[Federal Register Volume 61, Number 70 (Wednesday, April 10, 1996)]
[Notices]
[Pages 15955-15958]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-8900]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Agency for Health Care Policy and Research General
Reorganization; Statement of Organization, Functions, and Delegations
of Authority
This notice amends the following portions of Part E and Part H of
the Statement of Organization, Functions, and Delegations of Authority
for the Department of Health and Human Services: Part E, as last
amended at 60 FR 56605, November 9, 1995; and Part H, Chapter HP as
last amended at 60 FR 37898, July 24, 1995. Changes are being made
which: (1) designate the Agency for Health Care Policy and Research
(AHCPR) as an Operating Division reporting directly to the Secretary of
Health and Human Services and (2) reflect organizational refinements
which will enable the Agency to be more responsive to the evolving
needs of the health care system and a refocused government role.
Changes are as follows:
1. Under Part E, add Chapter E (Agency for Health Care Policy and
Research), as follows:
Chapter E--Agency for Health Care Policy and Research
Section E-00 Mission
Section E-10 Organization
Section E-20 Functions
Section E-30 Order of Succession
Section E-40 Delegations of Authority
Agency for Health Care Policy and Research
Section E-00. Mission. The Agency for Health Care Policy and
Research provides national leadership and administration of a program
to enhance the quality, appropriateness, and effectiveness of health
care services, and access to such services, through the establishment
of a broad base of scientific research and through the promotion of
improvements in clinical practice and in the organization, financing,
and delivery of health care services. The AHCPR supports research,
demonstrations, evaluations, and dissemination projects relating to:
(1) The effectiveness, efficiency, and quality of health care services;
(2) the outcomes of health care services and procedures; (3) clinical
practice, including primary care and practice-oriented research; (4)
health care technologies, facilities, and equipment; (5) health care
costs, productivity, and market forces; (6) health promotion and
disease prevention; (7) health statistics and epidemiology; (8) medical
liability; (9) delivery of health services in rural areas; and (10) the
health of low income groups, minority groups, the elderly, and other
special populations.
Section E-10. Organization. The Agency for Health Care Policy and
Research is under the direction of an Administrator who reports
directly to the Secretary of Health and Human Services. The Agency
consists of the following components:
A. Immediate Office of the Administrator
B. Office of Management
C. Office of Planning and Evaluation
D. Office of Policy Analysis
E. Office of Scientific Affairs
F. Office of the Forum for Quality and Effectiveness in Health Care
G. Center for Cost and Financing Studies
H. Center for Health Care Technology
I. Center for Health Information Dissemination
J. Center for Information Technology
K. Center for Organization and Delivery Studies
L. Center for Outcomes and Effectiveness Research
M. Center for Primary Care Research
N. Center for Quality Measurement and Improvement
Section E-20. Functions. In carrying out these responsibilities,
AHCPR engages in the following activities: (1) Supports, by means of
grants and contracts with public and private entities, research,
demonstration, and evaluation projects; (2) conducts economic and
statistical analyses, research, demonstrations, and evaluations through
the use of staff and facilities of the Agency; (3) administers and
supports health services research training programs; (4) assists public
and nonprofit private entities in meeting the costs of planning,
establishing and operating centers for multidisciplinary health
services quality and effectiveness research, evaluations, and
demonstrations; (5) facilitates development of guidelines, standards,
and parameters to enhance the quality and effectiveness of health care
and disseminates them to health services providers, review
organizations, health educational institutions, and consumers; (6)
advises the Secretary and other PHS Agency Heads about findings of the
Agency research programs and their potential implications for HHS
programs; (7) facilitates linkages among existing data bases and the
establishment of national data systems to support health services,
technology, quality and effectiveness research; (8) in consultation
with other PHS Agencies, coordinates health services and health care
technology research, evaluations, and demonstrations undertaken by the
Agency; (9) consults with public and private organizations and
individuals to identify the critical issues and problems to be
addressed through the Agency's research programs; (10) publishes and
disseminates the findings and the data obtained in the course of
research and evaluation, and in the development of guidelines,
standards, review criteria, evaluations, and demonstrations supported
or undertaken by the Agency; (11) undertakes programs to develop new
and improved methods for making such research findings available to the
medical community and for incorporating them into everyday medical
practice; (12) provides technical assistance, advice, and consultation
to organizations and individuals within and outside the Department
engaged in or concerned with the results of health services, health
care technology, health quality and effectiveness research,
evaluations, and demonstrations; (13) advises the
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Secretary on effectiveness of health care technologies and coverage
thereof under Medicare and Medicaid as appropriate; (14) undertakes and
supports research, demonstration projects and evaluations concerning
rural health and underserved populations; and (15) supports and
conducts patient outcome research.
Office of the Administrator (EA). Directs the activities of the
Agency for Health Care Policy and Research to ensure the achievement of
strategic objectives. Specifically: (1) Determines that Agency programs
support Administration goals and objectives; (2) plans, directs,
coordinates, and evaluates the administrative policies and procedures,
the research and training programs, and the dissemination activities of
the Agency; (3) manages the Equal Employment Opportunity programs; (4)
maintains the scientific integrity of the research program and the
staff; (5) establishes Agency program and budget priorities; (6)
represents the Agency within the Public Health Service, at the highest
levels of Government, and to the public; and (7) makes recommendations
to the Secretary on Federal reimbursement programs with respect to
health care technologies and health care policies and research.
Office of Management (EAA). Directs and coordinates Agency-wide
administrative activities. Specifically: (1) Manages and coordinates
the human resource activities of the Agency including personnel
operations and the allocation of personnel resources; (2) provides
organizational and management analysis, develops policies and
procedures, and implements Agency management policies; (3) coordinates
the Agency Federal Managers' Financial Integrity Act and Privacy Act
activities; (4) plans and directs financial management activities
including budget formulation, presentation, and execution functions and
supports the linking of the budget and planning process; (5) conducts
all business management aspects of the review, negotiation, award and
administration of Agency grants and contracts; (6) manages the
analysis, selection, and implementation of the information resource
management and telecommunication systems; and (7) provides Agency
support services including the acquisition, management, and maintenance
of supplies, equipment, and space.
Office of Planning and Evaluation (EAB). Directs and coordinates
the strategic planning and program evaluation of the Agency.
Specifically: (1) Directs and coordinates program planning activities
of the Agency and prepares the strategic plan; (2) plans and manages
the program evaluation activities of the Agency including evaluations
of dissemination, training, and research programs; (3) plans and
coordinates Agency research activities that focus on special
populations and initiatives, including minority health, women's health,
and HIV; (4) manages and coordinates development and clearance of
proposed regulations, reports, and program announcements; and (5)
represents the Agency in meetings with other Public Health Service and
Department planning and evaluation offices.
Office of Policy Analysis (EAC). Provides support to the
Administrator and unbiased technical assistance to the Public Health
Service, the Department, and other public and private sector users of
health services research. Specifically: (1) Reviews Agency research
plans and programs to determine their relevance to current and emerging
health policy issues; (2) provides unbiased analyses of significant
health policy issues using relevant health services research, data, and
information produced by the Agency and others; (3) synthesizes research
findings on policy and program issues of concern to the Administrator;
(4) conducts and supports special projects and studies to inform health
policy; (5) develops and manages an extramural centers program designed
to provide timely studies of immediate and emerging health policy
issues; (6) coordinates the legislative activities of the Agency
including the development of legislative proposals and analysis of
health legislative initiatives; (7) provides support and management for
the activities of the Agency's National Advisory Council; (8) maintains
ongoing liaison with public and private sector producers and users of
health services research; and (9) represents the Agency in meetings
with components of the Public Health Service, the Department, and other
government agencies and with private organizations on health policy
issues.
Office of Scientific Affairs (EAE). Directs the scientific review
process for grants and contracts, the assignment of projects to Agency
Centers, manages Agency research training programs, and evaluates the
medical and scientific contribution of proposed and on-going research,
demonstration, and evaluations. Specifically: (1) Directs the process
for selecting, reviewing, and funding grants and reviewing contracts
for scientific merit and program relevance; (2) assigns grant proposals
to Centers for administrative action; (3) manages the process for
making funding decisions for grants; (4) directs Agency research
training programs and implementation of the National Research Service
Award authority; (5) manages the scientific integrity processes for the
intramural and extramural programs of the Agency; and (6) represents
the Agency in meetings with experts and organizations on issues related
to the administration of the scientific program.
Office of the Forum for Quality and Effectiveness in Health Care
(EB). Arranges for the development and evaluation of clinical practice
guidelines. Specifically: (1) Supports the development and evaluation
of clinical practice guidelines dealing with the prevention, diagnosis,
and treatment of illness; (2) provides national leadership on guideline
development and assessment of methodologies; (3) supports development
of medical review criteria, performance measures, and standards of
quality; (4) conducts and supports studies of the economic impact of
Agency guidelines; and (5) represents the Agency in meetings with
experts and organizations involved in producing, implementing, and
evaluating clinical practice guidelines.
Center for Cost and Financing Studies (EC). Conducts and supports
studies of the cost and financing of health care and develops data sets
to support policy and behavioral research and analyses. Specifically:
(1) Conducts and manages research and analysis of trends and patterns
of health expenditures, public and private insurance coverage, use of
personal health services, health status, and cost effectiveness of care
for the general population and subgroups of policy interest; (2)
conducts and manages health sector surveys such as medical expenditure
surveys; surveys of employers and other sources of insurance coverage
and health benefits; and surveys of the use, cost, and financing of
care for special populations; (3) collects, reorganizes, and analyzes
administrative databases related to health use, status, cost and
financing; (4) provides modeling and projections of health care use,
status, expenditures, and payments for policy research; (5) conducts
and supports statistical and methodological research on survey design,
sampling and estimation techniques, and data quality; (6) conducts and
supports surveys and research of institutional and community based long
term care; (7) evaluates administrative data sets for intramural and
extramural research including policy and methodological studies; and
(8) builds research and data collection partnerships with the health
care sector,
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employers and foundations, and represents the Agency in meetings with
Federal agencies and experts on health policy issues especially issues
related to health expenditures and insurance, Federal and State health
care programs.
Center for Health Care Technology (EE). Conducts and supports a
comprehensive program of health care technology assessment.
Specifically: (1) Manages and conducts studies of the safety, efficacy,
effectiveness, and cost-effectiveness of health technologies; (2)
prepares recommendations on whether specific technologies should be
paid for by Federal programs that provide or reimburse for health
services including recommendations that such payment be subject to
specific conditions, requirements, or limitations; (3) maintains
liaison with other public and private organizations and entities with
regard to assessment strategies, priorities, and methodologies; and (4)
represents the Agency in meeting with international and domestic
experts and organizations concerned with health technology assessment.
Center for Health Information Dissemination (EF). Designs,
develops, implements, and manages programs for disseminating the
results of Agency activities. Specifically: (1) Conducts and supports
research on the techniques of providing information to the health care
industry, health care providers, consumers policy makers, researchers,
and the media; (2) manages the editing, publication, and information
distribution processes of the Agency; (3) provides the administrative
support for reference services and the distribution of technical
information to Agency staff; (4) manages the public affairs activities
of the Agency, an Agency clearinghouse for responding to requests for
information and technical assistance, and a consumer information
program; (5) directs a user liaison program to provide health care
research and policy findings to Federal, State and local public
officials, providers, payers, business, and the health care industry;
(6) evaluates the effectiveness of Agency dissemination strategies and
implements changes indicated by such evaluation; and (7) represents the
Agency in meetings with Department and Public Health Service
representatives on press releases, media events, and publication
clearance.
Center for Information Technology (EG). Conducts and supports
studies of health information systems, computerized patient record
systems, and medical decision analysis. Specifically: (1) Manages and
conducts research, demonstrations, and evaluations of computerized
health care information systems; (2) directs studies of data standards,
security, efficiency, and linkages; (3) directs studies of medical
decision making and decision support systems; (4) directs studies of
provider adoption and implementation of automated medical records,
information, and decision systems; and (5) represents the Agency in
meetings with international and domestic experts and organizations
concerned with developing and using medical information systems.
Center for Organization and Delivery Studies (EH). Conducts,
supports and manages studies of the structure, financing, organization,
behavior, and performance of the health care system and providers
within it. Specifically: (1) Conducts and manages quantitative and
qualitative research on changes in the organizational, financial, and
legal structure of the health care delivery system, particularly the
move to managed care and integrated networks; (2) conducts and manages
research on market forces, and regulatory, legal, and other factors
driving these changes; (3) conducts and manages research on the
changing continuum of care (acute, long-term, home, and community-
based), and organizational issues (integration, care management,
patient communication, and care for high-cost illnesses) in these
systems; (4) conducts and manages research on organizational behavior
and issues (leadership, governance, political culture, etc.) in the
changing delivery system; (5) conducts and manages research on the
impact of changing organizations and delivery systems on access, cost,
quality, providers, and public health; and (6) builds research
partnerships with the health care industry, employers and foundations,
and represents the Agency in meetings with Federal agencies and experts
on health policy issues related to the changing delivery system and its
impact on access, quality and cost of care.
Centers for Outcomes and Effectiveness Research (EJ). Conducts and
supports studies of the outcomes and effectiveness of diagnostic,
therapeutic, and preventing health care services and procedures.
Specifically: (1) Manages and conducts research, evaluations, and
demonstrations of the effectiveness of clinical interventions in terms
of patient outcomes; (2) directs an extramural research centers program
on medical effectiveness and patient outcomes; (3) directs and supports
a program of clinical research on the effectiveness of diagnostic and
therapeutic approaches to illness; (4) manages and conducts research
and related activities to improve methods and measures for
effectiveness research; and (5) represents the Agency in meetings with
domestic and international experts and organizations concerned with
medical effectiveness and outcomes research.
Center for Primary Care Research (EK). Conducts and supports
studies on primary care, and clinical, preventive and public health
policies and systems. Specifically: (1) Manages and conducts research
on, and demonstrations and evaluations of, primary care settings and
systems; (2) manages and conducts studies of rural health care services
and systems; (3) directs studies of the care of special populations;
(4) directs studies of the effectiveness of education, supply, and
distribution of the health care workforce; and (5) represents the
Agency in meetings with international and domestic experts and
organizations concerned with primary care.
Center for Quality Measurement and Improvement (EL). Conducts and
supports research on the measurement and improvement of the quality of
health care. Specifically: (1) Conducts and supports research,
demonstrations, and evaluations of the quality of health care; (2)
designs, conducts, and supports consumer surveys to assess the quality
of and satisfaction with health care services and systems; (3) develops
and tests measures and methods for evaluating the quality of care; (4)
provides technical assistance and gathers information on the use of
quality measures and consumer information on the use of quality
measures and consumer information and the resulting effects; and (5)
represents the Agency in meetings with domestic and international
experts and organizations concerned with measuring and evaluating the
quality of care.
Section E-30. Order of Succession. During the absence or disability
of the Administrator, or in the event of a vacancy in that office, the
first official listed below who is available shall act as
Administrator, except during planned periods of absence, when the
Administrator may specify a different order of succession. The order of
succession will be:
(1) Deputy Administrator
(2) Executive Officer
(3) Director, Office of Policy Analysis
(4) Director, Office of Planning and Evaluation
(5) Director, Office of Scientific Affairs
Section E-40. Delegations of Authority. All delegations and
redelegations of authority to officers and employees of the Agency for
Health Care Policy and Research which were in effect immediately prior
to the effective
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date of this reorganization shall continue in effect pending further
redelegation, provided they are consistent with this reorganization.
2. Under Part H, after Chapter HN (National Institutes of Health),
delete Chapter HP (Agency for Health Care Policy and Research) in its
entirety.
These changes are effective April 4, 1996.
Dated: April 4, 1996.
Clifton R. Gaus,
Administrator.
[FR Doc. 96-8900 Filed 4-9-96; 8:45 am]
BILLING CODE 4160-90-M
