Public Health Preparedness: HHS Emergency Agency Needs to Strengthen Workforce Planning
Fast Facts
The Administration for Strategic Preparedness and Response (ASPR)'s workforce planning problems are ongoing. These issues were part of the reason why we added the Department of Health and Human Services' leadership in public health emergencies to our High Risk list in 2022.
In this report, we recommend ways for ASPR to address the problems and improve emergency response, such as:
Setting specific goals and performance measures for the in-house hiring office it's establishing
Tailoring recruiting and hiring strategies to address a shortage of human capital staff
Planning and doing workforce assessments in critical areas and agency-wide
Highlights
What GAO Found
The Administration for Strategic Preparedness and Response (ASPR) leads the nation's medical and public health response to emergencies. Its workforce has increased substantially to fulfill this growing role, roughly doubling from 1,000 to almost 2,000 employees from fiscal year 2019 to 2022. Contract staff contributed to most of this growth. Officials stated they used these staff to scale up quickly to respond to the COVID-19 pandemic; use will decrease as the response unwinds.
ASPR Workforce by Position Type, from Fiscal Year 2019 to 2022
ASPR is developing an in-house hiring office with the aim of improving its hiring capabilities. ASPR officials expect the office to be fully operational by October 2025. The office is to address four areas of concern that ASPR had with services provided by the Department of Health and Human Services (HHS) staff division: hiring costs, time-to-hire, service quality, and unique workforce needs, according to ASPR documentation and interviews. However, ASPR does not have specific goals and performance measures to use for the office, once operational, to help ensure these areas of concern will be addressed. For example, while time-to-hire had been slow in the past, officials could not provide specific goals or measures that outline how the new office will improve upon the status quo, especially given that the HHS staff division has made service improvements, according to ASPR officials. Specific goals and measures provide a framework for monitoring progress and will allow ASPR to make adjustments, if needed. In addition, ASPR intends to hire 41 human capital staff for the office by October 2025. However, it does not have tailored recruitment and hiring strategies that account for government-wide shortages of these staff.
ASPR's December 2022 strategic plan prioritized strategic workforce planning, including conducting workforce assessments to identify critical skills and competencies needed to achieve the agency's mission. Further, in February 2023, ASPR announced a new organizational structure to better achieve its mission. However, ASPR has not identified critical areas in the agency that need workforce assessments nor developed a plan to conduct them. It also has not conducted an agency-wide workforce assessment to prioritize the skills and competencies of greatest need to achieve the agency's goals and mission. Without conducting these assessments, ASPR cannot be assured that its workforce has the skills and competencies in place to support its reorganization, and ultimately, to meet its mission of leading the nation's response to public health emergencies.
Why GAO Did This Study
ASPR is a component within HHS. GAO placed HHS's leadership and coordination of public health emergencies on its high-risk list in January 2022, in part because ASPR did not have strategic workforce planning in certain areas. ASPR has relied on an HHS staff division, and other agencies, to assist with its hiring needs.
The CARES Act includes a provision for GAO to report on oversight efforts related to the COVID-19 pandemic. This report examines: (1) the size of ASPR's workforce, (2) ASPR's plans for improving its hiring capabilities, and (3) ASPR's strategic workforce planning practices.
To conduct this work, GAO reviewed ASPR documentation and workforce data and interviewed HHS and Office of Personnel Management (OPM) officials. GAO assessed ASPR's actions against GAO's key principles of strategic workforce planning and agency reform and OPM guidance.
Recommendations
GAO is making four recommendations that ASPR (1) establish specific goals and performance measures to use for its new hiring office once it is fully operational, (2) develop tailored strategies for recruiting and hiring human capital staff for the new office, (3) identify the critical areas that need workforce assessments and develop plans to implement them, and (4) conduct an agency-wide workforce assessment. HHS neither agreed nor disagreed with the first two recommendations and agreed with the last two recommendations. GAO believes actions are needed to address all of the recommendations.
Recommendations for Executive Action
| Agency Affected | Recommendation | Status |
|---|---|---|
| Office of the Assistant Secretary for Preparedness and Response | The Assistant Secretary for Preparedness and Response should establish specific goals and related performance measures to use for its new in-house hiring office once it is fully operational. This could include goals and performance measures to help address areas of concern the new office was intended to address, including time-to-hire, service quality, and unique workforce needs. (Recommendation 1) |
HHS neither agreed nor disagreed with this recommendation. In July 2024, ASPR officials reported that it is working to establish performance measures for its new in-house hiring office and that these measures will be tied to ASPR's goals for the new office. As GAO reported in January 2024, ASPR has a defined goal for its new hiring office to save the agency about $7 million annually, starting at the end of 2025, but the agency lacks other goals and related performance measures, including for three areas of concern ASPR identified during our audit. These are time-to-hire, the quality of its hiring services, and the agency's unique workforce needs. GAO will continue to monitor ASPR's progress in developing specific goals and related performance measures for its new hiring office. Therefore, GAO considers this recommendation open.
|
| Office of the Assistant Secretary for Preparedness and Response | The Assistant Secretary for Preparedness and Response should develop tailored recruitment and hiring strategies to address government-wide shortages of human capital staff to meet the hiring needs of its in-house hiring office. (Recommendation 2) |
HHS neither agreed nor disagreed with this recommendation. In July 2024, ASPR officials reported that the agency had revised its hiring target for its new in-house hiring office from 41 human capital staff to 38 human capital staff. ASPR officials planned to hire 15 of these human capital staff in fiscal year 2024 and, as of July 2024 documentation, 14 were hired. ASPR officials stated that they utilized several hiring and recruitment strategies to fill these positions. These strategies included social media and website outreach; increased engagement with candidates on LinkedIn, USAJobs, and Handshake; and attending in-person recruitment events. In addition, as added incentives to attract potential candidates, all positions for the new in-house hiring office are telework- or remote- eligible, and ASPR may match salaries for some applicants. ASPR officials stated that it intends to hire the remaining 24 needed staff for the new office by the end of fiscal year 2025. Developing tailored strategies is a positive step forward. GAO will continue to monitor ASPR's efforts to implement these recruitment and hiring strategies as ASPR continues to hire to ensure they are effective at meeting the hiring needs of the in-house hiring office. Therefore, GAO considers this recommendation open.
|
| Office of the Assistant Secretary for Preparedness and Response | The Assistant Secretary for Preparedness and Response should identify the critical areas that need workforce assessments and develop plans to implement such assessments, before its planned in-house hiring office is fully established. Such plans could include determining which assessments need to be conducted, when they will be conducted, and related resource needs. (Recommendation 3) |
HHS concurred with this recommendation. In March 2024, ASPR awarded a contract to a vendor to conduct a workforce assessment across the agency, rather than just identifying the critical areas that need workforce assessments. According to the contract, conducting an assessment of the entire workforce was in recognition of the criticality of all ASPR centers and offices and the continued maturation of ASPR as an Operating Division as well as in response to GAO's recommendation. This contract was awarded in advance of establishing its planned in-house hiring office. This fulfills the intent of the recommendation.
|
| Office of the Assistant Secretary for Preparedness and Response | The Assistant Secretary for Preparedness and Response should conduct an agency-wide workforce assessment—that considers workforce needs identified by individual area assessments and available resources—to prioritize the skills and competencies of greatest need to achieve agency-wide goals and mission, as identified in its strategic plan. (Recommendation 4) |
HHS concurred with this recommendation. In March 2024, ASPR awarded a contract to a vendor to conduct a workforce assessment of ASPR's entire workforce. ASPR officials stated that they expect this assessment to be completed in the 12 months. According to ASPR officials, the assessment will allow the agency to thoroughly understand its current workforce structure, where gaps might exist, and potential pathways forward to remedy those gaps identified. ASPR officials stated that this assessment is critical for its understanding of the agency's workforce strengths and areas for improvement and that it will facilitate the development of strategic plans to enhance productivity and the effectiveness of ASPR's workforce. GAO will continue to monitor ASPR's progress in conducting this agency-wide workforce assessment. Therefore, GAO considers this recommendation open.
|