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«U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Program Support Center Human Resources Service Division of Commissioned Personnel 5600 Fishers Lane, ...»

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During the war, the use of science required the diversion of the National Institutes of Health research to war problems: studying effects of high altitude flying, improved yellow fever and plague vaccines, improved antimalarial drugs, and developing better methods for purifying water for fighting men in tropical countries. Thanks to a vaccine developed by the Service before the war, not one death from typhus fever occurred during the war among our own troops, in spite of frequent exposure to this disease.

Under the malaria-control-in-war-areas program, epidemiologist, entomologists, and engineers assisted greatly in eradicating malaria in this country, and today still keep surveillance against its reentry from abroad. Officers on overseas wartime duty helped make possible the building of the Burma Road through these malaria control activities. Others have fought tropical disease in Central America so the Pan American Highway could be built, and braved the rigors of far northern cold to advance the Alaskan Highway.

In 1944, Congress consolidated all laws relating to PHS (i.e., The Public Health Service Act--P.L. 4l0, 78th Congress). It was the first Act of record which codified all legislation pertaining to a Federal agency. The Service was consolidated under four bureaus. Executive Order 9575 declared "the Commissioned Corps of the Public Health Service to be a military service and a branch of land and naval forces of the United States...." This status existed until the cessation of hostilities in the Korean conflict.

F. EXPANDING HEALTH RESOURCES

In the exciting post-World War II years, the Nation experienced a growing consciousness of the significance of health to its national life. Within the Service, appropriations multiplied and so did the number of personnel, with the categories of vocations growing to more than 350. For ever-growing health programs, the Service facilities expanded to include more than 50 general and specialized hospitals, more than 135 outpatient clinics, and more than 100 field stations around the world.

During the postwar years, the Nation began expanding medical research significantly. The National Institutes of Health expanded to a total of 11 national institutes including: cancer; heart, lung, and blood diseases; child health and human development; allergy and infectious diseases; arthritis, diabetes, and digestive and kidney diseases; dental research; eye; neurological and communicative disorders and strokes; aging; and environmental health sciences.

These years also witnessed progress in the following areas: water pollution control, establishment of the Centers for Disease Control, expansion of hospital construction programs, transfer of the Office of Vital Statistics from the Census Bureau, awarding of the first training grants, opening of the Clinical Center at the National Institutes of Health, establishment of the Robert A. Taft Sanitary Engineering Center, transfer of the Indian health program to PHS, initiation of air pollution control, establishment of the

-8Commissioned Corps Officer’ Handbook, 1998 s National Library of Medicine, expanded participation in international health, expansion of programs on mental health and mental retardation, accident prevention, health education, development of nursing resources, community programs for health services, and authorization for an Environmental Health Center.

G. PHS TODAY

PHS has undergone significant change in the last two decades with the creation of the Environmental Protection Agency and the Health Care Financing Administration, into which were incorporated major activities previously conducted within PHS. During this same period, the Food and Drug Administration became a part of PHS. Major new programs were created such as the National Health Service Corps, the National Institute for Occupational Safety and Health, the Center for Devices and Radiological Health, the Fogarty International Center, and many others.

In recent years, the PHS function has continued to evolve. Care for merchant seamen and the eight hospitals and twenty-seven outpatient clinics at which such care was provided, have been transferred to other organizations. The transfer of this function reduced PHS clinical activities by one-third, but the remaining clinical programs, especially the Indian Health Service, have grown steadily. PHS has

accepted increased responsibility for:

!

Expanding research into the cause, treatment, control and prevention of disease;

!

Increasing emphasis on noninfectious diseases such as: cancer and heart disease;

!

Supplying health-professional assistance to local, State, national, and international health organizations to cope with special health needs and challenges;

!

Furthering programs to treat mental illness more effectively, to promote better mental health, and to combat drug abuse, alcoholism, and other hazards to health;

!

Expanding food and drug programs to safeguard the health of the consuming public;

!

Strengthening communicable disease control at home and abroad;

!

Initiating the National Health Service Corps to provide health professionals for isolated communities without medical care;

!

Expanding medical, dental, and environmental health programs for Alaskan Natives and American Indians;





!

Expanding efforts to achieve a smoke-free society; and !

Mobilizing Acquired Immune Deficiency Syndrome (AIDS) research and focusing on AIDS prevention.

In response to the increased responsibility, PHS has grown from a small nucleus of health professionals to more than 6,000 officers of the commissioned corps working in a wide variety of health programs.

–  –  –

Eight of the OPDIVs of the Department of Health and Human Services (HHS) comprise the health agencies of HHS. The range of their activities is enormous, from direct health care to administration of major health programs, and their work affects not only the health of the citizens in the United States

but also citizens in many countries around the world. The eight health agencies of the HHS are:

Agency for Health Care Policy and Research; Agency for Toxic Substances and Diseases Registry;

Centers for Disease Control and Prevention; Food and Drug Administration; Health Resources and Services Administration; Indian Health Service; National Institutes of Health; and the Substance Abuse and Mental Health Services Administration. In addition, OPDIVs of HHS include: Administration on Aging, Administration for Children and Families, Health Care Financing Administration, Office of Public Health and Science, and Program Support Center.

The HHS OPDIVs are shown in Table 1. Following the table are descriptions of the various components and other programs to which commissioned corps officers are assigned. Also included are the addresses of the personnel offices of each OPDIV which can be contacted for additional information on employment opportunities and vacancies within these OPDIVs.

–  –  –

AHCPR’ Mission: The AHCPR, an OPDIV of HHS, is the lead agency charged with s supporting research designed to improve the quality of health care, reduce its cost, and broaden access to essential services. AHCPR develops and disseminates research-based information to increase the scientific knowledge needed to enhance consumer and clinical decision making, improve health care quality, and promote efficiency in the organization of public and private systems of health care delivery.

–  –  –

The FDA is a regulatory agency which protects the public health by ensuring that foods, drugs, biological products, cosmetics, medical devices, ionizing and nonionizing radiation-emitting electronic products and substances, poisons, pesticides, and food additives are safe for human and animal use.

–  –  –

5. HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA)

HRSA assures access to essential health care and qualified providers to people who are poor, uninsured, live in isolated areas, or have special health conditions. HRSA provides primary and preventive care to vulnerable populations through community health centers, expands the services available to pregnant women and their children, supports health care for people living with HIV/AIDS and other conditions, and advocates for a primary health care workforce that is trained and motivated to serve the underserved. Assisting the traditional providers of care to the underserved in making the transition to managed care is a high priority throughout the OPDIV.

HRSA supports more than 60 programs with a total budget of $3.6 billion in Fiscal Year 1998.

HRSA was created by combining existing HHS agencies on September 1, 1982.

–  –  –

IHS provides a comprehensive health services delivery system for American Indians and Alaska Natives with opportunity for maximum tribal involvement in developing and managing programs to meet their health needs. The goal of IHS is to raise the health status of the American Indian and Alaska Native people to the highest level possible.

To carry out its mission and to attain its goals, IHS: (1) assists Indian Tribes in developing their health programs through activities including health management training, technical assistance and human resource development; (2) facilitates and assists Indian Tribes in coordinating health planning, in obtaining and utilizing health resources available through Federal, State, and local programs, in operating comprehensive health programs, and in health program evaluation; (3) provides comprehensive health care services; including hospital and ambulatory medical care, preventive and rehabilitative services, and development of community sanitation facilities; and (4) serves as the principal Federal advocate for Indians in the health field to assure comprehensive health services for American Indians and Alaska Natives.

- 21 Commissioned Corps Officer’ Handbook, 1998 s The IHS is responsible for providing Federal health services to 1.4 million American Indian and Alaska Native members of 500 sovereign tribal governments residing in 33 "reservation" States. The Federal responsibility has its basis in the transfer of vast expanses of land, repeatedly affirmed through treaties, legislation, and court decisions. The IHS and tribal government are partners in policy development, operations, and management of health services and programs.

The IHS, tribal governments, and urban Indian organizations, within the limits of annual appropriations, provide an unprecedented, comprehensive scope of preventive, clinical, and environmental health services, augmented by community and human resources development programs. No other national, public, or private organization embraces this spectrum of services. Nevertheless, the IHS is not an entitlement program and does not offer a guaranteed and uniform benefits package to each eligible American Indian and Alaska Native. Services are provided directly at IHS and tribal hospitals and clinics and urban clinics; and are purchased from other public and private providers, including sharing agreements with the Departments of Defense and Veterans Affairs.

More than 500 health facilities are operated in the most remote and harsh environments in the United States, on isolated Indian reservations, in Alaska villages, in other rural areas, and in cities. The IHS operates 43 hospitals, 64 health centers, 5 school health centers, and 50 health stations. Tribal governments through self-determination contracts operate 8 hospitals, 116 health centers, 3 school health centers, 56 health stations, and 167 Alaska village clinics.

–  –  –

All of these Institutes and Divisions are located in Bethesda and Rockville, Maryland, with the exception of the National Institute of Environmental Health Sciences, which is at Research Triangle Park, North Carolina. A part of the intramural research program of the National Institute on Aging is located at the Gerontology Research Center, Francis Scott Key Medical Center, Baltimore, Maryland. In addition, some Institutes maintain satellite activities outside the main Bethesda location.



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