Detailed Information on the
Office of Minority Health Assessment

Integrate the Strategic Framework for Improving Racial & Ethnic Minority Health and Eliminating Racial & Ethnic Health Disparities developed by OMH, OMH performance measures, and OMH evaluation planning guidelines & protocols into the National Partnership for Action to End Health Disparities (NPA) and other key OMH-funded initiatives, events, and publications

Complete development of logic models* and identification of any unique OMH performance measures for each OMH grant program, including umbrella cooperative agreements, and other key OMH-funded initiatives. (*Logic models originate from the evaluation field and are simply a way to plan, implement, and evaluate programmatic efforts, and to provide the theory or rationale undergirding what is being done. They usually include the problem to be addressed, factors contributing to the problem, strategies and practices being employed, measurable outcomes and impacts, and long-term objectives and goals.)

Integrate OMH performance measures, program logic models, evaluation protocols, and linkages with Healthy People 2010 objectives and the OMH Strategic Framework into regular training and technical assistance (T/TA) activities of all new OMH grantees, contractors, other partners, and key OMH staff.

Receive, review, and analyze reports of evaluation results from FY 2007 new OMH grantees (first recipients of OMH's Evaluation Planning Guidelines in Summer 2006 grant announcements).

Draft a plan for coordinating a systems approach to addressing minority health problems and racial/ethnic (r/e) health disparities, using draft performance measures.

Develop a draft strategic framework & logic model with preliminary long- and short-term performance goals that are clearly linked to each other, reflect OMH's overall mission, and enable measurement of progress. Obtain review & comment and revise the draft framework/logic model and performance measures accordingly. Incorporate final goals and measures, and related evaluations and reporting requirements, into new announcements and agreements with OMH partners as well as budget requests.

Complete a draft performance contract for the OMH Director and finalize.

Measure: Increase awareness of racial/ethnic health status and health care disparities in the general population (New measure, February 2007)

Explanation:The lack of general awareness and understanding about the nature and extent of racial and ethnic health disparities in the U.S. and the impact of such disparities on the overall health of the Nation has been cited as a major barrier to the provision of programmatic, budgetary, and policy attention to these issues. This measure is intended to promote such awareness and subsequent action. Source: Data from survey of public perceptions and experience about racial/ethnic disparities in health care - Kaiser Family Foundation and Princeton Survey Research Assocites.

Measure: Increase the percentage of measurable racial/ethnic minority-specific Healthy People 2010 (HP2010) objectives and subobjectives that have met the target or are moving in the right direction. These objectives are a comprehensive set of disease prevention and health promotion objectives for the Nation to achieve over the first decade of the new century. Created by scientists both inside and outside of government, they identify a wide range of public health priorities and specific, measurable objectives. (New measure, February 2007)

Explanation:OMH's overarching goal is to improve the health of racial/ethnic minorities and to address health disparities that disproportionately impact these populations in the U.S. HP2010's overarching goals are to improve the health of U.S. populations and to eliminate health disparities which include, but are not limited to, those defined by race/ethnicity. Accomplishing OMH's goal contributes to achievement of the HP2010 goals; and, making progress on the population-based objectives of HP2010 contributes to progress on the HP2010 objectives overall.

Measure: Increase the average number of persons participating in OMH grant programs per $1 million in OMH grant support. (New measure, February 2007)

Explanation:A large proportion of OMH's funding supports grant programs to address a range of needs within racial/ethnic minority health communities across the Nation. OMH will continue to work with its grantees to ensure greater cost-efficiency while expanding the reach of its grant programs.

Measure: Increase the percentage of measurable racial/ethnic minority-specific Healthy People 2020 (HP2020) objectives and subobjectives that have met the target or are moving in the right direction. These objectives are a comprehensive set of disease prevention and health promotion objectives for the Nation to achieve over the second decade of this century. Created by scientists both inside and outside of government, they identify a wide range of public health priorities and specific, measurable objectives. (New measure, July 2008)

Explanation:This measure is the same as the Healthy People 2010 measure, concentrating on the HP2020 data. 2010 will be the baseline year, with targets being developed as part of reviews.

Is the program purpose clear?

Explanation: OMH was established in 1985 to serve as the federal focal point for leadership, coordination, and guidance on policies and programs aimed at improving minority health and ameliorating long-standing health disparities between racial and ethnic minorities and the rest of the U.S. population. It advises the Secretary of HHS and the Office of Public Health and Science on public health policy and program activities affecting minority communities.

Evidence: Report of the Secretary's Task Force on Black & Minority Health (1985); OMH Mission Statement "To improve and protect the health of racial and ethnic minority populations through the development of health policies and programs that will eliminate health disparities"; Authorizing Legislation (H.R. 5702) establishing OMH and its coordinative role and mandate.

Does the program address a specific and existing problem, interest, or need?

Explanation: OMH addresses the health status and quality of life for racial and ethnic minority populations in the United States. It provides national leadership to improve minority health by developing and implementing new policies; partnering with States, tribes, and communities; developing and implementing data policy; and disseminating information.

Evidence: Numerous reports, within and outside of HHS, including the 1985 Report of the Secretary's Task Force on Black and Minority Health, the Agency for Healthcare Research and Quality's 2004 National Health Care Disparities Report, and the Institute of Medicine's 2003 report, "Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care," document and call attention to persistent minority health problems and health disparities. Selected data/tables in Health U.S. 1983, 1990, 2004 for health conditions/ diseases disproportionately impacting racial/ethnic minority populations. (Examples: Diabetes rates are more than double that of the white population for some minority populations; % of dialysis patients on waiting list for transplants are half that of the white population according to "Understanding Racial and Ethnic Disparities in Health".)

Is the program designed so that it is not redundant or duplicative of any other Federal, state, local or private effort?

Explanation: Although OMH's coordinating role is unique, many efforts are duplicative of others including states, federal entities, and private entities. In fact OMH has worked to establish state offices of minority health to facilitate collaboration and coordination in the management of critical local and regional health and related programs on a local level in order to target minority health issues through similar means.

Evidence: A google search on "Minority Health" yields 21,600,000 hits. Many hits include university-sponsored programs, federal (HHS OPDIV) programs, state-sponsored commissions, and private programs. For instance, the state of New Hampshire's program focuses on eliminating heath disparities barriers and addressing access; the state of Ohio envisions achieving health parity for minority populations.

Is the program design free of major flaws that would limit the program's effectiveness or efficiency?

Explanation: Within OMH, there are four Divisions: the Office of the Director (policy leadership), Division of Program Operations (grants, cooperative agreements, and contracts), Division of Information and Education (outreach and education), and the Division of Policy and Data (evaluation, data development, research outcomes/information). The functions of each OMH Division are appropriate for supporting the office's mission. Three major design elements employed in carrying out the OMH mission are: 1) coordinating and leveraging funds with other critical partners within and outside of the Department; 2) managing and/or working with coordinative bodies, and 3) limiting efforts to those addressing weaknesses or gaps in programs or partnerships required to improve minority health and reduce health disparities.

Evidence: OMH's design efforts are supported through partnerships with HHS divisions: grants, cooperative agreements, and/or contracts with States, tribal organizations, community based organizations, and national health organizations; and information, technical assistance, and other support services through the OMH Resource Center (OMHRC).

Is the program design effectively targeted so that resources will address the program's purpose directly and will reach intended beneficiaries?

Explanation: OMH's policy, programmatic, and other activities are aimed broadly at ameliorating minority health problems and racial and ethnic health disparities. Only those organizations that have established relationships and demonstrated success in working with the racial and ethnic minority populations targeted by OMH's efforts can apply for and receive OMH funds. Applicants for OMH funding must document access to minority populations, provide letters of support for proposed efforts from organizations working with the racial and ethnic minority population proposed, and provide copies of Memoranda of Understanding from collaborating organizations as part of their request for funding (applications) as evidence that the targeted community will be reached under the demonstration project. OMH resources cannot be used to supplant other sources/existing funds.

Evidence: OMH's modest grants program reaches national and community-based minority-serving organizations, minority-serving institutions of higher education, tribal organizations, and others critical to addressing the priority diseases/health conditions and crosscutting issues facing racial and ethnic minorities. (See program guidelines for various grant programs; funding memos describing recipients of grant awards; charts of current OMH grantees identifying awards by racial/ ethnic minority population served, health issue, organizational type, & State.)

Does the program have a limited number of specific long-term performance measures that focus on outcomes and meaningfully reflect the purpose of the program?

Explanation: OMH's overarching goal is to reduce and, ultimately, eliminate health disparities disproportionately impacting racial and ethnic minorities in the U.S. OMH's performance measures are reflective of strategies it employs to accomplish its mission (i.e., influencing and effecting policy, building science/ expanding knowledge, communicating strategically, and building and expanding partnerships). Although these measures reflect OMH's overall mission, they are output based and don't provide a clear understanding of the long-term goals and direction of the program. OMH is in the process of developing measures that will more clearly reflect OMH's mission, priorities, and the outcomes of its efforts.

Evidence: OMH GPRA Report of FY'04 Actual Performance & Updated FY'05-06 Targets (with OMH-specific long-term measures); HHS Strategic Goals & Objectives; HHS Plan to Eliminate Racial & Ethnic Disparities in Health with crosscutting strategies, actions, & proposed measures to drive HHS-wide actions; discussions with OMH.

Does the program have ambitious targets and timeframes for its long-term measures?

Explanation: OMH is working on developing an overall framework with long-term outcome measures that capture the performance expectations for its total portfolio of policy and programmatic responsibilities. Once these have been determined, realistic targets and timeframes will be established.

Evidence: OMH GPRA Report of FY'04 Actual Performance & Updated FY'05-06 Targets (with Operating Principles & supporting data/information, 12/16/04); OPHS FY 2006 Performance Plan; OPHS Strategic Goal.

Does the program have a limited number of specific annual performance measures that can demonstrate progress toward achieving the program's long-term goals?

Explanation: Currently, the performance measures used by OMH are based on outputs and processes. OMH has already begun the process of re-examining, revising, and strengthening its annual and long-term measures to ensure the measures more clearly reflect OMH's mission, priorities, and the products and services valued by its customers.

Evidence: Selected tables from the OPHS FY 2006 GPRA Plan (with FY'04 actual performance) & draft FY'06 Congressional Justification (including links to the HHS Strategic Plan).

Does the program have baselines and ambitious targets for its annual measures?

Explanation: OMH has not developed a way of rolling up its annual measures into a limited number of measures that may demonstrate OMH's overall progress in achieving its long-term goals.

Evidence: OMH Strategic Performance Goals, Measures, & Targets Table; OMH GPRA Report of FY'04 Actual Performance & Updated FY'05 & FY'06 Targets; selected tables from the OPHS FY 2006 GPRA Plan.

Do all partners (including grantees, sub-grantees, contractors, cost-sharing partners, and other government partners) commit to and work toward the annual and/or long-term goals of the program?

Explanation: While OMH's partners are committed to the mission of the program, workplans and budgets do not reflect the goals and measures trying to be achieved. Numerous national and local organizations that support minority health-related initiatives (HHS agencies that have partnered in support of OMH-led health disparities campaigns, contractors who support OMH conferences and conduct policy-relevant research studies/evaluation projects) commit through interagency agreements, memoranda of understanding, and contractual arrangements to selected elements contained in OMH's performance plan and the 2002 HHS Plan to Eliminate Racial and Ethnic Disparities in Health. However, efforts are needed to develop outcome and efficiency goals to which all partners can contribute.

Evidence: FY '05 Regional Workplan & Budget Instructions with examples of annual workplans from RMHCs; OMH Strategic Performance Goals, Measures, & Targets Table; OMHRC FY'04 work plans. Note that partners include other HHS agencies, other Federal Departments, State and local public health entities, community- and faith-based organizations, institutions of higher education, and business and industry.

Are independent evaluations of sufficient scope and quality conducted on a regular basis or as needed to support program improvements and evaluate effectiveness and relevance to the problem, interest, or need?

Explanation: Formal evaluation plans with proposals for priority projects are developed each year. These evaluations are carried out by a range of qualified agencies and organizations external to HHS (such as Cosmos Corporation, American Institutes of Research). OMH uses these results and information to initiate or improve policy, enhance program effectiveness, strengthen relations with constituents, and guide resource development and allocation strategies.

Evidence: Program improvements and program effectiveness/relevance include: 1) results of an evaluation of the Bilingual/Bicultural Service Demonstration Grant Program led to the development and implementation of a Uniform Data Set now being required for use by all new OMH grantees to better assess the impacts of grant programs and other OMH-funded activities, and 2) recommendations from a study of state minority health infrastructure and capacity to address health disparities prompted national forums with tribal and other leaders on American Indian and Alaska Native health issues as well as the development and conduct of workshops on the collection, tracking, and dissemination of racial and ethnic health data.

Are Budget requests explicitly tied to accomplishment of the annual and long-term performance goals, and are the resource needs presented in a complete and transparent manner in the program's budget?

Explanation: OMH's current goals, measures, and targets are highlighted and included in annual OMH Congressional Justifications (CJ). However, the FY 2006 Budget does not provide a presentation that clearly ties the impact of funding decisions to expected performance or explains why the requested performance and resource mix is appropriate.

Evidence: OMH Section of OPHS/OS Congressional Justifications for FY 2006; OPHS Budget Table, Statement of Agency Mission, & Overview of OPHS Performance, FY 2006 CJ.

Has the program taken meaningful steps to correct its strategic planning deficiencies?

Explanation: Over the past year, OMH's leadership initiated and implemented a number of actions to strengthen its strategic planning efforts at the individual and overall programmatic levels. Efforts are also underway to develop strategic plans focused on each of the four minority populations and crosscutting issues (such as cultural competency in health care) that are included in OMH priorities; as well as to draft long- and short-term outcome measures.

Evidence: Steps to strengthen performance planning includes sections of the 2002 HHS Plan to Eliminate Racial & Ethnic Disparities in Health, reflecting intent to establish measures to drive HHS-wide actions; a "Strategic Approach" & draft framework for accomplishing OMH's mission & priorities.

Does the agency regularly collect timely and credible performance information, including information from key program partners, and use it to manage the program and improve performance?

Explanation: OMH routinely collects performance related information from contractors, cost-sharing partners, and grantees during the term of the project or program activity to assess performance. OMH contractors also are required to submit work plans at the outset of their projects as well as monthly reports of progress along with their invoices. Grantees are required to submit progress reports (which may impact continuation decisions). Site visits to grant and cooperative agreement projects are performed to assess progress and verify written reports regarding program activity and progress. Regional minority health consultants (RMHCs) are also required to submit monthly reports of progress and expenditures per previously submitted workplans and budgets.

Evidence: Native American Management Service Performance Reports (from contractors); RFC for the Uniform Data Set (UDS) Implementation Project requiring work plans & monthly progress reports (this implementation resulted from the Bilingual/Bicultural Demonstration grant mentioned in Question 2.6); sample notices of grant awards with requirements for evaluation plans, progress & financial status reports; sample program guidelines with requirements for reporting & example of use of reports to monitor/ensure performance.

Are Federal managers and program partners (including grantees, sub-grantees, contractors, cost-sharing partners, and other government partners) held accountable for cost, schedule and performance results?

Explanation: The Director of OMH is held accountable for relevant contributions to HHS & OPHS program objectives as reflected in the Performance Contract for the Acting Assistant Secretary for Health; however, a performance contract for the Director is yet to be completed.

Evidence: The FY'04 Performance Contract for the Acting ASH which includes addressing outcomes for racial/ethnic minorities and facilitating support of recommendations fo the Health Disparities Council.

Are funds (Federal and partners') obligated in a timely manner and spent for the intended purpose?

Explanation: OMH funds are apportioned for operating and programmatic expenses. For the time periods that were immediately available, there have been no documented lapses of appropriated funds. This is particularly due to established procedures to plan for and monitor expenditure of all funds. These procedures include preparation of a detailed spending plan that corresponds to a timeline for completing OMH-funded activities. In addition, procedures are in place within OMH and OPHS to confirm availability of funds and to continually review proposed expenditures against available funds. Further, OMH requires that Divisions meet established deadlines for carrying out activities in the fourth quarter of the budget year. During the fourth quarter, expenditures are reviewed bi-weekly.

Evidence: OMH spending plans are developed to be consistent with Congressional Justifications and appropriations; expenditures are closely monitored against these plans. Grant and procurement deadline schedules are used to ensure timeliness of funding obligations. Financial status reports are required of all funded projects and audits are conducted in accordance with the respective OMB Circular guidance to ensure appropriate use of funds. For contracts, monthly invoices submitted by the contractors are reviewed by OMH project officers to ensure that funds are spent for the intended purpose. Evidence also addresses follow-up procedures for audit findings.

Does the program have procedures (e.g. competitive sourcing/cost comparisons, IT improvements, appropriate incentives) to measure and achieve efficiencies and cost effectiveness in program execution?

Explanation: [Note: Efficiency Measure: A measure of internal efficiencies is under development.] The majority of OMH's budget is awarded competitively through grants, cooperative agreements, and contracts. As guided by the General Acquisitions Branch in HHS' Program Support Center (PSC), OMH issues requests for contracts on the full and open market for its evaluation projects, to small business/8A firms, and to a pool of potential contractors competitively selected for an Indefinite Delivery Indefinite Quantity Task Order Contract (who may have to "compete" again within the pool for specific Task Orders). For OMH grant and cooperative agreement programs, OMH posts its announcements of funding opportunities on the http://fedgrants.gov website in order to reduce publication costs and increase efficiencies and cost savings. OMH recently began requiring new grantees to use a Uniform Data Set (UDS), to report information and data on project performance. The OMH Resource Center (OMHRC) also uses telecommunication, Internet, and website technologies to improve reach and services to OMH's customers.

Evidence: Competitive procurements for contractors with RFPs and evaluation factors for award; OMH efforts to implement a web-based Uniform Data Set for data collection and reporting by grantees and other recipients of OMH funds; memo/examples of electronic and web-based postings of grant announcements & other OMH funding opportunities; OMHRC Performance Analysis.

Does the program collaborate and coordinate effectively with related programs?

Explanation: OMH leads and coordinates advisory bodies and committees (e.g., the HHS Health Disparities Council and the Racial & Ethnic Data Working Group of the HHS Data Council) as well as initiatives and events focused on targeted populations, priority disease/health conditions, and crosscutting issues (e.g., Closing the Health Gap Initiative on Infant Mortality, and the National Forum on Health Disparity Issues for American Indians and Alaska Natives).

Evidence: Amended Charter for the Advisory Committee on Minority Health; Action Memo & Meeting Minutes for HHS Health Disparities Council depicting OMH leadership/coordination role within HHS; SG/Acting ASH memo & White House Exec. Agenda from a National Forum on Health Disparities issues for AI/AN, follow-up meeting of Tribal Colleges and Universities Presidents. At this particular meeting, discussions surrounded pipeline programs at TCUs to eliminate health disparities in AI/AN communities. Collaborations and coordinative efforts (with participating State entities) have, for example, resulted in improved efforts aimed at improving health outcomes for minority populations.

Does the program use strong financial management practices?

Explanation: The Office of Inspector General audit of the financial statement for the Department of Health and Human Services in FY 2004 reflects an unqualified audit of the Department. OMH's leadership monitors overall expenditures routinely against spending and travel plans, including approved regional work plans and budgets, and requires regular reports from OMH Division managers, Regional Minority Health Consultants (RMHCs), and project officers of their activities. Grantees are also governed by various uniform administrative requirements and cost principles (e.g., CFR and OMB circulars), and are required to submit financial status reports and conduct audits to ensure appropriate use of funds. As necessary, grantee site visits may be conducted. Project Officers approve monthly invoices prior to payment and, along with those for grants, may impose other administrative and fiscal controls.

Evidence: Selected minutes of OMH Directors Meetings; examples of financial status reports; examples of audits, grant suspension; grant funding & payment restrictions. OPHS requires that its offices, including OMH, prepare a"P-DASH form" with expenditure requests. The P-DASH form requires information on how the proposed activities are aligned with Secretarial priorities and must be completed and submitted to OPHS headquarters for approval before the expenditure can be obligated.

Has the program taken meaningful steps to address its management deficiencies?

Explanation: Under new leadership, OMH is undergoing a number of changes to manage and improve effectiveness and efficiency of its capital and human resources. Employee performance plans are being modified to reflect OMH goals and priorities and support of HHS management objectives. A review commissioned by the OPHS Executive Officer of OMH's grant system recognized strengthened program operations, and identified deficiencies which are being addressed, including increased site visits, objective reviews, and audits.

Evidence: Sample elements included in OMH employee performance plans in support of HHS management objectives; various OMH Directors Meeting minutes. Implementation of a Uniform Data Set for electronic grant reporting and for better assessment of impacts, use of informal and formal evaluation results to improve the OMH Resource Center's operations, and support of an initiative to increase evaluation capability of grantees and the pool of "promising practices" are additional means underway to strengthen management for results.

Are grants awarded based on a clear competitive process that includes a qualified assessment of merit?

Explanation: All initial grant and cooperative agreement applications are competed and objectively reviewed. The objective review process includes published evaluation criteria and requirements for reviewers to complete written evaluations, orally present/defend their assessments, and score each application under review. All contracts and evaluation projects are either competed fully and openly, among small business/8A firms, or among a pool of potential contractors competitively selected for an Indefinite Delivery Indefinite Quantity Task Order Contract. Non-competing continuation applications are requests for assistance for a second or subsequent budget period within a previously approved project period. These continuation applications are not reviewed competitively, but are reviewed by program and grants management staff to determine progress in achieving grant objectives. Barring any major problems and depending upon availability of funding, awards are issued.

Evidence: Federal Register Notices to show funding availability through competition for OMH grant programs and disparities initiatives (e.g., Stroke); sample reviewer score sheets & reviewer evaluation reports for FY'04 competed programs; sample funding memos with recommendations to show that grant awards were funded in rank order of reviewer scores; examples of competed procurements for contracts (UDS development, community-based health screening project).

Does the program have oversight practices that provide sufficient knowledge of grantee activities?

Explanation: OMH leadership holds weekly meetings with its Division Directors to guide, coordinate, and monitor efforts across the office. OMH leadership also holds periodic meetings with individual project officers and/or a small group of project officers and OMH division managers to assess for progress on given projects and develop remedial plans as necessary. Regional Minority Health Consultants (RMHCs) are required to submit monthly reports of progress and expenditures consistent with their work plans and budgets. All contractors are required to submit workplans at the outset of their work and monthly reports along with their vouchers for review and approval by respective OMH project officers. In addition, evaluation project officers are expected to submit reports of their projects and participate in management review meetings on a quarterly basis. Standard operating procedures and policies outline the role and responsibilities of program managers and project officers for all grant programs, with elements embedded in their performance plans and ratings. Grantee activities are, in turn, monitored through mandatory grantee meetings, regular conference calls, regular progress and financial status reports, audits, and site visits.

Evidence: Requirements for mandatory grantee meetings & draft agenda for recent meeting; examples of telephone calls, final report reviews, site visit reports, financial status reports, audits to keep abreast of grantee activities. SOPs governing responsibilities of gov't project officers, project leads, and oversight.

Does the program collect grantee performance data on an annual basis and make it available to the public in a transparent and meaningful manner?

Explanation: OMH collects performance data from its Division and program managers at least twice a year and submits it as part of the budget process for OPHS. Such data are usually identified in Congressional Justifications and other budget documents available to lawmakers and other interested parties. It is a general policy for OMH project officers of grants and cooperative agreements to forward grant-produced products, such as final reports, deemed to be of public interest to the OMH Resource Center for public access (via its website) and to encourage grantees to disseminate their products to the general public.

Evidence: FY'06 Congressional Justification; Table of Contents of OMH's SOPs for grants & cooperative agreements with guidance about disseminating grant-produced materials of interest/value to broader audiences and example of same; plans to increase the pool of 'promising model' programs resulting from grants; examples of OMH-funded evaluations and final products on OMHRC and HHS publicly available websites; examples of presentations made on OMH-funded efforts at professional conferences, published in professional journals.

Has the program demonstrated adequate progress in achieving its long-term performance goals?

Explanation: Adequate outcome measures are unavailable and thus, it is not possible to measure the program's progress in achieving its long-term performance goals. (Program received No on 2.1)

Evidence: OMH GPRA Report of FY'04 Actual Performance & Updated FY'05 & FY'06 Targets ; FY 06 Congressional Justification.

Does the program (including program partners) achieve its annual performance goals?

Explanation: The program does not have a limited number of annual performance goals that link to the long-term performance goals. Therefore, annual goals are not adequate and do not meet standards appropriate to annual goals. (Program received No on 2.3)

Evidence: OMH GPRA Report of FY'04 Actual Performance & updated FY'05 & FY'06 Targets; FY'06 Congressional Justification for OPHS/OMH.

Does the program demonstrate improved efficiencies or cost effectiveness in achieving program goals each year?

Explanation: The program is currently developing a measure of efficiency and/or cost effectiveness; thus it is not possible to measure the program's progress in this area.

Evidence: OMH GPRA Report of FY'04 Actual Performance & updated FY'05 & FY'06 Targets; FY'06 Congressional Justification for OPHS/OMH.

Does the performance of this program compare favorably to other programs, including government, private, etc., with similar purpose and goals?

Explanation: Without a clearly defined set of long-term and annual performance measures, it is difficult to compare the program's performance to other programs with similar purpose and goals. OMH does; however, compare favorably in program areas that have similar counterparts, both at the state and federal levels. This is based on stakeholder feedback and qualitative comparisons.

Evidence: Favorable responses to OMH-led racial/data improvement efforts by HHS Data Council, conference programs reflecting the scope and influence of OMH's policy leadership and coordination role; impact of OMH role/influence on quality health care services for culturally and linguistically diverse populations.

Do independent evaluations of sufficient scope and quality indicate that the program is effective and achieving results?

Explanation: OMH's record with respect to using independent evaluations to monitor effectiveness and improve performance is reflected in (1) the number and nature of ongoing and completed OMH evaluation projects included in annual reports on evaluation (Performance Improvement) submitted by the HHS Office of the Assistant Secretary for Planning & Evaluation to Congress, and (2) OMH's efforts to enlist the services of outside contractors through competitive procurement processes to ensure expertise, objectivity, and cost-effectiveness. Such projects include, but are not limited to: an evaluation of the Bilingual/Bicultural Service Demonstration Grant Program whose results showed some effectiveness, and led to the development and implementation of a Uniform Data Set now being required for use by all new grantees to better assess the impacts of grant programs and other OMH-funded activities; recommendations from a study of state minority health infrastructure and capacity to address health disparities which prompted national forums with tribal and other leaders on AI/AN health issues as well as the development and conduct of workshops on the collection, tracking, and dissemination of racial and ethnic health data.

Evidence: Relevant sections of annual Reports to Congress on HHS evaluation activities identifying completed & ongoing OMH projects; examples of competitive solicitations for contractors to conduct OMH evaluation projects; executive summaries and/or key findings from various completed OMH evaluation projects with information on how results have been used to inform program & policy-relevant decisions; standard study descriptions and results to date of current Uniform Data Base implementation efforts and an evaluation of statistical methods for data collection & analysis on racial & ethnic minorities.