GAO Makes 16 New Recommendations to Improve Implementation of CARES Act and COVID-19 Response

Washington, D.C. (September 21, 2020) –The U.S. Government Accountability Office (GAO) today issued its third report examining the implementation of the CARES Act and other pandemic relief measures and outlining steps needed to improve the nation’s response.

GAO has identified issues in need of attention by the Administration and the Congress, including the need to collect reliable data that can drive decision-making; to establish mechanisms for accountability and transparency; and to protect against ongoing cyber threats to patient information, intellectual property, public health data, and intelligence.

“Our report contains 16 new, concrete recommendations where timely and concerted actions by the Administration and Congress can help address the coronavirus crisis,” said Gene L. Dodaro, Comptroller General of the United States and head of the GAO.  “If implemented, those suggestions have the potential to significantly improve the nation’s response to the current pandemic as well as strengthen preparations for future public health emergencies.”

GAO’s report outlines the many effective steps the Administration and the Congress have taken to address the issues. We also make the following recommendations to enhance the nation’s ability to respond to the remaining challenges of the pandemic:

• Medical Supply Chain. A supply chain with limited domestic production and high global demand has led to shortages of personal protective equipment and testing supplies. GAO recommends that the Department of Health and Human Services (HHS), in coordination with the Federal Emergency Management Agency (FEMA), should immediately document roles and responsibilities for supply chain management functions transitioning to HHS, including continued support from other federal partners, to ensure sufficient resources exist to sustain and make the necessary progress in stabilizing the supply chain. HHS, in coordination with FEMA, should also further develop and communicate to stakeholders plans outlining specific actions the federal government will take to help mitigate supply chain shortages for the remainder of the pandemic. Finally they should also devise interim solutions to help states better track the status of supply requests and plan for supply needs for the remainder of the pandemic.
• Vaccines and Therapeutics. On September 16, HHS and DOD issued two documents outlining a strategy for distributing a COVID-19 vaccine. GAO will evaluate these documents and report on them in future reports, including whether they are consistent with best practices for project planning and scheduling and outline how efforts will be coordinated across federal agencies and nonfederal entities.
• COVID-19 Data. Data collected by the Centers for Disease Control and Prevention (CDC), suggests a disproportionate burden of COVID-19 cases, hospitalizations, and deaths among racial and ethnic minority groups. To better understand the differences in burden, CDC should determine whether it needs authority from Congress to require the reporting of race and ethnicity information for cases and hospitalizations. It also needs to involve key stakeholders to completely and consistently collect demographic data, and take steps to ensure its ability to comprehensively assess the long-term health outcomes of COVID-19 patients, including by race and ethnicity. In addition, HHS’s data on COVID-19 in nursing homes do not capture the early months of the pandemic. HHS, in consultation with the Centers for Medicare & Medicaid Services (CMS) and CDC, should develop a strategy to capture more complete data on COVID-19 cases and deaths in nursing homes retroactively back to January 1, 2020.
• Economic Impact Payments. The Department of the Treasury’s Internal Revenue Service (IRS) has issued economic impact payments (EIP) to all eligible individuals for whom IRS has the necessary information to do so; however, not everyone eligible was able to be initially identified. To help ensure all eligible recipients received their payments in a more timely manner, IRS took several actions to address challenges GAO reported on in June, including a policy change that should allow some eligible recipients to receive supplemental payments for qualifying children sooner than expected. However, Treasury and IRS lack updated information on how many eligible recipients have yet to receive these funds. The lack of such information could hinder outreach efforts and place potentially millions of individuals at risk of missing their payment. GAO recommends that Treasury, in coordination with IRS, update and refine the estimate of eligible recipients who have yet to file for an EIP to help target outreach and communications efforts.
• Coronavirus Relief Fund.  Additional audit guidance is needed for COVID-19-related programs. Supplemental information on auditing such programs, including the Coronavirus Relief Fund payments, is expected this fall, but further delays in issuing this guidance could undermine auditors’ ability to issue consistent and timely reports. GAO recommends that the Office of Management and Budget, in consultation with Treasury, issue this audit guidance as soon as possible, as many audit efforts are underway.
• Guidance for K-12 Schools. Portions of CDC’s guidance on reopening K-12 schools are inconsistent, and some federal guidance appears misaligned with CDC’s risk-based approach on school operating status. CDC should ensure that its federal guidance on reassessing schools’ operating status is cogent, clear, and internally consistent.
• Tracking Contract Obligations. Federal agencies are tracking contract actions and associated obligations in response to COVID-19 using a National Interest Action (NIA) code in the Federal Procurement Data System-Next Generation. GAO has identified inconsistencies in establishing and closing these codes following previous emergencies and remains concerned about the criteria the Department of Homeland Security (DHS) and DOD rely on to determine whether to extend or close a code and whether the code meets long-term needs. GAO recommends that DHS and DOD ensure that the criteria for extending or closing the NIA code reflect government-wide needs for tracking contract actions in longer-term emergencies, such as a pandemic.
• Cybersecurity Weaknesses. GAO has identified numerous cybersecurity weaknesses at multiple HHS component agencies, including CMS, CDC, and the Food and Drug Administration, during the last six years.  Based on the imminent cybersecurity threats, GAO urges HHS to expedite implementation of GAO’s prior recommendations regarding cybersecurity weaknesses at its component agencies

For more information, contact Chuck Young, Managing Director of GAO Public Affairs, at youngc1@gao.gov or 202-512-4800.

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