Date: December 27, 2002
For Release: Immediately
Contact: HHS Press Office
(202) 690-6343
HHS -- Highlights of 2002
Following is a summary of significant news highlights at HHS
during 2002:
o Bioterrorism
preparedness
o Expanded access to
health care
o Disease prevention
initiative
o Improving quality of
care
o Next steps for helping
those in need
o Smoking, teen
substance abuse decline
o Protecting patient
privacy
o Regulatory reform
BIOTERRORISM PREPAREDNESS - America ended the year 2002 much
better prepared
to confront terrorism. Under HHS Secretary Tommy G.
Thompson's leadership,
the department led the nation's efforts to be ready in
particular for
possible incidents of bioterror:
· Spending increased
ten-fold - HHS' budget for bioterrorism
preparedness increased ten-fold, from $305 million in FY
2001 to $2.98
billion in FY 2002.
· Support for states and
major cities - Of the budget increase, more
than $1 billion was provided to states and major cities to
support increased
preparedness by hospitals and public health systems.
HHS worked with states
on preparedness plans, emphasizing coordination and regional
cooperation.
The objective is local preparedness, with national resources
ready to be
deployed immediately whenever and wherever needed.
· Smallpox and other
vaccines - HHS took steps to provide enough
smallpox vaccine to be able to vaccinate every American, in
the possible
event of a release of this disease. In December,
President Bush announced a
careful policy of voluntary vaccination for front-line
health care and
emergency personnel, to ensure effective response if the
disease were
released. Vaccination of others is not recommended at
this time, in the
absence of an emergency. In addition, production of
the current anthrax
vaccine was resumed, and research into improved vaccines for
anthrax and
other diseases was accelerated.
· Disease surveillance
and communications - In order to detect any
possible release of disease agents by terrorists, the
nation's disease
surveillance system is being expanded, with spending
increased from $67
million in FY 2001 to $940 million in FY 2002. This
expansion will also
help to quickly identify outbreaks of naturally-occurring
diseases. HHS'
Centers for Disease Control and Prevention's (CDC)
"Epidemic Information
Exchange" (Epi-X) is being strengthened. The
nation's network of public
health laboratories is being expanded. And health
communications systems
overseen by CDC are being improved and expanded.
· Pharmaceutical
stockpile - The National Pharmaceutical Stockpile
completed purchase of more than a billion doses of
antibiotics and other
materials to be ready on stand-by. The number of
50-ton "Push Packs," ready
to reach any part of the U.S. within 12 hours, was increased
from eight to
12.
· Research - Research
into disease agents, diagnostic tools, vaccines
and treatments is being rapidly expanded, a key element of
the long-term
strategy for countering bioterrorism. Research funding
increased from $53
million in FY 2001 to $151 million for FY 2002, with much
larger increases
planned for FY 2003 to begin carrying out research agendas
developed this
year. The President has proposed building new
laboratory facilities for
research involving the most dangerous pathogens. Over 700
new research
proposals were funded this year. In addition, new
rules were issued for
registering and controlling potential bioterror disease
agents by
researchers.
· Food safety - With 80
percent of America's food supply regulated by
HHS' Food and Drug Administration (FDA), resources for food
inspections were
increased. More than 700 new inspectors were hired,
making it possible for
FDA to conduct 24,000 on-site import inspections, nearly
double the past
capacity. FDA also developed new risk assessment
methods for targeting
potential problem areas. Working with the Agriculture Department,
FDA also
expanded the capacity of its systems for identifying
foodborne illness
outbreaks.
· Personnel and
leadership - Training for the nation's health care
professionals was increased. In addition, HHS created
a new Office of
Public Health Emergency Preparedness to coordinate efforts
within HHS and
with the new Department of Homeland Security. HHS also
hardened its own
information systems, and created a new central command and
communications
center for emergencies.
EXPANDED ACCESS TO HEALTH CARE -- In 2002, HHS successfully
expanded access
to health care for Americans - both by expanding the number
and reach of
community health centers nationwide and by helping states to
offer health
coverage to more uninsured Americans through the State
Children's Health
Insurance Program (SCHIP) and Medicaid:
· Expanding coverage
through SCHIP and Medicaid - In 2002, HHS
approved waiver and plan amendments for state SCHIP and
Medicaid programs
that expanded access to health coverage to more than 600,000
additional
Americans. These changes provided additional services
to more than 1
million other beneficiaries. Since the start of Bush
Administration, HHS
has approved waivers and plan amendments that expand access
to coverage to
nearly 1.8 million Americans and improved benefits for more
than 5 million
other Americans. HHS provides matching funding
for coverage provided by
states under Medicaid and SCHIP.
· Expanding Community
Health Centers - In 2002, HHS completed the
first full year of President Bush's five-year initiative to
add or expand
health centers in 1,200 communities by 2006 and to increase
the number of
patients served annually to more than 16 million -- up from
10 million in
2001. During the fiscal year, HHS funded 171 new
health center sites and
awarded 131 grants to existing centers to help them build
capacity and
expand services. Together, these new and
expanded health centers will
serve an additional 1.5 million patients each year,
including many without
insurance.
· Bringing doctors and
other clinicians to underserved areas - To
support the growth of the health centers, HHS also expanded
its National
Health Service Corps, which offers scholarships and loan repayment
plans to
students and fully trained clinicians who agree to serve in
health centers
and other underserved communities.
· Promoting seniors'
access to prescription drugs - While Congress
failed to enact a Medicare prescription drug benefit, HHS
developed a model
waiver template in 2002 to encourage states to offer
low-income seniors
access to prescription drugs through the Medicaid
program. By the end of
the year, HHS approved Pharmacy Plus waivers in five states
- Florida,
Illinois, Maryland, South Carolina and Wisconsin, helping
more than half a
million seniors afford access to prescription drugs.
· Encouraging high-risk
insurance pools - In November 2002, HHS
launched a new program to help states create high-risk pools
that will
provide health coverage to individuals who otherwise would
have difficulty
obtaining coverage because of their health status.
HHS' Centers for
Medicare and Medicaid Services (CMS) is offering seed grants
of up to $1
million to support state efforts to create high-risk pools,
typically
non-profit associations. A total of $20 million is
available through this
program. In addition, HHS expects to offer a total of
$80 million in grants
over two years to help cover losses incurred by states with
existing
high-risk pools.
DISEASE PREVENTION INITIATIVE - Secretary Thompson launched
his
comprehensive initiative on disease prevention in a National
Press Club
speech April 30, outlining steps that individuals can take
on their own for
good health. President Bush joined in the call for
healthy personal choices
in events at the White House June 20, and a new Web site
"HealthierUS.gov"
was created. Working through HHS agencies and in partnership
with many other
organizations, new activities were launched throughout the
year to support
healthy choices and behaviors:
· Physical Activity -
HHS released a report April 7 showing that seven
in 10 American adults are not regularly active. In
another report June 21,
HHS outlined the special benefits of physical activity and
moderate exercise
for older Americans. CDC launched a $190 million
multicultural media
campaign July 17 aimed at promoting a healthier lifestyle
for young people,
especially those aged 9 to 13. HHS also joined with
the U.S. Department of
Education to encourage communities and businesses to find
new ways to
support physical activity among children. And in May,
Secretary Thompson
marked Older Americans Month with a new campaign, "USA
on the Move: Steps to
Healthier Aging," in cooperation with the Center on
Nutrition and Aging at
Florida International University.
· Healthy Diet -
Secretary Thompson released a report June 20 showing
that overweight and obesity cost America $117 billion annually
and account
for at least 14 percent of deaths in the U.S., or some
300,000 premature
deaths each year. Nearly one-third of U.S. adults now
classify as obese,
and obesity among young people is growing rapidly. In
April, HHS joined
with the U.S. Department of Agriculture in expanding a
campaign to promote
consumption of fruits and vegetables. In October,
Secretary Thompson and
USDA Secretary Ann M. Veneman met with officials from the
National
Restaurant Association and the National Council of Chain Restaurants
to
begin a cooperative effort to improve health information and
healthy foods,
especially for young people. In December, FDA launched
a new effort to
improve health labeling for nutritious foods.
· Diabetes - Sedentary
lifestyle and poor eating habits increase the
risk of diabetes, and the prevalence of diabetes and
pre-diabetes is
increasing rapidly in the U.S. On November 20,
Secretary Thompson launched
the first national diabetes prevention campaign, "Small
Steps - Big
Rewards," which builds on new findings that modest
lifestyle changes can
have a major impact on preventing the disease. Earlier
in the year, HHS had
also launched new steps with the American Diabetes
Association (ADA) to
better inform those with diabetes of the most severe effects
of the disease.
HHS also worked with the ADA and the National Association of
Chain Drug
Stores on a campaign to help women recognize the danger
signs of diabetes.
The campaign also provided free diabetes screening for women
in cities with
a high incidence of the disease. In addition,
beginning in October, $100
million was made available to tribal organizations for
prevention and
treatment of diabetes among American Indians and Alaska
Natives, especially
children and teenagers. On average, American Indians and
Alaska Natives are
2.6 times more likely to have diabetes than non-Hispanic
whites of similar
age.
· HIV/AIDS - In addition
to efforts to improve health for all
Americans through healthy diet and exercise, HHS maintained
and expanded its
efforts to prevent HIV/AIDS and support treatment, both
domestically and
internationally. Total HHS spending on HIV/AIDS
increased from $11.4
billion in FY 2001 to $12.1 billion in FY 2002, with a
further increase of
almost $1 billion proposed in the President's budget for FY
2003. HHS'
contribution to the global effort against HIV/AIDS increased
from $276
million in FY 2001 to $468 million in FY 2002.
· Racial and ethnic
health disparities - HHS also undertook new
efforts toward closing the health gap between non-minority
Americans and
racial and ethnic minorities. Total HHS spending
especially directed at
minority health (not including the Indian Health Service)
was $2.6 billion
in FY 2002, up from $2.3 billion in FY 2001. Grants to
support elimination
of disparities were made nationwide by the HHS Office of
Minority Health and
the National Institute of Health's (NIH) institutes.
In addition, HHS
convened the first National Leadership Summit on Eliminating
Racial and
Ethnic Disparities in Health; and HHS launched a two-year
demonstration
project in five states to test new ways of improving flu
vaccination rates
in minority communities. HHS' Health Resources and
Services Administration
(HRSA) expanded its Diabetes Collaboratives to better reach
minorities, who
suffer disproportionately from diabetes. And a new
effort, "Take a Loved
One to the Doctor Day," was launched in partnership
with ABC broadcasting's
Urban Radio Network to encourage improved health screening
and access to
health care facilities for minority Americans.
IMPROVING QUALITY OF CARE - In 2002, HHS moved ahead with a
far-reaching
effort to promote higher-quality care among healthcare
organizations in part
by measuring and reporting quality information to
consumers. CMS and
HHS'Agency for Healthcare Research and Quality (AHRQ) have
worked to
validate quality measures using available data and then
develop meaningful
measures that can be used by health care providers to
improve quality and
reported to the public to empower consumers to choose
quality healthcare
providers.
· Publishing national
nursing home quality measures - In November
2002, HHS launched a national nursing home quality
initiative that combines
comparative data about quality for consumers with
intensified efforts to
assist nursing homes to improve the quality of care that
they provide to
their residents. The consumer data for all nursing
homes serving Medicare
and Medicaid patients is available at http://www.medicare.gov or
by calling
1-800-MEDICARE. Ten quality measures, developed with
private-sector help,
are included in the data. CMS pilot-tested the
consumer data in six states
before launching the effort nationally.
· Developing hospital
quality measures - In December 2002, HHS joined
the nation's major hospital trade associations in announcing
a new
initiative to provide quality information about hospitals to
the public.
Under the program, HHS will help validate and publish key
quality measures
involving cardiac care and pneumonia that hospitals
voluntarily report. In
addition, AHRQ will develop a standardized patient survey
that will provide
comparative information about hospitals.
· Developing new tools
to measure quality - AHRQ continued efforts
toward building a national information structure to provide
sound measures
of health care quality. During 2002, AHRQ introduced
the Prevention Quality
Indicators, a software tool for detecting potentially avoidable
hospital
admissions for illnesses which can be effectively treated
with high-quality,
community-based primary care. AHRQ also launched its
Inpatient Quality
Indicators, a software tool consisting of 29 measures that
can be used to
help hospitals identify potential problem areas and provide
an indirect
measure of hospital quality of care.
· Hormone therapy - NIH
stopped a major clinical trial early, which
was looking at risks and benefits of combined estrogen and
progestin therapy
in healthy menopausal women. The study was stopped
when conclusive evidence
was found of increased risk of invasive breast cancer.
The study also found
increases in coronary heart disease, stroke and pulmonary
embolism. NIH
convened a scientific workshop to review the findings and
help clinicians
and patients understand the implications of current
knowledge for decisions
regarding use of such therapy. The U.S. Preventive
Services Task Force
published new recommendations on the use of the
therapy. And FDA undertook
proceedings to consider appropriate label changes for
hormone therapy
products.
NEXT STEPS FOR HELPING THOSE IN NEED - The number of
Americans on welfare
continued to go down, despite a slower economy, and more of
those receiving
welfare were taking part in work or training.
Secretary Thompson led the
Administration's efforts toward reauthorization of the 1996
welfare reform law, with stronger work requirements, more
supports for
families to achieve self-sufficiency, and greater flexibility
for states.
In addition, HHS led the administration's efforts to enable
more faith-based
and community organizations to deliver federally-supported
services. HHS
also led special initiatives for Americans with
disabilities, reading
readiness in Head Start, and new adoption efforts.
· Welfare caseload stays
down - In November, HHS released the latest
data on the nation's welfare caseload. The number of
Americans receiving
welfare assistance declined again, by about 4.5 percent,
between December
2001 and June 2002. Altogether, the number of
individuals receiving welfare
has declined 58 percent since enactment of welfare reform
law in 1996.
Census data released in September also showed that in 2001
the poverty rate
for African-American children reached the lowest level ever
reported. As
governor of Wisconsin, Secretary Thompson had created the
national model for
welfare reform, and he led the administration's efforts this
year to achieve
the next step in reform by reauthorizing and improving the
1996 law. While
a measure passed in the House of Representatives, the Senate
failed to take
action. Reauthorization efforts will resume in 2003.
· Faith-based initiative
- HHS provided $30 million in funding for the
President's Faith-Based and Community Initiative, to help
level the playing
field for religious and other organizations seeking to use
HHS funds to help
those in need. Faith- and community-based
organizations are often the most
effective groups in helping confront poverty, homelessness,
substance abuse
and other problems addressed by HHS programs. Yet many
do not have the
expertise needed to apply for and manage federal
funds. The HHS funding
from the new Compassion Capital Fund provides for technical
assistance,
especially to smaller charities and faith-based
organizations, to use HHS
funds to help them deliver services to people in need.
In December HHS also
published proposed regulations clarifying the rights and
responsibilities of
religious organizations if they become HHS grantees.
· Americans with
disabilities - Secretary Thompson led the
Administration's efforts under the President's "New
Freedom Initiative,"
aimed at eliminating barriers to community living for Americans
with
disabilities. In May, Secretary Thompson delivered to
the President the
most comprehensive report ever compiled on legal and
programmatic barriers,
and steps that could be taken across government to help
persons with
disabilities. At the same time, HHS released a new
waiver template making
it easier for states to make changes in their Medicaid
programs to serve
people with disabilities in their own homes. The first
Independence Plus
waiver was granted to New Hampshire in December. HHS
also created a new
Secretarial-level Office on Disability to oversee
coordination, development
and implementation of programs and special initiatives
across HHS. In
addition, the President established his "New Freedom
Commission on Mental
Health," and HHS is helping lead this effort to improve
mental health
services, especially community-based services.
· Early literacy skills
for Head Start children - As part of the
President's "Good Start/Grow Smart" initiative,
HHS took new steps to assure
early literacy skills throughout the Head Start
program. New training was
provided for Head Start teachers, and development began for
a new system to
measure early literacy. The new system will help
ensure for the first time
that every Head Start child is assessed on development of
early literacy
skills.
· Adoption - HHS'
Administration for Children and Families (ACF)
launched a cooperative effort to make adoption information
available via the
internet at AdoptUSKids, a database of children awaiting
adoption and
families approved to adopt. In 2001, nearly 50,000
children were adopted
with the involvement of the public child welfare system, a
79 percent
increase since 1996, when 28,000 adoptions were finalized.
· National Youth Summit
- ACF sponsored the first National Youth
Summit in June, bringing together about 2,000 professionals,
parents,
advocates, researchers and young people to focus on
successful achievements
and strategies for youth. The summit was designed to
help build state and
regional partnerships to support America's youth.
SMOKING AND TEEN SUBSTANCE ABUSE DECLINE - Smoking is the
leading
preventable cause of death in America, responsible for some
440,000
premature deaths per year, including 87 percent of lung
cancer deaths.
Early data for 2002 show a continuing decline for smoking in
the United
States. Only about one in five Americans now smokes,
compared with almost
one in four just five years earlier and more than 40 percent
at the highest
measured point, in 1965. Teen smoking declined sharply
in 2002, as did teen
alcohol abuse and illicit drug use.
· Teen smoking - Results
from the "Monitoring the Future" survey for
2002, released in December, showed a significant decrease in
smoking by
teens, accelerating a trend that began after teen smoking
reached a high
point in 1996. This year's survey also showed that
teen alcohol consumption
was down, as was teens' use of illicit drugs.
· Sales of cigarettes to
teens - HHS released data in September
showing that retailers are continuing to reduce sales of
cigarettes to those
under 18. The retailer violation rate fell to 16.3
percent in 2001, from
40.1 percent in 1996.
· Anti-tobacco campaigns
- In addition to ongoing public information
campaigns, CDC launched a new national campaign aimed at
reducing smoking
among Hispanics. HHS launched a Tobacco-Free Sports
public education
campaign at the 2002 Olympic and Paralympic Winter Games.
PROTECTING PATIENT PRIVACY - In 2002, HHS completed
the first-ever
comprehensive federal patient privacy regulations giving
patients sweeping
protections over the privacy of their medical records.
The regulations
empower patients by guaranteeing them access to their
medical records,
giving them more control over how their protected health
information is used
and disclosed, and providing a clear avenue of recourse if
their medical
privacy is compromised. The privacy rule covers
medical records and other
personal health information maintained by certain health
care providers,
hospitals, health plans, health insurers and health care
clearinghouses.
Most covered entities must comply with the regulations by
April 14, 2003:
· Protecting patients
from non-routine use and disclosure - Under the
rule, patients must give specific authorization before
covered entities
could use or disclose protected information in most
non-routine
circumstances - such as releasing information to an employer
or for use in
marketing activities.
· Ensuring patients'
access to medical records - Patients generally
will be able to access their personal medical records and
request changes to
correct any errors.
· Written privacy notice
-- Covered entities generally will need to
provide patients with written notice of their privacy
practices and
patients' privacy rights. Patients will generally be
asked to sign or
otherwise acknowledge receipt of the privacy notice from
direct treatment
providers.
· Restricting marketing
based on protected health information -
Pharmacies, health plans and other covered entities must
first obtain an
individual's specific authorization before sending them
marketing materials.
At the same time, the rule permits doctors and other covered
entities to
communicate freely with patients about treatment options and
other
health-related information, including disease-management
programs.
REGULATORY REFORM - In 2002, HHS moved to restore
common sense to its
regulatory process in order to remove unnecessary barriers
between patients
and their doctors, nurses and other health care
providers. During the year,
Secretary Thompson's newly created Advisory Committee on
Regulatory Reform
made hundreds of recommendations to remove potential
obstacles to patients'
access to care, reduce the time doctors and other health
care professionals
must spend on paperwork, improve communication with
consumers, and improve
the use of technology to promote quality care while ensuring
patients have
strong privacy protections. HHS has already moved to
implement dozens of
those recommendations:
· Streamlining home
health paperwork - In June, CMS launched a new
effort to streamline Medicare's paperwork requirements for
home health
nurses and therapists so that they can focus more on
providing quality care
to their patients. As a result, required assessments
will include only
those elements needed to promote quality of care and to
ensure proper
payment.
· Promoting appropriate
emergency room care - In May, CMS proposed
common-sense improvements to clarify the requirements for
hospitals to
screen and treat emergency room patients. The proposed
revisions would
ensure that patients with possible emergency conditions
receive appropriate
care as rapidly as possible.
· Eliminating repetitive
insurance requests - CMS also reduced the
frequency that hospitals must gather detailed information
from Medicare
beneficiaries about other insurance. This change means
hospitals will not
have to ask patients repeatedly for the same data.
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