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THE WHITE HOUSE WASHINGTON CABINET AFFAIRS STAFFING MEMORANDUM Date: 4/3/84 Number: 168955CA Due By: Subject: Cabinet Council on Human Resources - Friday, April 6, 1984 2:00 p.m. Roosevelt Room Action FYI Action FYI ALL CABINET MEMBERS CEA CEQ Vice President State X OSTP Treasury Defense Attorney General x Interior x Agriculture X Baker Commerce R Deaver Labor HHS Darman (For WH Staffing) X Jenkins HUD Mc Farlane P Transportation Svahn Energy Education Counsellor x OMB CIA UN USTR CCCT/Gunn GSA CCEA/Porter CCFA/ EPA OPM CCHR/Simmons X VA CCLP/Uhlmann SBA CCMA/Bledsoe CCNRE/ REMARKS: The Cabinet Council on Human Resources will meet on Friday, April 6, 1984 at 2:00 p.m. in the Roosevelt Room. The agenda and background papers for the first two agenda items are attached. No paper will be distributed for the third agenda item. RETURN TO: Craig L. Fuller Katherine Anderson Don Clarey Assistant to the President Tom Gibson Larry Herbolsheimer for Cabinet Affairs Associate Director 456-2823 Office of Cabinet Affairs 456-2800 THE WHITE HOUSE WASHINGTON CABINET COUNCIL ON HUMAN RESOURCES April 6, 1984 Roosevelt Room AGENDA 1. Fairness to Families (CM#463) paper attached 2. Handicapped Policy (CM#430) paper attached 3. Briefing on the 1983 Fiscal Year Report on Historically Black Colleges and no paper to be Universitites (CM#466) distributed THE WHITE HOUSE WASHINGTON April 3, 1984 MEMORANDUM FOR PAUL SIMMONS FROM: BRUCE CHAPMAN BC SUBJECT: Family Issues: Cabinet Council Discussion The CCHR should formally consider a number of proposals for inclusion in the Administration's program objectives for helping families. (Programs underway or already approved and about to be announced are covered later in this memo.) Possible family programs to be considered by the Administration. o Tax Fairness for Families is a keystone of our policies. The issue is of importance to every family with children, while virtually all other family concerns are of interest only to certain families under certain conditions. The Secretary of the Treasury has authorized his support for the following Presidential statement: "The Secretary of the Treasury has assured me that in its analysis of fundamental tax reform the Treasury Department will consider ways to increase the fairness of the tax treatment of families. Part time job development in the federal government. The federal government has already embraced flexitime policy, but other flexible arrangements are under preliminary consideration. OPM is considering a Federal Personnel Manual Bulletin which would encourage additional federal jobs under the Part Time Employment Act. Encouragement of home-based businesses. The Labor Department has announced a regulatory effort to remove prohibition on the employment of one class of home-based workers, knitters of outer wear. However, Republicans in the Senate are pushing for more far-reaching legislation which would free all categories 2 of homework from prohibitions contained in present regulation. Meanwhile, the Small Business Administration has several initiatives to train entrepreneurs starting home-based businesses. Homework helps mothers, old people and the handicapped and this subject should be developed for full CCHR discussion. Regulatory review of government policy toward families. It has been proposed that each Cabinet Department undertake a review of all its regulations to determine how they affect the family. Such reviews have been undertaken to determine the effect of regulations on the budget, the environment, the paperwork burden, energy usage, and other similar factors. No factor in American life is more important than the stability of families. Should a similar review be ordered to determine the effect of regulations on families? Adoption. While hundreds of thousands of couples yearn to adopt a child, many single mothers opt for abortion or raising a child out-of-wedlock because the adoption option often unexplained, may be seen as too expensive or difficult. Four ways to encourage the adoption option are proposed: --Operate an HHS education program to encourage the discussion of adoption option in counseling sessions with unwed pregnant teenagers and other women at counseling centers supported by Title X Funds. "Outreach" to the voluntary sector to bring back the maternity home and inform both states and maternity homes of the federal assistance for which homes are eligible but which they presently seldom receive. --Reaffirm the AFDC reform, proposed by the President in May, would lessen the incentive for unwed motherhood among teenagers, by requiring that minor mothers live with their families in order to be eligible for AFDC payments. --Reform of adoption-related regulation at the state and local level to remove unnecessary barriers and deterrents to adoption. The federal government can assist in this reform by preparing model regulations (e.g., many states prohibit adoption parents over age 40, even when they are related to the prospective adoptive child). --Open up child placement services to voluntary and private agencies. Ineffective public agencies now have a disincentive to contract with effective private and voluntary agencies to place minor wards of the state for adoption, because as long as the children are not placed the public agencies receive federal subsidies to keep them in foster care. This situation can be corrected by amendment to P.L. 96-272, the Adoption Assistance and Child Welfare Act of 1980. OPE is now preparing language for such an amendment. 3 --The CASA program (see below) also relates to adoption, because it facilitates the removal of children from foster care to permanent adoptive homes. --Further proposals to encourage adoption will be forthcoming. Family Programs being developed by the Administration, nearly ready for announcement. (These do not require new CCHR approval.) They include: National Center for Missing and Exploited Children. Developed by the Department of Justice, this program will provide preventive education, computer assisted search techniques and media support in the search for missing children. In addition, it will provide technical assistance to state and local law enforcement agencies in the investigation, prosecution and treatment of expolited child cases. It will also help locate those children who are abducted and harmed. Moreover, it will provide an information exchange to protect children who "run away" from home only to find exploitation and degradation when they reach their destination. The Center will open May 25. Court Appointed Special Advocates. Developed by Justice in cooperation with the National Association of Juvenile and Family Court Judges, this program will seek volunteers to serve as advocates for children who become wards of the courts. Too often, today, the interest of the child are lost in the rush of court procedure. Volunteers will serve as officers of the court and attempt to rescue children from revolving-door foster care and return to abusive homes. A national conference on this subject is being held in Washington on June 11-13 and would provide an ideal opportunity for announcement of this Administration initiative. National Center for the Analysis of Violent Crime. Being developed by the Department of Justice, this center would provide a national link-up of law enforcement offices with sophisticated computer capabilities, enabling police forces to coordinate information on unsolved murders, violent rapes, unidentified bodies, missing person reports and other information which suggests a serial killer who travels from jurisdiction to jurisdiction. Family violence. The Family Violence Task Force, under the leadership of Assistant Attorney General Lois Herrington, is about to make its recommendations, although a specific timetable has not been announced. 4 Family programs already a part of approved Administration policy include: Child Support Enforcement. The House of Representatives unanimously passed the Administration's bill to improve efforts of families to collect legally-required child support payments from absent parents. This bill should reach the President's desk in the near future. Child Pornography legislation, strongly pushed by the President, has passed both the House and the Senate and Conference language is expected to reach his desk in the near future. This will be a major tool for law enforcement agencies against the exploitation of children. Tuition tax credits, although temporarily set back by defeat in the Senate, remain an Administration effort to improve the ability of families to choose educational opportunities for their children. Education Savings Accounts, endorsed by the President, would provide an incentive for families to save for their chilren's college education. The increasing cost of college is of overwhelming concern to hundreds of thousands of American families whose financial capacities are being strained. Improved educational standards and a new emphasis on discipline in the schools have inspired positive responses from families and school districts around the nation concerned about the future of their children. The Youth Employment Opportunity Wage (youth minimum wage) is a constructive family initiative designed to give young people a start in the work environment and an experience base from which to grow for the future. THE WHITE HOUSE WASHINGTON March 29, 1984 MEMORANDUM FOR THE CABINET COUNCIL ON HUMAN RESOURCES FROM: PAUL B. SIMMONS ACTING EXECUTIVE SECRETARY SUBJECT: Recommendation for the Establishment of a White House Task Force on Handicapped Programs Report of the Working Group on Handicapped Policy The Working Group on Handicapped Policy (see attached list) has reviewed the extent of the Federal investment in programs for handicapped individuals and finds the following: There are more than 150 identified Federal programs serving handicapped people (see attached). All of these individual programs address important needs, but often operate at cross purposes. For example, while SSDI and SSI programs provide income and medical security for handicapped persons, they also contain financial incentives to keep these same individuals unemployed; meanwhile, the Rehabilitation Services Administration Program provides incentives to put handicapped persons to work. There is a lack of coordination in Federal programs. For example, job placement efforts for handicapped are lodged within the Departments of Labor, HHS, Education, the President's Committee on Employment of the Handicapped and Veterans Administration. At least 32 Federal agencies fund handicapped research. Forty-two separate Federal programs specifically aimed at the handicapped population have a combined annual budget of over $36 billion. 58.5 percent of disabled men and 76.3 percent of disabled women are not even looking for employment. Eighty-seven percent of severely disabled individuals do not try to find work, even while new technology is opening many new opportunities for them. - 2 - The current population of Americans who regard themselves as disabled to some extent is estimated at 35 million. There are five committees, with 56 Presidential appointees, that are addressing the needs of the handi- capped population in America, often with overlapping missions. There are many other ad hoc committees of Federal employees and interagency councils addressing various aspects of handicapped policy in the Federal Government. There are several actions that have already taken place as a result of the Working Group on Handicapped Policy recommendations. O The President made a statement on November 28, 1983 before several hundred handicapped individuals at a White House reception establishing the goal of economic independence for handicapped Americans. Three new programs were also announced at that time: (1) expansion of Private Sector Job Opportunities Program (HHS) ; (2) a cooperative effort between HHS and Education to assist handicapped young people in their transition from school to work; (3) a national information and referral system for physicians and consumers to facilitate access to health and social services by handicapped persons and their families. (Public Health Service -- Dr. C. Everett Koop) Cabinet Council on Human Resources -- Action Item A White House task force consisting of managers of handi- capped programs should be established to: A. review present laws, regulations and policies and recommend changes needed to bring them into compliance with the President's stated goal of economic independence for handicapped Americans; B. identify disincentives to economic independence in Federal laws and regulations; C. review on a continuing basis proposed policies, programs and initiatives coming out of Executive Branch Agencies and recommend ways to eliminate program overlap; - 3 - D. bring various agency managers together to discuss cooperative programs that would reduce costs and encourage employment of handicapped persons in the private sector; E. identify and highlight programs of primary prevention, already underway in the Federal Government. The composition of the task force would be as follows: 1. Dr. C. Everett Koop (Chairman) 2. Dr. William Roper, Special Assistant to the President for Health Policy (Vice Chairman) 3. Representatives from: (a) Health and Human Services (1) SSA (2) HCFA (3) HDS (b) Education (c) Labor (d) Veterans Administration (e) Justice (f) OMB JawB.Sins March 29, 1984 REPORT OF THE WORKING GROUP ON HANDICAPPED POLICY BACKGROUND PAPER On April 6, 1983 the President announced the establishment of a Working Group on Handicapped Policy under the Cabinet Council on Human Resources at the White House. Three objectives were identified as follows: encourage care for the handicapped within the context of the family and the community; promote integration of the handicapped into society, schools and the workplace; foster independence and dignity in the lives of handicapped persons. Clearly there is a strong moral commitment to provide some form of protection and compensation for disabled people in this country. However, increases in public spending on programs for the disabled and the network of regulations established in any attempt to integrate fully handicapped people into society have caused even the traditional supporters of government intervention to pause. Concern with the rising cost of disability programs has affected all recent administrations, irrespective of political party. Any debate over the direction of the United States disability policy must take into account the complex nature of the existing system -- the size, structure, recent growth, economic status, and labor market effects. The many programs serving the disabled population in the United States are interrelated in complicated ways, they are costly, and they are growing rapidly. One question that needs to be addressed is why and to what degree should the public sector -- the Federal Government in particular -- engage in activities to provide income support, compensate for the loss of work capacity due to injuries, provide medical care, provide training, provide rehabilitation services, or stimulate employment demand for disabled workers? To what degree should the government accept the goal of "equal access" to education, employment, and mobility for disabled people? Is public intervention based on efficiency principles, or on equity and humanitarian grounds? One of the major problems affecting the administration of disability programs is that many of them are overlapping and nonintegrated. -2- To some degree rehabilitation and training services to handicapped workers offset the disincentives implicit in income support programs. For example, vocational rehabilitation, sheltered workshops, direct job creation and regulations to ensure equal access. The evaluation of these programs is incomplete because of their relatively new arrival on the scene. A definition of disablement or impairment is necessary to identify the working aged, disabled population. Unfortunately there is no correct definition as the concept of disability ultimately rests on a social judgement. One definition of impairment would be: A limitation of a physical, mental, or emotional sort which reduces, to varying degrees, ones ability to perform the functions required for the jobs one is, on other grounds, qualified to hold. An estimate of the number of U.S. disabled workers based on this definition would be ideal; unfor- tunately, such a survey has not been undertaken in the United States, and the required data is not available. The present definition of a disabled person is based primarily on self-evaluation. For example a person is provided with a definition of disability in a set of work-related degrees of impairment consistent with this definition, then asked to classify him/herself appropriately. Roughly 82% of non-disabled persons are participants in the labor force, compared to 13% of the severely disabled. And only 51% of the severely disabled employed are full-time workers. Generally the severely disabled earn only about 1/3 of the income of the non-disabled, while the not severely disabled have wage earnings of about 2/3 of the income of the non-disabled population. Presently government policy in the disability area would appear to have two primary functions: establishing mechanisms to achieve the appropriate sharing of costs of impairments and sponsoring programs to achieve an optimal reduction in the aggregate cost of disability. As a result of the historic civil rights legislation in the 1960s, the Federal Government intervened to provide equal justice, equal opportunity, and equal access to citizens regard- less of color. Affirmative action programs were the principal tool used to integrate racial minorities into the society. The same revolutionary change in government policy toward the handicapped occurred in the 70s and is based on a similar com- mitment by society to use the same civil rights techniques in order to integrate handicapped people into an able-bodied society. The implementation of that commitment -- both then and now -- is controversial. -3- The revolution in public policy toward the handicapped in the 1970s was marked by the acceptance of the proposition that the handicapped represented a distinct minority group which is subject to economic discrimination. That is, handicapped people possess characteristics that distinguish them from other members of society, and based on these characteristics they were "discriminated" against. Government's responsibility, then, was to reduce or eliminate this discrimination. The crucial impli- cation of this justification for public intervention was that, just as one would not cure racial discrimination by making Blacks White, the cure to the disability problem did not lie in reducing the functional limitations of the disabled. It did not lie in overcoming these limitations through traditional programs that shared the cost of disability through income maintenance, or in counteracting disability with increased training. Rather, it meant compelling society to change the network of private relationships which prevents this social minority from being fully integrated into all aspects of society. According to some handicapped people, claim to a fair share of jobs and income will be satisfied only when the patterns of discrimination against the disabled individuals in given plants, companies, or industries are exposed and government-enforced affirmative action plans are imposed. o It is estimated that there were about 21.3 million disabled working age people in the United States in 1978, of which 10.8 million were severely disabled and another 4.7 million were occupationally disabled. The large number of separate programs providing assistance to disabled workers is a serious impediment to evaluating the equity and efficiency impacts of the "system". The potential for multiple-program participation is enormous, assessing how funds are distributed has been virtually impossible. With such a long list of disparate programs targeted toward disabled workers, it seems unlikely that an efficient and integrated pattern of assistance and service is now available. The implications of this long list of programs for effective budgetary control are obvious. In addition to assistance, rehabilitation, and direct job creation programs, there exists another set of public policies targeted at the handicapped. These policies are regulatory in nature and seek to impose standards on private business and public sector organizations in their dealings with the handicapped. The objective of these policies is to provide handicapped people with equal access or equal opportunities in three aspects of their lives: employment, education, and mobility. Because these issues involve rulemaking policies, -4- their costs are not reflected in public expenditures; nor are their benefits reflected in the numbers of people being supported or provided services. Rather, the costs of these policies are imposed on private or public sector organizations and become indirectly reflected in the prices of goods and services or in other public budgets. This approach to disability policy has been discussed for many years. Its implementation is a phenomenon of the 1970s. The primary legislation of this sort is the Rehabilitation Act of 1973 (PL 93-112). As public policy has developed with regard to the disabled population, the increase in administrative conflicts are an inevitable result of our multi-program approach. The justification for a multi-program approach to disability is that it is able to protect those who would "fall through the cracks" of a system with less overlap. While this may be a benefit, the redundancy cost of such a system are also clear. Fear that any Federal program for the disabled would expand beyond that justified on efficiency grounds alone has been born out by the first 25 years of disability policy in the United States. The system has quickly expanded from a narrow, medically-defined, disability system to one that includes job-related as well as health-related criteria. In addition, the emergence of SSI has provided welfare benefits to some part of the disabled population regardless of work history. The system now provides a strong safety net that virtually guarantees that no worker who is severely disabled will fall into poverty. Further, it guarantees that those who are severely disabled from birth will be assured a minimum income. There are three segments to disability policy for the united states. one is the traditional income support provisions, second are rehabilitation strategies, and third are the affirmative action/civil rights legislative mandates that grew out of the civil rights activities of the 60s. Private Sector Costs There are no reliable estimates on the extent of the costs incurred by private business and government as a result of law suits requiring accessibility for the handicapped. However, when one contemplates the changes required by these regulations if they were to be fully enforced, the total bill is not likely to be substantially less than that entailed by environmental and occupational health and safety regulations. -5- To many of the handicapped, equal access is a fundamental principle, and its achievement is to be secured as a matter of right, irrespective of cost. Since World War II, government policy toward the disabled working age has concentrated on programs designed to share directly the cost of disability by providing income support to the most severely disabled. These programs, together with a provision of moderate amounts of assistance for rehabilitation, sheltered workshops, and direct job creation, were the basis of the disability policy system until the 1970s. In the mid-1970s direct job creation and the provision of equal access to employment, education, and mobility emerged as major new thrusts. The major commitment by the Federal Government to assure "equal access" to employment, education, and mobility inorder to integrate fully handicapped people into the broader community has resulted in a major increase in government intervention into the private sector. This intervention forms part of the tangle of regulations that presently exist in programs serving the handicapped. There are several areas of policy that need to be considered as we review the entire Federal commitment to disabled people in America. Some of these areas are indicated as follows: o What is the appropriate level of disability cost which should be borne by society at large, and by what criteria should assistance to the disabled be allocated among potential claimants for it? What role does the disability system play in employment policy? How should rehabilitation and training, as well as more direct intervention in the market -- job subsidies, job creation, or job quotas -- fit into the overall policy debate? To what degree should the disability system attempt to alter the socio-economic structure of society to accommodate impaired citizens? And to what degree should society be transformed so that impairments are made irrelevant to normal interactions? What are the implications of "equal access"? What are the costs and benefits of improving equal access? O What role do government regulations play in achieving equal access? The debate over the degree to which governments should redistribute income through the disability system has been a continuous one. Those who favor an increase in the commitment to -6- income redistribution have supported a broadening of the definition of a "qualified" impairment as a means of establishing a universal "safety net" for all poor people. The political commitment to such reform clearly varies with the general economic conditions. The pressure for increasing this redistribution commitment is exercised on two levels. The first is direct pressure on the government to increase explicitly the commitment of public programs to aid the disadvantaged. Proposals in this vein suggest relaxing the eligibility criteria of ongoing programs, increasing the benefit levels of these programs, or creating new programs. The second form of pressure involves increased utilization of current programs by the covered population or an administrative relaxation in enforcement of current program rules. Conclusion The American people have traditionally banded together and extended their network of moral responsibility for the disabled through family units, religious organizations, trade unions, and private charities, and to some extent such private collection and action can replace public programs. The Federal Government has long espoused a policy of increasing the ability of disabled workers to overcome their impairment through rehabilitation and job training. However, the resources committed to this effort have been far fewer than those committed to income support. Beginning in the 1970s, the government moved toward guaranteeing the disabled "equal access" to education, employment, and mobility. By declaring that living in a barrier free environment is a fundamental "right" of disabled people, the government for the first time stated its intent to adjust social norms to accommodate the handicapped, rather than to provide assistance to the handicapped in their efforts to adjust to social norms. The crucial policy issue on which the debate over this approach must focus is the cost of this strategy to the non-disabled relative to the benefits conveyed to the disabled. The debate will not be decided on cost reducing grounds, but on some social judgment regarding the size and configuration of public intervention that must be imposed by the political process. It is possible that the policy that "a little bit more is always a good thing and anything less is inconceivable" may be replaced by an older tradition, one based on the premise that government intervention does not always yield benefits commensurate with costs, and that a search for those cases in which it does is in order. CABINET COUNCIL ON HUMAN RESOURCES WORKING GROUP ON HANDICAPPED POLICY (Established April 6, 1983) OFFICE OF POLICY DEVELOPMENT Robert W. Sweet, Jr. (Chairman) Senior Staff Member, OPD COUNCIL OF ECONOMIC ADVISERS David Henderson Senior Staff Economist DEPARTMENT OF HEALTH & HUMAN SERVICES Dorcas R. Hardy Assistant Secretary for Human Development Services Dr. Jean K. Elder Commissioner Administration on Developmental Disabilities Human Development Services Margaret Porter Program Analyst Office of Assistant Secretary for Planning and Evaluation DEPARTMENT OF HOUSING & URBAN DEVELOPMENT Peter Tropp Executive Assistant to the Assistant Secretary for Policy, Development & Research DEPARTMENT OF TRANSPORTATION Charles Swinburn Deputy Assistant Secretary for Policy & Intergovernmental Affairs Joseph Canny Deputy Director Environmental & Policy Review Office of Economics NATIONAL COUNCIL ON THE HANDICAPPED Sandra Parrino Chairman Harvey C. Hirschi Executive Director -2- DEPARTMENT OF EDUCATION Madeleine C. Will Assistant Secretary for Special Education & Rehabilitative Services DEPARTMENT OF LABOR Sandra Solowiej Special Assistant Office of the Assistant Secretary for Policy DEPARTMENT OF JUSTICE William Bradford Reynolds Assistant Attorney General for Civil Rights Kevin R. Jones Attorney Advisor Office of Legal Policy VETERANS ADMINISTRATION Anthony Principi Associate Deputy Administrator for Congressional & Public Affairs Dr. Henry E. Spuehler, Director Audiology & Speech Pathology Service Lawrence DeMeo Confidential Assistant to the Administrator Billy R. Smith Health Systems Specialist & Special Assistant to the Deputy ACMD for Rehabilitation Services OFFICE OF MANAGEMENT & BUDGET John Cogan Associate Director for Human Resources, Veterans & Labor WHITE HOUSE OFFICE OF PUBLIC LIAISON Judy Buckalew Special Assistant, OPL VICE PRESIDENT'S TASK FORCE ON DEREGULATION C. Boyden Gray Counsel to the Vice President -3- ACTION Betty H. Brake Deputy Director James Williams Assistant Director Office of Policy & Planning NATIONAL SCIENCE FOUNDATION Dr. Lawrence A. Scadden Program Director Science & Technology to Aid the Handicapped NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION Erika Jones Special Assistant to the Deputy Administrator PRESIDENT'S COMMITTEE ON MENTAL RETARDATION Elsie Helsel Vice Chairman OFFICE OF PERSONNEL MANAGEMENT Cynthia E. Tapscott Special Assistant to the Director DEPARTMENT OF THE TREASURY Susan Jewett Attorney Advisor Office of Tax Legislative Counsel SOCIAL SECURITY ADMINISTRATION Martha McSteen Commissioner GENERAL SERVICES ADMINISTRATION Richard Nelson Director of Congressional Affairs HEALTH CARE FINANCING ADMINISTRATION Carolyne K. Davis Administrator FEDERAL PROGRAMS ASSISTING THE HANDICAPPED Portion of Funds are 1983 C.F.D.A. Reserved for Handicapped Appropriations Dept. or Agency Number Individuals (In Thousands) DEPT. EDUCATION Ofc. of Voca- 84.048 Vocational Education -- 56,360K tional & Adult Basic Grants to States Education DEPT. HEALTH & HUMAN SERVICES Ofc. of Human 13.600 Head Start 11,900K Development Services FEDERAL PROGRAMS ASSISTING THE HANDICAPPED Dept. or Agency C.F.D.A. Primary Mission: Assist 1983 Number Handicapped Appropriations (In Thousands) DEPT. EDUCATION Ofc. Special 84.009 Education of Handicapped 146,520 Education & Re- Children in State Operat- habilitative ed or Supported Schools Services 84.023 Handicapped Research & De- 12,000 monstration 84.024 Handicapped Early Childhood 16,800 Assistance 84.025 Handicapped Innovative Pro- 15,360 grams -- Deaf Blind Cntrs. 84.026 Handicapped Media Services/ 12,000 Captioned Films 84.027 Handicapped Preschool & 995,000 School Programs 84.028 Handicapped Regional 2,880 Resource Centers 84.029 Handicapped Personnel Pre- 49,300 paration 84.030 Handicapped Teachers Re- 720 cruitment & Information 84.078 Regional Education Programs 2,832 for Deaf & Other Handicapped Persons 84.086 Innovative Programs for Se- 2,880 verely Handicapped Children 84.125 Clearinghouse on the Handi- N/A capped 84.126 Rehabilitation Services and 943,900 Facilities -- Basic Support 84.128 Rehabilitation Services & 31,094 Facilities -- Special Projs. 84.129 Rehabilitation Training 19,200 84.132 Centers for Independent 17,280 Living -2- Dept. or Agency C.F.D.A. Primary Mission: Assist 1983 Number Handicapped Appropriations (In Thousands) DEPT. EDUCATION (CONT'D.) Ofc. Special Edu- 84.133 National Institute of Handi- 30,060 cation & Rehabili- capped Research tative Services (Cont'd.) DEPT. HEALTH & HUMAN SERVICES Ofc of Human 13.613 President's Committee on 792 Development Mental Retardation Services 13.630 Developmental Disabilities 47,500 -- Basic Support & Advocacy 13.631 Developmental Disabilities 2,500 -- Special Projects 13.632 Developmental Disabilities 7,500 -- University Affiliated Facilities Public Health 13.965 Coal Miners Respiratory 3,120 Service Impairment Treatment, Clinics and Services Social Security 13.802 Social Security Disabil- 17,137,700 Administration ity Insurance 13.806 Special Benefits for Dis- 1,093,000 abled Coal Miners DEPT. OF LABOR Employment Stand- 17.302 Longshoremen's & Harbor 4,000 ards Administra- Workers' Compensation tion 17.307 Coal Mine Workers' 856,000 Compensation (Black Lung) -3- Dept. or Agency C.F.D.A. Primary Mission: Assist 1983 Number Handicapped Appropriations (In Thousands) DEPT. OF LABOR (CONT'D.) Office of Assist- 17.801 Disabled Veterans Out- 57,200 ant Secretary for reach Program Veterans Employment LIBRARY OF CONGRESS 42.001 Books for the Blind & 33,555 Physically Handicapped OFC OF PERSONNEL 27.005 Federal Employment for 250 MANAGEMENT Handicapped PRESIDENT'S CTE. ON 53.001 Handicapped Employment 1,987 EMPLOYMENT OF HANDI- Promotion CAPPED SMALL BUSINESS 59.021 Handicapped Assistance 15,500 ADMINISTRATION Loans: Direct & Guaranteed VETERANS ADMINIS- TRATION Dept. of Medicine 64.007 Blind Veterans Rehabili- 6,129 & Surgery tation Centers 64.013 Veterans Prosthetic 81,615 Appliances Dept. of Veterans 64.100 Automobiles & Adaptive 15,723 Benefits Equipment for Certain Disabled Veterans & Members of Armed Forces 64.104 Pension for Non-Service- 2,662,150 connected disability for Veterans 64.106 Specially Adapted Housing 17,950 for Disabled Veterans -4- Dept. or Agency C.F.D.A. Primary Mission: Assist 1983 Number Handicapped Appropriations (In Thousands) VETERANS ADMINIS- TRATION (CONTINUED) Dept. of Veterans Benefits (Cont'd.) 64.109 Veterans Compensation for 7,856,600 Service-Connected Dis- ability 64.116 Vocational Rehabilitation 121,636 for Disabled Veterans: Direct Payments & Loans 64.118 Veterans Housing -- Direct 802,000 Loans for Disabled Veterans 64.119 Rehabilitative Research 7,500 Architectural & Transpor- 2,020 tation Barriers Com- pliance Board EQUAL EMPLOY- Interagency Committee on N/A MENT OPPORTUNITY Handicapped Employees COMMISSION FEDERAL PROGRAMS ASSISTING THE HANDICAPPED Handicapped Individuals 1983 C.F.D.A. are Included in the Appropriations Dept. or Agency Number Population Served (In Thousands) ACTION 72.001 Foster Grandparent Program 48,055K 72.008 Senior Companion Program 11,871K 72.010 Mini-Grant Program 0 COMMISSION ON 29.001 Clearinghouse Services, Not Available CIVIL RIGHTS Civil Rights & Sex Dis- crimination Complaints DEPT. AGRICULTURE Farmers Home Ad- 10.410 Low to Moderate Income Not Available ministration Housing Loans 10.415 Rural Rental Housing Loans Not Available 10.417 Very Low Income Housing Re- Not Available pair Loans & Grants 10.423 Community Facilities Loans Not Available Science & Edu- 10.500 Cooperative Extension 8,400K cation Admin. Service DEPT. DEFENSE 12.500 U.S. Soldiers' & Airmens' 2,976K Home DEPT. EDUCATION Office for Civil 84.004 Civil Rights Not Available Rights Elementary and 84.034 Library Services & Con- Not Available Secondary Educa- struction Act tion 84.083 Women's Educational Equity Not Available 84.117 Educational Research & Development -2- Handicapped Individuals 1983 C.F.D.A. are Included in the Appropriations Dept. or Agency Number Population Served (In Thousands) DEPT. EDUCATION (CONT'D.) Office of Post- 84.042 Special Services for Dis- 1,821K secondary Edu- advantaged Students cation Office of Voca- 84.002 Adult Education -- State 4,750K tional & Adult Administered Programs Education 84.049 Vocational Education -- Not Available Consumer & Homemaking Education 84.050 Vocational Education -- 10,095K Program Improvement Grants DEPT. ENERGY 81.042 Weatherization Assistance Not Available DEPT. HEALTH & HUMAN SERVICES Health Care 13.714 Medical Assistance Pro- Not Available Financing grams (Medicaid) Administration 13.773 Medicare -- Hospital In- 4,300,000K surance 13.774 Medicare Supplementary 2,000,000K Medical Insurance Office of Human 13.608 Child Welfare Research Not Available Development & Demonstration Services Grants 13.645 Child Welfare Services -- Not Available State Grants 13.647 Social Services Research Not Available & Demonstration -3- Handicapped Individuals 1983 C.F.D.A. are Included in the Appropriations Dept. or Agency Number Population Served (In Thousands) DEPT. HEALTH & HUMAN SERVICES (CONT'D.) Office of Human 13.659 Child Adoption Assistance Not Available Development Services (Cont'd.) 13.667 Social Services Block Not Available Grant Office of the 13.675 Civil Rights Compliance 9,100K Secretary Activities Public Health 13.110 Maternal & Child Health 55,600K Service Federal Consolidated 13.242 Mental Health Research 31,000K Grants 13.244 Mental Health Clinical or 20,100K Service Related Train- ing Grants 13.262 Occupational Safety & 5,100K Health Research Grants 13.263 Occupational Safety & 4,700K Health Training Grants 13.268 Childhood Immunization 27,400K Grants 13.281 Mental Health Research 1,800K Scientist Development & Research Scientist Awards 13.282 Mental Health National 6,700K Research Service Awards for Research Training 13.393 Cancer Cause & Prevention Not Available Research -4- Handicapped Individuals 1983 C.F.D.A. are Included in the Appropriations Dept. or Agency Number Population Served (In Thousands) DEPT. HEALTH & HUMAN SERVICES (CONT'D.) Public Health 13.394 Cancer Detection & Diag- Not Available Service (Cont'd.) nosis Research 13.395 Cancer Treatment Research Not Available 13.396 Cancer Biology Research Not Available 13.837 Heart & Vascular Disease Not Available Research 13.838 Lung Diseases Research Not Available 13.839 Blood Diseases & Re- Not Available sources Research 13.842 Craniofacial Anomalies Not Available Research 13.846 Arthritis, Bone & Skin Not Available Disease Research 13.847 Diabetes, Endocrinology, Not Available & Metabolism Research 13.848 Digestive Diseases and Not Available Nutrition Research 13.849 Kidney Diseases, Urology, Not Available & Hemotology Research 13.853 Clinical Research Not Available 13.854 Biological Basic Research Not Available 13.855 Immunology, Allergic & Not Available Immunological Diseases Research 13.862 Genetics Research Not Available 13.865 Research for Mothers & Not Available Children -5- Handicapped Individuals 1983 C.F.D.A. are Included in the Appropriations Dept. or Agency Number Population Served (In Thousands) DEPT. HEALTH & HUMAN SERVICES (CONT'D.) Public Health 13.866 Aging Research Not Available Service (Cont'd.) 13.867 Retinal & Choroidal Not Available Diseases Research 13.868 Corneal Diseases Research Not Available 13.869 Cataract Research Not Available 13.870 Glaucoma Research Not Available 13.992 Alcohol & Drug Abuse & 469,000K Mental Health Services Block Grants 13.994 Maternal & Child Health 422,100K Services Block Grants Social Security 13.807 Supplemental Security 5,665,000K Administration Income 13.808 Assistance Payments -- Not Available Maintenance Assist- ance (State Aid) 13.812 Social Security Assist- Not Available ance Payments Re- search DEPT. HOUSING & URBAN DEVELOPMENT Community Plan- 14.218 Community Development 8,000K ning & Develop- Block Grants/Entitle- ment ment Grants 14.219 Community Development Not Available Block Grants/Small Cities Program 14.220 Section 312 Rehabili- Not Available tation Loans -6- Handicapped Individuals 1983 C.F.D.A. are Included in the Appropriations Dept. or Agency Number Population Served (In Thousands) DEPT. HOUSING & URBAN DEVELOPMENT (CONT'D.) Federal Housing 14.105 Interest Reductions -- 0 Commissioner Homes for Lower In- come Families 14.138 Mortgage Insurance -- 0 Rental Housing for the Elderly 14.141 Nonprofit Sponsor Not Available Assistance Program 14.142 Property Improvement 0 Loan Insurance 14.156 Lower Income Housing 157,000K Assistance (estimate) 14.157 Housing for the Elderly 50,000K or Handicapped (direct loans) 14.170 Congregate Housing Not Available Services Program DEPT. INTERIOR Bureau of Indian 15.103 Indian Social Services -- 10,390K Affairs Child Welfare Assist- ance & BIA Education -- Institutionalized Handicapped Heritage Conser- 15.916 Outdoor Recreation, Ac- Not Available vation & Recrea- quisition, Develop- tion Service ment & Planning 15.919 Urban Park & Recreation Not Available Recovery Program -7- Handicapped Individuals 1983 C.F.D.A. are Included in the Appropriations Dept. or Agency Number Population Served (In Thousands) DEPT. LABOR Employment & 17.207 Employment Service 24,300K Training Admin- istration 17.233 Employment & Training 3,600K Research & Develop- ment Projects 17.235 Senior Community Not Available Service Employment Program Employment Stand- 17.301 Equal Employment Oppor- 5,300K ards Administra- tunity by Federal tion Contractors 17.303 Minimum Wage & Hour Not Available Standards Occupational 17.500 Occupational Safety & Not Available Safety & Health Health Administration DEPT. TRANSPORTATION Urban Mass Trans- 20.500 Urban Mass Transpor- 25,000K portation Admin- tation Capital istration Improvement Grants Handicapped Services 25,000K Grants 20.502 Urban Mass Transpor- Not Available tation Grants for University Research & Training 20.504 Mass Transportation Not Available Technology Grants & Contracts 20.505 Urban Mass Transpor- Not Available tation Technical Studies Grants -8- Handicapped Individuals 1983 C.F.D.A. are Included in the Appropriations Dept. or Agency Number Population Served (In Thousands) NATIONAL AERO- 43.002 Technology Utilization 750K NAUTICS & SPACE (Rehabilitation/Biomed- ADMINISTRATION ical Program) NATIONAL SCIENCE 47.009 Scientific Personnel 0 FOUNDATION Improvement 47.041 Engineering & Applied 2,000K Science 47.051 Biological, Behavioral, & Social Sciences VETERANS ADMINIS- TRATION Dept. Medicine & 64.001 Biomedical Research Not Available Surgery 64.005 Grants to States for 18,000K Construction of State Home Care Facilities 64.008 Veterans Domiciliary 100,284K Care 64.009 Veterans Hospitalization 4,821,880K 64.010 Veterans Nursing Home 322,507K Care 64.011 Veterans Outpatient Care 1,553,250K 64.014 Veterans State Domicil- 12,688K iary Care 64.015 Veterans State Nursing 31,599K Home Care 64.016 Veterans State Hospital 3,611K Care 64.022 Hospital Based Home Care (9,910K) (included above in Vet- erans Outpatient Care) -9- Handicapped Individuals 1983 C.F.D.A. are Included in the Appropriations Dept. or Agency Number Population Served (In Thousands) VETERANS ADMINIS- TRATION (CONT'D.) Dept. Veterans 64.119 Veterans Housing -- Not Available Benefits Mobile Home Loans EQUAL EMPLOYMENT Nondiscrimination & Not Available OPPORTUNITY COM- Affirmative Action MISSION Federal Spending on Selected Major Programs Serving the Disabled ($ in millions/appropriations (BA)) MAR 16 1984 Program 1970 1980 1983 1984 2/ 1985 3/ HHS/Medicare 1/ 7,149 35,034 57,428 66,026 75,858 HHS/Medicaid 1/ 2,727 13,957 19,047 20,674 21,213 HHS/Disability Ins. 2,954 15,332 18,305 18,528 18,803 HHS/Supplemental Security Income --- 6,468 8,544 8,376 5/ 9,346 5/ VA/Direct Payments (Comp. Pensions, etc.) 5,280 11,136 13,519 14,118 14,534 VA/Rehab. Services 16 76 92 102 109 Education/Handic. Educ. 122 1,193 1,346 1,386 1,361 Education/Rehab. Services 521 921 1,045 1,121 1,092 Labor/Coal Miners' Black Lung Comp. --- 808 855 855 1/ 950 SBA/Handic. Assist. Loans -- 24 23 25 5 HHS/Disabled Coal Miners' Parts 17 1,040 1,093 1,058 1,024 HHS/Develop. Disabilities 20 62 61 62 64 Labor/Federal Workmen's Comp. 118 785 980 1,040 1,071 HUD/Housing for Elderly and Handicapped -- 805 564 631 498 Transportation/Transportation Access 5 95 75 75 75 Labor/Disabled Vets. Outreach ------- 27 57 60 59 TOTAL 18,929 87,763 123,034 134,137 146,062 Change from Prior Column (%) -- +363.6% +40.2% +9.0% +8.9% Change from Prior Column ($) : +68,834 +35,271 +11,103 +11,925 1/ For some of these programs (for example, Medicare, Medicaid, SSI) only a portion of funds serve disabled; for others (for example, handicapped education) all funds serve disabled. Table entries are total Federal program funds, not exclusively those serving disabled. 2/ Enacted 3/ 1985 column of 1985 President's Budget. 4/ Outlays 5/ FY 83 includes 13 months of benefit payments, FY 84 includes 11 months of benefit payments; and FY 85 includes 12 months of benefit payments.