GAO says HHS failed to coordinate two emergency programs that fund $900 million

The Government Accountability Office on Feb. 23, 2026 concluded that the Department of Health and Human Services needs to improve coordination across two major emergency-preparedness grant programs that together awarded about $900 million to states and localities in fiscal year 2024. In a report titled Public Health Preparedness: Improved Coordination Needed for HHS’s Emergency Preparedness Programs (GAO-26-107507), auditors said the lack of alignment risks wasted resources and weaker responses when disasters or disease outbreaks strike.

“The two HHS agencies that administer these programs lack a formal mechanism, such as joint exercises, written agreements, or working groups, to coordinate them,” GAO wrote in its highlights. The programs, which the report links to both public health departments and health care systems including hospitals, are intended to prepare local and state systems to respond to threats. GAO said coordination is vital: “Coordination between public health departments and health care systems is vital for responding to public health emergencies.”

GAO identified clear, practical opportunities to improve coordination. For example, funding recipients from both programs could be required to conduct joint training and exercises, a measure the auditors said would encourage shared planning and reduce duplication. Officials from selected jurisdictions told GAO that greater interagency coordination could help reduce resource inefficiencies associated with implementation of PHEP and HPP.

The report places the newest critique atop a long trail of GAO findings that HHS has struggled to lead national preparedness. GAO has issued 155 recommendations to HHS over past years aimed at strengthening leadership and coordination; as of April 2023, 91 of those recommendations remained unimplemented. GAO added “HHS’s leadership and coordination of our nation’s preparedness for, and response to, public health emergencies” to its High-Risk List in January 2022, saying the area “is an area in need of transformation.”

Past GAO work cited multiple systemic shortfalls. The agency has said “HHS has not developed clear roles and responsibilities, including exercising them;” that “HHS has not developed an interoperable network of systems for near real-time public health situational awareness, as required in statute since 2006;” and that “HHS has not provided clear, consistent communication about disease outbreaks, including information about COVID-19 testing.” One GAO statement summarized the stakes: “Improving HHS’s leadership and coordination in this area will better prepare the nation for future emergencies and help mitigate their devastating public health and economic effects.”

Workforce and measurement gaps compound the coordination shortfall. GAO noted that “in 2024 we recommended ways for ASPR to address ongoing workforce planning problems and improve emergency response,” and external studies funded by HHS found “a lack of sustained, longer-term public health funding was one of the most common barriers to recruiting and retaining jurisdictional public health workers.” An ASPE review cited by GAO added that “Although the development of tools like the NHSPI, TFAH tool, COPI, and others listed in Appendix B has advanced STLT preparedness measurement, noteworthy gaps remain in public health preparedness metrics and in STLT emergency preparedness more broadly.”

GAO’s report recommends actions to strengthen coordination and improve information collection and analysis; the highlights note that “Our recommendations address this and other issues we found.” The full report GAO-26-107507, released Feb. 23, 2026, lays out specific changes federal agencies could make to align grants, share data, and support jurisdictions that must translate federal dollars into local readiness.