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Federal Domestic Violence Assistance: HHS Should Assess Accessibility-Related Technical Assistance for Local Centers

GAO-24-106366 Published: Sep 12, 2024. Publicly Released: Sep 19, 2024.
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Fast Facts

Data shows that people with disabilities experience domestic violence at 5 times the rate of those without disabilities. People with intellectual disabilities are especially at risk. Some survivors may not be aware of or have access to services from local domestic violence programs.

The Department of Health and Human Services has a key role in ensuring local programs that receive federal funds are accessible. HHS gives these programs technical assistance, but it hasn't asked for feedback on whether the assistance is helping them help people with disabilities.

We recommended that HHS evaluate its technical assistance to local programs.

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Highlights

What GAO Found

The estimated rate of reported violence against people with disabilities by an intimate partner or relative (domestic violence) was about five times higher than the rate for people without disabilities from 2017 through 2022, according to Department of Justice data (see figure). Among people with disabilities, rates of domestic violence were higher for those with cognitive disabilities compared to those with other disability types, women compared to men, and certain racial and ethnic groups compared to others.

Estimated Rate of Reported Domestic Violence by Disability Status of the Victim, 2017–2022

Estimated Rate of Reported Domestic Violence by Disability Status of the Victim, 2017–2022

Note: Estimates are based on the noninstitutionalized U.S. resident population aged 12 or older. The rate for the population without a disability was age-adjusted.

Officials from selected local domestic violence centers funded by the federal family violence prevention program reported taking actions to make services accessible to survivors with disabilities, but said challenges remain. For example, local center officials GAO interviewed reported reaching out to disability groups, providing survivors opportunities to disclose a disability, and modifying facilities to make them more physically accessible. However, officials at local centers and at domestic violence groups described challenges such as identifying local disability groups for outreach, finding interpreters for Deaf survivors, and having limited knowledge of how to work with survivors with disabilities.

The Department of Health and Human Services (HHS) has taken steps to monitor and support family violence prevention program grantees' accessibility efforts, but gaps remain with its assessment of technical assistance.

  • HHS routinely collects information from grantees on the services they provide but has not asked specifically about services for people with disabilities. The agency is planning to add more accessibility-related questions to its monitoring forms.
  • HHS supports some accessibility-related technical assistance for grantees. However, it lacks comprehensive data on accessibility-related technical assistance that would allow it to assess whether such technical assistance is reaching and meeting grantees' needs. Furthermore, most officials at local centers GAO interviewed said they could benefit from additional guidance on topics such as how to work with survivors with various types of disabilities and how to identify mental health issues. A better understanding of technical assistance efforts and any needed improvements would help HHS ensure that those efforts are meeting the needs of local centers to better support survivors with disabilities.

Why GAO Did This Study

HHS's family violence prevention program provides grants to states to support domestic violence shelters and other services delivered by local centers. Federal law requires these services to be accessible to people with disabilities. For example, to make its services more accessible, a local center might provide a survivor who is blind with information in braille. GAO was asked to examine efforts to ensure such services are accessible.

This report (1) describes the prevalence of reported domestic violence against people with disabilities, (2) describes actions that selected local centers funded by the family violence prevention program have taken to improve accessibility and any challenges, and (3) assesses the extent to which HHS monitors and supports states' efforts to ensure accessibility.

GAO analyzed data from two nationally representative federal surveys for 2016/2017 and 2017–2022; reviewed related literature, relevant federal laws and regulations, and HHS documents; interviewed officials from three states, one Tribe, and 12 local centers that were selected for geographic diversity and other factors; and interviewed officials at HHS and stakeholder organizations.

Recommendations

GAO recommends that HHS implement a process to systematically review whether the accessibility-related technical assistance it supports meets the needs of local centers receiving family violence prevention program funds and, if warranted, take steps to improve it. HHS agreed with GAO's recommendation.

Recommendations for Executive Action

Agency Affected Recommendation Status
Department of Health and Human Services The Secretary of HHS should ensure that the Administration for Children and Families establishes and implements a process to systematically review whether the accessibility-related technical assistance that it supports under the family violence prevention program is reaching and meeting the needs of local centers and, if warranted, take steps to improve the quality and dissemination of technical assistance and ensure that it covers needed topics. For example, HHS could use its revised monitoring tools to collect input from grantees and subgrantees on their accessibility-related technical assistance needs, consider accessibility-related technical assistance when selecting training to observe, or improve the consistency of the data on requests that national resource centers receive for accessibility-related technical assistance from local centers. (Recommendation 1)
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HHS agreed with this recommendation and noted steps it plans to take to address it. For example, HHS said that after it has implemented the new performance progress report form for national resource centers discussed in our report, the agency plans to survey family violence prevention program grantees on their technical assistance needs to help ensure that resource centers are addressing those needs, including needs related to serving survivors with disabilities. HHS plans to develop this survey in fiscal year 2025. While this survey could represent a first step toward implementing this recommendation, HHS will need to use the information it collects from the survey as input for a systematic review of its accessibility-related technical assistance. Also, although HHS developed a new mechanism to collect data from national resource centers on the accessibility-related technical assistance they provide, the agency continues to lack consistent data on requests that the centers receive for such technical assistance. We will monitor the progress of these efforts.

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Topics

Domestic violenceMental healthPeople with disabilitiesPhysical disabilitiesPublic healthSexual violenceTechnical assistanceViolent crimesWomenFederal assistance programs