With President Trump now in workplace, his cupboard nominees proceed to testify at congressional hearings as a part of the nomination course of. Robert F. Kennedy Jr. is the nominee to be the secretary of the Division of Well being and Human Providers (HHS), and his nomination hearings will highlight a variety of HHS actions however could not contact on the complete scope of the division’s obligations. To higher perceive HHS’s influence on the well being care system and the American folks’s protection, public well being, security, and well-being, what follows is an summary of the actions of the division.
Overview of HHS
The Division of Well being, Schooling, and Welfare was established in 1953 and developed into the Division of Well being and Human Providers in 1980 after the Division of Schooling was established as an impartial entity. A comparatively new division of the 15 present government department departments, HHS has a Fiscal 12 months (FY) 2024 funds funding estimated at $1.7 trillion, and the division’s funds is a couple of quarter of the full FY 2024 U.S. federal funds. It has the most important funds of any federal company and is the largest grant-making agency.
Most federal executive branch health policy is applied and managed inside HHS, although the White Home sometimes performs a serious position in policymaking. The division has 13 operating divisions, most of which have a well being focus in areas of protection, analysis, regulation, useful resource supply, and coaching. Others are targeted on social help and assist for households and communities in want. More than 80,000 HHS employees are situated throughout the U.S. and the world and half of the workforce is exterior the larger Washington, D.C. space.
The Public Well being Service (PHS) predates HHS and now exists throughout ten of the 13 working divisions throughout the division:
- The Administration for Strategic Preparedness and Response (ASPR)
- The Superior Analysis Initiatives Company for Well being (ARPA-H)
- The Company for Healthcare Analysis and High quality (AHRQ)
- The Company for Poisonous Substances and Illness Registry (ATSDR)
- The Facilities for Illness Management and Prevention (CDC)
- The Meals and Drug Administration (FDA)
- The Well being Assets and Providers Administration (HRSA)
- The Indian Well being Service (IHS)
- The Nationwide Institutes of Well being (NIH)
- The Substance Abuse and Psychological Well being Providers Administration (SAMHSA)
Led by the Assistant Secretary of Health and the U.S. Surgeon General, the greater than 6,000 United States Public Well being Service Corps work throughout HHS and several other different federal departments in on a regular basis roles involving their well being experience, however they’re additionally the nation’s frontline staff for emergency response together with public well being emergencies.
Well being Care Protection and Affordability
The biggest division of HHS is the Facilities for Medicare and Medicaid Providers (CMS), liable for administering or overseeing medical insurance protection for Medicare, Medicaid, the Youngsters’s Well being Insurance coverage Program, and the Inexpensive Care Act’s Health Insurance Marketplaces. Collectively, these packages present well being protection entry to 170 million People—greater than half the inhabitants. Nonetheless, the influence of HHS on the nation’s medical insurance system goes properly past the packages it administers, as it’s closely concerned within the federal regulation of private health insurance, together with employer-sponsored medical insurance protecting greater than 150 million folks, at the side of the Departments of Labor and the Treasury.
Past the core medical insurance packages CMS administers, HHS additionally helps entry to well being care providers in a number of different methods. Community health centers present main care and a few extra providers to low-income and uninsured populations and sometimes serve particular populations, e.g., folks experiencing homelessness, migratory agricultural staff, and rural residents. HHS has a central position in setting requirements and offering vital funding by means of numerous sources. HHS additionally offers medical and public well being care to American Indians and Alaskan Natives by means of a community of suppliers run or contracted by the Indian Well being Service. It has packages addressing the wants of particular populations, together with the Ryan White HIV/AIDS program, refugee health, mental health and substance use treatment packages, and maternal and child health, to call a couple of.
Public Well being and Illness Management
The general public well being position of HHS has been within the spotlight because of the COVID-19 pandemic, however its position throughout the disaster was primarily based on pre-existing infrastructure and routine actions that adapt to the wants of the day. The division has a long-standing position in monitoring, stopping, and lowering the unfold of infectious and non-communicable illnesses. Its position encompasses a variety of obligations, together with analysis, screening, coverage improvement and steering, public training, therapy, and funding for state and native well being departments.
Other than COVID-19, HHS has been lively in addressing infectious illness outbreaks of H5N1 avian flu, mpox, and hepatitis A prior to now 5 years and works on long-term challenges just like the HIV/AIDS epidemic. The position of HHS in vaccination dates again to the Fifties polio vaccine and it continues to have a substantial role in influencing the country’s vaccine policy.
Emergency Preparedness and Response
The routine well being actions of HHS usually merge with its position in addressing the well being impacts of public emergencies and disasters. Occasions just like the September 11, 2001, terrorist assaults, the opioid epidemic, the Flint, Michigan water disaster, pure disasters of hurricanes, tornadoes, and wildfires, and illness outbreaks have all triggered an HHS response at the side of different federal businesses.
HHS has offered emergency coordination and strategic planning to arrange shelters for acute medical care and psychological well being assist, generally using the National Disaster Medical System, accessed stockpiles of important gear and medication, led investigations and expanded on testing and monitoring actions, and assisted with survivor and group restoration together with continuity of well being care providers.
Meals and Drug Security
Arguably, the broadest contact level for HHS’ influence on People’ each day lives is its position in food safety. The Meals and Drug Administration (FDA) oversees most meals security except for meat and poultry and shares duty for egg merchandise with the Division of Agriculture. It additionally regulates the details about dietary dietary supplements offered to shoppers, although it doesn’t have authority to approve them for security and effectiveness. Among the many actions associated to meals security are conducting inspections of amenities, labeling necessities, issuing meals recollects and alerts, and making certain imported meals meets U.S. requirements. Nonetheless, the FDA isn’t the one HHS company that performs a big position in meals security, because the Facilities for Illness Management’s broad position of monitoring and responding to illness outbreaks additionally consists of these associated to consuming contaminated meals.
HHS has a serious position in regulating medical drugs and devices, primarily by means of the FDA. This consists of pre-market testing for the protection and effectiveness of a product’s meant use, monitoring of permitted merchandise for any hurt to shoppers, and laws for producing and labeling such merchandise.
Scientific Analysis and Innovation
HHS, primarily by means of the Nationwide Institutes of Well being, is the world’s largest public funder of health research. Whereas the analysis usually carried out can middle on the fundamentals of science and biomedicine, it has led to breakthroughs like the primary profitable polio vaccine, therapies for most cancers and HIV/AIDs, the event of MRI expertise, and the flexibility to personalize medication due to the mapping of the human genome.
Supporting Households and Communities
The well being of people will be impacted by a number of non-medical components usually categorized as social determinants of well being. HHS has a variety of social service programs that might not be sometimes thought-about well being providers, however often issue within the stability of particular person and household lives.
Monetary help for low-income households with kids has lengthy been a federal program, and Temporary Assistance for Needy Families (TANF) is the first money help program for this inhabitants. TANF is run by the HHS Administration of Children and Families (ACF) which additionally has packages associated to little one assist enforcement, foster care, adoption, and little one care. It additionally promotes early childhood improvement in low-income kids beneath the age of 5 by means of Head Start.
One component of the division’s assist providers that has gained vital consideration over the previous decade, significantly as refugee resettlement submissions to the U.S. have sharply increased, is the array of providers provided by the Workplace of Refugee Resettlement (ORR). Established 45 years ago, ORR goals to combine people, together with unaccompanied minors, and households into American society and supply a pathway to self-sufficiency. Providers provided embrace monetary help, housing, medical care, and employment providers.
