United States Department of Health and Human Services

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Department of Health and Human Services
US-DeptOfHHS-Seal.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
Formed April 11, 1953 (as the Department of Health, Education, and Welfare)
May 4, 1980; 43 years ago (1980-05-04)
Preceding agencies
Jurisdiction Federal government of the United States
Headquarters Hubert H. Humphrey Building
Washington, D.C. Lua error in package.lua at line 80: module 'strict' not found.
Employees 79,540 (2015)[1]
Department executives
Child Department
Website www.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".[3] Before the separate federal Department of Education was created in 1979, it was called the Department of Health, Education, and Welfare (HEW).

History

Federal Security Agency

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.[4]

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
  5. Social Security Board

Origins

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  • These components, however, could be[weasel words] traced back to the early days of the Republic. On July 16, 1798, President John Adams signed an act creating the Marine Hospital Service to furnish treatment to sick and disabled American merchant seamen. On April 29, 1878, the first Federal Quarantine Act enlarged the Service's responsibilities to include prevention of epidemics from abroad. On August 14, 1912, the name was changed to the Public Health Service (PHS). On May 26, 1930, the Hygienic Laboratory of the Service was redesignated the National Institutes of Health (NIH). PHS was transferred from the Treasury Department to the FSA in 1939.
  • Even though the first steps toward public education were taken in 1647 by the Massachusetts Bay Colony and land was set aside for public schools by the Congress of the Confederation in 1785, the idea of universal, free public schools did not become firmly established until the Civil War era. Even then, only half of the States had an efficient public school system. In 1867, Congress established the Department of Education to promote the cause of education and collect and disseminate facts and statistics about education. Until it was transferred to the FSA, the Office of Education and its predecessor organization had been part of the Department of the Interior.
  • The Civilian Conservation Corps (CCC) was born during the Great Depression to provide employment for American youth and advance conservation of the Nation's natural resources. It operated from April 5, 1933 until June 30, 1942. During that time, the CCC provided work training to 3 million men and advanced conservation by more than 25 years. It was an independent agency until it came to FSA.
  • The Nation's social security and public assistance programs also were born during the Depression with approval of the Social Security Act on August 14, 1935. The initial Act of 1935 established the Social Security Board to administer Titles I, II, III, IV, and X of the Act. It remained an independent organization until its transfer to FSA. The Social Security Act Amendments of 1939 revised and expanded basic provisions of the program and eligibility requirements and extended protection to aged wives, dependent children and certain survivors of insured workers.
  • Organized in 1855 and incorporated by the Kentucky Legislature in 1858, the American Printing House for the Blind was established to produce educational materials for the blind and since 1879 has received an allocation of Federal funds to help support this activity. Federal responsibility regarding the Printing House was transferred to FSA from the Treasury Department on July 1, 1939.
  • Established in 1935 to provide youth with work training, the National Youth Administration later trained young people for jobs in war industries. It was supervised by the Office of the Administrator from the time FSA was created in 1939 until 1942, when it was transferred to the War Manpower Commission.

Early years

  • Under a Reorganization Plan that became effective on June 30, 1940, the organization of the Federal Security Agency (FSA) was enlarged:[4]
  1. The Food and Drug Administration (FDA) was transferred from the Department of Agriculture; and
  2. Saint Elizabeth's Hospital, Freedmen's Hospital, and
  3. Federal functions relating to Howard University and the Columbia Institution for the Deaf were transferred to FSA from the Department of the Interior
    • As a result of pressure for the Federal Government to control adulterated and misbranded foods and drugs, the Food and Drugs Act was enacted on June 30, 1906. These responsibilities were entrusted to the Bureau of Chemistry in the Department of Agriculture in 1907 and were organized into a Food, Drug and Insecticide Administration in 1927, renamed the Food and Drug Administration (FDA) in 1931. Transferred to FSA in 1940, FDA also was responsible for administering the Tea Importation Act (1897), the Filled Milk Act (1923), the Caustic Poison Act (1927), and the Food, Drug, and Cosmetic Act (1938).
    • Saint Elizabeths Hospital, created by Act of Congress in 1852 as the Government Hospital for the Insane, received its first patients on January 15, 1855. Founder of Saint Elizabeth's was Dorothea Dix, the most prominent humanitarian of the era. The name was changed by Act of Congress in 1916. Freedmen's Hospital was an outgrowth of the Bureau for the Relief of Freedmen and Refugees authorized by the Act of March 3, 1865. In 1871, the hospital was transferred to the Department of the Interior.
    • Howard University' was established by an act of March 2, 1867, to provide higher education for Negroes. Education for the deaf was made available in the District of Columbia through the Columbia Institution for the Deaf established by the Act of February 16, 1857. The name was changed to Gallaudet College in 1954.
  • The Vocational Rehabilitation Act Amendments of 1943 expanded functions relating to vocational rehabilitation and assigned them to the Federal Security Administrator, who established the Office of Vocational Rehabilitation on September 4, 1943, to carry out these functions. Since the original Vocational Rehabilitation Act of 1920, certain vocational rehabilitation and vocational education activities had been a responsibility of the Office of Education, first when it was part of the Department of Interior, then after it became part of FSA in 1939.
  • Impact of World War II
    • World War II had a broad impact on the social programs of FSA. Between 1941 and 1947, the Government recognized the need to maintain essential health and welfare services. The Federal Security Administrator also served as coordinator of the Office of Health, Welfare, and related Defense Activities, renamed the Office of Defense, Health, and Welfare Services in September 1941, which provided health care, education, and related services necessitated by the war effort. It was responsible for adjusting the distribution of remaining professional personnel to meet the requirements of the population. In 1943, the Office's title was again changed to the Office of Community War Services, which was abolished on June 30, 1947.
    • The FDA during the war was charged with maintaining food standards to insure delivery of properly tested foods and drugs to the military establishment.
    • The Public Health Service was in charge of protecting both the general population and military personnel against epidemics and carrying out medical research.

Post-WWII

Organizational Changes[4]

When the war ended, President Truman moved to "strengthen the arm of the Federal Government for better integration of services in the fields of health, education, and welfare."

  • 1947. In 1947, the Administrator directed the establishment of a central library, consolidating the resources of three independent libraries at the SSA, the Office of Education, and the Office of Vocational Rehabilitation. This library eventually became the central library of the Department of Health, Education, and Welfare.
  • 1949
    • The Federal Property and Administrative Services Act of 1949 gave the Federal Security Administrator authority to dispose of surplus Federal propel property to tax-supported or nonprofit educational institutions for health or educational purposes.
    • During 1949, the Federal Security Agency began the establishment of 10 FSA regional offices to replace the 11 previously operated by the SSA and consolidated those being operated by other FSA constituents into one common regional office structure. Previous to the consolidation, constituent agencies were maintaining five and, in some cases, six independent regional offices in a single city.
  • 1950
    • On May 24, 1950, Reorganization Plan No. 19 of 1950 transferred from FSA to the Department of Labor the Bureau of Employees Compensation and the Employees Compensation Appeals Board. Then, the FSA abolished the Office of Special Services that had administered the two transferred units plus the Office of Vocational Rehabilitation (OVR) and the Food and Drug Administration. The effect of this action was to elevate OVR and FDA to agency status.
    • In 1950, two important national conferences required months of staff work by FSA personnel. The Mid-century White House Conference on Children and Youth was held in Washington, D.C. in December 1950. Nearly 6,000 representatives of 100,000 local and community groups throughout the country met to discuss the "spiritual values, democractic practice, and the dignity and worth of the individual." In August of that year, a Conference on Aging was called by the FSA Administrator to study the needs and problems of the older segment of the population.
    • In September 1950, Congress authorized the impacted aid program-to relieve the impact on local school facilities of a heavy influx of Federal civilian and military personnel-and in FY 1951 appropriated $96.5 million for school construction under P.L. 81-815, September 23, 1950, and $23 million for school operating expenses under P.L. 81-874, September 30, 1950.
    • The Social Security Act Amendments of 1950 added to the social security rolls about 10 million persons who previously had been ineligible. These persons included agricultural workers and selfemployed small shop owners. Others who benefitted from the changes were the elderly and those who had job-related disabilities. This expansion of beneficiaries was made possible by revisions to the oldage and survivors insurance and long-term disability insurance sections of the original Act.
  • 1951. In May 1951, a citizens committee, the National Mid-century Committee for Children and Youth, was established to provide national follow-up to the problems discussed at the White House Conference. Staff of the Children's Bureau worked closely with the Committee until it was dissolved in 1953.
  • 1952. The year 1952 was a period of transition for FSA. Despite the contributions made by the Agency during and before the Korean War, most of the defense-related activities in FSA were being phased out. The FDA continued to study chemical and bacteriological warfare agents but other FSA components were mobilized to provide disaster relief and health care assistance to a number of foreign countries. Technical assistance, under the Federal "Point IV" and Mutual Security Agency programs, provided needed help to many underdeveloped countries. The Agency also furnished guidance for foreign representatives sent to this country to study American programs and methods in the fields of health and education. Later in the year, FSA accelerated its response to the Nation's social needs.
  • 1953. FSA Becomes DHEW
    • 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. All of the responsibilities of the Federal Security Administrator would be transferred to the Secretary of Health, Education, end Welfare and the components of FSA would be transferred to the Department. A major objective of the reorganization was to improve administration of the functions of the Federal Security Agency. 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[5]

Name Dates of Service
Paul V. McNutt July 13, 1939-September 14, 1945
Watson B. Miller October 11, 1945-August 26, 1947
Oscar R. Ewing August 27, 1947-January 20, 1953
Oveta Culp Hobby January 21, 1953-April 11, 1953

Department of Health, Education, and Welfare

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).[5]

List of Secretaries of Health, Education, and Welfare[5]

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

The Department of Health, Education, and Welfare was renamed the Department of Health and Human Services (HHS) in 1979,[6] when its education functions were transferred to the newly created United States Department of Education under the Department of Education Organization Act.[7] 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.

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, Sylvia Mathews Burwell, was sworn in on June 9, 2014.

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.

Office of Inspector General

The Office of 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 of 2009, and the Affordable Care Act of 2010, the Office of 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.[8] 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.[10]

Strengthening Communities Fund

In June 2010 the Department of Health and Human Services created the Strengthening Communities Fund[11] 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.[12]
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.

Organization

Internal Structure

HHS business areas.jpg

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.

Several agencies within HHS are components of the Public Health Service (PHS), including AHRQ, ASPR, ATSDR, CDC, FDA, HRSA, IHS, NIH, SAMHSA, OGHA, and OPHS.[13]

Budget and finances

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

Historical Budgets

HHS.Gov provides complete details on current and historical budgets for that agency. Budgets for fiscal years prior to 2014 are archived by Archive-It as requested by HHS.

Quick Links: FY2016, FY2015, FY2014, FY2013, FY2012, FY2011, FY2010, FY2009, All HHS budget collections on Archive-It

Former operating divisions and agencies

Programs

The Department of Health and Human Services' administers 115 programs across its 11 operating divisions.[15] 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[16]

Health care reform

The 2010 United States federal budget establishes a reserve fund of more than $630 billion over 10 years to finance fundamental reform of the health care system.[17]

Related legislation

See also

Notes and references

  1. HHS FY2015 Budget
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  4. 4.0 4.1 4.2 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). Excerpted and retrieved here http://aspe.hhs.gov/info/hewhistory.htm on January 9, 2014.
  5. 5.0 5.1 5.2 Preliminary inventory of the records of the Department of Health, Education, and Welfare (PI 181, Record Group 235), National Archives and Records Service, 1975.
  6. Office of the Law Revision Counsel, U.S. House of Representatives, Title 20, Section 3508
  7. Full text of the Department of Education Organization Act, P.L. 96-88
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  13. HHS.gov
  14. 2015 Department of Health and Human Services Budget-in-Brief, pg 10, United States Department of Health and Human Services, Accessed 2015-07-14
  15. Budget and Performance. HHS.gov. Retrieved on 2014-04-15.
  16. http://www.acf.hhs.gov/programs/css
  17. WhiteHouse.gov

External links