Recommendation: Congress should consider requiring that states notify parents/guardians of changes in students' federal special education rights when a student with a disability is moved from public to private school by their parent.

Agency: Congress
Status: Open

Comments: As of August 2019, Congress has not considered this matter.

Recommendation: The Assistant Secretary for Special Education and Rehabilitative Services should review information provided by states related to changes in federal special education rights when a parent places a student with a disability in a private school and work with states to correct inaccurate information.

Agency: Department of Education: Office of Special Education and Rehabilitative Services
Status: Open
Priority recommendation

Comments: Education generally agreed with this recommendation. However, the agency believes it is necessary to review the full documents containing information provided by states, so that it can determine the context in which the information was presented. We will coordinate with Education as appropriate to facilitate such a review. As of March 2020, the agency worked with relevant states to improve the information provided, and reviewed states' revised information to parents about federal rights of children with disabilities who are placed by parents in private schools. Education stated that this effort did not identify any inaccurate or inconsistent information. However, some states appear not to have modified language that Education previously identified as inaccurate. Education did not explain why it has determined that this information is now accurate. To fully address this recommendation, Education should either provide this explanation or have these states correct any inaccurate information.

Recommendation: The Attorney General should study the implementation of federal accessibility requirements in the context of early in-person voting and make any changes to existing guidance that are determined to be necessary as a result of the study. (Recommendation 1)

Agency: Department of Justice
Status: Open

Comments: The Department of Justice (DOJ) agreed with this recommendation and stated it would make any changes to existing guidance that it determines to be necessary as a result of the study. DOJ also outlined its efforts to enforce the protections for voters with disabilities found in federal law. As of October 2019, DOJ indicated that the agency planned to study these issues and has not made any changes to its guidance. We will consider closing this recommendation when the agency has completed these efforts.

Recommendation: The Acting Commissioner of the Social Security Administration should analyze the SEIE data to determine why a large proportion of transition-age youth on SSI with reported earnings did not benefit from the SEIE and, if warranted, take actions to ensure that those eligible for the incentive benefit from it.

Agency: Social Security Administration
Status: Open

Comments: SSA agreed with this recommendation. In August 2018, the agency reported that it was evaluating the accuracy of its SEIE data and once completed, the agency would analyze these data to determine whether there are significant numbers of students with earnings who are not benefiting from the SEIE. In February 2020, SSA reported that it was still working to resolve the issues with SEIE data identified during GAO's audit. SSA does not currently have a timeline for completing its analysis of its SEIE data. SSA also reported that it has submitted legislative proposals in several Presidential Budgets, most recently in fiscal year 2021, that would eliminate earnings reporting for youth, which would prevent similar concerns in the future. GAO will close this recommendation when SSA analyzes SEIE data and, if warranted, takes actions needed to ensure those eligible for SEIE benefit from it, or when all students with earnings receive SEIE because SSA's legislative proposal was enacted.

Recommendation: The Acting Commissioner of the Social Security Administration should analyze options to improve communication about SSA-administered work incentives and the implications of work on SSI benefits, with a goal of increasing understanding of SSI program rules and work incentives among transition-age youth and their families. This should include, but not necessarily be limited to, updating SSAs procedures for staff meeting with SSI applicants, recipients, and their families to regularly and consistently discuss - when applicable--how work incentives can prevent reductions in benefit levels and how work history is considered during eligibility redeterminations.

Agency: Social Security Administration
Status: Open

Comments: SSA disagreed with this recommendation. In August 2018, SSA noted it already requires staff to meet with SSI recipients regularly and instructs staff to discuss relevant work incentives, and that there is no indication that staff are not providing youth with appropriate work incentive information. However, SSA did not explain how it knows or ensures that staff are providing this information and SSA policies do not instruct staff to consistently convey information to youth and families on how work may or may not affect age 18 redetermination. SSA also reported that Work Incentives Planning and Assistance (WIPA) projects must prioritize working with youth who are referred to them. While we recognize the important role that WIPA projects play in providing work incentives counseling to SSI youth, as we previously reported, WIPA projects have limited capacity for serving youth along with other SSI recipients and disability insurance beneficiaries. In June 2019, SSA reported it had updated a brochure-containing information in English or Spanish on age-18 redeterminations, impact of earnings on benefits, work incentives and contact information to include information on SSA work incentives that may allow recipients who work to keep their Medicaid benefits. As of February 2020, the agency reported that it began sending this brochure to approximately 358,000 youth between the ages of 14 and 17 who receive SSI, and made this brochure available on its website. SSA also reported that it has begun exploring ways to better utilize social media to reach youth. While these are positive steps, we previously reported that written information may not be sufficient for conveying complex information. GAO continues to believe that SSA field office staff are both obliged and best-positioned to explain these rules. Moreover, in response to an SSA request for information in January 2018, SSA received public feedback on how it might improve transition outcomes for youth on SSI through better communication, suggesting that SSA's current communication strategies may not be sufficiently effective. We will consider closing this recommendation when SSA has taken further steps to ensure field staff are providing consistent and accurate information.

Recommendation: The Acting Commissioner of the Social Security Administration should work with the Secretary of Education to determine the extent to which youth on SSI are not receiving transition services through schools that can connect them to VR agencies and services.

Agency: Social Security Administration
Status: Open

Comments: SSA partially agreed with this recommendation, but after discussing it with the Department of Education, reported that significant challenges exist to pursuing certain implementation approaches. In December 2019, SSA reported that it continues to support research to identify the connection between youth on SSI and the receipt of VR services through its Retirement and Disability Research Consortia and its Analyzing Relationships Between Disability, Rehabilitation, and Work programs. SSA also reported that until very recently, data on open VR cases were unavailable at the national level; thus, it has not been possible to actively monitor SSI and VR participation in a timely manner. However, SSA reported that the agency will explore the possibility of using newly available data on open VR cases as resources allow. Determining the extent to which SSI youth are receiving or have access to services may help youth on SSI achieve employment and, potentially, self-sufficiency.

Recommendation: The Acting Commissioner of the Social Security Administration should explore various options for increasing connections to VR agencies and services, including their potential costs and benefits. One option, among others, could be to expand the Ticket to Work program to include youth.

Agency: Social Security Administration
Status: Open

Comments: SSA agreed with this recommendation and, in August 2018, SSA officials reported that they had taken several steps to explore and pursue options for increasing youths' connections to vocational rehabilitation agencies and services. Specifically, officials previously reported that they published a request for information (RFI) in the Federal Register in January 2018 that asks, among other things, for strategies to connect youth receiving Supplemental Security Income (SSI) with vocational rehabilitation agencies and about options for programs like a Ticket to Work for youth. In July 2019, SSA reported receiving and analyzing almost 200 responses to its RFI and indicated that it plans to discuss its findings with federal partners and other stakeholders. SSA officials also previously reported that the agency reviewed the Social Security Act and that the law precludes SSA from directly or indirectly referring youth on SSI to vocational rehabilitation agencies. Therefore, as of December 2019, the agency reported that it has submitted legislative proposals in several presidential budgets, including its fiscal year 2021 budget justification, that would allow SSA to refer youth to vocational rehabilitation agencies. SSA officials also reported that the agency has initiated demonstration projects to determine whether youth on SSI benefit from referrals to vocational rehabilitation agencies and commissioned reports related to services for youth.. According to information provided in July 2019, one of SSA's demonstration projects analyzes an experimental intervention to improve the outcomes of children receiving SSI by providing personalized information to families about the likelihood that a child will not continue on SSI as an adult, as well as resources to help these youth with the transition to employment. The resources offered will include: math tutoring, SAT/ACT test preparation, and help with applying for vocational rehabilitation services. In addition, according to information SSA provided in July and December 2019, the agency's second demonstration project will involve testing direct referrals to VR in one state for 19 year olds who are or may become SSI or Social Security Disability Insurance beneficiaries, and involves data sharing between SSA and the state on individuals eligible to participate in the project. This project is scheduled to begin recruiting participants in January 2020. SSA also reported that it has commissioned two reports on youth services that will help it identify implementable polices related to youth. Exploring the potential costs and benefits of employment support services for youth who receive or are at risk of being disability program beneficiaries as adults may help SSA develop programs to support the self-sufficiency of these youth. However, to date, SSA has not indicated that it has explored, or it may be too soon to explore, the costs and benefits of any of the options SSA has considered for increasing access to vocational rehabilitation agencies for youth on SSI.

Recommendation: To better ensure FEMA's regional activities effectively support individuals with disabilities, the Secretary of Homeland Security should direct the FEMA Administrator to take steps to establish written procedures for how regions should involve the Office of Disability Integration and Coordination in clarifying disability integration staff's roles, evaluating staff performance, and setting expectations for how staff communicate with headquarters and the regions.

Agency: Department of Homeland Security
Status: Open

Comments: FEMA agreed with this recommendation and FEMA's Office of Disability Integration and Coordination (ODIC) is in the process of establishing a working group that will clarify and codify the roles, responsibilities, and expectations among the various agency offices and personnel involved in carrying out the agency's disability integration mission. In January 2018, FEMA reported that it had created Regional Integration Teams in the regions to improve the efficiency and efficacy of mission delivery. In August 2018, ODIC reported its goal to meet with Regional Administrators and other senior leaders across the agency by the end of CY 2018 to refine the role for disability integration staff. The reported intent of refining the role is to better align it with the FEMA Administrator's goal of empowering emergency managers in states, localities, tribes, and territories. In June 2019, ODIC officials reported plans to convene a workgroup to examine the role of the Regional Disability Integration Specialist, including their reporting chain and their roles and responsibilities in each of FEMA's ten regions. The workgroup will meet over two months and develop recommendations to be considered by FEMA's Chief of Staff by August 23, 2019. GAO is encouraged by FEMA's efforts to engage Regional Administrators and other senior leaders in its refinement of the role of disability integration staff, and awaits evidence of FEMA establishing documentation of the agency's procedures for carrying out its disability integration mission.

Recommendation: To help ensure its key training on incorporating access and functional needs into emergency planning reaches a sufficiently wide audience, the Secretary should direct the FEMA Administrator to collect information about the potential pool of participants, set general goals for the number of state and local emergency managers that will take this course, and implement the delivery methods needed to meet these goals.

Agency: Department of Homeland Security
Status: Open

Comments: FEMA agreed with this recommendation and reported that it will work with its regional staff to map potential training participants in each state and set goals for delivery of the course to state and local emergency managers. The agency also reported that it may be able to use data in the State Preparedness Report and states' self-reporting on the need for training on integrating the needs of people with access and functional needs into emergency management. As of January 2018, the Office of Disability Integration and Coordination reported plans to hire a permanent staff person to review, assess, and recommend how FEMA should incorporate disability into all internal and external training. In August 2018, FEMA reported hiring a new Program and Policy Branch Chief in July 2018, and noted that this individual will formulate a plan to incorporate the needs of people with disabilities into internal and external training over several weeks. However, FEMA did not address whether this individual will seek information about the potential pool of external participants, or set goals for the number of state and local emergency managers who could participate in external training. FEMA also reported providing just-in-time training in the field to support field staff in providing services to people with disabilities. The agency anticipates completing these efforts by December 31, 2019 and we will consider closing this recommendation when the agency can document it has addressed the recommendation.

Recommendation: To improve performance management of the Telecommunications Relay Service, following the establishment of TRS's performance goals, the Chairman of the Federal Communications Commission should conduct a robust risk assessment that can help FCC design a comprehensive internal-control system.

Agency: Federal Communications Commission
Status: Open

Comments: FCC indicated that a draft document was under review to implement this recommendation and would be approved before the end of FY-19. However, in September 2019, when we asked FCC for an update, we did not receive one. We will continue to communicate with FCC about the status of this recommendation.

Recommendation: To promote and enhance federal, state, and local coordination activities, the Secretary of Transportation, as the chair of the Coordinating Council, should convene a meeting of the member agencies of the Coordinating Council and define and report on desired outcomes and collect related data to track and measure progress in achieving results, including the extent of coordination efforts that are under way, such as improved services for older adults. This effort could be conducted as a part of the Coordinating Council's process to update its strategic plan, which we have also recommended in a concurrent report.

Agency: Department of Transportation
Status: Open

Comments: The Federal Transit Administration (FTA) has taken steps to enhance older adult mobility. As of September 2020, FTA stated they continued to make progress toward implementing the recommendation by November, 2020. The Coordinating Council for Access and Mobility plans to issue its report to Congress and the President on September 30, 2020, and we will continue monitor FTA's progress on its efforts when the report is released.

Recommendation: To improve the transparency of the process for reviewing and approving spending limits for comprehensive section 1115 demonstrations, the Secretary of Health and Human Services should reconsider adjustments and costs used in setting the spending limits for the Arizona and Texas demonstrations, and make appropriate adjustments to spending limits for the remaining years of each demonstration.

Agency: Department of Health and Human Services
Status: Open

Comments: As of January 2020, the Department of Health and Human Services (HHS) has taken steps to address GAO's 2013 recommendation, but more actions are needed for GAO to consider this recommendation implemented. Beginning in May 2016, the Centers for Medicare & Medicaid Services (CMS) began implementing a new budget neutrality policy. The new policy was outlined in a Letter to State Medicaid Directors in 2018, and it addressed certain problems GAO identified regarding states' allowed methods for determining budget neutrality of their demonstrations. CMS has begun phasing in the methods established under this new policy for all states, including the two states (Arizona and Texas) for which GAO recommended adjustments. One portion of the policy--under which spending limits will be updated to reflect more recent spending data--will be implemented beginning in 2021 and will address concerns GAO identified in Arizona's spending limit once its demonstration is renewed. In January 2019, CMS officials told GAO that the agency continues to allow states to include hypothetical costs when determining demonstration spending limits, an action GAO identified as a concern in Texas' demonstration. While CMS officials provided documentation on changes the agency made in the spending limit approved for Texas' new demonstration period beginning in January 2018, GAO reviewed these changes and found that further adjustments are needed to remove additional hypothetical costs from the Texas' spending limit.