Annual Performance Plan and Report - HHS.gov

AnnualPerformance Plan and Report

Released February 2016

PERFORMANCE

RESULTS

HITTINGTHEMARK

SUCCESS

U.S.DepartmentofHealth&HumanServices

Message from the HHS Performance Improvement Officer

The U.S. Department of Health and Human Services (HHS) supports and implements programs that contribute to the health, safety, and well-being of the American people and the world. Our Operating and Staff Divisions strive each day to help more Americans acquire affordable health care, to protect and enhance the health of the people of this country and the world, and to assist those who are least able to help themselves, often through the Department's state, local, and tribal partners. In accordance with the Government Performance and Results Act (GPRA) of 1993, as amended in the GPRA Modernization Act (GPRAMA) of 2010, I am pleased to present the Fiscal Year 2017 Annual Performance Plan and Report documenting the Department's performance during the past year and its plans for the future. Further information detailing HHS performance is available at .

In FY 2015, HHS monitored five priority goals and over 1,000 performance measures to manage departmental programs and activities and improve the efficiency and effectiveness of these programs. Included in this report is a representative set of 144 performance measures that illustrate progress toward achieving the Department's strategic goals. The information provided spans many of HHS's eleven Operating Divisions and fifteen Staff Divisions and includes work across the country and throughout the world. Each HHS component has reviewed their submissions and I confirm, based on certifications from the Divisions, that the data are reliable and complete. When results are not available because of delays in data collection, the report notes the date when the results will be available.

The Affordable Care Act continues to improve the lives of many. Millions have signed up for health care coverage on and the state Marketplaces and paid their premiums. Millions more are receiving the care that they need through expanded Medicaid eligibility. Medicaid and the Children's Health Insurance Program enrollments are increasing, providing our youngest access to necessary healthcare. HHS plans to examine a number of health challenges facing the public through a new set of priority goals over the next two years, including serious mental illness, opioid abuse, antibiotic resistant bacteria, tobacco use, and food safety, while also exploring improvements to early childhood education and paying for healthcare. HHS is also working to keep America healthy, advance science and research, serve our citizens at key stages of life, and enhance the Department's administration and operations. The results presented here demonstrate that HHS is performing well across a wide range of activities and has plans in place to continue that success in the future.

Ellen G. Murray Assistant Secretary for Financial Resources U.S. Department of Health and Human Services

Table of Contents

Message from the HHS Performance Improvement Officer .................................................................................. 2 Table of Contents ..................................................................................................................................................................... 3 Overview ..................................................................................................................................................................................... 5 Mission Statement................................................................................................................................................................... 5 HHS Organizational Structure ............................................................................................................................................ 5 Organizational Chart Department of Health and Human Services ..................................................................... 7 Cross-Agency Priority Goals................................................................................................................................................ 8 Strategic Goals Overview...................................................................................................................................................... 8 Management Objectives and Priorities........................................................................................................................... 8 Performance Management .................................................................................................................................................. 8 HHS Agency Priority Goals .................................................................................................................................................. 9 HHS Agency Priority Goals Progress Summary FY 2014 ? FY 2015................................................................... 9 HHS Agency Priority Goals FY 2016 ? FY 2017.........................................................................................................11 Annual Performance Plan and Report ..........................................................................................................................13 Goal 1. Objective A: Make coverage more secure for those who have insurance, and extend affordable coverage to the uninsured...........................................................................................................................14 Goal 1. Objective B: Improve healthcare quality and patient safety ..............................................................20 Goal 1. Objective C: Emphasize primary and preventive care, linked with community prevention services ......................................................................................................................................................................................31 Goal 1. Objective D: Reduce the growth of healthcare costs while promoting high-value, effective care ..............................................................................................................................................................................................34 Goal 1. Objective E: Ensure access to quality, culturally competent care, including long-term services and supports, for vulnerable populations .................................................................................................38 Goal 1. Objective F: Improve health care and population health through the meaningful use of health information technology ........................................................................................................................................48 Goal 2. Objective A: Accelerate the process of scientific discovery to improve health ..........................54 Goal 2. Objective B: Foster and apply innovative solutions to health, public health, and human services challenges................................................................................................................................................................65 Goal 2. Objective C: Advance the regulatory sciences to enhance food safety, improve medical product development, and support tobacco regulation........................................................................................68 Goal 2. Objective D: Increase our understanding of what works in public health and human services practice ......................................................................................................................................................................................72 Goal 2. Objective E: Improve laboratory, surveillance, and epidemiology capacity.................................77

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Goal 3. Objective A: Promote the safety, well-being, resilience and healthy development of children and youth ..................................................................................................................................................................................81 Goal 3. Objective B: Promote economic and social well-being for individuals, families, and communities ............................................................................................................................................................................89 Goal 3. Objective C: Improve the accessibility and quality of supportive services for people with disabilities and older adults..............................................................................................................................................97 Goal 3. Objective D: Promote prevention and wellness across the lifespan ............................................ 103 Goal 3. Objective E: Reduce the occurrence of infectious diseases.............................................................. 110 Goal 3. Objective F: Protect Americans' health and safety during emergencies, and foster resilience to withstand and respond to emergencies............................................................................................................... 118 Goal 4. Objective A: Strengthen program integrity and responsible stewardship by reducing improper payments, fighting fraud, and integrating financial, performance, and risk management. .................................................................................................................................................................................................... 125 Goal 4. Objective B: Enhance access to and use of data to improve HHS programs and support improvements in the health and well-being of the American people........................................................... 136 Goal 4. Objective C: Invest in the HHS workforce to help meet America's health and human service needs........................................................................................................................................................................................ 142 Goal 4. Objective D: Improve HHS environmental, energy, and economic performance to promote sustainability ........................................................................................................................................................................ 147 Evidence Building Efforts................................................................................................................................................ 150 HHS OIG FY 2015 Top Management and Performance Challenges ............................................................... 150 Cross-Agency Collaborations......................................................................................................................................... 150 GAO High Risk Items ......................................................................................................................................................... 150 Lower-Priority Program Activities.............................................................................................................................. 153 Changes in Performance Measures ............................................................................................................................. 154 Data Sources and Validation .......................................................................................................................................... 161

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Overview

The U.S. Department of Health and Human Services is the United States government's principal agency for protecting the health of all Americans and providing essential human services, especially for those who are least able to help themselves. HHS is responsible for almost a quarter of all federal expenditures and administers more grant dollars than all other federal agencies combined.

Eleven operating divisions, including eight agencies in the United States Public Health Service and three human service agencies, administer HHS's programs. In addition, sixteen staff divisions provide leadership, direction, and policy and management guidance to the Department.

Through its programming and other activities, HHS works closely with state, local, and U.S. territorial governments. The federal government has a unique legal and political government-to-government relationship with tribal governments and a special trust obligation to provide services for American Indians and Alaska Natives (AI/ANs) based on this association. HHS works with tribal governments, urban Indian organizations and other tribal organizations to facilitate greater consultation and coordination between state and tribal governments on health and human services.

HHS also has strong partnerships with the private sector and nongovernmental organizations. The Department works with partners in the private sector, such as regulated industries, academic institutions, trade organizations, and advocacy groups. The Department recognizes that leveraging resources from organizations and individuals with shared interests allows HHS to accomplish its mission in ways that are the least burdensome and most beneficial to the American public. Private sector grantees, such as academic institutions and faith-based and neighborhood partnerships, provide many HHS-funded services at the local level. In addition, HHS works closely with other federal departments and international partners to coordinate its efforts to ensure the maximum benefit for the public.

Mission Statement

The mission of the U.S. Department of Health and Human Services is to enhance the health and wellbeing of Americans by providing for effective health and human services and by fostering sound, sustained advances in the sciences underlying medicine, public health, and social services.

HHS Organizational Structure

The Department includes eleven operating divisions that administer HHS programs. These operating divisions are:

Administration for Children and Families (ACF) Administration for Community Living (ACL) Agency for Healthcare Research and Quality (AHRQ) Agency for Toxic Substances and Disease Registry (ATSDR) Centers for Disease Control and Prevention (CDC) Centers for Medicare & Medicaid Services (CMS) Food and Drug Administration (FDA) Health Resources and Services Administration (HRSA) Indian Health Service (IHS) National Institutes of Health (NIH) Substance Abuse and Mental Health Services Administration (SAMHSA)

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In addition, staff divisions provide leadership, direction, and policy and management guidance to the Department. Many of these divisions have responsibilities for achieving performance objectives, contained in this report, including,

Office of the Assistant Secretary for Administration (ASA) Assistant Secretary for Preparedness and Response (ASPR) Immediate Office of the Secretary (IOS) Office of the Assistant Secretary for Health (OASH) Office of Inspector General (OIG) Office of Medicare Hearings and Appeals (OMHA) Office of the National Coordinator for Health Information Technology (ONC) Throughout this document the operating divisions and staff divisions will be collectively referred to as HHS components. The HHS organizational chart is available at .

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Organizational Chart Department of Health and Human Services

Also, see the text version of the HHS Organizational Chart with links to agencies and their charts. Page 7 of 197

Cross-Agency Priority Goals

Per the Government Performance and Results Modernization Act (GPRAMA) requirement to address Cross-Agency Priority (CAP) Goals in the agency strategic plan, the annual performance plan, and the annual performance report, please refer to for the agency's contributions to those goals and progress, where applicable. The Department of Health and Human Services currently contributes to the following CAP Goals: Customer Service, Benchmarking, Open Data, Lab-to-Market, and People and Culture.

Strategic Goals Overview

HHS developed a new strategic plan in 2013 to encompass the period from FY 2014 to 2018. This plan, available at , identifies four strategic goals and 21 related objectives. The four strategic goals are:

Goal 1: Strengthen Health Care Goal 2: Advance Scientific Knowledge and Innovation Goal 3: Advance the Health, Safety, and Well-being of the American People Goal 4: Ensure Efficiency, Transparency, Accountability, and Effectiveness of HHS Programs

Management Objectives and Priorities

The structure of the FY 2014-2018 HHS Strategic Plan aligns Strategic Goals 1 through 3 to missionfocused efforts while Strategic Goal 4 aligns to HHS's overall management objectives. The emphasis on efficiency, transparency, accountability, and effectiveness of HHS programs in Goal 4 serves to highlight efforts across the Department to enable enhanced program performance in strengthening program integrity, creating innovations for data access and use, investing in the HHS workforce, and promoting sustainability. The planned actions, performance targets, and indicators used to measure progress for these efforts can be found in the Goal 4 section of this document.

Performance Management

Performance goals and measurement are powerful tools to advance an effective, efficient, and productive government. HHS regularly collects and analyzes performance data to inform decisions. HHS staff constantly strives to achieve meaningful progress and find lower-cost ways to achieve positive impacts, in addition to sustaining and spreading information on effective and efficient government programs.

Responding to opportunities afforded by GPRAMA, HHS continues to institute significant improvements in performance management including:

Developing, analyzing, reporting, and managing five Priority Goals for the period of FY 20142015 and conducting quarterly performance reviews between HHS component staff and HHS leadership to monitor progress toward achieving key performance objectives.

Coordinating Strategic Reviews process supporting decision-making and performance improvement across the Department.

Enhancing the coordination of performance measurement, budgeting, strategic planning, and program integrity activities within the Department.

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