Summary

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 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.