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Department of Health and Human Services Agency-Wide Plan (as of June 2010)

Table of Contents


Print Version of All HHS Plans

Broad Recovery Goals

HHS has been entrusted with carefully investing $145.7 billion of taxpayer’s funds over 10 years for these purposes and the Department is committed to making every dollar count. HHS Recovery Act activities are creating jobs, expanding early care and educational opportunities for children and providing immediate relief to States and local communities. In addition, HHS Programs supported by the Recovery Act serve as the foundation upon which the new Affordable Care Act will be implemented. Taken together, these two landmark pieces of legislation will help bring down healthcare costs for families and businesses, raise the quality of care in this country and give Americans more control over their own health care. The early investments made in health information technology, prevention and wellness, scientific research, training for health care professionals, and resources directed towards maintaining and expanding access to care in the Recovery Act are already paying dividends.

HHS Recovery Act activities touch the lives of Americans by:

  • Increasing the number of health care professionals through additional grants to health care workforce training initiatives;
  • Computerizing Americans’ health records, which will improve the quality of health care, reduce medical errors, and prevent unnecessary health care spending;
  • Advancing biomedical research;
  • Promoting economic and social well-being of individuals, families, and communities;
  • Expanding services for the early care and education of children;
  • Strengthening necessary health care services for medically underserved individuals, and as part of the unique relationship between Tribes and the Federal government, providing health care services to American Indians and Alaska Natives;
  • Promoting patient-centered research, so that scientifically-valid information on the relative strengths of various medical interventions will be available to clinicians and patients so that they can make informed decisions about their care;
  • Expanding access to vaccines and vaccination services and preventing healthcare-associated infections;
  • Promoting prevention of disease and improving healthy lifestyles through a large-scale community-oriented prevention initiative, which expands the use of evidence-based strategies and mobilizes local resources at the community level to reduce rates of chronic disease, increase physical activity, improve nutrition, decrease obesity rates and decrease tobacco use.
  • Identifying and managing risk to ensure that all Recovery Act funds achieve the goals of the Act and specific program goals.

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List of Recovery Programs within HHS:

Improving and Preserving Health Care

Accelerating the Adoption of Health Information Technology

Strengthening Scientific Research and Facilities

Improving Children and Community Services

Strengthening Community Health Care Services

Supporting Comparative Effectiveness Research

Promoting Prevention and Wellness

 Improving Accountability and Information Technology Security

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Funding Table:


Program Area

Program Level
(dollars in billions)

Improving and Preserving Health Care *

$91.6

Accelerating the Adoption of Health IT

25.8

Improving Children & Community Services

13.3

Supporting Scientific Research and Facilities

10.0

Strengthening Community Health Care Services

2.8

Supporting Comparative Effectiveness Research

1.1

Promoting Prevention & Wellness

1.0

Accountability and IT Security

0.1

HHS Total

$145.7

* This includes an estimated $4.3 billion in financial relief to States by reducing the amount they would have to pay the Federal government to offset the cost of Medicare coverage for prescription drugs for their residents eligible for both Medicare and Medicaid.

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Competition of Contracts (excludes contracts under grants):

Baseline Competition Performance: HHS has achieved great success awarding its contract dollars competitively. In fiscal years 2007 and 2008, HHS awarded 80 percent and 84 percent of its available dollars competitively. Similarly, in fiscal years 2009 and 2010 (to date), HHS awarded 80 percent and 89 percent of its available dollars competitively. The funds that were not available for competition were obligated through statutorily exempt processes, such as the SBA 8(a) Business Development Program and Indian Self-Determination and Education Assistance Act (Section 638).

Recovery Act Competition: HHS issued Department-wide guidance emphasizing its commitment to competitive procedures for Recovery Act-funded acquisitions and its intention to strengthen internal controls to maximize competition. Representatives from HHS’s acquisition community meet regularly to share information and lessons, to reinforce the need for contracting officials to be business advisers to their program offices, and to reemphasize the need to steward public funds responsibly. As of April 29, 2010, HHS had awarded 65 percent of its Recovery Act contract dollars competitively. A single $302 million Recovery Act-funded sole-source contract between the National Cancer Institute and its Federally Funded Research and Development Center (FFRDC) accounts for the difference in competition between HHS contracts using all appropriations and its Recovery Act-funded contracts.

Increased Scrutiny of Non-Competitive Recovery Act Contracts: For actions that will not be competed, program and contracting officials have been put on notice that their justifications for other than full and open competition must demonstrate the soundness of limiting competition and withstand public scrutiny. Each of HHS’s Justifications for Other than Full and Open Competition is published on the Federal Business Opportunities (FedBizOpps) website.

Periodic Updates: This plan will be updated annually to reflect actual levels of competition, achievements against plans, and issuance of additional competition-related policy.

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Contract Type (excludes contracts under grants):

Baseline Contract Type: For fiscal years 2007 and 2008, HHS awarded 45 percent and 38 percent, respectively, of its contract actions on a fixed price basis. In FY 2009 and 2010 (to date) 62 percent and 70 percent, respectively, were fixed price contracts.

Recovery Act Contract Type The Acting Senior Procurement Executive issued, through the Office of Recovery Act Coordination, Department-wide guidance emphasizing HHS’ commitment to using fixed price type contracts to award Recovery

Act-funded acquisitions. Representatives from HHS’s contracting community meet weekly to share information and lessons, to reinforce the need for contracting officials to be business advisers to their program offices, and to reemphasize the need to steward public funds responsibly. As a result, as of April 29, 2010, 86 percent of HHS Recovery Act-funded contract actions were fixed price.

Increased Scrutiny of Other Than Fixed Price Recovery Act Contracts: For actions that will not be fixed price, program and contracting officials have been put on notice that they must demonstrate the basis for determining the contract type. Accordingly, HHS has developed a standard template to document the basis for determining that a contract using Recovery Act funds could not be fixed price. In addition, non-fixed priced Recovery-funded contract actions must be justified in FedBizOpps.

Periodic Updates: This plan will be updated annually to reflect actual contract types, achievements against plans, and issuance of additional contract type-related policy.

Description of Agency Accountability Mechanisms:

HHS has been moving quickly and carefully to award Recovery Act funds in an open and transparent manner that will achieve the objectives of each Recovery Act program and meet the statute’s and President’s mandate for accountability and transparency. A Recovery Act Implementation Team, comprised of the heads of the Department’s Operating Divisions and Staff Divisions, meets monthly to review specific program plans and Recovery Act policies being implemented in HHS. The Implementation Team’s work was refocused in January 2010 from the initial planning phrase to concentrate on:

  • Tracking and accelerating obligations and outlays;
  • Measuring program performance, such as by the number of new patients served at health centers, the number of meals delivered to seniors, or the number of additional children benefiting from Head Start;
  • Informing the public about results;
  • Identifying and managing risks;
  • Collaborating with other Departments on the Vice President’s “Impact Communities” initiative; and
  • Reviewing and improving quarterly recipient reporting.

Ensuring accountability has been a key HHS objective from the very beginning of implementation of the Recovery Act. HHS established new policy and technical processes to implement the Recovery Act’s transparency and accountability requirements. The Department continues to refine them and establish new ones as necessary. In addition to the Implementation Team, HHS created a Recovery Act Technical Council consisting of senior management officials from the Department’s Operating Divisions and the heads of business functions across the Office of the Secretary that meets regularly to address operational issues. The Office of Recovery Act Coordination was established in March 2009 to ensure that HHS fully implements the Act’s requirements and OMB’s guidance, and provides staff support to these groups.

Examples of ongoing activities to minimize risk and ensure accountability include:

  • The HHS Risk Management and Financial Oversight Board provides executive leadership and establishes accountability for the risk assessment process related to internal controls over financial reporting, and the HHS Senior Assessment Team ensures that risk assessment objectives are clearly communicated throughout the Department.
  • Focusing, from the very beginning, on designing our programs to identify and mitigate the risks of non-performance and waste, fraud, and abuse in each step of program implementation.
  • Working proactively with the Office of Inspector General on the design of our programs to prevent fraud, waste, and abuse.
  • Incorporating accountability measures for Recovery Act programs in personnel performance appraisal systems.
  • Conducting risk assessments, establishing risk mitigation strategies, and monitoring results.
  • Monitoring of program performance reports and financial reports for individual programs by program project officers and contracting officer technical representatives.

 

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 Summary of Significant Changes:

The current plan updates the funding chart to take into account actuarial changes in calculating mandatory spending. In addition, the chart reflects new financial relief for States by reducing the amount they would have to pay the Federal government to offset the cost of Medicare coverage for prescription drugs for their residents eligible for both Medicare and Medicaid.