Expanding Contracting Authorities Across the Department of Health and Human Services Family of Agencies to Address Critical Public Health Needs

The COVID-19 pandemic revealed gaps in the Department of Health and Human Services’ (HHS) contracting authorities that limited rapid expansion of medical countermeasure (MCM) services, such as no-cost COVID-19 testing. The CDC’s Increasing Access To Community Testing (ICATT) program initially used temporary waivers to quickly partner with non-traditional pharmacy vendors, enabling more than 10,000 community testing sites. When these waivers were later discontinued, many vendors could no longer qualify for federal contracts, resulting in the loss of over 1,700 sites and blocking access to thousands more potential locations. These challenges stem from the absence of broad, department-wide Other Transaction Authorities (OTAs) within HHS, which would allow flexible agreements similar to those used effectively by the Department of Defense. Although a few HHS agencies hold limited OTAs, none are authorized to acquire MCM service capabilities such as testing. Expanding OTA authority across HHS, and explicitly including MCM services, would enable faster, more adaptable engagement with non-traditional partners during public health emergencies. Establishing department-level OTA policy, training, and guidance would further strengthen national preparedness and ensure more resilient responses in future crises.