The Department  -  “One HHS”

The over-arching central direction of the Department is to function as a single entity – as One HHS.  To ensure that the Department of Health and Human Services (HHS) is “One Department” rather than a collection of disparate and unrelated agencies, we have taken a number of steps, and are planning more. 

For example, we have consolidated administrative support activities to increase efficiency of administrative services to the entire Department and have begun to implement more effective coordination of HHS research and demonstration activities.   In the future we will be increasingly collaborating and coordinating significant activities among HHS agencies, such as work on delivery of health care services to children and families, and privacy and confidentiality policies.   For the first time ever, the HHS Strategic Plan contains a Management Improvement Goal, including strategies to reduce the number of personnel offices; modernize and improve human, financial, and technological management, including the information technology governance process, at HHS; and reform regulations to reduce excessive paperwork and burden on doctors, nurses, and other health care professionals.  To provide accountability as well as feedback and tracking of how we are doing, we are instituting performance contracts (tied to the strategic goals and objectives) for the Department’s senior leadership, which will cascade throughout the Department.  These performance contracts will institute explicit standards against which HHS officials’ work will be measured.

In terms of our structure, HHS is one of the largest federal departments, the Nation’s largest health payer, and the largest grant-making agency in the United States federal government.  The Department promotes and protects the health and well-being of all Americans and provides world leadership in biomedical  and public health sciences.  As indicated above, in doing this, HHS is committed to becoming a unified Department, and has developed the “One HHS” eight outcome goals and 40 objectives designed to progress in achieving the outcome goals.

Development and Update of the Plan

In 1997, HHS published its first strategic plan in response to the Government Performance and Results Act (GPRA).  This plan was updated and transmitted to Congress in September 2000.   We utilized key indicators and research on objectives in the previous Strategic Plan to track data trends and determine how strategic objectives should be revised in the new plan.  Also a planning assessment initiative was conducted on two of the strategic objectives in the 2001 plan:  improving diet and physical activity and reducing violence and injuries.  We constructed extensive logic models and conducted evaluation syntheses to determine what is known about how effective HHS’ strategies are for these four strategic areas.  Based in part on the research, improving diet and physical activity were retained as key strategies (Objective 1.1) to improve healthy behaviors, and reducing injuries and violence was retained as a strategic objective with updates to the strategies as appropriate (Objective 1.6).

In addition, HHS uses a variety of program evaluation techniques (see Appendix E) to review the effectiveness of programs and to ensure that programs are on target so that HHS can meet its strategic goals.  Comprehensive, independent evaluations are an important component of the HHS strategy to improve overall program effectiveness and ensure that the goals identified in the Strategic Plan accurately represent HHS’ progress in improving the overall health of the nation. These evaluations are an important component in evaluating whether or not programs are effective, well designed, and well managed.  The development of Corrective Action Plans for the FY 2004 Program Assessment Rating Tools (PART) represents another important element of our strategy to improve program effectiveness.  Following the FY 2004 PART process, HHS’ Departmental Annual Performance Planning Team requested and received corrective action plans from the HHS agencies for 14 selected programs.  These were reviewed and evaluated with specific comments and suggestions provided to the agencies so they could begin implementing corrective actions.  HHS will continue to use the results of PART reviews and other independent evaluations to inform the Department’s strategic direction.

Our quality improvement efforts in strategic planning have focused on updating the HHS Strategic Plan to reflect the emergence of new priorities and the experience that has been gained while implementing the initial two plans.  The result is an expansion and revision of the Strategic Plan goals and objectives.  The discussion of implementation strategies also is expanded and refined.  Strategic outcome indicators are presented and an explanation of how the strategic and annual performance plans are closely linked is discussed in detail (Appendix A).   A more thorough discussion of data and management challenges and solutions is provided (Appendices D and H), and a more complete analysis of external factors that might affect the goals/objectives and how the Department might mitigate them is included (Appendix C).  Perspectives and outlook concerning overall health or human services trends are discussed at the beginning of each strategic goal. 

Despite these changes, the basic logic of the plan remains the same.  The strategic goals and objectives reflect Department-wide priorities that cut across individual HHS agencies and programs.  In contrast, our implementation strategies are aligned with the authority and funding of categorical programs (see Appendix J).  Often, however, individuals and families have needs that go beyond the individual Department programs.  For example, the person who is moving from welfare  to work may also need access to affordable housing¾a program that is within the purview of the Department of Housing and Urban Development (HUD).  In this respect, the HHS implementation strategies for helping these individuals would appear to be constrained by the scope of the programs that we administer.  However, HHS works with a wide range of federal, state, tribal, and local service providers  to coordinate the planning and delivery of services in a way that maximizes resources and provides individuals with an integrated approach to meeting their needs. The discussion of internal and external coordination has been expanded to provide a clearer sense of where the Department’s programs and activities intersect with each other and with organizations outside HHS (see Appendix B).

In addition, Appendix B describes the unique service delivery partnerships  that we have with state and local governments, tribes, and private organizations that have programs and goals similar to those of HHS.  The appendix provides a discussion of how these partnerships work in planning and delivering services and the important role that these organizations play in helping us achieve the objectives we have set in the HHS Strategic Plan.

Many of the Department’s objectives and implementation strategies focus on populations within our program authority[1] (e.g., persons with particular diseases, low-income, underserved and minority populations ). Given finite resources, where we have discretion, we target groups with the greatest needs.  We do not cast our objectives and implementation strategies by particular populations, given the number of separate populations that are eligible for special services. 

Similarly, the Strategic Plan is not a depository for all actions that we might take to achieve an objective.  Therefore, implementation strategies under each objective are merely illustrative and not meant as a catalogue of all potential implementation plans; they illustrate the general direction we plan to take.  For example, a research strategy may be central to achieving one of our objectives.  In this case, we would list selected research priorities to provide readers with the major thrust of our agenda and how research relates to achieving the particular objective.  Listing every possible research activity would be impossible, given the number of potential research priorities that we might support.

Planning and Assessment Cycle

In revising the plan, HHS consulted widely with stakeholders on proposed revisions.  The plan was posted on the web and comments were solicited from service delivery partners (e.g., health care practitioners), employees, unions, patients, beneficiaries, the general public, and other stakeholders.  Letters were sent to approximately 1,200 stakeholder organizations inviting attendance at an open stakeholder meeting and/or written comments by e-mail, fax, or regular mail.  Stakeholders were also provided phone numbers to call and discuss the plan.  We met with 225 stakeholder representatives from a wide variety of organizations all across the United States.  The comment period yielded over 400 suggestions, with input ranging from editorial to more substantive comments.  Many of these were quite useful and helpful, and we made a number of changes (including revisions to strategic objectives in some cases) and additions to the plan based on the comments that we received. 

Our Mission

The mission of the Department of Health and Human Services is to enhance the health and well-being of Americans by providing for effective health and human services and by fostering strong, sustained advances in the sciences underlying medicine, public health, and social services.

Our Vision for a Healthy and Productive America

Healthy and productive individuals, families, and communities are the very foundation of the Nation’s present and future security and prosperity.  Through leadership in medical  sciences and public health, and as guardian of critical components of America’s health and safety net programs, HHS seeks to improve the health and well-being of people in this country and throughout the world.  

The Department’s successes are measured against a yardstick of steady, progressive improvements in the physical and mental health  and economic well-being of individuals, families, and communities, and advances in medicine and public health that benefit the entire world.  Achieving and sustaining good health as individuals and communities is a shared responsibility.  To realize our goals, we will develop the policies, tools, and resources that are appropriately national in scope.  To realize the objectives for improving the Nation’s health, strengthening the social and economic fabric, and contributing to global health, the Department will form many kinds of partnerships.  These include partnerships with other federal departments; state, local, and tribal governments; academic institutions; the business community; nonprofit and volunteer organizations; and our counterparts in other countries and international organizations. 

Strategic Goals

The HHS strategic goals are broad statements of what we plan to accomplish over the next five years.  More detailed objectives are set for each goal.  We have articulated the key strategies we plan to undertake to work toward our objectives and goals in order to help us to achieve the overall HHS mission.  The HHS annual performance plan and report contains more detailed performance goals related to the strategic goals and objectives.  Individual HHS Agency annual performance plans and reports, which are part of each agency’s budget request, also link to the strategic goals and objectives by setting interim (annual) performance targets for specific programs and/or populations.

While there is a need in developing a strategic plan to focus on particular and focused goals and objectives, the reality is that objectives and strategies are inter-related and inter-dependent.  For example, in leaving no child behind, strategies must be implemented to improve their health and nutrition, as well as to maintain the foundation of social and emotional competence and strengthen the language and literacy among our Nation’s children.  

The final Strategic Plan will be posted on the Internet, and the site as well as a summary of Strategic Goals and Objectives will be shared with employees.  HHS stakeholders (including partners, interest groups, and customers) will be sent a summary of the Plan along with the link to the Internet site.  The Goals, objectives, and strategies will be used as the basis for our budget requests, financial statements, and constructing performance plans for HHS officials throughout the Department.

Our Core Values

In the Department’s ongoing management of its programs, and in our strategic planning process, we have been guided by a set of core values that define HHS.  These are:

• To deliver results that are useful both to the people and communities that are directly served by the Department’s programs and to the taxpayers who pay for these programs.
• To be an accountable steward of the Department’s programs and enhance the efficiency and quality of the services provided.
• To focus on health promotion and the prevention of disease and social problems, including the prevention and correction of unlawful discrimination in the provision of health and human services.
• To create useful, effective forms of collaboration with partners in regulation, research, service delivery, and management.
• To provide accurate, reliable, understandable, and timely information to our partners and customers.
• To apply the most current scientific knowledge when making decisions that affect public well-being.
• To foster flexibility and encourage innovation in the effective delivery of health and human services programs.
• To maintain a work environment  that encourages creativity, diversity, innovation, teamwork, accountability, continuous learning, a sense of urgency, enthusiasm, trust, celebration of achievement, and the highest ethical standards.
• To work as a single corporate entity with a “One HHS” approach to management.

• To be an accountable steward of the Department’s programs and enhance the efficiency and quality of the services provided.
• To focus on health promotion and the prevention of disease and social problems, including the prevention and correction of unlawful discrimination in the provision of health and human services.
• To create useful, effective forms of collaboration with partners in regulation, research, service delivery, and management.
• To provide accurate, reliable, understandable, and timely information to our partners and customers.
• To apply the most current scientific knowledge when making decisions that affect public well-being.
• To foster flexibility and encourage innovation in the effective delivery of health and human services programs.
• To maintain a work environment  that encourages creativity, diversity, innovation, teamwork, accountability, continuous learning, a sense of urgency, enthusiasm, trust, celebration of achievement, and the highest ethical standards.
• To work as a single corporate entity with a “One HHS” approach to management.

[1] Given the broad range of HHS programs, there are numerous program authorities for HHS work, many of which are found in the Public Health Service Act, the Social Security Act (where Medicare and Medicaid program authorities stem from), the Food, Drug, and Cosmetic Act (FDA), the Head Start Act, and the Older Americans Act. 

[ Previous | Table of Contents | Next ]