The Department of Health and Human Services (HHS) should take actions in four critical areas in order to serve the millions dependent on it for benefit payments and services. First, HHS should improve departmental management by investing in department-wide planning, its personnel, and its financial and information management. HHS can eliminate role confusion among its senior executives by restructuring the role of the Chief of Staff. Second, HHS must continue to pursue the cost-containment goal. Positive steps include refining Medicare's hospital prospective payment system and improving controls over payments for physician and related services. The Secretary of HHS must also develop a strategy for addressing the long-term care problem. Third, HHS needs to enhance the financing and delivery of Social Security benefits. The Secretary should take special care to preserve the security of its financing, continue efforts to enhance public confidence in the program, and ensure that the Social Security Administration delivers high-quality service to the public. Fourth, the Secretary must provide strong leadership to implement welfare reform. HHS should reorient the country's view of welfare's role and strengthen programs to promote parental responsibility. (YLB)