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FY 2007 Budget in BriefGeneral Departmental ManagementOn this page: General Departmental Management Overview Table
General Departmental Management (GDM) supports the Secretary in his role as chief policy officer and general manager of the Department. General Departmental ManagementThe FY 2007 budget request for GDM provides a total program level of $413 million, including appropriations of $368 million, interagency transfers of $40 million in evaluation funds, and $5 million in health care fraud and abuse funds. The GDM account supports those activities associated with the Secretary's roles in administering and overseeing the organization, programs, and activities of the Department. These activities are carried out through 15 Staff Divisions (STAFFDIVs). The GDM budget request for FY 2007 totals $413 million an increase of $10 million or 3 percent above the comparable FY 2006 level. The GDM request provides funding for the following activities: Office of Population Affairs (OPA/Adolescent Family Life (AFL): The AFL request of $30 million will continue to provide support for the AFL demonstration and research program authorized under Title XX of the Public Health Services (PHS) Act. Through the grants awarded under this program, AFL provides funding in three areas; care demonstration projects, prevention projects, and research projects. This request includes $13 million in abstinence-only prevention projects, as defined by Welfare Reform legislation (P.L. 104-193). Office of Minority Health (OMH): The OMH request of $46 million, a net $10 million decreasefrom FY2006, provides funding to continue disease prevention, health promotion, service demonstration, and educational efforts to reduce and ultimately eliminate disparities for racial and ethnic minority populations. The reduction is attributed to a FY 2006 Congressional earmark which is not continued in FY 2007. Office on Women's Health (OWH): The OWH request of $28 million, the same as the FY 2006 level, will provide funding to continue the advancement of women's health programs through the promotion and coordination of research, service delivery, and education - both throughout HHS agencies and offices, with other government organizations, and with consumer and health professional groups. Minority HIV/AIDS: The FY 2007 request includes $52 million, the same level as FY 2006, to support innovative approaches to HIV/AIDS prevention and treatment in minority communities heavily impacted by this disease. These funds allow the Department to continue priority investments and public health strategies targeted to reduce the disparities and burden of HIV/AIDS in racial and ethnic minority populations. Afghanistan: Included in the FY 2007 request for the Office of Global Health Affairs (OGHA) is $6 million to continue support of HHS health care initiatives in Afghanistan, particularly in the areas of maternal and child health. Embryo Adoption Awareness Campaign: The FY 2007 budget request includes $2 million to continue the Embryo Adoption public awareness campaign grant award program. Commissioned Corps: The FY 2007 budget request includes $14 million for the Transformation of the Public Health Services (PHS) Commissioned Corps, an increase of $10 million above FY 2006. This is the Department's multi-year process to revitalize and improve the Corps' ability to respond to public health emergencies and deliver timely and effective public health services in underserved and hazardous situations. This effort will involve modernizing the force strength and management of the Corps, streamlining the assignment and deployment process, and increasing our ability to recruit talented candidates to become Corps officers. The FY 2007 funding will be used to develop new systems to support total force management; train and equip officers to respond to emerging public health threats and situations; and to improve response operations and develop a team-oriented deployment process. Other General Departmental Management (GDM): The FY 2007 budget request includes $190 million to fund offices which provide leadership, policy, legal, and administrative guidance to HHS components. One of the offices included in Other GDM is the Office on Disability (OD). OD has been charged to: lead the HHS New Freedom Initiative; and oversee, coordinate, develop, and implement disability programs and initiatives within HHS that affect persons with disabilities. Office of Medicare Hearings and Appeals Overview Table
The Office of Medicare Hearings and Appeals provides the basic mechanisms through which individuals and organizations who are dissatisfied with Medicare determinations affecting their rights to, or their participation in, the Medicare program may administratively appeal these determinations, in accordance with the requirements of the Administrative Procedures Act and the Social Security Act. Office of Medicare Hearings & AppealsThe FY 2007 budget request for the Office of Medicare Hearings and Appeals (OMHA) is $74 million, an increase of $15 million over the FY 2006 level. Funds are being requested from the Federal Hospital Insurance (HI) and Supplemental Medical Insurance (SMI) Trust Funds to hear cases under Title XVIII of the Social Security Act, and related provisions in Title XI of the Act. The creation of OMHA was mandated by Section 931 of Public Law 108-173, the Medicare Prescription Drug, Improvement, and Modernization Act (MMA), enacted on December 8, 2003. MMA transferred the responsibility for hearing Medicare appeals at the Administrative Law Judge (ALJ) level - the third level of Medicare claims appeals - from the Social Security Administration (SSA) to the Office of the Secretary at HHS. The Medicare Benefits Improvement Protection Act of 2000 (BIPA) also mandated that ALJ appeals be heard within 90 days after receipt of a request from a Medicare appellant for such a hearing. In July 2004, the OMHA Transition office was created to manage the transfer of the ALJ appeals function from SSA, establish OMHA, and enable OMHA to begin hearing ALJ cases during the last quarter of FY 2005. The newly-hired Acting Chief ALJ assumed full responsibility for OMHA operations in March 2005. OMHA officially opened its doors on July 1, 2005, and is now functionally staffed and operational. OMHA's central office and Atlantic field office are co-located in Arlington, Virginia. Other field offices include: the Southern field office in Miami, Florida; the Midwestern Field Office in Cleveland Ohio; and the Western Field Office in Irvine, California. Additionally, OMHA utilizes video-teleconferencing to provide appellants with more timely hearings, closer to their homes, and with more access points. With the requested funding level of $74 million, OMHA will be able to process the full ALJ appeal workload for Medicare Parts A, B, C and D cases received within the BIPA mandated timeframe by utilizing state-of-the-art technology, hiring appropriate levels of staffing and increasing access to hearing sites and services by appellants. Emergency Preparedness Overview Table
Emergency PreparednessTo protect our Nation from the threat of pandemic influenza, the FY 2007 request includes $352 million in HHS-wide funding to build on current efforts to implement the HHS Pandemic Influenza Plan. The budget also includes a $2.3 billion allowance for the next phase of critical preparedness activities needed to reach our goals of:
The $2.3 billion is shown in the budget as an allowance, which means a formal request for these funds will be transmitted to Congress in the coming months. Also included in the FY 2007 budget request is approximately $4.4 billion designated to protect Americans from a possible terrorist attack. Funding for these activities is appropriated to the Public Health and Social Services Emergency Fund (PHSSEF) and to agencies. The PHSSEF request includes $82 million in FY 2007 and finances HHS preparedness and response activities to protect the Nation against bioterrorist attacks and other public health emergencies. PANDEMIC INFLUENZA When major changes occur to the influenza strain genetic structure, widespread disease and death can result. Animals are the most likely reservoir for these emerging viruses, and avian viruses have played a role in the three such global events called pandemics - that occurred in the 20th century. The current pandemic influenza threat, the H5N1 virus strain, stems from an outbreak of avian influenza in Asia and Europe. The ability of the H5N1 virus to infect a wide range of hosts, including birds and humans, is of great concern to the public health community. Although the virus has not yet shown an ability to transmit efficiently between humans, through genetic mutation or exchange of genetic material with a human influenza virus, it might acquire this capability. While it is impossible to know whether the currently circulating H5N1 virus will cause a human pandemic, such a pandemic could cause an additional 90,000 to 300,000 + deaths in the U.S., especially if adequate vaccines were not available quickly. Once a pandemic began, there would be a small window of opportunity to accomplish the necessary research, development, and delivery of vaccines required to mitigate its impact. According to Secretary Leavitt: "...Preparation saves lives. We have an opportunity to become the first generation in history to prepare for a pandemic." To engage in pandemic influenza preparation activities, in FY 2006, the Administration announced an emergency budget request of $7.1 billion, of which $6.7 billion was for HHS pandemic influenza activities. The HHS request was broken down into funding needs over the course of three years, $3.2 billion in FY 2006, $2.3 billion in FY 2007, and $1.1 billion in FY 2008. Congress appropriated $3.3 billion in emergency funding in FY 2006 for HHS. Following the release of this emergency budget request, HHS released the HHS Pandemic Influenza Plan, a detailed guide for how the Nation's healthcare system can prepare and respond to an influenza pandemic. The HHS plan delineates four components of preparedness and response necessary to effectively respond to a pandemic, which include:
Of the $3.3 billion FY 2006 emergency funding total, approximately $2.3 billion is funding activities designed to increase vaccine production capacity and stockpiles of vaccines and antivirals. Specifically, $1.6 billion supports private sector contracts to:
Additionally, HHS is allocating $350 million to fund advanced development work on promising antiviral drugs and antigen-sparing strategies that would decrease the amount of vaccine needed to protect an individual. Approximately $361 million will finance the procurement of enough antiviral courses to treat 20 million people and six million additional courses designated to contain one to two isolated domestic outbreaks. To help create a seamless network of Federal, State, and local preparedness, $520 million is funding a variety of State and local preparedness activities and subsidizing State purchases of antivirals. An additional $162 million in emergency funding will go to increase supplies needed in a pandemic, such as ventilators and personal protective equipment in the Strategic National Stockpile. The Centers for Disease Control and Prevention (CDC) will invest $200 million to intensify surveillance, containment, and outbreak response measures and establish additional laboratory capacity. Additionally, $96 million is funding international, communications, and research activities within the Office of the Secretary (OS) and the National Institutes of Health (NIH), and $20 million is supporting the Food and Drug Administration's (FDA) work with influenza vaccine manufacturers. The FY 2007 budget includes a $2.3 billion allowance related to the next phase of critical preparedness activities outlined in the National Strategy for Pandemic Influenza, consistent with the President's FY 2006 emergency request of $7.1 billion, and $352 million in annual funding. The $2.3 billion will support planned efforts to expand:
An additional $352 million is requested in the budgets of the CDC, FDA, NIH, and OS and will finance ongoing activities including:
Of this total, $145 million will support international efforts designed to strengthen the public health and vaccine manufacturing infrastructure, expand surveillance systems, and improve preparedness and response capabilities in countries in Southeast Asia with the highest numbers of confirmed H5N1 cases. Pandemic Influenza
Terrorism Preparedness The HHS FY 2007 request includes $4.4 billion for terrorism preparedness activities, a net increase of $178 million above FY 2006. PHSSEF Activities: Of the terrorism preparedness total request, $81.6 million is funded through the PHSSEF. These funds will support activities within the Office of the Secretary (OS), including the Mass Casualty Initiative, the Medical Reserve Corps, cybersecurity efforts for the Department, and ongoing operations, emergency response, international surveillance activities, and targeted advanced research projects in the Office of Public Health Emergency Preparedness. The $20 million increase over FY 2006 will support the OS portion of the Mass Casualty Initiative, and the remainder of funds will support:
In addition to funding in the PHSSEF, another $4.3 billion in bioterrorism funding is requested directly in the appropriations for CDC, HRSA, FDA, NIH, and General Departmental Management. Highlighted Terrorism Preparedness Activities Morbidity, loss of human life, and economic disruption caused by a terrorist attack could be substantially reduced by detecting and containing an infectious outbreak early, ensuring proper preparedness and response to an event, and having the countermeasures needed to treat and protect citizens against potential harmful exposures. Detection and Containment: The FY 2007 President's Budget request supports the goal to rapidly contain and detect an outbreak by providing continued funding for CDC's Biosurveillance Initiative. This funding will allow CDC to improve the capabilities of the existing quarantine stations, expand the number of stations, and expand critical ongoing work in BioSense, an advanced approach to infectious disease surveillance capable of highlighting a potential outbreak early. The request also includes increased funding of $3 million in CDC to develop techniques that will improve CDC and State and local health departments' ability to rapidly detect exposure to or contamination by botulinum toxin and other toxins used as bioweapons. The development of these techniques will improve early detection, leading to prompt treatment and prevention of additional exposure. FDA also plays a critical role in early detection through its food defense program. To protect our Nation's food supply, $178 million, an increase of $20 million over FY 2006, will continue support for food defense activities, such as developing analytic surge testing capacity for biological, chemical, and radiological threat agents for the Food Emergency Response Network (FERN). FDA will also work to coordinate food surveillance activities within the Biosurveillance Initiative. Emergency Preparedness and Response: To minimize injury and loss of life resulting from a terrorist attack, our Nation must also have the ability to effectively prepare for and respond to such an event. CDC and HRSA continue to demonstrate a strong commitment to prepare States and local public health departments and hospitals for public health emergencies and acts of bioterrorism. Approximately $7 billion will have been invested between FY 2002 and FY 2006 by CDC and HRSA in these efforts. A further $1.3 billion is requested for such efforts in FY 2007. The FY 2007 President's Budget also includes $79 million within HHS for the Mass Casualty Initiative. Since FY 2002, HRSA has funded an expansion of State and local hospital surge capacity to be able to respond to a mass casualty event involving the use of weapons of mass destruction. The FY 2007 Mass Casualty Initiative builds on these activities, and the requested funds will support the four-pronged initiative:
Protection and Treatment: A vital part of our bioterrorism readiness efforts includes the ability to quickly protect Americans that have been exposed to a biological, chemical, or radiological threat agent and to treat those who have become sick following an exposure. Research activities in this arena are critical, because our Nation's ability to counter bioterrorism ultimately depends on the state of biomedical science. The FY 2007 President's Budget includes $1.9 billion for biodefense efforts within the NIH. These funds will support basic and applied research on agents with bioterrorism potential and advanced development efforts, which will lead to the availability of new or improved vaccines and therapies created to protect or treat persons exposed to threat agents. Of this total, NIH will invest $160 million for the advanced development of biodefense countermeasures that are priority Project BioShield acquisition targets. This represents an increase of $110 million over the FY 2006 level. As in FY 2006, $96 million will be designated for targeted research efforts to develop medical countermeasures against radiological, nuclear, and chemical threats. For many threat agents, effective countermeasures, such as vaccines and pharmaceuticals, already exist and are available for purchase. In the event of a large scale terrorist attack, rapid access to large quantities of these vaccines and medications is critical for saving the lives of those exposed. The FY 2007 President's Budget includes $593 million, an increase of $68 million over FY 2006, for CDC's Strategic National Stockpile (SNS), a federally-owned repository of these types of countermeasures. Additionally, the SNS contains medical supplies and hospital beds that would be needed in a mass casualty event. As a critical part of our Nation's defense against a bioterrorist attack, SNS funding will continue to support the ability to distribute these assets anywhere in the country within 12 hours of an event. Increasing State and Local Preparedness for Bioterrorism Events CDC's Terrorism Preparedness and Emergency Response program enhances the ability of the Nation's healthcare system to effectively respond to bioterrorism and other public health challenges. CDC addresses the ongoing problem of threats from intentional release of smallpox, anthrax or plaque, chemical attacks and other threats such as an influenza pandemic. CDC's Strategic National Stockpile (SNS) supplies access to medical countermeasures for these threats quickly when needed. However, to be effective, State and local public health agencies must be prepared to use material contained in the SNS. In 2005, CDC exceeded its goal of 70 percent for State and local preparedness, with 76 percent (41 out of the 54 States and directly-funded cities) meeting the minimum standards for demonstrating preparedness to use SNS assets. The FY 2007 target is to achieve a level of 90 percent of grantees meeting the minimum standards. Terrorism Preparedness Table
Office of the National Coordinator for Health Information Technology
The Office of the National Coordinator for Health Information Technology provides leadership for the development and nationwide implementation of an interoperable health information technology infrastructure to improve the quality and efficiency of health care and the ability of consumers to manage their care and safety. The FY 2007 budget request includes a total of $116 million for the Office of the National Coordinator for Health Information Technology (ONC). ONC was created in April 2004 by Presidential Executive Order, to address strategic planning, coordination, and analysis related to key technical, economic and other issues surrounding the public and private adoption of health information technology (health IT). ONC is well underway with initiatives to create adoption breakthroughs and to develop industry infrastructure to realize the President's goal. This request will support key initiatives and activities that will be accomplished through strategic partnerships and coordination in the public and private sectors, including:
In addition to funds requested within ONC, the FY 2007 request includes $50 million in the Agency for Healthcare Research Quality to advance the use of health IT to enhance patient safety. There is also $4 million in the Office of the Assistant Secretary for Planning and Evaluation for independent evaluations of EHR adoption and economic factors influencing health IT implementations in the health sector. Health Information Technology as a Tool During National Disasters During Hurricane Katrina, thousand so patients' medical records were destroyed and many patients and health professionals did not have access to medication and prescription drug records. The Office of the national Coordinator for Health Information Technology facilitated a collaborative response to Hurricane Katrina that involved more than 150 organizations. These organizations developed and launched KatrinaHealth.org, an online service for authorized health professionals to gain electronic access to the medication history and prescriptions for evacuees. The site enables authorized physicians and pharmacies to review critical medications, coordinate care, and avoid potential medication errors, when renewing or prescribing new medications for 1.1 million Gulf Coast evacuees. |
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Last revised: February 20, 2006
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