Office of Population Affairs

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2. Overview . HHS Strategic Plan and PrioritiesOPA Structure and FunctionsProgramsFundingQuestions. 3. HHS Mission. To enhance the health and well-being of Americans by providing effective health and human services and by fostering sound, sustained advances in the sciences underlying medicin

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Office of Population Affairs

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1. 1 Office of Population Affairs Evelyn Kappeler Acting Director August 6, 2007

2. 2 Overview HHS Strategic Plan and Priorities OPA Structure and Functions Programs Funding Questions

3. 3 HHS Mission To enhance the health and well-being of Americans by providing effective health and human services and by fostering sound, sustained advances in the sciences underlying medicine, public health, and social services. Accomplished through more than 300 programs and initiatives FY 2007 HHS Budget - $698 billion (a quarter of all federal expenditures) More than 66,000 employees

4. 4 HHS Strategic Plan 2007-2012 Updated every 3 years Draft posted on http://www.hhs.gov/strategic_plan/ Describes HHS Operating and Staff Divisions work to address health and human services issues Focused on a limited set of broad outcomes and impacts to demonstrate Departmental progress Four Strategic goals

5. 5 HHS Strategic Plan 2007-2012 Four Strategic goal areas: Health Care: Improve the safety, quality, affordability and accessibility of health care, including behavioral health care and long-term care. Public Health Promotion and Protection, Disease Prevention, and Emergency Preparedness: Prevent and control disease, injury, illness, and disability across the lifespan, and protect the public from infectious, occupational, environmental, and terrorist threats. Human Services: Promote the economic and social well-being of individuals, families and communities. Scientific Research and Development: Advance scientific and biomedical research and development related to health and human services.

6. 6 HHS Strategic Plan 2007-2012 Incorporates priorities and concepts from: Secretary’s 500-Day Plan Secretary’s Ten Health Care Priority Activities Departmental Twenty Objectives Healthy People 2010 Objectives

7. 7 In the Spotlight: HHS Plans and Priorities Secretary’s 500 Day Plan and 250 Day Update Secretary’s management tool focusing on specific strategies Key focus areas: Transform the health care system Modernize Medicare and Medicaid Advance Medical Research Secure the Homeland Protect Life, Family, and Human Dignity Improve the Human Condition Around the World http://www.hhs.gov/secretary/planning/index.html

8. 8 HHS Plans and Priorities Secretary Leavitt HHS Priorities (May 2007) Every American Insured Insurance for Children in Need Value-Driven Health Care Information Technology Personalized Health Care Health Diplomacy Prevention Louisiana Health Care System Preparedness http://www.hhs.gov/secretary/priorities/index.html

9. 9 HHS Plans and Priorities Departmental Objectives (2006) Twenty Department - wide objectives Updated annually Expand on the Secretary’s goals from the 500 Day Plan and include objectives related to effective management http://www.hhs.gov/pma/depObj.html

10. 10 Department Twenty Objectives 1. Accelerate Personalized Healthcare 2. Recruit, Develop, Retain, and Strategically Manage a World-Class HHS Workforce 3. Modernize Medicaid 4. Continue our Leadership Role and Success in Competitive Sourcing 5. Turn Adversity to Advantage for the New Orleans Health System 6. Improve Financial Performance 7. Promote Health Information Technology 8. Expand Electronic Government 9. Continue to Improve Medicare 10. Improve Budget and Performance Integration

11. 11 Departmental Twenty Objectives 11. Harness the Power of Transparent Healthcare 12. Implement the Real Property Asset Management Program and Strategically Manage our Real Property 13. Emphasize Prevention and Healthy Living 14. Broaden Health Insurance and Long-Term Care Coverage 15. Prepare for an Influenza Pandemic 16. Promote Quality, Relevance & Performance of Research and Development Activities 17. Enhance Emergency Response and Renew the Commissioned Corps 18. Improve the Service of Management Functions and Administrative Operations for the Support of the Department’s Mission 19. Emphasize Faith Based and Community Solutions 20. Eliminate Improper Payments

12. 12 Healthy People Healthy People 2010 Comprehensive set of disease prevention and health promotion objectives for the Nation Overarching goals are to increase quality and years of healthy life end eliminate health disparities 28 focus areas, including focus area 9 – Family Planning http://www.healthypeople.gov/ Healthy People 2020 Plans under way December 2008 proposed release date

13. 13 Healthy People

14. 14 U.S. Department of Health and Human Services (DHHS)

15. 15

16. 16 Office of Population Affairs “Family Planning Services and Population Research Act of 1970” (P.L. 91-572) Created the national family planning program as Title X of the Public Health Service Act Defined purposes of the program Established the Office of Population Affairs (OPA) and its functions Established the position of Deputy Assistant Secretary for Population Affairs (DASPA) under the direct supervision of the ASH; established functions and duties of the DASPA

17. 17 Office of Population Affairs Deputy Assistant Secretary for Population Affairs (DASPA) (who is also the Director/OPA) Has delegated authority from the Secretary of HHS to administer two discretionary grant programs: Family Planning Program authorized by Title X of the Public Health Service Act Adolescent Family Life Program authorized by Title XX of the Public Health Service Act

18. 18 OPA Location and Component Offices U.S. Department of Health and Human Services Office of the Secretary Office of Public Health and Science Office of Population Affairs Office of Adolescent Pregnancy Programs (Supports adolescent pregnancy prevention and care grants) Office of Family Planning (Supports grants to public / private not for profits for family planning services) Office of Research and Evaluation (Supports a focused approach to OPA sponsored research and special projects)

19. 19 Office of Population Affairs Program Functions Most of you have seen this slide before…Most of you have seen this slide before…

20. 20 FY 2008 Appropriations Action House adopted July 19, 2007 H.R. 3043 House Appropriations Committee Report 110-231 Title XX = $30.3 million/level funding EAA = $1.98 million/level funding Title X = $310.9 million/+$27.7 million

21. 21 FY 2008 Appropriations H. Rept. 110-231 page 84 Family planning The Committee provides $310,910,000 for the family planning program, which is $27,764,000 above the fiscal year 2007 funding level and $27,807,000 above the budget request. The Committee recommends the $27,764,000 increase as part of its initiative to help reduce the number of abortions in America by alleviating the economic pressures and other real life conditions that can sometimes cause women to decide not to carry their pregnancies to term. The program currently serves over five million low-income women and men at 4,400 clinics nationwide. This funding increase will allow the program to serve 98,000 new clients. Family planning funds in the bill are expected to prevent more than one million unintended pregnancies. The program provides grants to public and private non- profit agencies to support a range of family planning and reproductive services, as well as related preventive health services such as patient education and counseling, breast and cervical cancer examinations, STD and HIV prevention education, counseling and testing and referral, and pregnancy diagnosis and counseling. The program is the only source of health care for many of its clients.

22. 22 FY 2008 Appropriations Action Senate S. 1710 Senate Appropriations Committee Report 110-107 Title XX = $30.3 million/level funding EAA = $4 million/+$2.02 million (allows funds to be available to pay medical and administrative costs deemed necessary to facilitate embryo donation and adoptions) Title X = $300 million/+$16.8 million

23. 23 FY 2008 Appropriations S. Rept. 110-107 page 62 Family Planning The Committee provides $300,000,000 for the title X family planning program. The fiscal year 2007 comparable level was $283,146,000 and the budget request for fiscal year 2008 was $283,103,000. Title X grants support primary health care services at more than 4,400 clinics nationwide. About 85 percent of family planning clients are women at or below 150 percent of poverty level. Title X of the Public Health Service Act, which established the family planning program, authorizes the provision of a broad range of acceptable and effective family planning methods and preventive health services to individuals, regardless of age or marital status. This includes FDA-approved methods of contraception. The Committee remains concerned that programs receiving title X funds ought to have access to these resources as quickly as possible. The Committee again instructs the Department to distribute to the regional offices all of the funds available for family planning services no later than 60 days following enactment of this bill. The Committee intends that the regional offices should retain the authority for the review, award and administration of family planning funds, in the same manner and timeframe as in fiscal year 2006. The Committee intends that at least 90 percent of funds appropriated for title X activities be for clinical services authorized under section 1001 of the act. The Committee further expects the Office of Family Planning to spend any remaining year-end funds in section 1001 activities.

24. 24 Title XX of the Public Health Service Act Adolescent Family Life Act (AFL) Program created in 1981 as Title XX of the Public Health Service Act Administered centrally by the Office of Adolescent Pregnancy Programs (OAPP) within OPA Providing funds for -- Care and Prevention Demonstration Grants -- Research Activities

25. 25 Mission The OAPP demonstrates effective means to promote premarital abstinence from sexual activity and to ameliorate the adverse consequences of adolescent childbearing. Under the authority of the Title XX of the Public Health Service Act, the OAPP awards and administers demonstration and research grants to address these issues and disseminates their findings.

26. 26 AFL in 2007 $30 million 57 Prevention Grants 32 Care Grants 6 Research Grants

27. 27 Prevention Demonstration Projects To find effective means, within the context of the family, to reach adolescents before they become sexually active to encourage them to abstain from premarital sexual activity. Services and activities must be consistent with A-H definition of abstinence education. FY 2007 Funding Announcement – Applications under review Evaluation Intensive Offers comprehensive HEALTH, EDUCATION AND SOCIAL SERVICES to help these young adolescents through the pregnancy and parenting crisis Can be provided at a single site or through partnerships with a variety of agencies. This means that programs are usually implemented by multi disciplinary or interdisciplinary teams. It is a kind of strange combination of health professionals, education professionals and social services professionals in an attempt to ensure that clients receive the best combination of services to achieve good outcomes or results - More on that later. Comprehensive services means that a grantee MUST have available 10 CORE services and MAY provide any or all of 6 SUPPLEMENTAL SERVICES - name all of them or have a handout This does not mean that ALL CLIENTS will need all 10 CORE services or any or all of the SUPPLEMENTAL services, but a grantee must have them available either directly or though agreements with partners in other agencies Title XX requires that all clients must have parental consent before they can continue to receive services. All projects must be evaluated by an independent evaluator associated with a college or university in the grantee's home state All grantees must provide a fee for service document showing what it would charge clients if the clients could pay - GMO will say more about that. One of the chief features of the AFL program is that no funds may be used to provide, counsel on refer for abortion except in one unique situation where PARENTS AND THEIR ADOLESCENT REQUEST SUCH COUNSELING AND REFERRALOffers comprehensive HEALTH, EDUCATION AND SOCIAL SERVICES to help these young adolescents through the pregnancy and parenting crisis Can be provided at a single site or through partnerships with a variety of agencies. This means that programs are usually implemented by multi disciplinary or interdisciplinary teams. It is a kind of strange combination of health professionals, education professionals and social services professionals in an attempt to ensure that clients receive the best combination of services to achieve good outcomes or results - More on that later. Comprehensive services means that a grantee MUST have available 10 CORE services and MAY provide any or all of 6 SUPPLEMENTAL SERVICES - name all of them or have a handout This does not mean that ALL CLIENTS will need all 10 CORE services or any or all of the SUPPLEMENTAL services, but a grantee must have them available either directly or though agreements with partners in other agencies Title XX requires that all clients must have parental consent before they can continue to receive services. All projects must be evaluated by an independent evaluator associated with a college or university in the grantee's home state All grantees must provide a fee for service document showing what it would charge clients if the clients could pay - GMO will say more about that. One of the chief features of the AFL program is that no funds may be used to provide, counsel on refer for abortion except in one unique situation where PARENTS AND THEIR ADOLESCENT REQUEST SUCH COUNSELING AND REFERRAL

28. 28 Care Demonstration Projects Evaluation of COMPREHENSIVE health, education, and social services to help adolescents through pregnancy and parenting 10 CORE services and 6 supplemental services (see hand-out) Parental consent Independent evaluation (intensive as of 2004) Fee for service No referral, provision of abortion Offers comprehensive HEALTH, EDUCATION AND SOCIAL SERVICES to help these young adolescents through the pregnancy and parenting crisis Can be provided at a single site or through partnerships with a variety of agencies. This means that programs are usually implemented by multi disciplinary or interdisciplinary teams. It is a kind of strange combination of health professionals, education professionals and social services professionals in an attempt to ensure that clients receive the best combination of services to achieve good outcomes or results - More on that later. Comprehensive services means that a grantee MUST have available 10 CORE services and MAY provide any or all of 6 SUPPLEMENTAL SERVICES - name all of them or have a handout This does not mean that ALL CLIENTS will need all 10 CORE services or any or all of the SUPPLEMENTAL services, but a grantee must have them available either directly or though agreements with partners in other agencies Title XX requires that all clients must have parental consent before they can continue to receive services. All projects must be evaluated by an independent evaluator associated with a college or university in the grantee's home state All grantees must provide a fee for service document showing what it would charge clients if the clients could pay - GMO will say more about that. One of the chief features of the AFL program is that no funds may be used to provide, counsel on refer for abortion except in one unique situation where PARENTS AND THEIR ADOLESCENT REQUEST SUCH COUNSELING AND REFERRALOffers comprehensive HEALTH, EDUCATION AND SOCIAL SERVICES to help these young adolescents through the pregnancy and parenting crisis Can be provided at a single site or through partnerships with a variety of agencies. This means that programs are usually implemented by multi disciplinary or interdisciplinary teams. It is a kind of strange combination of health professionals, education professionals and social services professionals in an attempt to ensure that clients receive the best combination of services to achieve good outcomes or results - More on that later. Comprehensive services means that a grantee MUST have available 10 CORE services and MAY provide any or all of 6 SUPPLEMENTAL SERVICES - name all of them or have a handout This does not mean that ALL CLIENTS will need all 10 CORE services or any or all of the SUPPLEMENTAL services, but a grantee must have them available either directly or though agreements with partners in other agencies Title XX requires that all clients must have parental consent before they can continue to receive services. All projects must be evaluated by an independent evaluator associated with a college or university in the grantee's home state All grantees must provide a fee for service document showing what it would charge clients if the clients could pay - GMO will say more about that. One of the chief features of the AFL program is that no funds may be used to provide, counsel on refer for abortion except in one unique situation where PARENTS AND THEIR ADOLESCENT REQUEST SUCH COUNSELING AND REFERRAL

29. 29 EVALUATION Mandated by Statute - 1 to 5 % - waived to 20-25% Viable comparison strategy Appropriate follow-up Independent Evaluators - local college/ university Qualitative and quantitative methods

30. 30 Embryo Donation and/or Adoption Public Awareness Campaign Legislative History In fiscal year 2002, for the first time, Congress appropriated $1 million which authorized HHS to conduct a public awareness campaign to education Americans about the existence of frozen embryos for adoption. Previous program announcements published in fiscal years 2002, 2004, 2005, 2006 Funds a series of embryo donation &/or adoption public awareness campaign grant projects that were specifically directed at education and information for potential donor and recipient couples, a well as individuals who work in assisted reproductive technology clinics or the area of adoption

31. 31 Embryo Adoption Public Awareness Campaign - Program Purpose To develop and implement public awareness campaigns regarding embryo adoption in order to educate Americans about the existence of frozen embryos available for donation and/or adoption.

32. 32 Overview of 2007 EAA Program Announcement Total Funding: $2 million $1 million for new grants $1 million for continuation grants Number of Expected New Grant Awards: 4-5 Ceiling on Individual Awards; $350,000 (Applications exceeding the award ceiling will not be accepted and reviewed) Projected Start Date: September, 2007 Project Period: 24 months Funding Mechanism: Cooperative agreement Cost Sharing: None required

33. 33 Any Questions?

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