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United States Department of Health and Human Services

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United States Department of Health and Human Services
Seal of the United States Department of Health and Human Services.svg
Seal of the U.S. Department of Health and Human Services
Flag of the United States Department of Health and Human Services.svg
Flag of the U.S. Department of Health and Human Services
DHHS2 by Matthew Bisanz.JPG
Hubert H. Humphrey Building, Department Headquarters
Department overview
FormedApril 11, 1953; 65 years ago (1953-04-11) (as Department of Health, Education, and Welfare)
May 4, 1980 (1980-05-04) (as United States Department of Health and Human Services)
Preceding agencies
JurisdictionFederal government of the United States
HeadquartersHubert H. Humphrey Building
Washington, D.C., U.S.
Employees79,540 (2015)[1]
Department executives
Websitewww.hhs.gov
The HHS headquarters in Washington, D.C.

The United States Department of Health and Human Services (HHS), also known as the Health Department, is a cabinet-level department of the U.S. federal government with the goal of protecting the health of all Americans and providing essential human services. Its motto is "Improving the health, safety, and well-being of America".[2] Before the separate federal Department of Education was created in 1979, it was called the Department of Health, Education, and Welfare (HEW).

HHS is administered by the Secretary of Health and Human Services, who is appointed by the President with the advice and consent of the Senate. The United States Public Health Service (PHS) is the main division of the HHS and is led by the Assistant Secretary for Health. The current Secretary, Alex Azar, assumed office on January 29, 2018, upon his appointment by President Trump and confirmation by the Senate.

The United States Public Health Service Commissioned Corps, the uniformed service of the PHS, is led by the Surgeon General who is responsible for addressing matters concerning public health as authorized by the Secretary or by the Assistant Secretary of Health in addition to his or her primary mission of administering the Commissioned Corps.

History[edit]

Federal Security Agency[edit]

The Federal Security Agency (FSA) was established on July 1, 1939, under the Reorganization Act of 1939, P.L. 76-19. The objective was to bring together in one agency all federal programs in the fields of health, education, and social security. The first Federal Security Administrator was Paul V. McNutt.[3] The new agency originally consisted of the following major components: (1) Office of the Administrator, (2) Public Health Service (PHS), (3) Office of Education, (4) Civilian Conservation Corps, and (5) Social Security Board.

By 1953, the Federal Security Agency's programs in health, education, and social security had grown to such importance that its annual budget exceeded the combined budgets of the Departments of Commerce, Justice, Labor and Interior and affected the lives of millions of people. Consequently, in accordance with the Reorganization Act of 1949, President Eisenhower submitted to the Congress on March 12, 1953, Reorganization Plan No. 1 of 1953, which called for the dissolution of the Federal Security Agency and elevation of the agency to Cabinet status as the Department of Health, Education, and Welfare. The plan was approved April 1, 1953, and became effective on April 11, 1953.

Unlike statutes authorizing the creation of other executive departments, the contents of Reorganization Plan No. 1 of 1953 were never properly codified within the United States Code, although Congress did codify a later statute ratifying the Plan. Today, the Plan is included as an appendix to Title 5 of the United States Code. The result is that HHS is the only executive department whose statutory foundation today rests on a confusing combination of several codified and uncodified statutes.[citation needed]

List of Federal Security Agency Administrators
Name Dates of service
Paul V. McNutt[4] July 13, 1939 – September 14, 1945
Watson B. Miller[4] October 11, 1945 – August 26, 1947
Oscar R. Ewing[4] August 27, 1947 – January 20, 1953
Oveta Culp Hobby[4] January 21, 1953 – April 11, 1953

Department of Health, Education, and Welfare[edit]

Seal of the U.S. Department of Health, Education, and Welfare
Flag of the U.S. Department of Health, Education, and Welfare
Flag of the U.S. Secretary of Health, Education, and Welfare
Flag of the U.S. Under Secretary of Health, Education, and Welfare
Flag of the U.S. Assistant Secretary of Health, Education, and Welfare
The seal of the U.S. Department of Health, Education, and Welfare, the flag of the U.S. Department of Health, Education, and Welfare, the flag of the U.S. Secretary of Health, Education, and Welfare, the flag of the U.S. Under Secretary of Health, Education, and Welfare, and the flag of the U.S. Assistant Secretary of Health, Education, and Welfare.

The Department of Health, Education, and Welfare (HEW) was created on April 11, 1953, when Reorganization Plan No. 1 of 1953 became effective. HEW thus became the first new Cabinet-level department since the Department of Labor was created in 1913. The Reorganization Plan abolished the FSA and transferred all of its functions to the Secretary of HEW and all components of the Agency to the Department. The first Secretary of HEW was Oveta Culp Hobby, a native of Texas, who had served as Commander of the Women's Army Corps in World War II and was editor and publisher of the Houston Post. Sworn in on April 11, 1953, as Secretary, she had been FSA Administrator since January 21, 1953.

The six major program-operating components of the new Department were the Public Health Service, the Office of Education, the Food and Drug Administration, the Social Security Administration, the Office of Vocational Rehabilitation, and St. Elizabeth's Hospital. The Department was also responsible for three federally aided corporations: Howard University, the American Printing House for the Blind, and the Columbia Institution for the Deaf (Gallaudet College since 1954).[4]

List of Secretaries of Health, Education, and Welfare[4]
Name Dates of service
Oveta Culp Hobby April 11, 1953 – July 31, 1955
Marion B. Folsom August 1, 1955 – July 31, 1958
Arthur Flemming August 1, 1958 – January 19, 1961
Abraham Ribicoff January 21, 1961 – July 13, 1962
Anthony J. Celebrezze July 31, 1962 – August 17, 1965
John W. Gardner August 18, 1965 – March 1, 1968
Wilbur J. Cohen (designate) March 22, 1968 – May 16, 1968
Wilbur J. Cohen May 16, 1968 – January 20, 1969
Robert H. Finch January 21, 1969 – June 23, 1970
Elliot L. Richardson June 24, 1970 – January 29, 1973
Caspar W. Weinberger February 12, 1973 – August 8, 1975
Forrest David Mathews August 8, 1975 – January 20, 1977
Joseph A. Califano Jr. January 20, 1977 – August 3, 1979
Patricia Roberts Harris August 3, 1979 – May 4, 1980

Department of Health and Human Services[edit]

The Department of Health, Education, and Welfare was renamed the Department of Health and Human Services (HHS) in 1979,[5] when its education functions were transferred to the newly created United States Department of Education under the Department of Education Organization Act.[6] HHS was left in charge of the Social Security Administration, agencies constituting the Public Health Service, and Family Support Administration.

In 1995, the Social Security Administration was removed from the Department of Health and Human Services, and established as an independent agency of the executive branch of the United States Government.

The 2010 United States federal budget established a reserve fund of more than $630 billion over 10 years to finance fundamental reform of the health care system.[7]

Organization[edit]

The Department of Health and Human Services is led by the United States Secretary of Health and Human Services, a member of the United States Cabinet appointed by the President of the United States with the consent of the United States Senate. The Secretary is assisted in managing the Department by the Deputy Secretary of Health and Human Services, who is also appointed by the President. The Secretary and Deputy Secretary are further assisted by seven Assistant Secretaries, who serve as top Departmental administrators.

As of Jan. 20, 2018, this is the top level of the organizational chart. HHS provides further organizational detail on its website.

Several agencies within HHS are components of the Public Health Service (PHS), as noted below.

Office of Inspector General[edit]

The Office of the Inspector General (OIG) investigates criminal activity for HHS. The special agents who work for OIG have the same title series "1811", training and authority as other federal criminal investigators, such as the FBI, ATF, DEA and Secret Service. However, OIG Special Agents have special skills in investigating white collar crime related to Medicare and Medicaid fraud and abuse. Organized crime has dominated the criminal activity relative to this type of fraud.

HHS-OIG investigates tens of millions of dollars in Medicare fraud each year. In addition, OIG will continue its coverage of all 50 states and the District of Columbia by its multi-agency task forces (PSOC Task Forces) that identify, investigate, and prosecute individuals who willfully avoid payment of their child support obligations under the Child Support Recovery Act.

HHS-OIG agents also provide protective services to the Secretary of HHS, and other department executives as necessary.

In 2002, the department released Healthy People 2010, a national strategic initiative for improving the health of Americans.

With the passage of the Fraud Enforcement and Recovery Act of 2009, and the Affordable Care Act of 2010, the Office of the Inspector General has taken an emboldened stance against healthcare related non-compliance, most notably for violations of Stark Law and the Anti-Kickback Statute.[8]

In 2015, the OIG issued a fraud alert as a warning to hospitals and healthcare systems to monitor and comply with their physician compensation arrangements.[9]

Recent years have seen dramatic increases in both the number and the amounts of Stark Law violation settlements, prompting healthcare experts to identify a need for automated solutions that manage physician arrangements by centralizing necessary information with regard to physician-hospital integration.[10] Contract management software companies such as Meditract provide options for health systems to organize and store physician contracts. Ludi Inc introduced DocTime Log®, an SaaS solution that specifically addresses this growing concern, automating physician time logging in compliance with contract terms to eliminate Stark Law and Anti-Kickback Statute violations.[11]

Former operating divisions and agencies[edit]

Relationship with state and local health departments[edit]

There are three tiers of health departments, the federal health department, state health department and local health department. In relation with state and local government, the federal government provides states with funding to ensure that states are able to retain current programs and are able to implement new programs. The coordination between all three health departments is critical to ensure the programs being implemented are well structured and suited to the corresponding level of health department. The health department at state level needs to safeguard good relations with legislators as well as governors in order to acquire legal and financial aid to guarantee the development and enhancements of the programs. Assemblies are set up to guide the relationships between state and local health departments. The state sets up the regulations and health policies whereas the local health departments are the ones implementing the health policies and services.[12][13]

As of 2018, there are ten regional offices that have separated the states in groups of four to eight. These offices directly work with the state departments, local governments, and tribal councils. The directors from each regional office are appointed directly by the active president. The follow is a list of who runs each regional office:

Region 1: John McGough Region 6: Mervin Turner

Region 2: Dennis González Region 7: Jeff Kahrs

Region 3: Matt Baker Region 8: Brian Shiozawa

Region 4: Renee Ellmers Region 9: Unknown

Region 5: Douglas O' Brien Region 10: John R. Graham

Budget and finances[edit]

The Department of Health and Human Services was authorized a budget for fiscal year 2015 of $1.020 trillion. The budget authorization is broken down as follows:[14]

Program Funding (in billions)
Management and Finance
Departmental Management $1.4
Public Health and Social Services Emergency Fund $1.4
Operating Divisions
Food and Drug Administration $2.6
Health Resources and Services Administration $10.4
Indian Health Service $4.8
Centers for Disease Control and Prevention $6.7
National Institutes of Health $30.4
Substance Abuse and Mental Health Services Administration $3.4
Agency for Healthcare Research and Quality $0.4
Centers for Medicare and Medicaid Services $906.8
Administration for Children and Families $51.3
Administration for Community Living $2.1
TOTAL 1,020.3

Programs[edit]

The Department of Health and Human Services' administers 115 programs across its 11 operating divisions.[15] The United States Department of Health and Human Services (HHS) aims to "protect the health of all Americans and provide essential human services, especially for those who are least able to help themselves."[16] These federal programs consist of social service programs, civil rights and healthcare privacy programs, disaster preparedness programs, and health related research. HHS offers a variety of social service programs geared toward persons with low income, disabilities, military families, and senior citizens.[17] Healthcare rights are defined under HHS in the Health Insurance Portability and Accountability Act (HIPAA) which protect patient’s privacy in regards to medical information, protects workers health insurance when unemployed, and sets guidelines surrounding some health insurance. HHS collaborates with the Office of the Assistant Secretary for Preparedness and Response and Office of Emergency Management to prepare and respond to health emergencies.[18][19] A broad array of health related research is supported or completed under the HHS; secondarily under HHS, the Health Resources & Service Administration houses data warehouses and makes health data available surrounding a multitude of topics.[20] [21] HHS also has vast offering of health related resources and tools to help educate the public on health policies and pertinent population health information. Some examples of available resources include disease prevention, wellness, health insurance information, as well as links to healthcare providers and facilities, meaningful health related materials, public health and safety information.[22][23][24][25][26][27]

Some highlights include:

  • Health and social science research
  • Preventing disease, including immunization services
  • Assuring food and drug safety
  • Medicare (health insurance for elderly and disabled Americans) and Medicaid (health insurance for low-income people)
  • Health information technology
  • Financial assistance and services for low-income families
  • Improving maternal and infant health, including a Nurse Home Visitation to support first-time mothers
  • Head Start (pre-school education and services)
  • Faith-based and community initiatives
  • Preventing child abuse and domestic violence
  • Substance abuse treatment and prevention
  • Services for older Americans, including home-delivered meals
  • Comprehensive health services for Native Americans
  • Assets for Independence
  • Medical preparedness for emergencies, including potential terrorism
  • Child support enforcement[28]

The Health Insurance Portability and Accountability Act (HIPAA)[edit]

This program is to ensure the act and accountability of medical professionals to respect and carry-out basic human health rights. In the United States, the government feels that it is essential for the American people to understand their civil duty and rights to all of their medical information. That includes: health insurance policies or medical records from every doctor or emergency visit in one’s life. Through Health & Human services one is able to file a complaint that their HIPAA rights have been violated or a consultant that will be able to decide if their rights were violated.  

Social Services[edit]

This branch has everything to do with the social justice, wellness, and care of all people throughout the United States. This includes but is not limited to people who need government assistance, foster care, unaccompanied alien children, daycares (headstart included), adoption, senior citizens, and disability programs. Social services is one of it not the largest branch of programs underneath it that has a wide variety throughout the United States at a state and local level.

Prevention and Wellness[edit]

The prevention and wellness program’s main idea is to give the American people the ability to live the healthiest and best lifestyle physically that they can. They are the ones who deal with vaccines and immunizations, which fight from common diseases to deadly ones. The nutrition & fitness program that are the basics of healthy eating and regular exercise. Health screenings & family health history which are crucial in the knowledge of each individual’s health and body. A severely important one especially in today’s society is mental health & substance abuse in where they help people with mental illness and drug abuse. Lastly, they help with environmental health where people are researching and studying how our environments both physical and metaphorically have a short and long term effect on our health and wellness.

Strengthening Communities Fund[edit]

In June 2010, the Department of Health and Human Services created the Strengthening Communities Fund[29] as part of the American Recovery and Reinvestment Act. The fund was appropriated $50 million to be given as grants to organizations in the United States who were engaged in Capacity Building programs. The grants were given to two different types of capacity builders:

  • State, Local and Tribal governments engaged in capacity building: grants will go to state local and tribal governments to equip them with the capacity to more effectively partner with faith-based or non-faith based nonprofit organizations.[30] Capacity building in this program will involve education and outreach that catalyzes more involvement of nonprofit organizations in economic recovery and building up nonprofit organization's abilities to tackle economic problems. State, Local and Tribal governments can receive up to $250,000 in two year grants
  • Nonprofit Social Service Providers engaged in capacity building: they will make grants available to nonprofit organizations who can assist other nonprofit organizations in organizational development, program development, leadership, and evaluations. Nonprofits can receive up to $1 million in two year grants

Criticisms and controversies[edit]

In 2016, a published US Senate report revealed that several dozen unaccompanied children from Central America, some as young as fourteen years old, were released from custody to traffickers where they were sexually assaulted, starved or forced to work for little or no pay.[31] The HHS sub agency Office of Refugee Resettlement (ORR) released approximately 90,000 unaccompanied children during 2013-2015 but did not track their whereabouts or properly screen families accepting these children.[32]

To prevent similar episodes, the Homeland Security and Health and Human Services Departments signed a memorandum of understanding in 2016, and agreed to establish joint procedures within one year for dealing with unaccompanied migrant children. As of 2018 they have failed to do so. Between October and December 2017, officials from ORR tried to contact 7,635 children and their sponsors. From these calls, officials learned that 6,075 children remained with their sponsors. Twenty-eight had run away, five had been removed from the United States and fifty-two had relocated to live with a non sponsor. However, officials have lost track of 1,475 children.[33] ORR claims it is not legally liable for the safety and status of the children once released from custody.[34]

Freedom of Information Act processing performance[edit]

In the latest Center for Effective Government analysis of 15 federal agencies which receive the most Freedom of Information Act (United States) (FOIA) requests published in 2015 (using 2012 and 2013 data, the most recent years available), the DHHS ranked second to last, earning an F by scoring 57 out of a possible 100 points, largely due to a low score on its particular disclosure rules. It had deteriorated from a D- in 2013.[35]

Related legislation[edit]

See also[edit]

Notes and references[edit]

  1. ^ (ASFR), Office of Budget (OB), Assistant Secretary for Financial Resources (March 27, 2014). "2015 Budget in Brief". Archived from the original on May 2, 2015.
  2. ^ "About HHS". U.S. Department of Health & Human Services. Archived from the original on November 13, 2013. Retrieved November 13, 2013.
  3. ^ "Department of Health, Education, and Welfare. A Common Thread of Service: An Historical Guide to HEW. DHEW Publication No. (OS) 73-45". July 1, 1972. Archived from the original on February 14, 2014. Retrieved January 9, 2014.
  4. ^ a b c d e f Preliminary inventory of the records of the Department of Health, Education, and Welfare (PI 181, Record Group 235), National Archives and Records Service, 1975.
  5. ^ "Office of the Law Revision Counsel, U.S. House of Representatives, Title 20, Section 3508". house.gov. Archived from the original on June 19, 2012. Retrieved January 7, 2012.
  6. ^ Full text of the Department of Education Organization Act Archived May 7, 2018, at the Wayback Machine., P.L. 96-88.
  7. ^ "Archived copy" (PDF). Archived (PDF) from the original on March 6, 2009. Retrieved March 6, 2009.
  8. ^ "Becker's Hospital Review". Archived from the original on August 29, 2015.
  9. ^ "Becker's Hospital Review" (PDF). Archived (PDF) from the original on July 1, 2015.
  10. ^ "Becker's Hospital Review". Archived from the original on July 14, 2015.
  11. ^ "Ludi, Inc. Closes $1M in Series A Financing". Business Wire. Archived from the original on September 10, 2015.
  12. ^ "Policy Statement Development Process". American Public Health Association. Archived from the original on October 1, 2017. Retrieved September 30, 2017.
  13. ^ "The State Health Department". American public health department. Archived from the original on September 17, 2017. Retrieved September 30, 2017.
  14. ^ 2015 Department of Health and Human Services Budget-in-Brief Archived March 26, 2015, at the Wayback Machine., pg 10, United States Department of Health and Human Services, Accessed July 14, 2015.
  15. ^ Budget and Performance Archived April 28, 2015, at the Wayback Machine.. HHS.gov. Retrieved on April 15, 2014.
  16. ^ (ASPA), Assistant Secretary for Public Affairs (January 29, 2015). "Programs & Services". HHS.gov. Archived from the original on September 17, 2017.
  17. ^ (ASPA), Digital Communications Division (DCD), Assistant Secretary for Public Affairs (February 26, 2015). "Social Services". hhs.gov. Archived from the original on September 17, 2017.
  18. ^ "Preparedness Home - PHE". www.phe.gov. Archived from the original on September 19, 2017.
  19. ^ "Office of Emergency Management - PHE". www.phe.gov. Archived from the original on September 7, 2017.
  20. ^ (ASPA), Digital Communications Division (DCD), Assistant Secretary for Public Affairs (February 26, 2015). "Research". hhs.gov. Archived from the original on September 17, 2017.
  21. ^ "HealthData.gov". www.healthdata.gov. Archived from the original on September 17, 2017.
  22. ^ (ASPA), Assistant Secretary for Public Affairs (January 29, 2015). "Programs & Services". HHS.gov. Archived from the original on September 17, 2017.
  23. ^ (ASPA), Digital Communications Division (DCD), Assistant Secretary for Public Affairs (February 26, 2015). "Prevention & Wellness". hhs.gov. Archived from the original on September 17, 2017.
  24. ^ (ASPA), Digital Communications Division (DCD), Assistant Secretary for Public Affairs (February 26, 2015). "Health Insurance". hhs.gov. Archived from the original on September 17, 2017.
  25. ^ (ASPA), Digital Communications Division (DCD), Assistant Secretary for Public Affairs (April 9, 2015). "Providers & Facilities". hhs.gov. Archived from the original on September 17, 2017.
  26. ^ (ASPA), Digital Communications Division (DCD), Assistant Secretary for Public Affairs (March 3, 2015). "Featured Topic Sites". hhs.gov. Archived from the original on September 17, 2017.
  27. ^ (ASPA), Digital Communications Division (DCD), Assistant Secretary for Public Affairs (February 26, 2015). "Public Health & Safety". hhs.gov. Archived from the original on September 17, 2017.
  28. ^ "Home - Office of Child Support Enforcement - Administration for Children and Families". Archived from the original on August 18, 2015.
  29. ^ "Strengthening Communities Fund". U.S. Department of Health and Human Services. Archived from the original on February 1, 2013.
  30. ^ "Strengthening Communities Fund: American Recovery and Reinvestment Act Implementation Plan" (PDF). U.S. Department of Health and Human Services. May 24, 2010. Archived from the original (PDF) on January 16, 2013.
  31. ^ "Almost 1,500 Migrant Children Placed in Homes by the U.S. Government Went Missing Last Year". Time. Retrieved 2018-05-26.
  32. ^ "U.S. Placed Immigrant Children With Traffickers, Report Says". The New York Times. 2016-01-28. ISSN 0362-4331. Retrieved 2018-05-26.
  33. ^ "Federal Agencies Lost Track of Nearly 1,500 Migrant Children Placed With Sponsors". The New York Times. 2018-04-26. ISSN 0362-4331. Retrieved 2018-05-26.
  34. ^ CNN, Dakin Andone,. "US lost track of 1,500 immigrant children, but says it's not 'legally responsible'". CNN. Retrieved 2018-05-26.
  35. ^ Making the Grade: Access to Information Scorecard 2015 Archived March 13, 2016, at the Wayback Machine. March 2015, 80 pages, Center for Effective Government, retrieved March 21, 2016.

External links[edit]