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Public Health Preparedness: HHS Emergency Agency Needs to Strengthen Workforce Planning

GAO-24-106108 Published: Jan 16, 2024. Publicly Released: Jan 16, 2024.
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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

Health worker in full protective gear including face mask, face shield, and body suit, administering a COVID-19 test to a person sitting in a chair.

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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 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 Sort descending
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)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
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)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
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)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
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)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

Full Report

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Topics

Human capital managementLabor forcepandemicsPersonnel managementPublic healthReorganizationWorkforce needsWorkforce planningHealth carePerformance measurement