Federal watchdog assails HHS COVID-19 management

The Government Accountability Office faulted the agency’s leadership in emergencies, including the coronavirus pandemic.

The watchdog of the federal government has issued a report with sharp criticisms of the U.S. Department of Health and Human Services.

The Government Accountability Office said it has issues with how the agency’s leadership has responded to the COVID-19 pandemic and other emergencies. The GAO provides non-partisan analysis of government spending and management to Congress and the White House.

In a Jan. 27 report, the GAO said it’s placing the HHS on its “High Risk List.” The GAO places agencies on the list when they are deemed to be especially vulnerable to waste and fraud and need transformation. The GAO said it’s putting HHS on the list so that it will gain “sustained attention” from President Biden's administration and Congress.

“For over a decade, we have found issues with how HHS's leadership prepares for and responds to emergencies, including COVID-19, other infectious diseases, and extreme weather events, such as hurricanes,” the GAO stated.

The GAO said the agency has followed up on some of its recommendations for improvements over the years. But the GAO said the health department’s management failings have hindered the response to the coronavirus pandemic and other outbreaks, including the H1N1 pandemic, Zika and Ebola.

The watchdog also said it’s prodding the health department to make changes to handle future emergencies, including new pandemics and natural disasters, such as hurricanes.

“Not being sufficiently prepared for a range of public health emergencies can also negatively affect the time and resources needed to achieve full recovery,” the GAO said.

The GAO said the health and human services department hasn’t followed up on some of its most important recommendations to improve.

COVID-19 funds

The GAO has been pushing the health and human services department to come up with more specific timetables for distributing billions of dollars in COVID-19 relief funds.

HHS has received about $484 billion in COVID-19 relief funds, the GAO noted. As of Nov. 30, 2021, the health department said it had obligated about $387 billion and spent about $226 billion.

The GAO said it has previously recommended the health department provide Congress with projected time frames on spending the rest of the money. The watchdog said HHS partially concurred with the recommendation but also said it couldn’t provide a detailed timeline for all the funds, saying that it needs flexibility. The watchdog disagrees.

“Providing projected time frames would not affect HHS’s ability to be flexible in its spend plans, as these plans are not binding to the agency and can be revised,” the GAO said. “GAO will continue to examine HHS’s oversight of COVID-19 relief funds.”

Supply chain woes

The watchdog faulted the health department for not doing more to avoid supply chain problems that have bedeviled healthcare organizations throughout the pandemic.

“HHS has not addressed our September 2020 recommendation to work with the Federal Emergency Management Agency to develop plans to mitigate supply chain shortages for the remainder of the pandemic, thus contributing to the shortage of such supplies as of January 2022,” the GAO said.

Testing strategy

The GAO credited the health department for procuring more COVID-19 tests, an area some critics said the agency should have done much sooner. But the GAO also said, “HHS had not issued a comprehensive and publicly available testing strategy, which we recommend it do in January 2021.”

“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,” the watchdog stated.

Areas of concern

The GAO said it has found persistent deficiencies in HHS' preparedness and response efforts in five areas.

  1. Setting clear roles for key federal, state, local, tribal and non-governmental partners;
  2. Collecting and examining data to make decisions, now and in the future;
  3. Communicating clearly with the public;
  4. Establishing "transparency and accountability" for public trust;
  5. Understanding the strengths and weaknesses of key partners