HHS New Strategic Plan Violates Separation of church and state, defines life at conception, allows denial of service based on religion objections, and pushes short term benefits and return to work.
There is so much to unpack here.
New Plan with comments available: https://www.hhs.gov/about/draft-strategic-plan/index.html
Old Plan is accessible on the left column (Strategic Plan FY 2014-18
Major changes marked in bold purple.
The department of Health and Human Sevices has released its draft strategic plan. It proposes huge shifts in US policy towards women, families, the disabled that show a deep lack of understanding and empathy towards the people the agency is meant to protect.
Summary: The new HHS Strategic plan has huge changes in store for the organization. Here's my first draft response and preliminary analysis:
Lets break it down, section by section: (work in progress)
Mission: NO Change
Old: The mission of the U.S. Department of Health and Human Services (HHS) is to enhance the health and well-being 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.
The mission of the U.S. Department of Health and Human Services (HHS) is to enhance the health and well-being 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.
Organizational Structure: adds Global responsibility??
HHS accomplishes its mission through programs and initiatives that cover a wide spectrum of activities, serving Americans at every stage of life. Eleven operating divisions, including eight agencies in the U.S. Public Health Service and three human services agencies, administer HHS’s programs. In addition, staff divisions provide leadership, direction, and policy management guidance to the Department.
HHS accomplishes its mission through programs and initiatives that cover a wide spectrum of activities, serving and protecting Americans at every stage of life, beginning at conception. Eleven operating divisions, including eight agencies in the U.S. Public Health Service and three human services agencies, administer HHS’s programs. While HHS is a domestic agency working to protect and promote the health and well-being of the American people, the interconnectedness of our world requires that HHS engage globally to fulfill its mission. In addition, staff divisions provide leadership, direction, and policy guidance to the Department.
Cross Agency Collaborations and Partnerships
"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 obligation to provide services for American Indians and Alaska Natives based on these individuals’ relationship to tribal governments. HHS works with tribal governments, urban Indian organizations, and other tribal organizations to facilitate greater consultation and coordination between states and tribes on health and human services issues.
HHS also has strong partnerships with the private sector and nongovernmental organizations. The Department partners with the private sector, such as regulated industries, academic institutions, trade organizations, and advocacy groups. The Department leverages resources from these organizations to enable HHS to accomplish its mission through strategies that minimize the burden on, and increase the benefits to, the American public. This effort occurs through faith-based and neighborhood partnerships as well as grantees in the private sector, such as academic institutions and community-based nonprofit organizations, which provide many services at the local level. HHS collaborates with other federal departments and international partners to ensure the maximum impact for the public.
The narrative and strategies under each strategic goal and objective describe how the Department collaborates with governmental and nongovernmental groups."
New: NOT present
Strategic Plan Development - No substantive changes
Old:Every four years, HHS updates its Strategic Plan, which describes its work to address complex, multifaceted, and evolving health and human services issues. An agency strategic plan is one of three main elements required by the Government Performance and Results Act (GPRA) of 1993 (P.L. 103-62) and the GPRA Modernization Act of 2010 (P.L. 111-352). An agency strategic plan defines its mission, goals, and the means by which it will measure its progress in addressing specific national problems over a four-year period.
Each of the Department’s operating and staff divisions contributed to the development of the Strategic Plan, as reflected in the Plan’s strategic goals, objectives, strategies, and performance goals. A workgroup of liaisons from the Department’s operating and staff divisions developed the narrative, strategies, and performance goals for the Plan. The workgroup ensured that the Plan aligns with the Department’s annual GPRA reporting in Congressional Budget Justifications and the Summary of Performance and Financial Information, which together fulfill HHS’s annual GPRA performance reporting requirements. This Plan also aligns strategic goals and objectives with priorities of the Administration, the Department, and HHS divisions.
Every four years, HHS updates its strategic plan, which describes its work to address complex, multifaceted, and evolving health and human services issues. An agency strategic plan is one of three main elements required by the Government Performance and Results Act (GPRA) of 1993 (P.L. 103-62) and the GPRA Modernization Act of 2010 (P.L. 111-352). An agency strategic plan defines its mission, goals, and the means by which it will measure its progress in addressing specific national problems over a four-year period.
All OpDivs and StaffDivs within HHS contributed to the development of this draft of the HHS Strategic Plan FY 2018 – 2022 (Strategic Plan), as reflected in its strategic goals, objectives, and strategies. The Strategic Plan’s content aligns with the priorities of the Administration and HHS.
Goals - This is the "meat". What the agency wants to accomplish
Goal 1: Reform, Strengthen and Modernize the Nation’s Health Care system
Goal 2: Protect the Health of Americans Where They Live, Learn, Work, and Play
Goal 3: Strengthen the Economic and Social Well-Being of Americans across the Lifespan
Goal 4: Foster Sound, Sustained Advances in the Sciences
Goal 5: Promote Effective and Efficient Management and Stewardship
Goal 1: Changes Summary:
Actual Text- Old:
"In March 2010, the President signed into law the Patient Protection and Affordable Care Act (P.L. 111-148) and the Health Care and Education Reconciliation Act of 2010 (P.L. 111-152), collectively referred to as the Affordable Care Act. The Affordable Care Act increases access to care, makes health insurance more affordable, strengthens Medicare, and ensures that Americans have more rights and protections — and more security that health insurance coverage will be available when it is needed. The Affordable Care Act has given states the option to expand access to Medicaid for low-income adults and families. The federal government will pay for 100% of the costs of covering newly eligible adults for three years beginning in 2014. The federal amount decreases gradually and becomes 90% of the costs in 2020 and subsequent years.
HHS is responsible for implementing many of the provisions included in the Affordable Care Act that seek to expand coverage, emphasize prevention, improve the quality of health care and patient outcomes across health care settings, ensure patient safety, promote efficiency and accountability, and work toward high-value health care. The Health Insurance Marketplace, also known as Exchanges, helps consumers find health insurance that fits their budget. Every health insurance plan in the Marketplace will offer core benefits and increased protections from high out-of-pocket expenses, and consumers will be able to compare their insurance options based on price, benefits, and quality. Lower- and moderate-income families and many small businesses will be eligible for financial assistance, including a premium tax credit and cost-sharing reductions, to help pay for health insurance. In addition to increased coverage options, the Affordable Care Act protects against medical bankruptcy because it prohibits insurers from imposing an annual or lifetime dollar limit on essential health benefits, and it makes it illegal for them to discriminate against anyone because of a pre-existing condition. The goal is to lower overall health care costs by improving health status among individuals and communities.
HHS is providing the American public with the means to make more informed choices about their health care through resources such as HealthCare.gov, which provides information about health insurance options. HHS is developing evidence-based tools, health care provider incentives, and payment reforms that support the delivery of high-quality, effective, and efficient health care services; expanding coordinated care through integrated care models; and promoting the meaningful use of electronic health records and other health information technology. HHS also is working to reduce disparities in health and access to health care among vulnerable populations."
Objective A: Make coverage more secure for those who have insurance, and extend affordable coverage to the uninsured
Objective B: Improve health care quality and patient safety
Objective C: Emphasize primary and preventive care, linked with community prevention services
Objective D: Reduce the growth of health care costs while promoting high-value, effective care
Objective E: Ensure access to quality, culturally competent care, including long-term services and supports, for vulnerable populations
Objective F: Improve health care and population health through meaningful use of health information technology
Actual Text New:
HHS is dedicated to reforming, strengthening, and modernizing the Nation’s health care system. By promoting greater affordability and balancing spending, strengthening health care quality and patient safety, improving access and expanding choices, and investing in the health care workforce, HHS seeks to improve health care outcomes for people we serve. While we may refer to the people we serve as beneficiaries, enrollees, patients, or consumers, our ultimate goal is to improve healthcare outcomes for all people, including the unborn, across healthcare settings.
New Goal 1.3
Vigorously enforce laws, regulations, and other authorities, especially Executive Order 13798 of May 4, 2017, Promoting Free Speech and Religious Liberty, to reduce burdens on the exercise of religious and moral convictions, promote equal and nondiscriminatory participation by faith-based organizations in HHS-funded or conducted activities, and remove barriers to the full and active engagement of faith-based organizations in the work of HHS through targeted outreach, education, and capacity building
Goal 2 :New Protect the Health of Americans Where They Live, Learn, Work, and Play
No comparable old.
Objective 2.1: Empower people to make informed choices for healthier living
Objective 2.2: Prevent, treat, and control communicable diseases and chronic conditions
Objective 2.3: Reduce the impact of mental and substance use disorders through prevention, early intervention, treatment, and recovery support
Objective 2.4: Prepare for and respond to public health emergencies
NEW Goal 2.1:
"2.1 Strategies (ed: looks like the govt is planning to fund faith based organizations)
Ensure people have the information they need to make healthier living choices
Goal 3: Strengthen the Economic and Social Well-Being of Americans across the Lifespan
"A core component of the HHS mission is our dedication to serve all Americans from conception to natural death, but especially those individuals and populations facing or at high risk for economic and social well-being challenges, through effective human services. HHS efforts to improve human services include efforts to support socially and economically safe, stable environments for individuals, families, and communities. This strategic goal also focuses on HHS efforts to improve outcomes for children and families, older adults, people with disabilities, and people with limited English proficiency."
NEW Goal 3.1
HHS invests in safety net programs as well as programs that seek to assist specific populations who are, or who are at risk of, being unemployed or underemployed – such as youth, people with disabilities, and formerly incarcerated individuals – in preparing for, acquiring, and sustaining employment. HHS implements strategies to strengthen self-sufficiency and independence through personal responsibility and economic opportunity.
3.1 StrategiesReform safety net programs to assist disadvantaged and low income populations
Old: (Unrelated) Advance the Health, Safety, and Well-Being of the American People
Goal 4: Foster Sound, Sustained Advances in the Sciences
Objective 4.1: Improve surveillance, epidemiology, and laboratory services
Promote use of youth-focused surveillance and data collection to inform school and community actions that improve the health of adolescents
Support and enhance the collection of behavioral health survey and surveillance data to establish trends and detect aberrations, particularly in response to local or national disasters, in order to respond to community level emergencies and localized public health threats
Strengthen understanding of the opioid crisis through better public health surveillance to inform clinical management decisions for patients, including effects of opioid use in pregnancy and neonatal abstinence syndrome
Facilitate information sharing, exchange, and alignmentImplement information technology solutions that support timely information exchange among local, state, international, and federal agencies, healthcare facilities, and laboratories while ensuring that these systems minimize threats to information security
Objective 4.2: Expand the capacity of the scientific workforce and infrastructure to support innovative research
Objective 4.3: Advance basic science knowledge and conduct applied prevention and treatment research to improve health and development
Objective 4.4: Leverage translational research, dissemination and implementation science, and evaluation investments to support adoption of evidence informed practices
Compare to old goal 2 Advance Scientific Knowledge and Innovation
Objective A: Accelerate the process of scientific discovery to improve health
Objective B: Foster and apply innovative solutions to health, public health, and human services challenges
Objective C: Advance the regulatory sciences to enhance food safety, improve medical product development, and support tobacco regulation
Objective D: Increase our understanding of what works in public health and human services practice
Objective E: Improve laboratory, surveillance, and epidemiology capacity
Ideas and Commentary on the Resistance by K Cleland