[Federal Register Volume 68, Number 143 (Friday, July 25, 2003)]
[Notices]
[Pages 44084-44088]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 03-18911]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Agency for Healthcare Research and Quality (AHRQ)


Statement of Organization, Functions, and Delegations of 
Authority

    Part E, Chapter E (Agency for Healthcare Research and Quality), of 
the Statement of Organization, Functions, and Delegations of Authority 
for the Department of Health and Human Services (61 FR 15955-58, April 
10, 1996, most recently amended at 66 FR 44149-50 on August 22, 2001) 
is further amended to reflect recent organizational changes. The 
specific amendments are as follows:
    Under Section E-10, Organization, delete A. through K. and replace 
with the following:
    A. Office of the Director.
    B. Center for Delivery, Organization, and Markets.
    C. Center for Financing, Access, and Cost Trends.
    D. Center for Outcomes and Evidence.
    E. Center for Primary Care, Prevention, and Clinical Partnerships.
    F. Center for Quality Improvement and Patient Safety.
    G. Office of Communications and Knowledge Transfer.
    H. Office of Extramural Research, Education, and Priority 
Populations.
    I. Office of Performance, Accountability, Resources and Technology.
    Under Section E-20. Functions, delete all titles and statements and 
replace with the following:
    Office of the Director (EA). Directs the activities of the Agency 
for Healthcare Research and Quality (AHRQ) to ensure the achievement of 
strategic objectives. Specifically: (1) Provides overall leadership for 
the Agency; (2) maintains the scientific integrity and objectivity of 
the Agency's research; (3) directs and coordinates the Agency's 
research, research training programs, and dissemination activities; (4) 
ensures that Agency programs support Administration goals and 
objectives; (5) represents the Agency within the Department, at the 
highest level of Government, and to the public; (6) coordinates the 
legislative activities of the Agency, the review and clearance of 
Department and other Federal policies and regulations, and reports to 
Congress; (7) controls the flow of correspondence and official 
documents entering and leaving the Agency; (8) manages the National 
Advisory Council; and (9) supports the AHRQ Ombuds.
    Center for Financing, Access, and Cost Trends (EC). Conducts, 
supports and manages studies of the cost and financing of health care, 
the access to health care services and related trends. Develops data 
sets to support policy and behavioral research and analyses. These 
studies and data development activities are designed to provide health 
care leaders and policymakers with the information and tools they need 
to improve decisions on health care financing, access, coverage and 
cost. Specifically: (1) Conducts, supports 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 access to care for the general population and subgroups of 
policy interest; (2) conducts and manages health sector surveys such as 
medical expenditure surveys; surveys of medical care providers, 
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 care use, health 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, employers, and foundations, and represents the Agency in 
meetings with Federal agencies and experts on health policy issues 
especially issues related to health expenditures, access, and 
insurance, Federal and State health care programs.
    Division of Modeling and Simulation (ECB). Provides research, 
models, and data bases to support microsimulation analyses of household 
impacts and trends in health expenditures from health policies embodied 
in current law and from health care policies embodied in generic 
versions of proposed health care reforms. Specifically: (1) Projects 
the National Medical Expenditure Survey and the Medical Expenditure 
Panel Survey household expenditure data to future years; (2) aligns the 
projected household expenditure data to the Health Care Financing 
Administration's National Health Expenditures by type of health service 
and payment source; (3) uses a variety of outside data sources to 
project, for example, the household population, Medicaid enrollees, 
household income, and private and public health insurance benefits; (4) 
develops and updates the Agency's MEDSIM microsimulation model's 
software to estimate current household income and payroll taxes, 
current private and public insurance coverage and benefits, and the 
costs and consequences of generic versions of proposed health care 
reforms; (5) provides the latest versions of the projected expenditure 
data bases and associated research products on the Agency home page; 
(6) uses MEDSIM and its data bases to conduct and publish research on 
current and proposed health policies and on trends in household health 
care expenditures; and (7) provides cost and distributional MEDSIM 
estimates of specific legislative health care reform proposals to 
provide predecisional guidance to requesting federal officials.
    Division of Social and Economic Research (ECC). Provides basic 
descriptive and behavioral analyses of the population's access to, use 
of expenditures and sources of payment for health care; the 
availability and costs of private health insurance in the employment-
related and non-group markets; the population enrolled in public health 
insurance coverage and those without health care coverage; and the role 
of health status in health care use, expenditures, and household 
decision-making, and in health insurance and employment choices. 
Specifically: (1) Provides analytical input to the design and 
development of primary data collection efforts and research-related 
data bases; (2) develops a research agenda related to health care use, 
expenditures, access to care, sources of payment, health insurance, and 
health status; (3) conducts applied research in these areas by applying 
substantive research tools from the fields of health services research, 
health economics, medical sociology, public policy analysis, 
demography, statistics and econometrics; (4) disseminates research 
findings through presentations at conferences, publications in peer 
reviewer journals, book chapters, and conference volumes; (5) provides 
substantive technical expertise on health care use, expenditures, and

[[Page 44085]]

insurance coverage to other units within AHRQ, other governmental 
units, private sector research institutions, and by serving as 
technical reviewers and advisors to scholarly journals, technical 
advisory committees, and private and public sector task forces.
    Division of Statistical Research and Methods (ECD). Plans and 
conducts studies on statistical methods and the use of statistics in 
survey design in health services research. These studies provide the 
bases for policy research and analysis and for technical assistance 
provided to other Centers and Offices within the Agency. Specifically: 
(1) Identifies, designs, conducts, and implements statistical research 
and evaluation studies in accordance with the Agency's research 
priorities; (2) oversees the statistical design of the National Medical 
Expenditure Panel Survey (MEPS); and (3) conducts research in the areas 
of survey design, sampling, estimation, imputation, the analysis of 
complex survey data, and the reduction of sources of sampling and 
nonsampling errors in the design of national health care surveys.
    Division of Survey Operations (ECE). Plans, implements and monitors 
the fielding of CFACT surveys. Specifically: (1) Develops and 
disseminates public use data files which including editing, imputation 
and estimation tasks; (2) assists in the development of data reports 
which are of particular interest to the Department and other Federal, 
State and local government agencies as well as the larger research 
community; and (3) monitors the development of Computer Assisted 
Personal Interviewing (CAPI) data collection instruments.
    Center for Delivery, Organization, and Markets (EH). Provides a 
locus of leadership and expertise for advances in health care delivery, 
organization, and markets through research. Specifically: (1) Conducts, 
supports, and manages studies designed to give health care leaders and 
policy makers the information and tools they need to improve health 
system performance; (2) generates evidence on how health care delivery 
and organizational dynamics affect performance through qualitative and 
quantitative research, delivery-based research networks, data and tool 
development and other state, federal, and private partnerships; (3) 
examines the impact of delivery and organizational attributes and 
changes--including payer mix, delivery sites, practice patterns, 
structure, workforce, leadership, governance and culture--across acute, 
community-based, and long-term-care settings; (4) studies how market 
forces and reactions to them--such as payment methods financial and 
non-financial incentives, safety net funding, employer purchasing 
strategies, quality measurement and reporting, and regulations--
influence performance; and (5) represents the Agency in meetings with 
Federal agencies and experts on health policy issues especially those 
related to advancing evidence-based decision making in organizations 
and the public policy arena.
    Center for Outcomes and Evidence (EJ). Conducts and supports 
research and assessment of health care practices, technologies, 
processes, and systems. Specifically: (1) Conducts and supports 
research, assessments, and demonstrations on safety, quality, 
effectiveness, cost-effectiveness, and other relevant attributes of 
health care practices, technologies, processes and systems; (2) 
facilitates and coordinates the development of infrastructures for 
collection, analysis, and synthesis of evidence and data on the safety, 
effectiveness and quality of health care practices, technologies, 
processes, and systems; (3) serves as a center of excellence for 
methods and measurement development for the conduct and analysis of 
outcomes research, cost effectiveness analysis, and evidence-based 
systematic reviews and technology assessments; (4) serves as a source 
of evidence based information about therapeutics, technologies, and 
healthcare practices for clinical and policy decision makers; (5) 
directs and supports research on and implementation of the appropriate 
use of therapeutics and medical technologies, including preventing 
overuse, under-use and adverse effects; (6) provides an array of tools 
and products to promote and facilitate evidence-based clinical 
practices and health care decision making; (7) fosters partnerships 
with health care provides, insurers, employers and consumers to bring 
about sustainable systemic change to implement evidence-based practices 
and improve patient outcomes and quality of care; and (8) represents 
the Agency in meetings with experts and organizations in the areas of 
outcomes research and evidence-based medicine and organizes conferences 
on these topics.
    Center for Primary Care, Prevention, and Clinical Partnerships 
(EK). Expands the knowledge base for clinical providers and patients 
and to assure the translation of new knowledge and systems improvement 
into primary care practices. Supports and conducts research to improve 
the access, effectiveness, and quality of primary and preventive health 
care services in the United States. Specifically: (1) Supports primary 
care practice-based research networks (PBRNs) in order to investigate 
questions related to community-based practice and to improve the 
quality of primary and preventive care; (2) responsible for the 
rigorous evaluation of clinical research assessing the merits of 
preventive measures, including screening tests, counseling, 
immunizations, and chemoprevention through the United States Preventive 
Services Task Force; (3) serves as the Agency's locus for the use of 
information technology to improve health care and facilitates the 
evaluation and diffusion of effective information technology tools into 
clinical practice; and (4) supports research and demonstrations that 
improve healthcare system preparedness for bioterrorism and other 
public health threats, with an emphasis on the role of front-line 
clinical providers.
    Center for Quality Improvement and Patient Safety (EL). Works to 
improve the quality and safety of our health care system through 
research an implementation of evidence. Specifically: (1) Conducts and 
supports research, demonstrations, and evaluations of the quality of 
health care and patient safety across our health care systems and, 
specifically, for priority populations; (2) conducts and supports 
research on the measurement of health care quality and promotes the use 
of these measures; (3) conducts and supports research on effective ways 
to improve the quality of health care and participates in the 
dissemination of this knowledge; (4) evaluates methods for identifying, 
preventing and ameliorating medical errors and enhancing patient 
safety; (5) designs, conducts, and supports surveys to assess the 
quality of and patients' experiences with health care services and 
systems; (6) develops and disseminates annual reports on health care 
quality, disparities and patient safety; (7) provides technical 
assistance and gathers information on the use of quality measures, 
consumer and patient information, and reporting on patient safety and 
the resulting effects; (8) supports dissemination and communication 
activities to improve quality of care and patient safety; (9) partners 
with stake holders to implement research findings and evidence related 
to quality measurement, quality improvement and patient safety; and 
(10) represents the Agency in meetings with domestic and international 
experts and organizations concerned with measuring and

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evaluating the quality of care and enhancing patient safety.
    Office of Communications and Knowledge Transfer (EN). Designs, 
develops, implements, and manages programs for disseminating the 
results of Agency activities with the goal of changing audience 
behavior. Specifically: (1) Communicates the results and significance 
of health services research and other AHRQ initiatives to the health 
care industry, health care providers, consumers and patients, policy 
makers, researchers, and the media with particular emphasis on 
communicating AHRQ initiatives in the ways each of these constituencies 
are most interested and are likely to lead to behavior change; (2) 
manages the editing, publication, and information distribution 
processes of the Agency, including Freedom of Information Act 
administration; (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, Agency 
clearinghouse for responding to requests for information and technical 
assistance, and a program for consumer information about health care 
research findings; (5) directs a user liaison program to provide health 
care research and policy findings to Federal, State and local public 
officials, and other audiences as appropriate; (6) evaluates the 
effectiveness of Agency dissemination strategies and implements changes 
indicated by such evaluations; and (7) represents the Agency in 
meetings with Department representatives on press releases, media 
events, and publication clearance.
    Division of Print and Electronic Publishing (EBB). Responsible for 
disseminating AHRQ's many and varied informational products.Ensures 
that findings and information from conducted or funded by AHRQ are 
created in forms useful to intended recipients. Specifically: (1) 
Produces information products in a variety of print and electronic 
formats that are scientifically bound and appropriately targeted to 
various audiences; (2) edits and controls the review and publication of 
all AHRQ documents; (3) ensures proper clearance procedures consistent 
the Departmental rules; (4) provides interfaces with the Government 
Printing Office and National Technical Information Service; (5) 
organizes and conducts AHRQ's exhibits program and provides conference 
support services to program staff; (6) provides and coordinates 
graphics, printing and visual aids production for AHRQ; (7) analyzes 
AHRQ audiences and information needs, and recommends information 
products that meet AHRQ's scientific information and dissemination 
goals; and (8) works with and assists the National Library of Medicine 
in efforts to improve the availability of health services information 
to the public.
    Division of Public Affairs (ENC). Responsible for planning and 
carrying out the public affairs activities the Agency. Specifically: 
(1) Handles AHRQ media relations; (2) develops health care research 
information dissemination partnerships with other Federal agencies, 
provider groups, the continuing education and continuing medical 
education communities, and the private sector; (3) ensures that 
findings and information from research conducted or funded by AHRQ are 
made promptly available to the public and private sectors; (4) analyzes 
AHRQ audiences and information needs and recommends new outreach/
dissemination programs and information products to meet AHRQ's 
scientific information and dissemination goals and needs of AHRQ target 
audiences; (5) recommends the most effective and efficient approaches 
to information dissemination; (6) develops and evaluates the 
effectiveness of Agency dissemination strategies; (7) manages AHRQ's 
publication clearinghouse; (8) responds to public inquires about AHRQ 
and its research; (9) makes final reports of Agency-supported research 
available to the public through the National Technical Information 
Service; and (10) carries out AHRQ's Freedom of Information Act 
activities.
    Division of User Liaison and Research Translation (END). Provides 
direction and coordination of the Agency's program to define the 
issues, problems, and information needs of selected users of health 
services research, especially public and private sector policymakers, 
and to disseminate to them relevant research findings, program data, 
and descriptive information related to the organization, planning, 
management, financing, delivery, evaluation, and outcomes of health 
services at the Federal, state, and local level. Specifically: (1) 
Develops syntheses of research findings focused on particular issues 
dealing with policy concerns and operational problems; (2) plans and 
conducts workshops and seminars to provide research findings and 
related information to policymakers and other consumers of health 
services research to allow them to make better informed health care 
policy decisions; (3) maintains liaison with State and local government 
organizations, public policy organizations, and with the research 
community and receives and appropriately transmits information which 
may impact the Agency's research plan and priority setting process; (4) 
formulates, in collaboration with Agency staff, appropriate policies 
and activities to develop effective linkages with potential users of 
health services research; (5) communicates information regarding user 
research needs to the Agency Director and appropriate Agency staff to 
ensure user needs are adequately addressed in current and planned 
Agency project; (6) develops and implements mechanisms to identify and 
contact potential users of research findings and related information; 
(7) plans meetings and coordinates contacts between Agency staff and 
individual users and representatives of users' groups and 
organizations; (8) provides assistance and advice to other Federal 
agencies and organizations in evaluating the utility of Federally-
sponsored research to State and local government officials; and (9) 
provides technical assistance for the design and implementation of 
research projects undertaken by State and local governments.
    Office of Extramural Research, Education, and Priority Populations 
(EP). Directs the scientific review process for grants and Small 
Business Innovation Research (SBIR) contracts, manages Agency research 
training programs, evaluates the scientific contribution of proposed 
and on-going research, demonstrations, and evaluations, and supports 
and conducts health services research on priority populations. 
Specifically: (1) Directs the process for selecting, reviewing, and 
funding grants and reviewing SBIR contracts for scientific merit and 
program relevance; (2) assigns grant applications to Centers and 
Offices for administrative action; (3) manages the process for making 
funding decisions for grants; (4) directs Agency research training and 
career development programs and implementation of the National Research 
Service Award authority; (5) manages the committee management and 
scientific integrity processes for the intramural and extramural 
programs of the Agency; (6) develops and coordinates clearance of peer 
review regulations, as required, policy notices and program 
announcements; (7) facilitates Agency-wide communication and 
coordination regarding extramural policy, planning, and analysis; (8) 
represents the Agency in meetings with experts and organizations on 
issues related to the administration of the Agency's scientific 
programs; (9) advises the Agency

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leadership on matters pertaining to the health needs and health care of 
priority populations, including scientific, ethical, legal and policy 
issues; (10) prepares the agenda for priority populations research--
both extramural and intramural--through the Agency's strategic planning 
process, needs assessments, and user input; (11) serves as an expert 
resource within the Agency on priority populations to assist program 
development and participates in the development of policies and 
programs to implement the Agency's priority populations agenda; (12) 
fosters new knowledge, tool, talent, and strategy development related 
to priority populations by recommending, leading, coordinating and 
conducting new initiatives, including intramural initiatives; (13) 
works in partnership with other Centers and Offices to design and 
implement efforts to translate, disseminate, and implement evidence-
based initiatives and programs to improve health care for priority 
populations; (14) evaluates the degree to which the Agency is meeting 
its goals for priority populations; (15) provides national expertise to 
Agency staff and Agency partners on priority populations issues, 
establishing and maintaining liaison with other knowledgeable or 
concerned agencies, governments and organizations; (16) establishes new 
contacts and cultivates present ones with external groups (a) To spur 
increased awareness and emphasis on priority populations within the 
health services research, health care policy, and health care delivery 
communities, (b) to partner with organizations and agencies to expand 
research on priority populations, thereby securing additional resources 
for these activities, and (c) to build research and implementation 
capacity on priority populations; and (17) enhances the visibility of 
the Agency in priority populations through frequent presence and 
delivery of speeches and scientific presentations of meetings of 
relevance to the field and to AHRQ's mission.
    Division of Research Education (EPB). Develops, implements, and 
evaluates a comprehensive extramural health services research education 
program which supports the career development of predoctoral and 
postdoctoral students. Specifically: (1) Manages the AHRQ research 
education/training portfolio, which includes National Research Service 
Award (NRSA) institutional training grants, NRSA individual 
postdoctoral training grants, dissertation training grants, and 
incentive innovation awards; (2) establishes systems/mechanisms to 
monitor the external health care environment for research needs of 
potential private and public sector employers and to anticipate special 
training needs; (3) implements new programs and support mechanisms, and 
modifies existing ones to meet changing needs; (4) develops and manages 
activities intended to evaluate the effects of past investments in 
health services research training by examining career patterns, 
publication records, and research productivity of persons supported by 
AHRQ; (5) promotes visibility for the field of health services research 
and the availability of training support through a variety of 
mechanisms; (6) keeps abreast of Department policies and procedures 
which pertain to extramural research education training, and assures 
compliance at the AHRQ level; and (7) works with AHRQ leadership to 
sure communication and collaboration between ORREP and program centers 
with an interest in research education.
    Division of Scientific Review (EPC). Plans and carries out the 
scientific review for all AHRQ extramural research grants and SBIR 
proposals. Specifically: (1) Assures compliance with organizational, 
regulatory, and policy aspects of peer review; (2) determines review 
requirements for standing study sections and special emphasis panels; 
(3) anticipates needs/changes regarding the charters of standing study 
sections, establishes and implements procedures for chartering study 
sections, filling study section vacancies and appointing new members 
and chairpersons, orient new reviewers to peer review processes; (4) 
advises Agency staff on peer review processes and grant solicitations; 
(5) keeps abreast of departmental, especially NIH, policies and 
procedures regarding peer review to assure compatibility of AHRQ 
processes; (6) interacts with the health services research community 
and keeps abreast of emergent research developments as they relate to 
review planning; (7) establishes and maintains continuous quality 
monitoring and improvement activities; and (8) coordinates funding 
meetings and relevant follow-up activities.
    Division of Priority Populations Research (EPD). Coordinates, 
supports, manages and conducts health services research on priority 
populations. Specifically: (1) Advises the Agency leadership on matters 
pertaining to the health needs and health care of priority populations, 
including scientific, ethical, legal and policy issues; (2) prepares 
the agenda for priority populations research through the Agency's 
strategic planning process, needs assessment, and user input; (3) 
serves as an expert resource within the Agency on priority populations 
to assist program developments and participates in the development of 
policies and programs to implement the Agency's priority populations 
agenda; (4) fosters new knowledge, tool, and talent development related 
to priority populations by recommending, leading, coordinating and 
conducting new initiatives; (5) assists in the translation, 
dissemination, and application of Agency initiatives and programs to 
improve health care for priority populations; (6) evaluates the degree 
to which the Agency is meeting its goals for priority populations 
research; (7) provides national expertise to Agency staff and Agency 
partners on priority populations issues, establishing and maintaining 
liaison with other knowledgeable or concerned agencies, governments and 
organizations; (8) establishes new contacts and cultivates present ones 
with external groups (a) To spur increased awareness and emphasis on 
priority populations within the health services research community, (b) 
to partner with organizations and agencies to expand research on 
priority populations, thereby securing additional resources for the 
these activities, and (c) build the research capacity on priority 
populations; and (9) enhances the visibility of the Agency in priority 
populations research.
    Office of Performance, Accountability, Resources, and Technology 
(EQ). Directs and coordinates Agency-wide program planning and 
evaluation activities and administrative operations. Specifically: (1) 
Ensures program planning is integrated with budget formulation and 
performance and serves as the Agency's focal point for Government 
Performance and Results Act activities; (2) plans and directs financial 
management activities including budget formulation, presentation, and 
execution functions and supports linking of the budget and planning 
processes; (3) provides human resource consultation services regarding 
all aspects of personnel management, workforce planning and 
restructuring, and the allocation and utilization of personnel 
resources; (4) provides organizational and management analysis, 
develops operating policies and procedures, and implements and carries 
out Agency management programs and policies; (5) coordinates the 
Agency's Federal Managers' Financial Integrity Act, competitive 
sourcing and FAIR Act, and Privacy Act activities; (6) conducts all 
business management aspects of the review, negotiation, award, and 
administration

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of Agency research grants, cooperative agreements, and contracts; (7) 
manages the analysis, selection, implementation, and operation of all 
aspects of the Agency's information technology infrastructure and 
telecommunication systems; (8) provides other Agency support services 
including the acquisition, management, and maintenance of supplies, 
equipment, and space.
    These changes are effective upon date of signature.

    Dated: July 8, 2003.
Carolyn M. Clancy,
Director.
[FR Doc. 03-18911 Filed 7-24-03; 8:45 am]
BILLING CODE 4160-90-M