Date:  December 27, 2002

For Release:  Immediately

Contact:  HHS Press Office

(202) 690-6343

HHS -- Highlights of 2002


Following is a summary of significant news highlights at HHS during 2002:


o       Bioterrorism preparedness

o       Expanded access to health care

o       Disease prevention initiative

o       Improving quality of care

o       Next steps for helping those in need

o       Smoking, teen substance abuse decline

o       Protecting patient privacy

o       Regulatory reform

BIOTERRORISM PREPAREDNESS - America ended the year 2002 much better prepared

to confront terrorism. Under HHS Secretary Tommy G. Thompson's leadership,

the department led the nation's efforts to be ready in particular for

possible incidents of bioterror:


       Spending increased ten-fold - HHS' budget for bioterrorism

preparedness increased ten-fold, from $305 million in FY 2001 to $2.98

billion in FY 2002.


       Support for states and major cities - Of the budget increase, more

than $1 billion was provided to states and major cities to support increased

preparedness by hospitals and public health systems.  HHS worked with states

on preparedness plans, emphasizing coordination and regional cooperation.

The objective is local preparedness, with national resources ready to be

deployed immediately whenever and wherever needed.


       Smallpox and other vaccines - HHS took steps to provide enough

smallpox vaccine to be able to vaccinate every American, in the possible

event of a release of this disease.  In December, President Bush announced a

careful policy of voluntary vaccination for front-line health care and

emergency personnel, to ensure effective response if the disease were

released.  Vaccination of others is not recommended at this time, in the

absence of an emergency.  In addition, production of the current anthrax

vaccine was resumed, and research into improved vaccines for anthrax and

other diseases was accelerated.


       Disease surveillance and communications - In order to detect any

possible release of disease agents by terrorists, the nation's disease

surveillance system is being expanded, with spending increased from $67

million in FY 2001 to $940 million in FY 2002.  This expansion will also

help to quickly identify outbreaks of naturally-occurring diseases. HHS'

Centers for Disease Control and Prevention's (CDC) "Epidemic Information

Exchange" (Epi-X) is being strengthened.  The nation's network of public

health laboratories is being expanded.  And health communications systems

overseen by CDC are being improved and expanded.


       Pharmaceutical stockpile - The National Pharmaceutical Stockpile

completed purchase of more than a billion doses of antibiotics and other

materials to be ready on stand-by.  The number of 50-ton "Push Packs," ready

to reach any part of the U.S. within 12 hours, was increased from eight to



       Research - Research into disease agents, diagnostic tools, vaccines

and treatments is being rapidly expanded, a key element of the long-term

strategy for countering bioterrorism.  Research funding increased from $53

million in FY 2001 to $151 million for FY 2002, with much larger increases

planned for FY 2003 to begin carrying out research agendas developed this

year.  The President has proposed building new laboratory facilities for

research involving the most dangerous pathogens. Over 700 new research

proposals were funded this year.  In addition, new rules were issued for

registering and controlling potential bioterror disease agents by



       Food safety - With 80 percent of America's food supply regulated by

HHS' Food and Drug Administration (FDA), resources for food inspections were

increased.  More than 700 new inspectors were hired, making it possible for

FDA to conduct 24,000 on-site import inspections, nearly double the past

capacity.  FDA also developed new risk assessment methods for targeting

potential problem areas.  Working with the Agriculture Department, FDA also

expanded the capacity of its systems for identifying foodborne illness



       Personnel and leadership - Training for the nation's health care

professionals was increased.  In addition, HHS created a new Office of

Public Health Emergency Preparedness to coordinate efforts within HHS and

with the new Department of Homeland Security.  HHS also hardened its own

information systems, and created a new central command and communications

center for emergencies.


EXPANDED ACCESS TO HEALTH CARE -- In 2002, HHS successfully expanded access

to health care for Americans - both by expanding the number and reach of

community health centers nationwide and by helping states to offer health

coverage to more uninsured Americans through the State Children's Health

Insurance Program (SCHIP) and Medicaid:


       Expanding coverage through SCHIP and Medicaid - In 2002, HHS

approved waiver and plan amendments for state SCHIP and Medicaid programs

that expanded access to health coverage to more than 600,000 additional

Americans.  These changes provided additional services to more than 1

million other beneficiaries.  Since the start of Bush Administration, HHS

has approved waivers and plan amendments that expand access to coverage to

nearly 1.8 million Americans and improved benefits for more than 5 million

other Americans.   HHS provides matching funding for coverage provided by

states under Medicaid and SCHIP.


       Expanding Community Health Centers - In 2002, HHS completed the

first full year of President Bush's five-year initiative to add or expand

health centers in 1,200 communities by 2006 and to increase the number of

patients served annually to more than 16 million -- up from 10 million in

2001.  During the fiscal year, HHS funded 171 new health center sites and

awarded 131 grants to existing centers to help them build capacity and

expand services.   Together, these new and expanded health centers will

serve an additional 1.5 million patients each year, including many without



       Bringing doctors and other clinicians to underserved areas - To

support the growth of the health centers, HHS also expanded its National

Health Service Corps, which offers scholarships and loan repayment plans to

students and fully trained clinicians who agree to serve in health centers

and other underserved communities.


       Promoting seniors' access to prescription drugs - While Congress

failed to enact a Medicare prescription drug benefit, HHS developed a model

waiver template in 2002 to encourage states to offer low-income seniors

access to prescription drugs through the Medicaid program.  By the end of

the year, HHS approved Pharmacy Plus waivers in five states - Florida,

Illinois, Maryland, South Carolina and Wisconsin, helping more than half a

million seniors afford access to prescription drugs.


       Encouraging high-risk insurance pools - In November 2002, HHS

launched a new program to help states create high-risk pools that will

provide health coverage to individuals who otherwise would have difficulty

obtaining coverage because of their health status.  HHS' Centers for

Medicare and Medicaid Services (CMS) is offering seed grants of up to $1

million to support state efforts to create high-risk pools, typically

non-profit associations.  A total of $20 million is available through this

program.  In addition, HHS expects to offer a total of $80 million in grants

over two years to help cover losses incurred by states with existing

high-risk pools.


DISEASE PREVENTION INITIATIVE - Secretary Thompson launched his

comprehensive initiative on disease prevention in a National Press Club

speech April 30, outlining steps that individuals can take on their own for

good health.  President Bush joined in the call for healthy personal choices

in events at the White House June 20, and a new Web site ""

was created. Working through HHS agencies and in partnership with many other

organizations, new activities were launched throughout the year to support

healthy choices and behaviors:


       Physical Activity - HHS released a report April 7 showing that seven

in 10 American adults are not regularly active.  In another report June 21,

HHS outlined the special benefits of physical activity and moderate exercise

for older Americans.  CDC launched a $190 million multicultural media

campaign July 17 aimed at promoting a healthier lifestyle for young people,

especially those aged 9 to 13.  HHS also joined with the U.S. Department of

Education to encourage communities and businesses to find new ways to

support physical activity among children.  And in May, Secretary Thompson

marked Older Americans Month with a new campaign, "USA on the Move: Steps to

Healthier Aging," in cooperation with the Center on Nutrition and Aging at

Florida International University.


       Healthy Diet - Secretary Thompson released a report June 20 showing

that overweight and obesity cost America $117 billion annually and account

for at least 14 percent of deaths in the U.S., or some 300,000 premature

deaths each year.  Nearly one-third of U.S. adults now classify as obese,

and obesity among young people is growing rapidly.  In April, HHS joined

with the U.S. Department of Agriculture in expanding a campaign to promote

consumption of fruits and vegetables.  In October, Secretary Thompson and

USDA Secretary Ann M. Veneman met with officials from the National

Restaurant Association and the National Council of Chain Restaurants to

begin a cooperative effort to improve health information and healthy foods,

especially for young people.  In December, FDA launched a new effort to

improve health labeling for nutritious foods.


       Diabetes - Sedentary lifestyle and poor eating habits increase the

risk of diabetes, and the prevalence of diabetes and pre-diabetes is

increasing rapidly in the U.S.  On November 20, Secretary Thompson launched

the first national diabetes prevention campaign, "Small Steps - Big

Rewards," which builds on new findings that modest lifestyle changes can

have a major impact on preventing the disease.  Earlier in the year, HHS had

also launched new steps with the American Diabetes Association (ADA) to

better inform those with diabetes of the most severe effects of the disease.

HHS also worked with the ADA and the National Association of Chain Drug

Stores on a campaign to help women recognize the danger signs of diabetes.

The campaign also provided free diabetes screening for women in cities with

a high incidence of the disease.  In addition, beginning in October, $100

million was made available to tribal organizations for prevention and

treatment of diabetes among American Indians and Alaska Natives, especially

children and teenagers. On average, American Indians and Alaska Natives are

2.6 times more likely to have diabetes than non-Hispanic whites of similar



       HIV/AIDS - In addition to efforts to improve health for all

Americans through healthy diet and exercise, HHS maintained and expanded its

efforts to prevent HIV/AIDS and support treatment, both domestically and

internationally.  Total HHS spending on HIV/AIDS increased from $11.4

billion in FY 2001 to $12.1 billion in FY 2002, with a further increase of

almost $1 billion proposed in the President's budget for FY 2003.  HHS'

contribution to the global effort against HIV/AIDS increased from $276

million in FY 2001 to $468 million in FY 2002.


       Racial and ethnic health disparities - HHS also undertook new

efforts toward closing the health gap between non-minority Americans and

racial and ethnic minorities.  Total HHS spending especially directed at

minority health (not including the Indian Health Service) was $2.6 billion

in FY 2002, up from $2.3 billion in FY 2001.  Grants to support elimination

of disparities were made nationwide by the HHS Office of Minority Health and

the National Institute of Health's (NIH) institutes.  In addition, HHS

convened the first National Leadership Summit on Eliminating Racial and

Ethnic Disparities in Health; and HHS launched a two-year demonstration

project in five states to test new ways of improving flu vaccination rates

in minority communities.  HHS' Health Resources and Services Administration

(HRSA) expanded its Diabetes Collaboratives to better reach minorities, who

suffer disproportionately from diabetes.  And a new effort, "Take a Loved

One to the Doctor Day," was launched in partnership with ABC broadcasting's

Urban Radio Network to encourage improved health screening and access to

health care facilities for minority Americans.


IMPROVING QUALITY OF CARE - In 2002, HHS moved ahead with a far-reaching

effort to promote higher-quality care among healthcare organizations in part

by measuring and reporting quality information to consumers.  CMS and

HHS'Agency for Healthcare Research and Quality (AHRQ) have worked to

validate quality measures using available data and then develop meaningful

measures that can be used by health care providers to improve quality and

reported to the public to empower consumers to choose quality healthcare



       Publishing national nursing home quality measures - In November

2002, HHS launched a national nursing home quality initiative that combines

comparative data about quality for consumers with intensified efforts to

assist nursing homes to improve the quality of care that they provide to

their residents.  The consumer data for all nursing homes serving Medicare

and Medicaid patients is available at or by calling

1-800-MEDICARE.  Ten quality measures, developed with private-sector help,

are included in the data.  CMS pilot-tested the consumer data in six states

before launching the effort nationally.


       Developing hospital quality measures - In December 2002, HHS joined

the nation's major hospital trade associations in announcing a new

initiative to provide quality information about hospitals to the public.

Under the program, HHS will help validate and publish key quality measures

involving cardiac care and pneumonia that hospitals voluntarily report.  In

addition, AHRQ will develop a standardized patient survey that will provide

comparative information about hospitals.


       Developing new tools to measure quality - AHRQ continued efforts

toward building a national information structure to provide sound measures

of health care quality.  During 2002, AHRQ introduced the Prevention Quality

Indicators, a software tool for detecting potentially avoidable hospital

admissions for illnesses which can be effectively treated with high-quality,

community-based primary care.  AHRQ also launched its Inpatient Quality

Indicators, a software tool consisting of 29 measures that can be used to

help hospitals identify potential problem areas and provide an indirect

measure of hospital quality of care.


       Hormone therapy - NIH stopped a major clinical trial early, which

was looking at risks and benefits of combined estrogen and progestin therapy

in healthy menopausal women.  The study was stopped when conclusive evidence

was found of increased risk of invasive breast cancer.  The study also found

increases in coronary heart disease, stroke and pulmonary embolism.  NIH

convened a scientific workshop to review the findings and help clinicians

and patients understand the implications of current knowledge for decisions

regarding use of such therapy.  The U.S. Preventive Services Task Force

published new recommendations on the use of the therapy.  And FDA undertook

proceedings to consider appropriate label changes for hormone therapy



NEXT STEPS FOR HELPING THOSE IN NEED - The number of Americans on welfare

continued to go down, despite a slower economy, and more of those receiving

welfare were taking part in work or training.  Secretary Thompson led the

Administration's efforts toward reauthorization of the 1996

welfare reform law, with stronger work requirements, more supports for

families to achieve self-sufficiency, and greater flexibility for states.

In addition, HHS led the administration's efforts to enable more faith-based

and community organizations to deliver federally-supported services.  HHS

also led special initiatives for Americans with disabilities, reading

readiness in Head Start, and new adoption efforts.


       Welfare caseload stays down - In November, HHS released the latest

data on the nation's welfare caseload.  The number of Americans receiving

welfare assistance declined again, by about 4.5 percent, between December

2001 and June 2002.  Altogether, the number of individuals receiving welfare

has declined 58 percent since enactment of welfare reform law in 1996.

Census data released in September also showed that in 2001 the poverty rate

for African-American children reached the lowest level ever reported.  As

governor of Wisconsin, Secretary Thompson had created the national model for

welfare reform, and he led the administration's efforts this year to achieve

the next step in reform by reauthorizing and improving the 1996 law.  While

a measure passed in the House of Representatives, the Senate failed to take

action.  Reauthorization efforts will resume in 2003.


       Faith-based initiative - HHS provided $30 million in funding for the

President's Faith-Based and Community Initiative, to help level the playing

field for religious and other organizations seeking to use HHS funds to help

those in need.  Faith- and community-based organizations are often the most

effective groups in helping confront poverty, homelessness, substance abuse

and other problems addressed by HHS programs.  Yet many do not have the

expertise needed to apply for and manage federal funds.  The HHS funding

from the new Compassion Capital Fund provides for technical assistance,

especially to smaller charities and faith-based organizations, to use HHS

funds to help them deliver services to people in need.  In December HHS also

published proposed regulations clarifying the rights and responsibilities of

religious organizations if they become HHS grantees.


       Americans with disabilities - Secretary Thompson led the

Administration's efforts under the President's "New Freedom Initiative,"

aimed at eliminating barriers to community living for Americans with

disabilities.  In May, Secretary Thompson delivered to the President the

most comprehensive report ever compiled on legal and programmatic barriers,

and steps that could be taken across government to help persons with

disabilities.  At the same time, HHS released a new waiver template making

it easier for states to make changes in their Medicaid programs to serve

people with disabilities in their own homes.  The first Independence Plus

waiver was granted to New Hampshire in December.  HHS also created a new

Secretarial-level Office on Disability to oversee coordination, development

and implementation of programs and special initiatives across HHS.  In

addition, the President established his "New Freedom Commission on Mental

Health," and HHS is helping lead this effort to improve mental health

services, especially community-based services.


       Early literacy skills for Head Start children - As part of the

President's "Good Start/Grow Smart" initiative, HHS took new steps to assure

early literacy skills throughout the Head Start program.  New training was

provided for Head Start teachers, and development began for a new system to

measure early literacy.  The new system will help ensure for the first time

that every Head Start child is assessed on development of early literacy



       Adoption - HHS' Administration for Children and Families (ACF)

launched a cooperative effort to make adoption information available via the

internet at AdoptUSKids, a database of children awaiting adoption and

families approved to adopt.  In 2001, nearly 50,000 children were adopted

with the involvement of the public child welfare system, a 79 percent

increase since 1996, when 28,000 adoptions were finalized.


       National Youth Summit - ACF sponsored the first National Youth

Summit in June, bringing together about 2,000 professionals, parents,

advocates, researchers and young people to focus on successful achievements

and strategies for youth.  The summit was designed to help build state and

regional partnerships to support America's youth.



preventable cause of death in America, responsible for some 440,000

premature deaths per year, including 87 percent of lung cancer deaths.

Early data for 2002 show a continuing decline for smoking in the United

States.  Only about one in five Americans now smokes, compared with almost

one in four just five years earlier and more than 40 percent at the highest

measured point, in 1965.  Teen smoking declined sharply in 2002, as did teen

alcohol abuse and illicit drug use.


       Teen smoking - Results from the "Monitoring the Future" survey for

2002, released in December, showed a significant decrease in smoking by

teens, accelerating a trend that began after teen smoking reached a high

point in 1996.  This year's survey also showed that teen alcohol consumption

was down, as was teens' use of illicit drugs.


       Sales of cigarettes to teens - HHS released data in September

showing that retailers are continuing to reduce sales of cigarettes to those

under 18.  The retailer violation rate fell to 16.3 percent in 2001, from

40.1 percent in 1996.


       Anti-tobacco campaigns - In addition to ongoing public information

campaigns, CDC launched a new national campaign aimed at reducing smoking

among Hispanics.  HHS launched a Tobacco-Free Sports public education

campaign at the 2002 Olympic and Paralympic Winter Games.


PROTECTING PATIENT PRIVACY  - In 2002, HHS completed the first-ever

comprehensive federal patient privacy regulations giving patients sweeping

protections over the privacy of their medical records.  The regulations

empower patients by guaranteeing them access to their medical records,

giving them more control over how their protected health information is used

and disclosed, and providing a clear avenue of recourse if their medical

privacy is compromised.   The privacy rule covers medical records and other

personal health information maintained by certain health care providers,

hospitals, health plans, health insurers and health care clearinghouses.

Most covered entities must comply with the regulations by April 14, 2003:


       Protecting patients from non-routine use and disclosure - Under the

rule, patients must give specific authorization before covered entities

could use or disclose protected information in most non-routine

circumstances - such as releasing information to an employer or for use in

marketing activities.


       Ensuring patients' access to medical records - Patients generally

will be able to access their personal medical records and request changes to

correct any errors.


       Written privacy notice -- Covered entities generally will need to

provide patients with written notice of their privacy practices and

patients' privacy rights.  Patients will generally be asked to sign or

otherwise acknowledge receipt of the privacy notice from direct treatment



       Restricting marketing based on protected health information -

Pharmacies, health plans and other covered entities must first obtain an

individual's specific authorization before sending them marketing materials.

At the same time, the rule permits doctors and other covered entities to

communicate freely with patients about treatment options and other

health-related information, including disease-management programs.


REGULATORY REFORM  - In 2002, HHS moved to restore common sense to its

regulatory process in order to remove unnecessary barriers between patients

and their doctors, nurses and other health care providers.  During the year,

Secretary Thompson's newly created Advisory Committee on Regulatory Reform

made hundreds of recommendations to remove potential obstacles to patients'

access to care, reduce the time doctors and other health care professionals

must spend on paperwork, improve communication with consumers, and improve

the use of technology to promote quality care while ensuring patients have

strong privacy protections.  HHS has already moved to implement dozens of

those recommendations:


       Streamlining home health paperwork - In June, CMS launched a new

effort to streamline Medicare's paperwork requirements for home health

nurses and therapists so that they can focus more on providing quality care

to their patients.  As a result, required assessments will include only

those elements needed to promote quality of care and to ensure proper



       Promoting appropriate emergency room care - In May, CMS proposed

common-sense improvements to clarify the requirements for hospitals to

screen and treat emergency room patients. The proposed revisions would

ensure that patients with possible emergency conditions receive appropriate

care as rapidly as possible.


       Eliminating repetitive insurance requests - CMS also reduced the

frequency that hospitals must gather detailed information from Medicare

beneficiaries about other insurance. This change means hospitals will not

have to ask patients repeatedly for the same data.



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