The staff offices supported by this activity provide assistance to the Secretary in the formulation of broad policy direction to the operating programs of the Department. This assistance includes development of the Department's legislative program and liaison with the Congress; coordination of the Department's international activities; program planning and evaluation; and providing policy direction and coordination of the Department's health programs. An increase of forty five positions is requested for Executive Direction in FY 1974 to strengthen the Executive Secretariat (+1), the Office of Health (+14), the Office of Legislation (+14), and the Office of Planning and Evaluation (+16). Accomplishments FY 1972-73 Secretary and Under Secretary During FY 1972-73 the Immediate Office of the Secretary and Under Secretary made substantial progress in increasing the effectiveness of the Department's management and policy development process the Counselor to the Department fulfilled overall liaison responsibilities to the White House, Office of Management and Budget, and the Domestic Council; the Executive Secretariat advised the Secretary on the assignment of action responsibility, monitored policy development and implementation, and assumed the responsibility for coordination, follow through, and internal informational flow in the Department; and a position of Special Assistant to the Secretary for External Affairs served as liaison to public interest groups concerned with HEW programs and as a coordinator of the Department's contacts with these groups. Program Plans FY 1974 In FY 1974, the Immediate Office of the Secretary and Under Secretary plan to improve techniques in assigning responsibility, to provide for expeditious coordination, communication and follow-through on Secretarial decisions, and to improve information flow within the Department and within the Executive Branch on issues relating to HEW. The Immediate Office will also continue to initiate and coordinate special projects of particular concern to the Secretary and Under Secretary. In addition, continuing efforts will be given to improving the Secretary's management of the Department, including coordinating efforts relative to the President's reorganization plan and other initiatives directed toward improving the quality of health, education, and welfare services. An increase of one position is requested in FY 1974 to meet new responsibilities and additional correspondence workloads in the Executive Secretariat. Health Accomplishments FY 1972-73 The Assistant Secretary for Health is the principal advisor and assistant to the Secretary on health policy and all health-related activities in the Department. He is responsible for the direction of the health agencies of the Department, for providing leadership and policy guidance for health-related activities throughout the Department and for maintaining relationships with other governmental and private agencies concerned with health. In 1972-73 the Office of the Assistant Secretary for Health initiated a major effort to develop and coordinate health planning and policy making in the health agencies as well as with other Federal Health programs. Major policy issues included those relative to national health insurance, health maintenance organizations, comprehensive health planning, and renewal of Public Health Service Act authorities. Also requiring considerable staff effort was the monitoring of implementation of new health legislation pertaining to sickle cell disease, Emergency Health Personnel Act Amendments and comprehensive health manpower. A major study on the costs of medical education was designed and monitored in coordination with the Institute of Medicine. In response to the President's initiatives to improve nursing home care, the Regional Offices and States were assisted in adopting and implementing proper nursing home certification procedures. Common standards for Medicaid and Medicare skilled nursing facilities and standards for intermediate care facilities will be promulgated by the end of the fiscal year. Over 1200 enviromental impact statements were received for review and comment from other Federal agencies and State and local governments. Additionally, plans for the open air testing and disposal of lethal chemical agents were reviewed and liaison was provided with the Enviromental Protection Agency on issues involving environmental health effects, including lead in gasoline and air quality documents. Activities to implement the Professional Standards Review Organization provi- ̧ sion of H.R. 1 were initiated. Norms for patient care and PSRO models are being developed and PSRO's are being designed. There were 36 new positions requested in the FY 1973 Appropriation to provide staff to lead and guide this major new function. The Commission on Medical Malpractice submitted its final report to the Secretary in January 1973. The report calls upon each of the major organizations and groups concerned with the problem to take actions to reduce the number of unnecessary or unwarranted malpractice claims, to provide speedy and more equitable resolution of medical malpractice disputes, and to develop alternative medical injury compensation systems that are not predicated upon findings of fault. Implementation of the Commission's recommendations will require the cooperative efforts of health care providers, patients, attorneys, the malpractice insurance industry, and State and Federal Governments. Program Plans FY 1974 The Office of the Assistant Secretary for Health requests an increase of 14 positions. Ten of the positions would be used to strengthen the short and longrange policy development capability of the Assistant Secretary. This would continue a major FY 1973 effort to develop and coordinate health planning and policy within the Department especially in areas of major national issues such as health insurance, health maintenance organizations, comprehensive health planning, health manpower, and preventive medicine. Four of the new positions would be used for moni toring agency attainment of objectives, coordinating agency implementation of new legislation, and coordinating program changes resulting from the expiration of major health legislation. In addition, the office will expand national health insurance analysis activities, initiate a contract study on Federal-State-local interrelationships in health planning and regulation, and conduct research on consumer health education, cost containment, and manpower distribution. Professional Standards Review Organization area designations will be completed, prototype and conditional PSRO's will be designated, and a preliminary report will be issued on norms for patient utilization in hospitals and other institutions. A national nursing home data collection system will be installed and linked with existing State and local data systems. Additionally, a nation-wide effort to survey and certify approximately 15,000 intermediate care facilities under new Title XIX standards will be planned and monitored. Work on enviromental health standards will increase because of the need for revision of existing pollution standards and the establishment of standards for pollutants not currently covered. In the chemical-biological area the level of activity in the Assistant Secretary's Office will increase sharply because the Department of Defense is planning to establish an open air testing program of lethal chemical agents and initiate large scale disposal operations which involve movement of large quantities of lethal chemical agents. Office of the Assistant Secretary for Legislation Accomplishments FY 1972-73 The Assistant Secretary for Legislation is principal advisor to the Secretary on legislative programs and the Department's relations with the Congress. This office helps to develop legislative proposals and to coordinate these proposals with the constituent agencies, the Office of Management and Budget, the White House, and the Congress. In addition, the office provides information to the staffs and Members of Congress about HEW activities. Finally, the office helps to maintain liaison with associations and other groups interested in the Department's legislative program. During FY 1972-73, the Office of the Assistant Secretary for Legislation coordinated and participated in the development of legislative initiatives or strategies in the following areas: A. B. Health 1. 2. 3. 4. 5. 6. 7. Drug abuse prevention, including the Comprehensive Drug Abuse Preven- Health manpower legislation, including the Health Training Improvement An increase of 14 positions is requested for FY 1974 to meet workload increases in each unit of the Office. The Immediate Office of the Assistant Secretary would utilize two positions to meet increased clerical workload; The offices serving Departmental program areas would utilize new staff to handle increases in workload caused by new legislation including the Higher Education Amendments of 1972 and HR1. These offices include the Deputy Assistant Secretaries for Health Legislation (+3), for Education Legislation (+2), and for Welfare Legislation (+2). The Deputy Assistant Secretary for Congressional Liaison would utilize 5 positions to meet heavy new workload related to Congressional communications. The Office of the Assistant Secretary for Legislation will be involved in continuing work on legislative initiatives begun earlier in this Congress. In addition, the office has started coordination of the legislative program which will be introduced and considered during the 2nd session of the 93rd Congress. Following is a summary of the legislation and related activities to which the office will devote major efforts during 1973 and 1974. 3. Legislative preparation in connection with the expiration on 1. 2. 3. 4. Education Revenue Sharing To simplify State formula gra.t programs by providing States with a more flexible method of funding. Equal Educational Opportunities Act To provide for the more effective use of funds for desegregating schools. Implementation of the Education Amendments of 1972, including its major new provisions for student aid and other substantial reform in Federal assistance to higher education. Legislative preparation in connection with the expiration on June 30, 1974, of authority for education programs, including the Elementary and Secondary Education Act if not extended by June 30, 1973. C. Welfare 1. Allied Services Act To streamline and simplify the delivery of services by strengthening State and local planning and administrative capacities, allowing for the transfer of funds among various HEW programs, and permitting the waiver of certain cumbersome Federal requirements. |