Management of HHS:

Using the Office of the Secretary to Enhance Departmental Effectiveness

HRD-90-54: Published: Feb 9, 1990. Publicly Released: Feb 9, 1990.

Additional Materials:

Contact:

Gregory J. McDonald
(202) 512-7225
contact@gao.gov

 

Office of Public Affairs
(202) 512-4800
youngc1@gao.gov

GAO examined the role and operations of the Health and Human Services' (HHS) Office of the Secretary (OS) in managing HHS programs and activities.

GAO found that: (1) the lack of an effective strategic planning management system within OS hampered many secretaries' capacity to effectively manage administrative matters and programs; (2) although HHS decisionmaking processes tended to be slow but generally effective, their quality suffered if OS inappropriately used a clearance process designed to ensure that the secretary obtained the knowledge and perspective of department officials before making a decision; (3) although secretaries have appointed chiefs of staff to assist in HHS management, their involvement in various departmental matters has often overlapped with and caused confusion over the duties and responsibilities of other senior OS officials; (4) although secretaries retained authority for policy activities and delegated administrative and program activities to others, they did not monitor those activities to ensure effectiveness and efficiency; (5) HHS did not have an agency-wide, coordinated approach to systematically address its work-force problems; (6) although some operating divisions attempted to solve their own work-force problems, they lacked the comprehensive perspective needed to match human resources to changing operational and program objectives; (7) information management problems in many HHS programs contributed to difficulties in providing good service and assessing program performance; (8) before 1986, OS attempts to improve HHS information management failed because it exerted too much direct control over information management activities; and (9) although past attempts to correct long-standing problems in establishing an effective financial management system proved unsuccessful, HHS developed a plan called the Phoenix Plan, aimed at long-term financial management enhancement efforts.

Recommendations for Executive Action

  1. Status: Closed - Implemented

    Comments: After experiencing a period of uncertainty regarding the extent of staff resources, the Phoenix project now receives adequate resources and complete secretarial support. The project is expected to be implemented fully and meet revised milestones.

    Recommendation: The Secretary of Health and Human Services should support the goals and objectives of the Phoenix plan by providing enough qualified staff to operate and maintain the modern systems.

    Agency Affected: Department of Health and Human Services

  2. Status: Closed - Implemented

    Comments: The Secretary stated that he will conduct daily meetings with key staff and use senior staff retreats for review of strategic plans and development of policy issues.

    Recommendation: To help develop an effective leadership team and foster accountability within HHS, the Secretary of Health and Human Services should establish formal or informal means to oversee and monitor the performance of key departmental programs and administrative activities that are delegated to others to manage.

    Agency Affected: Department of Health and Human Services

  3. Status: Closed - Implemented

    Comments: The Secretary strengthened the HHS policy development process by clarifying the role of the Policy Council, eliminating the Management Council, and re-affirming the roles and relationships of key managers, particularly the Executive Secretary. OS will pretest policies prior to implementation, when appropriate.

    Recommendation: The Secretary of Health and Human Services should take steps to ensure that HHS: (1) consults in a timely manner with appropriate external parties having an interest in the policy being considered; and (2) pretests those policies that involve public education strategies.

    Agency Affected: Department of Health and Human Services

  4. Status: Closed - Implemented

    Comments: The Secretary stated that the Executive Secretariat's role has been strengthened and that the role of each departmental component in the clearance process clarified. Follow-up will determine if these actions were sufficient to prevent circumvention of the process.

    Recommendation: The Secretary of Health and Human Services should use the Executive Secretary clearance process as the key vehicle for managing decisions and enhance its effectiveness by preventing individuals from circumventing the process.

    Agency Affected: Department of Health and Human Services

  5. Status: Closed - Implemented

    Comments: The Secretary stated that the Executive Secretariat's decisionmaking role has been strengthened, and that he has established a system for early warning and identification of policy issues. He does not state explicitly, however, that the new early warning system is included in Executive Secretariat activities.

    Recommendation: The Secretary of Health and Human Services should use the Executive Secretary clearance process as the key vehicle for managing decisions and enhance its effectiveness by using the clearance process to provide early guidance on significant issues.

    Agency Affected: Department of Health and Human Services

  6. Status: Closed - Implemented

    Comments: The Secretary stated that he enhanced the role of the Executive Secretariat in managing the department's decisionmaking process. He did not mention specifically that this includes stronger linkage with standing councils.

    Recommendation: The Secretary of Health and Human Services should use the Executive Secretary clearance process as a key vehicle for managing decisions and enhance its effectiveness by integrating the clearance process with standing councils or other decision mechanisms used in HHS.

    Agency Affected: Department of Health and Human Services

  7. Status: Closed - Implemented

    Comments: The Secretary stated that he reinforced the role of the Executive Secretariat in managing the department's decisionmaking process, and clarified the role of each departmental component's participation in the clearance process.

    Recommendation: The Secretary of Health and Human Services should use the Executive Secretary clearance process as the key vehicle for managing decisions and enhance its effectiveness by establishing some means to resolve significant disputes promptly, such as setting deadlines for when unresolved disputes will be referred to the Secretary.

    Agency Affected: Department of Health and Human Services

  8. Status: Closed - Implemented

    Comments: The Secretary stated that HHS has established activities to monitor departmental milestones, and the Policy Council tracked key policy issues. The Secretary meets daily with key staff and uses monthly reports to keep on top of current activities and impending issues.

    Recommendation: The Secretary of Health and Human Services should establish some means to monitor and oversee the progress that HHS makes toward achieving desired goals and objectives.

    Agency Affected: Department of Health and Human Services

  9. Status: Closed - Implemented

    Comments: The Secretary stated that HHS established planning activities to systematically develop departmental objectives, will use the Policy Council to develop key policy issues, and provide secretarial guidance in the development of regulatory and other policy proposals.

    Recommendation: The Secretary of Health and Human Services should develop and institute a departmental planning process to develop alternative strategies to accomplish those departmental goals and objectives.

    Agency Affected: Department of Health and Human Services

  10. Status: Closed - Implemented

    Comments: The Secretary stated that he has clarified the roles of the Under Secretary, Chief of Staff, and Executive Secretary. He did not state specifically, however, that the duties and responsibilities of each have been clearly delineated.

    Recommendation: To help develop an effective leadership team and foster accountability within HHS, the Secretary of Health and Human Services should, if he or she chooses to continue the use of the chief of staff position, define the duties and responsibilities of that position so that they do not conflict with the formal authorities assigned to other high-level departmental officials.

    Agency Affected: Department of Health and Human Services

  11. Status: Closed - Implemented

    Comments: The Secretary stated that he has clarified the roles of the Under Secretary, Chief of Staff, and Executive Secretary. He did not state specifically, however, that the authorities of each have been clarified.

    Recommendation: To help develop an effective leadership team and foster accountability within HHS, the Secretary of Health and Human Services should clarify early in his or her term the roles and authorities to be assigned to key HHS leaders, formally communicate those roles and authorities through updated mission and function statements, and adhere to the assigned lines of authority.

    Agency Affected: Department of Health and Human Services

  12. Status: Closed - Implemented

    Comments: After several assessments by the Assistant Secretary for Personnel (ASPER), HHS has put in place a strategic human resources planning process led by ASPER. The process involves HHS' operating divisions and develops short and long-range planning objectives reflecting budget and operational issues.

    Recommendation: The Secretary of Health and Human Services should establish and lead a departmental strategic workforce planning effort. Successful accomplishment of such planning will require integration of budget and personnel functions to consider both workforce size and skill needs.

    Agency Affected: Department of Health and Human Services

  13. Status: Closed - Implemented

    Comments: The Secretary continues to fund and support the goals and objectives of the Phoenix project. The project is expected to meet its revised implementation milestones.

    Recommendation: The Secretary of Health and Human Services should support the goals and objectives of the Phoenix plan by providing adequate funding for the upgraded systems.

    Agency Affected: Department of Health and Human Services

  14. Status: Closed - Implemented

    Comments: The IRM Information Strategy Planning Process supports the department's strategic planning process and provides a rational process for funding IRM applications development. The DAS supports the integration of OS data systems, identifying barriers to effective systems, and elimination of redundant systems. The DAS will enhance systems interconnectivity by using a "information engineering" model.

    Recommendation: The Secretary of Health and Human Services should continue the HHS investment in its IRM program by ensuring that resources are available to continue to provide technical support to OS.

    Agency Affected: Department of Health and Human Services

  15. Status: Closed - Implemented

    Comments: The Deputy Assistant Secretary for IRM has resources available for assessing HHS IRM skill needs. The DAS coordinates with HHS components to address this area.

    Recommendation: The Secretary of Health and Human Services should continue the HHS investment in its IRM program by ensuring that resources are available to assess HHS IRM skill needs.

    Agency Affected: Department of Health and Human Services

  16. Status: Closed - Implemented

    Comments: The Deputy Assistant Secretary for IRM has resources available to continue reviews of operating divisions' IRM offices. The DAS has a mandate to organize and build a departmentwide, coordinated IRM system.

    Recommendation: The Secretary of Health and Human Services should continue the HHS investment in its IRM program by ensuring that resources are available to start and continue ASMB broad reviews of operating division IRM offices.

    Agency Affected: Department of Health and Human Services

  17. Status: Closed - Implemented

    Comments: The Deputy Assistant Secretary for IRM has resources available to implement an IRM strategic planning process. Further, the DAS has formulated subsequent action plans needed to accomplish specific IRM objectives. The HHS budget provides resources for IRM strategic planning.

    Recommendation: The Secretary of Health and Human Services should continue the HHS investment in its IRM program by ensuring that resources are available to implement the Office of the Assistant Secretary for Management and Budget (ASMB) IRM strategic planning process, focusing on information planning and extending the process to include steps discussed in this report.

    Agency Affected: Department of Health and Human Services

  18. Status: Closed - Implemented

    Comments: In June 1990, the Secretary ensured resources would be available to HHS IRM efforts by selecting a new Deputy Assistant Secretary for IRM. The DAS upgraded and instituted procedures to develop IRM strategic policies, and formulated subsequent action plans. IRM policies have been documented and published; as a result, there is much better awareness of IRM policy.

    Recommendation: The Secretary of Health and Human Services should continue the HHS investment in its Information Resources Management (IRM) Program by ensuring that resources are available to develop needed IRM policies.

    Agency Affected: Department of Health and Human Services

  19. Status: Closed - Implemented

    Comments: The Secretary has endorsed the ASPER role in implementing TQM throughout the department. To guide and support HRM activities, ASPER now focuses on meeting the needs of HHS personnel lists and line managers as part of a new customer orientation.

    Recommendation: The Secretary of Health and Human Services should establish and lead a departmental strategic workforce planning effort. Successful accomplishment of such planning will require a new leadership role for the Assistant Secretary for Personnel Administration (ASPER) to guide and support human resources management (HRM) efforts throughout HHS.

    Agency Affected: Department of Health and Human Services

  20. Status: Closed - Implemented

    Comments: The Secretary has sponsored a departmentwide Total Quality Management (TQM) effort that encourages cooperation between line and staff managers. The HHS Quality Council, comprised of staff from the OS and component divisions, makes recommendations and identify TQM pilot projects.

    Recommendation: The Secretary of Health and Human Services should establish and lead a departmental strategic workforce planning effort. Successful accomplishment of such planning will require cooperation between line and staff managers.

    Agency Affected: Department of Health and Human Services

  21. Status: Closed - Implemented

    Comments: The Secretary now leads a departmentwide planning process with HHS component heads. HHS published a strategic plan which outlines national health and human services goals and objectives. The Secretary meets quarterly with program directors to review national health and human services policy and to improve intra-departmental coordination.

    Recommendation: The Secretary of Health and Human Services should develop and institute a departmental planning process to establish goals and objectives for the future of HHS operations and the nation's health and human services programs.

    Agency Affected: Department of Health and Human Services

 

Explore the full database of GAO's Open Recommendations »

Sep 29, 2016

Sep 28, 2016

Sep 27, 2016

Sep 26, 2016

Sep 23, 2016

Sep 21, 2016

Sep 7, 2016

Aug 30, 2016

Looking for more? Browse all our products here