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Open Recommendations

Temporary Assistance for Needy Families: Enhanced Reporting Could Improve HHS Oversight of State Spending
GAO-25-107235
Jan 13, 2025
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3 Open Recommendations
Agency Affected Recommendation Status
Congress Congress should consider granting HHS the authority to collect from states specific additional information needed to enhance its oversight authority, such as planned and actual TANF non-assistance expenditures, beyond what is provided for in the Personal Responsibility and Work Opportunity Reconciliation Act of 1996. (Matter for Consideration 1)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Health and Human Services The Secretary of HHS should ensure ACF design control activities to help ensure states are submitting complete narrative data in their expenditure reporting. (Recommendation 1)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Health and Human Services The Secretary of HHS should ensure ACF conducts a review of all TANF reporting requirements and forms and make appropriate changes within its statutory authority to enhance reporting for oversight of TANF funds. (Recommendation 2)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

Older Americans: HHS Should Apply Leading Practices as It Coordinates Overlapping Programs
GAO-25-107020
Jan 08, 2025
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1 Open Recommendations
Agency Affected Recommendation Status
Department of Health and Human Services The Secretary of HHS should ensure that ACL, in consultation with other member agencies as appropriate, develop a written plan for its work with the Coordinating Committee that incorporates the eight leading practices on enhancing interagency collaboration. (Recommendation 1)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

Substance Misuse Treatment and Recovery: Federal Guidance Needs to Address Work Arrangements for Those Living in Residential Facilities
GAO-24-106101
Jul 08, 2024
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2 Open Recommendations
Agency Affected Recommendation Status
Department of Health and Human Services The Assistant Secretary of SAMHSA should incorporate single state agencies (SSA) into existing guidance development processes or develop a formal process to proactively consult SSAs about the information they need regarding how work should be incorporated into substance misuse treatment and recovery, and use the SSA feedback from such processes to inform the development of publicly available guidance. (Recommendation 1)
Open
HHS agreed with this recommendation. HHS noted that informational guidance it develops would focus on how work should be incorporated into substance use disorder treatment and separately how work should be addressed with respect to recovery housing. We will monitor the progress of their efforts.
Department of Health and Human Services The Assistant Secretary of SAMHSA should explicitly state in SUPTRS Block Grant application materials (1) that incorporating work into a treatment facility resident's treatment plan should involve an individualized assessment to determine if and when work is appropriate, and that requiring work as a condition for accessing treatment services is not acceptable, and (2) if and when requiring work as a condition of accessing services is acceptable at recovery housing. (Recommendation 2)
Open
HHS agreed with this recommendation. The agency stated that it would incorporate a statement in the fiscal years 2025-2026 SUPTRS Block Grant application materials to address the recommendation. We will monitor the progress of their efforts.

Family Child Care Networks: Actions Needed to Better Assess Quality Improvement Efforts
GAO-23-105640
Jun 09, 2023
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2 Open Recommendations
Agency Affected Recommendation Status
Office of Child Care The Director of OCC should provide written guidance to states on developing performance measures for CCDF quality activities that reflect appropriate attributes of successful performance measures, such as linkage to goals, clarity, and measurable targets. (Recommendation 1)
Open
HHS agreed with this recommendation and identified steps to implement it. Specifically, HHS said that OCC will further support more effective performance measures by providing training and technical assistance to grant recipients on how to develop effective benchmarks and performance measures that include goals, clarity, and measurable targets. As of December 2023, HHS reported that OCC was in the process of adding two full-time staff to provide training and technical assistance and develop guidance and resources to help states establish effective performance measures and benchmarks. In addition, HHS reported that OCC was revising the form for CCDF State Plans - in which states specify their performance measures - to clarify what states must submit and help states produce better performance measures.
Office of Child Care The Director of OCC should assess and report to Congress and the public on states' progress in improving the quality of child care. For example, OCC could provide Congress with the number of states that met their targets for their selected quality activities as established in their CCDF plans. (Recommendation 2)
Open
HHS agreed with this recommendation and identified steps to implement it. Specifically, HHS said that OCC will explore strategies for conducting analysis and reporting to Congress on states' progress toward setting and achieving meaningful quality improvement goals, using available data and resources from existing administrative data collections. As of December 2023, HHS reported that OCC was exploring data sources for assessing and reporting on states' progress in improving the quality of child care.
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