COVID-19: HHS funds allocated to support communities disproportionately affected

What the GAO found

The Department of Health and Human Services (HHS) provided $75 billion in pandemic relief funds from its Public Health and Human Services Emergency Fund to four agencies: the Centers for Disease Control and Prevention (CDC), the Health Resources and Services Administration, the Indian Health Service, and the Office of Minority Health. CDC received more than half of the funds. The GAO found that these agencies directed $29 billion (more than 35 percent) of this funding to programs that specifically support communities disproportionately affected by COVID-19. In addition, the agencies allocated $33 billion to programs with the recommendation that the awardees, often state health departments, support those communities with the funds.

HHS agency allocations of select funds to programs that support communities disproportionately affected by COVID-19

Note: Amounts do not add up to $75 billion in pandemic relief funds due to rounding.
aHHS officials told the GAO that many grantees chose to support disproportionately affected communities with these funds.

States had discretion in the allocation and use of federal aid funds provided through various CDC programs. The GAO of five selected states reviewed selected CDC funding to support a variety of COVID-19 testing, vaccines, and other response efforts in disproportionately affected communities. However, state officials reported challenges in doing so, challenges that CDC officials said many other states faced:

  • Delays in state acceptance of federal funds. Health departments in three selected states waited between 3 and 9 months for the state to accept certain funds awarded by the CDC.
  • capacity challenges. Consistent with findings from other GAO work, the five selected states reported recruitment and workload issues, as well as challenges due to limited capacity from local partners, which constrained their efforts to allocate and use funding. CDC.

Why GAO did this study

Between March 2020 and March 2021, six pandemic relief bills allocated billions of dollars to the HHS Public Health and Human Services Emergency Fund. This fund is used for HHS emergency preparedness and response activities, including addressing health effects felt disproportionately in certain communities.

The CARES Act includes a provision for the GAO to report on its ongoing COVID-19 monitoring and oversight efforts. The GAO was also asked to review how HHS allocated pandemic relief funds to support communities disproportionately affected by COVID-19. This report describes (1) how much four HHS agencies allocated to support communities disproportionately affected by COVID-19; and (2) how a sample of states allocated selected CDC funds to support disproportionately affected communities.

GAO reviewed agency data and documentation and interviewed officials from all four HHS agencies. GAO also reviewed documentation and interviewed health department officials from five states. The states—Arizona, Louisiana, Michigan, New Hampshire, and Washington—were selected to reflect variation in geography and racial and ethnic populations, among other characteristics.

HHS provided technical comments on a draft of this report, which have been incorporated as appropriate.

For more information, contact Carolyn L. Yocom at (202) 512-7114 or [email protected]