums in health insurance plansObjective_6ec81c0f-35dc-4f23-9716-8456e55629a015unnamed generic groupDigital StrategiesEnhance digital strategies to empower consumersObjective_599750f8-124c-490e-8e76-66ee37e486ea16unnamed generic groupRegulatory RequirementsExamine regulatory requirements that may differentially burden providersObjective_b3264b1e-5569-4bd0-9506-4e3d009dffd317unnamed generic groupPreventive CarePromote preventive care to reduce future medical costs.Objective_7b687be4-d63b-4f72-ae41-b5af7a375c6918Chronic diseases, such as heart disease, cancer, and diabetes, are responsible for 7 of every 10 deaths among Americans each year and account for 75 percent of the Nation’s health spending. The Department is working to promote preventive care to reduce future medical costs through several strategies: Note: Additional strategies on preventive care are in Strategic Objectives 2.1, 2.2, and 2.3.unnamed generic groupPrenatal, Maternal & Postpartum CareReduce the need for avoidable medical costs and improve health outcomes of pregnant women and newborns by increasing use of timely prenatal, maternal, and postpartum careObjective_1f192018-003c-4e29-b72d-75f558c6a4d919Pregnant WomenNewbornsDiabetes & Cardiovascular DiseasePromote and implement lifestyle change interventions and intensive case management to reduce risk of diabetes and cardiovascular disease in high-risk individualsObjective_c495071f-90cd-4945-9355-7493c59012cf20unnamed generic groupChronic ConditionsProvide chronic care management services to patients with multiple chronic conditions, including comprehensive care management, a care plan, and care transitionsObjective_6c840683-cb94-490e-9c5f-e933872ed1e321unnamed generic groupCost & ValueStrengthen consumer decision making and transparency about the cost and value of healthcareObjective_5987252c-2c24-46f9-952c-a54aad08499322In 2015, approximately 20.1 million people in the United States delayed medical care during the preceding year because of worry about the cost, and 14.2 million did not receive needed medical care because they could not afford it. The Department is working to strengthen informed consumer decision making and transparency about the cost and value of healthcare through the following strategies:Healthcare ConsumersComparison & Decision-MakingEnhance comparison and decision-making tools, such as Hospital Compare and Nursing Home Compare, to help Americans make informed decisions about healthcare, including coverage options, providers, and treatmentsObjective_06984f69-23cb-4577-b2d2-80eacde7ff6223unnamed generic groupSpending, Services & SupportBuild out and broaden models, such as Medicaid's Self Directed Services, that allow beneficiaries the option of managing more of their healthcare dollars, services, and supportsObjective_b35b9847-6edc-44b2-b583-44911f271b7a24MedicaidHealth LiteracySupport health literacy tools, such as Coverage to Care or the Person and Family Engagement Strategy, which focus on increasing health literacy and consumer connections to healthcare, as well as partnership efforts to promote understanding of health coverage, costs, and terminology, so that consumers can choose the most appropriate, affordable health plan to receive the healthcare services they needObjective_a6e45f96-cdd1-4f4d-bfb5-e7547238a57125unnamed organisationIndividual MarketStabilize the market, implement policies that increase the mix of younger and healthier consumers purchasing plans through the individual market, and reduce premium increasesObjective_e4916c9c-2433-4f60-999d-a048ad27a88926Healthy AmericansYoung AmericansEligibility & EnrollmentStreamline eligibility and enrollment processes for community supports so that all populations have access to the services they needObjective_01982f49-80c9-494b-8c04-305478b5e52427unnamed generic groupQuality & ValueIncentivize healthcare quality and value-based care.Objective_fc0f506d-743a-4720-b298-ed35bddd8bbb28Value-based programs reward healthcare providers with incentive payments for the quality of care they provide. These programs seek to achieve better care for individuals, better health for populations, and lower costs overall. The Department is working to incentivize healthcare quality and value-based care through the following strategies: Note: Additional healthcare quality strategies are in Strategic Objective 1.2.unnamed generic groupRisk & DetectionPromote the application of proven clinical preventive services for high-impact risk factors and early-stage disease detection, through Federal guidelines, quality measurement, and partnerships with accrediting and other organizationsObjective_a7e7351c-fff8-4518-860f-aa96fdc8417d29Accrediting OrganizationsROIImprove return on investment of Federal and State spending by encouraging development of payment models that reward value over volume Incentivize better planning, coordination, and management of services across the continuum of care to improve outcomes for people with chronic conditionsObjective_d38857fe-8b29-4209-8d30-5744fb676bf730unnamed generic groupModelsBuild out and broaden models that improve quality and reduce costsObjective_21f135bd-4d16-4aa7-b611-3a14639b60e531unnamed generic groupOptions, Innovation & CompetitionExpand safe, high-quality healthcare options, and encourage innovation and competitionObjective_c29bbf5e-6bca-42d1-b3ba-baa694c19f3432Performance Goals: * Increase the percentage of hospitals reporting implementation of antibiotic stewardship programs fully compliant with the CDC Core Elements of Hospital Antibiotic Stewardship Programs * Reduce the all-cause hospital readmission rate for Medicare-Medicaid enrollees * Meet the following patient safety goals: - Improve hospital patient safety by reducing preventable patient harms - Reduce the standardized infection ratio for central line–associated bloodstream infections in acute care hospitals - Reduce the standardized infection ratio for hospital-onset Clostridium difficile infections. Strengthening the Nation's healthcare system cannot be achieved without improving healthcare quality and safety for all Americans. The immediate consequences of poor quality and safety include healthcare-associated infections, adverse drug events, and antibiotic resistance. Healthcare safety is a national priority. When the Office of Inspector General examined - PDF the health records of hospital inpatients in 2008, it determined that hospital care contributed to the deaths of 15,000 Medicare beneficiaries each month. Healthcare-associated infections are infections people get while they are receiving medical treatment or undergoing surgery. At any given time, about 1 in 25 patients have an infection related to hospital care. Infections lead to the loss of tens of thousands of lives and cost the U.S. healthcare system billions of dollars each year. Adverse drug events -- injuries resulting from medical intervention related to a drug -- result in more than 3.5 million physician office visits, 1 million emergency department visits, and 125,000 hospital admissions each year. Antibiotic overuse has contributed to Clostridium difficile infections, the most common microbial cause of healthcare-associated infections, responsible for more than half a million infections and nearly 15,000 deaths in a single year. And each year in the United States, 2 million people become infected with antibiotic-resistant bacteria, directly resulting in the deaths of 23,000 people each year, as well as $20 billion in increased healthcare costs and $35 billion in lost productivity. Yet these consequences are preventable. Recognizing the unique challenges of different healthcare settings -- including acute care hospitals, ambulatory surgical centers, dialysis centers, and long-term care facilities -- HHS has developed specific strategies to reduce the incidence and impact of healthcare-associated infections in these settings. Through surveillance, antibiotic stewardship, diagnostic innovations, and research strategies, HHS is working to combat antibiotic-resistant bacteria. HHS also focuses on three key drug classes -- anticoagulants, diabetes, and opioids -- to prevent adverse drug events. HHS investments in prevention have yielded both human and economic benefits. From 2010 to 2014, efforts to reduce hospital-acquired conditions and infections have resulted in a decrease of 17 percent nationally, translating to 87,000 lives saved, $19.8 billion in unnecessary health costs averted, and 2.1 million instances of harm avoided.ONCOCRACLCDCCMSHRSAAHRQSAMHSALong-Term Care FacilitiesAmbulatory Surgical CentersAcute Care HospitalsDialysis CentersIncentivesIncentivize safe, high-quality care.Objective_880ab426-8819-479b-ae86-4b38d644219733Through the Quality Payment Program authorized by the Medicare Access and CHIP Reauthorization Act of 2015 (Pub. L. 114–10), the Department has new ways to provide incentives to pay physicians and other practitioners for providing cost-effective, high-quality care to Medicare beneficiaries, and to provide incentives to physicians to participate in alternative payment models, which reward value over volume. Through these and other efforts, the Department is working to incentivize safe, high-quality care through the following strategies:unnamed generic groupPayment & DeliveryDevelop new payment and service delivery model concepts that aim to reduce healthcare costs by speeding the adoption of best practices, encouraging care coordination, and promoting evidence-based care, and expand opportunities for Medicare and Medicaid alternative payment models to incentivize value-based care optionsObjective_fbc212ba-639f-4cd2-ad63-13129e07374534unnamed generic groupPreventive ServicesImprove provision of, and access to, appropriate preventive services for Medicare beneficiaries, through improved understanding of uptake of preventive benefits, particularly for those individuals who are high riskObjective_d19c5f6e-3cde-465f-b873-aaaf9a7229c235Medicare BeneficiariesMetricsStrengthen the development, implementation, and reporting of measures for reducing health disparitiesObjective_8f357480-46af-42bd-b77b-e58f3ca51c1936unnamed generic groupQuality VariationPromote research on how to recognize variation in quality of healthcare provision due to circumstances outside the control of the providerObjective_488c8701-c7d6-4ea4-bd7b-aa633c54d9c937unnamed generic groupSafety & Adverse EventsImprove patient safety and prevent adverse events.Objective_9390e9c4-5044-4332-ae29-e5c2d7c68eb738The Healthcare-Associated Infections Progress Report found that rates of central line-associated bloodstream infections declined 50 percent from 2008 to 2014, and rates of surgical site infections declined 17 percent, although the rate of catheter-associated urinary tract infections did not change. The 2016 National Healthcare Quality and Disparities Report, which tracks a broad range of patient safety indicators, found that about two-thirds of patient safety measures were improving. The Department continues to work to improve patient safety and prevent adverse events such as healthcare-associated infections and medication harms across the healthcare system through the following strategies:PatientsResearch & InnovationSupport research and innovation to strengthen evidence-based recommendationsObjective_9acb5337-19fb-4d54-933b-13136e22caaa39unnamed generic groupGaps & RisksAddress quality gaps and safety risks for healthcare-associated conditionsObjective_ee3430f8-ce10-4c81-ad6c-a1c36a149f4540unnamed generic groupInfections & Antibiotic ResistanceDevelop improved methods and strategies to prevent healthcare-associated infections and combat antibiotic resistanceObjective_c3dd1e02-06a3-4fc1-870e-ae2e75549a7341unnamed generic groupTools, Training & ResourcesTranslate knowledge and evidence into practical tools, training, and other resources to accelerate progress to improve quality and patient safetyObjective_795582c9-ee8d-4cda-aeb7-0c05a01a511042unnamed generic groupInformation TechnologyLeverage technology solutions to support safe, high-quality care.Objective_bfce4851-6b64-41bf-a97e-9bdef5a5335643The 21st Century Cures Act of 2016 (Pub. L. 114–255) provides the Department with authority to advance the interoperability and usability of health information technology. In 2015, 77.9 percent of office-based physicians had a certified electronic health record system. However, in 2015, only about one-third of physicians had electronically sent, received, integrated, or searched for patient health information with other providers, and only 8.7 percent had performed all four of these activities. In 2015, the Shared Nationwide Interoperability Roadmap was published to enhance the Nation’s health information technology infrastructure to support information sharing. The Department will work to leverage technology solutions to support safe, high-quality care through the following strategies:unnamed generic groupClinical InformationAdvance interoperable clinical information flows so that patients, providers, payers, and others can efficiently send, receive, and analyze data across primary care, acute care, specialty care including behavioral healthcare, and post-acute care settingsObjective_6cc9f80e-70c1-4d86-998c-66924f1f28e444PatientsProvidersPayersTools & WorkflowsPromote implementation of understandable, functional health information technology tools to support provider and patient decision making, and to support workflows for healthcare providers.Objective_829882fb-7606-4669-ad56-76f379c62f1145Healthcare ProvidersTeamsImplement team-based approaches to care.Objective_8172f74e-8534-42af-8450-84c3bf89719646Team-based care is the provision of health services to individuals, families, and communities by at least two health providers who work collaboratively with patients and their caregivers to accomplish shared goals and achieve coordinated, high-quality care. The Department is working to implement team-based approaches to care through the following strategies:Healthcare TeamsInnovation & EvidenceCollaborate with healthcare systems and community partners to facilitate the spread of evidence-based clinical practices and the appropriate incorporation of innovations that advance patient careObjective_aa79f365-cd0a-40e4-acd4-6539d5562a3b47unnamed generic groupConnections & TransitionsPromote and implement models that connect primary care, acute care, behavioral healthcare, and long-term services and supports, and that use health information technology effectively, to facilitate transitions between care settings, especially for dually eligible Medicare-Medicaid enrolleesObjective_912907ec-fbec-4a6b-a08a-88aff4427c1248Medicaid EnrolleesMedicare EnrolleesBehavioral HealthImplement a collaborative model for behavioral health integration with primary care that is team driven, population focused, measurement guided, and evidence based.Objective_c813d382-62ac-4f95-8378-bf685cddc50149unnamed generic groupPerson-Centered CareEmpower patients, consumers, families, and other caregivers to facilitate the delivery and increase the use of person-centered care.Objective_57458038-c989-4eec-88b1-2ea96f8e3bac50Person-centered care is an approach to service delivery that ensures that services are respectful of, and responsive to, the preferences, needs, and values of people and those who care for them. The Department is working to empower patients, consumers, families, and other caregivers to facilitate the delivery and increase the use of person-centered care through the following strategies:CaregiversConsumersPatientsFamiliesEngagementExpand the engagement of patients, families, and other caregivers in developing and implementing programs that improve the quality of care and increase access to services available to themObjective_37b78f7e-d6e3-4f7e-9280-6c7725f156bc51PatientsCaregiversFamiliesExperience & Outcome MetricsPromote the development, implementation, and use of experience and outcome measures, including patient-reported data and price transparency data, as appropriate, for use in quality reportingObjective_436312b7-87ff-403f-b8c2-30b6e591e53552unnamed generic groupCare PlanningSupport patient, consumer, and caregiver involvement in care planning, as appropriate, to ensure that care is person centered, responding to the needs and wishes of those being served, including their religious or conscience needs and wishesObjective_d5e324ac-b523-4072-b97e-7878cd93b81353ConsumersCaregiversPatientsDisparitiesReduce disparities in quality and safety.Objective_fdd6dc23-0a16-4cfb-be66-84ec91e1689f54While patient safety measures have been improving overall, disparities persist. For example, hospital readmissions for conditions like congestive heart failure and pneumonia are higher for people on Medicaid than for Medicare beneficiaries, yet adverse drug events in hospitals are higher among Medicare beneficiaries than for people on Medicaid. The Department is working to reduce disparities in quality and safety through the following strategies: Note: Additional strategies to strengthen the healthcare workforce are in Strategic Objective 1.4.unnamed generic groupHealth Information TechnologyEnhance the use of health information technology among safety-net providers and community-based organizations to inform decision making, better engage people in their care, improve public health outcomes, and increase public health reportingObjective_1ba4f51b-812e-4c03-a3a4-a9351f0b4b5d55Safety-Net ProvidersCommunity-Based OrganizationsCulturally Appropriate CareEncourage and support a healthcare workforce that delivers culturally appropriate care, across all settingsObjective_7bae1f2a-9248-44c7-9a98-045c05e8b23c56Healthcare WorkforcePerson-Centered CareIncrease capacity to provide person-centered care by promoting geriatric-competent, disability-competent, and culturally competent care through training programs that teach these concepts and require practicing themObjective_2b68ddec-0218-4d5c-a632-01d77b8588a957unnamed generic groupTraining & AssistancePromote technical training and assistance to disseminate promising practices around geriatric-competent, disability-competent, and culturally competent careObjective_42ebcb54-8f5f-4e9c-9786-9a8082ef385558unnamed generic groupInformation Levels & FormatsProvide health information in culturally appropriate and health-literacy-appropriate levels, and in alternative formats, such as in languages other than English, to improve access to health informationObjective_f2b10ef3-7686-4a2d-8012-16a9b4765e6f59unnamed generic groupRisk FactorsConduct, fund, and apply research on the role of other risk factors and their impact on health, as appropriate, to improve health outcomes, including access, quality, and safetyObjective_041a1fd4-9d71-4133-9b16-9f4b7d4e2aa060unnamed generic groupDataCollect, analyze, and apply data to improve access to safe, high-quality healthcare.Objective_bc2ec4fe-86b7-4aea-9dd1-e2a436b575ed61The two primary systems for tracking progress toward safe, high-quality healthcare are the National Healthcare Quality and Disparities Report, which directly tracks measures of healthcare quality, and Healthy People, which tracks measures of health. Both reports noted significant variation in the proportion of healthcare quality measures that were improving in relation to sex, race/ethnicity, socioeconomic status, disability status, and geographic location. The Department will continue to work to collect, analyze, and apply data to improve access to safe, high-quality healthcare through the following strategies:unnamed generic groupEvidence & ImprovementImprove quality in healthcare delivery by helping healthcare organizations apply evidence for continuous policy, process, and outcomes improvement, such as through Medicare's Quality Payment ProgramObjective_245bc21d-5cfb-41e8-a264-c537269bec8a62MedicareHealthcare OrganizationsPerformance DataExpand measurement and reporting of stratified performance data to identify health disparities, show gaps in access to safe, high-quality healthcare options, and enable quality improvementObjective_cc16714a-2630-4dac-867a-bf29386e917463unnamed generic groupAccess, Engagement & PracticesCollect additional data that will allow HHS to identify barriers to access, facilitate consumer engagement, and promote evidence-based practices, to improve access to physical and behavioral health servicesObjective_10eeb3c2-6873-44a0-aa7f-9e17346eebf964unnamed generic groupQuality & DisparitiesMeasure and report on healthcare quality and disparities at the national, State, Tribal, local, territorial, and individual provider level to facilitate a more complete understanding of the factors that may influence healthcare quality and lead to improvements in the healthcare systemObjective_cf6fa7ba-efce-4fa9-8cd0-37d515c2c3d565Health Care ProvidersCommunication & CoordinationSupport communication and coordination between public health practitioners and clinicians to improve use of data and increase use of evidence-based prevention strategies to address risk factors, and their underlying causes, for disease and health conditions, and implement rapid responses to address outbreaks of infectious diseaseObjective_36aa8c4e-99d0-419a-9d73-8b0db575a3f166Public Health PractitionersCliniciansAccess & OptionsImprove Americans' access to healthcare and expand choices of care and service optionsObjective_179dead4-cd2f-4d5e-bfae-d188601c32b767Performance Goals: * Track the number of individuals who receive direct services through the Federal Office of Rural Health Policy Outreach grants, subject to the availability of resources * Improve patient and family engagement by improving shared decision making Increase telebehavioral health encounters nationally among American Indians and Alaska Natives. The Department defines access to health services as "the timely use of personal health services to achieve the best health outcomes." It involves gaining entry into the healthcare system, usually through payment; gaining access to diverse options for receiving treatment, services, and products, including physical locations and online options; and having a trusted relationship with a healthcare provider. Efforts to improve access to care are not limited to physical healthcare. Improving access to behavioral and oral healthcare, including through innovative solutions that use health information technology, also is critical, especially for populations experiencing disparities in access. Lack of access to care presents a myriad of problems with both human and economic costs -- including clinically significant delays in care, increased complications, higher treatment costs, and increased hospitalizations. The Department pursues multiple approaches to address barriers to care... To improve outcomes in this objective, HHS is working to address the high cost of care, lack of availability of services, and lack of culturally competent care. Strategies related to promoting affordability and strengthening the workforce are addressed in Strategic Objectives 1.1 and 1.4. This Strategic Objective focuses on how HHS, rather than instituting government mandates, is giving people more control over how they access care, through increasing the spectrum of consumer options and expanding competition among healthcare providers, including by removing barriers to participation in the healthcare sector for religious, faith-based, and other providers.ACLOGAIHSOCRCMSIEAHRSASAMHSAAlaska NativesUninsured PeopleIn 2014, 86.7 percent of people younger than age 65 had health insurance, including government and private coverage, and 76.4 percent of people had a usual primary care provider. However, more than 10 percent of all people were unable to obtain or delayed obtaining necessary medical care, dental care, or prescription medicines.WomenThe 2016 National Health Interview Survey reports that 4.4 percent of people failed to obtain medical care due to cost, with adult women more likely than adult men to have failed to obtain needed medical care due to cost.Tribal PopulationsFor Tribal populations, the Department plans and constructs healthcare facilities, youth regional treatment centers for substance abuse, small ambulatory care facilities, and other healthcare resources to eliminate geographic barriers that can prevent people from accessing care. In addition, the Department continues to be committed to implementing Executive Order 13166, Title VI of the Civil Rights Act of 1964, Sections 504 and 508 of the Rehabilitation Act of 1973, the Americans with Disabilities Act of 1990, the Age Discrimination Act of 1975, Section 1557 of the Patient Protection and Affordable Care Act to support access to care and prevent discriminatory practices, and authorities that protect religious freedom and the exercise of conscience rights.American IndiansSome populations, including American Indians and Alaska Natives, experience unique challenges when attempting to access care, due to factors such as inadequate supply of healthcare providers and geographic barriers.ChoicesImprove consumer choices.Objective_28687d68-07ef-4098-a7d2-31a642d018ae68Executive Order 13765, Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal, and Executive Order 13813, Promoting Healthcare Choice and Competition Across the United States, instituted policies intended to improve consumer choices. In support of these Executive orders, the Department will pursue the following activities:Healthcare ConsumersCosts & BurdensTo the maximum extent permitted by law, waive, defer, grant exemptions from, or delay implementation of any provision or requirement of the Patient Protection and Affordable Care Act that would impose a fiscal burden on any State or cost, fee, tax, penalty, or regulatory burden on individuals, families, healthcare providers, health insurers, patients, recipients of healthcare services, purchasers of health insurance, or makers of medical devices, products, or medicationsObjective_dac8276a-91a7-4008-af82-ca18b2a2fc8669Health InsurersRecipients of Healthcare ServicesIndividualsPurchasers of Health InsuranceHealthcare ProvidersFamiliesPatientsMakers of Medical DevicesMakers of Medical ProductsStatesMakers of MedicationsLimited-Duration InsurancePropose regulations or revise guidance, consistent with law, to expand the availability of short-term, limited-duration insurance, which is exempt from certain Federal insurance mandates and regulationsObjective_43e51462-3828-4286-bf21-88857fe4c2c570unnamed generic groupReimbursementsPropose regulations or revise guidance, to the extent permitted by law and supported by sound policy, to increase the usability of health reimbursement arrangements, to expand employers' ability to offer this option to their employeesObjective_baf2e3cc-1477-4ab4-9922-6e9aaf47748a71EmployeesEmployersOptionsExpand healthcare coverage options.Objective_cd380211-ab57-4cee-98e5-a9df5bbbd3ba72The Department is committed to promoting access to high-quality, affordable healthcare for all Americans, increasing patient choices, and lowering premiums. A key component of current healthcare reform efforts emphasizes price transparency of all healthcare providers, allowing consumers to shop more easily for the best prices for their care. Consumers of healthcare should be able to choose the options that make the most sense for themselves, their families, and their budgets. The Department is working to expand healthcare coverage options through the following strategies:unnamed organisationMedicare Advantage & Part DExpand plan choice in the Medicare Advantage and Part D Prescription Drug programs by reducing administrative, regulatory, and operational burdens, while protecting the integrity and soundness of these programsObjective_7c6cf307-e5f2-4381-bb4b-11e51b54e50273Medicare EnrolleesNew & Innovative ProductsPromote patient access to new and innovative medical products by conducting timely, patient-centered reviews for coverageObjective_bd27d886-c336-41af-8090-1be1cebb777174unnamed generic groupCoverage DecisionsMake information regarding coverage decisions publicly available where possibleObjective_90bc67eb-34c2-47e8-b733-69566a23f84875unnamed generic groupPhysical & Behavioral CareImprove access of Medicare-Medicaid dual enrollees to fully integrated physical and behavioral care options, such as Medicare-Medicaid Plans, Programs of All-Inclusive Care for the Elderly (PACE), and dual-eligible Special Needs Plans, designed to address the unique healthcare needs of dual-eligible individualsObjective_189947e0-88d2-49ea-bd23-518e8ceeefa376Medicaid EnrolleesMedicare EnrolleesEmploymentAllow State Medicaid programs to promote employment, to help improve health outcomes among recipients of medical assistanceObjective_4d3c28ea-0c46-4f13-be1f-23193122be5d77State Medicaid ProgramsAlzheimer's Disease & DementiasEnhance care quality and efficiency by exploring the effectiveness of new models of care and advancing coordinated and integrated health and long-term services and supports for people living with Alzheimer's disease and related dementiasObjective_a847dffe-334c-4ca8-bc2c-d282958cc4f078unnamed generic groupUnderstanding & DecisionsImprove consumer understanding of healthcare options and consumer-directed healthcare decisions.Objective_03182eae-b08f-4674-ab62-54fdbcd4be0479Healthcare reform will focus on improving quality and affordable care for all Americans. The Department is committed to strengthening consumers’ informed healthcare decision making through cost-quality comparisons and tools to reduce individual and overall costs in healthcare. The Department is pursuing the following strategies to improve consumer understanding of healthcare options and consumer-directed healthcare decisions:Healthcare ConsumersCare & Insurance OptionsPromote information and assistance that is accessible, transparent, and provided in understandable formats to ensure that care and insurance options meet consumers' needsObjective_d98cede3-9aaf-4e96-9cc5-bb411723b32f80unnamed generic groupMental Health & AddictionCollaborate across Federal agencies and stakeholders to ensure effective and coordinated implementation and enforcement of mental health and addiction parity lawsObjective_089e6804-4a3f-4129-9307-88d8b0519e8d81unnamed generic groupPayment & Service DeliveryExpand the use of innovative payment and service delivery models, including those to encourage patients to use high-value clinical services and optimize medication use based upon their specific healthcare needsObjective_47750c79-ff25-410d-97c4-3a4481745af082unnamed generic groupBenefits, Fraud & AbuseProvide information through partners and trusted intermediaries, including Tribes and faith-based and other community organizations, on how to access and use benefits and avoid fraud or abuseObjective_d5e79401-96b3-4199-9a23-eb2c3ad87c9683Faith-Based OrganizationsTribesCommunity OrganizationsOptionsDesign healthcare options that are responsive to consumer demands, while removing barriers to participation for faith-based and other community-based providers.Objective_c2d81592-617a-467a-b5da-4a0e5c44167884Evidence supports policies of increasing consumer engagement and public awareness as solutions to reducing healthcare costs, but much remains to be done. Americans may be willing to price-shop, but their priorities for maintaining a preferred provider and the challenges of coordinating care across many providers must continue to be studied for their impact on healthcare reform. The Department is designing healthcare options that are responsive to consumer demands, while removing barriers to participation for faith-based and other community-based providers, through the following strategies:Faith-Based ProvidersCommunity-Based ProvidersGlobal PartnersEngage with global partners to learn about effective healthcare models and best practices that could be used domestically for the benefit of the American peopleObjective_25f1da6d-881e-438d-bafe-df8642e85cc285unnamed generic groupIdeas, Strategies & Best PracticesSeek ideas, strategies, and best practices from the private sector, Tribes, and faith-based and community organizations that can be introduced to Department-administered programs, to meet evolving consumer needsObjective_2c96ec53-ec6b-4122-b893-8ee395a69f9386Private SectorTribesFaith-Based OrganizationsCommunity OrganizationsDisparitiesReduce disparities in access to healthcare.Objective_563c0edb-6e4d-4ad0-9a7b-3f3ee767acf387Despite the Nations advancements in health and medicine, care is still not equally available and accessible across communities, populations, socioeconomic groups, and ethnicities. Disparities in access to, use of, and quality of care can lead to disparities in health outcomes. For example, American Indians and Alaska Natives born today have a life expectancy that is 4.4 years less than that of the average U.S. population. The Department is working to reduce disparities in access to healthcare through the following strategies:unnamed organisationPerson-Centered CareAssess person-centered models of care, including patient-centered medical home recognition and care integration, and support the adoption and evolution of such models that reduce expenditures and improve qualityObjective_7925dd45-d3c7-4576-b635-205fc698a73688unnamed organisationEnrollment, Retention & ProvidersSimplify enrollment, eliminate barriers to retention, and address shortages of healthcare providers who accept Medicare or Medicaid and providers who offer specialized careObjective_2d3a2238-3a2b-4faf-bce1-c8dd3997894989Medicare ProvidersMedicaid ProvidersSpecialized Care ProvidersCoverage OptionsProvide consumers more options to shop for coverage in the individual insurance marketObjective_aeae6dc3-2e07-4d28-8bb1-f63daecbe4f290Healthcare ConsumersHealthcare AccessProvide resources and tools to providers and plans to encourage implementation of activities and strategies to help improve healthcare accessObjective_793eed85-f4ea-49ff-9ee0-fd2a65c5ea5191unnamed organisationChronic DiseaseIncrease access to preventive services, home and community-based services and social supports, and care management in areas and populations with high chronic disease burdensObjective_afcf91d3-d261-45c8-bef1-f409b4032a7292unnamed organisationWomen's HealthIncrease access to preventive services to support women's health, including adaptive mammography equipment in clinics, prenatal/pregnancy care and supports, and lactation accommodations and other breastfeeding supportsObjective_5d8dd888-aef8-4095-af04-d2203d75e69993WomenHealthy PregnancyPromote healthy pregnancy by protecting unborn children from harm through proven strategies such as receipt of adequate prenatal care and the identification and treatment of diabetes and hypertensionObjective_76f2c47e-8d50-44c4-8ac1-35b2937338df94Unborn ChildrenIndividuals & Populations at RiskIdentify individuals and populations at risk for limited healthcare access and assist them to access health services, including prevention, screening, linkages to care, clinical treatment, and relevant support services, including through mobilization of Tribes and faith-based and community organizationsObjective_40cd3983-486c-4bf3-b7dd-c0d8803c1fbc95Populations at RiskIndividuals at RiskPeople with DisabilitiesRemove barriers to inclusion and accessibility for people with disabilities in acute care, post-acute care, and community-based settingsObjective_38c2cb1c-d9a2-4fb3-8801-15e7c5d618f696People with DisabilitiesWorkforceStrengthen and expand the healthcare workforce to meet Americas diverse needsObjective_9be0e616-ff0e-462b-96bb-cb0e6d4d0b1297Performance Goals: Support field strength of the National Health Service Corps through scholarship and loan repayment agreements. Whether people access healthcare in a doctor’s office, in a health center, in a pharmacy, at home, or through a mobile device, they depend on a qualified, competent, responsive workforce to deliver high-quality care. Yet population growth and the aging U.S. population, among other factors, are generating increasing demand for physicians, with demand among the older population expected to grow substantially. From 2014 to 2025, the U.S. population age 65 and older is expected to grow 41 percent, compared with 8.6 percent for the population as a whole and 5 percent for those younger than age 18. Because the elderly have higher healthcare use per capita, compared with younger populations, the increase in demand for healthcare services for older adults is projected to be much greater than the increase in demand for pediatric healthcare. The U.S. Health Workforce Chartbook estimated that more than 14 million individuals -- 10 percent of the Nation's workforce -- worked for the healthcare sector in 2010. The largest health occupation groups were registered nurses; nursing, psychiatric, and home health aides; personal care aides; physicians; medical assistants and other healthcare support occupations; and licensed practical and licensed vocational nurses. Employment in healthcare occupations is projected to grow 19 percent from 2016 to 2026 much faster than the average for all occupations, because of the aging population and increased access to health insurance and medical assistance. HHS regularly produces reports projecting growth or deficits in the supply and demand of various occupations in the healthcare workforce. At a national level, by 2025, demand is expected to exceed supply for several critical health professions, including primary care practitioners, geriatricians, dentists, and behavioral health providers, including psychiatrists, mental health and substance abuse social workers, mental health and substance use disorder counselors, and marriage and family therapists. At a State level, the picture is more complex, with some States projected to experience greater deficits in certain healthcare occupations. For example, rural areas experience greater shortages in the oral and behavioral health workforces. HHS works in close partnership with academic institutions, advisory committees, research centers, and primary care offices. These collaborations help HHS make informed decisions on policy and program planning to strengthen and expand the workforce.OCRCMSSAMHSAIHSCDCHRSADataCollect, analyze, and apply data to understand opportunities to strengthen the healthcare workforce.Objective_93096f27-aeab-43f1-9f84-e38e8de01bf498The Department provides detailed information on 35 healthcare occupations and occupational groupings, describing variations in age, demographics, work settings, and geographic distribution of the healthcare workforce. The Department will collect, analyze, and apply data to understand opportunities to strengthen the healthcare workforce through the following strategies:Healthcare WorkforceCharacteristics, Gaps, Needs & TrendsConduct monitoring, occupational forecasting, data collection and analysis, and general research on the healthcare workforce to identify the characteristics, gaps, needs, and trends, and determine where to target resources to strengthen the workforceObjective_efd6ad0d-9e20-4637-8d25-8098f410dee799unnamed generic groupAmbulatory CareCollect data on ambulatory care services in hospital emergency and outpatient departments and ambulatory surgery locations, to estimate the number of physicians needed to provide careObjective_26674a2e-e6d2-49bd-ab6d-4425f20b0960100PhysiciansAmbulatory Surgery LocationsHospital Emergency DepartmentsOutpatient DepartmentsProfessional DevelopmentSupport professional development of the workforce.Objective_26f0ada1-08a2-4eb7-b42a-e5169fef557f101Training, fellowships, and other opportunities not only strengthen the healthcare workforce, help them learn new skills, and advance their careers, but also result in better care. The Department is supporting professional development of the workforce through the following strategies:Healthcare WorkforceSafety & Scientific KnowledgeIncrease awareness and promote use of clinical decision support and patient-provider communication tools, and share evidence-based practices and training opportunities to provide safety and scientific knowledge to the workforceObjective_d85465ca-9e73-4e4a-abb9-454a54c23f09102unnamed generic groupHealth OccupationsExpand and transform the healthcare workforce through the training and engagement of emerging health occupations, such as community health workers and promotores de salud, and community partners to enhance the provision of culturally, linguistically, and disability-appropriate services, and increase workforce diversityObjective_99fd63d7-cefa-465e-b347-e18a1ed1dfed103Promotores de SaludCommunity PartnersHealthcare WorkforceCommunity Health WorkersClinical TrainingTransform clinical training environments to develop a healthcare workforce that maximizes patient, family, and caregiver engagement and improves health outcomes for older adults by integrating geriatrics and primary careObjective_2b10e1a9-453b-42e6-aec4-c20e13e9921b104unnamed generic groupCompetency TrainingIncrease access to quality trainings for public health workers that address cross-cutting competenciesObjective_a6974bfe-ddb6-48ea-aafd-acccd511ee08105Public Health WorkersProvider ShortagesReduce provider shortages in underserved and rural communities.Objective_7cd91995-61b8-4fe7-9995-7dd8d2a9eae7106Throughout the United States, some geographic areas, populations, and facilities have too few primary care, dental, and mental health providers and services, and are classified as Health Professional Shortage Areas. The Department is working to reduce provider shortages in underserved and rural communities through the following strategies:Underserved CommunitiesRural CommunitiesPrimary Care & Behavioral Health ProvidersSupport the training, recruitment, placement, and retention of primary care providers and behavioral health providers in underserved and rural communities through scholarships, student loan repayment, local recruitment, externships, and other incentivesObjective_e5203201-f14e-4e8a-aa34-9f16e4a3fc50107Underserved CommunitiesRural CommunitiesPrimary Care ProvidersBehavioral Health ProvidersIncentivesIncentivize healthcare providers to work in underserved and rural areas, including Tribal communitiesObjective_a170c756-a9b6-4468-8d01-ca8216148ab4108Tribal CommunitiesUnderserved AreasRural AreasHealthcare ProvidersMental DisordersAssist primary care practices in integrating services for mental disorders, including substance use disorders, to expand access in underserved and rural communitiesObjective_0fe84fb0-5d31-4820-8589-4abbcd64f69d109Primary Care PracticesRural CommunitiesUnderserved CommunitiesBehavioral & Oral Health ServicesImprove access to behavioral and oral health services in underserved and rural communities by supporting the recruitment, placement, and retention of behavioral health, dental health, and primary care providers to address workforce shortages, reduce disparities, and ensure an equitable workforce distributionObjective_c3aa22e8-f85d-4056-9a9e-a44270b8f840110Behavioral Health ProvidersDental Care ProvidersPrimary Care ProvidersTelehealth & TechnologyUse telehealth and technology solutions to increase access to and improve quality of care in rural and underserved areas, including for American Indians and Alaska NativesObjective_6a6035c6-a843-4c12-8b51-386cc6e7a526111Rural AreasUnderserved AreasAmerican IndiansAlaska NativesReligious FreedomSupport religious freedom and ensure removal of barriers to participation in healthcare for healthcare providers with religious beliefs or moral convictionsObjective_968e0943-496f-40b0-8b31-787b9e8b0310112Executive Order 13798, Promoting Free Speech and Religious Liberty, instituted a policy that protects the freedom of Americans and their organizations to exercise religion and participate fully in civic life without undue interference by the Federal Government. In addition, there are long-standing laws, applicable to HHS and its programs, which protect the religious liberty and conscience rights of healthcare providers and others. In support of religious freedom, and to ensure removal of barriers to participation in healthcare for healthcare providers with religious beliefs or moral convictions, the Department will pursue the following activities:Healthcare ProvidersLaws, Regulations & AuthoritiesVigorously enforce laws, regulations, and other authorities protecting religious freedom and conscience in HHS-funded, HHS-regulated, HHS-conducted, and/or HHS-administered programs or activities, and engage in related outreachObjective_3901b5f1-8db5-4e5f-8eb3-ea3838d97071113unnamed generic groupBarriers & BurdensIdentify and remove undue barriers to, or burdens imposed on, the exercise of religious beliefs and/or moral convictions by persons or organizations partnering with or served by HHS, and affirmatively accommodate such beliefs and convictions, to ensure full and active engagement of persons of faith or moral conviction and of faith-based organizations in the work of HHSObjective_85f65b48-f4bb-4627-99d9-6a4e555c59fd114Faith-Based OrganizationsPersons of FaithParticipationPromote equal and nondiscriminatory participation by persons of faith or moral conviction and by faith-based organizations in HHS-funded, HHS-regulated, HHS-conducted, and/or HHS-administered programs or activities, including through outreach, education, and capacity buildingObjective_657c5362-3302-4212-b18a-bea57a55b7b0115Faith-Based OrganizationsPersons of FaithHealth ProtectionProtect the Health of Americans Where They Live, Learn, Work, and PlayGoal_bf6a727c-3267-42ff-b17b-c184561549b62Healthy living involves more than avoiding risky behavior and disease; health and wellness improve with healthful eating, regular physical activity, preventive care, and positive relationships. Yet in 2015, 30 percent of adults did not engage in any leisure-time physical activity, and from 2011 to 2014 only 28.9 percent of adults had a healthy weight. The Department invests in health promotion and wellness activities, including health literacy, to help Americans take control over their health. Beyond ensuring Americans have the resources they need to make healthier living choices, health promotion efforts also involve focusing on environmental health and reducing the burden caused by disease and other conditions. Nine of the 10 leading causes of death in 2015 were caused by communicable and chronic disease—heart disease, cancer, chronic lower respiratory diseases, stroke, Alzheimer’s disease, diabetes, influenza and pneumonia, kidney disease, and suicide. Together, these causes of death accounted for an estimated 74 percent of the 2.6 million deaths recorded in 2015. In some cases, Americans may have multiple chronic conditions at the same time, creating functional limitations and increasing the risk of mortality. Approximately one in four Americans has multiple chronic conditions. In addition to chronic conditions, the Department is working to prevent, treat, and control communicable diseases that pose a threat to the health of Americans. Although rates of new infections of HIV have declined for the last decade, nearly 40,000 people were diagnosed with HIV in 2015. New infections of hepatitis A, as well as acute hepatitis B and hepatitis C and chronic hepatitis B, increased in 2015. Most recently, the Nation has witnessed the emergence and outbreak of communicable diseases including severe acute respiratory syndrome (SARS), pandemic influenza A (H1N1), Ebola, and Zika virus. Millions of adolescents and adults across the Nation are affected by mental and substance use disorders. In 2016, an estimated 44.7 million adults, or 18.3 percent of all adults in the United States aged 18 or older, had a mental illness. Of those 44.7 million adults, an estimated 10.4 million were diagnosed with a serious mental illness. In 2016, approximately 20.1 million people in the United States aged 12 or older had a substance use disorder related to alcohol or illicit drug usage. Of 176.6 million alcohol users, an estimated 17 million have an alcohol use disorder, and excessive alcohol use is responsible for 88,000 deaths each year. The Surgeon General’s Report on Alcohol, Drugs, and Health highlights the important health and social problems associated with alcohol and drug misuse in the United States. The most common substance use disorder among illicit drug users involved marijuana and prescription pain relief medication. The issue of co-occurring mental illness and substance use disorders is also a public health concern. In 2016, an estimated 7.9 million adults aged 18 or older had co-occurring mental and substance use disorders. In 2017, large parts of the United States saw public health emergencies caused by natural disasters, including Hurricanes Harvey, Irma, Maria, and Nate, affecting several southeastern States and territories, and wildfires in California. In addition to natural disasters, the Nation also saw adverse health effects of recent outbreaks of Ebola and Zika virus, calling for raised awareness and actions from both domestic and international partners. Preparing for and addressing the immediate and persisting health impacts that stem from natural disasters, naturally occurring diseases and illnesses, and chemical, biological, radiological, or nuclear agents is critical to securing and maintaining a healthy population. The Department works every day to improve public health. This work is achieved through strategic partnerships with State, Tribal, local, territorial, and nongovernmental organizations within the United States. Partnerships, including with Tribes and faith-based and community organizations, are critical to promoting healthy living and addressing factors that influence the health of Americans. In addition, the Department actively provides leadership and expertise in global health diplomacy to contribute to a safer, healthier world. Through relationships with other Federal agencies and departments, multilateral organizations, foreign governments, ministries of health, civil society groups, and the private sector, the Department creates and maintains the pathways to apply expertise globally, learn from overseas counterparts, and advance policies that protect and promote health within our borders and worldwide.NIHunnamed organisationAdministration for Community Living (ACL)SAMHSAunnamed organisationOffice of the Assistant Secretary for Health (OASH)unnamed organisationunnamed organisationCMS unnamed organisationIHSunnamed organisationunnamed organisationAgency for Healthcare Research and Quality (AHRQ)unnamed organisationCenters for Disease Control and Prevention (CDC)unnamed organisationACFOffice of the Assistant Secretary for Public Affairs (ASPA)IHSCDCunnamed organisationOCRunnamed organisationOASHunnamed organisationOASHunnamed organisationOffice for Civil Rights (OCR)SAMHSAunnamed organisationACLHRSAFood and Drug Administration (FDA)CDCCMSunnamed organisationSAMHSAunnamed organisationHRSAunnamed organisationunnamed organisationFDAIEAOASHATSDRIHSASPAOCROCRunnamed organisationunnamed organisationFDAOffice of Global Affairs (OGA)unnamed organisationunnamed organisationAHRQACLunnamed organisationHRSAunnamed organisationunnamed organisationMedical Reserve CorpsCDCOSSIunnamed organisationOGAunnamed organisationOffice of Intergovernmental and External Affairs (IEA)NIHASPRunnamed organisationOGAIHSunnamed organisationunnamed organisationNIHACLCMSunnamed organisationASPAFDAASPROffice of Security and Strategic Information (OSSI)unnamed organisationHealth Resources and Services Administration (HRSA)unnamed organisationunnamed organisationNational Disaster Medical Systemunnamed organisationCDCunnamed organisationOGAAgency for Toxic Substances and Disease Registry (ATSDR)unnamed organisationSubstance Abuse and Mental Health Services Administration (SAMHSA)ASAHRSAunnamed organisationunnamed organisationunnamed organisationACFNational Institutes of Health (NIH)unnamed organisationunnamed organisationIndian Health Service (IHS)Centers for Medicare & Medicaid Services (CMS)SAMHSAunnamed organisationOffice of the Assistant Secretary for Administration (ASA)U.S. Public Health Service Commissioned CorpsFDAIEAunnamed organisationunnamed organisationOffice of the Assistant Secretary for Preparedness and Response (ASPR)Administration for Children and Families (ACF) U.S. Public Health Service Commissioned CorpsACFPeople with Mental IllnessPublic Health ProvidersMental Health WorkersIntergovernmental Organizationsunnamed generic groupunnamed generic groupHealth Systemsunnamed generic groupPublic Health OfficialsFaith-Based PartnersCommunity OrganizationsCommunity OrganizationsLocal CoalitionsFirst RespondersEmergency Preparedness Workforceunnamed generic groupEmergency Response Workforceunnamed generic groupunnamed generic groupCommunitiesunnamed generic groupStatesStatesunnamed generic groupOutpatient SettingsChildrenEmergency ManagersVolunteer Health ProfessionalsCommunity OrganizationsPublic Health Providersunnamed generic groupunnamed generic groupunnamed generic groupDiverse Populationsunnamed generic groupunnamed generic groupunnamed generic groupunnamed generic groupPeer Providersunnamed generic groupunnamed generic groupunnamed generic groupHHS DivisionsWithin HHS, the following divisions are working to achieve this goal:Familiesunnamed generic groupState Governmentsunnamed generic groupunnamed generic groupAt-Risk PopulationsTribesHealth FacilitiesTribesunnamed generic groupTerritorial GovernmentsIndividualsCommunity Organizationsunnamed generic groupunnamed generic groupunnamed generic groupTribal GovernmentsHuman Service Workersunnamed generic groupunnamed generic groupEmergency ManagersCommunity PartnersNational CoalitionsPublic Health Professionalsunnamed generic groupunnamed generic groupHHS Workforceunnamed generic groupunnamed generic groupunnamed generic groupunnamed generic groupHealthcare ProvidersChildrenFaith-Based OrganizationsCommunitiesunnamed generic groupunnamed generic groupPeople with AddictionParaprofessionalsunnamed generic groupSchoolsHealthcare Providersunnamed generic groupFaith-Based Organizationsunnamed generic groupEmergency Managersunnamed generic groupunnamed generic groupunnamed generic groupCommunitiesunnamed generic groupunnamed generic groupTerritoriesFaith-Based OrganizationsMediaFaith-Based Organizationsunnamed generic groupEmergency DepartmentsInpatient SettingsHuman Services Providersunnamed generic groupStatesHealthcare Providersunnamed generic groupunnamed generic groupHealthcare CoalitionsInteragency Organizationsunnamed generic groupCliniciansunnamed generic groupunnamed generic groupLocal Governmentsunnamed generic groupunnamed generic groupunnamed generic groupTribal OrganizationsRegional CoalitionsIndividuals with Functional & Access NeedsHuman Services ProvidersNongovernmental Organizationsincluding faith-based and community organizationsunnamed generic groupYouthChoicesEmpower people to make informed choices for healthier livingObjective_bd9d8a0d-1e2e-40ed-8fb5-2596456dd0ff1Health promotion and wellness activities involve providing information and education to motivate individuals, families, and communities to adopt healthy behaviors, which ultimately can improve overall public health. However, the lack of access to and understanding of health information can lead people to make uninformed decisions and engage in risky behavior. Inadequate health literacy can lead Americans to make uninformed health choices and engage in behavior that can put their health at risk, such as smoking tobacco. More than 16 million people have at least one disease caused by smoking. The total economic cost of smoking is more than $300 billion per year, including $170 billion in direct medical care for adults and more than $156 billion in lost productivity. Poor nutrition is another health outcome that affects the lives of Americans due to inadequate health education and lack of exposure to nutrition information. The typical American diet exceeds the recommended levels of or limits on calories from solid fats and added sugars, refined grains, sodium, and saturated fat. Additionally, the typical American intake of vegetables, fruits, whole grains, dairy products, and oils is less than is recommended. In the United States, an estimated 80 percent of people do not meet national physical activity recommendations for aerobic exercise and muscle strengthening. Estimates show that about 45 percent of adults in the United States do not engage in sufficient physical activity to achieve health benefits. The level of inadequate physical activity - PDF amounts to an estimated $117 billion in healthcare costs to Americans. Physical inactivity and the resulting health impacts are often due to a lack of health literacy and to health information that is not easy to use or understand. By supporting healthy choices and expanding access to healthier living supports, HHS is helping to curb threats to public health, promote a healthier population, and avoid the economic and human costs of poor health. HHS is working with partners, including faith-based and community organizations, to help people and communities take steps to identify and address priority health issues. The Department supports a series of programs and initiatives aimed at improving nutrition; increasing physical activity; reducing environmental hazards; increasing access to preventive services; and reducing the use of tobacco, alcohol, and illicit drugs and prescription drug abuse. These outcomes are achieved through culturally competent and linguistically appropriate health education, services, and supports made possible through strategic partnerships.NIHOASHFDAIHSACFOGACDCSAMHSAOCRATSDRHRSATobaccoReduce tobacco-related death and disease.Objective_d191f5f4-a598-4256-a1a5-0feddd84449b2Smoking is the leading cause of preventable death, responsible for more than 480,000 deaths per year in the United States. If smoking continues at the current rate among U.S. youth, 5.6 million of today’s Americans younger than 18 years of age are expected to die from a smoking-related illness. The Department is working to reduce tobacco-related death and disease through the following strategies:unnamed organisationHealth EffectsReduce the negative health effects of tobacco use by implementing a comprehensive approach that includes regulating the manufacturing, marketing, and distribution of tobacco products; assisting States to implement proven tobacco-control programs; discouraging people from starting to use tobacco products; and educating parents on the potential harm to their children if the parents smokeObjective_f79c12aa-d8e6-4969-8325-0f0e07abea7c3unnamed organisationRegulationRegulate the manufacturing, marketing, and distribution of tobacco products.Objective_c6e1e399-dbb9-452f-9241-8ef0b44c88994unnamed organisationAssistanceAssist States to implement proven tobacco-control programs.Objective_90138144-3def-4921-99f8-f66318f1d8785StatesDiscouragementDiscourage people from starting to use tobacco products.Objective_a9e9fae8-25e6-4bb3-b8df-49f038f200846unnamed organisationEducationEducate parents on the potential harm to their children if the parents smoke.Objective_f2e4f045-dc0b-4c1b-812a-bb6d35ba70437unnamed organisationCessationReduce the harm caused by tobacco use by educating tobacco users on the availability of smoking cessation programsObjective_ba063196-3a98-410d-b711-20595a3d5ec08unnamed organisationUnderage AccessReduce underage access to tobacco products by ensuring tobacco is not sold to individuals younger than age 18Objective_6fa37c2f-d6c4-493a-8f1a-dcd549ad03349unnamed organisationNutrition & ActivityPromote better nutrition and physical activity.Objective_56669271-935d-410b-9dc2-e6eeb404570910More than one-third of adults in the United States were obese in 2011–2014. For youth aged 2 to 19 years, the prevalence of obesity is about 17 percent, affecting 12.7 million children and adolescents. In that same period, all States had more than 20 percent of adults with obesity. Around $117 billion in healthcare costs are associated with inadequate physical activity. The Department is promoting better nutrition and physical activity through the following strategies:unnamed organisationFood Labeling & Nutrition InformationEnhance understanding of how consumers notice, understand, and act on food labeling and nutrition information, including nutrition facts labels, nutrition product claims, and dietary recommendationsObjective_49909b26-659d-4aea-9695-62da8d7c467b11unnamed organisationObesityDecrease prevalence of obesity by encouraging breastfeeding, promoting healthful food and beverage consumption, and promoting increased physical activityObjective_c6a4044e-ebea-45d0-b438-0d8448f51ea912unnamed organisationBehaviors & Chronic DiseasesReduce chronic diseases and related health behaviors that impact older adults and people with disabilities by adapting and implementing evidence-based programs and policies, such as implementing nutrition standards and guidelinesObjective_659df542-d1fd-4471-a4a5-2aca3ca7e2ff13unnamed organisationHealth EducationIncrease access to health education services, including opportunities to learn about the importance of healthful eating and physical activityObjective_a20dab85-fc4c-465d-852e-48bb0e052c4314unnamed organisationWellness, Activity, Literacy & NutritionForm public-private partnerships to promote health in academic and religious institutions, such as wellness workshops, physical activity, health literacy, and nutritional excellence programsObjective_fa28009b-ae59-43ad-a192-aba369b9ba4c15unnamed organisationNutrition EducationIncrease collaboration with stakeholders, including industry, consumer, and public health groups, to enhance consumer nutrition education directed toward age and demographic groups with specific needsObjective_cdd086f8-0d5e-4de8-a01b-284cdcc8ec6f16unnamed organisationOral HealthPromote oral health.Objective_c758a45e-a3c9-4b20-bfdb-7f9b3a14eb4c17In 2013 - 2014, more than 14 percent of children had untreated dental decay in their primary or permanent teeth, and only 43.1 percent of children, adolescents, and adults had used the oral healthcare system in the last year. The Department is working to promote oral health through the following strategies:unnamed organisationOral Health LiteracyStrengthen oral health literacy, and integrate oral health awareness into clinics, early childhood settings, and social service agenciesObjective_907a53aa-914b-4b57-b438-5f8e8240792318unnamed organisationOral CarePromote dental screenings and preventive oral care for children and adolescentObjective_326b67e7-9663-4301-8f04-90413f3cabb119unnamed organisationInformationEnsure people have the information they need to make healthier living choices.Objective_f53a50c8-be02-4719-85ec-b29f16e9017020Health services should be delivered in ways that are easy to understand and that improve health, longevity, and quality of life. The Department is working to ensure people have the information they need to make healthier living choices through the following strategies:unnamed organisationLanguage & FormatsCommunicate culturally competent and linguistically appropriate messages in plain language, as well as in accessible formats for persons with disabilities, using approaches that leverage new and emerging communications and appropriate messengers, including faith-based and other community organizationsObjective_be7c113b-2226-4675-9394-b1d86eb2f15d21unnamed organisationUnderstandingSupport programs and build partnerships with organizations (including faith-based and community organizations) that build the health literacy skills of disadvantaged and at-risk populations, and promote proven methods of checking understanding to ensure individuals understand health and prevention information, recommendations, and risk and benefit tradeoffsObjective_6907dc6b-92af-410c-a3e3-4f08cdaa79e022unnamed organisationTools & ResourcesEncourage providers to communicate effectively with patients, families, and caregivers by offering tools and resources to assist discussions centered around care and healthier livingObjective_dc2952a7-c52f-4d78-bb2c-64ee5329046523unnamed organisationEnvironmental HazardsSupport development of tools that provide information about potential environmental hazards in the natural and built environmentsObjective_a7a192c3-0552-449c-b7e1-13d005f8a27224unnamed organisationEducation, Training & QualityDevelop tools and resources that improve health department and healthcare setting efficiency in providing education, training, and quality assurance for screening, treatment, services, and prevention messagesObjective_346d436d-c3d5-4027-9836-9af218a8863f25unnamed organisationChoicesPartner with private organizations, including Tribes and faith-based and community organizations, to develop and implement programs to help people make healthy life choicesObjective_effd6a27-f58b-4ba6-9e97-c899335278f426unnamed organisationBehaviorsIncrease awareness of the importance of healthy lifestyle behaviors among patients and caregivers to reduce risk of chronic conditions and other illnessesObjective_f71127cd-8345-45a1-8ae6-1ccbb773e3fa27unnamed organisationInformationEnsure people have the information they need to make healthier living choices.Objective_e0e4073a-4676-4085-b5ee-ecb5bf635f6528Health services should be delivered in ways that are easy to understand and that improve health, longevity, and quality of life. The Department is working to ensure people have the information they need to make healthier living choices through the following strategies:unnamed organisationLanguage & FormatsCommunicate culturally competent and linguistically appropriate messages in plain language, as well as in accessible formats for persons with disabilities, using approaches that leverage new and emerging communications and appropriate messengers, including faith-based and other community organizationsObjective_4038379c-5967-4df1-a36a-5ae251b67d8129unnamed organisationHealth LiteracySupport programs and build partnerships with organizations (including faith-based and community organizations) that build the health literacy skills of disadvantaged and at-risk populations, and promote proven methods of checking understanding to ensure individuals understand health and prevention information, recommendations, and risk and benefit tradeoffsObjective_8f003649-ea9d-4e1b-aeca-69c1c168906130unnamed organisationTools & ResourcesEncourage providers to communicate effectively with patients, families, and caregivers by offering tools and resources to assist discussions centered around care and healthier livingObjective_6db92db6-ac85-47c4-8bb0-6e5aeea8616d31unnamed organisationEnvironmental HazardsSupport development of tools that provide information about potential environmental hazards in the natural and built environmentsObjective_2dabddf7-8d8e-462c-a8ec-f3c10fd851b332unnamed organisationScreening, Treatment & PreventionDevelop tools and resources that improve health department and healthcare setting efficiency in providing education, training, and quality assurance for screening, treatment, services, and prevention messagesObjective_68c9a742-559a-465b-adf9-27dbab3bcd5533unnamed organisationChoicesPartner with private organizations, including Tribes and faith-based and community organizations, to develop and implement programs to help people make healthy life choicesObjective_8f87f63f-1008-42b9-85df-b0717234c66034unnamed organisationBehaviorsIncrease awareness of the importance of healthy lifestyle behaviors among patients and caregivers to reduce risk of chronic conditions and other illnessesObjective_32cf7ed4-1c50-4397-89c9-9dc99be865b635unnamed organisationDiseases & ConditionsPrevent, treat, and control communicable diseases and chronic conditionsObjective_9005cec4-017a-4881-949a-96218d35ed7536Performance Goals: * Increase the percentage of Ryan White HIV/AIDS Program clients who are receiving HIV medical care and have had at least one viral load test demonstrating suppression of the virus * Increase the percentage of adults aged 18 years and older who are vaccinated annually against seasonal influenza * Continue advanced research and development initiatives for more effective influenza vaccines and the development of safe, broad-spectrum therapeutics for use in seriously ill and/or hospitalized patients, including pediatric patients. Communicable diseases and chronic conditions affect the lives of millions of Americans every day. The emergence and spread of infectious diseases -- such as HIV/AIDS, hepatitis, tuberculosis, measles, and human papillomavirus (HPV) -- can quickly threaten the stability of public health for communities and place whole populations at risk. The rise of globalization and ease of travel also has made it easier for domestic and international outbreaks -- such as recent outbreaks of measles, pandemic influenza A (H1N1), Ebola, Zika, and chikungunya -- to create public health challenges. Moreover, the prevalence of chronic conditions -- such as diabetes, heart disease, stroke, and cancer -- in the United States continues to contribute to the daily struggles of Americans. The occurrence of multiple chronic conditions also exacerbates the adverse health impacts and healthcare costs associated with chronic conditions and their associated health risks. In 2014, an estimated 17.8 million visits to physician offices were due to infectious and parasitic diseases. More than 1.1 million people in the United States are infected with HIV; estimated lifetime treatment costs are more than $400,000 per person living with HIV. Viral hepatitis affects approximately 4.4 million people - PDF, and curing hepatitis C costs between $45,000 and $94,000 per person. Up to 13 million Americans are infected with the bacteria that cause tuberculosis; multiple drug resistant tuberculosis can cost between $134,000 and $430,000 to treat. Many Americans are negatively affected by the high costs associated with chronic conditions. According to 2010 Medical Expenditure Panel Survey (MEPS) data, an estimated 86 percent of annual healthcare expenditures are for individuals who have at least one chronic condition. In the 40 years leading up to 2015, heart disease and cancer remained the top two leading causes of death. In 2015, heart disease and cancer alone accounted for an estimated 45 percent of the 2.7 million deaths recorded that year. However, in recent years, data have shown a decrease - PDF in death rates from cardiovascular disease, stroke, and cancer, which can be attributed to increased efforts in prevention, early detection, treatment, and care. The prevention and management of communicable diseases require strategic coordination, collaboration, and mobilization of resources among governmental and nongovernmental partners within and outside of the United States. Similarly, managing chronic conditions requires support for affected individuals, families, caregivers, health professionals, and service providers. HHS programs and initiatives focus on promoting partnerships, educating the public, improving vaccine development and uptake, advancing early detection and prevention methods, and enhancing surveillance and response capacity.OASHHRSASAMHSAASPRCMS ASPACDCIHSACLFDAOGANIHAntibiotic ResistanceReduce the emergence and spread of antibiotic-resistant infections.Objective_ad85bfce-7ff6-4764-bf3e-4f0c92fc204637Antibiotic-resistant infections are a major health and economic burden for the United States. Patients who survive antibiotic-resistant infections usually require significantly longer hospitalizations, more medical visits, and a lengthier recuperation and experience a higher incidence of long-term disability. The Department has made significant progress in combating antibiotic-resistant infections and in conducting research and development to discover new antibiotics, diagnostics, therapeutics, and vaccines. The Department is working to reduce the emergence and spread of antibiotic-resistant infections through the following strategies:unnamed generic groupSurveillance, Detection & ResponseIncrease surveillance, early-detection methods (e.g., the use of point-of-care diagnostics), and response capacity, in order to reduce the domestic and international emergence and spread of antibiotic-resistant infectionsObjective_74157b3e-7ae2-4a59-be41-32ac9035d4df38unnamed generic groupTreatmentExpand the study of low-cost, readily available treatment regimens that limit the emergence of drug resistance, by identifying new antibiotic classes and agents, screening existing products, and combining new or existing compounds to treat drug-resistant infectionsObjective_5897c08c-520d-40a6-8c9c-4a9d476522d739unnamed generic groupResearchAdvance preclinical and clinical research to accelerate the translation of promising antibiotic products into safe and effective treatment regimensObjective_a770476a-54dc-4996-9133-f2a5a8615da140unnamed generic groupAppropriate UsageFoster improvements in the appropriate use of antibiotics by improving prescribing practices and promoting antibiotic stewardship across all healthcare settings and in all veterinary settingsObjective_8d68ffa7-3b90-4bc1-af44-9555f78743ce41unnamed generic groupClinical TestingExpand the development and clinical testing of potential vaccines to prevent infections by drug-resistant pathogensObjective_99420d0a-a1f2-497f-a28a-710c77dc3c3142unnamed generic groupCollaboration & CapacityImprove international collaboration and capacities for antibiotic resistance prevention, surveillance, and control and for antibiotic research and developmentObjective_e81bb62a-ba7b-4ce1-8c99-b17018c83d4c43unnamed generic groupInfectious DiseasesPrevent and control infectious diseases.Objective_4332cf31-7475-4ba0-9b1d-b2b0b1bdf52744Infectious diseases are a major health and economic burden for the United States. Each year in the United States, on average, 5 to 20 percent of the U.S. population gets the flu, a vaccine-preventable illness. Tens of thousands are hospitalized, and thousands die from flu-related illness, resulting in an estimated $10.4 billion a year in direct medical expenses and an additional $16.3 billion in lost earnings annually. The Department will work to prevent and control infectious diseases such as influenza through the following strategies:unnamed generic groupDiscovery & ImplementationIncrease research on vaccine discovery and implementation science on best approaches for enhancing dissemination and uptake of effective vaccines domestically and internationallyObjective_5bf1be69-b20c-4b0c-9f33-f321488aa8ed45unnamed generic groupVaccinesMobilize resources to support the development, testing, and preparation of vaccinesObjective_8dcbd35f-4975-4665-a2e8-f48a8406faa046unnamed generic groupInterventionsImplement effective and coordinated public health and healthcare interventions to detect, prevent, and control environmental, person-to-person, and zoonotic transmission of infectious diseases in the United States and globallyObjective_af420bf5-b4fa-4928-bb41-cd9a3410d9a947unnamed generic groupOutbreaksRespond to outbreaks of infectious diseases to identify their cause, limit their spread, and identify strategies for preventing future outbreaksObjective_62c2294e-1018-48fd-9a86-7248a4007c7248unnamed generic groupFood SafetySupport food safety.Objective_3d8c4f81-bfe5-4b75-9d81-452ce54508d149While the American food supply is among the safest in the world, an estimated 48 million cases of foodborne illness occur annually -- the equivalent of sickening 1 in 6 Americans each year. Each year, these illnesses result in an estimated 128,000 hospitalizations and 3,000 deaths. The Department will work to support food safety through the following strategies:unnamed generic groupStandardsWork with stakeholders, including food facilities, manufacturers, farmers, and distributors, to implement science-based preventive control standards for domestic and imported foodsObjective_251f3881-947a-445e-9322-744a980f613250unnamed generic groupCommunications, Outreach & ResearchIncrease consumer-based communications, outreach, and research on measures to improve consumer behaviors and practices related to food safetyObjective_6aae7691-4323-4ce7-af6b-fb2f25f2edc951unnamed generic groupResearch, Analysis & EvaluationIncrease research, data analysis, and systematic evaluation to improve the effectiveness of food safety education in changing unsafe consumer food handling behaviorsObjective_da4308e4-c411-46e5-b900-a96572d7e99652unnamed generic groupDetection & TreatmentSupport early detection and treatment of communicable and chronic diseases.Objective_54b2bf90-9d51-4ac6-be49-7d3c34ef544953The percentage of adults aged 18 years and over with hypertension who have their blood pressure under control increased by 42 percent between 2001–2004 and 2011–2014, from 35.5 percent to 50.3 percent. In 2010, 58.2 percent of adults aged 50 to 75 years received a colorectal cancer screening, 72.6 percent of women aged 50 to 74 years reported recent mammography, and 80.7 percent of women aged 21 to 65 years reported a recent Pap test (age-adjusted). The Department will work to support early detection and treatment of communicable and chronic diseases through the following strategies: Note: Additional strategies on mental health and substance use are in Strategic Objective 2.3.unnamed generic groupPreventionSupport access to preventive services including immunizations and screenings, especially for high-risk, high-need populationsObjective_deb46e67-c650-4f41-8862-3a1228acd51454unnamed generic groupScreeningSupport screening for tobacco use, alcohol misuse, substance use disorder, and obesity, and offer counseling and treatment as appropriateObjective_ae074033-c6a9-4af6-bd2f-bf97776b973855unnamed generic groupChronic ConditionsImprove early detection and treatment of people with multiple chronic conditions, such as heart disease, asthma, diabetes, kidney disease, cancer, chronic pain, and dementiaObjective_cba663c2-e29e-414e-b9ad-b3bc36d0e4dc56unnamed generic groupHIV Suppression & PreventionImprove HIV viral suppression and prevention by increasing engagement and re-engagement activities for screening, treatment, care, and support servicesObjective_f6c3927b-b8d9-4670-b20f-aabff4a73bb657unnamed generic groupHIV ProgramsImplement HIV programs, including prevention, testing, treatment, and retention interventions, provide technical assistance, and conduct research in support of the President's Emergency Plan for AIDS ReliefObjective_fb82d42b-c246-4ad5-a7c2-e2db7752456b58unnamed generic groupHepatitisIncrease access to hepatitis B and hepatitis C screening, treatment, and care for people with hepatitis B or hepatitis C infectionObjective_ec338865-24ae-4ef2-b43c-945aa210938d59unnamed generic groupMedical ProductsSupport the development of new, safe, and effective medical products, including drugs, vaccines, and devices, for the treatment of communicable diseases and chronic conditionsObjective_e9f5edfa-8578-42a6-8b6f-f6105ff6663560unnamed generic groupOpioids & Other DrugsPrevent the spread of infectious diseases among persons who inject opioids or other drugs by supporting implementation of effective, comprehensive community- and school-based interventions that reduce the infectious risks associated with injection of opioids and other drugs, increase screening and treatment for bloodborne pathogens, and provide access to effective treatment of substance use disordersObjective_108a03aa-975d-4f0b-8c89-7f17e74c367261unnamed generic groupTriage & ScreeningImprove triage and screening for the prevention of communicable diseases and the future development of chronic diseases in children through annual health screenings and age-appropriate immunizations for childrenObjective_b573badf-57f1-4815-a199-3bd22eec045962unnamed generic groupInterventionsSupport chronic disease management interventions.Objective_755c7dc3-6660-445c-b068-aeaf94ae52a363Chronic disease management interventions, which involve coordinated healthcare services and communications for populations with conditions in which patient self-care is important, have been clearly shown to improve health outcomes in patients with such diverse conditions as diabetes, heart failure, chronic obstructive pulmonary disease, hypertension, anxiety, and depression. The 2017 National Diabetes Statistics Report estimated that 9.4 percent of the U.S. population had diabetes, with the highest rates among American Indians and Alaska Natives. The Department will work to support chronic disease management interventions through the following strategies:unnamed generic groupPlanning, Coordination & ManagementImprove planning, coordination, and management of services to better meet the needs of people with complex healthcare needs and chronic health conditionsObjective_b3317f41-6423-4ed6-8a54-f0c773f8844664unnamed generic groupSelf-ManagementExpand participation by older adults and adults with disabilities in self-management education interventionsObjective_be2fe9bf-161a-4a27-9a71-2fa3806d005665unnamed generic groupMental & Substance Use DisordersReduce the impact of mental and substance use disorders through prevention, early intervention, treatment, and recovery supportObjective_0cb608ee-a4ce-4d9c-844f-517f8cb7aeb766Performance Goals: * Meet the following opioid-related goals: - Reduce the age-adjusted annual rate of overdose deaths involving prescription opioids per 100,000 population among States funded through the Prescription Drug Overdose Prevention for States program - Increase the number of persons receiving outpatient medication-assisted treatment for opioid use disorder from a substance use disorder treatment facility - Increase the availability of electronic clinical decision support tools related to safe pain management and opioid prescribing - By 2020, evaluate the efficacy of new or refined interventions to treat opioid use disorders * Meet the following goals related to mental illness: - Increase the percentage of youth ages 12 to 17 who experienced major depressive episodes in the past year receiving mental health services - Increase the percentage of adults with serious mental illness receiving mental health services -- Mental illness and substance abuse create health risks and place a heavy burden on affected individuals and their families. Substance use disorders arise from the recurring use of alcohol and/or drugs, which lead to clinically and functionally significant impairments. Mental disorders are health conditions that involve significant changes in thinking, emotion, and/or behavior and lead to distress and/or problems functioning in social, work, or family activities. Mental and substance use disorders are illnesses that impact people’s ability to go about their daily lives in family, social, and professional settings and place individuals at risk of additional health problems. Mental illness and substance abuse have a known impact on public health. In 2016, an estimated 20.1 million people - PDF aged 12 or older in the United States had a substance use disorder related to alcohol consumption or illicit drug use in the previous year. In 2016, approximately 2 million people had an opioid use disorder - PDF. The number of deaths related to overdose involving opioids, including prescription opioids and heroin, has quadrupled since 1999. The recent increase in deaths appears to be largely a result of use of heroin and synthetic opioids. Between 2015 and 2016 alone, the death rate from synthetic opioids other than methadone, including fentanyl, increased by 100 percent, and the death rate from heroin increased by 19.5 percent. In 2016, one in five American adults experienced a mental illness - PDF, and 13 percent of adolescents met criteria for depression - PDF. The number of emergency department visits that involved mental disorders as the primary diagnosis was approximately 5 million in 2014. In 2014, suicide ranked as the 10th leading cause of death. In the same year, suicide deaths reached 13.4 deaths per 100,000 people. Records show that rates of suicide have steadily increased since the baseline year of 2007 in the United States. HHS works closely with Federal, State, Tribal, local, territorial, and community partners and stakeholders, including faith-based and community organizations, to help identify and address mental health problems and substance use disorders. The Department invests in programs and interventions focused on prevention, screening, and early detection of serious mental illness and substance abuse, including those related to opioid abuse. Other HHS activities involve improving the provision of comprehensive, coordinated, and evidence-based community recovery supports for affected individuals and improving access to treatment options. Continuing to advance research and work in these areas raises awareness and facilitates the adoption of best practices across communities to minimize the negative health impacts caused by mental and substance use disorders.FDAAHRQACFACLCMSSAMHSAHRSAIEACDCOCRIHSMental Illness & Substance AbuseExpand prevention, screening, and early identification of serious mental illness and substance abuse.Objective_e7f4bcb0-fcbf-4447-aecd-a98aa75d9daa67The National Survey on Drug Use and Health recently found that, while serious mental illness among age groups 26 and older has remained constant for nearly a decade, the prevalence of serious mental illness, depression, and suicidal thoughts has increased among young adults in recent years. In 2016, approximately 20.1 million people aged 12 or older had a substance use disorder. The Department is expanding prevention, screening, and early identification of serious mental illness and substance abuse through the following strategies:unnamed organisationOpioidsApply a public health approach for preventing opioid misuse, opioid addiction, and opioid overdose deaths including through promoting safer prescribing practicesObjective_51dddf9a-4b68-4f86-b8c0-1be9dab04bbd68unnamed organisationRecognition, Screening & IdentificationEducate and empower individuals and communities, including partnerships with Tribes and faith-based and community organizations, to recognize the signs of serious mental illness and substance abuse to encourage screening and identification of such problemsObjective_0022c252-e406-4c6b-a5b5-0cf05eebdb1469unnamed organisationScreeningEnsure early screening of children and youth to identify those with or at risk for serious emotional disturbance or substance use disorders, and expand access to integrated mental health or substance use disorder servicesObjective_845d194b-fa7b-403f-8650-51683b8574a770ChildrenYouthDepression, Suicide Risk, Substance Use, Dementia & Other DisordersIncrease screening for depression, suicide risk, substance use, dementia, and other behavioral disorders in schools, emergency departments, and inpatient and outpatient settingsObjective_77f29612-76aa-4984-a508-72f8ce64cbe971Inpatient SettingsEmergency DepartmentsOutpatient SettingsSchoolsScreening & InterventionEncourage healthcare providers' use of screening and brief intervention approaches for alcohol, opioid, and other substance use disorders to reduce consequences of risky behavior, including effects of harmful substance use in pregnancyObjective_70231dff-3e0f-4828-8d5e-3f8051ddc29472Healthcare ProvidersSubstance MisuseSupport adoption of other evidence-based prevention strategies, including environmental strategies and community capacity/mobilization strategies, to prevent substance misuse and substance use disordersObjective_181f905d-6b57-468c-a15e-a4e48f2bc35e73unnamed generic groupSuicidesPrevent suicides and suicide attempts by expanding evidence-based approaches for adults and youth and helping State, Tribal, local, and territorial governments and communities take advantage of the best available evidence to prevent suicideObjective_819e6147-244d-4c27-ba36-266f98ba170674unnamed generic groupCare & TreatmentImprove access to high-quality care and treatment for mental and substance use disorders.Objective_905d9751-97e6-439f-8c44-8a39f208307b75In 2016, an estimated 21 million people aged 12 or older needed substance use treatment, but only 3.8 million people received treatment. Of the 3.1 million adolescents with a major depressive episode in the same year, only 1.2 million received treatment. Similarly, of the 16.2 million adults with a major depressive episode in the same year, only 10.6 million received treatment. The Department seeks to improve access to high-quality care and treatment for mental and substance use disorders through the following strategies: Note: Additional behavioral healthcare quality strategies are in Strategic Objective 1.2.unnamed organisationCare ContinuumSupport the integration of the full continuum of behavioral healthcare and primary care and medical systems, and increase the capacity of the specialty behavioral health systems to ensure that the physical health needs of the people they serve are metObjective_4a902c75-832e-479e-96a5-0d7fc037bffe76unnamed organisationChild & Family SupportProvide integrated child and family supports to parents/guardians with addiction to support healthy child development and preservation of familiesObjective_dfadc4c6-c7e9-4f09-ad86-c716afb4842c77FamiliesChildrenMental Illness, Addition & DepressionImprove adoption and continued refinement of selected evidence-based practices for serious mental illness, medication-assisted treatment for alcohol and opioid addiction, and effective use of psychotherapy and antidepressant medication for depressionObjective_540941b4-83a0-408b-b802-2d5ff55b284778unnamed generic groupMedicationsImprove access to medications that reverse opioid overdose and prevent deathObjective_cc059022-4931-4c2a-b0b8-7b2bc97e354879unnamed generic groupTreatmentSupport efforts to increase engagement in treatment following an opioid overdoseObjective_06fac805-d38b-4388-afda-12d47320e73e80unnamed generic groupClinician TrainingStrengthen clinician training on evidence-based practices related to pain management and the prevention and treatment of opioid use disorders to inform clinical management decisions for patients, including effects of opioid use in pregnancyObjective_1365555a-1164-4b64-8e45-67f744d7c54b81CliniciansMental Illness & Substance Use DisordersImprove access to recovery support for people with serious mental illness and substance use disordersObjective_41bcac30-d8e1-4383-9009-d0470783a6dd82Recovery support is provided through treatment, services, and community-based programs by behavioral healthcare providers, peer providers, family members, friends and social networks, Tribes, and people with experience in recovery. The Department will employ the following strategies to improve access to recovery support for people with serious mental illness and substance use disorders:unnamed organisationPeer Providers & ParaprofessionalsWork with States to encourage the training, certification, and supervision of peer providers and paraprofessionalsObjective_3084d45b-39a7-4586-b2f8-cd0f786d909a83ParaprofessionalsPeer ProvidersStatesHousing, Employment & EducationEncourage broad adoption of evidence-based recovery housing, supported housing, supported employment, and supported education programsObjective_829bb08a-f947-4be8-943f-8142a69e0eb284unnamed generic groupRecovery SupportEngage individuals and communities, including faith-based and community organizations, to provide social and community recovery supportObjective_cb2a549b-c610-4736-a626-84909b1e49f685CommunitiesFaith-Based OrganizationsCommunity OrganizationsIndividualsCareImprove access to a full evidence-based continuum of care for people with mental illness and addiction, including medication-assisted treatment, follow-up from inpatient and residential care, and recovery supports, with a focus on opioid use disorder and serious mental illnessObjective_e274ad61-ef39-4703-a8ce-275b442518ef86People with Mental IllnessPeople with AddictionCapacity & CollaborationBuild capacity and promote collaboration among States, Tribes, territories, and communities.Objective_8a7ef8f6-2129-4e16-b053-90652b3d7f6c87The Department values its strong partnerships with external groups to respond to stakeholder needs, and supports investments to build the expertise, infrastructure, and other capacity to reduce the impact of mental health and substance use disorders. The Department is working to build capacity and promote collaboration among States, Tribes, territories, and communities through the following strategies:CommunitiesTerritoriesStatesTribesCapacityImprove community capacity to provide comprehensive, coordinated, and evidence-based supports for people with serious mental illness, addiction, and serious emotional disturbances with a focus on reducing crises and use of emergency services, hospitalization, and involvement with the criminal justice systemObjective_1341cf13-b835-4a65-9496-332a5a47ab9588CommunitiesCollaborationImprove collaboration with Federal and non-Federal stakeholders to promote the health and independence of older adults with or at risk for behavioral health conditions including mental illness, substance use disorders, and suicideObjective_a5b2b24c-357b-4fcb-8e48-6e17897926f289unnamed generic groupRelationshipsFoster and strengthen relationships with national, regional, and local coalitions, including with Tribes and faith-based and community partners, to encourage their full and robust involvement in addressing the opioid crisis by providing accurate, up-to-date information regarding health and human service activities, resources, and subject matter expertiseObjective_5198e126-bb09-478e-b687-0270644c29f890Faith-Based PartnersRegional CoalitionsNational CoalitionsTribesLocal CoalitionsCommunity PartnersTechnology & InnovationLeverage technology and innovative solutions to improve access to and quality of behavioral healthcareObjective_48a503ce-15dd-4aeb-b670-8264df07100b91As described in Strategic Goal 1: Reform, Strengthen, and Modernize the Nation's Healthcare System, accessing high-quality behavioral healthcare providers in rural or underserved communities can be challenging. The Department is working to leverage technology and innovative solutions, such as telehealth, electronic health records, and health information exchange, to improve access to and quality of behavioral healthcare through the following strategies:unnamed organisationDecision SupportDevelop, test, and disseminate clinical decision supports through electronic health records to use evidence-based mental health and substance use disorder guidelines for preventing and treating mental health and substance use disorders and increase access to appropriate behavioral care servicesObjective_a2ebc799-148b-40b7-9f5f-a12a8534da4092unnamed organisationInformation ExchangeIncrease the use of health information exchange to improve the coordination and integration of care, including by increasing the number of behavioral health providers using interoperable electronic health records and by addressing confidentiality policy barriers to health information exchangeObjective_4abfdef1-9fc8-4250-af35-8c9acb8e6d6f93unnamed organisationBarriersAddress the barriers, real or perceived, under the Health Insurance Portability and Accountability Act of 1996 (Pub. L. 104-191) and 42 CFR Part 2, Confidentiality of Alcohol and Drug Abuse Patient Records, to the appropriate sharing of mental health and substance use disorder informationObjective_3db79433-7a12-4bc5-8123-6d187f983f4994unnamed organisationAccessImprove access to mental health and substance abuse care for rural and underserved populations, including American Indians and Alaska Natives, by supporting care through telehealth services through regulation and policy clarification and refinement; collaboration with States; and technical assistance, training, and funding opportunitiesObjective_4783e68e-914b-4913-af00-56cedec9086f95unnamed organisationEmergenciesPrepare for and respond to public health emergencies.Objective_8e1d5005-cf46-4c27-a1bc-ec23c32cb25096Performance Goals: * Increase the percentage of CDC-funded Public Health Emergency Preparedness State and local public health agencies that can convene, within 60 minutes of notification, a team of trained staff that can make decisions about appropriate response and interaction with partners * Increase the number of new licensed medical countermeasures within the Biomedical Advanced Research and Development Authority. -- The health of Americans during public health emergencies and other incidents depends on the effectiveness of preparedness, mitigation, response and recovery efforts. Threats in an increasingly interconnected, complex, and dangerous world include naturally emerging infectious diseases; frequent and severe weather events; state and nonstate actors that have access to chemical, biological, radiological, or nuclear agents; nonstate actors who commit acts of mass violence; and cyber attacks on healthcare systems and infrastructure. HHS provides strong leadership by setting the strategic direction to improve preparedness, mitigation, response, and recovery capabilities, such as through the National Health Security Strategy and the National Biodefense Strategy. HHS, as the coordinator of Emergency Support Function 8 (ESF 8) and the Health and Social Services Recovery Support Function, works with other departments to establish, evaluate, and conduct preparedness, mitigation, response, and recovery activities to support efforts by States, Tribes, localities, and territories. HHS leads the Federal public health and medical response to emergencies and incidents conducted in accordance with the ESF 8 (Public Health and Medical Services) annex of the National Response Framework and the Health and Social Services annex of the National Disaster Recovery Framework. HHS is working to ensure that a national disaster healthcare system is integrated within the healthcare delivery infrastructure—hospitals, emergency medical services, emergency management, and public health agencies—to provide safe and effective healthcare during emergencies and other disasters. In addition, National Disaster Medical System teams and the U.S. Public Health Service Commissioned Corps complement non-Federal efforts during incidents. HHS supports local Medical Reserve Corps units, which supplement the capacity of States, Tribes, localities, and territories. Through direct services and partnerships with State, Tribal, local, and territorial governments, with faith-based and community organizations, and with the private sector, HHS works to strengthen the Nation’s emergency preparedness, response, and recovery efforts. HHS is engaged in the research, development, and procurement of medical countermeasures, including vaccines, drugs, therapies, and diagnostic tools. HHS collaborates with others to ensure that the appropriate number of safe and effective medical countermeasures are developed and stockpiled and can be easily distributed and used to save lives during an incident. HHS invests in building the capacity of other countries to detect, prevent, and respond to incidents -- thus providing early warning to or reducing the impact to the United States. The international public health professionals trained by the Global Disease Detection Operations Center monitor 30 to 40 public health events each day, and can deploy within 24 hours of learning about an outbreak.CDCIHSIEACMSASPAOCRACLSAMHSAASPRASAFDAHRSANIHACFOSSIOASHOGAPreparedness & ResponsePromote emergency preparedness and improve response capacity.Objective_c914d8d8-a449-4b21-aa06-c61c9bd354c197Federal statutes, Presidential directives, and strategies set the Nation’s approach to preparing for threats and hazards that pose the greatest risk to the security of the United States. National preparedness is a shared responsibility of the government and nongovernmental sectors, as well as individuals. The Department promotes emergency preparedness and improves response capacity through the following strategies:unnamed organisationExpertiseProvide subject expertise and tools to State, Tribal, local, and territorial governments, health systems and facilities, and faith-based and community organizations, to strengthen their capabilities to provide continuous, safe, and effective healthcare, public health, and social services in the aftermath of disasters and through the recovery period, including when such care or services may need to be delivered in alternate settings or by alternate mechanismsObjective_064fe158-ec55-4666-b348-523f7134bec998Health FacilitiesHealth SystemsTerritorial GovernmentsLocal GovernmentsCommunity OrganizationsState GovernmentsFaith-Based OrganizationsTribal GovernmentsDataDevelop and implement data-driven approaches that prioritize resources and technical support for underprepared geographical regions and communities to maximize preparedness across the NationObjective_c34b78cc-8089-41fb-8023-4bc355b1fce599unnamed generic groupSituational AwarenessExpand the use and availability of public health and healthcare emergency response situational awareness tools, including investments in new systems and technologies that support rapid risk assessment, decision making, resource coordination across many levels, and monitoring of the effectiveness of interventionsObjective_89ae06ac-1841-4dec-85c5-9a3896ca839a100unnamed generic groupMedical CountermeasuresDetermine appropriate type and quantities of medical countermeasures, ensure timely access to medical countermeasures during response, and maximize effective utilization of medical countermeasures through clinical guidance and public health communicationsObjective_f47dadc2-9242-42a7-ab0f-8cfcb7391ca4101unnamed generic groupPlanningAssess preparedness to plan for the timely access to and capacity to use medical countermeasures during disasters and other public health emergencies, and establish requirements based on estimated response needs, capacity to use, and desired characteristics of medical countermeasures to protect the publicObjective_30e4fda9-e0d5-4794-999a-96455aa993c0102unnamed generic groupResponse & RecoverySupports timely, coordinated, and effective response and recovery activities.Objective_7ae5d61d-47b5-4cd3-9b71-c29cbd702d00103The Secretary, through the National Response Framework, leads and coordinates the Federal public health and medical response and provides supplemental support to States, Tribes, localities, and territories that are responding to incidents. The Department supports timely, coordinated, and effective response and recovery activities through the following strategies:unnamed generic groupRisk ReductionPromote effective disaster risk reduction strategies to mitigate the adverse physical and behavioral health impacts of disasters and public health emergenciesObjective_2d1621f8-7e39-4180-a56d-473116499228104unnamed generic groupInformation, Coordination & ResearchRespond rapidly to limit the impacts of incidents by gathering, analyzing, and disseminating information; coordinating requests for public health and medical services with partners; executing response operations and risk communication plans; and conducting research to inform current and future incident responsesObjective_5620d10f-24f2-49e8-ab87-a7ea360effc4105unnamed generic groupAt-Risk PopulationsEnsure that the needs of at-risk populations and those with access and functional needs are met during incidents, through integrated and informed preparedness, response, and recovery activities at the Federal, State, Tribal, local, and territorial levels of governmentObjective_32202af7-69b5-4d2d-9b14-03cbba3fd539106At-Risk PopulationsPlanningProvide tools and guidance to interagency, intergovernmental, Tribal, and faith-based and community organizations to improve the Nation's planning, to ensure timely human services response to incidentsObjective_df9b8f00-5c65-44a1-8255-6d6639becee5107Community OrganizationsIntergovernmental OrganizationsFaith-Based OrganizationsInteragency OrganizationsTribal OrganizationsCollaboration, Communication & CoordinationImprove collaboration, communication, and coordination with partners.Objective_9d9fdc2c-531c-4aea-85d1-968b71a2210f108Public health emergencies are not confined by geographic borders; response efforts often must engage various States, Tribal governments, localities, or territories. Response efforts must be undertaken in coordination with critical partners, such as hospitals, schools, houses of worship and faith-based organizations, and individual citizens. The Department is working to improve collaboration, communication, and coordination with partners through the following strategies:unnamed generic groupCommunication & MediaProvide accurate and timely public health communication and media support to non-Federal stakeholders and leaders, as well as deployed HHS leaders and teamsObjective_9448a5ac-d42e-439d-ac84-f6f6add2a18c109MediaDecision SupportImprove decision support at all levels through active collaboration with State, Tribal, local, and territorial partners to share human health, environmental, zoonotic health, and other relevant information to improve situational awarenessObjective_b1a39569-ced8-4ade-b6ae-fb7c887fa124110unnamed generic groupHealthcare CoalitionsBuild resilient healthcare coalitions that integrate efforts of healthcare facilities, emergency medical services, emergency management, and public health agenciesObjective_c89512ec-b086-4950-b094-6e66881a3df2111Healthcare CoalitionsCommunication, Response & Recovery PlansJointly develop, exercise, and maintain coordinated risk communication, response, and recovery plans among governments and nongovernmental partnersObjective_91f7e573-91b9-48ad-a7c3-6fd481b8541c112unnamed generic groupPartnershipsFormalize strategic partnerships to better ensure that medical countermeasure products and policies that guide their safe and effective use can be implemented effectively during an incidentObjective_5a32348e-4c87-4c7c-a781-3cba7cc4c99d113unnamed generic groupWorkforceStrengthen and protect the emergency preparedness and response workforce.Objective_ea5c2512-c8f9-4ac9-8955-5e91140b7e25114The emergency preparedness and response workforce includes, but is not limited to, those engaged through the National Disaster Medical System, the U.S. Public Health Service Commissioned Corps, the Medical Reserve Corps, volunteer health professionals, mental health and human service workers, and nongovernmental organizations (including faith-based and community organizations). The Department is strengthening and protecting the emergency preparedness and response workforce through the following strategies:Medical Reserve CorpsNational Disaster Medical SystemU.S. Public Health Service Commissioned CorpsVolunteer Health ProfessionalsMental Health WorkersHuman Service WorkersEmergency Preparedness WorkforceEmergency Response WorkforceNongovernmental Organizationsincluding faith-based and community organizationsHazardous ExposuresReduce illness and injury due to hazardous exposures in first responders, emergency managers, and public health, healthcare and human services providers, through health and safety training, education, and medical countermeasuresObjective_d0ff67f0-c771-4f2d-b327-f8aeee987880115Human Services ProvidersHealthcare ProvidersFirst RespondersPublic Health ProvidersEmergency ManagersTrainingTrain the HHS workforce, and support the training of other partners, to strengthen the health response to incidents and protect communities from domestic and global threatsObjective_b4611f62-3028-4469-913b-98c8e21f0cb9116HHS WorkforcePublic Health ProfessionalsReview the U.S. Public Health Service Commissioned Corps structure and modernize how HHS employs public health professionals and responds to public health emergenciesObjective_a4999d98-b436-4a3b-ad6b-a011320ceb16117U.S. Public Health Service Commissioned CorpsPublic Health ProfessionalsWorkforce GapsCoordinate with human resources to help fill hard-to-fill assignments, bridge critical workforce gaps, and respond to public health and medical emergenciesObjective_4639ed79-eaeb-4529-bc8c-706767bbedbc118unnamed generic groupIndividuals with Functional & Access NeedsIncrease capacity of emergency managers; healthcare, public health, and human services providers; and faith-based and community organizations to address needs of at-risk individuals with functional and access needs during incident preparedness, response, mitigation, and recoveryObjective_83368b4a-45cd-460b-8dfe-bc0a74760c4d119Healthcare ProvidersPublic Health ProvidersCommunity OrganizationsFaith-Based OrganizationsHuman Services ProvidersEmergency ManagersIndividuals with Functional & Access NeedsDiverse PopulationsDevelop cultural and linguistic competency to allow public health officials and emergency managers to better meet the needs of diverse populations and improve the quality of services and health outcomes during and after a disasterObjective_04148c98-9271-4fd2-b7b6-c0b5d2d86e65120Diverse PopulationsPublic Health OfficialsEmergency ManagersGlobal HealthAdvance global health security.Objective_5dc62881-7e59-414d-b692-4d1ee50a3bd0121HHS is working with other Federal departments, foreign governments, and multilateral organizations to create a world safe and secure from public health threats. The Department is working to advance global health security as a national priority through the following strategies:unnamed generic groupInformation, Communication & ResponseRespond rapidly to limit the impacts of incidents by using and sharing incident information, coordinating communications with international partners, and conducting response operations, risk communication, and research to respond to emerging and re-emerging diseases; chemical, biological, radiological, and nuclear agents; and other threats to health securityObjective_83f4d0a5-aa83-4537-b3e0-9f9df7c9f74b122unnamed generic groupPreparednessEnhance international preparedness activities at the national, regional, and global levels to identify gaps, build capacity, and track progress to prevent, detect, and respond to health threats, respecting cultural differences and the inherent dignity of persons from conception to natural deathObjective_7c44e9ec-2461-4b5c-992c-98ee2e6b8043123unnamed generic groupProducts & BehaviorsPromote and support, where appropriate, the development, deployment, and use of medical products to prevent, mitigate, or treat adverse health effects in response to a global public health emergency, as well as the development, understanding, and use of behaviors or actions that people and communities can take to help slow the spread of disease or limit the impact of threat agents in response to a public health emergencyObjective_f6743b5c-69ab-4a96-a9e3-fbe2e6ed0a96124unnamed generic groupProgramsCollaborate with, and provide leadership to, international programs and initiatives to strengthen global preparedness and response to public health and medical emergenciesObjective_35499a69-895e-4161-b61b-a8017fb73e9d125unnamed generic groupPlansFurther develop, exercise, and update plans for responding to global threats that have the potential to impact national health securityObjective_134902fb-f070-447d-b943-24eb3afd4f44126unnamed generic groupWell-BeingStrengthen the Economic and Social Well-Being of Americans Across the LifespanGoal_0a231717-542a-4d15-aa6c-2aabfbecc8263Poverty, unemployment, family disruptions, aging, and disability can threaten independence and self-sufficiency and increase Americans’ need for safety-net programs. Violence and preventable injuries threaten the security and social stability of the American people. HHS is committed to supporting the social and economic well-being of all Americans, including those individuals and populations who are at high risk of social and economic challenges. A core component of the HHS mission is the dedication to serve all Americans from conception to natural death, including those individuals and families who face or who are at high risk of economic and social well-being challenges. According to the U.S. Census Bureau, the official poverty rate in 2016 was 12.7 percent, down 0.8 percentage points from 13.5 percent in 2015. Both the percentage of the U.S. population in poverty and the unemployment rate have declined in the last three years. According to the U.S. Department of Labor’s Bureau of Labor Statistics, in 2017 the monthly unemployment rate averaged 4.4 percent, down from 4.9 percent in 2016. However, some Americans still experience challenges. According to the 2016 Annual Homeless Assessment Report - PDF, on a single night in 2016, nearly 550,000 people were experiencing homelessness in the United States. Additionally, in 2011, 4.8 million formerly incarcerated individuals were under community supervision. Many individuals returning to the community after serving time experience challenges due to limitations on their eligibility for access to public housing, employment, and healthcare. Job training and social supports are imperative for ensuring that these individuals are able to reintegrate into their communities. Both unintentional injuries and those caused by acts of violence are among the top 15 causes of death for Americans. Nearly 200,000 people in the United States die every year from injuries and violence related to preventable events such as drug overdoses, falls, drowning, and self-harm. Even when people do not die from injuries and violence, many experience long-term effects. Survivors often face lifelong mental, physical, and financial problems. In 2014, 26.9 million people were treated in an emergency department for injuries, and 2.5 million people were hospitalized. In 2013, costs associated with fatal injuries totaled $214 billion, while nonfatal injuries resulted in $457 billion in costs. The Department’s effort to support all Americans includes empowering families to encourage positive child and youth development. Financial and emotional support can encourage children and youth to continue education and make healthier decisions. In 2010, 71 percent of children younger than 18 were reported to be living with at least one parent who was employed full-time, year round. In 2014, 79.3 percent of adolescents age 12 to 17 surveyed said they had an adult in their lives with whom they can discuss serious problems, up from 78.2 percent in 2013. Over the past 15 years, there has been significant improvement in the teen birth rate. The teen birth rate declined by 63 percent between 1990 and 2015 and is now at a record low. In 1990, the teen birth rate was 60 births per 1,000 teenage girls. By 2015, the rate had dropped to 22 births per 1,000 teenage girls. Some subpopulations are at high risk of poor economic and social outcomes. In 2015, 35 percent of single-parent families had incomes below the poverty line, compared with 8 percent of married couples with children. Over the past decade, the percentage of children in single-parent families has increased from 32 percent to 35 percent, although the percentage has remained stable since 2011. Additionally, the more than 400,000 children who live in foster homes face a complex set of challenges. Older foster youth who age out of foster care are at a higher risk of teen pregnancy, employment instability, and homelessness. Older Americans and Americans with disabilities also face a number of obstacles. Over the past 10 years, the population 65 and over increased by 30 percent from 36.6 million in 2005 to 47.8 million in 2015, and this age group is projected to more than double to 98 million in 2060. More than 4.2 million older adults lived below the poverty line in 2015. At least 90 percent of older adults receiving help with daily activities receive some form of unpaid care, and about two-thirds receive only unpaid care. Almost 12 percent of working-age adults in the United States have some type of disability. Of these adults, 51 percent had a mobility disability, and 38.3 percent had a cognitive disability. Working-age adults with disabilities are more likely to live in poverty, have less than a high school education, and be unemployed.ACLOASHunnamed organisationHRSASAMHSAIHSACFunnamed organisationOASHAdministration for Children and Families (ACF)unnamed organisationACFCDCSubstance Abuse and Mental Health Services Administration (SAMHSA)Health Resources and Services Administration (HRSA)OASHCenters for Disease Control and Prevention (CDC)ACFunnamed organisationACFunnamed organisationunnamed organisationACLACLCDCAdministration for Community Living (ACL)MedicaidIHSElder Justice Coordinating CouncilACLIndian Health Service (IHS)unnamed organisationMedicareCenters for Medicare & Medicaid Services (CMS)unnamed organisationunnamed organisationunnamed organisationCMsunnamed organisationOlder AmericansHRSAunnamed organisationSAMHSAIHSunnamed organisationCMSSAMHSAunnamed organisationCDCunnamed organisationunnamed organisationOffice of the Assistant Secretary for Health (OASH)unnamed organisationTribal PartnersAdult Protective ServicesHealth Delivery SystemsFederal PartnersCaregiversLow-Income PopulationsCommunity OrganizationsState Housing Finance AgenciesYoung ChildrenPrivate PartnersCommunity Organizationsunnamed generic groupChildrenChildrenState Medicaid AgenciesAdolescentsFamily Support ServicesLicensed Social WorkersUnpaid Family CaregiversPeersCommunity OrganizationsParentsYouthChildrenFathersDirect Service WorkforceIndividuals with DisabilitiesLocal StakeholdersPersons with DementiaGuardiansYoung Childrenunnamed generic groupHomeless YouthPeople with DisabilitiesEarly Care SettingsDomestic Violence SurvivorsRunaway YouthParentsFamiliesChildrenBehavioral Health PractitionersFamiliesTribal StakeholdersCommunity-Based Services (HCBS)Healthcare WorkforceCaregiversPeople with DisabilitiesState Government EntitiesFaith-Based OrganizationsState PartnersLocal Government EntitiesOlder Adultsunnamed generic groupRefugeesAt-Risk PopulationsExtended Birth FamiliesFaith-Based OrganizationsCaregiversCaregiversParentsLow-Income AdultsOlder AdultsAdolescentsYoung ChildrenCaregiversEarly Childhood SettingsHuman Service Providersunnamed generic groupAmerican IndiansFaith-Based InitiativesCaring AdultsOlder AdultsTerritorial StakeholdersPeople with DisabilitiesHCBS Providersunnamed generic groupStatesPublic Health AgenciesFamiliesHousing AuthoritiesHealthcare ProvidersOlder AdultsAmericansNongovernmental Stakeholdersunnamed generic groupOlder AmericansFaith-Based OrganizationsOlder AmericansTribal Government EntitiesChildren with DisabilitiesCommunity OrganizationsChildren with DisabilitiesPeople with DisabilitiesOlder AdultsChild Care ProgramsChildrenunnamed generic groupEducatorsYoung AdultsOlder AdultsStatesChildrenYouthKinship CaregiversFamiliesTribesYoung ChildrenPregnant WomenTerritorial PartnersCaregiversPeople with Disabilitiesunnamed generic groupFaith-Based OrganizationsPeople with DisabilitiesChildrenPeople with DisabilitiesNonprofitsEducation SettingsFamiliesChildrenYouth with DisabilitiesFaith-Based OrganizationsUnemployed Noncustodial ParentsPeople with DisabilitiesYoung ChildrenChild Welfare ProfessionalsCaregiversParentsOlder AdultsYouthPeople with DisabilitiesTeachersCaregiversCommunity InitiativesLocal PartnersCaregiversYouthCommunity OrganizationsAdoptive FamiliesFederal AgenciesInfantsTribesParentsCommunity OrganizationsFaith-Based OrganizationsFederal Government EntitiesTeachersMedical PractitionersPeople with DisabilitiesTribesCaregiversCommunitiesFormerly Incarcerated Individualsunnamed generic groupAcademiaLong-Term Care FacilitiesState StakeholdersFaith-Based OrganizationsYouthYouthunnamed generic groupChildrenYouthSchoolsFamiliesOlder AdultsChildrenTerritorial Government EntitiesFamiliesCaregiversOlder AdultsOlder AdultsFaith-Based OrganizationsYouthParentsChildrenPeople with DementiasChildrenPeople with Alzheimer's DiseaseAlaska NativesAdults with DisabilitiesPeople with DisabilitiesOlder AdultsCommunity OrganizationsAdults with DisabilitiesEarly Childhood Programsunnamed generic groupVictims of Family ViolenceCommunity OrganizationsCommunity OrganizationsNewbornsAdultsFederal StakeholdersHealthcare ProvidersFaith-Based OrganizationsSelf-Sufficiency, Responsibility & OpportunityEncourage self-sufficiency and personal responsibility, and eliminate barriers to economic opportunityObjective_3c19fbc9-ed22-472f-96b7-57c5c76f38581Performance Goals: * Increase the percentage of adult TANF recipients and former recipients who are newly employed * Increase the percentage of refugees who are self-sufficient (not dependent on any cash assistance) within the first 6 months after arrival -- Strong, economically stable individuals, families, and communities are integral components of a strong America. Many Americans currently experience or are at risk for economic and social instability. The social and health impacts of poverty can include reduced access to nutritious food; fewer educational opportunities and poor educational outcomes; a lack of access to safe and stable housing; increased risk of poor health outcomes including obesity and heart disease; and difficulty obtaining work opportunities. In 2016, a family of three was considered to be living in poverty if they earn less than $19,105 per year. According to the Census Bureau, the poverty rate in 2016 was 12.7 percent, with 40.6 million people living in poverty; this number was down 0.8 percentage points from 2015. For most demographic groups, the number of people in poverty decreased from 2015, with adults older than 65 the only population group experiencing an increase in the number of people living in poverty. By providing opportunities for work and work supports, the Department is dedicated to improving the education, skills, health, and resources of low-income individuals and families to help them expand their productivity, achieve economic independence, and enhance their economic and health outcomes. To reach this goal, the Department coordinates safety-net programs across the Federal Government; State, local, Tribal, and territorial governments; and faith-based and community organizations. One of the Department’s primary programs for families in need is the Temporary Assistance for Needy Families (TANF) program. TANF provides States with block grants to design and operate programs that help needy families reach self-sufficiency, with a focus on preparing parents for work. The Department coordinates with the U.S. Departments of Labor and Education to implement the Workforce Innovation and Opportunity Act, which is designed to help young job seekers and people with disabilities access employment education, training, and support services and match employers with skilled workers.CMsACLACFEducation, Training & WorkInvest in education, training, and work.Objective_252508f2-cd3c-41d3-bf2b-2a6dc6d218de2In March 2017, nearly 2.5 million people across all 50 States, the District of Columbia, Guam, Puerto Rico, and the U.S. Virgin Islands received cash assistance from TANF programs. The Department invests in education, training, work, and work supports through the following strategies: Note: Additional strategies on supporting independence for people with disabilities are in Strategic Objective 3.4.unnamed organisationEmploymentInvest in evidence-informed practices that enable low-income adults, unemployed noncustodial parents, youth, and individuals with disabilities to prepare for, acquire, and sustain employment, including for fast-growing professions in healthcareObjective_cc9a1da6-32d6-440d-bf7b-3df6cb0600c63Individuals with DisabilitiesUnemployed Noncustodial ParentsYouthLow-Income AdultsWork ParticipationStrengthen the required work participation rate standards for States receiving TANF funds, and provide guidance and technical assistance to State TANF programs to engage adult cash assistance recipients who have the capacity to work in work activitiesObjective_5c472a3b-440d-4fab-b690-1ba51b96912f4StatesStability & SupportPromote innovation in the TANF program to advance the objective of helping families in need find stability and support through the employment and economic independence of adult participants and the healthy development of children whose families receive assistanceObjective_1a84282d-e0bb-4c28-9505-02b9712622125unnamed generic groupRefugeesIntegrate refugees entering the country into American society and connect them with wraparound services and resources, using faith-based and community organizations, to provide economic opportunity and successObjective_6f869ab8-adce-4805-8f3f-1435503357c46RefugeesAssistive TechnologyProvide assistive technology equipment to people with disabilities, allowing them more self-sufficiency and eliminating barriers to their economic opportunityObjective_02001eb2-51fe-4f58-9e36-fc9ac82cb1387People with DisabilitiesPeople with DisabilitiesIncrease the number of employed people with disabilities by encouraging and assisting integration into the greater community's workforceObjective_ac0c81b8-d8a1-4fef-8a8f-56fafcf32ec08People with DisabilitiesLow-Income PopulationsReform human services programs to assist low-income populations.Objective_c6c4ae50-97ee-4b0b-8fa9-86d1d791d55d9Although the number of people in poverty is shrinking, in 2016, 40.6 million people lived below the poverty line, with 32 percent of these people under the age of 18. The Department is working to reform human services programs to assist low-income populations through the following strategies:Low-Income PopulationsSafety-Net ProgramsFoster coordination and innovation across safety-net programs, including faith-based and community organizations, to help individuals and families in need to become self-sufficient and end dependency through employment and growth in habits of personal responsibilityObjective_840478b1-ba4d-4105-95cc-8e237f2e57e910unnamed generic groupTransitional ServicesIncrease access to comprehensive services as part of short-term, transitional public welfare services in partnership with other Federal agencies and faith-based and community organizations, including programs to promote social and economic self-sufficiency for American Indians and Alaska NativesObjective_b91a5e36-8196-4c3d-bdef-78a342a8eab411Community OrganizationsFederal AgenciesAlaska NativesAmerican IndiansFaith-Based OrganizationsFormerly Incarcerated IndividualsSupport formerly incarcerated individuals in obtaining and maintaining employment, developing habits of personal responsibility, reconnecting with their children and families, paying child support, and avoiding recidivismObjective_ef8789b7-3c8e-4622-be33-7242f0ae4a9c12Formerly Incarcerated IndividualsEconomic IndependenceBecome a center of excellence in the research and practice of facilitating rapid and sustained economic independence for diverse at-risk populationsObjective_74150002-e3c7-4bc3-8d28-4a7ddeb0e95613At-Risk PopulationsPersonal Responsibility, Education, Employability & RelationshipsSupport youth as they transition to adulthood by assisting them to develop habits of personal responsibility, to obtain an education, to strengthen employability skills, and to establish and maintain positive, healthy relationships (including through evidence-based or evidence-informed healthy marriage and relationship education)Objective_4a65dbad-3f3e-4fd9-bfbc-5d29e188a0ca14YouthHomelessnessReduce the incidence of homelessness.Objective_77b9559e-4fee-492d-8da6-9b8bfa15845915The Department participates in the U.S. Interagency Council on Homelessness, which coordinates the Federal response to homelessness by partnering with 19 Federal agencies, State and local governments, advocates, service providers, and people experiencing homelessness, with a goal of ending all homelessness in America. The Department is working with its partners to reduce the incidence of homelessness through the following strategies:unnamed organisationEmergy ShelterTest and invest in models, including emergency shelter and Housing First, to support homeless domestic violence survivorsObjective_61f094de-3343-4715-b98a-3ca6637c0c7916Domestic Violence SurvivorsRunaway & Homeless YouthStrengthen programs for runaway and homeless youth that provide outreach, crisis intervention, shelter, counseling, family reunification, and aftercare servicesObjective_6881a95e-20a9-48b7-a900-78b40abaaf6217Runaway YouthHomeless YouthInjuries & ViolenceSafeguard the public against preventable injuries and violence or their resultsObjective_ff7a9849-992e-4968-a3c6-13da90bf622818Performance Goals: * Increase the percentage of domestic violence program clients who have a safety plan * Decrease the percentage of children with substantiated or indicated reports of maltreatment that have a repeated substantiated or indicated report of maltreatment within 6 months * Increase intimate partner (domestic) violence screening among American Indian and Alaska Native females -- Injuries and violence affect all Americans regardless of an individual’s age, race, or economic status. Preventable injuries and violence -- such as falls, homicide stemming from domestic violence, and gang violence -- kill more Americans ages 1 to 44 than any other cause, including cancer, HIV, or the flu. Hospitalizations, emergency room visits, and lost productivity caused by injuries and violence cost Americans billions of dollars annually. Individual trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being. The Department supports multiple trauma-informed care initiatives to integrate a trauma-informed approach into health, behavioral health, and related systems, to reduce the harmful effects of trauma and violence on individuals, families, and communities. In 2015, the age-adjusted rate of unintentional injuries (43.2 per 100,000) increased 6.7 percent from the rate in 2014. The largest subcomponent of injury mortality is poisoning, with a rate 1.5 times greater than that of motor vehicle traffic deaths. In 2015, the age-adjusted rate of drug overdose deaths was more than 2.5 times the rate in 1999. The pattern of drugs involved in drug overdose deaths also has changed in recent years. In 2010, 29 percent of drug overdose deaths involved natural and semisynthetic opioids, and 12 percent involved methadone. In 2015, the percentage of drug overdose deaths involving these drugs decreased to 24 percent and 6 percent, respectively. In contrast, drug overdose deaths involving heroin increased from 8 percent in 2010 to 25 percent in 2015. Increases also were seen in drug overdose deaths involving synthetic opioids other than methadone, from 8 percent in 2010 to 18 percent in 2015. In 2014, according to the National Center for Health Statistics National Vital Statistics System, nearly 200,000 people died of injuries, including poisoning, resulting in a mortality rate of 62.6 per 100,000. In that same year, 39.5 million (126.3 per 1,000) medically attended injury and poisoning episodes occurred in the United States. In 2013, 1.4 million emergency department visits were due to assault alone. In 2014, 33,594 people died from all firearm-related injuries. In 2013, these issues cost the United States an estimated $671 billion in medical care and lost productivity.ACLOASHACFSAMHSACDCIHSPracticesIdentify and disseminate evidence-based practices to reduce injuries and violence.Objective_203bbb60-fb42-40cd-9607-13306137771319HHS funds 23 State health departments through the Core State Violence and Injury Prevention Program (Core SVIPP), which helps States implement, evaluate, and disseminate strategies that address the most pressing injury and violence issues, including child abuse and neglect, traumatic brain injury, domestic violence, and sexual violence. Core SVIPP aims to decrease injury- and violence-related morbidity and mortality and increase sustainability of injury prevention programs and practices. The Department also is working to identify and disseminate evidence-based practices to reduce injuries and violence through the following strategies:unnamed organisationAbuse InterventionExpand knowledge about important abuse intervention models to enhance evidence-based services for older adults and adults with disabilitiesObjective_5e75065d-a32b-4ca7-8949-a8dc860295a920Older AdultsAdults with DisabilitiesChildren & Youth SafetyDisseminate evidence-based strategies to keep children and youth safe from violence and injuries -- including child maltreatment, unintentional poisoning, drowning, fires and burns, and infant suffocationObjective_23dd8731-625d-4390-807e-d251daebb99d21YouthChildrenInfantsFoster CareEnsure more children safely avoid foster care placement by encouraging the availability of effective, accessible family support services to address the issues families face, including the opioid crisisObjective_586ace81-a5ce-4685-98de-f7d1ff013f7022Family Support ServicesChildrenServicesFund services to support those who have been impacted by injuries and violence.Objective_2fb2998c-8ac9-4bfb-a0d8-62eed14ed50423Homicide is the third leading cause of death for young people ages 15 to 24, with more than 4,000 young people dying by homicide each year. One in four women, and one in nine men, were victims of sexual violence, physical violence, or stalking by an intimate partner, resulting in injury, fear, and a concern for their safety. The Department funds services to support those who have been impacted by injuries and violence, including through the following strategies:unnamed organisationCenters of ExcellenceFund National Centers of Excellence in Youth Violence Prevention to better understand youth violence, implement and evaluate programs to prevent violence, and promote safe and supportive environmentsObjective_d491f7ae-4242-4fe2-95ff-5fbe0d6fd0ca24unnamed organisationEmergency SheltersProvide support for emergency shelters and related assistance for victims of family violenceObjective_0cd3085b-312b-4dcb-a53c-674aa779484225Victims of Family ViolenceAbuse, Neglect & ExploitationPrevent abuse, neglect, and exploitation for older Americans.Objective_d4475868-7fea-4aba-bb95-2071a2d16ec326An estimated 1 in 10 older adults will be a victim of elder maltreatment. The Department works to prevent abuse, neglect, and exploitation for older Americans through the following strategies: Note: Additional strategies to support older adults are in Strategic Objective 3.4.Older AmericansElder JusticeCoordinate elder justice activities within HHS and across the Federal Government through the Elder Justice Coordinating CouncilObjective_31376ebb-df8a-43c9-9f5b-c3d2f01c728827Elder Justice Coordinating CouncilLong-Term Care FacilitiesFoster the health, safety, rights, and welfare of individuals who live in long-term care facilities through promoting person-centered quality care, monitoring, and ombudsman programsObjective_f6115f98-593c-492d-9724-24a3f20eccdd28Long-Term Care FacilitiesResources & EducationImprove access to resources and education to help local communities identify and responding to elder abuse, neglect, and exploitationObjective_36abccb3-3aaf-4bd1-8ffc-ff70316ee6fb29Older AmericansMaltreatmentEnhance knowledge about preventing elder maltreatment, through researchObjective_00409200-52f6-44c5-9c68-a4fe030270bd30unnamed generic groupProtective ServicesStrengthen adult protective services' timely and effectively responses to older adults who are maltreated through practice guidelines, data collection and reporting, and technical assistanceObjective_1a13c146-bbef-43ab-b592-fd42bbfd6f3431Adult Protective ServicesPartnershipsExpand partnerships with Federal, State, Tribal, local, and territorial government entities and other stakeholders to reduce injuries and violenceObjective_0b746591-9b26-484a-9369-61171c7a949532The Department works across the Federal Government, and with States, territories, Tribes, and faith-based and community organizations, to address injuries and violence -- monitoring accidental and violence-related injuries, supporting research on the factors that put people at risk, creating and evaluating preventative programs, helping partners plan and implement programs, and conducting research on the effective adoption and dissemination of these strategies. The Department is working to expand partnerships with Federal, State, Tribal, local, and territorial government entities and other stakeholders to reduce injuries and violence through the following strategies:State Government EntitiesTribal Government EntitiesLocal Government EntitiesFederal Government EntitiesTerritorial Government EntitiesPregnant WomenProtect women from harmful exposures before, during, and after pregnancy, such as from domestic violence, tobacco exposure, and alcohol, opioid, and other harmful substance use, and improve outcomes for newborns and pregnant womenObjective_51306050-3636-4e78-9d8b-3011254d53e033NewbornsPregnant WomenDomestic & Dating ViolenceExpand interagency partnerships and systems to train healthcare and human service providers to assess for domestic and dating violence and do brief interventions to link victims to safety and support services, including through faith-based and community organizationsObjective_1626bbc0-d259-4c58-9dfe-9fbc17d31a2134Human Service ProvidersCommunity OrganizationsHealthcare ProvidersFaith-Based OrganizationsBullying & Dating ViolenceExpand bullying prevention and youth dating violence prevention partnerships with Federal, State, Tribal, local, territorial, and nongovernmental stakeholders to support safety and well-beingObjective_cefabb6f-56c6-43b4-abca-78663ad4187d35Territorial StakeholdersLocal StakeholdersNongovernmental StakeholdersFederal StakeholdersState StakeholdersTribal StakeholdersGangsExpand and strengthen partnerships with Federal, State, local, Tribal, and territorial partners, including faith-based and community organizations, on gang prevention programs as well as investing in youth mentoring and coaching, counseling, and life skills and workforce trainingObjective_f1fc5a37-ae17-43fd-a618-3badec26342636Federal PartnersFaith-Based OrganizationsState PartnersCommunity OrganizationsTerritorial PartnersTribal PartnersLocal PartnersHuman TraffickingAssess and increase the capacity of medical and behavioral health practitioners, nonprofits, faith-based and community organizations, licensed social workers, child welfare professionals, housing authorities, and public health agencies to provide comprehensive and survivor-informed services for victims of human traffickingObjective_365f00b8-44ce-478d-bd5b-ea2e6765b86337Medical PractitionersNonprofitsBehavioral Health PractitionersPublic Health AgenciesLicensed Social WorkersHousing AuthoritiesChild Welfare ProfessionalsCommunity OrganizationsFaith-Based OrganizationsChild Welfare SystemImprove services to children and families in the child welfare system as a result of parental or caretaker opioid or other substance use disorder, including through faith-based and community organizationsObjective_03108c20-b38d-430a-b853-508bc0ddbafa38FamiliesChildrenCultural CompetenceEnhance the cultural competence of the workforce in the delivery of social services to children, youth, and families through research, technical assistance, and trainingObjective_f4b55c23-c163-471c-9c36-c18648f90a9039unnamed generic groupDataCollect, analyze, and report national data on the incidence and consequences of injuries and violenceObjective_badd81c5-d95a-48bb-befe-9becf396e6c740Nearly 192,000 people die from violence and injuries each year -- nearly 1 person every 3 minutes. The Department is working to collect, analyze, and report national data on the incidence and consequences of injuries and violence through the following strategies: Note: Additional surveillance strategies are in Strategic Objective 4.1.unnamed organisationHealthcare Use & CostAssess healthcare use and costs associated with violence and unintentional injury, including patient safety events that occur in healthcare settings, to inform actions to prevent injury and violence and describe the return on investment of public health actionObjective_aedcf369-5c78-4c52-a217-aacf7ea1a9d541unnamed organisationMonitoringDevelop and enhance timely, coordinated data systems to monitor injuries and violence by using expanded surveillance, innovative methods, and new technology, to inform and evaluate national and State prevention activitiesObjective_e846bd34-6152-4130-9f29-3aab0e7d336f42unnamed organisationChild MaltreatmentAddress gaps in data on prevalence and risk factors for child maltreatmentObjective_0b1ea144-c7e0-47e7-bb05-4139d291693843ChildrenFamilies & ChildrenSupport strong families and healthy marriage, and prepare children and youth for healthy, productive livesObjective_308808e7-04a9-4438-ba3f-1d740695301e44Performance Goals: * Reduce the proportion of Head Start preschool grantees receiving a score in the low range on any of the three domains on the basis of the Classroom Assessment Scoring System (CLASS: Pre-K) * Reduce the proportion of children and adolescents ages 2 through 19 who are obese * Maintain the proportion of youth living in safe and appropriate settings after exiting ACF-funded Transitional Living Program services * Increase the number of participants in ACF-funded healthy marriage and relationship education services -- Families are the cornerstone of America's social fabric. A strong family can lead to many positive outcomes for the health, social, and economic status of both adults and children. People live longer, have less stress, and are more financially stable in a healthy family environment where both parents are present, share the responsibility of the household, and raise the children. Additionally, in these households, children tend to be healthier, both mentally and physically, and are better able to have their fundamental needs met. The Department supports healthy families and youth development through collaborations across the Federal Government and with States, territories, community partners, Tribal governments, and faith-based organizations. Head Start - PDF served 1.1 million children from birth to age 5 and pregnant women in 2015–2016, and approximately 1.4 million children per month received child care assistance in 2015. Recommendations for best practices for early child development are shared with partners across the country. Transitions from youth to adulthood are supported through the promotion of strength-based approaches, multisector engagement, and youth engagement efforts. Through programs like the Healthy Marriage and Relationship Education Grant Program, the Department funds organizations (including faith-based and community organizations) across the country to provide comprehensive healthy relationship and marriage education services, as well as job and career advancement activities to promote economic stability and overall improved family well-being. Children with involved fathers are more likely to perform well in school, have healthy self-esteem, and display empathy and pro-social behavior, compared with children who have uninvolved fathers. The New Pathways for Fathers and Families funds organizations across the United States to provide responsible-fatherhood activities that strengthen positive father-child engagement, improve employment and economic mobility, and improve relationships (including couple and coparenting) and marriage. The Department also supports reentry efforts for incarcerated fathers. Approximately 1.7 million State and Federal inmates are fathers of minor children. The impacts of incarceration affect the lives and well-being of their children and families. The Responsible Fatherhood Opportunities for Reentry and Mobility program funds grants that are specifically tailored to the needs of fathers transitioning from incarceration to their families and communities. Grants help fathers stabilize their lives, establish or reconnect with their children and families, develop habits of personal responsibility, obtain employment, and achieve economic mobility.ACLACFSAMHSAIHSOASHCDCHRSAChildrenFamiliesChildrenSupport the healthy development and well-being of children.Objective_77120e30-40ff-4813-97bc-ed48f300472545In 2016, the United States was home to 73.6 million children, a number that is projected to grow to 74.5 million by 2022 and 76 million by 2029. The Department supports the healthy development and well-being of children through the following strategies:ChildrenHealthy DevelopmetnPromote healthy development in young children to avoid behavioral challenges, support school readiness and learning, and offer parents of young children access to evidence-based, culturally appropriate parenting education and supportsObjective_3af6472f-c773-4ded-8d6c-990a316319e346ParentsYoung ChildrenQualityImprove the quality of care and education settings through effective professional development, coaching, monitoring for health and safety, provision of comprehensive services, and other training and technical assistance in order to promote positive teacher-child interactions and support children's skill development in all domains, including language, early literacy, numeracy, cognitive, and social-emotional developmentObjective_e075174c-3990-43d9-b646-1dfb69797b1847ChildrenTeachersLanguage DevelopmentTo achieve optimal brain development for all children, identify and promote effective approaches for early language development to integrate them into existing programs that reach young children, and leverage partnerships (including with faith-based and community organizations) to encourage broad implementationObjective_fa9c50f2-3eeb-467c-a36a-e4bd46757ead48Young ChildrenFaith-Based OrganizationsCommunity OrganizationsActivity, Play, Nutrition & ContactPromote increased physical activity and active play, improved nutrition, reduced screen time, and increased interpersonal contact with and between children in child care and early childhood development programsObjective_0c163c4f-8025-4e37-a0ac-0ce50d9d52a949Early Childhood ProgramsChild Care ProgramsChildrenEarly Care & EducationImprove access to high-quality early care and education opportunities for young children by improving the quality of existing early care and education settings, including those offered by Tribes and faith-based and community initiatives, and building the supply of high-quality options for familiesObjective_7ae30473-5955-4d8b-aa9b-a424c5b97b8e50Community InitiativesFaith-Based InitiativesEarly Care SettingsTribesYoung ChildrenEducation SettingsChildren with DisabilitiesRemove barriers to inclusion and accessibility to early child care and education for children with disabilitiesObjective_b4ad8320-9de5-4388-ac15-dd56b076baa651Children with DisabilitiesPrograms & ServicesReduce barriers to child and family participation in early childhood programs and servicesObjective_22e6f4ce-de6b-40f2-88ea-5a5a4ff49ccc52FamiliesChildrenEarly Childhood SettingsProvide effective training and technical assistance to help parents and families have greater involvement with teachers, educators, and caregivers to improve the quality of early childhood settingsObjective_45b52c7d-f5b4-4a3c-ab73-d165ae5e2d3a53Early Childhood SettingsTeachersCaregiversFamiliesEducatorsParentsAdolescents & Young AdultsSupport the healthy development and well-being of adolescents and young adultsObjective_f08124e0-575b-4d1f-9985-4617d7a683a054Through the Interagency Working Group on Youth Programs, the Department collaborates with other Federal departments and agencies to support at-risk youth through adolescence and young adulthood. The Department supports the healthy development and well-being of adolescents and young adults through the following strategies:AdolescentsYoung AdultsYouth TransitionsSupport successful youth transitions to adulthood by strengthening relationship and employability skills and the development of habits of personal responsibilityObjective_4d79b6f6-e573-4f35-9c66-33e53531c60255YouthRelationshipsHelp youth establish and maintain positive, healthy relationships, including connections with peers and caring adults, through demonstration programs and evidence-based or evidence-informed programs (including programs that provide healthy marriage and relationship education), including programs provided by faith-based and community organizationsObjective_b7b52f01-9aae-4e45-9a78-39eeb0aee97b56YouthPeersCaring AdultsMental IllnessInvest in training to support adults in detecting and responding to mental illness in children and youth, including encouraging adolescents and their families to seek treatmentObjective_98a57927-7749-4a38-996c-fa572a67245b57ChildrenAdultsYouthMorbidity, Mortality & Risk BehaviorsPrevent and reduce morbidity, mortality, and key risk behaviors among youth by supporting schools and communities to improve youth skills through sound health education and connection to needed services, and promoting school environments that protect and nurture youth to avoid risk and make positive life choicesObjective_9f252c59-e976-4869-8fbc-c5029acd83a458YouthSchoolsCommunitiesFoster CareSupport efforts to place children in foster care with extended birth family and support these kinship caregiversObjective_8073ccf1-9063-40bb-9959-bfaa2babe7ed59Kinship CaregiversChildrenExtended Birth FamiliesAdoptive FamiliesPromote efforts to recruit, train, and support adoptive families for children and youth whose birth parents and relatives cannot or will not safely care for themObjective_eca2e290-b839-4010-a3ef-9b84fb239f4160Adoptive FamiliesChildrenFoster CareSupport efforts to ensure the well-being of children in foster care and those who age out of foster care without a familyObjective_33b7d356-0a53-4e8c-ac59-5843cc90664461unnamed generic groupHealthy DecisionsProvide adolescents with information and support to make healthy decisions regarding their health and well-being, including risk avoidance and establishment of positive life choicesObjective_2e9bd58c-fd20-45a7-8aff-9e5eb0fa80c662AdolescentsParents, Guardians & CaregiversSupport parents, guardians, and caregivers.Objective_3d6c4fd6-9e79-4e53-88d7-7c66fec2bbe363While most children live with two parents, the Census Bureau estimates that 23 million children live in households with only one parent or no parent at all. The Department supports parents, guardians, and caregivers through the following strategies:GuardiansParentsCaregiversParentingImprove opportunities for parent participation in an evidence-based parenting curriculum or mentoring programs to improve parenting skills and lead to better learning and development outcomes for children and marital and family stabilityObjective_32071486-bf83-472f-b3c0-b44056228fa564ParentsFamiliesChild Development & ParentingSupport efforts, including through Tribes and faith-based and community organizations, to educate parents and caregivers about healthy child development, effective parenting practices, and specific developmental and health concerns faced by their childrenObjective_78e01bb4-d98e-4c53-8d9e-82890c220c5965Faith-Based OrganizationsTribesCommunity OrganizationsParentsCaregiversFatherhoodSupport and engage fathers in innovative program models across agencies to better integrate them into their families' lifeObjective_710d57e6-b341-4504-914b-1a0e90813b9166FathersFamiliesParental Mental Health & Substance AbuseSupport families with young children by addressing parental mental health or substance abuseObjective_ad6d88a3-4208-4317-a790-e6c059e1a19b67Young ChildrenParentsMarriages & RelationshipsDevelop and implement local and national dissemination strategies to communicate the value of healthy marriages and relationships, and of the success sequence, which recommends completing education, obtaining employment, and getting married before a first or subsequent child, across all socioeconomic demographicsObjective_1303a6cf-01b3-4f93-9204-81c48c84340a68unnamed generic groupServices & HealthIntegrate human services and health supports to support the well-being of children, youth, and families.Objective_b6e47e37-910a-4464-8dc8-6bc3e73bf0b069The Department recognizes that other risk factors like poverty, food insecurity, and housing instability can negatively impact health, and is working to integrate human services and health supports to support the well-being of children, youth, and families through the following strategies:unnamed organisationPreventive & Primary HealthcareEnsure more young children become up to date on all age-appropriate preventive and primary healthcare, including sensory and developmental screening, with appropriate referral and interventionObjective_7b851535-7090-44df-9973-2098848a4e6e70Young ChildrenService AccessPromote interagency Federal, State, and local coordination, including through Tribes and faith-based and community organizations, to facilitate families' access to services and help them navigate systems of care across the full spectrum of family needs, including housing, education and training, healthcare, child care, social services, and economic supportsObjective_388d0ad6-2c75-43d6-8aab-3bbfc82033d871unnamed organisationRisks & ChoicesIntegrate age- and developmentally appropriate strategies into programs designed to help all youth avoid risk and make better choicesObjective_3f7c1231-e7e2-4733-960e-4dbcb65da56072YouthPediatric CareIntegrate trauma-informed, family-focused behavioral health services with pediatric primary careObjective_77f95629-adc5-4479-8b2f-021d91b359af73unnamed organisationOlder Adults, People with Disabilities & CaregiversMaximize the independence, well-being, and health of older adults, people with disabilities, and their families and caregiversObjective_d153958c-0a4c-474d-8971-287287d4016474Older adults and people with disabilities face a complex set of difficulties. About one in every seven, or 14.9 percent, of the population is an older American - PDF. Approximately 12 percent of working-age adults in the United States have some type of disability. Of these adults, 51 percent had a mobility disability, and 38.3 percent had a cognitive disability. Older people and people with disabilities often rely on other people to fulfill fundamental needs and complete daily tasks. In order to facilitate adequate care and maximize independence, older adults and people with disabilities of all ages should be able to live where they choose, with the people they choose, and with the ability to participate fully in their communities. To support older adults, people with disabilities, and the system of friends, family, and community members that support them, the Department collaborates across the Federal Government, with States, Tribes, and territories, and with faith-based and community organizations. Aging and Disability Resource Centers provide a gateway to a broad range of services and supports for older adults and people with disabilities. Centers for Independent Living are community-based centers that offer services to empower and enable people with disabilities to stay in their communities. Every State and territory has an Assistive Technology Act program that can help people find, try, and obtain assistive technology devices and services. Assistive technology includes resources ranging from "low tech" helping tools -- like utensils with big handles -- to higher-tech solutions like talking computers. The Department also supports caregivers of older Americans and Americans living with disabilities. At least 90 percent of older adults receiving help with daily activities receive some form of unpaid care, and about two-thirds receive only unpaid care. In 2011, an estimated 18 million unpaid caregivers provided 1.3 billion hours of care on a monthly basis to Medicare beneficiaries age 65 and over. Strategies relating to supporting the healthcare needs of older adults and people with disabilities can be found in Strategic Goal 1: Reform, Strengthen, and Modernize the Nation's Healthcare System and Strategic Goal 2: Protect the Health of Americans Where They Live, Learn, Work, and Play. This Strategic Objective focuses on human services -- efforts to support the economic and social well-being of these populations.CMSHRSAACFACLCDCOASHIHSSAMHSAOlder AdultsCaregiversPeople with DisabilitiesCommunity LivingStrengthen supports for community living.Objective_5d95f183-4815-4c72-8851-f602325e0a9175Stable housing is foundational to good health and well-being. Accessible, affordable housing is essential to community integration and aging-in-place. For some older adults and people with disabilities, additional assistance is required to support community living. The Department works to strengthen supports for community living through the following strategies:unnamed organisationLivable CommunitiesSupport age- and dementia-friendly livable communities to improve quality of life for older adults, families, caregivers, people with disabilities, and the larger communityObjective_c56c4564-722d-4aec-ae50-138f2e6e11ed76People with DisabilitiesOlder AdultsFamiliesCaregiversIndependencePromote independence of older adults and people with disabilities through improved collaboration, including with Tribes and faith-based and community organizations, to ensure opportunities to live and receive services in the communityObjective_45acba4b-3ffa-4b97-813c-5e0e9a230bca77Older AdultsPeople with DisabilitiesInclusion & AccessibilityFoster culture change through inclusion and accessibility for children and adults with disabilities and older adults by removing physical and other barriersObjective_7f91d35a-0495-43e0-843b-99cb3a14dc1178Adults with DisabilitiesChildren with DisabilitiesOlder AdultsProgramsSupport programs for people with disabilities and older adults that help protect them from all forms of abuse, including physical, mental, emotional, and financial abuse, and help ensure their ability to exercise their rights to make choices, contribute to their communities, and live independentlyObjective_5b2a8883-192e-42d1-87b7-88900e883c6c79Older AdultsPeople with DisabilitiesRelationshipsSupport focused technical assistance to States aimed at forging stronger relationships between State Medicaid agencies, State housing finance agencies, and private partners including faith-based and community organizations with the goal of expanding community-living capacity in StatesObjective_0bc23fec-28e5-47cc-ad13-34d3318ce44880Community OrganizationsFaith-Based OrganizationsState Medicaid AgenciesPrivate PartnersState Housing Finance AgenciesCare Continuum, Transitions & Coordinationsupport choice across the care continuum, as well as improved care transitions and care coordination.Objective_4719e83c-65f6-42dd-b7ac-1bd2b591e41f81In Olmstead v. L.C., the Supreme Court affirmed that under the Americans with Disabilities Act, people with disabilities cannot be unnecessarily segregated and must receive services in the most integrated setting appropriate for their needs. Federal and State efforts following this landmark decision have increased community participation and independence of people with disabilities and older Americans who are living in communities, including those who have transitioned from nursing homes and other institutions. The Department is working to support choice across the care continuum, as well as improved care transitions and care coordination, through the following strategies:unnamed organisationCollaborationPromote collaboration among Federal, State, Tribal, local, territorial, and private-sector partners that serve older adults, people with disabilities, and their families and caregivers to improve access to a full range of healthcare services, and home and community-based servicesObjective_85ec7aa0-b13c-4bc9-b48f-b90845aeac5382People with DisabilitiesCaregiversOlder AdultsTransitionsPursue initiatives and programs to provide support to older adults, people with disabilities, and their families and caregivers as individuals move between the settings that best address their unique needsObjective_e42d92e9-dd7c-4e04-aaf8-13e0ddf0bb4a83Older AdultsPeople with DisabilitiesCaregiversPlansIncrease the proportion of youth with disabilities who have plans in place for transitioning from pediatric to adult careObjective_16101461-f0df-46ed-a9fa-d634dd151fb684Youth with DisabilitiesLong-Term Services & SupportsImprove quality and availability of long-term services and supports, including home and community-based services (HCBS)Objective_2ab0765d-cb5c-4fd1-8c1f-682b93c9f1f885Approximately 20 percent of older Americans receive assistance with their care needs. Medicaid is the largest source of support for long-term services and supports, with an estimated $131.4 billion annually expended at the Federal and State levels. The Department is working to improve quality and availability of long-term services and supports, including home and community-based services (HCBS), through the following strategies:Community-Based Services (HCBS)Performance MeasuresSupport the development of a core set of performance measures for HCBS that can provide data that can be used in quality and outcome measurement and reportingObjective_a9e3309a-24e0-4346-8262-69644fb058b386unnamed generic groupDelivery Models & FlexibilitySupport innovative delivery system models and program flexibilities that include HCBS to improve quality, accessibility, and affordability in Medicare and MedicaidObjective_98131a4f-856c-437b-b8c8-1a809866073987unnamed generic groupPerson-Centered CareConsider new person-centered models of care in Medicare and Medicaid that provide an integrated approach to addressing individuals' medical, behavioral, long-term services and supports, and other needs to maintain health, well-being, and independenceObjective_114c1872-75fb-4b5c-9fdd-894d45c2b0bb88MedicaidMedicarePersons with DementiaIdentify opportunities to accelerate the development, evaluation, translation, implementation, and scaling up of comprehensive care, services, and supports for persons with dementia, families, and other caregiversObjective_332adb37-d835-4f53-8039-e5d9edcaef4b89CaregiversPersons with DementiaLong-Term Services & SupportAssist States in strengthening and developing high-performing long-term services and supports systems that focus on the person, provide streamlined access, and empower individuals to participate in community livingObjective_72dfcb86-6878-4588-a5b5-4b751d1876e990StatesDisaster & Emergency PreparednessEducate and improve the awareness of HCBS providers of the need to integrate the access and functional needs of older adults and people with disabilities into disaster and public health emergency preparedness, response, mitigation, and recoveryObjective_6ca902c0-66eb-42b6-bb01-78cf7695648a91Older AdultsPeople with DisabilitiesHCBS ProvidersAlzheimer's Disease & DementiasAddress Alzheimer's disease and related dementias.Objective_d50d9aff-aeb0-4913-b208-fa1e54d68bb792Alzheimer’s disease (AD) is an irreversible, progressive brain disease that affects as many as 5.3 million Americans. The prevalence of people with AD doubles for every 5-year interval beyond age 65. Without a preventive treatment or cure, the significant growth in the population over age 85 that is estimated to occur between 2015 and 2050 (from 6.3 million to 19 million) suggests a substantial increase in the number of people with AD. The Department is working to address Alzheimer’s disease and related dementias through the following strategies: Note: Additional strategies on preventive care are in Strategic Objectives 1.3 and 4.3.unnamed organisationEducation, Training & SupportExpand supports for people with Alzheimer's disease and related dementias and their families through culturally sensitive education, training, and support; assessing housing and other needs; and assisting families in planning for future care needsObjective_94a45ffa-95c8-4f01-8da0-7df6fa3bce3c93People with Alzheimer's DiseasePeople with DementiasDiagnosis & Clinical ManagementEnhance public awareness and engagement to reduce misperceptions about diagnosis and clinical managementObjective_20084824-428c-4569-b1a3-bf7e58f66c0794unnamed organisationDataImprove data to track the burden of Alzheimer's disease and related dementias, identify and monitor trends in associated risk factors, and assist with understanding health disparitiesObjective_63f100f2-0816-4ba5-aea2-4e357949346a95unnamed organisationCaregiversStrengthen supports for caregivers.Objective_0af35a99-1bcd-436a-88e7-4671ae915fd496Caregivers provide care to people of all ages who live in residential or institutional settings. Caregiving can be both paid and unpaid; a 2009 survey found that approximately 25 percent of adults reported providing care to a person with a long-term illness or disability in the past 30 days. The Department is working to strengthen supports for caregivers through the following strategies:CaregiversSupportProvide support for unpaid family caregivers, to maximize the health and well-being of the caregivers and the people for whom they provide careObjective_e6c77706-6011-4232-8add-5edbb0e8eb2597Unpaid Family CaregiversCommunity SupportEducate and empower community supports, such as faith-based and community organizations, for providing support of all types for caregiversObjective_87cd781d-5d9c-4319-a209-06025962ad4e98Community OrganizationsFaith-Based OrganizationsResearch Gaps & FindingsIdentify research gaps in caregiving, and optimize sharing of research findingsObjective_67a5ab04-5f94-4dc4-a0ee-5d008704768e99unnamed generic groupCaregiver ResourcesImprove access to educational and community-based resources that caregivers can use to maintain and/or increase their health and well-beingObjective_0e2bd46d-945c-4c04-b88a-6d33864b4e0f100CaregiversService DisparitiesReduce disparities in services for older adults and people with disabilities.Objective_e8d4e29a-741c-46d9-ae0d-b50fd1281bc6101For people with complex health needs, such as older adults and people with disabilities, accessing high-quality and affordable care -- healthcare, as well as assistance for daily living -- can be challenging. Geographic disparities, as well as economic constraints, can limit the number and quality of available options. The Department is working to reduce disparities in services for older adults and people with disabilities through the following strategies:People with DisabilitiesOlder AdultsRightsEnsure that individual rights are protected and addressed through enforcement of mental health and substance use parity laws, Olmstead, Americans with Disabilities Act, and other protectionsObjective_0fc1c05f-8b41-48fd-b3d7-55cbd1a9c9db102unnamed generic groupCare PlanningInclude culturally appropriate, person- and family-centered care planning in Federal social and healthcare services for older adults and persons with disabilities to protect individual choice and address a person's current and future economic resources, including advance care planning needsObjective_47d56266-4a9b-4917-b77e-f094202be563103unnamed generic groupMonitoring & ReportingMonitor, using existing data sources, the status of the health, well-being, and independence of older adults and people with disabilities, and improve reporting on these populationsObjective_4a2246cd-5513-4a95-a60b-6f6f10b93e0e104Older AdultsPeople with DisabilitiesWorkforceStrengthen the workforce providing services to people 65 years old and older.Objective_4736d30f-87cd-487b-afcb-9ca9c790f1f8105The number of people 65 years old and older is expected to double between 2000 and 2030. Providing high-quality services to this growing population requires a high-quality workforce. The Department seeks to strengthen the workforce through the following strategies:Older AmericansEducationEducate the healthcare and service professional workforce on the concerns of a geriatric population to ensure awareness of the unique challenges and issues of older adultsObjective_3d8a2076-d8e7-4a90-aa64-b011e83387cc106unnamed organisationCompetencyImprove and increase competency in the healthcare and direct service workforce in person-centered approaches and cultural competencyObjective_c6ff3e6b-411e-4c0f-b21f-d8638201a072107Healthcare WorkforceDirect Service WorkforceTraining & CapacityStrengthen the training and capacity of healthcare providers to recognize, assess, refer, connect, and engage caregiversObjective_2b247d34-acbe-46b4-8536-d2bb86c520b0108Healthcare ProvidersCaregiversPartnershipsStrengthen partnerships between academia, health delivery systems, Tribes, and faith-based and community organizations to educate and train the workforce to provide high-quality, culturally competent careObjective_92ec10b9-9bf8-4f8d-8e9b-b2c2156cfd3d109TribesAcademiaCommunity OrganizationsHealth Delivery SystemsFaith-Based OrganizationsScienceFoster Sound, Sustained Advances in the SciencesGoal_086af586-61a8-49d9-986e-0a2f712b95194According to a recent study, the United States makes about 44 percent of the total global biomedical research investments worldwide. Together with foundations, charities, private industry, and State, Tribal, local, and territorial governments, the Department’s scientific investments seek to unlock mysteries to improve health and well-being; reduce the burden of death, disease, and disability; and extend and improve quality of life. These scientific investments are to be conducted consistent with the understanding that all human life is valuable and that the human subjects protection regulations apply to all human beings from conception to natural death.
Making better decisions in health, public health, and human services often depends on data obtained through surveillance, epidemiology, and laboratory services—at the Federal, State, Tribal, local, and territorial levels. HHS efforts in this area help to track and trace disease outbreaks, connect the data to tell a more complete story of public health issues, and facilitate speedier responses to threats to health and well-being.
Success in this domain starts with our scientific workforce. To date, 153 NIH-supported researchers have received Nobel Prizes for their achievements. HHS strives to expand the capacity of the research workforce, and equip them with the tools to make the discoveries of tomorrow.
The NIH’s Human Genome Project—completed under budget and 2 years ahead of schedule—has led to the discovery of more than 1,800 disease genes and is sparking the development of more powerful, preventive, personalized medical interventions. Basic science and applied research investments—whether intramural or extramural—seek solutions to the health, public health, and human services challenges articulated throughout this Strategic Plan.
To be truly effective, these discoveries must be shared, adopted, scaled up, and implemented with fidelity. HHS is working to promote evidence-informed practices in the health, public health, and human services domains. As a steward of the public trust, HHS has a responsibility to promote approaches that will improve health and well-being.OASHACFunnamed organisationCDCunnamed organisationunnamed organisationHRSAunnamed organisationunnamed organisationAHRQAHRQunnamed organisationunnamed organisationunnamed organisationFDAOffice of the Assistant Secretary for Health (OASH)unnamed organisationNIHNational Institutes of Health (NIH)unnamed organisationunnamed organisationunnamed organisationNIHunnamed organisationunnamed organisationunnamed organisationCDCunnamed organisationunnamed organisationAHRQAdministration for Children and Families (ACF)unnamed organisationAgency for Healthcare Research and Quality (AHRQ)unnamed organisationunnamed organisationunnamed organisationCDCOASHCDCNIHACLOGAunnamed organisationunnamed organisationunnamed organisationunnamed organisationunnamed organisationOffice of Global Affairs (OGA)unnamed organisationunnamed organisationOGAunnamed organisationunnamed organisationSAMHSAunnamed organisationunnamed organisationunnamed organisationHealth Resources and Services Administration (HRSA)Office for Civil Rights (OCR)unnamed organisationOffice of the Assistant Secretary for Preparedness and Response (ASPR)unnamed organisationSubstance Abuse and Mental Health Services Administration (SAMHSA)Food and Drug Administration (FDA)unnamed organisationOCRunnamed organisationCenters for Medicare & Medicaid Services (CMS)unnamed organisationunnamed organisationunnamed organisationunnamed organisationCenters for Disease Control and Prevention (CDC)unnamed organisationunnamed organisationunnamed organisationOASHunnamed organisationCMSunnamed organisationunnamed organisationSAMHSAunnamed organisationunnamed organisationunnamed organisationunnamed organisationunnamed organisationFDANIHAdministration for Community Living (ACL)SAMHSAASPRunnamed organisationunnamed organisationunnamed organisationunnamed organisationunnamed organisationFDAunnamed organisationunnamed organisationACLFDAunnamed organisationPublic Health ScientistsLaboratory ManagersAt-Risk PopulationsPublic Health ProvidersPrimary Care Providersunnamed generic groupLaboratoriesSchoolsPrivate SectorChildrenLocal Agenciesunnamed generic groupU.S. Preventive Services Task ForceScientific WorkforceCaregiversunnamed generic groupMedical Product DevelopersDisproportionately Affected PopulationsLaboratory ScientistsInternational AgenciesGovernment AgenciesChildrenFamiliesInvestigatorsChildrenLaboratory WorkforceHealthcare ProvidersYouthHealthcare ProvidersCommunity Organizationsunnamed generic groupunnamed generic groupInternational AgenciesHuman Subjectsunnamed generic groupunnamed generic groupunnamed generic groupAcademic InstitutionsLaboratory PersonnelPopulations at RiskPatientsAdultsDisadvantaged PopulationsAmerican IndiansLaboratoriesParentsunnamed generic groupunnamed generic groupHealthcare Providersunnamed generic groupSurvey StatisticiansChildrenPublic Health Research NetworksDomestic Violence ProgramsU.S. Preventive Services Task Forceunnamed generic groupAcademiaYouthGranteesEarly-Career ScientistsClinical PartnersFamiliesPeople with DisabilitiesAdolescentsunnamed generic groupunnamed generic groupService Delivery ProfessionalsOlder AdultsYouthAt-Risk PopulationsChildrenDisproportionately Affected PopulationsHealthcare Research NetworksScientific Workforceunnamed generic groupAdultsFaith-Based OrganizationsAlaska NativesScientific WorkforceMicrobiology LaboratoriesInvestigatorsSystems of CareCommunitiesScientific Research WorkforceFederal AgenciesResearch CommunityPublic Health Laboratory Partnersunnamed generic groupunnamed generic groupTribesPatientsStatesHuman Service System Research Networks Healthcare FacilitiesDisadvantaged PopulationsSurveillance, Epidemiology & LabsImprove surveillance, epidemiology, and laboratory servicesObjective_50fa214f-db63-4e8f-b5c3-cc7a91b32aab1Performance Goals: * Increase the percentage of laboratory reports on reportable conditions that are received through electronic means nationally * Increase the percentage of notifiable disease messages transmitted in HL7 format to improve the quality and streamline the transmission of established surveillance data * Increase the number of people for whom the FDA is able to evaluate product safety through the Mini-Sentinel/Sentinel system
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In an increasingly interconnected world, public health threats can quickly escalate from an isolated incident to a regional or even global emergency. A flu outbreak in one State can quickly spread to multiple States -- keeping children out of school and adults away from work, and threatening the lives of the very young and very old. Rapid changes in public health patterns -- such as the growth in opioid use and overdose -- can strain the resources and capacity of first responders, health systems, and communities.
Identifying and mitigating urgent and persistent threats to public health depends on the quality of surveillance, epidemiology, and laboratory services—at the Federal, State, and local levels as well as with U.S. territories, Tribes, and international partners. Public health surveillance data, applied epidemiology, and laboratory best practices can guide better decision making to target interventions more responsibly, and ultimately improve health.
The Department is dedicated to conducting and funding scientific research that leads to evidence-based, high-quality care and responsive interventions to mitigate health crises. Data and information from surveillance, epidemiology, and laboratory services can aid in the prevention and early intervention of foodborne illnesses, such as listeria and norovirus, and infectious disease outbreaks, such as Zika and Ebola. To achieve this objective, the Department is working to facilitate information exchange to identify risks quickly and efficiently, strengthen the quality and safety of our Nation’s laboratories, and strengthen the alignment of surveillance, epidemiology, and laboratory services.
As response rates to surveys fall and primary data collection costs increase, the need to use and leverage new sources of data for public health surveillance becomes critical. Within the Department, efforts are underway to use electronic health records for infectious disease surveillance and to facilitate coding of causes of death on death certificates. At the National Center for Health Statistics, linkages between survey data, mortality data, hospital administrative data, electronic health records, Medicare data, and housing data have been created and should greatly expand public health surveillance opportunities. In addition, HL7 Continuity of Care Document specifications have been published to facilitate the submission of standardized electronic health information to the National Health Care Surveys, enhancing their usability for surveillance.OGACMSSAMHSAASPRNIHOCRCDCFDAOutcomesApply surveillance data and epidemiological findings to improve outcomes.Objective_4b049006-4b5c-4bd3-a9cd-0caa9619ef0b2The value of data, as articulated by the HHS Data Council, is its relevance, timeliness, availability when needed, and distinctive contributions. The Department will apply surveillance data and epidemiological findings to improve outcomes through the following strategies:unnamed organisationData StandardsEstablish data standards and, as appropriate, ensure that Federally conducted or supported healthcare or public health programs, activities, or surveys collect and report data in five specific demographic categories: race, ethnicity, sex, primary language, and disability statusObjective_13114c50-99c4-4efe-86ff-892eac77c3bf3unnamed organisationAmerican Indians & Alaska NativesEngage with American Indians/Alaska Natives to explore opportunities to improve data collection effortsObjective_398abccf-0ee3-45db-bff5-6b6da2670d664American IndiansAlaska NativesPopulation HealthCollect, analyze, and report granular or disaggregated data to support population healthObjective_2f7c03cf-96b6-4c0a-b93c-57851814dd1c5unnamed organisationHealth & Human ServicesApply surveillance data and epidemiological findings to improve health, public health, and human services.Objective_247647f4-3662-4613-8381-8fb14c63a9656In addition to these more general strategies with applicability across settings, the Department will apply surveillance data and epidemiological findings to improve health, public health, and human services through the following strategies:unnamed organisationYouthPromote use of youth-focused surveillance and data collection to inform school and community actions that improve the health of adolescentsObjective_3a1ed4e6-166b-482d-933a-9d05d5cc3d6b7CommunitiesSchoolsYouthAdolescentsMedical ProductsIdentify and assess adverse events related to the use of regulated human and animal medical products, including the development and more effective use of large nationally representative database systems, electronic health records, common data models, and natural language processingObjective_6d71cc08-4d2e-4cd9-8404-b29b7bb158398unnamed organisationFoodImplement advanced laboratory, epidemiologic, and environmental methods across Federal and State agencies to identify, investigate, and stop foodborne outbreaks sooner and prevent future illness by identifying and addressing gaps in the food safety systemObjective_2fb91c03-553f-4627-b4f9-6a124132035a9unnamed organisationInfluenzaEnhance domestic and global capacity for influenza surveillance to ensure rapid detection and reporting of cases or outbreaks of influenza viruses that have pandemic potential and to monitor trends in seasonal influenza epidemiologyObjective_6c307fc7-9214-4340-becd-e406e7e64ad110unnamed organisationOpioidsStrengthen understanding of the opioid crisis through better public health surveillance to inform clinical management decisions for patients, including effects of opioid use in pregnancy and neonatal abstinence syndromeObjective_689613fa-3ece-4a52-b2bc-eecc504c373c11unnamed organisationBehavioral DisparitiesAnalyze data on behavioral health disparities to increase understanding of factors contributing to disparities, identify disadvantaged and at-risk populations, assess trends, and inform policy and program developmentObjective_93e0b2b3-91ff-403c-b5ab-1f4df741ebfd12Disadvantaged PopulationsAt-Risk PopulationsEmergenciesSupport a data-driven approach to emergency preparedness, response, and recoveryObjective_ecd35998-0525-4e93-ad24-869cc05fec5a13unnamed organisationInjury & ViolenceAssess healthcare use and costs associated with violence and unintentional injury, including patient safety events that occur in healthcare settingsObjective_a57bfbc8-bccd-4c1b-96d4-0d8633a274af14unnamed organisationMonitoringDevelop and enhance timely, coordinated data systems to monitor injuries and violence by using expanded surveillance, innovative methods, and new technology to inform and evaluate national and State prevention activitiesObjective_9424ca89-5215-4318-b5fc-43a82d49281b15StatesData & InformationFacilitate better information sharing, exchange, and alignment of data.Objective_0ffa1f3f-2a6f-4818-96de-7d93fe3e998e16Improving data's value also involves integrating data from two or more sources such as surveys, administrative and claims data, public health surveillance data, and clinical data. The Department is working to facilitate better information sharing, exchange, and alignment of data through the following strategies:unnamed organisationData CollectionImprove data collection methodologies and systems for enhancing real-time and local data collection in order to minimize local burden, and improve timeliness, reliability, and comparability of the data, allowing for local public health and healthcare providers to use data for decision making and response mobilizationObjective_5d5de483-f25c-4244-9b44-dcbacbd08c4717Healthcare ProvidersPublic Health ProvidersInformation ExchangeImplement information technology solutions that support timely information exchange among local, State, international, and Federal agencies, healthcare facilities, and laboratories while ensuring that these systems minimize threats to information securityObjective_391595cf-21de-4e1f-a0eb-01c8f832f7f618International AgenciesFederal AgenciesLocal AgenciesHealthcare FacilitiesLaboratoriesInternational AgenciesInfectious & Chronic DiseaseModernize domestic and international infectious and chronic disease surveillance systems to improve system interoperability and enable more rapid reporting, data exchange, and use to drive timely public health and medical action and responseObjective_b5e9724d-e441-4796-8901-bbd768ce722e19unnamed organisationInnovationPromote new and innovative methods to rapidly collect, store, standardize, share, and analyze data across all levels of government, and with nongovernmental partners, to improve situational awareness and public health surveillance before, during, and after public health and medical emergenciesObjective_4c6f4c14-fd04-489d-b59b-e0652ab5566120unnamed organisationData Collection StrategyConsistent with any limitations on the use or disclosure of such data, develop and implement a Department-wide data collection strategy to strengthen the capacity of HHS resources; promote synergy across systems; assure efficiencies, quality, utility, and timeliness; and address high-priority data gapsObjective_e3acc4d1-e989-45a4-9b19-93f13e7e253a21unnamed organisationQuality & SafetyPromote and protect laboratory quality and safety.Objective_e25feeeb-2bde-46de-b04b-20092390cf5822Across the Department, laboratories house efforts to find the cures to disease; detect infectious organisms, foodborne outbreaks, and biosecurity threats; screen for genetic and health risks; and identify environmental hazards. Ensuring that laboratories follow safe practices and meet high standards of quality is essential to preserve the integrity of these essential resources. The Department works to promote and protect laboratory quality and safety through the following strategies:
Note: Additional strategies to strengthen the scientific workforce and infrastructure are in Strategic Objective 4.2.LaboratoriesProfessional DevelopmentProvide ongoing professional development opportunities to help the laboratory-based workforce remain on the cutting edge of relevant scientific and technological advancementsObjective_0af23300-9dcb-4e20-a428-b63ad1315f2223Laboratory WorkforceTrainingEnsure training for laboratory personnel and management, and promote employee safety, security, and occupational health through laboratory evaluations and inspectionsObjective_6821b7d0-3c9d-429b-bff5-1586bc81242524Laboratory ManagersLaboratory PersonnelQuality & Safety StandardsReview standards for laboratory quality and strengthen guidance to increase patient and laboratory safetyObjective_48600d8f-bcfd-4c84-842e-7c61abcbc78625unnamed generic groupCapacityEnhance and sustain national and international laboratory capacity to manage samples, conduct research, and analyze and report test results that leads to the development of interventions associated with disease detection and surveillanceObjective_1181340d-9b5b-4021-bfb4-970e93004a8326unnamed generic groupTechnologiesSupport the development, implementation, and evaluation of new laboratory technologies (such as telemedicine, metagenomics, next-generation sequencing), and their use for emerging infectious diseases, antimicrobial resistance, food safety, pharmaceutical safety, chronic disease risk factors, and environmental biomonitoringObjective_bd37fae7-6255-411d-b603-b73d32de66d327unnamed generic groupMicrobiology LaboratoriesDevelop reporting guidelines for microbiology laboratories, based upon Federal, State, and local requirements, to improve surveillance of antimicrobial resistanceObjective_b226fa7b-cef1-4d7c-be0d-7ef0d4d9517628Microbiology LaboratoriesRegulatory ComplianceLeverage expertise of clinical and public health laboratory partners on improving regulatory compliance to ensure quality laboratory testing operations during emergency response effortsObjective_c6fe72ce-6f86-42af-bb57-51d92690ec7e29Public Health Laboratory PartnersClinical PartnersAlignmentStrengthen the alignment of surveillance, epidemiology, and laboratory services to improve health outcomes.Objective_15e629f7-2806-416a-a594-a5a0ebbdd0ee30Effective surveillance systems not only serve as an early warning system for threats to public health; when aligned with epidemiological and laboratory services, they can investigate and confirm outbreaks to facilitate a speedier response. The Department is strengthening the alignment of surveillance, epidemiology, and laboratory services to improve health outcomes through the following strategies:unnamed organisationEpidemiological DataDevelop innovative solutions for conducting population health monitoring, risk assessments, and analysis of epidemiological data to improve our understanding of health risk factors and the effectiveness of health interventionsObjective_84fdca61-61f5-4ebf-a33a-2e8389bc8a9c31unnamed organisationPartnershipsFoster State, Federal, and international partnerships to improve surveillance and laboratory capacity across the continuum of care to identify and control threats to public health and health security, including infectious disease threats, healthcare-associated infections, antimicrobial-resistant pathogens, and environmental health hazardsObjective_1e924a5a-adfb-451e-8152-b4b40a26818132unnamed organisationInterventionsSupport the private and secure collection, maintenance, analysis, and sharing of information to improve surveillance and expand the evidence base for high-quality care and rapid interventions, through Health Insurance Portability and Accountability Act of 1996 (Pub. L. 104–191) rules and guidanceObjective_28ae7ac9-c736-4f13-8b02-f1095dc1070433unnamed organisationData Science & Information SystemsEnhance domestic and international information systems (e.g., data linkage, shared services, data standards) and apply modern data science methods to provide timely, high-quality, and actionable data for early outbreak detection, rapid response to public health threats, programmatic planning, and targeted interventions for populations at riskObjective_b70e81ea-afd2-41b0-8007-b6ee5ddbb2c334unnamed organisationOutcomesImprove health and behavioral health outcomes for children and their parents by using surveillance data to build epidemiological capacity in States and counties to identify high-need issues and particular areas of risk, and then responding with appropriate evidence-based interventions and policy developmentObjective_9efcfd00-1314-46ce-b54b-0d189755ef5235ParentsChildrenWorkforce & InfrastructureExpand the capacity of the scientific workforce and infrastructure to support innovative researchObjective_9606bf04-9346-44b3-8539-5c2f254208d836Performance Goals: * By 2021, develop, validate, and/or disseminate three to five new research tools or technologies that enable better understanding of brain function at the cellular and/or circuit level * Increase the percentage of scientists retained at the FDA after completing fellowship or traineeship programs
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Tomorrow's scientific breakthroughs depend on a highly trained and ethical scientific workforce, working in facilities and with tools that foster innovation. Efforts to expand the capacity of the scientific workforce and infrastructure can better prepare the Nation for global health emergencies, extend the reach and impact of scientific investigations, and contribute to research of national or global significance.
Through various initiatives and programs, HHS recruits and trains students, recent graduates, and other professionals to conduct rigorous and reproducible research. HHS provides research training and career development opportunities to ensure that highly trained investigators will be available across the range of scientific disciplines necessary to address the Nation’s biomedical and scientific research needs.
HHS invests in Federal statistical units responsible for national surveys that provide reliable, timely, and policy-relevant information for policymakers and researchers. HHS also invests in strengthening the research infrastructure, ensuring that research facilities are constructed, modernized, and equipped with state-of-the-art tools and resources to support the scientific community.
A critical component of this objective is HHS leadership in protecting the rights, welfare, and well-being of human subjects involved in research, and in investigating unethical behavior and misconduct in research. These human subjects protections apply to all human beings, from conception to natural death. Through the Federal Policy for the Protection of Human Subjects (The Common Rule, 45 CFR Part 46, Subpart A), the Department describes Institutional Review Boards, informed consent processes, and Assurances of Compliance, as well as additional protections for biomedical and behavioral research involving pregnant women, human fetuses, neonates, prisoners, and children (45 CFR Part 46, Subparts B–D).
Scientific integrity is a priority for the Department. Divisions responsible for research have developed policies and procedures to ensure the highest degree of scientific integrity in the research HHS conducts, funds, and supports -- to ensure that our research is credible and worthy of the public’s confidence.SAMHSAOASHAHRQNIHFDACDCOGAScientific WorkforceRecruitment, Training & RetentionRecruit, train, and retain a scientific workforce responsive to future demands.Objective_39ec9e51-b5b0-457a-9d20-3abbc75222b837The Department recognizes that our ability to develop the breakthroughs of tomorrow depends on our ability to recruit the next generation into careers in science, technology, engineering, and math today. The Department is recruiting, training, and retaining a scientific workforce responsive to future demands through the following strategies:Scientific WorkforceRecruitment & TrainingSupport fellowships and other training programs in academic, industry, and government settings to help recruit and train early-career scientists, laboratory scientists, public health scientists, and survey statisticiansObjective_2fc60351-e488-4a00-9a3a-6ecd2f09c94938Laboratory ScientistsSurvey StatisticiansEarly-Career ScientistsPublic Health ScientistsTraining & Career DevelopmentProvide research training and career development opportunities to ensure that a diverse pool of highly trained investigators will be prepared for and available across the range of scientific disciplines necessary to address the Nation's biomedical and scientific research needsObjective_316a7dbc-eb11-45fa-9003-49fe3f164e1439InvestigatorsScientific Workforce DevelopmentImplement and evaluate the effectiveness of scientific workforce development programs, including training and formal mentorship of new scientists, including data scientists, to guide and support staff performance and professional development and to improve the sustainability and quality of workforce programsObjective_e07f5783-e919-465f-b7ac-4ce06b2f5dfa40Scientific WorkforceTraining & FellowshipsConduct joint fellowship programs and other training programs targeted to researchers and regulatory reviewers to provide multidisciplinary training across the interrelated areas of basic and translational scienceObjective_8d58d1da-fca2-4431-8b63-bd90f1bb3dac41unnamed generic groupSystems & PoliciesEnsure administrative systems and policies are aligned with anticipated workforce needs to support comprehensive capacity building and consistent quality improvement programsObjective_b4509227-bc36-4dc3-b61a-579361a2697342unnamed generic groupEthics & ResponsibilitiesPromote ethical and responsible research.Objective_3bb11553-b34c-4adb-b668-4a19a341315743Guidelines for ethical and responsible research consider the boundaries between biomedical and behavioral research and the accepted and routine practice of medicine, risk-benefit criteria, appropriate guidelines for selection of human subjects for participation, and informed consent. The Department promotes ethical and responsible research through the following strategies:unnamed organisationPeer ReviewsAssess peer review practices and provide the workforce with best practices for peer reviewObjective_82634113-7508-4162-ab1d-da1c943305a144unnamed organisationHuman SubjectsImprove human subjects protection, and enforcement of human subjects protection regulations and other laws governing research, especially with respect to research involving human embryos or embryonic stem cells/tissue, fetal tissue, genetic engineering and manipulation of the germ cell, and the creation of chimerasObjective_685fae06-14bb-4c88-8859-1bd71db6e11b45Human SubjectsGuidance & ToolsProvide guidance and tools, including required trainings, to ensure that researchers are able to conduct research ethically, safely, securely, and responsiblyObjective_607ab06a-0378-4cf0-9604-c72aa255532e46unnamed organisationRigor, Transparency & ReproducibilityImprove the methodological rigor, transparency, and reproducibility of federally funded research and surveys to strengthen public confidence in federally supported research and survey findingsObjective_dfa86450-b0fb-47d8-9b50-0119c691e21047unnamed organisationInnovationCollaborate with the broader research community to strengthen innovation.Objective_aba2bff4-ee98-4163-82c8-504ca149e6a448Approximately 84 percent of the NIH budget is dedicated to supporting more than 300,000 members of the research workforce in the extramural biomedical, behavioral, and social science research communities. The Department collaborates with the broader research community to strengthen innovation through the following strategies:Research CommunityInteractions & CollaborationFacilitate interactions with domestic and international partners to promote basic science and research/educational collaborations and to engage in innovative joint research projectsObjective_107fe63f-b80a-4706-9580-8a1ed0813fd349unnamed generic groupCulturePromote a culture of responsible data sharing, openness, and collaboration to better engage with academia and the private sector, consistent with applicable privacy and security requirementsObjective_24332bbe-4c52-4ca6-8318-69c33a8fe64b50AcademiaPrivate SectorFacilities & InfrastructureStrengthen core facilities and infrastructure capacity.Objective_f32563bc-8848-453e-b119-be5feca8ce1751Core facilities are centralized shared resources that provide access to instruments, technologies, services, expert consultation, and other services to scientific and clinical investigators. The Department is strengthening core facilities and infrastructure capacity through the following strategies:unnamed organisationFacilitiesLeverage facilities as shared resources, which provide investigators access to advanced technologies through cutting-edge instrumentation operated by appropriately trained staffObjective_4f136b0b-e989-4b14-a7da-fcba7cc535ab52InvestigatorsToolsEnsure that the scientific research workforce has access to modern tools, including resources for data science and scientific computingObjective_3f1a035a-b571-434a-830a-bd0ee89edac253Scientific Research WorkforceModernization & ImprovementSupport modernization and improvements of research facilities through alterations, renovations, and new equipment purchasesObjective_00d38375-2483-4aaa-811d-ddebec1a3aa054unnamed organisationBasic ScienceAdvance basic science knowledge and conduct applied prevention and treatment research to improve health and development.Objective_2b8fc6eb-3edd-458a-aa2b-fe8ec4d5496a55Performance Goals: * By 2023, develop, optimize, and evaluate the effectiveness of nano-enabled immunotherapy (nano-immunotherapy) for one cancer type * By 2022, evaluate the safety and effectiveness of one to three long-acting strategies for the prevention of HIV * By 2020, identify risk and protective alleles that lead to one novel therapeutic approach, drug target, or pathway to prevention for late-onset Alzheimer’s disease
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The impact of scientific discoveries cannot be underestimated. Research-related gains in average life expectancy between 1970 and 2000 have an economic value of $3.2 trillion dollars per year. A $1.00 increase in public basic research stimulates an additional $8.38 of industry research and development investment after 8 years.
Basic science and applied prevention and treatment research are critical not just to the American economy, but to quality of life. Infant mortality has dropped by more than 75 percent since 1960. For children born in 2009, childhood vaccinations are expected to save $13.5 billion in direct healthcare costs over the course of their lifetimes. The death rate from unintentional injuries - PDF has decreased almost 40 percent since 1969. And a 20-year-old HIV - PDF-positive adult receiving treatment to suppress the virus can expect to live into their early 70s—nearly as long as someone without HIV.
For nearly every Strategic Objective in this Strategic Plan, HHS is conducting, supporting, or funding research to expand our knowledge about how to achieve positive outcomes—to improve health and well-being and extend quality of life. Partnerships with the private sector, academia, and governments at the Federal, State, Tribal, local, and international levels are critical to success in this objective.
HHS conducts, funds, and supports a broad and diverse portfolio of biomedical research in a range of scientific disciplines, including basic and translational research, to augment scientific opportunities and innovation for public health needs. HHS works to strengthen basic and applied science and treatment pipelines to assess potential health threats and bolster the fundamental science knowledge in these risk areas to expedite the development of therapies. As described in Strategic Objective 4.2, Expand the capacity of the scientific workforce and infrastructure to support innovative research, research is conducted ethically and responsibly.ACLAHRQFDAOASHCDCNIHCauses of DeathReduce the incidence of the leading causes of death.Objective_c780e3cb-460b-45c9-8936-b523acce0a5656Heart disease, cancer, chronic lower respiratory diseases, unintentional injuries, stroke, Alzheimer's disease, diabetes, influenza and pneumonia, kidney diseases, and suicide were the 10 leading causes of death in 2016. The Department is working to reduce the incidence of the leading causes of death through the following research strategies:unnamed organisationRisk FactorsDiscern risk factors and mechanisms underlying the leading causes of death to accelerate applied and preventive research solutionsObjective_e4c2bf54-0e27-47b0-b734-9437fb54ba2857unnamed organisationStudies, Reporting & TestingSupport research to prevent the leading causes of death in adults by improving the quality and specificity of reporting causes of death, developing systematic studies, and testing interventions to determine and prevent the actual causes of deathObjective_778c9573-4d63-4727-8dcb-f815c8e8719058unnamed organisationClinical Preventive ServicesDevelop and test methods to increase adoption by primary care providers of recommendations from the U.S. Preventive Services Task Force for clinical preventive services that address the leading and actual causes of deathObjective_4926ec16-2b40-43b9-a5f9-18cb07245be359U.S. Preventive Services Task ForcePrimary Care ProvidersInterventionsAssess the 5-year health outcomes and adverse events of preventive interventions that target the actual and leading causes of death, to assist the U.S. Preventive Services Task Force in providing evidence-informed recommendationsObjective_fa24e10e-a73a-489c-b178-861da1b008a360U.S. Preventive Services Task ForceAccess, Safety & QualityInvest in research to promote access, patient safety, and healthcare quality.Objective_acbb4a05-946b-418b-9fdf-3828cd0a4cbc61Strategic Objective 1.2, Expand safe, high-quality healthcare options, and encourage innovation and competition, describes the Department’s efforts to improve patient safety and healthcare quality, including within healthcare settings. Strategic Objective 1.3, Improve Americans' access to healthcare and expand choices of care and service options, describes how the Department works to connect the people HHS serves to quality options. To build knowledge about effective approaches, the Department is investing in research to promote access, patient safety, and healthcare quality through the following strategies:PatientsMedical Product DevelopmentFacilitate patient-focused medical product development to inform regulatory decision makingObjective_4c9d9729-4399-4925-a6ef-575f0474a92962unnamed generic groupDataConduct and support data collection, research, and evaluations to support healthcare safety, delivery, quality, efficiency, and effectiveness for all populations, including those experiencing healthcare disparitiesObjective_4dfd2f3e-5c58-4168-8655-7f416562d9fb63unnamed generic groupLifestyle, Environment & iologyConduct research that takes into account individual differences in lifestyle, environment, and biology, to determine new pathways for preventing and treating diseaseObjective_b89626df-63a7-47fa-af13-76fdde0a782364unnamed generic groupPersonalized MedicineFoster and capitalize on advances in personalized medicine to accelerate health research and medical breakthroughs, enabling individualized prevention, treatment, and care for all people and addressing unmet medical needsObjective_a9e9c773-0f0f-43ad-94b6-8ebe5ee47b2065unnamed generic groupInsuranceSupport research to provide evidence on how to ensure access to affordable, physical, oral, vision, behavioral, and mental health insurance coverage for children and adultsObjective_eee4e0bf-03d8-46c6-b8df-75a4d9b8f02866ChildrenAdultsMedical ProductsConduct research to facilitate development and availability of innovative, safe, and efficacious human and animal medical products, including development of regulatory scienceObjective_5d8cec5e-b764-47ad-a3ae-6b3f196f644267unnamed generic groupRisk FactorsConduct, fund, and apply research on the role of other risk factors and their impact on health access, quality, and safetyObjective_cc8c023c-a488-465f-94df-c133acd1d12068unnamed generic groupOutcome AssessmentFacilitate the development and qualification of clinical outcome assessment tools to measure clinical benefit in medical product developmentObjective_dcdef22a-0e97-416b-9afc-4d777dc8e67369Medical Product DevelopersPharmaceutical TechnologySupport and facilitate the adoption of innovative pharmaceutical technology to modernize product development and manufacturing, ensuring the consistent supply of high-quality medicine for patientsObjective_9570a820-9c0e-4dc8-b2e6-320a4d80970b70unnamed generic groupQuality, Access, Disparities & RisksProduce and promote healthcare delivery methods and interventions that improve care quality, promote healthcare access, reduce disparities, and address other risk factors among populations at risk for poor health outcomesObjective_66e3f5f0-8f63-4518-bf2a-f912b603827e71unnamed generic groupAlzheimer's Disease & DementiasExpand our understanding of the causes of, treatments for, and prevention of Alzheimer's disease and related dementias, including accelerating efforts to identify early and presymptomatic stages and translating findings into medical practice and public health programsObjective_ce01491d-9d87-4349-807c-16c7be4d6f7372unnamed generic groupHealthcare ProvidersInvest in research on strengthening and supporting healthcare providers.Objective_ed8730b1-9d42-46f7-9a41-7a48cd31dfda73Strategic Objective 1.4, Strengthen and expand the healthcare workforce to meet America's diverse needs, describes the Department's efforts to recruit, retain, and train the healthcare workforce. To build our knowledge, the Department is investing in research on strengthening and supporting healthcare providers through the following strategies:Healthcare ProvidersClinical DecisionsEvaluate the adoption, implementation, and impact of clinical decision support systems, and evidence-based guidelines on clinical and community preventive services and treatments to improve both behavioral and physical health and well-beingObjective_6bf8341d-a8d8-4077-93c4-080d28cd058874unnamed generic groupShared Decision MakingFund research on shared decision making to support healthcare providers' efforts to deliver healthcare services that empower patients, families, and caregivers to implement lifestyle behavior modification aimed at better health and healthcare outcomesObjective_06d38adb-842e-4c1f-96f1-62782e588d2b75PatientsHealthcare ProvidersFamiliesCaregiversService Delivery ProfessionalsFund applied research, development, training, and sharing of information and products to improve knowledge and practice of service delivery professionals who are supporting disadvantaged and at-risk populationsObjective_9309e013-b60f-4831-ab3c-99caffd483a076Service Delivery ProfessionalsSystems of CareConduct research and disseminate findings on systems of care and strategies such as team-based care, enhanced communication, and improvements in technology that reduce burden and burnout of healthcare professionals and that create healthy workplacesObjective_69157ab1-46b5-4082-b07b-dbb18be2b75177Systems of CareHealth & WellnessInvest in research to promote health and wellness.Objective_ad1b50c6-ae5d-4272-8ff4-bb6d3364faa678Strategic Objective 2.1, Empower people to make informed choices for healthier living, describes the Department’s efforts to promote health and wellness in the public. To expand our knowledge base, the Department is investing in research to promote health and wellness through the following strategies:unnamed organisationBehavior ChangeInvest in research and education on behavior change methods, such as effective stress management, proper nutrition, and regular exerciseObjective_90b71120-060d-4680-a209-cbbb603dc39d79unnamed organisationChildhood ObesityAccelerate research and national efforts to implement solutions at the individual, family and community level, including through partnerships with Tribes and faith-based and community organizations, to reduce childhood obesity, including focusing on the pregnancy period to age five in terms of the etiology and interventionsObjective_ffe34c0a-64ef-4c68-ae32-2170f459e5b280TribesCommunity OrganizationsChildrenFaith-Based OrganizationsCommunicable DiseasesInvest in research to prevent, treat, and control chronic conditions and communicable diseases.Objective_302b1375-156f-4033-aabe-6911b6bc863e81Strategic Objective 2.2, Prevent, treat, and control communicable diseases and chronic conditions, describes the Department’s efforts to promote public health on the ground. To develop our understanding about best practices and build the evidence base, the Department is investing in research to prevent, treat, and control chronic conditions and communicable diseases through the following strategies:unnamed organisationInfectious DiseasesSupport basic science and applied prevention and treatment research on approaches to reduce the global burden of infectious diseases such as HIV, viral hepatitis, tuberculosis, malaria, and neglected tropical diseasesObjective_60cddc15-3bc8-4c65-8113-2f4f6cb4a7dc82unnamed organisationEnteric & Respiratory DiseasesSupport basic and applied research to prevent and treat enteric and respiratory diseasesObjective_2238c660-4d18-4c9b-85ad-80371d5eebf283unnamed organisationVaccinesConduct basic science and applied research and disseminate findings to maximize the use of age-appropriate vaccines to minimize the burden of preventable diseases across the lifespanObjective_657a46b7-1c64-48d3-8355-bb60aaeec3b484unnamed organisationPrevention, Detection & InvestigationDevelop and assess improved methods for rapidly detecting and investigating disease outbreaks and developing new preventive and therapeutic strategiesObjective_94156088-d93c-48b3-b5d4-6690ede3c1ce85unnamed organisationHigh-Impact InterventionsDevelop, evaluate, and implement high-impact public health interventions domestically and internationally, and advance policies to increase community and individual engagement in infectious disease prevention effortsObjective_8f54aaa0-b91d-4b0b-9ec1-fe049701dd1b86unnamed organisationSocial & Behavioral InterventionsInvest in research on the use of specific social and behavioral interventions to prevent, treat, and control communicable and chronic conditionsObjective_e4095fc6-e026-4721-884a-72d8f860262f87unnamed organisationVector-Borne DiseasesIdentify, develop, and evaluate effective prevention and control practices for Lyme and other vector-borne diseasesObjective_c713c062-7f4b-49f6-95a9-85f962b06f9188unnamed organisationBehavioral HealthInvest in research to improve behavioral health.Objective_163d0662-8c24-4daf-9c00-a6f446496a6c89Strategic Objective 2.3, Reduce the impact of mental and substance use disorders through prevention, early intervention, treatment, and recovery support, describes the Department’s direct supports related to mental health and substance abuse. To expand the knowledge base, the Department is investing in research to improve behavioral health through the following strategies:unnamed organisationModifiable Risk FactorsConduct applied research to identify the most effective health and community-based system interventions that address the modifiable risk factors for prescription opioid misuse, heroin initiation, and opioid use disorder and overdoseObjective_1c7a1428-f9da-4d61-97b6-1e1fc24567bd90unnamed organisationGenomics & ProteomicsFoster integration of behavioral and social science research into research involving acceptability and understanding of genomics and proteomics, to accelerate time-to-trial as well as improve study designsObjective_f254c4ef-3c98-48b4-89bc-8b74035ae3eb91unnamed organisationPublic Health EmergenciesDevelop the knowledge to support evidence-based interventions for public health emergencies.Objective_b7eb87e3-bef0-4d0f-bf5b-485026640be992Strategic Objective 2.4, Prepare for and respond to public health emergencies, articulates the Department’s emergency preparedness and response activities. The Department is developing the knowledge to support evidence-based interventions for public health emergencies through the following strategies:unnamed organisationStrategies, Interventions & EvaluationsEnhance the portfolio of strategies, interventions, and evaluations to prevent and respond to public health emergenciesObjective_5e4a01ff-8f27-45fa-9afd-2767836258c493unnamed organisationPreparedness & CountermeasuresAccelerate research on novel therapeutics, vaccines, rapid diagnostics, and behavioral interventions to expand evidence-based biomedical countermeasures and preparedness strategiesObjective_9bdb258d-95b8-491d-824b-1d41077839fd94unnamed organisationResearch & EvaluationInvest in research and evaluation to strengthen human services programs.Objective_5d847c07-ba2f-42bc-bd44-8c532f266f7e95The Strategic Objectives in Strategic Goal 3: Strengthen the Economic and Social Well-Being of Americans Across the Lifespan describe the Department’s efforts to provide high-quality, evidence-based human services programs. The Department is investing in research and evaluation to strengthen human services programs through the following strategies:unnamed organisationFamiliesDevelop evidence on policies and practices that support stable, economically secure families, with a focus on TANF, employment, education and training, behavioral science, and safety-net researchObjective_01d9de74-30d6-4696-9866-b7c9aa57928196unnamed organisationPrevention StrategiesInvest in rigorous research and evaluation to identify effective violence and injury prevention strategies, and support the adoption of evidence-based practices to address these issuesObjective_d68c876f-30d0-43bd-b94b-df77ace2df2597unnamed organisationDomestic ViolenceInvest in rigorous research on and evaluation of domestic violence programsObjective_f536a3d6-b975-4e83-a7dd-beefef426eee98Domestic Violence ProgramsInterventionsInvest in research on individual and community-wide interventions and approaches for children, youth, and adults who have experienced adverse childhood experiences, to learn what trauma-informed programs and services demonstrate positive effectsObjective_08319a18-b4ea-436d-a4ef-b768c98e3aac99YouthAdultsChildrenChildrenConduct applied research and disseminate findings to maximize use of evidence-based strategies to improve the well-being of children at all stages of development, youth, and familiesObjective_d9f4698a-b9c3-479e-895d-af8128d1bad5100YouthChildrenFamiliesHousingSupport research and test approaches to effective housing with services for people with disabilities and older adults aimed at maximizing independence, choice, and healthObjective_950347f5-4451-4004-8b95-d34fbe30b65a101People with DisabilitiesOlder AdultsDissemination, Implementation & EvalutationLeverage translational research, dissemination and implementation science, and evaluation investments to support adoption of evidence-informed practicesObjective_60dbd3d8-3f85-45fa-94f6-003415951eff102Performance Goals: * Increase the percentage of Community-Based Child Abuse Prevention total funding that supports evidence-based and evidence-informed child abuse prevention programs and practices * By 2020, develop and test the effectiveness of two strategies for translating cancer knowledge, clinical interventions, or behavioral interventions to underserved communities in community-based clinical settings
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Translational research, dissemination and implementation science, and evaluation investments help to ensure that critical knowledge from basic and applied research finds its way into practice in clinical, public health, and community settings.
Translational research, dissemination, and implementation science help increase understanding about how best to support knowledge, adoption, and faithful implementation of best practices in the community. Selecting and adopting evidence-based approaches to tackle health, public health, and human services challenges can be a complex undertaking. HHS programs balance requirements to implement high-quality programs with fidelity, while acknowledging the unique needs of specific individuals or target populations, recognizing differences in program and community settings and resources, and respecting linguistic or cultural differences. Understanding threats to successful implementation of a promising practice can help the Department prevent and mitigate those risks early.
Evaluation and evidence can support the Department’s efforts to improve program performance by applying existing evidence about what works, generating new knowledge, and using experimentation and innovation to test new approaches to program delivery. HHS is committed to integrating evidence into policy, planning, budget, operational, and management decision making. HHS funds multiple types of evaluation and evidence-generating activities; these activities may examine how well a program is implemented, whether it achieves intended outcomes, the overall impact of a program, or all three. Results of these types of activities may be used to plan programs, assess program performance, understand how to improve a program, and inform policy decisions.ACLAHRQACFSAMHSACDCNIHHRSAOASHFDAPopulations at RiskImprove programs for populations at risk for poor health and well-being outcomes.Objective_293c6068-5136-4241-8ad3-4c0f9cd510b1103Numerous factors affect whether an intervention will have a positive health, public health, or human services outcome on individuals or targeted populations, including the selected model of the intervention, the population served, and the fidelity of implementation. The Department works to improve programs for populations at risk for poor health and well-being outcomes through the following strategies:Populations at RiskAccess & OutcomesAssess evidence-based practices and service delivery system improvements to increase access to services and improve outcomes for disproportionately affected populationsObjective_aed0ec5f-0cbc-4bff-9119-c34ae63ca846104Disproportionately Affected PopulationsSettingsSupport research conducted in a variety of settings and populations, to improve the quality and utility of evidence generated from HHS investments and the impact of those investments on a broad range of outcomesObjective_8e751021-4452-4eb4-8592-ad0d61e71b73105unnamed generic groupMultifaceted StrategiesEvaluate multifaceted strategies to apply evidence-based interventions to reach disproportionately affected populations and reduce health disparitiesObjective_4f2cbd4c-8155-4392-bcb0-967f7a21cc5a106Disproportionately Affected PopulationsBehavioral Health DisparitiesAnalyze data on behavioral health disparities to increase understanding of factors contributing to disparities, identify disadvantaged and at-risk populations, assess trends, and inform policy and program developmentObjective_01af2f48-0b7c-4e07-be76-d07db861f3b4107Disadvantaged PopulationsAt-Risk PopulationsInterventionsDisseminate knowledge about evidence-based interventions.Objective_6e1e6cec-49da-4a5e-9483-5b5016d6856c108Dissemination is the intentional, strategic distribution of information and intervention materials to a specific public health or clinical practice audience. HHS is working to disseminate knowledge about evidence-based interventions through a number of strategies:unnamed organisationEvidence-Based PracticesIncrease dissemination and implementation of evidence-based practices and provide training and technical assistance to stakeholders to improve outcomesObjective_f6dc4a84-4a24-403a-949a-ad687986a859109unnamed organisationEffectivenessSystematically review current evidence on the effectiveness of programs and policy, and disseminate findings in easily accessible formats to practitioners and decision-makersObjective_a90ed2fb-3dc6-4a01-a81d-5562af40f8e1110unnamed organisationOutcome ResearchDisseminate patient-centered outcome research findings to health professionals and organizations that deliver healthcareObjective_15b66a3b-fefd-449d-aa99-141e24d8530e111unnamed organisationEfficiency & EffectivenessInvest in programs to determine their efficiency and effectiveness.Objective_b43d9ebb-8ec1-423c-98bd-243fe25e21ff112Evaluation involves the systematic collection of information about the activities, characteristics, and outcomes of programs to make judgments about a program, improve program effectiveness, and/or inform decisions about future program development. HHS invests in programs to determine their efficiency and effectiveness through several strategies, including the following:unnamed organisationLearning AgendasEncourage the use of learning agendas or other tools to prioritize critical questions that generate evidence to guide decision making and continuous learning, including short- and long-term questions that build a portfolio of evidence about what works for whomObjective_681aeba6-40b2-4fd2-97ad-36870d79b88d113unnamed organisationLearning, Coordination & CollaborationFoster a culture of learning through opportunities for coordination and collaboration within and across HHS and with external partnersObjective_48beabe6-26cc-4a1a-98e0-03dfce43c9c7114unnamed organisationImprovementsIdentify improvements to existing evidence-based programs and policies to share broadly with local communities for public health impactObjective_7960ceba-957e-413a-8a21-dc8018628c77115unnamed organisationEvidence & PoliciesPromote the use of common evidence standards, principles and practices for evaluation, and policies that support rigorous, relevant, transparent, independent, and ethical evidence-building activitiesObjective_4766ea0e-e86c-46d0-8c45-eab80ad7de1e116unnamed organisationUptake, Adoption & ImplementationSupport the uptake, adoption, and implementation of evidence-based interventionsObjective_906ebb52-a349-467b-84ef-a277b4057dd5117Implementation science is the study of methods to promote the integration of research findings and evidence into healthcare policy and practice. HHS is working to support the uptake, adoption, and implementation of evidence-based interventions through a number of strategies:unnamed organisationEngagement, Adaptation & CustomizationEngage healthcare, public health, and human service system research networks to study and support local adaptation or customization of evidence-based practicesObjective_db37b5bb-ea69-4e82-a10e-dc71710e9e40118Public Health Research NetworksHealthcare Research NetworksHuman Service System Research Networks Tools & Technical AssistanceDevelop and disseminate tools and provide technical assistance that supports adoption and implementation of evidence-based practices to improve access to high-quality public health, healthcare, and human servicesObjective_fe9045af-00be-4d32-b638-4d4724e8be65119unnamed organisationKnowledge TranslationSupport knowledge translation capacity and practice to ensure that knowledge generated by grantees and others working in the field is used or adopted by its intended usersObjective_61fb46a3-415d-4208-bc9e-12fa40ae3dff120GranteesChangeAccelerate change.Objective_b840b3ed-d9e8-4a47-98ab-1fcf3e37a2e8121Facilitating the adoption of evidence-based solutions into practice requires active engagement of change agents and innovators across health, public health, and human services domains. The Department works to accelerate change through the following strategies:unnamed organisationProcesses & ObstaclesPromote innovative approaches to translating research into interventions that improve health and well-being, by modernizing processes and removing obstacles to bring more effective practices to more people more quicklyObjective_ad061367-ed87-4e6a-9f04-4862ec0aaa21122unnamed organisationPlatforms for InteractionLeverage cutting-edge science to support product development strategies, regulatory evaluation, and implementation science by establishing platforms for interaction with academic institutions, other government agencies and their investments, and industryObjective_d8084950-3b5b-4ed8-9828-034644a53f53123Academic InstitutionsGovernment AgenciesManagement & StewardshipPromote Effective and Efficient Management and StewardshipGoal_44a689dc-58ac-42d5-bdca-f1b96a30bdfa5This Strategic Goal describes efforts to act as responsible stewards of the financial resources the American taxpayers and Congress entrust to the Department, to support and cultivate top talent, to develop robust and responsive information management systems, and to create a safe and secure environment for human, digital, and physical assets.
HHS is responsible for almost a quarter of Federal outlays and administers more grant dollars than all other Federal agencies combined. Ensuring the integrity of direct payments, grants, contracts, and other financial transactions requires strong business processes, effective risk management, and a financial management workforce with the expertise to comply with legislative mandates, including the Federal Managers’ Financial Integrity Act of 1982 (Pub. L. 97–255), the Federal Funding Accountability and Transparency Act of 2006 - PDF (Pub. L. 109–282), and the Improper Payments Elimination and Recovery Improvement Act of 2012 (Pub. L. 112–248).
More than 91,000 permanent and temporary employees serve the public through the Department, providing direct clinical care, serving as emergency responders, researching cures, working with grantees to improve outcomes, and performing other critical functions. Half of the Department’s employees work in Washington, DC, with others serving in States and territories, on Tribal lands, and around the globe. Through a new Federal Human Capital Framework, the Federal Workforce Priorities Report, and annual Human Capital Review sessions with the Office of Personnel Management, required by 5 CFR Part 250, Subpart B, Strategic Human Capital Management, HHS will work to identify and implement strategies to strengthen its workforce.
The information technology landscape has changed significantly in this century. How we collect and consume information, how we purchase resources, and even how we interact with each other has been revolutionized by technology—and will continue to evolve and change. The Department’s information technology investments focus on accessible, user-friendly design and promote business efficiencies, and also must comply with Office of Management and Budget (OMB) guidance and legislative mandates, such as the Federal Information Security Modernization Act (Pub. L. 113–283).
Finally, to accomplish the HHS mission, its staff, data, and infrastructure must be safe and secure. The Department is working to safeguard assets against threats and hazards, whether internal or external, unintentional or malicious, natural or manmade. Securing staff, software, and systems is guided by specific supports, such as Homeland Security Presidential Directive 12, and standards, measurements, and testing promoted by the National Institute of Standards and Technology.Office of Security and Strategic Information (OSSI)Office of the Assistant Secretary for Administration (ASA)Office of the General Counsel (OGC)Office of the Assistant Secretary for Financial Resources (ASFR)Office of the Chief Technology Officer (CTO)unnamed generic groupunnamed generic groupunnamed generic groupunnamed generic groupHHS Employeesunnamed generic groupunnamed generic groupunnamed generic groupunnamed generic groupVeteransunnamed generic groupunnamed generic groupunnamed generic groupInformation Technology Workforceunnamed generic groupunnamed generic groupunnamed generic groupunnamed generic groupunnamed generic groupunnamed generic groupunnamed generic groupunnamed generic groupunnamed generic groupPrivileged Usersunnamed generic groupunnamed generic groupunnamed generic groupunnamed generic groupunnamed generic groupunnamed generic groupunnamed generic groupunnamed generic groupTechnology Practitionersunnamed generic groupunnamed generic groupunnamed generic groupEmployees with Disabilitiesunnamed generic groupunnamed generic groupunnamed generic groupunnamed generic groupHHS Employeesunnamed generic groupunnamed generic groupunnamed generic groupunnamed generic groupunnamed generic groupunnamed generic groupunnamed generic groupunnamed generic groupunnamed generic groupunnamed generic groupunnamed generic groupunnamed generic groupunnamed generic groupunnamed generic groupunnamed generic groupHHS WorkforceHHS DivisionsAll operating divisions and staff divisions within HHS are committed to achieving this goal, with the Office of the Assistant Secretary for Financial Resources (ASFR), the Office of the Assistant Secretary for Administration (ASA), the Office of the Chief Technology Officer (CTO), the Office of the General Counsel (OGC), and the Office of Security and Strategic Information (OSSI) playing key roles.unnamed generic groupunnamed generic groupunnamed generic groupunnamed generic groupunnamed generic groupunnamed generic groupunnamed generic groupunnamed generic groupHHS Supervisorsunnamed generic groupunnamed generic groupunnamed generic groupFinancial ManagementEnsure responsible financial managementObjective_bf5a4f74-7db8-488b-ad3c-6d99fd0893d01Performance Goals: * Meet the following goals related to improper payments: - Reduce the percentage of improper payments made under the Medicare Fee-for-Service Program - Reduce the improper payment rate in the Medicaid Program - Reduce the improper payment rate in the Children’s Health Insurance Program - Reduce the percentage of improper payments made under Medicare Part C, the Medicare Advantage Program - Reduce the percentage of improper payments made under the Part D Prescription Drug Program --
Responsible financial management is the Department's foundation for meeting its commitment to making sure taxpayer dollars are spent wisely. Strong, modern financial systems and practices and targeted investments improve accountability, reporting, and decision making, which can lead to cost savings and efficiencies that improve how the Department manages its public funds. Program integrity is a priority.
In 2016, the Department awarded $1.0 trillion in grants, contracts, loans, and other financial assistance, including Medicare and Medicaid. State, Tribal, local, and territorial governments, and educational, cultural, faith-based, and community organizations, received $481.9 billion in HHS-funded grants. Large and small vendors were awarded $24.7 billion in contracts. Effectively managing these funds presents a range of challenges in preventing fraud and abuse, preventing misuse of funds by grantees, streamlining acquisition planning and procurement, and dealing with the root causes of improper payments. While not all improper payments are the result of intentional activity to defraud the government, any improper payment reduces public confidence in the Department’s ability to manage its programs.
HHS is addressing these and other challenges that come from managing the diverse portfolio of financial agreements, systems, and reporting requirements across its 11 agencies and other offices. The Department is a member of the Healthcare Fraud Prevention Partnership, a voluntary public-private partnership between the Federal Government, State agencies, law enforcement, private health insurance plans, and healthcare anti-fraud associations, to prevent and detect healthcare fraud. HHS works with other Federal agencies to promote and implement practices, including shared services, to simplify the acquisition process and to improve performance and increase savings. As a member of the Chief Financial Officers Council, the Department engages with other Federal departments and agencies to share best practices in consolidating and modernizing financial systems, improving the quality of financial information, and complying with legislation affecting financial operations and organizations. The Department met new governmentwide standards to exchange and report financial information and share its spending data with the public.
Leading and implementing these efforts are staff working in the Department's financial management, acquisition, and grants workforce who need to keep up with changing demands. Auditing and acquisitions are mission-critical occupations, and grants management is a mission-critical competency. The Department will expand its training and development efforts to close the skill and knowledge gaps in these positions and strengthen the competencies of all HHS staff with responsibilities that impact the Department's fiscal stewardship.unnamed generic groupStreamliningStreamline business processes.Objective_aeb6ca64-18ab-4028-a068-84310245250a2Each year, the Department publishes its Agency Financial Report, which shares its progress in modernizing financial systems to strengthen system security, reliability, and availability. Among the Department's efforts to streamline business processes are the following strategies:unnamed generic groupQuality ImprovementUse quality improvement principles to review key business processes, and identify opportunities to reduce risk and improve outcomes in areas such as financial management, grant management, and acquisitionsObjective_bb46d346-3a69-4fd0-b4a2-491286a855083unnamed generic groupRecordingReduce inconsistent recording and incomplete financial data and, thus, reduce efforts required to perform data cleanup and data transformationObjective_9c657fcd-8fe4-476f-9c5c-afe4b184a0214unnamed generic groupTrust & StewarshipPreserve public trust and stewardship of taxpayer funding by ensuring effective internal controls and efficient operating policies and procedures are in place that can result in an unqualified audit opinion with no material weaknessesObjective_70ad8418-dfd4-42ad-babf-62bd1340f22c5unnamed generic groupRisk anagementPromote effective and efficient risk management across HHS and its programs.Objective_03a36e56-059b-4509-8fbc-393900a677416OMB Circular A-11 and OMB Circular A-123, Management’s Responsibility for Enterprise Risk Management and Internal Control, charge Federal agencies with implementing an enterprise risk management approach to address significant risks, improve mission delivery, and prioritize corrective actions. The Department promotes effective and efficient risk management across HHS and its programs through the following strategies:unnamed generic groupRisk AssessmentsConduct and use risk assessments within an enterprise risk management framework to improve information sharing and leadership decision making, resulting in risk-informed strategy execution and program implementationObjective_52e2a595-5639-4b0e-9a48-d76654253dda7unnamed generic groupPartnershipsUse public-private partnerships to prevent and detect fraud and other inappropriate payments across the healthcare industry by sharing fraud-related information and data, promoting best practices, and educating partnersObjective_7664566c-04b5-4eed-8fcb-1911f57e21df8unnamed generic groupMedicare & MedicaidProtect Medicare and Medicaid through prevention and detection of fraud, waste, abuse, and improper paymentsObjective_65566b52-3e93-4034-936e-2fa073c7c3ad9unnamed generic groupPrivate ExpendituresManage the costs associated with governmental imposition of private expenditures through implementation of Executive Order 13771 of January 30, 2017, Reducing Regulation and Controlling Regulatory Costs, by ensuring that, consistent with the Administrative Procedure Act and as informed by the terms of the Executive Order and associated guidance, as appropriate, for every one new regulation issued, at least two prior regulations are identified for elimination, and the cost of planned regulations are managed through a budgeting processObjective_351d9fb2-e2b4-4e7b-8406-05206370007510unnamed generic groupWorkforceStrengthen the financial management, acquisition, and grants workforceObjective_b1cad53f-953d-4c38-b0f8-aed7281c537a11In a Federal department responsible for the administration of more than a trillion taxpayer dollars, the financial management workforce needs to have the skills and competencies to maximize and leverage the Department’s financial resources. The Department is strengthening the financial management, acquisition, and grants workforce through the following strategies:
Note: Additional strategies on strengthening the workforce are in Strategic Objective 5.2.unnamed generic groupKnowledge GapsReduce knowledge gaps within the financial management, acquisition, and grants workforce by supporting hiring, training, and development programs to strengthen competenciesObjective_3b769f10-cb25-4216-8a07-e74ae7d4772b12unnamed generic groupTraining & Knowledge TransferSupport knowledge transfer programs and training strategies so that the financial management, acquisition, and grants workforce can respond to challenges and changing demands across the enterpriseObjective_24f8aa7e-8841-4626-9bef-9a0e2f15889313unnamed generic groupKnowledge TransferDevelop a financial management, acquisition, and grants workforce that uses cross-functional and knowledge transfer training programs to respond to challenges and changing demands across the HHS enterpriseObjective_e29fda6c-793d-4c49-87bb-54aedf8995bb14unnamed generic groupHuman CapitalManage human capital to achieve the HHS missionObjective_10b0237f-2e45-4dda-908e-d40f5d5bbb3e15Performance Goals: * Increase HHS employee engagement through the Federal Employee Viewpoint Survey * Decrease the cycle time to hire new employees -- As the Department looks to FY 2022 and beyond, it imagines all the achievements that can be reached when workforce performance is heightened, efficiencies achieved, and accountability strengthened. The Department must continue to create a flexible and agile workforce that responds and adapts to change: change in technology, change in society, change in expectations, and change in scientific findings. HHS needs the leaders of tomorrow today. To this end, the Department will build a world-class Federal management team and a workforce ready to collaborate with colleagues within the Department, among other Federal departments, and outside the Federal Government, to seek change that improves and enhances the health and well-being of Americans.
The HHS workforce comprises more than 91,000 permanent and temporary employees, serving in every region of the United States, including Tribal communities and the U.S. territories, and 66 countries around the world. To achieve its mission, HHS will need to recruit, hire, and retain a qualified, talented, diverse, and inclusive workforce. As the majority of HHS staff nears retirement eligibility, human resources offices throughout the Department help HHS components to hire the best talent from all segments of society and strengthen succession planning, to ensure the Department can continue to support mission-critical functions.
Management will need to help build and maintain the workforce in a way that retains current knowledge, anticipates advances in medicine and technology, and prepares internal staff for future leadership positions. To fulfill the Department’s mission, there is a need to recruit, hire, and retain talent with STEM (science, technology, engineering, and math) skills. Targeted recruitment efforts will become more important as mission-critical positions are vacated. Competition from private industry for new employees will continue to be a challenge in recruitment efforts.
An improved and engaged workforce is enhanced by a world-class management team. HHS will strengthen its management team by providing the tools, training, skill development, and empowerment needed to encourage its workforce to work to its highest potential, accountable for its efficiency and effectiveness toward meeting the HHS mission. To keep abreast of advances and lead change in these fields, HHS will continue to bring together the best expertise and talent -- to serve the American people the best way possible.HHS EmployeesWorkforceBuild a high-quality workforce to respond to current and emerging demands.Objective_e2d39516-96e9-4986-9b7b-3c1c0a151b9d16Among large agencies, HHS was ranked the second "Best Place to Work" in 2017. The Department is working to build a high-quality workforce to respond to current and emerging demands through the following strategies:HHS WorkforceRecruitmentDeploy creative and strategic recruitment strategies to target talent to fill mission-critical occupationsObjective_10f60625-b805-44c2-810f-1ae206108da817unnamed generic groupQualificationsRecruit and retain the most qualified candidates to best meet the needs of the populations served by the DepartmentObjective_034b0a0b-716d-4ac4-8841-f705edb1ccc518unnamed generic groupEfficiency & EffectivenessIncrease the efficiency and effectiveness of recruitment efforts by partnering with hiring managers and leveraging data to make informed decisions regarding recruitment and retention strategiesObjective_9823d49f-2604-42fb-8815-b6caf57e1ff419unnamed generic groupFlexibilities & IncentivesUse existing flexibilities and pursue new retention incentives to ensure HHS retains the highest caliber workforceObjective_ce66dab5-3ffb-4620-a5af-845ba4ffa14320unnamed generic groupWorkforce PlanningImprove workforce planning efforts by integrating succession management activities into efforts to retain employees and manage knowledge transfer within governmentwide and agency-specific mission-critical occupations and other shortfall areasObjective_842bdd28-a9a3-49a4-8619-8b282f9a682b21unnamed generic groupEmployee DevelopmentAdvance employee development by increasing opportunities for cross-training activities, developmental and rotational assignments, mentoring and coaching, and other cross-functional activitiesObjective_6043424c-8b3d-496b-bd4f-76884580d25c22unnamed generic groupDevelopment OpportunitiesCreate and implement development opportunities to provide staff with the leadership, technical, and behavioral skills to succeed in their current and future positions in Federal serviceObjective_7df82b34-c096-4903-80e0-a8798312b29023unnamed generic groupEmployee ContributionsMaximize opportunities for employees to contribute to mission success.Objective_42aac306-7f77-422b-86c7-1ec1981ab4ba24In 2017, the Department ranked second among large agencies in employee engagement, according to the Federal Employee Viewpoint Survey. The Department is maximizing opportunities for employees to contribute to mission success through the following strategies:HHS EmployeesDiversity & InclusionDeploy diversity and inclusion activities to create an environment where people feel valued and can effectively contribute their talents to the missionObjective_6f180f26-c614-4246-8e90-7a168dc9beb025unnamed generic groupWorkforce CompositionDeploy legally permissible strategies to achieve workforce composition goals, including efforts to increase the Veteran workforce and to increase the number of employees with targeted disabilitiesObjective_4f7b41a0-0667-4745-9731-f0a7e0e8f38926VeteransEmployees with DisabilitiesFeedback & Best PracticesUse employee feedback and best practices from across the Federal Government to identify and develop strategies to act on employee input and increase employee engagement, such as brown-bag lunches, midcycle surveys, improved analytics, and action guidesObjective_9cbe944b-760c-4ffc-90ca-5115d602024127unnamed generic groupEngagementIncrease employee engagement, participation in the Federal Employee Viewpoint Survey, and belief that results will be used to improve the organization, by helping managers devise strategies to increase employee engagement and scores around belief in actionObjective_37aeb53e-4669-4922-a11e-9018933130ed28unnamed generic groupPerformance & AccountabilityStrengthen performance and accountability.Objective_bb431c50-62b9-4198-987f-03bcc6c210ed29OMB Memorandum M-17-22, Comprehensive Plan for Reforming the Federal Government and Reducing the Federal Civilian Workforce, charged all Federal agencies with ensuring that supervisors and managers are held accountable for managing employee performance and conduct. The Department is strengthening performance and accountability through the following strategies:unnamed generic groupSupervisory TrainingConduct supervisory training sessions to ensure supervisors are aware of the tools available to engage employees, recognize performance, and strengthen accountabilityObjective_b1897493-36bd-4e3a-aa10-ff6e218090b430HHS SupervisorsRewards & RecognitionEnhance and promote reward and recognition tools available throughout HHSObjective_295323cd-3651-4888-8326-c352eeb37ad431unnamed generic groupPerformance ManagementStrengthen the performance management process, including better ensuring critical elements are directly linked to the work being performedObjective_516e108e-1c08-4f41-ba50-a64be21e4a9432unnamed generic groupHuman CapitalLeverage technology to support human capital management.Objective_ceb96a38-6608-4f79-aa47-0236b97e155533The Department is working to build better, stronger, integrated systems that will save hundreds of hours of labor and bring human resources data, tools, and services into the 21st century. The Department works to leverage technology to support human capital management through the following strategies:unnamed generic groupIT ToolsDeploy new and enhanced information technology tools to strengthen the human capital management program at HHS, to reduce administrative burdens, strengthen the human capital program, and improve reporting capabilities as well as promote uniformity and data transparency, appropriate controls, and enterprise-wide analysis to strengthen decision makingObjective_8a91f881-2ebe-4520-8331-9f2cc505991134unnamed generic groupInformation TechnologyOptimize information technology investments to improve process efficiency and enable innovation to advance program mission goalsObjective_b35a7c1b-c9f3-482e-bda0-2f0cbc2598cb35Performance Goals: * Increase the percentage of systems with an Authority to Operate (ATO) * Improve the score to an "A" in each of the FITARA-related Scorecard Metrics, per GAO and the House Oversight and Government Reform Committee -- New technology is changing how Americans, businesses, governments, and other organizations expect the Federal Government to manage and deliver services. These individuals and entities expect the same innovation, speed, and quality when they interact with HHS. The right technology investments can help reduce costs as the Department becomes more agile and responsive in an environment of rapid change.
HHS information technology investments help achieve the Department's mission by acquiring and managing the technology infrastructure and systems for its healthcare and human services programs and mission-support programs. From externally facing websites like HHS.gov to internal applications that manage programs and resources, HHS needs information technology solutions to be modernized, secure, and responsive to customer demands.
The HHS Information Technology Strategic Plan 2017 - 2020 and the HHS Implementation Plan for the Federal Information Technology Acquisition Reform Act (FITARA) guide information technology decision making across the Department. The Department’s current modernization investments include cloud computing, data center consolidation and improvements, information technology portfolio reviews, shared services, and a digital strategy that makes it easier to access information using HHS websites and tools. HHS is working to increase partnerships with industry, academia, and other organizations to leverage their technology expertise as well.
Planning and managing information technology investments is a challenge. HHS will upgrade its legacy systems, increase interoperability to allow systems to exchange information and use the information to make better decisions, and improve the management of its information technology investments to ensure quality service delivery. For example, through the HHS Strategic Plan for Data Center Optimization, the Department is working to reduce costs on infrastructure, curtail excessive energy usage, leverage cloud-based technologies, and minimize or eliminate security risks.
Through its participation on the Chief Information Officers (CIO) Council, the Department engages with other Federal departments and agencies to implement information resource management objectives described in the E-Government Act of 2002 (Pub. L. 107-347), the Government Paperwork Elimination Act (Pub. L. 105-277), the Paperwork Reduction Act of 1980 (Pub. L. 96-511), and the Information Technology Management Reform Act of 1996 (Pub. L. 104-106). The Department also has established clear lines of authority among the Office of the Chief Information Officer and CIOs in each of its operating divisions, to ensure shared and transparent responsibility for information technology investments, and more effective management of the information technology portfolio.unnamed generic groupCustomer ExperienceProvide easily understandable, easily accessible information technology solutions.Objective_4febc71c-4615-4a62-99bf-f6a0d623368636User-centered design in information technology involves understanding who will be using a resource, what they need, what they value, and their abilities and limitations. The Department’s externally facing information technology solutions help States look for early warning data on infectious disease outbreaks, such as flu; share information about health insurance coverage options with older adults and the general population; and provide research data to universities and colleges with which the Department is collaborating to find the cures of the future. The Department is working to provide easily understandable, easily accessible information technology solutions, to improve the customer experience, through the following strategies:unnamed generic groupUser-Centered DesignPromote adoption of user-centered design for information technology services targeted to the American publicObjective_d86406c3-b2cb-4043-ad5b-c821d6ec5bb537unnamed generic groupSystemsBuild multiuse and interconnected systems that are intuitive, usable, and accessibleObjective_edeadf50-7a0f-4556-9fdf-edc2fd2c6cb338unnamed generic groupInternal CommunicationsImprove internal communications, including through unified communications technology, to integrate email, voice mail, and other systems, so that staff may access these work supports regardless of division or work locationObjective_77c4b653-b49d-4d79-99d9-acdc4ccf196239unnamed generic groupModernizationModernize information technology systems.Objective_6d602b65-e575-47ac-8608-0aab2c2387d340About 40 percent of the systems of record at HHS are "legacy" information technology, meaning they are no longer supported by their manufacturers. The Department is working to modernize information technology systems to reduce the risk associated with unsupported or end-of-life systems by identifying opportunities to modernize, decommission, or replace legacy systems, through the following strategies:unnamed generic groupBest PracticesCapitalize on and leverage best practices from divisions within HHS and the private sector to develop enterprise-wide information technology solutions, while minimizing custom application development, maximizing collaboration, and reducing costObjective_4109fc08-6e9a-4065-b8d4-bdb5bb54f43941unnamed generic groupComputing ServicesSupport the capability of high-performance computing services, such as sharing large data sets between research institutions, to deliver parallel processing for running advanced application programs efficiently, reliably, and quicklyObjective_79197c45-bb62-4efe-87d0-2da96440e08f42unnamed generic groupAssets & ServicesImprove acquisition of information technology assets and services.Objective_329493cb-4194-46eb-8d41-c1a05d1ed98e43Informed by FITARA and the Making Electronic Government Accountable By Yielding Tangible Efficiencies (MEGABYTE) Act of 2016 (Pub. L. 114-210), as well as by OMB M-16-12, Category Management Policy 16-1, Improving the Acquisition and Management of Common Information Technology: Software Licensing, the Department is working to improve acquisition of information technology assets and services through the following strategies:unnamed generic groupPurchasingImplement cost-efficient and effective purchasing of software and services that serve as a bridge between operating systems, databases, and applicationsObjective_2da175ac-8e97-4f6c-9ac7-494cd3bbfc4044unnamed generic groupAcquisition ProcessesAlign acquisition processes, including those required by the Federal Acquisition Regulation and internal policies, with information technology business models and practices, to remove barriers for purchasing responsive technology in a timely manner to meet ongoing and urgent business needsObjective_8b063d7b-3b64-4fe9-bde0-6b8b28c0ab9645unnamed generic groupWorkforceStrengthen the information technology workforce.Objective_0af34c49-bc5e-4c1e-9b08-ad99d88b05d746Competing with the private sector is a perennial challenge to recruiting and retaining top talent in the government sphere. The Department is working to strengthen the information technology workforce through the following strategies:
Note: Additional strategies on strengthening the workforce are in Strategic Objective 5.2.Information Technology WorkforceManagement & PlanningSupport ongoing management and planning to optimize use of technology expertise and resources, properly align staffing and responsibilities, and maximize resourcesObjective_b3ae7188-c400-4cca-9608-f8af8d39a68b47unnamed generic groupTrainingImplement skills-based workforce training for technology practitioners who design, manage, operate, and support information technology investmentsObjective_18e162df-2182-4950-906c-81fbb2c744c448Technology PractitionersDecision MakingOptimize HHS capacity for data-driven decision making.Objective_ee665157-b23a-43b5-b962-61cf850afbf149Through the HHS Data Council, operating divisions and staff divisions from across the Department promote a coordinated strategy on data issues, by supporting strong data collection, analysis, and dissemination systems and by collaborating with other health and human services entities on common data interests. But data collected by the Department also include data related to business and operational functions. The Department is optimizing HHS capacity for data-driven decision making through the following strategies:unnamed generic groupInteroperabilityImprove system interoperability to allow efficient data sharing; strengthen detection and surveillance of regulated products; reduce risks in manufacturing, production, and distribution of regulated products; and increase regulatory science capacity to effectively evaluate productsObjective_c7e2e9b3-aa85-4e12-83ab-bb5ece2072e350unnamed generic groupDataImprove the capture, use, and management of operational and administrative data, including financial management and human capital management systems, by establishing formal processes, rules, and templates to control data sharing and protect sensitive informationObjective_94a79941-8620-4dd5-8a81-82cf776fbeea51unnamed generic groupHuman, Physical & Digital AssetsProtect the safety and integrity of our human, physical, and digital assetsObjective_b2f03d43-7880-4390-bb1d-93faf2a6b32652Performance Goals: * Decrease the percentage of susceptibility among personnel to phishing * Increase the number of days since last major incident of personally identifiable information breach -- Through dedicated personnel, the vigilance of all of our employees, and physical and technological investments, the Department actively works to protect the safety and integrity of its personnel and the people served through HHS programs.
Threats to the people working in and served by the programs, facilities, and systems prevent the Department from focusing on its mission. Breaches of information technology systems can compromise electronic health records and privacy, and cause physical and financial harms to patients and financial harm to people and organizations that do business with HHS. In response to the increased threats to Federal information technology systems and cybersecurity attacks, Federal agencies are responsible for developing an information security program and managing cybersecurity risks for their networks and information technology infrastructure. HHS has implemented plans and processes to address different security incidents, from improper use to web attacks; continue operations during emergencies; and provide training to HHS staff and contractors.
Protecting the privacy of personally identifiable information—such as birthdates and Social Security numbers—and securing Federal information systems and critical infrastructure are challenges for Federal agencies. HHS is working to improve how it protects the security and privacy of electronic health information and to consistently address controls that prevent unauthorized use and unauthorized changes to information system resources, monitor building and access control systems, and ensure that all HHS staff and contractors are vetted properly and understand cybersecurity risks. Keeping personal information safe increases trust and confidence in HHS and its information and reporting systems.
Yet providing security for HHS involves more than preventing breaches or cybersecurity attacks. The Department’s operating divisions and staff divisions participate in efforts to preserve physical security; personnel security and suitability; security awareness; information security, including the safeguarding of sensitive and classified material; and security and threat assessments. In addition, the Department has established a network of scientific, public health, and security professionals internally, as well as points of contact in other agencies, in the intelligence community, and in the Information Sharing Environment Council. The Department has specialized staff to provide policy direction to facilitate the identification of potential vulnerabilities or threats to security, conduct analyses of potential or identified risks to security and safety, and work with agencies to develop methods to address them.unnamed generic groupSafety, Security & IntegrityIdentify, assess, remediate, and monitor risks to safety, security, and integrity.Objective_a7e59672-b2fd-41e1-9ee6-8a4035036e6453Strategic Goal 5: Promote Effective and Efficient Management and Stewardship has described our efforts to promote integrity in our financial management systems, strengthen our human capital, and optimize our information technology investments. Protecting these assets and mitigating threats to these systems require an enterprise-wide approach. The Department is working to identify, assess, remediate, and monitor risks to safety, security, and integrity through the following strategies:unnamed generic groupRisk ManagementAdvance an enterprise-wide risk management approach that continually provides situational awareness of HHS's risk posture by effectively identifying, assessing, remediating, and monitoring risksObjective_36f36704-6700-4d18-b2d5-0f136f21aef154unnamed generic groupSafety & SecurityEstablish enterprise-wide safety and security models that incorporate best practices from other Federal agenciesObjective_2aa81b60-a6a0-4c45-9afd-3e8c08634c9055unnamed generic groupCybersecurityProtect information technology systems, data, and sensitive information, and prevents, detects, mitigates, and responds to cybersecurity events.Objective_6ddd0502-5ce5-4d44-b164-eb6ecf3399ab56The Federal Information Security Modernization Act (Pub. L. 113–283) and the HHS Information Technology Strategic Plan guide the Department’s efforts to protect data and electronic data systems from threats, including those from state actors, hackers, and internal threats. The Department protects information technology systems, data, and sensitive information, and prevents, detects, mitigates, and responds to cybersecurity events, through the following strategies:unnamed generic groupData Access & SecurityMaximize enterprise-level data access and security for stakeholders while ensuring data integrity and privacy in support of streamlined program flexibilities, accountability, and information exchangeObjective_e3ec7336-2857-4109-b1ba-7c22af9ba86857unnamed generic groupAuthenticationEnsure stronger authentication of privileged users to support application securityObjective_90436b13-bfda-4185-afeb-22e144f9b27058Privileged UsersIntelligenceImprove the sharing of intelligence with Federal and private-sector partners to improve situational awareness and reduce cyberthreatsObjective_855f9918-da74-4a91-b6bf-b7b6a356d99b59unnamed generic groupData Access & UsabilityMaximize data access and usability to internal and external users while protecting data confidentiality, integrity, and availability, including beneficiary privacyObjective_e4dd8062-58b5-4b71-a700-a1c3922587fa60unnamed generic groupIntegrationPromote integration of electronic data systems to increase efficiency and minimize redundancy while maintaining appropriate standards for identity management and the protection of personally identifiable information (PII) and protected health information (PHI)Objective_2a1bca28-2c51-4da5-99c0-13389cf2b81a61unnamed generic groupRisk ManagementUse a priority-based risk management approach that focuses on the protection of sensitive data, including PII and PHI data sets, High Value Assets, and mission-essential systemsObjective_be51cc87-9d03-4388-887c-d0e51b4492c562unnamed generic groupContinuity of OperationsExecute essential functions, even in the event of an emergency, while protecting the safety of the HHS workforce.Objective_ad1f787c-30f4-4f8d-ba50-147a75aa192863Through Federal Continuity Directives 1 and 2, the Federal Emergency Management Agency mandates that the executive branch prepare a Continuity of Operations Plan to be implemented in the event of service disruptions affecting any facility. The Department will execute essential functions, even in the event of an emergency, while protecting the safety of the HHS workforce, by employing the following strategies:unnamed generic groupEssential FunctionsPromote and ensure the execution of essential Federal functions, while providing for the safety and well-being of employees during emergency situations, including continuity of operations and emergency evacuations, and ensure that all safety and emergency plans take into consideration the varying needs of the HHS workforceObjective_e381719d-9380-4454-aa6d-6859eee2f13a64unnamed generic groupContinuity PlansReview and update continuity plans and procedures to ensure the safety of our workforce while taking advantage of available technologies, increasing efficiency, and minimizing duplication of effortsObjective_257ffa8f-26f3-4ac7-af12-49015407cf9a65unnamed generic groupInformation SecurityIntegrate information security with emergency preparedness efforts, to prepare for broad-scale cyberattacks or security breaches, and proactively engage with stakeholders on best practices in protecting the health of cyberspaceObjective_599b8e2f-b89c-4672-8264-c7b3f309723366unnamed generic groupHSPD 12Protect HHS facilities, information, and infrastructure through implementation of HSPD 12.Objective_48386d4b-673c-4405-aae0-53ebb15ace3967Homeland Security Presidential Directive (HSPD) 12 establishes a requirement for all Federal agencies to create and use a governmentwide secure and reliable form of identification for their Federal employees and contractors (a personal identity verification credential). The Department is working to protect HHS facilities, information, and infrastructure through implementation of HSPD 12, as well as the following strategies:unnamed generic groupInfrastructureStrengthen physical, organizational, and functional infrastructure to maximize HHS's ability to meet increased demandsObjective_cd2a56d7-4a92-4061-a4ff-1514d033041b68unnamed generic groupBest PracticesImplement best practices in identity and access management to enforce appropriate levels of protection of HHS-owned physical and logical assets and to ensure only authorized users are given access to resources and informationObjective_992a116a-a1cd-4940-a786-c10a2d3faab269unnamed generic groupStrategyPlan_faab0d7b-eeb7-412f-a271-10cb360d8bad2018-02-282022-09-302021-11-06Submitter_faab0d7b-eeb7-412f-a271-10cb360d8badOwenAmbur