What GAO found
The Department of Health and Human Services (HHS) has provided $75 billion in pandemic relief funding from its Public Health and Social Services Emergency Fund to four agencies: the Centers for Disease Control and Prevention (CDC), the Health Resources and Services Administration, the Indian Health Services Administration and Office of Minority Health. The CDC received more than half of the funding. GAO found that these agencies spent $29 billion, or more than 35 percent, of this funding on programs that specifically support communities disproportionately impacted by COVID-19. In addition, the agencies have allocated $33 billion in grants to projects and recommended that award recipients, usually state health departments, use those funds to support these communities.
HHS agencies allocate selected funds to programs supporting communities disproportionately impacted by COVID-19
Note: Amounts do not sum to $75 billion in pandemic relief due to rounding.
A sort ofHHS officials told GAO that many recipients chose to use the funds to support hard-hit communities.
States have discretion over the allocation and use of federal relief funds provided through various CDC programs. The five selected states reviewed by GAO allocated selected CDC funding to support a range of COVID-19 testing, vaccinations, and other response efforts in hard-hit communities. However, state officials have reported challenges in doing so — challenges CDC officials say many other states face:
- Delays in state acceptance of federal funding. Health departments in the three selected states waited 3 to 9 months before the state accepted some funding awarded by the CDC.
- Ability challenge. Consistent with findings from other GAO efforts, all five selected states reported recruitment and workload issues, as well as challenges due to limited capacity of local partners, which limited their efforts to allocate and use CDC funds.
Why GAO is doing this study
Between March 2020 and March 2021, six pandemic relief laws allocated billions of dollars to HHS’s Public Health and Social Services Emergency Fund. This fund is used for HHS emergency preparedness and response activities, including addressing health impacts that are disproportionately felt by certain communities.
The CARES Act includes a provision requiring GAO to report on its ongoing COVID-19 monitoring and oversight efforts. GAO was also asked to review how HHS allocates pandemic relief funds to support communities disproportionately impacted by COVID-19. This report describes (1) how much funds were allocated by four HHS agencies to support communities disproportionately impacted by COVID-19; and (2) how a sample of states allocated selected funds from CDC to support hard-impacted communities.
GAO reviewed agency data and documents, and interviewed agency officials at four HHS agencies. GAO also reviewed documents and interviewed health department officials in five states. Arizona, Louisiana, Michigan, New Hampshire, and Washington were chosen to reflect differences in geography, racial and ethnic populations, and other characteristics.
HHS provided technical comments on drafts of this report, which have been incorporated as appropriate.
For more information, please contact Carolyn L. Yocom at (202) 512-7114 or YocomC@gao.gov.