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' 4789:;<+(y3D" 3"  0,X,` XX0 323  0    AgencyMission 3c݌ (#(# Ќ  TheDepartmentofHealthandHumanServices(HHS),throughOCR,promotesandensuresthatpeople 0  haveequalaccesstoandopportunitytoparticipateinandreceiveservicesinallHHSprogramswithout X facingunlawfuldiscriminationandthattheprivacyoftheirhealthinformationisprotectedwhile 0 ensuringaccesstocare.Throughpreventionandeliminationofunlawfuldiscriminationandby  protectingtheprivacyofindividuallyidentifiablehealthinformation,OCRhelpsHHScarryoutits  overallmissionofimprovingthehealthandwell-beingofallpeopleaffectedbyitsmanyprograms.#&t%% &tפ#&t%%&tԀ h #&t%%&t# &t%%&tStatuteandregulationhavegivenOCRtheresponsibilitytobeakeystewardoftheintegrityofanyHHS h programforwhichFederalfinancialassistancehasbeenauthorized,toensurethatsuchfundsdonot @ supportunlawfuldiscrimination.#&t%% &t0 #&t%%&tԀ#&t%%&t׈ # &t%%&tHHS#&t%% &t #&t%%&tԀadministersagreaterthan$400billionbudgetfromwhich  Federalfinancialassistanceisprovidedtoavastarrayofhealthandhumanserviceprograms.Underthe  HealthInsurancePortabilityandAccountabilityAct(HIPAA)PrivacyRule,OCRhasadditional x responsibilityforseveralmillionhealthcareproviders,plans,andclearinghouses,includingthosethat P receiveFederalfinancialassistancethroughHHS.Theseprogramsareadministeredbyandthrougha (x widearrayofgovernment,nonprofit,andprivateentities.Theseprogramsandservicesaffectthe P qualityoflifeandwellbeingofvirtuallyeveryoneintheUnitedStates.#&t%%&t # &t%%&tWithinthiscontext,OCRs ( missionandresponsibilitiesarebroadandinclusiveand,necessarily,ouractivitiesinvolvemany   dimensionsandchallengesgiventhenumberofauthoritiesforwhichwehaveenforcementresponsibility  ! andthedifficultyofthecivilandprivacyrightsissueswefacetoday. `!" ! ! ' 4789:;<+(yy' 4789:;<+" 3"   323  0    OverviewofPlanandPerformanceReport  3݌#`$(#(# Ќ  OCRleadershiphasconcludedthatthegoalsandmeasuresinpreviousannualplansneedtobe $ & restructuredto: % ' Ѐ! ! B 4789:;<(Exy' 4789:;<+  " 3"   32E3  0    betteralignwithandsupporttheHHSStrategicPlan;the OneHHSDepartmentwideoutcome H'") goals; 3݌ (p#*(#(# Ќ  " 3"     32E3  0    capturemoreofOCRsresultsfromabroaderarrayofcomplianceactivities;and 3+݌(H$+(#(# Ќ  " 3"     32E3  0    continuetofocusactivitiesonthekeyareasinOCRsStrategicPlan. 3@݌) %,(#(#    *%- P     Inaddition,theannualplanrequiredupdatingasaresultofOCRsnewresponsibilitytoenforcethe   PrivacyRuleunderHIPAA.OCRsgoalsremainthesame:  ! ! B 4789:;<(ExxB 4789:;<    " 3"   3 2E3  0    GoalI #&t%% &tK#&t%%&t ToincreasenondiscriminatoryaccessandparticipationinHHSprogramsandprotect 8 theprivacyofprotectedhealthinformation. 3 6݌`(#(# Ќ  ! ! B 4789:;<(ExxB 4789:;<" 3"     3G2E3  0    #&t%%&t׬# &t%%&tGoalII#&t%% &t#&t%%&tToenhanceoperationalefficiency.#&t%%&t6# &t%%&t 3G݌ (#(# Ќ  OCRsreviewofprioryearplansdeterminedthattheobjectivesinthoseplansincludedsomethat p  focusedonlegalauthorities,whileothersfocusedonprogramsorspecificissues.Inaddition,we H   determinedthatitisessentialforOCRtofocusoncivilrightscomplianceworkdirectlyrelatedtoOCRs  p  mission.Achievementofseveralofthemeasuresinprioryearplanscouldnotdistinguishtheeffectof  H  OCRsworkfromothercontributingfactors.OCRsrestructuredperformanceplanisdesignedtocover   abroaderarrayofOCRstraditionalcomplianceresponsibilitiesaswellascoveredentitiesunderthe   PrivacyRule,notallofwhichreceiveFederalfinancialassistance.Italsoaddressesabroaderrangeof   beneficiariesofHHSfundedservicesaswellasagreaternumberofpotentialbarrierstoservices.The X  restructuredperformanceobjectivesunderGoalIareasfollows: 0   (8xB 4789:;<" 3"     3 2  A  .3  0    Increaseaccesstoandreceiptofnondiscriminatoryqualityhealthcareandtreatment,while 0 protectingtheintegrityofHHSFederalfinancialassistance. 3 ݌(#(# Ќ  " 3"     3H"2  B  .3  0    Increaseaccesstoandreceiptofnondiscriminatorysocialservices,whileprotectingtheintegrity  ofHHSFederalfinancialassistance. 3H""݌h(#(# Ќ   p(88! !" 3"     3[$2  C  .3  0    Increaseaccesstoandreceiptofcommunitybasedservicesandnondiscriminatorytreatmentfor @ personswithdisabilities,whileprotectingtheintegrityofHHSFederalfinancialassistance. 3[$$݌h(#(# Ќ  " 3"     3&2  D  .3  0    IncreaseawarenessofandcompliancewiththePrivacyRuleunderHIPAA. 3&:&݌@(#(# Ќ   r(j88p! !#&t%% &tך#&t%%&tObjectives#&t%%&t'# &t%%&tԀADsupporttheoverallprogram#&t%% &t/(#3&t%%&tgoal:Increasenondiscriminatoryaccesstoandparticipation  inHHSprogramsandprotecttheprivacyofprotectedhealthinformationwhileensuringaccesstocare. x Further,#&t%%3&tג(#&t%%&tobjectives#&t%%&tת)# &t%%&tԀAD#&t%% &t)#&t%%&tԀ#&t%%&t<*# &t%%&tsubsumethepreviousFY2003objectivesandaddthenewprogram P responsibilityforthePrivacyRule(seetheSummaryofChangesinFY2003FinalGPRAAnnual (x PerformancePlanintheAppendixpages6974).Ineachoftheseareas,OCRsactivitiescutacrossa P wideswathofthepopulation,includingracialandethnicminorities,personswithdisabilities,and ( variousagegroups.   TheperformanceobjectivesunderGoalIIhasbeenrestructuredtofocusonprogramefficiencyas `!" follows: 8"# Ѐ t(z88r"4;"  4;-0  2z  A  .3  0(#(#  Increasetheefficiencyofcaseprocessing.4;--݌#8%(#(# Ќ  TheperformanceobjectiveunderGoalIIfocusesone#&t%% &t*#3&t%%&tnhancing#&t%%3&t.# &t%%&toperationalefficiency.#&t%% &tB/#3&t%%&tԀThisobjectiveis % ' arevisedversionofthe#&t%%3&tל/# &t%%&tԀFY2003objectivethataddressedorganizationalefficiencyandthePresidents p&!( ManagementAgendaworkforcerestructuringandhumancapitalinvestmentobjective.Giventhegreater H'") inclusivenessoftheoverallprogramobjectivesintheFY2004plan,therevisedobjectiveaddressesthe  (p#* efficiencyofallofOCRscaseprocessingratherthanfocusingonincreasingthepercentageofresources (H$+ dedicatedtohighpriorityissues.In2002OCRcompletedtheorganizationalstreamliningsubobjective ) %, oftheformerFY2003operationalefficiencygoal.Givenachievementoftheplannedstreamliningof *%- regionalmanagementtoincreasethestafftosupervisoryratios,theorganizationalstreamliningobjective +&. isnotrepeatedintheFY2004annualplan.#&t%% &t0#&t%%&tԀTheProgramPerformanceReportSummaryTablebelow  showsthat,asaresultofthebroaderconceptionalframeworkoftherestructuredobjectives,OCR#&t%%&t3#&t%%&tԀhas  reducedthenumberofperformancemeasuresforreportingaccomplishments.#&t%%&t4#&t%%&t ` @*   ProgramPerformanceReportSummaryTable #&t%%&tm5# &t%%&t# X}X% &t"# ` 5 @ X X}  #@   @6#IƮ @*P"uddd Xdd Xdd X(#(#,dd ,dd ,dd ,rdd ,Fdd +     #@ IƮ6#@  @   :  MeasuresinPlan  ' :" ' ResultsReported ' : " ' ResultsMet ' : " ' Unreported @6 : " <@1999<@@1999 _U* l  <@1999 <@  @@32@@_32 e[1 l "  @@32 @@   @8 @e8 dZ0 l"   @8  @  @6@d6 e[0 l"  @6 @  8@248@e24 _U1 l"  8@24 8@ @@2000@@_2000 _U*N  @@2000 @@  >@30>@_30 f\1N "  >@30 >@  3@193@f19 e[1N "  3@19 3@  "@9"@e9 e[0N "  "@9 "@  &@11&@e11 _U1N "  &@11 &@ D@2001D@_2001 _U*  D@2001 D@  4@204@_20 LB1 "  4@20 4@ L6 3) " 34 3) " 314 F< " H@2002H@F2002 _U*  H@2002 H@  6@226@_22 e[1 "  6@22 6@   @8 @e#@  @H8#@  @#X}X @y6#@ XX}8 dZ0 "   @8  @  @6@d#X}X @@#@ XX}#@  @?#@  @6 e[0 "  @6 @  ,@14,@e14 _U1 "  ,@14 ,@ L@2003L@_2003 _U*4  L@2003 L@  1@171@_17 F<14 !"  1@17 1@ F '4 "" ' '4 #" ' @64 $" P@2004P@@2004 _U*f % P@2004 P@  1@171@_17 F<1f &"  1@17 1@ F 'f '" ' 'f (" '"f )"  "#@  @A# @  @ # X}X  @@#   D X X}# X}X  DD# &t%X X}Withrespecttotargets#&t%% &teD#&t%%&tԀandaccomplishments,inourFY2003FinalRevisedGPRAAnnualPerformance * PlanandFY2002AnnualPerformanceReport,weshoweddataintablesassociatedwithspecifically + delineatedmajorareasofprogramemphasis(i.e.,adoption,managedcare,LEP,TANF,qualityhealth d, careforminorities,mostintegratedsettingsforpersonswithdisabilities).Further,eachobjectivehad <- measuresthatfocusedonthesesubsetsofOCRsoverallhealthandsocialservicesnondiscrimination d. work.#&t%%&tIE# &t%%&tԀTheOCRFY2004Planhasrevisedtheprogramobjectivestobemoreinclusiveofthetotalityof </ OCRscompliancework.Inthiscontext,OCRsFY2003FinalRevisedGPRAAnnualPerformance 0 PlanhasbeenmodifiedtobeconsistentwithhowtheprogramwillbefocusedandmanagedinbothFY 1 2003andFY2004.Inbothyears,itsetsworkloadbasedtargetsformeasuresundertherestructured t2 ObjectivesAD,atahighertotallevelthanthetargetssetinprioryearplansbecausewewillbereporting L3 onabroaderspectrumandmoreofourwork. $t4 InFY2003,ourreportingwillreflectthetransitionfromthetargetssetforthemeasuresunderthe $6 objectivesinourprioryearplanstothenewmeasuresundertherestructuredobjectivesADinFY2004. 7 Specificallybecause,inFY2003,weneedtobeabletoshowtherelationshipbetweenourformer 8 objectives,measures,andaccomplishmentsandourFinalRevisedFY2003PlanandFinalFY2004Plan \9 objectivesandmeasures,weareprovidingacrosswalkbetweenmeasuresandtargetsonachartinthe 4 : ProgramPerformanceAnalysissectionofthisPlan(seepage66).  !\; Inadditiontobeingaffectedbyreconfigurationofourobjectives,thecomparabilitybetweenFY2004 " = andprioryearswillalsobeaffectedbyourtighteningOCRwidedefinitionsofwhatconstitutes #>  outreach.BeginninginFY2003,outreachwillincludeonlyconsultations,technicalassistance,and l$? collaborativeactivitiesthatarepartofanoverallsetofstrategicallyplannedactivitiesthatbuildupon D% @ oneanothersystematicallytoaddressthehealthcare,socialservice,disability,orprivacyobjectives. &l!A Finally,whenlookingattheresourceallocationsectionforeachofthefourobjectives,itisimportantto '#C notethatthesumexceedsthetotalOCRbudgetforeachofthefiscalyearsinquestion.Thisisbecause (#D activitiesreportedunderthedisabilityobjectivemayoverlapboththehealthcareandsocialservices |)$E nondiscrimination#&t%% &tG#&t%%&tԀobjectives. T*%F #&t%%&trQ# &t%%&t# X}X% &tD#   X X}# X}X  R# &t%X X}  +,'H I.OverviewofPerformanceMeasurement   ThethreebroadgoalsestablishedinOCRsStrategicPlancontinuetobethefocalpointofour ` complianceactivities.Thesegoalsareto:1)provideleadershipinthecreationandevolutionofaDepart 8 mentwidecivilrightsprogram,2)increasenondiscriminatoryaccesstoandparticipationinHHS ` programs,and,3)redevelopOCRsinfrastructureandinvestinitsstaff. 8 InFY2004,OCRwillcontinuetoaddress,withinthebroadandinclusiveobjectivesoftherestructured   plan,thehighpriorityareasadoption,servicesforlimitedEnglishproficientpersons,Temporary p  AssistanceforNeedyFamilies(TANF),nondiscriminatoryqualityhealthcare,andservicesinthemost H   integratedsettingforindividualswithdisabilitiesidentifiedduringOCRsplanningprocess.The  p  planningprocessincludedpublicforumswithcommunitybasedandotherorganizations,stateandlocal  H  agencies,serviceproviders,andotherDepartmentalcomponents.#&t%% &tQ#&t%%&tԀTheseissueshavebeenconsistentlyat   theforefrontofheightenedCongressional,Departmental,andpublicinterest.#&t%%&tlW#&t%%&tԀInaddition,thepassageof   newlegislation,PresidentialandSecretarialpriorities,continuingchangesinhealthcaredelivery   systems,recentresearchfindings,mediareporting,informationfromcommunitybasedorganizations, X  andongoingOCRcomplianceactivitiesconfirmthatitisimportantthatOCRcontinue,withinabroadly 0  basedcivilrightscomplianceprogram#&t%%&t9X#&t%%&t,toaddress#&t%%&t>Z# &t%%&tԀthesekeyareaswheresubstantialinformationindicates X ahighincidenceofpossiblediscrimination. 0 ~{I[_ROCRsobjectivesandcooperativeactivitieswithintheDepartmentplayacrucialroleinhelpingthe  DepartmentrealizeitsStrategicPlansobjectivesasoutlinedinthefollowingannualplan roadmap. h  ' 4789:;<+(y8t " 3"   3\23  0    #&t%% &t׌Z#&t%%&tReport/PlanRoadMapandBudgetLinkage#&t%%&tח]# &t%%&tԀof#&t%% &t^#&t%%&tOCRGPRAGoals/ObjectivestoHHSStrategic h PlanGoals  3\+]݌D(#(# Ќ  I. OCRSGPRAGoalIToincreasenondiscriminatoryaccessandparticipationinHHS  programswhileprotectingtheprivacyofprotectedhealthinformationencompassesthefollowing  HHSStrategicPlanGoals: X    4789:;<+(yy' 4789:;<+" 3"   3`2o3  0    HHSGoal1:ReducethemajorthreatstothehealthandwellbeingofAmericans  3``݌X(#(# Ќ  OCRGPRAObjectiveA:Toincreaseaccesstoandreceiptofnondiscriminatoryqualityhealthcareand    treatment,whileprotectingtheintegrityofHHSFederalfinancialassistance.  !   B 4789:;<(Exy 4789:;<+  #&t%%&tF^#&t%%&t*X"[dddd dd dd rdd rFdd FP"u(#(#,dd ,dd +  D"#D" #&t%%&t.c#&t%%&tLimitedEnglishproficiency(LEP) "$ Qualityhealthcare(healthdisparities) #% Privacyofprotectedhealthinformation#&t%%&tׄd#&t%%&t  X$& BudgetReference:#&t%%&t`e#&t%%&tԀ2122,29,3233,36,4041 "' BudgetReference:2122,30,31,35,3940,42#&t%%&te#&t%%&t #( BudgetReference:#&t%%&tif#&t%%&t18,2425,28,32,4344#&t%%&tf#&t%%&t#X}X%&t]R#&t%XX} X$) #&t%%&t,g#&t%%&t  4789:;<+(yxB 4789:;<" 3"   3jh2o3  0    HHSGoal2:EnhancetheabilityoftheNationspublichealthsystemtoeffectivelyrespondto 8&!* bioterrorismandotherpublichealthchallenges   p      3jhh݌'d"+(#(# Ќ  OCRGPRAObjectiveA:Toincreaseaccesstoandreceiptofnondiscriminatoryqualityhealthcareand ($- treatment,whileprotectingtheintegrityofHHSFederalfinancialassistance.  )$.  #&t%%&tg#&t%%&t  t*%/ [    *"dddd dd X"[(#(#,<dd ,<dd +   #&t%%&tk#&t%%&tLEP d  Privacyofprotectedhealthinformation#&t%%&tׄl#&t%%&t < Qualityhealthcare(healthdisparities)#&t%%&tm#&t%%&t   BudgetReference:#&t%%&t׎m#&t%%&tԀ2324,31,3435,4243#&t%%&tm##X}X%&tng#&t%XX}&t%%&t d #&t%%&tגn#&t%%&tBudgetReference:#&t%%&tn#&t%%&tԀ#&t%%&t FY03:baseline   A  FY03:baseline# X}X  @: # xX X} E  #x x #xx +"2F" +Budget VG Pages23,26, H 31,3336,41 b I 42,43(& J  " (*"dddd edd eSdd Sdd "(#(#,dd ,edd ,Sdd ,dd +  jJj TotalProgramFunding($in000's) JK  #X}XxG!#  ~M  #X}XXX}̤!# X}XXX} @ X X}FY04:$11,284 JN FY03:$11,108# X}X  @u$# lO  #X}XX X}V$#X}XXX} rQ   JR #X}XXX}&%# X}XXX}  xX X} OneHHS JS Outcome T Goals8&9# X}X x%##X}XX X}̢%#X}XXX}  VU &t%XX}OverviewoftheRevisedGoalI.ObjectiveB.Measures  zV   1' 1.0  Increased#correctiveactionsandnoviolationfindings,reviews,outreach,consultations,  *X technicalassistance,andjointprojects. !Y(#(#  Performance: SeerevisedGoalI.ObjectiveA.measure1 fordescription.  6#[ 2.0  Numberofactionstakenbyrecipient/coveredentitiestoreducebarriers.(developmental $f!] throughFY04)#&t%%&tw&#&t%%&t %>"^(#(#  Performance: SeerevisedGoalI.ObjectiveA.measure2 fordescription.  p'#`   L($a Forexample,if,asaresultofOCR'sinvolvement,aTANFprogramputintoplacecommunication $)%b policiesthatprovideforinterpretersandauxiliaryaidssothatLEPpersonscancommunicateeffectively )x&c withjobdevelopmentandplacementcounselors,thepreviousmeasurescouldnotdistinguishtheeffect *P'd ofOCRsworkfromothercontributingfactors.GiventhemorebroadlyinclusivenewobjectiveB,the +((e previousFY2003measuresaresubsumedinthenewmeasure2.whileaccountingforawiderangeof ,)f otheroutcomesofOCRswork. \-)g  Further,underthenewmeasure,OCRwillstillbeabletoaddressissueswheredatahasshownthat,when \ comparedtononminoritychildren,adisproportionatenumberofminoritychildrenwereinthe 4 adoption/fostercaresystemwerewaitingpermanentadoptiveplacementandthatthewaitingtimefor   minoritychildrenwaslongerthanthatexperiencedbynonminoritychildren. `  3.0  TheamountofHHSfundingreceivedbycoveredentitiesthathavebeenfoundtobein  compliance,orhavemadechangestocomeintocomplianceonissuesthathavebeen l  investigatedbyOCR(developmentalthroughFY04)D (#(# Performance: SeerevisedGoalI.ObjectiveA.measure3 fordescription. #&t%%&tH)#&t%%&t  p   4.0  Increasednumberofminoritypersonsandpersonswithdisabilitiesprovidedaccessto,  $  nondiscriminatorytreatmentin,andequalopportunitytobenefitfromprogramsorservicesin   compliancewithTitleVIandtheAmericanswithDisabilitiesActand/orSection504ofthe X  RehabilitationActof1973,asamended,respectively #&t%%&t)0#&t%%&t.Ԁ 92(developmentalthroughFY04) #&t%%&t2# &t%%&t0 (#(#  2Performance: ThismeasuredirectlyrelatestheoutcomeofOCRscomplianceworktothe ` requirementsofTitleVIoftheCivilRightsActof1964andtheAmericanswithDisabilitiesAct/Section < 504.ItisameasureofhowwellOCRisdoingitsworkanddistinguishestheeffectofOCRsworkfrom  othercontributingfactors.    p    r   AsisthecaseunderObjectiveA,OCRwillbeabletoaddressissueswhereinformationfromOCR   compliancereviewshaveshownthatprovidersfrequentlydonothaveanadequatenumberof t interpreters,documents,andotheraidsthatcanassistlimitedEnglishproficientindividualstoaccessand L benefitfromservices.Further,stakeholders,includingcommunitybasedorganizations,haveindicated $ concernsthatbothminoritiesandpersonswithdisabilitiesarebeingsteeredtolowerendjobsand  trainingopportunitiesunderTANF. ThepreviousFY2003measurepertainingtoincreasednumberof X minorities(includingnationalorigin/LEPpersons)anddisabledpersonsservedissubsumedinthisnew 4 measure.Also,t hismeasurewillindicatewhetherOCRscompliancereviewshaveresultedinincreased   accessforthesepopulations. `  ProgramTargetsandActualPerformance    SeeintroductoryparagraphinObjectiveA. D " [[ OverviewofNewObjectiveC: Toincreaseaccesstoandreceiptofcommunitybasedservicesand !p$ nondiscriminatorytreatmentforpersonswithdisabilities,whileprotectingtheintegrityofHHSFederal "L% financialassistance#&t%% &t2#&t%%&t.#&t%%&t:#&t%%&t #$ & OCRmodifiedthewordingofthepreviousFY2003objectiveF:MostintegratedSettingforPersons X%!( withDisabilities(MIS/Olmstead)Subobjective1:Increasestateandlocalagenciesandservice 0&") providersfoundincompliancewithSection504andADAwhileincreasingHHSOPDIVstaffs', '#* grantees',programproviders',andfaithbasedandcommunitybasedorganizations'knowledgeof '\$+ requirementstoprovidehealthandhumanservicesinmostintegratedsettingstopersonswith (4%, disabilities. ThenewwordingofobjectiveCfocusesattentiononoutcomesofOCRscompliancework, ) &- ratherthanontheprocessesbywhichoutcomesareachieved. l*&. SincetheJune1999SupremeCourtdecisionintheOlmsteadcase,OCRhasbeenworkingwithstatesto ,(0 developstatelevelcomprehensive,effectivelyworkingplanstointegratepersonswithdisabilitiesinto ,p)1 communities.Further,HHS,withOCRsinvolvement,hastakentheleadinimplementationofthe  PresidentsNewFreedomInitiativethathasidentifiedbarrierstocommunitybasedservicesforpersons \ withdisabilitiesanddevelopedablueprintforchange.OCRhasincludedthispopulationfocused 4 programmaticobjectiveinthisplaninsupportofthePresidentsandtheSecretaryscommitmentto   addressingthishighvisibilityissue. `   *"dddd edd eSdd Sdd "(#(#,dd ,edd ,Sdd ,dd +  4 4#X}X%&t׶&#xXX}PerformanceGoalsandMeasures A,!t" ATargets A,!t" AActualPerformance A,!t " AReference ="W(&t "   =#X}XxC#xXX}Measuresforrevised/newFY2003/2004ObjectiveC: N   Toincreaseaccesstoandreceiptofcommunitybased    servicesandnondiscriminatorytreatmentforpersons  R  withdisabilities,whileprotectingtheintegrityofHHS    Federalfinancialassistance.#xx;#xx ^  1.0 @ increased#correctiveactionsandnoviolation b  findings,reviews,outreach,consultations, &  technicalassistance,andcollaborativeactivities.n @=@= 2.0 @ numberofactionstakenbyrecipient/covered 2  entitiestoreducebarriers.(developmental)r@=@=  !(E88! !" 3"   3H2E  3  .3  0 @   #xx$F# xxtheamountofHHSfundingreceivedbycovered 6 entitiesthathavebeenfoundtobeincompliance, ~ orhavemadechangestocomeintocompliance B onissuesthathavebeeninvestigatedbyOCR.  (developmentalthroughFY04)#x x0I#xx 3HH݌F@=@= Ќ  4.0 @ increasednumberofpersonswithdisabilities   providedwithanequalopportunitytobenefit R fromprogramsorservicesincompliancewiththe  AmericanswithDisabilitiesActand/orSection V 504oftheRehabilitationActof1973,as  amended.#X}XxD# 5"$"b @=@="W 5#X}XXX}̡J# X}XXX} @ X X}FY04:265 > ) FY03:258 X * FY04:  , developmental# X}X  @L#  2-  @ X X} FY04: n/ developmental # X}X  @M# @ X X}  0  # X}X  @DN# @ X X}FY04: "5 developmental# X}X  @N# @ X X}  D6  # X}X  @O##X}XX X}L#X}XXX} +"69" + #X}XXX}̒O# X}XXX}  @ X X}FY03:250# X}X  @,P##X}XX X}P# X}XXX}  R @  @ X X} FY03:baseline zC FY03:baseline # X}X  @P# TF   @ X X}FY03:baseline TK # X}X  @nQ# #X}XX X}̛P#X}XXX} +"vL" +xXX}BudgetPages N M 1820,29,40  N 41#X}XxHR#( RO  " (*"dddd edd eSdd Sdd "(#(#,dd ,edd ,Sdd ,dd +  VOV xXX}TotalProgramFunding($in000's)#X}Xx0T##X}XXX}Q#X}XXX}  6P #X}XXX}̷T# X}XXX} @ X X}FY04:$15,735 6Q FY03:$15,487# X}X  @6U##X}XX X}U#X}XXX} XR   6S #X}XXX}U# X}XXX}  xX X}OneHHS 6T OutcomeGoals "U 2,5,&8# X}X xgV##X}XX X}DV#X}XXX} jV #X}XXX}W#X}XXX} .W ?] ]XeXXr?&t%XX}RevisedGoalI.ObjectiveC.Measures 6 X  1.0  Increased#correctiveactionsandnoviolationfindings,reviews,outreach,consultations, !bZ technicalassistance,andjointprojects. ":[(#(#  CXr] ]XeXWC<Xf!s#XXr<Performance: SeerevisedGoalI.ObjectiveA.measure1 fordescription.  r$ ]  @XrXf!s#XbY@2.0  Numberofactionstakenbyrecipient/coveredentitiestoreducebarriers. &&"_(#(#  Performance: SeerevisedGoalI.ObjectiveA.measure2 fordescription.  'R$a   (.%b  Forexample,ifasaresultofOCRswork,beneficiarieswillreceiveservicesinthemostintegrated )&c settingappropriatetotheirneeds,thepreviousmeasurescouldnotdistinguishtheeffectofOCRswork b*&d fromothercontributingfactors.#&t%%&tqW#&t%%&tԀGiventhemorebroadlyinclusivenewObjectiveC,thepreviousFY :+'e 2003measuresaresubsumedinthenewmeasure2whileaccountingforawiderangeofotheroutcomes ,(f ofOCRswork.#&t%%&tר\#&t%%&tԀ ,f)g  ->*h  3.0  TheamountofHHSfundingreceivedbycoveredentitiesthathavebeenfoundtobein  compliance,orhavemadechangestocomeintocomplianceonissuesthathavebeen \ investigatedbyOCR.(developmentalthroughFY04)4(#(# Performance: SeerevisedGoalI.ObjectiveA.measure3 . fordescription. #&t%%&t]# &t%%&t `  4.0  Increasednumberofpersonswithdisabilitiesprovidedwithanequalopportunitytobenefit  fromprogramsorservicesincompliancewiththeAmericanswithDisabilitiesActand/or p  Section504oftheRehabilitationActof1973,asamended. H (#(#  Performance: ThismeasuredirectlyrelatestheoutcomeofOCRscomplianceworktotherequirements  t  oftheAmericanswithDisabilitiesActandSection504oftheRehabilitationActof1973,asamended.It  P  isameasureofhowwellOCRisdoingitsworkanddistinguishestheeffectofOCRsworkfromother  (  contributingfactors.ThismeasurewillindicatewhetherOCRscomplianceactivitieshaveresultedin   increasednondiscriminatoryaccesstocommunitybasedandotherservicesforpersonswithdisabilities. \  Stakeholders,particularlyinterestedoraffectedgroups,haveraisedconcernsthatpersonswith 4  disabilitiesarebeinginappropriatelyprovidedservicesininstitutionalsettingsandarethereforebeing    deniedplacementsinthemostintegratedsettingappropriatetotheirneeds.Further,personswith ` disabilitiesmaybedeniedequalopportunitytoservicesinavarietyofsettings,notonlyincommunity 8 basedcareandservicessettings.Thisoutcomemeasureisdevelopmentalbecauseitwilltakeayearor  twotoestablishbaselines. SubsumedinthismeasureisthepreviousFY2003measure I.F.3.b: l Increasednumberofpeoplewithdisabilitiesreceivingservicesinthemostintegratedsetting. H  ProgramTargetsandActualPerformance t  SeeintroductoryparagraphinObjectiveA.  $ #&t%%&t_# &t%%&tOverviewofNewObjectiveD: IncreaseawarenessofandcompliancewiththeHealthInformation X PrivacyRule(_HIPAA_).  4  Themeasuresforthenew_HIPAA_ԀPrivacyRulecomplianceprogramarebasedonOCR'sexperiencein ` itscivilrightscompliancework.Therewehavelearnedthataflexibleapproachisrequiredtoincrease 8 compliancethroughtailoringactivitiestoaddresstheuniquecircumstancesofcoveredentities,rather   thanadheringtoapredeterminedsetofactivities.InFY2004,OCRwillfocusonthemeasuresinthe l! tableonthefollowingpage:  D " *"dddd edd eSdd Sdd "(#(#,dd ,edd ,dd ,edd +  4 4# X}X% &tW# xX X}PerformanceGoalsandMeasures A,!d" A# X}X xsl# xX X}Targets A,!d" AActualPerformance A,!d" AReference ="W(&d"   =# X}X xm#  xX X}Measures#x xg#xxԀfornewFY03/04#xxn#xxԀObjectiveD: Increase > awarenessofandcompliancewiththeHealth  InformationPrivacyRule(_HIPAA_).#xxn#xx  D  !(E88! " 3"   3p2E  1  .3  0 @   Increased#correctiveactions,noviolation N  findings,reviews,outreach,consultations,    technicalassistance,andcollaborativeactivities.   R   (developmental)  3pp݌  @=@= Ќ  2.0 @ numberofactionstakenbycoveredentities ^   indicatingincreasedawarenessofandcompliance "  withtheHealthInformationPrivacyRule.  b  (developmental) #X}Xx=n# 5"$" & @=@="W 5 #X}XXX}o# X}XXX} @ X X}FY04: T developmental# X}X  @s#  n  @ X X} FY04: j  developmental# X}X  @Vt##X}XX X}̪s#X}XXX}     +"  " + #X}XXX}t# X}XXX} @ X X}FY03:initialbaseline  V$ FY03:initialbaseline# X}X  @u#Ԁ  l )  +" X *" + xX X}Budget >+ Pages18,24 ~, 25,28,32, B- 4344# X}X xrv#(.  " ( *"dddd edd edd edd e"(#(#,dd ,edd ,dd ,edd +  t .t    xX X}TotalProgramFunding($in000's)# X}X x|x#  \ /   @ X X}FY04:$6,113 \ 0 FY03:$4,948# X}X  @y##X}XX X}̃u#X}XXX}Ԁ v 1  b 2   \ 3  #X}XXX}̘y# X}XXX} xX X} OneHHS \ 4 Outcome   5 Goal10# X}X xKz# ` 6   &t%X X}NewObjectiveDMeasures:  j7 1.Increased#correctiveactions,noviolationfindings,reviews,outreach,consultations,technical 9 assistance,andjointprojects.(developmental,baselineinFY03) v:   Performance: OCRwillhaveasthemajorstrategyforimplementationofthenewHealthInformation &< PrivacyRuleafocusonpubliceducation,outreachandvoluntarycomplianceactivities,collaborative ~= activities,andtechnicalassistance/consultations.ThissingleoutcomeindicatorreflectsOCRsflexible V> approachtoincreasingcompliance(preventingandcorrectingunlawfuldiscrimination),bytailoringits .? activitiestoaddresstheuniquecircumstancesofcoveredentitiesratherthanadheringtoastrictly @ prescribedsetofactivities.  bA 2.Numberofactionstakenbycoveredentitiesindicatingincreasedawarenessofandcompliance C withtheHealthInformationPrivacyRule.(developmental,baselineinFY03) fD Performance: Thisnewmeasure2.innewObjectiveDmeasuresdirectlytheresultsofOCRs F compliancework.ThismeasuredirectlyrelatestheoutcomeofOCRscomplianceworktothe v G requirementsofthe_HIPAA_ԀPrivacyRule.Forthismeasure,OCRwouldcountthenumberofoutputs N!H (e.g.,newpoliciesputintoplace,thenumberoftrainingprogramsinstituted,thenumberofsystems &"I changed).TheseoutputscanbedirectlyassociatedwithchangesthatresultfromOCR'sinvolvementand "zJ thatultimatelywillresultingreaterprotectionofindividualsprivacyrights. #R K    r ProgramTargetsandActualPerformance  %"M OCRhasnotsettargetsforthesemeasuresasthecomplianceprogramwillbecomeeffectivemorethan 6'#O midwaythroughFY2003.AlthoughOCRhassetFY2003asaninitialbaselineyearfordeveloping ($P targets,OCRwillneedtohavetwocompletefiscalyears(FY2004andFY2005)ofcompliance (b%Q experienceanddatainthisarenabeforeanybaselinesandtargetscanbevalidated.Atbest,OCRcan ):&R projectinitialtargets,subjecttoconsiderablechange,followingtheendofFY2003. *'S   7#&t%% &t,z#&t%%&t  F,(U GoalII:TOENHANCEOPERATIONALEFFICIENCY    OverviewofNewObjectiveA :IncreasetheEfficiencyofCaseProcessing  4  InFY2003,OCRsGPRAperformanceplanwaspredicatedonallocatingstaffandotherresourcestothe d highestprioritycivilrightsissues.Thisperformanceplanrevisestheoperationalefficiencyobjective < thathadcalledforincreasingthepercentageofresourcesdedicatedtohighpriorityissues.Instead,due  tothegreaterinclusivenessoftheoverallprogramobjectivesintheFY2004plan,OCRhasrevisedthe p  operationalefficiencyobjectivetofocusaswellonincreasingtheefficiencyofallofitscaseprocessing, H  notonlyprocessingofasubsetofitsactivities.InFY2004,thepreviouspriorityissuesaresubsumed    withintheoverallefficiencyobjective.OCRhascommittedconsiderableenergiesduringthepastfew  t  yearstostreamliningcaseprocessing,strengtheningitsCaseResolutionManual,anddeveloping  L  guidanceandtrainingforinvestigators.AlloftheseactivitiesareaimedatincreasingOCRsabilityto  $  betterserveitscustomersbyincreasingtheefficiencyofcaseprocessingoverallasshownbydecreasing   theaverageageofallcaseclosures. X   #X}X%&tz#9,XX4 XXr9*"dddd edd edd edd e"(#(#, dd ,dd ,dd ,dd +  4   4xXX}PerformanceGoalsandMeasures A,!l " A=Xr,XX4 X=?] ]XeXXr?Targets A,!l " ACXr] ]XeXCActualPerformance A,!l " AReference @W+&l "   @ Measure#xxw#xxԀforrevised/newObjectiveA:  >  IncreasetheEfficiencyofCaseProcessing#xxz#  1.Decreaseaverageageofallcaseclosures. 'W '?] ]XeXXr?FY04:360  FY03:380 N Ѐ ' 'CXr] ]XeXCFY02:399(baseline) '$ '?] ]XeXXr?Budget >% Pages21, & 24,25,31 /"WJ' /CXr] ]XeXC<'KwXS !#XXr< MeasurexxԀforrevised/newObjective#xx#xx B: j( Streamlinemanagementstructureand 0) increasestafftosupervisorratio. x* 1.Streamlineregionalmanagementstructure |, ЀbyeliminatingBranchChiefpositions. @- 2.Increasestafftosupervisorratio. 2  +" !4"W +@Xr'KwXS !#X@FY03:20regional z9 managementpositions >: 0 $ 0$$  FY02:20regional J< managementpositions = FY03:0 X 1:9.0?XX FY02:0 X 1:7.50@Z @XX  +"!A" +FY03: zF FY02:#xx]#xxԀ20managers#xx#xx JI FY01:25managers J 0  (baseline)NK FY03:0  Z M FY02:1:7.9#xx`#xx !N FY01:1:5.6 !^O 0  (baseline) 5"$"""P" 5?] ]XeXXr?(jQ  " (#X}Xx)#*"dd dd dd dd dd "(#(#, dd ,dd ,dd ,dd +  # Q#  xXX}TotalProgramFunding($in000's)#X}Xxٚ#  #z R  #X}XXX}i# X}XXX} xX X}FY04:$34,250 #z S FY03:$33,257 $>!T FY02:$31,430# X}X x##X}XX X}̄#X}XXX} %"U   #z V #X}XXX}\#}Xe&XXX}G#X}X&X}XeԜ#X}XXX} #z W   CXr] ]XeXC?] ]XeXXr?CXr] ]XeXC&t%XX}RevisedGoalII.ObjectiveAMeasure: f'#X  1.Decreasedaverageageofallcaseclosures )%Z Performance: OCRhasmodifiedthisindicator.InFY2004,OCRwillcontinuetouseasingleoutcome *B'\ indicator(i.e.,closure,correctiveaction/noviolationfindings,andthepubliceducation,outreach,and +(] collaborativeprojectactivities)butwillsetclosuretargetsonallcasesasopposedtoaproportionofthe z,(^ complianceworkloadthatfocusesonhighpriorityissuesaswasthecaseinFY2003askeyindicatorsof R-)_ |[ |9 |  programmaticachievement.OCRselectedthisperformancemeasurebecauseitindicateshowefficiently  staffareprocessingcasesandtheextenttowhichstaffarebecomingincreasinglyfamiliarwiththe \ complexissuesincreasinglyraisedinourcases.AsinFY2003,pursuanttothefindingsoftheInspector 4 GeneralsauditofOCRsFY1999GPRAachievementsandreport,inFY2004andsubsequentyears   OCRwillremoveanycaseswhichwereclosedadministratively(withoutafinding)afterarequestfor ` datahadbeensenttoagrantee/provider. 8  ! ! B 4789:;<(Ex8!OverviewofDeletedFY03ObjectiveB: Streamlinemanagementstructureandincreasestaffto l  supervisorratio.?] ]XeXXr? H  InFY2001,OCRcompletedareorganizationofitsheadquartersoperationsandsignificantlystreamlined  t  thehierarchyandexpandedthespanofcontrolforremainingmanagers.Atthattime,OCRmovedfroma  L  HQorganizationwith20managementpositions(notallfilled)toanewstreamlinedorganizationwitheight  $  managers(includingone_SES_Ԁpositionthatiscurrentlyunfilled).OCRwillcontinuetorefineandadjustthe   HQorganizationandoperationstosustainsuccessfullythedelayeredmanagementapproach. X  Asoftheendof2002,OCRhadstreamlineditsmanagementstructureandincreasedstafftosupervisor   ratio,andeliminatedtheregionalBranchChiefpositions.InFY2003,OCRsoperationalefficiency \ measurefocusedon:(1)reducinglayersofmanagementinOCRsregionalofficesand(2)reducingthestaff 4 tosupervisorratiointhetenregionaloffices.Inseveralofitsregionaloffices,OCRhasalreadymovedtoa   structurewithaRegionalManagerandaDeputyservingasthedailyoperationalandsupervisoryfocal h points.Thishasservedtostreamlinetheregionalstructureandincreasethenumberofstafftoprovidemore @ directandenhancedcustomerservice.Asoftheendof2002,OCRhadincreasedtheregionalstaffto  supervisorratio. CXr] ]XeXC l     ' 4789:;<+(yxB 4789:;<#&t%%&t# &t%%&t" 3"   323  0    ProgramPerformanceAnalysis  3݌ $ $ Ќ  #&t%%&tn# &t%%&tAspreviouslydiscussed,OCRhasrestructureditsapproachtoresultsplanningtocaptureabroaderarrayof P complianceoutcomes# X}X% &t$# &t%X X}.Therefore,ourprogramperformanceanalysisreflectsthetransitionfromthemore ( narrowissuespecificsetofmeasuresinourFY2002plantothemeasuresunderthemoreinclusive | objectivesADintheRevisedFinal# X}X% &t\# &t%X X}FY2003PlanandtheFinalFY2004Plan.# X}X% &tע# &t%X X}ԀUnderthesebroaderand T moreinclusiveobjectives# X}X% &t # &t%X X},OCRcontinuestoaddresstheissuespecificareasthatwereincludedinourFY , 2002planadoption,servicesforlimitedEnglishproficientpersons(LEP),TemporaryAssistancefor   NeedyFamilies(TANF),nondiscriminatoryqualityhealthcare(healthdisparities),andservicesinthemost `! integratedsettingforindividualswithdisabilities# X}X% &tו# &t%X X}Ԁ(MIS).Weareprovidingacrosswalk# X}X% &tk# &t%X X}onthechart  onthe 8 " nextpagetoshowOCRsaccomplishmentsinFY2002againstbothourFY2002Planandtargets# X}X% &tӲ# &t%X X}underthe !# restructuredGPRAPlanobjectivesADinFY2003and2004. !d$   #&t%% &tׅ#&t%%&t#X}X%&tש#&t%XX}#&t%%&td#&t%%&t#X}X%&tצ#  # & [      GoalOneTargetsandAccomplishmentsFY2002Plan,RevisedFinalFY2003andFinal#X}XXX}#X}XXX}  FY2004Plan&t%XX}  p #X}X%&tX# XX} $ $L $*"dd dd dd dd dd " $ $,dd ,Xdd ,Xdd ,Xdd ,Xdd ,Xdd ,Xdd ,Xdd ,Xdd ,Xdd ,Xdd +  (   (#X}X ¶#^zP(\XX}  Objectives#X}X(\^zP#&t%XX}#&t%%&t#&t%%&t  9#&t%%&t״#&t%%&t#X}X%&tr#^zP(\XX} <2#wd^^ <FY00 .$p" .FY01 .$p " .FY02 .$p " .FY03 .$p " .FY04 @ .$p " . ! j  ! Target 2.J " 2Actual 6,!J". 6Target 2.J" 2Actual 6,!J". 6Target 2.J" 2Actual 6,!J". 6Target 2.J" 2Actual 6,!J". 6Target 'J" 'Actual J"  ObjectivesFY2002Plan #X}X(\^zP]#^zP(\XX} ) ,  )#X}X(\^zPm#^zP(\XX} A,!, 3 A#X}X(\^zPؾ#^zP(\XX} A,!, 3 A#X}X(\^zP[#^zP(\XX} A,!, 3 A#X}X(\^zP޿#^zP(\XX} A,!, 3 A#X}X(\^zPa#^zP(\XX} A,!, 3 A#X}X(\^zP#^zP(\XX} A,!, 3 A#X}X(\^zPg#^zP(\XX} A,!, 3 A#X}X(\^zP#^zP(\XX} A,!, 3 A A,!,  3 A -#!, !3 -#X}X(\^zPm#@ XX}Adoption >4 J "  B@37B@>37 q.\1J #3  B@37 B@  D@40D@q40 uk@J $3  D@40 D@.  E@42E@u#X}X @^#@ XX}#@  @#@  @42#@  @#@  @#X}X @#&t%XX} q.\1J %3  E@42 E@  R@72R@q#X}X%&tט#@ XX}#@  @V#@  @72#@  @#@  @#X}X @K#&t%XX} uk@J &3  R@72 R@.  F@44F@u#X}X%&t#@ XX}#@  @#@  @44#@  @ #@  @#X}X @#&t%XX} q.\1J '3  F@44 F@  H@48H@q#X}X%&tה#@ XX}#@  @R#@  @48#@  @#@  @#X}X @G#&t%XX} uk@J (3  H@48 H@.  G@46G@u#X}X%&t#@ XX}#@  @#@  @Ԁ46#@  @#@  @#X}X @#&t%XX} Q.<1J )3  G@46 G@ Q#X}X%&t׏#^zP(\XX}#^zP(\(\^zPM#^zP(\(\^zPԄ#^zP(\(\^zPd#^zP(\(\^zP#X}X(\^zP"#&t%XX} A,!J *3. 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K.6+n3Z2d K#X}X @/#@ XX}Ԅ#X}X @r0#&t%XX} KZ6!n3. 2dK#X}X%&t׹0#@ XX}Dev.#X}X @F1#&t%XX} K.6+n3Z2d K#X}X%&t׌1#@ XX}Ԅ#X}X @2#&t%XX} 6,!n3. 6#X}X%&t`2#@ XX}Dev.#X}X @2#&t%XX} 2.n3 2#X}X%&t3#@ XX}Ԅ#X}X @3#&t%XX} 6,!n3. 6#X}X%&t3#@ XX}TotalRevisedTargets > andAccomplishments#X}X @Q4#&t%XX} 2` 2 A,!>3 A A,!>3 A A,!>3 A mZX!>3 @16002d@m#X}X%&t4#@ XX}1600 .yL>3 @1600 @Z2d @2135@#X}X @t6#@ XX}2135#X}X @H7#&t%XX} ZyB>3 @2135 @. @16422d@#X}X%&t׎7#@ XX}1642#X}X @^8#&t%XX} l.WL>3 @1642 @Z2d l#X}X%&tפ8#@ XX}Ԅ#X}X @R9#&t%XX} mZX!>3. T@16852dT@m#X}X%&tי9##X}XXX}{# X}XXX}@ XX}1685#X}X @:##X}XXX}q:# l.WL>3 T@1685 T@Z2d l@ XX}Ԅ#X}X @e;#&t%XX}1'%>3  . 1 #X}X%&t׬;#@ XX}*802doesnotincludehealthdisparitiesandMISactivities.1,199includestheseactivitiesinFY2002#X}X @%<#&t%XX}. . InFY2002,the#X}X%&t<#&t%XX}programoutcomemeasuresunderGoalI,twoofwhichweredevelopmental,#X}X%&t9=#&t%XX}&t%%&tԀfocusedon Z specificissues(i.e.,adoption,managedcare,LEP,TANF,qualityhealthcareforminorities,andmost  2 integratedsettingsforpersonswithdisabilities)#&t%%&t=#&t%%&t#X}X%&t=#&t%XX}ԀunderOCRsoverallhealthandsocialservices !  nondiscriminationprotectionmission#&t%%&t>#&t%%&t#X}X%&t8?#&t%XX}.#&t%%&t?##X}X%&t'@#&t%XX}ԀUnderGoal&t%%&t#X}X%&t׍@#&t%XX}ԀII,theperformanceobjectives#X}X%&t@#&t%XX}Ԁaddressedorganizational f" efficiencyandworkforcerestructuringunderthePresidentsManagementAgenda#X}X%&t[A#&t%XX}#&t%%&t׸@#&t%%&tԀHumanCapital ># Investmentobjective.#X}X%&tB#&t%XX}ԀOCRmetorexceededthetargetsforthree(adoption,LEP,andTANF)ofthefour $  programoutcomemeasuresunderGoalIthatwerenotdevelopmental,whilecompletingasignificant $j! numberofactivities(i.e.,correctiveactions,noviolationfindings,reviews,outreach, %B" consultations//technicalassistance,andjointprojects)underthetwodevelopmentaloutcomemeasure &# (HealthDisparitiesandMIS). v'# OCRmisseditstargetinonlyoneprogramareamanagedcare.Fromitsexperienceduringthepastfew &)% years,OCRlearnedthatmanagedcaresettingswereonlyasmallpartofthecomplexinterrelationships )z& betweeninsurers,providers,andpatientsthatmayresultindiscriminationanddisparitiesinhealth *R' outcomes.Therefore,OCRdecidedtoallocatesomeoftheresourcespreviouslyanticipatedformanaged +*(  careactivitytothebroaderspectrumofhealthdisparitiesworkconsistentwiththeSecretarys OneHHS ,) [    _objectives.AlthoughOCRknowinglymissedthepreviouslyestablishedmanagedcaretargetby38  activities,itwasabletocomplete163activitiesinsupportofreducingoreliminatinghealthdisparities. \  Atthebottomline,thetotalofOCRstargetsineachofthefournondevelopmentalprogramobjectiveswas   tocomplete748activities.NotincludingthedevelopmentalhealthdisparitiesandMISobjectives,OCR ` completed802activities,exceedingthetotalofalltargetsby7.2%.Includingactivitiescompletedunderthe 8 twodevelopmentalobjectives,OCRcompletedatotalof1,199activities,amorethan60percentgreater  number(+451activities)#X}X%&tB#&t%XX}#&t%%&t^B#&t%%&tԀthanthetargetsestablishedinitsFY2002Plan.#X}X%&tK##X}XXX}JK#X}XXX}&t%XX} l  OCRsinitialGPRAPlancontained32measures.OCRhascontinuedtolearn,includingthroughourFY    2002experience,thatitisimportanttoreducethenumberofmeasuresandbroadenourobjectivesinorder  p  tomoreaccuratelyreportonthetotalityofitsnondiscriminationwork.Thatis,ineachyear,whileOCR  H  mayhavemissednarrowlyfocusedobjectivesandtargets,thetotalityofourresultsexceededthesumofthe   plansissuespecificparts. |  IntheRevisedFinalFY2003PlanandtheFinalFY2004Plan,OCRfurtherconsolidatesitscivilrights ,  programobjectivesandmeasuresintoonlythreeobjectives(HealthCare,SocialServices,andCommunity   BasedServices/Disability).Throughthisconsolidation,OCRwillbereportingontheentiretyofits X complaint,postgrantreview,outreach,publiceducation,technicalassistance/consultationwork,ratherthan 0 onsmallerissuespecificsubsets.Thechartonthepreviouspagesetstargetsinthesethreeinclusive  programareasforFY2003andFY2004.Thesetargetsineachoftheseyears(1,642and1,685)aremore d thandoubletheactualaccomplishments(802activities)underthefournondevelopmentalissuespecific < objectivesinFY2002andmorethanonethirdhigherineachyearthanthetotalof1,199activities  completedundernondevelopmentalanddevelopmentalmeasuresinFY2002. h ЀAsacrosswalk,thechartalsoshowswhatwouldhavebeenthetargetsforeachofthemoreinclusive  objectivesandthetotalofthethreetargets.Hadthesebroader,moreinclusiveobjectivesbeeninplace t duringFY2002,OCRwouldhavemetorexceededeachofthemandatthebottomlinewouldhave L exceededthetotaloftheseobjectives(1,600)by33.4%(+535). $ ThetargetssetunderthethreebroadgaugedcivilrightsobjectiveforFY2003andFY2004aremorethan P 20percentlowerthanactualFY2002accomplishments.ThisisbecauseOCRhastightenedthedefinition ( #&t%%&tK#&t%%&tofwhatconstitutes outreach.IntheRevisedFinalFY2003PlanandtheFinalFY2004Plan,the   definitionof outreachwillonlyincludeconsultations,technicalassistance,andcollaborativeactivities \! thatarepartofanoverallsetofstrategicallyplannedactivitiesthatbuildupononeanothersystematicallyto 4 " addressthehealthcare,socialservice,disabilityorprivacyobjectives.#&t%%&t׃U#&t%%&t#X}X%&tL#&t%XX}  !# #&t%%&tךW#IntheareaofhealthinformationprivacyunderHIPAA&t%%&t,inFY2002therewerenoobjectivesormeasures. "8% However,OCRcompletedsignificantworkinthisareathatarenotcapturedinthisanalysis.InFY2002, # & OCRbegantheprocessofdevelopingtheinfrastructureforaHealthInformationPrivacyRulecompliance l$ ' program,engagingextensivelyandcollaborativelywithDepartmentalOPDIVSandSTAFFDIVSand D%!( providingtechnicalassistanceandpubliceducationtocoveredentitiesunderthePrivacyRuleandothers. &") DuetothenascentnatureofthePrivacyRuleprogram,OCRhasdeterminedthatweneedtocollectdata &p#* duringFY2003throughFY2005beforesettingbaselinesforHIPAAprogramtargets.Following 'H$+ completionoftwofullfiscalyearsofcomplianceinvestigations,publiceducationandoutreachfollowing ( %, thePrivacyRulecomplianceeffectivedateofApril14,2003,OCRprojectsthatitwillbeabletoseta |)%- baseline.#X}X%&tW#&t%XX} T*&. _  ,(0  #X}X%&t\#&t%XX} @\ #X}X%&tO]#&t%XX}GoalIIOperationalEfficiencyTargetsandAccomplishmentsFY2002Plan#X}X%&tש]#&t%XX} 󀀀  #X}X%&t8^#&t%XX}#&t%%&tiX#&t%%&tInFY2002,OCRs#&t%%&t^#&t%%&t#X}X%&tן^#&t%XX}ԀperformanceobjectiveunderGoalIIfocusedone#&t%%&t7_#3&t%%&tnhancing#&t%%3&t_#&t%%&toperationalefficiencyand 8 onthePresidentsManagementAgendaobjective#X}X%&ty_#&t%XX}Ԁforworkforcerestructuringandhumancapitalinvestment.  #X}X%&t`##X}XXX}7`#&t%XX}OCRmetitsFY2002targetsforoperationalefficiencyoutcomemeasuresunderGoalIIbyensuringthat49 d percentofitscompletedactivitieswereinpriorityareas.Itisimportanttonotethatalthoughthepercentage < targetonlyincreasedfrom48to49percentfromFY2001toFY2002,duetotheoverallincreaseinOCRs  totalworkload(bothinpriorityandotherareas),achievingthe49percenttargetrequiredOCRtocomplete p  73morepriorityissuespecificactivitiesthanhadbeenachievedinFY2001. H  OCRmissedmeetingitsefficiencyobjectivefortheaverageageofhighprioritycasesby36daysor14.3%.  t  ThiswasdueinparttoOCRsdecisionduringthepasttwotothreefiscalyearstohandleOlmstead  L  complaintsusingavarietyofvoluntarycompliance,outreach,alternativedisputeresolution,andpublic  $  educationtechniquestoresolvecases.Insteadofengaginginimmediateinvestigationofallegations,OCR   hasworkedtogetherwithstatesandotherstoresolvepotentialcomplianceproblems.Casessusceptibleto X  earlyresolutionthroughinvestigationhavebeenhandledinthismannerandwhenvoluntarycompliance 0  effortshavefaltered,OCRhasmovedtomoretraditionalinvestigativemethods.Thishasmeant,however,   thatinpursuitofcommongroundwithstatesandprovidersofcommunitybasedservices,theamountof \ timededicatedtothesecomplaintshasincreased. 4 OCRisworkingtoachievecompliancethroughthefullspectrumofmethodsavailabletous.Givenour h objectiveofusingthemethodthatcanbetailoredmosteffectivelytothefactsofanygivencaseoroutreach @ needandbecausewehavemodifiedtheprogramobjectives#X}X%&t׎a#3X}XXX}3&t%X3X}tocoverabroaderarrayofourwork,inFY  2003andFY2004,theefficiencyobjectiveintheplannolongerfocuseson highpriorityactivitiesbut l ratherlooksforefficiencyresultsforallofourwork.Theobjectivehasbeenrevisedtofocusonreducing D theaveragedurationofallcases.InFY2002,OCRcompletedprioritycasesinanaverageof288days.  OCRstargetforcompletingallcasesinFY2003andFY2004willbe260and247daysrespectively,or x approximately10and14percentbelowthe288dayprioritycaseageinFY2002. P #&t%%3&tצi#&t%%&t#X}X%&ti#&t%XX}WithrespecttothePresidentsManagementAgendaobjective#X}X%&tl#&t%XX}Ԁforworkforcerestructuringandhuman | capitalinvestment#X}X%&tqm#&t%XX},in2002OCRcompletedandmetbothofthetargetsunderobjectiveBundergoalIIto T streamlineitsregionalmanagementstructurenationwidebyeliminatingalayerofmanagement(Branch , Chiefs)therebyincreasingthenationwidestafftosupervisorratio.#X}X%&tn#&t%XX}IntheFY2003andFY2004GPRA   Plans#X}X%&tmo#&t%XX},#&t%%&tׯl#3&t%%&tԀOCRhasdeletedthisobjectivesinceithasalreadybeenaccomplished. `! #3X}X%3&to#3&t%X3X}#&t%%3&t+p#3&t%%&t#&t%%3&t q##X}X%&tp#&t%XX}Insummary,lookingatallofthetargetsunderGoalsIandIIintheFY2002Plan,OCR&t%%&t#X}X%&tqq#&t%XX}Ԁmetorexceeded !# targetsinsixofeightprogramandoperationalefficiencyobjectives.#&t%%&tq##X}X%&t)r# !d$     r      r 9s X}XXX}&t%XX}  $!' III.AppendixtothePerformancePlan   К 5(8y' 4789:;<+  ' 4789:;<+(y85" 3"   3u23  0    LinkagetoHHSandAgencyStrategicPlans  3uBu݌4 $ $ Ќ  ! ! ' 4789:;<+(yy' 4789:;<+OCRwilluseoutcomestomeasureperformanceduringFY2004.Previously,startinginFY1998,OCR ` hadfocuseditscomplianceandoutreach/educationactivitiesonthehighpriorityperformanceobjectives. 8 Recently,OCRassessedtheeffectivenessofOCRsexistingGPRAPerformancePlan.Outofthat  assessmentcamearestructuredperformanceplanthatbetteralignswithandsupportstheHHSStrategic l  Plan,the OneHHS10DepartmentwideOutcomeGoalsandbetteraddressesthepriorityareasinOCRs D  StrategicPlan;andaddsOCRsnewresponsibilitytoenforcethePrivacyRuleunder_HIPAA_.Pleasesee    chart PerformanceMeasurementLinkagesonpage79.  p   " 3"   3y23  0    Changes/ImprovementsoverPreviousYear  3y*z݌  $ $ Ќ  ForFY2004,OCRhasrestructureditsperformanceplantocoverabroaderarrayofOCRscompliance T  responsibilities(e.g.,civilrightsstatutoryauthorities,relatedprogramissues,programservicesand ,  providersofsuchservicesfundedbyHHS,aswellascoveredentitiesunderthePrivacyRule,notallof   whichreceiveFederalfinancialassistance(seethe SummaryofChangesinFY2003FinalGPRAAnnual X PerformancePlanonpages7578).Therestructuredplanalsoaddressesabroaderrangeofbeneficiaries 0 ofHHSfundedservicesaswellasagreaternumberofpotentialbarrierstoservices.Further,the  performanceindicatorsmeasuredirectlytheresultsofOCRscomplianceworkhowwellOCRisdoingits d workanddistinguishestheeffectofOCRsworkfromothercontributingfactors.Inaddition,OCRplans < todevelopapreliminarybaselineforPrivacyRuleactivities,includingcorrectiveactionsandnoviolation  findingsbasedoncomplaintreceiptsandclosuresduringFY2003,beginningwiththecomplianceeffective h dateofApril14,2003.Thiswillbesubjecttochangeduetotheneedtohavemorethanafewmonthsof @ experiencebeforesettingtargetsbasedonthis.  DuringFY1998,OCRdevelopedGPRAdatafieldsforthecollectionofcaseandoutreachrelateddata L withinitsexistingComplianceActivityTrackingSystem(CATS).OCRhascollecteddatatoestablish $ baselinesagainstwhichtheFY2004outcomeswillbemeasured.Basedonitsexperienceoverthepasttwo x years,OCRmodifiedtheoutcomeindicatorsintheFY2001reportandsubsequentyearsplansby P combiningwhathadbeenmultipleoutcomeindicatorsintoasingleindicatorthatincludeseachofthe ( complianceactivitieslistedbelow:   0  increasednumberofreviewsconducted;4 " $ $ 0  increasednumberofcorrectiveactionsandnoviolationfindingsfromreviewandcomplaint  !# investigations;!`$ $ $ 0  increasednumberofconsultations/technicalassistanceprovided(e.g.,eithercaserelatedorresponsesto "8% requestsforspecificassistanceinavoidingorresolvingpotentialcivilrightsproblems);# & $ $ 0  increasednumberofcollaborativeefforts(e.g.,coordinatedprojectsplannedwithotherHHSagencies, l$ ' states,localgovernments,providers,andcommunitybasedandotherorganizationsinwhichshared D%!( objectivesaresetandimplemented);and&") $ $ 0  increasednumberofpubliceducationandoutreachactivitiesconducted(e.g.,specialprojectsor &p#* significantplannedactivitiesfocusedonthecomplianceneedsofstates,localgovernments,providers, 'H$+ andcommunitybasedandotherorganizations).( %, $ $ ThecombinedindicatormoreaccuratelyreflectsOCRsflexibleoutcomebasedapproachtoincreasing T*&. compliance(preventingandcorrectingunlawfuldiscrimination),bytailoringitsactivitiestoaddressthe ,+'/ uniquecircumstancesofHHSgrantees/providers,ratherthanadheringtoastrictlyprescribedsetofmethods ,(0 oractivities.Althoughtheactivitiesnotedabovearenotexactlycomparable,eachcanbeequallyeffective ,X)1 inreachingcompliance.EachrequiresaconsiderablelevelofeffortinworkingwithrecipientsofFederal  financialassistanceandotherstopreventorcorrectdiscriminatorypoliciesorpractices.Likewise,it \ requirescomparablelevelsofeffortinworkingwithcoveredentitiesunderthePrivacyRuletoensurethat 4 theycomplywithrequirementstoprotecttheprivacyofhealthinformation.Onaverage,theseactivitiesare   estimatedtotakesimilaramountsofstafftime.Asinthisinstance,consultation/technicalassistance,joint ` efforts,andoutreachactivitiesallinvolveplannedandcoordinatedeffortsthatarepartofanoverall 8 strategicapproachtoresolvingpotentialcivilrightsproblems.  OCRhasdeterminedthattheconsolidatedoutcomemeasurewillproveabetterindicatorofitssuccessin D  educatingproviders,communitybasedandotherorganizations,andprogrambeneficiariesaboutcivilrights    requirementsandresponsibilities,andcoveredentitiesaboutresponsibilitiesunderthePrivacyRule.Public  p  knowledgeoftheserequirementsandresponsibilitiesisamajorfactorinensuringcompliance.Elementsof  H  theconsolidatedindicator,suchasthenumberofcollaborativeactivities,consultations,technicalassistance,   andoutreachactivitiesreflecttheextentofOCRscoverageoftheextensivenetworkofprovidersandusers |  ofHHSfundedservicesandthelargeruniverseofcoveredentitiesunderthePrivacyRule.Thenumberof T  reviewsandthenumberofcorrectiveactionsor noviolationfindingsinOCRscaseworkaremeasures ,  bothofthescopeofOCRscoverageoftheuniverseofHHSgranteesandofOCRssuccessinachieving   civilrightscompliancethroughoutreach,collaborativeactivities,technicalassistance,andinvestigative X activities.TheinterrelatedsetofcomplianceactivitiesisintegraltoOCRsflexibleapproachtoworking 0 withandrespondingtothediverseneedsofOCRsstakeholders.  Further,becauseinFY2001,HHSOfficeofInspectorGeneralraisedquestionsregardingtheoutcome < measurethatisbasedon correctiveaction,OCRhasclarifiedthedefinitionfor correctiveactionto  includeclosedcasesinwhichrecipientseitherhavemadechangesandhaveagreedtomakefurtherchanges h tobringthemintocompliance. @ OCRhasdevelopedanewsetofcivilrightscomplianceoutcomesthatarebeingcapturedinitsnewPIMS t systemthathasbeenimplementedinFY2003.Withrespecttooutcomemeasures,inFY2001,basedon L preliminaryresultsfromanInspectorGeneralsauditandOCRstaffexperienceinreviewingdata,OCR $ includedanadditionaldataverificationprocesspriortogeneratingfinalFY2000data.Sincethattime, x OCRhasimplementedapproachestoeffectivelycoordinateprogrammanagement,incorporatearesults P orientationintoongoingoperations,andimprovedatacollectionandreporting. (  #&t%%&t|s# &t%%&t# X}X% &tכs# &t%X X}AsnotedinthebodyoftheFinalFY2004GPRAPlan,thePlanincludesanewobjectiveD: #&t%% &tʗ#&t%%&tIncrease \! awarenessofandcompliancewiththeHealthInformationPrivacyRule(_HIPAA_)and#&t%%&tׯ# &t%%&tԀtwoproposed 4 " developmentalperformancemeasures.ThetwoproposedmeasuresaredevelopmentaluntilFY2005.  !# AlthoughOCRplanstodeveloppreliminarytargetsbasedonFY2003data(startingfromthecompliance !`$ effectivedateofApril14,2003),OCRbelievesthatitwillneedatleastthefullyearinFY2004inorderto "8% developbaselinesthatcanbevalidatedinFY2005.Indevelopingtargetsforthesemeasuresforthenew # & PrivacyRuleprogram,wewillassessourexperienceinGPRAplanningandtargetsettingduringthelast l$ ' severalyearsforthetraditionalcivilrightsprogram.# X}X% &t ##X}XX X}̋#X}XXX}&t%XX} D%!( ! ! ' 4789:;<+(yy' 4789:;<+ " 3"   323  0    PartnershipsandCoordination  3ܝ݌&p#* $ $ Ќ  Throughconsultations,technicalassistance,andotheroutreachactivities,OCRwillcontinuetoeducate ( %, HHSagencies,stateandlocalagencies,serviceproviders,andotherorganizationstoensureadherenceto |)%- civilrightsandPrivacyRulerequirements.OCRwillworkwithsuchentities,includingregionallybased T*&. taskforcesthathavebeenestablishedaspartofOCRsdiscriminationandracialandethnichealth ,+'/ disparitiesactivities,toidentifypossiblecomplianceproblems,andwhereappropriate,conductjoint ,(0 activitiestoensurenondiscriminatoryaccesstoservices.Forexample,OCRisworkingwithACFinthe ,X)1 areasofadoptionandwelfarereformtoensurethattheprovisionsoftheSmallBusinessJobProtectionAct  of1996andTANFareimplementedinanondiscriminatorymanner.OCRwillalsocoordinatewiththe \ CentersforMedicare&MedicaidServices(CMS)intheareasofdataneeds,provisionoftechnical 4 assistance,andconductingjointcomplianceactivities,includingactivitiesunderthenondiscriminatory   qualityhealthcarepriorityarea. ` IntheLEParea,OCRcoordinateswithHHSagencies(notablyCMSandACF),othergovernmentagencies  suchastheDepartmentofJustice(DOJ)andtheWhiteHouse.OCRalsoworkswithotherorganizations, l  includinghealthcareorganizations,tohelptheirmembershipunderstandandimplementtheLEPpolicy D  guidanceandwithstateagenciesandcommunitygroupstoconductLEPoutreachandtrainingeventsto    showcasepromisingpracticeswithregardtoprovidinginterpreterservices.OCRisalsoanactive  p  participantinthegovernmentwideLEPworkgroupconvenedbyDOJ.  H  Inaddition,intheareaofTANF,OCRhasbeenprovidingtechnicalassistancetocoveredentitiessuchas |  states,providers,andvendorsinvolvedinadministeringTANFprogramstohelpthemrecognizepotential T  civilrightsissuesandpreventproblemsfromoccurringastheycarryoutwelfaretoworkprograms. ,    Also,inthedisability(mostintegratedsetting)area,OCRwillcontinuetoworkjointlywithHHS X componentsandotherfederalagenciesaswellasstatestohelpthemcarryouttherequirementsofthe 0 SupremeCourtsOlmsteaddecisionandthePresidentsNewFreedomInitiative.OCRhasbeenworking  withstatesandotherinterestedpartiesinthedevelopmentofOlmsteadplanningcoalitionstodevelopstate d comprehensiveworkingplanstoservepeoplewithdisabilitiesinthemostintegratedsettingappropriatefor < them.  Further,initsnondiscriminationandracialandethnicdisparitieswork,OCRcoordinateswithother @ agenciesincludingtheOfficeofMinorityHealth,CentersforDiseaseControlandPrevention,theAgency  forHealthcareResearchandQuality,HUD,DOJ,stateagencies,andlocaltaskforces.Theselocaltask t forcesarecomposedofmedicalproviders,representativesofacademiaincludingmedicalandotherhealth L careprofessionalschoolfaculty,governmentagencies,thefaithcommunity,professionalassociations, $ hospitalsocieties,andothersineachregion.OCRwillinvolvethemdirectlyineducation,technical x assistance,andotheroutreachactivitiesandtousetheirexpertiseasOCRimplementsavarietyof P complianceactivities. ( Finally,withitsnewresponsibilitiesunderthePrivacyRule,OCRwillcoordinatewithotherHHS \! componentsthroughtheDepartmentsPrivacyCouncilandwithawidearrayofcoveredentities, 4 " representativeorganizations,andthepublic.ThiswillentailprovidingtechnicalassistancetoHHS  !# componentswhicharecoveredentitiesorwhichprovidegrantstoorpartnerwithcoveredentitiestoensure !`$ compliancewiththePrivacyRuleandconsistencyinitsimplementationandinterpretation. "8% ! ! ' 4789:;<+(yy' 4789:;<+" 3"   3 23  0    DataVerificationandValidation  3 ;݌l$ ' $ $ Ќ  ThedatatomeasureitscomplianceactivitiesisderivedfromOCRsCATSsystem.Aspreviouslynoted, &") duringFY2003,OCRhasimplementedasystemsmodernizationbeginningOctober1,2002,bybringingon &p#* lineanewwebbasedinformationmanagementsystem(PIMS)thatwillincludedocument,knowledge,and 'H$+ workflowmanagementcapabilitiesandadatabaseinarelationalformatinwhichanunderlyingtable ( %, structurewillenablegreatereaseofdatagenerationandanalysis.Thesystemalsowillcollectstaffresource |)%- andotherresourceinputs(e.g.,travel,expertconsultants). T*&. Briefly,asbackgroundofourdatacollectionefforts,OCRestablishedinitialFY1998baselinedataforthe ,(0 majorityofitscaserelatedoutcomemeasures.BecauseFY1998dataonoutreachactivities,collaborative ,X)1 activities,consultations,andtechnicalassistanceprovidedwereinadequatetoestablishbaselines,OCRused  FY1999datatoestablishbaselinesfortheselatteractivities.InFY2000,OCRestablishedabaselinefor \ theoneremainingcaserelatedoutcomemeasure(managedcarereviews)forwhichabaselinehadnotbeen 4 setunderthefirstfourpriorityareas.InFY2001,OCRcombinedseveraloutcomemeasuresintoa   consolidatedmeasurethatenablesgreaterflexibilityincomplianceprogramdesignandgreaterabilityto ` tailoritsactivitiestoaddressthespecificcircumstancesofindividualcoveredentities(customers).Inthe 8 FY2004GPRAPlan,OCRrestructureditsplanandestablishedanewObjectiveDToincreaseawareness  ofandcompliancewiththeHealthInformationPrivacyRule(_HIPAA_)andtwomeasuresbasedonOCRs l  experiencesincetheimplementationofthePrivacycomplianceprogrambegan(seeObjectiveD,1.and2.). D  Thedeterminationofwhatotherperformancemeasureswillbedevelopedforthe_HIPAA_Ԁprivacyactivity    willrequireseveralyearsofexperiencewiththenewprogram.ItislikelythatOCRwillneedatleastafull  p  yearofimplementation(onlypartofFY2003willbeafterthecompliancedateofApril13,2003)to  H  establishabaselinefortargetsandanothertwotothreeyearsofexperiencewithprivacyofhealth   informationactivitiesbeforeestablishinganyotherperformancemeasures. |  OCRusesanumberoftechniquesinordertovalidatedatacollected.Theseincludeconductingadditional ,  onsitecomplianceactivities,examiningfilesandotherrecords,andanalyzingdatafromindependent   sourcessuchasotherHHScomponents,stateorlocalgovernmentalagencies,orotherorganizations.Data X onthenumberofreviews,correctiveactionsandnoviolationfindings,outreachactivities,andother 0 collaborativeactivities,thenumberofconsultations/technicalassistanceprovided,andothercountsofOCR  contacts/projectsarereportedbyeachregiontoOCRheadquarters.Wheretherearevariancesfromwhatis d expected,OCRprogramoperationsstaffcontacttheregionstoverifysuchdifferences.Wheredatareported < forcomparableactivitiesacrossseveralregionsappeartobeskewedinagivenregionortwo,programstaff  followsuptoidentifyreasonsforsuchvariances.Inaddition,OCRwillcontinuetovalidatealldataasit h hasinthepastthroughperiodicmanagementreviewsorevaluationsofcivilrightsprogramimplementation. @ Inaddition,thereisclosemonitoringofdatareportedinitstrackingsystem.Whendataappeartobe  inconsistent,headquartersstaffnotifiesregionalstafftocheckthedata,verifyaccuracy,andmakechanges t asnecessary.Inanefforttoensurethatdatainputintothesystemareaccurate,headquartersstaffprovided L onsitetrainingtoallstaffinsixregionaloffices,whileworkingwiththeremainingfourregionsona $ monthlybasistoassistthemincollectingandenteringvaliddata. x OCRcontinuesitsefforttoensurethatthedataOCRcollectsareaccurateandeffectivelyverifiedandthat ( itsexplanationsofwhatiscollectedandreportedareconsistentwithOCRoperations.Asaresultofthe   HHS_OIG_ԀFY1999auditofOCRsPerformanceReport,OCRclarifiedseveraldefinitions.Forexample, \! OCRclarifiedthedefinitionof correctiveactiontoincludecomplaintinvestigationsorreviewsclosed 4 " duringtheyearforwhichthedataarereportedandinwhicharecipienthasalreadymadeoneormore  !# changestocomeintocompliance;and,ismakingsurethatallactivitiesreportedinitsdatasystemashigh !`$ priorityactivitiesareinfactincorporatedashighpriorityactivitiesinlettersoffindingsorother "8% documentationissuedbyOCR.#&t%%&t׶# &t%%&tBeginninginFY2003,outreachwillincludeonlyconsultations,technical # & assistance,andcollaborativeactivitiesthatarepartofanoverallsetofstrategicallyplannedactivitiesthat l$ ' buildupononeanothersystematicallytoaddressthehealthcare,socialservice,disability,orprivacy D%!( objectives.#&t%% &t#&t%%&tOCRanticipatesthatthenewPIMSwillvastlyimprovetheaccuracy,uniformity,andvalidation &") ofdataforGPRAreporting.DuringFY2004,OCRwillcontinuetocollectdatathatwillenable &p#* developmentandrefinementofoutcomebaselines.ThesebaselineswillenableassessmentofOCRs 'H$+ successinmeetingitsgoalofincreasingaccesstoandparticipationinHHSprogramsthroughthe ( %, preventionorcorrectionofunlawfuldiscriminatorybarriersandpractices.TheGPRAAnnualPerformance |)%- Planalsoincorporatesoutcomemeasuresthatservebothasmeasuresofoperationalefficiencyandas T*&. intermediateandinterimmeasuresuntilOCRhasbeenabletocollect,monitor,andvalidateatleastafull ,+'/ yearofdatareportedintothenewPIMStobeimplementedduringFY2003. ,(0  ,X)1 OnefactorthatmayaffectOCRsreportingonperformanceinvolveslimitationsofdata.OCRhadadapted  itsCATSinformationsysteminordertobeabletocaptureandanalyzepreandpostreview/complaint \ investigationdata.Asaresultofitsanalysisofdatareportedinfiscalyears2000through2002,OCRhas 4 determined,aspreviouslynoted,thattheoutcomemeasuresrequirecollectionofdatathatarenot   necessarilydirectlyrelatedtocomplianceinvestigationsorreviews.OCRhasfoundthatcoveredentities ` viewtheadditionaldatarequestedasintrusiveandwebelievethatcontinuingtoaskforsuchdataroutinely, 8 hashadachillingeffectonourabilitytoworkcooperativelytoseekvoluntarycompliance.Inthecontextof  PIMSimplementation,OCRisdevelopingasetofcomplianceoutcomesthatareadirectresultofOCRs l  complianceworkandthatwillnotrequirerecipientstoprovideanymoredatathanisnecessaryforOCRto D  makeacompliancedetermination.OCRsmodifiedoutcomeswilleliminatewhatmayhavebeenviewedas    burdensomeand/orduplicatereporting.  p  WherebaselinesweredevelopedinFY1998andFY1999,OCRhasevaluatedaccomplishmentofand,as   notedelsewhereinthisPlan,hasmodifiedmeasuresbasedonanalysisofdataavailablethroughitsCATS |  systemandineachsubsequentfiscalyear.ExternalfactorsthatmayaffectOCRsproposedoutcomes T  include: ,   = 4789:;<(xy' 4789:;<+" 3"   323  0    Legislation,AdministrativeAction,andCourtDecisions:0@ $ $Federalorstateadministrativeaction,court X actions,orchangesinlawsmayaffectOCRsabilitytoachieveitsoutcomes.Forexample,litigation 0 abouttheADA,TitleVI,orthePrivacyRuleandensuingcourtdecisionscouldchangeOCRsabilityto  conductenforcementactivitiesincertainareas. 3݌d $ $ Ќ  0  FiscalAvailability:Significantcutsinfundingforstateandlocalprogramsbudgetswouldhavea  deleteriouseffectonproposedoutcomes.Cutsinservicesinstateandlocalprogramswouldresultin h fewerminoritiesanddisabledpeoplebeingserved.Additionally,ifcommunitybasedgroupsandother @ organizationsexperiencecutsinfoundation,government,andprivatefunding,OCRmaynotbeableto  workaseffectivelywiththesegroupsasenvisionedbytheplan.t $ $ 0  EconomyandDemographics:ChangesintheeconomymayhaveanaffectonOCRsmeetingits $ outcomes.Forexample,ifunemploymentincreasessignificantly,theremaybeasmallerpoolof x availableadoptiveparents.Ifthatwerethecase,therewouldprobablybeanincreaseinthetimeall P children,includingminoritychildren,wouldhavetowaittobeadopted.Also,changesinthedemogra ( phicsofprogramparticipantsduetoavarietyoffactorscouldcauseOCRtomodifyprogramobjectives   relatedtominorityaccesstoservices.Anexampleofcircumstancesinwhichanobjectivemayhaveto \! bechangedwouldbeifthenumberofminorityparticipantsinawelfaretoworkprogramdecreasesdue 4 " tosuccessfuljobplacements. !# $ $ ! ! ' 4789:;<+(yx= 4789:;<" 3"   323  0    ݀TechnologyPlanning  3݌"8% $ $ Ќ    AlloftheperformanceobjectivesaredirectlylinkedtoOCRsFY2004budgetrequest.AsnotedinPartII, l$ ' Section2.1.1above,OCRsFY2004budgetrequestof$34,250,000reflectsbothanongoingcommitment D%!( tostrengthenHHScivilrightscomplianceprogramandcontinuingitsroleunder_HIPAA_.OCRresources &") willsupport:developmentofcomprehensive,effectivelyworkingplansforprovisionofservicestopersons &p#* withdisabilitiesinthemostintegratedsettingpossible(Olmstead);maximizingparticipationintheState 'H$+ ChildrensHealthInsuranceprogram(_SCHIP_)andMedicaidbyeliminatingdiscriminatorybarriersto ( %, participation;outreachandothercomplianceactivitiesrelatedtowelfarereformandcivilrights; |)%- nondiscriminatoryqualityhealthcarefocusedonracialandethnicdisparitiesinhealthcareandhealth T*&. status;and,languageaccess,includingimmigrantaccesstobenefitsforwhichtheyareeligible.InFY2004, ,+'/ OCRwillfocusonthepreviousprogramsandissuesinthecontextofensuringnondiscriminationinawide ,(0 varietyofhealthandsocialservicessettings.OCRsFY2004fundingincrementismadeupoffundsto ,X)1 supporttheallocationof12additionalFTEtoPrivacyRulefunctionsandtosupportbuiltinincreases(for  payrelatedcosts)offsetbysavings#&t%%&t׌#&t%%&t#X}X%&t՜#&t%XX}Ԁresultingfrommanagementandproductivityefficiencies.Thefunding \ willcontinuetosupportthelevelofstaffingandcomplianceactivitiesprojectedforFY2003. 4 #&t%%&t# &t%%&tWithrespecttohumanresourcesplanning,OCRsubmittedaworkforceplantotheformer_ASMB_Ԁandthe ` ImmediateOfficeoftheSecretaryinMarch2001withanaddenduminApril2001.Theplanassessed 8 variousstaffingandskillneedsassociatedwithcivilrightsandprivacyrightsissues.Further,theplannoted  thatinFY2001,OCRhadreorganizeditsheadquartersoperationtoincreasethespanofcontrolwhile l  reducingmanagementlayersinanefforttoensurethatexpertconsultationoncivilrightsauthoritiesis D  readilyavailabletofrontlinestaff.InFY2003andFY2004,OCRwillbuildonthisrefocusingofstaff    expertiseandoncontinuingtrainingandcapacitybuildingactivities.# X}X% &t_#  p  d   H   d ^zP(\X X}  [SummaryofChangesinFY2003FinalGPRAAnnualPerformancePlan   ^**"d ddd Xdd XXdd XXdd XXdd XXdd XXdd XXdd XXdd XXdd XXdd X" $ $*,s dd ,s dd ,s dd +  ) )OriginalFY2003Indicator 'x" 'Revised/NewFY2003/2004Indicator 'x" 'RationaleforChange #x"  # GoalI:Toincreasenondiscriminatoryaccessand  participationinHHSprograms.     GoalI:Toincreasenondiscriminatoryaccessand  participationinHHSprogramsandprotectthe    privacyofprotectedhealthinformation.  .  TherevisedgoaladdsOCRsnewresponsibilityfor   implementingtheHealthInformationPrivacyRule    (_HIPAA_).  .   ObjectiveA:AdoptionSubobjective1: Increase L #stateagenciesandadoptionagencies(local)found T tobeincompliancewiththenondiscrimination b  provisionsoftheSmallBusinessJobProtectionAct  h whileincreasingHHSOPDIVstaffs',grantees', v  programproviders',andfaithbasedandcommunity  | basedorganizations'knowledgeandunderstandingof   adoptionandfostercarenondiscrimination   requirements.     SubsumedinnewObjectiveB:Toincreaseaccessto L andreceiptofnondiscriminatorysocialservices, R whileprotectingtheintegrityofHHSFederal `  financialassistance.   f Theobjectiveismorebroadlyinclusiveofthefull L rangeofissues,socialserviceprograms,and R providersinwhichOCRactstoensure `  nondiscriminatoryaccesstoandreceiptofservices.  f Ittherebyaddressesabroaderrangeofpopulations t  andbarrierstoservicesfacedbythesegroups,while  z  reportingonmoreactivitiesthatsupport OneHHS  ! objectives.   "  ObjectiveA,Subobjective1Measures   8 # / 8 $ / $ 8 % $a.Increased#correctiveactions,noviolation V & findings,reviews,outreach,consultations,technical d ' assistance,andjointprojects.  j ( Sameasmeasure1.undernewObjectiveB.  V ) Nochange.  V * b.Decreased#orproportionofminoritychildren   + waitingadoptiveplacement.(developmentalwith , baselineyearofFY02)   - Subsumedinmeasure4.innewObjectiveB:   . Increasednumberofminoritypersonsprovided 0 accesstoandnondiscriminatorytreatmentin $1 programsorservicesincompliancewithTitleVI.  22 ThismeasuredirectlyrelatestheoutcomeofOCRs   3 complianceworktotherequirementsofTitleVIof 4 theCivilRightsActof1964.Itisameasureofhow  5 wellOCRisdoingitsworkanddistinguishesthe &6 effectofOCRsworkfromothercontributing 47 factors.  :8 c.Decreasedwaitingtimesforminoritychildren. X9 (developmentalwithbaselineyearofFY02)  f: Subsumedinmeasure2.innewObjectiveB: X; Numberofactionstakenbyrecipient/coveredentities j= toreducebarriers.  x> ThismeasuresdirectlytheresultsofOCRs X? compliancework.Thepreviousmeasurecouldnot f@ distinguishtheeffectofOCRsworkfromother lA contributingfactors.Giventhemorebroadly zB inclusiveobjective,thismeasurealsosubsumesthe C priormeasurewhileaccountingforawiderangeof  D otheroutcomesofOCRswork.  E None.  6F Newmeasure3.innewObjectiveB: 6G TheamountofHHSfundingreceivedbycovered JI entitiesthathavebeenfoundtobeincompliance,or PJ havemadechangestocomeintocomplianceon ^K issuesthathavebeeninvestigatedbyOCR. dL (developmentalthroughFY04)  rM Thismeasurewillenabledeterminationofafiscal 6N returnoninvestmentincivilrightsinvestigationsand <O reviewsthatsimultaneouslyprotecttherightsof JP HHSbeneficiariesandtheintegrityofprogramsand PQ servicesfinancedbyHHS.  ^R  ObjectiveB:ManagedCare  S Subobjective1: 󀀀Increase#managedcareplans T foundtobeincompliancewithTitleVI,Section504  U andtheAmericanswithDisabilitiesActwhile .V increasingmanagedcareplans'awarenessand 4W understandingofcivilrightsrequirements.  B X SubsumedinnewObjectiveA:Toincreaseaccessto  Y andreceiptofnondiscriminatoryqualityhealthcare Z andtreatment,whileprotectingtheintegrityofHHS [ Federalfinancialassistance.  ,\ Theobjectiveismorebroadlyinclusiveofthefull  ] rangeofissuesandhealthcaresettingsinwhich ^ OCRactstoensurenondiscriminatoryaccesstoand _ receiptofservicesandtreatment.Itthereby ,` addressesabroaderrangeofpopulationsandbarriers 2a toservicesandtreatmentfacedbythesegroups, @ b whilereportingonmoreactivitiesthatsupport One  Fc HHSobjectives.  T!d  ObjectiveB,Subobjective1Measures  r"e /r"f / $r"g $a.Increased#correctiveactions,noviolation # h findings,reviews,outreach,consultations,technical $ i assistance,andjointprojects.  $ !j Sameasmeasure1.undernewObjectiveA.  # k Nochange.  # l b.Increased#minoritypractitionersproviding %>"m servicesinmanagedcareplans.(developmentalwith L&"n baselineyearofFY02)  &R#o Subsumedinmeasure4.innewObjectiveA: %>"p Increasednumberofminoritypersonsprovided# X}X(\ ^zP?# ^zP(\X X} &P#r accessto,nondiscriminatorytreatmentin,andequal ^'#s opportunitytobenefitfromprogramsorservicesin 'd$t compliancewithTitleVI.  r($u ThismeasuredirectlyrelatestheoutcomeofOCRs %>"v complianceworktotherequirementsofTitleVIof L&"w theCivilRightsActof1964.Itisameasureofhow &R#x wellOCRisdoingitsworkanddistinguishesthe `'#y effectofOCRsworkfromothercontributing 'f$z factors.  t(${ c.Increased#interpreter/bilingualcontacts/hoursfor )&| LEPenrollees.(developmentalwithbaselineyearof *&} FY02)  *"'~ Subsumedinmeasure2.innewObjectiveA: )& Numberofactionstakenbyrecipient/coveredentities * ' toreducebarriers.  .+' ThismeasuresdirectlytheresultsofOCRs )& compliancework.Thepreviousmeasurecouldnot *& distinguishtheeffectofOCRsworkfromother *"' contributingfactors.Giventhemorebroadly 0+' inclusiveobjective,thismeasurealsosubsumesthe +6( priormeasurewhileaccountingforawiderangeof D,( otheroutcomesofOCRswork.  ,J) d.Increased#interpretercontacts/hoursfor d  hearing/speechimpairedindividuals.(developmental  withbaselineyearofFY02)  x Sameasabove.  d Sameasabove.  d None.  6 Newmeasure3.innewObjectiveA: 6 TheamountofHHSfundingreceivedbycovered J  entitiesthathavebeenfoundtobeincompliance,or 2  havemadechangestocomeintocomplianceon ^   issuesthathavebeeninvestigatedbyOCR.  F  (developmentalthroughFY04)  r   Thismeasurewillenabledeterminationofafiscal 6 returnoninvestmentincivilrightsinvestigationsand  reviewsthatsimultaneouslyprotecttherightsof J HHSbeneficiariesandtheintegrityofprogramsand 2 servicesfinancedbyHHS.  ^   ObjectiveC:LimitedEnglishProficiency(LEP)   Subobjective1: Increase#HHSgranteesand  v providersfoundtobeincompliancewithTitleVIin   LEPreviews/investigationswhileincreasingHHS .  OPDIVstaffs',grantees',programproviders',and    faithbasedandcommunitybasedorganizations' B  knowledgeandunderstandingofLEPpolicy *  guidance.  V  SubsumedinnewObjectivesAandB.   ObjectiveA:Toincreaseaccesstoandreceiptof   nondiscriminatoryqualityhealthcareandtreatment, ,  whileprotectingtheintegrityofHHSFederal    financialassistance. @  ObjectiveB:Toincreaseaccesstoandreceiptof T " nondiscriminatorysocialservices,whileprotecting < # theintegrityofHHSFederalfinancialassistance.  h $ Theissueofnationalorigindiscriminationraisedby  % limitedEnglishproficiencycrosscutsallhealthand  v& socialservicesprovidedthroughprogramsfundedby  ' HHS.SubsumingtheLEPobjectiveinthetwonew , ( objectivesfocusesattentiononoutcomesofOCRs   ) compliancework,ratherthanontheprocessesby @ * whichoutcomesareachieved.  ( +  ObjectiveC,Subobjective1Measures   , / - / $ . $a.Increased#correctiveactions,noviolation / findings,reviews,outreach,consultations,technical .0 assistance,andjointprojects.  1 Sameasmeasure1.undernewObjectivesA&B.  2 Nochange.  3 b.Increased#LEPpersonsserved.(developmental 44 withbaselineyearofFY02)  `5 Subsumedinmeasure4.innewObjectivesA&B: 46 Increasednumberofminoritypersonsprovided# X}X(\ ^zP# ^zP(\X X} F8 accessto,nondiscriminatorytreatmentin,andequal r9 opportunitytobenefitfromprogramsorservicesin Z: compliancewithTitleVI.# X}X(\ ^zPn# ^zP(\X X}  ; ThismeasuredirectlyrelatestheoutcomeofOCRs 4< complianceworktotherequirementsofTitleVIof `= theCivilRightsActof1964.Itisameasureofhow H> wellOCRisdoingitsworkanddistinguishesthe t? effectofOCRsworkfromothercontributing \@ factors.  A c.Increased#interpreter/bilingualcontacts/hoursfor B LEPenrollees.(developmentalwithbaselineyearof 0C FY02)  D Subsumedinmeasure2.innewObjectivesA&B: E Numberofactionstakenbyrecipient/coveredentities G toreducebarriers.  BH ThismeasuresdirectlytheresultsofOCRs I compliancework.Thepreviousmeasurecouldnot 0J distinguishtheeffectofOCRsworkfromother K contributingfactors.Giventhemorebroadly DL inclusiveobjective,thismeasurealsosubsumesthe ,M priormeasurewhileaccountingforawiderangeof XN otheroutcomesofOCRswork.  @O d.Increased#servicesforLEPpersons. ^P (developmentalwithbaselineyearofFY02) Q   pR Sameasabove.  ^S Sameasabove.  ^T e.Increased#translateddocumentsavailable. 0U (developmentalwithbaselineyearofFY02)  V Sameasabove.  0W Sameasabove.  0X None.   4Y Newmeasure3.innewObjectivesA&B:  4Z TheamountofHHSfundingreceivedbycovered !H\ entitiesthathavebeenfoundtobeincompliance,or t"] havemadechangestocomeintocomplianceon "\^ issuesthathavebeeninvestigatedbyOCR #_ (developmentalthroughFY04)  $p` Thismeasurewillenabledeterminationofafiscal  4a returnoninvestmentincivilrightsinvestigationsand `!b reviewsthatsimultaneouslyprotecttherightsof !Hc HHSbeneficiariesandtheintegrityofprogramsand t"d servicesfinancedbyHHS.  "\e  ObjectiveD:TemporaryAssistanceforNeedy .% f Families(TANF) %!g Subobjective1: Increase#stateandlocalTANF B&!h agenciesandserviceprovidersfoundtobein &,"i compliancewithTitleVI,Section504andADA X'"j whileincreasingstateandlocalwelfareagencies'and '@#k serviceproviders',andfaithbasedandcommunity l(#l basedorganizations'knowledgeandunderstanding (T$m ofTitleVI,Section504andADArequirementsin )$n theadministrationofTANF.   *h%o SubsumedinnewObjectiveB:Toincreaseaccessto .% p andreceiptofnondiscriminatorysocialservices, %!q whileprotectingtheintegrityofHHSFederal B&!r financialassistance.  &*"s Thepreviousobjectivefocusedonasingleprogram .% t andtheprocessesbywhichoutcomesareachievedin %!u thatsingleprogramratherthanontheoutcomes B&!v themselves.ThenewobjectiveintowhichtheTANF &*"w objectivehasbeensubsumedcoversabroaderarray V'"x ofservicesthatarebroughttobearinincreasingself '>#y sufficiency,whilefocusingonOCRsdirect j(#z complianceresponsibilities.  (R${  ObjectiveD,Subobjective1Measures  (+&| /(+&} / $(+&~ $a.Increased#correctiveactions,noviolation F,' findings,reviews,outreach,consultations,technical ,.( assistance,andjointprojects.  Z-( Sameasmeasure1.undernewObjectiveB.  F,' Nochange.  F,' [    b.Increased#minority(includingnational d  origin/LEP)personsserved.(developmentalwith  baselineyearofFY02)  x Subsumedinmeasure4.innewObjectiveB: d Increasednumberofminoritypersonsprovided v # X}X(\ ^zPo# ^zP(\X X}accessto,nondiscriminatorytreatmentin,andequal  opportunitytobenefitfromprogramsorservicesin , compliancewithTitleVI.# X}X(\ ^zPB.# ^zP(\X X}    ThismeasuredirectlyrelatestheoutcomeofOCRs d  complianceworktotherequirementsofTitleVIof   theCivilRightsActof1964.Itisameasureofhow x  wellOCRisdoingitsworkanddistinguishesthe   effectofOCRsworkfromothercontributing . factors.   c.Increased#disabledpersonsserved,including 4 familieswithdisabledchildren.(developmental)  `  Subsumedinmeasure4.innewObjectiveB: 4 Increasednumberofpersonswithdisabilities  F providedaccessto,nondiscriminatorytreatmentin, r  andequalopportunitytobenefitfromprogramsor  Z servicesincompliancewiththeAmericanswith   DisabilitiesActand/orSection504ofthe  n RehabilitationActof1973,asamended.    ThismeasuredirectlyrelatestheoutcomeofOCRs 4 complianceworktotherequirementsofthe `  AmericanswithDisabilitiesActand/orSection504  H oftheRehabilitationActof1973,asamended.Itisa t  measureofhowwellOCRisdoingitsworkand  \ distinguishestheeffectofOCRsworkfromother   contributingfactors.   p  None.    ! Newmeasure3.innewObjectiveB:   " TheamountofHHSfundingreceivedbycovered * $ entitiesthathavebeenfoundtobeincompliance,or V % havemadechangestocomeintocomplianceon > & issuesthathavebeeninvestigatedbyOCR. j ' (developmentalthroughFY04)  R ( Thismeasurewillenabledeterminationofafiscal   ) returnoninvestmentincivilrightsinvestigationsand B * reviewsthatsimultaneouslyprotecttherightsof * + HHSbeneficiariesandtheintegrityofprogramsand V , servicesfinancedbyHHS.  > -  ObjectiveE:Increasenondiscriminatoryquality n . healthcareforminorities.Subobjective1:  /  Increase#HHSprovidersfoundtobeincompliance $0 withTitleVIwhileincreasingthe#ofhealthcare  1 providers,medicalschools,faithbasedand 82 communitybasedorganizations,professional  3 organizations,HHSagencies,andstateandlocal L4 agenciesworkingincoalitionstoimprove 45 nondiscriminatoryqualityhealthcareforminorities `6 includingmentalhealthcareandorganandtissue H7 donation/transplantation.  t8 SubsumedinnewObjectiveA:#^zP(\(\ ^zPs##X}X(\^zP./# X}XXX} ^zP(\X X}ԀToincreaseaccessto n 9 andreceiptofnondiscriminatoryqualityhealthcare  : andtreatment,whileprotectingtheintegrityofHHS $; Federalfinancialassistance.# X}X(\ ^zP{;# ^zP(\X X}#^zP(\(\ ^zP\;# ^zP(\(\^zP   < Theobjectiveismorebroadlyinclusiveofthefull n = rangeofissuesandhealthcaresettingsinwhich  > OCRactstoensurenondiscriminatoryaccesstoand $? receiptofservicesandtreatment.Itthereby  @ addressesabroaderrangeofpopulationsandbarriers 8A toservicesandtreatmentfacedbythesegroups,  B whilereportingonmoreactivitiesthatsupport One LC HHSobjectives.  4D  ObjectiveE,Subobjective1Measures  E /F / $G $a.Increased#correctiveactionsandnoviolation H findings,reviews,outreach,consultations,technical :I assistance,andcollaborativeactivities. "J (developmental)  NK Sameasmeasure1.undernewObjectiveA.  L Nochange.  M None.  jN Newmeasure3.innewObjectiveA: jO TheamountofHHSfundingreceivedbycovered ~Q entitiesthathavebeenfoundtobeincompliance,or fR havemadechangestocomeintocomplianceon S issuesthathavebeeninvestigatedbyOCR. zT (developmentalthroughFY04)  U Thismeasurewillenabledeterminationofafiscal jV returnoninvestmentincivilrightsinvestigationsand RW reviewsthatsimultaneouslyprotecttherightsof ~X HHSbeneficiariesandtheintegrityofprogramsand fY servicesfinancedbyHHS.  Z  ObjectiveF:MostintegratedSettingforPersons  [ withDisabilities(MIS/ Olmstead )Subobjective L!\ 1: Increasestateandlocalagenciesandservice !6] providersfoundincompliancewithSection504and d"^ ADAwhileincreasingHHSOPDIVstaffs',grantees', "L_ programproviders',andfaithbasedandcommunity x#` basedorganizations'knowledgeofrequirementsto $`a providehealthandhumanservicesinmostintegrated $b settingstopersonswithdisabilities.  %t c SubsumedinnewObjectiveC:Toincreaseaccessto  d andreceiptofcommunitybasedservicesand L!e nondiscriminatorytreatmentforpersonswith !4f disabilities,whileprotectingtheintegrityofHHS `"g Federalfinancialassistance.# X}X(\ ^zP<# ^zP(\X X}  "Hh Modifyingthewordingofthisobjectivefocuses  i attentiononoutcomesofOCRscompliancework, L!j ratherthanontheprocessesbywhichoutcomesare !4k achieved.  `"l  ObjectiveF,Subobjective1Measures  4&!m /4&!n / $4&!o $a.Increased#correctiveactionsandnoviolation R'"p findings,reviews,outreach,consultations,technical ':#q assistance,andjointprojects(developmental)  f(#r Sameasmeasure1.undernewObjectiveC.  R'"s Nochange.  R'"t b.Increased#peoplewithdisabilitiesreceiving )$u servicesinthemostintegratedsetting. *l%v (developmental)  *%w Subsumedinmeasure4.innewObjectiveC: )$x Increasednumberofpersonswithdisabilities *%z providedaccessto,nondiscriminatorytreatmentin,  +~&{ andequalopportunitytobenefitfromprogramsor +'| servicesincompliancewiththeAmericanswith 4,'} DisabilitiesActand/orSection504ofthe ,(~ RehabilitationActof1973,asamended.# X}X(\ ^zPG# ^zP(\X X}  H-( ThismeasuredirectlyrelatestheoutcomeofOCRs )$ complianceworktotherequirementsofthe *l% AmericanswithDisabilitiesActand/orSection504 *% oftheRehabilitationActof1973,asamended.Itisa "+& measureofhowwellOCRisdoingitsworkand + ' distinguishestheeffectofOCRsworkfromother 6,' contributingfactors.  ,( /d / /d / $d $None.  $ ObjectiveD:Increaseawarenessofandcompliance $ withtheHealthInformationPrivacyRule(_HIPAA_).   (NewObjective)  8 OCRsnewprogramresponsibilitywithaneffective $ compliancedateinmidFY03.      NewObjectiveDMeasures  T  /T  / $T  $None.  r   1.Increased#correctiveactions,noviolation r  findings,reviews,outreach,consultations,technical  Z assistance,andjointprojects.(developmental   withbaselineyearofFY03)   n Thismeasureforthenew_HIPAA_ԀPrivacyRule r  complianceprogramisbasedonOCR'sexperiencein  Z itscivilrightscompliancework.Therewehave   learnedthataflexibleapproachisrequiredto  n increasecompliancethroughtailoringactivitiesto   addresstheuniquecircumstancesofcoveredentities, $  ratherthanadheringtoapredeterminedsetof   activities.  8  None.  V  2.Numberofactionstakenbycoveredentities V  indicatingincreasedawarenessofandcompliance >  withtheHealthInformationPrivacyRule. j  (developmentalwithbaselineyearofFY03)# X}X(\ ^zPM# ^zP(\X X}#^zP(\(\ ^zP<# ^zP(\(\^zP  R  ThismeasuredirectlyrelatestheoutcomeofOCRs V  _HIPAA_Ԁprivacyoutreach,publiceducation,andother >  complianceworktotherequirementsoftheRule.  j ! /n " / /n # / $n $ $ GoalII:Toenhanceoperationalefficiency  . % Same.  . & Nochange.  . '  ObjectiveA:Increase%ofresourcesfocusedon L( highpriorityissues. 󀀀 Subobjective1: Increase% 4) and/or#ofOCRcomplianceactivitiesfocusedon b* highpriorityissues.  J+ ObjectiveA:Increasetheefficiencyofcase L, processing.  4- OCRisfocusingonoutcomesofallofitsactivities L. andwhatwereformerlypriorityissuesarebeing 4/ subsumedwithinthemoreinclusiveOCRsnew `0 objectivesunderGoalI.Theseobjectivearemore H1 broadlyinclusiveofthefullrangeofissues,health t2 care,andsocialserviceprogramsandprovidersin \3 whichOCRactstoensurenondiscriminatoryaccess 4 toandreceiptofservices.  p5  ObjectiveA,Subobjective1Measures  06 /07 / $08 $a.Increased%and/or#correctiveactions,no N9 violationfindings,andoutreachactivitiesthatare 6: focusedonhighpriorityissues.  b; Deleted.  N< Sameasabove.  N=  Subobjective2: Decreaseaverageageofpriority > caseclosures.   j? Subobjective1:Decreaseaverageageofallcase @ closures.   hA Sameasabove.  B  ObjectiveA,Subobjective2Measures  *C /*D / $*E $a.Decreasedaverageageofallprioritycase HF closures.  0G 1.Decreasedaverageageofallcaseclosures.  HH Sameasabove.  HI  ObjectiveB :Streamlinemanagementstructureand NJ increasestafftosupervisorratio. Subobjective1  | K Streamlineregionalmanagementstructureby !fL eliminatingBranchChiefpositions.  !M Deleted.  NN Thiswasaccomplishedbytheendof2002.  NO  ObjectiveB,Subobjective1Measures  "P /"Q / $"R $a.Establishconsistentregionalstructurewithtwo #,S managers(RegionalManagerandDeputy).  X$T Deleted.  #,U Sameasabove.  #,V  Subobjective2: Increasestafftosupervisorratio.  v% W Deleted.  v% X Sameasabove.  v% Y  ObjectiveB,Subobjective2Measures  &!Z /&![ / $&!\ $a.Increasedstafftosupervisorratio.  '#] Deleted.  '#^ Sameasabove. '#_ 7    n(#_ # X}X(\ ^zPV#@22\ PerformanceMeasurementLinkages      r        r      @ X X}Լ   r *"Ad8ds dd s s dd s s dd s " $ $,dd ,dd ,Fdd ,Fdd ,dd ,dd +  ( (6*P ,Xr6HHS R STRATEGICOBJECTIVE:Xr*P 0 g: t    <2#  "nny$ <OCRGPRAGOALS/OBJECTIVES .$x " .6*P ,Xr6 %   %  Goal1:ToincreasenondiscriminatoryaccessandparticipationinHHSprogramsand j  protecttheprivacyofprotectedhealthinformation *    *:Xr*P 0 i:]i  Goal2:ToEnhance j Operational   Efficiency " " "6*P ,Xr6 ! t  !}jObjectiveA:  T   Increaseaccessto   andreceiptof  .  nondiscriminatory P  qualityhealthcare  j  andtreatment,   whileprotectingthe *  integrityofHHS D  Federalfinancial f  assistance. '  'kObjectiveB:  T   Increaseaccessto   andreceiptof  .  nondiscriminatory P  socialservices,while  j ! protectingthe  " integrityofHHS * # Federalfinancial D $ assistance. 'f % ':Xr*P 0 j:(m<%XXXr<ObjectiveC:  T&   Increaseaccessto  ( andreceiptof  . ) communitybased P * servicesand  j + nondiscriminatory  , treatmentforpersons * - withdisabilities, D . whileprotectingthe f / integrityofHHS  0 Federalfinancial 1 assistance.# X}X  @.f# @ X X} '@2 'oObjectiveD:  T3   Increase  5 awarenessofand  . 6 compliancewith P 7 theHealth  j 8 Information  9 PrivacyRule * : (_HIPAA_) 'D ; 'Dq   ObjectiveA:  T< Increase%of  > resourcesfocusedon  . ? highpriorityissues P @ zr  Goal1:Reducethemajor rA threatstothehealthandwell B beingofAmericans. '*C '6sX 'rD" ' 'rE" ' 'rF" ' 'rG" ' rH" Goal2:Enhancetheability \I ofthenationshealthcare ~J systemtoeffectivelyrespond K to_bioterrorism_Ԁandother 6L publichealthchallenges. 'XM 'X '\N" ' '\O" ' '\P" ' '\Q" ' \R" #@   @W#@  @Goal3:Increasethe S percentageofthenation's (T childrenandadultswhohave BU accesstohealthcareservices, dV andexpandconsumer ~W choices. 'X '#@  @v# @  @X 'Y" ' 'Z" 'X '[" 'X '\" '* ]" #@   @w#@  @Goal5:Improvethequality N^ ofhealthcareservices. 'p_ '#@  @x# @  @X 'N`" ' 'Na" ' 'Nb" 'X 'Nc" '* Nd" #@   @y#@  @Goal6:Improvethe e economicandsocialwell @ f beingofindividuals,families  Zg andcommunities,especially |!h thosemostinneed. '"i '#@  @z# @  @ 'j" 'X 'k" 'X 'l" ' 'm" '* n" #@   @{#@  @Goal7:Improvethestability L#o andhealthydevelopmentof #f p ournation'schildrenand $!q youth. '&%!r '#@  @|# @  @ 'L#s" 'X 'L#t" 'X 'L#u" ' 'L#v" '* L#w" #@   @}#@  @Goal8:Achieveexcellence X&"x inmanagementpractices. '&r#y '#@  @~# @  @ 'X&"z" ' 'X&"{" ' 'X&"|" ' 'X&"}" 'X"X&"~" "*ThisGPRAobjectiveisfocusedonimprovingoperationalefficiencyandthereforeincreasingtheproportionofresourcesbeingdevotedtoall b($ issues.Therefore,insomesense,theoperationalefficiencygoalsupportsalloftheHHSStrategicPlanobjectivesnotedabovebecausesuccessunder )|% OCRsefficiencygoalwillresultinincreasedresourcesfocusedonpriorityissuesthataddresstheHHSgoalsandotherinitiativessuchas:improved )& humancapitalmanagement,improvedfinancialmanagement,andintegratingbudgetandperformanceinformation.#@   @##X}X @p# <*&