Federal Disability Assistance
Wide Array of Programs Needs to be Examined in Light of 21st Century Challenges Gao ID: GAO-05-626 June 2, 2005In 2003, GAO designated modernizing federal disability programs as a high-risk area requiring urgent attention and organizational transformation to ensure that programs function as efficiently and effectively as possible. GAO found that although social attitudes have changed and medical advancements afford greater opportunities for people with disabilities to work, the Social Security Administration and the Department of Veterans Affairs have maintained an outmoded approach that equated disability with inability to work. We have prepared this report under the Comptroller General's authority as part of a continued effort to help policymakers better understand the extent of support provided by federal programs to people with disabilities and to assist them in determining how these programs could be better aligned to more effectively meet the needs of individuals with disabilities in the 21st century. This report identifies (1) the wide array of federal programs that serve people with disabilities, and (2) the major challenges these federal programs face in the 21st century. In addition, GAO presents factors policy makers and program administrators should address in assessing whether, and how, they could be transformed to better meet 21st century challenges.
More than 20 federal agencies and almost 200 programs provide a wide range of assistance to people with disabilities, including employment-related services, medical care, and monetary support. About half of these programs serve only people with disabilities while the rest serve people both with and without disabilities. In fiscal year 2003, more than $120 billion in federal funds was spent on programs that only serve people with disabilities, with over 80 percent of these funds spent on monetary support. In addition, considerable funds are spent on people with disabilities by programs that also serve people without disabilities, like Medicare and Medicaid. The program challenges cited most frequently in our recent survey of nearly 200 programs serving people with disabilities are largely consistent with several of the key findings from past reports that led GAO to place federal programs supporting people with disabilities on its high-risk list. Both our recent survey and our past work have identified challenges in (1) ensuring timely and consistent processing of applications; (2) ensuring timely provision of services and benefits; (3) interpreting complex eligibility requirements;( 4) planning for growth in the demand for benefits and services; (5) making beneficiaries or clients aware of benefits and services; and (6) communicating or coordinating with other federal disability programs. In light of the vital role federal programs play in providing assistance to people with disabilities and in helping to ensure an adequate national labor force, we have identified a number of factors that are important to consider in assessing the need for, and nature of, program transformations including (1) program design issues; (2) fiscal implications of proposed program changes; and (3) feasibility of implementing program changes.
GAO-05-626, Federal Disability Assistance: Wide Array of Programs Needs to be Examined in Light of 21st Century Challenges
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Report to Congressional Committees:
United States Government Accountability Office:
GAO:
June 2005:
Federal Disability Assistance:
Wide Array of Programs Needs to be Examined in Light of 21st Century
Challenges:
GAO-05-626:
GAO Highlights:
Highlights of GAO-05-626, a report to Congressional Committees:
Why GAO Did This Study:
In 2003, GAO designated modernizing federal disability programs as a
high-risk area requiring urgent attention and organizational
transformation to ensure that programs function as efficiently and
effectively as possible. GAO found that although social attitudes have
changed and medical advancements afford greater opportunities for
people with disabilities to work, the Social Security Administration
and the Department of Veterans Affairs have maintained an outmoded
approach that equated disability with inability to work.
We have prepared this report under the Comptroller General's authority
as part of a continued effort to help policy makers better understand
the extent of support provided by federal programs to people with
disabilities and to assist them in determining how these programs could
be better aligned to more effectively meet the needs of individuals
with disabilities in the 21ST century. This report identifies (1) the
wide array of federal programs that serve people with disabilities, and
(2) the major challenges these federal programs face in the 21st
century. In addition, GAO presents factors policy makers and program
administrators should address in assessing whether, and how, they could
be transformed to better meet 21ST century challenges.
What GAO Found:
More than 20 federal agencies and almost 200 programs provide a wide
range of assistance to people with disabilities, including employment-
related services, medical care, and monetary support. About half of
these programs serve only people with disabilities while the rest serve
people both with and without disabilities. In fiscal year 2003, more
than $120 billion in federal funds was spent on programs that only
serve people with disabilities, with over 80 percent of these funds
spent on monetary support (see figure below). In addition, considerable
funds are spent on people with disabilities by programs that also serve
people without disabilities, like Medicare and Medicaid.
Federal Spending for Wholly Targeted Programs by Primary Type of
Assistance, Fiscal Year 2003:
[See PDF for image] --graphic text:
Pie graph with 5 items.
Monetary support: 86%;
Education: 8%;
Medical care: 2%;
Employment-related: 2%;
Other: 1%.
Source: GAO analysis of survey data.
[End of figure]
The program challenges cited most frequently in our recent survey of
nearly 200 programs serving people with disabilities are largely
consistent with several of the key findings from past reports that led
GAO to place federal programs supporting people with disabilities on
its high-risk list. Both our recent survey and our past work have
identified challenges in (1) ensuring timely and consistent processing
of applications; (2) ensuring timely provision of services and
benefits; (3) interpreting complex eligibility requirements;( 4)
planning for growth in the demand for benefits and services; (5) making
beneficiaries or clients aware of benefits and services; and (6)
communicating or coordinating with other federal disability programs.
In light of the vital role federal programs play in providing
assistance to people with disabilities and in helping to ensure an
adequate national labor force, we have identified a number of factors
that are important to consider in assessing the need for, and nature
of, program transformations including (1) program design issues; (2)
fiscal implications of proposed program changes; and (3) feasibility of
implementing program changes.
www.gao.gov/cgi-bin/getrpt?GAO-05-626.
To view the full product, including the scope and methodology, click on
the link above. For more information, contact Robert E. Robertson at
(202) 512-7215 or RobertsonR@gao.gov.
[End of section]
Contents:
Letter:
Results in Brief:
Background:
Over 20 Different Agencies Administer Almost 200 Programs That Provide
a Wide Range of Assistance:
Federal Programs That Support People with Disabilities Face An Array of
Challenges:
Key Factors to Consider in Transforming Programs for the 21st Century:
Appendix I: Scope and Methodology:
Appendix II: Federal Programs Serving People with Disabilities:
Appendix III: GAO Contact and Staff Acknowledgments:
Tables:
Table 1: Federal Agencies That Administer Programs Assisting People
with Disabilities:
Table 2: Number of Programs Serving People with Disabilities, by
Federal Agency and Primary Type of Assistance:
Figures:
Figure 1: Primary Types of Assistance Provided by Federal Programs to
Individuals with Disabilities, Indicating Percentage of Programs
Providing Such Assistance and Examples of Programs:
Figure 2: Number of Federal Programs Providing Various Primary Types of
Assistance to Individuals with Disabilities:
Figure 3: Percentage of Federal Programs Providing Multiple Types of
Assistance:
Figure 4: Federal Spending for Wholly Targeted Programs by Agency,
Fiscal Year 2003:
Figure 5: Federal Spending for Wholly Targeted Programs by Primary Type
of Assistance, Fiscal Year 2003:
Figure 6: Key Factors and Questions Concerning Transformation of
Programs Serving Individuals with Disabilities:
Abbreviations:
CFDA: Catalog of Federal Domestic Assistance:
CFFR: Consolidated Federal Funds Report:
DI: Disability Insurance:
GAO: Government Accountability Office:
HHS: Department of Health and Human Services:
SSA: Social Security Administration:
VA: Department of Veterans Affairs:
United States Government Accountability Office:
Washington, DC 20548:
June 2, 2005:
Congressional Committees:
In 2003, GAO designated modernizing federal disability programs as a
high-risk area--one that requires urgent attention and organizational
transformation to ensure that programs function in the most economical,
efficient, and effective manner possible. This designation was based on
more than a decade of research focusing primarily on the nation's
largest disability programs, which are administered by the Social
Security Administration (SSA) and the Department of Veterans Affairs
(VA). GAO's work has found that these programs are neither well aligned
with 21st century realities nor are they well-positioned to provide
meaningful and timely support for Americans with disabilities. For
example, despite opportunities afforded by medical and technological
advancements and the growing expectations that people with disabilities
can and want to work, federal disability programs remain grounded in an
approach that equates medical conditions with the incapacity to work.
Given the projected slowdown in the growth of the nation's labor force,
it is imperative that those who can work are supported in their efforts
to do so. Yet federal disability programs are not well-positioned to
provide this support. Solutions to these problems are likely to require
fundamental changes, including regulatory and legislative action.
In addition to disability programs operated within SSA and VA, there
are a number of other federal programs that provide various levels of
support to individuals with disabilities. We have prepared this report
under the Comptroller General's authority as part of a continued effort
to help policy makers better understand the extent of support provided
by federal programs to people with disabilities and to assist them in
determining how these programs could more effectively meet the needs of
individuals with disabilities in the 21st century. In this report, we
(1) identify the many federal programs that play a role in supporting
people with disabilities and (2) identify some of the major challenges
that federal programs face in supporting people with disabilities in
the 21st century. We also present factors that we believe are important
for programs to consider in assessing whether, and how, they could be
transformed to better meet 21st century challenges. As this report may
prove helpful in the deliberations of committees with oversight
responsibilities or jurisdiction over disability issues, we have
addressed this report to each of these committees.
To obtain information on federal disability programs and the challenges
they face, we (1) reviewed the Catalog of Federal Domestic
Assistance[Footnote 1] (CFDA) and agency Web sites to identify federal
programs that provide assistance to people with disabilities; (2)
conducted a Web-based survey of the programs we identified to obtain
descriptive information on these programs and the challenges they face;
(3) interviewed selected agency officials and officials from disability
advocacy organizations to obtain additional information on the
challenges federal programs face; and (4) reviewed pertinent agency
documents, GAO reports, and academic research on disability issues. We
conducted our work between March 2004 and March 2005 in accordance with
generally accepted government auditing standards. For more details
about our scope and methodology, see appendix I.
Results in Brief:
More than 20 federal agencies and almost 200 programs serve people with
disabilities in a multifaceted and complex manner. About half of these
programs serve only people with disabilities, while the rest serve
people both with and without disabilities. Together these programs
provide a wide range of assistance such as employment-related services,
medical care, civil protections or legal services, education, and
monetary support. Multiple agencies administer programs that provide
similar types of assistance, but these programs often serve different
populations of people with disabilities because of varying eligibility
criteria. For example, the Department of Education and the Department
of Veterans Affairs have separate programs that provide vocational
rehabilitation services to American Indians and veterans, respectively.
In fiscal year 2003, over $120 billion in federal funds were spent on
programs that only serve people with disabilities, with over 80 percent
of these funds spent on monetary support.[Footnote 2] Although
insufficient data were available to estimate the total additional funds
spent on people with disabilities by programs that also serve people
without disabilities, this amount is significant given that benefit
payments in fiscal year 2002 for people with disabilities for two such
programs alone--Medicare and Medicaid--amounted to about $132 billion.
The challenges cited most frequently in our recent survey of nearly 200
programs serving people with disabilities are largely consistent with
several of the key findings from our past reports that led GAO to place
federal programs supporting people with disabilities on its high-risk
list. Our past work examining the federal government's disability
programs--particularly those administered by SSA and VA--revealed
challenges these programs face in a variety of areas including ensuring
timely and consistent processing of applications for assistance,
ensuring timely provision of services and benefits, interpreting
complex eligibility requirements, planning for growth in the demand for
program benefits and services, making beneficiaries or clients aware of
program services or benefits, and communicating and coordinating with
other federal programs serving individuals with disabilities. Our
recent survey of nearly 200 programs serving people with disabilities
indicates that many of these programs face challenges similar to those
we have previously identified. For example, in responding to our
survey, 54 percent of the programs that provide medical care and 46
percent of the programs that provide employment-related assistance
reported that planning for growth in the demand for assistance was a
major or moderate challenge. In addition, 53 percent of the programs
that provide monetary support to people with disabilities reported that
interpreting complex eligibility requirements was a major or moderate
challenge.
Over the past several years, GAO has identified the need to reexamine
and transform federal disability programs to better position the
government to meet the new challenges and changing expectations of the
21st century. We have identified several key factors that are important
to consider in assessing the need for, and nature of, program
transformations including (1) program design issues, particularly those
affecting individual work incentives and supports; (2) fiscal
implications of proposed program changes, such as their affordability
and effects on federal and state spending and tax revenues; and (3)
feasibility of implementing program changes, which would include
considering whether appropriate processes and systems are in place
including those related to the planning and management of human capital
and information technology. In addition to considering these factors,
it is also important that some mechanism be established for looking
across programs to assess their overall effectiveness and integration
and whether they achieve similar or complementary goals.
Background:
Recent economic, medical, technological, and social changes have
increased opportunities for individuals with disabilities to live with
greater independence and more fully participate in the workforce. For
example, over the past several decades, the economy has shifted towards
service-and knowledge-based jobs that may allow greater participation
for some persons with physical limitations. Also, advances in medicine
and assistive technologies--such as improved treatments for mental
illnesses and advanced wheelchair design--afford greater opportunities
for some people with disabilities. In addition, social and legal
changes have promoted the goal of greater inclusion of people with
disabilities in the mainstream of society, including adults at work.
For example, the Americans with Disabilities Act supports the full
participation of people with disabilities in society and fosters the
expectation that people with disabilities can work and have the right
to work. More recently, the President announced the New Freedom
Initiative, a set of guiding principles and initiatives aimed at
improving the integration of people with disabilities in all aspects of
society, including employment.
Public concern and congressional action have produced a broad array of
federal programs designed to help people with disabilities. However,
our prior reviews of the largest federal disability programs indicate
that such programs have not evolved in line with these larger societal
changes and therefore, are poorly positioned to provide meaningful and
timely support for people with disabilities. Furthermore, program
enrollment and costs for the largest federal disability programs have
been growing and are poised to grow even more rapidly in the future,
further contributing to the federal government's large and growing long-
term structural deficit.[Footnote 3] For example, from 1982 to 2002,
the number of disabled workers receiving benefits under SSA's
Disability Insurance (DI) program doubled from 2.6 million to 5.5
million, while payments quadrupled from about $14.8 billion to $60
billion. Moreover, these disability programs are poised to grow even
more as baby boomers reach their disability-prone years. This program
growth is exacerbated by the low rate of return to work for individuals
with disabilities receiving cash and medical benefits. In addition, the
projected slowdown in the growth of the nation's labor force has made
it more imperative that those who can work are supported in their
efforts to do so.
Over 20 Different Agencies Administer Almost 200 Programs That Provide
a Wide Range of Assistance:
We identified over 20 federal agencies and almost 200 federal programs
that are either wholly or partially targeted to serving people with
disabilities. These programs provide a wide range of assistance such as
employment-related services, medical care, and monetary support.
Multiple agencies run programs that provide similar types of
assistance, but these programs often serve different populations of
people with disabilities because of varying eligibility criteria. About
59 percent of the programs we identified provide indirect support to
people with disabilities through means such as grants to states, while
the rest provide support directly to people with disabilities. In
fiscal year 2003, over $120 billion in federal funds were spent on
programs that serve only people with disabilities. Although there were
insufficient data available to estimate the total additional funds
spent on people with disabilities by programs that also serve people
without disabilities, benefit payments for people with disabilities for
two such programs alone--Medicare and Medicaid--amounted to about $132
billion in fiscal year 2002.
Multiple Federal Agencies Administer Programs Serving People with
Disabilities:
Twenty-one federal agencies--under the jurisdiction of more than 10
Congressional committees--administer 192 programs that target or give
priority to people with disabilities (see table 1). However, four
agencies--the departments of Health and Human Services (HHS),
Education, Veterans Affairs, and Labor--are responsible for over 65
percent of these programs. About half of the programs that we
identified are wholly targeted (targeted exclusively) to people with
disabilities. The rest of the programs are partially targeted to people
with disabilities--they serve people with and without
disabilities.[Footnote 4] Specifically, of the 192 programs we
identified, 95 reported being wholly targeted, and 97 reported being
partially targeted. The wholly targeted programs reported that they
served over 34 million beneficiaries or clients in fiscal year 2003,
with the largest among these--SSA's DI program and VA's Veterans
Compensation for Service-Connected Disability program--serving about 10
million of these beneficiaries. Although some of the partially targeted
programs we surveyed could not provide data on the number of people
with disabilities they serve, our survey data indicate that these
programs served at least 15 million beneficiaries or clients with
disabilities in fiscal year 2003, with the largest of these programs--
SSA's Supplemental Security Income Program--serving about 5.7 million
of these beneficiaries.[Footnote 5]
Table 1: Federal Agencies That Administer Programs Assisting People
with Disabilities:
Federal agencies: Department of Health and Human Services;
Number of wholly targeted programs: 17;
Number of partially targeted programs: 23;
Total number of programs supporting people with disabilities: 40.
Federal agencies: Department of Education;
Number of wholly targeted programs: 27;
Number of partially targeted programs: 6;
Total number of programs supporting people with disabilities: 33.
Federal agencies: Department of Veterans Affairs;
Number of wholly targeted programs: 20;
Number of partially targeted programs: 12;
Total number of programs supporting people with disabilities: 32.
Federal agencies: Department of Labor;
Number of wholly targeted programs: 8;
Number of partially targeted programs: 14;
Total number of programs supporting people with disabilities: 22.
Federal agencies: Department of Housing and Urban Development;
Number of wholly targeted programs: 6;
Number of partially targeted programs: 10;
Total number of programs supporting people with disabilities: 16.
Federal agencies: Social Security Administration;
Number of wholly targeted programs: 6;
Number of partially targeted programs: 4;
Total number of programs supporting people with disabilities: 10.
Federal agencies: Department of Agriculture;
Number of wholly targeted programs: 1;
Number of partially targeted programs: 8;
Total number of programs supporting people with disabilities: 9.
Federal agencies: Department of Transportation;
Number of wholly targeted programs: 2;
Number of partially targeted programs: 4;
Total number of programs supporting people with disabilities: 6.
Federal agencies: Department of Justice;
Number of wholly targeted programs: 0;
Number of partially targeted programs: 5;
Total number of programs supporting people with disabilities: 5.
Federal agencies: Equal Employment Opportunity Commission;
Number of wholly targeted programs: 1;
Number of partially targeted programs: 2;
Total number of programs supporting people with disabilities: 3.
Federal agencies: Office of Personnel Management;
Number of wholly targeted programs: 2;
Number of partially targeted programs: 1;
Total number of programs supporting people with disabilities: 3.
Federal agencies: Department of Commerce;
Number of wholly targeted programs: 0;
Number of partially targeted programs: 2;
Total number of programs supporting people with disabilities: 2.
Federal agencies: Department of Treasury;
Number of wholly targeted programs: 0;
Number of partially targeted programs: 2;
Total number of programs supporting people with disabilities: 2.
Federal agencies: Library of Congress;
Number of wholly targeted programs: 1;
Number of partially targeted programs: 1;
Total number of programs supporting people with disabilities: 2.
Federal agencies: Access Board;
Number of wholly targeted programs: 1;
Number of partially targeted programs: 0;
Total number of programs supporting people with disabilities: 1.
Federal agencies: Committee for Purchase from People Who are Blind or
Severely Disabled;
Number of wholly targeted programs: 1;
Number of partially targeted programs: 0;
Total number of programs supporting people with disabilities: 1.
Federal agencies: Department of Defense;
Number of wholly targeted programs: 1;
Number of partially targeted programs: 0;
Total number of programs supporting people with disabilities: 1.
Federal agencies: Department of Energy;
Number of wholly targeted programs: 0;
Number of partially targeted programs: 1;
Total number of programs supporting people with disabilities: 1.
Federal agencies: Department of the Interior;
Number of wholly targeted programs: 1;
Number of partially targeted programs: 0;
Total number of programs supporting people with disabilities: 1.
Federal agencies: Railroad Retirement Board;
Number of wholly targeted programs: 0;
Number of partially targeted programs: 1;
Total number of programs supporting people with disabilities: 1.
Federal agencies: Small Business Administration;
Number of wholly targeted programs: 0;
Number of partially targeted programs: 1;
Total number of programs supporting people with disabilities: 1.
Federal agencies: Total number of programs in our survey;
Number of wholly targeted programs: 95;
Number of partially targeted programs: 97;
Total number of programs supporting people with disabilities: 192.
Source: GAO analysis of survey data.
[End of table]
Federal Programs Provide a Wide Range of Assistance to People with
Disabilities:
Federal programs provide a wide range of assistance to people with
disabilities (see fig. 1). The most common primary types of assistance
provided are employment-related services and medical care, although a
number of programs provide civil protections or legal services,
education, and monetary support as well as other benefits or services
(see fig. 2).
Figure 1: Primary Types of Assistance Provided by Federal Programs to
Individuals with Disabilities, Indicating Percentage of Programs
Providing Such Assistance and Examples of Programs:
[See PDF for image]
[End of figure]
Figure 2: Number of Federal Programs Providing Various Primary Types of
Assistance to Individuals with Disabilities:
[See PDF for image]
[End of figure]
Most of the federal programs provide more than one type of assistance
and over one-quarter of the programs provide three or more types of
assistance to people with disabilities (see fig. 3). For example, the
Developmental Disabilities Basic Support and Advocacy Grants program
run by HHS provides multiple types of assistance to people with
disabilities including housing, education, transportation, and
information dissemination services.
Figure 3: Percentage of Federal Programs Providing Multiple Types of
Assistance:
[See PDF for image]
Note: Numbers in this figure do not add up to 100 percent due to
rounding.
[End of figure]
About 59 percent of the programs we identified provide support
indirectly through other entities such as state agencies or private
organizations, while the rest provide it directly to people with
disabilities. For example, the Department of Education's Preschool
Grants program provides special education to preschool children with
disabilities via funding to state education agencies, whereas the
Department of Labor's Coal Mine Workers' Compensation program provides
monetary support directly to eligible coal mine workers with
disabilities. Of the programs that provide assistance indirectly to
people with disabilities, the most common means is through nonfederal
government entities (e.g., state or local agencies).
Multiple Federal Agencies Provide Similar Types of Assistance:
Multiple federal agencies administer programs that provide similar
types of assistance to people with disabilities (see table 2). For
example, seven agencies--including the Social Security Administration,
the Committee for the Purchase from People who are Blind or Severely
Disabled, the Office of Personnel Management, and the departments of
Agriculture, Education, Labor, and Veterans Affairs--administer 28
programs that primarily provide employment-related services to people
with disabilities.
Table 2: Number of Programs Serving Individuals with Disabilities, by
Federal Agency and Primary Type of Assistance:
[See PDF for image]
Source: GAO analysis of survey data.
[End of table]
Although programs from multiple agencies provide the same primary type
of assistance, these programs often have varying eligibility criteria
that may limit the populations served to distinct groups of people with
disabilities. For example, the American Indian Vocational
Rehabilitation Services program run by the Department of Education and
the Department of Veterans Affairs' Vocational Rehabilitation for
Disabled Veterans program each provide employment-related assistance,
but to distinct groups of people.[Footnote 6] Furthermore, the 28
programs that primarily provide employment-related services often have
distinct eligibility criteria beyond the specific populations served.
Billions Are Spent on Programs for People with Disabilities:
The programs that provide assistance only to people with disabilities
spent over $120 billion in fiscal year 2003.[Footnote 7] SSA and VA
accounted for about 88 percent of this amount (see fig. 4). In
particular, SSA's DI program accounted for about 64 percent of the
total spending for wholly targeted programs, and the VA's Veterans
Compensation for Service-Connected Disability program accounted for
approximately 17 percent of this total. Approximately 86 percent of the
wholly targeted program spending was for programs that primarily
provided monetary support to people with disabilities (see fig. 5).
Figure 4: Federal Spending for Wholly Targeted Programs by Agency,
Fiscal Year 2003:
[See PDF for image] --graphic text:
Pie chart with five items.
SSA: 64%;
VA: 24%;
Education: 10%;
HHS: 2%;
Other agencies: 1%.
Note: The percentages in this figure are calculated based on fiscal
year 2003 program obligations that we were able to identify. Therefore,
it does not reflect the spending of a number of programs (and agencies)
for which we were unable to obtain any fiscal year 2003 spending data
or which provided data representing program outlays rather than
obligations. For example, the Department of Labor's reported outlays of
almost $3 billion for wholly targeted programs are not reflected in
this figure. For a more comprehensive listing of program spending, see
appendix II. Numbers in this figure do not add up to 100 percent due to
rounding.
[End of figure]
Figure 5: Federal Spending for Wholly Targeted Programs by Primary Type
of Assistance, Fiscal Year 2003:
[See PDF for image] --graphic text:
Pie graph with 5 items.
Monetary support: 86%;
Education: 8%;
Medical care: 2%;
Employment-related: 2%;
Other: 1%.
Source: GAO analysis of survey data.
Note: The percentages in this figure are calculated based on fiscal
year 2003 program obligations that we were able to identify. Therefore,
it does not reflect the spending of a number of programs for which we
were unable to obtain any fiscal year 2003 spending data or which
provided data representing program outlays rather than obligations. For
a more comprehensive listing of program spending, see appendix II.
Numbers in this figure do not add up to 100 percent due to rounding.
[End of figure]
In addition to the billions of dollars spent on programs that serve
only people with disabilities, additional amounts are spent on
individuals with disabilities by partially targeted programs whose
beneficiaries also include people without disabilities. While we were
not provided with sufficient data to determine the total amount spent
by all of these partially targeted programs on benefits or services for
individuals with disabilities,[Footnote 8] these costs are certainly
significant given that they include such programs as Supplemental
Security Income (SSI), Medicaid, and Medicare. In 2002, SSI paid about
$26 billion in cash benefits to people with disabilities and Medicaid
and Medicare together paid about $132 billion in benefits for such
individuals.
Federal Programs That Support People with Disabilities Face an Array of
Challenges:
Both our past work and our recent survey of federal programs supporting
people with disabilities indicate that these programs face a number of
challenges. Among these are challenges in ensuring timely and
consistent processing of applications for assistance, ensuring timely
provision of services and benefits, interpreting complex eligibility
requirements, planning for growth in the demand for program benefits
and services, making beneficiaries or clients aware of program services
or benefits, and communicating or coordinating with other federal
programs.
Timely and Consistent Processing of Applications for Assistance:
Our past work examining disability programs administered by SSA and VA
highlighted the challenges that federal programs face in ensuring
timely and consistent processing of applications for assistance. Both
SSA and VA have experienced lengthy processing times for disability
claims over the past several years, with claimants waiting, on average,
more than 4 months for an initial decision and for more than 1 year for
a decision on appeal of a denied claim. In addition, we have also
pointed out that inconsistencies in these agencies' disability claim
decisions across adjudicative levels and locations have raised
questions about the fairness, integrity, and cost of these programs.
Our survey provides further evidence of such challenges facing programs
that provide monetary support. Almost half of these programs reported
that ensuring timely processing of applications was a major or moderate
challenge,[Footnote 9] and more than one-quarter of monetary support
programs reported that consistent processing of applications was a
major or moderate challenge.[Footnote 10]
Timely Provision of Services and Benefits:
Our past work also identified the challenges encountered by federal
programs in ensuring timely provision of services and benefits. For
example, we noted that structural weaknesses in SSA's DI and SSI
programs have prevented the agency from offering return-to-work
services when it may help most--soon after a person becomes disabled.
Our survey indicates that some other federal programs also face the
challenge of providing services in a timely fashion. For example, 38
percent of the programs that provide employment-related assistance to
people with disabilities reported that ensuring timely provision of
services and benefits was a challenge.[Footnote 11] Officials from the
Department of Education, for instance, told us that of the 80
Vocational Rehabilitation (VR) agencies they are responsible for
overseeing, about half of these agencies operate under a special
procedure for prioritizing services[Footnote 12] because the demand for
VR services outweighs the available resources.
Interpreting Complex Eligibility Requirements:
Our past work indicated that SSA and VA's eligibility requirements are
complex and difficult to interpret. For example, we have reported that
the high costs of administering SSA's DI program reflects the complex
and demanding nature of making disability decisions. Our survey
provides further evidence of such challenges for federal disability
programs. For example, 53 percent of programs providing monetary
support to people with disabilities reported that interpreting complex
eligibility requirements was a challenge.[Footnote 13]
Planning for Growth in the Demand for Services and Benefits:
Our past work noted that federal disability programs are facing
challenges in planning for the anticipated increase in demand for their
benefits and services. For example, by the year 2010, SSA expects the
number of Social Security DI beneficiaries to increase by more than one-
third over 2001 levels. However, our past work found that most of the
state Disability Determination Services agencies responsible for
processing DI claims face significant challenges in ensuring there are
enough trained staff to handle DI as well as SSI claims. Similarly, in
our prior work we reported that despite VA's recent progress in
reducing its disability claims workload, it will be difficult for the
agency to cope with future workload increases due to several factors,
including increased demand for services as a result of military
conflicts and legislative mandates. Our survey of federal disability
programs indicates that planning for growth in the demand for benefits
or services is also a challenge for other programs that support people
with disabilities. For example, 54 percent of the programs that provide
medical care and almost half of the programs that provide employment-
related assistance reported that planning for growth in the demand for
assistance was a challenge.[Footnote 14] Our discussions with
responsible agency officials reinforced the challenges posed by
potential growth in demand for program services or benefits. For
example, officials from the Department of Labor's one-stop center
program[Footnote 15] told us they are not sure if the program has
sufficient resources to meet any increased demand for services that
might result from the outreach they are conducting to people with
disabilities.
Making Beneficiaries or Clients Aware of Program Services and Benefits:
Our past work highlighted challenges in making beneficiaries aware of
services offered under federal disability programs. For example, we
reported that SSA's work incentives are ineffective in motivating
people to work, in part, because many beneficiaries are unaware that
the work incentives even exist. Our survey indicated that 69 percent of
programs that disseminate information to people with disabilities
reported that making beneficiaries or clients aware of their programs'
services was a challenge.[Footnote 16] The need to make people more
aware of disability program services has also been noted by other
entities. For example, in 1999, the Presidential Task Force on
Employment of Adults with Disabilities[Footnote 17] suggested that the
White House take more action to make people aware of programs that
support people with disabilities.
Communication and Coordination among Programs Serving Individuals with
Disabilities:
Both our work and the work of others suggests some weaknesses in
communication and coordination among various federal disability
programs. In a 1996 report, we noted that programs helping people with
disabilities do not work together as efficiently as they could to share
information about their programs and to overcome obstacles posed by
differing eligibility criteria and numerous service providers. We said
that the lack of coordination among programs could result in
duplication or gaps in services provided to people with disabilities.
Others have also identified the need for greater coordination among
federal disability programs. For example, in announcing the New Freedom
Initiative--a federal effort to remove barriers and promote community
integration for people with disabilities--the President identified
policy areas, such as the provision of assistive technology, where
better federal coordination was needed. Also, in a review of programs
for low-income adults with disabilities, Urban Institute researchers
described the safety net supporting such individuals as "a tangled web
of conflicting goals and gaps in needed services."[Footnote 18] In
addition, officials at the National Council on Disability told us that
although various interagency commissions exist to address issues faced
by people with disabilities, most of these commissions have weak
authority or have never met as a group. Our survey provides further
evidence of the coordination and communication challenges facing
federal programs serving individuals with disabilities. About one-third
of these programs indicated that, in their efforts to support people
with disabilities, they experienced challenges in obtaining information
from or coordinating with other federal or nonfederal
programs.[Footnote 19]
Key Factors to Consider in Transforming Programs for the 21st Century:
Over the past several years, GAO, in reporting that the largest federal
disability programs were mired in outdated concepts of disability, has
identified the need to reexamine and transform these programs to better
position the government to meet the challenges and expectations of the
21st century. In identifying the wide range of federal programs serving
individuals with disabilities and some of the major challenges these
programs face, this report raises several questions about whether other
federal disability programs may also need to be reoriented and
transformed. In particular, are the nearly two hundred programs that
provide assistance to people with disabilities well-suited to address
these challenges, and are they structured in a manner that collectively
allows them to provide coherent and seamless support to people with
disabilities? Also, in light of the nation's large and growing
structural deficit, do these programs represent the most cost-effective
approaches to serving individuals with disabilities?
On the basis of more than a decade of research focusing on the nation's
largest disability programs and our review of prior GAO reports
examining efforts to reform federal programs and transform agencies, we
have identified several key factors that are important to consider in
assessing the need for, and nature of, program transformations. In
particular, our prior work identifying shortcomings in the work
incentives and supports provided by the largest federal disability
programs indicates that these basic program design issues need to be
addressed. Second, given the tight fiscal constraints facing both
federal and state governments, programs will need to carefully consider
the sustainability of current costs and the potential costs associated
with transformation initiatives. Finally, programs will need to
evaluate the feasibility of any transformation efforts, considering
whether appropriate processes and systems--including those related to
the planning and management of human capital and information
technology--are in place to effectively carry out current operations or
proposed changes. Figure 6 presents a list of questions that may serve
as a guide for addressing these factors.
Figure 6: Key Factors and Questions Concerning Transformation of
Programs Serving Individuals with Disabilities:
Program Design--Individual incentives and supports:
* Are the program's eligibility criteria up to date, taking into
consideration (1) medical and technological advances;
(2) changes in the labor market (e.g., shift toward more service and
knowledge-based work); (3) social changes (e.g., altered expectations
focusing on work and self-sufficiency and legal protections for workers
with disabilities); and (4) changing demographics (i.e., aging of the
Baby Boom generation)?
* Does the program appropriately identify those who can't work and
provide them with financial support?
* Does the program provide effective work supports to individuals to
enhance their chances of entering, returning to, or staying in the
workforce?
* Does the program provide return to work assistance at the optimal
time (i.e., soon after a person incurs a disability, when they may be
more motivated to return to work)?
* Should some beneficiaries be required to accept assistance to enhance
work capacities as a precondition for benefits?
* Is the program sufficiently coordinated with related programs to
provide coherent and integrated assistance to individuals with
disabilities as well as incentives promoting work?
* Is the program flexible enough to support the changing needs of
people with disabilities?
Fiscal implications:
* What would be the program costs (both short and long term) of
specific efforts to streamline and modernize disability programs and
what are the implications of these costs for the nation's fiscal
outlook?
* What would be the financial benefits (e.g., increased tax revenues
from individuals who return to work) of such efforts?
* Who will pay for program benefits and services (e.g., medical and
assistive technologies) and will beneficiaries be required to defray
some portion of the costs?
* What are the fiscal implications for states and localities and for
nongovernmental organizations?
Feasibility of Implementation and Transformation:
* Has the program established clear standards, and are these standards
applied accurately and consistently?
* Does the program have personnel who are capable of carrying out
eligibility determinations and assessments?
* Are eligibility determinations and assessments completed in a timely
manner?
* Does the program have appropriate controls in place to ensure program
integrity?
* Does the program make use of information systems which not only
facilitate day-to-day processing needs but also provide sufficient
information for longer term performance evaluation and policy
assessment?
Source: GAO.
[End of figure]
In addition to addressing these questions, which will provide a basic
framework for individually assessing existing programs and proposals
for transforming them, it is also important that some mechanism be
established for looking across programs to assess their overall
effectiveness and integration and whether they are designed to achieve
similar or complimentary goals. The diffusion of responsibility for
federal programs serving people with disabilities across multiple
agencies and the absence of any clear central authority for guiding a
fundamental reassessment of federal disability policy will likely pose
significant impediments to such action. However, a reexamination could
serve to identify programs and policies that are outdated or
ineffective while improving the targeting and efficiency of remaining
programs through such actions as redesigning allocation and cost-
sharing provisions and consolidating facilities and programs. Our
recently issued report concerning "21st Century Challenges" identifies
approaches--such as the use of special temporary commissions to develop
policy proposals and the exercise of congressional oversight through
hearings on the activities of federal agencies--that may be used for
such a reexamination should the Congress choose to pursue this course
of action.[Footnote 20] Addressing the individual program
transformation questions we identify above in conjunction with a
reexamination of how these programs work collectively represent key
steps in efforts to meet 21st century social and economic expectations
of individuals with disabilities and the general public.
Copies of this report are being sent to: the Secretaries of
Agriculture, Commerce, Defense, Education, Energy, Health and Human
Services, Housing and Urban Development, Interior, Justice, Labor,
Transportation, Treasury, and Veterans Affairs; the Commissioner of
SSA; the Director of the Office of Personnel Management; the
Administrator of the Small Business Administration; the Chairman of the
Railroad Retirement Board; the Chairperson of the Committee for
Purchase from People who are Blind or Severely Disabled; the Chair of
the Access Board; the Chair of the Equal Employment Opportunity
Commission; the Librarian of Congress; appropriate congressional
committees; and other interested parties. The report is also available
at no charge on GAO's Web site at http://www.gao.gov.
If you or your staff have any questions about this report, please
contact me at (202) 512-7215 or RobertsonR@gao.gov. Contact points for
our Offices of Congressional Relations and Public Affairs may be found
on the last page of this report. GAO staff who made major contributions
to this report are listed in appendix III.
Signed by:
Robert E. Robertson:
Director, Education, Workforce, and Income Security Issues:
List of Committees:
The Honorable Thad Cochran:
Chairman:
The Honorable Robert C. Byrd:
Ranking Minority Member:
Committee on Appropriations:
United States Senate:
The Honorable Charles E. Grassley:
Chairman:
The Honorable Max Baucus:
Ranking Minority Member:
Committee on Finance:
United States Senate:
The Honorable Michael B. Enzi:
Chairman:
The Honorable Edward M. Kennedy:
Ranking Minority Member:
Committee on Health, Education, Labor, and Pensions:
United States Senate:
The Honorable Susan Collins:
Chairman:
The Honorable Joseph Lieberman:
Ranking Minority Member:
Committee on Homeland Security and Governmental Affairs:
United States Senate:
The Honorable Larry Craig:
Chairman:
The Honorable Daniel Akaka:
Ranking Minority Member:
Committee on Veterans' Affairs:
United States Senate:
The Honorable Jerry Lewis:
Chairman:
The Honorable David R. Obey:
Ranking Minority Member:
Committee on Appropriations:
House of Representatives:
The Honorable John A. Boehner:
Chairman:
The Honorable George Miller:
Ranking Minority Member:
Committee on Education and the Workforce:
House of Representatives:
The Honorable Joe Barton:
Chairman:
The Honorable John D. Dingell:
Ranking Minority Member:
Committee on Energy and Commerce:
House of Representatives:
The Honorable Tom Davis:
Chairman:
The Honorable Henry A. Waxman:
Ranking Minority Member:
Committee on Government Reform:
House of Representatives:
The Honorable Steve Buyer:
Chairman:
The Honorable Lane Evans:
Ranking Minority Member:
Committee on Veterans' Affairs:
House of Representatives:
The Honorable William M. Thomas:
Chairman:
The Honorable Charles B. Rangel:
Ranking Minority Member:
Committee on Ways and Means:
House of Representatives:
[End of section]
Appendix I: Scope and Methodology:
For our review, we defined a federal program as a function of a federal
agency that provides assistance or benefits to a state or states,
territorial possession, county, city, other political subdivision, or
grouping or instrumentality thereof; or to any domestic profit or
nonprofit corporation, institution, or individual, other than an agency
of the federal government.[Footnote 21] We defined the scope of our
review to include those federal programs meeting one of more of the
following criteria: (1) people with disabilities are specifically
mentioned in a program's authorizing legislation as a targeted group,
(2) people are eligible for the program wholly because of a disability,
(3) people are eligible for the program partially because of a
disability, (4) people with disabilities are given special
consideration in eligibility determinations, or (5) people with
disabilities are given priority in being served. Programs that serve
individuals without respect to disability (i.e., disability is not an
explicit criteria for program eligibility) but that serve some
individuals with disabilities (such as Temporary Assistance for Needy
Families) are beyond the scope of our review. In addition, we excluded
programs whose principal focus is research, demonstrations, training
for professionals who work with people with disabilities, technical
assistance, or special transportation, as well as disability retirement
programs for federal workers.
To develop a list of programs that met these criteria, we first
conducted a systematic search in the Catalog of Federal Domestic
Assistance (CFDA) to identify programs that have some role in serving
people with disabilities and the respective agencies responsible for
administering each of these programs. In addition, we reviewed federal
agency Web sites to identify additional programs that were not included
in the CFDA. We then submitted the list of programs administered by
each agency to that agency for verification. (The final list of
programs along with some descriptive information on each program can be
found in app. II.) In developing our list, we included federal programs
regardless of how the benefit, service, or assistance is ultimately
delivered to the individual (e.g., directly by the federal agency or
indirectly by another entity, such as a state agency).
To obtain information on federal programs supporting people with
disabilities and the challenges they face, we conducted a Web-based
survey, which collected basic information on each program, including
the types of assistance provided, whether the assistance is provided
directly to beneficiaries or indirectly through other entities, whether
the program is partially or wholly targeted to people with
disabilities, the number of beneficiaries served, program spending, and
the challenges faced by these programs (i.e., obstacles that hindered a
program's ability to effectively and efficiently support people with
disabilities). (A more complete tabulation of the survey results
related to program challenges is available on the GAO Web site at
www.gao.gov/cgi-bin/getrpt?GAO-05-695SP.) To identify the appropriate
program officials to respond to the survey, we submitted the list of
programs that we compiled to liaisons at each agency. These liaisons
then identified the appropriate respondents at their respective
agencies. We pretested the content and format of our survey with
officials from eight programs to determine if it was understandable and
if the information was feasible to collect, and we refined the survey
as appropriate. We then sent e-mail notifications to the identified
officials of 299 programs beginning on June 15, 2004, asking them to
complete the survey by June 28, 2004. To encourage respondents to
complete the survey, we sent e-mail messages to prompt each
nonrespondent 1 and 2 weeks after the initial e-mail message. We closed
the survey on August 16, 2004. We obtained survey responses from 258
programs, for an overall response rate of 86 percent. In addition, for
11 of the 41 programs that did not submit survey responses, we obtained
descriptive information from the CFDA to answer a limited number of
survey questions to the extent that such information was available.
Based on responses to survey questions asking programs to identify the
criteria they apply in serving people with disabilities and the primary
type of assistance they provide, we identified 192 programs (comprising
64 percent of all programs surveyed) that met our criteria for defining
programs as either wholly or partially targeted towards serving
individuals with disabilities.
Although our survey asked programs to provide spending data, because of
limitations or inconsistencies in the spending information reported by
survey respondents, we obtained spending data from the Consolidated
Federal Funds Report (CFFR)--a database compiled by the Bureau of the
Census--for all of the relevant programs listed in this
database.[Footnote 22] For programs that did not have data reported in
the CFFR, we used spending information from the survey data. In a few
cases where spending data was not available from either the CFFR or
survey data, we obtained this information from the CFDA. To verify the
spending data that we present in this report, we sent each program an e-
mail message asking them to confirm the amounts we had identified.
While many programs confirmed the spending amounts that we listed in
our message, others identified different amounts. The spending data we
present in this report are based on the final verified spending amounts
identified by programs in their response to our e-mail. These data are
not entirely consistent across programs. For example, while most of
these data represent spending for fiscal year 2003, some programs
instead provided data for other fiscal years. Also, some programs
included administrative costs in their spending figures while others
did not include such costs. In addition, while the majority of the
spending data we report represent program obligations, some of the data
instead represent outlays.[Footnote 23] Of the 95 wholly targeted
programs in our analysis, we were able to obtain some type of spending
data for 85 programs. However, many partially targeted programs were
unable to provide us with data pertaining to their programs' spending
on people with disabilities because they do not separately track or
collect such data for these individuals. As a result, we do not present
spending data in this report for partially targeted programs except for
three programs (Supplemental Security Income, Medicare, and Medicaid)
for which we were able to obtain a breakdown of spending on people with
disabilities from agency documents.
Because we relied extensively on program spending data derived from the
2003 CFFR data that are available on-line from the CFFR Web site
(http://www.census.gov/govs/www/cffr.html), we conducted limited tests
of the reliability of these data, including frequency analyses of
critical data fields. We restricted our reliability assessment to the
specific variables that were pertinent to our analysis. These tests
indicated that the critical data fields were sufficiently complete and
accurate for the purposes of our analysis.
To obtain additional information on the challenges faced by programs,
we conducted interviews with federal agency officials and officials
from disability advocacy organizations, and reviewed pertinent agency
documents, GAO reports, and academic research on disability issues.
To identify questions that should be addressed in transforming federal
disability programs, we reviewed the major findings and recommendations
that have resulted from the substantial body of GAO research on federal
disability programs over the past decade. We also examined past GAO
reports on program reform and organizational transformation throughout
the federal government.
Because our questionnaire was not a sample survey, there are no
sampling errors. However, the practical difficulties of conducting any
survey may introduce errors, commonly referred to as nonsampling
errors. For example, difficulties in how a particular question is
interpreted, in the sources of information that are available to
respondents, or in how the data are entered into a database or were
analyzed, can introduce unwanted variability into the survey results.
We took steps in the development of the questionnaire, the data
collection, and the data analysis to minimize these nonsampling errors.
For example, social science survey specialists designed the
questionnaire in collaboration with GAO staff with subject matter
expertise. Then, as mentioned earlier, the draft questionnaire was
pretested with program officials to ensure that the questions were
relevant, clearly stated, and easy to comprehend. When the data were
analyzed, a second, independent analyst checked all computer programs.
Since this was a Web-based survey, respondents entered their answers
directly into the electronic questionnaire. This eliminated the need to
have the data keyed into a database, thus removing an additional source
of error.
We performed our work at various locations in Washington, D.C. We
conducted our work between March 2004 and March 2005 in accordance with
generally accepted government auditing standards.
[End of section]
Appendix II: Federal Programs Serving People with Disabilities:
The following table presents an overview of the 192 federal programs
that we identified as targeted to people with disabilities. The
information presented in this table is based mostly on the programs'
survey responses, although it also presents data obtained from other
sources. In particular, the spending information is derived from
multiple sources, including programs' survey responses and federal
government reports on program spending. The spending data we present
below represent either obligations, expenditures, or appropriations, as
indicated by the table notes accompanying each reported amount. Due to
the various sources that we used to identify program spending and
possible inconsistencies in these data (e.g., differences in the fiscal
years for which spending was reported by programs), we advise caution
in efforts to compare or sum spending figures across programs. Also,
given the significant limitations in the spending data available for
partially targeted programs, we do not present such data in this table.
(See app. 1 for a more detailed discussion of our methodology for
collecting spending data and other information on these programs.)
Table 3: Federal Programs Serving People with Disabilities:
Program: Access Board;
Primary area of assistance: Other: Guidelines on accessibility;
Spending (for fiscal year 2003 unless otherwise indicated):
$4,000,000[A,B,C];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Committee for Purchase From People Who Are Blind or Severely
Disabled: Javits-Wagner-O Day Program (Committee for Purchase From
People Who Are Blind or Severely Disabled);
Primary area of assistance: Employment-related;
Spending (for fiscal year 2003 unless otherwise indicated):
$4,629,000[A,B,C];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Agriculture: Assistive & Ergonomic Technology
(Target Center, USDA, Washington, D.C.);
Primary area of assistance: Assistive technology;
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Agriculture: Assistive and Ergonomic Technology
(Midwest Target Center, St. Louis, Missouri);
Primary area of assistance: Assistive technology;
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Agriculture: Assistive Technology Program for
Farmers with Disabilities: AgrAbility Project;
Primary area of assistance: Employment-related;
Spending (for fiscal year 2003 unless otherwise indicated):
$4,002,000[A,C];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Agriculture: Child and Adult Care Food Program;
Primary area of assistance: Food;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Agriculture: Food Stamps;
Primary area of assistance: Food;
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Agriculture: Rural Rental Assistance Payments;
Primary area of assistance: Housing;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Agriculture: Rural Rental Housing Loans;
Primary area of assistance: Housing;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Agriculture: Section 538 Rural Rental Housing
Guaranteed Loans;
Primary area of assistance: Housing;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Agriculture: Summer Food Service Program for
Children;
Primary area of assistance: Food;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Commerce: Public Telecommunications Facilities
Program;
Primary area of assistance: Other: Telecommunication and information
technology;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Commerce: Technology Opportunities Program;
Primary area of assistance: Other: Telecommunication and information
technology;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Defense: Computer/Electronic Accommodations
Program;
Primary area of assistance: Assistive technology;
Spending (for fiscal year 2003 unless otherwise indicated):
$4,662,000[A,B,C];
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Education: Access to Telework;
Primary area of assistance: Loans;
Spending (for fiscal year 2003 unless otherwise indicated):
$20,000,000[A,C];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Education: Adult Education and Family Literacy
Act State Grants;
Primary area of assistance: Education;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Education: American Indian Vocational
Rehabilitation Services;
Primary area of assistance: Employment-related;
Spending (for fiscal year 2003 unless otherwise indicated):
$28,399,000[D,E];
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Education: American Printing House for the
Blind;
Primary area of assistance: Other: Educational materials;
Spending (for fiscal year 2003 unless otherwise indicated):
$15,399,000[D,E];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Education: Assistive Technology Act;
Primary area of assistance: Information dissemination;
Spending (for fiscal year 2003 unless otherwise indicated):
$22,289,000[A,C];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Education: Assistive Technology Alternative
Financing Program;
Primary area of assistance: Loans;
Spending (for fiscal year 2003 unless otherwise indicated):
$13,001,000[A,F,C];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Education: Assistive Technology State Grants for
Protection and Advocacy;
Primary area of assistance: Civil protections or legal services;
Spending (for fiscal year 2003 unless otherwise indicated):
$4,573,000[D,E];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Education: Carl D. Perkins Vocational and
Technical Education State Grants;
Primary area of assistance: Education;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Education: Client Assistance Program;
Primary area of assistance: Civil protections or legal services;
Spending (for fiscal year 2003 unless otherwise indicated):
$12,068,000[A,G];
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Education: Congressionally-Directed Projects;
Primary area of assistance: Other: Disability-related earmarks;
Spending (for fiscal year 2003 unless otherwise indicated):
$3,517,000[A,C];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Education: Gallaudet University;
Primary area of assistance: Education;
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Education: Helen Keller National Center;
Primary area of assistance: Employment-related;
Spending (for fiscal year 2003 unless otherwise indicated):
$8,660,000[A,C];
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Education: Independent Living Services;
Primary area of assistance: Personal assistant services;
Spending (for fiscal year 2003 unless otherwise indicated):
$68,820,000[A,G];
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Education: Independent Living Services for Older
Individuals Who are Blind;
Primary area of assistance: Personal assistant services;
Spending (for fiscal year 2003 unless otherwise indicated):
$27,538,000[A,G];
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Education: Independent Living State Grants;
Primary area of assistance: Personal assistant services;
Spending (for fiscal year 2003 unless otherwise indicated):
$21,930,000[A,G];
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Education: Migrants and Seasonal Farmworkers;
Primary area of assistance: Employment-related;
Spending (for fiscal year 2003 unless otherwise indicated):
$2,306,000[A,C];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Education: National Technical Institute for the
Deaf;
Primary area of assistance: Education;
Spending (for fiscal year 2003 unless otherwise indicated):
$53,699,000[A,G];
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Education: Native Hawaiian Special Education;
Primary area of assistance: Education;
Spending (for fiscal year 2003 unless otherwise indicated):
$3,100,000[D,E];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Education: Payments for Children with
Disabilities;
Primary area of assistance: Education;
Spending (for fiscal year 2003 unless otherwise indicated):
$50,669,000[A,G];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Education: Program of Protection and Advocacy of
Individual Rights;
Primary area of assistance: Civil protections or legal services;
Spending (for fiscal year 2003 unless otherwise indicated):
$16,585,000[A,G];
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Education: Projects with Industry;
Primary area of assistance: Employment-related;
Spending (for fiscal year 2003 unless otherwise indicated):
$21,708,000[A,G];
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Education: Randolph-Sheppard Vending Facilities
Program;
Primary area of assistance: Employment-related;
Spending (for fiscal year 2003 unless otherwise indicated):
$31,400,000[A,F,C];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Education: Recreational Programs;
Primary area of assistance: Other: Recreational programs;
Spending (for fiscal year 2003 unless otherwise indicated):
$2,354,000[A,G];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Education: Rehabilitation Services Vocational
Rehabilitation Grants to States;
Primary area of assistance: Employment-related;
Spending (for fiscal year 2003 unless otherwise indicated):
$2,480,000,000[A,G];
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Education: Special Education--Pre-School Grant
Program;
Primary area of assistance: Education;
Spending (for fiscal year 2003 unless otherwise indicated):
$384,223,000[A,G];
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Education: Special Education--Grants for Infants
and Families with Disabilities;
Primary area of assistance: Other: Early intervention services;
Spending (for fiscal year 2003 unless otherwise indicated):
$429,307,000[A,G];
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Education: Special Education--Grants to States;
Primary area of assistance: Education;
Spending (for fiscal year 2003 unless otherwise indicated):
$8,858,398,000[A,G];
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Education: Special Education--Parent Information
Centers;
Primary area of assistance: Information dissemination;
Spending (for fiscal year 2003 unless otherwise indicated):
$26,327,000[A,G];
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Education: Special Education--Technology and
Media Services for Individuals with Disabilities;
Primary area of assistance: Education;
Spending (for fiscal year 2003 unless otherwise indicated):
$37,962,000[A,G];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Education: Star Schools;
Primary area of assistance: Education;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Education: Supported Employment Services for
Individuals with Severe Disabilities;
Primary area of assistance: Employment-related;
Spending (for fiscal year 2003 unless otherwise indicated):
$37,525,000[A,G];
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Education: Tech Prep Education State Grants;
Primary area of assistance: Education;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Education: TRIO Student Support Services;
Primary area of assistance: Education;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Energy: Weatherization Assistance for Low-Income
Persons;
Primary area of assistance: Other: Energy efficiency;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Health and Human Services: Adoption Assistance;
Primary area of assistance: Monetary support;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Health and Human Services: Aging and Disability
Resource Center;
Primary area of assistance: Information dissemination;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Health and Human Services: Alzheimer's Disease
Demonstration Grants to States;
Primary area of assistance: Other: Respite;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Health and Human Services: Attention Deficit
Hyperactivity Disorder;
Primary area of assistance: Information dissemination;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Health and Human Services: Black Lung Clinics
Program;
Primary area of assistance: Medical care;
Spending (for fiscal year 2003 unless otherwise indicated):
$5,563,000[D,E];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Health and Human Services: Block Grants for
Community Mental Health Services;
Primary area of assistance: Other: Development of comprehensive systems
of care;
Spending (for fiscal year 2003 unless otherwise indicated):
$437,140,000[A,B,C];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Health and Human Services: Child Care Mandatory
and Matching Funds of the Child Care and Development Fund;
Primary area of assistance: Other: Child care subsidies;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Health and Human Services: Civil Rights and
Privacy Rule Compliance Activities;
Primary area of assistance: Civil protections or legal services;
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Health and Human Services: Comprehensive
Community Mental Health Services for Children with Serious Emotional
Disturbances;
Primary area of assistance: Medical care;
Spending (for fiscal year 2003 unless otherwise indicated):
$80,078,000[D,E];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Health and Human Services: Developmental
Disabilities Basic Support and Advocacy Grants;
Primary area of assistance: Other: Systems change and capacity
building;
Spending (for fiscal year 2003 unless otherwise indicated):
$133,236,000[D,E];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Health and Human Services: Developmental
Disabilities Projects of National Significance;
Primary area of assistance: Other: Independent living support;
Spending (for fiscal year 2003 unless otherwise indicated):
$12,403,000[H,G];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Health and Human Services: Disabilities
Prevention (Disability and Health);
Primary area of assistance: Other: Capacity building and information
dissemination;
Spending (for fiscal year 2003 unless otherwise indicated):
$25,551,000[D,E];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Health and Human Services: Early Hearing
Detection & Identification;
Primary area of assistance: Other: Early hearing detection;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Health and Human Services: Family Support
Payments to States Assistance Payments (Adult Programs in the
Territories);
Primary area of assistance: Monetary support;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Health and Human Services: Grants to Provide
Outpatient Early Intervention Services with Respect to HIV Disease;
Primary area of assistance: Medical care;
Spending (for fiscal year 2003 unless otherwise indicated):
$19,000[D,E];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Health and Human Services: Hansen's Disease
National Ambulatory Care Program;
Primary area of assistance: Medical care;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Health and Human Services: Head Start;
Primary area of assistance: Education;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Health and Human Services: HIV Care Formula
Grants;
Primary area of assistance: Medical care;
Spending (for fiscal year 2003 unless otherwise indicated):
$1,022,337,000[D,E];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Health and Human Services: HIV Emergency Relief
Project Grants;
Primary area of assistance: Medical care;
Spending (for fiscal year 2003 unless otherwise indicated):
$600,673,000[D,E];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Health and Human Services: Maternal and Child
Health Federal Consolidated Programs-- Special Projects of Regional and
National Significance/Awareness and Access to Care for Children and
Youth with Epilepsy;
Primary area of assistance: Medical care;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Health and Human Services: Maternal and Child
Health Federal Consolidated Programs-- Special Projects of Regional and
National Significance/CISS/Community Systems for CSHCN;
Primary area of assistance: Other: Systems building;
Spending (for fiscal year 2003 unless otherwise indicated):
$1,873,000[A,B,C];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Health and Human Services: Maternal and Child
Health Federal Consolidated Programs-- Special Projects of Regional and
National Significance/Early Detection and Intervention for Children
with Autism;
Primary area of assistance: Other: Infrastructure and support systems;
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Health and Human Services: Maternal and Child
Health Services Block Grant to the States (Title V);
Primary area of assistance: Other: Systems of care;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Health and Human Services: Medicaid
Infrastructure Grants To Support the Competitive Employment of People
with Disabilities;
Primary area of assistance: Other: Infrastructure and coordination;
Spending (for fiscal year 2003 unless otherwise indicated):
$35,000,000[A,I];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Health and Human Services: Medical Assistance
Program--Medicaid;
Primary area of assistance: Medical care;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Health and Human Services: Medicare Hospital
Insurance;
Primary area of assistance: Medical care;
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Health and Human Services: Medicare
Supplementary Medical Insurance;
Primary area of assistance: Medical care;
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Health and Human Services: National Family
Caregiver Support;
Primary area of assistance: Other: Multifaceted support systems;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Health and Human Services: Nutrition Services
Incentive Program;
Primary area of assistance: Food;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Health and Human Services: PATH Formula Grant--
Homeless;
Primary area of assistance: Other: Outreach and case management;
Spending (for fiscal year 2003 unless otherwise indicated):
$41,306,000[D,E];
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Health and Human Services: Protection and
Advocacy for Individuals with Mental Illness;
Primary area of assistance: Civil protections or legal services;
Spending (for fiscal year 2003 unless otherwise indicated):
$34,620,000[A,B,J,I];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Health and Human Services: Real Choice Systems
Grants for Community Living;
Primary area of assistance: Other: Infrastructure and support services;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Health and Human Services: Ryan White CARE Act -
Title IV: Grants for Coordinated HIV Services and Access to Research
for Women;
Primary area of assistance: Medical care;
Spending (for fiscal year 2003 unless otherwise indicated):
$69,936,000[D,E];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Health and Human Services: Ryan White HIV/AIDS
Dental Reimbursements;
Primary area of assistance: Medical care;
Spending (for fiscal year 2003 unless otherwise indicated):
$9,843,000[A,C];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Health and Human Services: Special Programs for
the Aging Title III, Part B, Grants for Supportive Services & Senior
Centers;
Primary area of assistance: Other: Multifaceted support systems;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Health and Human Services: Special Programs for
the Aging Title III, Part C Nutrition Services;
Primary area of assistance: Food;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Health and Human Services: Special Projects of
National Significance (Ryan White CARE Act);
Primary area of assistance: Medical care;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Health and Human Services: Traumatic Brain
Injury;
Primary area of assistance: Information dissemination;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Health and Human Services: Voting Access for
Individuals with Disabilities--Grants for Protection and Advocacy
Systems;
Primary area of assistance: Civil protections or legal services;
Spending (for fiscal year 2003 unless otherwise indicated):
$2,000,000[D,E];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Health and Human Services: Voting Access for
Individuals with Disabilities--Grants to States and Local Governments;
Primary area of assistance: Civil protections or legal services;
Spending (for fiscal year 2003 unless otherwise indicated):
$12,849,000[D,E];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Housing and Urban Development: Architectural
Barriers Act Enforcement;
Primary area of assistance: Civil protections or legal services;
Spending (for fiscal year 2003 unless otherwise indicated): NA;
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Housing and Urban Development: Assisted Living
Conversion for Eligible Multifamily Housing Projects;
Primary area of assistance: Housing;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Housing and Urban Development: Elderly/Disabled
Service Coordinator Program;
Primary area of assistance: Other: Service coordination;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Housing and Urban Development: Fair Housing
Initiatives Program;
Primary area of assistance: Other: Fair housing assistance;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Housing and Urban Development: Housing
Opportunities for Persons with AIDS;
Primary area of assistance: Housing;
Spending (for fiscal year 2003 unless otherwise indicated):
$252,200,000[A,G];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Housing and Urban Development: Lower Income
Housing Assistance Program Section 8 Moderate Rehabilitation;
Primary area of assistance: Housing;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Housing and Urban Development: Mortgage
Insurance Rental Housing for the Elderly;
Primary area of assistance: Loans;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Housing and Urban Development: Multifamily
Housing Service Coordinators;
Primary area of assistance: Information dissemination;
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Housing and Urban Development: Non-
Discrimination in Federally Assisted and Conducted Programs (on the
Basis of Disability);
Primary area of assistance: Civil protections or legal services;
Spending (for fiscal year 2003 unless otherwise indicated): NA;
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Housing and Urban Development: Non-
Discrimination on the Basis of Disability by Public Entities;
Primary area of assistance: Civil protections or legal services;
Spending (for fiscal year 2003 unless otherwise indicated): NA;
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Housing and Urban Development: Public and Indian
Housing;
Primary area of assistance: Housing;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Housing and Urban Development: Resident
Opportunity and Self-Sufficiency;
Primary area of assistance: Information dissemination;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Housing and Urban Development: Section 202
Housing;
Primary area of assistance: Housing;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Housing and Urban Development: Shelter Plus
Care;
Primary area of assistance: Housing;
Spending (for fiscal year 2003 unless otherwise indicated):
$76,822,000[D,E];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Housing and Urban Development: Supportive
Housing for Persons with Disabilities;
Primary area of assistance: Housing;
Spending (for fiscal year 2003 unless otherwise indicated):
$286,652,000[A,G];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Housing and Urban Development: Supportive
Housing Program;
Primary area of assistance: Housing;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Justice: Civil Rights of Institutionalized
Persons;
Primary area of assistance: Civil protections or legal services;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Justice: Equal Employment Opportunity;
Primary area of assistance: Civil protections or legal services;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Justice: Protection of Voting Rights;
Primary area of assistance: Civil protections or legal services;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Justice: Public Safety Officers' Benefits
Program;
Primary area of assistance: Monetary support;
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Justice: Public Safety Officers' Educational
Assistance;
Primary area of assistance: Education;
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Labor: Coal Mine Workers' Compensation;
Primary area of assistance: Monetary support;
Spending (for fiscal year 2003 unless otherwise indicated):
$370,389,000[A,C];
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Labor: Disability Info.gov;
Primary area of assistance: Information dissemination;
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Labor: Disability Navigator;
Primary area of assistance: Employment- related;
Spending (for fiscal year 2003 unless otherwise indicated):
$3,000,000[A,B,C];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Labor: Disabled Veterans' Outreach Program;
Primary area of assistance: Employment-related;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Labor: Employer Assistance Referral Network;
Primary area of assistance: Employment-related;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Labor: Employment Service;
Primary area of assistance: Information dissemination;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Labor: Energy Employees' Occupational Illness
Compensation Program;
Primary area of assistance: Monetary support;
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Labor: Federal Employees' Compensation Program;
Primary area of assistance: Monetary support;
Spending (for fiscal year 2003 unless otherwise indicated):
$2,345,471,000[A,C];
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Labor: Job Accommodation Network;
Primary area of assistance: Information dissemination;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Labor: Job Corps;
Primary area of assistance: Employment-related;
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Labor: Longshore and Harbor Workers'
Compensation;
Primary area of assistance: Monetary support;
Spending (for fiscal year 2003 unless otherwise indicated):
$2,817,000[A,C];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Labor: O*Net;
Primary area of assistance: Information dissemination;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Labor: Office of Federal Contract Compliance
Programs;
Primary area of assistance: Civil protections or legal services;
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Labor: One-Stop Career Center System;
Primary area of assistance: Employment-related;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Labor: Small Business and Self-Employment for
People with Disabilities;
Primary area of assistance: Information dissemination;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Labor: United We Ride;
Primary area of assistance: Transportation;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Labor: Veteran's Preference in Federal
Employment;
Primary area of assistance: Employment-related;
Spending (for fiscal year 2003 unless otherwise indicated): NA;
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Labor: Veterans Workforce Investment Programs;
Primary area of assistance: Employment-related;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Labor: Wage and Hour Division;
Primary area of assistance: Civil protections or legal services;
Spending (for fiscal year 2003 unless otherwise indicated): NA;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Labor: WIA Youth Program (formula grants);
Primary area of assistance: Employment-related;
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Labor: Work Incentives Grant;
Primary area of assistance: Employment- related;
Spending (for fiscal year 2003 unless otherwise indicated):
$20,000,000[A,I];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Labor: Workforce Recruitment Program;
Primary area of assistance: Employment-related;
Spending (for fiscal year 2003 unless otherwise indicated):
$500,000[A,B,C];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of the Interior: Assistance for Indian Children
with Severe Disabilities;
Primary area of assistance: Education;
Spending (for fiscal year 2003 unless otherwise indicated):
$60,000[D,K];
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Transportation: Capital and Training Assistance
Program for Over-the-Road Bus Accessibility;
Primary area of assistance: Transportation;
Spending (for fiscal year 2003 unless otherwise indicated):
$6,905,000[A,I];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Transportation: Capital Assistance Program for
Elderly Persons and Persons with Disabilities;
Primary area of assistance: Transportation;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Transportation: Capital Investment Grants;
Primary area of assistance: Transportation;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Transportation: FTA general activities and
technical assistance related to disability issues;
Primary area of assistance: Information dissemination;
Spending (for fiscal year 2003 unless otherwise indicated):
$3,000,000[A,C];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Transportation: Nonurbanized Area Formula
Program;
Primary area of assistance: Transportation;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Transportation: Urbanized Area Formula Program;
Primary area of assistance: Transportation;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Treasury: Tax Deduction to remove barriers for
the Elderly and Disabled;
Primary area of assistance: Other: Tax deduction;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Treasury: Work Opportunity Tax Credit;
Primary area of assistance: Other: Tax credit;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Veterans Affairs: Automobiles and Adaptive
Equipment for Certain Disabled Veterans and Members of the Armed
Forces;
Primary area of assistance: Transportation;
Spending (for fiscal year 2003 unless otherwise indicated):
$30,013,000[D,K];
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Veterans Affairs: Blind Rehabilitation Centers;
Primary area of assistance: Medical care;
Spending (for fiscal year 2003 unless otherwise indicated):
$59,569,000[A,B,C];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Veterans Affairs: Compensation for Service-
Connected Deaths for Veterans' Dependents;
Primary area of assistance: Monetary support;
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Veterans Affairs: Life Insurance for Veterans;
Primary area of assistance: Monetary support;
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Veterans Affairs: Montgomery GI Bill Educational
Assistance (Chapter 30);
Primary area of assistance: Education;
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Veterans Affairs: Monthly Allowance for Children
of Vietnam Veterans Born with Spina Bifida;
Primary area of assistance: Monetary support;
Spending (for fiscal year 2003 unless otherwise indicated):
$13,900,000[D,L];
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Veterans Affairs: Native American Veteran Direct
Loan Program;
Primary area of assistance: Loans;
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Veterans Affairs: Pension for Non-Service-
Connected Disability for Veterans;
Primary area of assistance: Monetary support;
Spending (for fiscal year 2003 unless otherwise indicated):
$2,489,932,000[D,L];
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Veterans Affairs: Pension to Veterans Surviving
Spouses, and Children;
Primary area of assistance: Monetary support;
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Veterans Affairs: Post-Vietnam Era Veterans'
Educational Assistance;
Primary area of assistance: Education;
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Veterans Affairs: SMI: Psychotic Disorders;
Primary area of assistance: Medical care;
Spending (for fiscal year 2003 unless otherwise indicated):
$1,655,076,000[A,B,C];
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Veterans Affairs: SMI: PTSD;
Primary area of assistance: Medical care;
Spending (for fiscal year 2003 unless otherwise indicated):
$139,873,000[A,B,M,C];
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Veterans Affairs: SMI: Substance Abuse;
Primary area of assistance: Medical care;
Spending (for fiscal year 2003 unless otherwise indicated):
$44,083,000[A,B,C];
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Veterans Affairs: Specially Adapted Housing for
Disabled Veterans;
Primary area of assistance: Housing;
Spending (for fiscal year 2003 unless otherwise indicated):
$17,324,000[D,K];
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Veterans Affairs: Spinal Cord Injury;
Primary area of assistance: Medical care;
Spending (for fiscal year 2003 unless otherwise indicated):
$301,666,000[A,B,C];
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Veterans Affairs: Survivors and Dependents
Educational Assistance;
Primary area of assistance: Education;
Spending (for fiscal year 2003 unless otherwise indicated):
$275,123,000[D,K];
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Veterans Affairs: Traumatic Brain Injury;
Primary area of assistance: Medical care;
Spending (for fiscal year 2003 unless otherwise indicated):
$12,668,000[A,C];
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Veterans Affairs: Veterans Compensation for
Service-Connected Disability;
Primary area of assistance: Monetary support;
Spending (for fiscal year 2003 unless otherwise indicated):
$20,622,189,000[D,L];
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Veterans Affairs: Veterans Dental Care;
Primary area of assistance: Medical care;
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Veterans Affairs: Veterans Dependency and
Indemnity Compensation for Service- Connected Death;
Compensation for Service;
Primary area of assistance: Monetary support;
Spending (for fiscal year 2003 unless otherwise indicated):
$3,773,937,000[D,L];
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Veterans Affairs: Veterans Domiciliary Care;
Primary area of assistance: Medical care;
Spending (for fiscal year 2003 unless otherwise indicated):
$295,505,000[A,B,C];
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Veterans Affairs: Veterans Home-Based Primary
Care;
Primary area of assistance: Medical care;
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Veterans Affairs: Veterans Housing--Guaranteed
and Insured Loans;
Primary area of assistance: Loans;
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Veterans Affairs: Veterans Medical Care
Benefits;
Primary area of assistance: Medical care;
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Veterans Affairs: Veterans Nursing Home Care;
Primary area of assistance: Medical care;
Spending (for fiscal year 2003 unless otherwise indicated):
$1,684,725,000[A,B,C];
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Veterans Affairs: Veterans Prosthetic
Appliances;
Primary area of assistance: Medical care;
Spending (for fiscal year 2003 unless otherwise indicated):
$523,366,000[H,G];
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Veterans Affairs: Veterans State Domiciliary
Care;
Primary area of assistance: Medical care;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Veterans Affairs: Veterans State Hospital Care;
Primary area of assistance: Medical care;
Spending (for fiscal year 2003 unless otherwise indicated):
$41,937,000[D,E];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Veterans Affairs: Veterans State Nursing Home
Care;
Primary area of assistance: Medical care;
Spending (for fiscal year 2003 unless otherwise indicated):
$327,524,000[D,E];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Veterans Affairs: Vocational and Educational
Counseling for Separating Service Members (Chapter 36);
Primary area of assistance: Employment-related;
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Department of Veterans Affairs: Vocational Rehabilitation for
Disabled Veterans;
Primary area of assistance: Employment-related;
Spending (for fiscal year 2003 unless otherwise indicated):
$376,622,000[D,K];
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Department of Veterans Affairs: Vocational Training and
Rehabilitation for Vietnam Veterans' Children with Spina Bifida or
Other Covered Birth Defects;
Primary area of assistance: Employment-related;
Spending (for fiscal year 2003 unless otherwise indicated):
$26,000[A,B,C];
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Equal Opportunity Employment Commission: Employment
Discrimination Section 501 of the Rehabilitation Act (federal
employees);
Primary area of assistance: Civil protections or legal services;
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Equal Opportunity Employment Commission: Employment
Discrimination State and Local Fair Employment Practices Agency
Contracts;
Primary area of assistance: Civil protections or legal services;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Equal Opportunity Employment Commission: Employment
Discrimination Title I of The Americans with Disabilities Act;
Primary area of assistance: Civil protections or legal services;
Spending (for fiscal year 2003 unless otherwise indicated): NA;
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Library of Congress: Access Programs;
Primary area of assistance: Other: Accessibility of facilities and
services;
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Library of Congress: Library Services for the Blind and
Physically Handicapped;
Primary area of assistance: Other: Library service;
Spending (for fiscal year 2003 unless otherwise indicated):
$50,632,000[A,B,C];
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Office of Personnel Management: Federal Employment Assistance
for Veterans;
Primary area of assistance: Employment-related;
Spending (for fiscal year 2003 unless otherwise indicated): NA;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Office of Personnel Management: Federal Employment for
Individuals with Disabilities;
Primary area of assistance: Employment-related;
Spending (for fiscal year 2003 unless otherwise indicated): NA;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Office of Personnel Management: Government Telework Program
Guide;
Primary area of assistance: Information dissemination;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Railroad Retirement Board: Social Insurance for Railroad
Workers;
Primary area of assistance: Monetary support;
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Small Business Administration: Veterans Entrepreneurial
Training and Counseling;
Primary area of assistance: Other: Multi-faceted services for small
businesses;
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Social Security Administration: AeDib - Electronic Disability
Claims Imaging and Processing Project;
Primary area of assistance: Employment-related;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Social Security Administration: Social Security Benefits
Planning, Assistance, and Outreach Program;
Primary area of assistance: Information dissemination;
Spending (for fiscal year 2003 unless otherwise indicated):
$23,000,000[A,B,C];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Social Security Administration: Social Security Disability
Insurance;
Primary area of assistance: Monetary support;
Spending (for fiscal year 2003 unless otherwise indicated):
$77,146,763,000[D,L];
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Social Security Administration: Social Security Retirement
Insurance;
Primary area of assistance: Monetary support;
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Social Security Administration: Social Security State Grants
for Work Incentives Assistance to Disabled Beneficiaries;
Primary area of assistance: Employment- related;
Spending (for fiscal year 2003 unless otherwise indicated):
$7,000,000[H,G];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Social Security Administration: Social Security Survivors
Insurance;
Primary area of assistance: Monetary support;
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Social Security Administration: State Vocational
Rehabilitation Cost Reimbursement Program;
Primary area of assistance: Employment-related;
Spending (for fiscal year 2003 unless otherwise indicated): NA;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Social Security Administration: Supplemental Security Income;
Primary area of assistance: Monetary support;
Direct or indirect assistance to individuals with disabilities: Direct;
Wholly or partially targeted to individuals with disabilities:
Partially.
Program: Social Security Administration: Ticket to Hire;
Primary area of assistance: Information dissemination;
Spending (for fiscal year 2003 unless otherwise indicated):
$140,000[A,C];
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Program: Social Security Administration: Ticket to Work and Work
Incentives Program;
Primary area of assistance: Employment-related;
Spending (for fiscal year 2003 unless otherwise indicated): NA;
Direct or indirect assistance to individuals with disabilities:
Indirect;
Wholly or partially targeted to individuals with disabilities: Wholly.
Source: GAO analysis of survey data and of program information
presented in federal government reports (see table notes below).
Note: "NA" means Not Available.
[A] Data source: Program-reported data (e.g., through our survey or
agency correspondence).
[B] Survey respondent indicated that this figure includes
administrative costs.
[C] Expenditure.
[D] Data source: Consolidated Federal Funds Report.
[E] The data sources used for the CFFR vary by major category of
federal government expenditure or obligation. The spending data for
this program are included in CFFR's "Grant" category, which includes
formula grants, project grants, block grants, and cooperative
agreements. The data for about 98 percent of all grants reported in the
CFFR come from the Federal Assistance Award Data System, which
represent the federal obligations incurred at the time the grant is
awarded.
[F] Data for FY 2001.
[G] Obligation.
[H] Data source: Catalog of Federal Domestic Assistance.
[I] Appropriation.
[J] Data for FY 2004.
[K] The data sources used for the CFFR vary by major category of
federal government expenditure or obligation. The spending data for
this program are included in CFFR's "Other Direct Payments" category.
The data for this category come from the Federal Assistance Award Data
System. These amounts generally represent obligations incurred during
the fiscal year.
[L] The data sources used for the CFFR vary by major category of
federal government expenditure or obligation. The spending data for
this program are included in CFFR's "Retirement and disability payments
to individuals" category. The data for this category are compiled by
federal agencies for the Federal Assistance Award Data System. Reported
amounts represent obligations of federal funds during the fiscal year.
[M] Data for FY 2002.
[End of table]
[End of section]
Appendix III: GAO Contact and Staff Acknowledgments:
GAO Contact:
Robert E. Robertson, (202) 512-7215:
Staff Acknowledgments:
The following individuals made important contributions to this report:
Shelia D. Drake, Erin M. Godtland, Joel A. Green, Mark de la Rosa,
David J. Forgosh, Mark Trapani, Stuart M. Kaufman, and Daniel A.
Schwimer.
FOOTNOTES
[1] The Catalog of Federal Domestic Assistance is a database of all
federal programs available to state and local governments (including
the District of Columbia); federally-recognized Indian tribal
governments; territories (and possessions) of the United States;
domestic public, quasi-public, and private profit and nonprofit
organizations and institutions; specialized groups; and individuals.
[2] The $120 billion estimate represents reported obligations for
fiscal year 2003 and includes administrative costs for some programs
(i.e., those that included these costs when reporting total program
spending to us).
[3] Long-term budget simulations by GAO, the Congressional Budget
Office, and others show that, over the long term the U.S. faces a large
and growing structural deficit due primarily to known demographic
trends and rising health care costs.
[4] We considered a program to be wholly or partially targeted to
people with disabilities if it met one or more of the following
criteria: (1) people with disabilities are specifically mentioned in
legislation as a targeted group, (2) people are eligible for the
program wholly because of a disability, (3) people are eligible for the
program partially because of a disability, (4) people with disabilities
are given special consideration in eligibility determinations, or (5)
people with disabilities are given priority in being served.
[5] The number of beneficiaries or clients served by these programs in
any given year is probably significantly higher than the numbers we
report here for fiscal year 2003 because many programs did not provide
us with estimates of the number of beneficiaries or clients they serve,
or they provided us with estimates for a different fiscal year. Wholly
targeted programs reported serving a total of about 44 million
beneficiaries or clients, 10 million of whom were for fiscal years
other than 2003. Similarly, partially targeted programs reported
serving a total of about 22 million beneficiaries, 7 million of whom
were for fiscal years other than 2003.
[6] Approximately 77 percent of the wholly targeted programs we
identified limit eligibility to a specific population of people who
have a disability (e.g., to a certain age group, disability type, or
population group).
[7] Of the 95 wholly targeted programs in our analysis, we were able to
obtain some type of spending data for 85 programs (either from federal
government data on program spending or from our web-based survey). The
$120 billion estimate represents reported obligations for fiscal year
2003 and includes administrative costs for some programs (i.e., those
that included these costs when reporting total program spending to us).
However, data on fiscal year 2003 obligations were not available or
reported for some programs. In those instances, some programs instead
provided data on outlays or appropriations, and these data, in some
cases, pertained to a fiscal year other than 2003. For example, in
addition to the more than $120 billion in fiscal year 2003 obligations
that we report, other wholly targeted programs reported outlays of over
$7 billion in fiscal year 2003. (See appendix I for a more detailed
discussion of our methodology and see appendix II for a more detailed
listing of spending by individual programs.)
[8] Some of these programs were unable to provide us with information
pertaining to their programs' spending on people with disabilities
because they do not separately track or collect spending data for
individuals with disabilities.
[9] In discussing our survey results throughout the remainder of this
section, our figures regarding the percentage of programs that
considered particular issues to be a "challenge" includes programs that
identified an issue as either a "major" or "moderate" challenge in
their responses to our survey. Also, the survey results presented in
this section combine responses from both grant-making and non-grant-
making programs. The responses of grant-making programs reflect these
programs' views of the challenges their grantees face. A more complete
tabulation of the survey results related to program challenges is
available on the GAO Web site at www.gao.gov/cgi-bin/ getrpt?GAO-05-
695SP.
[10] Of all 192 federal programs included in our analysis, including
programs providing monetary support, 21 percent reported that ensuring
timely processing of applications for assistance was a challenge and 15
percent reported that ensuring consistent processing of applications
for assistance was a challenge.
[11] Of all 192 federal programs included in our analysis, including
programs providing employment-related assistance, 24 percent reported
that ensuring timely provision of services and benefits was a challenge.
[12] Under the Rehabilitation Act of 1973, states that cannot provide
vocational rehabilitation services to all eligible applicants must
provide assurances that those with the most severe disabilities will be
selected first under "order of selection" criteria.
[13] Of all 192 federal programs included in our analysis, including
programs providing monetary support, 30 percent reported that
interpreting complex eligibility requirements was a challenge.
[14] Of all 192 federal programs included in our analysis, including
programs providing medical care and employment-related assistance, 36
percent reported that planning for growth in the demand for assistance
was a challenge.
[15] The Workforce Investment Act of 1998 (WIA) requires states and
localities to bring together a number of federally funded employment
and training services into a single system--the one-stop system. Funded
through different federal agencies, these programs are to provide
services through a statewide network of one-stop career centers to
adults, dislocated workers, and youth.
[16] Of all 192 federal programs included in our analysis, including
information dissemination programs, 38 percent reported that making
beneficiaries or clients aware of their programs' services and benefits
was a challenge.
[17] The Presidential Task Force on the Employment of People with
Disabilities was established to create a coordinated and aggressive
national policy to bring adults with disabilities into gainful
employment at a rate that is as close to the employment rate of the
general adult population. The Task Force published a series of reports
over the course of four years entitled Re-charting the Course.
[18] David Wittenburg and Melissa Favreault, "Safety Net or Tangled
Web? An Overview of Programs and Services for Adults with
Disabilities," Occasional Paper Number 68, The Urban Institute, p. 23
(Washington, D.C; November 2003).
[19] Although our survey asked programs to report information sharing
or coordination challenges with both federal and nonfederal programs,
most of the respondents who reported having such challenges indicated
that these challenges related to their interactions with other federal
programs, either within or outside of their own agency.
[20] GAO, 21st Century Challenges: Reexamining the Base of the Federal
Government, GAO-05-325SP (Washington, D.C.: February 2005).
[21] Our definition of a program is derived from the Catalog for
Federal Domestic Assistance (CFDA), a database of all federal programs
available to state and local governments (including the District of
Columbia); federally-recognized Indian tribal governments; territories
(and possessions) of the United States; domestic public, quasi-public,
and private profit and nonprofit organizations and institutions;
specialized groups; and individuals. The CFDA states that "A 'Federal
domestic assistance program' may in practice be called a program, an
activity, a service, a project, a process, or some other name,
regardless of whether it is identified as a separate program by statute
or regulation." The CFDA further notes that " 'Assistance' or
'benefits' refers to the transfer of money, property, services, or
anything of value, the principal purpose of which is to accomplish a
public purpose of support or stimulation authorized by federal statute."
[22] The CFFR reports federal government expenditures or obligations in
state, county, and subcounty areas of the United States as well as the
District of Columbia and U.S. outlying areas. Various federal
government agencies provide the data for this report from their
existing reporting systems.
[23] In addition, several programs provided us with data on their
appropriations, rather than either obligations or outlays.
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