Department of Health and Human Services: Amounts Charged to the Department for Events Attended by the President

Published by the Government Accountability Office on 2003-06-09.

Below is a raw (and likely hideous) rendition of the original report. (PDF)

United States General Accounting Office
Washington, DC 20548

          June 9, 2003

          The Honorable Charles B. Rangel
          Ranking Minority Member
          Committee on Ways and Means
          House of Representatives

          Subject: Department of Health and Human Services: Amounts Charged to the
          Department for Events Attended by the President

          Dear Mr. Rangel:

          You requested information concerning amounts charged to the Department of Health
          and Human Services (HHS) by the White House for events attended by President
          George W. Bush. Specifically, you asked that we provide the following information:

                •   total number of events attended by the President and charged to any
                    department within HHS;
                •   total amount charged for the events;
                •   specific offices within HHS that were billed for the events;
                •   relevant subject matter of each event; and
                •   number of events that coincided with campaign-related events.

          In addition, you asked that we inform you, to the extent information is available,
          about how many such events have been billed to HHS under the current
          administration as compared to the previous one.

          To address your inquiry, we requested, obtained, and reviewed financial records and
          other documentation from HHS, interviewed HHS management and staff, and
          conducted Internet and literature searches. We also compared HHS’s procedures for
          documenting events attended by the President with our Standards for Internal
          Control in the Federal Government.1 Additionally, we verified the mathematical
          accuracy of all schedules of events provided by HHS. We did not request information
          from the White House because our review focused on the proper use of HHS funds.
          We conducted our work in Washington, D.C. from January 16, 2003, through May 29,
          2003, in accordance with generally accepted government auditing standards.

              GAO/AIMD-00-21.3.1, November 1999.

                                                        GAO-03-791R Presidential Events Charged to HHS
Based on information obtained from HHS, we determined that the White House
entered into agreements to charge HHS for 15 events attended by President
George W. Bush from January 2001 through January 2003. A memorandum of
agreement (MOA) between the White House and HHS was prepared to support each
of the 15 events. Each MOA specifies the date of the event and the city where the
event occurred. The MOAs also specify the maximum amount that the White House
was allowed to charge HHS for each event.

According to the MOAs, the White House was allowed to charge HHS a maximum of
about $523,000 in total for the 15 events attended by the President. Through May
2003, the White House had charged HHS about $252,000 for 8 of the 15 events.

HHS could not provide a detailed description of what the White House charges were
for because, according to HHS officials, the White House does not provide them with
copies of invoices or other records that describe the charges in detail. Our Standards
for Internal Control in the Federal Government require that all transactions be
clearly documented and that documentation be properly maintained and managed
and readily available for examination. Further, an agency’s management directives,
administrative policies, or operating manuals should specify the internal controls and
documentation requirements for these transactions. HHS is currently developing
written operating procedures that require specific information with each request
from the White House for funding an event. However, we noted that these
procedures do not currently require HHS to obtain copies of invoices or other
itemized statements that provide detailed support for the final charges billed to HHS.

The limited billing documentation provided by HHS included actual amounts charged
by the White House to HHS for the events, the specific offices to be billed, and
generally brief descriptions of the subject matter covered during the events. For the
8 events billed by the White House, several offices within HHS were charged
including the Administration for Children and Families, the Centers for Medicare and
Medicaid Services, and the Office of Public Health and Science. The events covered
issues such as welfare reform, genetics, and bioterrorism.

We determined and confirmed with HHS officials that the Secretary of Health and
Human Services or another HHS official accompanied the President at 12 of the 15
events. We also determined from public records of the President’s schedule and other
literature searches that the President was involved in what appeared to be campaign-
related events that coincided with at least 9 of the15 HHS events. These campaign-
related events were separate from the official HHS events but occurred on the same
day in the same city or close by. The enclosure to this report summarizes the
information we obtained on events attended by President Bush.

Regarding amounts billed to HHS for events attended by President William J. Clinton,
HHS provided a schedule that included events attended by the former President from
April 21, 1997, to September 29, 2000. This schedule showed that President Clinton

  HHS officials reported that no additional agreements were established from January 31, 2003, through
May 29, 2003, for the White House to charge HHS for events attended by the President.
  According to HHS officials, there is often a significant time lag between the occurrence of the event
and the billing from the White House.

Page 2                                               GAO-03-791R Presidential Events Charged to HHS
attended 37 events and that HHS was charged about $101,0004 for these events. HHS
also provided other information that made reference to 20 potential events attended
by President Clinton. However, HHS could not determine if these events occurred.
We had planned, as requested, to use the data regarding President Clinton’s
attendance at events to draw certain comparisons between the current and prior
administrations. However, HHS’s uncertainty about the potential events discussed
above, as well as the fact that HHS was not able to provide us with assurances that it
has records for all events attended by President Clinton, led us to conclude that
making such comparisons would not be appropriate.

Conclusion and Recommendations

While HHS maintains summary information on events billed by the White House, such
as the total amount charged for events, the offices billed for the events, and the
relevant subject matter of each event, records that adequately describe the charges to
ensure proper accountability were not maintained. Agreements between the White
House and HHS do not currently require that HHS receive copies of invoices or other
itemized statements as support for the final charges billed to HHS nor do the draft
operating procedures that HHS is developing to direct its staff in managing
information related to events charged by the White House.

We are therefore recommending that the Secretary of Health and Human Services
direct the Assistant Secretary for Administration and Management to

    •    establish and institute procedures to ensure that HHS obtains adequate
         documentation from the White House, including itemized statements that
         explain and support the propriety of charges made by the White House
         against HHS appropriations, and
    •    issue a policy on how such documentation will be maintained and managed to
         ensure that it is readily available for examination.

Agency Comments and Our Evaluation

We requested comments on a draft of this report from the Secretary of Health and
Human Services or his designee. On June 5, 2003, the Assistant Secretary for
Administration and Management provided us with oral comments on the draft. In his
comments, the Assistant Secretary agreed with our recommendations and indicated
that when finalized, HHS’s processing procedures for the White House events
discussed in this report will provide directives on processing requests from the first
contact with the department through final payment and closeout of the event,
including requesting itemized invoices from the White House. The Assistant
Secretary also noted that under prior administrations there was no centralized

  HHS also provided information for 13 events attended by either Vice President Gore or Mrs. Gore
from April 1997 through September 2000. The costs billed to HHS for those events were reported as
$142,900. However, because the scope of our review focused on events attended by Presidents Bush
and Clinton, we did not request detailed information concerning these events. HHS officials stated
that they are not aware of any charges to the department for events attended by Vice President
Cheney, Mrs. Bush, or Mrs. Cheney.

Page 3                                             GAO-03-791R Presidential Events Charged to HHS
process similar to what HHS currently has implemented to handle the processing of
the Presidential events. The Assistant Secretary stated that HHS’s current centralized
process allows for closer review and follow-up of each event in order to ensure
proper closeout of the events. We did not verify how prior administrations processed
these events as this was outside the scope of our review.

As agreed with your office, unless you publicly announce the contents of this report
earlier, we plan no further distribution until 30 days from its date. At that time we
will send copies to the Secretary of Health and Human Services and interested
congressional committees. We will also provide copies to others on request. This
report will also be available at no charge on the GAO Web site at http://www.gao.gov.

If you have any questions about this report, please contact me on (202) 512-9508. Key
contributors to this assignment were Kimberly Brooks, Phil McIntyre, and Gina Ross.

Sincerely yours,

Linda M. Calbom
Director, Financial Management and Assurance


Page 4                                      GAO-03-791R Presidential Events Charged to HHS
Events Attended by President Bush (January 2001- January 2003)

        Event                       Funding               MOA         Bill Amount                        HHS Official Campaign Event
                                                                                1                                                       2
        Date        Destination     Agency                Amount      (and Date)  Subject of Event       At Event     Day of HHS Event
    1   2/5/2002    Pittsburgh,     Office of Public       $25,000.00 $20,646.16 Tour of medical         Secretary    Could not determine
                    Pa.             Health                            (12/4/2002) center/
                                    Preparedness                                  bioterrorism
    2   2/11/2002   Milwaukee,      Centers for            25,000.00 18,041.50    Genetics               Secretary     Scott McCallum for
                    Wis.            Medicare and                      (12/4/2002)                                      Governor
                                    Medicaid Services                                                                  Reception: Pfister Hotel
    3   2/27/2002   Charlotte,      Administration for     60,000.00   58,012.11     Welfare reform &    Secretary     Robin Hayes Congress &
                    N.C.            Children and                       (12/4/2002)   job training                      Elizabeth Dole Senate
                                    Families                                                                           GOP Luncheon: Charlotte
                                                                                                                       Convention Center
    4   4/29/2002   Albuquerque,    Substance Abuse        20,000.00   Not Yet       Mental health       Information   Heather Wilson for
                    N. Mex.         and Mental Health                  Billed                            not           Congress
                                    Services                                                             provided      Luncheon: Crowne Plaza
                                    Administration                                                                     Pyramid Hotel
    5   5/10/2002   Columbus,       Administration for     35,000.00   20,960.57     Welfare reform      Secretary     Bob Taft for Governor
                    Ohio            Children and                       (2/3/2003)                                      Luncheon: Hyatt Regency
                                    Families                                                                           Hotel
    6   5/13/2002   Chicago, Ill.   Administration for     55,000.00   42,563.33     Welfare to work     No HHS        Jim Ryan for Governor
                                    Children and                       (2/3/2003)                        official      Luncheon: Sheraton
                                    Families                                                                           Chicago Hotel
    7   6/3/2002    Little Rock,    Administration for     40,000.00   27,726.07     Welfare to work     Secretary     Could not determine
                    Ark.            Children and                       (2/3/2003)
    8   6/20/2002   Washington,     Office of Public       20,877.77   20,877.77     White House         Secretary     Could not determine
                    D.C.            Health and Science                 (8/15/2002)   Fitness Expo
    9   6/21/2002   Orlando, Fla.   Office of Public       26,000.00   Not Yet       Fitness             No HHS        Jeb Bush for Governor
                                    Health and Science                 Billed                            official      Republican Party Majority
                                                                                                                       Dinner: Universal Studios
                                                                                                                       Portofino Hotel
    10 7/2/2002     Milwaukee,      Faith-Based and        20,000.00   Not Yet       Faith based         Secretary     Could not determine
                    Wis.            Community                          Billed
    11 7/11/2002    Minneapolis,    Centers for            36,000.00   Not Yet       Prescription drugs Secretary     Norm Coleman & John
                    Minn.           Medicare and                       Billed                                         Kline Minnesota
                                    Medicaid Services                                                                 Republican Party Victory
                                                                                                                      2002 Dinner: Target
                                                                                                                      Center Arena
    12 7/25/2002    Greensboro,     Centers for            35,000.00   Not Yet       Medical liability   Secretary    Elizabeth Dole for Senate
                    N.C.            Medicare and                       Billed        reform                           Finance Dinner:
                                    Medicaid Services                                                                 Grandover Resort and
                                                                                                                      Conference Center
    13 7/29/2002    Charleston,     Administration for     45,000.00   43,544.02     Welfare to work,    Secretary    Mark Sanford for
                    S.C.            Children and                       (2/3/2003)    abstinence, and                  Governor Luncheon:
                                    Families                                         marriage                         North Charleston
                                                                                                                      Convention Center
    14 8/8/2002     Waco, Tex.      Assistant Secretary    50,000.00   Not Yet       Economic forum      Bobby Jindal Could not determine
                                    for Planning and                   Billed                            Assistant
                                    Evaluation                                                           Secretary
                                                                                                         Planning &
    15 1/29/2003    Grand         Centers for              30,000.00   Not Yet       Medicare,           Secretary    Could not determine
                    Rapids, Mich. Medicare and                         Billed        Prescription
                                  Medicaid Services                                  Drugs, Expanded
                                                                                     Senior Health
        Total                                             $522,877.77 $252,371.53
Source: HHS data and GAO research

    Events billed as of May 29, 2003.
    For some events, we could not determine from available information whether a campaign related event coincided with the HHS event.