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75-576: AHRQ's earliest predecessor was the National Center for Health Services Research and Development , established in 1968 within the PHS Health Services and Mental Health Administration (HSMHA) during the 1966–1973 PHS reorganizations . It was established largely through the efforts of members of the NIH Division of Research Grants Health Services Study Section. The new center quickly absorbed

150-610: A cadre of mobile, career service physicians, who could be assigned as needed to the various Marine Hospitals. The commissioned officer corps was formally established by legislation after the fact in 1889, and signed by President Grover Cleveland . The scope of activities of the Marine Hospital Service began to expand well beyond the care of merchant seamen in the closing decades of the nineteenth century, into control of infectious disease , collection of health statistics, and basic science research. Following cholera epidemics in

225-506: A cataract guideline and concern by the pharmaceutical industry over a reduction in the use of new drugs. When the agency produced a guideline that concluded that back pain surgery was unnecessary and potentially harmful, a lobbying campaign aided by Congressmen whose backs had been operated on changed the name of the agency and scaled back the guidelines program, which existed as the National Guideline Clearinghouse . until it

300-444: A configuration substantially similar to the current one as of 2021. In all, PHS had at least eight discrete reorganizations in as many years. The quick succession of reorganizations created several operating agencies that existed for a short time, as individual components were shifted between them. This was in contrast to the decades prior and afterwards, in which organizational changes were incremental and did not substantively change

375-540: A decrease of $ 30 million from FY 2014, and $ 106 million from the Patient-Centered Outcomes Research Trust Fund, an increase of $ 13 million above FY 2014. The FY 2015 budget is intended to ensure the Agency continues its progress on health services research to improve outcomes, affordability, and quality. The budget also supports the collection of information on health care spending and use through

450-500: A different destination: The rapid shifts in organizational names and structures did not go unnoticed. One employee recalled that a common joke at the time was, "If my boss calls me while I'm gone, find out who it is." A 1969 publication about CPEHS contained the editor's note, "Another reorganization of the Food and Drug Administration has occurred since this paper was prepared. Even though these organizational details are no longer accurate,

525-626: A few new divisions would be created. Because the Service took on broader responsibilities, in 1902 it was renamed as the Public Health and Marine Hospital Service. In 1912, under new authorizing legislation, it was established as the Public Health Service (PHS) to express the enlarged scope of its work. The 1912 PHS law ( Pub. L.   62–265 ) expanded the agency's mission from communicable to include non-communicable diseases . In 1913,

600-481: A holistic approach to large, overarching problems. Additionally, a second wave of hospital closings during 1965–1970 closed the three remaining general hospitals at inland locations along the Mississippi River and Great Lakes , as well as the 19th-century Savannah hospital. In addition, St. Elizabeths Hospital and the psychiatric hospitals at Lexington and Fort Worth were transferred to other agencies, and

675-464: A person's natural environment but also the products they consumed. Ultimately four discrete reorganization orders would occur during this period: Reorganization Plan No. 3 of 1966; HEW reorganization order of April 1, 1968; HEW reorganization order of July 1, 1968; and HSMHA reorganization of October 31, 1968. The collective effect of these reorganizations was to split BSS split three ways into an interim bureau structure, with each part having

750-663: A series of reorganizations occurred of the United States Public Health Service (PHS) within the Department of Health, Education and Welfare (HEW). The reorganization by 1968 replaced PHS's old bureau structure with two new operating agencies: the Health Services and Mental Health Administration (HSMHA) and the Consumer Protection and Environmental Health Service (CPEHS). The goal of the reorganizations

825-554: A single autonomous regulatory body. During 1970–1971, most of the CPEHS was moved out of PHS and HEW to form the core of the newly created EPA. This was accomplished in two phases, with the HEW reorganization order of January 16, 1970 and Reorganization Plan No. 3 of 1970 . Some CPEHS components remained within PHS. The Food and Drug Administration had already become its own operating division within

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900-479: Is a collection of agencies of the Department of Health and Human Services concerned with public health , containing nine out of the department's twelve operating divisions. The Assistant Secretary for Health oversees the PHS. The Public Health Service Commissioned Corps (PHSCC) is the federal uniformed service of the PHS, and is one of the eight uniformed services of the United States . PHS had its origins in

975-458: Is considered military service for retirement purposes. Under 42 U.S.C.   § 213 , active service in the PHSCC is considered active military service for the purposes of most veterans' benefits and for antidiscrimination laws. Modern public health began developing in the 19th century, as a response to advances in science that led to the understanding of the source and spread of disease. As

1050-652: The Agency for Toxic Substances and Disease Registry was created. The Health Resources Administration and Health Services Administration would merge in 1982 to form the Health Resources and Services Administration . Two new PHS operating agencies were then formed by promoting divisions out of other operating agencies. The Indian Health Service split from the Health Resources and Services Administration in 1988. The Agency for Health Care Policy and Research split from

1125-679: The Bureau of Indian Affairs in the Department of the Interior . Between 1966 and 1973, a series of reorganizations and realignments led to the end of the bureau structure. The reorganization by 1968 replaced PHS's old bureau structure with two new operating agencies: the Health Services and Mental Health Administration (HSMHA) and the Consumer Protection and Environmental Health Service (CPEHS), with NIH remaining independent and less affected by

1200-555: The Bureau of Medical Services provided direct patient care through hospitals and clinics as well as foreign quarantine facilities, and the National Institute of Health remained independent to perform laboratory research activities. Additionally, all of the laws affecting the functions of the public health agencies were consolidated for the first time in the Public Health Service Act of 1944 . The mid-20th century

1275-600: The Bureau of Radiological Health , which moved into FDA; and the Bureau of Community Environmental Management, which was later absorbed by EPA and CDC in 1973. The Bureau of Solid Waste Management, Bureau of Water Hygiene, and the rest of the Bureau of Radiological Health were transferred to EPA in 1971. HSMHA was unpopular with many in PHS, as they felt that it shifted the focus from PHS physicians to department bureaucrats. In addition, National Communicable Disease Center Director David Sencer became acting HSMHA Administrator at

1350-792: The Centers for Disease Control and Prevention . Beginning in the late 1920s and continuing through the New Deal era, a significant building campaign upgraded several marine hospitals into large, monumental buildings, in contrast with the smaller buildings common for the 19th-century buildings. PHS's headquarters were in the Butler Building , a converted mansion across the street from the United States Capitol , from 1891 until April 1929. It expanded into office space in Temporary Building C on

1425-564: The Division of Indian Health and Division of Hospitals were part of BMS; the National Communicable Disease Center , Division of Occupational Health , and National Center for Radiological Health were all part of BSS's Environmental Health Divisions; and the National Center for Health Statistics was part of OSG. The Food and Drug Administration was part of HEW, but not yet part of PHS. The initial reorganizations of

1500-768: The East Coast , and as the boundaries of the United States expanded , so too were marine hospitals. The Marine Hospital Service was placed under the Revenue Marine Service (a forerunner of the present-day Coast Guard ) within the Department of the Treasury . A reorganization in 1871 converted the loose network of locally controlled marine hospitals into a centrally controlled Marine Hospital Service , with its headquarters in Washington, D.C. This reorganization established

1575-537: The Galveston hospital was replaced with one acquired by PHS in nearby Nassau Bay . This left eight general hospitals plus the National Leprosarium in the system. The new agencies came to be seen as unwieldy and bureaucratic, and they would turn out to be short-lived. CPEHS was broken up in 1970, as much of it was transferred out of PHS to form the core of the new Environmental Protection Agency . Around

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1650-667: The Healthcare Cost and Utilization Project (HCUP) and Medical Expenditure Panel Survey (MEPS). In July 2018, the National Guideline Clearinghouse (NGC) and the National Quality Measures Clearinghouse (NQMC), two longtime online resources from the AHRQ, were shut down because federal funding ceased to be available to them. Other stakeholders were exploring options for hosting the NGC ]; should that happen, it will return to

1725-509: The January 6 Capitol riot . Following Khanna's resignation, deputy director David Meyers served as acting director from 2021 to 2022. Robert Otto Valdez was appointed director on February 27, 2022. The Agency has multiple offices and centers including the Center for Evidence and Practice Improvement (CEPI), the Center for Financing, Access and Trends, the Center for Delivery, Organization and Markets,

1800-718: The National Institutes of Health , began as a single-room laboratory for bacteriological investigation at the Staten Island Marine Hospital , and moved to Washington, D.C. in 1891. In 1899, internal divisions were formed for the first time, specifically the Divisions of Marine Hospitals, Domestic Quarantine, Foreign Quarantine, Sanitary Reports and Statistics, Scientific Research, and Personnel and Accounts. These original divisions would remain through 1943, although there were minor name changes throughout this time, and

1875-753: The National Mall in July 1920, which became its temporary headquarters after the Butler Building was closed for demolition. In May 1933, the new Public Health Service Building opened on the National Mall . By 1943, PHS contained eight administrative divisions, plus the National Cancer Institute , St. Elizabeths Hospital , and Freedmen's Hospital under the direct supervision of the Surgeon General . These divisions often had overlapping scopes, which

1950-620: The Office of the Assistant Secretary for Health in 1989. In 1992, the Alcohol, Drug Abuse, and Mental Health Administration was abolished, with its three institutes and their research programs moved into NIH, and their treatment functions split off to form the new Substance Abuse and Mental Health Services Administration . Key: United States Public Health Service The United States Public Health Service ( USPHS or PHS )

2025-675: The 1967 Clean Air Act redirected attention to larger air quality control regions. In 1932, the Public Health Service, working with the Tuskegee Institute in Tuskegee, Alabama, began a study to record the natural history of syphilis in hopes of justifying treatment programs for blacks. It was titled the Tuskegee Study of Untreated Syphilis in the Negro Male . The study initially involved 600 black men—399 with syphilis, 201 who did not have

2100-529: The Assistant Secretary for Health in 2002. The Office of Public Health Emergency Preparedness was created in 2002, which in 2022 became the Administration for Strategic Preparedness and Response . The Advanced Research Projects Agency for Health was created by the Consolidated Appropriations Act, 2022 . Public health worker Sara Josephine Baker , M.D. established many programs to help

2175-713: The Center for Quality and Patient Safety, the Office of Management Services, the Office of Extramural Research and Priority Populations, and the Office of Communications. The Office of Communications was previously known as the Office of Communications and Knowledge Transfer. Within CEPI, the Evidence-Based Practice Centers (EPCs) develop evidence reports and technology assessments on topics relevant to clinical and other health care organization and delivery issues—specifically those that are common, expensive, and/or significant for

2250-618: The Communicable Disease Center became the National Communicable Disease Center, and several divisions relating to environmental and occupational health were merged into the National Center for Urban and Industrial Health. However, this system would be short-lived as a more radical reorganization was carried out in 1968. The purpose of the 1968 reorganization was to create agencies that could coordinate

2325-606: The Corps wear uniforms similar to those of the United States Navy with special PHSCC insignia, and the Corps uses the same commissioned officer ranks as the U.S. Navy , the U.S. Coast Guard , and the NOAA Commissioned Officer Corps from ensign to admiral , uniformed services pay grades O-1 through O-10 respectively. According to 5 U.S.C.   § 8331 , service in the PHSCC after June 30, 1960,

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2400-521: The Marine Hospital Service as its own bureau within the Department of the Treasury. The position of Supervising Surgeon (later titled the Surgeon General ) was created to administer the Service, and John Maynard Woodworth was appointed as the first incumbent in 1871. He moved quickly to reform the system and adopted a military model for his medical staff; putting his physicians in uniforms, and instituting examinations for applicants. Woodworth created

2475-599: The Medicare and Medicaid populations. With this program, AHRQ serves as a "science partner" with private and public organizations in their efforts to improve the quality, effectiveness, and appropriateness of health care by synthesizing the evidence and facilitating the translation of evidence-based research findings. Topics are nominated by Federal and non-Federal partners such as professional societies, health plans, insurers, employers, and patient groups. Health Services and Mental Health Administration Between 1966 and 1973,

2550-448: The National Institute of Mental Health as well as the recently created National Institute on Alcohol Abuse and Alcoholism and National Institute on Drug Abuse . By the end of 1973, PHS had the following operating agencies: This overall organizational structure has not substantially changed as of 2021, although there have been a few new operating agencies and minor reorganizations, the most recent of which occurred in 1992. In 1980,

2625-575: The PHS Division of Chronic Diseases, which dated back to 1949, in order to access the latter's larger budget. When HSMHA was split up in 1973, the center moved into the PHS Health Resources Administration . It was renamed the Bureau of Health Services Research that year, and then the National Center for Health Services Research in 1975. In 1978 it was transferred to the Office of the Assistant Secretary for Health . In 1985 it

2700-477: The PHS earlier in 1970, causing CPEHS to be briefly renamed simply the Environmental Health Service . On the other hand, the entire National Air Pollution Control Administration was moved to EPA. The Environmental Control Administration's five bureaus were spit between PHS and EPA. PHS retained the Bureau of Occupational Safety and Health, which moved into HSMHA and soon became NIOSH ; part of

2775-455: The PHS, and absorbed NIOSH. The remaining functions of HSMHA were assigned to newly established Health Services Administration and Health Resources Administration, the latter of which also acquired the Bureau of Health Manpower from NIH. Finally, under the HEW reorganization order of September 25, 1973, a new operating agency, the Alcohol, Drug Abuse, and Mental Health Administration , incorporated

2850-468: The Public Health Service: The other three agencies are the Centers for Medicare and Medicaid Services , Administration for Children and Families , and Administration for Community Living . The Public Health Service also encompasses two staff offices: The United States Public Health Service Commissioned Corps (PHSCC) employs more than 6,000 uniformed public health professionals for

2925-633: The US in 1873, the National Quarantine Act of 1878 vested quarantine authority to the Marine Hospital Service. Under the Public Health Act of 1879 , this authority was temporarily shared with the U.S. Army and Navy through the National Board of Health , until 1883. Given the prevalence of infectious disease among immigrants arriving from famine and war areas of Europe, the Marine Hospital Service

3000-592: The United States eight uniformed services , the PHS Commissioned Corps fills public health leadership and service roles within federal government agencies and programs. The PHSCC includes officers drawn from many professions, including environmental and occupational health, medicine, nursing, dentistry, pharmacy, psychology, social work, hospital administration, health record administration, nutrition, engineering, science, veterinary, health information technology, and other health-related occupations. Officers of

3075-637: The United States in Bethesda, Maryland . Secretary of State Hillary Clinton apologized to the Republic of Guatemala for this program in 2010, in light of the serious ethical lapses in moral judgement which occurred. [REDACTED] This article incorporates text from this source, which is in the public domain : History of the Commissioned Corps, PHS [REDACTED]  This article incorporates public domain material from websites or documents of

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3150-463: The administrative Office of the Surgeon General (OSG). This setup persisted unto 1966, although there were minor reorganizations of the individual divisions within the agencies. After 1960, BSS grouped its divisions into Community Health Divisions and Environmental Health Divisions . By 1966, predecessors of several current organizations were recognizable. NIH was already an operating agency;

3225-587: The agencies they were stationed in than to the Corps itself. By the end of 1968, PHS's operating divisions were the National Institutes of Health, HSMHA, and CPEHS, the last two of which were organized as follows: The breakup of CPEHS was largely a consequence of the formation of the Environmental Protection Agency (EPA) in 1970, as the result of a desire by the new Nixon administration to gather all federal environmental activities into

3300-515: The agencies within PHS was shifted from the Assistant Secretary for Health to report directly to the Secretary of Health and Human Services , eliminating PHS as an administrative level in the organizational hierarchy, although the agencies and offices are still legally designated as part of PHS. The Office of Global Affairs was formed from two components within the Office of the Secretary and Office of

3375-550: The bacteriological quality of the water, particularly among small systems, was of concern. The 1963 Clean Air Act gave the Public Health Service in the Department of Health, Education, and Welfare the authority to take abatement action against industries if it could be demonstrated that they were polluting across state lines, or if a governor requested. Some of these actions involved the Ohio River Valley, New York, and New Jersey. The service also began monitoring air pollution.

3450-495: The beginning of the Nixon Administration in 1969. HSMHA was reportedly referred to as "HSMA-ha-ha-ha" at NCDC headquarters, and Sencer was seeking to expand NCDC's scope by absorbing other components of HSMHA. As part of this, NCDC was renamed to Center for Disease Control in 1970. Under the HEW reorganization order of July 1, 1973, HSMHA was abolished. The Center for Disease Control became its own operating agency within

3525-487: The disease. The study was conducted without the benefit of patients' informed consent. Researchers told the men they were being treated for "bad blood", a local term referring to several ailments, including syphilis, anemia, and fatigue. In truth, they did not receive the proper treatment needed to cure their illness. In exchange for taking part in the study, the men received free medical exams, free meals, and burial insurance. Although originally projected to last six months,

3600-536: The former Cincinnati Marine Hospital building was reopened as a Field Investigation Station for water pollution research. This was the beginning of the PHS Environmental Health Divisions , a precursor to the Environmental Protection Agency . In 1914, the Office of Industrial Hygiene and Sanitation , the direct predecessor of the National Institute for Occupational Safety and Health ,

3675-421: The former Cincinnati Marine Hospital to the newly constructed Robert A. Taft Sanitary Engineering Center. However, the period was one of decline for the marine hospital system. In 1943, the hospital system had reached its peak of 30 hospitals. During 1944–1953, a wave of closings eliminated nine of the ten Marine Hospitals that had not been upgraded since the 1920s, as well as three newer general hospitals and

3750-470: The governmental health agency expanded. Most of the Public health activity in the United States took place at the municipal level before the mid-20th century. There was some activity at the national and state level as well. In the administration of the second president of the United States John Adams , Congress authorized the creation of hospitals for mariners through the 1798 Act for the Relief of Sick and Disabled Seamen . They were initially located along

3825-407: The knowledge of contagious diseases increased, means to control them and prevent infection were soon developed. Once it became understood that these strategies would require community-wide participation, disease control began being viewed as a public responsibility. Various organizations and agencies were then created to implement these disease preventing strategies. As the U.S. expanded, the scope of

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3900-441: The operating divisions was accomplished during 1966–1968 in two waves. An initial reorganization into a five-bureau structure was accomplished in 1967. The new bureau system was oriented around "national centers", with larger divisions simply being renamed, and smaller divisions being combined as programs within the national centers. For example, the Division of Radiological Health became the National Center for Radiological Health,

3975-445: The organization. In 1968, the position of Assistant Secretary for Health was created, supplanting the Surgeon General as the top leader of the Public Health Service, although the Surgeon General was retained in a subordinate role. Also in 1968, the Food and Drug Administration , which traced its origins to 1862, became part of the PHS. The goal of the reorganizations was to coordinate the previously fragmented divisions to provide

4050-403: The overall organizational structure of PHS. PHS first created internal divisions in 1899, when it was still called the Marine Hospital Service . Its only major reorganization since then had occurred in 1943, which collected its several divisions into three operating agencies: the Bureau of Medical Services (BMS), Bureau of State Services (BSS), and National Institutes of Health (NIH), plus

4125-471: The paper is being published..." The resulting organizations came to be seen as large and unwieldy. Another effect of the reorganizations was the creation of the position of Assistant Secretary for Health , a political appointee who supplanted the Surgeon General as the head of the PHS. This was seen as undermining the chain of command of the PHS Commissioned Corps , beginning a long-term shift where Commissioned Corps officers were more responsible to

4200-423: The poor in New York City keep their infants healthy, leading teams of nurses into the crowded neighborhoods of Hell's Kitchen and teaching mothers how to dress, feed, and bathe their babies. Another key pioneer of public health in the U.S. was Lillian Wald , who founded the Henry Street Settlement house in New York. The Visiting Nurse Service of New York was a significant organization for bringing health care to

4275-502: The purpose of delivering public health promotion and disease prevention programs, and advancing public health science. The mission of the U.S. Public Health Service Commissioned Corps is to protect, promote, and advance the health and safety of the people of the United States. According to the PHSCC, this mission is achieved through rapid and effective response to public health needs, leadership and excellence in public health practices, and advancement of public health science. As one of

4350-401: The relationships between divisions with similar focus, providing a holistic rather than fragmented approach. HSMHA in particular was created with the recognition that, with the recent creation of Medicare and Medicaid increasing financing of healthcare, increased demand was straining healthcare delivery resources. CPEHS stemmed from a belief that environmental health concerned not only

4425-420: The rest of the Division of Scientific Research, of which it was formerly part, and in 1938 it moved to its current campus in Bethesda, Maryland . In 1939, PHS as a whole was transferred from the Department of the Treasury into the new Federal Security Agency . In 1942, the Office of Malaria Control in War Areas was created, which in 1946 became the Communicable Disease Center, which would eventually become

4500-457: The same time, the National Institute for Occupational Safety and Health was created out of the former Division of Industrial Hygiene by the Occupational Safety and Health Act of 1970 . HSMHA was broken up into four successor agencies in 1973. Since 1973, PHS has encompassed between six and ten operating agencies anchored by NIH, FDA, and CDC. The organizational changes in the 20th century after 1973 have been: The PHS hospital system had been

4575-400: The study actually went on for 40 years. Penicillin —which can be used to treat syphilis—was discovered in the 1940s. However, the study continued and treatment was never given to the subjects. Because of this, it has been called "arguably the most 'infamous' biomedical research study in U.S. history". A USPHS physician who took part in the 1932–1972 Tuskegee program, John Charles Cutler ,

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4650-474: The system of marine hospitals that originated in 1798. In 1871 these were consolidated into the Marine Hospital Service , and shortly afterwards the position of Surgeon General and the PHSCC were established. As the system's scope grew to include quarantine authority and research, it was renamed the Public Health Service in 1912. A series of reorganizations in 1966–1973 began a shift where PHS' divisions were promoted into departmental operating agencies. PHS

4725-463: The target of efforts to close the entire system since the mid-1970s. As the result of pressure from the Reagan administration , the PHS hospital system was abolished in 1981, with the last eight hospitals transferred to other organizations: five to non-governmental entities, two to the Department of Defense , and one to the State of Louisiana . PHS would however continue to operate the National Leprosarium until 1999. In 1995, supervision of

4800-422: The tuberculosis sanatorium at Fort Stanton . However, PHS funded construction of hospitals by the states through the 1946 Hill–Burton Act . In 1953 the Federal Security Agency was abolished and most of its functions, including the PHS, were transferred to the newly formed Department of Health, Education and Welfare . In 1955 the Division of Indian Health was established upon transfer of these functions from

4875-472: The urban poor. In the area of environmental protection and public health, a Public Health Service 1969 community water survey that looked at more than a thousand drinking water systems across the United States drew two important conclusions that supported a growing demand for stronger protections that were adopted in the 1974 Safe Drinking Water Act . The survey concluded, first, that the state supervision programs were very uneven and often lax, and, second, that

4950-494: The web. Carolyn Clancy was the director from 2002 to 2014. Richard Kronick was director from 2013 to March 2016. Sharon Arnold was acting director from February to April 2016, replacing Richard Kronick in February 2016. Andrew Bindman was the director of AHRQ from April 2016 until January 2017. Prior to joining AHRQ, Bindman served as faculty of UCSF School of Medicine . Gopal Khanna was appointed as Agency director on May 9, 2017, and resigned on January 11, 2021, in response to

5025-444: Was a time of expansion for both NIH and the PHS environmental health programs. In 1948, NIH's name was changed to the plural National Institutes of Health, and by the end of 1950 six new institutes had been created within it. The environmental health programs expanded from water pollution into air, industrial, and chemical pollution and radiological health research during and after World War II, and in 1954 they moved across town from

5100-417: Was assigned to medically inspect immigrants at such sites as Ellis Island in New York Harbor . In 1878, an act of Congress enabled the Marine Hospital Service to collect data on communicable diseases and perform surveillance of the incidence and distribution of diseases; these programs would eventually become the National Center for Health Statistics . In 1887, the Hygienic Laboratory, the predecessor of

5175-420: Was defunded in 2018. AHCPR was reauthorized December 6, 1999, as the Agency for Healthcare Research and Quality (AHRQ) under the Healthcare Research and Quality Act of 1999 , which amended Title IX of the Public Health Service Act (42 U.S.C. 299 et seq). The 2015 budget for AHRQ was US$ 440 million, $ 24 million less than FY 2014. The budget includes $ 334 million in Public Health Service (PHS) Evaluation Funds,

5250-453: Was established as a thin layer of hierarchy above them rather than an operating agency in its own right. In 1995, PHS agencies were shifted to report directly to the Secretary of Health and Human Services rather the Assistant Secretary for Health, eliminating PHS as an administrative level in the organizational hierarchy. Ten of the thirteen operating agencies within the Department of Health and Human Services (HHS) are designated as part of

5325-435: Was founded at the Pittsburgh Marine Hospital . Both of these offices were within the Division of Scientific Research. The Division of Venereal Diseases was established in 1918, and the Narcotics Division in 1929 (it eventually became the National Institute of Mental Health ). In 1930, the Hygienic Laboratory was redesignated as the (singular) National Institute of Health (NIH) by the Ransdell Act ; in 1937, it absorbed

5400-536: Was in charge of the U.S. government's syphilis experiments in Guatemala , in which in the Central American Republic of Guatemala , Guatemalan prisoners, soldiers, orphaned children, and others were deliberately infected with syphilis and other sexually-transmitted diseases from 1946 to 1948, in order to scientifically study the disease, in a project funded by a grant from the National Institutes of Health of

5475-578: Was renamed the National Center for Health Services Research and Health Care Technology Assessment . In 1989, the agency became its own operating agency within PHS, and was renamed Agency for Health Care Policy and Research (AHCPR) by the Omnibus Budget Reconciliation Act of 1989 (103  Stat.   2159 ). However, AHCPR became controversial when it produced several guidelines that some thought would reduce medical drugs and procedures. This included concern from ophthalmologists on

5550-513: Was seen as administratively unwieldy. Additionally, some of these had been created and specified through several pieces of legislation that were inconsistent in their scope, while some had been created internally by PHS or delegated from the parent Federal Security Agency. In 1943, PHS's divisions were collected into three operating agencies by law (57  Stat.   587 ). The Bureau of State Services administered cooperative services to U.S. states through technical and financial assistance,

5625-441: Was to coordinate the previously fragmented divisions to provide a holistic approach to large, overarching problems. However, the new agencies came to be seen as unwieldy and bureaucratic, and they would turn out to be short-lived. CPEHS was broken up in 1970, as most of it was transferred out of PHS to form the core of the new Environmental Protection Agency . HSMHA was broken up in 1973. This left PHS with six operating agencies,

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