Recent public health emergencies—such as the COVID-19 pandemic and
Hurricanes Maria and Irma that caused catastrophic loss of life and destruction—
have highlighted the importance of coordination among the federal agencies
responsible for responding to such incidents. The ability of these agencies to
seamlessly work together is critical to national preparedness and to ensuring an
effective response to public health emergencies. The Department of Health and
Human Services (HHS) is responsible for leading the federal public health and
medical response to public health emergencies and other incidents.
In recent years, GAO and others have expressed concerns about HHS’s leadership
and coordination of public health emergencies. GAO added this area to our High-
Risk List in 2022, citing the critical need for the nation to be prepared for, and
effectively respond to, future public health threats and emergencies.
1
The Consolidated Appropriations Act, 2023, includes a provision for GAO to report
on HHS’s interagency agreements and efforts to coordinate with other relevant
federal agencies.
2
This report describes the guidance and statutory authorities
available to HHS to coordinate the federal response to public health emergencies
and its general approach for such coordination.
• HHS relies on national guidance and some interagency agreements to
coordinate the response to public health emergencies.
• HHS officials told us the department has not used its statutory authorities to
establish an interagency agreement where it assumes operational control of
other agencies’ emergency public health and medical response assets or to
coordinate with federal departments and agencies, primarily because the
national guidance is sufficient to coordinate a response.
The National Response Framework provides guidance on how the nation
responds to all types of disasters and emergencies.
3
The framework includes 15
emergency support functions (ESF) that provide the structure for coordinating
federal support during a national response.
Within HHS, the Administration for Strategic Preparedness and Response
(ASPR) is the lead agency for ESF #8—the public health and medical services
response. Under ESF #8, ASPR is responsible for coordinating with federal
agencies to conduct a variety of activities including assessment of public health
and medical needs, patient evacuation, patient care, the provision of medical
equipment and supplies, and public health communication.
HHS also has statutory authority to enter into interagency agreements and to
coordinate with other federal departments and agencies as part of a public health
emergency response. For example:
U.S. Government Accountability Office
Public Health Preparedness:
Exploring HHS Interagency Agreements
-25-107633
Report to Congressional Committees
ecember 20, 2024
What guidance and
authorities
HHS to coordinate
to
a public health
emergency?
