How Federal Developmental Disabilities Programs Are Working

HRD-80-43: Published: Feb 20, 1980. Publicly Released: Feb 20, 1980.

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GAO was requested to make a comprehensive examination of the overall administration and operation of four developmental disability programs: (1) State Formula Grant, (2) State Protection and Advocacy, (3) Special Projects, and (4) University-Affiliated Facilities. These programs were designed to improve and coordinate services to the developmentally disabled and to protect their rights. The 2 million developmentally disabled have disabilities originating before the age of 18 which constitute a substantial handicap to their ability to function normally in society and are expected to continue indefinitely. Mental retardation, cerebral palsy, epilepsy, autism, and severe dyslexia are the conditions generally accepted as constituting a developmental disability.

All the programs have funded projects and activities to help the developmentally disabled. However, the Depatment of Health, Education, and Welfare (HEW) has not developed criteria or standards to measure program performance or made any in depth reviews of the programs' overall impact on the conditions of the persons they were meant to serve. The State Formula Grant Program had problems so fundamental and pervasive that major improvements are needed. Designated state agencies for the State Protection and Advocacy Program have legal authority to push for actions and obtain needed services. While it enabled the disabled to go outside established service delivery systems and assure their rights are protected, the program had problems and lacked funds. The Special Projects Program was not unique. Many of its projects were similar to projects funded under the Formula Grant Program. Regional projects were narrow in scope, not designed for widespread application or reapplication, and were providing conventional services instead of developing unique or innovative techniques for service delivery. Program funds were often used to continue projects started under nondevelopmental disability programs. The principal problems with the University-Affiliated Program were that it is funded from numerous sources with no fixed pattern, had vague mission statements, and had varying and incompatible guidelines. All four programs need closer monitoring and more specific direction from HEW if they are to be effective, viable forces in improving conditions of the developmentally disabled.

Matter for Congressional Consideration

  1. Status: Closed

    Comments: Please call 202/512-6100 for additional information.

    Matter: Because of the intrinsic and pervasive nature of many of the problems with this program, Congress should clearly delineate what it wants the program to accomplish.

Recommendation for Executive Action

  1. Status: Closed

    Comments: Please call 202/512-6100 for additional information.

    Recommendation: The Secretary, HEW, should direct the Commissioner of the Rehabilitation Services Administration (RSA) to: develop uniform standards to help program administrators, state councils, and others evaluate program performance; formulate standards to measure the performance of state councils; encourage states to establish more effective and accountable grant review mechanisms; provide states with more specific guidance for reporting program expenditures; ensure that the states develop and use appropriate monitoring and evaluation tools to assess their programs; and increase HEW regional monitoring and evaluation efforts. To improve the State Protection and Advocacy Program the Secretary should direct the Commissioner, RSA, to: formulate specific regulations and guidelines; assist States in accessing other funds for their programs; require the states to establish a mechanism for coordinating the advocacy activities of this program with the Formula Grant Program; and establish standards to measure program performance. The Secretary should also improve the Special Projects Program by requiring the Commissioner, RSA, to: review all projects currently being funded under this program and discontinue support to those which are not, or do not hold promise of fulfilling legislative objectives; fully inform Congress on how program funds are spent and what has been accomplished; strengthen grant review procedures; increase program monitoring and evaluation, including site visits to projects; and establish a system to follow up on project accomplishments and dissemination of project results. Further, the Secretary, HEW, should ensure that the Commissioner, RSA, establishes goals, objectives, and performance standards for the University-Affiliated Facilities Program supported with developmental disabilities funds and periodically evaluate supported facilities.

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