ACF is headed by an assistant secretary appointed by the President and confirmed by the Senate. That position was created by section 416 of the Social Security Act as the “Assistant Secretary for Family Support.” The only duty of that office specified by law is administration of the Temporary Assistance for Needy Families block grant program and the Child Support and Establishment of Paternity program; however, nothing prevented the secretary from assigning the assistant secretary additional duties, so the title of that position was changed administratively to the “Assistant Secretary for Children and Families.” We could find no other statutory provisions limiting the secretary’s authority to reorganize or reassign any of these programs or officials to other parts of the department.

Administration on Aging

Of the non-PHS agencies in the department, the Administration on Aging (AoA) is subject to the most limiting statutory provisions dictating its organizational placement and structure. Section 201 of the Older Americans Act9 establishes the Administration on Aging and creates the position of assistant secretary for aging, appointed by the President with the advice and consent of the Senate. The statute requires that there be a direct reporting relationship between the assistant secretary and the secretary, and in performing his functions under the statute the assistant secretary must be directly responsible to the secretary. None of the functions of AoA (including those carried out in the regional offices) may be delegated to an official who is not directly responsible to the secretary.

The statute also specifies the creation of certain offices within AoA, including an Office for American Indians, Alaskan Natives, and Hawaiian Programs; an Office of Long-Term Ombudsman Program; and an office responsible for elder abuse and prevention services.

Centers for Medicare and Medicaid Services (CMS)

As discussed earlier, programs authorized under the Social Security Act (SSA), such as Medicare and Medicaid, are subject to almost no statutory directions or limitations with respect to how or where they are


42 U.S.C.A. ­§ 3011.

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