COVID-19: Critical Vaccine Distribution, Supply Chain, Program Integrity, and Other Challenges Require Focused Federal Attention

What GAO Found

Since November 2020, the number of COVID-19 cases in the U.S. has rapidly increased, further straining health care systems across the country. Between December 31, 2020, and January 13, 2021, new reported COVID-19 cases averaged about 225,000 per day—over 7 and 3 times higher than the surges the nation experienced during the spring and summer of 2020, respectively. (See figure.) The country also continues to experience serious economic repercussions and turmoil as a result of the pandemic. As of December 2020, there were more than 10.7 million unemployed individuals, compared to nearly 5.8 million individuals at the beginning of the calendar year. Until the country better contains the spread of the virus, the pandemic will likely remain a significant obstacle to more robust economic activity.

Reported COVID-19 Cases per Day in the U.S., Through January 13, 2021

As of January 2021, 27 of GAO’s 31 previous recommendations remained unimplemented. GAO remains deeply troubled that agencies have not acted on recommendations to more fully address critical gaps in the medical supply chain. While GAO recognizes federal agencies continue to take some steps, GAO underscores the importance of developing a well-formulated plan to address critical gaps for the remainder of the pandemic, especially in light of the recent surge in cases. In addition, implementation of GAO’s recommendation concerning the importance of clear and comprehensive vaccine distribution and communication plans remains a work in progress. Moreover, slow implementation of GAO’s recommendations relating to program integrity, in particular those made to the Small Business Administration (SBA) and Department of Labor (DOL), creates risk of considerable improper payments, including those related to fraud, and falls far short of transparency and accountability expectations. See appendix III for the status of GAO’s past recommendations.

GAO is pleased that the Consolidated Appropriations Act, 2021—enacted in December of 2020—requires a number of actions that are consistent with several of GAO’s prior recommendations, including those related to the medical supply chain, vaccines and therapeutics, and COVID-19 testing. GAO will monitor the implementation of the act’s requirements.

GAO’s new recommendations are discussed below.

COVID-19 Testing

Diagnostic testing for COVID-19 is critical to controlling the spread of the virus, according to the Centers for Disease Control and Prevention. GAO found that the Department of Health and Human Services (HHS) has not issued a comprehensive and publicly available national testing strategy. HHS’s national strategy documents are not comprehensive because they only partially address the characteristics that GAO has found to be desirable in an effective national strategy. For example, testing strategy documents do not always provide consistent definitions and benchmarks to measure progress, not all documents clearly define the problem and risks, and there is limited information on the types of resources required for future needs.

Furthermore, some of the documents have not been made public. While the national testing strategy is formally outlined in a publicly available document, HHS has provided only Congress with the COVID-19 Testing Strategy Reports, which detail the implementation of the testing strategy. Stakeholders who are involved in the response efforts told GAO they were unaware of the existence of a national strategy or did not have a clear understanding of the strategy. Without a comprehensive, publicly available national strategy, HHS is at risk of key stakeholders and the public lacking crucial information to support an informed and coordinated testing response. GAO is recommending that HHS develop and make publicly available a comprehensive national COVID-19 testing strategy that incorporates all six characteristics of an effective national strategy. Such a strategy could build upon existing strategy documents that HHS has produced for the public and Congress to allow for a more coordinated pandemic testing approach. HHS partially concurred with this recommendation and agreed that it should take steps to more directly incorporate some of the elements of an effective national strategy.

Vaccines and Therapeutics

Multiple federal agencies, through Operation Warp Speed, continue to support the development and manufacturing of vaccines and therapeutics to prevent and treat COVID-19. As of January 8, 2021, two of the six vaccines supported by Operation Warp Speed have been authorized for emergency use, and vaccine distribution and administration have begun. (See figure below). However, distribution and administration fell short of expectations set for the end of the year. As of December 30, 2020, Operation Warp Speed had distributed (shipped) about 12.4 million doses of COVID-19 vaccine and providers reported administering about 2.8 million initial doses, according to Centers for Disease Control and Prevention data. In September 2020, GAO stressed the importance of having a plan that focused on coordination and communication and recommended that HHS, with the support of the Department of Defense, establish a time frame for documenting and sharing a national plan for distributing and administering COVID-19 vaccine, and among other things, outline an approach for how efforts would be coordinated across federal agencies and nonfederal entities.To date, this recommendationhas not been fully implemented. GAO reiterates the importance of doing so. Effective coordination and communication among federal agencies, commercial partners, jurisdictions, and providers is critical to successfully deploying COVID-19 vaccines and managing public expectations, especially because the initial supply of vaccine has been limited.

Status of Development of Six Operation Warp Speed COVID-19 Vaccine Candidates, as of January 8, 2021

Figure described in preceding paragraph. For additional information about this figure, refer to contacts listed at http://www.gao.gov/products/GAO-21-265

Medical Supply Chain

The pandemic has highlighted vulnerabilities in the nation’s medical supply chain, which includes personal protective equipment and other supplies necessary to treat individuals with COVID-19. The Strategic National Stockpile (SNS) is an important piece of HHS’s recently developed strategy to improve the medical supply chain to enhance pandemic response capabilities. However, the department has yet to develop a process for engaging about the strategy with key nonfederal stakeholders that have a shared role for providing supplies during a pandemic, such as state and territorial governments and the private sector. GAO’s work has noted the importance of directly and continuously involving key stakeholders, including Congress, in the development of successful agency reforms and helping to harness ideas, expertise, and resources.

To improve the nation’s response and preparedness for pandemics, GAO recommends that HHS establish a process for regularly engaging with Congress and nonfederal stakeholders—including state, local, tribal, and territorial governments and private industry—as the agency refines and implements its supply chain strategy for pandemic preparedness, to include the role of the SNS. HHS generally concurred with this recommendation and noted that the department regularly engages with Congress and nonfederal stakeholders. GAO maintains that capitalizing on existing relationships to engage these critical stakeholders as HHS refines and implements a supply chain strategy, to include the role of the SNS, will improve a whole-of-government response to, and preparedness for, pandemics.

In August 2020, the President issued an Executive Order directing agencies to take steps toward the goal of strengthening domestic drug manufacturing and supply chains. Federal agencies have started implementing the Executive Order, but expressed concerns about their ability to implement some of the provisions. In particular, GAO found that federal agencies do not have complete and accessible information to identify supply chain vulnerabilities and to report the manufacturing supply chains of drugs that were procured by the agency.

To help it identify and mitigate vulnerabilities in the U.S. drug supply chain, GAO recommends that the Food and Drug Administration (FDA) ensure drug manufacturing data obtained are complete and accessible, including by working with manufacturers and other federal agencies, such as the Department of Defense and the Department of Veterans Affairs and, if necessary, seek authority to obtain complete and accessible information. HHS neither agreed nor disagreed with this recommendation.

COVID-19 Data for Health Care Indicators

The federal government does not have a process to help systematically define and ensure the collection of standardized data across the relevant federal agencies and related stakeholders to help respond to COVID-19, communicate the status of the pandemic with citizens, or prepare for future pandemics. As a result, COVID-19 information that is collected and reported by states and other entities to the federal government is often incomplete and inconsistent. The lack of complete and consistent data limits HHS’s and others’ ability to monitor trends in the burden of the pandemic across states and regions, make informed comparisons between such areas, and assess the impact of public health actions to prevent and mitigate the spread of COVID-19. Further, incomplete and inconsistent data have limited HHS’s and others’ ability to prioritize the allocation of health resources in specific geographic areas or among certain populations most affected by the pandemic.

To improve the federal government’s response to COVID-19 and preparedness for future pandemics, GAO recommends that HHS immediately establish an expert committee comprised of knowledgeable health care professionals from the public and private sectors, academia, and nonprofits or use an existing one to systematically review and inform the alignment of ongoing data collection and reporting standards for key health indicators. HHS partially concurred with this recommendation and agreed that it should establish a dedicated working group or other mechanism with a focus on addressing COVID-19 data collection shortcomings.

Drug Manufacturing Inspections

FDA is responsible for overseeing the safety and effectiveness of all drugs marketed in the U.S., including those manufactured overseas, and typically conducts more than 1,600 inspections of foreign and domestic drug manufacturing establishments every year. In light of the COVID-19 pandemic, since March 2020, FDA has limited domestic and foreign inspections for the safety of its employees. (See figure below.)

FDA has used alternative inspection tools to maintain some oversight of drug manufacturing quality while inspections are paused, including inspections conducted by foreign regulators, requesting and reviewing records and other information, and sampling and testing. Although FDA has determined that inspections conducted by certain European regulators are equivalent to an FDA inspection, other tools provide useful information but are not equivalent to an FDA inspection. As a result, FDA could be faced with a backlog of inspections, threatening the agency’s goal to maximize inspections prioritized by its risk-based site selection model each year.

GAO recommends that FDA (1) ensure that inspection plans for future fiscal years identify, analyze, and respond to the issues presented by the backlog of inspections that could jeopardize its goal of risk-driven inspections, and (2) fully assess the agency’s alternative inspection tools and consider whether these tools or others could provide the information needed to supplement regular inspection activities or help meet the agency’s drug oversight objectives when inspections are not possible in the future. FDA concurred with both recommendations.

Number of FDA-Conducted Domestic and Foreign Drug Manufacturing Establishment Inspections, Fiscal Years 2019–2020, by Month

Figure described in preceding paragraph. For additional information about this figure, refer to contacts listed at http://www.gao.gov/products/GAO-21-265

Federal Contracting

Federal agencies are using other transaction agreements to respond to the pandemic, which are contracting mechanisms that can enable agencies to negotiate terms and conditions specific to a project. GAO found that HHS misreports its other transaction agreements related to COVID-19 as procurement contracts, including other transaction agreements with about $1.5 billion obligated for Operation Warp Speed and other medical countermeasures. HHS’s approach is inconsistent with federal acquisition regulations and limits the public’s insight into the agency’s contract spending. To ensure consistent tracking and transparency of federal contracting activity related to the pandemic, GAO recommends that HHS accurately report data in the federal procurement database system and provide information that would allow the public to distinguish between spending on other transaction agreements and procurement contracts. HHS concurred with this recommendation.

Oversight of Worker Safety and Health

GAO identified concerns about federal oversight of worker safety and health amid the COVID-19 pandemic. Specifically, the Occupational Safety and Health Administration (OSHA) has adapted its enforcement methods for COVID-19 to help protect agency employees from the virus and address resource constraints, such as by permitting remote inspections in place of on-site inspections of workplaces. However, gaps in OSHA’s oversight and tracking of its adapted enforcement methods prevent the agency from assessing the effectiveness of its enforcement methods during the pandemic, ensuring that its adapted enforcement methods do not miss violations, and ensuring that employers are addressing certain identified violations.

To improve its oversight, GAO recommends that OSHA (1) develop a plan, with time frames, to implement the agency’s oversight processes for COVID-19-adapted enforcement methods, and (2) ensure that its data system includes comprehensive information on use of these enforcement methods to inform these processes. The agency neither agreed nor disagreed with these recommendations.

Additionally, OSHA’s data do not include comprehensive information on workplace exposure to COVID-19. For example, OSHA does not receive employer reports of all work-related hospitalizations related to COVID-19, as disease symptoms do not appear within the required reporting time frames. Employers may also face challenges determining whether COVID-19 hospitalizations or fatalities are work-related because of COVID-19’s incubation period and the difficulties in tracking the source of exposure. GAO recommends that OSHA determine what additional datamay be neededfrom employers or other sources to better target the agency’s COVID-19 enforcement efforts. The agency neither agreed nor disagreed with this recommendation.

Assistance for Fishery Participants

The CARES Act appropriated $300 million in March 2020 to the Department of Commerce (Commerce) to assist eligible tribal, subsistence, commercial, and charter fishery participants affected by COVID-19, which may include direct relief payments. After administrative fees were assessed, $298 million of the $300 million appropriated was obligated for fishery participants.Widespread restaurant closures in the spring of 2020 led to a decrease in demand for seafood, adversely affecting the fisheries industry.

As of December 4, 2020, all funds had been obligated and only about 18 percent ($53.9 million) of the CARES Act funding obligated for fishery participants had been disbursed, which is inconsistent with Office of Management and Budget guidance on the importance of agencies distributing CARES Act funds in an expedient manner. Commerce’s National Oceanic and Atmospheric Administration (NOAA) officials said they expect that the vast majority of funds will be disbursed to fisheries participants by early 2021. However, the agency does not have the needed information centralized to help ensure that funds are being disbursed expeditiously and efficiently. GAO recommends that NOAA develop a mechanism to track the progress of states, tribes, and territories in meeting established timelines to disburse funds in an expedited and efficient manner. NOAA concurred with this recommendation.

Program Integrity

GAO continues to identify areas to improve program integrity and reduce the risk of improper payments for programs funded by the COVID-19 relief laws now that federal agencies have obligated a total of $1.9 trillion and expended $1.7 trillion of the $2.7 trillion appropriated for response and recovery efforts as of November 30, 2020. Federal relief programs remain vulnerable to significant risk of fraudulent activities because of the need to quickly provide funds and other assistance to those affected by COVID-19 and its economic effects.

In this report, GAO identifies concerns about overpayments and potential fraud in the unemployment insurance (UI) system, specifically in the federally funded Pandemic Unemployment Assistance (PUA) program, which provides UI benefits to individuals not otherwise eligible for these benefits, such as self-employed and certain gig economy workers. As of January 11, 2021, states that had submitted data to DOL reported more than $1.1 billion in PUA overpayments from March through December 2020. While DOL requires states to report data on PUA overpayments, as of the beginning of 2021, the agency was not tracking the amount of overpayments recovered, limiting insight into the effectiveness of states’ efforts to recoup federal funds. To better track the recovery of federal funds, GAO recommends that DOL collect data from states on the amount of PUA overpayments recovered. DOL concurred with this recommendation, and has taken the first step toward implementing it by issuing new guidance and updated instructions for states to report PUA overpayment recovery data.

GAO also remains concerned about SBA’s management of internal controls and fraud risks in the Economic Injury Disaster Loans (EIDL) program. COVID-19 relief laws made qualifying small businesses and nonprofit organizations adversely affected by COVID-19 eligible for financial assistance from the EIDL program. Some approval requirements were also relaxed, such as requiring each applicant to demonstrate that it could not obtain credit elsewhere, through December 31, 2021. As of December 31, 2020, SBA officials said they had approved about 3.7 million applications for loans related to COVID-19, totaling about $200 billion. SBA rapidly processed loans and advances to millions of small businesses affected by COVID-19. GAO’s analysis of SBA data shows that the agency approved EIDL loans and advances for potentially ineligible businesses. For example, SBA approved at least 3,000 loans totaling about $156 million to potentially ineligible businesses in industries that SBA policies state were ineligible for the EIDL program, such as insurance and real estate development, as of September 30, 2020. GAO recommends that SBA develop and implement portfolio-level data analytics across EIDL loans and advances made in response to COVID-19 as a means to detect potentially ineligible and fraudulent applications. SBA neither agreed nor disagreed with this recommendation.

For more information, contact A. Nicole Clowers at (202) 512-7114 or clowersa@gao.gov.

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    Since 2015, Congress has not changed parts of the U.S. Bankruptcy Code (Code) related to financial companies or the Orderly Liquidation Authority (OLA). However, the Federal Deposit Insurance Corporation (FDIC) and the Board of Governors of the Federal Reserve System (Federal Reserve) have updated the resolution planning process to better match resolution planning requirements to the risks of companies. OLA is a regulatory alternative to bankruptcy for resolving failed, systemically important financial institutions, and resolution plans describe how a financial company may be resolved in an orderly manner if it fails. In November 2019, FDIC and the Federal Reserve finalized amendments to the Resolution Plans Required rule, establishing different filing cycles and content requirements for resolution plans based on the asset size and risk profile of companies. Regulators also finalized other rules related to OLA and resolution planning and proposed several additional rules. The 2007–2009 financial crisis and the failures of large, complex financial companies led some financial and legal experts to question the adequacy of the U.S. Bankruptcy Code for effectively reorganizing or liquidating these companies. These experts, government officials, and members of Congress responded by proposing changes to the Code and the supervisory process leading to a bankruptcy filing. The Dodd-Frank Wall Street Reform and Consumer Protection Act (Dodd-Frank Act) established OLA as a regulatory alternative to bankruptcy. Under OLA, the Secretary of the Treasury may appoint FDIC as a receiver to resolve systemically important financial institutions. In addition to OLA, the Dodd-Frank Act requires financial companies to file periodic resolution plans with the Financial Stability Oversight Council, Federal Reserve and FDIC describing how they could be resolved in an orderly manner in the event of material financial distress or failure. The Dodd-Frank Act also includes a provision for GAO to study, at specified intervals, the effectiveness of the Code in facilitating the orderly liquidation or reorganization of financial companies and ways to make the orderly liquidation process under the Code more effective. This report examines (1) proposed or enacted changes to the Code related to financial companies and OLA since 2015, and (2) regulatory actions related to resolution planning and OLA. GAO reviewed proposed legislation, regulations, prior GAO reports, and agency reports and presentations on financial company bankruptcies, OLA, and resolution planning. GAO also reviewed comment letters to the 2019 proposed Resolution Plans Required rulemaking. GAO interviewed officials from the Administrative Office of the United States Courts, FDIC, and the Federal Reserve. GAO also interviewed six industry stakeholders, including academics, a consumer group, industry associations, and former regulatory officials, about the 2019 Resolution Plans Required Rule. For more information, contact Michael Clements at (202) 512-8678 or ClementsM@gao.gov.
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  • Arleigh Burke Class Destroyers: Observations on the Navy’s Hybrid Electric Drive Program
    In U.S GAO News
    In 2009, the Secretary of the Navy set goals to reduce fuel consumption and, 2 years later, initiated a program to install Hybrid Electric Drive (HED) systems on its fleet of Arleigh Burke class (DDG 51 Flight IIA) destroyers. The HED system draws surplus power from the ship's electric system and uses it to propel the ship. This allows the crew to turn off the propulsion engines and save fuel. Since 2011, Navy officials told us that they have spent over $100 million on the development, purchase, and upgrade of six HED systems. In October 2018, the Navy completed installation of one of the systems on the USS Truxtun (DDG 103). However, the Navy has yet to install the remaining five HED systems and now plans to use them to support another research effort. The Navy issued a January 2020 report to Congress on the HED system installed on the USS Truxtun, but did not include some requested information. For example, while the report included performance information from operations on board the USS Truxtun, it did not include sufficient information to determine the overall performance of the HED system. A comprehensive test and evaluation could have assessed the system's performance, reliability, and cyber survivability to inform program decision-making. Further, the report did not include a summary of planned investment that includes: an assessment of the costs and benefits of the HED system, or a projection of the funding needed to execute the program. The Navy stated that it did not include a summary of the planned investments in the report because the HED program was not included in the President's fiscal year 2020 budget and also due to the need for additional HED data. However, Congress appropriated $35 million in funding for the HED program in 2020, which was available to support ship installation of the five previously purchased HEDs. The Navy stated that it can only use a small portion of this funding before it expires in September 2022 since the systems cannot be upgraded and incorporated into a ship's maintenance schedule in the next 3 years. In summer 2020, Navy requirements officials informed GAO and Congress that they plan to suspend the HED program and send the five surplus HED systems to support research into a new electric motor, known as Propulsion Derived Ship Service (PDSS). Navy requirements officials identified several reasons for suspending the HED program, but these reasons differ from information GAO obtained during the course of this review. For example: Navy officials stated that it is expensive to maintain the HED system. However, the commanding officer and crew of the USS Truxtun and senior Navy engineers stated that the system requires little maintenance. Navy officials also stated that the HED is not used very often in operations. According to the Navy's January 2020 report, the system was designed for low-speed operations (speed up to 11 knots), which comprise more than one-third of a typical DDGs operating profile. GAO did not assess the Navy's decision to use the HED systems for PDSS research because the Navy did not have documentation regarding the requirements, testing, schedule, or costs of the PDSS effort. GAO could not determine the merits of suspending the HED program and using the other five HED systems for the PDSS effort because the Navy has yet to complete analysis that determines the costs, benefits, and performance necessary to support such a decision. If the Navy completes a further assessment—which has been requested by Congress—it could provide the information necessary to inform future decisions about the HED program. This report assesses the Navy's HED program. Senate Report 115-262 accompanying the John S. McCain National Defense Authorization Act for Fiscal Year 2019 asked the Navy to submit a report on the HED system installed on the USS Truxtun. GAO was asked to review the Navy's report and the Navy's recent decision to suspend the HED program to pursue the PDSS research project. This report (1) examines the extent to which the Navy's report on the USS Truxtun included information regarding the assessment areas as requested by Congress; and (2) describes the Navy's decision to suspend the HED program and use the HED systems for the PDSS research effort. To conduct this work, GAO reviewed the Navy's 2020 report on the HED system, analyzed data and documentation the Navy used to guide investments, and assessed HED performance information. GAO also interviewed relevant Navy officials, such as the commanding officer and other senior crew of the USS Truxtun, and Navy engineers. GAO is not making any recommendations. For more information, contact Shelby S. Oakley at (202) 512-4841 or oakleys@gao.gov.
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  • Joint Statement by the U.S. Equal Employment Opportunity Commission, Department of Justice, and Department of Labor Commemorating the 30th Anniversary of the Americans with Disabilities Act and its Impact on the American Workforce
    In Crime News
    July 26, 2020, marked the 30th anniversary of the enactment of the Americans with Disabilities Act (ADA).  This landmark civil rights law protects access and opportunity for people with disabilities across community life, including employment.
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  • Man Purchased Lamborghini After Receiving $3.9 Million in PPP Loans
    In Crime News
    A Florida man pleaded guilty today for fraudulently obtaining approximately $3.9 million in Paycheck Protection Program (PPP) loans and using those funds, in part, to purchase a $318,000 Lamborghini sports car for himself. Authorities seized the Lamborghini and $3.4 million from the bank accounts of David T. Hines, 29, of Miami, at the time of his arrest. Hines pleaded guilty today to one count of wire fraud and is scheduled to be sentenced on April 14.
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  • Justice Department Files Enforcement Action Against Bain& Company As Part of Its Investigation Into Visa Inc’s Proposed Acquisition of Plaid Inc
    In Crime News
    Today, the Department of Justice filed a petition in the U.S. District Court for the District of Massachusetts to enforce Bain & Company’s compliance with the department’s Civil Investigative Demand (CID).  
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    In Crime News
    The Department of Justice announced today that it will participate in the Computational Antitrust project, hosted by the Stanford University CodeX Center and created by Professor Thibault Schrepel. The project brings together academics from law, computer science, and economics as well as developers, policymakers, and antitrust agencies from around the world to discuss how technology and automation can improve antitrust enforcement.
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  • Child Care: Subsidy Eligibility and Receipt, and Wait Lists
    In U.S GAO News
    An estimated 1.9 million children received child care subsidies in fiscal year 2017, representing approximately 14 percent of all children estimated to be eligible under federal rules – and 22 percent of all children estimated to be eligible under state rules -- in an average month. These figures are from the Department of Health and Human Services' (HHS) analysis of fiscal year 2017 data, the most recent year for which such analysis is available. Generally, fewer families qualify for subsidies under state eligibility rules than under federal eligibility rules since most states use flexibility provided by HHS to set their income eligibility limits below the federal maximum. Health and Human Services’ Estimated Number of Children Eligible Under Federal and State Rules, and Estimated Number Receiving Child Care Subsidies, Fiscal Year 2017 GAO found that the extent to which children who meet federal child care eligibility requirements also meet state eligibility requirements varies by state as does the share of eligible children who receive Child Care and Development Fund (CCDF) subsidies. Under state requirements, the CCDF subsidy receipt rate ranged from 5 percent to 32 percent of eligible children. Under federal requirements, the CCDF subsidy receipt rate ranged from 4 percent to 18 percent of federally eligible children. According to HHS estimates, among families who met federal child care eligibility criteria, children from lower-income families were more likely to receive child care subsidies compared to children from higher-income families. These estimates also showed that preschool-age children were more likely to receive subsidies compared to older, school-age children and that Black children were more likely to receive subsidies compared to children of other races / ethnicities. As reported in previous GAO work, states have varied strategies for managing their wait lists. Some states have a single statewide list while others have sub-state lists that allow sub-state areas to have their own policies. Some states conduct full or partial eligibility determinations prior to placing families on wait lists, and many states require periodic reviews of their wait lists. According to state administrators GAO interviewed, the strategies that states use to manage their wait lists pose certain challenges. For example, state administrators told GAO that sub-state lists can contain duplication, making state-wide estimates of families in need difficult. And administrators told GAO that maintaining up-to-date contact information is challenging, in part due to insufficient technology. The Coronavirus Disease 2019 (COVID-19) pandemic has impacted child care in several ways, including cost, eligibility and subsidy receipt, according to some members of the National Association of State Child Care Administrators (NASCCA). These members told GAO that despite initial declines in the number of families receiving subsidies, some states are seeing their child care costs increase due to, for example, more school-age children using full-day care; increased expenses for additional health and safety measures; paying for more absences and for parent co-pays; and families applying for subsidies for relative care. NASCCA members noted that some states have made changes to policies to help families and providers. To help families access child care, some states have increased income eligibility for subsidies to 85 percent of the state median income; temporarily waived work requirements to receive subsidies; and covered family fees for parents when a family must quarantine due to a COVID-19 exposure. Changes to some state policies aimed at helping providers include providing funds to providers to help with increased costs, such as personal protective equipment (PPE) and additional cleaning supplies; paying providers based on their pre-COVID-19 level authorized enrollments; and raising the state's provider reimbursement rate to help providers cover overhead costs. The federal child care subsidy program known as CCDF is one of the primary sources of federal funding dedicated to assisting low-income families with child care who are working or participating in education and training. Funding for CCDF, which is administered by HHS at the federal level, comes from two funding streams: discretionary funding in the form of block grants authorized by the Child Care and Development Block Grant (CCDBG Act) of 1990, as amended, and mandatory and matching funding authorized under section 418 of the Social Security Act. CCDF was appropriated more than $8 billion in federal funds in 2019. For more information, contact Kathryn Larin at (202) 512-7215 or larink@gao.gov.
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  • Final Member of Violent Baltimore “Trained to Go” Gang Sentenced to More Than 11 Years in Federal Prison for Racketeering and Drug Conspiracies
    In Crime News
    A Baltimore, Maryland, man was sentenced today to 138 montjhs in federal prison, followed by five years of supervised release for federal charges of conspiring to participate in a violent racketeering enterprise known as Trained To Go (TTG), and for conspiracy to possess with intent to distribute controlled substances. 
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