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Title page

Contents

Highlights 2

Letter 6

Background 10

Federal Laws and Guidance Advise Agencies on Identification of Duplication, Overlap, or Fragmentation 12

Federal Agencies, Including HHS, Face Privacy Challenges 15

HHS Has Not Identified and Reduced Unnecessary Duplication, Overlap, or Fragmentation of Data in Its Pandemic Systems 16

HHS Has Not Developed a Comprehensive List of Systems Supporting Pandemic Public Health Preparedness and Response 16

HHS Has Not Identified and Reduced Unnecessary Duplication, Overlap, or Fragmentation 18

We and Others Identified Examples of HHS Component Agency Systems Collecting Duplicative Data 20

Shortfalls in Comprehensive List and Review Process Are Due, in Part, to Lack of Prioritization 22

HHS Had Not Proactively Identified Funding and Staffing Resources for Its Pandemic Systems 23

HHS and Its Component Agencies Had Not Identified Funding Sources and Costs for Pandemic Systems 23

HHS and Its Component Agencies Had Not Identified Staffing Resources 27

HHS Partially Implemented Key Privacy Safeguards for Collecting PII in Systems Supporting Pandemic Response 29

HHS and Its Component Agencies Established Officials Responsible for Privacy 29

HHS Component Agencies Did Not Develop Privacy Impact Assessments for Many Pandemic Systems 30

HHS Partially Implemented Key Privacy Requirements for Selected Pandemic Systems That Include Personal Information 32

Conclusions 43

Recommendations for Executive Action 44

Agency Comments and Our Evaluation 46

Appendix I: Objectives, Scope, and Methodology 49

Appendix II: HHS Component Agencies Use Various Systems to Prepare for and Respond to Pandemic Public Health Emergencies 55

Appendix III: HHS Component Agency Comments on the Impact of Pandemic Funding 72

Appendix IV: Comments from the Department of Health and Human Services 74

Appendix V: GAO Contact and Staff Acknowledgments 76

Tables

Table 1. Department of Health and Human Services (HHS) Pandemic Public Health Preparedness and Response Systems with the Greatest Reported Costs in... 26

Table 2. Department of Health and Human Services (HHS) Pandemic Public Health Preparedness and Response Systems 55

Figures

Figure 1. Department of Health and Human Services (HHS) Component Agencies that Support Public Health Preparedness and Response and Their Key Missions 11

Figure 2. GAO Definitions of Duplication, Overlap, and Fragmentation 14

Figure 3. Examples of Funding Sources for the Department of Health and Human Services (HHS) Pandemic Public Health Preparedness and Response Systems 24

Figure 4. Steps for Implementing the Risk Management Framework 33

Figure 5. The Extent to Which HHS Component Agencies Implemented Key Privacy Requirements for Selected Systems 35

Figure 6. The Extent to Which HHS Component Agencies Implemented System of Record Notices for Selected Systems 36

Figure 7. The Extent to Which HHS Component Agencies Developed Security Categorizations for the Selected Systems 38

Figure 8. The Extent to Which HHS Component Agencies Developed Privacy Plans for the Selected Systems 40

Figure 9. The Extent to Which HHS Component Agencies Assessed Privacy Controls for the Selected Systems 41

Figure 10. The Extent to Which HHS Component Agencies Developed Authorizations to Operate for the Selected Systems 42

Figure 11. The Extent to Which HHS Component Agencies Conducted Monitoring for Privacy Controls for the Selected Systems 43

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