ED 207 270

AUTHOR

TITLE

.INSTITUTION'

r k SPONS AGENCY

DOCUMENT RESUME

BC 133 584

it Gettfngs, Robert M.; Mens#, Stephanie

Summary of Existing Legislation Relating to the

Handicapped.

National AssoCiation of State Mental Health Program.

Directors,iashington, D. C.

t. REPORT NO . PUB DATE

. CONTRACT

NOTE

AVAILABLE FROM

EDRS. PRICE

DESCRIPTORS

Office of Special Educaiion and Rehabilitative

Services (ED) , Washington, D.C.

E-80-22011

Aug 80

105-79-4300

158p. . DA Superintendent of Documents, U.S. Governmeft 'tinting

Office, Washington,.= 7'1402:

M F01/PC07 Plus Postage.

*civil Liberties; *Disabilities;,Educational

Benefits; Employment; *Federal Legislation; Health;

Housing; Incbme; Nutrition; Social Services;

Transportation; Vocational Rehabilitatidn

ABSTRACT

The book provides a summary of relevant federal laws

on the legal rights and benefits of.mentally and physically disabled

citizens. various laws are organized into 11 subject,areas;

education, employment, health, housing, income maintenance,

nutrition, rightst.social services, transportation, vocational

rehabilitation, and miscellaneous. Aviong.the acts covered are-the

Education the Handicapped Act, Comprehensive Employment and

raining Act, Social Security Act, Hopsing Act of 1959, Nation . .SchoO1 Lunch Act, Urban Mass TransportatiOn Act, RehabilitatioN'Act

of 1973, and Internal Revende Code. Provisions of each act are

described in nontechnical lan4uage, using a MommorrIB711t. After ., prpviding a brief overview of the law!s baaic purpose/ and structure,

the major programs autho;ized under the statute which _affect

handicapped persons are described. Appendixes contaaa legislative

history of key statutes relating-to the handicapped_ and a table,of

prograes. (s El) _

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Reproductions supplied by EDRS are the best that can bemide

from the original document. . ******************************************f****************************
Summary of

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2,1 Rdlating to

the Handicapped

Us. imPAAimilvir OF EDUCATION NATIONAL INSTITUTE OF EDUCATION

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-- U.S. DEPARTMENT OF EDUCATION

Office of Special Education a d Rehabilitirtive Services

Office for Nandi ped Individuals

Washingto D.C. 20202

trl Publication N 8O-22014

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, This report was developed with financial assistance from

the Office for Handicapped Individuals, Departmtrit of

Health, Education, and Welfare ((onfrat No. HEW v 105,79-43M, dated September 30, 1979), by Robert M.,

Gettmgs, Executpie Director, and Stephanie Mensh, Legg.

lative Assistant, of the National Association of State Mental

Retardation Program Directors, .2001 *Jefferson Davis

Highway, Arlington, VA 22202.

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For sale by the Superintendent Of Document.. U S Government Printing Office

. Washington. Dt 20402

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INTRODUCTION

While the first Federal laws assisting disabled citizens date back to the

early years of the Republic, prior to World War lT the statute books - contained rel4w6ly few. acts auth&izing special benefits Ipr handicapped personi, other than disabled war .veterans. Howeverin recent

yearsparticularly since the early 1960'sthe& has been a veritable

avalanche of Fe deril Itsislation affecting handicapped persons

While these statutes have been organized and codified in the United

States Code for purposes of legal references, until now iliere,has been

no reliable, comprehensive summary of relevant Federal laws available

to individuals concerned with the legal rights and benefits of mentally

and physically disabled citizens This publication is designed to

fill that purpose.

Since the 88th Congress (1963-64), similar summaries pf newly enactecri

and amended laws have been,published biennially by the Office for

Handicapped Individuals (and its predecessor agencies) to provide the

interested public with a basic understanding of actions' taken by

Congress' which affect handicapped children and adults. However, these

past summaries have provided only "snapshots" of legislation passed

over a two-year period, without offering a complete picture of the

existing statutory framework. This publication attempts to provide,

under one toyer, a summary of nearly sixty key Federal laws affecting

handicapped persons. t

The 'various laws are organized into general subject' areas. The provisions of each separate act are desSribed in nonechnrcai language,

using a common format After providing a brief .overview.of the law's

basic purpose and structure, the major programs authorized under the

statute which affect handicapped persons are described. We conclude

with an encapsulate4 legistatrre history of the saw, highligihting_major

milestones in the 'develoPment of the statute as it impacts on mentally , ..and/or physically disabled persons.

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- ts Most statutes are Prise:nte'd under the single subject category to which

1they apply (e g , The_Public Health Same Act appears cider the

section 9n Health, and the Education of the Hindioapped Act appears

under the section on, Education) However. the Social Security Act,

. which authorizes health, income maintenance- and sociaiseroces pro- . grams under its various titles, has been divided among the appropriate

sections and pertinent titles are treated separately (with cross-references, as indicated) In addition, the section on Rights describes selected

provisions of various statutes that enunciate and protect certain basic

rights ot,..kaklicapped citizens Because of the current emphasis on

rights, we decided to treat these provisions in'a separate section of the

report with cr,9ssrreferences to other sections of the report, so the

reader may refer to the more detailed discussion of other relevant provi - sioris'ot the acts i

NIL . , Minor legislation affecting handicapped persons is summarized in an

abridged format, mcluding a br,. discussion of the lawlimportance

and its legislative origins .__ Following the descriptions of each major program effecting harrdi

capped persons under a particular act, there is a list of reference documents the reader may wish to consult for further information. The . so ted are (I) the public law numbers of the act and/or its

per endments, (2) the United States Code reference (abbrk

rated as U ), and (3) the Catalog of Federal Domestic Assistance

(abbreviated as F D A.) number. These Source documents are avail

.. able ire mo rge public libraries, law school libraries, and 'certain

gove ent offices for indivicluals desiring to pursue in-depth research

is publication is not intended to be an exhaustive analysis of all

t Federal statutes affecting handicapped persons Nor is the material

designed to provide legal interpretations of the relevant statutes

Person interested in the precise language of the law should refer to

. ' the prOiary source documents cited in the report.

Okily tfi,ose laws, containing explicit provisions relating to physically

and/or mentally handicapped persons are summarized in this report

Thel'.one major exception relates to lalis ,kuthonzing benefits for dis

abled veterans. Since ,information an material on

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such statutes are

generally available through the Vete ans Administration . we decided

not to include informatioii on laws aimed exclusively at this popula-

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, Furthermore, readers should be aware of the fact that information

, contained in this report is restricted to the prOvisions of the Federal

laws discussed No material is included on regulatory and other admirustrative policies implement statutory provisions .

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Additional information on actual program operations is usually available in the Catalog of Federal Domestic Assistance. This is one reason

for including the appropriate Catalog reference number at the ent of

each program summary Annotated versions of the United States Code

also provide cross references to the Code of Federal Regulations, which

is the primary source of information ol.9,rogram operating policies

and procedures.

Each progralh descritatidn includes a FY 1980 appropriations figure

These figuies may not be exact, due to revisions made throughout the

Fiscal year and, therefore, should be viewed only as general indicators

of a program's scope It is also important to note that the appropriations figures represent funding for the program as a whole, the portion

of expenditures directly benefiting handicapped persons may be only

a small fraction of the total dollars appropriated (e g , funds appro-`

pnated for the Food Stamp Progrgmnn FY 1980 totaled over S7

billion but $nly a tiny portion of that amount will be used on behalf

of eligible handicapped recipients), . % It is our hope that the Information included In this summary report

will prdye helpful to Federal and state politymakers, professional

workers, program 'administrators, handicapped 4.,onsumers, students

and other individuals with an interest in Fe er egislation tha directly

impacts on handicapped persons Since current ansatl fo updating

this publication periodically, the Office for Han4. a. Individuals

would welcome reader input regarding the types of information which

should be addi d, deleted or revised future editions of the pubhca

tion . Abbrevtati ns used in this text

DA' Catalog of Federal Domestic Assistance

F Y. Fiscal Year

H H S Department of Health and Human Services (formerly

-HEW)

Public Law

U S C. tes Code

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TABLE OF CONTENT4

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11. .

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. . .Introduction. .... . ui

EDUCiTION. .

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Public Health Service Act

National Research Institutes )49

Elementary and Secondary Education Act . . ..r.... ,, . I- _.../

Education of the-Handicapped Act 5

Library SeEvices and Construction Act 16.

Higher Education Act. . "I. % 18 - . .. Vocalloval Education Act i, 20.

Model Elementary and Secondary Schools for the .1

Deaf Acts . 23

Depart'nient of Education Organization Act of 1979 23

Career Education Incentive Act .., 24

National Library Service for the t310 and I. Physicilly Hairdicapped 25

Impact Aid to Federally Affected Alas 25

EMPLOYMENT 2.7

Comprehensive Employment and Training Act , 27

Fair Labor Standards Act , 31

Small Business Act 33,

WagnerPeyser Act 2. . . 34

Public Works and Economic Development Act ,i7,- 35

HEALTH 1, 3L

Social Security Act

Maternal and Child He and Crippled Children's

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. Services 37

Health Insurance for/ e Elderly and Handicapped .. (Medicare) . 40

Grants to States for Medical Assistance (Medicaid). . . . . 43

Community Mental Health Centers Act 46

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C L\ Other Health Programs and Services

Health Planntheand Resource Development .. ..... Military Medical Benefits MI (CHAMPUS)....

HOUSING .

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61 A United States Housing Act'of 1937.... ....... 61

(Housuig Act of 1949.. . 63

Housing Act of 1959 .. ' ildusing and Community Development Act of 1974.. . . 67

'Consolidated Farms and Rural DevelopmentAct 69

1NCOMBMAINTENNCE . 71

Social Security Act

SociatSecurity Disability Insurance . ....... ........ ,71

Supplemental Security !Nome , .. 75

. NUTRITION 81

National School Lunch Act . 81

Child Nutrition Act , 84

Food Stamp Act .. 86

RIGHTS . . 89

Nondiscrimination .. 89 -

., Education . .. . . :. . 90

Billof Rights, Developmentally Disabled 91

Architectural Access ., 92

0 Other . : 93

SOCIAL SERVICES 95

Social Security Act

Child Welfare Services 95

Social Service, Program . 96

Development Disabilities Assistante and Bill of , a. Rights Act 101

Domestic Voliinteer Service Act of 1973 .. , 107

Conkmunity Services Act of 1974 (Head Sta 108

Child Abuse Prevention and Treatment and Adoption

Reform .... ,...::-... 109

TRANSPORTATION ; I 1 1

Urban Mass Transportation Act 111

FederalAid Highway Act . 112 t.'

Rail Passenger Service Act 112

VOCATIONAL REHABILITATION 115

Rehabilitation Act of 1973. '''' ' 115

Wagner O'Day Act , gs

. Randolph-Sheppard Act l 1 ...1;8

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MISCELLANEOUS 131

Internal Revenue Code .... , . 131

Energy conservation and Production Act 133

NatioriaTEterfy Conservation Policy Act 13

Home Heating Assistance Act of 1979 r 134

Copxralit Act f e 135

APPENDICES

Appendix A!

Appendix B.

Legislative History of Key Statutes Relating

tra the Handicapped : 138

TakIe of Programs ." 153

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EDUCATION

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ELEMENTARY AND SECONDATION ACT

A. Overvird

The Elementary and Secondary Education Acts the pnmaty source

of Federal aid to the Nation's public school systems. Originally

enacted in 1965, Title I of the Act authorizes federal aid to support

supplenfentary educational services to children from low-income

families, incluaing handicapped youngsters, in 90, percent of the

,school districts across the country. Title I funds also are available to

meet the special educational *needs of handicapped children in state

operated and supported schools for the handicapped. Other titles of

the Act establish a-wide variety of research, training, demonstration

4 and other grant authorities, many of which offer at least tangential

benefits to handicapped children.

The Elementary and Secondary Education Act of 1945, as amended,

is composed of ten titles. The various programs included under this

omnibus statute touch on pkactically 'every aspect of educating

children at the _elementary and secbndary school level; Howevei, , the programs most directly relevant to handicapped' children are,

contained iriaitles I and IV of the Act.

B. Major Prolpems,Affecting the Handicapped

1. State Operated and Supported S chools The purpose of the progran) authorizid under Part B, Title I of the Act is to provide comprehensive educational programs for handicapped children who are.

enrolled' in state operated or supported schools. Part B project funds

may be psed to support educational aid related services, including,

inttruction, physical education, iiobility training, counseling, prevocational and vocational educatiOn, training of teackers and teacher

aides, and constructing and equipping state operated or supported

schools. However. funds may not be,used for construction and

installation of equipment iii nonpublic school, nonessential

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construction or remodeling, or projects prepommantly for persons

over age 20.

Grants are made to state agencies responsible for operating or

supporting schools for the hart:Mapped and to local educational

agencies on behalf of children who were formerly enrolled in state

schools For purposes of the program, the term "handicapped children" is defined to include youngsters who are mentally retarded,

.hard of hearing, deaf, speech impaired, visually handicapped, se-

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riously emotionally disturbed, orthopedically handicapped (Or those

with other health impairments), deaf-blind, or those with a specific,

learning disability

A state agency's alloCation is determined by mbltiply mg the number

,ipf eligible handicapped children (2.1 years of age or under) tunes 40

percent of the.state's average per capita expenditure onr behalf of . all children enrolled in public lementary and secondary schools or

the national average per pu expenditure, whichever is higher

Since Part B allocations are c culated before other Title 1 grants

are awarded, state educational agencies generally are assured of

receiving their full entitlements n behalf of eligible youngsters

Fiscal Year 1980 appropriafions 5143 million

ReIrremes Pin B Title I, tiementary and SecondsilyCdAYMIOls

amended P I, 89.10, P I, 89-313 P 1, 90-247, P 1, 91-230, P I. 93-380, and

PI 95-561 U S Code 20 U S C 241e(a) (5) C rDA 13 427 .

2 Improvement in Local Educational Practices. Title IV grants

are made to state educational agencies These funds may be used

for the unprovengit of local educational practices} including. , -7.--

the development and demonstration of activities addressing

serious educational problems, including the need for effective pro -

rams for (a) children with special needs, such.as educationally

eprived, gifted and talented, and handicapped children, and (b)

children in nonpublic schools;

the unprovement of educational programs in areas with large

concentrations of low-income families; IN a

... activities to improve achievement in basic skills,

activities to encourage parental participation,'

' - the development of diagnostic methods for assessing the aclueVement of children in public and nonpublic schools;

professional development programs for teachers, administrators , arid other instructional personnel,

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early childhood and fan%ly education programs;

. the expansion of education beyOnd the school tudding. and

! innovations in compensatory education. ,

Fifteen percent of all formula grants appropriated under Title IV

of the Act must be expended on special programs or prOjects for

the ecrtIcatton of handicapped Children. FY 1980 appropriations.

S197.4 million.

Referenccs Title IV, Elementary and Secondary Education Mt of 1965, as

amended P L 89-10, P L 89-750, P L 90-247, P L. 91-230 and P L 95-561

U,S Code 200.SC 1831X F D A 13 571

C. Legislative History

The EleMenta and Secondary Education Act of 1965 (P.L. 89-10)

. represented t e first 'Major legislative commitment made by the

Federal cove ent to the unprovemerit of elementary and secondary education. The core of the Act, Title 1, was a multibillion

dollar program of aid to states for distribution to local school distracts hailing children from low-income families who were considered

"educationally deprives! " Local school districts receiving funds were

required to provide supplementary services to meet the special Deeds

of these children In the legislative history of the Act, Congress

defined "educationally disadvantaged children" ,to include hanch-

. capped youngsters.

The Act was signed into law by President Johnson in the spring of

1965 That same fall, Title 1 of the Act. was amended (by P.L

89313) to authorize aid to state agencies operating or supporting

schools for handicapped children Initially, such state agencies were edtitled to receive aid calculated on the basis of the number of

eligible handicapped children multiplied by-the state's aveldge per

capita expenditure on behalf of all children enrolled in elementary

and secondary schools.

Full funding for state operated and suppbrted schools for the handicapped was mandated under the 1967 amendments to the Act

(PI 90-247). This same set of amendment% direcled the

Office of Education to calculate a state agency's Title I allocation

on either the ,state or the national average per pupil expenditure

for elementary education, whichever was higher.

Amendments in 1969 (P.L. 91-230) advanced appropriations for

. all ESEA programs. The purpose of this step was to synchronize

the federal funding cycle more closely to the school year.

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The Edudition Aptendments of 1974 (P.L. 93.380) included major

revisions in the Title I formula for distributing funds to stateoperlited and suppoited schools:The per capita Support level was

reduced from 50 to 40 percent of the average per pupil costs of

'educating a child within the state (or in the nation, if higher)..In

addition, 'henceforth, no .state or local school agency would. be

perinittedlto rieeiveess than 80 percent or more than 120 percent

. of the national average per pupil expenditure.

$ ..--Jhe revised fdrrnuLa was intended to equalize per capita 'federal aid

among states and local *hoof districts, incorporate a fairer poverty

standattWand account for population shifts since the 1 60 census.

The overall effect was to give more aid to sdlithern, ri ur areas and less to large cities an relatively wealthy stns e y 'placing

reduced emphasis in the funding-formula on the.nundler Of children

irrAFDCfainihes within the state). *" . 7-Arsa

. . 1 .. ..The.1974 arne dments alsc; aided a 'Proviiion which rnutted a

.. state agency, f r purposes of determining its Titleg, ES entitlements, to con ue to count a hanclicappetchild when res niihdity for, thl c $ education was transferred from 'a state-dperated

or supported facility to a local school district. Ifo)vever, the legislation required that, in such case,s, fonds received had td be forwarded

to the local educational agency actually* providing seriricesito theptrtgular handicapped child.

In order to avoid cutbacks in aid toistate oger ated and supported

for handicapped children, whkh would halm beep mandated

under the new Title I formula, P.L. 93-380included language which.

,,protected state'agencies froin, regtang less in FY 1975 and subsequent fitcalYeals than,they received in FY 1974. Withol this provision, Title I aid to the handicapped would halo been reduced by 524

million beginning in FY 1975.

Ameitdmentso the Mt in 1973 (1'.L. 95-560made several minor

changes in the Title I prograrkof aid to state operated and supported

schools for the handicAppLMElhe basic purpose of these aniendrhents was to mace the program's statutoty authority more consistent

with thy-Education of the HandicaypedAct (described on page 5),

as amefidid in 1975: The 1978 revisions incorporated the following

chianti. (a) the defdition ihandicapped children was deleted and

repl 5.adlilth a Jeferen o the definition under the Education Of

then Handicapped Act, ) a te,chnical revision was made in the

language of Section ,l46 gamily 121c) to clarify the fact that

limitations on the lase of Title I fun& apply to both the stip administering agency and other agencies or institutions receiving funds

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s ml (viler .this authority, (c) the existing reference to using funds to

acquire equipment and construct school facilities was eliminated,

and (d) programs assisted through Title I funds were required to be

consistent with the provisions of Part B of the Education 'of the

Handicapped Act. (inn Title IV '(Part C) program for improving local educational

practices was uutially authorized as a'sepes of, separate programs

for innovation and development of special services Under the 1966.

amendments to the Act (Is L 89-750), these piograms weie cdnsolidated under a single title (then Title HO: The 1567 amendments to

ESEA (P La 90-247) required states fo use at least 15 percent of

their Title III funds for'special programs and project designed to'

educate handicapped thadren In 1970. Title III was f rther revised

(P L. 91-230) and, in 1978, it was redesignated as Tie IV, Pait C

of the Act (P.I. 95-561), both revisions retained the 15 percent setand; for handicapped-education projects.

EDUCATIONrOF THE HANDICAPPED ACT

Overview

The Education of the Handicapped Act is a primary source of .

Federal aid to state and local school systemt for instructional and

support services to handicapped children. The centsiplece of the Act

is a state.grant-in-aid program, authorized under Tart B, which requires participating slates 'to furnish all handicapped children with

a free. appibpriate public education in the least restrictive setting r

In addition to formula grants, to the sates, the-legislation author

Jzes an array of discretionary grant programs, aimed at stimulating

improvements in educational services for Handicapped children.

included-are grant programs designed to .promote the recruitinen$

and training of special Education personnel, the conduct of research

and demonstration projects, and the development and diss'minatiOn

of instructional materials

, The Education of the Handicapped Act, as:amended, is composed

of six parts. Part A outlines Congressional findings and sets:forth

th primary aim of the Act. "to assure. that 'all- handicapped%children have availabl them a free appropriate public education

which'imphasize . ucation and relaied services designed

to meet their s." Part A also includes (1), definition

of temp, (2) a jaw' requiring the establishment of a Bureau

of Education for the Handicapped in the Vffice of Education,

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headed by a Deputy Commissioner,' (3) restrictions governing the

acquisition of equipment and construction of necessary facilities,

andl4) authority for grants to remove architectural barriers.

B. Major Programs Affecting the Handicapped

1 Basic State Grants for 11(nd:capped education. As noted above,

Part B of the Adauthonzes formula grants to the states to cover a

percentage of the costs of providing special education and related

services to handicapped children. The pbrpose of this formula grant.

program is to assist states in providing a "free.appropriate public

education" to all handicapped children in,participating jurisdictions.

The educational and related services supported under this program,

must conform to a Federally approved state plan. As specified in the

Act, a "free appropriate public education" includes. (1) special

education. defined as "specially designed instruction to meet the

unique needs of a handicapped child, including classroom mstrucHon, instruction in physical education, home instruction and instruction in hospitals and institutions", ane(2) related services, defined

is "transportation, develovental, corrective and other supporter

services to assist a handicaNed child to benefit from special education. including speech pathology and audiology, psychological

services, physical and Occupational therapy, recreation, medical

and counseling services Ifor evaluation purposes), and early identification and assessment of handicapping conditions in children."...

SPeiial education and related services are to be provided at no cost . to the parentsr

Part B funds are allocated among the states on the basis of a statutory formula which takes into account the relative number of handicapped children in any given state who are being futrushed a fr e,.

appropngte public education The total number of children counted

(the state's "child count") is multiplied times the average per pupil

'expenditure on behalf of all children in public elementary and secondary schools across the Nation to determine a state's'entitlement.

State educational agencies are required to pass on 75 percent of their

allotments to local educational agencies. FY 1980 appropriations.

$804

References Part B, Education of the Handicapped Act, as amended, P.L. 89.750,

P L 90-247, Ft.L. 91-230, P.1 93.380, and P.L. 94-142. U.S. Code. 20 U.S C.

14.11. C.F.D.A.: 13 449.

The Bureau has sin44 been reicKated in the Office of the Assistant Secretary for

Special Education and Rehabilitative Services, as put of the newly-forMed

Department of 'Education For details on the establishment of the new cabinetlevel Department. see page 23

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2. Ptescho741 Incentive Grants. Separate ,allotmen4s are Rade to

states under Part B to encourage the 'provisio'n of *ma] education

and related services to preschool handicapped children, aged 3 to 5

Such funds are awarded td state educational agencies to supplement

their basic Part B allotmentjo the extent that the state is providing

a free appropnate public education for handicapped childrtn within

this age range. A state's allbcation is determined by multiplying the e number of ciul,dren bekween 3 and 5 yeats of age who are receiving

a free, apprqpriate,..public education by $300. FY 1980 appropriations $17.5

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References Part B, Education oethe flanditapped &Las amended Pi.. 94-142

U S Code 20 t3 S.0 101, C FDA 13 449

3. Regional Resource Centers, The purpose of this project grant

program, authorized under Part C of the Act, is to pay all or part~ a- of the cost of establishing and/or operating regional resource centers

- These centers provickldvice and [ethnical assistance to educators

in an effort to improve instructional services for handicapped chit

dren Institutions of higher education and state and local educational

agencies are elfgte to receive grants to-establish regional resource

centers. FY 1980 appropriations S9.') million.

Referenses Part C. Edu..atio o therlfandkapped Act, as amended P 1, 90-247,

P.L. 91.230 and P L 95 U.S.,Code 20 US C: 1421 C.f D A 13 450.

,4. Centers and diervrcei for Deaf-Blind Children, Project grants are

awarded under Part C of the Act to public or nonprofit agencies,

organization'sor instiiuthafis to establish regional centers for deafblind children. These centers are responsible for furnishing the

following (1) comprehensive diagnostic and evaluative services.

(2) a program of eilacation, adjastmept and orientation, .(3)

consultation services for parents, teachers and others involved in the

wt14re, (4 in selvice tramuy,(5) dissemination df materials

and .information, and (6) cons don. FY 1980 -appropriations

516 million. - Refertnees PAO C,..FiducatA of the 11andn.4 Act. as amended P.1 90-247 N. PL. 9J.230 and P L. 95-49 LS. Code 20 U.F$C 142 CI,D,A 13 445

5. Early ChildhoOd &Oration This ploject grant program, authorized under Part C if the Act, suppoiV aperimental demonstration

.rojects, outreach, andAstate tmplemeAtation of preschool and early

Ihildhood projects:Tor handicappdchildren, from birth to age eight

Project activities include parental participation, dissemination of

information to the.professional community altd general public. and

evaluation of the,egectiveness of the project. Public agencies and,

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private nonprofit` organizations are eligible to receive early childhood education grants. FY 1980 appropriations, S20 million:

Refere,pes Put C. Education of the Handicapped Act. as amended P L 90-538,

PL 91-230 andP1 9549 US CoJe 20 USC .1423 CFDA .13444

6 Innovative Progr,ams, for Severely Handicapped Children. e putpose of this project grant, authorized under Vail of the ct,

is to support innovative approaches to (I) unpro, g e cational

and training services for severelkflandicapptil children, (2) p`kovi4ing

-mservice training to educators and other staff working with handicapped youngsters, (3) disseminating materials and information, and

(4) improving the general acceptance of the handicapped by the

cdmmunity, professionals and possible employers Grants and contracts are made to public and nonprofit private agencies, organizations or institutions, madding state departments of education, intermediate or local educational agencies, institutions of higher

education, professional organizations and, voluntary associations

FY 1980 appropriations $5 million.

References Part C. Education of the Handicapped Act, as amended PI 90.247,

PL 91-23'0, P L 95-49 US Code 20 U.S C 1424 CFDA 13 568

7 Re tonal Sdimation Programs for the Handicapped Grants are

made hnder Part ( to institutiokispf higher education, including

junior and community colleges, vocational and technical institutions, and other nonprofit educational agencies,for the development

and operation of specially designed or modified programs of vocational, tAchnical, postsecondary or adult education for handicapped

persons. These projects provide supportive services for handicapped

persons enrolled in post (secondary programs, such as interpreting,

reading, tutoring, counseling, housing referral, registration.assistance

and personal attendantsifY 1980 appropriations $2.4 million.

Referent-es Part C. Education of the Handicapped A4.t. as amended PI 90-247,

P L 91-230, and P L 95.49 U.S Code 20 U S e 1424a C I D A. 13.560.

8 Training for Laticaturs zind Otheor Personnel Serving Handicapped

Children. Project grants are made under Art D of the Act to improve the quality and increase the supply of teachers, supervisors,

administrators, researchers, teacher educators, paraprofessionals,

speeclj correctionists, and other special educational personnel, surly

as specialists' in physical education and recreation These grants are

4 awarded to institution vf higher education, state and local educational agkicies arid 'otNer public and nonprofit private agericiw

Funds may be used to cover student stiPeRds, dependency allowances, antlinstitutionil support for 'undergraduate. graduate and

5 8

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I

summer traineeships, sppci4eudy institutes and projects 'FY 1980

appropriations: SSS 4 million.

References Part D. Edna. tioniaf the Handicapped Act, as amended P L 88-164,

P.L. 89.10S, P.L. ,90.170, Pl. 90.247, P L. 21-230 and P L 95-49 U.S Code

20 U S C.-1431. C F.D.A. 13451.

9. Handicapped Teacher Recruitment and Infonnatwn Project

grants areawarded under Part D for the following purposes (ly to

disseminate educatignal and related information, to parents and

others interested in the well-being of handicapped children, (2) to

help parent/consumer groups provide inform?tion ind referial

services, (3) to recruit potential teachers .to areas of shortage m special education, and (4) to encourage schools to respond to .the

special needs of handicapped children by providing them with

factual information on what can'be done by and for handicapped

persons. Grants are made to public or nonprofit private agencies, -

organizations or institutions FY 1980 appropriations SI million

ReferenceS:,Part D, Education of the Hanchcapped,Act, as amended P L 88-164,

P L 89.105, PI 90-170, P Is 90-247, P II, 91.230 and Pi. 95-49 US "Code

20 U S.C. 1433 C.F.D A.. 13.452. / I 10. Research and Demonstration in Education of the Handicapped

Under Part E of the Act. project grants are awarded to support

research and related activities, including the initiation of model

programs designed to improve the education of handicapped duidren and physicaNducation and'recreational activities for the Nandi

capped. (Research in the area of learning disabilities was initially

authorized as part of a septarate Part G, however, when learning

disabilities were recognized as a distinct 'handicapping condition for

purposes of the Act, this function was consolidated under Part E.I

Grants and contracts are made to state or local educational agencies,

public and private institutions or higher education and other public

or private educational or research agenciet and organizaticins. FY

appropriationt S20 million.

References, Part E, Education of the Handicapped Act, as amended. P.L. 88-164,

P:L. 89.105, P.L. 90-247, P.L. 91.230 and P.k. 95 .49 US. Code 20 US C.

1441 C.F.D.A : 13.443. . w 11. Instructional Media and Captioned Films for the Handicapped

Project grants are made under Part F of the Act to public and private agencies and organizations to support the following types of

activities. (19 to maintain a free loan service of captioried films for

the deaf and instructional material for the educational, cultural

and vocation:it enrichment of the handicapped, (2) to acquire and

distribute media materials and equipment, (3) to support research

94(

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. into the use of media, and (4) to train teachers, parents and others

in media utilization FY 1980 appropriations S19 million,

References Part F, Education of the filridik.:pped AO. as Amended P L 89.258,

P L 90.247, P L' p1-230 and P L 95-49 U.S Code 20 U S C 1451 C 1 D A.

13 446 . s C Legislative History /

. In 1966, Congressional hearings revealed that only about onethird

of the .5 5 million handicapped children in the country were being

provided appropriate special education services. According to a

Senate Committee report' ;ssued at .the time, the remaining two-

'thirds were either totallY efxdiuded from public schools or "sitting

idly in regular classrooms awaiting the time when they were old

enough to 'drop out '" Federal "programs directed at handicapped

children, the Senate'-Committee reported, were "minimal., fraction.

ated, uncoordinated, and frequently given a low priority in the

education community

I State'l'ormula Grants, In response to this situation, Congress

passes P L 89-750 which added a new Title VI to the Elementary

and Secondary` Education Act Under this new, authority, a pro,

gram of grants to the states was established to assist in the education

of handicapped children The 1966 legislation also created a Na.

bona! Advisory Committee on Handicapped Children and mandated

the creation of a Bureau of Education for the Handicapped within

the U.S Office of Education The Bureau was to be responsible for

adniunstermg piggrams and projects relating' to the education and

timing of the handicapped, including programs and projects for

training teachers and for conducting research in the field of special

education. , i

In 1967, amendments to the Elementary and Secondary Education

Act (P L 90-247) stipulated that no state would receive less than

Si00,000pr 3/10 of I percept of the annual Congressional appro.

pnation for Part B grants, whichever wasgreater. This provision was

,intended to assure that each state received a large enough grant to

,

,,.

make the pro ,ram effective..

The Elementary and Secondary Education Amendments of 1970

(P..1.91-230) consolidated into one act a number of previously

separate federal grant authorities relating to handicapped children, . U.S Senal,p, Committee on Labor and Public Welfare, Subcommittee on the

' Handicapped. Report on Lducation of the Handicapped Act, as amended

through December 31, 1973, US GPO, Washrrigion, D.0 August. 1976, page

126 .

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includnlig TitleVI of ESEA. This pew authOrity was entitled the

` Education of the Handicapped Act.",

The EdidatIon.Ainind ments or 1971 ((.L. 93-380) authorized a

scarp grease in funds to assist in-educatint handicapped children

in the public 'sch&Iseorder to help states faced with meeting

court or legislatively imposed "right to education" mandates P L

V-380 also required the states to establish a goal of ptoviding full =. educational opportunities for all handicapped children and submit.

by August° 2l, 1974. a detailed plan and timetable 4:1 achieving

.this goal. In addition, the ,Oct provided procedural safeguards for

. use 111. identifying, evaluating and placing handicapped children,

f. mandated that such youngsters be integrated into regular classes

whenever possible, and required assurances that testing and evatua-

. Hon. materials would be.selected and-administered on a nondiscruni

nitory basis FinaliY, P.L. 93.380 elevated the head of the Bureau

of Education for the Ilandic..apped to the status of Deputy Commis

stoner of Education. ......------k

In 1975, the Educatiosn for All Handicapped Children Act (P L

94.142) expanded the Part B program into a multl-billion dollar "

Federal commitment to assist state and local educational agencies

to provide appropriate educational services for handicapped chil. . dren. Passage of the legislation marked a significant milestone in

the nation's efforts to provide ,full and appropriate educational

services for handicapped children.

P.L. 94-142 established a new allocation fomiula under Which states

would be entitled to receive In amount equal to the number of

handicapped children, age 3 through 21, receiving special education

and related services, tunes a specified percentage of the average per

pupil expenditure in public elementary .arid secondary schools in

the U.S. The Act called for a gradually mcr[asing percentage of

Federal aid, beginning with 5 percent in FY 1978. to 10 percent in

FY 1979, to 20 percent in FY 1980,30 percent in FY 1981, and 40

percent in FY 1982 and succeeding fiscal years.

In order to prevent states from including non - handicapped children,

P.L. 94.142 ihitiarly limited the number of children who could be

counted to twelve percent of the total school age population between the ages of five and seventeen. In addition (a) no more than

.1/6 oE a state's total count (or 2 Krcent) could consist of children

with specific learning; disabilities, and (b) children counted for

.purposes of deterrhefung the`state's entitlement under, Title I of the

Elementary and Secondary Education Act (as amended by P L.

89-313) could not be counted under the Part B progilm. The

/A .

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I

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ft lialitation on the number of learning disabled children in a state's

"child count" since has been lifted.

During FY 1976 and FY 1977 all federal funds were controlled by

the state education agency and distributed to local agencies accord,-

mg to an approved state plan. After the new distribution formula'

went into effect, however, a setpercentage of federal assistance had

to be passed through to local education agencies. In FY 1978, 5.0

percent of a state's allotment had to be forwarded to,,LEA's while

in FY 1979 and succeeding fiscal years 75 percent had lobe passed

through In addition, under the broad authority of the .General

Education Provisions Act of 1969 (P.L. 91-230), appropriations for

education of the handicapped programs may be "forward-funded'

made available in the fiscal year preceding the fiscal year in which

the money will be used or obligated.

In order to qualify for federal assistance under Part B, a state had

to agree to establish a goal of serving all handicapped children

between the ages of 3 and J8 by September 1, 1978, and between 3

and 21 by September 1, 1980. However, this timetable does not'

apply to children from 3 to 5 and 18 to 21 where mandatory ser

vices to such children would be inconsistent with state law or practice or a binding court order.

A separate authority was included in the Act to encourage states to

serve children between the ages of 3 and 5. States are entitled to

receive up to 5300 for each child served within this age ramp. Per

capita grants are ratably\ reduced if appropriations are insufficient

in any fiscal year to cover the states' full entitlements.

P L '94-142 stipulated that an individualized educational program

must be developed for each handicapped child, including. (a) a statement of the child's current eduCational performance, (b) annual

goals and short-term instructional objectifies, (c) a description of the

services to be provided and the extent to which the child will be

able to participate in regular educational programs, and (d) the

projected -initiation date and the anticipated duration of services.

The law also required that each child's Individualized educational

program be reviewed at least annually. . .."`" Under the Act, first priority was to be given to unselvtd children

and second priority to severely handicapped youngsters who were not receiving adequate services.In order to qualify,for -federal

assistance under Part B, a state was'require,d to submit a plan to the

U.S. Commissioner of Education Which. (a) assured that all federally

funded education, programs for the handicapped (including those

funded under TitleA. ESEA add the Vocational Education Act) 41.
were con stent with the state's P.L. 94-142 plan, (b) outlined a

comprehensive plan for personnel development, (c) provided for free

services to handicapped children placed by LEA's in private elementary and secondary schools, (d) assured that federal funds will be

u sed to supplement and =rase and not to supplant state and

local funds, (e) described procedures for evaluating, at least annually, the effectiveness of programs in meeting the educational

needs of handicapped children, (1) provided for the appointment of

a panel to advise State education Officials on unmet needs and program regulations, and (g) specified procedures for record keeping

and accounting for federal funds.

Local education agencies (and intermediate school units) were re-

. coned to submit an application to the appropriate state education

agency in order to qualify for federal suppott. This application was

to. (a) assure that federal funds would IA used exclusively to pay

the excess,costs attributable to the education, of handicapped children, (b) provide that all handicapped children within the Jurisdiction, regardless of the seventy of their handicaps, Would be identified. located and evaluated, (c) establish policies to safeguard the

confidentiality of personal records, (d) establish .e goal of providing

full educational opportunities to all handicapped children, (e)

.establish a detailed timetable for accomplishing this goal, and (I)

describe the kinds and number of facilities, personnel and services

necessary to accomplish the goal,, .c

The state education agency was authorized to withhold federal

- funds if any local or intermediate school district failed to comply,

with the above requirements . All of the due process safeguards incorporated in the 1974 amendments to the Act (P.L..93-380) were retained and several further

provisions, designed to protect the interests of the handicapped_

child and his or her parents, were added. These additional rights

of the handicapped child and his parents or guardian included.

in opportunity tOtaignirie all relevant records regarding identification, evaluation and educatiohal placement 6f-the ehild, . written notice of identification, evaluation or placement of the

child in an 'educational. program (including the right to be notified

in one's native language);

an opportunity to preseilt complaints.

In addition, state, or local edurationaZagencies were to conduct

impartial due - process hearings on a complaint received from

a parent Or guardlin. At such hearings the parents were to have

111 13

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the right to be represented by counsel. to_present evidence. cross- eziamme and compel.the at4endance of Yfilflenes, and receive a state-

. ment of factual findings and dectsidns,

P L 94 -14 stipulated that the state education agency woul4 be

responsibIlf for insuring that the provisilausdef the Part B program

were carried out. In addition, the state agency was to 'assure that

all educational programs for/handicapped children, including those

administered by other state and local agencies', were under their

general suporvision and met education agency standards.

P L 94-142 required all recipients of federal assistance under the

Kct to take affirmative steps to employ and advance in .employ.

ment qualified, handicapped individuals' The Act also authorized

such =rheas may be necessary for the purpose of removing.architectuf_al barriers in educational facilities

2 Centers and Services. The Elementary and Secondary Education

Amendmentyf 1967 (P L 9.247) authorized the establishment

of regional resource centerst aimed at assisting teachers and other

school personnel through the evaluation of educational Materials and

the development ant dissemination of `specific educational strategies

for use with handicapped children P L. 90-247 also authorized cent

fen and services for deafblind children.

Among the specific statutory responsibilities of these centers were

the provision of (a) comprehensive diagnostic and evaluation

services, (b) programs for education, orientation and adjustment.of

such children, (c) consultative services for parents, teachers and

others working with deaf-blind youngsters, and (d) training teachers

and related specialists in research and demonstration activities,

Early ed ucation services for han dicapped youngsters initially were

authorized under the Handicapped Children's Early Education Assistance Act of 1968 (P.L. 90-538) The Act established a project grant

program to support experimental preschool and early education pro.

grams for handicapped children, including activities and services

designed .to encourage mtellectualz-emotional, physical, mental, so- cial and language development. In 1970, this program was extended

and folded into Part C of the Education of the Handicapped Act

Oection-614-r-PL. 91.230).

Congress huttally enacted the Captioned Films for the Deaf Act in

1958 (P.1 8-405). It permitted the Office of Educatitm to purchase, lease or accept films (primarily recreational films), provide

captions for them, and distribute them through state schools for the

deaf, as well as through other appropriate agencies.

23,

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Amendments to the Act in 1962 (P L 87.815) authorized the production of captioned films, the training of persons in their use, and

the conduct of research to improve the quality and effectiveness

production, and broad utilization of the film medium. In 1965 is

authority was broadened to include other forms of instructional

materials,- sucb as tapes, transparencies and prograrmled gistructonal materials. (P.L. 89-358).

The ESEA Amendments of 1967 (Pl. 90-247) expanded the program to provide for the production and distribution of educational

media for the use of all types of handicapped persons (not Just deaf),

then parents, actual or potential employers, and other persons

directly involved in worli for the advancement of the handicapped

, The amendments also authorized research and training of person,s

in the tise of educational. media for teaching handicapped persons

The Education. tif the Handicapped Amendments of 1977 (P L.

05-49) continued the program without change.

3. Training Federal assistance in preparing teachers of handicapped

children was initially authorized under the National Defense Education Act of 1958 (P.L. 85-926). The Mental Retardation Facilities

and Community, Mental Health Centers Construction Act of 1963

(P.L. 88-164) expanded the provisions for the training of personnel

to all areas of education for the handicapped, at all academic levels

from teacher training to the training of college instructors, research

personnel, and administrators and supervisors of teachers of the

handicapped, The 1965 amendments to the Act (P.L. 89-105)

extended the teacher training authority, while 1967 amendments

(Pt. 90470) added provisions for training physical education and

recreation personnel for mentally retarded and other handicapped

children.

The Elementary- and Secondary Educalion Act Amendments of

1967 (Pl. 90-247) expanded teacher training to-include an information dissemination prograrni4he Education of the HapdiellSped

Amendments of 1977 (P.L.(9.5149) 'continued the authorization For

these activities with minor modifications.

4. Research. Federal funding for research and demonstration projects related to education of handicapped children was originally,'

auttioilzed ,under the National Defense Education Act Of 1958 (P L.

85.926). The Mental Retardation Facilities and Community Mental'

Health Centers Construction Act of 1963 (P.L. 88-164) extended

and expanded the special education research and demonstration

authority under P.L. 85-926. The J965 amendments (PI 89-105)

once ,again extended tip research and demonstration program 'foe

"

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haridicapped children., The Elementary and 'Secondary Education

Amendment of 1967 (P.L. 90.247) ded authority to conduct

intramural research and to'support extr arch grants to

pnvateos well as public, educational or research institutions or organizations. '

Research and model dem onstration projects related to specific

learning disabilities were originally authorized under the ESEA

Amendments of 1969 (P.L. 91-230),.. In 1977, this authority was

transferred to Part E of tho Education of the Handicapped Act (P.L. 9544).

LIBRARY SERVICE AND CONSTRUCTION ACT

- A. Overview

The Library Services and Construc tion Act is the primary source of

f ederal support for the nation's public libraries. Originally enacted,

in 1957 as a program to help local communities develop library

services m rural areas, the Act since has been expanded to covet

urban libraries as well as library services for patients and inmates

. of state.supported institutions, physically handicapped persons,

and disadvantaged individuals in low income areas. The Library Services and Construction Act is composed of four

titles. Tide I authorizes basic grants-in-aid to the slates. to assist

them in expanding and improving library services. Title H provides

grants ,for -.he construction of new libraries. Title )11 grants are designed t stirnulite interlib-rary cooperative activities. Title IV

earmarks funk for Improving library services for older persons.

B. Major Programs Affecting the Handicapped

1. Bask State Grants. Title I of the Act provides formula grants

to !tate library agencies *accordance with-approved state plans,

for the following purKses. (1) to develop and improve public

library services to geographic areas and to grodps of persons without

such sl.rvices, (2) to provide library services for patients and inmates

in state.supported institutions, physically handicapped persons, and

disadontaged pers7ons in low income areas (urban and rural),(3) to

strengthen metropolitan public libraries which function as regional

pr national resource centers, and (4) to strengthen the capacity of

the state library agency to meet the information needs of all the

people. . Grant funds may be used to purchase books, equipment and other

libriry materials, pay salaries and other operating expenses, cove''r

the cost of administrating the state plan.: and to strengthen the

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capacity bf state library admestratiye agencies.to meet the needs

Of the state's citizens. FY 1980 appropriations 556,9 millions

Referents Title la Library Services and Construction Act, is amended P L

89.511, P L 91.600. and P L 95-123 U S Code 29 U.S C 351. CFDA

13 464

2. Interlibrary Cooperation Title 111 uthorizes formula grants to

state library agencies for, planninfrestabhshing and maintaining

cooperative networks of libraries at the local, regional or interstate

level Support for systematic coordination of resources in school,

'public, academic and special-libraries and information centers is

also permitted under this title in order to improve supplementary

services for the special clientele that each type of library gerves

istgo appropriations: S3%3 million.

#

Referenkes. Title 111, Library Services and Construction Act, as amended P L

89.511, P 1, 91-600, and P L 95-12,-U S. Coale zo u.s C 355e'C F D A.

13 465 i

C. Legislative History

Feder5.1 assistance to public libraries began in fiscal year 1957 when

ngress, originally passed theta ),serr Services Act (pt. 84-597)

and provided Si million 'in fun&g for the developmenj of library

services in rural areas In 1964, the Act bras amended (P.L. 88-269)

to extend toveragello urliaklibraries as well as rural projects and to

add a new program of library facility construction grants The Act

also was renamed the ,Library Services and Construction Act at this

time

The Library Services and Construction Ace Amendments of 1566

(P.L. 89.511) added a new Title IV to the Act. Part A of Title IV

authoream to assist states in providing library services in

state institutions for inmates, patients and residents. Services were

also authorized for physically or mentally handicapped students who

were in residential schools for the hand4capRed.that were operated

or substantially supported by the state. Part B of Title IV made

Federal funds available to state agencies for library services for

individuals who were certified bya responsible authority as unable

to read or to use conventional printed matbrials as a result of physical limitations, Such services could be provided through public or

nonprofit library agencies or organizations.

Adendmentk to the Act in 1970 (P.L. 91400) consolidated .the

various categorical grant progrrams .under Title IV, including" the

authority for library services to residents of institutions, into an

bxpanded basic state formula grant authority for librairy services,

17'1'

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a undei Title 1 of the Act. The 1977 Amendments (P.L. 95.123)

extended prograntauthonzations through fiscal 1981.

HIGHER EDUCATION ACT $ - e

: A. Overview .' . 4

. The Higher Educa.tioliAct of 19fi5, as amended, authorizes certain

direct and indirect educational benefits' for handicapped persons

'through various grant and loan pro4ams, training oE teachers of

handicapped childrerto and' certain barrier removal assistance u

. maitistions of higher edudation, j

iv e iligher "Educltion Act of 1965, as amended, is composed of

t elvt titles which authorize a broad array of Federal financial

isfance for the initiation and support of post-secondary edbcaton programs. Among the titles of the Act which directly or in. ( iinectly affect handicapped persons are. (1) Title I, Community

Services and Continuing 'Education, (2) Title IV, Student Assistance,

. (3) Title V, Teacher Training Programs, and (4) Title VII, Construc-

, tion, Reconstruction, and Renovation of Academic Facilities.

Major Programs Affectint the Handicapped

I Community' Services and Continuing Education. The principal

aim of Title I of the Ad is to encourage colleges and universities

to expand continuing education and other learning opportunities

for adults and to assist communities in creams or strengthening

new community service programs. Special community service

projects may be directed at regional or national needs, including

special pr ems fob handicapped individuals. Title I provides

`assistance t u formula grants se..t0e states, which, in turn, are

awarded to titutions of higher education, and through dirt

project grants to universities, colleges and other postsecondary

institutions.1 80 appropriations: 59 mllion

Refeiences Title I. Higher Lducati6n, Act,of 1965'.-ta amended, P.L. 89.329,

P L 90-575, PL 92-318, P.L. 94.482, and P.1:. 95-43. U.S Code, 20 U.S C. )-1001 13.49.1. and 13 557.

2. Cancellation of Direct Loans to Students. Under Part E,of Title

ilV, the Federal Grovernment is authorized to repay (cancel) direct

joans made student" for their college education, if the student

upon graduation enters certain public service fields, including service

as a full-time teacher of handicapped children in a public or other

minprofit ciementarydr secondary sthool. EY 1980 appropriations.

$14.8

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7

References. Title IV, Iligher 1.44..atton Act of 1965, as amended P L 92-318

and'P.L 95461.11.S. Code 20 U.S C. 1087ee C I- DA 13 470

r.

3. Educational Information Centers Subpart 5, Part A of Title IV,

authorizes a program of form grants to the states for estabhsh,

Educational Information ters that will make available information, guidance ,,anNi counseling, and referral services These Centers

also are expected to provide information and talent search services,

And are designed to "seek out and encourage participation in ful

tune and part-tune post-secondary education or- training of per

who could benefit from such education or training," including

physically handicapped persons FY 1980 appropnations S3

million

References Titl&I, Higher Education Act of 1965, as amended P.L 94482

U S. Code U.S C 10704-2 C F.D.A 135

4. Teacher enters. Part B of Title V authorizes funds to establish

teacher training programs, including Teacher Centers that will serve

as a source for inservice training of teachers and as a.focus for

curriculum development. Project grants are made to local educational agencies or to institutions of higher education to develop and

operate such Teacher Centers. The Centers are guided by a policymaking board, composed of a majority of teachers, including special

education and vocational education teachers One function of the

Center is to improve the,skills of teachers to "better meet the special

edocanonal needs" of handicapped and other'filsadvantaged students

-I FY 1980 appropriations- S13 million, - References Title V, Higher Edlicabon Act of 1965, as amended. P L 92-318.

P L. 94482, and P L 95-561 U S Code 20 U S C 1119a. C F D A. 13 416

C. 1. 5. Construction, Reconstruction and Renovation of Academw

Facilities. Part B. of Title VII authorizes loans to institutions of

higher education to bring their academic facilities into conformity

with the' accessitfility requirements of the Architectural Barners

Act of 1968. FY 198Q appropriations. S25 million (S15 million has

." been rescinded).

References Higher Education Act of 1965, as amended P L. 94c482, and P.L

. 95.43. U.S Code 20 U.S C:1132b, ., .,c. Legislative History

.1. F.ederaj support for !uglier education dates back to the early days

of the Republic under the Morrill Act which established state landgrant universities. Among the more recent, well-known Federal

higher education statutes were the GI Bill, which provided educational assistance to ex-servicemen after World War II, and the

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National Defense Education Act (P.L. 85-864), which authorized

funds to assist and stimulate higher education in the applied sciences

(after the Russians launched the Sputnik satellite).

In 1965, several existing federal laws were recodified and expanded

into the Higher Education Act (P31. ,89329)1A new system of

student grants and guaranteed loans was estalished under this

legislaticin. In addition, the 1965 Act authorized financial assistance

for the procurement of undergraduate instructional equipment, the

init4tion of community service programs, the 'support of college

-^tYraries and developing institutions, and the creation of the Teacher

Corps. The Higher Education Act also initiated a national policy of

increasing accessibility of disadvantaged students to postsecondary

education.

Amendments to the:Ifigher Education Act in 1972 (P.L. 92-318)

were aimed at improving the Title EV student assistance programs.

Among the revisions was the addition of provisions forcancellation

of student Ioans in exchange for public service. The 1972 amendments also authorized the development of Teacher Centers under

Title y of the Act.

In 1976, Congress amended the Act (P.L. 94-482) to place increased

iiismphasis on coTninuing education and community learning opportunities. The purpose of this change was to take cognizance of the fact

that the "typical" college student was likely to be otder and have

had previous work experience. For the first time, the Act gave 1

explicit attention to the post-highrhoo41$ducational nods of handicapped individuals:

Amendments to the Act in 1977 (P.L. 9543) and 1978 (P.L.

95.561) extended authorizations for the various higher education

programs and made minor modifications.

VOCATIONAL EDUCATION ACT

A. Overview

The Vocational Education Act of 1963, as amended, authorizes a

program of grantwn-aid to the states In order to expand and improve vocational education services. The Act also empowers the

Secretary of Education to award discretionary grants for the con- duct of research; demonstration projects and personnel and curriculum development projects in the area of vocational education.

Handicapped persons are eligible to participate in vocational titteirr--,-

lion activities supported under the Act. In addition, the itiii0te

20

,29
Sorequires a set-aside of funds from the formula grant allotted to each

state.for the express purpose,of serving handicapped individuals,

The Vocatiobal Education Act of 1963, as amended, fi composed of

three parts. (1) Part A iuthot.,;:block" grants to assist the states

m expandingand improving vocatOmt education program's, including services to persons "with apectal educational handicaps , ", (2)

Part B authorizes rant support for projects of national significance,

trailing and . development of vocational education personnel, and

assistance in remodeling and renovating vocational education facilities; and (3) Pig C'elefines terms used in the Act.

For the puiposer of the Act, the term "handicapped persons" is

defined as. "persons who are mentiiily retarded, hard of hearing,

deaf, speech impairea,, 'visually" handicapped, seriously ernotionally

disturbed, cripple uk or otherlitIth impaired persons who by reason

,thereof requirb *la' education and related services, and who,

because of their handkappmg condition, cannot succeed in the

regular-Necational education program without special education f assistance or who require a modified vocational education program."

B. Major ProoramlAffacting the Hand icipped.

1. Basic Grants to States for Vocalional Education. The Part A

(Subpart f) prograni of forinula grants to state boards for vocational

... education is the baic source of Federal support under the Act

Formuli grant activities may include. basic vocational education

program!, pooperative programs, energy.education, construction of

area vocational school facilities, provision of stipends, placement

'services, industrial arts programs, programs ibr special groups, construt-tic& and operation of residential vocational education facilities,

and state sand local administrative costs. Ten percent of a state's

allotmeqt must be used to provide ibcational education, services to

handicapped individuals. FY 1980 appropriations. $473.4 million.

References.tPadA, VocatsoniIEducation At of 1963, u amended P.L. 88-210,

P.L. 90-576, P.L. 94-482, and 11:L. 95-40. U.S. Code 20 U.S.C. 2301. C.F.D.A.

13:493: °

. 2. Consumer and Homemaking Education. Subpart 5 of Part A

authorizes formula grants to to states for consumer and homemaker eciacatIon programs. Those grants are aime at providing

instruction in, consumer education, food and nu tion, family

living and parenthood education, child developm and guidance,

housing and home management (inauding resource management),

and clothing and textiles. The program also supports: (1) outreach

activities for youth and adults, including persons with special needs,

.such as tiandicapped individuals, and (2) related services, including

...,

4
teacher training and supervision, cumculum development, research,

program evaluation, special demonstration and experimental programs, development of instructional materials, exemplary projects,+

provision of equipment, and state administration. FY 1980 appropriations: $43.4 million.

References Put A. Vocational Education Act of 1963, as axnend ed.P L 90-576,

P.L. 94-482, P.L. 95-40.b.S.C,ode 20 U.S.C. 2380. C.F D A. 13 493.

3,,,n2gram Imprptement Pro/eels. Part. B of the Act authorizes

Federal support for projects to improve vocational education ser- vices. Such project grants may be awarded to public and private

organizitions and agencies to support. (1) research, curriculum development and demonstration projects, and (2) the operation of a

National Center for Research in Vocational Education. In the past,

several projects have been funded to improve access of disadvantaged

and handicapped persons to vocational education services. FY 1980

appropriations: S9 million.

References Part B, Vocational Education Act of 1963, as amended P.L. 90-576,

P L. 94-482, and P L. 95-40. U.S. Code, 20 U.S C. 2401. C.F.D.A. 13 498.

C. Lagislative History

Federal support for vocational education programs dates back to

the Smith-Hughes Act of 1917. More recent federal efforts to

expand and improve vocational education can be traced back to the

-Vocational Education Act of 1963 (P.L. 88.210). The 1963 Act

created a permanent authority, to assist the states in supgortuig

vocational training for youth and adults through the public schools.

The legislation also authorized funds for the construction of area vocational schools, work-study programs and demonstration projects.

In 1968, the Vocational Education Act was amended (P.L. 90.576)

to give the rates inslreased flexibility in the use of Federal formula

grant fun4W. The 1968 amendments also required each participating

state to _earmark ten percent of its vocatibnal education allotment

for services to handicapped persons who, because of their disabling

condition, were unable to succeed in regular vocational educational

classes without special educational assistance.

The 'Education Amendments of 1976 (P.L. 94482)continued the

10 percent set-aside of vocational education 'funds for handicapped

persons, requiring the states. (1) to establish a 50 percent state

matching rate for services to handicapped persons, in order to

eliminate the practice of replacing state funds with federal monies,

(2) to use the set'aslde funds to assist handicapped individuals, to

- the maximum extent possible, to participate in 'regular vocatioCal

14:

22

t

Im

...=10
it 4:6

. . ,

.. .. .i. . education programs and to reduce the numbeyf handicapped students placed in segregated vocational classes, and (3) to estabhsh

policies and plans fur expending vocational education set-aside funds`

-, which are consistent with the state's education of the handicapped

plan under P.L.94-142 Amendments In 1977 (P.L 95-40) extended

vocational educate n program authorizations and made minor mods- - fications ,.

f

MODEL ELEMENTARY AND SECONDARY SCHOOLS FOR THE

DEAF ACTS

In 1966. Congress passed the Model.Secondary School for the Deaf Act

(P L ..69-694), which authorized the Secretary of Health, F4ucation,

and Welfare to enter into an agreement with Gallaudet College to

?establish a model secondary school for the deaf. This high school, while

serving primarily the needs of the National Cipital Area and nearby

states, was to be a model for the development of similar programs

across the country.

The Model Elementary School for the Deafict of 1970 (P.L. 91- 587)

. authorized Gallaudet College to estabhsh the Kendall School to provide

day and residential facilities for elementary age deaf children The

schoorquch focuses primarily on District of Columbia residents, also

serves as a national demonstration program for elementary-level education of deafyoungsters.

DEPARTMENT OF EDUCATION ORGANIZATION ACT OF 1979

On October 19, 1979, President Carter signed into law a measure authorizing th establishment of a new, ,Cabinet.levelDepartment of Etlucation 96-88)., The new Department was to open with 17,000

emplo s and a FY 1980 budget totaling 514.2 billion. Under its

jurisdiction were most of the education programs formerly operated by

the Office of £clucation in the Department of Health, Education, and

Welfare, as well as Overseas Pefense Department schools and other

scattered educatignal programs. It Old not, however, include child

nutrition, veterans edhcatiorr, Head Start, alto the arts and humanities, or educational activities of the National Science Foundation.

Under the Act, the Department of Health, Education, and Welfare

was renamed the Department of Health and Human Services.

The Act established a new Office of Special Education and Rehabilitative Services, headed 6y an Assistant Secretary. The statutory mission

of this Office was to administer programs authorized under the Education of the Handicapped Act, and the Vocational Rehabilitation and

Randolph-Sheppard Acts. These illograms previons1y were administered

a. 23"
(.

by the Bureau of Education for the Handicapped d by. the Rehabanalion Services Administration, respectively. The Developmental Disabilities Program, which had been located in the RehabItatioAServices

Administration, was not transferred into the new Department, instead,

it was housed in the. Administration on Developmental Di abthttes,

Office of Human Development Services, within the Department of

Health and Human Services.

CAREER EDUCATION INCENTIVE ACT

The Career Education Incentive Act authorizes grant funds to assist

elementary and secondary schools in providing information and educa.

Lion on career opportunities. Emphasis is placed on overcoming bias and

stereotyping associated with race, sex, age, economic status or handicapping conditions in selecting careen. The Act defines 'handicapped'

to mean °mentally retarded, hard of hearing, deaf, speech impaired,

visual] handicapped, seriously emotionally disturbed, orthopedically

earning

ed, or other health impaired persons, or persons with specific

earning disabilities who reqoue rpecial educationand related services. - Career education encompasses activities involving career awareness,

attitude towards work, career planning, election and decision-making,

and a broad view of career choices begun in the early stages of educa.

Lion. Specific job skill training, however, is not included within the

program's purview.

Jo* Federal support for career education programs began under Title EV

(Sectio; 406) of ,the Education Amendments of 1974 (P.L. 93.380).

The 1974 amendments provided fOr discretionary grant programs and

the establishment of a. separate Federal Office of Career Education,

within the US. Office of Education. Section 406 specified that dem.

onttration projects for career education must include "models in

which handicapped children receive appropriate career education either

by participation in regular or modified programs with nonhandicapped

children or where. necessary in specially designe,d programs for handicapped children whose handicaps are or such seve)114 that they cannot

ritenefit from regular or modified programs."

The 1977 Act :Iso authorized states to conduct comprehensiye programs for the, development and implementation of collaborative relationships witiyorgantzations 'apresenting the handicIpped:induding

the use of such organizatiops is resources in the schools and for field

trips. The Act continued the requiremeqt for a separate Office of

Career Education, however, the Socretiry of the Department of Education subsequently was givenaugiority to discontinue the office, if need

be, under the Department of Education Organization Act (P.L. 96-88).

. 4

24

33

t
a

(For details on the Department of Education Organisation Act, see

Page 23.) Provision for demonstration grants also were continued under

P.L. 95.207. . . ---- - Refriences., Career Education Incentive Act of 1977 P L 93.380 and P L

95.207. U.S. Code. 20 U.S.C. 2501. C.F.D A. 13 554 and 13.596

NATIONAL LIBRARY SERVICE FOR THE ,BLIND AND PHYSICALLY HANDICAPPED . 7, dr

Linter legislation initially enacted by Congress in 1904, the Library

of Congress makes available free braille and recorded materials to blind

and physically thandicapped persons. The program, called the National

Library SerncelQaLtheo-Bluid and Physically Handicapped, distributes

full-length books and magazines in braille- and on recorded discs and

cassettes through a cooperative network of regional and lor41,hbranes

Materials are circulated free of charge to eligible borrowers. Eligibility

for this service .is extended to Apyone who is unable to read or use

standard printed materials as a result of temporary or permanent visual

or physical limitations. /

The original 1904 legislation authorized the mailing of free braille

N books to blind adults. in 1931, the Pratt-Smoot Act established a centrahzed national library service for adult blind readers, administered

by the Library of Congress. The program was expanded in 1934 to

include talking book services, at no cost to adult readers. The national books-fore-blind program was extended to children in 1952,

by an amendm&t that deleted the word "adult." Music instruction

materials, including musical scores in braille, textsand related information were added to the library service by 1962 amendments (P.L.

87.765).

Ameridmetits In 1966 (P.L. 89-511 and P.L. 89.522) extended the

service to "other physically hisfidicapped readers certified by a compe

tent authority as unable to read normal printed materials as a result of

physical limitations." FY 1980 appropriations. $36.9 million.

References: Act to Provide Books for the Blind. as amended P.L. 89-511 and I P.L. 89422. U.S. Code:. 2 US C. I . C.F.D.A. 42.001.-

'

1.

IMPACT AID TO FEDERALLY AFFECTED AREAS

Legislation authorizing aid 113 local educational agencies in areas

affected by Federal activities was originally enacted in 1951 (Pl.

81.874 and P.L. 81.815). This "IniRact aid" program was basal on the

assumption that Federal activities, such as military bases and governmehroffices, placed a finanaliTetfen.on school districts by reducing

25

.

, 34 1

\
local tax ie'venues while increasing the number of children to be

educati.d.

School districts are eligib to receive impact aid if at least three percent

of their enrollment, or students, are from Federally-connected

families Such childrerrare divided into two major categones (1) Part A

children arc youngsters living on, and having a parent employed On,

, Federal property, and (2) Part B children are youngsters living on or

having a parent employed on Federal property or in the uniformed

services` Funds are allocated to local educational agencies through a

formula based on the number of children counted as eligible under

Part A and Part B Aitroximately one out of every four sch mulcts

in the country receives Federal impact aid allocations.

The Education Amendments. of 1974 (P L. 93.380) permitted local

educational agencies to receive 150 percent of their per pupil reunburserrient under impact aid for handicapped children eligible under

Part A or Part B. However, to receive the higher reimbursement, the

child must be enrolled in a public school districtprogram which meets his or her special educational needs. "Handicapped children" are

defined as children who meet the definition contained in the Education of the Handicapped Act (see page 5)

The Education Amendments of 1978 (P.L. 95.5614 extended impact

aid reimbursement for handicapped children to those who are placed

by the focal educational agency into special pnvate schools or schools

outside of the school district. FY 1980 (estunated) appropriations. "1$483 million.

r References Educational Agencies Financial Aid Act, as amended P L 93-380

and 1'1'95-561 1.I.S Code 20 U.S C 238-C F D A 13 477 and 13 478

1

3 5 26
7-

EMPLOYMENT IP COMPREHENSIVE EMPLOYMENT AND TRAINING ACT

A. Overview

The Comprehensive Employment and Training Act of 1973, as

amended, authorizes a range of programs to assist unemployed

persons to develop job skills and work potential. It also provides

pubhc semce employment opportunities anda job counseling to

unemployed and underemployed persons. Handicapped persons

are eligible to participate in most CETA programs, under both

semces targeted specifically; to handicapped indlnduals and certain

programs provided for the "economically disadvantaged" and "un.

employed."

CETA defines the term "handicapped individual" to mean ',law

mdmdual who ha a phyilcal or mental disability which for such

individual constitutes or results to substantial Handicap to employment." "Economically disadvantaged" and "unemployed" persons

are defined by the Act to includein cases pen;nitted under Labor

Department regulationshandicapped persons living at home or in

an institution or receiving semces in a sheltered workshop, prison,

hospital, or similar community or institutional are facility.

4 The Comprehensive Employment and Training Act of 1963, as

amended, Is composed of eight titles, authorizing Federal assistance . to help economically disadvantaged, unemployed and underem

ployed persons obtain the necessary job skills and lqcate suitable

employment. Tide II authonzes grantsinvaid to state and local prime

sponsors to provide and/or coordinate the provision of services

to eligible/ recipients. Such services may incictle. training, work

experience, upgrading skills, retraining, and public service employ.

_ment. for the economically disadvantaged, including certain

. capped persons. Tide III Of the Act authorizes programs and projects

to serve persons with particular disadvantages in the labor market.

Title IV' authorizes various job training and work experience

27

.4
It

programs for teenagers, including handicapped youth Wm programs supported under CETA, include. (1) countercyclical public

service' employment, (2) private sector opportunities for the economically disadvantaged, and (3) the Young Adult Conservation

Corps. ...c B. Major Programs Ails Cling the Handicapped

1. CoMprehensive Empidyment and Training Services. Parts A, B,

and C of Title H authorize formula grant funds to stattand local

"prime sponsors " entities designaled to administer compr ehensive

employment and training services. Handicapped persons who are

economically disadvantaged and unemployed, or in school, are

eligible to benefit from programs funded py such prime sponsors.

Pan ID provides funds, to prime sponsors for transitional public

service employment, aimed at enhancing a worker's opportunity to

seek employment in the private sector.

. . . Fiscal 1980 appropriations. S5.2 billion (out of which funds were

also drawn for countercyclical public service employment prograng

authorized under Title Vi of the Act), , References: Title 11, Comprehensive yment and Trelnins Act of {973,

u amended. P.L. 93203 and P.L. 95 ill S. Code 29 U.S C. 801. C.F.D.A.

17.232.%

2. Speck! Target Population A of Title 111 authonzei project

grants to state and ldral governments, private organizations and

educational institutions to provide or coordinate the provision of job

training, related services and employment opportunities for handicapped persons and ether targeted populations with sppcial employment and training needs. Program funds also may be used to train

.personnel to work with and assist handicapped children and adults.

FY 1980 appropriations: $132.7 million. .. '

. . References. Title 111, Comprehensive Employment and Trent:La Act of 1973,

as amended. P.L. 93-203 tpd P.L. 95.524. U.S. Code. 29 U.S.C. 871. C.F.D.A..

17.243. . . 3. Research and Demonstration Grants. Part B of Title Hi authorizes

research, demonstration and experimental project grants. State and

. local governments and institutions of higher education are eligible to

receive such grants. Projects must be designed to assist unemployed

persons who have "serious problems in the labor market," including

mentally and emotionally handicapped persons, to acquire the skills

necessary to hold a job, through temporary, highly structured and

supervIred work experience and training. Part B also provides for

educational and assistance programs designed to eliminate artificial

barriers to employment. FY 1980appropriations. $14.3 million.

28

37

w

4-"N
Reference Title Ill, Cproprehensive Employment and Training Act of 1973, as

amended P L 93.203 and P.L. 95.524 U.S. Code 29 US C 879. C.F.D A

17.233.

4. Employment Demonstration Programs. Part A ofiltle IV authorizes the Youth-Community Conservation Improvement Project (for

persons aged 16-19) and the Youth Employment and Training

Program (for persons 16.21). State and local prune sponsors are

entitled to receive grants under these authorities to establish wellsupervised work programs which benefit the community, make a

significant long -term impact on the structural unemployment prob

lems of youth, and enhance jobtrospects and career opportunities

of young persons. Under both prdirams, sponsors must make appro -(

pnate efforts to include youth who are experiencing severe handicaps in obtaining employment, including mentally and physically

handicapped youth. Removal of a.rchitectural barriers and certain

social services for handicapped persons are considered acceptable

employment activities under the two programs. EY 1980.appropnations. $134 -nrillion for YCCIP and $797.9 million for YETP.

References Title IV Comprehensive Employment and TrIUMM Act of 1973,

_as amended P L 93-203 and P.L. 95-524. U 8. Code 29 U.S C 891. C.F.D.A.

17.239 and 17,241.

5. Job Corps. The Job Corps program, authorized under Part B,

Title IV of the Act, authorizes project grants to state and local

agencies and private organizations for the purpose, of operating

residential centers-serving low-income youth (ages 16-21) who require intensive educational and-vocational training services in order

to secure meaningful employment. Training may extend for periods

from 6 months to 2 years. Trainees receive a monthly allowance and

readjustment payments when they return to the community. The

age limit may be waived to permit handicapped individuals, over 21

years of age, to participate in Job Corps programs. FY 1980 appropriations: $415.7 million.

References Title IV, Comprehensive Employment and Training Act of 1973, as

amended P.L. 93-203, and P.L. 95.524 U.S. Code. 29 USX. 923. C.F.D.A..

17.211.

C. Lagisava History

The Comprehensive Employment and Training Act was enacted in

1973 (Pl. 93.203) to consolidate Federally-funded employment

and training programs that had defeloped under the former Manpowet Development and Training Act. The aim of Congress was to

fix responsibility for operating such programs with a network of

29

38
state and local administrative and service delivery units, referred to

in the legislation as "prime sponsors." - Although many handicapped individuals were eligible to participate

in CETA programs by virtue of inadequate income and lack of employability, specific recognition of the employment and training

needs of handicapped persons as not included in statute until the

CETA Amendments of 1978 (P.L 95-524). In that legislation, a

series of provisions were added to the Act to emphasize the e

Nifty of handicapped youth and adults to participate in an 'enefit

from CETA-funded projects. Among these provisions were requirements that:

CETA prime sponsors include in their master and annual plans

descriptions of employment and training services to handicapped

and disabled individuals,

the prime sponsor's annual plan set forth an affirmative action

program for outreach, training, placement and advancement of

handicapped persons in CETA programs, including (a) a description of the extent and methods used to meet the special needs of

handicapped persons, and (b) the number of handicapped individuals

served during each of the preceding two years, the type of training

or employment they were placed in, and the number who were

moved into unsubsidized employment;

the prinie sponsor's planning council and the state employment

and training council include in their membership representatives

of the handicapped;

all CETA prime sponsors and subcontractors prohibit discrunination on the basis of handicap.

part-time, flexitime and other alternative working arrangements

be permitted for individuals unable, because of age, handicap or

other factors, to work full time; and

prime sponsors make an effort to remove architectural barriers

to employment of the handicapped. ,While such efforts are not

Intended to authorize CETA funding for major construction programs, prime sponsors may use CETA and other funding to remove

barriers that prevent qualified handicapped persons from filling

available positions or impede ready access to public facilities and

services.

Recognition of the special needs of handicapped individuals also

was incorporated in Title III of the Act under the 1978 amendments. A new Section 306 was added to Title III, which Called for

39

30 > -410
r

(a) the establishment of programs to tram personnel working with

and assisting handicapped individuals, and (b) the establishment of

admuustrative procedures, including the use of personnel having

particular competence in the field, to meet the special needs of

handicapped persontreceiving CETAfunded services.

Section 306 also set forth a Congressional finding that. (a) due to

the rapid implementation of the Education for All Handicapped

Children's Act 94-142) and Section 504 of the Rehabilitation

Act of 1973 (P.L. 93-112), there is a need for specialized supportive

services and removal of architectural barriers, and 00 handicapped

individuals. represent a large percentage of the unemployed, and

CETA-funded training and .employment services can provide a

meaningful improvement in their lives.

FAIR LABOR STANDARDS ACT

A. Overview . The Fair Labor Standards Act of 1938, as amerdei, -etPlishes

minimum Federoi requirements for hours of work, equitable wages,

overtime pay, record-keeping, and the conditions under which children may be employed. Over 50 million full and part-time workers

. to theiUnited States are covered by the provision? of the Act. In

addition to its general requirements, the Act includes special provisions governing the employment of mentally and physically handicapped persons in sheltered workshops and similar work settings,

B. Major Provisions Affecting the Handicapped

1. Ceuificates for Special Aftnip4m Wages. Section 14 of the Act

establishes requirements governing ,the employment of learners,

apprentices, students and handicapped workers. Under this section,

the Secretary of Labor is authorized to issue special certificates,

"in order to prevent curtailment of opportunities for employment"

of individuils "whose earning or productive capacity is impaired

by age or physical or mental deficiency." In 1966, amendments to

the Act (P.L. 89-601) required employers who .under a special

certificate, pay workers less than the minimum wage establiked

under the Act to assure that wages. (a) are commensurate with the

_wages paid to nonhanditaiied workers in industry in the same area

, for essentially the same types, quality and quantity of work, and (b)

are not less than 50 percent of the prevailing minimum wage.

Special certificates alseinay be granted by the Secretary of Labor,

with the approval- of the state vocational rehabilitation agency,

for less than sdperaeot of minimum skate in .the case of: (a)

31

40
handicapped workers engaged in work which is incidental totrauung

or evaluation programs, (b) multihandicapped individuals whose

earning capacity is so severely zmpaued that they are unable to

engage in competitive employment, and (c) handicapped clients

emplOyed in "work activity centers," defined as. "centers planned

and designed exclusively to provide therapeutic activities for ... clients-whom physical or mental impairments are so severe as to make

their productive capacity inconsequentia4."

However, in the;e instances, the hohrly pay scale still must be

commensurate with wages earned by nonhandicapped workers

performing the same type, quality and quantity of work.

2. Employees of an Entergnses Engaged in Coinlierce. Section 8 of

the Fair Labo Standards Act specifies the types of employees

covered by the provisions of the statute. In 1966, the Act was

amended (P.L. 89.601) to revise the statutory definition of a business enterprise engiged in convnerce or in the production of goods

4. for.nmerte. Under the revised definition, coverage was extended

to, employees of institutions serving 'handicapped persons. The fol- . lowing ffistitutions were included under the new definition.

hospital. an institution primarily engagati in the care of a sick,

the aged, the mentally ill or defective who reside on the premises of

such institution, a school for .mentally or physically handicapped

or gifted children, a preschool, elementary or secondary school, or

an institution of hither education (regardless of whether or not

. such hospital, istitution or school is public or private or operated

for profit oriiorfor profit)."

Howeler, as the result of a 1976 Supreme Court decision (National

League of Cities, et. aL 1). Usety), federal mmununt wage and hour

requirements do not apply' to employees of institutions operated

by a state oz.-local government agency. In " the National League of

Cities case, the Court ruled that it is unconstitutional for federal

wage and hour standards to be, imposed ore state and local governments.

4, IC

3. Minimum Wage Commission .and.Study. The 1977 Fair Latior

Standards Amendments (P.L. 95-151) increased the Federal mini

mum wage and established a Minimum Wage and Study Commission

to analyze the social. political, and economic ramifications of minimum yage, overtime, and other requirements of the Fair Labok

Standards Act of 1938, as amended. Included in the study was.to be

an assessment of the potential effects on the employment ofhandicapptd turd elderly persons of incteasing the minimum wage rate

apd/or providing a different minimum wage,rate.

1
References. Fair Labor Standards Act, as amended. PI 89-601 and 4.1. 95-151.

U S. Code; 29 U.S C. 203,

SMALL1USINESS ACT

A. Overview

The Small Business Act of 1953, as emended, authorizes a series of

progrims, designed to preserve "... free, competitive entetprise in

order to strengthen the Nation's economy." The Act permits certain.

handicapped businesses to compete for small business procurement

set-asides, and establishes two loan programs specifically aimed at

assisting handicapped persons Under one program, the Small Busi

ness Administration is authorized to make direct or guaranteed loans

to nonprofit sheltered workshops and -other similar organizations to

enable them to produce and provide marketable goods and services.

The second loan program is designed to assist handicapped inch

viduals establish, acquire or operate their own small businesses. In

both cases,4loans of up to $350,000 may be approved for a maximum penod of 15 years.

The Act defines the term "handicapped individual" to mean. "a

person who hafa Physical, mental or emotional impairment, defect,

ailment, disease or disability of a permanent nature Which in any

way limits the selection of any type of employment for which the

individual would otherwise be qualified or qualifi;ble."

B. Major Programs Affecting the Handicapped

1. Workshop Loans. Handicapped Assistance Loans may be awarded

to help non-profit sheltered workshops or simOir organizations

(HAL-1) construct facilities or acquire working capital) if such funds

are not available from other sources. Loans may not be used for

training, education, housing or other supportive services. Nonprofit

organizations must be operating in the interests of handicapped

persons and must, employ handicapped persons for at least 75

percent of the man -hours required for the direct productibn of

commodities or services. . . References: Smelt Busmen Act of 1953, as amended P.L. 92-595, and P.L. 9 9549. U.S. Code: IS U.S.C. 636. C.F.D.A.: 59 021.

2. Handicapped-Owned Busifrtessex Handicapped Asses ance Loans

to small busiliess concerns (HAL -2) may be used to. (a) construct,

expand, or convert Tacilitiesi (b) purchase building equipment or

materials, and (c) provide working capital, Eligible small business

6cerns are those that are indtpendently owned and operated,

1

33

42
not dominant in then field, meg SBA requirements and are 100

percent-owned by handiespnadindmduals.

FY (980 appropriations (HAL-1 and HAL-2). - $20.5 million for

direct !bans, S53 million for guaranteed loans

References Small Business Act of 1953, as amended P L. 92-515. and P.L

95.89. U.S. Code 15 U.S.C. 636 C F.D A 59.021.

3 PrOcurement Set-Asides. Entities eligible.. for Handicapped

Assistance Loans are permiftest, to compete for Federal small business procurement set-asides. The Act establishes procurement setandes and other assistance to assure small businesses a fair share of

contracts for producing Federal govemnient .supplies and services.

References Small Business Act of 1953, as amended. P L. 95.89 and P L 96-302

U.S. Code: 15 U.S C. 637. C F.D A 59 009.

C. Legislative History

The 1972 amendments to the 'Small Business Act of 1953 (P.1.

92-595) expanded the authonty ..?f the Small Business Administration to provide direct 'and guaranteed loans for. (1) nonprofit

sheltered workshops employing handicapped persons and, (2) ...

handicapped individuals Interested in establishing then own busi- nesses. In 1977 (P.L. 95-89), Congress permitted small businesses eligible.

for handicapped assistance loans to compete, on a one-year experimental basis, for Federal procurement contracts set aside for small

businesses. A total of S100 million in procurements was authorized.

ThP3Smalijusiness Admirustration also was directed to submit a

report to Congress on the' impact such small bpsinesS set-asides

)tad on orgaruzitions for handicapped individuals. The procurement

authonty for handicapped businesses was continued fqr three years,

at the annual level of 5100 million by 1980 amendments to the Act

(P.L. 96.302).

WAGNER-PEYSER ACT

s The Wagner-Peyser Act of 1933, as amended, authorizes the establish

ment and operation of the Federal-state employment security system to

help individuals find jobs and assist employers in locating qualified

workers. Amendments to the Act in 1954 expanded the program by

requiring every local employment service or job service) office to

designate at least one staff member responsible for helping severely

handicapped individuals locate training 'resources and/or suitable em

ployment.

43

34

4o,
Applicants are considered handicapped if they have physical, mental

or emotional impairments that constitute an obstacle tot ten errkloyment Alcohol and drug ?busers are included. The goals of the Employment Service's program for handicapped persons cover. (1) equal opportunity for employment and equalzpay in competition with other

applicants, (2) employment at the highest skill level permitted by their

occupational qualifications, (3) satisfactory adjustment to their chosen

occupations and work situations, and (4) employinent that will not endanger others OF aggravate their own chsabilities."The Act also requires

state employment services to coordinate their activities with state vocational rehabthtation- agencies. FY 1980 appropriations. 511.1 million.

Referenda The Wainer-Peyser Act of t933, as amended P.L 73.30, P,L.

93-263, and P 1. 95-524. U.S Code 29 IS C. 49, and 39 U.S C. 338. C.F.D.A..

17.207

PUBLIC WORKS -AND ECONOMIC DEVELOPMENT ACT

. The :Public 'Works and Economic Ekvelopment Act of 1965 (P.L.

89430, as amended, authorizes project grants and loans to assist in

The construction of public facilities needed to initiate and encourage

long-term economic growth in specified geographic areas. The Act also

proviuts funding for constructio projects aimed at furnishing mi

mediate employment in areas of gh or sudden unemployment. The

construction of vocationill.schools considered an appropriate public works project For ex- le, WI' States have utilizet public work

funds to construct r dential treatment facilities for

mentally retardedand.mentally s. In 1977; amendmtnts to the Public Works Employment Act (P.L. 95

28) added a new regirement thil'applicants for public works projects give assurances to*the Departrneht °fCo ik that their proposed

projects comply with f handicapped persons,

as set forth under IA f ct of 1968. The Architectural and Transportation .- mers Corp; I. ce Board is authorized to

insure that all new, buildinss and, facilities meet accessibility standards. P L 95 -28 also au" fizes orks projects for the construction,

renovation, repair Attier impro ments in health care or rehabilitation faagities, owne4 d operate by private nonprofit organizations

went,, sIdered eligible under prior law).

Refereach. PublIC Wolis and.F.00nomic Development Act of 1965, Usmended.

P.L. 89-134, P.L. 94-487, and P.L. 95-28. US. Code ,42 U.S C. 313.1..C.F.D:A.. 11) 30001.304, 11.307 and 11.308.

'

sY 35

*44

1

C.
HEALTH

MATERNAL AND CHILD HEALTH AND CRIPPLED CHILDREN'S

SERVICES

A. Overview

The Social Setistity Act of 1935 was enacted with provisions for an

entitlement program aimed at improving health care for mothers and

young chil en. Title V, of the Act, as amended, authorizes grantsin-aid to th states, special project grants and research and training

support to rther the development and improvement of .a national

system of services to reduce infant mortality, enhance prenatal and

potpartuni care, and ameliorate the effects of handicapping condidi:his originating in childhood.

Separate provisions are contained in Title V, authorizing formula

grants to the states for. (1) maternal and child health services (Section 503), and (2) crippled children's services (Section 504). In

order ,to qualify for state allotments (funding for the two programs is combined into one grant award), a state mud submit a plan

which provides for. (1) cooperation between the maternal and child*

health and crippled children's services agency(ies) and other medical,

health, nursing, education, welfare anti vocational rehabilitation

agencies and organizations, (2) early identification of children in

need of health services and folloW-up care and treatment required by

such children "to correct or ameliorate defects or chronic condi- * tions" discovered in the process, and (3) a program aimed at helping

to reduce the incidence of mental. 'retardation and other handicapping conditions ofiglnating at binh, with particular emphasis on

mothers azid,children in low-income areas.- Section 511 of the Act

authorizes project grants for the training of maternal and child

health personnel. Also included are training grants for university

affiliated facilities for developmentally disabled children.

37

r a45
A

41 B. Major Programs Affecting the Handicapped

1. Crippled Children's Services. Formula giants are awarded to state

crippled children's agencies to extend and improve medical and

related services to cnppled children and children suffering from

conditions that lead to cnppling, conditions. In addition, project

gr&its may be made to state crippled children's agencies or.mstitutiqns of higher education for special projects of regional or national

significance designed to improve services to such children. These

grant funds may be used so locate crippled children and provide

medical, surgical, corrective and etAer services, including diagnosis,

hospitalization, and aftercare for crippledichildren.

The statute broadly defines "cnppled children" to include individuals under tfie age of 21 who have ..an organic disease, defect, or

condition which may hinder the achievement ofnormal growth and

development. FY 1980 apptopnations 5102 1 million.

References Title V. Social Secunty Act, as amended 13 L 88-156. P 1. 89.97

and P L 90.248 U S Code 42 US C 704 CT DA 13 211

2 Maternal and Child Health Services. This program provides

formula and project grants to the states and to institutions of higher

education for. (a) services aimed at reducing infant mortality and

improving the health of mothers and children, (b) providing programs and services designed to reduce the incidence of mental

retardation and other handicapping conditions caused by complications associated with childbearing. (c) promoting the health and

dental health of children and youth of preschool and school age,

and (d) developing special pr jects,of regional or national significance for improving maternatand child health services. FY 1980'

appropriations. $243 4 million

References Title V. Soul' Secunty Alta as amended P L 88-156, P L. 89-97

and P L. 90248 U S. Code 42 US C. 7 CED.A 13 232. 4s 3. Research Projects. Project gra is are awarded to support research

. studies relating to the., advan ent of maternal and child health

or crippled children's 'se i s. Public and nonprofit institutions

of higher education, st e and local government agencies and other

organizations engage in research related to maternal and child

health or cnppled children's programs are eligible to apply for such

grams. Examples of past research projects have included. (a) methods of increasing the effectiveness of child health programs, especially services for school-aged mentally retarded, children, (b) studies

of the prevalence of handicapping oondttions, Ind (c) evaluatiots

of such programs. FY 1980 appropriations S5.3, million

38

6 "
I 1 References Title V. Socul Security Act, as amended P.L. 88-156. P.L. 89-97-7

and Pl. 90-248. U.S. Code 42 U S C. 712. C.F.D A. 13 231,

4 Personnel Training. Project grants are made to public and nonprofit institutions of higher education to train personnel for health

care and related services to mothers and children, particularly

mentally retarded children and children with multiple handicaps.

Such grant funds may be used to support faculty, traineeships,

services, clinical facilities, and short-term workshops and institutes.

Since this grant program 'vas originally authorized by Congress in

1965, the majonty of funds appropriated under Section 511 of the

Act have been used to support training programs in university

affiliated facilities for developmentally disabled children. FY 1980

appropriations: S26 6 million.

References Title V, Social Secunty, u amended P.L. 89.97 and P.L. 90-24.

U.S. Code: 42 U.S.0 711. C.F.D A.. 13.231

C. Legislative History

The Nation's fir. st health services formula grant prograrn,..enacked

in 1921, was the predecessor of today's maternal and child health

and crippled children's services programs. The Ad, which was in

force through 1929, was known as the Sheppard-Tower Act or the

Maternity and Infancy Act.

In 1935, the Sheppard.-Tower Act was revitalized and greatly ex- panded under Title V of the Social Secunty Act (P.L. 74271).

For the rust ,tune, the legislation established a federal-state system

of crippled children's service's In addition, a centrally administered

special fund was established for demonstration projects and the..

training of personnel.

In 1963, Congress amended Title V (P1.88.156) to establish a new

project grant program to improve prenatal care to women from

low-income, families where the risk of mental retardation and tither

birth defects was known to be inordinately high. In addition, authorizations for grants to the states under the maternal and child health

and crippled children's programs were increased by the the legislation

and a research grant program was added to suppert studies "which

show promise of substantial costslution to the advancement" of

such service programs. These amendments to title V were part of

a legislative packet submitted to Congress by the Kennedy Admmistratictrl to implement several recommendations contained in the

October 1962 report of the President's Panel on Mental Retardation.

The Social Security Act Amendments of 1965 (P.L. 89.97) authorized special project grants for the development of comprehensive

39

. , 47. 7.
maternal and child health care services and grants for multidisci

plularj4 training of specialists to work with retarded and handicapped

children. The latt5 program was intended to provide support for

training activities in university affiliated facilities for the mentally

retarded (see Developmental Disabilities Assistance and Bill of

Rights Act, page 101)

The 1965 amendments also initiated a project grant program to

improve health and related services to pre-school and school-aged

children in low-income neighborhoods. Programs developed under

this authority were designed to demonstrate that early attention

to potentially handicapping conditions could improve the ability

of such children to live more productive lives.

The Social Security Amendments of 1967 (P.L. 90-248) torisoh-

, dated maternal and child health and crippled children's services

under a single grant authorization, with a funding split of 50 percent

for formula grants, 40 percent for project grants, and 10 percent

for research and training. Effective July 1, 1972 (effective dale was

later extended to July 1, 1973 by P.L. 92-345, thenib July 1,1974

by P.L. 93-53), the 40 percent fir special projects was to be added

to the states' formula grants, with the result that 90 percent would

be allocated directly to the states through the formula grant programs_ However, states were required to include in their Title V

plans, provisions for conducting activities similar to those previously'

authorized under these special programs The ten percent allocated

to research and training continues to be awarded by the Depart

ment through project grants.

HEALTH INSIAANCE FOR THE ELDERLY AND HANDICAPPED

(MEDICARE)

A. Overview

Title XVIII of the Social Security Act (the Medicare program)

authorizes health insurance benefits for eligible elderly and hindicapped persons. Under *Medicare, direct payments are pliovided for

medical services on behalf of eligible participants. The prograni.is

Federally financed and administered by the U.S. Department of

Health and Human Services, with local administration carried out

through fiscal intermediaries, usually private health insurance

companies.

Title XVIII of the Social Security Act is divided into three parts.

Part A authorizes hospital insurance benefits, while art B provides

for supplemental medical insurance benefits. Part C of Title XVIII

contains miscellaneous provisions; including definitions of terms

C

40

Is
and coverage parameters for persons suffering from end stage renal

-disease.

Basic eligibility for Medicare benefits is extended to persons over age

65 who qualify for social security benefits. The following categories

of handicapped persons, however, also are eligible for Medicare

coverage under certain conditions:

(1) Disabled workers who have met the Social Secildo+ contribution

requirements prior to the onset of their disability SIM no longer

are capable of engaging in substantial gainful activity

(2) Perions severely disabled during childhood who are the dependents of persons eligible for Social Security benefits who have

either died, retired or are themselves eligible for disability benefits,

(3) Disabled widows or widowers aged 50 and order; and

(4) Any'individual suffeimg from end stage renal (kidney) disease.

8. Major Programs Affecting the Handicapped--

1 Hospital Insurance The Part A hospital insuras program

reimburses participating hospitals,"sicilled nursing facilities and home

health agencies for the reasonable cost of furnishing medically necessary inpatient and (limited) in-home services to eligible aged and

disabled Medicare beneficiaries.

Inpatient hospital stays are covered for the first 60 days in a benefit

period with a deductible piid by the beneficiary. A per diem coinsurance payment is also required for hospital stays from the 61st

through the 90th day A per diem coinsurance payment is required

for are provided in a skilled nursing facility after the 2.0th day of a

benefit period. Posi-hospital home health are services are reimbursable in full for up to 100 visits pet.calendar year. FY 1980 ft stimated) appropriations: S23.2 billion. =,t, Refer Title XVIII, Social Sepority Amendments of 196$, u

amended. P L 89-9/, P L. 90-248, P.L. 92-603, N... 93-233, P.L 94-182, P.L.

94-43/, P L. 95-210 and PL 95-292. U.S. Code. 42 U.S.C. 139$. C.P.D.A..

13.773.

2 Supplementary Medical Insurance. The Part B supplementary

modica_Asoranoe program is phased by Medicare-eligible elderly

ad- handicapped persons for a monthly premium. Part B pays for

80 percent of the reasonable charge, after a deductible has been met,

for doctor's services, outpatient hospital care, outpatient physical

therapy air speech pathology services, home health visits pot <-

covered under Part A, outpatient surgery, Xraist prescription

drugs that cannot be self-administered, ,and certain services of

41
chiropractors and podiatrists If the pr*titiontr does not accept the

Medicare reasonable chaise, beneficiaries are required to pay add'

tional costs above 80 percent of the reasonable charge for that

'particular service. FY 1980 (estimated) appropriations 59 6 billion

References. Part IL Title XVIII. Social Security Amendments of 1965, as

amended P L S9-97, P L. 90-248, P L. 92-603. P L 93-233, P L 94-182. P,

94 7 P L. 95.210' and P L. 95 -292. U S Code X.2 U SIC 1395 C F D.A

4,4Mal Disease Program, Under the end-stage renal (kidney)

disease program, Medicare coverage is provided to individuals under

age 65 for the cost of services and supplies furnished in connection

with the treatment of 4.1ronk, end,-stage renal disease. (Renal disease

patients age 65 and over are protested under the regular Medicare

program)

Generally. coverage includes inpatient hospital costs of thalysis.arul.

kidney transplants, the cost of physician services. out-patient hospital services and other out-of hospital rileclidIal services and supplies

References Part C. Title XVIII. Social Security At of 1965, as amended P

92-603, and P L 95-292 U S Code 42 U S C 1395

C. Legislative History

The Social Security Amendments of 1965 (P L 89-97) established

'the Medicare program under a new 'Rile XVIII In 1967, amendments to the Act (Pi. 90-244 directd Secretkry of Lialth,

Education. and Welfare to establish an advisory council to study the

question of providing health insurance for disabled Social Security

beneficiaries. The Adyisoty Council was'to, report its findings and

recommendations to the Secretary by Janualy I, 1969.

A Under the Social Security Amendments of 1972 (P4. 92.603),

Medicare coverage was authorized for disabled Socia unty

beneficiaries after they fulfilled a 24-morith waiting period. The

1972 amendments also extended Medicare reimbursement to persons

under 65 years of age who were suffering from chronic end-stage

renal disease In 1978. the Title XVIII renal disease program was

revised (PI ) 95 292) to authorize cost saving incentives and more

flexibility in utilizing different modes of treatment for renal disease,

kidney dialysis and transplantation.

In 1977. the Riiral Health - Clinics Act (11.1.; 95-210) amended Title

XVIII to permit Medicare reimbursement for nonphysician directed

services provided through rural health clinics. Rural health clinics

may be headed by a physician assistant or purse practitioner. how2° ever. they must have arrangements for ref,rral and periodic review

42

: 5 0 I
with a local physician and a nearbyhospital The dams must provide services prilna,tily on an outpatient basis.

GRANTS TO STATES FOR MEDICAL ASSISTANCE (MEDICAID)

4 A. Overview

Title XIX of the Social Security Act contains the statutory authority

forth federal-state Medical Assistance program, or, as it is better

known, the Medicaid program. Initially authorized under the Social

Security Act of 1965. the original statutory goal of the program

was to improve the accessibility and quality of medical tare for all

low income Ameiicans.

Although the 1965 legislation contained no special provisions

related to handicapped persons, in recent years Medicaid has emerged

as a primary source of finding for serviceCto severely disabled individuals both because the incidence of disability is higher among lowincome grows d due to subsequent amendments to the Act which

added (-mimed benefits for uistitulionalized mentally ill and

mentally retarded persons.

Eligibility for medical assistance is based on Financial need. Handicapped individuals may be eligible, if they Meet the following_

general criteria for participation:

(1) Gstegoncally needy States must cover (a) . all persons receiving

cash benefits under Title IV-A of the Social Security Act (Aid to

Families with Dependent Children), and4b) 'either all persons

teceivink cash benefits under Title XVI of the Act (Supplemental

Security Income) or, at least, those who meet additional, more

restrictive Medicaid - eligible conditions set by the particular state.

(2) Medically needy. In addition to categorically 'needy persons,

states may elect to cover, under their Medicaid plans, certain groups

of mdtviduals whose incomes are higher than the SSI or AFDC maximums, but who cannot afford needed medical assistance. A separate

income level is established for these "medically needy groups.

B. Major Programs Affecting the Handicapped Altx

Medicaid provides each participating state with broad flexibility to

design a Medical assistance program which meets the needs of its

citizenry, as a result. Medicaid programs differ markedly from state

to State Federal grant-in-aid fuhding is available' to match state

expenditures for medical care on behalf ofeligible clients, as specified

under an HEW-approved state plan The Federal share of reimbursable costs range from 50 percent to 78 percent, according to a

43
formula which takes into account the state's relative per capita

income FY 1980 (estimated) appropriations 512.6 billion

4 States are mandated under Title XIX to provide the following services

to categoncallymeedy Medicaid recipients without charge (a)

inpatient hospital services (except services in a mental hospital or

tuberculosis facility), (b) outpatient hospital services, (c) laboratory

and Xray services, (d) skilled nursing facility and Home health

services for mdmduals over 21 years of age,. (e) physician services,

(f) early periodic screening, diagnosis and treatment (EPSDT) ser- vices for individuals under age 21, (g) family planning, services, and

(h) certain rural health clinic services.

States may limit the amount, duration and scope of such mandated

services e , luriits on the number of days in a hospital or visits by a

.horlm health aide), as long as adequate care is provided. In addition,

states are requited to provide (a) arrangements to assure that remp-i

cents can get to and from needed medical services, (b) freedom, of

choice for recipients among qualified providers of care, and (c)

access to health services on a statewide basis.

States are permitted to offer the following types of optional services, provided they are specified in the state plan (a) private duty

nursing services. (b) clinic services, (c) dental services, (d) physical

therapy, occupational therapy and treatment for speech, hearing

and language- disorders, (e) prescribed drugs, dentures, prosthetic

devices, and eyeglasses, (f) other diagnostic:Screening and rehabilitative winces, (g) inpatient hospital, services, and skilled nursing

facility services, (h).intermediate care facility services, including

specialized ICF services for the mentally retarded, 0) inpatient

psychiatric services for individuals over age 65 and under age 21,

and 0) any other type of mental or remedial care rkognized

under state law and approved by the Secretary of Health and Human

Services.

References. Title XIX, Social Security Act Amendments of 1965, as amended.

PA.. 89.97, P L. 90.248, P L 91-56. P L 92-223, P.L 92-603, P L 9346, Pi

93-233, P L. 93-368. P.L.-34-182, PA, 95-142, and P L '5-210 U,S Code

42 U.S C. 1396. C F.D.A 13 714

C. Legislative History

The 1965 amendments to the pocial Security Act (Pt. 89-97)

added 'a new Title XIX to the Act, authorizing grantsi-aid to

states for the establishment of medical assistance programs. Now

known as Medicaid, expanded the previous "KerrMals" program of medi, aid for needy aged, blind, and disabled

persons and dependent children. Medicaid was aimed at individuls44
receiving public assistance, but also permitted states to extend cover- age to groups above the poverty level, or the "medically" needy. The

initial statutory goal of the program was to initiate, in all participating states, a program of comprehensive health care for needy persons.

This included statutory authority for Federal assistance to needy

aged persons residing in mental (and mental retardation) or tuberculosis vistuutions (provided at the state's option).

In the context of the. 1965 amendments, the provisionsestablistung

the Medicaid program were devised as a complement to Title XVIII,

the statutory authority for the Medicare program (see discussion on

page 40) Medicaid (Title XIX), however, differed from Medicare

(Title XVIII) in the following fundamental ways. (1) Medicare was an insurance program, under which recipients were to be eligible

only if they had contributed to Social Security, Medicaid, on the

other hand;Was intended as a program for individuals receiving federal cash assistance or other=financially needy persons, (3) Medicare

was to be adminismred and funded entirely by the Federal government, Medicaid was to be administered b$' the states and funded

jointly by Federal and State contributions, and (3) states, were to

have the option of covenfig a broader range of medicaLservices

under Medicaid than was the case under Medicare.

ts In an effort to curb the Medicaid program's rapidly escalating

costs, Title XIX was amended in 1967 (P.L. 96.248) by adding

provisions which (I) restricted the conditions under which the

Federal government would participate in the cost of services to

medically needy recipients,(2) specified reqpued and optional

services, {3) permitted 'recipients freedom of choice among qualified

providers; (4) required standards of care in skilled nursing facilities,

(5) mandated reviews of the utilization of medical services ander

Title XIX, and (6) required participating states to offer early and

periodic screening, diagnosis and treatment services to all Medi

eligible children.

In 1971, amendments tq Title XIX (P.I. 92-223) authorized Medicaid reimbursement for intermediate care facility services. Prior to

1971. ICF services were reimbursed under Title XI of the Act. ICF

services were statutorily defined as services designed to meet the

needs of individuals "... who do not require the degree of care and treatment which a hospital or skilled nursing facility is designed

to provide, but who because of their mental or physical condition

.require care and services (above the level of room and board) which

can be made available to them only through institutional

facilities ..." /

45

F 53

gp
P.L. 92-223 also amended the Act to authorize public institutions

for the mentally retarded to be certified as intermediate care facilities, unde,r the following conditions. (1) the 'primary Rprpose. of

the institution, or distinct part thereof, was the provision orhealth

and rehabilitative services to the mentally retarded, (2) institutional

residents participating in the program were receiving "active treatment", (3) the facility was in compliance with,,,standards prescribed

by the Secretary of IIHS, and (4) the states were maintaining their

prior level of state local fiscal support for facilities certified as ICE/

MR's. PAL. 92-223 also required the states to conduct Independent

Professional Reviews of the quality and appropriateness of services

to residents in [CF facilities.

In 1972, reimbursements under Medicaid were extended to inpatient

care for otherwise eligible mentally ill children, under 21 years of

age, 1n public and pri'ate psychiafric facilities In order to qualify,

the facility had to be (a) providing active treatment programs for

all eligible children, and (b) be accredited by the Joint Commission

on tl Accreditition of Hospitals In addition, participating states

were required to maintain at least their prior level of expenditures

on behalf of such chatid?en.

Numeroui other ntaJor and minor amendments to Title XIX have

been approved by Congress since 1965, hoWever, the abovementioned changes constitute the ones most directly relevant to

services and benefits for handicapped persons.

COMMUNITY MENTAL HEALTH CENTERSICT,

A. Ortreieiv

The Community Mental Health Centers Act of 1963, as amended,

is an important source of Federal support for services to mentally

ill children and adults These centers provide direct care, on an

inpatift and outpatient basis, as well as consultation to other

local agencies who may come in contact with mentally ill persons.

They promote general public awareness 9f programs relating to

mental health and the availability of services. Centeis also are

expected to provide specialized mental health services for children

or the elderly:

Eligibility for services is based on residence in a center's defined

"catcliment", area. centers funded under the Act may be public or

non-profit entities, and are authorized to charge fees for services,

based on a client's ability to pay.

54

46
. , . , B4Maior Programs Affecting the Handicap ed

- HT.Corrimunity Menial Health Cc ers Act authorizes a series of

glint; for planning, establishing, s mg andfnaintairung the operation of tented designed to offe coeprehensivc mental health

services,to citizens in a geograptucall efined catchment area. Each

center is rcquued. to provide the follow &services. (1) inpatient,

outpatient, and emergency mental health.seres, (2) assistance to

courts Id other public agencies in screening residents of the center's

catchment area whb are being considered for referral to a state i.

'mental health facility for inpatient treatment, to deternune if they

should be referred there, or if they could be treated through the

center .as an alternative to institutionalization, and (3) follow-up

Cafe fog residents pf its catchment area who have been discharged

from inpatient treatment at a mental heOth facility.

*N'411. eon'impnity %menial health centers also are requited to provide

.

consultation and education services which. (1) cater to a wide

range of individuals and entrues,involved with mental health services,

inciudinaealth professionals, schools, courts, state and local law

4 enforcemen t and Correctional agencies, members of the clergy,

public ±,veIfar j encies, and health, serncesagencies, and (2) include

a wide range a ties (other than direct clinical services) designed

to develot e we mental health programs in the center's catchment area, condinate thp provision of mental'health iervices among

various entities wiring ,the center's catchment area, increase awareness of the nature of mendr4ealth ,problems and the types of.

serviits" available, and promote the prevention and control of rape

and the proper treitinent oft victims'

New community metal health centersrhave thre,e years to develop

tiff aboveprogram,s. After that pepod, a center is expected to establish (1) day 'tare aria other palml hospItaiza on services, (2) a

prograni of specialized services for the me health of children,

including a full range of diagnostic, treatment, liaison and follow-up

services, t(3) a similar .program of specialized 'services for elderly

"0 perions, (4) a program of transitional halfway houses to assist de-

' institutionalized mental patients or individuals who otherwise would

be placed in a mental institution, and (5) progiams for the preven;

tion, treatment and rehabilitation of alcohol and drug abusers, in

areas where such services are needed. ;

FY 198d appropriations. 5178'1 million for initial operation grants,

i 19 million for consultation and education activities, $1.8 milli°

-"Tor converting to newly required services, and SI.2 million for gra&

to finncially distressed centers.

47

-55

I

se
- 4

References. Community Mental Health Centers Act of 1963, u amended P L

88-164, P.L. 89-105. P.L. 90-31, PI 91-211, P L 93-45, P.I. 94-63, and P L.

95422. U.S Code 42 U S C.2681. C.F D A 13 925

, . C. Legislative. History

The Community Mental Health Centers Act. originally was authorized una'eijitle II of the Mental Retardation Facilities and Community Mental Health Centers Act of 1963 (P. 88-164). The

1963 Act authorized grants to states to assist m e construction

of public or nonprofit community mental heal centers. The.

. facilities were to house service programs aimed at, the prevention

or diagnosis of mental illness, care and treatment \c,f mentally di

persons, and rehabihtation of persons recovering from mental illness.

Allotments of funds to the states were based on a formula that took

into account the sflite's relative population, need for mental health

services and financial need

'

In 1965, amendments to the Act (P L. 89-105) authorized a program

of grants to cover the costs of staffing community mental health

. centers with technical and professional personnel, during the rust

51 months of operations. The 1967 amendments (P.L. 90.31)

extended the authority construction and initial staffing grants

through fiscal 1970, a d permitted funds to be used for the acquisition and/or renovation of existing buildings to serve as centers

The Coinmunity Mental Health Centers Amendments of 1970 (P.L.

9.1 -211) provided for a three-year extensidn of construction and

staffing grants. P.L. 91.211 also contained a new project grant program to allow centers to provide mental health' services to children.

Federal share of fundihg for construction was raised to two- . - thiMs in nonpoverty areas and 60 percent in poverty areas. The

maximum duration of staffing .grants was extended to eight years,

with a declining level of Federal aid ranging from 80 percent funding

ai the first two years to 30 percent in the sixth through the eighth

years. . A

I' 4 Title III of the Special Health...RevenueSharing Act of 1975 (P L.

94.63) significantly revised and expanded the Community Mental

Health Centers Act, Applicants for grants under the Act were reowed to plan for and provide a comprehensive range of mental'

health services. P.L. 94-63 restructured the financing of centers

by expanding grant programs for construction and staffing to the

following six types of grants. (1) grunts to help public and non-

* profit agencies plan for the .development of community mental

health centers, (2) initial operation grants to assist public or nonprofit centers in meeting the start-up costs associated 'with running a

2,

111.

A 48

5 (;
center, for a maximum, period of eight years (with a deckung

Federal share over the period), (3) consultation and education grants

to centers, (4) conversion gnats to provide Federal assistance to

eidsting centers for expanding their services to meet the comprehensive-services. mandate, (5) financial distress grants for centers in

danger of having fc reduce the types or quality of services provided

due to the termination of staffing and Operating grants, and (6)

facilities grants to states for purchasing, renovating, feasuig and

equipping community mental health centers and for the construction of centers serving poverty areas:

In 1978, amendments to the Centers Act (I' L 95-622) eased the

requirement.; for the provision of comprehensive services' by allowing centers to develop their programs in two stages. To open, centers- - were required to provide (1) inpatient, outpatient and emergency

services, (2) assistance in determining the need to institutionalize

an individual, (3) follow-up care for demstitutionalized mental

patients, and (4) consultation and education services. After three

years of operation, centers had to be prepared to provide a comprehensive array of community mental health services.

114 NATIONAL RESEARCH INSTITUTES Ix

A. Overview

Title PJ of Ihe Public Health Service Attauthorizes a broad array of

biomedical research activities, many of which directly or indirectly

relate to the diagnosis, treatment and prevention of various types of

disabling conditions. Generally, the national research institutes

established under Title IV. provide:

(I) for the conduct of intramural research in Federal government

laboratories;

(2) support for extramural research conducted in universities,

hospitals and research. institutions the . United States and

abroad;

(3) assistance to nonprofit institutions to build and equip bio.

medical research facilities,

(4) suet for training of career research scientists; and

(5) ways.to cornmunidte biomedical information to scientists,

health practitioners and the general public.

49

4 57

ti
I.

7 B. Major Programs Affecting the Handicapped

1 Arthlitis. Rheumatism, Diabeles and Other-tetabolic Diseases.

The National Institute on Arthritis, Metabolism, and Digestive

Disea§esj authorized under Part D of Title IV, conducts research

related to (1) arthritis. bone and skin diseases, (2) diabetes, eldocri

nolioR and metabolism, (3) digestive diseases and nutrition,and (4)

kidney diseases, urology and hematology

Rtferemes Part D, Tale 1V , Pubh% Head Service Act, as amended P L 89692,

L 92-305. P L 9j354, PI, 93440. PA, 94.562. and P L 95.83 L Sr. Code

42 SC 281c CFDA 13846, 13847. 13848. and 13849.

2 'Neurological and Communicative Disorders and Stroke. The

National Institute of Neurological and Communicative Disorders

and Stroke, authorized under Part D of Title I1;- provides grants and

contracts for research into (I),corrimurucative disorders, (2) neurological disorders, (3) stroke and nervous system trauma, and (4) the

fundanientil neurosuences. The study of epilepsy ,. cerebral palsy

and multiple sclerosis are mclu4ed in the statutory purposes of this

Institute FY 1980 appropriations 5243 million.

Reference% Part D, Title 11.0 Publt% Health Service Ai.t. as amended P L 89.239.

P L 93-348. P L 94.278 and P L 95.83 U S Code 42 U,S C 289a CFDA

13 851, 13 852, 13 853 13 854

3 Child Health and Human Development The National Institute

of Child Health and Human Development, authonzled undegart E

of Title IV, .onducts biomedical and behavioraVesearch studies into

6undititins related tomentak retardation and other developmental*

disabtiQies, Sudden Infant Death Syndrome, and other conditions

;elated' to child growth and development, including maternal and

infant care. FY 1980 appropriations 5209 mWiOn.

References Part k, Title . Publx Health Scrim A.A. as amended P L 87.838,

L, 91-572, P.L 93-270, P L 94,278 ACP L 95-83 U S Code 42 USCi

289d CFDA 13 86and 13 865

4, National bye institute The National Eye Institute, authorized

under Part F ofJitle, XV, supports research into (1) retinal and

choroidal diseases, (2) corneal diseases, (3) cataracts, (4) glaucgrna,

and (5) sensory and motor disorders of vision. FY 1980 appropriations 5113 hon.

1

References Part Ale 11.0 Pubh., Health Service Act. as amendeLt P L 90-489,

PL 94.278 and PL 95.83 US Code 42USC 2891 CFDA. 13 867.13 868.

13 869. 13 87Q and 13t7)

NOTE Oilici Icxar..li plograins are being conducted' y the Na

tional Cancer Institute. National. Heart Lung and Blood Institute,

58

50
National Institute of Allergies and Infectious Diseases. and the National Institute of General Medical Sciences.

C. Legislative History

The Public Health Service Act of 1944 (PI 78410) provided

teal structure for research into a number of diseases and health problems confronting the nation Title IV of the Act established several

national relarch institutes In 1948, the National Heart Act (Pl.

84.655) amended the Public Health Service Act to support specific

research and training into diseases of the heart and circulatory

system.

In 1950, the PHS Act amendments (P.L. 81-962) provided for re.

search and training into questions relating to arthritis and rheumatism, multiple sclerosis, cerebral palsy, epilepsy, poliomyelitis,

blindness, leprosy and other diseases The National Institute of

Child Health and Human Development and the,,,tiational Jistitute

for General Medical Sciences were established under 1962 amendments to the Act (P.L. 87.838).

More recent amendments to the Public Health Service Act ;elated

to research activities have included. (1) the National Diabetes

Mellitus Research and Education Act of 1974 (P.L. 93-354), (2)

the National Arthritis Act of 1974 (P.L. 93-640), (3) the National

Research and Health Services Amendments of 1976 (P.L. 94-278),

(4) the Arthritis, Diabetes, and Digestive Diseases Amendments of

1976 (P1. 94562), and (5) the Health Services Programs Exten- . sion Act of 19/7 (P.L. 95-83).

OTHER HEALTH PROGRAMS AND SERVICES

A. 'overview

The Public Health Service Act is a major, long-standing source of

federal support for basic health care services. Handicapped citizens

benefit from both the Act's support of general preventive health

services, and the spec:allied programs targeted at ameliorating

diseases and conditions which may lead to illness or disability.

B. Major Programs Affecting the Handicapped

1. Pram' non. Prevention activities autllorned under the Public

Health Service Act which relate most directly to handicapping conditions include (a) control of communicable diseases that lead to

disability,.(b) prevention of-lead-based paint poisoning, which can

cause mental retardation, (c) screening, and counseling for genetic

. '

51
1 diseases that may result in disability at birth, (d) hemophilia treatment centers, and (e) physical lances, a. Control of Communicable Diseases. Section 317 and 318

of the Act authorize project grants to state health authorities

to support the control, through immunization and other activities, of diseases or conditronfamenable to reduction. Targeted

diseases or conditions include tuberculosis, rubella, measles;

pohom itisc diphtheria, tetanus, pertussn, mumps, venereal

disease, and-ether communicable diseases, as well as arthritis,

diabetes, hypertension, pulmonary diseases, cardiovascular

diseases and RH disease FY 1980 appropnatiops S65 5 million.

References Title III, Public Health Service Act. as amended P L. 92-449, P,L

94-317, and P L 95.626 U S Code 42 U SC. 247b-c. C -F DA 13 268

b. Prevention of Lead-Based Paint Poisoning Section 316 of the

Act authorizes project grants for the development of compre- . henswe lead-based paint poisoning prevention programs in local

communities, and the establishment of state laboratory facilities

for detecting and analyzing levels of lead in the environment.

The program focuses on screening of children, follow-up services

and protection from further exposure to lead sources. Lead , poisoning has been shown to cause mental retardation and other

health problems. FY 1980 appropriation S10 million.

References Title III, Public Health Service AA as amended P L. 91-695, P L

93-151, P 94-317, Ind P L 95676: US Coda 42 t5 SC 4801 C F.D A

13166.

c. Genetic Diseases Research. resting and Counseling Services.

Title XI, Part A, of the PHS Acts authorizes project grants to

establish and Operate voluntarii genetic testing and counseling

programs. State and local public agenciesand nonprofit organizations ate eligible, for the project grants Semces are aimed at high

risk populations. F Y. 1980 appropriations. S4 million

Part A also authorizes grants and contracts to support basic research into understanding. diagnosing, treating ind controlling

genetic diseases Funds are awarded to 'universities, hospitals,

labpratones, other institutions, state and local government

agencies, or certain individual researchers 'Activities may include

education, training and public awareness concerning genetic

. diseases, as well as the developtheht of model ttsting and counsel

mg programs Priority may be given to applications for research .

Into sickle cell anemia or Cooley's anemia. FY 1980 appropriations: $95.8 million. -

52

fhi
References. A, Title XI, Public Health Same Act, as amended. P L. 92 .414,

P.L. 92-214, P. 94-278 and P L. 95.626 U S Code 42 U.S C. 300b. C.F D.A.

13 862 and 13.8

d. Hemophdo Treatment Centers. XI, Part C of the PHS

,Act provides for project grants to state or local public agencies or

nonprofit organizations to develop comprehensive diagnostic and

treatment centers for perspns with hemoptula. 'Riese centers are

requited to provide. (1) access to services for all individuals with

-hemophilia in the project's geographic "catchment" area, (2)

personnel tralrung, (3) programs of social, vocational"and genetic

counseling, (A) a wntten comprehensive care plan, and (5) training in home care. FY 1980 approinations. 53 million.

References. Part C, Title XI. Public Health Service Act, as amended. P.L. 94-278

and P L. 95426. U S.C. 300c, C.F.D.A. 13.296.

e. Physical Fitness Improvement. Title XVIII, Section 1708 of

the Aet authpnzes project grants and contracts for physical

fitness. improvement Funds may be awarded to public or pnvate

entities to conduct research and develop model projects. Projects

may encompass communiues, educational settings for specific

age groups, or groups of handicapped individuals.

Referencetl} Title XVIII.. Public Health Service Act, Pi. 95.626 U.S. Code

42 U S C 300u. C F R.A. 13 289

2. Mental Health Programs. Title III of the Public Health Service

Actaglprizes mental health revrcli, training avd statewide p14-

wig and service provision Research and trainin s under

Section 301 and 303 of the Act include ental health research

grants, 12) mental hospital improve nt and staff development

grants, (3) mental health clinical or service related training grants,

arid (4) mental health research personnel, awards. FY 1980 appro.

priations.'5236 million.

Formula grants tp states for comprehensive mental health planning

and services are authorized under Section 314(g) of the Act. State

mental health plans are incorporated into the state's general health

fan, developed under Title XV of the Act (see page 56). State

mail] health authonties are funded under the Act to perform the

following functions. (I) develop and administer the state mental

health plan, (2) prescnbe and provide for the enforcement of minimum standards for the maintenance and operation of mental health

facilities and programs, including community mental health centers,

(3) provide assistance in screening persons who may be placed in

mental institutions and follow -up services for discharged mental

patients, ind (4) develop a plan to prevent inappropriate

53

6

e.
t

institutionalization, provide alternatives, and-protect the mterests.

of employees of institutions who may be affected by the decline in

institutionalization FY 1980 appropriations 57 6 million.

Mental health programs are administered at the Federal level by the

National Institute of Mental Health, established under Part G, Title

IV of the Act.

f

References 'ink III. Public Health Service Act, as amended P L 88.164, P L

89-109, P L 91 -211, P L 91-515. P L 9443, P L, 95422, U S Code 42

C 242 C,F D A 13'237, 13 238, 13 242.13 244.13 281. and 13 210

3 Ethical Conneferartorp. Title XVIII of the Act establishes the

President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research Among the statutory

aims of the Commission is the study of issues concerning hands

capped persons, covering (a) the protection of human subjects in

research, including mentally incompetent and institutionalized

persons, (b) the requirements for informed consent, and Zc) the

protection of privacy Other issues to be studied by the CommisSion include (a) defining "death". (b) voluntary genetic testing

and counseling, (c) differences in the availability of health services in

regard to a person's income or location. and (4:1) confidentiality of

records

References Title X% iii. Public Health Service Act. P L. 93-348 and P 1. 95422,

S. Code 42 C S C 300v

C. Legislative History

I Prevennon. Title Ill of t he Public Health 'Service Act of 1944

(P L 78-410) established the general powers and duties of the

Federal Public Health Serpce, including a number ,A prevention

activities The following amendments to,the Act further enhanced

the prevention functions of the Service

a In 1962. the Vaccination Assistance Act (P.I. 87-868) provided assistance to state and community health agenciesto carry

out intensive vaccination programs, particularly for preschool

children, against polio, diphtheria, whooping cough and tetanus.

The Act wad later extended by the Communicable Disease Control Amendments of 1970 (P.L791-464), 1972 (P.L 92-449), and

1976 (P.L. 94.317).

b In 1970, the Leadbased Paint Poisoning Prevention Act (P.L.

91-695) was enacted to authorize Federal assistance to protect

children from the dehilirming effects of lead in their ennron.

ment. The Act was later amended and extended in 1974 (P.L.

93.151),1976 (P.I. 94.317) and 1978 (P.L. 95426),

. 62

54
I

;

- -C. Research into the genetic or hereditary causes. of Cooley's

anemia and sickle cell apenua, and testing, counselin &and treatment of these'cliseases were authorized in 1972 by the National

Cooley's Anemia Control Act (Pt. 92414) and the National

Sickle Cell Anemia Control Act (P.L. 92-q94),

d. The Health Research and Health Semces Amendments of"

1976 (P.L. 94-278) replaced the sickle cell anemia and Cooley's

anemia programs with an expanded authority applicable, to all

genetic diseases, with priority retained for anemia projects

Amendment; to the Act In 1978 (P.L. 95626) expanded the

description of genetic conditions covered under the Act to

Include mental retardation and other genetically-caused mental

disorders;

e. P L. 94-278 and P.L. 95626 also provided for the establishment of hemophilia research and, treatment centers, and

1. Programs administered by the former Office of Physical

Fitness and Sports were transferred into a new Office of Health

Information and Health Promotion by the Health Services and

Centers Amendments of 1978 (P.L 95626) Under the legislation, physical lanes programs were extended and revised to

emphasize health promotion.

2. 111ental Health Programs

Mental health, research, training and statewide planning and senkes

were originally authorized under Tide I11 of the Public Health Service Act, as amended in 1946. The National Mental Health Act of

1946 (P.L. 79487) provided for research relating %o psychiatric

disorders, and aid in the development of more effective methods of

prevention, diagnosis and, treatment of such disorders. The 1956

amendments to the Act (P.L. 84-911) authorized the training of

mental health personnel.

State level mental health planning and semces were added to Section 314(d) of the PHS Act by the Comprehensive Health Planning

and Public Health Semces Amendments of 1966 (P.L. 89-749). The

legislation stipulated that fifteen percent of the funds appropriated

for comprehensive health services under Section 314(d) were to be

set aside for state mental health programs..

In 1965, amendments to Title III (P.L. 94-63) required state mental

health authorities to submit demstitutionalization plans and to

perform oilier functions including aandaid-RttIng,saeerung lierits

before commitment to a mental institution, and follow-up services

for discharged patients. The Community Mental Health Centers

55

63
Amendmenti of 1978 (P L 95:622) pulled state mental health

planning and services out of Section 314(d) and established it as a separate authority under Section 314(g), with a separate funding

authorization The planning functions of state mental health au- thorities were expanded by provisions coordthatingilhe mental

, health plan with the state health plan developed under Title XV of

the PHS Act ee page 56).

3 Commission on Ethical Issues Medicine Reflecting the growing

national concern over the adequacy dr procedures for reviewing

and monitoring research projects involving human subjects, especially mentally incompetent, institutionalized individuals, Congress.

in 1974, established the President's Commission on Protection ofHuman Subjects of Biomedical and Behavioral Research Authority

for the Commission was contained in the National Research Act

of that year (P L 93-348) The Commission was reauthorized and

its mandate broadened under the Public Health Service Act Amendments of 1978 (P.L. 95.622) At that time thr Commission was

renamed the President's Commission for the Study of Ethical

Problems in Medicine and Biomedical and Behavioral Research and

its authority placed in a new Title XVIII of the PHS Act.

HEALTH PLANNINGAND RESOURCE bEVELOPMENT

A. Overview

Titles XV and XVI of the Public 'Health Service Act establis44. rational program to stimulate unproved health planning and resobrce

development These planning and development activities are aimed

at the orderly and cost effective growth of institutional and noninstitutional health care services in the United States, The main

goalt of the program are to (1) improve the health of American

citizens, and (2) increase accissibility (including overcoming geo.

graphic, architectural and transportation barriers), acceptability,

continuity and ,qualitP of health services. In addition to addressing

the general health-care needs of all Americans, the mechanisms and

programs authorized under Titlo XV and XVI of the Act are

intended to ,deal with the special health and,related service needs of

handicapped cluligin and adults.

B. Major Programs Affecting the Handicapped

I State and Aregivide Health Planning Under Title XV of the Act,

project giants are awarded to specially designated state and areawide

health 'planning agencies to carry out health planning activities.

This planning effort is aimed at addressing problems in health care delivery, such as the maldithbution of facilities and personnel and

56

64

SRi
the rapidly escalating co of health care. Each Health Systems

Agency and State Health rdinating Council, desigiated under'the

7\ Act, must .develop and maintain an areawide or state health plan,

yehich meets muumurhospecifications set forth in the legislation

and implementing Federal regulations. In addition,,the state and

local health planning agencies are required to perfOrm "certificate

of need" reviews for all proposed new or expanded institutional

health care facilities, including facilities certified as Medicaid or

Medicare providers. The purpose of these reviews is to assure that

a need exists for additional health facilities in the particular geographic catchment area FY 1980 appropriations. S30 million for

state-level planning and 5115 million for area He Systems

Agencies.

References. Title XV, Pubhc Health Service Act P 1, 93-641. U S. Code 42

U.S C. 300 (1-m). C F.D.A. 13 293 and 13 294

2. Medical Facilities Modernization Loans. Part C of Title XVI

authorizes direct Federal loans and guarantee,d mortgage loans

to cover the costs of constructing medical facilities in areas where

additional inpatient and outpatient faaties are needed due to

rapid population growth, and to modernize existing medical facilities in othq parts of the country. State and local governments and

other entitles having bonding authority are eligible for dire& loans..

Private nonprofiNgarnzations are eligible for guaranteed loans.

Funds may be used for- expandIng, remodeling, or replacing facilities, however, all such projects must have received the prior approval of the responsible state and local health planning agencies. FY

1980 appropriations. 548.9 million.

References Part C, /rale XVI, Publicilealt ice Act, P L.93-641 U.S Code.

42 U.S C 300q, C F D A. 13,253

3. Medical Facilities Construct n. Project grants are authorized

under Title XVI, Part D, for construction and modernization of

medical facilities and to assist in the preventionor elimination of

safety hazards in pubhclrowned of Operated medical facilities.

Grants may also be made to help facilities come into compliance

with licensure or accreditation sividards. Awards are made to public

or quasi-public agencies, or organizations owning or operating

medical facilities. This program was dot funded In FY 1980.

References. Part D, Title XVI, Public Health Service Act, P 1, 93-641. U.S.

Code, 42 U S C. Mr. CF DA , 13 887. . . C. Legislative History

-Planning and resource development has been an important activity

under the Public Health ,Service Act since 146. The Hospital

57

u

:r

gin
Survey and Construction Act of 1946 (P.L. 79.71 rovided assistance to help the pates both determine the need for new hospitals

and develop hospital construction programs States which applied

for funds were required to establish a state advisory council to

consult with the state agency responsible for surveying and building

hospitals. - The Comprehensive Health Planning and Public Health Service

Amendments of 1966 (PI, 89-749) significantly expanded the national focus on pomprehensive health planning activities P.L. 89-749

auth6rizid grants to the state for comprehensive planning, with

allotments based on population and per capita income. The 1966

amendments also provided for project grants to support (I) areawide health. planning, (2) health services development, (3) training

stitches, and (4) demonstration projects

This comprehensive health planning authority, was revised and

extended by amendments to die Public Health Service Act in 1967

(P L 90-147), 1968 (P.L. 90-574). 1970 (P.L. 91.515), and 1973

93.45).

The National Health Planning and Resource Deve

1974 (P L 93-641) consolidated the former comp

planning and regional medical programs under a new Title

the Public Health Seryice Act.. Health planning agencies,'fo

first time, wer,e given authority to enforce their plans throug a

regulatory mechanism ,called "certificate of need." tinder the 1 74

Act. all proposed new construction of health facilities or addition of

services was to be subject to prior review and approval- by state

and local health planninf agtncres These planning agencies were

also given a role in approving Federal health and mental health

wants, contracts, loans and loan guarantees made under the Public

Health Service Act and the Community Mental Health Centers

Act.

P.L. 93.641 also (1) established a nationwide network of public

and nonprofit agencies called Hea,lth Systems Agencies (HSA) to

be responsible for health and mental health planning and resource

development in specified geographic areas, (2) required the states

to create State Health Planning and Development AgenCtes to

health planning and development functions These agencies,'

in turn, were to receive advice from Slate Health Coordinating

COuncils. (3) established a National Health Planning and Information

Center, (4) creak-cl I National Advisory Council on Health Planning

and Development to advise the Secretary of US, and (5) authorized

Federal aid to the states for health planning and development.

58

6c
R

Federal involvement in the construction of health facilities also

began with the passage of the hospital Survey and Construction.

Act of 1946 (P.L. 79-725), the "Hill-Burton.' Act. The Act authorized grants to assist states in the construction of public and nonprofit hospitals. In 1964, the Hill-Harris Hospital and Medical

Facilities Amendments (P.& 88-443) consolidated and revised the

1946 legislation relating to hospital and medical, facility development. The 1964 amendments also authorized grants to state agencies

for the construction of public or nonprofit facilites for long term

cue, dugnostc or treatment centers, and rehabilitation facilities

The Medical Facilities Construction and Modernization Amendments

of 1970 (P.L. 91-296) authorized grants, loan guarantees and direct

loans for the construction and m =anon of hospitals and other

medical facilities. The amendment milted grant funds to be

used to construct or modernize em racy rooms in general hospitals and for the eSiation of health programs.

The Health Planning and Resource Development Act of 1974 (P.L.

93.641) once again revised health facilities construction and modernization programs rued funding for developing new health

resources. These programs were rgaruud under a new Title XVI

of the Pubic Health Service Act. Under the 1974 legislation, the

statutory requirements of Title XVI were coordinated with the

health planning provisions of Title XV.

MILITARY MEDICAL BENEFITS ACT (CHAMPUS)

. The Military Medical Benefits Act Amendments of 1966 (P.L 89-614) a

expanded health care benefits for dependents of active duty members

of the uniformed services (the Army, tlavy, Marine Corps, Au Farce,

Coast Guard and the commissioned corps of the Public Health Service).

Among the expanded benefits of the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) was coverage for certain

services to handicapped dependents.

Under the CHAMPUS Program for the Handicapped, the spot ustor

I- Child of an active duty member is eligible for semen if he or she has a

serious physical handicap or is modeptely to severely mentally retarded.

The dependent's condition, however, must. (1) be expected to result

in death, have Lasted for 12 months and be expected to last for at

least another 12 months, and (2) keep the individual from engaging in

gibstantially productive activity of daily living expected Of ummpaued

. . individuals in the same age group.

The Program for the Handicapped covers the f !lowing health and

tipshication.related costs (I) diagnosis, (2) inpa , outpatigu. and

6

. 59 Ale
,-.. home treatment, (3) tramtng,yehabilitation and special education, and ,

(4) institutional care in public and private nonprofit institutions and

facilities, and transportation to and front such facilities when necessary. . . The law provides for 1 sliding scale of monthly deductibles payable by

the active duty member, based upon his or her pay grade. Those in the

lowest enlisted pay grade are required to pay the first 325 each month

of expenses incurred by their dependents Four star generals And

admirals are similarly required to pay the first 5250 each month. All

other active duty members with participating dependents pay amounts

in between these statutory limits, as determined by the Secretary. of

Defense However, CHAMPUS will not pay benefits under the Program

for the Handicapped, when public resources are available to the handicapped dependent in the same manner and to the same extcnt as any

other citizen of the local community or state. . The Program for the Handicapped was established bJcause of the

recognition that payment for the special needs of mentally retarded and

physically handitapped dependents is frequently such a drain on the

financial resources of the serviceman that it prevents him from main- .- taming an acceptable standard of living In addition, handicapped

dependents of servicemen on)ctive duty may not qualify for public

programs because they do nckteet residency requirements.

. ,-- In 1971, amendments/to the Act (P L. 92-58) extended benefits under

r''' the Program for theeartapped to an unmarW,chdd, under age 21,

of a deceased service, member who died while 'eligible for hostile fire

pay or from a disease or injury incurred while eligible for such pay.

Referenas Military Medical Benefits Act, as amended P L 89-614 and P L.

92-58 ELS Code IOU SC 55 ..-- -

1 1

i

$

.. 60

66

,

...---------"..

.. .

;

0

I
. UNITED STATES HOUSING

ING

CT OF 1937*

%"`

A. Overvjew

The Housing Act of 1937, as amended, authorizes two programs that

may be used to assist handicapped and elderly persons obtain suitable

living accommodations. Section 8 of the Act provides for a program

of direct housing assistance payments, or rent subsidies, on,behalf of

low-income families. The basic statutory aim of the,so-called Lower

income Housing Assistance program is to help economically disadantaged families obtain "a decent pee to live` and to promote

"economically mixed housing."

Section 7 of the Act authorizes congregate housing services fourderly

and handicapped persons. Congregate housing servicesarejefined as

a combination of residential shelter and social services,such as meals,

housekeeping assistance, and help with grooming and personal

hygiene.

B. MajorlFrograms Affecting the Handicappod

c_ ..."'"

1. Rent Subsidies The Lower' Income Housing Assistance program

aiithorizes' direct payments to participating private home owners and

public housing agen4ies in return for furnishing decent, safe and sane

tary housing for certain low income families. Housing assistance pay

ments,are used to make up the difference between the maximum

apprutd "fair market" rent for the dwelling unit and the occupant

family's net ificorfiel Assisted families are rdquired, by _law, to

contribute betweeli 15 and 25 percent of their adjusted family

income toward rent. As defined in the Act, the term lower income

family" includes single handicapped persons. The term "handicapped" refers to persons who have an-trivonnent which (1) Js

expected to be of long - continued and indefinite difratIon, (2) sub -

stantially impedes his or her ability to livenindepeodently, and (3) is

of such a nature that the person's abilities Could be expected to be

improved by more suitable housing conditions.

-..,, 61

( 60
vie

The Section 8 program is aimed not only at the need. to increase

the rent-paying capacity 4low-incume families, but also to stimulate

the production and rehabilitation of kw-income housing. Section 8

assistance is administered as four sepdrate, but parallel programs.

/according tofthe tollowrng types of housing (1) existing housing, (2)

privately developed new or )ubst.intidlly rehabilitated housing, (3)

publicly developed new or substantially raiabihtated housing, and

(4) new state agency-sponsored housing developments, lb; which

Section 8 set-asides are allocated FY 1980 appropriations SI 1

billion

Rcicrcoei,1 Ifittucin, '4.ct A 017 s, s twndcd p I 93 3K1 P L 94 375 and P L 95.557 l S ( ode 42 1. SC 14371 C I I) 1 14 156

2 Congregate Housing The Section 7 congregate housing services

program is aimed at enabling functionally impaired persons to remain

'substantially independent, within their own residences, and thus

asoid unnecessary institutionalization The program provides fob

3-to-5 year contracts with local public housing JUillOrrhe5 or Section

202 elderlyThandicapped housing sponsors Contractors are responsible .ior turrushIng otherwise unavailable social services to frail

elderly and handicapped tenants A full food service program (at least

two meals per day seven days per week) is the minimum service

which a contractor must proyide -however, the sponsor is given (Iva.

Imlay in deseloping other sctual services designed to meet the needs

of impaired tenants r- /-

Applicants serving nonelderly handicapped persons are obliged to

consult with agedues responsible for serving the handicapped, inchiding vocational rehabilitation agencies, developmental disabilities

councils, and state mental health/mental retardation agencies FY

I 9,80 a ppropriit ions S I 0 million

References ifous:ng Act of 1937 as sinsnded P L 91.609. P L 93.383, and P L

95.557 U S Code 42 1.) S C 1437e

C, Lekilative History

I Rent S'ubstdtes The first attempt .to federalltsubsidize ,. families in

privately owned and managed housing came and r Section 23 of she

Housing Act 01.1265 (P L 89-117), the so-called Leased Housing

Program This program allowed local housing authorities to lease

apartment units available in the private housing market Eligible lowmcome families were placed in these units and the federal government

pad the difference between the monthly rent and 25 percent of the

family's adjusted income

62

ft%

EA.(
(

The Housing and Community Development Amendments of 1974

(P 1'93-383) expanded the Section 23 program into a w Lower

Income Assistance program, established as Section 8 of the sing

Act of 1937 (P,L, 75412) The 1974 amendments defined "lowincome tamales,' for purposes of Section &to include families con

soling of single persons who were disabled as defined in Setion,223

. , uf the Social Security Act, or Section 102 of the Developmental

Disabilities Act Familie e also defined to helude two or more

gi# elderly. disabled or h Aped individuals living together, or one

''% or Tore persons living ith another determined to be essential to

their care and well beopg

The Housing Authorization Act, of 1976 (P L 94-375) prohibited

rent subsidy payments under Section 8 from being counted as income

, in deterniininjkvhethei an aged or handicapped person was eligible

fur Supplemeifial Security [myrtle benefits. This provision was intended to prevent certain needy elderly and handicapped persons

from suftering a reduction in their SS! benefits when they move into

a-Federally-assisted housing project

The Housing and Cunernimity Development Amendments of 1978

(P.L 95.9557) authorized funds for "moderate rehabilitation" projects in Section 8-subsidized existing housing units The new provi- ' slims scaled Fair Market Rents in rehabilitated units to the amount

of the owner s investment in the project In 1978, Section 7 c the

Act was revised fuller (P L 95-557) to authorize direct federal support for the provision of congregate services to elderly and noneldeb_clisabled Pei suns Under the new la nguage ,HUD was permitted

ocenter into contracts with Section 202 housing sponsors and iti%1

public housing authorities fur the proftion of congregate housing

I services to such persons These contractors were obligated to furnish 401" otherwise unavailable social services, including meal services, to frail

elderly and nonelderly disabled persons

4 HOUSING ACT OF 1949

A. Overview

i

Title V of the Housing Act of 1949, as amended, authorizes direct

and insured loans for the development and rehabilitation of rural

housing Handicapped persons were made eligible to participate in

such rural housing programs under the Housing and Community

Development Amendments of 1971(P L 95.128)

Among several. huusi9g assistance program's authorized under Title

V, the Rural Housing Loan program and the Rural Rental Assistance

63

. 71 q

d 4

N

#A, ...-..
Payments program offbr the greatest potential benefits to handicapped persons

For purposes of Title V programs, a person is considered handicapped

if he or she is darmined to tiave an impairment which (I) is expected to be of long-continued and indefinite duration, (2) substantially impedes his tit her ability to live independently, and (3) is of

such a nature that such ability 'could be unproved by more suitable

housing conditions A person is also considered to be handicapped if

he or she has a developmental disability, as defined iii the Developmental Disabilities Services and Facilities Construction Act of 1970

B. Major Programs Affecting the Handicapped

1 Rural Housing for Elderly and Handicapped Persons. Section 515

of the Act authorizes guaranteed/insured loans to assist in the purchase, construction, improvement or repair of rental or cooperative

housing for elderly and handicapped tenants in rural, areas. Loans

may be made to individuals, cooperatives, nonprofit organizations,

trusts or rartnecships The proceeds of such loans may be used to

finance (a) the construction of congregate housing, (b) certain

specially designed equipment required by handicapped persons, such

adjustable work surfaces and grab bars, and (c) certain

related services or recreational facilities. FY 1980 appropriations

S868 million

References_ Title V, Housing Act of 1949, az amended P L. 89-754, P.1, 93.383,

and P L 95-128 u 5 Code 42 US C 1485, C.F D.A 10 44 5.

2 RuralRental Assistance Payoents Section 521 of the Act author-0

izes a program of direct subsidies to reduce the effective rents paid

by low - income farnMes, including elderly and handicapped families

or individuals, residing in rural rental housing, rural cooperative

housing or farm labor housingprojects The Section 521 rent subsidy

program is patterned after the Section 8 housing assistance payments

program (see page 41) Contracts are made with the housing project

sponsor to subsidize the rents f eligible tenants, when 25 percent of

their net income will not c er the rental cost of decent housing

FY 1980 appropriations 53 3 million.

References Title V, Housing Act of 1949, as amended 111/A. 90 .448, P L 93-383.

and P.L. 95-128. U.S Code 1490a C.F D A 10427

C. Legislative History

The Housing Act of 1949 ..J.dralended by the Semoi Citatns Housing Act of 1962 (P L 87-723). At that time, a new Section 515 was added to the Act to authorize rural rental loans for housing designed

to meet the needs of elderly persons. Authority for.a ruralierifal4

Fob 7`)

64 .
6 assistance program was included in the Act under the Housing and

Urban Development Act of 1968 (P.L. 90-448), Title V was expanded

to cover handicapped persons by the Housing and Community Development Amendments of 1977 (P.L. 93-128). The 1977 amendments also-extended the Section 515 loan program to cover congregate housing for elderly and disabled persons. Congregate housing

was defined in P.L. 95-128 as facilities for elderly or handicapped

persons requiring some supervision and centralize services, but who

otherwise were capable of canng for themselves Such housing was

permitted to be used in conjunction with education and training

facilities.

HOUSING ACT OF 1959

A. Overview :

,

, . Section 202 of the Housing Act of .1959 authorizes direct loans for

the construction or rehabilitation of rental (or cooperative) housing

for elderly and handicapped persons. Under Section 202, the term

"handicapped persons" is defined at persons having an impaurcient

which (1) is expected to be of longcontinued and indefite duration, (2),substantially impedes his or her ability to live indeparOently,

and (3) is of such a nature that such ability could be improved by

. mote suitable housing conditions. Die definition also specifically

includes developmentally disabled persons.

Elderly or handicapped "families" eligible to live in Section 202

vprojects may include. (1) two or more elderly or handicapped persons living togethei, and (2) one or more elderly or handicapped

persons hviiig with another person who is determined to be essential

to his or her care or well-being. In addition to building or renovating

the basic housing units, Section 202 direct loans py be Used for '. certain related structures, designed to meet the specialized needs of

elderly and handicapped persons, including " cafeterias or dining r

halls,commumty rooms or bluldings, workshops or intumaries or

. other inpatient or outpatitaLKITh facilities, or other essential

same facilities."

, B. Major Programs Affecting the Handicapped

Section 202 au rips 1jnverm direct federal loans to rivate

nonprofit cdrporati ns an c.orisumer poperatives to provide owing

and related facilm (such as central dining rooms) for elderly ar'di

handicapped pe ns. Such loads may be used to finance the construchr or rehab tation9f-detachecl, semlidetached, row, walk-up

. or elevator-type s csur6 Households of oue or more persons, the,

head of w at least 62 years old or handicapped, are eligible to

,-

.

,

. 65
,a

live in such structures In FY 1980, funding reservations for Section

202 !cans totaled 5840 million, of which approximately 550 million

was allocated to housing projects designed to serve nonelderly handicapped persons

References Title 11. Housing Act of 1959.as amended P L 88.564. P L 93.383,

P 1.-04-375, PI 95-128 and P L. 95.557 T. S Code 12 LIS C 1701q CI DA

14 157

C. Legislative History

Section 202 of the'Housing Act of 1959 (01:86-372)orgmated as a program of direct loans to aid local. nonprofit agencies in furnishing

appropriate housing for elderly individuals The Housing Act of 1964

(P L 88-560) amended Section 202 to extend housmgloans to prop.

ects for physically handicapped persons as well The Housing and

Ccomunity Development At of 1974 (P.L 93.383) further revised

the Section 202 loan program to provide a substantially improved

subsidy mechanism and' a broader target population, encompassing._

both physically and mentally handicapped persons DsvelopmenT

tally dabled individuals were explicitly included in the amended

statutory definition of eligible "low income familia."

The Housing kiiCorization Amendments of 1976 (P L 94,375)

eliminate several, additional barriers to participation by nonelderly

handicapped persons @flanges made by the 1976 amendments

included (1) increased authorization levels for the program, (2)

modification of the definition. of p-elderly or handicapped families"

to rant certain additional groupings of such persons to qualify,

and (3) provisions designeito lower the effective interest rates on

Section 202 loans.

The Housing and Community Development Ad of 1977 (P L,

95-I28) eliminated one further barrier to financing appropnate

housing projects under Section 202, by eliminating the requirement

that Section 202 project costs bled to mortgage insurance program

limits, established under Scalia 231i The 1977 amendments also

mandated coordination and jol'nt processing of applications for Section 202 loans and Section 8 rental assistance payments, in qrdlirto

reduce the time required to process Section 202 projects.

The Housing and Community Development Amendments of 1978

L 95-557) mandated that a minimum of S50 million in FY 1979

Section 202 loan funds be set aside for the construction and rehabilitation of housing for nonelderly handicapped persons These.ear-

_marked funds werF to be used to "serve the unique needs-opandicapped individuals between the ages of 18 and 62 or families wO, a

handicapped member or members of any age." The statutory purppse

1 66

74

dr

ti
of these setaside funds was to (I) support innovative methods of

meeting the needs of handicapped persons by providing a variety of

housing options,ranging horn small group homes to independent

hying complexes, (2) provide handicapped occupahts with an assured

range of serviceSeind opportunities for optima! independent hvingand

participation in normal daily activities. and (3) facilitate the access

of handicapped persons to general community activities and td suit

able employment within the community.

Pt. 95.557 also authorized the inclusion of expenses for movable

furnishings in the development costs of a Section 202project Such

costs could be centred by the loan, the legislation provided, if they

were necessary to the basic operation of the project

HOUSING AND COMMUNITY DEVELOPMENT ACT OF 1974.

A( Overview

The Housing and Community Development Act of 1974 authorizes

the Community Development Block Grant program, a major source

of Federal aid for urban areas These bloc* grants may be used to

support a number of projects benefiting handicapped persons. including architectural barrier removal and construction of special

pubhc facilities The needs of the handicapped also must be reflected

in each locality's Housing Assistance Plan, a blueprint for developing

appropriate housing for low-income families and individuals in the

community.

B. Major Programs Affecting the Handicapped

Title I of the Act authorizes formula grants to clues and urban

counties which agree to perform a variety of housing and community

development functions Allocations are based on a statutory formula

Among the wide range of purposes for which a local jurisdiction may

use Title 1 dollars are the follzwutg activities which may benefit

handicapped persons (a) the acquisition, construction, reconstruction

rehabilitatioThEf public facilities, including centers for the hands

upped, (b) special projects to remove architectural barriers ;and (c)

the provision of public services under certain restricted circumstances

In general, /file I funds may not be used to (a) construct general

government buildings, schools, hospital's, nursing homes and residenJii hal housing, (0) purchase equipment or transportation facilities, (e)

cover operating and maintenance expenses (except for eligible public

services), and (d) makynoome maintenance payments.

The basic CDBG apphcatioii must include (1) an identification of

community development and hoiksing .needs, including both

67

75
short-ten:it and long-term objectives, (2) a list of the activities to be

4,, undertaken, (3) an estimate of costs, (4) the general locations of all

activities, (5) a description of other resources that will be utilized,

(6) maps indicating any concentrations of minority groups or lowermeow families, (7) a Housing Assistnce Plan which includes a survey of the housing stock in the local jurisdiction, an estimate or

the housing assistance needs of lower-income families, both one-year

and three-year housing assistance goals, and the locations proposed

for new construction or rehabilitation activities FY 1980 appropriations. S2.7 billion

Wet Title I, Housing and Community Development Act of 1974, as., amen d. P L 93.383, P L 95-128. and P L 9$-547 U S Code 42 U 5301 C.F D A. 14 218.

C. Legislative History

The Federal government's involvement in community development

assistance 'began with.the passage of Title 1 of the Housing Act of

X1949 (p.i. 81-171) Title I authorized urban renewal assistance to

stimulati improvements in urban areas, slum clearance, and new

construction Various housing and urban development acts in the

1950% and 1960's created additional urban sustance programs,.

including model 'cities aid, water and sewer acthnes loans, open

spaces and neighborhood improvement gantsohousing.rehabihtation, and public facilities loans Title 1 of the Housing and Community Development Act of 1974 (Pl. 93-383) consolidated these

various categoncal urban aid programs into a single formula grant

program, called the Community Development Block Grant program

The program was designed to "provide assistance on an annual basis,

with maximum certainty and minimum delay, upon which commutrties can rely in their planning." Authority and responsibility

for hating and implementing community development plans were assigiltd to local elected officials. HUD was to participate as a review

agency with limited power to disapprove the award of block grant

funds.

. The jective of the CD/3G program was the development

of mable ban communities, by providing decent housing and a

suitable living environment and expanding economic opportunities

principally for persons of IOW and moderate income. There were two

general types of funds available under the Community Development . Block Grant program (1) Entitlement Funds and (2)Discretionary

Funds Cities with populations of 50,000 or more, urban counties

with 200,000 or -more, and central cities m metropolitan regions

68
(Standard Metropolitan Statistical Areas or SMSA's) were ehgible for

entitlement funds. , -

. Under the original 1974 Act, the funding level for a particular community was based upon a formula which took into account population, overcrowded housing, and poverty (the latter factor was

double-weighted). However, the Housing and Community Development Act of 1977 (P.L. 95-128) added an alternative formula-Under

the new approach, communities were permitted to receive either the

amount computed under the old formula or under a new formula,

whichever was greater. The new formula was calculated by multiplymg growth lag (20 percent) times poverty (30 percent) tunes age o1

housing (50 percent). 4 The 1977 amendments also added a general requirement that the

CDBG program description of community facilities and public improvements insure full opportunity for participation by, and benefits

to, handicapped persons i

. 4

The Housing and Community Development Amendments of 1976

(P.L. 94-375) added "Centers for the Handicapped" to the statutory

list of purposes for which CDBG funds could be used.

CONSOLIDATED FARMS AND RURAL DEVELOPMENT ACT

Section 306 of the Consolidated Farms and Rural Development Act of

1972 authorizes a program ofl n s for li-tal community facilitie Loans

may be used to construct, enbrg extd or otherwise improve public

facilities providing essential sekvices to rural residents Eligible applicants

include state and local government agencies and other nonp tfit orkam

zations or assocutions. A numbed of lOcal cdnimuruties ha, used the

prot.eeds from sitch loans to build group homes and sheltered workshops

for deyelopmentally disabled persons over the past few years FY 1980

"appropriations S 50 million. ,. . References. Co cd Fums and Rural-Development Act of 1972 1) L.

92-419. U.S Code 7US C 1926. C F D.A.. 10.423,

I

69
INCOME MAINTENANCE

SOCIAL SECURITY DISABILITY INSURANCE

Ai; Ovenriaw

Title II of the Social Security Act authorizes a program of Federal

disability insurance benefits for workers who have contributed to

"the Social Security trust funds and become disabled or blind before

retirement age. Disabled spouses and dependent children of fully in

sured workers (often referred to as the primary beneficiary) also are

eligible for disability benefits upon the retirement, disability or

death ce the primary beneficiary.,

Applicants must furnish' medical and other evidence as specified by

the Social Security Administrition to prove the existence of a disability. Spouses may be determined to'be eligible for disability num

ante benefits if they possess a physleal or mental impairment of such

senty as to preclude engaging in any substantial gainful activity 11:

pbndent children of fully insured workers who have retired, died

or are themselves disabled are eligible for Title II benefits, under the

following circumstances. (I) the child is unmarried and either under

I firyears of age or, if a student, under age 22, or (2) the dependent

has a disability which meets the statutory test of seventy that precludes substantial gainful activity, and began prior to age 22

Individuals who have been entitled to disability benefits for 24 consecutive months are eligible to receive health insurance benefits under

Title XVIII of the Social Security Aa (Medicare). (For details on

Medicare, see page 40.) In addition, the law requires that Social

Secunty Disability Insurance applicants be referred to the state's

vocational rehabilitation agency in an effort to maximize the number

of disabled individuals returned to productive activity.

71

78'
B. Major Programs Affecting the Handiapped

I Disability Insurance Ben s Title II authorizes a program of

monthly cash benefits paid duiectly to eligible disabled persons and

their eligible dependents throughout a period of disability There are no restrictions on the use of payments received by Social Security

beneficiaries The amount of the payment is based on the disabled

perion'sjpnmary insurance arrunt," an amount deternuned by

averaging the worker's monthly licome,plunng a specified period of

time prior to the onset of disability. After making application, individuals are required to wait five months before qualifying for benefits

To qualify for monthly payments, an individual must meet the statutory test of disability or blindness Under this test, a person must be

unable " to engage m any substantial gainful activity" either due

to (1) a " 'medically determinable physical or mental impairment

which can be expected to result in death or which has lasted or can

be erected to last for a continuous period of not less than 12

months", or (2) blindness-1 e ,".. a central visual acuity of 20/200

or less in thebetter eye with the use of corrective lens..," (or a

limitation of 20 percent or more in visual field). (An exception Is

made for otherwise eligible, older blind persons (55 years of age or

older) who meet this statutory test of blindness. Such individuals are not required to meet the "substantial gainful activity" test applicable

to other blind and disabled persons ) FY 1980 (estimated) appropnations. 5153 billion.

References Title 11. Social Security Act of 1935, as amended, P L 89-97, P4...

90448, Pd. 92-603, PI. 93-66. P L. 93433, and P L. 95-216. 11 S. Code 42

US.C. 401 C.F D.A 13 802

2 Adult Disabled Chad Program Section 202(d) of the Act author.

izes disability innirance payments to surviving chdden of retired,

deceased or disabled workers (who were eligible to receive Social

Security benefits), if the children possess a permanent disability

originating before age 22. The child's benefit payment LS one-half

the primary insurance amount of the eligible parent while the parent

is and rebetving Social Security retirement. or disability benefits, and three-fourths of the primary utsurance amount after the

eligible carat has deceased. FY 1980 appropriations, included in

the total for the Disability Insurince program (see above).

References Title 11. Social Security Act of 1935, as amended P.L. 90.248, P L.

92-603, P.L. 046, and P L.95-216. U.S.Cde 42 US C 401. C.F.D A 13 802,

3 Rehabilitation Services. Section 222 of the Act requires that all

applicants and recipients of Disability Insurance benefits be referred

to the state vocational rehabilitation agency. In addition, this section

72

79
Y of the statute authimzes the transfer of furkds from the Disability

Insurance Trusi Fund to state vocational rehabilitation agencies in

order to reimburse such agencies for the provision of certain rehabili

town services provided to Title 11 applicInts and beneficianes. The

primary aim of such services is to reduce the dependency of disabled

beneficiaries on Income assistance payments and, whenever possible,

to fetum them to remunerative employment.

Section 222 also_ authorizes a nine month "trial work period" for

disabled Title II ieneficianes who are attempting to return to work

During this penod, benefits are continued even though the benefice

ary's monthly earnings may exceed the "substantial gainful activity"

test. (Under t Imlay Amendments of 1980 (P.L.,96-265),

effective Dec 980, a 'disabled beneficiary will be eligible to

have benefits rei red if his or her earning fall below theSGA test

level during any month subsequent to the teriunation-of benefits at

the end of a tnal work penod. This change, in effect, extends the

tnal work period to 24 months, although the beneficiary will not be

entitled to cash benefits dtqing the second 12 month period if he or

she is earning over the SCA-level (3300 a month in calendar year

1980.)

In FY 1980, approiumately 397 million was transferred from the

Disability Insurance Trust Fund to pay for vocational rehabilitation

services, under the "Beneficiary Rehabilitation" program.

References Title 11, Social Security Acr of 1935, as amended. P L. 89-97, P.L

92-603, P.L. 93-66, P.L. 93-233, and P.L 95-116. U.S. Code. 42 U.S C 422.

C.F.D A.: 13 802.

C. Ligisistiv* History '-

The Social Security Disability Insurance program ongnated m 1954,

when amendments to the Social Security Act (P.L.81-76I)Included

a provision for a disability "freeze" which would allow disabled

workers to protect their ultimate retuement.benifits against the

effects of nonearnIng years.

In 1956, amendments to the Act (P.L. 84.880) established the Disability Insurance Trust Fund under Title 11, and prodded for the

payment of benefits to disabled workers, but not to their dependents. Under the 1956 logslation, benefits were to begin after a six

ntll waiting period and were !milled to workers aged 50 or over

whO had recently and substantially paid Social Secunty taxes: The

disability bad to be severe enough to prevent the individual from

engaging Jn .any substantial employment and be of "long-continued

and indefinite cluration." The 1956 amendments also made "adult

disabled cluldren,/' who were dependents of retired or deceased
3

V workep, eligible for Social Security benefits provided the dependent's disability began prior to age 18

Amendments to the Act in 1958 (P.L. 85.840) and 1960 (P.L. 86-.778)

authorized the extension of benefits tip dependent spouses and children of disabled workers and eased the requirements related to the

worker's prior (covered) work history and contributions to the Social

Securityifend- Also in 1960, the lunitatioll on benefits to workers

over age 50 was eliminated, and beneficiaries were encouraged to

return to work by the addition of provisions. (1) authorizing a nine

month trial work period during which the recipient could have earn-e

ings withput imperiling benefit payments, and (2) eliminating the six

month waiting period for benefits if a worker applied for disability a

second time after failing in an attempt to return to work

The 1965 amendments to the Act (P L 89-97) revised the definition

of disability from "long-continued and inclefimte duration" to dis:

abilities expected to last at least 12 months or result in death. The

definition of disability in regard to blindness also was liberalized to

exempt legally band individuals, between 55 and 65 years of age,

from the.,substanuaI gainful aotivity test An alternate nisuled status

also was provided for persons who were disabled with blindness be- -

fore age 31." -

in addition, P L 89-97 authorized reimbursement from the Disability

Insurance Trust Fund to state vocational rehabilitation agencies for

the colst of rehabilitation services furnished to selected disabled Title

11 beikficiaries. Reimbursethents, however, were limited to one percent of the previous year's expenditures fOr disability insurance

PaYmePts.

Abend:gents to the Act in 1967 (PI. 90.248) emphasized the role

of medusal factors in the determination pf disability and provided

more specific guidelines for considering vocational facts rsjhe 1067

amendments stipulated that individuals could be determined disabled

only if their impairments were so severe that they were not able to

do their previods work and could not, considering age, education

and work experience, engige in any other kind of substaptial gainful

'work which existed in the national economy...'

The Social Security Amendments of 1972 (P.L. 92.603) reduced the

waiting period for disability benefits from six to five months and

increased the limit oh reimbursements to state vocational rehabilitation agencies for services to disability insurance recipients from one

pertent to one and a half percent of the previous year's di y

payments.

74

81
In 1973, Social Security Act amendments (P.L. 93.-66) tied increases

in benefit levels under the disability insurance program to the consumer price index, thus authorizing automatic annual cost oi_living

adjustments in benefit payments.

The Social Security Act Ambndments of 1977 (P.L. 95-216) increased

the Social Secuniy tax !ate and modified other prOvzsions in order

to restore the financial solvency of the Social Secunty. trust funds. In

addifiCtri,`P L. 95-1.16 stipulated that 'a blind beneficiary would not

be consuleyedlo,flave engaged in substantial gainful activity. unless

his or her monthly income exceeded the retireiz)ent test under Title

II. However, he substantial gainfuLactivity test would continue to

be applied to nonbhnd, disabled recipients. 1>,: 4.0.

SUPPLEMENTAL SECURITY INCOME A A. Overview

Title, XVI of the Social Security Act authorizes the Supplemental

Security Income (SS1 program, a Feddally-admsrustered cash assistance program designed to provide needy aged, blind and disabled

persons with a minimum income. Unlike Social Security 'Disability

Insurance ..benefits (see page 71), SSI cash payments are available

only to aged, blind and disabled persons who meet a statutory test

of financial need Another pnncipal difference between the two

income maintenance programs is that SSI benefits are paid from

general revenues eppropriated by Congress, while SSDI benefits

are derived from a special trust fund financed through Social Security

taxes paid by over 100 million covered workers and their ernklozers.

B. Major PrograigAffacting the handicapped

. 1. Basic Supplemental Security Income Program. Title XVI authorizes federal financial benefit's for needy disabled, blind and aged

individuals (and couples), who lify for direct cash payments.

Monthly payment rates to in' viduals and couples are 4djusted

annually to account for changes n the cost of living. Effective tly,

1980, eligible individuals will r ewe $238 a month, while eligible

couples will get $357 per month

a

I

.on-thevidividual's (or-couples)-

age or disability status, combined with evidence of financial need.

The definition of disability and blindness used under the SSI prograin

parallels the language of Title II1(Social Security) of the Itc see page 71). The one exception is !hat Title XVI requiresVuldh

,SSI recipients (18 years of age or younger) to have a medically de tern21.nable physical or mental impairment of comparable severity to

. 41

75

81"
the (it criteria. (Since, under Title XVI, children are entitled to

SSI benefits on then Oweiehalf, it is necessary for the law (and tmplemenung regulations/administrative "041,licies)' to apply a standard

other than Vability to engage in substantial-gainful activity" to deter- .

'mine the severity of-a fluldhood disability.)

- -

ft.

In calculating an individual's eligibility, the Spcial Security Administration -the federal -agency responsible for administering the SSI , . 6gram-is directed to disregard the first $20 of monthly income anmdmdual receives from any source. and up to $65 tvny additional

earned income Any Additional unearned, income Ifn applicant or /

recipient receives each month results in a dollar- for- dollar reduction

.u.fhis or her SSI btnefit Earned income abo/ve the original disregard 4

.665 a morA, or up to 585, if the in clividuarhas no unearned income),

1causes a oce dollar reduction in the benefit payment .

for every two

. dcdlars of additional earnings.

- 1.41, 1'

In addition to meeting the above incom, test, an individual cannot

havilpersSnal resources which exceed stain st4tutory limits. For 6example, an Mclividual with savings exceedipg $1,5043 is not eligible

to receive S51 benefits however, ownership of a car or a modestpriced horrie are no[ taken tnto account in calculating an individual's

(or couple's) eligibility for benefits.

If an eligible Individual is living in another person's household and

receiving supportAnd maintenance from thit person, tie SSI basic

payment rnount is reduced by.one- third. Furthermore, if an eligible

individual is linng'in a public nonmedical institution, ht is inebgible1

for benefits If, on the -other hand, fie resides in a public medical '

institution or a ppte health care fa ity which receives substantial

payments on his or herikehall under 1~ &aid, Federal SSI benefits

are reduced to a persbnal needs arfowanc of $25 per month.

,States ?nay electr to4supplement the basic Federal SSI payment.

Stich supplemental payments may ?Hirer directly

by tha.staies or through a contractual arrang ent-with the Social

',Security Administration. If a state elects Federal administration of

lysuppgmental payments, then all associated costs

b6rde by the Feileralgovernmenf. FY 1980 tappro awns- - ,$5.6 ' If it

Reference l ;tile XVI. Sd.elat Socurity01%1935As amended. Pd.- 92-603,

PI 13-66, P L 93-233.ti L, it566, an 94.565% if s, Code .42111S C. 1381. . C1 I) A. 13 807 .

'. «, . . : s- 2. Rehabilitalion; TA:arrant. Referral and Counseling, Services.

-, Under Section 1615 of the Act, adults, under 65 years Of pillo.who

. ire receiving 555 benefits, enlist be referred to the state vocational

1

. .. 4 76

-11; -.
rehabilitation agency On the other hand, childhood recipients, under

age 16, must be referred to the designated state SSI disabled chilse dren's agency Similar to the requirement under the Title II disability

insurance program (see page 72), SSI recipients may not, without

good cause, rifuse rehabilitation services. Services provided to ulected

SSI recipient's through state vocational rehabilitation agency ls may

be reimbursed by the Federal government out of a special appropnanon set aside for this purpose The arm of this program As to assist

disabled and blind SSI recipients entei or re-enter the work force,

whenever possible

Blind,and d isabled children under age 16 receiving SSI benefits must

be referred to thestate's crippled children's agency (see page 37) or

n alternate agency designated by the Governor. This agency is

responsible for providing such children and their families with. (a)

counseling services, (b) individual service plans, (c) referral to apprcr

pnate medical, educational and socialservices,(e)monitoring services

to assure adherence to the individual service plans, and (e) direa

medical,social, developmental and rehabilitative services to children

under age 7, and youngsters between ages 7 and 15 who have never atteraled public school and require preparation to take advantage of

, public educational services.-

Section 1615(b) of the Act authonies 530 million annually to assist

states in providing the above services Each state receive; an annual

allocation, based' on the relative number of children under age 7. At

least 90 perciTt of a state's allocation must be used to provide ser- vices to children six years of age or idunget or those who have never

amended public school

References Title XV!, Social Security Act, as amended. P1,92-603, and P L

94.566 U S. Code 42 U S C. 1382d.

C. Legislative History

The Social Security Al., as originally enacted in 1935, did not contain disability benefits for low income individuals, although there

were limited provisions for assisting blind persons. In 1950, a public

assistance program for The "totally and permanently disabled" was

added to the Social Security Act. Basic eligibility sea dards and assistance levels were determined by each state, within broad standards

-set forth in the statute This "Aid to the Permane tly and Totally

lYisabled" program was administered by the star s' with financial

assistance ram the Federal government. Over the.kext two decades, numerous ges were made in the statutory aulhonty for this

program, but, the essentially,state-run,Tederally.assisted character

of the program remlaed unalterid.

g

t

77

. . % 84

40
c.

Under the Social SecuritrAmendments of 1972 (P L. 92.603), how- -, ever, Congress repealed the then existing public assistance programs

for the elderly, blind and disabled and added a new Title XVIto the

Ac: This new title authorized a consolidated, Federally-adminniereci

program sof cash benefits for needy adults, called theSupplemental

Security Income program. Under the Arogiam , a basic, Federal mcome

support level was established for,aged, blind and disabled individuals

and couples Eligibility was to be determined and benefits paid by

the Federal goverrurieT, acting through the Social Security Adpunisnation States were permitted to supplement the basic -Federal

income support levels on behalf of selected classes of teciplents.

The definitions of disability and blindness used in Title XVI generally followed the provisions of Title 11 of the Act. In addition,'for

the first time, disabled and blind children'under 18 years of ,age were

made eligible for benefits, provided their disabilities were of coin.

parable seventy to adult recipients4lowever, while P.L. 92403

relieved parents of Snancial liability for support of their adult, disabled offspring, the law continued to hold parents habit to*r the care

of disabled TINGII as long as they were living at home.

In 1973, two sets of amendments to the Social Security Act (P.L.

93-66 and P L 93-233) modified Title XVI:to assure elderly and

disabled individuils an adequate income and to protect certain

teciplehts against loss of benefits Included in the amendments were

-provisions Vuch

extended SSI benefits to so-called "essential pens s per.

siVs.....neesled_to care fos SEL rwpients..under_cer -- 93.66).

a

required states to supplement Federal SSI payments to current

aged, blind and disabled recipients who otherwise would have had

their payments reduced when theriew "federalized" program went

into effect (P.L. 93-66), and,

protected certain groups of SS1 recipients against loss

eligibility after SS1 went into effect including (1) essential persons,

(2) disabled individuals- who did not meet the Federal definition of

disability and yet were eligible for Medicaid as a medically needy

person, and (3) individuals ,who were inpatients in medical institutions and whose special needs made them eligible for assistance (P.L.

93-66).

In 1976, a ,-series of Social Security Act amendments were eti ed

under the Unemployment Compensation Amendments of 976

. to 78

S F
(P L 9466), which contained the following provisions relating to

the Supplemental Security Income program:

The Social Secunty Admuustratiokwas required ito refer all SSI

eligible children, under 16 years of age, to the stale cnppled children s

agency or another. agency designated by the Governor. This desig-1

nated agency was obligated to develop a state plan which included

provision for (a) administration of the program, (b) coordination,

with other gencies serving disabled children, and (c) establishment

tof a unit which would be responsible for counseling, referring and

Irving blind and disabled youngsters who were eligible for SSI

benefits.,

Section 505 of PA 94.566, the "Keys Amendment", modified

the definition of a public institution-to exclude publicly operated

community residences serving 16 or fewer individuals. The purpose

of the amendment was to eliminate a major disincentive to the

development of group homes for the mentally retarded under public

auspices, '

Section 505 also stipulated that assistance furnished on the basis

'of need to, or op behalf of, an SSI applicant by a state or local govern -

(,... jinent would not be counted as unearned income for purposes of

determining eligibility or the amount of an individttal,s SSI payment.

. Under the previous law, only certain types of public payments were

disregarded (e.g, formal state supplemental pay nents and paymetns

-. ' for medical care and social services.)

Section 1616(e) of the Act was repealed by P.L. 94-566. This

controversial provision called for a dollar - for - dollar reduction in the ,..

federal SSI payment when a state made a supplemental payment on

behalf of any eligible resident in a facility, providing services wlutch

could have been finanadunder tile state's Medicaid program. In Its

place, the 1976 amendments substituted a provision requiring the

states to establish and enforce standards governing care in nonmedical facilities housing a significant number of SSI recipients.

' P L 44-566 directed the Social Secuhty Administration to publish

criteria for making childhood disabdit determinations within 120

day/after enactment of the legislation. "(

Presumptive disability, a procedure for initiating paytnena to certain

severely handicapped Individuals pnor to completion of a formal

disability determination, was extended to blind persons in i916

(P L 94-569) Prior tothe enactment of thislIgislation, 6n1'y disabled

applicants could be declared prelwnptively eiigible

79

86, ,
NUTRITION

NATIONAL SCHOOL LUNCH ACT

A. Overview

The National School Lunch Act of 1946, as amended, authorizes

several cash assistance and commodity donations programs to assist

provide nutritious meals to eligible students. Schools, day cue pro.

public and private schools, child case cen?ers and other institutions

grams, sut camp for handicapped children, and residential

facilities g mentally ill and mentally retarded children are

eligible to participate in the various meal programs authorized under

the Act.

B. Mbior Programs Affecti4 the Handicapped

..' I School Lunch Progiant. Section 4 of the Act authorizes financial

,..,. assistance and food donations to participating public and private

schools and child care fallties, and residential child care institutions

(including schools dr institutions for handicapped children) to help

them furnish, to eligible children, lunches which meet nutntional

--requirements prescribed by the Department of Agriculture.

Participating schools are reimbursed at prescribed rates, which are / adjusted on a semiannual basis to reflect changes in the Consumer

Price Index Schools must agree to supply free and redJced price

lunches to eligible children. Eligibility is based on the family's income and nurnt?er of participating children. FY1980 appopnations.

S2,1 billion.

References Natxmal School Lunch Act of 1946, as amended. P.L. 90.302. Ph91-248 PL. 92.153, P L 92433, PA. 93-150, P.L. 93-326, P.L. 94-105, P.L.

95-166, and P.L. 95427. U.S. Code. 42 US.C. 1753. C.F.D.A.. 10.555.

2 Commodity Distribution Program. Section 6 Of the Act author-

' izes the tronation of food to qualified households, individuals,

child feeding prcigrarns, schools, charitable institutions, *Von

programs for e elderly, and nonprofit summer Camps for children.

#

81

1
Formula grants are made to state agencies which administer the dm-

.. tribution program. Commodities are purchased b)- the Federal government under agriculture surplus removal or price support programs

and then made arailablei to the states for distribution. In FY 1980,

the value of food donated under this program totaled $806 million.

funding for administrative costs was $616

References National School Lunch Act of 1946. at ame ided PL 91-248, P

. 92-153. P L 92-433. P L. 93-150. P L 93-288. P L 93 326. Pi- 94-105. P L.

/07-J95-166. and P L. 95-627 U S Code 7 U S C 612 C F D} 10.559

3 Summer Food Seince Program Section 13 of the Act au thorizes

formula grants to the states for the initiation, maintenance and ex- , pansion of nonprofit food servile programs for children in institutions and summer camps (including schools and institutions for the

handicapped) during the summer months. Grant funds are intended

to cover the lull cost of food service operations, withio certain costper-meal limits. Meals must meet minimum nutritional requirchents

established by the Department of Agriculture. Funds also are made

available for certain state adsnuustrative expenses FY 1980 appro-,

prawns $136 million.

References National Schaal Lunch Act of 1946..aymended P L 90-302. P L

94-105, P L 95.166, and 95427. U S Code 42 U S C 1761 Cr DA

10 559 'fI 4 Child Care Facia Program Section 17 of the A(t provides grants-.

in-aid to the states for tkie estabhshment and operation of nonprofit

food service programs f4i children in nonresidential day care facilities. Stites &Muse funds to eligible public and nonprofit private

organizations, including day care centers, recreation-centers, family

and group d* care programs, Headstart centers, and other institu-

. tions providing day care services for handicapped children. Disbursements are made on the bins of the number of lunches, suppers,

breakfasts and snacks _served to eligible children, using federallyestabhshed reimbursement rates. Meals mutt meet minimum nutriAtonal requirements, set by the Agriculture Department. FY 1980

aPpropnations 5214 milhon.

References Natrona School Lunch Act of 1946, as amended P L '90-302. P.L.

94-105. P L 95-166 and 111.. 96427 U S Code 42 U.S C 1766 CI DA

10 558

9:Legislative Hi

to4

the enactment of the National School Lunch Program, some

ived federal loans and agricultural surpluses los their

lunch Rograms In 1935, the U.S. Department of Agriculture imti

ated I direct purchase and distribution program under which donated

82

,,88
farm surpluses were distributed to schools in an effort to dispose of

such commodities andllid schools et, providing nutntious, low-cost

meals to their students. In 1946, the school lunch program was per.

manently authorized under the Natiodal School Lunch Act (P.L.

-49-396). The Act established a grant program to enable states to aid

non-profit school hatch programs in public and private schools. Payments to the states were to bi made on a matchuigbasts, according

to a formula that took into account the degree of need in each state.

In addition, the Agriculture Department was authorized to continue

providing federally donated food commodities to supplement cash

assistance.

In 1962, amendments to the Act (P.L. 87-823) changed the formula

by which Federal funds were allocated, in order to account for rate

of participation in the program and need for assistance. The 1962

amendments also authorized a i¢ecial assistance program to aid

schools in providing fre and reduced -price lunches to needy children.

The Child Care Food program was first established in 1968 (P.L.

302) as the year-round component of the Special Food Service Program for children, a Ouse-year pilkt program that included both\the

child care food program and the forerunner to the summer food ser- vice prograks. The child care component was aimed at prRvtding

Federal assistance for meals served in institutions providing amendential day care for childrenAhe institutions eligible to participate

included day care centers, settlement houses, recreation centers and

' institutions providing day are for handicapped youngsters.

The 1975 amendments to the Act (P.L. 94105) streamlined aid un- Tilave4 existing federal pthgrams by increasing eligibility for reduced.

cost meals, expanding the summer feeding and schoolareakfist programs and extending child nutrition benefits to cluldren in residential

institutions. The definition of a'school" under the National School

Lunch Act and Child Nutrition Act Amendments of 1966 was

expanded to include "any public or liceded nonprofit private

residential child care institution (including. but not limited to, Ir orphdiages and homes for the mentally retarded)..." This amend.

ment ;rakes public and nonprofit residential institutions for the

Mentally retarded eligib e for assistance under the School Lunch and

School Breakfast pr am Previously, such facilities were only

entitled to receive surpl mmodities.

In addition, a broader C Care Foo' d Program was iuthorket to

replace the former Spec Food Service Program for Children.

Nonresidential child care institutions serving needy youngsters,

e

"13

8)
'

'

alb

including facilities "providing day care services for handicapped

children," were declared eligible for aid.

The 1975 amendments also.

extended the Special Supplemental Food Program for Women, - fants, and Chi idlen through September 30,1977 an expanded program authorizations,

broadened the Summer Food Program and extended its authonzations through September 30,1977.

increased eligibility for reduced price lunches by raising the family

income ceding to 95 percent above the poverty income guidelines

Previously, maximum, family Income was fixed at 75 percent above

the poverty level.

in 1977 amendments to the Act (Pi. 95-166), eligibility for the

Summer ePood Service program was exte ed to allow individuals

-*over age 18 to receive benefits if they w re mentally or physically

handicapped and participating in a public hoot program established

to meet their needs. The Act was amende4 gamin 1978 (P.L 95 -627k

to extend eligibility under the Child Car Food program to mentally

or physically handicapped pepuns ove 18 ?ears of age who were

enrolled in a program serving a majont of persons 1,8 years of 4

of under.

CHILD NUTRITION ACT

A. Overview

The child Ninntion Actof 19.66, s an -iendd, authorizes- -fe deral

assNtance in the establishment ari operation of school meal programs. Programs established underlithis Act complement the basic

nutrition programs authorized and the National School Lunch Act

(see page 81) Residential and cl ytime schools 'for handicapped

children and otter child care p grams,ate eligible to participate

in the School Breakfast, the Scho Milk, Equipment Assistarice, and

Nutrition. Educanonind liar fg programs authorized under the

Act.

B. Major Programs Affecting She nclicapped

1. School Milk Program Sect n 3 of the Act authorizes formula

grants to the states to en urage the, corisumptidn of n ilk by

school -aged children.Reimbu ents are made to eligible nonprofit,

schools and child care in. itutions. Nonptofif elementary and

secondtry schools, nurser schools, child care centers,, summer

camps and similar Institut'. devoted to the care-and training of

i 84

at.

Ty

4
4

*o.

children are eligible to participate in the prograni. Disbursements

are made on the basis of the number of half pmts of milk served,

within limits specified by law and Department of Agriculture regulations. FY 1940 appropriations: 532 million.

References. Child Nutrition Act of 1966, as amended. P.L.91-295, 93-150.

P L. 93-34f, P L. 94-105, and P L 95-166 U.S Code 42 U.S.C. 1772 C F.D A.

,10.556. #

2 School Breakfast Program. Section 4 df the Act 'authorizes

formula grants to the states for the purpoie of reimbursing participating publierand nonprofit private schools, including schools for

handicapped children, ror breakfasts served to eligible children, food

must meet the Department of Agriculture's nutritional requirem*s.

Reimbursement is based on the number of breakfasts served, with

rates adjusted semi-annually according to the Consumer Price Index.

4Y 1980 appropriations; 5225 million.

References. Quid ?jutntion Act of 1966, u =elided. P.1, 89442, pl., 90.302,

P L. 91-248, P.L. 92-32, P.L 92-433, and P L. 94-105. U.S Code. 42 U.S C.

1773. C F.D.A 10.553.

3 Non-Food or Equipment Assistance Section 5 of the Act provides formula grants to the states to help supply schools m low.

income areas with equipment for storing, prepartzfg, transporting and

serving food to children. Grant funds may cover up to 100 'percent

of the cost of such equipment in especially needy schools without

food service programs. Schools approved for equipment assistance

must agree to take part in the National School Lunch or School

Breakfast programs. FY 1980 appropriations. 520

Referenget.tht.IL.Not966,-asamencled. P.L. 89442, P.L. 91-248,

PAL.' 92-433, P L 93-326, and P.L 94-105. U.S. Code 42 U.S C. 1774. C.F.D.A.

10.554.

4 Nutrition Education and Trazning. Section 1% of the ictcluthorzzes grants to state educational agencies to stimuli& improved

nutritional training of educational and food service+ personnel,

training in food .service management and the conduct of nutrition

vilt education *activities in schools and child care institutions. FY 1980

appropriations. $20 , - Refetelnes. Child Nutrition Act of 1966, u amended. Y.L. 95-166. U.S. Code.

42 U.S.C. 1788. c.F,,p .10 564.

,41. Logi:lath,* Hi ry

The Child Nutrition Act of 1966 (Pi. 89.642) extended the

__Federal government's involvement in furnishing meals to schoofi

aged chslUn by (1) establishing the school. breakfast program,

X85
(2) expanding the special milk and nonfood (equipment) assistance

programs. and (3) providingis,sistance in feeding preschool children

As established under the 1966 Act, the School Breakfast Program

was limited to schools located in poverty areas which had a substan

teal number of children who had to ride lung distances to school In

1971. the Act was amended (P Ir 92-32) td' remove the limitation

on the types of schools eligible for the prograrri and authorize a

Federal share of up to 100 percent of the lull operating costs of

breakfast programs in needy schools In 1975, amendments (P L

94405) provided a permanent open-ended authorization of funds

for the School Breakfastoprogram

.The 1975 amendments also .extended the definition of 'school

under the 1966 Act. ju inclu4e any public ur licensed nonprofit

private residential chdd.cate institution (including but not limited

to orphanages and homes for the mentally retarded) This change

allowed public and nonprofit residential institutions to participate

in the School Breakfast Milk and Equipment Assistance programs

for the first tune'.

The 1978 afne.pdments to the Act L 95-627) provided for (a)

the expansion ul the breakfast program by permitting combined

record keeping equipment assistance and funds for schools in

especially needy areas. (b) the authority for children who qualify

.tor free lunches to be eligible for free milk at the option of the

school 'or local educational agency, and (6) a requirement that each

state educational 'agency establish eligibility standards fur providing

additional assivance to schools in severe need including those

schools requiroillo sere breakfast under state law

FOOD STAMP ACT

A. Overview

The Food Stamp Act.uf 1977. as amended. provides direct assisLance in the Corm of coupons. to irklindup and families who

otherwise would be unable to pork:hay aile4uate quantities of

lood at -local retail stores to fneet their rrilnurium nutritional needs

Coupons are used to offset part of the cost of purchasing food. and

thus. assist a low-income ingivklaali and family to stretch their f:

'loud budgets Handicapped individuals and households who meet

inlome eligibility criteria are eligible .to participate Iii addition.

certain blind and djsabled persons living in community living ar

rangeorepts. which house less than 16 persons. also may be eligible

for food stamps

.86

1

1
B.

0,- pr Programs Affecting the Handicapped

Under the Food Stamp Act, eligible households receive a free

coupon allotment, an amount which vanes according to household

size and net income. The coupons may be used in participatut

retail stores kbuy food. In addition, food coupons may be used

by certain eldirly and handicapped persons and their spouses who

cannot prepare their own meals to pay for meals delivered to them

in their homes by authorized meal delivery services Food coupons

also may be used to purchaiffood on behalf of blind or disabled

recipients of Social Security Disability Insurance or Supplemental

Security Income benefits who reside in small, commuruty-based

group living arrangements, housing no more than 16 persons.

Households must 'be individually certified as eligible by slate or

local welfare offkles, based on national eligibility standards which

take into account family size, income and level of resources In FY

1980, approximately 57 billion was spent on food ip benefits

to eligible reclplints

References, Food Stamp Act of 191. as amended P L 95 -113, and P.L. 96.58

S Code 7 U S C 3012 C FDA 10 551 - C. Legislative History

j

The first Federal Food Stamp Program wakestablished 4s an experiment in 1939, for tht dual purpose of stabilizing food prices by

removing surplus agricultural commodities from the market and

feeding poor families The program ended with World War II, but

was revived in 1961 by President Kennedy, as a pilot project in .a

few scattered needy areas of the country. This pilot project was

expanded and refined by the passage of the Food Stamp Act of

1964 Amendments to the Act in 1971 changed the basis of the

program by establishing uniform Federal eligibility standards and

coupon values. In 1973, Congress mandated that all areas of the

country offer Food Stamps and conveit from other Federal Mod

. distribution progranis

The Food Stamp Act of 1977 (P.L 95-113) was one of the most

comprehensive revisions of the program's statutory authority since

its inception P.L. 95-113 authorized-the Issyance of stamps at no

cost to eligible individuals or families, and the establishment of uniform national eligibility standards, The Act also provided for a

limited exception to the prohibition against providing food stamps

to institutionalized persons, in the case of indivicluals participating

ln alcohol or drug abuse treatnlent centers or residing in Federallysubsidized housing for the elderly.

87

. 93
r

In addition, P.L. 95-113 permitted certain public assistance offices

to determine diem eligibility for food stamps Specifically, a single

interview could be conducted to determine both eligibility for food

stamps and eligibility for Aid to Families with Dependent Children,

or households composed entirely of Supplemental Security Income

recipients could apply for food stamps at Social Sectinty Administration offices and be certified as eligible, based on information in

their SSI files.

The Act authorized the Agriculture Department to co nduct pilot

proyecu, including a test of "cashing-out" food stamps (i e ,paying

the value of food stamps in cash rather than in coupons) for house

holds composed entirely of members who are either age 65 or over

or are SS1 recipients. P L 95-113 also requited the.state agency

administering the food stamp program to notify SS1 recipients about

the availability and benefits of the food stamp program, as well as

eligibility requirements.

The Food Stamp Amendments of 1979 (P L. 96.58), was an emergency measure aimed primarily at increasing the program's statutory

spending ceiling and relaxing certain restrictions on shelter and

medical expense deductions ions under the 1977 Act P L 96.58 also, for

te first time, authorized food stamps for residents of community.

living arrangements for blind and disabled persons, by redefiriug'

"eligible households" to include

Disabled or blind recipients of benefits under Title 11 or Tale XVI

of the Social Security Act who are residents in a public or private

nonprofit group living arrangement thlt is certified by the appro

prate state agency or agencies tidier regulations issued under

Section 1616(e) of the Social Security Act, which serves no more

than 16 residents er".

Each otherwise eligible blind or disabled person is to be treated

as an individual household for purposes of determining hisfher

eligibility and monthly coupon allotment In addition to amending

the statutory definition of the term "household," the 1979 amend

ments also redefine the term "food," to mean Meals served in small

group living arrangements, and the term "rola food store" to include group living arrangements. This allowt some flexibility in the

method of administering Food Stamp benefits

Prior to the enactment of P.L. 96-58, group hoynes which provided

meals to their residents were considered "institutions" and there

fore, residents were considered ineligible for Food Stamps.

(

88

9 4 .
RIGHTS

A. Overview

During the 1970's, Congress enacted several pieces of legislation

aimed at protecting handicapped persons against discrimination and

other forms of unjust treatment. Among the types of statutory safeguards extended to handicapped individuals under these laws welt.

(1)protection against discrimination in Federally assisted pr

(2) accessibthty to facilities and programs supported or opetaed by

the Federal Government, and (3) the right_to a free appropriate edit.

cation (Legislation permitting the Justice Departnientto initiate civil

suits against states to proect the rights of mentally retarded and

other institutionalized individuals was enactld_m 1980 (Pl.. 96.247),

B. Major Legislation Affecting the Handicapped

1 Rehabilitation Act of 1973. (See also page 115 for other pron. sionsf this Act ) Tide V of the Rehabilitation Act of 1973, as

amend d, contains a number of provisions designed to safeguard

the rights of handicapped persons. Section 5134 *of the Act affords

'handicapped persons protection against discrimination in all Fed.

erallyvassisted programs and activities. The Act states that.

"No otherwise qualified lAndicapped individual in the United

States, as defined in Section 7(7), shall, solely by reis' on of his

handicap, be excluded fr9m the participation in, be denied the.

benefits of, or be. subjected to discrimination under luny program

or activity receiving Federal financial assistance or under any

program or activity conducted by any Executive agency or by the

Uruted States Postal Service."

4

Section 7(7) defines the term "handicapped individual" to mean.

"any person who. (1) has a physical or mental impairment which

substantially limits one or more of such person's major life activities, (2) has a record, of such an impairment, or (3) is regarded as having

such an impairment " Federal agencies are lequired to promulgate

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regulations to carry out their activities in a nondiscriminatory

'fashion 1

Sections 501 and 503 of the Act protect handicapped persons froilt

employment discrimination by Federal agencies or FederaLcontrac

tors Each Federal agency is required under Section 501 to develop

an affirmative action plan fur hiring. placing, and advancing hank

upped individuals within the agency An Interagency Committee

on Handicapped Employees Ow is established under Section 501 to

monitor implementation of this requi,re ent

Linder Section 503 of the Act, an contractor entering into a con-

%factual agreement in excess u1 S .500 with any Federal depirtmeni

or agency for the procureme of personal .property or a nonper

sonal ,service is required to take affirmative adtion to employ and

advance in employment handicapped persons The statutory defini

Lion of a 'handicapped individual' for employment purposes "does(

not include any individual who is an alcoholic or drug aNscr whose

current use of alcohol or drugs prevents such individual orqarforming the duties of the lob in question or whose emplo niny

reason of such current alcohol or drug abuse, would constitute a

direct threat to property or the safety of others The Secretary of

Labor 14 responsible fur prumulfating regulations and enforcing the

provisions of Section 503

2 Educatton of theyandlcappl (Other 'provisions of this Act are

described one page 9 ) The tducation of the Handicapped Act. as

amended. expressed Conn Lindl i t that all handicapped dui,

then have a rightly fteeappro late public education Section 3(c)

of the Act states

"It is the purpose of this Act to 'assure that all handicapped chil

dren have available to them, within the time periods specified in

Section 612(2) (B), aifree appropriate-public education which

emphasizes special' education and related services designed to meet

their unique needs, to assure that the rights of handicapped children and their parents or guardians are protected, to assist states

and localities to provide for the education of all handicapped cluldron, and to assess and assure the effectiveness of efforts to educate handicapped children "

4 Re ultitic+ns implemenlinio Section 504. 43 issusd by the primary I edera! .igrnoes serving the handicapped. are surnI1141141 in At 1, Federal Rezulattons

fectgru the Handicapped 1977 78. published by the. ()nice toe handicapped

111 W Publication No (0111)S) 80.22008 ,

90

91;
. In o&der for a stAte to qualify for formula grant funding under Part B

of the Education for the Handicapped Act, it must submit a plan -

that provides assurances that all handicapped children w1thin tie state, between the ages of three and twenty-one, will be enrolled in a

'free, appropriate educational program no later than September 1,

1980 The only statutory exception to this requirement is that such

services need no/ be mandatory.for children, between the ages of 3 .

to 5 and 18-to 21, if state law or a binding court order does not provide for such coverage,

3 Bill of Rights for the Developmentally Disabled. (Other provisions of this Act are described. on page 101,) Sectiop I l 1 of the

Developinental Disabilities, Assistance and Bill of Rights Act, as

amended, sets forth the following Congressional findings respecting

the rights of persons with developmental disabilities

(1) that perslans with developmental disabilities have a right tonpropriate treatment, services, and habilitation; in the least restrictive

setting, which are designed to maximize their developmental potential,

(2) that the. Federal government and the states both have an obligation to assure that public funds are not provided to any institutional

or other residential program which, (a) does not provide treatment,

services and habilitation appropriate to the needs of the develop.

mentally disabled persons they serve,?,,pr (b) -fails to meet the follow.

mg minimum Standardsprovision of a nourishing, well-balanced daily diet,

provision of appropriate and sufficient medical and dental

services,

maieenance and enforcement of pohciei prohibiting the use of

physical.restraint, unless absolutely necessary] and not,,as a form of

punishinent;

maintenance and enforcement of policies prohibiting the exces- sive use of chemical restraints;

a pohctes grantnig permission for close relatives to visit residents

at reas9nable hours without prior notice, and

compliance with adequate fire ancfpfety standards

In addition to the geperal and specific rights outlined above, Se'ction 111 expresses the intent of Congress that all residential and

nonresidential programs serving developmentally disabled pe .pons

provide appropriate care and seances and comply with all relevant

91 4)

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standards In particular, residential facilities providing comprehensive health-related, habilitative or rehabilitative services, should meet

; 41 standards "at least equivalent" to Federal Medicaid standards gov-

&rip intermediate care facilities for the mentally retarded.

4 Architectural Barriers Removal Congress, in 1968tpassed the Architectural Barriers Act (P.L. 90480), requiring most buildings and

facilities designed,, constructed or altered with federal -funds after

1969 to be accessible to physically handicapped persons, The General Services Administration issued minimum accessibility guidelines

in4eptember 1969. \ '

In 1970, the Act was amended (P L. 91.205) to include a requirement that facilities constructed as pit of the 'Washington, D.C. . metropolitan subway system be accessible to handicapped persons.

Under Title 11 of the Public Building Cooperative Use Act orl97

(P L 94-541) the Act was amended to impose a clear statutory man -'

date that public buildings be accessible to physically handicapped

persons. Coverage of the Act was also extended to. Governmentleased buildings intended for public use or in which physically

handicapped persons might be employed, including buildings teased

for public housing or for use by the U.S Postal Sernoe.

In addition, the 1976 legislation required designated agencies (HEW,

GSA, DOD and HUD) to establish a system of continuoupsurveys in

order lo insure compliance with the Architectural Barriers Act, The

Administrator of the General Services Administration was directed

to report annually to Congress on the status of activities refated to

the Architectural Barriers Act. . Section 502 of the Rehabilitation Act of 1973 (11.L 93-112) established the Architectural and Transportalion Comphance Board to

(I) insure compliarice with the standards issued under the Architectural Barriers Act.,of 1968, (2) investigate and examine alternative approaches to die architectural, teansportation, communication

and attitudinal barriers confronting handicapped individuals, and (3J

deterrhme measures] befrig,taken by federal, state and local governments, and other public or nonprofit agencies, to eliminate such., ^ barriers. ,---'re' ..- ,

,. Originally, the Board was composed of the heads of representatives

from the follesksig Federal departments and agencies. Health, Education, and Welfare, Transportation, Housing and Urban Development, Labor, Interior, General Services Administration, Veterans'

Administration, Defense, and United States Postal Service. The 1978

, amendments to the Rehabilitation Act (P L 95.402) added eleven

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I
, pub 'c members, appointed by the President, and one moreFederal

,

, agency (Justice). P L. 95-602 also expanded A&TBCB's enforcement authority by granting itiower to (I') bring civil 1ction in any

appropriate. U.S district court, to enforce any final order of the

Board, arid (2) irteMne, appear and participate (either directly or as ' amicus curiae) in any US. or state court in civil actions related to

the Board activities or the Architectural Barriers Act of 1968.

Congress also required the A&TBCB to determine withirone year the

colts to state and local governments of providing handicapped. per,

sons with full access to all programs and activities receiving Federal

assistance. (1 e , We cost of complying with`Aection 504, nondiscmh-

.. illation regulations) (As of mid-1980, the cost study had not been

conducted because the Board -lacked the resburces.) Finally, the

Board was authorized to set minimum guidelines for standards issued

under the 1962 Act And to provide ttchnical assistance to agencies

and individuals affected by regulations mandating the removal of

architectural, transporlation, and communications barriers.

5 Other Protections for Handicapped Peso. ns. The Civil Rights

Commission Act Amendments of 1978 (P I, 95-444) expanded .

the jurisdiction of the Civil Rights,Conunission to include protection against discrimination 'on the basis of handicap. The Act

itself did not define the term "handicap," but referred instead to

the definition contained in the, Rehabilitation Act of 1973, is

amended.

The Civil'Ilig hts Commission generally carries out factfinding active

ties, Investigates allegatiohs of. discrimination and maintains, an

forbution clearinghouse However, it has no direct enforcement

authority.

The Legal Services Corpftion Act Amendments of 1977 (P.L.

95-222) Added handicap persons.to the list of clients eligible for

services Legal service corporations are lOcal organizations that provide An affray of legal counseling and referral services, as well as representation for needy indivictiials: P.1. 95.222 -also required !col

service corporations to adopt procedures for determining and impiementing legal.assis,tance priorities, taking into accountthe relative

needs 'of eligible clients The Statute specified that special priority

should be given to serving particularly,needy clients, including handicapped andelderly persons, who have special difficulties in accessing

legal services or special legal problems.

The C141 scitice Reform Act of 1978 (P.L. 95.454) mandated

sweeping reforms in tie employment practices of the Fedefial gov.

ernment Included in the Act ukas,authority for agency icends to

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employ reading assistants for blind employeesInd interpreting assistants for deaf employees, when such services are necessary to enable

disabled employees to perform their work. Interpreters or reading assistants not assigned by the agency are permitted to receive pay for

their services either from the blind or deaf employee or from a non

profit osgazuzpon.'

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SOCIAL SERVICES

CHILD WELFARE SERVICES ;

A. Overview

Title 111E of the Sacral Security Act authomes ',grants to the states

to expand and Improve child weifitriservICts.

Section 425 of the Act defines the term "child welfare services" to

rem.

Public social services which supplement, or substitute for, parental are and supervisioi for the purptose of (1) preventing or remedying, or assisting in the solution of problems which may result

in, the neglect, abuse, exploitation, or delinquency of children,

(2) protecting and caring for homeless, dependent, -or neglected

en, (3) protecting and promoting the welfare of cluldren, of

wo9ddngmothers, and (4) otherwise protecting and promoting the

welfare of children, including the strengthening of their own

homes .where possible, or where 'needed,%the provision of adequate are of children away flom their homes in foster family

homes or daycare or other childcare

B. Major Programs Affecting the Handicapped

1. State Gran I s e for Child Welfare Services Title 1VB authorizes, a

program of formula cants to designated date,agencies for the provision of ehiRl welfare services. Stater receive allotments based on

the' relative number of childrenUnder age 21, compared to the U.S..

total in this age group. Funds may be used for.(a) referral of prod.

don of special are to mentally and physically disabled children and

assistance to children discharged from institutions, (b) licensing and

standard-setting, for private child-care agencies and institutions, and

(c) foster dsy care, homemaker services, return of runaway

children, and- a tive placements ot chilaren.

States are required 'to develop child welfare plans for the expencti

cure of Sunda that include providoni for coordination with other

mean:

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progra ms and agencies providing health, educational and related

services to children. FY 1980 appropriations. S56 5 million

References Title STD, Social. Security Act, as amended P L 90-248, and P L.

92-603. U S. Cods' 42 U Se 620. C.F D.A. 13 645.

2 Research. Demonstration and Darning Promos Title P 9 audiorues project grants for research, demonstration and traluing

in the field of child welfare. Public and nonprofit institutions of

higher education, certain public and nonprofit child welfare agencies

and research organuatiOns are eligible for research grants under this

authority State and local government agencies also may.riceive project ts to demonstrate the utilizationof research finch* related.

to c d welfare services Finally,, public and nonprofit institutions

of higher education are eligible for grants to support training of child

Welfare personnel. FY 1980 appropriations. 513 2 million.

References Title 1V-B, Social Security Act, as amended P L 0-248 U.S. Code

42-US C. 626 C.F.D A . 13.608

C. Legislative History ', . Grants for child welfare services have been awarded under the Social

Security Act since its inception in 1935. The 1935 Act included

provisions for supporting services to children in predominantly rural

areas and other areas Of special need. Amendments to the Act in.

1972 (is I. 92-603) authorized a major increase in Federal funding,

aimed at expanding foster are and preventing the removal of chit.

then from their families, thus avoiding the need'fbr foster care. The

increased funds also were to be used by the states for adoption ser- vices; including activities fo increase adoptions among hard-to-place

children (The Adoption Assistance and Child Welfare Act of 1980

(P L 96.272) revises the allotment base for Title IV-B grants, a; well

as the specification for qualifying for Federal support. The main aim

of these amendments is to minimize the need for foster are placements PL 96-272 also adds a new Title IV-E to the Act, audio"

razing federsifrupport for adoption subsiclies.)Y.

SOCIAL SERVICES PROGRA M

Is A. Overviea

Title XX of the Social Security Act authorizes Federal assistance to

help slates provide a broad range otsocialisemcesto recipients of

pubbt assistance and other low-income thdividuals and families.

Many states use r portion of their Title XX allotments to provide

special services to handicapped persons. , k

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"B: Major Programs Affecting the Handicaisped

I Basic &lad Services Prograriz. Title XX,authonzes formula grants

to assist designated state sociaI'services agencies to support activities

aimed* at achieving the following goals on behalf of certam_lowincome-, needy persons and recipients of public assistance. (a) achieving o,Lmaintaining economic self-support to prevent, reduce or elan

mate dependency, (b) achieving or maintaining self-sufficiency, includ6ig reduction or prevention of dependency, (c) preventing or remedying neglect, abuse, or exploitation of children and adults un- 4

able to protect their own interests,, or preserving, rehabilitating or

reuniting families, (d) preventing or reducing inappropriate institutional care by providing for community-based care, home-based

care, or other farms of less intensive care, or (e) securing referral or

admission for institutional care when other forths of care are not

appropriate, of providing serlices to individuals in institutions.

Social services directed at these goals may include. child care services, protective services for children and adults; services for children

and adultsin Foster care, services related to the management and

maintenance of the horhe, day care services for adults, transporta-

' tion services, employment services, information, referral and cowlseling services, the preparation and delivery of meals, health support

services and appropriate combinations of services designed to meet

the special needs of children, the aged, the mentally retarded, the

blind, the emotionally disturbed, the physically handicapped, alto

holies and drug addicts.

States have broad discretion to define social services, supportable

tinder this Federal-state prograni provided such services are directed

at the above statutory goals. However, use *Federal funds to alpport the following activities is prohibited:

supporting an educational servic e'if a State makes the service

"generally available to its residents without cost and without regard

to their income."

supporting medical or remedial services to persons which can be

. paid for under Medicaid or Medicare, unless such services are an

integral and subordinate part of a social service;

purchasing, constructing or making any rnalor modifications in

land, buildings or other facilities;

using social service funds for cash payments to an individual or

family;

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financing services to individuals living in any hospital, skilled

nursing facility, or intermediate care facility (including any hospital

or facility for mental disease or for the mentally retarded), any

prison or foster family home, unless the service (a) is provided.by

an agency, other than the facilitIbithe individual is living in, and (b) is

provided under the sine's plan to persons not living in the faidity,

supporting m- horrie child care services which fail to fleet state

§tandaids establish& in accordance with the recommended standards of nitionat organizations,

payingfor room --and board only when such costs are an integral

and subordinate part of the delivery of skial services and then for

no more than six consecutive months, and

paying ,l`or out-of-home child care services which fail to meet

prescribed day care standards

Eligible recipients of social services include '(a) recipients of Sup - pitmental Security Income benefits and/or recipients of state

supplemental payments, (b) beneficiaries of Aid to Families with

Dependent Children, and (c) other need persons whose income

does not exceed a state-established percentage of the state's median

income (not exceeding 115 percent of the state's median income,

adjusted for family size) States are permitted to vary the family/

individual * ncome limits according to the type of servimrl. For example, a number of states have established higher fairnly income

eligibility standards for services to developmentally disabled clients

than for other services rendered,under their Title XX plans ) '

In addition, states may offer the following services to anyone who

,needs them, without regard to income or other eligibility limitations (1) mfOrmatton arid referral services, (2) protective services to

children and adults who are subject to abuse, neglect or exploitation, and (3) family planning services.

States are required tAharge fees, reasonably related to income, for

services to individuals and families with Moilatly gross incoines of

between 80 peltent of the state'median income (or 100 percent

of the national median, if low'er) and 115 percent of the state's

median income Federal reimbursement is not available for services

to Individuals or families with incomes exceeding 115 percent of the

4 states median income.

..t The states are required to prepare comprehensive social service plans

in advance of the program yeai 'and provide ample opportunity

for public comment prior to final approval. This plan must include

an indication of (a) the objectives to be achieved, (b) the categories

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of individuals to be served, (c) the services to be provided and' their

relationship to the statutory goals (a state is required to provide at

least One service directed at Jach of the goals and at least three types

of services to SSI recipients), (d) the geographical areas to be served,

(e) the planning, reporting 'and orgaruzitioual structure to be used,

(0 how services will be coordinated with other welfare.related service programs in the state, (g) estimated expenditures under the program by category, service and geographical area, and (h) the steps

taken to assure that the needs of all tesidents of the state were con-

' sidered uti developing the. plan The states also must conform to

Federal reporting requirements.

Severity five percent Federal matctring is authorized for social services, except for family planning serviceswhich receive 90 percent

mktclag Congress has authorized S2 beton for Title XX expenditures in FY 1980. (This level wa set 1980 Social Services

Amendments (P L. 96.272.) / * V 4 ' Referiinces 'file XX, Social SecureAct, as amended, -P.L 93:547. P.1.. 94 -401,

and P I-, 9$-.600, 42 US c, im.0 F D.41t. 13 642 ,. . .'

4 . 2,Sonat ,,W4:44* Tg. Title XX also authorizes funds for training WorkelkiyraiiiriesponsibIe for. the provision of social services

funded undevt the AO, fneludirtil. staff of.the designated state

. agency, volunteers attached to the agcniy7 Ind vice delivery personnel from..provider,,yencies (e g . vertdor ag +providing speci;Isted,..sernies to mentallyt.rd physically han 'capped persons).

....Gralits also ma be made ito'iklueational institutions to prepare stir',

dents for socillfsethces employment. FY 1980.(estimated) appro-

.. . priations SRI million (The Adoptiop Assistance and Child 'Welfare

A\ct of 1980 (Pt 96.272) places a gelling on Title XX training expenditures in FY 1980 and 1981. Thereafter, states will be required

to submit a training plan spelling out anticipated outlays prior to

receivingreinibursement.)

.References Title XX, Social Security Act, as amended P,L. 93-647 U S Code

7 42 U S C, 139t. C F,D.A .13 644. \

C. Legislative History '

.. . . In 1i56, Congress amended the Social Security Act to authorize the

provision of services to Federally-assisted welfare recipients, provided such services were furnished by the staff of the designated

state welfare igency The Federal matching ratio for such services.

Was set at 50 percent, l'nor t6 theienoctment of this authority. federal assistance to needy families and adult recipients under the Act

was limited to cash benefits. , ,

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. The Federal matching ratio for social services was increased to 75

percent in 1962. In addition, state welfare agencies were permitted

to purchase services from other public agencies, both on behalf of

current welfare recipients and persons likely to become recipients

The intent of Congress in extendingservices to potential welfare

recipients was to prevent needy individuals and families from becoming dependent on welfare.

In 1967, Federal financial participation was expanded to Include a

wide range of mandatory and optional social services available to

needy individuals and families. In addition,.for the first time, Federal matching was authorized for services p iset.ty welfare

agencies from private vendors of service. . Due to growing Congressional concern over the rapidly escalating

costs of social services to needy recipients, in 1972 a rider was add'id

-to the General Revenue Shaving Act (P.L. 92-512) which placed. a

S2.5 billion ceiling on Federal funding for tits piirpose and required

the states to expend at least 90 percent of their outlays on applicants for, or recipients of, Federally-assisted welfare payments. The

following types of services were exempted from the 90 percent requirement. (a) child care services related to employment or training

of a fuzzily member or the death, incapacity or continued absence of

* the parent/guardian, (b) services to mentally retarded persons,

(c) family planning sennces;f(d) services to drug addicts and altohohcs undergoing treatment, and (e) services to children in foster; care. The social Services Amendments of 1974 (P.L. 93.647) consoli..

dated social service grants to the states under a new Title XX of the

Act P.L1 93.647 established statutory 'sociONservices goals, revised

eligibility criteria, specified program planning requirements and,

generally, clarified operating procedures for expending Federal

social services funds? The spinding ceiling under P.L. 93647 re-

. mained at $2.5 billioh. . The Social ServiCes Amendments of 1976 (P.L. 94401) made the

following modifications iriTitle XX: , permitted thrstates to naive individual agility determination

procedures for certain groups when there was reason to believe that

a substantial portion of the group had incomes below 90 percent

of t]e state's median income; and

. . temporarily imitated authorized ,Title XX expenditures (the

S2..5 billion ceiling) by $200 million annually to support child day .

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. care services, anraintinateithe required state matching for Ohtlays

from this special allotmEnt.

r"--Subsequent amendments to the Act (P.L. 95-171 arid ,P.L. 95-600)

have (a) continued the special earmarked funds rcir quid day care

services, and (b) temporarily (for FY 1979 only) increased the basic

expenditure ceiling to 52.7 billion. (In 1980, the Title XX program

was significantly revised, under P.L. 96-272. Among- the major

changes re (1) permanent funding authorization increases over a

six nod, culminating in a FY 1985 ceiling of $3.3 billion,

restrictions on the amount of funds available for Tide XX train-

,inc activities, (3) a multi-year planning authority, and (4)a separate

funding authority for Puerto Rico and the territories.) . DEVELOPMENTAL Dl57CBILITIES ASSISTANCE AND BILL

RIGHTS ACT

A. Overview

The Developmental Disabilities Assistance and Bill of Rights Act, as

amended, authorizes grant support for planning, coordinating and

delivering specialized services to persons with devielopmental die

abilities The 'term "developmental disability," as used in the Act,

means an mdpnclual with a severe, chronic mental or physical impairment, which (a) originated at birth or diking childhood, (b) is

expected to continue indefinitely, and (c) substantially restricts the

individual's functioning in several .areas of major life activity In

addition to basic grants -maid to assist states in supporting such

planning, coordinating and service activipes, the Act authorizes. NP-7, (a) a formula grant program to support the establishment, and operanon of state protection and advocacy systems, (b) a project grant

program to demonstrate new approaches to delivering services and

training personnel, and (c) a project grant program to support

university-affilpted facilities for tfie development4ly disabled.

111 The term "developmental disability," as defined in the Act, means.

. a severe, chronic disability of a person which(A) is attributable

to a mental oz physical impairment or combination of mental or

physical impairments, (B) is manifested before the person attains

age twenty-two, (C) is likely to continue indefinitely, (D) results

in substantial functional !Mutations in three or more of the fO1-

lowing areas of major Ilk activity. (I) selkare, (2) receptive and

expressive language. (3) learning, (4) mobility, (5) self-direction,

(6) capacity for independent living. and (7) economic sufficiency,

and (E) reflects the person's need for a combination and sequence

of special, interdisciplinary, or gencs1c care, treatment, or other

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services which are of lifelong.or extended duration and are 14-

vidually plinped and coordinated.

B. Major Programs Affecting the,Handleapped

Bastc,Crants to States for Planning.pndServic es Formula grants to

states are authorized urider Part C of the' Act Tot receive its Part

allotment, a state or territory is required to establisha state Developmental Disabilities Planning Council This council, working in tandem with the designated state administering agency, is responsible

for developing and submitting a state plan which specifies existing

gaps in services and identifies one or more priority service areas in

which the state will focus its attention. By .law, the state council

must be composed of representatives of the state agencies primarily

responsible for serving deoveloptnentally disabled persons, and providers and consumers of such services.,

States may select among the following priority service areas specified

in the statute (1) case management services, dhild development

services, (3.) alternative community living arrangement services,

and (4) nonvocational social-developmental servic,es. rn addition,

under certain circumstances, a state may elect another priority

service area, provided th$ area is specified in its state plitn As de-

, fined in the law, service activities include delivery of services, model

service programs, activities to increase the capacity o1 institutidns

and agencies to deliver services, coordinating with other services,

outreach to individuals, and training of providers.

A state *mus expend a minimum of SI00,000 or-65. percent (which-

. ever is greater) of its Part C allotment tor activities related to pry:4-

ity service areas Funds must be spent on only one or two, areas in

years when the total Federal appropriation for basic state grants is,

S60 million or less. States may opt to make their second priority

area melt' their own designation, as long as the first is one olf the

four identified above. In years when Federal appropriations range.

from 560 milliOn to S90 million, states may fund a Maximum of

'three areas Under limited circumstances, HHS may grant a state a

special waiver, to select an alternative service priority area. FY 1980

appropriations: S43 million

.Rejerences Developmental Disabilities Assistarict and Bill of Rights AO, as

amended. 1'1. 88-164. PL. 91-517, P L 94-103. and P.L. 95.602 U S. Code

42 U SC. 6061. C.F D ,I4.4 13 630,

2 Grants to Protection and Advocacy Systems. Section 11.3 of the

Act authorizes formula graitts to states for the establishment of a

system to protect the rights of persons with developmental disabilities, The basic mission of a state protection and advocacy

108

102.
system is to pursue legal. administrative and other appropriate remedies to insure thit deyelopmentally disabled persons receive ap- . prosiate care andtfeatment, The protection and advocacy agency

trust pte an autonorrilus unit, independent of any agency responsple

For rendering sell/ices tt.) developmentally disabled persons, including

the state DD council Each Eland A agency is responsible for report-,

ing on its activities too the-Secretary :of:Health and Human Services

- EY 1980 apprbprianons $7.5 mrilton .

Reference; Developmental Disabintbes Act, as amended P L 88464, P L

91-517,P L 94-103, and PL 9$402 42 U SC 6012 C D A 13 630 . I 3 Grants to University Affiltate,1 Paul:ties Parr il of the Act authorizes grants to support the administration and operation of uni4isity

affiliated facilities Grant funds may be used, to support. (a) till

terdisciplinary training for personnel preparing to serve developmentally disabled persons. (b) clemonstrationS of t4, provision pf exern-

,plary services to developmentally disabled churl ipr and.aduits. and . (3). applied .r.dea,,r0 and demonstration of findings related to thee

, , provision of services FY 1980 appropriation; 57 million . Rjererfces 13evelopmentar Disabillt!es' Assistance and Bill of Rights Act, as

arfiended P L 88.164: P L 91-517, P L 94-103. and-P 1, 95.602 U S Code

42 SC 6oa1 CPI) A 13632 . 4 Special Plyiee Grams Part D 6f the Act authorize s*grarus to

state and local public agencies an0 mmprofirorganizations to'support projects whicli "hold promise of expanding or otherwise improvibg §ervices , to persons- with developmental .disabilities

Such prOeets may focus on (1) public awareness, (2) coordination

of available community resources, (3) the dertorsacr.alion of service

provision tec.hnntiues for disadvantaged persons wanevelopmental,

disabilities, (4) the provision of technical assistance relating t9 planning, services and facilities, (5) the training of specialized pervimel,

(6) the development,or demonVration of-new techniques for service

provision ,*(7) the collection and' dissemination of information, and

(8) the 'general improvement of the veiny ad administration of

services, and the retention of personnel servuTlevelopmentqlly diif

/

abled persons :FY 1980 appropriations $4.7

References Develogmental pt i,aitles Assrstarice and Bill of Rights Act. u

amended. P L. 94-103..and P 95.602 iJ S Code 42 U.S C 6081 CF.D A.

136.3h

C. Legislative History

The Developmental Disabilities Assistance and Bill of Rights Act

evolved from the Mental Retardation-Facilities Construction Act of

_103

1 0 9

I

4,
1.963 (Title 1, P L. 88-164). The 1963 Act authorized Federal sup , port 'for the construction of mental retardation research centers,

university:affiliated training facilities, and community service lack

-ties for mentally retarded children and adults The Mental Retardation anendments of 1967 (P L 90-170) extended and expanded the

legislation by authorizing Federil funds to assist in the rosts of nun-

' awl services in cdmmuruty mental retardationlacilities.

The Developmental Disabilities Services and Facilities Construction

Amendments of 1970 (P.L. 91-517) significantly expanded the

scope and purposes of the Mental Retardation Facillties ConstriTctioh Act of 1963. The 1978 legislation was designed to provide

states pith broad responsibility for planning and implementing a

comprehensive program of services and to offer local communities a

strong voice in determining needs, establishing priorities, and deyel.

,oping a system for delivering services.

Aid for the construction acommunity facilities for the mentally

.(retarded was replaced by a combined formula ang project grant

program covering both construction of facilities and the provision of

services. In adds ton, the scope of the program was broadened to include not only the mentally retarded but also persons suffering from

other serious developmental clivbilities originating in childhood.

The term developmental disability was defined in the 1970 Act to

mean "a disability attributable, to mentatretardluon, Cerebral-palsy,

epilepsy, or another neurological condition found by the Secretary

of Health, Education, and Welfare to Be clpfely related to mental

_retardation or to recppre treatment similar to that requireB for

mentally retarded individuals ," In addition, the disability was regulled to pe,substar itial nature and have originated before the individual reached age eighteen and have continued or be expected Co

continue indefinitely. -)

Title I allotments to the idles were tb bocialcidatedA the basis of

population, need for services, and the financial Weed cif the state.

Howevet, each state was to receive a minimum of S.100,00Q per year.

The Developmental Disabilities Assislanoeband Bill of Rights Act of

1975 (P.L,. 94-103)authonzed a thleenyear extenlion of state formula grants.to assist in planning aid ,-plerrienting programs on betsf divelopmentallydisabled M d adults and continued

11514ort for university affiliated -:-1 addition, P.L. 94.193

made several significant changes mu . ginal statutory authority

104 ' It

I
for die Developmental Disabilities prograd. Among these changes were: (1) The term "developniental disability" was broadened to include

autism and dyslexia, however, only dyslexic children and adults who

also, suffered from mental retardation, cerebralfpalsy, esdepsy or autism were to be eligible for services.

(2) A new fundinuthonty was added to assist in renovating and

modernizing university affiliated facilities In addition, a portion of

increased UAF grant funds was to be set aside for feasibility studies

and operating ;Support for satellite centers in states without UAF

iprograms.

(3) A new specuil project authonty-was included in the legislation.

Thi purpose of this program was to'assist public agencies and nonprofit orianizations to demonstrate new and improved techniques

for service delivery and information dissemination. Twenty-five percent of appropriated funds had to be set aside for national sigrufi- -. can cc grants.

(4), Numerous changes were made in state plan requirements, including. (a) a reduction in the maximum percentage of a. state's allotment which could be obligated for construction purposes (from 50

to 10 percent), (b) a requirement that the state plan incorporate a demstuutioAallation and institutional reform plane (c) provision

for the state plannm,council, to review and comment on all state

plans affecting the developmentally.disabled, to the maximum extent feasible, and (d) provision for protecting the interests of em- ployeeilm any deMstitutionalization plans.

11S1'

i

(5) A requirenfelifihTit all DDSA grantees takejaffinnative actio q_

employ and advance qualified handicapped individuals was added to

,the Act.

(6) P.1. 94-103 directed the Secretary ttf HEW to develop a com- prehensive performance based system for the evaluation of services

provided to developmentally disabled persons within two years after

o, the enactment of the legislation States, in tum, were required to ImpIement the system within,two years_after Its promulgation by the

SecreterY

(7) The composition of the National Advisory Council on Services

and Facilities for the Developmentally Disabled was revised to include nine ex-officio members and sixteen members appointed by

the Secretary of HEW In addition, the duties of the Council were expanded to include, (a).advising the Secretary on grants made

105

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r.) under the 'Act,,and (b) submitting an annual report to Congress on

the administration of the p?bgtem.

In addition to changes in,the existing Developmental Disabilities pro

gram, P.L. 94-103 added a new title (Title II) designed to protect the

rights of 'deveJopmentally disabled individuals. (For details on rights

of-developrhentilly disabled persons, see page 9!.)

Title Ill of P.L. 94-103 directed the Secretary to forward to Consuss, within six months after enactinynt'if the legislation (end an-

. nually thereafter), his recommendations On conditions which should.

be included in the term "developmental disabditiell The Secretary

also was required to commission an independent 4.ontractual 4tudy

of the appropriateness of the currerirderuution, recommendations

for revisions in the defirktion, and the adequacy of services to ex-

.* eluded disabled groups, , In 1978, the Developmental Disabilities At was furtter revised by

the Rehabilitation, Comprehensive 8er/ices and Developmental

Disabilities Amendments (P L 95402) chaiges in the bb program

included (a) a revised definition.of the Aligibk popula ion, b

shift of emphasis for planning to`priority, service areas, (c) a clarifi

cation in the rolkand changes in the cpmpoition of state planning

'councils, (di a clearer statutory delineation of the Mission of umver

sIty ahiliated facilities, (e).increased authorization levels for state

r otec t Ion and advocacy systems, and..(t) dIscontinuation of the

National Adnsvry Council.

Under P.C. 95-602, Congress adopted a new. definition of the term

"developmental disability" which stuffed' the emphasis from etio

logicat_duability.--eattefics_to_the_sezerity_ of functional impair

meUts The new defuutinn eliminated. the previous references to

specific disability categories (e g mental tetardation, cerebral palsy.

epilepsy and autism) and substituted language which underscored

the, early severity and chronicity of" the functi impairments

among the special target population of the program.

P.L. 95402 required the states focusqn increased staid e of t elf

Fide/al-state grant funds on a limited. number of pr1611 ce areas. The Act also specified that tht couftcil and the administering

agency were_to "Jointly" ,develop the state developmental disabilities plan. . The composition d the state planning council was modified to allow

. at least one-half, instead of one-thudrof its members to be consumer

representatives The remaining hal( was to be made up,of provider

and state agency representatives.

106 .

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, P L 95-602 clanfied the functions of UAFs arid satellite centers.

The statute also mandated the istablishmenr of UAF standards

'within six months of enactment of P.L. 95-66rin addition; P.L.

95-602 provided for a minimum allotment of 3150,00010 univer-.

sity affiliatedfacilities and 57$,000 to existing satellite centers

The 1978 Amendments made one substantive change to the prowinos governing state' protection and ,advbcacY systems-1 e , it

estabhstied a muurnum state allotment of $50,000.

DOMESTIC VOLUNTEER SEFIVICE ACT OF 1973

The Domestic Volunteer Services Act, of 1973, as amended, authonzes

several Federg assistance programs aimed at harnessing the resources of,

volunteers to help underprivileged people Among the progranis authorized under the Act arc /he Foster Grandparent Program, and the

"Helping Hand" Program The Foster Grandparent program provides

grants )to public and nonprofit private agencies and organizations to

cover up to 90 percent of the costs of developing and operating projects

designed to give lowitncome, aged persons opportunities to receive

modest finanestal compensation while serving children with exceptional

needs in health, education, and welfare. settings. Approximately 70

percent of all foster grandparents currently involved in the program are

working with 'genially retardy youngsters in institutional and coinmutiny settings.

The Foster Grandparent program originally was authorized under the

Economic Opportunity Mt of 1964, as part of President Johnson's

"Wai on Poverty " in 1967, however, legislative authority for the pro- \ r eisern w trar4ferred to the Older Americans Act (Pt. 91-69).

In 1973, ngress consolidated a variety of existing Federal voluntary

service pro s under a single statutory authority, called the Domestic Volunteer rv1ce Act (P,L 93-113). The X973' legislation also.

(a) created, b Alaw, the ACTION agency, an independent Federal

agency responsible for administering volunteer service programi, and

(b) established tve Senior Compankin Program to permit lorneome,

elderly volunteers to aid adult, with exceptional needs. The Senhir

Companion Program was Ihtended to provide a parallel auShonty

to the Foster Grandparent Program, focused on dependedt adults,

especially frail eld,erly persons. - The Older Americans Amendments of 1975 (P.L. 94.135) extended the

authorizations for the Foster Grandparent anit Senior Companion

Programs, while the 1976 amenam{nts (P.L. 442 3) to the Domestic

Volunteer jernct Act directed the ACTION agency to all7w mtptally

107
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retarded individuals who were participating in Foster Grandparent pro

grams to continue receiving services, under certain circumstances, after

they reached 21 years of age. P L. 94.293 gave private nonprofit

agencies operating Foster Grandparent programs broad discretion to

determine. (a) whirl children should receive services, and (b) the length

of time a duld'may participate in the program .However, the primary

focus of a FosterGrandparent grant program still was to be on services

i to children under 21 years of age.

The Comprehensive Older Americans Act of [978 (P L. 95478) once

again extended the Foster Grandparent program for three years, consul

idating its authorizations with the Senior Companion Program The

legislation also raised the stipend that participants could receive from

$1.60 to $2.00 per hour (if overall appropriations for the program are

high enough to fund at least the current number of slots) The legisla

lion also redefined the term "low income" to mean persons with annual

income of 125 percent (rather than 100 percent) of the government's

poverty mulex

The Domestic Volunteir Service Amendments of 1979 (P.L 96 143)

established a new demonstrauun program aimed at ledticjng the need

for institutionalization among handicapped" and elderly persons. The

so-called "Helping Hand" program was designed to utilize person-toperson services, involving both younkr and older volunteers, in an

effort to increase the ability of elderly and handicapped persons to

remain in the community and toreduce their isolation. The program

is to be coordinated with the state's Developmental Disabilities Protec

tion and Advocacy System.

References Domestic Volunteer Service At of 1973, as amended P L 9169,

P L 93-113, P L 94-135, P L 94-293, P L 95478, and P L. 96-143 U.S Code

42 1./ S.0 5011 C.F.D.A., 72.001 and 72 008

COMMUNITY SERVICES ACT OF 1974 [HEAD START)

The Head Start program, Mai:illy deSigned as part of President

Johnson's "War on Poverty," offers comprehensive health, educational,

nutritional, social and other services to economically deprived, pre

school children Project grants are made to local public agencies and

nonprofit organizations, to operate Head Start classes.

Originally authorized under the Economic OpportunitY)Act of 1964,

the statutory authority for the program was amended in 1972 (PI

?2-424) to require that not less than ten pertent of the total number of

children enrolled In Head Start programs nationwide be handicapped

youngsters. The COmmiinity Services Act of 1974 (Pl. 93-644)

reauthorized certain programs originally included in the Economic 0 -.. 108

114

k*
e

Opportunity Act of 1964 P.L. 93.644 also established the Community

Services Administration, an independent Federal agency, to replace the

Office of Econgnuc Opportunity: - . The 1974 Act also revised the requirerhent for involving handicapped

children in Head Start programs, by stipulating that each state assure

that ten. percent of enrollees were handicapped children. In their re- ports on the 1974 legislation, both the House,Education and Labor

Committee and the Senate labor and Public .WeIfee Committee ex- pressed deep concern about the manner in which many Head Start

agencies were implementing the ten percent mandate They noted that

many- youngsters with mild speech 'impediments and other minor disorders were being classiflid as handicapped children in contravention

of the stated intent of Congress. The Department and Head Start

grantees were directed to take the necessary steps to assure that only

children with disabilities severe enough to requires special educatio

related services' be classified and counted as handicap children.

FY 1980 appropriations 5100 mjhon. - References Community Servioes Act of 1974, as amended. P.L. 92.424 and

.P L 93-644, U.S Code 42 U S C. 2921 C.F.D.A 13 sop.

. CHILD ABUSE PREVENTION AND TREATMENT AND ADOPTION

REFORM , i

The Child Abuse Prevention and Treatment and Adoption Reform Act

of,1978 (PI., 95-266) extends child abuse prevention and treatment

programs through fiscal year 1981 and authorizes adoption programs

aimed at children, including handicapped children, in institutions and

foster care homes for whom .adoption may be the best alternative to

assure their healthy development. P.L. 95-266 establishes._ (a) a national adoption information-and exchange system, (b) a national adop

ton and foster care data gathering and inalysis system, (c) technical

. assistance, education and training materials for adoption and adoption

assistance programs, and (d) development of model adoption legislation

and procedures.

References Child Abuselrevention and Treatment 'arid Motion Reform Act

of 1978 P 1- 95-266 U S. Code 42 U S C. S113 C.F.D.A. 13.652.

t

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:TRANSPORTATION

' lifikIAN MASS TRANSPORTATIpN ACT

Section' 1,6(b) Of the Urban Mass. Transportation Act of 1964 was amended in 1970 to require eligible local Jurisdictions to plan and

design miss transportation facilities and services to be available to and

usable by elderly and handicapped persons (P.L. 91453). A special

program of grants and loans also was authorized under the Act to help

state and Jodi' public agencies provide mass transportation services,

which are "planned, designed, and carried out so as to meet the special needs of elderly and handicapped persons?' Such agencies were per- niltted to use Federal funds to purchase special buses or vans for trans-

. porting persons with severe mobility limitations:

The Federal -Aid Highway Act of 1973 (Pl. 93-87) extended eligibility

fof Section 16(b) grants and loans to private nonprofit corporations.ln

addition,lhe 1973 amendments permitted this Secretary of Transporta- e don to earmark up to two percent of the Urban Mass Transportation Fund for special oansportation services benefiting elderly and handl

capped individuals.

The Urban Mass Transportation Act contains three additional 'programs

that affect handicapped persons. The Mass Transportation Technology

Restuch and Demonstration Program provides funding to projects addressed to national'pnorities, including transportation accessibility

for elderly and handicapped persons. The design for the "Transbus," a

sp ecially designed vehicle for transporting physically handicapped per- sons, was financed through this authority.

The Urban Maiss Transportation Technical Oldies program provides grants\ to assist in planning, engineering and designing mass transit projecti, including special phuining efforts for transporting elderly and

handicapped' persons, he Urban Mass Transportation Deinozutration

Grants program supports demonstrationi projects using innovative

techniques and methOds "in an operational environment" that will

improve mass transit service, including special services for elderly and

handicapped riders.

I11 - 11.6
The Urban Mau Transportation formula grant program was %mended

by the National Mass Transportation Assistance Act of 1974 (Pt.

91:503) to require project applicants to assure that the fares charged

elderly and handicapped persons during nonpeak hours do not exceed

one-half the generally applicable rate for other persons during peak

hours In addluon, localities were permitted under Pt. 93-503 to transport elderly and handicapped persons free of charge and still be eligible

for. Federal formula grant aid.

The Surface Transportation Assistance Act of 1978 (P L 95-599) conturned the authorizations for programs serving handicapped persoqs and

emphasized the need to consider handicapped persons under all transportation assistance authonues. The 1978 Act also created a-ntwira&

program for national or local programs that address human resource

needs, as they apply to public transportation activities

References Urban Mass Transportation Act of 1964, as wended P.L. 91453,

P L, 93-87, P.L. 93-503, and P.L. 95-599. U S Code 491.1.5 C. 1601 CF D A

20.504,20.505 and 20 506

FEDERAL-AID HIGHWAY ACT

The Federal-Aid Highway Act-of 1973 (P.L. 93-87) included authonty

for the use of funds under the highway unprovement progrard"to provide adequate and reasonable access for the safe and convenient moye- --

ment of physically handicapped persons .. across curbs constructed

or replaced on or after July I, 1976, at all pedestrian crosswalks

,throughout the state:. Highway Improvement funds also may be used

for providing accessible rest stop facilities

References Federal -Ad Highway Act of 1973. as =enact; P.L. 93-87, P.L.

93643. P.L. 94.280, and P.L. 95-599. U.S. Code. 23 U.S C. 402 C.F.D A.

20.205.

RAIL PASSENGER SERVICE ACT

The Amtrak Improvement Act of 1973 (Pt. 93-146) amended the

Rail Passenger Service Act to establish the National Rail Road Passenger

Corporation, Thu new Corporation was directed to "take all steps necessary to Insure that no elderly or* handicappet1 Individual IS denied

Intercity t ?ansportation on any passenger train operated by or on behalf

of the Corporation." Such steps may include. (I) acquiring special

equipment and devices and conducting special training for employees,

(2) designing and acquiring new equipment and facilities and eliminating architectural and other barriers In existing equipmerli and facilities,

and (3) pioviding special assistance to elderly and handicapped persons

while boarding and alighting and within terminal areas:

117 4
References. Rail 'Passenger Service Act, as amended. P.1.. 93-146 U.S. Code

4$ U.S.C. sot

^ I

113

4 1.18
4,c

I e

4.

VOCATIONAL RE,HABICITATION

REHAB! LITATION'ACT OF 1073

111111.4411

C A. Overview

The Rehabilitation At of1973, as amended. authorizes otter a billion dollars m fedelt4suppoii for training and placing mentally

andphysically handicapped- persons into remunerative employment

To assist in accomplishing this iQdl, a wide vanety o service, demonstration. training and research 4.trii p?tigianis arerestablihed under

the Act. including a maloi federal-state grant-in-aid program.

The origins of the Federal state vocational rehabilitation prograni

can be traced back to 190 when Congress enacted the first civilian

program for assistin,f disabled persons regain work skills Since

that time. the Act has been gradually expanded to include services

-to persons with a wide array of handicapping conditions and. in re-

. cent years. to 'focus increased attention an,. the needs of sevelioly

disabled individuals

vt. The Act. defines the term "handicapped individual" to mean any

individual who (I) has a physical or mental disability which for

such, individual constitutes or results in a substantial handicap to

employment, and (2) can reasonably be expected to benefit in terms

of employability from vocational rehabilitation services- provided

pursuant to Titles I and 111 of this Act " (Note that the definition is

modified for purposes of the rights protected under Title V and for

the scope of interests of the National Council on the Handicapped

Pee POO 127).) " The Act also defines On term "severe handicap" to meada

ity which, reckintes Multiple services over an extended period-ef time

'and results from amputation. blindness. cancer, cerebral palsy; cystic

fibrosis, deafness, heart disease, hemiplegia. mental retardation.

mental illness. multiple scleions, muscuiat dystrophy. neuroltigical

disorders (including stroke and epilepsy), paraplegia, qua*plegia

and other spinal cord conditions. rend failure, respiratory or

119

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"-*.'t pulmonary dysfunctio and any othek disability specified . regulations."

B.Major Programs Affecting the Handicapped

1, Banc Federal-State Vocanonal Rehabilitation Grants Title 1 offi

the Act authorizes formula grants to designated state vocational

'rehabilitation agencies to provide basic services related to rehabil

gating handicapped persons. Funds may be used for the following

purposes.

diagnosis and evaluation of rehabilitation potential and related ' services;

couriseit4g, guidance,,referral and placement services, inclUding

follow-up and follovbalong and other post-employment services,

vocational% and other training services, Including personal and

vocational adjustment services, books and other training materials,

, and family adjustment services,

physical and mental restoration semces, including corrective

surgery or therapeutic treatment and related hospitalization, pros-

, thetic and mho& devices, eye glasses, special services, and diagnosis

and treatment for mental and emotional disorders;

income maintenance for subsistence during the rehabilitation

penod;

interpreter and reader services, rehabilitation teaching services,

orientation and mobility services for the blind; and

transportation to rehabilitation services, and occupational licenses, tools, equipment, and butialstocks and supplies.

In order to receive funds under the Act, statesmust submit a plan to

the. Commissioner of the ltehabtlitatioti Services Administration,

includes the following pro tons (a) designation of a single

state vocational rehabilitation agentgito administer the grant funds,

(b) assurances that each handicapped perSon will receive rehabilita

Iron semces under an indrnduahzed written rehabilitation program,

(c) agreement to cooperate with other agencies serving handicapPed

persons, and (d) agreement to conductstudies of the handicapped

population in need of service and those having received services.

' Funds are allotted to states on a formula based on relative popula

non and per capita Income. FY 1980 appropriations $817 million

References Tile 1, Rehabilitation Act of 1973, as amended. P.L. 93-112, P L.

934516, P.L. 94.230, PI, 95-602, U S. Code.,29 US C 701. C.F D.A. 13 624

4

a 116 nr
2. Innovation ,and Expansion Grants. Palt C of Title.' authorizes

grants to state vocational rehajitation agencies to plan, develop,

initiate and expand special services to the most severely handicapped

persons Funds may also be used.to develop special programs for

groups of handicapped individuals, such as poor clients, who have

difficult or unusual problems in accessing rehabilitation services.

FY 1980 appropriations: 511.7 million.

RefetenceS Put C, Title I, Rehabilitation Act or1973. u amended P.L. 93-112,

P L 93-516, P L 94-230, and P L. 95.602 U.S Code 29 1.1.S C 740.C.F.D A.

13.649

3 American Zan Vocational Rehabilitanori Services. Part D of

Title I authorizes grants to Indian tribal bodies, to cover up to 90

percent of the costs of vocational rehabilitation services furnished

to their members. A state, must continue to provide'services to

Indians if it includes any Indians in its population count used to

determine the state's basic federal vocational rehabilitation allotment (not funded in FY 198 '4 . References Part D, Title I, Rehabs non Act of 1973, as amended P.L. 95.602.

U S. Code 29 UpS C. 750.

4 Research Title II of the Ac t establishes the National Ipstitute of

Handicapped Research and authorizes project grants for research,

demonstration and related activities designed to develop methods,

procedures and devices to assist in the provision of vocational rehabilitation services to handsNOW individuals, el/email), those with

the most severe handicaps. Such project's may include. (1) studies

and analyses of industrial, vocational, focial, psychiatric, psychological, economic, and other factors affetting rehabilitation of handlcaiSpedindividuals, (2)4pecial problems. of homebound And institutionalized individuals, (3) studies, analyses and demonstrations of

architectural and engineering assign adapt9,40 meet the special

needs of handicapped Individuals, and (4) related activities which

hold *promise of increasing knowledge and improving methods of

rehabilitation of handicapped individuals, including those with the

most severe handicaps.

The Natiorial Institute of Handicapped Research is responsible for.

(11Cchninistenng the. research projects mentioned above, (2)

establishing, a network of research centers, (3) disseminating research

findings and other related information, (4) disseminating educational

materials to elementary and stcondary schools, institutions of higher

education, and the general public, Including information relating to

family care and self care, (5) conducting conferences, seminars,

workshops, and inserticepuni, programs concerning research and

117 121
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. engineering advances in rehabilitation, and (6) developing statistical

reports and studits'on the employment, health, income and other,

demographic characteristics of handicapped individuals

The director of NIHR is appointed by the President (and confirmed

by the Senate) and is directly responsible to the Assistant Secretary

, for Special Education and Rehabilitative Services ire Department

of Education. FY 1980 appropriations 531.5 million.

'References Title II. Rehabilitation Act of 197. as arnendrd. PA. 93-112, P L.

) 93-516. P L 94-230, and P L 95-602. U.S Code 29 U.S C 760. C 1 D A.

13 627

- 5 Construction Grants and Loans for Rehabilitation Facilities.

Part A of Title (IfI authorizes grants and loan guarantees tb cover

the cost of con t(usting rehabilitation facilities Grants may be made

to state agencies, public or nonprofit organizations for the construction, staffing and planning of rehabilitation facilittta. Staffing costs

may cover compensation of professional or technical personnel of

the facility from the opening to the fourth year of operation, with a

gradually' decreasing percentage of federal support o r period.

The federal share of construction costs is hnut to # tentage

established by the Commissioner. . / ,

d

Federal funding is also availal?le to guarantee 'paygient of the principal and interest on loans glade to nonprofit, private entitiesty nonfederal lenders and by'the Federal Financing Bank for the'conStruction and equipping of rehabilitation facilities (not funded in FY

1980). . - '' ,..' , References Title III. Rehabilitation Act of )973. as amended P L 93-112, P.L.

93,516..P.L.94-230 2011P I 4502. U.S. Cock. 29 U.S C. 771. . ,

6 Training. Title III of the Act also authorizes grants to state

agencies and other public or nonprofit, organizations, including

institutions of higher education, to support tralniag projects,

traineeslups, aisd related activities designed to assist in increasing

the numbers of qualified personnel available to provide vocational,

medical, social and psychological components of rehabilitation services to handicapped persons, , Training also may be provided for personnel ...specially, .trained in

providing employment assistance to handicapped individuals through

Job development and Jo'b plactment services, recreation for ill and

hlndicapped individuals, and other areas of triming.contnbutuig to

i the rehabilitation of handicapped persons, incllichng persons who are

homebound, initliutionaliz,ed or have limited English-speaking abii-

. Ines. FT 1980 appropriations; 328.5 million. ,

1 . 122 118 "

A.

NO

S

(

s ...-
a. '.

. ...0* - l,l.., s

.

. &tapas Title III, Rehabilitation Act of I973b.as amended P L. 93.1)2,

Mr. 93-516, P L. 94.230, and EL, 95-602. U S Code. 29 USC 763. C F D A.

. 13 629.., . ,.. 9

' 7, Special Programs and Supplementary Services Title 1l of the

Rehabilitation Act also authorizes aesenes of special grant programs .... to issist in :the rehabilitation of certain groups of handicapped In&

viduals. FY 1980 appropriations. 426.8 million. s. i

C. 4

a Rehabilitation Centers. Section 305, authorizq. the eftablishmerit and operation of Comprehensive Relpabilitatip,e Centers. e..., Grants are made to state vocational rehabilitation agencies to set

up centers servingXs the focal points in the communities for the

development 'id delivery of servtces,to handicapped indundusals, . including th't provision of information and referral, counseling,

. a

.job placement, health, educational, social and recreational

se jukes,

. b Spinal Cordfinjury Projects. Section 311 authorizes grants to

state_and other public and nonprofit 'organizations for special

demonstration projects relating to serving severely handicapped . persons, especially persons with spinal cord injuries and deaf and

blind individuall, regardless ol their rehabilitation potential. A or C Migratory Workers. Sectfan 312 provides for grants to state or

local agencies to cover the costs of vocational rehabilitation

services to migratory workell. Applicants for these grants must

Assure that activities and assistance will be coordinated with other

. programs serving migratory workers.

A Deaf-Blind Center. Section 313 authorizes the establishment

and operation of the Helen eller National Center for Deaf2Blind

Youth and. dults. The cen r is responsible for. (1) demonstrating methods of providing into sive specialized services needed to

rehabilitate deaf-blind individuals and tinning professional and

allied personnel to deliver st .-1rvices, (2) conducting researcti;

into the problems of rehabiliiifflfg deaf-bhnimdividuals, and (3)

supporting related activities to expand or improve public ulder.

_54 stancling of' deackhyd Individuals, ,

'Reader

... . e. e and Interpreter Services. Sections 314 and 315 author

raze grants to.state agencies and other public or nonprofit organizations for the establishment of reader services for blind and

interpreter services for deaf individuals.

f. Recreation. Section 316 authorizes grants to state agencies

. . and public and nonprofit orenizations for the developme4 of

jirograms to provide,, handicapped perso s with recreational

PI activities to aid in their mobility and

%., anion.

112 :

.

, . 12 S a , I ... . % .

'4

..
Ism

References. Title W, Rehabilitation Act of 1973. as amended. P.L. 93-112,

P,L. 93-516, P.L. -94-230 and P.L. 95.602 US Code. 29 U.S C 770.

C F.D.A.: 13.626.

8. Employment Opportunities. Title VI o...f9,;h: Act establishes three

special programs aed at enhancing empl aimed ent opportunities for

handicapped persons.

a. Community Service Employment. Se tion 611 authorizes the

Community. Service Employment Pilot =Program, administered by

the U.S. Department of Labor. The main aim of the program is

to provide full or part-time community employment to handicapped persons referred by state vocational reh bilitation agencies. The Labor Department is authorized to e ter into agreements yr* public an4 private nonprofit agen es, including

national orgaruzatizns and state and local governor nts, to conduct such pilot prole The Federal govenuneIN w ay up to

VII percent of the costs 6f carrying out sitch.projects.

The pilot projects will offer. (I) training and subsisten payments during the training pehod, (2) payment for any reasonable

work-related expenses, transportation and attendant careLand (3)

placement services for employees in unsubsidized jobs when

federal assistance for the project terminates.

b. Projects with Industry. Section 62I authorizes the "Projects

with Industry"sprogram. Under this authority, the Federal government ray 'efiter into agreements"with mdividuil employers

and others to establish jointly Minced projects (maximum federal share of 80 percent) that deliver training and employment

services to" physically and mentally handicapped persons in a

realistic work setting. Follow -up supportive services are to be

provided in conjunction with the project in order to assure

-handicapped persons continued employment opportunities ilz

Jobs for which they have been pained.

c. Business Opportunities. Sectiog 622 establishes a program to

expand opportunities for handicapped personsitg,open small

businesses. Grants and contracts are authorized to enable such

individuals to start up and operate commercial enterprises and

to assist in the development or marketing of their services/

products:.

References. Title VI, Rehabilitation Act of 1973, as amended. P.L. 93-112,

P.L. 93-516, P.L. 94-230 and P.L. 95-602. U.S. Code. 29 U.S.C. 795.

9. Comprehensive Services for Independent Living. Part A of 'ridsVICauthorizes formula grants to state vocational rehabilitation.

120

W.
agencies (or another agency specifically designated by the Governor

and approved by the Secretary) for the provision of comprehensive

independent living services Such services must be designed to meet

the current and future needs of Individuals whose disabilities are so

severe that they do not presently have the potential for employment

but may benefit from vocational rehabilitation serriceilvluch will

enable them to live and function independently Priority will be

given to disabled persons not currently served by other programs

under the Rehabilitation or Developmental Disabilities Acts

Independent living services may include (1) counseling, including

psychological, psychotherapeutic and related services, (2) housing,

including, appropriate accommodations and rhodifications of any

space to serve handicapped persons, (3) appropriate Job placement

sernces, (4) transportation, (5) attendant care, (6) physical rehabilitation, (7) theraikutic treatment, (8) needed prostheses and other

appliances and devices, (9) health maintenance, (10) recreational

activities, (11) services to children of preschool age, including

physical therapy, development- of language and communication

skills, and child development services, and (12) appropriate preventive services to decrease the needs of individuals served under this

program for future independent living services

Allotments to the states under tfir comprehensive independent

living .services program will be distributed according to relative

population, with a minimum of $200,000 per state, or one-third

01 one percent of the Punts appropriated in any given year (whichever is greater) The state vocational rehabilitation agency ideng

rated as the administering agency for program, with aMority

to contract with other agencies and organizations for the provision

of serncos To receive funds under Part A, a state must submit a

three-year plan .for comprehensive independent living services to

"RSA (The Part A program was not funded in FY 1980.) The plan

must include

a descriptioq of the quality, scope and extent of services and the

state's goals and plans for distributing funds to independent living

services programs:

assurances that service delivery facilities will be accessible to

handicapped peisoni;

assurances that special efforts will be made to provide technical

assistance to poverty areas;

stipulations that up to 20 percent of the state's allotment for

comprehensive services will be passed along to local public agencies,

121

425
or private nonprofit organizationk(the Commissioner o(the Rehabilitation Services Adminstrition has the duthonty to waive this

_requuernent)..

- References Put A. Title VII. Rehabilitation Act of 1973, P L. 95402. U.S

Code. 29 U S C 796.

-10. Centers for Independent Living. In states having approved independent living pldns, RSA,may make grants to vocational rehabilitation agencies to establish and.operate centers for independent

living. Handicapped individuals rritijt be substantially involved in the

policy development and management of such centers, which may

provide intake counseling,and evaluation of client needs, referral

and counseling for attendant care, advocacy , reggiiing legal and

economic rights, skills training, housing andiwnsportation referral

and assistance, health proparts, Ipommunity group living arrangements, indrndfal/group social and recreational activities, and attendant care and training of personnel to provide such care. FY 1980

appropnations: 315 million.

References Put B. Title V11 Rehabilitation Ace of, 1973, as amended P

95.602 U.S. Code 29 US C, 796 C.F.D A.:13453.

11 Services for Older Blind Individuals. This special program provides independent living services for peisons over age 51 whose visual

.imparment is -severe enough to make gainful employnient extremely

difficult, but for whom independent living goals are feasible. Services

under Part C include, qutzeach, treatment, provision iof eyeglasses

and other aids, motlity training, and guide and reader services. j

Funding for this part may not exceed 10percent of the amount appropriated for Title VII This program was-not funded in FY 1980.)

References Put C. Title VII. Rehabilitation Act of 1973. as amended. P.L.

95402. U S. Code 29 U.S C.796.

12. Protection and Advocam. Under the general prove ons of Part

1), -grants to states are luthorized tp-tiliblIshAnte , independent

of service delivery agencies, for the protection and advocacy of the

individual right's of tandicapped persoris. Such systems may pursue

legal, administrative and other appropriate remedies In cases where

the rights of disabled per are being violated. (This program was

not funded in FY 1980.)

Reference:4 Put D, Title yn't Rehabilitation Act of 1973. fs amended. P.L.

95-602..0 S. Code 29 U.S.C. 796.

C. Legislative History

The Federal -state vocational relibilitation program can trace its

origins to the National Civilian Vocational Rehabilitation Act of

126

122
0

te A 1920, which established a system of state vocational rehabilitation

agencies. Major revisions to the program were adopted in 1954,

when the Act became known as the-Vocational Rehabilitation Act.

The Act was completely rewritten once again in 1973 (P.L 93-112)

to -place a stronger fo9iron rehabilitation services to severely Nandi- * capped clients. This emphasis was significantly expanded under tht

Rehabilitation, Comprehensive Services, nd Developmental Disabilities Amendments of 1978 (P L. 95 -602), by the addition of grant

authority,for comprehensive independt.* hying services to severely

handicapped persons The 1978 Amendments- also significantly revamped the Act's research authority, including language establishing

a National Institute of tiandicapped Research.

1. Banc State Grant Program. The 1965 Vocational Rehabilitation

Amendments (P,L. 89.333) provided for more flexible financing and

administration of state vocational rehabilitation programs, including

provisions alloWing F deral matching of local public funds made

available to the states P.L. 89-333 also permitted Federal funding to

be used for extended uation periods of up to 18 months in the

case of mentally retarde ns and other persons with disabilities

designated by the cre ry:

Amendments to e Act in 1967 (P L. 90-99) required the states

to eliminate re dency requirements which excluded from vocational

rehabilitation crvices otherwise eligible handicapped persons whio

were residing in the state. In 1968, P.L. 90-391 made a number of

modifications in state plan requilements and increased the Federal

shore of vocational rehabilitation funding to 80 percent.

The Rehabilitation Act of 1973 (Pt. 93-112) recodified and revised

the fainer Vocational Rehabilitation Act, placing a new emphasis

on expandliig services to more severely handicapped clients. or the

(fist time, state vocational rehabilitatiorOgencies were direc ed to

give priortgli; serving "those individual; with the most vere handicaps" in their basic stateiyovams In addition, state age es were required to describe "the method to be used to expand d

improve services" to this target populatidh.Sfmilar provisions gra

Ins priority to the most severely handicapped were included in th

statutory authority for other programs under the Act.

The Rehabilitation As4.of 1973 also required that the state agency

develop an individusliml written rehabilitation program on each

client it served. This prOgram, which was to be jointly developed by

the rehabilitation counselor and the handicapped individual (or,

in appropriate cases, his parents or guardian), was to spell out the

terms, conditions, rights and remedies under which services were to

be provided to the individual and establish the long range and

123

127

rrowurk...
intermediate jolts to be attained The-Act required, that each individual's pjOgram be reviewed at least annually and safeguards be

included to assure that every individual capable of achieving a vocational goal had-an opportunitylp do so.

P.L. 93-112, for the first lime, also Istablished, by statute, a Rehabilitauon Services Administration within the Department of Health,

Education, and Welfare and delegated to the RSA Commissioner

responsibility for administering all aspects of the rehabilitation

program authorized under the Act (The. Rehabilitation Services

Adnumstratinn was later_ transferred to the Department of Educationtunder thik, terms of the Department of Education Organization

Act (P.I..96-88); see page 23.)

The 1974 amendments to tfie Act (P L. 93-516) clarified a number

of the provisions of the Rehabilitation Act of 1973. One modification was the addiuori of a broader definition of "handicapped pdf

vidual," applicable to\Title IV and Title V of the Act (see discussion

on page 115). P.L 93.516 also revised the requirement rorelitevelopmg di individualized v<ntten rehabilitation plan on each.' client.

Emphasis was placed on reporting and analyzing the reasons fdr

determinations of ineligibility for services and re-evaluating individuals refused services to ascertain whether they have any potential

for achievinivocational goals. Clients must be given an opportunity

to participate in any determination of service ineligibility and be

advised of their rights and the remedies available to them.

The Rehabilitation, Comprehensive Services and Developmental

Disabilities Amendments of 1978 (Pl. 95-602) revised the formula

for- determining state allotments, under the basic Federal-state

vocational rehibilitation grant-in-aid program and hap& future

funding increases for the program to the national Consumer Price

Index. The 1978 amendments also provided for the establahment of

a number of programs and the expansion of existing rehabilitation- related services to handicapped and severely handicapped persons

under the Rehabilitation Act of 1973.

For fiscal years 1979 through 1982, authorization levelrfor the

basic vocational rehabilitation program were tied to increases in the

Consumer Price Index. Adjustments will 15e made, using the base

funding level of 5808 million in FY 1979. Such levels were intended

124

128-,

aq.
to be a minimurn_threshold, the maximum authorization levels were

specified in the new law, as follows:

Basic State VR Grants

(urnulhons of dollars)

FY.1979 FY 1980 FY 1981 FY 1982

S808. $880 $945 , $972 11

2. innovation and Expansion Grass.. Innovation and expansion'

grants were authorized under Se,ctI6n 3 of, the Vocational Rehabilitation Act of 1954. These grants were to be used to expand and

improve reb4bilitation services, partiCularly services to severely

disabled and other hard -to- rehabilitate clients. In 1965, amendments

to the Act (P.I. 89-33) increased the Federal share for innovation

and expansiOn grants to 90 percent in the first three years of funding

and 75 percent of cost during the next two years. The Rehabilitation

Act of 1973 (P.L. 93112) recodified the alithonty for such grants.

3. Research. Research programs under the early versions of the Act

were 'significantly expanded by the 1978 amendments to the Rehabilitation Act (P.L..95-602). The 1978 amendments established a

National Institute of Thndicapped Research, with broad). nsibilities for an expanded research program. Among the key featu f

the statutory provisions authorizing the new Institute are the following:

The Institute was created as a separate administrative entity

within the Department, independent of the Rehabilitation Services

Administration, with a director appointed by the President,

A network of research and training centers, developed in conjuno

k 4 Lion with Institutions of higher education, was authorized to train rehabilitation, professionals and researchers and to coordinate and

conduct advanced research: The twenty existing federally-funded

Rehabilitation Research and Training Centen formed the balls of

this network;

A Federal'Interagency Committee was established to identify and

coordlritate all federil rehabilitatiod research activities, and

A long rangi plan fOr rehabilijation research.was to be developed

to identify research needs, funding priorities, and the goals of the Institute. ' Rehabilitation Research and Training Centers were mandated,

among their other lines of inquiry, to conduct ,research and model

programs demonstrating innovative methods of providing services

to -preschoolaged hanclicappeil children. Such service-related

125

4
111*15131f!rells

I

"4.

1.4

esearch was to include (a) early intervcntion. parent.counseling.

infant stimulation. and early identificatrun. c14,agnosis and evalua

tiun of severely handicapped physic-11 thelpyjangualke

development, and pediatric. nursing and psychiatric services. and id)

approprwe services for parents

4 R'ehabilliarbitt Factlaris Authorization to construction of rehabditaticn iacilities was included in 1964 amendments to the HillBurton medical facilities curistruAion pit rant IP L 158 .443), under

Title VI ofublic Health Seivice t\ct The 1965 amendments to the

Vocational Rehabilitation Act L 89-133) authorized a live -year

progren 01 Federal assistance to plan. build. equip. and initially

staff rehabilitation 4v-dines d workshops

The 1967 amendments to thc L 90 391) permitted funds

under the basic vocational iehabilitation program to be utilized tor

new construction as .well 4 expansion ankLoi alteration m existing

building) A state was permitted to use no more than.ten percent of

its basic allotment for Rich wristructioli activities.,In addition.

states were required to provide assurances thit other vocational

rehabilitation services would nut be diminished by the us(of funds

for construction

The Rehabilitation At ul 1973 (P l '91 112f established a program

of mortgage insurance for kehabilitatiun Jacjluies P L 93.112 authorized mortgage insurance to guarantee up to 100 percent of a loan

for the construction of public or rionproni tehabilitation facilities

Initial capital was authorizer/for the insurance fund and a $200

minion restriction was placed on the total mourn of outstanding

mortgages.

5s Special Projects Authority for special project/and supplementary services has been extended and expanded through anous

amendments to the Voidovnal Rehabilitatioa"Act. The 1967 amendments L 90-99) authorized funds-for the establishment of a

nal Centel fur Deaf Blind Youth and Adults. This federally-

,z,nstruoted ,*.enter was intended Co provide an intensive program of

specialize services to prepare ,deal-blind individuals for adult

espon dities.indudirsgemployment wherever possible. TheCenter

also is responsible for conducting extensive programs of research,

professional training, family Or.entatIon. gnd education, and for

organizing informational services It was named the "Helen Keller

'DK 11311 Buhion proo,Loro has brcomg. put oi rltt 1rc.Jih icwur_.sdoclop- , merit program, 44thocir..tqntin Ink XI.,1, tkre Punt Servm Act. set

ee 56

126

30
National Center for Deal-Mind Youth and Adults' under 1976 Mind

_amendments to the Act (P L. 94.288)

The 1967 amendments (P L 90 99) also a oriced special pioject

grants to state vocational rehabilitation agenci to Fray for up to 90

percent of thFi.ost of furnishing vocational rehabilitation servii.es iv

irugrato7 farm workers 'These services were to be provided in our

donation with other agencies supplying services to migran.t, WUlkei$

The 1968 amendments to the At (P.L 90-391) t xpandid the

authyrity ,,f'or special projects to include. (1) iehabilitation services , for mentally retarded persons. (2) projects with industry, a'nd (3)

- training grants for personnel in agencies serving the handicapped

.persons The Rehabilitation At of 1973 (P L 93-112).revised the

authority fur special projects by deleting provisions for'grants fur

programs serving mentally retarded-persons, and instead targeting

such funds on clients with the most severe handicaps

AMendments to the Act in 1974 (P L 93-516) provided for a White

House Conference on Handicapped Individuals The , purpose of

this conference was to explore the problems raced by handicapped

,Americans and develop administiative and legislative4e,ommenda

lions fork addressing these problems. The Conference was held in

1977,

I

6 National Council on the Handicapped The Rehabilitation Act

amendments of 1998 (P.L. 95.602) established a b member

National Council on the Handicapped Council members were to be

appointed by the President to represent consumers, national organizations, service providers and administrators. researchers. and

business and labor groups It must include at least five handicapped

persons, &heir parents or guardians.

The Council's duties. included. (a) continuing 'review and advice

on *1 policies, programs and activities v./naming handicapped

persons conducted or assisted by any federal agency, and (b) establishing general policy, recommending research activities and overseeing the- operation of the National Institute-of Handicapped

Research.

7. Compkhinstve Independent Living Services. The 1978 amendments (Pl. 95.-602) revised the Rehabilitation Act of 1973 by

adding a new Title VII, entitled "Comprehensive Services for In

dependent Living" The new title provided for. (1) grants to states

for comprehensive setvices (Part A); (2) discretionary grants to support .centers f. independent living (Part B), and (3) grants for

services to o Mind perstns (Part C). Also included in the new

S.

127
. Title Vii was authority to establish protection and advocacy systems

for severely disabled persons (Part D)

WAGNER O'DAY ACT

4 The .Wagner .O'Day Act of 1938..0 amended, establishes a program

tinder which federal wagerpes may procure selected commodities and

services from qualified workshops serving blind and other severely

handicapped individuals. The program's objective is to increase employment opportunities for such handicapped individuals. Procurement is

directed 'by the 15 member Committee for Purchase from the Blind and

Other Severely Handicapped The Corntruttee is responsible for. (I)

determining which commodities and services are suitable for procurement from qualified nonprofit agencies, (2) publishing a list of such

goods and )ervices, (3) deteirrurring the fair market price for items/

services on the procurement list and revising prices as market

conditions ge, and (4) promulgating necessary rules and regulations

irn ment the Act.

The Wagner -O'Day Act of 1938 originally authorized purchase froqi1

workshops fol the blind Amendments to the Act in 1971 (P.L. 92.28)

extended the authority to workshops for other severely handicapped

persons P 1,. 9 ? -28 defined the term "severely handicapped" to mean.

"an individual or class of individuals under a physical or mental disability, other than blindness, which constitutes a substantial handicap to employment and is of such a nature as to prevent the individual

under such disability from currently engaging In not a1 competitivt

employment " The 1971 Act, however, specified that preference wouldbe given to purchases from workshops for the blind through Decem;

31,1976.

rider the 1971 legislation, the Committee was to be composed of 14 -

person1-11 representativ,ed 01 designated Fedejal agencies and 3 I, representatives of the general public. The 1974 amendments to the At

added a fifteenth member to the Committee. The Act specified that the

additional member was to be a private citizen "conversant with the

problems incident to the employment of other severely handicapped

indtviduals."

References Wagner O'pay Act of 1938, as amended. P.L. 92.28, P.L. 93.76, aria

P.L. 93-358. U.S. Code: 41 U.S.C. 46.

RANDOLPH SHEPPARD ACT

Si0- . The Randolph-Sheppard Act authorizes a program designed to provide

gainfur employment for blind individuals operating vending facilities

128

4
411 t

on Federal property. The program was established 111 1938 (P L.

74.732). Authority for blind-operated vending facilities later was

expanded under the Vocatronal Rehabilitation Act of 1954 (11 L

' 83.565) and the Randolph-Sheppard Act Amendments of 1974 (P L.

93:516).

The, 1974 amendments (1) extended the scone of the Act's coverage to

federal property operated by any Federal department, agency or

instrumentality, (2) established guidelines for the operation o( the

programby state licensing agencies, (3) required coordination among

the agencies responsible for implementing- the program, (4) established

administrative and judicial procedures to assure fair treatment of blind

vendors, state licensing ..agencies and the federal government, (5) requued stronger Federal adminisiration and oversight by the RehAbil

station Servitief AdniMistration, and (6) permitted income from vending

machines ui direct competition with blind vendors to accrue to the

blind vendor, or to the state licensing agency for the purpose of establishing a fund for sick leave, vacation and retirement benefits for blind

vendors.

References. Randolph-Sheppard AFt of 1938 P.L. 8,i -565, and P L 93-515.

U.S. Code. 20 U.S C. 107. C F D.A 82.

129

. 5
?".

s ^ MISCELLANEOUS

INTERNAL REVENUE CODE . The Internal Revery Code provides certain special tax credits and

deductions relating to the needs of handicapped persons. .The Tax

Reform Act of 1976 (P.L. 94-455) provided the first comprehensive

overhaul of the U S. tax code since 1954. At that tirbethe following

provisions affectingThe.handicapped were added to the Act

1. Credit for Child Care Expenses: P.L. 94-455 permitted taxpayers

to claim a 20 percent credit for chill care expenses on their annual

income tax return, rather' than treating. such expenditures as an

itemized deduction. In addition, the Act eliminated the 535,000

annual income ceiling and set a limit on creditable expenses of

$2,000 for one dependent and 54,000 for two or more. Under

the former law, a taxpayer was allowed to deduct up to $4,800 for

child care expenses, but the maximum deduction wis reduced by

one dollar for every two dollars of annual income in excess of

535,000. . The net effect of this new approach to treating child care expenses,

benefits families who are required to pay for day care on behalf

of their disabled dependents. As under prior law, child care expenses

are generally limited to children under 15 years of age, except when

a dependent of the taxpayer is physically or mentally disabled and

incapable of selfcie.

d 2. Removal of Architectural and Transportation Barriers. Businesses

were permitted, to deduct up to $25.000 in any tax year for costs

incurred in removing archftectural and transportation barriers to

the elderly and handicapped (including the deaf and blind) in any

facility or public transportation vehicle owned or leased for use

in a trade or blisiness.

This` n ew provision of the Act was intended to encourage the elimination of architecturkl barriers by offering businesses an alternative

to depreciating renovation costs over the useful life of the property

All ,barrier removal projects illust ?meet existing government

131

1,3
ti standards for physical accessibility in order to qualify for the new

tax deduction. 4 3 Lobbying by Public Charitin A more precise delineation of the

restrictions on' lobbying by tax exempt organizations was also contained in the Tax Reform Act of 1976. Under prior law, charitable

organizations, exempt from Federal income tAps under Section

501(cX3) of the Internal Revenue Code, were not permitted to

devote any "substantial part" of their activities to "propaganda"

or other attempts to influence legislation. This statutory test, however, was so vague that IRS was widely criticized for capricious and

inequitable enforcement.

Effective January 1, 1977, P.L. 94-455 permitted charitable organs-

. zations to dither elect to remain under the "substantial part" test

or be covered under a new expenditures test. Under the new prowsions, a sliding scale limitation on overall lobbying activity was establishedranging from 20 percent of the annual expenditures

of,organizatidns with budgets of under $500,000 to $225,000 plus

ten meant of all outlays over 51.5 million for organizations with

annual budgets exceeding $1 5 million. Organizations electing this

new procedure are required to disclose their annual lobbying expenditures.

..

in addition, instead of having the withdrawal oftax exempt status

as the onlyznitity, the new provisions included authority to impose

an excise or minor violations. Loss of exemption is reserved for

sustained and excessive violations. What constitutes lobbying activities ties by tax exempt organizations was also spelled out in the Act.

The Tax Reduction and Simplification Act of 197r(P.L. 95.30) provides certain employers with a tax credit when they hire specific

categories of unemployed persons. This tax credit amount; to 50 percent of the increased taxable wages paid by the employer, above calent

dar year 1977 wages. Pi.L. 93-30 also allows an additional credit of ten

percent of the wages paid to employees who were vocational rehabilitation, refertall Vocational rehabilitation referrals are defined as individuals who (a) have a physical or mental disability which constitutes

or results in a substantial handicap to employment, and (b) have been

referred to the employer upon completion, or while receiving, rehabilitative services under an individualized written rehabilitation plan, as

part of an approved state vocational rehabilitation program.

P L. 95-30 places three limitations on the additional ten percent credit.

(1) only the handicapped person's first year of employment may be

taken into account and it must have occurred after December 31, 1976,

(2) only the first $4,200 of the handicapped person's wages May be

I f

130

132

a
1/4 taken into account, and (3) credits for handicapped persons may not

exceed 29 percent of the total amount of credit the employer earns.

for lining other targeted unemployed workers (N,.B., employers are

allowed- a maximum of 5100,000 in credits for other targeted new

, employees);

The Revenue Act of 1978 (P.L 95.600) amended-the job credit for

hiring targeted groups by allowing a 25 percent credit for the second

year of employment as well as SO percent for the first year Only the

.fast $6,000 of wages per year was to be taken into account The ten

percent additional credit for vocational rehabilitation referrals was

discontinued.

Persons referred by state vocational rehabilitation agencies were con- _

:Meted to be one of the targeted groups for the tax credits, as are

recipients of Supplemental Security Income and general assistance An

employer's tax credits under these provisions may not exceed-30 percent of the wages paid to all employees.

References Internal Revenue Code, as amended P L 94455, P.L. 95-30 and

P.L. 95-600. U.S Code: 26 U S C. 1, et a!

'ENERGY CcrtvSERVATION AND PRODUCTION ACT

The Energy C serntionind Production Mt of 1976 (P.L. 4-385)

authonzfd i pr am to assist, low income, persons, particular) elderly

and handicapped persons, to weatherize their dwellings. U to 5409

per dwelling was made available tainsulate 'homes. To the aximum

extent feasible, volunteers and trainees under Comprehensiv Employ

mint and Trauung Mt programs? and other public services ployees,

were to be used to install the insulation.

A "handicapped individual" was defined in P.L. 94-385 as any person.

eligible to receive benefits under the Rehattfitalion Act of 1973, the

Developmental Disabilities Act, and Titles II and XVI of the Social

Security ,Act. Individuals eligible for cash assistance programs and

those whose income falls below,* poverty level, as determined by the

Office of Management and Budget, were to be considered eligible low

income persons,

References: Energy Consemtion

S.

Production Act. Pl. 9,4-385 C.F.D.A

81.042. .

NATIONAL ENERGY CONSERVATION POLICY ACT

The National Energy Conservation Policy X (Pt. 95.619) authorized

two programs to assist schools, hospitals and public are institutions

to plan and install energy.saving measures. Both programs are divided

133

136 ar

'
1.

ONE. into two phases. (1) conductuurenergy "audits" to assess the condilions or needs of an institution's buildings, and (2) technic assistance

an d financial aid for planning and installing energy conservafion systems., ; : The'prcigrara for public and nonprofit school and hospitals authorizes a fufr ange of activities including initial audits, identification and

imp mentation of energy-saving maintenance and operating procedures, and evaluation, acquisition arid installation of...etergysaving

devices or systems The program for public care institutions (including

residential facilities for mentally retarded and mentally ill persons) is

limited to -energy conservation audits, assistance in doeyeloping facility

maintenance and operating procedures to reduce energy costs, and

technical assistance to determine that energy saving sy.stems or devices

installed Both progami are voluntary and are approved,

funded a d monitored by state energy offices.

Referents National Conservation, Policy Act -.P L. 95-619 C F.D.A.

81052 . HOME HEATING ASSISTANCE ACT OF 1979

The 'Home Ilel7ig Assistance Ail of 1979 (p.L. 96.126) authorized,

an emergency program of Federal payments to states and individuals 4

to off-set the impact of sharply increasing home heating costs on lowincome perstms, including recipients ofpublic assistance and Supple.

mental Security Income benefits" The program was made permanent

by tlte<Crude Oil Windfall PrpfiteTax Act of 1980 (P L 96-223).

Title ill of the Windfall Profit Tax Act authorized the Low Income

Enety AssistanCe Program, providing tax credits and direct payments

to low mconie individuals for the purpose of assisting them in meeting

increased home heating costs. Other energy needs, such as the increased

cost of transportation dile to rim gasoline costs, were not covered by

. this' Jegislation.

States were entitled under the Act to receive allocations based on an

approved energy assistance 'plan This plan must include provisions

for ,disbursing fands to home heating fuel suppliers and directly to lowincome persons In addition, states must operate an outreach program

4o inform elderly and handicapped persons, and other, persons Who

might be home-boynd or unaware of the program, of the availability

of energy assistance funds. States are to provide assuIances in their

plans that priority will be given tb eligible low-income households

havineat least one elderlyor handicapped individual.

Recipients of Supple:inertial Security Income benefits (under Title xyt

of the Social 'Security Act) are generally eligible .-to participate in the

I./

134 i 1 37

V

...E.

ti
home heating assistance program, except for those individuals whose

rfitle XVI payments are reduced because they reside. (1) in a medical

institution receiving funding tinder Title XIX of the Act (Medicaid),

(2) in a household of another, or (3) with a parent or spouse of a

parent (the eligible indiJidual is a child). However, unlike the emer

gency progr under P.L. 96-126, all energy funds under P L. 96-223

will.be all ted to the states, rather than reserving a portion for direct

federal pa ents to recipients of federally-assisted welfare payments

(i.e., SSI ai AFDC).

P.L. 945-223 specifically prohibited the amount of any fuel assistillice,

payment o allowance to be considered as income in calculating count

able two* or resources for any tax, public assistance or welfare program.

The Act authorized 53 billion in FY 1981, to be distributed, among the

states bastd on a complex formida that takes into account the number

of days eer year in the geographic area when heating or cooling is

required.. To assure turielinesst. funds may be aepropnated in the pre

ceding fiscal year.

References. Roble Heating Assistance Act of 1979, as amended. P L. 96-126 and

P.L. . . COPYRIGHT ACT

i The first comprehensive revision in the Federal copyright law since

1909 was enacted in 1976 (P.L. 94-553)

In addition to extending copyright privileges, allowing increased royal

ties for ¢ongwriters and affording authors and artists greater protection,

the 191,6 Amendments contamed the following provisions affecting%

Una and deaf individuals:

A Broa casting performances of nondramatic literary works, directed

at blind or deaf audiences, is not considered an infringe- 46.

ment of copyright, provided (a) the transmission is Made without

any pu se of commercial advantage, (b) the broadcasting facilities

are o ded by a governinental body, ,a noncommercial educational_

station a radio subcariiei or a cable system;

Broadcd Sting a single performance of .a dramatic literary work,

publish at least ten years before the performance date and directed Alt

prima y at blikd individualsois not considered an infringement of

copyri t, provided. (a) the transmission is made without any purpose

of ercial advantage, (b) the broadcast is made through the facil

.ities of a radio subcarrier, and (c) no more than one performance of the

135

13'; a
same work is completed by the same performers or under the auspices

of thtsame olgaruzation.

Under specified'cucumstances, up to ten copies or phonorecords of

copyrighted materials for broadcast by radio information service

carne.s may be made by a nonprofit organization for transmittal to

blind and deaf persons;

Braille copies are exempted from the statutory restriction against

the importation of nondramatic, English language_works_not-produged

in the United States or canada;

The Register of Copyrights is required to develop forms and procedures to obtain clearance to reproduce nondramatic literary Works

Seri braille or recorded form This amendment is intended to expedite

the production and,distribution of books in braille and recorded form

by the Division of the Blind and Physically Handicapped in the Library

of Congress.

References: Copynght Act of 1976 P1.94.553

13

136

410
APPENDIX A'

LEGISLATIVE HISTORY OF KEY STATUTES RELATING TO THE HANDICAPPED

Catagory/Lov Bill Np.

EDUCATION

Elementary & Secondery,

Education Act

ESEA Amendments of 1965

Federal Assistance to State

Operated .& Supported

co Schools for the Hands

capped

Education Amendments

of 1972

Genes*, Education

Hit 2382

9022

.S 659

H R. 7248

'Amendrnents. KR. 12253

Education Amendments S 2657

of 1976 H R, 12835

Edsucation Ametdments 6.1753

of 1978 H R. 16

.0*

I,

Repast No

House

Date of Passage Pubic Law Dominator

Senate House Senate Date

Signed No. House Senate

Federal

Administering

AgeMY

Page

89.143

89.587

921085

95.1'137

89.146

89483

92404

93474 , 94-882

95-856

3/26/65

8/30/65

11/ 5/71

1/28/74

'8/31/76

7/13/78

M1,

4/ 9/65

10/ 1/65

3/ 1/72

2/ 5/74,

8/27/76

8/24/781

4111(65

11/ 1/65

6/23/72

4/18/74

9/12/76

11/ 1/78

1 U

89-10

89413

92-318

93.269

94482'

95-561

Edit. LLHR Of lies of Elementary ft

Secondary

Ethic. Dept

of Education

na
Education of the Handicapped

Act

Captioned Films for the

4

- Deaf Act S 2232 89 1034 139-649 10/ 5'65 8e31/65

Elementary & Secondary I

Education Act Amend S 3046

of 1966 H R 13161 89-1814 891674 10/ 6/66 10/ ma

ESEA Arnendmenis of 1967 H R 7819 90-188 90426 .5/25/67 12/11/67

ESEA AMendrnents of 1970 H R 514 91 114. 91-634 4/23/69 2/19/70

Education Amendments S 1539

of 1974 H R 69 93.805 93.763 3/27173 # 5/20/73

Handicapped Children's.

Early Edudat4on Assistance

Act H R 18763 90-1793. 90-13861 9/16/68 9/17/68

Educatid'n of All Handl

capped Children Act of S

1975 H R 7217 94332 94-168 7/29/75 6/18/75

Authorizing Education

Programs for Handicapped S 725

Persons Ihrough FY 19$2 H R 6692 95-268 95-124 5/ 9/77 St23177

EMPLOYMENT

Comp:Olen:lye Employment

& Trending Act

Comprehensive grnplor

meat & Training Act

AuChi H R. 2992 95.123 95-174 3/29/77 5/25/77

Comprehensive Employment S 2570

& Training Act Amend H R 12462 95-1124 95-891 9/22/78 "8/25/78

141

110/19/65

11/ 3/66

1/ 2/68

4/13/70

8121/73

9/30/68

11/29/75

6/17/77

prism

10/27/78

a Uri 1 L&HR Office of

Spe4sal Educe

Lion &

5

89 258 1 Rehabilitative

Services, De

pertment of

89-750 Education

90.247

91-23'0

93-380

90 538

94.102

95-49

E&L L&HR Employment

end Training

27

95-44

Administration, Department of Labor

95-524
APPENDIX A

LEGISLATIVE HISTORY OF KEY STATUTES RELATING TO THE HANDICAPPEDContinued

Category/Law

---,- Bill No

Report No. * Data of Passage Public Lai Committee

Administering

Agency

Page

Senate House Sonata Date

Signed No. House Senate

, . HEALTH

Social Security Act !Fe. f74_ Social Secu- 37 Social Security Act W &M rity Adm. Amendments of 1963

Social Security Amend.

H A. 7544 88-637 88-551 8/27/63 10/12/63 10/24/83 88-156 Department

of Heeith end of 1964 H.R. 30473 88-1301 834 517 5127/64 8131 /64, 10113/64 88-641 Humen Social Security Amend. ' ` - Soma i of 1964 H.R. 9393 88-1279 88.1518 4/30/64 8/31/64 10/13/64 88650 Social Securlti Amend.

of 1965 H 8.6675 89-21; 89-404 4/ 8/65 7/ 9/65 7/30/65 89-97 . . Social Security Amend. . of 1967 .If R. 12090' 90-544 90.744 8/17/66 11/22/86 1/ 2/67 90;248 e Sociel Security Amend. .1,-- -

of 1972 H.R. 1 92-231 2-1230 10/17/72 10/ 5/72 10/30/12 92803

Intermediate Care,Amend. . of 1971 H.R. 10504 92-590 92.652 11/17/11 12/ 4171 12/2er71 92-223 ' Social Seamy Benefit ' Increase . H.R. 15390 92-1128 92-1215 6/27/72 8/30172 7/ 1172. 92-338 Murrell% Mild Haelth ., . - i

Amendments H R.9410 92 -1143. 6/30/72 6/30(72 7110/72 92-345

.

.- . o 14 )

ti

TO
.s.

So C30 Security Amend.

of 1973 H R. 11333 93-627 11115/73 12/21/73 12/31[73 93-233

Maternal & Child Health

Amendments H R.8410 93-267 93-249 6/13[73 6/27[73 6/ 1n3 93.53

Sods! Security Amend.

of 1977 1404 95-80 95-298.. 7/21/ 6/28/ t 6/30/ 95-59

To provide for reimbursement for rural health

clinic pervices under the

Medicare & Medicaid

VOWS= H.R. 8422 95-548 10./17/ 10/19/ 12/13/ 95-210

Social Security Financing

Amend. of 1977 . H R.9346 95-702 'I it/27/77 11/ 4/77 12/2007 95-216

Medicare End Sate Renal

Manse Program Ariiend. H.R. 8423 95-549 95414 012/77 4/10/77 6/13[77 95-292

Community Mental Health I FC LHR Nations!

Centers Act Institute of

Mental Retardation Facilities & Community

Mental Health Centers

r. Mental

Health, Dept.

of Health &

Construction Act or133

Mental Retardation

S. 1576 843-694 88-694 9/10/63 5/27/63 10/31/63 88-164 Services

Facilities & Community

Mental Health Centers

Construction Act of '65 H.R. 2986 89-278 89-386 57 4/66 6/28/65 8/ 4/65

Mental Health Amend.

of 1967 H.R. 6431 90-212 90-294\ V/17/67 0/ 8/67 . 6/24/67 90-31

1" 143
APPENDIX A

LEGISLATIVE HISTORY OF KEY STATUTES RELATING TO THE HANDICAPPEDContinued

a., t Category/Law

')

BM No.

Report No. Date of Passage Public Law Committee

Federal

Administering

Agency

Page

House Senate '" House Senate Data

S igned No.1 House

* Senate

-To provide vents for con. .___._. ..___

struction of cornmuntiy S. 2523 . mental health ctn. H.R. 14066 91.735 91-583 12/16/69 12/11/69 3113170 91.211 , Special Health Revenue

. S. 66

Sharing Act H.R.*4925 94-192 ' 94-29 611475 4/10/75 7/29/75 14-63

CommbnIty Health

Centers & B' ice' . - Research Ame is S. 2450 .. 95.838 10/15/78 6/26/78 11/ 8178 95-622 . Public Health Service Act v

'WC LHR Public Health 49

Hospital & Medical

Ficslitles Amendments

.

, . Service, Dept.

of Health & of 1964

Community Health Service

H.R. 10041 88-1340 88-1274 5/25/64 8/ 1/64 8/18/64 88443 . Human Ser

vices

ExtenSiOn Afriendmints S. 51()

of 1965 H 8.2946 89.249 89.1175/ 3/65 3/11/66 8/ 5/65 89.109

Hurt Disease. Cancer & S. 596

Stroke Amend, of 1965 H R. 2986 89-963 89-368 9/24/65 6/28/65 10/ 6/65 89239

a 144
2

.00 . fr 1

. r a s % Cornpolltntive Health

Manipur iftubl lc

Hasid) Servicei Amend:

of 1966, PAnership .. , S. 3i48

,.. for Health "' , H.R. 18231

, Partnership for Health

Arnencfnents. of 1967 4.I.R. 6418

Establ(shrent of Nation'al .

. Eye Institute H.14. 12843

64 Resit Soaks: di Pacilit,t

/emend. of41968 H R. 157g8

Yo prowls assistance in

devolopi4 & edmirms-. . rtering leed-baseil p=int - . el iminttiorrprogroals H.R. 19172 t -- cd" . National Advisory .

' th larrnmission on Multiple

'"". 4, Scferosis Acf

Health p.rograrnft xtensign

Act of 1973

LOKI Posed Paint PoisonIng Prevention Armacl.

Notion!. Research Act'

National Health Planning

Resources Doreloprne

Act of 1974

National Arthritis Act

of 1974

H 6. 154;$

5.4136 5, 5.607

KR. 7724

S. 2994

.R. 16204

S.2854 ,

89- 89-1 1047/66

90538 24 I 9/20/67

90-1644 8/ 1/68

901752 90-14.54 7/72/68.

91.1463 91.1432 10/ 5/68

924 i85 92.1604 8/ 1/72,

93. 227 93-87 5/31173

93- 373 83 -130 9/ 5173

93-224 934381 5/31/7,3

93-1382 93-1245 12/13/74

93-1251' 12/18173

Pt .145

10/

11/ 6/67

8/ 2/68

4/27/68

12/17/68

9/27/72

8/27/73,

5/ 9/73

9/11/73

4.4

11/ 3/66

12/ 5/67

8/16/68

10/15/68

J /13/69

841149

904 74

90-489

90-5.74

91.695
I

_ APPENDIX A

LEGISLATIVE HISTORY OF KEY STATUTES RELATING TO THE HANDICAPPEDContinued

Caterers/Law

., Bill No.

Report No. Date of Panne Public Law Committee . Federal

Administering

Agency

, Page

House Senate House Senate

. DIU

Signal

No. House Senate

Special Hee Ith Revenue S.66

Sharing Act H R.4925 94192 94.29 6/ 5/75 4/10/75 7/29/75 94-63

Health Research & Health 5.988 , Service Arnent1,41 '78 H.R. 7988 94-498 94-509 10/20/4tP2/11/75 4r22n6 94-278

National Health Promotion r""-*

. & Disease Prevention S. 1466

Act of 1976 H.R. 12678 94-1007 94-330 4/ 7/75 7/30/75 6/23/76 94317

Biomedical Research & ,... - Related Programs, FY 78 H.R. 4976 95-117 95102 3/31/78 5/ 4/78 8/ 1/78 95-83

Health Senna: Research

Statistical& Technology S.2466

Act of 1978 H.R. 12584 95-1190 95-839 9/25/78 8/ 9/78 11/ 9/78 05623

Health Senekss & Centers S. 2474

. Amendments of 1978 H R 12370 95-1191 95-860 10/13/ 9/29/ 11/10/ 95-626 . HOUSING / BFUA 8HUA Department of 61

Housing & Urban Develop- Housing and pint Alt of 1970 H R. 19436 91.1666 ,94.1216 12/ 3/20 12/ 8/70 12/31/70 91809 Urban Cleve.

Housing and Community S. 3068 ' cement

Development Act of 174 H.R. 16361 93. 1114 934393 8/20/74 3/11n4 . 8/22/74 93383 . 1 4 6.
seL

110tatro9 Auth0f12nsOn

Act of 1976

Housing Authorizations

f Housing & Community

Development Amend. '78

5.3295,

H R. 12945

H R.6655

S. 30134

H R 12433

94.1091

195-2313

%95-1161

94749

95-175

95-871

5/26/76

5/11/77

7/24/78

4/27/76

6/ 7177

7/20f7r

8/ 3/76

10/12/77

1

10/31/78

94-375

95.128

95-557

.

A ..

INCOME MAINTENANCE

Social Security Amend ----

of 1972

Social Security Amend.

of 1973

Supplemental Security

income Benelds

Extend Food Stamp EIigL.

batty to SS1 Recipients

Supplementary Security ,. income Arnendnynts

Supplementary Security

Income Amendments

Supplementary Security

Income Amendments

H R. 1

H.R. 11333

H 8.13025

H R. 15124

H.R. 14484

H R. 10210

H R. 13500

92-231

93-827

93. 871

93-1031

941296

94-755

94-1210

92-1230

93.735

-

' i

941265.

94-1345

. 10/17/72

11/15/73

. 3/ 5/74

6/18/74

6/28/76

729/76

° 6/ 8/7B

10/ -5/72

12/21/73

:

3/13/74

6/20/74

6/30/76

9/29/76

10/ 1/76

10/30/72

12/31/73

3/28/74

7/

7/14/76

10/20/76

''..

1041/76

8/74

.92-603

93-233

93-256

93435.

94-365

94566

94-585

W&M

1

FIN

..

.

Soma/ Secu

rity Adninistravois, Dept.

of Health &

Human Ser.

vices am

.

.

71

..

- 1

AILITRITION

Extend Food Stamp Elk'.

Nifty to =Recipients

National School Lunch &

01 od Nutrition Act of

1974

H R. 16124

6.3450

H R. 14354

93-1031

93-1022

- 93.830

6/18/84

6/ 7/74

. 6/20/74

5/21/74

1 k._

."-. i

7/ 8/74

6/30174

93-335

93326

AGR AGR.

...-- Food & Nutridon Service,

Department

of Agrk&II

. s

tune

m. 81

147
C

. APPENDIX A

LEGISLATIVE HISTORY OF KEY STATUTES RELATING TO'THE HANDICAPPEDContinued

Category /Law . Bill No

Report No. Date of Passage

, Pubic Law Committee . Fedora!

Adminrstenrog

Agency

Fag* ago

g House

.. Senate0

House Senate Data

Silind Heusi Senate

National School Lunch Act

& Child Nutrition Act

of 1966 Amend: of 1975 1 H.R. 4222 94-68 '84-259 4!28175. 7/10175 10/ 7/75 94.105 . S

National School Lunch & . Child Nutrition Act S. 1420

Amendments H.R. 1139 95.281 95-277 5/18/77 6130/77 11/10/77 95-166

Special Supplemental &

Child Care Food Programs S. 3085 , 954620 , 7.....

Extension H 8.12411 95-115,1 95-884 10/15/78 7/21/78 11/10/78 95-627

RIGHTS

.

% f li Elimination of Architectural

Barriers to Physiology S. 222

Handicapped H R 6589 90:1523 90.538 6/17/68 8/25/57 8/12/68 90-480 89

To loama that in fed- 1 . v. *toffy consteuctfactities . . be constricted so es to be

accasoble to the pliysically

handiceppi:-.1

.H R. 14464 91.50 91.658 12/15/69 2/10/70 3/ 5/70 91-205

14 S
r

-

,Rights of the Bind &

Other Physic:silly Handlcogged in O.C. 'H.R. 11032 92.1005 92.1238 4/24/72 9/30/72 10/21/72 92-515

Rehabilitation Amendments

of 1973 H.R. 8070 93.244 93-318 t 6/ 5/73 7/18/73 9/26/7i 93.112

Reatabilitstoon Act Amend S. 4194

of 1974 WR 17503 93-1297 11/28/74 11/26/74 12/7174 93-516

Zebvslopmeritiliy Disabled

Assist' axe & 841 of 5.482

Rights Act H R.4005 94-58 94-160 4/10/75 2175 10/ 4/75 94.103

Edo: Arbon for Ati Nandicapped Children Act of S. 6

1975 H.Rr7217 94-332 94-168 7/29/75 6/18/75 11/29/75 94-142

Public Budding Coopera- S -865

43. tive Use Act of 1976 H.RJ5134 941584 94-349 9/29/75 8/ 1/75 10/18 /76 94-541

Legal Sir vides Corpora- S. 1303

tlon Act Amend. of 1977 H R. 6686 95-310 95-172 6/27/77 X10/12/77 12/28/77 95-222

To extend for those years

c" the Commission on Civil S. 3067

Rights H R. 12432 95-1140 9/ 6/78 6/27/78 10/10/78 95-444

Civil Service Reform Act S. 2640

of 1976 HM. 11280 961403 95-969 9/13/78 8/24/78 10/13/78 95-454

Rehabilitation. Comprehensive Services & OD

Amendments H.R. 12467 95-1149 5/16/78 9/21/78 11/ 6/78 95602

1. ost:b. CI

I
. V

\ --,--N ' i APPENDIX A

LEGISLATIVE HISTORY OF KEY STATUTES RELATING TO THE HANDICAPPED -Continued

"

Category/Law

. Bill No.

i

, Report No.. 'Dais of Palmas Public Law Committee Federal

Administering

\ Agency

Page

House Senate House Senate Der

&Pod

No. House Senate

SQCIAL SERVICES

Developmental (Mobil hirs

Mental Reurdetion

Fecaities & Community

Memel Health Centers

Construction Act of 1963

Mental Retardation

Facilities 6 Communny

Menai Health linters

Construction Act of 1966

Mental Retardation Amend.

of 1967

Authorizing funds for

Increased facilities for

mentslreterdetion

programs

Developmentally Disabled

Asiistence es Bill of

Rights Act

S. 1676

H R. 2985

H R. 6430

S. 2846

H R. 14237

;141/2

HR. 4005

(.,

88-694

T.

89.278

e0-e6

91.1277

94-58

88694

89-366

,90-725

91.757

94160

9110/63

; 61 4/66

9/21/67

, 71.30/69

4110/76

1 5/27163

6/28/65

11/ 6/67

' 4113/69

6/ 2175

,...

10/31te3

, 8/ 4/65

12/ 4/67

10/30/69

. 10/ 4/75

_

88.164

. 89.105

. 90-170

91-617

"

94.103

I FC

,

LHR Adrn in istre

ton on Developmental

Disabilities;

Department

of Heath &

Human Ser.

vices

.

.

....-.

101

.

. 13 u
Rehabilitation, Compri- , hen** Services & DD

Amendments

.H.R. 12487 95-1149 5/16178

. 9/21/78 11/ 6178. 95602 . Child Welters Services

Social Security Amend:

mints of 1967

Social Security Amendmints A!_1972

. H.R. 12080

H.R. 1

90.544

92.231

90-744

92.1230

.7/17/67

10/17/72

s 11/22/67

10/ 6172

1/ 2/67

10/30/72

90.248

,92403

W&M if FIN

\

Office of Human Developmint Services,

Department of

Health end

Services

164

. Social Services Ilide XX)

'Social Services Amendments of 1974

Social Services Amendments

Child Core end Employmint of Welfare Recipients

ExtsTion

Revenue Act of 1978

H.R. 17045

H.R. 12456

H.R. 3387

IH.R. MO)

H.R. 13511

. 93-14

95439

95- 144696.1263

93-1356

768

1

12/ 9174

3/16/76,

6/18/78

8/10/78

a 12/17/74

3/20/76

10/17/78

10110/78

1/ 4/76

9/ 7/76

11/12/78

11/ 6/78

93447

94-401

95-171

95-800

W&M

-".

FIN Office of Human Developmint Services,

Department of

Health and

Human Ser.

vices

...

167

Domestic Volunteer Service

Act

Older Americans

Act Amendments of 1969

Domestic Volunteer Services

Act of 1973

(Sider Americans Amendmints of 1976

it R. 11235

S. 1148

S. 1425

H.R. 3922

91.285

93.406

94-87

91-340

..93-311

94-254

94-26e

.

6/16/69

9/17173

41 8/76

8/13/69

. mem

6/26/76

9/17/69

10/ 1/73

11/28/76

-9149

93.113

94-1135

E& L

1 1, HR ACTION

)..

. 107

x

a° 15
0

0

tcL

APPENDIX A . , LEGISLATIVE HISTORY OF KEY STATUTES RELATINe TOVHE HA ICAPRED -Continued /

. Category /Law

. BM No. , ei

Report No. Date of Passage Public Law' mints ."

Federal

Administering

Agency

..."

1Page

House Senate

, House Senate

. Date

Signed No. Houses Singe

Domestic Volunteer

Servsces Amindments

of 1976 a Older Amencicns Act ' endments of 1979

.1. . H R 12216

,s: 2850

H R 12255

' 95.110

- riri

95855

5/ 4/76

5/15/78

5/13/76

7124/78"

5/27/76

10/1817:

94-

95478

,

..

CoirenungtyiServicesAct

Economic Opportuniti

Amendments of 1972

COmmun!ty Services Act

of 1974

qt.&

S 3010

fri R 12350

Heg. 14449

92-815

93.1043

92-987

93129)

2117/72

5/29/74

" t

t

0

. 9/29/69

4/19/73

029/72

, 12/13/74

.

2/ 345*

05/73

.9/19/72

1/ 4/75

"

10/15/69

8/13/73

92424

93-644

r

""[

91.453

93.87

Eett.

ii

PAT

l

..,

L&HR

' CST

Office of Hu.

man Development Semmes.

Department of

Health and Hu

man Services

Urban Mass

Transportation

Administration

Department of

Libor i

108

'

'

111 '

TRAtisidff-TATION

Urban Mass Transportabon

Act of 1964 . . To provide longterm

"-- financing forrtxpoded

urban mast transportation

programs I

Feerel Aid Highway Act of

103

..S 3154

KR. 18185

S. 502,

,

91.1264

93.118

'91633

93-61

5 2
41

NIIKIInal Mass TransportsIron Assonance MI of

:1b74

Surface Transportation

Assistaisce Act of 1978

S 386

H R 6452

H R. 11733 95-1485

1 93.381 101 3/73

9128/78

9/10.

10/ 3178

11/26173

10/ :

93503

95-599

.

.

/

VOCATIONAL

R ?HABILITATION , ,Vocationei R that'll iia t ecorT

Act Amendmerhs of 1966 \

Vocational Rehabilitation

Amendments of 1967

Vocational Rehabilitation

Amendments of 1968

To extend for 1 y9er the

authorization for various

programs under the

Vocational Rehabilitation

Act.

Rehibilotation Apendments

of 1973

Rehabilitation Act

Amendments of 1974

Rehabilitation Amendments

of 1978

Rehabilita hon. Comprehenshe Semen and

DD,Otmendmenis

H R 8310

H R. 12257

S 32ta

H R 116189

H R 19401

H.R. 8070

S.4194

H R. 17593

H R.'11045 .

H.R. 12467

89432

90.563

901346

1 91.1660

93.244

. . .94-721

95-1149

89-806

90-565

_ 90-1309

91.1433

93.318

93.1927

.

40...... 7t29/66

8/21/67

5/18/68

12/ 7/70

6/ 5/73

4. 11/26/74

. 12/15/75

5/16/78

10) 1/66

9/20/67

6/24/68

t

12/17/70

7/18/73

11126/74

12/19/75

9/21/78

11/ 8/66

IN 3/67

7/77/67

13/31/70

9/26173

12/ 7174

3/15/78

11/ 6178

89333

9019

-,/

90.391

s

s91-610

93.112

93.516

94.230

95-602

E.

'

LHR

.

..

Re-hal:MilsLion Services

Administration,

Department of

Education

.

115

1 53
4'

I

TABLE OFC01AMITTEE ABBREVIATIONS

Noun

EA education and Labor

I FC intentate and Foreign Commerce,

Ways and Man

BF rig. Finance' and Urban Affairs

AGR Agrk9

MT Pudic Works and Transportation

<, k t3/4.)

Sens

LHR Labor and Hulnan Resources

FIN , Firer. , BHUA Banking, Hindng and Urban Attain

AGR Aerkuttura . . CST Commerce. Science and TreraportatIon

2

6

\.. - 154

O

S.

we

4
APPENDIX B

TABLE OF PROGRAMS

CaPolY Mors" CAD A. r*

EDUCATION

Basic Ste. Grants

Pa9;

for Handicapped Education 13.449 6

for Ube* Servica N.. 13 484 16

for Vocational Education 13 493 21

Cancellation pf Direct Loans to Students,

Higher Education 13 470 18

Carew Education Incentive Grants . 13 554,

Centers and Services for Deaf -Slide

13.596 24

Ciildno 13445,

Community Salvias and Continuong

. 7

Education . 13 4911 13.557 18

Construction and Renovation of

Mica, Education Facilities 19

Consumer and Homemaker Education 13 493 21

Early Ch9dood Edwina 13 444

. 7

Educational Information Contra./--. 4

Higbee Education 13.585 19

Handicapped Teacher Reaultmelt t sgd Information 13 452 9

Impact Ald to Feciengly Affected

Arles 13.477,

Improvement In Local Educational

13 478 25

Practices 13.571 2

Innovative Prcgams foc Severely

'Handal:ad Children - 13 588 8

Instrucoons Nadia and Captioned Films 13.448 9

Intarlibrary Coopsation 13 465 17

Model Elementary and Secondary

Schools for the Deaf Acts 23

National Mary Services for the

Blind and Physically Handkatped 42.001 25

ens:hool laxative Grants 13.449 C-.. 7 Program Improvement, Vocational .._ 13.496 22

Regional EducationPrograms for the \-

Handkactial 13.580 8

'Regional fitsouroe Centers, Handkapped

.. Education 13.450 7

// Retards mil Demonstration,

Handicapped Eduction 13.443' 9

StatparatedelS Supported Schools 13.421 1 / Tatar Centers, Misfit' Education 13.418 19

Training for Educators and Other

Personnel, Handicapped Education 1r461 8

153

155
i

CerellorY/ProProm

EMPLOYMENT

Compiehenine Employment and Training

Services

C.F.D.A. *

17 232

Employment Demorirtretion Programs 17.239,17.241

Employment Security 17.207

Handicapped-Owned Busminees 59 021

Job Corps 17.211.

Procurement Set-esides 59 009

Public Works 11.300, 11.304, 11.307,

11.3011

Research and"Demonstration Grants, CETA 17 233

Special Target Populations, CETA 17 243

Workshop Loans 59 021

HEALTH

Arthritis, Rheumatism, Diabetes and Others

Metabolic Diseases, Institutes

13 846. 13.847, 13.848,

13.849

CHAMPUS Progrirn for the Handicapped

Child Health and Human Development,

Institute 13~,864, 13.965

Crippled Ch'ildrsns Services 13.211

Community Mental Heillth Canton Act 13 925

Maternal end Child Health Services 13 232

Medicaid 13 714

Medical Facilnies Construction 13 887

Medical F polities Modernization Lours 13.253

"Medicare 13 773, 13.774

Mental Health 13.237,13 238, 13 242,

13.244, 13.281, 13 210

.National Eye Ihrtitute

Neurological and Communicative

Disorders and Stroke

Personnel Training, Maternal and Child

Health /Crippled Children

Planning, and Alwyn& Ranh

Pirtontion

FIeseerch Irishtrtiee

13.867, 13.868,13.889,

13.870, 13 871

13.851, 13.852, 13.853, ' 13.854

13 233

13 293,3.294

13.266, 13.268. 13.862,

13.890, 13 296

FIeseerch ProlsCts. Maternal and Child 13 231

Health/Crippled Children

HOUSING

Community Development Block Grants 14 216

Congregtts Housing

Direct Loans for Housing the Elderly and

Handicapped (Section 202) 14 157

Rent Subsidies 16 14,156

Rural Housing Wens 10 415

Rural Community Facilities 10 423

Rural Rental Assistance 10 427

if

1 5 G

154

Page

28

28

33

50

59

.50'

38

47

38

43

57

57

41

53

50

50

39

56

51

49

38

67

62

65

61

64
,.

Gregory/Program

INCOME MAINTENANCE

of Page

Adult ()babied Chad Program 13.802 72

Olsolailrty Insurance Bensfits 13.802 72

Rehabilitation Sari/ices, Oisatnirty

I nuisance 13;802 72

. Rehabilitation, Referral and Cc:or:Kling

Services, SSI 13.807 76

,Supplerrentil Security Income 13.807 75

NUTRITION

Child Care Food Program 10 558 B2

a Commodity Orstribution 10 550 81

Equipment (non-food) A;sistaricar i 10 554 85

Food Stamp Program 10 551 . 86

Nutrition Education and Training 10 564 8.4 School Breakfast 10 553 85

School Lunch 10 656 81

School Milk 10 556 / 84

Summer Food Serval Program 10 559 e

62 a SOCIAL SERVICES.

Basic State Grants

for Child WOW, Services 13.645 . 95

for OevoloiTxnental °lambkin*: Service, 13.630 102

. for Social San/km (Title XX) . 13 642 97

Fostar Grandparent Program 72.001 107

Head SiortPrograrn 13.600 108

Senior Cornpariion Program

* Protection and Advocacy Systems,

72 008 \. 107

Developmental °mobilities 102

Reward), Demonstration and Training.

Child Welfare 13.608 96

Special Project Grants, Developmental

Oisebilnets 7 I 13.631

t,

103

Tnining, Social Services Mt! XX) 13.644 99

University Affiliated Facilities Grants 13.637 103 5 TRANSPORTATION

Fadaral Akl Highway Programs 20 205 112

Urban Mast Transportation Act Programs 20 604, 20105, 20 506 111

VOCATIONAL REHABILITATION

American Indian VR Services ^, %) 117

Basic State Grants for VR Services 1d 614 ' 116

centers for Independent Living 13.653 122

CommIttipa For.Purchasa fro, 81inil and

other Severely Handicapped 128

domprotentive Sprvlces for I

Living, e 120

Construction Grants and Loans for

Rehabilitation Facilities 118

155
_CtUpoly/Program * Pax

Employment Opponunides 120

Innovetion and Expansion Grants 13.849 117

Protection and Advocacy 122

Reesenth 13.827 117

SIMON for Olds-9311nd Individuals 122

Special FrOpinit and Supplementary

Services 119

Training 13.829 118

Vending Facilities for tin Blind 128

S

a

)

° V L COT02011317 tRINTIN 0 OTTICt IW III NI /f171

156

158