United States Department of Health and Human Services

The United States Department of Health and Human Services (HHS) is a cabinet-level executive branch department of the U.S. federal government created to protect the health of the U.S. people and providing essential human services. Its motto is "Improving the health, safety, and well-being of America". Before the separate federal Department of Education was created in 1979, it was called the Department of Health, Education, and Welfare (HEW).


HHS is administered by the Secretary of Health and Human Services, who is appointed by the president with the advice and consent of the United States Senate. The position is currently held by Xavier Becerra.


The United States Public Health Service Commissioned Corps, the uniformed service of the PHS, is led by the Surgeon General who is responsible for addressing matters concerning public health as authorized by the secretary or by the assistant secretary for Health in addition to his or her primary mission of administering the Commissioned Corps.

Structure

Internal structure

The Department of Health & Human Services is led by the United States Secretary of Health and Human Services, a member of the United States Cabinet appointed by the President of the United States with the consent of the United States Senate. The secretary is assisted in managing the department by the Deputy Secretary of Health and Human Services, who is also appointed by the president. The secretary and deputy secretary are further assisted by seven assistant secretaries, who serve as top departmental administrators.


As of January 20, 2018, this is the top level of the organizational chart. HHS provides further organizational detail on its website.


Several agencies within HHS are components of the U.S. Public Health Service (PHS), as noted below.

Immediate Office of the Secretary

The Immediate Office of the Secretary (IOS) is the top-level unit that directly reports to the Secretary of Health and Human Services. They assist in the administration of HHS and include the following components:

• Office of the Deputy Secretary (DS) – an Executive Schedule, Level II Position. This role is responsible for all departmental operations.
• Office of the Chief of Staff (COS) – This role is responsible for staff coordination and support.
• Office of the General Counsel (OGC)
• Executive Secretariat (ES or ExecSec) – Develops and reviews rules, regulations, correspondences, Reports to Congress, and other policy-related documents and decisions. Headed by the Executive Secretary to the Department and assisted by the Deputy Executive Secretary.
• Office of Health Reform – Oversees the implementation of new policies and legislation.
• Office of the Chief Technology Officer (CTO) – Oversees the use of Data and Technology implementations in HHS.
• Office of National Security (ONS) – A department-wide office that provides oversight, policy direction, standards, and performance assessments on all intelligence and national security related programs within HHS.

Office of the Secretary

The Office of the Secretary (OS) is the unit directly below the Immediate Office of the Secretary, but still directly reports to the Secretary. This unit consists of the offices of assistant secretaries including:

• Office of the Assistant Secretary of Health and Human Services for Financial Resources (ASFR)
• Office of the National Coordinator for Health Information Technology (ONC)
• Office of the Assistant Secretary of Health and Human Services for Public Affairs (ASPA)
• Office of the Assistant Secretary for Legislation (ASL)
• Office of the Assistant Secretary of Health and Human Services for Planning and Evaluation (ASPE)

Office of Intergovernmental and External Affairs

The Office of Intergovernmental and External Affairs (IEA) serves as the liaison to state, local and tribal governments as well as NGOs. Through the IEA, HHS directs oversees current federal health programs at the regional and tribal level.

• Headquarters Staff – assists the HHS Secretary in developing policies related to state and local government relations.
• Tribal Affairs – serves as the point of contact for HHS regarding HHS programs on Indian reservations.
• Center for Faith-based and Neighborhood Partnerships (a.k.a. the Partnership Center) – works to create partnerships with faith-based and community organizations at the local level.
• Office of Human Resources – the department-wide office for HR related issues.
• Regional Offices – Work with the subordinated state governments to institute HHS policy in the respective regions. Each office is led by a presidential-appointed regional director.

HHS IEA Regional Offices

Region	Regional Director	Subordinated States
Region 1		Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont
Region 2		New Jersey, New York, Puerto Rico, and the Virgin Islands
Region 3		Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, and West Virginia
Region 4		Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee
Region 5		Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin
Region 6		Arkansas, Louisiana, New Mexico, Oklahoma, and Texas
Region 7		Iowa, Kansas, Missouri, and Nebraska
Region 8		Colorado, Montana, North Dakota, South Dakota, Utah, and Wyoming
Region 9		Arizona, California, Hawaii, Nevada, American Samoa, Commonwealth of the Northern Mariana Islands, Federated States of Micronesia, Guam, Marshall Islands, and Republic of Palau
Region 10		Alaska, Idaho, Oregon, and Washington

U.S. Public Health Service

Within HHS is a collection of agencies and offices that fall under the Public Health Service. The PHS also is home to the Public Health Service Commissioned Corps (PHSCC).

• Office of the Assistant Secretary for Health (OASH) and the U.S. Surgeon General
• Office of Global Affairs

The subordinate operating agencies under the Public Health Service:

• National Institutes of Health (NIH)
• Centers for Disease Control and Prevention (CDC)
• Indian Health Service (IHS)
• Food and Drug Administration (FDA)
• Agency for Toxic Substances and Disease Registry (ATSDR)
• Health Resources and Services Administration (HRSA)
• Agency for Healthcare Research and Quality (AHRQ)
• Substance Abuse and Mental Health Services Administration (SAMHSA)
• Administration for Strategic Preparedness and Response (ASPR)

Human Services agencies

This list includes the subordinate agencies that do not fall under the Public Health Service, but are under HHS:

• Administration for Children and Families (ACF)
• Administration for Community Living (ACL)
• Centers for Medicare & Medicaid Services (CMS) – formerly the Health Care Financing Administration.

Office of Inspector General

The Office of Inspector General, U.S. Department of Health and Human Services (OIG) investigates criminal activity for HHS. The special agents who work for OIG have the same title series "1811" as other federal criminal investigators, such as the FBI, HSI, ATF, DEA and Secret Service. They receive their law enforcement training at the U.S. Department of Homeland Security's Federal Law Enforcement Training Center in Glynco, Georgia. OIG Special Agents have special skills in investigating white collar crime related to Medicare and Medicaid fraud and abuse. Organized crime has dominated the criminal activity relative to this type of fraud.


HHS-OIG investigates tens of millions of dollars in Medicare fraud each year. In addition, OIG will continue its coverage of all 50 states and the District of Columbia by its multi-agency task forces (PSOC Task Forces) that identify, investigate, and prosecute individuals who willfully avoid payment of their child support obligations under the Child Support Recovery Act.


HHS-OIG agents also provide protective services to the Secretary of HHS, and other department executives as necessary.


In 2002, the department released Healthy People 2010, a national strategic initiative for improving the health of Americans.


With the passage of the Fraud Enforcement and Recovery Act of 2009, and the Affordable Care Act of 2010, the Office of the Inspector General has taken an emboldened stance against healthcare related non-compliance, most notably for violations of Law and the Anti-Kickback Statute.


In 2015, the OIG issued a fraud alert as a warning to hospitals and healthcare systems to monitor and comply with their physician compensation arrangements.


Recent years have seen dramatic increases in both the number and the amounts of Stark Law violation settlements, prompting healthcare experts to identify a need for automated solutions that manage physician arrangements by centralizing necessary information with regard to physician–hospital integration. Contract management software companies such as Meditract provide options for health systems to organize and store physician contracts. Ludi Inc introduced DocTime Log®, an SaaS solution that specifically addresses this growing concern, automating physician time logging in compliance with contract terms to eliminate Stark Law and Anti-Kickback Statute violations.


According to a report released by the OIG in July 2019, more than 80 percent of the 4,563 U.S. hospice centers that provide care to Medicare beneficiaries surveyed from 2012 to 2016 have at least one deficiency and 20 percent have at least one "serious deficiency".


From January 2020, Christi Grimm became the principal deputy inspector general. She assumed the duties of an acting inspector general, because the inspector general post was empty.[16] In April 2020, Grimm released a report which surveyed the state of hospitals in late March during the COVID-19 pandemic in the United States. The hospitals reported "severe shortages of testing supplies", "frequently waiting 7 days or longer for test results", which extended the length of patient stays and strained resources, and "widespread shortages of PPE".[17] President Trump called the report "wrong" and questioned Grimm's motives. Later he called the report "Another Fake Dossier!" In May 2020, Trump nominated Jason Weida to be the permanent inspector general, pending confirmation by the U.S. Senate. According to a department spokeswoman, Grimm will remain as principal deputy inspector general.

Former operating divisions and agencies

• Social Security Administration, made independent in 1995.

History

Federal Security Agency

The Federal Security Agency (FSA) was established on July 1, 1939, under the Reorganization Act of 1939, P.L. 76–19. The objective was to bring together in one agency all federal programs in the fields of health, education, and social security. The first Federal Security Administrator was Paul V. McNutt. The new agency originally consisted of the following major components: (1) Office of the Administrator, (2) Public Health Service (PHS), (3) Office of Education, (4) Civilian Conservation Corps, and (5) Social Security Board.

Department of Health, Education, and Welfare

The Department of Health, Education, and Welfare (HEW) was created on April 11, 1953, when Reorganization Plan No. 1 of 1953 became effective. HEW thus became the first new Cabinet-level department since the Department of Labor was created in 1913. The Reorganization Plan abolished the FSA and transferred all of its functions to the secretary of HEW and all components of the agency to the department. The first secretary of HEW was Oveta Culp Hobby, a native of Texas, who had served as commander of the Women's Army Corps in World War II and was editor and publisher of the Houston Post. Sworn in on April 11, 1953, as secretary, she had been FSA administrator since January 21, 1953.


The six major program-operating components of the new department were the Public Health Service, the Office of Education, the Food and Drug Administration, the Social Security Administration, the Office of Vocational Rehabilitation, and St. Elizabeth's Hospital. The department was also responsible for three federally aided corporations: Howard University, the American Printing House for the Blind, and the Columbia Institution for the Deaf (Gallaudet College since 1954).

Department of Health & Human Services

The Department of Health, Education, and Welfare was renamed the Department of Health & Human Services (HHS) on October 17, 1979, when its education functions were transferred to the newly created United States Department of Education under the Department of Education Organization Act. HHS was left in charge of the Social Security Administration, agencies constituting the Public Health Service, and Family Support Administration.


In 1995, the Social Security Administration was removed from the Department of Health & Human Services, and established as an independent agency of the executive branch of the United States Government.


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

Type

Federal, Medical

Founding Date

April 11, 1953

Subsidiary Organizations

• Centers for Disease Control and Prevention