NCHS UpdateNAPHSIS 2005

Centers for Disease Control and PreventionNational Center for Health Statistics

Update Update

•New appointments and retirements •Budget

•Trends•Current Status•New formulations and impact

•HHS and CDC update•Program

•Evaluation •Confidentiality•Electronic medical records

New AppointmentNew Appointment

Linda Bilheimer

Associate Director:NCHS Office of Analysis and Epidemiology

RetirementsRetirements

•Jack Anderson, Deputy Director•Jennifer Madans and Mike Sadagursky acting co-deputy directors

•33 NCHS staff retired— many with early-out/buyout offers• 25 at Hyattsville• 8 at RTP• 9 total for DVS

Budget StatusBudget Status

National Center for Health National Center for Health StatisticsStatistics

Funding by Fiscal YearFunding by Fiscal Year

1994 1996 1998 2000 2002 2004 20060

50

100

150Appropriations ($ millions)

Fiscal year

FY 2005 BudgetFY 2005 Budget

•2005 total equates to $149.6 million; increase of $22 million

•$40 million moved to new CDC-wide indirect cost lines

•$109 million for NCHS’s direct program

•Prevents further erosion of NCHS statistical capacity

•Limited resources for new ventures

National Center for Health National Center for Health StatisticsStatistics

Funding by Fiscal YearFunding by Fiscal Year

1994 1996 1998 2000 2002 2004 20060

50

100

150Appropriations ($ millions)

Fiscal year

Total Appropriation

NCHS Program Funds

Allocation of FY 2005 BudgetAllocation of FY 2005 BudgetNCHS Program Total: $109 NCHS Program Total: $109

MillionMillion•DVS budget: 19 percent of the

total NCHS budget

•States receive 15 percent of the total NCHS budget through VSCP

•Enables NCHS to fully fund state contracts for 2005

•Can continue re-engineering contract with NAPHSIS

Impact of the 2005 BudgetImpact of the 2005 Budget

•Allows little, if any, for re-engineering and new items

• Intelligence bill and anti-terrorism legislation offers hope for significant Federal contribution for re-engineering

President’s FY 2006 Budget President’s FY 2006 Budget RequestRequest

•Decreases overall CDC budget by $491 million (6.1%) compared to FY 2005

•Maintains same funding level for NCHS as FY 2005

•Preserves gains achieved in 2005 appropriations cycle

•Allows for no new initiatives

CDC and HHSCDC and HHS

Coordinating Center for Health Information and Services

BusinessBusinessPublic Health Systems and Communities

Public Health Systems and Communities

Health Care Delivery

Health Care Delivery

FederalAgenciesFederal

AgenciesEducationEducation

NationalCenter for Health

Marketing

NationalCenter for Health

Marketing

National Center for

Public HealthInformatics

National Center for

Public HealthInformatics

National Center forHealth Statistics

National Center forHealth Statistics

Coordinating Center for Infectious Diseases

NCID, NCHSTP, NIP

Coordinating Center for Infectious Diseases

NCID, NCHSTP, NIP

Coordinating Center for

Health PromotionNCCDPHP, NCBDDD,

Genomics

Coordinating Center for

Health PromotionNCCDPHP, NCBDDD,

Genomics

Coordinating Center for EIO

NCEH/ATSDR

NCIPC

Coordinating Center for EIO

NCEH/ATSDR

NCIPC

Office of Global Health

Office of Global Health

Office of TerrorismPreparedness &

Emergency Response

Office of TerrorismPreparedness &

Emergency Response

Office of Strategy and Innovation

Office of Strategy and Innovation

Office of the Chief of Science

Office of the Chief of Science

Office of the Chief of Public

Health Improvement

Office of the Chief of Public

Health Improvement

Office of Human Capital and Professional

Development

Office of Human Capital and Professional

Development

CustomersPeople whose health we can improve

Executive Leadership BoardManagement Council CIO Directors

Partners Alliances Stakeholders

Office of the Chief Operating Officer

Office of the Chief Operating Officer

Office of the Chief of StaffOffice of the Chief of Staff

CDC Washington OfficeCDC Washington Office

DirectorDirector

Channels

The New CDC The New CDC The New CDC The New CDC

• New CDC organizational structure approved

•Task forces developed organizational structure for new Centers

•Recruiting nearly complete for 9 CIO Directors (including marketing and informatics) and one Coordinating Center Director

•Business improvement – consolidation and outsourcing continue

• Blake Caldwell and Ed Sondik - serving as acting co-directors of CoCHIS

Mike Leavitt – New HHS Mike Leavitt – New HHS SecretarySecretary

Electronic Health RecordsElectronic Health Records

Electronic Health RecordsElectronic Health Records

• Dr. David Brailer, MD, PhD:

National Coordinator for Health Information Technology

• Four overarching goals•Inform clinical practice•Interconnect physicians•Personalize care•Improve population health

2 8 .63 1 .2

1 7 .2

0

1 0

2 0

3 0

4 0Percentage

Physicianoffices

Emergency

Outpatient

SOURCE: CDC/NCHS, National Ambulatory Medical Care Survey, 2003 and National Hospital Ambulatory Medical Care Survey, 2001-2002

95% Confidence

Providers Using Electronic Medical Providers Using Electronic Medical RecordsRecords

Departments

Program Developments and Issues

Program Developments and Issues

Evaluation of NCHSEvaluation of NCHS

•Program Assessment Rating Tool (PART)

•Board of Scientific Counselors

•National Committee on Vital and Health Statistics

Program Assessment Rating Program Assessment Rating ToolTool

Office of Management and Office of Management and BudgetBudget

Program Assessment Rating Program Assessment Rating ToolTool

Office of Management and Office of Management and BudgetBudget• Product quality

•Relevance•Accuracy•Timeliness

• Program performance•Cost•Dissemination•Mission achievement

Board of Scientific Board of Scientific CounselorsCounselors

Board of Scientific Board of Scientific CounselorsCounselors

• Provides advice and make recommendations on scientific and technical programs, goals and objectives, strategies, and priorities of NCHS

• Diverse membership from state and local health departments, academia, federal agencies, foundations, and non-profits

• Dr. Alvin Onaka, Registrar, Hawaii

• Evaluation of NCHS programs• First up: Vital statistics

• Welcome NAPHSIS input

National Committee on Vital National Committee on Vital and Health Statisticsand Health Statistics

National Committee on Vital National Committee on Vital and Health Statisticsand Health Statistics

• Advises the Secretary on health data and statistics

• NCHS served as Executive Secretariat

• Covers issues from privacy to data quality and standards

• Coordinates with BSC on program evaluations

Confidentiality Data Access

Policy on Micro-Data Policy on Micro-Data DisseminationDissemination

Confidentiality and Data Release Confidentiality and Data Release Issues to ConsiderIssues to Consider

• NCHS protects confidentiality by law

• State law protects confidentiality

• Existing data release and disclosure policies carefully developed and implemented

• New data release policy limits access to national data for most users

Confidentiality and Data Release Confidentiality and Data Release Issues to ConsiderIssues to Consider

• NCHS protects confidentiality by law

• State law protects confidentiality

• Existing data release and disclosure policies carefully developed and implemented

• New data release policy limits access to national data for most users

• Vital statistics is an essential data set for public health

• One of few systems providing state and local data

• Changes in data access and release will affect data users and data uses

Data Releases Data Releases

2002 Infant Mortality 2002 Infant Mortality IncreaseIncrease

2002 Infant Mortality 2002 Infant Mortality IncreaseIncrease

• Announced – preliminary 2002 data

• Confirmed – final 2002 data

• Explained – linked file for 2002

5 0

5 5

6 0

6 5

7 0

7 5

8 0

8 5

Life Expectancy at BirthLife Expectancy at BirthYears of life

1970

1980

1990

2000

0

White female

Black female

White male

Black male

2003

Confidentiality and Data Release Confidentiality and Data Release Issues to ConsiderIssues to Consider

• NCHS protects confidentiality by law

• State law protects confidentiality

• Existing data release and disclosure policies carefully developed and implemented

• New data release policy limits access to national data for most users

• Vital statistics is an essential data set for public health

• One of few systems providing state and local data

• Changes in data access and release will affect data users and data uses