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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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