oversight

Employment for People with Disabilities: Little Is Known about the Effectiveness of Fragmented and Overlapping Programs

Published by the Government Accountability Office on 2012-06-29.

Below is a raw (and likely hideous) rendition of the original report. (PDF)

             United States Government Accountability Office

GAO          Report to Congressional Committees




June 2012
             EMPLOYMENT FOR
             PEOPLE WITH
             DISABILITIES
             Little Is Known about
             the Effectiveness of
             Fragmented and
             Overlapping Programs




GAO-12-677
                                              June 2012

                                              EMPLOYMENT FOR PEOPLE WITH
                                              DISABILITIES
                                              Little Is Known about the Effectiveness of
Highlights of GAO-12-677, a report to
                                              Fragmented and Overlapping Programs
congressional committees




Why GAO Did This Study                        What GAO Found
Many federal programs—within the              GAO identified 45 programs that supported employment for people with
Departments of Education, Labor, and          disabilities in fiscal year 2010, reflecting a fragmented system of services. The
Veterans Affairs; the Social Security         programs were administered by nine federal agencies and overseen by even
Administration; and other agencies—           more congressional committees. All programs overlapped with at least one other
help people with disabilities overcome        program in that they provided one or more similar employment service to a
barriers to employment. Section 21 of         similar population—people with disabilities. The greatest overlap occurred in
Pub. L. No. 111-139 requires GAO to           programs serving veterans and servicemembers (19 programs) and youth and
identify and report annually on               young adults (5 programs). In addition, GAO identified seven programs that did
programs, agencies, offices, and              not limit eligibility to any particular population and were potentially available to
initiatives that have duplicative goals or    veterans and servicemembers or youth. Some overlapping programs, such as
activities. GAO examined the extent to        those with specific eligibility requirements, have less potential for duplication—
which programs that support                   providing the same services to the same beneficiaries—than others. However,
employment for people with disabilities       even when the potential for duplication of services is low, there may be
(1) provide similar services to similar
                                              inefficiencies associated with operating multiple programs that provide similar
populations and (2) measure
                                              services to similar populations. Coordination across programs may help address
effectiveness. GAO identified programs
by searching the Catalog of Federal
                                              fragmentation and potential duplication, but officials that GAO surveyed reported
Domestic Assistance and consulting            only limited coordination. However, among six selected programs that only serve
agency officials. GAO surveyed and            people with disabilities—including the Department of Education’s Vocational
interviewed agency officials to               Rehabilitation program and the Social Security Administration’s Ticket to Work
determine program objectives and              program—officials cited more consistent coordination.
activities. Nine agencies reviewed the
draft report and five provided
comments. Labor was concerned that
GAO characterized its programs as
fragmented and potentially duplicative.
While multiple programs may be
appropriate, GAO maintains that
additional review and coordination may
reduce inefficiencies and improve
effectiveness among overlapping
programs.

GAO is not recommending executive
action at this time. In a recent report,      a
                                               The Department of Labor jointly administers the Workforce Recruitment Program with the Department of Defense
GAO suggested the Office of                   and the Work Opportunity Tax Credit with the Internal Revenue Service. These programs are therefore included
Management and Budget (OMB)                   under both the Department of Labor and the other administering agencies in the figure.
consider establishing governmentwide          Most (32) of the 45 programs surveyed tracked at least one employment-related
goals for employment of people with           outcome measure for people with disabilities, but overall little is known about the
disabilities, and working with agencies       effectiveness of these programs. The most commonly tracked outcomes for
that administer overlapping programs          people with disabilities were “entered employment” (28 programs) and
to determine whether consolidation
                                              “employment retention” (18 programs). However, it may be difficult to compare
might result in more effective and
                                              outcomes across programs, in part, because of variation in the type and severity
efficient delivery of services. GAO
continues to believe these actions are        of participants’ disabilities. In addition, only 10 of the 45 programs reported that
needed and will follow up with OMB to         an evaluation had been conducted in the last 5 years. Just one of the 45
determine their status.                       programs (Job Corps) reported conducting an impact study—a study that would
                                              most clearly show whether the program (and not other factors) was responsible
View GAO-12-677. For more information,        for improved employment outcomes for people with disabilities. However,
contact Daniel Bertoni at (202) 512-7215 or   additional studies are underway for at least two other programs.
bertonid@gao.gov.
                                                                                                    United States Government Accountability Office
Contents


Letter                                                                                         1
               Background                                                                      3
               Fragmentation and Overlap Prevalent among 45 Programs Serving
                 People with Disabilities                                                      6
               Programs Tracked Varying Outcome Measures, and Little Is Known
                 About Program Effectiveness                                                 25
               Concluding Observations                                                       29
               Agency Comments and Our Evaluation                                            30

Appendix I     Objectives, Scope, and Methodology                                            36



Appendix II    Selected Survey Data from Programs That Have Ended Since Fiscal
               Year 2010                                                                     44



Appendix III   Reported Program Obligations and Number of People with
               Disabilities Served                                                           47



Appendix IV    Reported Program Objectives and Eligibility Requirements                      51



Appendix V     Services Reported to Be Provided in Fiscal Year 2010, by Population
               and Program                                                                   64



Appendix VI    Employment-Related Outcome Measures Programs Reported
               Tracking for People with Disabilities in Fiscal Year 2010                     73



Appendix VII   Programs That Identified Performance Reviews Completed Since
               2006, by Type of Study                                                        80




               Page i                          GAO-12-677 Employment for People with Disabilities
Appendix VIII   Agency Comments from the Department of Agriculture                             81



Appendix IX     Agency Comments from the Department of Education                               82



Appendix X      Agency Comments from the Department of Labor                                   84



Appendix XI     GAO Contact and Staff Acknowledgments                                          85



Tables
                Table 1: Programs Reporting the Number of People with
                         Disabilities Served and Obligations, Fiscal Year 2010                 10
                Table 2: Reported Eligibility Requirements for Labor’s Three
                         Programs Limiting Eligibility to Students, Transition-age
                         Youth, and/or Young Adults                                            18
                Table 3: Programs Reporting Waiting Lists                                      19
                Table 4: Coordination Reported by All Programs in Our Scope                    22
                Table 5: Services Provided by 19 Programs That Limit Eligibility to
                         Servicemembers, Veterans, and/or Their Families                       64
                Table 6: Services Provided by Five Programs That Limit Eligibility
                         to Students, Transition Age Youth, and/or Young Adults                67
                Table 7: Services Provided by Seven Programs That Serve All
                         People with Disabilities                                              68
                Table 8: Services Provided by 14 Programs That Limit Eligibility to
                         Other Populations                                                     69


Figures
                Figure 1: Multiple Congressional Committees, Federal and State
                         Agencies, and Other Entities Oversee and Administer 45
                         Federal Programs that Support Employment for People
                         with Disabilities                                                       8
                Figure 2: Number of Programs Reporting Selected Employment
                         Services Provided to People with Disabilities, Fiscal Year
                         2010                                                                  12



                Page ii                          GAO-12-677 Employment for People with Disabilities
Figure 3: Selected Employment Services Reported to Be Provided
         by 19 Programs Limiting Eligibility to Veterans,
         Servicemembers, and/or Their Families, Fiscal Year 2010                          14
Figure 4: Selected Employment Services Reported to Be Provided
         by Five Programs Limiting Eligibility to Students,
         Transition-aged Youth, and/or Young Adults, Fiscal Year
         2010                                                                             15
Figure 5: Selected Employment Services Reported to Be Provided
         by Seven Programs That Serve All People with
         Disabilities, Fiscal Year 2010                                                   16
Figure 6: Measures Reported by Programs to Track Employment
         Outcomes for People with Disabilities                                            26
Figure 7: Criteria for Including Programs within Our Scope                                37




Abbreviations

Education         Department of Education
GPRA              Government Performance and Results Act of 1993
GPRAMA            GPRA Modernization Act of 2010
Labor             Department of Labor
OMB               Office of Management and Budget
SSA               Social Security Administration
VA                Department of Veterans Affairs
VR                State Vocational Rehabilitation Services
VR agency         vocational rehabilitation agency
VR&E              Vocational Rehabilitation and Employment
WIA               Workforce Investment Act




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Page iii                                GAO-12-677 Employment for People with Disabilities
United States Government Accountability Office
Washington, DC 20548




                                   June 29, 2012

                                   Congressional Committees

                                   Nearly one in five people in the United States are reported to have a
                                   disability. 1 Although some people are born with disabilities, everyone is at
                                   risk of experiencing a short-term or long-term disability, whether through
                                   accidents, employment-related injuries and illnesses, disease, or aging. In
                                   addition, individuals may have mental disorders or developmental
                                   disabilities, which are severe chronic conditions resulting from mental
                                   and/or physical impairments that can begin at any time during
                                   development and last throughout a person’s lifetime. A body of evidence
                                   indicates that many people with disabilities can and want to work.
                                   However, research has shown that people with disabilities may face
                                   multiple barriers to employment, including poor health or functioning;
                                   inadequate education, skills, or training; lack of transportation; lack of
                                   accessible workplaces or accommodations; and discrimination. Federal
                                   programs reported obligating more than $4 billion in fiscal year 2010 on
                                   employment-related supports for people with disabilities, compared to a
                                   significantly higher amount on income and medical supports for people
                                   with disabilities. Even with these expenditures, historically, people with
                                   disabilities have experienced higher unemployment and poverty rates
                                   than those without disabilities.

                                   Over the years, many federal programs across a number of federal
                                   agencies have been created or have evolved to address barriers to
                                   employment for people with disabilities, resulting in a fragmented system
                                   of supports. Recently, we identified 50 programs administered by nine
                                   federal agencies that supported employment for people with disabilities. 2
                                   This report provides additional information and context related to our work



                                   1
                                    U.S. Census Bureau, Americans with Disabilities: 2005. (Washington, D.C.: December
                                   2008). Data from the Survey of Income and Program Participation, June through
                                   September 2005.
                                   2
                                    GAO, 2012 Annual Report: Opportunities to Reduce Duplication, Overlap, and
                                   Fragmentation, Achieve Savings, and Enhance Revenue, GAO-12-342SP (Washington,
                                   D.C.: Feb. 28, 2012). This report was our second annual report to Congress in response
                                   to the statutory requirement that we identify and report annually on federal programs,
                                   agencies, offices, and initiatives that have duplicative goals or activities, in accordance
                                   with Pub. L. No. 111-139, § 21, 124 Stat. 29 (2010), 31 U.S.C. § 712 Note.




                                   Page 1                                  GAO-12-677 Employment for People with Disabilities
and addresses the following objectives: (1) to what extent do federal
programs that support employment for people with disabilities provide
similar services to similar populations and (2) to what extent has the
effectiveness of programs that support employment for people with
disabilities been measured?

To address our first objective, we identified programs that support
employment for people with disabilities by consulting with federal agency
officials and researchers knowledgeable about employment and disability
issues, searching the Catalog of Federal Domestic Assistance, and
reviewing our previous work. Consistent with our prior work on
duplication, we considered “programs” to include a variety of types of
assistance—such as grants, initiatives, and tax expenditures—and will
use that term throughout the report for simplicity. We included programs
that served only people with disabilities, as well as programs that served
a broader population but provided special consideration to people with
disabilities or their employers. 3 We also included programs for wounded,
ill, and injured servicemembers within our scope. After validating the list
of programs with agency officials, we fielded a web-based survey to each
program. The survey collected information on each program’s objectives,
eligibility requirements, services provided, outcome measures, and
obligations, among other data. We incorporated data reliability checks
into the survey instrument, reviewed documentation, and conducted
follow-up interviews as necessary. We determined that the data used in
this report were sufficiently reliable for the purposes of this report. We did
not conduct an independent legal analysis to identify relevant programs or
verify the program information provided by survey respondents. To further
explore coordination efforts among overlapping programs, we selected six
programs—administered by three different agencies—that serve only




3
 Specifically, in order to be considered within the scope of our work, agencies must have
reported that their programs met at least one of the following criteria and provided an
employment-related service in fiscal year 2010: (1) people with disabilities are mentioned
in the 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, (5) people with disabilities are given priority in being served, or (6)
employers of people with disabilities are a targeted group.




Page 2                                  GAO-12-677 Employment for People with Disabilities
                      people with disabilities. 4 We conducted interviews with officials
                      representing these six programs regarding their coordination efforts,
                      challenges to coordination, and factors that facilitate or create barriers to
                      coordination. To address our second objective, we collected data through
                      our survey on program outcome measures and any studies or evaluations
                      of program performance conducted since 2006. We reviewed the studies’
                      methodologies to determine whether they met our definition of an impact
                      study. 5 We conducted this performance audit from April 2011 to June
                      2012 in accordance with generally accepted government auditing
                      standards. Those standards require that we plan and perform the audit to
                      obtain sufficient, appropriate evidence to provide a reasonable basis for
                      our findings and conclusions based on our audit objectives. We believe
                      that the evidence obtained provides a reasonable basis for our findings
                      and conclusions based on our audit objectives. See Appendix I for a more
                      detailed description of our objectives, scope, and methodology.



Background
Improving and         In 2003, we first designated federal disability programs as a high-risk area
Modernizing Federal   because the programs require urgent attention and organizational
Disability Programs   transformation to ensure that they function in the most economical,
                      efficient, and effective manner possible. 6 We have also reported that
                      improving work participation among people with disabilities has been
                      challenging in part because the United States has a patchwork of
                      disability programs—developed individually over many years—and lacks



                      4
                        The selected programs were the Department of Education’s State Vocational
                      Rehabilitation Services and Assistive Technology State Grant programs; the Department
                      of Labor’s Disability Employment Initiative; and the Social Security Administration’s State
                      Vocational Rehabilitation Cost Reimbursement, Work Incentives Planning and Assistance,
                      and Ticket to Work programs. The Disability Employment Initiative was not included in our
                      analysis of the 45 programs that support employment for people with disabilities because
                      it is a new program, and it did not provide services in fiscal year 2010. We included this
                      program in our analysis of program coordination because its purpose is to increase
                      coordination across programs and agencies that support employment for people with
                      disabilities.
                      5
                       An impact study assesses the net effect of a program by comparing program outcomes
                      with an estimate of what would have happened in the absence of the program.
                      6
                      GAO, High-Risk Series: An Update, GAO-03-119 (Washington, D.C.: January 2003).




                      Page 3                                 GAO-12-677 Employment for People with Disabilities
                         a unified set of national goals that guide coordination among programs or
                         contribute to measuring desired outcomes. 7

                         In February 2012, we identified programs administered by nine federal
                         agencies that supported employment for people with disabilities, and
                         many of these programs overlapped in that they provided similar services
                         to similar populations. 8 We recommended that the Office of Management
                         and Budget (OMB), in consultation with those agencies that administer
                         programs that support employment for people with disabilities, take two
                         actions to improve coordination and program effectiveness and efficiency:
                         (1) consider establishing measurable, governmentwide goals for
                         employment of people with disabilities, and (2) continue to work with
                         executive agencies that administer overlapping programs to determine
                         whether program consolidation might result in administrative savings and
                         more effective and efficient delivery of services.

                         In response, the Office of Management and Budget (OMB) noted that, in
                         fiscal year 2012, the administration’s Domestic Policy Council will conduct
                         an internal review of ways to improve the effectiveness of disability
                         programs through better coordination and alignment of policies and
                         strategies. OMB also noted that the administration has set
                         governmentwide goals for employment and inclusion of people with
                         disabilities in the federal government, among other ongoing and planned
                         efforts to improve employment for people with disabilities.


GPRA Modernization Act   Responsibility for many federal efforts, including employment support for
of 2010                  people with disabilities, lies with more than one agency, yet agencies face
                         a range of challenges and barriers when they attempt to work
                         collaboratively. Both Congress and the Executive Branch have
                         recognized this, and in January 2011, the GPRA Modernization Act of
                         2010 (GPRAMA) was enacted, updating the Government Performance
                         and Results Act of 1993. 9 GPRAMA establishes a new framework aimed
                         at taking a more crosscutting and integrated approach for focusing on
                         results and improving government performance. Effective implementation


                         7
                          GAO, Federal Disability Programs: More Strategic Coordination Could Help Overcome
                         Challenges to Needed Transformation, GAO-08-635 (Washington, D.C.: May 20, 2008).
                         8
                         GAO-12-342SP.
                         9
                         Pub. L. No. 111-352, 124 Stat. 3866 (2011); Pub. L. No. 103-62, 107 Stat. 285.




                         Page 4                                GAO-12-677 Employment for People with Disabilities
of the law could play an important role in clarifying desired outcomes,
addressing program performance spanning multiple organizations, and
facilitating future actions to reduce unnecessary duplication, overlap, and
fragmentation. 10

GPRAMA requires OMB to coordinate with agencies to establish
outcome-oriented goals covering a limited number of crosscutting policy
areas as well as goals to improve management across the federal
government, and to develop a governmentwide performance plan for
making progress toward achieving those goals. The performance plan is
required to, among other things, identify the agencies and federal
activities—including spending programs, tax expenditures, and
regulations—that contribute to each goal, and establish performance
indicators to measure overall progress toward these goals as well as the
individual contribution of the underlying agencies and federal activities.
GPRAMA also requires similar information at the agency level. Each
agency is required to identify the various federal organizations and
activities—both within and external to the agency—that contribute to its
goals, and describe how the agency is working with other agencies to
achieve its goals as well as any relevant crosscutting goals. OMB officials
stated that their approach to responding to this requirement will address
fragmentation among federal programs. OMB and the agencies within our
scope identified several employment-related goals for fiscal year 2013,
including a goal to increase the percentage of eligible servicemembers
served by career readiness and preparedness programs, and a goal to
provide 2 million workers with skills training by 2015 and improve the
coordination and delivery of job training services. However, none of the
governmentwide goals established for fiscal year 2013 relate specifically
to employment for people with disabilities.

Members of Congress have expressed concern that there is no
consolidated list of all federal government programs, and that individual
federal agencies are not able to provide a list of all of their programs and
initiatives. GPRAMA requires OMB to create a single website, no later
than October 1, 2012, that lists each federal agency’s programs.
Agencies are required to identify how they define the term “program,”
consistent with guidance from OMB; a description of the purpose of each
program and how it contributes to the mission and goals of the agency;



10
 GAO-12-342SP.




Page 5                           GAO-12-677 Employment for People with Disabilities
                      and information on funding for the current fiscal year and two previous
                      fiscal years. In addition, in January 2012, OMB announced that it will work
                      with agencies to identify a comprehensive list of programs, pursuant to
                      the law. As a first step, OMB stated it will conduct a pilot for a selected
                      group of agencies and bureaus with programs related to trade, exports,
                      and competitiveness. Based on the pilot, OMB plans to issue guidance to
                      all federal agencies detailing the approach to be taken to develop a
                      governmentwide inventory of programs.


                      Fragmentation occurs when more than one federal agency (or
Fragmentation and     organization within an agency) is involved in the same broad area of
Overlap Prevalent     national need. As we have previously noted, fragmented programs that
                      do not coordinate effectively could waste scarce funds, confuse and
among 45 Programs     frustrate program beneficiaries, and limit the overall effectiveness of the
Serving People with   federal effort. 11 We identified 45 programs that supported employment for
Disabilities          people with disabilities in fiscal year 2010 and continued to do so as of
                      April 2012. 12 (See app. III for a complete list of programs.) Oversight and
                      administration of the programs is the responsibility of multiple
                      congressional committees, executive agencies, and state and local
                      offices. Most of the programs overlapped in that they provided similar
                      services to similar populations; however, differences in specific eligibility
                      criteria sometimes limited the potential for duplication. In general,
                      coordination among the 45 programs was limited. Selected programs that
                      serve only people with disabilities reported higher levels of coordination at
                      the state and local levels.



                      11
                       GAO-12-342SP.
                      12
                         In our contribution to our governmentwide examination of duplication (GAO-12-342SP),
                      we reported on 50 programs that supported employment for people with disabilities in
                      fiscal year 2010. For this report, we have omitted six of these programs—two of which,
                      that is, SSA’s Mental Health Treatment Study and Youth Transition Demonstration, were
                      demonstration studies of limited duration—that agency officials reported had been phased
                      out or ended by April 2012, when we finalized our data (see app. II for details on the
                      programs). In addition, we excluded an additional program—the Benefit Offset National
                      Demonstration—because, while the program had obligations in fiscal year 2010, SSA
                      officials reported that the demonstration did not begin enrolling participants until January
                      2011. In commenting on a draft of our prior report and, later, in verifying data previously
                      provided, Department of Defense officials requested that we add three programs that they
                      believed to be within the scope of this review. After reviewing the programs, we
                      determined that two met our criteria and we included them in our analyses for this report.
                      We did not include or review programs that may have been created or revised after fiscal
                      year 2010.




                      Page 6                                  GAO-12-677 Employment for People with Disabilities
Program Oversight and   Oversight and administration of programs that support employment for
Administration Is       people with disabilities is fragmented among various congressional
Fragmented              committees, multiple federal agencies, and state entities (see fig. 1).
                        Agency officials reported that 27 of the 45 programs were created by
                        statute, rather than at the agencies’ initiative. At least 13 congressional
                        committees are responsible for oversight of the 45 programs, which are
                        administered by nine federal agencies. In some cases, a range of
                        departments or offices within an agency are responsible for the programs.
                        For example, several offices in the Department of Labor (Labor)
                        administer 14 programs that provide employment-related services to
                        people with disabilities. Further, the Department of Defense has 10
                        programs within its purview in part because each service branch
                        administers its own program or programs to assist wounded, ill, and
                        injured servicemembers with employment. Adding to the fragmented
                        landscape, some of these federal programs are administered by
                        governmental and nongovernmental state or local entities, either in
                        collaboration or independently. In addition, agency officials noted that
                        states have various governmental structures to administer the programs.
                        For example, the Department of Education (Education) allocates formula
                        funds to states to carry out the State Vocational Rehabilitation Services
                        (VR) program. The state may create one vocational rehabilitation agency
                        (VR agency) or designate a separate VR agency to serve individuals who
                        are blind and a “general” agency for all other disability categories. In
                        addition, each state may organize its VR agency or agencies within
                        different government departments relative to other states, such as state
                        departments of labor or education, or they may be free-standing agencies
                        or commissions.




                        Page 7                          GAO-12-677 Employment for People with Disabilities
Figure 1: Multiple Congressional Committees, Federal and State Agencies, and Other Entities Oversee and Administer 45
Federal Programs that Support Employment for People with Disabilities




                                        Note: Labor jointly administers the Workforce Recruitment Program with the Department of Defense
                                        and the Work Opportunity Tax Credit with the Internal Revenue Service. These programs are
                                        therefore included under both Labor and the other administering agencies in the figure.


                                        The specific definitions of disability and eligibility requirements that
                                        programs use—often established by law—vary, which may contribute to
                                        fragmentation. For example, officials from 34 programs collectively
                                        reported using at least 10 different definitions of disability, and 10
                                        programs reported having no specific definition for disability. In addition,
                                        the 45 programs reported at least 26 specific limitations to eligibility, such
                                        as limiting services to Native Americans or people who are blind. The
                                        variation across programs allows policy makers and program officials to
                                        target certain populations and, as discussed later, may reduce the
                                        potential for duplicative services. However, variation in definitions of
                                        disability and eligibility requirements may lead to confusion among people
                                        with disabilities about their eligibility for a specific program, and may
                                        create additional administrative burdens for state and local agencies and
                                        private partners that deliver services.

                                        To address fragmentation among programs that support employment for
                                        people with disabilities, at least two programs have been created to assist
                                        clients in determining what services and benefits they are eligible for, and
                                        which would best meet their needs. Specifically, according to agency
                                        officials, the Social Security Administration’s (SSA) Work Incentives



                                        Page 8                                    GAO-12-677 Employment for People with Disabilities
Planning and Assistance program helps Social Security Disability
Insurance beneficiaries and Supplemental Security Income disability
recipients (for the purposes of this report, we will refer to these
populations collectively as “SSA disability beneficiaries”) understand
SSA’s complex work incentives and how working would affect their
disability benefits or payments. In addition, agency officials noted that
Labor’s Disability Program Navigators, jointly funded with SSA, provided
staff members in one-stop career centers to help people with disabilities
navigate multiple employment programs and services to meet their
employment needs. 13

The number and range of programs makes it difficult to estimate the total
federal funding dedicated to providing people with disabilities with
employment supports or the number of individuals served. Programs we
surveyed reported obligating about $4.1 billion to provide employment
support to at least 1.5 million individuals with disabilities in fiscal year
2010, but these numbers may be largely underestimated for several
reasons. (See table 1 for summary information on reported numbers of
people served and obligations in fiscal year 2010; see app. III for detailed
fiscal year 2010 participant and obligation data reported by each
program.) Of the 23 programs serving only people with disabilities, 18
reported on the number of people with disabilities receiving employment
supports and 18 reported data on obligations in fiscal year 2010. One
program—Education’s VR program—accounted for most of these funds
and participants (the program obligated $3 billion to serve more than 1
million people with disabilities). Even less is known about expenditures on
and the number of people receiving employment supports from the 22
programs serving people with and without disabilities. Specifically, only 13
of these programs reported how many people with disabilities received
employment supports and 10 reported obligations spent on people with
disabilities. Agency officials from some of these programs reported that
they do not systematically collect information on whether participants
have disabilities, while others indicated that program participants may not
always disclose that they have a disability. SSA officials noted that
Section 504 of the Rehabilitation Act of 1973, as amended—which
prohibits federal agencies and programs that receive federal funding from


13
  The Disability Program Navigator program was not included in analyses for this report
because it ended after fiscal year 2010. See appendix II. Best practices from the Disability
Program Navigator, including this function, were incorporated into the Disability
Employment Initiative, a new program.




Page 9                                  GAO-12-677 Employment for People with Disabilities
                                             discriminating against individuals with disabilities—limits programs’ ability
                                             to require individuals to disclose that they have a disability. Other
                                             programs, such as Labor’s Employer Assistance and Resource Network,
                                             serve employers of people with disabilities and do not track the number of
                                             people with disabilities who indirectly benefit from program services.

Table 1: Programs Reporting the Number of People with Disabilities Served and Obligations, Fiscal Year 2010

                                 Number of          Number of people with disabilities       Obligations for providing employment
                                 programs           receiving employment support             support to people with disabilities
Serve only people with           23                 1,313,046                                $4.1 billion
disabilities or their families                      (18 programs reporting)                  (18 programs reporting)
Serve people with and without    22                 224,141                                  $7.3 million
disabilities                                        (13 programs reporting)                  (10 programs reporting)
Total                            45                 1,537,187                                $4.1 billion
                                             Source: GAO analysis of survey data.




Overlap Was Greatest                         All 45 programs overlapped with at least one other program in that they
among Certain Programs                       provided one or more similar employment service to people with
                                             disabilities. To identify services provided, we asked survey respondents
                                             to indicate from a list of employment-related services and supports which
                                             ones their programs provide. Respondents indicated a range of services
                                             provided, with some services being provided more than others. 14 For
                                             example, survey responses revealed that 36 of the 45 programs provided
                                             employment counseling, assessment, and case management, with 23
                                             providing these services to more than half of their participants. On the
                                             other hand, agency officials reported that 17 programs provided remedial
                                             academic English language skills and adult literacy assistance, with 4 of
                                             those providing it to more than half of their participants. Two programs
                                             reported providing tax expenditures related to workers with disabilities.
                                             For example, the Work Opportunity Tax Credit provides a tax credit to
                                             employers who hire individuals from target groups, including disabled
                                             veterans. In addition, two programs—Education’s Randolph-Sheppard
                                             program and the U.S. AbilityOne Commission’s AbilityOne Program—
                                             help create jobs for individuals with disabilities through the federal



                                             14
                                               Survey respondents reported whether they provided the service to more than 50 percent
                                             of participants, less than 50 percent of participants, or that they provided the service but
                                             could not specify the level. We did not collect the number of participants receiving each
                                             service.




                                             Page 10                                 GAO-12-677 Employment for People with Disabilities
property management and procurement systems. Randolph-Sheppard
licenses people who are blind to operate vending facilities on federal or
other designated state properties. Under the AbilityOne program, federal
government agencies are generally required to purchase certain goods
and services from nonprofit agencies that employ people who are blind or
have some other severe disability. Several programs also noted that they
provided additional services not included on our list, such as financial
supports, resume preparation, job coaching, transportation, and medical
and psychiatric services.




Page 11                         GAO-12-677 Employment for People with Disabilities
Figure 2: Number of Programs Reporting Selected Employment Services Provided to People with Disabilities, Fiscal Year
2010




                                        Page 12                             GAO-12-677 Employment for People with Disabilities
Overlap was greatest in programs serving two distinct groups;
specifically, we identified 19 programs that provided employment services
to veterans and servicemembers (see fig. 3) and 5 programs that
provided employment services to students and young adults (see fig. 4).
In addition, 7 programs did not limit eligibility to any particular group and
therefore potentially overlapped with these and other programs in our
scope (see fig. 5). For example, 17 of the 19 programs that limit eligibility
to veterans and servicemembers reported providing job-readiness skills.
At the same time, any veteran or servicemember could receive these
services from 5 of the 7 programs that did not limit eligibility to any
particular population. The remaining 14 programs limited eligibility to
other specific groups or types of disabilities, such as SSA disability
beneficiaries, or people who are blind or visually impaired. For a complete
list of programs, their objectives, and eligibility requirements, see
appendix IV. For a list of programs, populations they serve, and the
services they reported providing, see appendix V.




Page 13                          GAO-12-677 Employment for People with Disabilities
Figure 3: Selected Employment Services Reported to Be Provided by 19 Programs Limiting Eligibility to Veterans,
Servicemembers, and/or Their Families, Fiscal Year 2010




                                        Page 14                              GAO-12-677 Employment for People with Disabilities
Figure 4: Selected Employment Services Reported to Be Provided by Five Programs Limiting Eligibility to Students,
Transition-aged Youth, and/or Young Adults, Fiscal Year 2010




                                        Page 15                              GAO-12-677 Employment for People with Disabilities
Figure 5: Selected Employment Services Reported to Be Provided by Seven Programs That Serve All People with Disabilities,
Fiscal Year 2010




                                        Page 16                             GAO-12-677 Employment for People with Disabilities
The Potential for           While many programs reported providing similar services to similar
Duplication in Services     populations, some programs have less potential for duplication—
May Be Low, but             providing the same services to the same beneficiaries—than others.
                            Some overlapping programs have specific eligibility requirements that
Administrative              make duplication less likely. For example, the Department of Veterans
Inefficiencies Are Likely   Affairs’ (VA) Compensated Work Therapy and Vocational Rehabilitation
With Multiple Programs      and Employment (VR&E) programs both reported providing vocational
                            rehabilitation and a number of other similar employment services to
                            veterans with disabilities. However, the work therapy program targets
                            veterans with mental illness or other severe disabilities who are patients
                            in VA medical centers, whereas the VR&E program serves veterans with
                            all types of disabilities. In addition, unlike the work therapy program, the
                            VR&E program requires that a veteran’s disability be connected to his or
                            her military service. 15 In another example, the Workforce Recruitment
                            Program, jointly administered by Labor and the Department of Defense, is
                            the only one of the five youth programs that reported limiting eligibility to
                            college students or recent graduates with disabilities.

                            On the other hand, we identified three programs—Labor’s Workforce
                            Investment Act (WIA) Youth, YouthBuild, and Registered Apprenticeship
                            for Youth and Young Adults with Disabilities programs—that are
                            potentially available to any youth with disabilities between the ages of 16
                            and 21 (see table 2) and reported offering many similar services, such as
                            job readiness skills, on-the-job training, and assistance in obtaining a high
                            school diploma. 16 Despite their similarities, Labor officials told us these
                            programs employ different strategies for providing services. For example,
                            the YouthBuild program focuses on helping youth earn their high-school
                            equivalency degree while learning job skills by building affordable housing
                            for homeless and low-income people, whereas the WIA Youth program is
                            broader in that it focuses on more than construction skills and serves a
                            larger population. The apprenticeship program is a small, 3-year pilot



                            15
                              In addition to differences in eligibility requirements, VA officials reported that the types of
                            services differ between the two programs. Compensated Work Therapy provides support
                            with entry into employment at the veteran’s current level of functioning, whereas VR&E
                            provides career-level services, including training at a college, vocational, technical, or
                            business school; on-the-job training; and nonpaid work experience to prepare veterans for
                            entry into careers. VR&E also provides an independent living program, which is not
                            available through the Compensated Work Therapy program.
                            16
                              As shown in table 2, the programs have different age ranges for eligibility, but all allow
                            eligible youth between the ages of 16 and 21 to participate.




                            Page 17                                   GAO-12-677 Employment for People with Disabilities
                                          program in two states administered in partnership with state-organized
                                          apprenticeship agencies to place young adults with disabilities in
                                          registered apprenticeships in the construction and health care fields.
                                          Labor officials said that case managers may refer a participant from the
                                          WIA Youth program to the YouthBuild program, for example, if they are
                                          interested in learning construction skills. However, it is difficult to
                                          determine the extent to which these different strategies reduce or prevent
                                          potential duplication in services among these programs.

Table 2: Reported Eligibility Requirements for Labor’s Three Programs Limiting Eligibility to Students, Transition-age Youth,
and/or Young Adults

Program name                              Reported eligibility requirements
WIA Youth                                 Youth, ages 14 to 21, with a low personal or family income who also meet one or more of
                                          the following criteria:
                                          •    deficient in basic literacy skills,
                                          •    school dropout,
                                          •    homeless,
                                          •    runaway,
                                          •    foster child,
                                          •    pregnant or a parent,
                                          •    an offender, or
                                          •    requires additional assistance to complete their education or secure and hold
                                               employment.
                                          Up to 5 percent of youth participants in a local area do not have to meet the income
                                          criterion if they meet one of the following criteria:
                                          •    school dropout;
                                          •    basic skills deficient;
                                          •    are one or more grade levels below the grade level appropriate to the individual’s
                                               age;
                                          •    pregnant or parenting;
                                          •    possess one or more disabilities, including learning disabilities;
                                          •    homeless or runaway;
                                          •    offender; or
                                          •    face serious barriers to employment as identified by the local board.
YouthBuild                                Youth ages 16 through 24 and a member of a disadvantaged population, such as:
                                          •   low-income,
                                          •   foster care (including youth aging out of foster care),
                                          •   youth offender,
                                          •   youth with a disability,
                                          •   child of an incarcerated parent,
                                          •   high school dropout, or
                                          •   migrant youth.




                                          Page 18                               GAO-12-677 Employment for People with Disabilities
Program name                              Reported eligibility requirements
Registered Apprenticeship for Youth and   Youth and young adults with disabilities ages 16 through 27
Young Adults with Disabilities
                                          Source: GAO analysis of survey data.


                                          Note: Another Labor program, Job Corps, also generally serves youth and has similar eligibility
                                          requirements to WIA Youth and YouthBuild programs. However, eligible people with disabilities can
                                          apply to participate in the program at any age. Therefore, we did not include Job Corps as a program
                                          that limits eligibility to students, youth, and young adults.


                                          Another factor affecting the potential for duplication is resource levels, in
                                          that some overlapping programs lack the capacity to serve all who apply,
                                          thereby reducing the potential for duplication in services. Six of the 45
                                          programs reported having a waiting list for services (see table 3). Three of
                                          these programs reported serving only people with disabilities. Individuals
                                          who are on a waiting list for one program may be eligible to receive
                                          services from another program. For example, Labor officials told us that
                                          individuals waiting for VR services could be referred to one-stop career
                                          centers for services. 17

                                          Table 3: Programs Reporting Waiting Lists

                                           Waiting list                 Number of programs
                                           Yes                          6 programs
                                                                        •   Computer/Electronic Accommodations Program (Department of
                                                                                    a
                                                                            Defense)
                                                                                       a,b
                                                                        •   VR program (Education)
                                                                        •   Job Corps (Labor)
                                                                                                       c
                                                                        •   Work Opportunity Tax Credit (Labor/Internal Revenue Service)
                                                                        •   Community Service Employment for Older Americans (Labor)
                                                                                                                     a
                                                                        •   Compensated Work Therapy program (VA)
                                           No                           26 programs
                                           Don’t know                   6 programs
                                           Not applicable               7 programs
                                          Source: GAO analysis of survey data.




                                          17
                                            In commenting on our report, Education noted that state VR agencies that are unable to
                                          serve all eligible individuals must give priority to those with the most significant disabilities.
                                          Individuals with less significant disabilities may be referred to other WIA partner programs.
                                          Likewise, other WIA programs may refer individuals with disabilities or suspected
                                          disabilities to VR agencies because of their capacity to provide specialized services.




                                          Page 19                                        GAO-12-677 Employment for People with Disabilities
a
    Programs that serve only people with disabilities.
b
    Education officials noted that some, but not all, state VR agencies have a wait list for services.
c
 Labor officials noted that State Workforce Agencies may have backlogs of requests from employers
to certify that an employee has met the eligibility requirements for the Work Opportunity Tax Credit
target group.

Even when the potential for duplication of services is low, there may be
inefficiencies associated with operating two or more separate programs
that provide similar services to similar populations. For example, in its
budget requests for fiscal years 2012 and 2013, Education proposed
consolidating two smaller programs in our scope—the Migrant and
Seasonal Farmworker and Supported Employment State Grants
programs—into its larger VR program. Education proposed this
consolidation in order to reduce duplication of effort and administrative
costs, streamline program administration at the federal and local levels,
and improve accountability.

Among the 19 programs that serve servicemembers and veterans, we
identified two programs—Labor’s Disabled Veterans’ Outreach and Local
Veterans’ Employment Representatives programs—that provide similar
services at similar locations, potentially by the same staff members. Both
programs reported that they provided job search and placement services
to veterans with disabilities, among other similar services. Labor officials
said that the veterans’ employment representatives were intended to
reach out to employers and the disabled veterans’ outreach specialists
were intended to work with job seekers. However, as we reported in May
2007, staff often performed the same roles in one-stop career centers
and, in some cases, the roles were carried out by the same staff
member. 18 A recent law gave states the flexibility—subject to the approval
of the Secretary of Labor—to consolidate these two programs in order to
promote more efficient provision of services. Labor officials noted that the
agency is in the process of developing criteria and procedures for making
determinations on consolidations. The law also requires the Secretary of
Labor to conduct audits to ensure that the veterans’ employment
representatives and the outreach specialists are performing their required




18
 GAO, Veterans’ Employment and Training Service: Labor Could Improve Information on
Reemployment Services, Outcomes, and Program Impact, GAO-07-594 (Washington,
D.C.: May 24, 2007).




Page 20                                          GAO-12-677 Employment for People with Disabilities
duties, and officials told us that they are in the process of defining the
requirements and protocols for these audits. 19

In another example, SSA administers two separate statutorily mandated
programs—the State Vocational Rehabilitation Cost Reimbursement and
the Ticket to Work programs—that perform similar functions in that they
provide funding for employment supports to serve SSA disability
beneficiaries. The Cost Reimbursement program reimburses state VR
agencies when they help disability beneficiaries find jobs and earn above
a certain threshold (known as substantial gainful activity) for 9 months. 20
The Ticket to Work program, established more than a decade after the
Cost Reimbursement program, also provides funding to service providers
(including, in some instances, VR agencies), when they help SSA
disability beneficiaries achieve employment outcomes; retain
employment; and whenever possible, support long-term financial
independence. 21 State VR agencies can decide, on a case-by-case basis,
whether to accept payments under the Ticket to Work or the Cost
Reimbursement programs, but they may not receive payment under both
programs at the same time for the same beneficiary. A senior SSA official
noted that the Ticket to Work and Cost Reimbursement programs were
both created to address a concern that VR and other workforce programs
were not adequately serving SSA disability beneficiaries, given the
severity of their disabilities. In addition, the official noted that both
programs were intended, in part, to achieve cost savings by helping SSA
disability beneficiaries achieve self-sufficiency and reduce or eliminate
their reliance on disability benefits or payments. However, SSA officials
also pointed out that the Ticket to Work program was intended, in part, to
provide beneficiaries more choices in receiving employment services
beyond those provided by VR agencies. In addition, officials noted that



19
 VOW to Hire Heroes Act of 2011, Pub. L. No. 112-56, § 241, 125 Stat. 712, 728.
20
  42 U.S.C. §§ 422(d) and 1382d(d); 20 C.F.R. §§ 404.2101 and 416.2201. Under
thresholds set annually by SSA, individuals are considered engaged in substantial gainful
activity if they had earnings in 2012 above $1,010 per month for nonblind beneficiaries
and $1,690 per month for blind beneficiaries.
21
  42 U.S.C. § 1320b-19; 20 C.F.R. §§ 411.100 – 411.730. Specifically, the Ticket to Work
program provides funding for SSA disability beneficiaries to receive employment services,
vocational rehabilitation services, or other services to help them obtain and retain
employment and reduce their dependency on benefits or payments. Individuals may
receive services from SSA-approved public or private providers, known as employment
networks, or traditional state VR agencies.




Page 21                                GAO-12-677 Employment for People with Disabilities
                          the two programs provide a continuum of services—VR agencies provide
                          more intensive, up-front services to help beneficiaries enter or return to
                          work, while employment networks under the Ticket to Work program can
                          provide longer-term supports to help beneficiaries stay at work.


Officials Surveyed        Coordination could help mitigate the potential for duplication among
Reported Limited          fragmented programs, but officials we surveyed reported limited
Coordination across All   coordination among the 45 programs in our scope. In our survey, we
                          asked respondents to indicate whether their program coordinated with
Programs                  any of the other programs receiving our survey. In 13 percent of cases,
                          two programs mutually reported coordinating with each other. However, in
                          most cases, respondents either reported not coordinating or
                          inconsistently reported coordinating with other programs (see table 4).
                          For example, although VA’s VR&E program reported coordinating with
                          Labor’s Veterans Workforce Investment Program and Disabled Veterans
                          Outreach Program, only one of the two Labor programs—the Disabled
                          Veterans Outreach Program—reported coordinating with the VA program.
                          Officials explained that, in some cases, federal-level program staff
                          responding to our survey may not be aware of coordination taking place
                          at the state and local levels. Further, although the rate of mutual
                          coordination reported is low among all the programs in our scope,
                          programs that have different missions or serve different populations may
                          not be expected to coordinate with one another. For instance, Labor’s
                          Senior Community Service Employment Program supports part-time work
                          opportunities for low-income senior citizens, and therefore may not need
                          to coordinate with Department of Defense transition programs—such as
                          Operation Warfighter—that help servicemembers returning to civilian life
                          gain employment experience.

                          Table 4: Coordination Reported by All Programs in Our Scope

                                                                 Both programs reported       Programs disagreed or did
                           Both programs                                that they did not        not know whether they
                           reported coordinating                              coordinate                    coordinate
                           13%                                                       44%                              43%
                          Source: GAO analysis of survey data.


                          In order to better understand our survey results, we held more detailed
                          discussions about coordination efforts with six selected programs that
                          serve only people with disabilities:




                          Page 22                                        GAO-12-677 Employment for People with Disabilities
•    Assistive Technology State Grant program (Education) 22

•    Disability Employment Initiative (Labor)

•    State Vocational Rehabilitation Cost Reimbursement Program
     (SSA) 23

•    Ticket to Work program (SSA)

•    VR program (Education)

•    Work Incentives Planning and Assistance program (SSA)

Officials cited more consistent coordination among these programs. In
response to our survey, all six programs had mutually reported
coordinating with the Ticket to Work and the VR programs. This is
perhaps not surprising, given that the VR program reported serving the
largest number of people with disabilities and the Ticket to Work program
is closely related to the VR program.

Although not all of the six programs mutually reported coordination,
federal program officials noted that a significant amount of coordination
occurs at the state and local levels where services are delivered. Labor
officials reported that its Disability Employment Initiative grantees at the
state and local level have established Integrated Resource Teams, which
include representatives from a number of programs—including the VR
program, the Assistive Technology State Grant program, and other state
and local programs—to leverage all available resources for individual
clients. To further encourage local coordination, Labor recently issued
guidance to state and local workforce agencies outlining ways in which
programs housed in one-stop career centers can coordinate with
providers under SSA’s Ticket to Work program. 24 Labor issued similar


22
  In commenting on a draft of this report, Education noted that the services provided by
the Assistive Technology State Grant program may facilitate employment or contribute to
obtaining employment, but it is not exclusively an employment program.
23
  As noted previously, SSA’s State Vocational Cost Reimbursement Program does not
directly serve individuals with disabilities. Rather, it reimburses state VR agencies when
they help disability beneficiaries find jobs and earn above a certain threshold for 9 months.
24
  Department of Labor, Training and Employment Notice No. 6-11: Increasing the Public
Workforce Development System’s Participation in the Ticket to Work (TTW) Program for
Disability Beneficiaries (Aug. 24, 2011).




Page 23                                 GAO-12-677 Employment for People with Disabilities
guidance listing available resources to help beneficiaries obtain assistive
technology, including Education’s Assistive Technology State Grant
program and SSA’s Ticket to Work program. 25

Agency officials also described efforts to increase coordination more
broadly among programs that support employment for people with
disabilities. For example, in 2008, Education and SSA established the
Partnership Plus initiative, which is intended to provide a seamless
approach to vocational services for people with disabilities. Individuals
who need intensive employment services, such as education or training,
can receive them first through the VR program, and then transition to an
employment network under Ticket to Work for job retention services, or
other ongoing services and supports to maintain employment and
increase earnings. In addition, officials described a new initiative that
coordinates programs and leverages resources from Education, the
Department of Health and Human Services, Labor, and SSA, and aims to
help youth receiving Supplemental Security Income to transition
successfully to higher education or employment by working with the entire
family to provide supports necessary to reduce barriers and improve
outcomes. 26

Officials from selected programs reported facing a number of challenges
in coordinating with each other. First, officials noted that coordination can
be challenging because programs are governed by separate statutes and
regulations containing different definitions and program requirements.
One official noted that aligning definitions of disability in statute would be
helpful to ensure programs established by WIA and the Rehabilitation Act
are complementary. In interviews with our six selected programs, officials
from each reported that individual programs lack the resources, both in
terms of funding and staff time, to pursue coordination with one another.
Finally, one official indicated that interagency working groups may have
limited effectiveness. He said that, in general, coordination could be more
effective if programs had a set of outcomes they were expected to
collectively achieve and were given the authority to work together to do


25
 Department of Labor, Training and Employment Notice No.16-11: Availability of
Assistive Technology (AT) Resources for Persons with Disabilities (Nov. 15, 2011).
26
  The Promoting Readiness of Minors in Supplemental Security Income (PROMISE)
initiative was first proposed in the President’s 2012 budget and therefore not within the
scope of this engagement, but demonstrates ongoing efforts for greater coordination
among federal agencies.




Page 24                                 GAO-12-677 Employment for People with Disabilities
                           so—including the authority to waive requirements that present barriers—
                           and given funding to support such collaboration. This is consistent with
                           concerns raised in our 2010 forum on employment for people with
                           disabilities, where participants noted that past interagency coordination
                           efforts have not been very successful at achieving significant change
                           because they have lacked sufficient authority, accountability, or
                           resources. 27

Programs Tracked
Varying Outcome
Measures, and Little
Is Known About
Program
Effectiveness
Programs Reported          Coordination efforts can be enhanced when agencies work toward a
Tracking Varying           common goal, yet outcome measures varied across programs and not all
Employment Outcomes for    programs reported outcomes specifically for people with disabilities.
                           Given a list of typical employment measures, 32 of the 45 programs
People with Disabilities   reported tracking at least one employment measure specifically for people
                           with disabilities. 28 The measures varied across programs, but the
                           measures most commonly tracked were “participants who enter
                           employment” (28 programs) and “participants’ employment retention” (18
                           programs). Some programs reported tracking other indicators, such as
                           quality of life. For instance, both VA’s VR&E program and Education’s
                           Helen Keller National Center track the number of participants who are
                           able to live independently or in less-restrictive residential programs. The
                           remaining 13 programs did not report tracking any employment-related
                           outcomes for people with disabilities, in part because they have a broader
                           mission. For instance, Department of Health and Human Services officials
                           reported that states are required to identify various performance
                           measures in their applications for the Medicaid 1915(c) Home and
                           Community-Based Services Waivers and the 1915(i) State Plan Home


                           27
                             GAO, Highlights of a Forum: Actions that Could Increase Work Participation for Adults
                           with Disabilities, GAO-10-812SP (Washington, D.C.: July 2010).
                           28
                            Nineteen of these programs reported limiting eligibility to people with disabilities.




                           Page 25                                 GAO-12-677 Employment for People with Disabilities
                                       and Community-Based Services related to participants’ health and
                                       welfare overall, but are not required to measure employment-related
                                       outcome measures because both programs provide a broad range of
                                       health care and other services beyond employment-related services. 29
                                       See Figure 6 for the number of programs tracking specific outcome
                                       measures.

Figure 6: Measures Reported by Programs to Track Employment Outcomes for People with Disabilities




                                       Despite some similarities in programs’ outcome measures, it can be
                                       difficult to compare relative performance due to variation across programs
                                       in the type and severity of participants’ disabilities. Just over half (24) of
                                       the 45 programs reported targeting or giving priority to people with
                                       significant or severe disabilities for whom it may be challenging to achieve




                                       29
                                         Both may be used to permit states to provide long-term care services, including
                                       employment-related services like supported employment, in home and community based
                                       settings as an alternative to institutional care under the Medicaid program. 42 U.S.C. §
                                       1396n(c) and (i).




                                       Page 26                                GAO-12-677 Employment for People with Disabilities
                         positive employment outcomes. 30 Further, some programs may use
                         different thresholds for their employment outcome measures. For
                         example, although 28 programs reported tracking “participants who enter
                         employment,” officials told us that some programs may consider just a
                         few hours of paid work per week as an employment outcome, while
                         others set a higher bar and require a participant to be working at a level
                         that would allow them to become self-sufficient and eliminate their
                         dependence on federal disability benefits.


Some Programs Have       Little is known about the effectiveness of the programs we identified as
Conducted Evaluations,   supporting employment for people with disabilities because only about
but Few Have Measured    one-quarter reported having a performance review. Ten of the 45
                         programs in our scope reported that a review or study had been
Their Impact             conducted to evaluate their program’s performance. 31 The studies varied
                         in methodology, and many examined program outcomes and proposed
                         ways to improve services, but fell short of determining whether outcomes
                         were a direct result of program activities. (See app. VII for programs that
                         reported performance reviews.) For example, the Department of
                         Agriculture’s AgrAbility program conducted a review of its activities
                         between 1991 and 2011 that found that 11,000 clients had been served,
                         and that 88 percent of those clients continued to be engaged in farm or
                         ranch activities. However, this study did not determine whether other
                         factors may have contributed to participants’ positive outcomes. Likewise,
                         a 2009 study evaluated aspects of Labor’s YouthBuild program—such as
                         recruitment and enrollment procedures, educational and vocational
                         services, and case management—to understand similarities and




                         30
                           Programs may have a variety of definitions for “severe” or “significant” disability. Our
                         survey instrument did not specify a definition, but we offered an example of one agency’s
                         definition of an individual with a “significant disability”: “an individual who has a severe
                         physical or mental impairment that seriously limits functional capabilities, such as mobility,
                         communication, or self-care.”
                         31
                           Officials from two additional programs reported conducting evaluation studies, but one
                         had not been completed at the time of our survey and the other was a GAO report that
                         was not an evaluation of program performance. In commenting on our draft report, Labor
                         noted that most of its programs have been or are being evaluated. Starting in fiscal year
                         2010, the agency stated that it expanded its evaluation activities with the creation of a
                         Chief Evaluation Office. Of the 10 programs in our scope that reported having an impact
                         evaluation or another review or study to evaluate program performance, three were Labor
                         programs.




                         Page 27                                  GAO-12-677 Employment for People with Disabilities
differences across grantees, but the study did not attempt to discern the
effect of the program on participants’ employment. 32

Only one program in our scope—Labor’s Job Corps program—reported
having a study that meets the criteria of an impact study. Impact studies
examine what would have happened in the absence of a program to
isolate its impact from other factors. Many researchers consider impact
studies to be the best method for determining the extent to which a
program is responsible for participant outcomes, but these studies can be
challenging to conduct. However, there are sometimes opportunities for
agencies to assess impacts without conducting full-scale impact studies.
As an example, Education officials noted that it may be more feasible to
conduct a rigorous study to evaluate the impact of providing enhanced
services over regular services, rather than the impact of providing
services over providing no services at all. The Job Corps impact study
compared the outcomes of participants in the program to outcomes of a
comparable group of individuals who did not participate in the program.
The study concluded that, although there were no long-term program
impacts on earnings for many Job Corps participants, the program
generated earnings gains for participants between the ages of 20 and 24,
who may be more highly motivated and disciplined.

Reports for two additional programs that were excluded from our scope—
SSA’s Youth Transition Demonstration and the Mental Health Treatment
Study programs 33—met the criteria for impact studies. Each of the
programs was a demonstration project that included an impact study to
determine whether the program produced positive outcomes. The Youth
Transition Demonstration Project had interim impact studies for three
project sites. 34 The studies concluded that, while the program did result in
greater use of services to promote employment, it did not impact the
employment of participants from two out of three project sites during the


32
  Social Policy Research Associates, Evaluation of the YouthBuild Youth Offender Grants
Final Report (May 2009). YouthBuild does not limit eligibility to people with
disabilities. This report did not focus specifically on youth with disabilities, but on
outcomes for all youth offenders participating in the program.
33
  Although we surveyed both programs, we excluded them from our data analysis for this
report because they were demonstration studies that had ended by December 2011. See
appendix II for more information.
34
  Youth Transition Demonstration–Interim Reports,
http://www.ssa.gov/disabilityresearch/interimreports.html, accessed June 13, 2012.




Page 28                                GAO-12-677 Employment for People with Disabilities
               1-year follow-up period. 35 The program also did not impact the education
               or income of participants from the three project sites during the 1-year
               follow-up period. The Mental Health Treatment Study program also
               published an impact study, which concluded that there was significant
               improvement in the 24-month employment rate for the group receiving
               services (61 percent versus 40 percent employment for the control
               group). 36

               Finally, agencies may have published or initiated impact studies after
               responding to our survey. For instance, officials at Labor notified us of two
               impact studies currently being planned or underway, for the YouthBuild
               program and for the Disability Employment Initiative.


               The number of programs providing similar employment services to people
Concluding     with disabilities—and the range of requirements and approaches they
Observations   entail—raises questions about the current structure of federal disability
               programs. In fact, several of the programs we identified were created in
               order to help people with disabilities navigate this fragmented system.
               Efforts such as Education’s proposed consolidation of several smaller
               programs into its VR program also indicate an awareness of the need to
               simplify the system and increase effectiveness and ease of use. In our
               February 2012 report on duplication and overlap in government
               programs, we suggested that OMB continue to work with executive
               agencies that administer overlapping programs to identify any
               opportunities for cost savings or streamlining, such as program
               consolidation. We continue to believe that such a review could result in
               more effective and efficient delivery of services to help people with
               disabilities obtain and retain employment.




               35
                 One study estimated that the City University of New York’s project increased
               participation in paid employment during the 1-year follow-up period. However, the study
               explains that this may be because site participants took part in summer employment
               through the project. Mathematica Policy Research, The Social Security Administration’s
               Youth Transition Demonstration Projects: Interim Report on the City University of New
               York’s Project, (April 2011). Available at http://www.mathematica-
               mpr.com/publications/pdfs/disability/SSA_YTD_CUNY.pdf, accessed June 15, 2012.
               36
                  Westat, Mental Health Treatment Study Final Report, (July 2011), available at
               http://www.ssa.gov/disabilityresearch/documents/MHTS_Final_Report_508.pdf, accessed
               June 15, 2012.




               Page 29                                GAO-12-677 Employment for People with Disabilities
                     We identified limited coordination among programs that provide
                     employment support for people with disabilities, which may exacerbate
                     the potential for duplication among fragmented programs. In addition,
                     many programs have not evaluated their programs for effectiveness, and
                     little is known about effectiveness overall, such that policymakers have
                     limited information to help them make informed decisions on allocating
                     scarce resources. In our February 2012 report, we noted that OMB
                     should consider establishing governmentwide goals related to
                     employment of people with disabilities, with agencies establishing related
                     outcome measures. We continue to believe that setting common goals
                     across programs that support employment for people with disabilities
                     could help spur greater coordination and more efficient and economical
                     service delivery in overlapping program areas, and plan to follow up with
                     OMB on its progress with respect to both of the actions we suggested in
                     our February 2012 report.


                     We provided copies of our draft report to the nine federal agencies that
Agency Comments      administer programs within the scope of this report for comment. The
and Our Evaluation   AbilityOne Commission; the Departments of Defense and Health and
                     Human Services; and the Internal Revenue Service had no comments.
                     The Departments of Education, Labor, and Veterans Affairs, and SSA
                     provided technical comments, which we incorporated into the report, as
                     appropriate. The Departments of Agriculture, Education, and Labor also
                     provided written comments, which are reproduced in appendixes VIII, IX,
                     and X, respectively.

                     In its comments, the Department of Agriculture noted that it generally
                     concurred with our findings. Education provided additional information
                     and examples of how its VR program coordinates services at the state
                     and local level that were not fully described in our report. For example,
                     Education noted that the program coordinates at the state level with each
                     state’s workforce investment system, and state VR agencies have staff
                     who provide a variety of education, training, and rehabilitation services to
                     one-stop career center customers with disabilities. Education also stated
                     that the capacity of the VR program to provide and coordinate a wide
                     range of individualized services to achieve employment outcomes for
                     individuals with disabilities—particularly individuals with significant
                     disabilities—is not duplicated by any other program.

                     Labor generally expressed concern that we found fragmentation among
                     the programs we examined, noting that our definition of fragmentation is
                     broad. We continue to believe that fragmentation—defined as more than


                     Page 30                          GAO-12-677 Employment for People with Disabilities
one federal agency (or organization within an agency) being involved in
the same broad area of national need—exists among the 45 programs we
identified across nine federal agencies. As we have noted, unless
programs coordinate effectively, fragmentation could lead to inefficient
use of scarce resources, confuse program beneficiaries, and ultimately,
limit the overall effectiveness of the federal effort. Labor also expressed
concern about our statement that certain youth programs with similar
eligibility requirements present a greater risk of potential duplication than
other programs, noting that we did not consider the unique characteristics
of the programs, such as the individual services provided, the program
design used, or the populations served. We did consider such factors and
provided some information in our report about the different ways these
programs serve the youth population. However, we were unable to
determine the extent to which these factors reduce the potential for
duplication.

Further, while Labor acknowledged that it is important to minimize
duplication and maximize efficiency, it noted that some overlap is
necessary and appropriate to ensure that all participants receive
comprehensive employment and training services. We agree that, in
some instances, overlap among programs involved in providing services
to similar populations may be appropriate. However, we continue to
believe there is value in examining overlapping programs to identify
opportunities for streamlining and coordination to more efficiently provide
services.

Labor also pointed out that several of its programs included in the scope
of our study were created to serve all job-seekers rather than specifically
to provide employment support for people with disabilities. Labor also
noted that, rather than being seen as duplicative or undesirable, service
integration and diversity of design are important for achieving inclusion of
people with disabilities consistent with what Congress envisioned. We
included such programs to provide a more comprehensive picture of the
services and supports available to help people with disabilities stay at
work or return to work. We did not label any given program as duplicative
or undesirable, but noted that, in some cases, having many programs
serving similar populations may result in administrative inefficiencies.




Page 31                          GAO-12-677 Employment for People with Disabilities
We are sending copies of this report to the AbilityOne Commission; the
Departments of Agriculture, Defense, Education, Health and Human
Services, Labor, and Veterans Affairs; the Internal Revenue Service; and
SSA. In addition, the report is available at no charge on the GAO website
at http://www.gao.gov.

If you or your staff have any questions about this report, please contact
me at (202) 512-7215 or bertonid@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 key contributions to this
report are listed in appendix XI.




Daniel Bertoni, Director
Education, Workforce, and Income Security




Page 32                          GAO-12-677 Employment for People with Disabilities
List of Committees

The Honorable Debbie Stabenow
Chairwoman
The Honorable Pat Roberts
Ranking Member
Committee on Agriculture, Nutrition and Forestry
United States Senate

The Honorable Carl Levin
Chairman
The Honorable John McCain
Ranking Member
Committee on Armed Services
United States Senate

The Honorable Max Baucus
Chairman
The Honorable Orrin G. Hatch
Ranking Member
Committee on Finance
United States Senate

The Honorable Tom Harkin
Chairman
The Honorable Michael B. Enzi
Ranking Member
Committee on Health, Education, Labor, and Pensions
United States Senate

The Honorable Joseph I. Lieberman
Chairman
The Honorable Susan M. Collins
Ranking Member
Committee on Homeland Security and Governmental Affairs
United States Senate




Page 33                         GAO-12-677 Employment for People with Disabilities
The Honorable Patty Murray
Chairman
The Honorable Richard Burr
Ranking Member
Committee on Veterans’ Affairs
United States Senate

The Honorable Tom Harkin
Chairman
The Honorable Richard Shelby
Ranking Member
Subcommittee on Labor, Health and Human Services,
  Education, and Related Agencies
Committee on Appropriations
United States Senate

The Honorable Frank D. Lucas
Chairman
The Honorable Collin Peterson
Ranking Member
Committee on Agriculture
House of Representatives

The Honorable Howard P. McKeon
Chairman
The Honorable Adam Smith
Ranking Member
Committee on Armed Services
House of Representatives

The Honorable John Kline
Chairman
The Honorable George Miller
Ranking Member
Committee on Education and the Workforce
House of Representatives

The Honorable Fred Upton
Chairman
The Honorable Henry A. Waxman
Ranking Member
Committee on Energy and Commerce
House of Representatives


Page 34                          GAO-12-677 Employment for People with Disabilities
The Honorable Darrell E. Issa
Chairman
The Honorable Elijah Cummings
Ranking Member
Committee on Oversight and Government Reform
House of Representatives

The Honorable Jeff Miller
Chairman
The Honorable Bob Filner
Ranking Member
Committee on Veterans’ Affairs
House of Representatives

The Honorable Dave Camp
Chairman
The Honorable Sander Levin
Ranking Member
Committee on Ways and Means
House of Representatives

The Honorable Denny Rehberg
Chairman
The Honorable Rosa DeLauro
Ranking Member
Subcommittee on Labor, Health and Human Services,
Education, and Related Agencies
Committee on Appropriations
House of Representatives




Page 35                          GAO-12-677 Employment for People with Disabilities
Appendix I: Objectives, Scope, and
Methodology

                       Our objectives were to examine: (1) to what extent do federal programs
                       that support employment for people with disabilities provide similar
                       services to similar populations and (2) to what extent has the
                       effectiveness of programs that support employment for people with
                       disabilities been measured? The interim results for this report were
                       included in our February 2012 report on duplication and overlap in
                       government programs. 1


                       We determined that programs included in the scope of our work should
Identifying Programs   meet two sets of criteria. Specifically, they should: (1) be targeted to
that Provide           people with disabilities or their employers and (2) have provided specific
                       employment and training services in fiscal year 2010. 2 See figure 7 for a
Employment-Related     detailed description of both sets of criteria.
Services to People
with Disabilities




                       1
                        GAO-12-342SP.
                       2
                        We excluded Recovery Act programs; loans (such as Pell Grants and federal student
                       loans); civil protection and legal services (such as nondiscrimination requirements and
                       protection and advocacy programs); research; personal assistant services (such as
                       independent living); training for professionals who work with people with disabilities;
                       federal employment and contracting preferences; and programs whose objectives do not
                       explicitly include helping job seekers enhance their job skills, find job opportunities, obtain,
                       or retain employment, including general education programs.




                       Page 36                                   GAO-12-677 Employment for People with Disabilities
Figure 7: Criteria for Including Programs within Our Scope




We identified and selected programs for inclusion in our review leveraging
a variety of sources and a multi-step process. Specifically, we identified
programs for potential inclusion using key terms to search the Catalog of
Federal Domestic Assistance (CFDA), reviewing our previous work on
related topics, and consulting with internal and external stakeholders. We
then reviewed the programs’ objectives and eligibility criteria from CFDA
or program websites to determine if the program met our inclusion
criteria. If key information, such as how a program focuses on people with
disabilities or provides employment-related services, was incomplete or
ambiguous, we kept the program in our preliminary list.

We sent our preliminary list of programs for validation to the 10 agencies
that administer the programs. The agencies requested we add several
programs to our list, and determined that others did not meet the criteria
for inclusion. We held follow-up meetings with agency officials to clarify
criteria, as appropriate. We determined that the two programs in our
preliminary list administered by the Small Business Administration did not




Page 37                             GAO-12-677 Employment for People with Disabilities
                     meet our criteria and thus we excluded the agency and the programs
                     from our review.

                     Our validation process yielded a total of 56 programs administered by
                     nine federal agencies. We surveyed these programs from August to
                     October 2011. Based on agency responses and follow-up conversations,
                     we omitted six surveyed programs because we found they did not meet
                     the inclusion criteria. 3 We reported on 50 of those programs in our
                     February 2012 report. 4

                     For this final report, we have omitted an additional 7 programs and added
                     2 new programs, for a total of 45 programs. We omitted six programs that
                     had ended as of April 2012, and one demonstration program—the Benefit
                     Offset National Demonstration—that did not begin enrolling participants
                     until January 2011. (See app. II for a list of programs we omitted.) In
                     commenting on a draft of our February 2012 report and, later, in verifying
                     data previously provided, Department of Defense officials requested that
                     we add three programs that they believed to be within the scope of this
                     review. After identifying the programs’ employment services to people
                     with disabilities, we determined that two—the Army Warrior Care and
                     Transition and the Marines Wounded Warrior Regiment programs—met
                     our criteria and thus were included in our analyses for this report.

                     We did not include or review programs that may have been created or
                     revised to meet our inclusion criteria after fiscal year 2010.


                     We designed a web-based survey to collect information on program
Surveying Programs   background, eligibility requirements and populations served, services,


                     3
                      Specifically, we excluded: the Department of Health and Human Services’ (HHS)
                     Demonstration to Maintain Independence and Employment because program officials
                     reported that the program was not funded in fiscal year 2010; the Department of Labor’s
                     (Labor) Homeless Veterans Reintegration Program and the Department of Veteran Affairs’
                     Educational and Vocational Counseling program because program officials reported that
                     the programs did not provide any special consideration to people with disabilities in
                     eligibility determinations; the Section 1915(b) waivers program (HHS) and the Section
                     1115 Medicaid demonstration projects (HHS) because officials reported that the programs
                     did not provide any of the employment-related services listed in the survey; and Disability
                     Program Navigator (Labor) because officials reported that the program was a subprogram
                     of another program included in our scope (Work Incentive Grants).
                     4
                     GAO-12-342SP.




                     Page 38                                GAO-12-677 Employment for People with Disabilities
                    outcome measures, and budget information. In designing this survey, we
                    reviewed our prior surveys used to collect similar information. 5 We
                    pretested the survey with three programs to minimize errors that may
                    arise from differences in how questions might be interpreted and ensure
                    that response categories were appropriate.

                    From August through October 2011, we fielded the web-based survey of
                    56 federal programs that support employment for people with disabilities.
                    Program representatives were identified by the agencies. Where
                    programs were jointly administered by two or more federal agencies, we
                    consulted with the agencies and asked them to designate one official to
                    fill out the survey and respond to questions for that program. In March
                    2012, we fielded the web-based survey to two additional programs that
                    were later determined to meet our inclusion criteria (Army Warrior Care
                    and Transition Program and the Marine Corps Wounded Warrior
                    Regiment, discussed earlier). We received completed questionnaires
                    from 58 programs, for a 100 percent response rate.


                    We used standard descriptive statistics to analyze responses to the
Quality Assurance   questionnaire. Because this was not a sample survey, there were no
                    sampling errors. To minimize other types of errors, commonly referred to
                    as nonsampling errors, and to enhance data quality, we employed
                    recognized survey design practices in the development of the
                    questionnaire and in the collection, processing, and analysis of the survey
                    data. For instance, as previously mentioned, we pretested the
                    questionnaire with program officials. We further reviewed the survey to
                    ensure the ordering of survey sections was appropriate and that the
                    questions within each section were clearly stated and easy to
                    comprehend. To reduce nonresponse, another source of nonsampling
                    error, we sent out e-mail reminder messages and made telephone calls to
                    encourage officials to complete the survey.




                    5
                     For example, we reviewed the survey used in the following GAO reports: Multiple
                    Employment and Training Programs: Providing Information on Colocating Services and
                    Consolidating Administrative Structures Could Promote Efficiencies, GAO-11-92
                    (Washington, D.C.: Jan. 13, 2011), and Federal Disability Assistance: Wide Array of
                    Programs Needs to Be Examined in Light of 21st Century Challenges, GAO-05-626
                    (Washington, D.C.: June 2, 2005).




                    Page 39                              GAO-12-677 Employment for People with Disabilities
                            In reviewing the survey data, we performed automated checks to identify
                            inconsistent answers. We further reviewed the data for missing,
                            ambiguous, or illogical responses and followed up with agency officials
                            when necessary to clarify their responses. In addition, we compared 2010
                            obligations data provided by survey respondents with data provided to us
                            in a previous survey and with appropriations data from the Consolidated
                            Federal Funds Report. Where obligations differed from the comparison
                            sources by 10 percent or more, we contacted program officials to confirm
                            reported data. Finally, in March and April 2012, we collected some
                            additional data from agencies and verified select data collected during the
                            initial survey. Because we updated selected data and the list of programs
                            included in our analyses, some data in our analyses have changed since
                            our February 2012 report. On the basis of our application of recognized
                            survey design practices and follow-up procedures, we determined that the
                            data were sufficiently reliable for our purposes. We did not conduct an
                            independent legal analysis to verify the program information provided by
                            survey respondents.



Survey Analysis
Fragmentation, Overlap,     We have defined fragmentation to be when more than one federal agency
and Potential Duplication   is involved in the same broad area of national need. To further expand on
                            this definition, we used the survey responses to identify: the number of
                            programs created in statute and variability in definitions of disability and
                            the ways in which programs deliver supports (e.g., directly to individuals,
                            or through federal, state, or local entities).

                            We have defined overlap to be instances where programs provide similar
                            services to similar populations. To identify areas of potential overlap
                            among programs that support employment for people with disabilities, we
                            reviewed survey responses from agency officials. We analyzed
                            responses to survey questions regarding any limitations in eligibility
                            based on populations or disability.

                            We sorted the 45 programs into 4 groups:




                            Page 40                          GAO-12-677 Employment for People with Disabilities
               1. Programs that limit eligibility to servicemembers and veterans (19
                  programs). 6

               2. Programs that limit eligibility to students, transition-age youth and/or
                  young adults (5 programs).

               3. Programs that limit eligibility to other populations or specific types of
                  disabilities (14 programs).

               4. Programs that serve all people with disabilities (7 programs).

               We have defined duplication as when the same beneficiaries receive the
               same or similar services. Although fragmentation and overlap may
               indicate the potential for duplication, we did not identify actual duplication
               in programs that provide employment support to people with disabilities
               because (1) due to data limitations, we did not attempt an intensive data
               matching among our universe of programs to identify instances where
               programs were providing the same or similar services to the same
               beneficiaries, and (2) programs do not consistently collect information on
               beneficiaries.

               Instead, we examined the potential for duplication by more closely
               examining the reported eligibility requirements among programs in our
               four groups.


               We asked survey respondents if their program coordinated with each of
Coordination   the other programs in our scope to reduce duplication and gaps and
               services. While we surveyed federal program officials, our survey
               question did not specify if we were requesting information on coordination
               at the federal level, or at the state and local level where services and
               supports may be delivered. We analyzed the data to identify mismatches
               in reported coordination. For example, we identified cases in which
               program A reported that they coordinated with program B, but program B
               did not report coordinating with program A.

               To further understand the nature and challenges of coordination, we
               selected a subgroup of programs with which to hold further discussion on


               6
                We combined programs serving servicemembers and those serving veterans because
               four programs reported serving both populations.




               Page 41                            GAO-12-677 Employment for People with Disabilities
                      coordination. Specifically, we selected six programs—administered by
                      three different agencies—that served only people with disabilities:

                      •   Assistive Technology State Grant program [Department of Education
                          (Education)]

                      •   Disability Employment Initiative (a new program that replaced the
                          Work Incentive Grants) [Department of Labor (Labor)]

                      •   State Vocational Rehabilitation Cost Reimbursement Program [Social
                          Security Administration (SSA)]

                      •   Ticket to Work program (SSA)

                      •   State Vocational Rehabilitation Services program (VR) (Education)

                      •   Work Incentives Planning and Assistance program (SSA)

                      We interviewed agency representatives for each program regarding their
                      coordination efforts, challenges to coordination, and factors that facilitate
                      or create barriers to coordination.


                      We asked all survey respondents to provide information on any
Performance           performance evaluations that have been completed since 2006 related to
Evaluations: Impact   employment for people with disabilities for their program and to provide
                      citations to those studies. We selected 2006 because studies conducted
Studies and Other     in the past 5 years were most likely to include services still offered by
Studies               each program and be relevant to the employment market participants are
                      currently facing. We reviewed the findings and conclusions of a total of 14
                      studies identified by programs in our scope to determine the elements of
                      program performance that had been evaluated. Although programs
                      identified a total of 18 program studies, 1 was not publicly available and 2
                      programs had identified a GAO report that had been published prior to
                      2006. In addition, we evaluated the methodology section of 11 of those
                      studies, which were identified as impact studies by 7 programs, to
                      determine if they met our criteria for an impact study—that is, the study
                      provides an assessment of the net effect of a program by comparing
                      program outcomes with an estimate of what would have happened in the
                      absence of the program.

                      We conducted this performance audit from April 2011 through June 2012
                      in accordance with generally accepted government auditing standards.



                      Page 42                           GAO-12-677 Employment for People with Disabilities
Those standards require that we plan and perform the audit to obtain
sufficient, appropriate evidence to provide a reasonable basis for our
findings and conclusions based on our audit objectives. We believe that
the evidence obtained provides a reasonable basis for our findings and
conclusions based on our audit objectives.




Page 43                         GAO-12-677 Employment for People with Disabilities
Appendix II: Selected Survey Data from
Programs That Have Ended Since Fiscal Year
2010

                  Number of people
                  with disabilities
                  receiving
                  employment
Program name      services (fiscal year
(agency)          2010)                 Services                                            Details on status
Medicaid          Program did not       •   Employment-related information                  The program, authorized for 11 years,
Infrastructure    provide data              dissemination                                   expired at the close of fiscal year 2011.
Grant Program                           •   Support services to employers of people with
(Department of                              disabilities
Health and
Human Services)
Mental Health     Program did not       •     Employment counseling, assessment and         The study to test how better access to
                              a
Treatment Study   provide data                case management                               treatment and employment services
(SSA)                                   •     Assistance in earning a high school diploma   would affect outcomes such as
                                              or its equivalent                             medical recovery, employment, and
                                                                                            benefit receipt for Social Security
                                        •     Job development
                                                                                            Disability Insurance ended field
                                        •     Job readiness skills                          operations on July 31, 2010.
                                        •     Job recruitment and referrals                 According to the agency’s budget
                                        •     Job retention training                        justification for fiscal year 2013, the
                                        •     Job search or placement activities            project’s funding continued and, going
                                                                                            forward, the agency will focus on best
                                        •     On-the-job training                           practices in services to individuals with
                                        •     Occupational or vocational training           schizophrenia and affective disorder
                                        •     Vocational rehabilitation                     and track employment and benefit
                                                                                            payments.
                                        •     Supported employment
                                        •     Remedial academic, English language skills,
                                              or adult literacy
                                        •     Employment-related information
                                              dissemination
                                        •     Entrepreneurship training and support
                                        •     Assistive technology and workplace
                                              accommodation
                                        •     Case management and nurse care
                                              coordinators




                                            Page 44                              GAO-12-677 Employment for People with Disabilities
                  Number of people
                  with disabilities
                  receiving
                  employment
Program name      services (fiscal year
(agency)          2010)                 Services                                            Details on status
National          1,300                •     Employment counseling, assessment and          This program, administered by the
Organization on                              case management                                National Organization of Disability,
Disability                             •     Job development                                provided services to wounded, ill, and
Wounded Warrior                                                                             injured U.S. Army personnel through a
                                       •     Job readiness skills
Career                                                                                      memorandum of agreement, which
Demonstration                          •     Job recruitment and referrals                  ended October, 2010.
Project                                •     Job retention training
(Department of                         •     Job search or placement activities
Defense)
                                       •     Occupational or vocational training
                                       •     Vocational rehabilitation
                                       •     Supported employment
                                       •     Remedial academic, English language skills,
                                             or adult literacy
                                       •     Work experience
                                       •     Employment-related information
                                             dissemination
                                       •     Entrepreneurship training and support
                                       •     Support services to employers of people with
                                             disabilities
                                       •     Assistive technology and workplace
                                             accommodation
                                       •     Funding may be provided to the veteran
Projects with     5,454                •     Employment counseling, assessment, and         The program was eliminated in the
Industry                                     case management                                fiscal year 2011 appropriation.
(Education)                            •     Assistance in earning a high school diploma
                                             or its equivalent
                                       •     Job development
                                       •     Job readiness skills
                                       •     Job recruitment and referrals
                                       •     Job retention training
                                       •     Job search or placement activities
                                       •     Occupational or vocational training
                                       •     Vocational rehabilitation
                                       •     On-the-job training
                                       •     Employment-related information
                                             dissemination
                                       •     Support services to employers of people with
                                             disabilities
                                       •     Assistive technology and workplace
                                             accommodation




                                           Page 45                              GAO-12-677 Employment for People with Disabilities
                    Number of people
                    with disabilities
                    receiving
                    employment
Program name        services (fiscal year
(agency)            2010)                 Services                                               Details on status
Work Incentive      Program did not      Employment counseling, assessment and case              The Work Incentives Grant funded the
Grant/ Disability   provide data         management                                              Disability Program Navigator Initiative.
Program                                  Employment-related information dissemination            Both programs ended effective June
Navigator (Labor)                                                                                30, 2010. A new program, the
                                         Entrepreneurship training and support                   Disability Employment Initiative, was
                                         Support services to employers of people with            informed by the best practices learned
                                         disabilities                                            through the Work Incentive
                                         Assistive technology and workplace                      Grant/Disability Program Navigator
                                         accommodation                                           initiative.
                                         Medicaid services
Youth Transition    1,290                Employment counseling, assessment and case              The program suspended services at
Demonstration                            management                                              the end of calendar year 2011. A 36-
Project (SSA)                            Assistance in earning a high school diploma or its      month evaluation of the impact of the
                                         equivalent                                              program is scheduled to follow.
                                                                                                 Funding was approximately $1.35
                                         Job development                                         million in fiscal years 2012 and 2013.
                                         Job readiness skills
                                         Job recruitment and referrals
                                         Job retention training
                                         Job search or placement activities
                                         On-the-job training
                                         Remedial academic, English language skills, or
                                         adult literacy
                                         Work experience
                                         Employment-related information dissemination
                                         Entrepreneurship training and support
                                         Support services to employers of people with
                                         disabilities
                                         Assistive technology and workplace
                                         accommodation.
                                          Sources: GAO survey and agency interviews.

                                          a
                                           This program enrolled participants on a rolling basis between 2006 and 2009 and served 1,121
                                          individuals over the course of the project.




                                          Page 46                                      GAO-12-677 Employment for People with Disabilities
Appendix III: Reported Program Obligations
and Number of People with Disabilities
Served

                                                                                      Portion of fiscal year
                                                                                      2010 obligation for
                                                                                      employment-related            Number of people with
                                                                                      services and support          disabilities provided
                                                      Fiscal year 2010                for people with               employment services,
                                                                                                  a
Program                                               obligation                      disabilities                  fiscal year 2010
U.S. AbilityOne Commission
AbilityOne Program                                                 $5,380,775                                  $0                    47,000
Department of Agriculture
Assistive Technology Program for Farmers with                       4,667,107                        4,667,107                         1,304
Disabilities: AgrAbility Project
Department of Defense
                                                                                  b                                                         b
Air Force Warrior and Survivor Care                         Data not available                                 0          Data not available
                                                                                  c                             b                           d
Army Warrior Care and Transition Program                        1,374,360,000                Data not available                       4,368
Computer/Electronic Accommodations Program                          8,847,404                        8,847,404                       11,775
                                                                                                                                            b
Marine Corps Wounded Warrior Regiment                                         0                                0          Data not available
                                                                                                                                            e
Marine Corps Wounded Warrior Intern Program                                   0                                0                        115
                                                                                                                                               f
Navy Safe Harbor Program                                            2,400,000                           24,000                           78
                                                                                                                                            b
Recovery Care Coordinator Program                                   3,825,960                                  0          Data not available
                                                                                                                                            b
Recovery Coordination Program – Operation                                966,502                       966,502            Data not available
Warfighter (Internships)
                                                                                                                b                           b
U.S. Special Operations Command Care Coalition                      3,592,700                Data not available           Data not available
Department of Education
American Indian Vocational Rehabilitation                          42,822,202                       42,822,202                         8,395
Services
Helen Keller National Center for Deaf-Blind Youths                  9,181,000                        9,181,000                         1,576
and Adults
                                   g
Migrant and Seasonal Farmworkers                                    2,197,283                        2,197,283                           137
                                                                                                                                            b
Model Comprehensive Transition and                                 11,000,000                       11,000,000            Data not available
Postsecondary Programs for Students with
                         g
Intellectual Disabilities
                                                                                  h
Randolph-Sheppard Vending Facility Program                                    0                                0                       2,319
                                                                                                                                            b
Rehabilitation Services Demonstration and                          11,601,000                        5,800,000            Data not available
Training Programs
                                                                                                                b
Assistive Technology State Grant program                           25,660,000                Data not available                        5,882
                                       g
Supported Employment State Grants                                  28,889,190                       28,889,190                       35,668
State Vocational Rehabilitation Services                        3,041,746,049                    3,041,746,049                    1,011,395
Department of Health and Human Services
                                                                                  b                             b                           b
1915(c) Home and Community Based Services                   Data not available               Data not available           Data not available
Waiver




                                            Page 47                                      GAO-12-677 Employment for People with Disabilities
                                                                                       Portion of fiscal year
                                                                                       2010 obligation for
                                                                                       employment-related           Number of people with
                                                                                       services and support         disabilities provided
                                                        Fiscal year 2010               for people with              employment services,
                                                                                                   a
Program                                                 obligation                     disabilities                 fiscal year 2010
                                                                                   b                                                        b
1915(i) State Plan Home and Community-Based                   Data not available                                0         Data not available
Services
                                                                                   b                            b                           b
Medicaid State Plan Services                                  Data not available              Data not available          Data not available
                                                                                                                                            b
Money Follows the Person Rebalancing                                105,596,872                                 0         Data not available
Demonstration
Department of Labor
                                                                                                                                               i
America’s Heroes at Work                                                   300,000                      300,000                No response
                                                                                                                b
Disabled Veterans’ Outreach Program                                  81,251,000               Data not available                     46,887
Employer Assistance and Resource Network                              1,600,000                       1,600,000      Not applicable (program
                                                                                                                          serves employers)
                                                                                                                                               j
Job Accommodation Network                                             2,366,318                       2,366,318                      12,800
          k                                                                                                     b
Job Corps                                                         1,712,000,000               Data not available                     12,079
                                                                                                                b
Local Veterans’ Employment Representatives                           76,481,000               Data not available                     36,322
program
                                                                                   b                            b                              l
REALifelines Initiative                                       Data not available              Data not available                      9,376
                                                                                   m                                                        n
Registered Apprenticeship for Youth and Young                                  0                                0                        21
Adults with Disabilities Initiative
                                                                                                                b                           p
Community Service Employment for Older                              825,400,000               Data not available                     17,885
Americans/Senior Community Service
                   o
Employment Program
                                          q                                                                     b                              r
Veterans’ Workforce Investment Program                                9,493,707               Data not available                        669
                                                                                   s                                                           t
Work Opportunity Tax Credit (joint with the Internal                 18,520,000                                 0                    33,644
Revenue Service)
                                                                                                                b                           u
Workforce Investment Act Youth Activities                           910,207,965               Data not available                     15,105
Workforce Recruitment Program (joint with the                              211,377                      211,377                        2,157
Department of Defense)
            v                                                                                                   b                              r
YouthBuild                                                           97,375,000               Data not available                        425
Department of Veterans Affairs
Compensated Work Therapy program                                                0                               0                    30,000
                                                                                   b                            b
Disabled Transition Assistance Program                        Data not available              Data not available                     36,386
Vocational Rehabilitation and Employment                            768,000,000                     768,000,000                      94,912
                                                                                   b                            b
Vocational Training and Rehabilitation for Vietnam            Data not available              Data not available                          14
Veterans’ Children with Spina Bifida or Other
Covered Birth Defects
Social Security Administration
                                                                                                                                               x
Work Incentives Planning and Assistance                              27,328,266                      27,328,266                      51,395
        w
program




                                              Page 48                                     GAO-12-677 Employment for People with Disabilities
                                                                                     Portion of fiscal year
                                                                                     2010 obligation for
                                                                                     employment-related         Number of people with
                                                                                     services and support       disabilities provided
                                                  Fiscal year 2010                   for people with            employment services,
                                                                                                 a
Program                                           obligation                         disabilities               fiscal year 2010
                                                                                                                                              y
State Vocational Rehabilitation Cost                             106,000,000                      106,000,000                          7,768
Reimbursement Program
                                                                                 z
Ticket to Work program                                           22,100,000                        22,100,000                          55,093
                                       Source: GAO survey.

                                       a
                                        Some programs were not able to identify obligations related to providing employment supports to
                                       people with disabilities.
                                       b
                                        ”Data not available” indicates that the program was not able to provide data on obligations or the
                                       number of people with disabilities served. For example, some programs—like Labor’s Workforce
                                       Investment Act Youth and YouthBuild programs—reported that they are not required to track the
                                       portion of obligations for employment-related services and support for people with disabilities.
                                       c
                                       A significant portion of these obligations ($578,500,000) was for constructing healing campuses for
                                       wounded, ill, and injured soldiers.
                                       d
                                           Data are from December 2010 to September 2011.
                                       e
                                           Data are from June to October 2010.
                                       f
                                           Data are from October to December 2010.
                                       g
                                        This program was proposed to be consolidated or eliminated in Education’s fiscal year 2012 budget
                                       request, but the department reported that funds were appropriated in fiscal year 2012. The program
                                       was also proposed to be consolidated or eliminated in Education’s fiscal year 2013 budget request. In
                                       addition, Education officials noted that the Supported Employment Services program provides
                                       supplemental funding to help state VR agencies cover the costs of Supported Employment State
                                       Grants participating in the State Vocational Rehabilitation Services program.
                                       h
                                        According to Education officials, there is no federal appropriation for this program. Direct federal
                                       costs to administer this program, including the costs of arbitrations, are covered by the Rehabilitation
                                       Services Administration’s salaries and expenses budget. Costs at the state level are paid from
                                       various sources, including vocational rehabilitation formula grant funds (the state VR agency serving
                                       individuals who are blind administers the program), state funds, program income and set-aside funds
                                       from vendor income. Exact funding mechanisms vary by state.
                                       i
                                       ”No response” indicates that the program did not respond to this survey question or otherwise provide
                                       this information.
                                       j
                                       Data are from September 2009 to September 2010. According to Labor, people with disabilities
                                       account for only about one third of the 36,500 individuals who contacted JAN for services. In addition,
                                       officials reported JAN receives 3.1 million Web page requests annually.
                                       k
                                        Total program obligations for Job Corps includes $102 million in American Recovery and
                                       Reinvestment Act obligations. Data on participants is from program year 2009, and is based on self-
                                       disclosed and readily observable disabilities.
                                       l
                                       Data are from May 2008 to October 2010. This data includes the number of participants contacted
                                       and services provided, including to spouses and caregivers.
                                       m
                                        According to Labor, this program did not receive funds in fiscal year 2010 and continued operating
                                       on previous year’s funding.




                                       Page 49                                          GAO-12-677 Employment for People with Disabilities
n
    Data are from June 2010 to June 2011.
o
 This program was proposed to be transferred to the Department of Health and Human Services in
Labor’s fiscal year 2013 budget request.
p
    Data are from July 2010 to June 2011.
q
 This program was proposed to be consolidated or eliminated in Labor’s fiscal year 2013 budget
request.
r
    Data are from July 2009 to June 2010.
s
 Reported obligations for the Work Opportunity Tax Credit are for Labor’s administration of the
program, according to agency officials. According to the Internal Revenue Service, in tax year 2009—
the most recent data available—there were more than $600 million in Work Opportunity Tax Credits
that were eligible to be claimed by individuals. In addition, for tax year 2009, there were more than $1
billion in Work Opportunity Tax Credits that were eligible to be claimed by corporations (including S
corporations).
t
 According to Labor, this number represents certifications issued by State Workforce Agencies to
employers that an employee has met the eligibility requirements for a Work Opportunity Tax Credit
target group for individuals with disabilities.
u
    Data are from April 2009 to March 2010.
v
    Program reported appropriated funds instead of obligations.
w
    According to program officials, this program is expected to end by the end of fiscal year 2012.
x
 According to SSA officials, this number only indicates those enrolled and served in fiscal year 2010
and not those enrolled in a previous year and served in fiscal year 2010.
y
 This number represents the number of people who achieved the outcome of 9 months of working
and earning at the substantial gainful activity level. As of October 25, 2010, the State Vocational
Rehabilitation Cost Reimbursement Program had served 235,346 people. In addition, an SSA official
noted that these participants may also be counted as participants in Education’s State Vocational
Rehabilitation Services program.
z
 Obligations reported for the Ticket to Work program in fiscal year 2010 represent the cost of funding
the Employment Networks and not the total cost of the program. Data on total obligations for fiscal
year 2010 will be available later in fiscal year 2012.




Page 50                                         GAO-12-677 Employment for People with Disabilities
Appendix IV: Reported Program Objectives
and Eligibility Requirements


Program title          Program objectives                                       Beneficiary eligibility requirements
U.S. AbilityOne Commission
AbilityOne Program     The purpose of the Javits-Wagner-O’Day Act is to         The primary requirement for a nonprofit agency to
                       generate employment and training opportunities for       participate in the AbilityOne Program is that, on an
                       people who are blind or have other severe                annual basis, 75 percent of all of the direct labor done
                       disabilities in the manufacture and delivery of          at a nonprofit agency be performed by people who are
                       products and services to the federal government.         blind or severely disabled. The term ‘‘blind’’ refers to
                       The law requires federal agencies to procure certain     an individual or class of individuals whose central
                       products and services that are produced and              visual acuity does not exceed 20/200 in the better eye
                       provided by community-based nonprofit agencies           with correcting lenses or whose visual acuity, if better
                       that are dedicated to training and employing             than 20/200, is accompanied by a limit to the field of
                       persons who are blind or have other severe               vision in the better eye to such a degree that its widest
                       disabilities.                                            diameter subtends an angle of no greater than 20
                                                                                degrees. The term “severely disabled” refers to an
                                                                                individual or class of individuals who has a severe
                                                                                physical or mental impairment other than blindness,
                                                                                which so limits the person’s functional capabilities
                                                                                (mobility, communication, self-care, self direction, work
                                                                                tolerance, or work skills) that the individual is unable to
                                                                                engage in normal competitive employment, over an
                                                                                extended period of time.
Department of Agriculture
Assistive Technology   AgrAbility increases the likelihood that individuals     The program targets accommodating disability in
Program for Farmers    with disabilities and their families engaged in          production agriculture. It provides education and
with Disabilities:     production agriculture (AgrAbility’s customers)          awareness to the public, agricultural, and rehabilitation
AgrAbility Project     become more successful. The program supports             professionals on what can be done to accommodate
                       cooperative projects in which State Cooperative          disability in the agricultural workplace. The program
                       Extension Services based at either 1862 or 1890          does not fund rehabilitation equipment or payments to
                       Land-Grant Universities or the University of the         individuals.
                       District of Columbia subcontract to private, nonprofit
                       disability organizations. Measures of success may
                       include improvements in customers’ financial
                       stability or access to life activities and in the
                       capacity of the states and regions to deliver
                       services this population requires in a timely and
                       satisfying manner. To address the specialized
                       needs of AgrAbility’s customers, the program builds
                       service capacity on national, regional, state, and
                       local levels through education and networking. In
                       the absence of capacity, projects provide assistance
                       to customers. The primary function of the National
                       AgrAbility Project is to support the state and
                       regional projects in developing their capacity to
                       meet these objectives.




                                          Page 51                                    GAO-12-677 Employment for People with Disabilities
Program title           Program objectives                                      Beneficiary eligibility requirements
Department of Defense
Air Force Warrior and   Develop programs to help identify all airmen that       The Air Force Warrior and Survivor Care programs are
Survivor Care           need assistance; continue to build mentorship           made available to all Active Duty, Air National Guard,
                        program to aid and benefit recovering airmen;           and Air Force Reserve members and their families to
                        employ dedicated qualified staff as Recovery Care       provide support in the event an airman is seriously
                        Coordinators and provide them with tools and            wounded, ill, or injured while serving. The level of
                        support needed to be successful; provide                support and benefit assistance provided is dependent
                        comprehensive policy for Mortuary, Casualty Affairs,    solely on need and is provided throughout the
                        Wounded Warrior, and Recovery Care Coordinator          continuum of care. If injuries or illness warrant, airmen
                        programs.                                               may enter the program at any time by self-referral or
                                                                                be referred by commander, spouses, supervisors, and
                                                                                medical personnel.
Army Warrior Care and   An Army-wide structure to provide support and           The Warrior Care and Transition Program is available
Transition Program      services for wounded, ill, and injured soldiers. The    to soldiers of all components (active and reserve
                        program enables the Army to evaluate and treat          components/active guard and reserve) on active duty
                        soldiers through a comprehensive, soldier-centric       who require complex medical care management of 6
                        process of medical care, rehabilitation, professional   months or longer duration. Additionally, eligibility is
                        development, and achievement of personal goals.         extended to activated reserve component soldiers
                                                                                requiring definitive medical care who have been
                                                                                approved by a Medical Review Board.
Computer/ Electronic    The Computer/Electronic Accommodations Program          To be eligible for CAP services, an individual must be
Accommodations          (CAP) is a program in the TRICARE Management            a federal employee with a disability in the Department
Program                 Activity, under the direction of the Assistant          of Defense or an employee with a disability at one of
                        Secretary of Defense for Health Affairs. CAP’s          the federal partners with CAP or an active duty
                        mission is to provide assistive technology and          wounded or ill servicemember.
                        accommodation services to federal employees with
                        disabilities and wounded servicemembers to
                        increase access to information environment and
                        employment opportunities in the federal
                        government.
Marine Corps Wounded To maintain a high level of coordination through a         Must be an active duty, reserve, retired, or veteran
Warrior Regiment     single command structure that delivers or facilitates      wounded, ill, or injured Marine.
                     delivery of nonmedical care to wounded, ill, or
                     injured Marines and their families.
Marine Corps Wounded To provide job skills and training to wounded, ill,        The Marine Corps Wounded Warrior Intern Program is
Warrior Intern Program and injured Marines pending medical separation.          open to all wounded, ill, and injured Marines. Spouses
                                                                                and caregivers of active duty wounded, ill, and injured
                                                                                Marines are eligible for some of the program benefits.




                                           Page 52                                   GAO-12-677 Employment for People with Disabilities
Program title         Program objectives                                     Beneficiary eligibility requirements
Navy Safe Harbor      1.   Provide optimal nonmedical care to all Safe       All seriously wounded, ill, or injured sailors and Coast
Program                    Harbor enrollees and their families throughout    Guardsmen not likely to return to duty in 180 days and
                           recovery, rehabilitation and reintegration        likely to be medically retired or separated; and high-
                      2.   Cultivate and institutionalize external and       risk, nonseriously wounded, ill, or injured sailors,
                           internal partnerships                             Coast Guardsmen and their families (case-by-case).
                      3.   Provide focused outreach opportunities for
                           wounded, ill, or injured sailors’ and Coast
                           Guardsmen’s family members, caregivers and
                           their support network
                      4.   Increase awareness of Navy Safe Harbor
                      5.   Align resources to effectively and efficiently
                           execute the Safe Harbor mission
                      6.   Attract and retain sustained superior
                           performers with demonstrated leadership
                           expertise to the Safe Harbor staff.
Recovery Care         The Recovery Care Coordinators (RCC) assist in         Populations served by the RCCs are wounded, ill and
Coordinator Program   the creation and management of the                     injured warriors and their families: troop program unit,
                      Comprehensive Recovery Plans for Wounded               Active Guard Reserve, Individual Mobilization
                      Warriors—Army, Marines, Navy, Air Force, and U.S.      Augmentee, Individual Ready Reserve, retirees, and
                      Special Operations Command—until they are either       veterans.
                      returned to duty or separated from the service due
                      to the extent of their injuries. The RCCs act as the
                      single point of contact for the Wounded Warriors
                      and their families as they receive care from multi-
                      disciplinary support teams, both medical and
                      nonmedical, in helping them obtain required
                      treatment, care, and family assistance.




                                         Page 53                                  GAO-12-677 Employment for People with Disabilities
Program title             Program objectives                                       Beneficiary eligibility requirements
Recovery Coordination Operation Warfighter (OWF) is a federal internship           Eligibility criteria require participants to be
Program-Operation        program for wounded, ill, and injured                     servicemembers in an active duty status assigned to a
Warfighter (internships) servicemembers. The main objective of OWF is to           military treatment facility or a service wounded warrior
                         place servicemembers in supportive work settings          program. If not assigned to one of these programs,
                         that positively impact their recuperation. The            servicemembers can still be eligible if they are going
                         program represents a great opportunity for                through the medical evaluation board and their chain
                         transitioning servicemembers to augment their             of command approves their participation.
                         employment readiness by building their resumes,
                         exploring employment interests, developing job
                         skills, benefiting from both formal and on-the-job
                         training opportunities, and gaining valuable federal
                         government work experience that will help prepare
                         them for the future. Operation Warfighter strives to
                         demonstrate to participants that the skills they have
                         obtained in the military are transferable into civilian
                         employment. For servicemembers returning to duty,
                         the program enables these participants to maintain
                         their skill sets and provides the opportunity for
                         additional training and experience that can
                         subsequently benefit the military. Operation
                         Warfighter simultaneously enables federal
                         employers to better familiarize themselves with the
                         skill sets and challenges of wounded, ill, and injured
                         servicemembers as well as benefit from the
                         considerable talent and dedication of these
                         servicemembers.
U.S. Special Operations To provide Special Operations Forces warriors and          Special Operations Forces wounded, ill, or injured
Command Care            their families a model advocacy program in order to        servicemembers and their families
Coalition               enhance their quality of life and strengthen overall
                        readiness of Special Operations.
Department of Education
American Indian           To provide vocational rehabilitation services to         American Indians with disabilities residing on or near a
Vocational                American Indians with disabilities who reside on or      federal or state reservation (including Native Alaskans)
Rehabilitation Services   near federal or state reservations in order to           who meet the definition of an individual with a disability
                          achieve gainful employment.                              in Section 7 (8)(A) of the Rehabilitation Act.
Assistive Technology      To provide states with financial assistance that       Individuals with disabilities.
State Grant program       supports programs designed to maximize the ability
                          of individuals of all ages with disabilities and their
                          family members, guardians, advocates, and
                          authorized representatives to obtain assistive
                          technology devices and assistive technology
                          services.




                                              Page 54                                   GAO-12-677 Employment for People with Disabilities
Program title           Program objectives                                      Beneficiary eligibility requirements
Helen Keller National   Authorized by an Act of Congress in 1967, the           The Helen Keller National Center for Deaf-Blind
Center for Deaf-Blind   Helen Keller National Center for Deaf-Blind Youths      Youths and Adults provides services on a national
Youths and Adults       and Adults is a national rehabilitation program         basis to adults who are deaf-blind, their families, and
                        serving youth and adults who are deaf-blind. The        service providers. The term “individual who is deaf-
                        purposes of the Center are to (1) provide               blind” means any individual - (A)(i) who has a central
                        specialized intensive services, or any other            visual acuity of 20/200 or less in the better eye with
                        services, at the Center or anywhere else in the         corrective lenses, or a field defect such that the
                        United States, which are necessary to encourage         peripheral diameter of visual field subtends an angular
                        the maximum personal development of any                 distance no greater than 20 degrees, or a progressive
                        individual who is deaf-blind; (2) train family          visual loss having a prognosis leading to one or both
                        members of individuals who are deaf-blind at the        these conditions; (ii) who has a chronic hearing
                        Center or anywhere else in the United States, in        impairment so severe that most speech cannot be
                        order to assist family members in providing and         understood with optimum amplification, or a
                        obtaining appropriate services for the individual who   progressive hearing loss having a prognosis leading to
                        is deaf-blind; (3) train professionals and allied       this condition; and (iii) for whom the combination of
                        personnel at the Center or anywhere else in the         impairments described in clauses (i) and (ii) cause
                        United States to provide services to individuals who    extreme difficulty in attaining independence in daily life
                        are deaf-blind; and (4) conduct applied research,       activities, achieving psychosocial adjustment, or
                        development programs, and demonstrations with           obtaining a vocation; (B) who despite the inability to be
                        respect to communication techniques, teaching           measured accurately for hearing and vision loss due to
                        methods, aids and devices, and delivery of services.    cognitive or behavioral constraints, or both, can be
                                                                                determined through functional and performance
                                                                                assessment to have severe hearing and visual
                                                                                disabilities that cause extreme difficulty in attaining
                                                                                independence in daily life activities, achieving
                                                                                psychosocial adjustment, or obtaining vocational
                                                                                objectives; or (C) meets such other requirements as
                                                                                the Secretary may prescribe by regulation.”
Migrant and Seasonal    The Migrant and Seasonal Farmworkers program            Individuals with disabilities and individuals with
Farmworkers             provides comprehensive vocational rehabilitation        significant disabilities as defined in Sections 7(9)(A)(B)
                        (VR) services available to migrant and seasonal         and 7(20)(A), respectively, of the Rehabilitation Act of
                        farmworkers with disabilities with the goal of          1973, as amended.
                        increasing employment opportunities for these
                        individuals. Projects also develop innovative
                        methods for reaching and serving this population.
                        Projects are required to coordinate with the VR
                        State Grants program.
Model Comprehensive     Create or expand model comprehensive transition         Students with intellectual disabilities enrolled in model
Transition and          and postsecondary programs for students with            programs or other comprehensive transition and
Postsecondary           intellectual disabilities. Funds also support a         postsecondary programs.
Programs for Students   coordinating center that provides related services.
with Intellectual
Disabilities




                                           Page 55                                   GAO-12-677 Employment for People with Disabilities
Program title             Program objectives                                       Beneficiary eligibility requirements
Randolph-Sheppard         According to the statute creating the Randolph-          To be eligible for this program, participants must be
Vending Facility          Sheppard program, the objectives of this initiative      blind, citizens of the United States, and meet any other
Program                   include providing blind persons with remunerative        specific standards that individual state licensing
                          employment, enlarging the economic opportunities         agencies may require.
                          of the blind, and stimulating the blind to greater
                          efforts in striving to make themselves self-
                          supporting. Toward this end, blind persons licensed
                          under the provisions of this chapter shall be
                          authorized to operate vending facilities on any
                          federal property. In layman language, the program’s
                          objectives are to create employment opportunities
                          by creating a priority for eligible blind people to
                          operate entrepreneurial ventures on federal and
                          other designated state properties. Throughout the
                          country, states have created similar priorities to
                          mirror the federal program in their specific
                          jurisdictions.
                                                                                                                a
Rehabilitation Services   To provide financial assistance to projects and          Individuals with disabilities.
Demonstration and         demonstrations for expanding and improving the
Training Programs         provision of rehabilitation and other services
                          authorized under the Rehabilitation Act, or that
                          further the purposes of the act, including related
                          research and evaluation activities.
State Vocational          To assist states in operating comprehensive,             Eligibility for vocational rehabilitation services is based
Rehabilitation Services   coordinated, effective, efficient, and accountable       on the presence of a physical or mental impairment,
                          programs of vocational rehabilitation; to assess,        which for such an individual constitutes or results in a
                          plan, develop, and provide vocational rehabilitation     substantial impediment to employment, and the need
                          services for individuals with disabilities, consistent   for vocational rehabilitation services that may be
                          with their strengths, resources, priorities, concerns,   expected to benefit the individual in terms of an
                          abilities, and capabilities so they may prepare for      employment outcome.
                          and engage in competitive employment.
Supported Employment To provide grants for time-limited services leading           Individuals with the most severe disabilities whose
State Grants         to supported employment for individuals with the              ability or potential to engage in a training program
                     most severe disabilities to enable such individuals           leading to supported employment has been
                     to achieve the employment outcome of supported                determined by evaluating rehabilitation potential. In
                     employment.                                                   addition, individuals must need extended services in
                                                                                   order to perform competitive work and have the ability
                                                                                   to work in a supported employment setting.
Department of Health and Human Services
1915(c) Home and          The Medicaid Home and Community-based                    In order to participate in a waiver, a person must meet
Community-Based           Services waiver program is authorized in section         the level of care specified for the waiver and also be a
Services Waiver           1915(c) of the Social Security Act. The program          member of a Medicaid eligibility group that a state
                          permits a state to furnish an array of home and          includes in the waiver. A state may include a Medicaid
                          community based services that assist Medicaid            eligibility group in the waiver only when it includes the
                          beneficiaries to live in the community and avoid         same group in its state plan.
                          institutionalization.




                                              Page 56                                   GAO-12-677 Employment for People with Disabilities
Program title         Program objectives                                       Beneficiary eligibility requirements
1915(i) State Plan    1915(i) allows states the option to add home and         Financial eligibility requirements: (1) eligible for
Home and Community-   community-based services to their Medicaid State         Medicaid and have income up to 150 percent of the
Based Services        Plans.                                                   federal poverty level, and (2) at the state’s option,
                                                                               eligible through a new Medicaid eligibility category at
                                                                               income up to 300 percent of Supplemental Security
                                                                               Income Federal Benefit Rate and eligible for a 1915(c)
                                                                               waiver or 1115 demonstration program in their state.
                                                                               Other eligibility requirements: (1) meet state-defined
                                                                               needs-based criteria, and (2) at the state’s option,
                                                                               meet the state-specified targeted population group for
                                                                               the 1915(i) benefit.
Medicaid State Plan   To provide parameters for the coverage of services       Each state plan service contains, either in statute or
Services              authorized by the Social Security Act to be part of      regulation, parameters for service provision, including
                      the Medicaid State Plan.                                 any functional eligibility requirements to be met.
Money Follows the     The Money Follows the Person (MFP) Rebalancing           As defined in Section 6071(b)(2) of the DRA and
Person Rebalancing    Demonstration, authorized by section 6071 of the         amended by Section 2403 of the Affordable Care Act,
Demonstration         Deficit Reduction Act of 2005 (Pub. Law No.109-          the term “eligible individual” means an individual in the
                      171), was designed to assist States to balance their     state who, immediately before beginning participation
                      long-term care systems and help Medicaid enrollees       in the MFP demonstration project: (1) resides (and has
                      transition from institutions to the community.           resided, for a period of not less than 90 consecutive
                      Congress initially authorized up to $1.75 billion in     days) in a qualified institution or inpatient setting
                      funds through federal fiscal year 2011. With the         (excluding days solely for the purpose of short-term
                      subsequent passage of the Patient Protection and         rehabilitation services); (2) is receiving Medicaid
                      Affordable Care Act (Pub. Law No.111-148) in             benefits for services furnished by such qualified
                      2010, Section 2403 extended the program through          institution or inpatient setting; and (3) with respect to
                      September 30, 2016. An additional $2.25 billion in       whom a determination has been made that, but for the
                      federal funds was appropriated through federal           provision of home and community-based long-term
                      fiscal year 2016. The MFP Demonstration supports         care services, the individual would continue to require
                      state efforts to rebalance their long-term support       the level of care provided in a qualified institution or
                      system so that individuals have a choice of where        inpatient setting.
                      they live and receive services. Transition individuals
                      from institutions who want to live in the community.
Department of Labor
America’s Heroes at   America’s Heroes at Work is a Department of Labor No eligibility requirements. Support services (website,
Work                  project that addresses the employment challenges toll-free assistance, and presentations) are available to
                      of returning servicemembers living with Traumatic    any group or individual that requests them.
                      Brain Injury (TBI) or Post-Traumatic Stress Disorder
                      (PTSD)—an important focus of the President’s
                      veterans agenda. The project equips employers and
                      the workforce development system with the tools
                      they need to help returning servicemembers
                      affected by TBI and/or PTSD succeed in the
                      workplace—particularly servicemembers returning
                      from Iraq and Afghanistan.




                                         Page 57                                    GAO-12-677 Employment for People with Disabilities
Program title          Program objectives                                     Beneficiary eligibility requirements
Community Service      The purpose of the Senior Community Service            Unemployed persons 55 years or older whose family is
Employment for Older   Employment Program (SCSEP) program is to               low-income (i.e., income does not exceed the low-
Americans/Senior       provide, foster, and promote useful part-time work     income standards defined in 20 CFR section 641.507)
Community Service      opportunities (usually 20 hours per week) in           are eligible for enrollment (20 CFR section 641.500).
Employment Program     community service training and employment              Low-income means an income of the family which,
                       activities for unemployed low-income persons who       during the preceding 6 months on an annualized basis
                       are 55 years of age and older. To the extent           or the actual income during the preceding 12 months,
                       feasible, SCSEP assists and promotes the transition    at the option of the grantee, is not more than 125
                       of program participants into unsubsidized              percent of the poverty levels established and
                       employment.                                            periodically updated by the Department of Health and
                                                                              Human Services (42 USC 3056p(a)(4)). The poverty
                                                                              guidelines are issued each year in the Federal
                                                                              Register and the Department of Health and Human
                                                                              Services maintains a page on the Internet which
                                                                              provides the poverty guidelines
                                                                              (http://www.aspe.hhs.gov/poverty/index.shtml,
                                                                              accessed May 30, 2012). Enrollee eligibility is re-
                                                                              determined on an annual basis (20 CFR section
                                                                              641.505).
Disabled Veterans’     To provide intensive services to meet the              Eligible veterans and eligible persons with emphasis
Outreach Program       employment needs of disabled and other eligible        on Special Disabled veterans, disabled veterans,
                       veterans with maximum emphasis in meeting the          economically or educationally disadvantaged veterans,
                       employment needs of those who are economically         and veterans with other barriers to employment.
                       or educationally disadvantaged, including homeless
                       veterans and veterans with barriers to employment.
Employer Assistance    EARN is a resource for employers seeking to            Any public or private employer seeking to advance the
and Resource Network   recruit, retain and advance individuals with           employment of individuals with disabilities is eligible for
(EARN)                 disabilities. (www.askearn.org, accessed May 30,       services.
                       2012)
Job Accommodation      The mission of JAN is to facilitate the employment     JAN services are available to all interested parties.
Network (JAN)          and retention of workers with disabilities by
                       providing employers, employment providers, people
                       with disabilities, their family members, and other
                       interested parties with technical assistance on job
                       accommodations, entrepreneurship, and related
                       subjects. JAN’s efforts are in support of the
                       employment, including self-employment and small
                       business ownership, of people with disabilities. This
                       free, confidential technical assistance is provided in
                       English and Spanish via telephone, email, chat, and
                       postal mail.




                                          Page 58                                  GAO-12-677 Employment for People with Disabilities
Program title              Program objectives                                        Beneficiary eligibility requirements
Job Corps                  Job Corps is the nation’s largest federally funded        To be eligible to become an enrollee, an individual
                           training program that provides at-risk youth, ages        shall be: (1) not less than age 16 and not more than
                           16-24, with academic instruction, toward the              age 21 on the date of enrollment, except that (a) not
                           achievement of a High School Diploma or General           more than 20 percent of the individuals enrolled in the
                           Education Development (GED) certificate, and              Job Corps may be not less than age 22 and not more
                           career training in high-growth, high-demand               than age 24 on the date of enrollment, and (b) either
                           industries. Upon exit from the program, participants      such maximum age limitation may be waived by the
                           receive transition assistance to employment, higher       Secretary, in accordance with regulations of the
                           education, or the military. The program is primarily      Secretary, in the case of an individual with a disability;
                           residential, serving nearly 60,000 students at 125        (2) a low-income individual; and (3) an individual who
                           centers nationwide.                                       is one or more of the following: (a) basic skills
                                                                                     deficient; (b) a school dropout; (c) homeless, a
                                                                                     runaway, or a foster child; (d) a parent; (e) an
                                                                                     individual who requires additional education,
                                                                                     vocational training, or intensive counseling and related
                                                                                     assistance, in order to participate successfully in
                                                                                     regular schoolwork or to secure and hold employment.
Local Veterans’            Conduct outreach and provide seminars to            Eligible veterans and eligible persons.
Employment                 employers which advocates hiring of veterans;
Representatives            facilitate Transition Assistance Program
program                    employment workshops to transitioning
                           servicemembers; establish and conduct job search
                           workshops; facilitate employment, training, and
                           placement services furnished to veterans in a state
                           under the applicable state employment service or
                           one-stop career center delivery systems whose sole
                           purpose is to assist veterans in gaining and
                           retaining employment.
REALifelines Initiative    The objective of REALifelines is to support the     Transitioning servicemembers and veterans who were
                           economic recovery of transitioning servicemembers wounded or injured while serving in Operation Iraqi
                           and veterans who were wounded or injured while      Freedom or Operation Enduring Freedom.
                           serving in Operation Iraqi Freedom or Operation
                           Enduring Freedom. The transition services are
                           extended to spouses and caregivers through the
                           resources at the one-stop career centers. Intensive
                           services are provided by our Disabled Veterans
                           Outreach Program specialists. The specialized
                           services are intended to identify and address any
                           barriers to employment.
Registered                 Increases systems capacity for integrated, inclusive Youth and young adults with disabilities ages 16
Apprenticeship for         apprenticeship training for youth and young adults   through 27.
Youth and Young            with a full range of disabilities
Adults with Disabilities
Initiative
Veterans’ Workforce        To provide services to assist in reintegrating eligible   Service-connected disabled veterans, veterans who
Investment Program         veterans into meaningful employment within the            have significant barriers to employment, veterans who
                           labor force and to stimulate the development of           served on active duty in the armed forces during a war
                           effective service delivery systems that will address      or in a campaign or expedition for which a campaign
                           the complex problems facing eligible veterans.            badge has been authorized, and veterans who are
                                                                                     recently separated from military service (48 months).




                                               Page 59                                    GAO-12-677 Employment for People with Disabilities
Program title            Program objectives                                     Beneficiary eligibility requirements
Workforce Investment     To help low-income youth, between the ages of 14       An eligible youth is an individual who: (1) is 14 to 21
Act Youth Activities     and 21, acquire the educational and occupational       years of age; (2) is an individual who received an
                         skills, training, and support needed to achieve        income or is a member of a family that received a total
                         academic and employment success and                    family income that, in relation to family size, does not
                         successfully transition to careers and productive      exceed the higher of (a) the poverty line or (b) 70
                         adulthood.                                             percent of the lower living standard income; and (3)
                                                                                meets one or more of the following criteria: is an
                                                                                individual who is deficient in basic literacy skills, a
                                                                                school dropout, homeless, a runaway, a foster child,
                                                                                pregnant or a parent, an offender, or requires
                                                                                additional assistance to complete their education or
                                                                                secure and hold employment.
                                                                                There is an exception to permit youth who are not low-
                                                                                income individuals to receive youth services. Up to 5
                                                                                percent of youth participants served by youth
                                                                                programs in a local area may be individuals who do
                                                                                not meet the income criterion for eligible youth,
                                                                                provided that they are within one or more of the
                                                                                following categories: school dropout; basic skills
                                                                                deficient; are one or more grade levels below the
                                                                                grade level appropriate to the individual’s age;
                                                                                pregnant or parenting; possess one or more
                                                                                disabilities, including learn disabilities; homeless or
                                                                                runaway; offender; or face serious barriers to
                                                                                employment as identified by the local board.
Work Opportunity Tax     The tax credit was designed to help individuals from   All employers seeking Work Opportunity Tax Credit
Credit (joint with the   12 target groups who consistently have faced           target group workers and target group members
Internal Revenue         significant barriers to employment move from           seeking employment. The members of the different
Service)                 economic dependency to self-sufficiency by             target groups have statutory definitions (per Pub. Law
                         encouraging businesses in the private sector to hire   No. 109-188, as amended) with specific eligibility
                         target group members and be eligible to claim tax      requirements that must be verified by the state
                         credits based on the wages they paid to the new        workforce agencies before a certification can be
                         hires during the first year of employment, up to a     issued to an employer or his representatives.
                         dollar wage limit.                                     Participating employers and their representatives must
                                                                                file their certification requests using Internal Revenue
                                                                                Service Form 8850 and ETA Form 9061 or 9062 within
                                                                                28 days after the employment-start day of the new
                                                                                hires. This timeliness requirement cannot be waived
                                                                                and must be met before a state can issue a
                                                                                certification for eligible target group members.
Workforce Recruitment The Workforce Recruitment Program is a                    The Workforce Recruitment Program for College
Program (joint with the recruitment and referral program that connects          Students with Disabilities serves individuals who have
Department of Defense) federal and private sector employers nationwide          disabilities, are enrolled at an accredited institution of
                        with highly motivated postsecondary students and        higher learning on a substantially full-time basis
                        recent graduates with disabilities who are eager to     (unless the severity of the disability precludes the
                        prove their abilities in the workplace through          student from taking a substantially full-time load) to
                        summer or permanent jobs.                               seek a degree or are enrolled at such an institution as
                                                                                a degree-seeking student taking less than a
                                                                                substantially full-time load in the enrollment period
                                                                                immediately prior to graduation or have graduated with
                                                                                a degree from such an institution within the past year,
                                                                                and are U.S. citizens.




                                            Page 60                                  GAO-12-677 Employment for People with Disabilities
Program title          Program objectives                                      Beneficiary eligibility requirements
YouthBuild             Provides disadvantaged youth with education and         Youth ages 16 through 24 and a member of a
                       employment skills necessary to achieve economic         disadvantaged population, such as: low-income, foster
                       self sufficiency in high demand occupations             care (including youth aging out of foster care), youth
                                                                               offender, youth with a disability, child of an
                                                                               incarcerated parent, high school dropout, or migrant
                                                                               youth.
Department of Veterans Affairs
Compensated Work       Compensated Work Therapy is a recovery-oriented,        A person who served in the active military, naval, or air
Therapy program        vocational model integrated into the continuum of       service and who was discharged or released under
                       Veterans Health Administration’s services, as           conditions other than dishonorable may qualify for VA
                       authorized by 38 USC § 1718. Department of              health care benefits. Reservists and National Guard
                       Veterans Affairs (VA) medical centers offer             members may also qualify for VA health care benefits
                       Compensated Work Therapy with both Transitional         if they were called to active duty (other than for training
                       Work Experience and Supported Employment                only) by a federal order and completed the full period
                       services for veterans with occupational dysfunctions    for which they were called or ordered to active duty.
                       resulting from their mental health conditions, or who
                       are unsuccessful at obtaining or maintaining stable
                       employment patterns due to mental illnesses or
                       physical impairments co-occurring with mental
                       illnesses. The scope of Therapeutic and Supported
                       Employment Services (TSES) includes skill
                       development opportunities both for veterans for
                       whom the primary objective is competitive
                       employment, and for veterans in need of therapeutic
                       pre-employment services designed to ameliorate
                       the consequences of long standing mental health
                       problems alone or with co-occurring physical illness.
                       The mission of TSES is to improve the veteran’s
                       overall quality of life through a vocational
                       rehabilitation experience in which the veteran learns
                       new job skills, strengthen successful work habits,
                       and regains a sense of self-esteem and self-worth.
                       The vision of TSES is that all veterans challenged
                       with physical or mental illness can obtain
                       meaningful competitive employment in the
                       community, working in jobs of their choice, while
                       receiving necessary and appropriate support
                       services. The goal of TSES is to provide a
                       continuum of therapeutic and skill development
                       services for veterans who have difficulty obtaining
                       or maintaining stable employment patterns due to
                       mental illnesses or physical impairments co-
                       occurring with mental illnesses. The objectives of
                       TSES are to provide an opportunity for work
                       hardening and skill development services to eligible
                       veterans regardless of diagnosis, disability, or
                       treatment goals; Collaborate with veterans and their
                       primary treatment team to assure each veteran has
                       the support necessary to achieve his or her
                       vocational goals; Ensure access to all components
                       in the continuum of TSES services as the veteran’s
                       needs change over the course of treatment,
                       rehabilitation, and recovery.



                                          Page 61                                   GAO-12-677 Employment for People with Disabilities
Program title         Program objectives                                       Beneficiary eligibility requirements
Disabled Transition   DTAP is an integral component of transition            Servicemembers who may be released because of
Assistance Program    assistance that involves intervening on behalf of      injuries or diseases that happened while on active
(DTAP)                servicemembers who may be released because of a duty, or were made worse by active military service.
                      disability or who believe they have a disability
                      qualifying them for VA’s Vocational Rehabilitation
                      and Employment program (VR&E). The goal of
                      DTAP is to encourage and assist potentially eligible
                      servicemembers in making an informed decision
                      about VA’s VR&E program. It is also intended to
                      facilitate the expeditious delivery of vocational
                      rehabilitation services to eligible persons by
                      assisting them in filing an application for vocational
                      rehabilitation benefits.
Vocational            To provide all services and assistance necessary to      Veterans of World War II and later service with a
Rehabilitation and    enable service-disabled veterans and service             service-connected disability or disabilities rated at
Employment (VR&E)     persons hospitalized or receiving outpatient medical     least 20 percent compensable and certain service-
                      care services or treatment for a service-connected       disabled servicepersons pending discharge or release
                      disability pending discharge to gain and maintain        from service if VA determines the servicepersons will
                      suitable employment. When employment is not              likely receive at least a 20 percent rating and they
                      reasonably feasible, the program can provide the         need vocational rehabilitation because of an
                      needed services and assistance to help the               employment handicap. Veterans with compensable
                      individual achieve maximum independence in daily         ratings of 10 percent may also be eligible if they are
                      living.                                                  found to have a serious employment handicap. To
                      The VR&E program is a comprehensive vocational           receive an evaluation for vocational rehabilitation
                      rehabilitation program that provides up to 48 months     services, a veteran must have received, or eventually
                      of extensive services leading to employment. Every       receive, an honorable or other than dishonorable
                      VR&E program participant is provided a                   discharge, have a VA service-connected disability
                      comprehensive vocational evaluation to determine         rating of 10 percent or more, and apply for vocational
                      transferable skills, aptitudes, and interests; explore   rehabilitation services.
                      labor market and wage information; and to focus on
                      vocational options that will lead to a viable suitable
                      employment or independent living goal. Results
                      from the evaluation help determine which of the five
                      tracks to success (Reemployment, Rapid Access to
                      Employment, Self Employment, Employment
                      Through Long-term Services, or Independent
                      Living) is most appropriate. Depending on the
                      rehabilitation needs of the individual, services may
                      include training such as on-the-job,
                      vocational/technical school, college-level
                      (certificate, 2-year degree, 4-year degree, or
                      beyond). VR&E pays for tuition, fees, books, and
                      supplies associated with training, as well as a
                      monthly subsistence allowance.




                                         Page 62                                   GAO-12-677 Employment for People with Disabilities
Program title             Program objectives                                         Beneficiary eligibility requirements
Vocational Training and   To provide vocational training and rehabilitation to       A child born with spina bifida or other covered birth
Rehabilitation for        certain children born with spina bifida or other           defects, except spina bifida occulta, who is the natural
Vietnam Veterans’         covered birth defects who are children of Vietnam          child of a Vietnam veteran and some Korean veterans,
Children with Spina       veterans and some Korean veterans.                         regardless of the age or marital status of the child,
Bifida or Other Covered                                                              conceived after the date on which the veteran first
Birth Defects                                                                        served in the Republic of Vietnam during the Vietnam
                                                                                     era and in particular areas near the demilitarized zone
                                                                                     (DMZ) in the Korean conflict. VA must also determine
                                                                                     that it is feasible for the child to achieve a vocational
                                                                                     goal.
Social Security Administration
Work Incentives           To comply with the Ticket to Work and Work                 All individuals within the state who are entitled to
Planning and              Incentives Improvement Act which was passed in             Social Security Disability Insurance benefits or eligible
Assistance program        December 1999, and reauthorized by the Social              for Supplemental Security Income payments based on
                          Security Protection Act of 2004, which requires SSA        disability or blindness.
                          to establish a community based work incentives
                          planning and assistance program. The purpose of
                          this program is to disseminate accurate information
                          to SSA disability beneficiaries (including transition to
                          work aged youth) about work incentives programs,
                          and issues related to such programs, to enable
                          them to make informed choices about working and
                          whether or when to assign their Ticket to Work, as
                          well as how available work incentives can facilitate
                          their transition into the workforce. The ultimate goal
                          of the Work Incentives Planning and Assistance
                          program is to assist SSA disability beneficiaries
                          succeed in their return to work efforts.
State Vocational          Makes vocational rehabilitation services more              Social Security Disability Insurance beneficiaries and
Rehabilitation Cost       readily available to disabled or blind SSA disability      Supplemental Security Income disability recipients
Reimbursement             beneficiaries.
Program
Ticket to Work program Provides SSA disability beneficiaries more choices            Social Security Disability Insurance beneficiaries and
                       for receiving employment services.                            Supplemental Security Income disability recipients
                                                                                     ages 18 through 64.
                                              Source: GAO survey.

                                              a
                                               In commenting on a draft of this report, Education noted that Rehabilitation Services Demonstration
                                              and Training Programs grantees may use funds to conduct a broad range of activities, the ultimate
                                              goal of which is to improve services for individuals with disabilities. However, in some cases,
                                              individuals with disabilities may not be the direct target population. For example, some of the program
                                              funds are used for providing training and technical assistance to service providers and parents of
                                              individuals with disabilities.




                                              Page 63                                      GAO-12-677 Employment for People with Disabilities
Appendix V: Services Reported to Be
Provided in Fiscal Year 2010, by Population
and Program
Table 5: Services Provided by 19 Programs That Limit Eligibility to Servicemembers, Veterans, and/or Their Families




                                                                                                                                                                                                                                                                                                                                                                                                     to workers with disabilities
                                                                                                                                                                                                                                                                                             English language skills, or




                                                                                                                                                                                                                                                                                                                                             information dissemination
                                                  high school diploma or its




                                                                                                                                                                                                                                                                                                                                                                         Entrepreneurship training




                                                                                                                                                                                                                                                                                                                                                                                                                                                               Assistive technology and
                                                                                                                                                                                                                                                                                                                                                                                                                                    employers of people with
                         Employment counseling,




                                                                                                                                                                                                                                                                                                                                                                                                     Tax expenditures related
                                                                                                                                                                                                                    Vocational rehabilitation




                                                                                                                                                                                                                                                                                                                                                                                                                                    Support and services to
                                                                                                                                                                                                                                                Supported employment
                                                  Assistance in earning a
                         assessment, and case




                                                                                                                                              Job retention training
                                                                                                                        Job recruitment and




                                                                                                                                                                                                                                                                                                                                             Employment-related
                                                                                                                                                                                                                                                                                             Remedial academic,
                                                                                                 Job readiness skills




                                                                                                                                                                       placement activities




                                                                                                                                                                                                                                                                       On-the-job training
                                                                                                                                                                                              vocational training
                                                                                                                                                                       Job search or job
                                                                               Job development




                                                                                                                                                                                                                                                                                                                                                                                                                                                               accommodations
                                                                                                                                                                                                                                                                                                                           Work experience
                                                                                                                                                                                              Occupational or
                         management




                                                                                                                                                                                                                                                                                             adult literacy




                                                                                                                                                                                                                                                                                                                                                                         and support




                                                                                                                                                                                                                                                                                                                                                                                                                                    disabilities
                                                  equivalent




                                                                                                                                                                                                                                                                                                                                                                                                                                                               workplace
                                                                                                                        referrals
Air Force Warrior and
                                 ●                          ●                           ●                    ●                  ●                    ●                         ●                     ○                           ○                          ○                ○                         ●                                                           ○                 *                                                         ●                         ●
Survivor Care
America’s Heroes at
                                 ○                                                      ○                      *                ●                    ○                         *                                                                              *                                                                       *                            ●                 *                                                         ●                         ●
Work
Army Warrior Care and
                                 ●                          ○                           ●                    ●                  ●                                              ●                     ○                           ○                          ○                ●                         ○                             ●                             ●                                                                                                     ●
Transition Program
Compensated Work
                                 ●                                                      ●                    ●                  ●                    ●                         ●                     ●                           ●                          ●                ●                                                       ●                             ●                                                  ○                        ○                          *
Therapy program
Computer/Electronic
Accommodations                   ○                                                                           ○                                       ○                                                                                                                       ○                                                       ○                             ○                                                                           ○                         ●
Program
Disabled Transition
                                  *                         *                            *                     *                 *                     *                       *                      *                            *                          *                *                        *                             *                             *                *                                                          *                         *
Assistance Program
Disabled Veterans’
                                 ●                                                      ○                    ●                  ●                    ○                         ●                                                                                                                                                      *                            ○                 *                                                          *
Outreach Program
Local Veterans’
Employment
                                 ○                                                      ●                    ●                  ○                    ○                         ●                                                                                                                                                      *                            ●                 *
Representatives
program




                                                                           Page 64                                                                                                                            GAO-12-677 Employment for People with Disabilities
                                                                                                                                                                                                        Program



                                                                                                                                 Recovery Care




                                                     and Employment
                                                                                                                                                                                                                           Warrior Regiment
                                                                                                                                                                                                        Navy Safe Harbor




                                                                                 Investment Program
                                                                                 Veterans’ Workforce
                                                                                                                                                                                 Operation Warfighter



                                                                                                                                 Coordinator Program
                                                                                                                                                       REALifelines Initiative
                                                                                                                                                                                                                                                  Warrior Intern Program
                                                                                                                                                                                                                           Marine Corps Wounded
                                                                                                                                                                                                                                                  Marine Corps Wounded




                                                                                                       U.S. Special Operations




                                                     Vocational Rehabilitation
                                                                                                       Command Care Coalition
                                                                                                                                                                                                                                                                           Employment counseling,




                                                          ●
                                                                                     ●
                                                                                                                                                       ●
                                                                                                                                                                                 ●
                                                                                                                                                                                                           ○
                                                                                                                                                                                                                               ●
                                                                                                                                                                                                                                                       ●
                                                                                                                                                                                                                                                                           assessment, and case
                                                                                                                                                                                                                                                                           management
                                                                                                                                                                                                                                                                           Assistance in earning a




                                                          *
                                                                                     *
                                                                                                                                                                                                                                                       *
                                                                                                                                                                                                                                                                           high school diploma or its
                                                                                                                                                                                                                                                                           equivalent
                                                                                                                                                                                                                                                                           Job development




                                                          ●
                                                                                     ●
                                                                                                                                                       ●
                                                                                                                                                                                 ●
                                                                                                                                                                                                           ○
                                                                                                                                                                                                                               ●
                                                                                                                                                                                                                                                       ●




Page 65
                                                                                                            *
                                                                                                                                                                                                                                                                           Job readiness skills




                                                          ●
                                                                                     ●
                                                                                                                                                       ●
                                                                                                                                                                                 ●
                                                                                                                                                                                                           ○
                                                                                                                                                                                                                               ●
                                                                                                                                                                                                                                                       ●                   Job recruitment and




                                                                                                            *
                                                                                                                                                                                 *




                                                          ●
                                                                                     ●
                                                                                                                                                       ●
                                                                                                                                                                                                           ○
                                                                                                                                                                                                                               ●
                                                                                                                                                                                                                                                       ●
                                                                                                                                                                                                                                                                           referrals
                                                                                                                                                                                                                                                       *




                                                          ●
                                                                                     ○
                                                                                                                                                                                 ●
                                                                                                                                                                                                                                                                           Job retention training

                                                                                                                                                                                                                                                                           Job search or job




                                                                                                            *
                                                                                                                                                                                 *




                                                          ●
                                                                                     ●
                                                                                                                                                       ●
                                                                                                                                                                                                           ○
                                                                                                                                                                                                                               ●
                                                                                                                                                                                                                                                       ●




                                                                                                                                                                                                                                                                           placement activities

                                                                                                                                                                                                                                                                           Occupational or




                                                          ●
                                                                                     ●
                                                                                                                                                       ○
                                                                                                                                                                                 ●
                                                                                                                                                                                                           ○
                                                                                                                                                                                                                               ○
                                                                                                                                                                                                                                                       ●




                                                                                                                                                                                                                                                                           vocational training




                                                          ●
                                                                                                                                                       ●
                                                                                                                                                                                 ○
                                                                                                                                                                                                           ○
                                                                                                                                                                                                                               ○
                                                                                                                                                                                                                                                       ○




                                                                                                                                                                                                                                                                           Vocational rehabilitation




                                                          *
                                                                                                                                                                                                                                                                           Supported employment
                                                                                                                                                                                 ○
                                                                                                                                                                                                           ○
                                                                                                                                                                                                                               ○
                                                                                                                                                                                                                                                       ●




                                                                                                                                                       *




                                                          ●
                                                                                     ○
                                                                                                                                                                                 ●
                                                                                                                                                                                                           ○
                                                                                                                                                                                                                               ○
                                                                                                                                                                                                                                                       ●




                                                                                                                                                                                                                                                                           On-the-job training

                                                          *                                                                                                                                                                                                                Remedial academic,
                                                                                                                                                       *




                                                                                                                                                                                                                                                                           English language skills, or
                                                                                                                                                                                                                                                                           adult literacy
                                                                                                                                                                                                                                                                           Work experience
                                                                                     ○

                                                          ●
                                                                                                                                                                                 ●
                                                                                                                                                                                                           ○
                                                                                                                                                                                                                                                       ●




                                                                                                                                                                                                                                                                           Employment-related
                                                                                                                                                                                                                                                                           information dissemination
                                                                                                            *

                                                                                     ○
                                                                                                                                     ○




                                                          ●
                                                                                                                                                       ●
                                                                                                                                                                                 ○
                                                                                                                                                                                                           ○
                                                                                                                                                                                                                               ●
                                                                                                                                                                                                                                                       ●




GAO-12-677 Employment for People with Disabilities                                                                                                                                                                                                                         Entrepreneurship training
                                                                                                                                                                                                                                                       *




                                                          ●
                                                                                                                                                       ●
                                                                                                                                                                                 ○




                                                                                                                                                                                                                                                                           and support

                                                                                                                                                                                                                                                                           Tax expenditures related
                                                                                                                                                                                                                                                                           to workers with disabilities


                                                                                                                                                                                                                                                                           Support and services to
                                                                                                                                                                                 *




                                                          ●
                                                                                                                                                       ●
                                                                                                                                                                                                           ○
                                                                                                                                                                                                                               ○
                                                                                                                                                                                                                                                       ●




                                                                                                                                                                                                                                                                           employers of people with
                                                                                                                                                                                                                                                                           disabilities

                                                                                                                                                                                                                                                                           Assistive technology and
                                                          ●
                                                                                                                                                       ●
                                                                                                                                                                                 ○
                                                                                                                                                                                                           ○
                                                                                                                                                                                                                                                       ○




                                                                                                                                                                                                                                                                           workplace
                                                                                                                                                                                                                                                                           accommodations
                                                                                                                                                                                                                                                              Credit
                                                                                                                                                                                                                                                                                     Birth Defects
                                                                                                                                                                                                                                                                                     Rehabilitation for
                                                                                                                                                                                                                                                                                     Vietnam Veterans’
                                                                                                                                                                                                                                                                                     Children with Spina


                                                                                                                                                                                                                                                              Work Opportunity Tax
                                                                                                                                                                                                                                                                                     Bifida or Other Covered
                                                                                                                                                                                                                                                                                     Vocational Training and
                                                                                                                                                                                                                                                                                                               Employment counseling,




                                                                                                                                                                                                                                                                                              ●
                                                                                                                                                                                                                                                                                                               assessment, and case
                                                                                                                                                                                                                                                                                                               management
                                                                                                                                                                                                                                                                                                               Assistance in earning a




                                                                                                                                                                                                                                                                                              *
                                                                                                                                                                                                                                                                                                               high school diploma or its
                                                                                                                                                                                                                                                                                                               equivalent
                                                                                                                                                                                                                                                                                                               Job development




                                                                                                                                                                                                                                                                                              ●




Page 66
                                                                                                                                                                                                                                                                                                               Job readiness skills




                                                                                                                                                                                                                                                                                              ●




                                                                                                                                                                                                                                        Source: GAO survey.
                                                                                                                                                                                                                                                                                                               Job recruitment and

                                                                                                                                                                                                                                                                                              ●
                                                                                                                                                                                                                                                                                                               referrals
                                                                                                                                                                                                                                                                                              ●
                                                                                                                                                                                                                                                                                                               Job retention training

                                                                                                                                                                                                                                                                                                               Job search or job
                                                                                                                                                                                                                                                                                              ●



                                                                                                                                                                                                                                                                                                               placement activities




                                                     * Service provided, but extent unknown
                                                                                                                                                                                                                                                                                                               Occupational or
                                                                                                                                                                                                                                                                                              ●




                                                                                                                                                                                                                                                                                                               vocational training
                                                                                                                                                                                                                                                                                              ●




                                                                                                                                                                                                                                                                                                               Vocational rehabilitation

                                                                                                                                                                                                                                                                                                               Supported employment


                                                                                                                                                                                                                                                                                                               On-the-job training
                                                                                              ○ Service provided to less than 50 percent of program participants
                                                                                                                                                                   ● Service provided to more than 50 percent of program participants




                                                                                                                                                                                                                                                                                                               Remedial academic,
                                                                                                                                                                                                                                                                                              ●




                                                                                                                                                                                                                                                                                                               English language skills, or
                                                                                                                                                                                                                                                                                                               adult literacy
                                                                                                                                                                                                                                                                                                               Work experience


                                                                                                                                                                                                                                                                                                               Employment-related
                                                                                                                                                                                                                                                                                                               information dissemination
                                                                                                                                                                                                                                                                  ●




GAO-12-677 Employment for People with Disabilities                                                                                                                                                                                                                                                             Entrepreneurship training
                                                                                                                                                                                                                                                                                                               and support

                                                                                                                                                                                                                                                                                                               Tax expenditures related
                                                                                                                                                                                                                                                                  ●




                                                                                                                                                                                                                                                                                                               to workers with disabilities


                                                                                                                                                                                                                                                                                                               Support and services to
                                                                                                                                                                                                                                                                  ○




                                                                                                                                                                                                                                                                                                               employers of people with
                                                                                                                                                                                                                                                                                                               disabilities

                                                                                                                                                                                                                                                                                                               Assistive technology and
                                                                                                                                                                                                                                                                                              *




                                                                                                                                                                                                                                                                                                               workplace
                                                                                                                                                                                                                                                                                                               accommodations
Table 6: Services Provided by Five Programs That Limit Eligibility to Students, Transition Age Youth, and/or Young Adults




                                                                                                                                                                                                                                                                                                                                                                                                       to workers with disabilities
                                                                                                                                                                                                                                                                                               English language skills, or




                                                                                                                                                                                                                                                                                                                                               information dissemination
                                                   high school diploma or its




                                                                                                                                                                                                                                                                                                                                                                           Entrepreneurship training




                                                                                                                                                                                                                                                                                                                                                                                                                                                                 Assistive technology and
                                                                                                                                                                                                                                                                                                                                                                                                                                      employers of people with
                          Employment counseling,




                                                                                                                                                                                                                                                                                                                                                                                                       Tax expenditures related
                                                                                                                                                                                                                      Vocational rehabilitation




                                                                                                                                                                                                                                                                                                                                                                                                                                      Support and services to
                                                                                                                                                                                                                                                  Supported employment
                                                   Assistance in earning a
                          assessment, and case




                                                                                                                                                Job retention training
                                                                                                                          Job recruitment and




                                                                                                                                                                                                                                                                                                                                               Employment-related
                                                                                                                                                                                                                                                                                               Remedial academic,
                                                                                                   Job readiness skills




                                                                                                                                                                         placement activities




                                                                                                                                                                                                                                                                         On-the-job training
                                                                                                                                                                                                vocational training
                                                                                                                                                                         Job search or job
                                                                                 Job development




                                                                                                                                                                                                                                                                                                                                                                                                                                                                 accommodations
                                                                                                                                                                                                                                                                                                                             Work experience
                                                                                                                                                                                                Occupational or
                          management




                                                                                                                                                                                                                                                                                               adult literacy




                                                                                                                                                                                                                                                                                                                                                                           and support




                                                                                                                                                                                                                                                                                                                                                                                                                                      disabilities
                                                   equivalent




                                                                                                                                                                                                                                                                                                                                                                                                                                                                 workplace
                                                                                                                          referrals

Model Comprehensive
Transition and
Postsecondary
                                                                *                                                                                                                                                               *
Programs for Students
with Intellectual
Disabilities
Registered
Apprenticeship Youth
                                   ○                            *                      *                  *                      *                      *                       *                     *                                                                  *                                  *                 *                      *                                                                                         *                           *
and Young Adults with
Disabilities Initiative
Workforce Investment
                                   ●                            *                      *                  *                      *                      *                       *                     *                                                                  *                                  *                 *                      *                            *                                                                                        *
Act Youth Activities
Workforce Recruitment
                                    *                                                                     *                     ●                                               *                                                                                                                                            ●                     ●                                                                                          ○                            *
Program
YouthBuild                         ●                            ●                     ●                  ●                       *                      *                      ●                     ●                                                *                  *                                 ●                 ●                     ●                              *
                                                                                Source: GAO survey.

                                                                                ● Service provided to more than 50 percent of program participants
                                                                                ○ Service provided to less than 50 percent of program participants
                                                                                * Service provided, but extent unknown




                                                                                Page 67                                                                                                                           GAO-12-677 Employment for People with Disabilities
Table 7: Services Provided by Seven Programs That Serve All People with Disabilities
                             Employment counseling,




                                                                                                                                                                                                                                                                                                                                                                                       Tax expenditures related
                                                                                                                                                                                                                     Vocational rehabilitation




                                                                                                                                                                                                                                                                                                                                                                                       Support and services to
                                                                                                                                                                                                                                                                                              English language skills,
                                                                                                                                                                                                                                                 Supported employment
                                                      Assistance in earning a
                                                      high school diploma or
                             assessment, and case




                                                                                                                                               Job retention training




                                                                                                                                                                                                                                                                                                                                                                                                                  Assistive technology
                                                                                                                                                                                                                                                                                                                                                                training and support




                                                                                                                                                                                                                                                                                                                                                                                       employers of people
                                                                                                                         Job recruitment and




                                                                                                                                                                                                                                                                                                                                           Employment-related
                                                                                                                                                                                                                                                                                              Remedial academic,
                                                                                                  Job readiness skills




                                                                                                                                                                        placement activities




                                                                                                                                                                                                                                                                        On-the-job training
                                                                                                                                                                                               vocational training
                                                                                                                                                                        Job search or job




                                                                                                                                                                                                                                                                                                                                                                Entrepreneurship
                                                                                Job development




                                                                                                                                                                                                                                                                                                                                                                                                                  accommodations
                                                                                                                                                                                                                                                                                                                         Work experience
                                                                                                                                                                                               Occupational or




                                                                                                                                                                                                                                                                                              or adult literacy




                                                                                                                                                                                                                                                                                                                                                                                       with disabilities
                                                                                                                                                                                                                                                                                                                                                                                       to workers with




                                                                                                                                                                                                                                                                                                                                                                                                                  and workplace
                                                                                                                                                                                                                                                                                                                                           dissemination
                                                      its equivalent
                             management




                                                                                                                                                                                                                                                                                                                                           information




                                                                                                                                                                                                                                                                                                                                                                                       disabilities
1915(i) State Plan Home                                                                                                  referrals
and Community-Based                    *                                            *                   *                        *                   *                          *                      *             ○                                 *                      *                                                                    *
Services
Job Accommodation
                                                                                                                                                                                                                                                                                                                                                   ●                   ○                                 ●               ●
Network
Job Corps                             ●                        ●                   ●                  ●                         ●                   ●                          ●                      ●                                                                      ●                        ●                       ●                    ●                   ○                                                ○
Medicaid State Plan
                                       *                                                                *                                                                                                                                              *                                                                                                                                                                 *
Services
Rehabilitation Services
Demonstration and Training             *                        *                   *                   *                        *                   *                          *                      *               *                               *                      *                        *                       *                   *                                                     *               *
Programs
Assistive Technology State
                                                                                                                                                                                                                                                                                                                                                                        *                                               ●
Grant program
State Vocational
                                      ●                        ○                   ○                  ○                         ○                   ○                          ●                      ●              ●                                ○                      ○                        ○                       ○                    ●                   ○                                 ○              ○
Rehabilitation Services
                                                                    Source: GAO survey.


                                                                    ● Service provided to more than 50 percent of program participants
                                                                    ○ Service provided to less than 50 percent of program participants
                                                                    * Service provided, but extent unknown




                                                                    Page 68                                                                                                                       GAO-12-677 Employment for People with Disabilities
                                                                                                                                            Waiver




                                                                                           Services
                                                                                                                               Program




                                                     Assistive
                                                                                                                               AbilityOne




                                                                                           Vocational




                                                     Disabilities:
                                                     Technology
                                                     Program for
                                                     Farmers with
                                                                                           Rehabilitation
                                                                                                                                            1915(c) Home

                                                                                                                                            Based Services
                                                                                                                                            and Community




                                                                                           American Indian




                                                     AgrAbility Project
                                                                                                                                                               served

                                                                                                                                                  persons




                                                                                                                      disabilities




                                                                        Profession-
                                                                                                                                                               Population

                                                                                                                                                  Low-income




                                                                                                  with disabilities
                                                                                                                      blind or visually
                                                                                                                      People who are


                                                                                                                      other significant




                                                                        specific persons
                                                                                                                      impaired or have


                                                                                                  American Indians
                                                                                                                                                               Employment counseling,




                                                                                                                                                 *




                                                                   ●
                                                                                                ●
                                                                                                                                                               assessment, and case
                                                                                                                                                               management
                                                                                                                                                               Assistance in earning a




Page 69
                                                                                                ○
                                                                                                                                                               high school diploma or its
                                                                                                                                                               equivalent




                                                                                                                                                 *




                                                                                                ●
                                                                                                                                                               Job development



                                                                                                                                                 *




                                                                                                ●
                                                                                                                                                               Job readiness skills

                                                                                                                                                 *             Job recruitment and




                                                                                                ●
                                                                                                                                                               referrals
                                                                                                                                                 *




                                                                                                ○
                                                                                                                                                               Job retention training
                                                                                                                                                 *




                                                                                                                                                               Job search or job



                                                                                                ○
                                                                                                                                                               placement activities
                                                                                                                                                                                             Table 8: Services Provided by 14 Programs That Limit Eligibility to Other Populations




                                                                                                                                                               Occupational or
                                                                                                ○                                                              vocational training




                                                                   *
                                                                                                ●

                                                                                                                                                               Vocational rehabilitation
                                                                                                                                                 *




                                                                                                ○



                                                                                                                                                               Supported employment
                                                                                                                                                 *




                                                                                                ○




                                                                                                                                                               On-the-job training
                                                                                                                                                               Remedial academic,
                                                                                                *




                                                                                                                                                               English language skills, or
                                                                                                                                                               basic adult literacy
                                                                                                *




                                                                                                                                                               Work experience

GAO-12-677 Employment for People with Disabilities
                                                                                                *
                                                                                                                                                 *




                                                                                                                                                               Employment-related
                                                                                                                                                               information dissemination

                                                                                                                                                               Entrepreneurship training
                                                                                                *
                                                                                                                                                 *




                                                                                                                                                               and support


                                                                                                                                                               Tax expenditures
                                                                                                                                                               Support and services to
                                                                   *
                                                                                                *




                                                                                                                                                               employers of people with
                                                                                                                                                               disabilities

                                                                                                                                                               Assistive technology and
                                                                   *
                                                                                                *
                                                                                                                                                 *




                                                                                                                                                               workplace
                                                                                                                                                               accommodations
                                                                                                                      Older




                                                                           Adults
                                                                                                                      Service
                                                                                                                      Service




                                                                                                    Network
                                                                                                                      Program




                                                     Seasonal
                                                                                                    Employer

                                                                                                    Resource




                                                                           Youths and
                                                                                                                      Community
                                                                                                                      Community




                                                     Migrant and
                                                                           Helen Keller
                                                                                                                      Employment




                                                     Farmworkers
                                                                           for Deaf-Blind
                                                                                                    Assistance and



                                                                           National Center
                                                                                                                      Employment for

                                                                                                                      Americans/Senior




                                                        groups
                                                                                                                                                         served




                                                                                   deaf-blind
                                                                                                       disabilities
                                                                                                       people with
                                                                                                                                                         Population



                                                                                                                                       55 and older




                                                                                                       Employers of



                                                                                   People who are
                                                                                                                                       income persons




                                                        Other population
                                                                                                                                       Unemployed low-
                                                                                                                                                         Employment counseling,




                                                        ●
                                                                                ●
                                                                                                                                   ●
                                                                                                                                                         assessment, and case
                                                                                                                                                         management
                                                                                                                                                         Assistance in earning a




Page 70
                                                        *
                                                                                                                                                         high school diploma or its
                                                                                                                                                         equivalent




                                                        ●
                                                                                ○
                                                                                                                                   ○
                                                                                                                                                         Job development




                                                        ●
                                                                                ●
                                                                                                                                   ●
                                                                                                                                                         Job readiness skills

                                                                                                                                                         Job recruitment and




                                                        ●
                                                                                ○
                                                                                                                                   ●
                                                                                                                                                         referrals




                                                        ●
                                                                                ●
                                                                                                                                   ●


                                                                                                                                                         Job retention training

                                                                                                                                                         Job search or job




                                                        ●
                                                                                ●
                                                                                                        ○
                                                                                                                                   ●




                                                                                                                                                         placement activities

                                                                                                                                                         Occupational or




                                                        ●
                                                                                ●
                                                                                                                                   ○




                                                                                                                                                         vocational training
                                                                                                                                   *




                                                        ●
                                                                                ●                                                                        Vocational rehabilitation




                                                        *
                                                                                                                                   *




                                                                                ○

                                                                                                                                                         Supported employment
                                                                                                                                   *




                                                        ●
                                                                                ●




                                                                                                                                                         On-the-job training
                                                                                                                                                         Remedial academic,
                                                                                                                                   *




                                                        ○


                                                                                                                                                         English language skills, or
                                                                                                                                                         basic adult literacy
                                                                                ○
                                                                                                                                   ●




                                                                                                                                                         Work experience

GAO-12-677 Employment for People with Disabilities
                                                        ○
                                                                                ●
                                                                                                                                   ●




                                                                                                                                                         Employment-related
                                                                                                                                                         information dissemination

                                                                                                                                                         Entrepreneurship training
                                                                                                                                   *




                                                                                                                                                         and support


                                                                                                                                                         Tax expenditures
                                                                                                                                                         Support and services to
                                                                                                                                   *




                                                        ○
                                                                                ○




                                                                                                                                                         employers of people with
                                                                                                                                                         disabilities

                                                                                                                                                         Assistive technology and
                                                                                *



                                                        ○
                                                                                                                                   ○




                                                                                                                                                         workplace
                                                                                                                                                         accommodations
                                                                              Cost

                                                                              Program
                                                                                                 Program
                                                                                                 Sheppard




                                                     Supported
                                                                                                 Randolph-
                                                                                                                         the Person
                                                                                                                         Rebalancing




                                                     Employment
                                                     State Grants
                                                                              Rehabilitation
                                                                                                                         Demonstration
                                                                                                                         Money Follows




                                                                              Reimbursement
                                                                                                 Vending Facility

                                                                              State Vocational
                                                                                                        blind
                                                                                                                                                served




                                                                        receive




                                                                        benefits
                                                                                                                            types of




                                                                        Disability
                                                                        Insurance



                                                     disabilities
                                                                                                                            disabilities
                                                                                                                                                Population




                                                                        People who

                                                                        Supplemental




                                                     People with the
                                                     most significant
                                                                                                        People who are




                                                                        Security Income
                                                                                                                            People with other




                                                                        or Social Security
                                                                                                                                                Employment counseling,




                                                                                                      *
                                                                                                                              *




                                                         ●
                                                                               ●
                                                                                                                                                assessment, and case
                                                                                                                                                management
                                                                                                                                                Assistance in earning a




Page 71
                                                                                                                              *




                                                         ○
                                                                               ○
                                                                                                                                                high school diploma or its
                                                                                                                                                equivalent




                                                                                                      *
                                                                                                                              *




                                                         ●
                                                                               ○
                                                                                                                                                Job development
                                                                                                                              *




                                                         ●
                                                                               ○
                                                                                                      ○
                                                                                                                                                Job readiness skills

                                                                                                                                                Job recruitment and
                                                                                                                              *




                                                         ○
                                                                               ○
                                                                                                      ○
                                                                                                                                                referrals
                                                                                                                              *




                                                         ○
                                                                               ○
                                                                                                      ○
                                                                                                                                                Job retention training

                                                                                                                                                Job search or job
                                                                                                                              *




                                                         ●
                                                                               ●
                                                                                                      ○




                                                                                                                                                placement activities

                                                                                                                                                Occupational or




                                                         ○
                                                                               ○
                                                                                                      ●




                                                                                                                                                vocational training




                                                         ●
                                                                               ●
                                                                                                      ●




                                                                                                                                                Vocational rehabilitation
                                                                                                                              *




                                                         ●
                                                                               ○




                                                                                                                                                Supported employment
                                                                                                                              *




                                                         ○
                                                                               ○
                                                                                                      ○




                                                                                                                                                On-the-job training
                                                                                                                                                Remedial academic,
                                                                               *




                                                         ○




                                                                                                                                                English language skills, or
                                                                                                                                                basic adult literacy
                                                         ●
                                                                               ○
                                                                                                      ●




                                                                                                                                                Work experience

GAO-12-677 Employment for People with Disabilities
                                                                                                      *
                                                                                                                              *




                                                         ○
                                                                               ○




                                                                                                                                                Employment-related
                                                                                                                                                information dissemination

                                                                                                                                                Entrepreneurship training
                                                         ○
                                                                               ○
                                                                                                      ●




                                                                                                                                                and support


                                                                                                                                                Tax expenditures
                                                                                                                                                Support and services to
                                                                                                      *
                                                                                                                              *




                                                         ○
                                                                               ○




                                                                                                                                                employers of people with
                                                                                                                                                disabilities

                                                                                                                                                Assistive technology and
                                                                                                      *
                                                                                                                              *




                                                         ○
                                                                               ○




                                                                                                                                                workplace
                                                                                                                                                accommodations
                                                                                                                                                                                                                                                                      program
                                                                                                                                                                                                                                                                                                     program




                                                                                                                                                                                                                                                                      Assistance
                                                                                                                                                                                                                                                                      Planning and
                                                                                                                                                                                                                                                                                                     Ticket to Work




                                                                                                                                                                                                                                                                      Work Incentives
                                                                                                                                                                                                                                                                                                                      served




                                                                                                                                                                                                                                                              receive
                                                                                                                                                                                                                                                                                        receive




                                                                                                                                                                                                                                                              benefits
                                                                                                                                                                                                                                                                                        benefits




                                                                                                                                                                                                                                                              Disability
                                                                                                                                                                                                                                                                                        Disability




                                                                                                                                                                                                                                                              Insurance
                                                                                                                                                                                                                                                                                        Insurance
                                                                                                                                                                                                                                                                                                                      Population




                                                                                                                                                                                                                                                              People who
                                                                                                                                                                                                                                                                                        People who




                                                                                                                                                                                                                                                              Supplemental
                                                                                                                                                                                                                                                                                        Supplemental




                                                                                                                                                                                                                                                              Security Income
                                                                                                                                                                                                                                                                                        Security Income




                                                                                                                                                                                                                                                              or Social Security
                                                                                                                                                                                                                                                                                        or Social Security
                                                                                                                                                                                                                                                                                                                      Employment counseling,




                                                                                                                                                                                                                                                                                               ●
                                                                                                                                                                                                                                                                                                                      assessment, and case
                                                                                                                                                                                                                                                                                                                      management
                                                                                                                                                                                                                                                                                                                      Assistance in earning a




Page 72
                                                                                                                                                                                                                                                                                               *
                                                                                                                                                                                                                                                                                                                      high school diploma or its
                                                                                                                                                                                                                                                                                                                      equivalent




                                                                                                                                                                                                                                        Source: GAO survey.
                                                                                                                                                                                                                                                                                               *
                                                                                                                                                                                                                                                                                                                      Job development


                                                                                                                                                                                                                                                                                               *
                                                                                                                                                                                                                                                                                                                      Job readiness skills

                                                                                                                                                                                                                                                                                                                      Job recruitment and
                                                                                                                                                                                                                                                                                               *

                                                                                                                                                                                                                                                                                                                      referrals




                                                     * Service provided, but extent unknown
                                                                                                                                                                                                                                                                                               *



                                                                                                                                                                                                                                                                                                                      Job retention training

                                                                                                                                                                                                                                                                                                                      Job search or job
                                                                                                                                                                                                                                                                                               ●




                                                                                                                                                                                                                                                                                                                      placement activities

                                                                                                                                                                                                                                                                                                                      Occupational or
                                                                                                                                                                                                                                                                                               *




                                                                                                                                                                                                                                                                                                                      vocational training
                                                                                                                                                                                                                                                                                               *




                                                                                                                                                                                                                                                                                                                      Vocational rehabilitation



                                                                                              ○ Service provided to less than 50 percent of program participants
                                                                                                                                                                   ● Service provided to more than 50 percent of program participants
                                                                                                                                                                                                                                                                                               *




                                                                                                                                                                                                                                                                                                                      Supported employment
                                                                                                                                                                                                                                                                                               *




                                                                                                                                                                                                                                                                                                                      On-the-job training
                                                                                                                                                                                                                                                                                                                      Remedial academic,
                                                                                                                                                                                                                                                                                                                      English language skills, or
                                                                                                                                                                                                                                                                                                                      basic adult literacy
                                                                                                                                                                                                                                                                                               *




                                                                                                                                                                                                                                                                                                                      Work experience

GAO-12-677 Employment for People with Disabilities
                                                                                                                                                                                                                                                                     ●
                                                                                                                                                                                                                                                                                               ●




                                                                                                                                                                                                                                                                                                                      Employment-related
                                                                                                                                                                                                                                                                                                                      information dissemination

                                                                                                                                                                                                                                                                                                                      Entrepreneurship training
                                                                                                                                                                                                                                                                                               *




                                                                                                                                                                                                                                                                                                                      and support


                                                                                                                                                                                                                                                                                                                      Tax expenditures
                                                                                                                                                                                                                                                                                                                      Support and services to
                                                                                                                                                                                                                                                                                               *




                                                                                                                                                                                                                                                                                                                      employers of people with
                                                                                                                                                                                                                                                                                                                      disabilities

                                                                                                                                                                                                                                                                                                                      Assistive technology and
                                                                                                                                                                                                                                                                                               *




                                                                                                                                                                                                                                                                                                                      workplace
                                                                                                                                                                                                                                                                                                                      accommodations
Appendix VI: Employment-Related Outcome
Measures Programs Reported Tracking for
People with Disabilities in Fiscal Year 2010

                                               Entered the                                                                            Measures
                                                 military,                                                      Reduced                tracked
                                             postsecondary                                                     reliance on           specifically
                                              education, or                         Wage                         federal             for people
                      Educational Credential    vocational     Entered  Employment gain or Customer                cash                  with
                      attainment attainment training program employment  retention change satisfaction           benefits    Other   disabilities
U.S. AbilityOne Commission
AbilityOne Program                                               ●                       ●           ●                        ●           ●
Department of Agriculture
Assistive
Technology
Program for
Farmers with
Disabilities:
AgrAbility Project
Department of Defense
Air Force Warrior
and Survivor Care
Army Warrior Care
and Transition
Program
Computer/Electronic
Accommodations                                                               ●                       ●                                    ●
Program
Marine Corps
Wounded Warrior                                                  ●                                   ●                                    ●
Intern Program
Marine Corps
Wounded Warrior                                   ●              ●           ●                                                            ●
Regiment




                                       Page 73                         GAO-12-677 Employment for People with Disabilities
                                               Entered the                                                                            Measures
                                                 military,                                                      Reduced                tracked
                                             postsecondary                                                     reliance on           specifically
                                              education, or                         Wage                         federal             for people
                      Educational Credential    vocational     Entered  Employment gain or Customer                cash                  with
                      attainment attainment training program employment  retention change satisfaction           benefits    Other   disabilities
Navy Safe Harbor
                          ●          ●                           ●                                   ●                                    ●
Program
Recovery Care
Coordinator
Program
Recovery
Coordination
                                                                 ●           ●                       ●                                    ●
Program–Operation
Warfighter
U.S. Special
Operations
                                                   ●             ●                                                                        ●
Command Care
Coalition
Department of Education
American Indian
Vocational
                          ●          ●             ●             ●           ●           ●           ●                        ●           ●
Rehabilitation
Services
Helen Keller
National Center for
                                                                 ●                                                            ●           ●
Deaf-Blind Youths
and Adults
Migrant and
Seasonal                                                         ●                       ●                                                ●
Farmworkers




                                         Page 74                       GAO-12-677 Employment for People with Disabilities
                                              Entered the                                                                            Measures
                                                military,                                                      Reduced                tracked
                                            postsecondary                                                     reliance on           specifically
                                             education, or                         Wage                         federal             for people
                     Educational Credential    vocational     Entered  Employment gain or Customer                cash                  with
                     attainment attainment training program employment  retention change satisfaction           benefits    Other   disabilities
Model
Comprehensive
Transition and
Postsecondary
                                    ●                                                                                                    ●
Programs for
Students with
Intellectual
Disabilities
Randolph-Sheppard
Vending Facilities                                              ●                       ●                                                ●
Program
Rehabilitation
Services
                         ●          ●             ●             ●                       ●                                    ●           ●
Demonstration and
                 a
Training Programs
Assistive
Technology State                                                                                                             ●           ●
Grant program
Supported
Employment State                                                ●                       ●                          ●         ●           ●
Grants
State Vocational
Rehabilitation                                                  ●                       ●                          ●         ●           ●
Services




                                        Page 75                       GAO-12-677 Employment for People with Disabilities
                                               Entered the                                                                            Measures
                                                 military,                                                      Reduced                tracked
                                             postsecondary                                                     reliance on           specifically
                                              education, or                         Wage                         federal             for people
                      Educational Credential    vocational     Entered  Employment gain or Customer                cash                  with
                      attainment attainment training program employment  retention change satisfaction           benefits    Other   disabilities
Department of Health and Human Services
1915(c) Home and
Community Based
Services Waiver
1915(i) State Plan
Home and
Community-Based
Services
Medicaid State Plan
Services
Money Follows the
Person Rebalancing
Demonstration
Department of Labor
America’s Heroes at
Work
Disabled Veterans’
                                                                 ●           ●                                                ●           ●
Outreach Program
Employer
Assistance and                                                   ●                                   ●                                    ●
Resource Network
Job Accommodation
                                                                             ●                       ●                                    ●
Network
Job Corps                 ●          ●             ●             ●           ●           ●                                                ●




                                         Page 76                       GAO-12-677 Employment for People with Disabilities
                                                   Entered the                                                                            Measures
                                                     military,                                                      Reduced                tracked
                                                 postsecondary                                                     reliance on           specifically
                                                  education, or                         Wage                         federal             for people
                          Educational Credential    vocational     Entered  Employment gain or Customer                cash                  with
                          attainment attainment training program employment  retention change satisfaction           benefits    Other   disabilities
Local Veterans’
Employment
                                                                     ●           ●                                                ●           ●
Representatives
program
REALifelines
Initiative
Registered
Apprenticeship for
Youth and Young               ●          ●             ●             ●           ●                                                ●           ●
Adults with
Disabilities Initiative
Community Service
Employment for
Older
Americans/Senior                                                     ●           ●           ●           ●                        ●           ●
Community Service
Employment
Program
Veterans’ Workforce
                                                                     ●           ●                                                ●           ●
Investment Program
Work Opportunity
Tax Credit (also
under the Internal
Revenue Service)
Workforce
Investment Act                ●          ●             ●             ●           ●           ●                                    ●           ●
Youth Activities




                                             Page 77                       GAO-12-677 Employment for People with Disabilities
                                                Entered the                                                                            Measures
                                                  military,                                                      Reduced                tracked
                                              postsecondary                                                     reliance on           specifically
                                               education, or                         Wage                         federal             for people
                       Educational Credential    vocational     Entered  Employment gain or Customer                cash                  with
                       attainment attainment training program employment  retention change satisfaction           benefits    Other   disabilities
Workforce
Recruitment
Program (also
                                                                  ●                                                                        ●
under the
Department of
Defense)
YouthBuild                 ●          ●             ●             ●           ●           ●                                    ●           ●
Department of Veterans Affairs
Compensated Work
                                                                  ●           ●           ●           ●                        ●           ●
Therapy program
Disabled Transition
Assistance Program
Vocational
Rehabilitation and                                  ●             ●           ●           ●                                    ●           ●
Employment
Vocational Training
and Rehabilitation
for Vietnam
Veterans’ Children
with Spina Bifida or
Other Covered Birth
Defects




                                          Page 78                       GAO-12-677 Employment for People with Disabilities
                                               Entered the                                                                                                             Measures
                                                 military,                                                                          Reduced                             tracked
                                             postsecondary                                                                         reliance on                        specifically
                                              education, or                         Wage                                             federal                          for people
                      Educational Credential    vocational     Entered  Employment gain or Customer                                    cash                               with
                      attainment attainment training program employment  retention change satisfaction                               benefits          Other          disabilities
Social Security Administration
State Vocational
Rehabilitation Cost
                                                                            ●                ●                                           ●                                  ●
Reimbursement
Program
Ticket to Work
                          ●          ●                                      ●                ●                          ●                ●                ●                 ●
program
Work Incentives
Planning and              ●          ●                     ●                ●                ●                                                                              ●
Assistance program
                                         Source: GAO survey.
                                         a
                                          In commenting on a draft of this report, Education officials noted that Rehabilitation Services Demonstration and Training Programs may track
                                         some of these measures on a project-specific basis, depending on the purpose of the demonstration project.




                                         Page 79                                     GAO-12-677 Employment for People with Disabilities
Appendix VII: Programs That Identified
Performance Reviews Completed Since 2006,
by Type of Study

                                                                                                  a
                 Program (agency)                                                 Impact study        Other study
                 AgrAbility (Department of Agriculture)                                                     ●
                 Compensated Work Therapy program (Department of
                                                                                                            ●
                 Veteran Affairs)
                                                                           b
                 Employer Assistance and Resource Network (Labor)                                           ●
                 Helen Keller National Center (Education)                                                   ●
                 Job Corps (Labor)                                                        ●
                                                          c
                 Mental Health Treatment Study (SSA)                                      ●
                 Randolph Sheppard Vending Facilities Program
                            d                                                                               ●
                 (Education)
                 Recovery Care Coordinator–Operation Warfighter
                                                                                                            ●
                 (Department of Defense)
                 Ticket to Work program (SSA)                                                               ●
                 Work Incentives Planning and Assistance program (SSA)                                      ●
                                                                      c
                 Youth Transition Demonstration Projects (SSA)                            ●
                 YouthBuild (Labor)                                                                         ●
             Source: GAO survey.
             a
              In response to our survey questions that asked whether any impact studies had been conducted,
             officials from five program provided references. We evaluated the methodology of each study and
             determined that three of them met the definition of an impact study provided in our questionnaire—a
             study that assessed the net effect of a program by comparing program outcomes with an estimate of
             what would have happened in the absence of the program—and had been completed since 2006.
             The other studies either did not meet our definition or were not available for review.
             b
              This program reported having conducted an impact study, but that it was still in progress as part of a
             larger effort.
             c
              Two of the three programs that conducted impact studies were excluded from our scope because
             they ended prior to April 2012, but are listed here because the studies are discussed in the report.

             d
                 This program cited a previous GAO study, which is not an program evaluation.




             Page 80                                          GAO-12-677 Employment for People with Disabilities
Appendix VIII: Agency Comments from the
             Appendix VIII: Agency Comments from the
             Department of Agriculture



Department of Agriculture




             Page 81                               GAO-12-677 Employment for People with Disabilties
Appendix IX: Agency Comments from the
         Appendix IX: Agency Comments from the Department of
         Education



Department of Education




                     Page 82                               GAO-12-677 Employment for People with Disabilties
Appendix IX: Agency Comments from the Department of
Education




            Page 83                               GAO-12-677 Employment for People with Disabilties
Appendix X: Agency Comments from the
             Appendix X: Agency Comments from the
             Department of Labor



Department of Labor




             Page 84                                GAO-12-677 Employment for People with Disabilties
Appendix XI: GAO Contact and Staff
                  Appendix XI: GAO Contact and Staff
                  Acknowledgments



Acknowledgments

                  Daniel Bertoni, (202) 512-7215 or bertonid@gao.gov
GAO Contact
                  Michele Grgich, Assistant Director; Rachael Chamberlin Valliere, Analyst-
Staff             in-Charge; Margaret J. Weber; and Miriam Hill made significant
Acknowledgments   contributions to all aspects of this engagement. Stuart M. Kaufmann,
                  Christine C. San, and Walter Vance assisted with the methodology,
                  survey development, and data analysis. Jessica A. Botsford and Sheila
                  McCoy provided legal assistance. Kate van Gelder and James Bennett
                  helped prepare the final report and graphics. Tom Moscovitch, John S.
                  Townes, and Jacques Arsenault verified our findings.




(131156)
                  Page 85                              GAO-12-677 Employment for People with Disabilties
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