[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

[[Page 15956]]
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,

[[Page 15957]]
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