WPC  e@V#/ܠb}XRPW{nERm>WJ[N7?$/2z}_QU-=՟e1r5U=a(vc$Γ߿P}:sUsxu(9tcM=ԕ|8gx.rld:ְui{z) q]iUhs.X W{*$pE W C %{p0ai[)Z zt`b%n 2K"5Fի%_<" M/sRôU/OT>RhĿ1ֈwx*&)-(sk7{myX)'0.6VOa{A!( y&{Wx7^;aӺztX2l/*5'˩ 8V}=il#!U N  %W 0(]^ w@4 m 0 2= *o 0, 0.% &S &y & & & & 7NHNJ 0DLUON 1uSN 0c 0w~ 0 0 0 0 0 0 Au 0 0KHT! 0h! a" 17r" 1 "z#UN$ 1KL%UP>% &'U;NU))U B*N* 0N* 1E+ 1+ 0lS, 0D,'- 1 *.N..XZ/&/ 10 _1 C&; 1< C!<N<z<a$> 1 8> 1>NL?N?f@@fBaB'BfC A/.QC(D 0^DD 0D2E 0DvEfE D3E B[ Ef FaFf"Fa$Ff8Fa:FfNFaPFadFfxFazFfFaFFU<$Hf`HabHfvHaxHfHaHaHfHaHHfZJa\J>pJfKaKfKaKfKaKNK 1KLMOf Qa"Qf6Qa8QfLQaNQfbQadQNxQ>zQRfTaT 1TfZUa\UNpUMrUMvU 0<zUEUeUMUUUVEXYCZ\ D?]o]-[_`: b9Dcf}ddaeyef(gh*gahh9j{Vk}lPNnfoaoofDqTFqra(t5UNsUNT'əl' :ȧzUN^EUNC?UNoЭUN?-UN:UNB9UNɳ3UNѶhUNոUNh{UN1PUNϽUNUNytUN;UNPUN.T|UNUNUN{UN]oUNhUNpUN UNpUN_pUN6kUNUN>UN)wUNtUNHUNFUNydUN}+UNUN UNUNUNfaHP LaserJet IIID,,,,,,0(hH  Z6Times New Roman RegularX($ճq(b vUwUxUy z{V|v0r\((:i+003|xU W:\GPRA\INTROD~1.WPDW:\GPRA\Introduction.wpdW:\GPRA\SectionI.wpdW:\GPRA\SECTIO~1.WPDW:\GPRA\SectionII.wpdW:\GPRA\SECTIO~2.WPDW:\GPRA\SectionIII.wpdW:\GPRA\1sumv2.wpdW:\GPRA\2sumv2.wpdW:\GPRA\3sumv2.wpdW:\GPRA\4sumv2.wpdW:\GPRA\5sumv2.wpdW:\GPRA\6sumv2.wpd')*(3$ !  (  Z 6Times New Roman Regular3#37=CIQYag1.a.i.(1)(a)(i)1)a)Level 1Level 2Level 3Level 4Level 5(;3$2#  0  .3  0  (O;$0  2#  a  .3  0` (#(#(b$0  0` (#(#2#   .3  0 ` (#` (#(xir$0  0` (#(#0 ` (#` (#2#(  0  )3  0 (# (#($0  0` (#(#0 ` (#` (#0 (# (#2#(  a  )3  0h(#(#(F$0  0` (#(#0 ` (#` (#0 (# (#0h(#(#2#(   )3  0h(#h(#($0  0` (#(#0 ` (#` (#0 (# (#0h(#(#0h(#h(#2#  0  )3  0(#(#(Vm$0   ({$0  0` (#(#0 ` (#` (#0 (# (#0h(#(#0h(#h(#0(#(#2#  a  )3  0p(#(#(,!$0  0` (#(#  (@$0  0` (#(#0 ` (#` (# ` ')* !"#$%&(xdCcgkosw{TrianglesTriangle Bullet !"#$%&(h@G_cgkosw{Bullet ListBullet List p W"  _YXX *XXX*  HHSGoal1:#XVJXY+# 5!XXVJ0  REDUCETHEMAJORTHREATSTOTHEHEALTH  ANDPRODUCTIVITYOFALLAMERICANS#XVJX! 5# w(hH  Z6Times New Roman Regular !"#$%&(x?[_cgkoswSquaresSquare Bullet\  `&Times New Roman  W"  _YXX -Xe` XX-  HHSGoal2:#XVJXY+#0 e  5!XXVJIMPROVETHEECONOMICANDSOCIALWELL  BEINGOFINDIVIDUALS,FAMILIESANDCOMMUNITIESINTHEUNITEDSTATES z#XVJX! 5#   W"  _YXX *XXX*  HHSGoal3:#XVJXY+#0  kXXVJIMPROVEACCESSTOHEALTHSERVICESAND  ENSURETHEINTEGRITYOFTHENATIONSHEALTHENTITLEMENTANDSAFETYNETPROGRAMS#XVJXk# w (hH  Z 6Times New Roman Regular  )  _A\) xdExA  2/7/00(#_HHS_ԀFY2001PerformancePlanandReportSummary!  1  \  `*Times New RomanTT(O$ !"#$%&(hFCEIMQUY]aAutoList2""""""""i)1)a) !"#$%&(hYEGKOSW[_cAutoList10"""""""")1)a)((3$ !      0  (#$  0    )  _A\) xdExA  "US //  3/17/00!  (#HHSFY2001PerformancePlanandReportSummary!  40   !"#$%&(h٘CEIMQUY]aAutoList1""""""""i)1)a) ;$    1    _ԀGAO/GGD99139VerificationandValidationofPerformanceData,p.14.<http://aspe.os.dhhs.gov/PIC/gate2pic.htm>.  )  _A\) xdExA  "US //  3/17/00!  (#HHSFY2001PerformancePlanandReportSummary!  5   !"#$%&(hjG_cgkosw{Oh My StarsOh My StarsHHHHHHHH W"  _ HHSStrategicGoals   L - !"#$%&(@hx, !"#$%&(LL C !"#$%&(jhh- !"#$%&(L*,w` XX*  3    3"2jH3  0 ,   0w, , Reducethemajorthreatstothehealth  andproductivityofallAmericans. 3"M݌ w w  Ќ    3    3@2jH3  0 ,   0w, , Improvetheeconomicandsocialwell  beingofcommunities,families,andindividualsintheUnitedStates. 3@k݌ w w  Ќ    3    32jH3  0 ,   0w, , Improveaccesstohealthservicesand LL  assuretheintegrityofthenationshealthentitlementandsafetynetprograms. 3݌ w w  Ќ    3    32jH3  0 ,   0w, , Improvethequalityofhealthcareand   humanservices. 3݌ w w  Ќ    3    32jH3  0 ,   0w, , Improvepublichealthsystems. 3݌w w  Ќ  0 ,  , ,    3    32jH3  0 ,   0w, , Strengthenthenationshealthsciences  researchenterpriseandenhanceitsproductivity. 3 ݌\\w w  Ќ  P - !"#$%&(@hhC !"#$%&(PL !"#$%&(Ehh- !"#$%&(L  3   0 ,  32E`3  0` , ,   Strengthenthe  nationshealthsciencesresearchenterpriseandenhanceitsproductivity. 3݌ ` `  Ќ  P - !"#$%&(@hh !"#$%&(jPL C !"#$%&(jih- !"#$%&(L d !"#$%&(p?AEIOW_gmsummaryi.(1)(a)(i)1)a))d p W"  _YXX *XXX*  HHSGoal1:#XVJXY+# 5!XXVJ0  REDUCETHEMAJORTHREATSTOTHEHEALTH  ANDPRODUCTIVITYOFALLAMERICANS#XVJX! 5# wTable_0 !"#$%&(h Ieimquy}Square BulleSquare Bullet(hCEKQW]cioAutoList61.1.1.1.1.1.1.1.  W"  _YXX *XXX*  HHSGoal3:#XVJXY+#0  kXXVJIMPROVEACCESSTOHEALTHSERVICESAND  ENSURETHEINTEGRITYOFTHENATIONSHEALTHENTITLEMENTANDSAFETYNETPROGRAMS#XVJXk# w   W"  _YXX -Xe` XX-  HHSGoal2:#XVJXY+#0 e  5!XXVJIMPROVETHEECONOMICANDSOCIALWELL  BEINGOFINDIVIDUALS,FAMILIESANDCOMMUNITIESINTHEUNITEDSTATES z#XVJX! 5# Table_0  )  _A\) xdExA  "US //  3/17/00!  (#HHSFY2000PerformancePlanandReportSummary!  63  VWXY[C<<CLevel 1Level 2Level 3Level 4Level 5(3$ !  (3$ !  ($$   1  \\\\'dxd dTable_0Table_0Table_0Table_0Table_0Table_0Table_0 v W"  _YXX *XXX*  HHS2.5:#XVJXY+#0   5!XXVJIncreaseOpportunitiesforSeniorstoHaveanActiveand  HealthyAgingExperience w#XVJX! 5# \ `$Times NewRomanTable_0Table_0Table_0Table_0Table_0  W"  _YXX *XXX*  HHS3.3:#XVJXY+#0   5!XXVJImproveAccesstoandtheEffectivenessofHealthCare  ServicesforPersonswithSpecificNeeds w#XVJX! 5# Table_0 4 W"  _YXX -Xe` XX-  HHSGoal5:#XVJXY+#0 e  5!XXVJIMPROVEPUBLICHEALTHSYSTEMS z#XVJX! 5# Table_0Table_0Table_0 !"#$%&(hIimquy}Triangle BulTriangle Bullet  )  _A\) xdExA  "US //  3/17/00!  !(#HHSFY2001PerformancePlanSummary!  164    W"  _YXX *XXX*  HHSGoal4:#XVJXY+#0  4XVJXXXVJ4 5!X4XVJIMPROVETHEQUALITYOFHEALTHCAREAND  HUMANSERVICES#4XVJX!4 5#4lX4XVJ#4XVJX4lh# w#XVJXX4XVJ#   W"  _YXX *XXX*  HHS4.1:#XVJXY+#0   5!XXVJPromotetheAppropriateUseofEffective#XVJX! 5# 5!XXVJԀHealthServices w#XVJX! 5%# Table_0Table_0Table_0Table_0 4 W"  _YXX -Xe` XX-  HHSGoal5:#XVJXY+#0 e  5!XXVJIMPROVEPUBLICHEALTHSYSTEMS z#XVJX! 5#   W"  _YXX *XXX*  HHS5.1:#XVJXY+#0   5!XXVJImprovethePublicHealthSystemsCapacitytoMonitor#XVJX! 5# 5!XXVJ  TheHealthStatusandIdentifyThreatstotheHealthoftheNationsPopulation w#XVJX! 56# Table_0 !"#$%&(hEIgkosw{Diamond Bu04Diamond Bullet````````Table_0<:Default Para     )  _A\) xdExA  "US //  3/17/00!  88"(#HHSFY2001PerformancePlanSummary!  70    W"  _YXX*XXX*  HHSGoal6:#XVJXY+#0   5!XXVJSTRENGTHENTHENATIONSHEALTHSCIENCES  RESEARCHENTERPRISEANDENHANCEITSPRODUCTIVITY w#XVJX! 5#  ; W"  _YXX *XXX*  HHS1.1:#XVJXY+#0   5!XXVJReduceTobaccoUse,EspeciallyAmongYouth w#XVJX! 5#   )  _A\) xdExA  2/7/00(#_HHS_ԀFY2001PerformancePlanandReportSummary!  4   9 W"  _YXX *XXX*  HHS1.2:#XVJXY+#0   5!XXVJReducetheNumberandImpactofInjuries w#XVJX! 5#   W"  _YXX*XXX*  HHSGoal6:#XVJXY+#0   5!XXVJSTRENGTHENTHENATIONSHEALTHSCIENCES  RESEARCHENTERPRISEANDENHANCEITSPRODUCTIVITY w#XVJX! 5# \\\\3 ShadowdZd e W"  _YXX *XXX*  HHS1.3:#XVJXY+#0   5!XXVJImprovetheDietandtheLevelofPhysicalActivityof  Americans w#XVJX! 5#  # W"  _YXX *XXX*  HHS1.4:#XVJXY+#0   5!XXVJCurbAlcoholAbuse w#XVJX! 5#  x W"  _YXX *XXX*  HHS6.1:#XVJXY+#0   5!XXVJImprovetheUnderstandingofNormalandAbnormal  BiologicalProcessesandBehaviors w #XVJX! 5# 0 W"  _YXX *XXX*  HHS1.5:#XVJXY+#0   5!XXVJReducetheIllicitUseofDrugs w#XVJX! 5#  / W"  _YXX *XXX*  HHS1.6:#XVJXY+#0   5!XXVJReduceUnsafeSexualBehaviors w#XVJX! 5#   )  _A\) xdExA  "US //  3/17/00!  88"(#HHSFY2001PerformancePlanSummary!  98  Table_0 o W"  _YXX *XXX*  HHS6.2:#XVJXY+#0   5!XXVJImprovethePrevention,Diagnosis,andTreatmentof  DiseaseandDisability w#XVJX! 5#  ^ W"  _YXX *XXX*  HHS2.1:#XVJXY+#0   5!XXVJIncreasetheEconomicIndependenceofFamilieson  Welfare w#XVJX! 5# Table_0  W"  _YXX *XXX*  HHS2.2:#XVJXY+#0   5!XXVJIncreasetheFinancialandEmotionalResourcesAvailable  toChildrenFromTheirNoncustodialParents w#XVJX! 5#   )  _A\) xdExA  "US //  3/17/00!  (#HHSFY2001PerformancePlanSummary!  128   q W"  _YXX *XXX*  HHS2.3:#XVJXY+#0   5!XXVJImprovetheHealthyDevelopmentandLearningReadiness  ofPreschoolChildren w#XVJX! 5#  s W"  _YXX *XXX*  HHS6.3:#XVJXY+#0   5!XXVJImprovethePublicHealthPreventionEffortsThrough  PopulationBasedResearch w#XVJX! 5#  F W"  _YXX *XXX*  HHS2.4:#XVJXY+#0   5!XXVJImprovetheSafetyandSecurityofChildrenandYouth w#XVJX! 5# Table_0  W"  _YXX*XXX*  HHS3.1:#XVJXY+#0   5!XXVJIncreasethePercentageoftheNationsChildrenand  AdultsWhoHaveHealthInsuranceCoverage w#XVJX! 5#  J W"  _YXX *XXX*  HHS3.2:#XVJXY+#0   5!XXVJIncreasetheAvailabilityofPrimaryHealthCareServices w#XVJX! 5#   W"  _YXX *XXX*  HHS2.6:#XVJXY+#0   5!XXVJExpandAccesstoConsumerDirected,Homeand  CommunityBasedLongTermCareandHealthServices w#XVJX! 5# Table_0  W"  _YXX *XXX*  HHS6.5:#XVJXY+#0   5!XXVJAcceleratePrivateSectorDevelopmentofNewDrugs,  BiologicTherapies,andMedicalTechnology w#XVJX! 5#  j W"  _YXX *XXX*  HHS2.7:#XVJXY+#0   5!XXVJImprovetheEconomicandSocialDevelopmentof  DistressedCommunities w#XVJX! 5#  w W"  _YXX *XXX*  HHS3.4:#XVJXY+#0   5!XXVJProtectandImproveBeneficiaryHealthandSatisfaction  withMedicareandMedicaid w#XVJX! 5#   W"  _YXX *XXX*  HHS3.5:#XVJXY+#0   5!XXVJEnhancetheFiscalIntegrityofHCFAProgramsand  EnsuretheBestValueHealthCareforBeneficiaries w #XVJX! 5# e W"  _YXX *XXX*  HHS3.6:#XVJXY+#0   5!XXVJImprovetheHealthStatusofAmericanIndiansandAlaska  Natives w#XVJX! 5#   )  _A\) xdExA  "US //  3/17/00!  (#HHSFY2001PerformancePlanSummary!  194    W"  _YXX *XXX*  HHSGoal4:#XVJXY+#0  4XVJXXXVJ4 5!X4XVJIMPROVETHEQUALITYOFHEALTHCAREAND  HUMANSERVICES#4XVJX!4 5#4lX4XVJ#4XVJX4lh# w#XVJXX4XVJ# Table_0  W"  _YXX *XXX*  HHS6.6:#XVJXY+#0   5!XXVJImprovetheQualityofMedicalandHealthScience  ResearchbyStrengtheningtheBaseofHighlyQualifiedScientificInvestigators w#XVJX! 5#  f W"  _YXX *XXX*  HHS4.2:#XVJXY+#0   5!XXVJReduceDisparitiesintheReceiptofQualityHealthCare  Services w#XVJX! 5#  f W"  _YXX *XXX*  HHS4.3:#XVJXY+#0   5!XXVJIncreaseConsumersUnderstandingofTheirHealthCare  Options w#XVJX! 5#  , W"  _YXX *XXX*  HHS4.4:#XVJXY+#0   5!XXVJImproveConsumerProtection w#XVJX! 5#   W"  _YXX *XXX*  HHS4.5:#XVJXY+#0   5!XXVJPromoteResearchThatImprovesQualityandDevelops  KnowledgeofEffectiveHumanServicesPractice w#XVJX! 5# Table_0 | W"  _YXX *XXX*  HHS5.2:#XVJXY+#0   5!XXVJEnsureFoodandDrugSafetybyIncreasingthe  EffectivenessofScienceBasedRegulation w#XVJX! 5#   )  _A\) xdExA  "US //  3/17/00!  !(#HHSFY2001PerformancePlanSummary!  209  Table_0  )  _A\) xdExA  2/7/00(#_HHS_ԀFY2001PerformancePlanandReportSummary!  1    )  _A\) xdExA  "US //  3/17/00!  (#HHSFY2001PerformancePlanandReportSummary!  5   p W"  _YXX *XXX*  HHSGoal1:#XVJXY+# 5!XXVJ0  REDUCETHEMAJORTHREATSTOTHEHEALTH  ANDPRODUCTIVITYOFALLAMERICANS#XVJX! 5# w(hH  Z6Times New Roman Regular  W"  _YXX -Xe` XX-  HHSGoal2:#XVJXY+#0 e  5!XXVJIMPROVETHEECONOMICANDSOCIALWELL  BEINGOFINDIVIDUALS,FAMILIESANDCOMMUNITIESINTHEUNITEDSTATES z#XVJX! 5# (hH  Z6Times New Roman Regular  W"  _YXX *XXX*  HHSGoal3:#XVJXY+#0  kXXVJIMPROVEACCESSTOHEALTHSERVICESAND  ENSURETHEINTEGRITYOFTHENATIONSHEALTHENTITLEMENTANDSAFETYNETPROGRAMS#XVJXk# w (hH  Z6Times New Roman Regular  W"  _YXX *XXX*  HHS6.4:#XVJXY+#0   5!XXVJIncreasetheUnderstandingofandResponsetotheMajor  IssuesRelatedtotheQuality,Financing,Cost,andCostEffectivenessofHealthCareServices wԀ#XVJX! 5#   W"  _YXX *XXX*  HHSGoal4:#XVJXY+#0  XVJXXXVJ 5!X4XVJIMPROVETHEQUALITYOFHEALTHCAREAND  HUMANSERVICES#XVJX!4 5#lX4XVJ#XVJX4lh# w#XVJXX4XVJ# (hH  Z6Times New Roman Regular(hH  Z 6Times New Roman Regular 4 W"  _YXX -Xe` XX-  HHSGoal5:#XVJXY+#0 e  5!XXVJIMPROVEPUBLICHEALTHSYSTEMS z#XVJX! 5# (hH  Z6Times New Roman Regular  W"  _YXX*XXX*  HHSGoal6:#XVJXY+#0   5!XXVJSTRENGTHENTHENATIONSHEALTHSCIENCES  RESEARCHENTERPRISEANDENHANCEITSPRODUCTIVITY w#XVJX! 5# (hH  Z6Times New Roman Regular  )  _A\) xdExA  "US //  3/17/00!  (#HHSFY2001PerformancePlanandReportSummary!  40    W"  _YXX *XXX*  HHS6.7:#XVJXY+#0   5!XXVJEnsureThatResearchResultsAreEffectively  CommunicatedtothePublic,Practitioners,andtheScientificCommunity w#XVJX! 5#  ;$    1    _ԀGAO/GGD99139VerificationandValidationofPerformanceData,p.14.  )  _A\) xdExA  "US //  3/17/00!  (#HHSFY2000PerformancePlanandReportSummary!  63   W"  _ HHSStrategicGoals   L - !"#$%&(@hx, !"#$%&(LL C !"#$%&(jhh- !"#$%&(L*,w` XX*  3    3"2jH3  0 ,   0w, , Reducethemajorthreatstothehealth  andproductivityofallAmericans. 3"M݌ w w  Ќ    3    3@2jH3  0 ,   0w, , Improvetheeconomicandsocialwell  beingofcommunities,families,andindividualsintheUnitedStates. 3@k݌ w w  Ќ    3    32jH3  0 ,   0w, , Improveaccesstohealthservicesand LL  assuretheintegrityofthenationshealthentitlementandsafetynetprograms. 3݌ w w  Ќ    3    32jH3  0 ,   0w, , Improvethequalityofhealthcareand   humanservices. 3݌ w w  Ќ    3    32jH3  0 ,   0w, , Improvepublichealthsystems. 3݌w w  Ќ  0 ,  , ,    3    32jH3  0 ,   0w, , Strengthenthenationshealthsciences  researchenterpriseandenhanceitsproductivity. 3 ݌\\w w  Ќ  P - !"#$%&(@hhC !"#$%&(PL !"#$%&(Ehh- !"#$%&(L  3   0 ,  32E`3  0` , ,   Strengthenthe  nationshealthsciencesresearchenterpriseandenhanceitsproductivity. 3݌ ` `  Ќ  P - !"#$%&(@hh !"#$%&(jPL C !"#$%&(jih- !"#$%&(L  )  _A\) xdExA  "US //  3/17/00!  88"(#HHSFY2001PerformancePlanSummary!  70   p W"  _YXX *XXX*  HHSGoal1:#XVJXY+# 5!XXVJ0  REDUCETHEMAJORTHREATSTOTHEHEALTH  ANDPRODUCTIVITYOFALLAMERICANS#XVJX! 5# w(hH  Z6Times New Roman Regular ; W"  _YXX *XXX*  HHS1.1:#XVJXY+#0   5!XXVJReduceTobaccoUse,EspeciallyAmongYouth w#XVJX! 5# (hH  Z6Times New Roman Regular 9 W"  _YXX *XXX*  HHS1.2:#XVJXY+#0   5!XXVJReducetheNumberandImpactofInjuries w#XVJX! 5# (hH  Z6Times New Roman Regular e W"  _YXX *XXX*  HHS1.3:#XVJXY+#0   5!XXVJImprovetheDietandtheLevelofPhysicalActivityof  Americans w#XVJX! 5# (hH  Z6Times New Roman Regular # W"  _YXX *XXX*  HHS1.4:#XVJXY+#0   5!XXVJCurbAlcoholAbuse w#XVJX! 5# (hH  Z6Times New Roman Regular 0 W"  _YXX *XXX*  HHS1.5:#XVJXY+#0   5!XXVJReducetheIllicitUseofDrugs w#XVJX! 5# (hH  Z6Times New Roman Regular / W"  _YXX *XXX*  HHS1.6:#XVJXY+#0   5!XXVJReduceUnsafeSexualBehaviors w#XVJX! 5# (hH  Z6Times New Roman Regular  )  _A\) xdExA  "US //  3/17/00!  88"(#HHSFY2001PerformancePlanSummary!  98    W"  _YXX -Xe` XX-  HHSGoal2:#XVJXY+#0 e  5!XXVJIMPROVETHEECONOMICANDSOCIALWELL  BEINGOFINDIVIDUALS,FAMILIESANDCOMMUNITIESINTHEUNITEDSTATES z#XVJX! 5# (hH  Z6Times New Roman Regular ^ W"  _YXX *XXX*  HHS2.1:#XVJXY+#0   5!XXVJIncreasetheEconomicIndependenceofFamilieson  Welfare w#XVJX! 5# (hH  Z6Times New Roman Regular  W"  _YXX *XXX*  HHS2.2:#XVJXY+#0   5!XXVJIncreasetheFinancialandEmotionalResourcesAvailable  toChildrenFromTheirNoncustodialParents w#XVJX! 5# (hH  Z6Times New Roman Regular q W"  _YXX *XXX*  HHS2.3:#XVJXY+#0   5!XXVJImprovetheHealthyDevelopmentandLearningReadiness  ofPreschoolChildren w#XVJX! 5# (hH  Z6Times New Roman Regular F W"  _YXX *XXX*  HHS2.4:#XVJXY+#0   5!XXVJImprovetheSafetyandSecurityofChildrenandYouth w#XVJX! 5# (hH  Z6Times New Roman Regular v W"  _YXX *XXX*  HHS2.5:#XVJXY+#0   5!XXVJIncreaseOpportunitiesforSeniorstoHaveanActiveand  HealthyAgingExperience w#XVJX! 5# (hH  Z6Times New Roman Regular  W"  _YXX *XXX*  HHS2.6:#XVJXY+#0   5!XXVJExpandAccesstoConsumerDirected,Homeand  CommunityBasedLongTermCareandHealthServices w#XVJX! 5# (hH  Z6Times New Roman Regular j W"  _YXX *XXX*  HHS2.7:#XVJXY+#0   5!XXVJImprovetheEconomicandSocialDevelopmentof  DistressedCommunities w#XVJX! 5# (hH  Z6Times New Roman Regular  )  _A\) xdExA  "US //  3/17/00!  !(#HHSFY2001PerformancePlanSummary!  128    W"  _YXX *XXX*  HHSGoal3:#XVJXY+#0  kXXVJIMPROVEACCESSTOHEALTHSERVICESAND  ENSURETHEINTEGRITYOFTHENATIONSHEALTHENTITLEMENTANDSAFETYNETPROGRAMS#XVJXk# w (hH  Z6Times New Roman Regular  W"  _YXX*XXX*  HHS3.1:#XVJXY+#0   5!XXVJIncreasethePercentageoftheNationsChildrenand  AdultsWhoHaveHealthInsuranceCoverage w#XVJX! 5# (hH  Z6Times New Roman Regular J W"  _ YXX *XXX*  HHS3.2:# XVJXY+#0    5!XXVJIncreasetheAvailabilityofPrimaryHealthCareServices w# XVJX! 5# (hH  Z6Times New Roman Regular  W"  _ YXX *XXX*  HHS3.3:# XVJXY+#0    5!XXVJImproveAccesstoandtheEffectivenessofHealthCare  ServicesforPersonswithSpecificNeeds w# XVJX! 5# (hH  Z6Times New Roman Regular w W"  _YXX *XXX*  HHS3.4:#XVJXY+#0   5!XXVJProtectandImproveBeneficiaryHealthandSatisfaction  withMedicareandMedicaid w#XVJX! 5# (hH  Z6Times New Roman Regular  W"  _YXX *XXX*  HHS3.5:#XVJXY+#0   5!XXVJEnhancetheFiscalIntegrityofHCFAProgramsand  EnsuretheBestValueHealthCareforBeneficiaries w #XVJX! 5#(hH  Z6Times New Roman Regular e W"  _YXX *XXX*  HHS3.6:#XVJXY+#0   5!XXVJImprovetheHealthStatusofAmericanIndiansandAlaska  Natives w#XVJX! 5# (hH  Z6Times New Roman Regular  )  _A\) xdExA  "US //  3/17/00!  !(#HHSFY2001PerformancePlanSummary!  164    W"  _YXX *XXX*  HHSGoal4:#XVJXY+#0  XVJXXXVJ 5!X4XVJIMPROVETHEQUALITYOFHEALTHCAREAND  HUMANSERVICES#XVJX!4 5#lX4XVJ#XVJX4lh# w#XVJXX4XVJ# (hH  Z6Times New Roman Regular(hH  Z 6Times New Roman Regular  W"  _YXX *XXX*  HHS4.1:#XVJXY+#0   5!XXVJPromotetheAppropriateUseofEffective#XVJX! 5# 5!XXVJԀHealthServices w#XVJX! 5%# (hH  Z6Times New Roman Regular f W"  _YXX *XXX*  HHS4.2:#XVJXY+#0   5!XXVJReduceDisparitiesintheReceiptofQualityHealthCare  Services w#XVJX! 5# (hH  Z6Times New Roman Regular f W"  _YXX *XXX*  HHS4.3:#XVJXY+#0   5!XXVJIncreaseConsumersUnderstandingofTheirHealthCare  Options w#XVJX! 5# (hH  Z6Times New Roman Regular , W"  _YXX *XXX*  HHS4.4:#XVJXY+#0   5!XXVJImproveConsumerProtection w#XVJX! 5# (hH  Z6Times New Roman Regular  W"  _ YXX *XXX*  HHS4.5:# XVJXY+#0    5!XXVJPromoteResearchThatImprovesQualityandDevelops  KnowledgeofEffectiveHumanServicesPractice w# XVJX! 5# (hH  Z6Times New Roman Regular  )  _A\) xdExA  "US //  3/17/00!  !(#HHSFY2001PerformancePlanSummary!  194   4 W"  _#YXX -Xe` XX-  HHSGoal5:##XVJXY+#0 e # 5!XXVJIMPROVEPUBLICHEALTHSYSTEMS z##XVJX! 5# (hH  Z6Times New Roman Regular  W"  _%YXX *XXX*  HHS5.1:#%XVJXY+#0  % 5!XXVJImprovethePublicHealthSystemsCapacitytoMonitor#%XVJX! 5#% 5!XXVJ  TheHealthStatusandIdentifyThreatstotheHealthoftheNationsPopulation w#%XVJX! 56# (hH  Z6Times New Roman Regular | W"  _'YXX *XXX*  HHS5.2:#'XVJXY+#0  ' 5!XXVJEnsureFoodandDrugSafetybyIncreasingthe  EffectivenessofScienceBasedRegulation w#'XVJX! 5# (hH  Z6Times New Roman Regular  )  _A\) xdExA  "US //  3/17/00!  !(#HHSFY2001PerformancePlanSummary!  209    W"  _*YXX*XXX*  HHSGoal6:#*XVJXY+#0  * 5!XXVJSTRENGTHENTHENATIONSHEALTHSCIENCES  RESEARCHENTERPRISEANDENHANCEITSPRODUCTIVITY w#*XVJX! 5# (hH  Z6Times New Roman Regular x W"  _,YXX *XXX*  HHS6.1:#,XVJXY+#0  , 5!XXVJImprovetheUnderstandingofNormalandAbnormal  BiologicalProcessesandBehaviors w #,XVJX! 5#(hH  Z6Times New Roman Regular o W"  _.YXX *XXX*  HHS6.2:#.XVJXY+#0  . 5!XXVJImprovethePrevention,Diagnosis,andTreatmentof  DiseaseandDisability w#.XVJX! 5# (hH  Z6Times New Roman Regular s W"  _0YXX *XXX*  HHS6.3:#0XVJXY+#0  0 5!XXVJImprovethePublicHealthPreventionEffortsThrough  PopulationBasedResearch w#0XVJX! 5# (hH  Z6Times New Roman Regular  W"  _2YXX *XXX*  HHS6.4:#2XVJXY+#0  2 5!XXVJIncreasetheUnderstandingofandResponsetotheMajor  IssuesRelatedtotheQuality,Financing,Cost,andCostEffectivenessofHealthCareServices wԀ#2XVJX! 5# (hH  Z6Times New Roman Regular  W"  _4YXX *XXX*  HHS6.5:#4XVJXY+#0  4 5!XXVJAcceleratePrivateSectorDevelopmentofNewDrugs,  BiologicTherapies,andMedicalTechnology w#4XVJX! 5# (hH  Z6Times New Roman Regular  W"  _6YXX *XXX*  HHS6.6:#6XVJXY+#0  6 5!XXVJImprovetheQualityofMedicalandHealthScience  ResearchbyStrengtheningtheBaseofHighlyQualifiedScientificInvestigators w#6XVJX! 5# (hH  Z6Times New Roman Regular  W"  _8YXX *XXX*  HHS6.7:#8XVJXY+#0  8 5!XXVJEnsureThatResearchResultsAreEffectively  CommunicatedtothePublic,Practitioners,andtheScientificCommunity w#8XVJX! 5# (hH  Z6Times New Roman Regular  )  _A\) xdExA  "US //  3/17/00!  (#HHSFY2001PerformancePlanSummary!  194  Table_0 !  _Xz  lXXTABLEOFCONTENTS #XVJXlM#  >3 ,XS XX3+s.  'Vm  'Vm0     INTRODUCTION#""J(#.` ` (#(##1'Vm4݌  Ќ  'Vm  'Vm0     SECTIONI:SUMMARYPERFORMANCEREPORT#""J(#.0(#(##4'Vm݌ t  Ќ  )!  )!0  0S(#(#    HHSGoal1:0 S(#S(#REDUCETHEMAJORTHREATSTOTHEHEALTHAND L  PRODUCTIVITYOFALLAMERICANS#""J(#.3 (# (##7)!݌ 8  Ќ  )!  )!0  0S(#(#    HHSGoal2:0 S(#S(#IMPROVETHEECONOMICANDSOCIALWELLBEINGOF $ t  INDIVIDUALS,FAMILIESANDCOMMUNITIESINTHEUNITEDSTATES#`"`"I(#.l l  (# (##13)!݌ L  Ќ  )!  )!T0  0S(#(#    HHSGoal3:0 S(#S(#IMPROVEACCESSTOHEALTHSERVICESANDENSURETHE 8  INTEGRITYOFTHENATIONSHEALTHENTITLEMENTAND)!To݌  (# (# Ќ  )!  )!0  0S(#(#    0SS(#S(#0 S(#S(#SAFETYNETPROGRAMS#`"`"I(#.) (# (##17)!݌   Ќ  )!  )!0  0S(#(#    HHSGoal4:0 S(#S(#IMPROVETHEQUALITYOFHEALTHCAREAND)!݌  (# (# Ќ  )!  )!y0  0S(#(#    0SS(#S(#0 S(#S(#HUMANSERVICES#`"`"I(#.``$ (# (##23)!y݌  Ќ  )!  )!s 0  0S(#(#    HHSGoal5:0 S(#S(#IMPROVEPUBLICHEALTHSYSTEMS#`"`"I(#.3 (# (##30)!s ݌  Ќ  )!  )!s 0  0S(#(#    HHSGoal6:0 S(#S(#STRENGTHENTHENATIONSHEALTHSCIENCESRESEARCH p ENTERPRISEANDENHANCEITSPRODUCTIVITY#`"`"I(#.dd= (# (##33)!s ݌ \ Ќ  'Vm  'Vm 0     SECTIONII:KEYHHSMEASUREMENTISSUES#`"`"I(#.1(#(##38'Vm ݌ 4 Ќ  )!  )! 0  0S(#(#    APPROACHTOPERFORMANCEMEASUREMENT#`"`"I(#.PP/S(#S(##39)! ݌  \ Ќ  )!  )! 0  0S(#(#    DEPARTMENTALCOMMITMENTTOMANAGEMENTIMPROVEMENT#`"`"I(#.=S(#S(##41)! ݌ H Ќ  )!  )!0  0S(#(#    DATACHALLENGES#`"`"I(#.L L S(#S(##55)!݌ 4 Ќ  )!  )!S0  0S(#(#    PROGRAMEVALUATIONANDPERFORMANCEMEASUREMENT#`"`"I(#.:S(#S(##59)!Sn݌   Ќ  'Vm  'VmE0     SECTIONIII:FY2001PERFORMANCEGOALSUMMARY#`"`"I(#.8(#(##61'VmEa݌  Ќ  )!  )!+0  0S(#(#    FY2001DEPARTMENTALINITIATIVESANDREPRESENTATIVE)!+F݌ S(#S(# Ќ  )!  )!0  0S(#(#    0SS(#S(#PERFORMANCEGOALS#`"`"I(#. S(#S(##62)!݌ l! Ќ  )!  )!0  0S(#(#    FY2001PROGRAMS,INITIATIVES,STRATEGIES,ANDPERFORMANCE)!݌ S(#S(# Ќ  )!  )!0  0S(#(#    0SS(#S(#GOALSTHATSUPPORTTHEHHSSTRATEGICPLAN#`"`"I(#.  8S(#S(##68)!݌ D#! Ќ  )!  )!0  0S(#(#    HHSGoal1:0 S(#S(#REDUCETHEMAJORTHREATSTOTHEHEALTHAND %l # PRODUCTIVITYOFALLAMERICANS#`"`"I(#.3 (# (##69)!݌ &X!$ Ќ  *  *0  0S(#(#0 S(#S(# S   HHS1.1:0 (# (#ReduceTobaccoUse,EspeciallyAmongYouth#`"`"I(#.dd@ (# (##70* ݌ &D"% Ќ  *  *#0  0S(#(#0 S(#S(# S   HHS1.2:0 (# (#ReducetheNumberandImpactofInjuries#`"`"I(#.> (# (##74*#>݌ '0#& Ќ  *  *?0  0S(#(#0 S(#S(# S   HHS1.3:0 (# (#ImprovetheDietandtheLevelofPhysicalActivityofAmericans#`"`"I(#.V (# (##81*?Z݌ ($' Ќ  *  *s0  0S(#(#0 S(#S(# S   HHS1.4:0 (# (#CurbAlcoholAbuse#`"`"I(#.( (# (##85*s݌ )%( Ќ  *  *y0  0S(#(#0 S(#S(# S   HHS1.5:0 (# (#ReducetheIllicitUseofDrugs#`"`"I(#.005 (# (##89*y݌ *%) Ќ  *  *0  0S(#(#0 S(#S(# S   HHS1.6:0 (# (#ReduceUnsafeSexualBehaviors#`"`"I(#.4 (# (##93*݌ +&* Ќ  )!  )!0  0S(#(#    HHSGoal2:0 S(#S(#IMPROVETHEECONOMICANDSOCIALWELLBEINGOF h-(, INDIVIDUALS,FAMILIESANDCOMMUNITIESINTHEUNITEDSTATES#`"`"I(#.l l  (# (##97)!݌ @/*. Ќ  *  *0  0S(#(#0 S(#S(# S   HHS2.1:0 (# (#IncreasetheEconomicIndependenceofFamiliesonWelfare#`"`"I(#.PPO (# (##99*݌ ,0|+/ Ќ  _*  *;0  0S(#(#0 S(#S(# S   HHS2.2:0 (# (#IncreasetheFinancialandEmotionalResourcesAvailabletoChildren*;V݌ (# (# Ќ  *  *X 0  0S(#(#0 S(#S(# S   0 (# (#FromTheir_Noncustodial_ԀParents#!!H(#.5 (# (##102*X s ݌  Ќ  *  *!0  0S(#(#0 S(#S(# S   HHS2.3:0 (# (#ImprovetheHealthyDevelopmentandLearningReadinessofPreschool  Children#!!H(#.0 0  (# (##104*!!݌ t Ќ  *  *"0  0S(#(#0 S(#S(# S   HHS2.4:0 (# (#ImprovetheSafetyandSecurityofChildrenandYouth#!!H(#.K (# (##111*""݌ ` Ќ  *  *$0  0S(#(#0 S(#S(# S   HHS2.5:0 (# (#IncreaseOpportunitiesforSeniorstoHaveanActiveandHealthyAging L  Experience#!!H(#. (# (##115*$$݌ 8  Ќ  *  *]%0  0S(#(#0 S(#S(# S   HHS2.6:0 (# (#ExpandAccesstoConsumerDirected,HomeandCommunityBased*]%x%݌$ t (# (# Ќ  *  *r&0  0S(#(#0 S(#S(# S   0 (# (#LongTermCareandHealthServices#!!H(#.((8 (# (##120*r&&݌  ` Ќ  *  *'0  0S(#(#0 S(#S(# S   HHS2.7:0 (# (#ImprovetheEconomicandSocialDevelopmentofDistressed*''݌ L  (# (# Ќ  *  *(0  0S(#(#0 S(#S(# S   0 (# (#Communities#!!H(#.! (# (##123*((݌  8  Ќ  )!  )!)0  0S(#(#    HHSGoal3:0 S(#S(#IMPROVEACCESSTOHEALTHSERVICESANDENSURETHE   INTEGRITYOFTHENATIONSHEALTHENTITLEMENTAND)!))݌  (# (# Ќ  )!  )!*0  0S(#(#    0SS(#S(#0 S(#S(#SAFETYNETPROGRAMS#!!H(#.) (# (##126)!**݌   Ќ  *  *+0  0S(#(#0 S(#S(# S   HHS3.1:0 (# (#IncreasethePercentageoftheNationsChildrenandAdultsWho*++݌  (# (# Ќ  *  *,0  0S(#(#0 S(#S(# S   0 (# (#HaveHealthInsuranceCoverage#!!H(#.4 (# (##128*,,݌ p Ќ  *  *-0  0S(#(#0 S(#S(# S   HHS3.2:0 (# (#IncreasetheAvailabilityofPrimaryHealthCareServices#!!H(#.44O (# (##131*-.݌ \ Ќ  *  */0  0S(#(#0 S(#S(# S   HHS3.3:0 (# (#ImproveAccesstoandtheEffectivenessofHealthCareServicesfor*/3/݌H (# (# Ќ  *  *400  0S(#(#0 S(#S(# S   0 (# (#PersonswithSpecificNeeds#!!H(#.XX1 (# (##141*40O0݌ 4 Ќ  *  *<10  0S(#(#0 S(#S(# S   HHS3.4:0 (# (#ProtectandImproveBeneficiaryHealthandSatisfactionwith*<1W1݌ p (# (# Ќ  *  *Q20  0S(#(#0 S(#S(# S   0 (# (#MedicareandMedicaid#!!H(#.+ (# (##149*Q2l2݌  \ Ќ  *  *S30  0S(#(#0 S(#S(# S   HHS3.5:0 (# (#EnhancetheFiscalIntegrityofHCFAProgramsandEnsurethe*S3n3݌H (# (# Ќ  *  *h40  0S(#(#0 S(#S(# S   0 (# (#BestValueHealthCareforBeneficiaries#!!H(#.,,> (# (##154*h44݌ 4 Ќ  *  *}50  0S(#(#0 S(#S(# S   HHS3.6:0 (# (#ImprovetheHealthStatusofAmericanIndiansandAlaskaNatives#!!H(#.\\V (# (##157*}55݌   Ќ  )!  )!60  0S(#(#    HHSGoal4:0 S(#S(#IMPROVETHEQUALITYOFHEALTHCAREAND)!66݌ (# (# Ќ  )!  )!70  0S(#(#    0SS(#S(#0 S(#S(#HUMANSERVICES#!!H(#.``$ (# (##162)!77݌  Ќ  *  *80  0S(#(#0 S(#S(# S   HHS4.1:0 (# (#PromotetheAppropriateUseofEffectiveHealthServices#!!H(#.N (# (##165*88݌  Ќ  *  *90  0S(#(#0 S(#S(# S   HHS4.2:0 (# (#ReduceDisparitiesintheReceiptofQualityHealthCareServices#!!H(#.W (# (##172*99݌ l Ќ  *  *:0  0S(#(#0 S(#S(# S   HHS4.3:0 (# (#IncreaseConsumersUnderstandingofTheirHealthCareOptions#!!H(#.T (# (##181*:;݌ X  Ќ  *  *5<0  0S(#(#0 S(#S(# S   HHS4.4:0 (# (#ImproveConsumerProtection#!!H(#.1 (# (##184*5<P<݌ D! Ќ  *  *E=0  0S(#(#0 S(#S(# S   HHS4.5:0 (# (#PromoteResearchThatImprovesQualityandDevelopsKnowledgeof 0"  EffectiveHumanServicesPractice#!!H(#.HH7 (# (##190*E=`=݌ #l! Ќ  )!  )!>0  0S(#(#    HHSGoal5:0 S(#S(#IMPROVEPUBLICHEALTHSYSTEMS#!!H(#.3 (# (##192)!>>݌ $D # Ќ  *  *?0  0S(#(#0 S(#S(# S   HHS5.1:0 (# (#ImprovethePublicHealthSystemsCapacitytoMonitorTheHealth*??݌%0!$ (# (# Ќ  *  *@0  0S(#(#0 S(#S(# S   0 (# (#StatusandIdentifyThreatstotheHealthoftheNationsPopulation#!!H(#.Z (# (##194*@@݌ &"% Ќ  *  *B0  0S(#(#0 S(#S(# S   HHS5.2:0 (# (#EnsureFoodandDrugSafetybyIncreasingtheEffectiveness*BB݌'#& (# (# Ќ  *  *C0  0S(#(#0 S(#S(# S   0 (# (#ofScienceBasedRegulation#!!H(#.1 (# (##203*C2C݌ (#' Ќ  )!  )! D0  0S(#(#    HHSGoal6:0 S(#S(#STRENGTHENTHENATIONSHEALTHSCIENCESRESEARCH |*%) ENTERPRISEANDENHANCEITSPRODUCTIVITY#!!H(#.dd= (# (##207)! D;D݌ h+&* Ќ  *  *sE0  0S(#(#0 S(#S(# S   HHS6.1:0 (# (#ImprovetheUnderstandingofNormalandAbnormalBiological*sEE݌T,'+ (# (# Ќ  *  *F0  0S(#(#0 S(#S(# S   0 (# (#ProcessesandBehaviors#!!H(#.44- (# (##209*FF݌ @-(, Ќ  *  *G0  0S(#(#0 S(#S(# S   HHS6.2:0 (# (#ImprovethePrevention,Diagnosis,andTreatmentofDisease*GG݌,.|)- (# (# Ќ  *  *H0  0S(#(#0 S(#S(# S   0 (# (#andDisability#!!H(#.$ (# (##213*HH݌ /h*. Ќ  *  *I0  0S(#(#0 S(#S(# S   HHS6.3:0 (# (#ImprovethePublicHealthPreventionEffortsThroughPopulationBased 0T+/ Research#!!H(#.` `  (# (##222*II݌  Ќ  *  *J0  0S(#(#0 S(#S(# S   HHS6.4:0 (# (#IncreasetheUnderstandingofandResponsetotheMajorIssues*J K݌ (# (# Ќ  *  *L0  0S(#(#0 S(#S(# S   0 (# (#RelatedtotheQuality,Financing,Cost,andCostEffectiveness*L#L݌  (# (# Ќ  *  *M0  0S(#(#0 S(#S(# S   0 (# (#ofHealthCareServices#!!H(#.- (# (##226*M+M݌ t Ќ  *  *N0  0S(#(#0 S(#S(# S   HHS6.5:0 (# (#AcceleratePrivateSectorDevelopmentofNewDrugs,Biologic*N/N݌` (# (# Ќ  *  *)O0  0S(#(#0 S(#S(# S   0 (# (#Therapies,andMedicalTechnology#!!H(#.7 (# (##229*)ODO݌ L  Ќ  *  *7P0  0S(#(#0 S(#S(# S   HHS6.6:0 (# (#ImprovetheQualityofMedicalandHealthScienceResearchby*7PRP݌8  (# (# Ќ  *  *MQ0  0S(#(#0 S(#S(# S   0 (# (#StrengtheningtheBaseofHighlyQualifiedScientificInvestigators#!!H(#.,,Y (# (##234*MQhQ݌ $ t Ќ  *  *}R0  0S(#(#0 S(#S(# S   HHS6.7:0 (# (#EnsureThatResearchResultsAreEffectivelyCommunicatedto*}RR݌ ` (# (# Ќ  *  *S0  0S(#(#0 S(#S(# S   0 (# (#thePublic,Practitioners,andtheScientificCommunity#!!H(#.M (# (##239*SS݌  L  Ќ   z{   8  {8VJXXdXXd8 <  |5||| LmMXXVJ  HHSPERFORMANCEPLAN  ANDPERFORMANCEREPORTSUMMARYMLm ` U    INTRODUCTION V  p V XVJX   uuuuu h   W  THISISASUMMARYDOCUMENT.nWHHSisalarge,decentralizedAgencythatadministersapproximately300programactivities,withover750annualperformancegoals.Tobestaccommodatethelinkageoftheseperformancegoalstothebudgetrequestsfortheseprogramactivities,HHShasincorporatedtheperformancegoalsintothebudgetsubmissionsfortheHHScomponentsthatadministertheprograms.ToviewallperformancegoalsforallHHSprogramactivities,includingthelatestperformanceresultsandotherrequiredinformation,readersarereferredtotheperformanceplansandreportsincludedinthebudgetjustificationfortheindividualHHScomponents.      uuuuu #XXVJV# x BZXVJXTheDepartmentofHealthandHumanServicesseekstoenhancethewellbeingofAmericansby  providingforeffectivehealthandhumanservicesandbyfosteringstrong,sustainedadvancesinthesciencesunderlyingmedicine,publichealth,andsocialservices.WeaccomplishthismissionthroughtheseparateandcollaborativeeffortsofouroperatingdivisionsandstaffofficeswithintheOfficeoftheSecretary:0   AdministrationonAging (AoA)servesastheprimaryfederalfocalpointandadvocacyagent 8! forolderAmericans.Throughanetworkofstateandareaagenciesonaging,AoAfundedprogramsdelivercomprehensiveinhomeandcommunityservices;andmakelegalservices,counseling,andombudsmenprogramsavailabletoelderlyAmericans (#(# 0   AdministrationonChildrenandFamilies (ACF)leadsthenationinimprovingtheeconomic %(!  andsocialwellbeingoffamilies,children,andcommunitiesthoughfederalgrantprogramslikeHeadStart,ChildSupportEnforcement,ChildWelfareServices,ChildCareandDevelopment,andTemporaryAssistancetoNeedyFamilies. (#(# 0   AgencyforHealthCareResearchandQuality (_AHQR_)enhancesthequality, x*%% appropriateness,andeffectivenessofhealthservicesandaccesstosuchservices,throughthepromotionofimprovementsinclinicalandhealthsystempractices,includingthepreventionofdiseasesandotherhealthconditions. (#(#    ,.|)) 0   CentersforDiseaseControlandPrevention (CDC)monitorshealth;identifiesand  investigatespublichealthproblems;promoteshealthybehaviors;anddevelopsandadvocatessoundpublichealthpoliciestopreventandcontroldisease,injury,anddisability. (#(# 0   FoodandDrugAdministration (FDA)promotesimprovementinthehealthoftheAmerican d publicbyensuringtheeffectivenessand/orsafetyofdrugs,medicaldevices,biologicalproducts,food,andcosmetics;andbyencouragingtheactiveparticipationofbusinessandthepublicinmanagingthehealthhazardsassociatedwiththeseproducts. (#(# 0   HealthCareFinancingAdministration (HCFA)paysMedicarebenefits;providesstateswith  T  matchingfundsforMedicaidbenefits;conductsresearch,demonstrations,andoversighttoensurethesafetyandqualityofmedicalservicesandfacilitiesprovidedtoMedicarebeneficiaries;andestablishesrulesforeligibilityandbenefitpayments. (#(# 0   HealthResourcesandServicesAdministration (HRSA)promotesequitableaccessto   comprehensive,qualityhealthcareforall,withaparticularfocuson_underserved_Ԁandvulnerablepopulations. (#(# 0   IndianHealthService (IHS)providescomprehensivehealthservicesforAmericanIndianand X AlaskaNativepeople,withopportunityformaximumtribalinvolvementindevelopingandmanagingprogramstoimprovehealthstatusandoverallqualityoflife. (#(# 0   NationalInstitutesofHealth (NIH),throughits25institutes,centers,anddivisions,supports  \ andconductsmedicalresearch,domesticallyandabroad,intothecausesandpreventionofdiseasesandpromotestheacquisitionanddisseminationofmedicalknowledgetohealthprofessionalsandthepublic. (#(# 0   ProgramSupportCenter (PSC)providesabroadrangeofadministrativeservicestoHHS  componentsandotherFederalagenciesonacompetitive,fee-for-servicebasis.PSCservicesareprovidedinthreebusinessareas:humanresources,financialmanagement,andadministrativeoperations. (#(# 0   SubstanceAbuseandMentalHealthServicesAdministration ,(SAMHSA)throughitsthree L"  centers,workstoimprovequalityandavailabilityofprevention,earlyintervention,treatment,andrehabilitationservicesforsubstanceabuseandmentalillness,includingcooccurringdisorders,inordertoimprovehealthandreduceillness,death,disability,andcosttosociety. (#(# 0   AssistantSecretaryforManagementandBudget (ASMB)advisestheSecretaryonall &<"% aspectsofadministrationandfinancialmanagement,andprovidesgeneraloversightanddirectionoftheadministrativeandfinancialorganizationsandactivitiesoftheDepartment. (#(# 0   AssistantSecretaryforPlanningandEvaluation (ASPE)providespolicyanalysisand *%) advice;guidestheformulationoflegislation;coordinatesstrategicandimplementationplanning;conductsregulatoryanalysisandreviewsregulations;overseestheplanningof evaluation,nonbiomedicalresearch,andmajorstatisticalactivities;andadministers h-(, evaluation,datacollection,andresearchprojectsthatprovideinformationneededforHHSpolicydevelopment. (#(#  0  XVJXXXVJ OfficeforCivilRights (OCR)promotesandensuresthatpeoplehaveequalaccesstoand t opportunitytoparticipateinandreceiveservicesinallHHSprogramswithoutfacingunlawfuldiscrimination.Throughpreventionandeliminationofunlawfuldiscrimination,theOfficeforCivilRightshelpsHHScarryoutitsoverallmissionofimprovingthehealthandwellbeingofallpeopleaffectedbyitsmanyprograms. (#(# #XVJXXXVJ_p#0   OfficeofInspectorGeneral (OIG)improvesHHSprogramsandoperationsandprotects  P  themagainstfraud,waste,andabuse.Byconductingindependentandobjectiveaudits,evaluations,andinvestigationsOIGprovidestimely,useful,andreliableinformationandadvicetoDepartmentofficials,theAdministration,theCongress,andthepublic. (#(# 0   OfficeofPublicHealthandScience (_OPHS_)providesseniorprofessionalleadershipacross   HHSonpopulation-basedpublichealthandclinicalpreventiveservicesbyprovidingscientificallysoundadviceonhealthandhealthpolicytotheSecretary,DepartmentalofficialsandothergovernmentalentitiesandcommunicatingonhealthissuesdirectlytotheAmericanpublic;conductingessentialpublichealthactivitiesthroughelevenprogramoffices,andprovidingprofessionalleadershiponcross-cuttingDepartmentalpublichealthandscienceinitiatives.#XXVJZ#XVJX ,|(#(#   _ <=U <_?,X,hX,XS X?̀  `    LmMXXVJSECTIONI: L  SUMMARYPERFORMANCEREPORT#XVJXMLmw# w   XXVJPROGRESSTOWARDS  p  ACHIEVINGDEPARTMENTALINITIATIVES#XVJX{x# (   w  4 _B55  lXXVJSUMMARYPERFORMANCEREPORT!PROGRESSTOWARDS  ACHIEVINGDEPARTMENTALINITIATIVES#XVJXly# yTheGovernmentPerformanceandResultsAct(GPRA)isavaluabletoolthatwillenhanceHHSeffortstoimproveprogramsthatservetheAmericanpeople.Withthecontinueddevelopmentofperformancegoalsandmeasuresforapproximately300programs,HHSiscompilinganextensivebodyofinformationthatisinformativeacrossprogramsandagencies.SuchdatawillbecomeincreasinglyimportanttoHHSsleadershipandprogramcoordinationefforts.AlthoughtheDepartmentconsistsoflargeagencieswithmanyanddisparatefunctions,HHScoordinatesthefocusanddirectionofitsprogramactivitiesthroughDepartmentalinitiativesdevelopedintheannualHHSbudgetdecisionmakingprocesses.PerformancemeasurementwillincreasinglystrengthentheseprocessesasdataonprogramperformancetrendsbecomeavailableandserveasindicatorstosupporttheidentificationofstrategiesandobjectivestocontinuouslyimproveprogramsacrosstheDepartment.AlthoughtheGPRAinformationprocessesarestilldeveloping,weareconfidentthattheGPRAmeasuresforHHSprogramswillsupporttheassessmentoftheDepartmentalinitiativesthatSecretaryShalalahaspursuedoverthelastfouryears,andwillcontributetothedevelopmentofDepartmentalinitiativesandperformancegoalsinthefuture.DetailedinformationonGPRAresultsforallHHSprogramactivitiesispresentedintheperformancereportsandplansforHHSprogramcomponents,whicharecontainedintheindividualagencychaptersoftheCongressionalJustificationoftheFY2001budgetforHHS.ThoseperformancereportsincludeFY1999resultsdataforoverhalfoftheapproximately750performancemeasuresincludedinthefinalperformanceplanssubmittedtoCongressinFebruary1999.ThepredominantportionofthemeasuresforwhichFY1999dataarenotyetavailableisforprogramsforwhichHHSmustrelyonStatesandotheroutsideentitiesforperformancedata.AsrequiredbyOMBguidance,HHSwillreporttheresultsofallsuchFY1999performancemeasuresinfutureperformancereportssubmittedtoCongress.BudgetdecisionmakinginHHShasbeenkeytoDepartmentalcoordinationofprogramactivityandperformancemeasurementinHHS.Inrecentyears,HHSmodifieditsDepartmentalbudgetformulationprocessesspecificallytobetterbringtogetherinformationandleadersfromthroughouttheDepartmenttodefinetheprograminitiativesthatwillmoveHHStowardthecontinuedaccomplishmentofitsmissionandtowardcoordinatedprogramimprovement.AnticipatingthatGPRAinformationwillincreasinglyenhancethisdecisionmakingprocess,HHSincorporatedGPRAannualplanningandreportingintothebudgetformulationprocessandintotheHHSbudgetdocuments.Whileemphasizingourbeliefthatperformanceinformationwillbecomeincreasinglyusefulasmeasuresmatureandperformancetrendsemerge,theFY1999performancereportsofHHScomponentstakenasawhole,aswellasadditionalprograminformationfrompreviousyears,indicate:1)thatHHSperformanceplansareemployingmeasuresthataddressthenationalneedsthatgenerateourbudgetinitiatives,and2)thatimprovedresults,strategies,performancegoals,andcoordinationarealreadyinevidenceforareascoveredbythebudgetinitiativesoftheDepartment. -), Inthepagesthatfollow,wesummarizeperformanceconditionsandprogressrelatedtobothDepartmentalbudgetinitiativesandtotheDepartmentsGPRAstrategicgoals,asreflectedinreportedGPRAperformancedataforHHS.TheinformationthatisprovidedforFY1999andpreviousyearssignifiesthatthepursuitofprogramcoordinationandimprovementareDepartmentaltraits,andmarksHHSasanentitythatisfocusedonconcertedprogresstowardtheachievementofthemission,goalsandobjectivesoftheFY1997HHSStrategicPlanthroughitsDepartmentalinitiatives.AsGPRAimplementationcontinuestomature,programexecutivesandmanagersthroughoutHHSexpecttousetrenddataonperformanceresultstoseekthecoordinatedimprovementofHHSprogramsonanongoingbasis,specificallyby:1)assessingperformanceactivityandresults,2)engaginginprogramevaluationactivitywheredeeperassessmentisrequired,3)redefiningprogramstrategiestoproduceimprovedresults,and4)modifyingfutureperformancetargetstobeconsistentwithavailableresourcesanduptodateprioritiesandpolicydecisions.    ? ,X X,X,hX?iU.5%!`z3 `E`ttx [i (#(#     (#(#iU5%!`z3 `E`ttx [i lXXVJS#XVJXlڍ#UMMARYlXXVJP#XVJXl$#ERFORMANCElXXVJR#XVJXlr#EPORT  L  HHScrosscuttingbudgetinitiativessinceFY1998havereflectedextensiveDepartmentalemphasisonreducingthreatstothehealthandproductivityofAmericans.Mostinitiativeshavefocusedonasetofthreatsthatrequireemphasisandpriorityovermultiplefiscalyears,particularlytobaccouse,substanceabuse,domesticviolenceandinjury,andunhealthysexualbehaviors.L - !"#$%&(@h3L ?,X,hX,X X?YouthTobaccoUse    ReducingtobaccousebychildrenandyouthremainsahighpriorityinitiativethroughoutHHSandtheAdministration.CDCsHeartDiseaseandHealthPromotionprogramseekstopreventtobaccouse.SAMHSAadministerstheSynarAmendmenttosupportprogramsforcompliancetoreducethesaleoftobaccotominorsandmeasureschangesinyouthsmoking.FDAeffortsemphasizeitsregulatoryroleandaimtoincreasethenumberofcompliancechecksperformedatretailshopstoenforcetherequirementthatminorsdonotpurchasetobaccoproducts.L 0 !"#$%&(xh- !"#$%&(L  3    323  0    ReducingTobaccoUse: Between1991and1997,tobaccouseamongyouthincreasedfrom  \ 27.5percentto36.4percent.Inresponsetothisdisturbingtrend,theDepartmentestablishedaninitiativetoreducetobaccouseamongminors,ledbyCDC,FDA,SAMHSA,andOPHS.TheDepartmentwillmeasuretheimpactofitsactivitiesthroughthesharedCDCandOPHSFY1999goaltostoptheincreaseinyouthsmokingattheFY1997levelof36.4percent.Whiledatathatindicatethelevelofachievementforthiscrosscuttinggoalwillnotbeavailableuntil2000,CDCexpectsthattobaccocontrolprogramsshouldstartproducingannualratesofdeclineinyouthtobaccousebyFY2001.Forthatreason,CDCandOPHSsFY2001targetstoreduceyouthtobaccouseto35.9willbethefirsttoreflectananticipatedreductioninyouthsmoking. 3݌ (#(# Ќ    3    323  0    EnforcementatRetailEstablishments: TheFDAsenforcementeffortssupportsthe 4$" Departmentalinitiativebyreducingthenumberofretailerswhoselltobaccoproductstominors.SinceFY1997,FDAhasenteredintocontractswithall50statestoconductcompliancechecksatretailestablishmentsthatselltobaccoproducts.Byexpandingitscoveragefrom10statesinFY1997to43statesandterritoriesinFY1999,FDAhasbeenabletoincreasethenumberofcompliancechecksfrom6,464inFY1997toapproximately106,000inFY1999.FDAexpectsthenumberofcompliancecheckstoincreaseinFY20000@d"3.0@d" 0 asaresultofcontractssignedinFY1999thatexpandedcoveragetoall50statesand3territories. 3݌ (#(# Ќ        3    3^23  0    ImplementingtheSynarAmendment: SAMHSAsignificantlyexceededitsFY1999 p-(, performancetargetofdoublingfrom4to8thenumberofStateswhoserateoftobaccosales `.)- tominorsviolationsisatorbelow20percent.Theagencyreportedthat21StatesachievedthislevelofperformanceinFY1999.SAMHSA,inturn,madeitsFY2001targetmorerigorous,projectingthat36Stateswouldachievethislevelofcompliance.  3^݌(#(# Ќ  P - !"#$%&(@hx0 !"#$%&(=P YouthSubstanceAbuse  L  HHScontinuestoworkcloselywiththeONDCPtowardtheachievementofmeasurablereductionsindrugandalcoholabuse,particularlyamongyoungpeople.dHHSprograminitiativeshavefocusedonbothpreventionandtreatmentactivitiesinSAMHSA.IHSyouthsubstanceabuseprogramsfortheAI/ANpopulationsalsofocusonpreventionandtreatment.dOPHShassupportedeffortstoworkwithcommunitycoalitionsandothers.Researchactivities,particularlytheprogramsoftheNationalInstituteonDrugAbuseofNIH,arealsoanimportantaspectofthisHHSinitiative.L 0 !"#$%&(xh- !"#$%&(L  3    3-23  0    EffectivenessofTreatment: Inits1996NationalTreatmentImprovementEvaluationStudy   (NTIES),SAMHSAfoundaclearlinkagebetweentheprovisionofsubstanceabusetreatmentservicesandimprovedlifeoutcomesforbothchildrenandadults.ThefollowingareexamplesofNTIESfindingsontreatmenteffectiveness:78percentreductioninthepercentageofindividualsengaginginboththesaleofillicitdrugsandviolentcrimes; 3-[݌ (#(# Ќ  0  19percentincreaseintherateofemployment;42percentdecreaseinthepercentageofindividualswhowerehomeless;53percentdecreaseinalcoholandotherdrugrelatedmedicalvisits;28percentdecreaseininpatientmentalhealthvisits;and3456percentdecreasein highrisksexualbehaviorsassociatedwiththetransmissionofHIV. (#(# 9,X,hX,X,hX9L 0 !"#$%&(yx0 !"#$%&(L  3    3ʥ23  0    AssessingOutcomesofTreatment: TheNTIESfindingshaveledSAMHSAandState  substanceabuseprogramstopursuethedevelopmentofoutcomemeasuresonawiderscale.Since1997,throughtheTreatmentOutcomesandPerformancePilotStudies(TOPPS)initiative,SAMHSAandtheStateshaveidentifiedasetofoutcomeindicatorsforchildrenandadultsthatcanbeusedacrossStatestoassesssubstanceabuseprogramperformance.WiththeexperienceofNTIESandTOPPS,SAMHSAhasestablishedFY2001outcomeperformancetargetsforthe19StatesthatwillparticipateinTOPPSII.Althoughthiseffortwillnotprovidenationalperformanceoutcomeestimates,itwillprovidesignificantlybetterinformationontreatmentimpactsforthoseStates,andwillprovideaknowledgebasetoallowforexpansiontomoreStatesinfutureyears. 3ʥ݌ (#(# Ќ    3    3ש23  0    CoordinationonReductionofDrugUse: SAMHSAandHHShavealsoadoptedthe %8!$ followingONDCPlongtermprevalencetargetsasagencyandDepartmentalgoals:dBy2002,reducetheprevalenceofpastmonthuseofillegaldrugsandalcoholbyyouthby20percentasmeasuredagainstthe1996baseyear.By2007,reducethisprevalenceby50percent.d 3ש݌ (#(# Ќ    3    323  0    dPublicInformationd: SAMHSAsNationalClearinghouseforAlcoholandDrugInformation *%) (NCADI)experiencedtremendousgrowthinthenumberofrequestsitreceivedforinformation.In1999,SAMHSAdramaticallyexceededitstargetofafivepercentincreasefromits1997baseline;NCADIhada129percentincrease,foranaverageof40,285requestsforinformationpermonth.Basedonits1999performance,SAMHSAhassetmoreambitious <.)- futuretargets.In2001,SAMHSAprojectsthatitwillreach260percentofits1997baseline./XVJXXXVJNCADIisrespondingtothedemandgeneratedbytheONDCPNationalYouthAntiDrug  MediaCampaign.NCADIhasimplementedcallcenteroperations24hoursaday,7daysaweek,toservetheONDCPmediacampaignaswellasvariouspubliceducationcampaigns,andhasalsotakenonresponsibilityforSAMHSAsNationalTreatmentHelpline.#XVJXX/XVJŮ#Ԁ 31݌`(#(# Ќ    3    323  0    EffectiveUseofPreventionFunds: SAMHSAalsostrivestoimprovehowstatesspend 8  theirsubstanceabusepreventiondollarsbyencouragingthemtopromotesixpreventionstrategies:informationdissemination,education,alternativeactivities,problemidentificationandreferral,communitymobilization,andenvironmentalactivities.SAMHSAexceededits1999goalof80percentbyhaving90percentofStatesspendingpreventionfundsineachofthesixstrategyareas. 3݌ (#(# Ќ    3    3S23  0    SubstanceAbuseamongTribalYouth: 1XVJXXXVJԀBecausestudiesindicatethatthelongerindividuals   areengagedintreatment(includingaftercare/continuingcare)thebettertheprognosis,#XVJXX1XVJ#1XVJXXXVJIHS   hasdevelopedagoalfocusedonassuringadequatefollowupcareforadolescentsdischargedfromIHSsupportedRegionalTreatmentCenters(RTCs)#XVJXX1XVJӴ#1XVJXXXVJ.#XVJXX1XVJ#1XVJXXXVJԀIHSmetits#XVJXX1XVJ#FY1999targetto x determinebaselinesfortheratesandintensityoffollowupcare.Thefollowupratewithinthecriticalfirst30dayswas64.5percent1XVJXXXVJforthe815youthsdischargedfromthe12RTCin P FY1999.Thisratedropsto55.2percentforthosewhoreceivefollowupat30daysandatleastasecondfollowupby6months,anddownto40.9percentforthosewhoreceivefollowupcontactsat30days,atleastasecondfollowupby6months,andatleastathirdat12monthsafterdischarge.  #XVJXX1XVJ#1XVJXXXVJIHShassetatargettoincreasethefollowuprateby10percentin P FY2000.Inaddition,IHSwillestablishabaselineforameasuretoassesscontinuedabstinence(sixmonthsoflessalcoholanddrugusethanbeforetreatment)inFY2000#XVJXX1XVJ#1XVJXXXVJ.#XVJXX1XVJ# 3S~݌((#(# Ќ   DomesticViolenceandInjuries   Initsbudgetinitiatives,HHShasintroducedcrosscuttingstrategiestoreducethethreatoffamilyanddomesticviolence,particularlyagainstwomenandchildren,andtoreduceinjuryforallAmericans.TheHHSinitiativesreflecteffortstoprovidemoreresponsiveservicestoindividuals L! whosufferviolence,todevelopresearchaboutriskfactorsforperpetuatingviolence,andtochangethewaysthatsocietythinksaboutandtoleratesviolence.L 0 !"#$%&(yy0 !"#$%&(L  3    3"23  0    Surveillance: Muchisunknownaboutthefactorsthatcontributetointimatepartnerviolence $L # orviolenceagainstwomen.Since1994,CDChasfundedanumberofprojectstoincreasetheunderstandingoftheriskfactorsassociatedwithviolenceagainstwomen,themethodsofviolenceandtheeffectivenessofspecificinterventionorpreventionprograms.Onesuchprojectisabiannualsurveytodeterminetheincidenceandprevalenceofviolenceagainstwomen,whichwillbedevelopedinFY2000. 3"P݌ (#(# Ќ    3    3ؿ23  0    RecognizingDomesticViolence: 1XVJXXXVJRecognizingthatfamilyviolencevictims(child,spouseor t+&* elder#XVJXX1XVJn#1XVJXXXVJ)cometothehealthcaresystemwithavarietyofphysicalinjuries,illnessesormedical d,'+ conditionsdirectlyrelatedtoabuse,#XVJXX1XVJ#1XVJXXXVJԀIHSdevelopedagoaltoassurethatprovidersconsistently P-(, screenforindicationsofviolence,abuseorneglect andmakeappropriatereferrals.#XVJXX1XVJ#1XVJXXXVJԀA#XVJXX1XVJ#1XVJXXXVJԀwritten <.)- protocolmakesthismorelikelybecausetheseeffortsbecomepartofthelocalqualityassuranceprocess.#XVJXX1XVJ #1XVJXXXVJIHSexceededits#XVJXX1XVJ#FY1999goaltoassurethatatleast50percentofIHS,  Tribal,andUrbanfacilitieswithurgentcareoremergencydepartmentswouldhavewrittenpoliciesandproceduresforroutinelyidentifying,treatingand/orreferringvictimsoffamilyviolence,abuseorneglect.Asurveyof223clinicsandhospitalsthatshowedthat64percenthadwrittenpoliciesandproceduresinplace.Inaddition,thesurveydemonstratedthathavingpoliciesandproceduresinplaceactuallyraisedthelikelihoodthatpatientsareregularlyscreenedforviolenceabuseandneglect.  3ؿ݌$ t(#(# Ќ  9,X,hX,X,hX9  3    323  0    AddressingDomesticViolence: ACFplanstoincreasethenumberofFederallyrecognized  L  IndianTribesthathavefamilyviolencepreventionprograms.AlthoughACFsetatargetof162TribeshavingsuchprogramsinFY1999,itsurpasseditsgoalwith174Tribeshavingtheseprogramsinplace.InFY2001,ACFsgoalistohave189Tribeswithfamilyviolencepreventionprograms.Inaddition,EtFXXVJԀACFoperatestheNationalDomesticViolenceHotlinein   ordertoprovidereferralsandcounselingtothoseexperiencingabuse.Initsfirstyearofoperation,theHotlineanswered73,540phonecallsandthenumberofincomingcallsisdprojectedtoincreasetoanaverageof10,000phonecallspermonthinFY2001.d#XVJXFEt #EtFXXVJ   @  3"݌l(#(# Ќ  #XVJXFEt#  3    3N23  0    BicycleRelatedInjuries: InFY1996,anestimated352,000childrensoughtemergency < roomcareforabicyclerelatedinjury,30percentofwhichwerehead,facialandearinjuries.Studiesindicatethatbicyclehelmetsprevent6988percentofseriousheadorbraininjuries.AspartoftheDepartmentseffortstoreducebicyclerelatedinjuries,CDChasestablishedademonstrationprojecttoincreasetheuseofbicyclehelmetsbychildbicyclistsinCDCffundedprojectareas.AlthoughfinaldataforthismeasurewillnotbeavailableuntilApril2000,preliminarydatafromFY1998indicatethathelmetusageincreasedinallfiveprojectareas. 3N|݌ (#(# Ќ    3    323  0    ReducingInjuries: Becauseinjuriesarealeadingcauseofhospitalizationanddeathfor  AmericanIndianandAlaskanNativepeople,IHSsetaFY1999goaltoassurethattheinjurydeathratewasnogreaterthan93per100,000deaths.WhileFY1999datawillnotbeavailableuntilXX,therateforFY19941996hasdroppedto92.6per100,000,from95per100,000inFY19921994.Infact,injurieshavedroppedfromtheleadingcauseofdeathintheearlypartofthedecadetothesecondleadingcauseofdeathcurrently.Andwhileseven ,"|  IHSAreasstillhaveratesthatareabovetheFY1999target,mostoftheseareasareintheruralwestwheretraveldistancesarelongandresidentsareathighriskformotorvehiclerelatedinjury.However,theseArearateshavebeentrendingdownward,duetoeffortstoreduceimpaireddriving,thetribespassingtougherdrunkdrivingandoccupantrestraintlaws,andstricterenforcementoftheselaws. 3݌ (#(# Ќ  ##P 0 !"#$%&(xy0 !"#$%&(ּP ReducingSexuallyTransmittedDiseases  )$( SexuallyTransmittedDiseases(STDs)areoneofthemostcriticalchallengesinthenationtodaybecauseoftheirsevere,costlyconsequencesforwomenandinfants;theirtremendousimpactonthehealthofadolescentsandyoungadults(especiallyamongminoritypopulations);andtheintegralroletheyplayinthetransmissionofHIVinfection.HHScrosscuttingbudgetinitiatives (.x)- havegivenemphasistobothpreventionandtreatmentstrategies.HHSconsistentlyseekstopromotehealthybehaviorsanddiscourageriskyones.Forexample,westrivetoextendHIVcounseling,testing,andreferralserviceswhereyoung,lowincome,andminoritychildrenareathighriskofinfection.SurveillanceofriskybehavioralfactorspredisposingchildrenandyouthtosexuallytransmitteddiseasehasbeenasignificantchallengefortheDepartmentaswepursueinformationthatisrelevanttopreventionpoliciesandapproachesfordecisionmakers.L 0 !"#$%&(xx0 !"#$%&(L  3    323  0    HIV/AIDSPreventioninYouth :CDCsHIV/AIDSprogrammonitorsstudents'exposure $ t toHIV/AIDSpreventioneducationinschools,whichhasbeendemonstratedtoreduceriskbehaviorsamongyouth,andyouthbehaviorsthataffecttheirriskofbecominginfectedwithHIV.InFY2000,theprogramwillreportonitsFY1999goaltomaintainthepercentageofhighschoolstudentswhohavebeentaughtaboutHIV/AIDSpreventioninschoolat90percentorgreater.TheFY1997rateis92percent,upfrom86percentin95.Inaddition,CDChassetFY2000targetstoreducethepercentageofhighschoolstudentswhohaveeverengagedinsexualintercourseto45percentfrom48percentinFY1997andtoreducethepercentageofcurrentlysexuallyactivehighschoolstudentswhoengageinsexualintercoursewithoutacondomto38percentfrom43percentinFY1997. 3A݌ (#(# Ќ  L 0 !"#$%&(xx0 !"#$%&(L  3    323  0    GonorrheaandChlamydia :CDCandOPHSperformancegoalsfocusonwomenaged L 15-44seenatpubliclyfundedfamilyplanningandSTDclinicsforseveralreasons:womenofchild-bearingageexperiencehighincidenceratesofgonorrheaandchlamydia;womeninfectedwithNeisseriagonorrheaorChlamydiatrachomatiscandeveloppelvicinflammatorydiseasewhichmay,inturn,leadtoadversereproductiveconsequences(e.g.ectopicpregnancy,tubalfactorinfertility;)familyplanningandSTDclinicsrepresentclinicsettingswiththehighestprevalenceratesforthesediseases;andCDCresourcessupportfamilyplanningandSTDclinics,therefore,performancemeasuresatthesesitesaregoodindicatorsforprogrameffectiveness. 3݌ (#(# Ќ  ݀L 0 !"#$%&(xx0 !"#$%&(LL , !"#$%&(dxx0 !"#$%&(L  3   0   32d3  0(#(#  Gonorrhea:In1998,355,642casesofgonorrheawerereportedtoCDC,foranoverall  rateof132.9casesper100,000population.Thiswasan8.9percentincreaseincasescomparedwith1997,andthefirstincreasesince1985.Theincreasein1998wasseeninalldemographicgroupsdefinedbyage,sex,andrace/ethnicity,andoccurredinallmajorgeographicregionsexcepttheNortheast.Possiblereasonsfortheincreaseingonorrheaincludeexpansionofscreeningprograms(motivatedby  theavailabilityofsimultaneous  $#t!  testingforgenitalchlamydialinfections),increaseduseofnewdiagnostictestswith $d" improvedsensitivity,improvementsinsurveillancesystems,and,insomesegmentsofthepopulation(includingmenwhohavesexwithmen),trueincreasesinmorbidity.ThisisalsoreflectedinthemostrecentdataforthejointCDC/OPHSgoaltoreducetheincidenceofgonorrheainwomenaged1544inpubliclyfundedfamilyplanningandSTDclinicstolessthan250per100,000byFY1999.FY1998datashowarateof292per100,000,risingfrom261inFY1997and259inFY1996. 3>݌ (#(# Ќ  0   (#(#   3   0   32d3  0(#(#  Chlamydia:In1998,CDCreportedagenitalchlamydiainfectionrateof233.7casesper t+&* 100,000population,thehighestratereportedsincecaseswerefirstreportedinthemid1980s.Theincreaseinreportedinfectionsreflectsthecontinuedexpansionofchlamydiascreeningprogramsandtheincreaseduseofmoresensitivediagnostictestsforthis 8.)- condition.Overthesameperiod,dataonchlamydiaprevalenceobtainedbymonitoringpositivityratesofpersonsscreenedinavarietyofclinicsettingshaveconsistentlydocumenteddeclininglevelsofinfectioninmanypartsoftheU.S.InFY1998,CDCreportsaprevalencerateof5.4percentamongwomenundertheageof25inpubliclyfundedfamilyplanningandSTDclinics,alreadysurpassingtheFY1999targetoflessthansixpercent.However,amonghighriskwomenunder25,theprevalenceratewas11.7 L  percent,wellabovetheFY1999targettolowertheprevalencerateto8percent. 3݌ (#(# Ќ  P 0 !"#$%&(xx, !"#$%&(P  3    323  0    PrimaryandSecondarySyphilis .From1990to1998,theprimaryandsecondarysyphilis  ` ratedeclinedby86percent,from20.3to2.6per100,000,thelowestlevelsincereportingbeganin1941.SyphilishasdeclinedinallregionsoftheUnitedStatesandinallracial/ethnicgroups,howeverratesremaindisproportionatelyhighamongnonHispanicblacksandintheSouth,andfocaloutbreakscontinuetooccur.Toaddresstheseregionaldifferences,CDCsetagoaltoreducetheincidenceofprimaryandsecondarysyphilisthroughthedevelopmentofsyphiliseliminationactionplansforeachstatewitharateofgreaterthanorequalto4per100,000population.InFY1998,CDCachieveditsFY1999targettoincreasethepercentofU.S.countiesthathaveanincidenceofprimaryandsecondarysyphilisinthegeneralpopulationoflessthanorequalto4per100,000. 3݌ (#(# Ќ    3    323  0    CongenitalSyphilis :In1998,801casesofcongenitalsyphiliswerereportedtoCDC,fora 8 rateof20.6casesper100,000livebirths,movingtowardsCDCsFY1999targetoflessthan20per100,000.Inparallelwiththedeclineinprimaryandsecondarysyphilis,therateofcongenitalsyphilishasdeclineddramaticallyfromapeakof107.3per100,000livebirthsin1991.Noorlatesyphilisserologictestingduringpregnancy,oftenrelatedtolackofprenatalcareorlateprenatalcare,remainsthemajorreasonthatcongenitalsyphilispersistsintheU.S.Congenitalsyphilisisahighpriorityforprogrammaticactivityandeachpositivetestinachildisconsideredamedicalemergencywithimmediatehealthservicesfollowup.Effectiveprenatalscreeningprogramsforpatientsathighriskofsyphilisaccountforasubstantialportionofthereduction. 3݌ (#(# Ќ   t iU25%!`z  `Ett oi (#(#      (#(#iU5%!`z  `Ett oi lXXVJS#XVJXl#UMMARYlXXVJP#XVJXl#ERFORMANCElXXVJR#XVJXl`#EPORT  8  Overthelastfouryears,crosscuttingDepartmentalbudgetinitiativessupportingthisstrategicgoalhavefocusedespeciallyonimprovingtheeconomicandsocialwellbeingofthemostvulnerableinthenation:childrenandtheirfamilies,theelderly,thedisabled,andthedisadvantaged.ProminentDepartmentalinitiativestoimprovethelivesofchildrenhaveinvolvedacrosssectionofHHSprograms,including:HeadStart,ChildCare,ChildSupport,ChildrensHealth,YouthSubstanceAbuse,theStateChildrensHealthInsuranceProgram(SCHIP),Medicaid,andMaternalandChildHealth.TheHHSinitiativeshavealsosoughtcontinuousimprovementfortheelderlywitheldercare,improvementsinMedicare,increasedhealthplanchoices,andreformoflongtermcare.AsanintegratedDepartment,HHShasalsopursuedimprovedhealthforthenationasawhole,withinitiativesthatfocusonimprovementsinareasreflectedintheleadinghealthindicatorsthatwillbeestablishedundertheDepartmentsHealthy p People2010program. \ L 0 !"#$%&(yx0 !"#$%&(LEtFXXVJ ChildrensHealthandDevelopment   p #XVJXFEt{#HHSscrosscuttingbudgetinitiativesforthehealthydevelopmentofchildrenhavefocusedon 8 theavailability,access,andqualityofcareinmultiplesettings.Initiativeshavecoveredhealth,safety,emotional,economicwellbeing,andknowledgedevelopmentforpreschoolersandolderchildren.HHSeffortscutacrosscomponentagenciesandalsofostercommunicationwithandbyStateandlocalagenciesthatservechildren.Forexample,throughAdministrationandHHSinitiativesofrecentyears,HCFA,HRSA,ACFandtheStatesarereachingouttouninsuredchildrenandtheirfamiliesthroughmultipleprogrammechanismstoensurethattheyhaveaccesstohealthinsurancecoverageandservices.EtFXXVJ \! #XVJXFEt#  3    3<23  0    ChildhoodVaccinations: Datashowthatcasesofvaccinepreventablechildhooddiseases 0#! havebeenreducedby97percentfrompeaklevelsbeforethevaccineswereavailable.Similarly,vaccinationofpreschoolagechildrenisatanalltimehighforallgroups.Toensurethatpreschoolagechildrencontinuetobevaccinatedagainstpreventablediseases,CDCandHCFAhavedevelopedcomplementarygoalstoincreasethepercentageof2yearoldchildrentoreceiveallrecommendedchildhoodvaccinations.CDCseffortsfocusonmaintaininga90percentcoveragerateamongchildren1935monthsforeachrecommendedvaccine.WhileFY1999datawillnotbeavailableuntil2000,datafromFY97indicatethatCDCmetthatgoalforallbuttwovaccines.HCFAwillcontinuetodevelopitsgoaltoincreasethepercentageofMedicaidtwoyearoldchildrenwhoarefullyimmunized.Thefirstgroupof16statesbegandevelopingtheirmethodsofmeasurementandperformancebaselinesinFY1999, andwillcompletesettingtheirbaselinesbytheendofFY2000.EtFXXVJ 3<j݌X-(,(#(# Ќ    3    3R23  0    #XVJXFEt#IHSWellChildVisits :1XVJXXXVJArecognizedstandardofcare,wellchildvisitshavebeenassociated   withimprovedpostneonatalmortalityandopportunitiestoimprovefamilyhealthandsafetyinthelongerterm.Ofparticularimportanceareeducationalinterventionswithparentsconcerningdietandnutrition,injuryprevention,andpreventionoffamilyviolence.Aspartoflargereffortstoim#XVJXX1XVJ#1XVJXXXVJprovechildandfamilyhealth#XVJXX1XVJ#1XVJXXXVJ,IHSsetaFY1999goal todeterminethe d proportionoftheAmericanIndianandAlaskanNativechildrenreceivingaminimumoffourwellchildvisitsby27monthsofage.ProvisionalFY1999dataindicatethatoutof9,873children,3,799or38.5percentofthechildrenmetthiscriteria.  #XVJXX1XVJ3#1XVJXXXVJԀIHShassetaFY2000target ( x