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 Companies (HHS), and his nomination hearings will highlight a variety of HHS actions however could not contact on the total scope of the division’s tasks. To higher perceive HHS’s affect on the well being care system and the American folks’s protection, public well being, security, and well-being, what follows is an outline of the actions of the division.
Overview of HHS
The Division of Well being, Schooling, and Welfare was established in 1953 and advanced into the Division of Well being and Human Companies 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 Yr (FY) 2024 finances funding estimated at $1.7 trillion, and the division’s finances is a couple of quarter of the whole FY 2024 U.S. federal finances. It has the most important finances 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 centered on social help and help for households and communities in want. More than 80,000 HHS employees are positioned throughout the U.S. and the world and half of the workforce is exterior the better Washington, D.C. space.
The Public Well being Service (PHS) predates HHS and now exists throughout ten of the 13 working divisions inside the division:
- The Administration for Strategic Preparedness and Response (ASPR)
- The Superior Analysis Tasks 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 Sources and Companies Administration (HRSA)
- The Indian Well being Service (IHS)
- The Nationwide Institutes of Well being (NIH)
- The Substance Abuse and Psychological Well being Companies 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 a number of 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 Companies (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 applications present well being protection entry to 170 million Individuals—greater than half the inhabitants. Nevertheless, the affect of HHS on the nation’s medical insurance system goes effectively past the applications 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 applications 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 infrequently serve particular populations, e.g., folks experiencing homelessness, migratory agricultural staff, and rural residents. HHS has a central position in setting requirements and offering important funding by varied sources. HHS additionally supplies medical and public well being care to American Indians and Alaskan Natives by a community of suppliers run or contracted by the Indian Well being Service. It has applications addressing the wants of particular populations, together with the Ryan White HIV/AIDS program, refugee health, mental health and substance use treatment applications, 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 as a result of 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 tasks, together with analysis, screening, coverage improvement and steering, public schooling, therapy, and funding for state and native well being departments.
Other than COVID-19, HHS has been energetic in addressing infectious illness outbreaks of H5N1 avian flu, mpox, and hepatitis A up 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 companies.
HHS has supplied emergency coordination and strategic planning to arrange shelters for acute medical care and psychological well being help, generally using the National Disaster Medical System, accessed stockpiles of essential tools and drugs, led investigations and expanded on testing and monitoring actions, and assisted with survivor and neighborhood restoration together with continuity of well being care providers.
Meals and Drug Security
Arguably, the broadest contact level for HHS’ affect on Individuals’ day by day lives is its position in food safety. The Meals and Drug Administration (FDA) oversees most meals security other than meat and poultry and shares accountability for egg merchandise with the Division of Agriculture. It additionally regulates the details about dietary dietary supplements supplied 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 guaranteeing imported meals meets U.S. requirements. Nevertheless, the FDA isn’t the one HHS company that performs a major 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 the FDA. This consists of pre-market testing for the protection and effectiveness of a product’s supposed use, monitoring of authorised merchandise for any hurt to shoppers, and laws for producing and labeling such merchandise.
Scientific Analysis and Innovation
HHS, primarily by the Nationwide Institutes of Well being, is the world’s largest public funder of health research. Whereas the analysis usually performed can heart on the fundamentals of science and biomedicine, it has led to breakthroughs like the primary profitable polio vaccine, remedies for most cancers and HIV/AIDs, the event of MRI know-how, and the power to personalize drugs due to the mapping of the human genome.
Supporting Households and Communities
The well being of people could 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 is probably not sometimes thought-about well being providers, however normally issue within the stability of particular person and household lives.
Monetary help for low-income households with youngsters 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 applications associated to little one help enforcement, foster care, adoption, and little one care. It additionally promotes early childhood improvement in low-income youngsters below the age of 5 by Head Start.
One factor of the division’s help providers that has gained important 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. Companies provided embrace monetary help, housing, medical care, and employment providers.
