GAO calls for major reforms at HHS to better prepare for future health emergencies

A top federal watchdog believes the Department of Health and Human Services (HHS) needs to totally transform how it handles public health emergencies.

The Government Accountability Office (GAO) issued a scathing report Thursday placing HHS on its “high risk” list reserved for government agencies that need transformation or are vulnerable to fraud or mismanagement. The watchdog flagged HHS for several deficiencies that include failing to establish clear roles and responsibilities across its vast purview and providing clear communications to the public.

“As devastating as the COVID-19 pandemic has been, more frequent extreme weather events, new viruses and bad actors who threaten to cause intentional harm loom, making the deficiencies GAO has identified particularly concerning,” the agency said in its report. “Not being sufficiently prepared for a range of public health emergencies can also negatively affect the time and resources needed to achieve full recovery.”

GAO made a sweeping examination of its recommendations to HHS for more than a decade. It found of the 115 recommendations GAO made, 72 remain unaddressed.

For instance, the agency recommended back in January 2021 that HHS create a publicly available testing strategy, which HHS has not done yet.

“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.

RELATED: GAO calls for HHS to develop testing, vaccination strategies to address gaps in fighting COVID-19

GAO found several broad deficiencies across the agency that need to be fixed. Chief among them is establishing clear roles and responsibilities across federal, state and tribal partners.

GAO found back in January 2021 that there was confusion among stakeholders and experts on the role of the Strategic National Stockpile in the response to the pandemic. But HHS has yet to develop a formal process for “engaging with key stakeholders for pandemic preparedness,” the GAO report said.

Concerns about clear roles and responsibilities have been a long-standing concern for GAO, warning the agency as far back as 2007 that roles and responsibilities need to be tested to ensure clarity during an emergency.

Other concerns include the need to provide 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, dinged the agency for not communicating better on initial vaccine distribution at the local level.

The communication lapses weren’t relegated to just the pandemic. States that had 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, GAO said.

“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.

GAO added HHS to the high-risk list to help ensure that the executive branch and Congress pay close attention to the agency and make progress in addressing GAO’s open recommendations.