Earlier this year, the Government Accountability Office (GAO) issued a report that puts the Department of Health and Human Services (HHS) on its “high risk” list of agencies that either need transformation or are vulnerable to fraud or mismanagement. GAO specifically called HHS out for failing to establish clear roles and responsibilities across its spectrum and providing clear communications to the public.
GAO also looked at the recommendations it made to HHS over the course of more than a decade. Of 115 recommendations made during that time by GAO, HHS has yet to address 72 of them. For instance, in January 2021, GAO recommended that HHS create a publicly available testing strategy. HHS had yet to take action on that recommendation. “Such a strategy is needed to ensure more timely proactive action in the future and the efficient use of billions of dollars in unobligated funds,” GAO said.
HHS’ Ability to Handle an Emergency
GAO found more broad and general deficiencies, including establishing clear roles and responsibilities across federal, state, and tribal partners. GAO has long held concerns over the lack of clear roles and responsibilities, going as far back as to 2007, when GAO told HHS roles and responsibilities needed to be tested to ensure clarity during a potential emergency.
GAO also found in January 2021 that there was confusion among stakeholders and experts on the role of the Strategic National Stockpile in the response to the COVID-19 pandemic. However, more than a year later, HHS has still not developed a formal process for “engaging with key stakeholders for pandemic preparedness,” according to the GAO report.
Similarly, GAO found that HHS needed to work on providing clear and consistent communications to the public and key partners. GAO cited prior reports that HHS hasn’t issued a national COVID-19 testing strategy and, back in April 2021, reprimanded the agency for not communicating better on initial vaccine distribution at the local level.
Importantly, the communication problems weren’t limited to just the COVID-19 pandemic. For example, states with a high number of Zika cases reported getting inconsistent guidance because entities in the Centers for Disease Control and Prevention weren’t talking with each other. “In the midst of a public health emergency, clear and consistent communication—among all levels of government, with healthcare providers and to the public—is paramount,” the report said.
What to Expect
GAO put HHS on the high-risk list so that the rest of the federal government, including Congress, can pay closer attention and help HHS make progress in addressing the open recommendations.