HHS Strategic Plan - Appendix B

HHS Strategic Plan
FY 2004-2009

APPENDIX B
Coordination

Many programs within the Department have goals, objectives, and target populations that appear similar. Likewise, many Department programs appear to overlap programs in other federal agencies. Many state, local, and private sector programs also have goals, objectives, and target populations in common with Department programs. Although many programs work to achieve similar goals and objectives, the specific activities that they undertake are often very different and represent complementary approaches to improving health and human services for the Nation’s population.

For example, a number of Department programs spend resources to reduce the use of tobacco (Objective 1.5). The same is true of state and local health departments and other public and private health organizations. While working to achieve this goal, the various agencies and organizations play different roles. The Centers for Disease Control and Prevention’s National Center for Chronic Disease Prevention and Health Promotion provides funds to states for the development of tobacco prevention programs. The Substance Abuse and Mental Health Services Administration (SAMHSA) implements the Synar Amendment and provides funds to states for compliance activities to prevent the sale of tobacco to minors. The National Institutes of Health (NIH) supports research on ways to reduce nicotine addiction and how to provide better prevention and treatment interventions. The Office of Public Health and Science (OPHS) works with Smoke-Free Kids, and other community coalitions to develop and incorporate prevention programs into their activities.

The example illustrates how programs with overlapping goals and objectives can be complementary. We use a variety of internal and external coordination mechanisms, such as coordinating committees and joint program planning to assure that the Department’s programs complement each other. These mechanisms are described in the sections on internal and external coordination that follow.

Internal Coordination

Over 300 Department programs make up the resource base that HHS deploys to implement the goals and objectives in this plan. Appendix J shows that deployment by program (or aggregated program categories).

The table illustrates the Department’s challenge: making sure that each program contributes to the achievement of Department goals and objectives in a way that is complementary and so that HHS resources are used effectively and efficiently. How this challenge is met and how coordination is achieved is critical. We achieve internal coordination in a number of ways:

Planning Systems

The Department maintains a number of planning systems that enable coordination of program operations across the operating divisions. In this respect, strategic planning, annual performance planning, and the annual budget process are primary tools for reviewing program priorities and harmonizing program activities. For example, the strategy sections of strategic and annual performance plans are used to plan and delineate the complementary roles of the various programs for achieving a particular goal. Additionally, the budget process gives Department staff the chance to review resource allocations each year and improve coordination and collaboration.

In addition to these major planning systems, the Department manages a process for coordinating the development of legislative proposals and regulations. More broadly, the Department engages in an annual planning process for research, demonstration, and evaluation activities. This planning involves representatives from all HHS agencies.

Joint Initiatives

Both to advance important areas of policy interest and to promote program coordination, HHS routinely designates special initiatives and assigns management responsibility to two or more operating divisions. The Department’s health disparity and anti-bioterrorism initiatives are representative of these initiatives. The Initiative to Improve Health Care Quality is another example, through which representatives from all HHS agencies collaborate to make information on quality easier for consumers to use (Objective 5.3), improve the quality of health care services delivered directly by Department programs (Goal 5), and expand research that improves health care quality (Goal 4). These special initiatives are subsequently incorporated into the strategic and performance plans.

Coordinating Committees/Activities

HHS establishes coordinating committees as a way to integrate a variety of internal activities. These established coordinating bodies include, for example:

The HHS Rural Task Force has completed a Department-wide assessment of how HHS agencies serve rural communities along with implementation recommendations. The Task Force will continue its work by working with HHS agencies to implement the recommendations of the Task Force, including better integration of health and social services and coordination of rural policy initiatives.
The Research Coordination Council (RCC), chaired by the Assistant Secretary for Planning and Evaluation (ASPE), and including representatives of HHS agencies, will foster greater interactions among its research programs. The RCC is being provided with information on FY 2004 Program Assessment Rating Tools (PART) as well as a list of the FY 2005 PARTs currently underway so that this information can be used in the process of setting HHS research priorities and in preparing the annual HHS Research Demonstration and Evaluation plan and budget. In coordinating these priorities, particular emphasis will be placed on addressing PART reviews that resulted in an “ineffective” or “results not demonstrated” rating. The Council will also further streamline research and evaluate Department-wide research priorities to ensure greater efficiencies in research, demonstration, and evaluation. The Council will strengthen HHS research coordination and planning around key Departmental priorities and themes.
The Federal Steering Group on Suicide Prevention is comprised of representatives from the Office of the Surgeon General, NIH, HRSA, CDC, IHS, and SAMHSA. It also has liaison members from 11 other federal offices. It works on developing research agendas, statements of work, guidance for applications, and conference grants.
The HHS Data Council advises the Secretary on data policy and serves as a forum for coordination and consideration of those issues. The Council also coordinates the Department’s data collection and analysis activities and ensures effective long-range planning for surveys and other investments in major data collection. The Council also serves as the Department’s focal point for data standards and national health information issues.
The Intradepartmental Council on Native American Affairs (comprised of representatives of the HHS operating and staff divisions) will develop recommendations for solutions to improve American Indian and Alaska Native (AI/AN) policies and programs, provide recommendations on how HHS should be organized to administer services to the AI/AN population, and ensure that the HHS policy on tribal consultation is implemented by all HHS divisions and offices.
The Oral Health Coordinating Committee examines issues of oral health that cut across all HHS agencies, such as oral health information needed for decision making and efforts related to reducing disparities and promoting multi-agency oral health initiatives.
The Interagency Narcotic Treatment Policy Review Board coordinates federal policy regarding the use of methadone. The board helps ensure that agencies responsible for regulatory and oversight activities, funding, technical assistance, and policy development meet, deliberate, review and comment on pertinent agency/departmental issues. Membership includes representatives from the Food and Drug Administration (FDA), SAMHSA, National Institute on Drug Abuse (NIDA), Centers for Medicare & Medicaid Services (CMS), Office of the Secretary (OS), Department of Veterans Affairs, Drug Enforcement Administration (DEA), and Office of National Drug Control Policy (ONDCP).
The Healthy People 2010 Steering Committee includes all HHS Operating Divisions/Agencies, and the Healthy People Consortium is comprised of 650 national and state organizations. Together, these bodies coordinate, advise, and plan activities for measuring and implementing health and social services throughout the Department.
The Secretary’s Council on National Health Promotion and Disease Prevention serves to further advise the Department with regard to the development, monitoring, measurement, and implementation of Healthy People 2010.
The Health Disparities Steering Committee coordinates efforts to improve the health of racial and ethnic groups across the Department.
The HHS Chief Financial Officers Council ensures that HHS’s financial management policy and reporting support program missions by providing accurate, timely, and useful information for decision making. The Council is also responsible for reporting financial information to the Congress, Office of Management and Budget (OMB), General Accounting Office (GAO), the Department of the Treasury, and the public.
The HHS Chief Information Officer (CIO) Advisory Council includes membership from each of the HHS agencies. The Council advises the Chief Information Officer on the promotion of Department-wide Information Resources Management (IRM) goals, strategic policies and initiatives, and enhanced communications among the agencies. In addition, CIO Advisory Council members serve on the HHS Information Technology Investment Review Board.
The Secretary’s Work Group on Ending Chronic Homelessness, comprised of representatives across HHS agencies, is charged with developing and recommending a comprehensive approach to improve access to treatments and supports for persons experiencing chronic homelessness and to prevent additional episodes from occurring.
The HHS Uniform Financial Management System (UFMS) Steering Committee provides strategic guidance and oversight for the UFMS Program.

External Coordination

Almost all health and human service programs entrusted to the Department intersect in some manner with programs of other federal agencies and the public and private sector. This diversity compounds the challenge of coordinating HHS programs with those outside the Department. In addition, Department programs are organized and delivered in a variety of ways, ranging from the direct provision of services where the Department supports most of the costs, to block grants to states where the Department supports a fraction of the costs. This diversity means that the mechanisms for achieving coordination are necessarily as varied as the programs. Coordinating mechanisms can be imbedded in service delivery partnerships. They can be formal mechanisms such as coordinating Councils. They can be ad hoc mechanisms such as meetings or workgroups. Department staff are also directly responsible for coordination. For example, the HHS Regional Directors help ensure that Department programs and activities are coordinated with state, local, tribal, and private organizations in their regions. A discussion of two of these coordination mechanisms follows.

Service Delivery Partnerships

Although the Department delivers services directly under several programs—most notably the Indian Health Service—HHS relies on a large network of state, local, and tribal government organizations, contractors, and private entities to help develop, finance, and carry out the goals, objectives, and programs that we share in common. Program services delivered by these organizations range from financing and providing health services (Medicaid and community health services) to providing services that help families, communities, and individuals improve their well-being (Temporary Assistance to Needy Families, Head Start and Refugee Assistance).

Several aspects of coordination are essential to these service delivery partnerships. First, the role of each partner must be well defined. Second, there must be a mutual understanding of the goals and objectives of the partnership. Finally, there must be a continuing dialogue between the partners to address ongoing policy and operational issues. Coordination is achieved in a variety of ways. Some of the most common mechanisms are:

Consultation with partners in the development of the program goals and objectives that we have in common.
Partnership agreements (grants, contracts, cooperative agreements, collaborations, memoranda of understanding, and other agreements).
Partnership meetings.
Advisory Councils.
Other Federal Agencies

A number of other federal agencies have goals and objectives and run programs that are parallel to or intersect with those of the Department. Often the people being served are the same or similar. When responsibilities are shared, it is important to ensure that efforts are harmonized, not duplicated. This is done in a number of ways, such as joint planning, coordinating councils and workgroups, and cooperative agreements. Several examples illustrate the priority placed on effective coordination between federal agencies and how coordination is accomplished:

Approximately 11 federal agencies are part of the Interagency Committee on School Health. The committee is tasked with jointly identifying needs and facilitating the planning of strategies to improve federal leadership in addressing school health needs.
Drug control efforts are coordinated by the Office of National Drug Control Policy through a comprehensive strategic plan that outlines the distinct roles and responsibilities of various federal agencies in the war on drugs .
The Quality Interagency Coordination Task Force (QuIC) ensures that all federal agencies involved in purchasing, providing, studying, or regulating health care services are working in a coordinated way toward the common goal of improving quality of care.

In addition to the examples of external coordination provided above, the following table (Table B) provides a more comprehensive list of HHS program activities that intersect with the programs and activities of organizations outside the Department and where coordination is important. The table also shows how coordination is achieved. (The content represents examples rather than an exhaustive list.)

Appendix B - Table B
EXTERNAL COORDINATION

Objective	Crosscutting Activity	HHS Agencies	External Organizations	Coordination Means
GOAL 1: Reduce the major threats to the health and well being of Americans
Objective 1.1 Reduce behavioral and other factors that contribute to the development of chronic diseases	Chronic disease prevention and management campaign	AoA, FDA, NIH	State and local health departments, state and area agencies on aging	Joint projects, joint planning
	State and community-based disease prevention programs	HRSA, CDC, AHRQ	State and local health departments, community based coalitions	Intra-agency planning group
Objective 1.2 Reduce the incidence of sexually transmitted diseases and unintended pregnancies	Prevention programs (domestic)	OPHS, CDC, HRSA, IHS, NIH	State and local departments of education and health, community prevention programs	HIV/AIDS Prevention Community Planning Process
	Prevention programs (international)	NIH, CDC, HRSA	USAID, World Health Organization, UNAIDS, European Union, Medical Research Council of the United Kingdom, Rockefeller Foundation	International working group on Microbicides, Sexually Transmitted Disease Diagnostics Initiative, Syphilis Research Initiative
	Surveillance	CDC	State and local health departments, other national and community organizations	Partnership agreements
Objective 1.3 Increase immunization rates among adults and children	Surveillance	CDC, FDA	Department of Agriculture, state and local health departments, international health organizations	Partnership agreements
	Immunization programs	CDC, FDA, IHS, CMS, HRSA, NIH	State and local health departments, state Medicaid and SCHIP state agencies, health care providers, voluntary health organizations, Quality Improvement Organizations	Joint planning, cooperative agreements, National Vaccine Advisory Committee
Objective 1.4 Reduce substance abuse	Substance abuse prevention campaigns	SAMHSA, HRSA	Departments of Transportation, Education and Justice; state and local health departments; community organizations; Office of National Drug Control Policy	Joint planning
	Substance abuse treatment services	SAMHSA, IHS	State, tribal, and local health departments; correctional institutions; community drug and alcohol treatment organizations; Office of National Drug Control Policy; Department of Justice	Joint national and regional meetings
	Research on prevention and treatment of substance abuse	HRSA, NIH, SAMHSA, CDC	Departments of Energy, Labor, Justice and Veterans Affairs; National Science Foundation; Uniformed Services University of the Health Sciences; institutions of higher education	Partnership agreements; Attorney Generals Methamphetamine Task Force; Interagency Narcotic Treatment Policy Review Board
Objective 1.5 Reduce tobacco use, especially among youth	Education programs to prevent tobacco use	CDC, NIH, SAMHSA, IHS, HRSA	State and local health departments, health promotion and research organizations, the film industry	Partnership agreements, HHS Interagency Working Group on Tobacco; enlist help of the film industry on the portrayal of smoking
	Research: National longitudinal study of adolescent health	NIH, CDC	Robert Wood Johnson Foundation	Joint planning and funding
	Research on smoking and the aged population	AoA	State and local health departments, state and area agencies on aging	Joint planning, interagency agreements
Objective 1.6 Reduce the incidence and consequences of injuries and violence	Surveillance/research on the causes of injury and violence and development of prevention strategies	CDC, IHS, ACF, SAMHSA, NIH	Departments of Justice, Labor, Education, and Transportation; state and local health departments; Brain Injury Association, American Academy of Physical Medicine and Rehabilitation, Consumer Product Safety Commission; consumer product safety organizations; World Health Organization	Partnership agreements and contracts; joint research, research planning, and information sharing
	Education programs to prevent violence and injury	CDC, IHS, ACF, SAMHSA, HRSA, AoA	Departments of Justice, Labor, and Transportation; Consumer Product Safety Commission; consumer product safety organizations; multiple state, tribal, and local government agencies; community organizations	Partnership agreements, joint planning
GOAL 2: Enhance the ability of the nation’s health care system to effectively respond to bioterrorism and other public health challenges
Objective 2.1 Build the capacity of the health care system to respond to public health threats in a more timely and effective manner, especially bioterrorism threats	Surveillance/Bio-monitoring	NIH, CDC, ATSDR, OPHEP	Association of Public Health Laboratories, state and local health agencies	Joint projects, partnership agreements
	Development of surveillance and response systems and plans for bioterrorism and other health threats	CDC, OPHS, HRSA, SAMHSA, NIH, FDA, OPHEP	Departments of Agriculture, Defense, Justice, and Transportation; Federal Emergency Management Agency; state and local health departments	Partnership agreements, Federal Interagency Workgroup
	Upgrading the public health information infrastructure	CDC, HRSA, SAMHSA, OPHEP	State and local health and substance abuse prevention and treatment agencies	Partnership agreements
Objective 2.2 Improve the safety of food, drugs, biological products, and medical devices	Food inspection and outbreak surveillance	FDA, CDC	Department of Agriculture, Environmental Protection Agency, state and local health departments	President’s Council on Food Safety, Foodborne Outbreak Coordinating Group, partnership agreements, integrated surveillance networks (e.g., FoodNet)
	Food safety research, education and information dissemination to regulated industries	FDA, CDC, NIH, ASPE	Department of Agriculture, Defense, other federal Departments, institutions of higher education, National Center for Food Safety and Technology, Food and Drug Law Institute, Drug Information Association	Advisory Councils, partnership agreements, Memoranda of Understanding
	Inspection of food imports	FDA	U.S. Customs Service	Cooperative development of processes
	Inspections for safety of blood products and vaccines	FDA, NIH, CDC, OPHS	American Red Cross, state health departments, blood banks, WHO, American Academy of Pediatrics	Collaborative standard setting
GOAL 3: Increase the percentage of the Nation’s children and adults who have access to health care services, and expand consumer choices
Objective 3.1 Encourage the development of new, affordable health insurance options	Oversight of HIPAA	CMS	Departments of Labor and Treasury	Joint Regulatory Development
	Enrollment outreach	CMS, AoA, ACF, HRSA	Departments of Agriculture and Education, child care providers, early education providers, state and local health departments, Medicaid and SCHIP state agencies, area agencies on aging	Partnership agreements, joint planning
Objective 3.2 Strengthen and expand the health care safety net	Financing and delivery of health care services for underserved populations in rural and urban areas	HRSA, CMS, IHS, SAMHSA, Office on Disability	State and local health departments, state Medicaid agencies, tribal representatives, health care providers	Joint planning, community-based health care coalitions
Objective 3.3 Strengthen and Improve Medicare	National Medicare Educational Program	CMS	Employers, unions, major trade and professional societies, consumer and senior advocacy groups	Joint planning with Medicare “Alliance Network” of over 140 national groups
Objective 3.3 Strengthen and Improve Medicare	Strengthen data collection, measurement, analysis, and intervention strategies related to beneficiary health and satisfaction	CMS, AHRQ	Departments of Labor and Defense and Veterans Administration	Joint planning through Quality Interagency Coordination Task Force (QuIC)
Objective 3.4 Eliminate racial and ethnic health disparities	Partner with faith-based and other community-based organizations to help reach diverse racial and ethnic populations concerning major health risks and prevention	OCR, AHRQ, CMS, CDC, HRSA, OPHS, NIH	State and local health departments, Medicaid and SCHIP state agencies, health care providers, state and local provider organizations, medical societies, universities, faith-based organizations, civil rights advocacy and community-based organizations	Local coalitions
	Outreach to raise awareness among minority communities about major health risks prevalent in their specific populations and provide access to information on how to reduce these risks	AoA, Office of Minority Health, CDC, NIH	Local media, state and local health departments, state and area agencies on aging	Joint planning
Objective 3.5 Expand access to health care services for targeted populations with special health care needs	Financing of HIV/AIDS prevention and treatment services	HRSA, CMS, IHS	State and local health departments, Medicaid and SCHIP state agencies, community health providers, AI/AN tribes	Joint planning, interagency agreements
	Building community-based systems of care for mental health services	SAMHSA, HRSA, ACF	Departments of Education and Justice, state and community mental health service providers, substance abuse service providers, homeless service providers	Joint planning
	Delivering health care services to adults and children with special health care needs	HRSA, CMS	Departments of Education and Labor, state and local health departments, state Medicaid agencies, President’s Council on Disabilities	Joint planning
	Provision of information and education on health care resources for children with special health care needs	HRSA	State and local health departments, health care providers, American Academy of Pediatrics, community organizations	Joint planning
Objective 3.6 Increase access to health services for American Indians and Alaska Natives (AI/AN)	Address health conditions that disproportionately affect American Indian and Native Alaskan populations in urban and rural settings initiatives	IHS, CMS, ACF/ Administration for Native Americans (ANA)	Departments of Interior, Housing and Urban Development, Transportation, and Justice, tribal governments	Interagency agreements, joint planning
	Development, implementation, and coordination of policies affecting Native Americans	ACF, IHS, AoA, CMS, AHRQ, CDC, ATSDR, FDA, HRSA, IHS, SAMHSA, OS	Department of Interior, tribal governments	Intra-departmental Council on Native American Affairs
GOAL 4: Enhance the capacity and productivity of the nation’s health science research enterprise
Objective 4.1 Advance the understanding of basic biomedical and behavioral science and how to prevent, diagnose, and treat disease and disability	Scientific research	NIH, CDC, FDA, AHRQ, Office on Disability	Extramural research community: academic institutions, hospitals, other research centers	Research partnerships
			Other federal agencies: NASA, Department of Education, and Environmental Protection Agency, VA, DOD, NSF	Joint program/project planning and coordination
			Private industry	Technology transfer agreements
Objective 4.2 Accelerate private sector development of new drugs, biologic therapies, and medical technology	Harmonizing regulatory standards with those of other nations	FDA, NIH	Foreign governments and organizations	International committees and organizations
Objective 4.3 Strengthen and diversify the pool of qualified health and behavioral science researchers	Training and career development programs	NIH, CMS, HRSA, AHRQ, CDC	Academic institutions, National Science Foundation	Advisory committees, joint grant announcements
Objective 4.4 Improve the coordination, communication, and application of health research results	Establish partnerships to more widely disseminate research findings	NIH, CDC, FDA, AHRQ, HRSA, CMS, OPHS’s President’s Council for Physical Fitness and Sports, Surgeon General’s Office	Academic institutions, voluntary health-related organizations, community organizations, state and local health departments, private sector organizations	Memoranda of understanding, partnership agreements, joint conferences and meetings
Objective 4.5 Strengthen the mechanisms for ensuring the protection of human subjects and the integrity of the research process	Strengthening Institutional Review Boards	OPHS, NIH, FDA, CDC, AHRQ, ACF, CMS, HRSA, ASPE	Academic institutions, foundations, industry associations, professional associations, accrediting organizations	Meetings, conferences, technical assistance
GOAL 5: Improve the quality of health care services
Objective 5.1 Reduce medical errors	Develop consensus on standards for content and transmission of patient-specific clinical information	AHRQ, CDC, NIH, FDA, CMS, HRSA	Department of Labor and all federal departments with health care responsibility	Joint planning though the Quality Interagency Coordination Task Force (QuIC)
Objective 5.1 Reduce medical errors	Improve reporting systems for medical errors and adverse events	AHRQ, FDA, CDC, NIH	All federal departments with health care responsibility	Task force
Objective 5.2 Increase the appropriate use of effective health care services by medical providers	Quality Improvement Initiatives	AHRQ, CMS, CDC, HRSA, NIH	Department of Labor and all federal departments with health care responsibility, Quality Improvement Organizations	Joint planning through the Quality Interagency Coordination Task Force (QuIC)
Objective 5.3 Increase consumer and patient use of health care quality information	Development and dissemination of health care quality information	CMS, HRSA, NIH, AHRQ, IHS, FDA, Office on Disability	Departments of Labor, Defense, and Veterans Affairs; and other federal departments with health care responsibility; consumer groups; health care providers; and trade associations	Joint planning, Quality Interagency Coordination Task Force, interagency agreements
Objective 5.4 Improve consumer and patient protections	Survey and certification	CMS	State survey agencies	Joint planning and budget formulation
Objective 5.5 Accelerate the development and use of an electronic health information infrastructure	Provide leadership to promote the rapid development of the technology and standards necessary for an electronic health record	CMS, IHS, ACF, AHRQ, NIH, CDC, ASPE	DOD, VA, HRSA, USDA, SSA, EHealth Initiative, Markle Foundation, Robert Wood Johnson Foundation, and other federal departments and private organizations with interest in electronic communication of health information	Consolidated Health Informatics (CHI) Council and sub-teams; partnership agreements and joint planning efforts
	Applied research	NIH, AHRQ, OPHS, CDC, SAMHSA, FDA, ASPE	VA, DOD, private industry, academic health centers, public health agencies, health plans	Advisory committee (NCVHS), HHS Data Council, joint projects, interagency agreements, grants
	Voluntary adoption of standards	CMS, AHRQ, CDC, HRSA, IHS, FDA, NIH, SAMHSA, ASPE	VA, DOD, OMB, health care organizations, health insurance plans, health care providers, public health agencies, research community	Advisory committee (NCVHS), joint planning through HHS Data Council, conference, interagency task forces
GOAL 6: Improve the economic and social well being of individuals, families, and communities, especially those most in need
Objective 6.1 Increase the proportion of low-income individuals and families including those receiving welfare who improve their economic condition	Develop and implement a comprehensive approach to end chronic homelessness that includes a focus on access, coordination, prevention, and research	ACF, AoA, CMS, HRSA, SAMHSA ASPE, ASBTF, ASL, OGC, IHS, OS	HUD, VA, DOL	Secretary’s Workgroup and Interagency Council on Homelessness, coordination of grants, development of appropriate service definitions
	Encourage states and tribes to use their flexibility and capacity to coordinate human services and workforce programs so families can better access services to obtain and maintain employment	ACF, ASPE, IGA	DOT, state and local TANF agencies, state and local transportation agencies	Joint planning, interagency agreements, joint regulatory guidance
	Reauthorize TANF, CCD BG, TMA, and related programs, and implement reauthorized provisions	ACF, OS	State and local agencies	Joint planning
Objective 6.2 Increase the proportion of older Americans who stay active and healthy	Research	NIH, AoA, CDC, CMS, AHRQ, President’s Council for Physical Fitness and Sports, Office on Disability	National Academy of Sciences, NASA, AARP	Interagency agreements, health promotion and education activities
Objective 6.3 Increase the independence and quality of life of persons with disabilities, including those with long-term care needs	Research and demonstrations on use of long-term-care services	CMS, AoA, OCR, SAMHSA, NIH, Office on Disability	State developmental disability agencies, long-term-care providers, state and local agencies on aging, state Medicaid agencies	Joint planning
Objective 6.4 Improve the economic and social development of distressed communities	Community building/ community development/ social services	ACF, HRSA, CDC, SAMHSA	Departments of Agriculture, Commerce, Education, HUD, DOJ, DOL, Small Business Association, state and local governments, philanthropic organizations, faith-based groups, local level community development and social service entities (e.g., CACs, CDCs, schools), homeless service providers and advocates	Joint planning
Objective 6.5 Expand community and faith-based partnerships	Improve communications and disseminate lessons learned and information on how to participate in federal programs and work together effectively	Faith-based organizations and all HHS agencies	Faith and Community-based organizations	Conferences, and technical assistance/guidance
Goal 7: Improve the stability and healthy development of our Nation’s children and youth
Objective 7.1 Promote family formation and healthy marriages	Program development, research, and best practices	ACF, NIH, ASPE	State TANF agencies, APHSA, NGA, NCSL	Joint planning committees pertaining to individual agency projects
	Work to promote parenting and family reunification as appropriate among parents in prison and upon re-entry into the community	ACF, ASPE, SAMHSA, CDC, OS (OWH and OMH)	Departments of Justice, Education, and Labor; HUD, NGA, Council of State Governments, APHSA, and other organizations, including faith-based organizations	Joint planning, interagency agreements, partnership agreements
Objective 7.2 Improve the development and learning readiness of preschool children	Strengthen language and early literacy services through evidence-based training and technical assistance	ACF, HRSA, CMS, IHS, OPHS, SAMHSA, Office on Disability	Department of Education; other federal agencies; state, tribal, and local education agencies; state and local health departments; Medicaid and SCHIP state agencies; health care providers; Head Start providers; day care providers	Joint planning, interagency agreements, partnership agreements, Interagency Children’s Health Outreach Task Force
	Early childhood research	ACF, NIH, ASPE, CDC, HRSA, SAMHSA, Office on Disability	Department of Education, USDA, and other federal departments and agencies	Joint planning, interagency and partnership agreements, working groups including: Early childhood research working group Science and Ecology of Early Development (SEED) Early Childhood Education and School Readiness Initiative
Objective 7.3 Increase the involvement and financial support of non-custodial parents in the lives of their children	Locating delinquent parents, enforcing child support orders, and promoting access and visitation	ACF, OIG, ASPE	Departments of Justice, State, and Treasury; state child enforcement agencies, National Child Support Enforcement Association, state courts	Joint planning committees pertaining to individual agency projects, state grantee meetings, work groups
Objective 7.4 Increase the percentage of children and youth living in a permanent, safe environment	Child abuse prevention, child welfare and independent living support services	ACF, SAMHSA	Outside stakeholders and state staff are used as peer reviewers in child and family service reviews (child welfare monitoring visits)	Interagency working group on child abuse and neglect includes approximately 15 federal agencies that meet quarterly. DOJ, DOL, and DOD (addresses child abuse/neglect among military families) and others participate
	Working with parents in prison and upon return to community to promote successful parenting and family reunification, as appropriate	ACF, ASPE, SAMHSA CDC, ACF	DOJ, ED, DOL, HUD, NGA, Council of State Governments, International Community Corrections Association, National Practitioners Network for Fathers and Families, prison fellowship ministries, and other faith-based organizations	Joint planning, interagency agreements, partnership agreements
GOAL 8: Achieve Excellence in Management Practices
Objective 8.1 Create a unified HHS committed to functioning as one Department	N/A (Internal HHS activity)	All	N/A (internal activity)	N/A
Objective 8.2 Improve the strategic management of human capital	Human Resources consolidation	All HHS operating divisions and staff divisions	Contractors, OMB, OPM	Implementation team joint decision making, including, HR Center Directors
	HHS recruitement and retention plan	All HHS operating divisions and staff divisions	OPM, OMB, external applicants	OHR oversight; quarterly scorecards
Objective 8.3 Enhance the efficiency and effectiveness of competitive sourcing	Restructuring and consolidation	All HHS operating divisions and staff divisions	OMB	Monthly meetings with HHS OPDIV managers; regular meetings with OMB representatives
Objective 8.4 Improve financial management	Unified Financial Management Systems (UFMS), including HIGLAS	All HHS Operating Divisions	Medicare contractors and private consulting organizations	UFMS committees, UFMS Program Management Office, UFMS Configuration Board, HHS Architecture Program Team, Information Technology Investment Review Board, Functional Control Change Board
	OIG Substantive Claims review	OS, OIG, CMS	Medicare contractors	Joint planning and coordination
	Comprehensive Error Rate Testing Program	OS, OIG, CMS	Medicare contractors	Joint planning and coordination
Objective 8.5 Enhance the use of electronic commerce in service delivery and record keeping	Consolidated Health Informatics (CHI)	CMS, IHS, ACF, AHRQ, HRSA, NIH, NLM	DOD, VA, USDA, SSA, and other federal departments and private organizations with interest in electronic communication of health information	CHI Council and sub-teams
	Modify and update technical standards related to HIPAA administrative simplification	CMS	Designated Standard Maintenance Organizations (DSMO), Workgroup for Electronic Data Interchange (WEDI)	Technical guidance and consultation
	Promote e-commerce applications such as electronic fund deposits and electronic billing	CMS, OCR, HRSA, IHS, NIH	Health care professionals, providers, suppliers, vendors, clearinghouses, contractors, trade associations	Forum and meetings, joint planning and development of educational videos
	E-Grants	All HHS grant-making agencies	26 federal grant-making departments including 11 partner agencies: HHS (managing partner); Defense; Education; Housing and Urban Development; Justice; Transportation; Agriculture; Commerce; Labor; FEMA; and NSF	E-Grants Program Office, forum and meetings
Objective 8.6 Achieve integration of budget and performance information	Program assessment rating tool	All HHS agencies	OMB, DOJ, state/local government agencies, trade organizations	Sharing drafts, final documents, information exchange, both formal and informal, collaboration on methods of budget integration
Objective 8.7 Reduce regulatory burden on providers and consumers of HHS services	Obtaining external comments and suggestions concerning regulatory streamlining	ASPE, CMS, FDA, NIH, HRSA, ASBTF	Any/all interested external groups (such as health care providers, health professionals and human services practitioners), trade associations, program beneficiaries, and the public at large	The Secretary’s Advisory Committee on Regulatory Reform, open door forums, listening sessions
	Improve coordination of Medicaid and Medicare for dually eligible individuals	CMS, ASPE	OMB, state Medicaid agencies, APHSA	Joint planning Medicaid /Medicare Technical Advisory Group

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Questions? Please contact Lynn Nonnemaker at lynn.nonnemaker@hhs.gov

HHS Strategic Plan FY 2004-2009

APPENDIX B Coordination