Older Americans Act: Agencies Should Take Steps to Better Manage Fraud Risks

What GAO Found

The Department of Health and Human Services' (HHS) Administration for Community Living (ACL) and the Department of Labor's Employment and Training Administration (ETA) administer multiple grant programs under the Older Americans Act. Although ACL and ETA identified various staff involved in financial management and program oversight, they have not assigned specific roles, responsibilities, or authorities for leading fraud risk management activities in their Older Americans Act programs. According to leading practices, program managers should designate an entity with defined responsibilities and necessary authority for leading and overseeing fraud risk management activities. Without designating an antifraud entity, ACL and ETA may not be positioned strategically to manage fraud risks in their Older Americans Act programs.

ACL and ETA have not assessed fraud risks in their respective Older Americans Act programs. Officials at ACL and ETA told GAO that their respective Older Americans Act programs are at a low risk for fraud, but they could not substantiate their conclusions, as they have not assessed fraud risks. Prior cases of fraud illustrate that fraud risks exist in Older Americans Act programs. For example, in January 2019, an individual was sentenced to 57 months in prison and ordered to pay restitution of over $600,000 for using Older Americans Act grant funds for personal expenses.

Leading practices in GAO's Fraud Risk Framework call for program managers to plan regular fraud risk assessments that are tailored to their programs. Further, the framework outlines five key elements for assessing fraud risks (see fig.).

Key Elements of the Fraud Risk Assessment Process

Officials at ACL and ETA told GAO that the agencies consider fraud in other risk assessments, such as those for improper payments. However, these assessments do not meet the five key elements above. ACL officials told GAO that the agency plans to assess fraud risks using an HHS tool in 2025. While the tool may help address the five key elements, the quality of ACL's fraud risk assessment will depend on how the agency implements the tool to carry out the assessment. Without policies for regular fraud risk assessments that address the five key elements, ACL and ETA may not effectively prevent, detect, or respond to fraud in their respective Older Americans Act programs.

Why GAO Did This Study

The Older Americans Act of 1965, as amended, authorizes a wide range of grant programs to help older individuals remain in their homes and to provide support for their needs. Older Americans Act programs received over $2.3 billion in funding in fiscal year 2023. As the percentage of the U.S. population in this age group increases, demand for these programs' services-such as in-home meals and caregiver support-will likely increase. GAO has previously found that there is an unmet need for services through the Older Americans Act programs, underscoring the importance of safeguarding these funds.

GAO was asked to evaluate fraud risk management in programs authorized by the Older Americans Act. This report examines the extent to which ACL and ETA have (1) designated entities to lead fraud risk management activities and (2) assessed fraud risks in their respective Older Americans Act programs. GAO reviewed relevant policies and documentation, interviewed agency officials, and compared this information with selected leading practices from GAO's Fraud Risk Framework.

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