Implementing value-based care at the state level: A conversation with Dr. Kara Odom Walker, Delaware Department of Health and Social Services Secretary.

Dr. Kara Odom Walker is Secretary of the Delaware Department of Health and Social Services (DHHS). Trained as a family physician, with advanced degrees in public health and health services research, Dr. Walker has worked for numerous organizations to advocate for health equity and care for underserved populations. As Delaware DHHS Secretary, she oversees a department with an annual budget of over $2 billion, responsible for health and social services administration.

Creating a Robust Digital Communications Strategy for the US Department of Health & Human Services.

The US Department of Health and Human Services (HHS) has developed and is implementing an agency-wide Digital Communications Strategy. A robust strategy to coordinate digital communications is vital at times of crisis, such as the COVID-19 pandemic - and will be needed as part of an effective HHS campaign to motivate individuals who are hesitant to accept coronavirus vaccines. Using science-based principles of systems change, a four-phase approach was developed in alignment with the 21st Century Integrated Digital Experience Act (IDEA). Phase I involved announcing a plan for creating and implementing the HHS Digital Communications Strategy, including support for it from the HHS Secretary. Phase II involved gathering information and stakeholder support, with an interview research study as the central component for providing input and encouraging stakeholder engagement. Phase III focused on building the Strategy through an iterative process. Phase IV, which is ongoing, concentrates on implementing the Strategy, measuring the impact of digital communications and supporting the budget required to modernize Federal digital communications approaches to meet the American public's needs. Learnings from the work so far are consistent with those from prior HHS systems change efforts in communications - and are helping to improve the Strategy in real time.

The Origins and Drafting of the Belmont Report.

This article describes the origins and drafting of the Belmont Report by members of the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research.

What Is Human Research For? Reflections on the Omission of Scientific Integrity from the Belmont Report.

The Belmont Report has provided a useful and virtually universal framework for protecting human subjects from research abuses. However, it provides little to no guidance on the substance of human research. In an environment where major decisions concerning health-care access, funding, and regulation hinge on human research, this omission leaves downstream users of human research virtually unprotected and with few tools or frameworks to protect against a variety of practices that compromise the social value of human research. This essay advocates for the addition of a fourth principle to the Belmont three: "scientific integrity." Such a principle would seek to train human research on important social objectives while maximizing the accessibility, credibility, and generalizability of findings.

The Time Is Now to End the HIV Epidemic.

In his State of the Union Address on February 5, 2019, President Donald J. Trump announced his administration's goal to end the domestic HIV epidemic. Following the announcement of the Ending the HIV Epidemic: A Plan for America initiative, the president proposed $291 million in new funding for the fiscal year 2020 Department of Health and Human Services (HHS) budget to implement a new initiative to reduce the number of new HIV infections by 75% in the next five years (2025) and by 90% in the next 10 years (2030). This is in addition to the $20 billion the US government already spends each year, domestically, for HIV prevention and care.With this initiative, HHS recognizes that the time to end the HIV epidemic is now: we have the right data, the right biomedical and behavioral tools, and the right leadership. With the new resources, the goal is achievable.This article outlines how this initiative will be accomplished through the implementation of four fundamental strategies that will be tailored by local communities on the basis of their own needs and strengths.

Seven Former FDA Commissioners: The FDA Should Be An Independent Federal Agency.

Seven former commissioners of the Food and Drug Administration (FDA) from both sides of the political aisle recommend that the FDA be moved out of the Department of Health and Human Services and reconfigured as an independent federal agency. We believe that such a reengineering would promote reliance on consistent science-based regulation and ensure that the American public has access to the best that science and industry can offer.

Broadening the Impact of Developmental Neuroscience on the Study of Adolescence.

Having been a significance source of the renewed interested in the adolescent period, developmental neuroscience now needs to build upon its achievements to date and expand in several areas in order to broaden its impact upon the field. Addressing both typical and atypical development, examining the interaction between brain development and the social environment, studying change over time, and including attention to population diversity can help to produce a truly integrative science of adolescent development. The papers in the special section provide nice examples of how developmental neuroscience can make such expansions and continue to contribute to the field in the years to come.

CDC's 6|18 Initiative: A Cross-Sector Approach to Translating Evidence Into Practice.

CONTEXT: As the US health care system continues to undergo dynamic change, the increased alignment between health care quality and payment has provided new opportunities for public health and health care sectors to work together. PROGRAM: The Centers for Disease Control and Prevention's 6|18 Initiative accelerates cross-sector collaboration between public health and health care purchasers, payers, and providers and highlights 6 high-burden conditions and 18 associated interventions with evidence of cost reduction/neutrality and improved health outcomes. This evidence can inform payment, utilization, and quality of prevention and control interventions. IMPLEMENTATION: The Centers for Disease Control and Prevention focused initially on public payer health insurance interventions for asthma control, unintended pregnancy prevention, and tobacco cessation. Nine state Medicaid and public health agency teams-in Colorado, Georgia, Louisiana, Massachusetts, Michigan, Minnesota, New York, Rhode Island, and South Carolina-participated in the initiative because they had previously prioritized the health condition(s) and specific intervention(s) and had secured state-level leadership support for state agency collaboration. The Centers for Disease Control and Prevention, the Centers for Medicare & Medicaid Services, the Center for Health Care Strategies, the Robert Wood Johnson Foundation, and other partners supported state implementation and dissemination of early lessons learned. EVALUATION: The Centers for Disease Control and Prevention conducted exploratory interviews to guide improvement of the 6|18 Initiative and to understand facilitators, barriers, and complementary roles played by each sector. Monthly technical assistance calls conducted with state teams documented collaborative activities between state Medicaid agencies and health departments and state processes to increase coverage and utilization. DISCUSSION: The 6|18 Initiative is strengthening partnerships between state health departments and Medicaid agencies and contributing to state progress in helping improve Medicaid coverage and utilization of effective prevention and control interventions. This initiative highlights early successes for others interested in strengthening collaboration between state agencies and between public and private sectors to improve payment, utilization, and quality of evidence-based interventions.