Department of Health and Human Services: Amounts Charged to the  
Department for Events Attended by the President (09-JUN-03,	 
GAO-03-791R).							 
                                                                 
GAO, answering a request from the House Committee on Ways and	 
Means, compiled information concerning amounts charged by the	 
White House for Department of Health and Human Services (HHS)	 
events attended by President George W. Bush and charged to any	 
department within HHS.						 
-------------------------Indexing Terms------------------------- 
REPORTNUM:   GAO-03-791R					        
    ACCNO:   A07131						        
  TITLE:     Department of Health and Human Services: Amounts Charged 
to the Department for Events Attended by the President		 
     DATE:   06/09/2003 
  SUBJECT:   Financial analysis 				 
	     Financial records					 
	     Intergovernmental fiscal relations 		 

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GAO-03-791R

GAO- 03- 791R Presidential Events Charged to HHS

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.

1 GAO/ AIMD- 00- 21. 3. 1, November 1999.

GAO- 03- 791R Presidential Events Charged to HHS Page 2 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. 2 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. 3 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 campaignrelated events that
coincided with at least 9 of the15 HHS events. These campaignrelated
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

2 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. 3 According to HHS officials,
there is often a significant time lag between the occurrence of the event
and the billing from the White House.

GAO- 03- 791R Presidential Events Charged to HHS Page 3 attended 37 events
and that HHS was charged about $101,000 4 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

4 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.

GAO- 03- 791R Presidential Events Charged to HHS Page 4 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

Enclosure

Enclosure

Events Attended by President Bush (January 2001- January 2003) Event Date
Destination

Funding Agency MOA

Amount Bill Amount (and Date) 1 Subject of Event HHS Official

At Event Campaign Event Day of HHS Event 2 1 2/ 5/ 2002 Pittsburgh,

Pa. Office of Public Health

Preparedness $25,000.00 $20,646.16 (12/ 4/ 2002) Tour of medical

center/ bioterrorism

Secretary Could not determine 2 2/ 11/ 2002 Milwaukee,

Wis. Centers for Medicare and

Medicaid Services 25,000.00 18,041.50

(12/ 4/ 2002) Genetics Secretary Scott McCallum for Governor

Reception: Pfister Hotel 3 2/ 27/ 2002 Charlotte,

N. C. Administration for Children and

Families 60,000.00 58,012.11

(12/ 4/ 2002) Welfare reform & job training Secretary Robin Hayes Congress
&

Elizabeth Dole Senate GOP Luncheon: Charlotte Convention Center 4 4/ 29/
2002 Albuquerque,

N. Mex. Substance Abuse and Mental Health

Services Administration

20,000.00 Not Yet Billed Mental health Information

not provided

Heather Wilson for Congress Luncheon: Crowne Plaza Pyramid Hotel 5 5/ 10/
2002 Columbus,

Ohio Administration for Children and

Families 35,000.00 20,960.57

(2/ 3/ 2003) Welfare reform Secretary Bob Taft for Governor Luncheon:
Hyatt Regency

Hotel 6 5/ 13/ 2002 Chicago, Ill. Administration for

Children and Families

55,000.00 42,563.33 (2/ 3/ 2003)

Welfare to work No HHS official

Jim Ryan for Governor Luncheon: Sheraton Chicago Hotel 7 6/ 3/ 2002 Little
Rock,

Ark. Administration for Children and

Families 40,000.00 27,726.07

(2/ 3/ 2003) Welfare to work Secretary Could not determine 8 6/ 20/ 2002
Washington,

D. C. Office of Public

Health and Science 20,877.77 20,877.77

(8/ 15/ 2002) White House

Fitness Expo Secretary Could not determine

9 6/ 21/ 2002 Orlando, Fla. Office of Public Health and Science 26,000.00
Not Yet

Billed Fitness No HHS official Jeb Bush for Governor

Republican Party Majority Dinner: Universal Studios Portofino Hotel 10 7/
2/ 2002 Milwaukee,

Wis. Faith- Based and Community

Initiatives 20,000.00 Not Yet

Billed Faith based Secretary Could not determine 11 7/ 11/ 2002
Minneapolis,

Minn. Centers for Medicare and

Medicaid Services 36,000.00 Not Yet

Billed Prescription drugs Secretary Norm Coleman & John Kline Minnesota

Republican Party Victory 2002 Dinner: Target Center Arena 12 7/ 25/ 2002
Greensboro,

N. C. Centers for

Medicare and Medicaid Services

35,000.00 Not Yet Billed

Medical liability reform

Secretary Elizabeth Dole for Senate Finance Dinner: Grandover Resort and
Conference Center 13 7/ 29/ 2002 Charleston,

S. C. Administration for

Children and Families

45,000.00 43,544.02 (2/ 3/ 2003)

Welfare to work, abstinence, and marriage

Secretary Mark Sanford for Governor Luncheon: North Charleston Convention
Center 14 8/ 8/ 2002 Waco, Tex. Assistant Secretary

for Planning and Evaluation 50,000.00 Not Yet

Billed Economic forum Bobby Jindal

Assistant Secretary Planning & Evaluation

Could not determine 15 1/ 29/ 2003 Grand

Rapids, Mich. Centers for Medicare and

Medicaid Services 30,000.00 Not Yet

Billed Medicare, Prescription

Drugs, Expanded Senior Health Care

Secretary Could not determine

Total $522,877.77 $252,371.53 Source: HHS data and GAO research 1 Events
billed as of May 29, 2003. 2 For some events, we could not determine from
available information whether a campaign related event coincided with the
HHS event. (190084)
*** End of document. ***