Organization

Internal structureedit

The Department of Health & Human Services is led by the United States Secretary of Health and Human Services, a member of the United States Cabinet appointed by the President of the United States with the consent of the United States Senate. The Secretary is assisted in managing the Department by the Deputy Secretary of Health and Human Services, who is also appointed by the President. The Secretary and Deputy Secretary are further assisted by seven Assistant Secretaries, who serve as top Departmental administrators.

As of Jan. 20, 2018, this is the top level of the organizational chart. HHS provides further organizational detail on its website.

Several agencies within HHS are components of the U.S. Public Health Service (PHS), as noted below.

• Secretary, Deputy Secretary, and Chief of Staff
  • The Executive Secretariat (ES)
  • Office of Intergovernmental and External Affairs (IEA)
    • Headquarters Staff
    • Regional Offices
    • Office of Human Resources
  • Office of Health Reform (OHR)
  • Office of the Secretary
    • Office of the Assistant Secretary for Administration (ASA)
      • Office of Business Management
      • Equal Employment Opportunity Office
      • Office of Human Resources
      • Program Support Center
      • Office of the Chief Information Officer
    • Office of the Assistant Secretary for Financial Resources (ASFR)
      • Office of Budget
      • Office of Finance
      • Office of Grants
      • Office of Acquisitions
    • Office of the Assistant Secretary for Health (OASH)
      • Office of the Surgeon General
      • Office of Disease Prevention and Health Promotion
      • Office of Human Research Protections
      • Office of Infectious Disease
      • Office of Minority Disease
      • Office of Population Affairs
      • Office of Research Integrity
      • Office of Women's Health
    • Office of the Assistant Secretary for Legislation (ASL)
    • Office of the Assistant Secretary for Planning and Evaluation (ASPE)
    • Office of the Assistant Secretary for Preparedness and Response (ASPR) – PHS component
    • Office of the Assistant Secretary for Public Affairs (ASPA)
    • Office for Civil Rights (OCR)
    • Departmental Appeals Board (DAB)
    • Office of the General Counsel (OGC)
    • Office of Global Affairs (OGA) – PHS component
    • Office of Inspector General (OIG)
    • Office of Medicare Hearings and Appeals (OMHA)
    • Office of the National Coordinator for Health Information Technology (ONC)
  • Operating Divisions
    • Administration for Children and Families (ACF)
    • Administration for Community Living (ACL)
    • Agency for Healthcare Research and Quality (AHRQ) – PHS component
    • Agency for Toxic Substances and Disease Registry (ATSDR) – PHS component
    • Centers for Disease Control and Prevention (CDC) – PHS component
    • Centers for Medicare & Medicaid Services (CMS)
    • Food and Drug Administration (FDA) – PHS component
    • Health Resources and Services Administration (HRSA) – PHS component
    • Indian Health Service (IHS) – PHS component
    • National Institutes of Health (NIH) – PHS component
    • Substance Abuse and Mental Health Services Administration (SAMHSA) – PHS component

Office of Inspector Generaledit

The Office of Inspector General, U.S. Department of Health and Human Services (OIG) investigates criminal activity for HHS. The special agents who work for OIG have the same title series "1811" as other federal criminal investigators, such as the FBI, HSI, ATF, DEA and Secret Service. They receive their law enforcement training at the U.S. Department of Homeland Security’s Federal Law Enforcement Training Center in Glynco, Georgia. OIG Special Agents have special skills in investigating white collar crime related to Medicare and Medicaid fraud and abuse. Organized crime has dominated the criminal activity relative to this type of fraud.

HHS-OIG investigates tens of millions of dollars in Medicare fraud each year. In addition, OIG will continue its coverage of all 50 states and the District of Columbia by its multi-agency task forces (PSOC Task Forces) that identify, investigate, and prosecute individuals who willfully avoid payment of their child support obligations under the Child Support Recovery Act.

HHS-OIG agents also provide protective services to the Secretary of HHS, and other department executives as necessary.

In 2002, the department released Healthy People 2010, a national strategic initiative for improving the health of Americans.

With the passage of the Fraud Enforcement and Recovery Act of 2009, and the Affordable Care Act of 2010, the Office of the Inspector General has taken an emboldened stance against healthcare related non-compliance, most notably for violations of Stark Law and the Anti-Kickback Statute.

In 2015, the OIG issued a fraud alert as a warning to hospitals and healthcare systems to monitor and comply with their physician compensation arrangements.

Recent years have seen dramatic increases in both the number and the amounts of Stark Law violation settlements, prompting healthcare experts to identify a need for automated solutions that manage physician arrangements by centralizing necessary information with regard to physician–hospital integration. Contract management software companies such as Meditract provide options for health systems to organize and store physician contracts. Ludi Inc introduced DocTime Log®, an SaaS solution that specifically addresses this growing concern, automating physician time logging in compliance with contract terms to eliminate Stark Law and Anti-Kickback Statute violations.

According to a report released by the OIG in July 2019, more than 80 percent of the 4,563 U.S. hospice centers that provide care to Medicare beneficiaries surveyed from 2012 to 2016 have at least one deficiency and 20 percent have at least one "serious deficiency."

From January 2020, Christi Grimm became the principal deputy inspector general. She assumed the duties of an acting inspector general, because the inspector general post was empty. In April 2020, Grimm released a report which surveyed the state of hospitals in late March during the COVID-19 pandemic in the United States. The hospitals reported "severe shortages of testing supplies", "frequently waiting 7 days or longer for test results", which extended the length of patient stays and strained resources, and "widespread shortages of PPE". President Trump called the report "wrong" and questioned Grimm's motives. Later he called the report "Another Fake Dossier!" In May 2020, Trump nominated Jason Weida to be the permanent inspector general, pending confirmation by the U.S. Senate. According to a department spokeswoman, Grimm will remain as principal deputy inspector general.

Former operating divisions and agenciesedit

• Social Security Administration, made independent in 1995.
• Health Care Financing Administration, renamed to Centers for Medicare and Medicaid Services

Relationship with state and local health departmentsedit

There are three tiers of health departments, the federal health department, state health department and local health department. In relation with state and local government, the federal government provides states with funding to ensure that states are able to retain current programs and are able to implement new programs. The coordination between all three health departments is critical to ensure the programs being implemented are well structured and suited to the corresponding level of health department. The health department at state level needs to safeguard good relations with legislators as well as governors in order to acquire legal and financial aid to guarantee the development and enhancements of the programs. Assemblies are set up to guide the relationships between state and local health departments. The state sets up the regulations and health policies whereas the local health departments are the ones implementing the health policies and services.

As of 2018, there are ten regional offices that have separated the states in groups of four to eight. These offices directly work with the state departments, local governments, and tribal councils. The directors from each regional office are appointed directly by the active president. The following individuals run each regional office.

• Region 1: John McGough
• Region 2: Dennis González
• Region 3: Matt Baker
• Region 4: Renee Ellmers
• Region 5: Douglas O'Brien
• Region 6: Mervin Turner
• Region 7: Jeff Kahrs
• Region 8: Brian Shiozawa
• Region 9: Unknown
• Region 10: John R. Graham