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. 
Page 2 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 2003.2

 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. 
Page 3 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 

 

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. 
Page 4 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 

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 Event2

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)