Health, Education, Employment, Social Security, Welfare, and Veterans
Reports (Letter Report, 08/01/95, GAO/HEHS-95-234W).

--------------------------- Indexing Terms -----------------------------

 REPORTNUM:  HEHS-95-234W
     TITLE:  Health, Education, Employment, Social Security, Welfare, 
             and Veterans Reports
      DATE:  08/01/95
   SUBJECT:  Health care services
             Educational programs
             Welfare benefits
             Veterans benefits
             Medicare programs
             Aid for training or employment
             Retirement pensions
             Medicaid programs
             Social security benefits
IDENTIFIER:  Bibliographies
             
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Cover
================================================================ COVER


Health, Education, and Human
Services Division Reports

August 1995

HEALTH
EDUCATION
EMPLOYMENT
SOCIAL SECURITY
WELFARE
VETERANS

GAO/HEHS-95-234W



Abbreviations
=============================================================== ABBREV

  AFDC - Aid to Families With Dependent Children
  AHCPR - Agency for Health Care Policy and Research
  CARE - Comprehensive AIDS Resources Emergency Act
  CHAMPUS - Civilian Health and Medical Program of the Uniformed
     Services
  CSRS - Civil Service Retirement System
  DC - District of Columbia
  DOD - Department of Defense
  DOE - Department of Energy
  EEO - Equal Employment Opportunity
  EEOC - Equal Employment Opportunity Commission
  ERISA - Employee Retirement Income Security Act of 1974
  GAO - General Accounting Office
  HCFA - Health Care Financing Administration
  HEHS - Health, Education, and Human Services Division, GAO
  HHS - Department of Health and Human Services
  HIV - human immunodeficiency virus
  HMO - health maintenance organization
  HRD - Human Resources Division, GAO
  JOBS - Job Opportunities and Basic Skills program
  NAFTA - North American Free Trade Agreement
  NASA - National Aeronautics and Space Administration
  NIH - National Institutes of Health
  NPR - National Performance Review
  NRC - Nuclear Regulatory Commission
  OHA - Social Security Administration's Office of Hearings and
     Appeals
  PBGC - Pension Benefit Guarantee Corporation
  SBA - Small Business Administration
  SSA - Social Security Administration
  SSI - Supplemental Security Income
  T&A - time and attendance
  VA - Department of Veterans Affairs
  WAIS - Wide Area Information Server
  WWW - World Wide Web

PREFACE
============================================================ Chapter 0

The General Accounting Office (GAO), an arm of the Congress, was
established to independently audit government agencies.  GAO's
Health, Education, and Human Services (HEHS) Division reviews the
government's health, education, employment, social security,
disability, welfare, and veterans programs administered in the
Departments of Health and Human Services, Labor, Education, Veterans
Affairs, and some other agencies. 

This booklet lists the GAO products issued on these programs.  It is
divided into two major sections: 

  Most Recent GAO Products:  This section identifies reports and
     testimonies issued during the past month and provides summaries
     for selected key products.

  Comprehensive 1-Year Listings:  This section lists all products
     published in the last year, organized chronologically by subject
     as shown in the table of contents.  When appropriate, products
     may be included in more than one subject area. 

You may obtain single copies of the products free of charge, by
telephoning your request to (202) 512-6000 or faxing it to (301)
258-4066.  Additional ordering details appear at the end of this
booklet.  Instructions for getting on GAO's mailing list appear on
page 43 of this booklet. 

You may access the Most Recent GAO Products section of this booklet
on Internet.  Instructions appear on the last page of this booklet.





Janet L.  Shikles
Assistant Comptroller General


MOST RECENT GAO PRODUCTS
(JULY 1995)
============================================================ Chapter 1


   HEALTH
---------------------------------------------------------- Chapter 1:1


      SELECTED SUMMARIES
-------------------------------------------------------- Chapter 1:1.1

Medicare:  Modern Management Strategies Could Curb Fraud, Waste, and
Abuse (Testimony, 7/31/95, GAO/T-HEHS-95-227). 

GAO's work has shown that Medicare's vulnerability stems from a
combination of factors:  (1) higher than market rates for certain
services, (2) inadequate checks for detecting fraud and abuse, (3)
superficial criteria for confirming the authenticity of providers
billing the program, and (4) weak enforcement efforts.  Various
health care management techniques help private payers alleviate these
problems, but these techniques are not generally used in Medicare. 
The program's pricing methods and controls over utilization,
consistent with health care financing and delivery 30 years ago, are
not well aligned with today's major financing and delivery changes. 
To some extent, the predicament inherent in public programs--the
uncertain line between adequate managerial control and excessive
government intervention--helps explain the dissimilarity in the ways
Medicare and private health insurers administer their respective
plans. 

Medicaid:  Matching Formula's Performance and Potential Modifications
(Testimony, 7/27/95, GAO/T-HEHS-95-226). 

In 1965 when the Medicaid program was established, the matching
formula was adopted to narrow the differences likely to result among
the Medicaid programs of wealthier and poorer states.  By giving
poorer states (as measured by per capita income) a higher federal
match, the formula was designed to reduce disparities across states
in (1) population groups and services covered in each state program
and (2) the tax burden imposed by the financing of Medicaid relative
to the size of the state's financial resources.  GAO has found that
the Medicaid matching formula, with its reliance on per capita income
as a measure of state wealth, has not significantly reduced wide
differences in states' Medicaid programs or the tax burdens to
support them.  Large disparities persist in coverage of population
groups and types of services as well as in the burdens state
taxpayers bear in financing state programs.  Certain modifications to
the formula could enhance the ability of federal payments to narrow
program disparities. 

Medicare:  Enhancing Health Care Quality Assurance (Testimony,
7/27/95, GAO/T- HEHS-95-224). 

The Health Care Financing Administration (HCFA) has three quality
assurance programs.  These programs (1) assess whether
fee-for-service institutional providers meet certain Medicare
conditions of participation, (2) assess whether health maintenance
organizations (HMO) meet similar requirements, and (3) review
inpatient care and ambulatory surgery furnished under fee-for-service
arrangements or by HMO providers.  Although these programs represent
reasonable approaches, GAO has reported serious problems with their
implementation.  HCFA is beginning to enhance its quality assurance
programs in several ways.  These changes include a greater emphasis
on continuous quality management, performance measurement, and
patient satisfaction.  Furthermore, HCFA is strengthening its
collaboration with the private sector.  The changes HCFA is making
will take advantage of successful private-sector approaches and are
consistent with the recommendations of experts GAO interviewed.  But
HCFA faces a challenge in implementing these changes while avoiding
the kind of implementation problems that have occurred with its past
efforts. 

Practice Guidelines:  Overview of Agency for Health Care Policy and
Research Efforts (Testimony, 7/25/95, GAO/T-HEHS-95-221). 

In 1989 the Congress created the Agency for Health Care Policy and
Research (AHCPR) within the Department of Health and Human Services
(HHS) Public Health Service as the federal government's focal point
for effectiveness and outcomes research.  As part of this effort, the
Congress directed the agency to sponsor the development of clinical
practice guidelines.  GAO found that during AHCPR's first 5 years,
its performance has received mixed reviews from potential users of
clinical guidelines.  On the one hand, the agency has demonstrated
strengths in the difficult process of guidelines development.  It has
been praised for its use of a rigorous, evidence- based methodology,
multidisciplinary panels, and emphasis on health care consumers.  On
the other hand, however, weaknesses in the guidelines make them not
very user friendly.  Specifically, the agency has been criticized for
the broadness of the guideline topics selected and the formats in
which they are published.  The agency is aware of these criticisms
and plans to modify its guidelines-development efforts to improve the
timeliness and presentation of its clinical practice guidelines. 

Employer-Based Health Plans:  Issues, Trends, and Challenges Posed by
ERISA (Report, 7/25/95, GAO/HEHS-95-167).  Testimony on same topic
(7/25/95, GAO/T-HEHS- 95-223). 

Although the Employee Retirement Income Security Act of 1974 (ERISA)
preemption effectively blocks states from regulating most
employer-based health plans, it permits states to regulate health
insurers.  GAO estimates that roughly 114 million individuals (44
percent of the U.S.  population) are covered by ERISA health plans. 
In most of these ERISA plans, the employer purchases health care
coverage from a third-party insurer that is subject to state
insurance regulation and insurance premium taxation.  But for nearly
40 percent of these plans, covering about 44 million people, the
employer chooses to self-fund and retain the risk for its health
plan.  Because these self-funded plans are not deemed to be
insurance, ERISA preempts them from state regulation and premium
taxation.  All ERISA health plans, including self-funded ones, are
subject to federal fiduciary and reporting standards.  Available data
suggest that self-funding is increasing, particularly among smaller
firms.  The growth of self-funding poses concerns for the states
because fewer individuals are insured by health plans that states
oversee. 

Prescription Drugs and the Elderly:  Many Still Receive Potentially
Harmful Drugs Despite Recent Improvements (Report, 7/24/95,
GAO/HEHS-95-152). 

The inappropriate use of prescription drugs is a potential health
problem that is particularly acute for the elderly.  GAO's analysis
of 1992 data from the Medicare Current Beneficiary Survey found that
about 17.5 percent of almost 30 million noninstitutionalized Medicare
recipients 65 or older used at least one drug identified as generally
unsuitable for elderly patients since safer alternative drugs exist. 
Inappropriate prescription drug use can result from the behavior not
only of the physician but also of the pharmacist and patient. 
Although the experts GAO interviewed agreed that the inappropriate
use of prescription drugs remains a significant health problem, they
identified several recent efforts that are helping to address this
problem.  Changes in the health care delivery system also have the
potential to reduce the inappropriate use of prescription drugs. 

Medicare:  Adapting Private-Sector Techniques Could Curb Losses to
Fraud and Abuse (Testimony, 7/19/95, GAO/T-HEHS-95-211). 

Medicare could save billions of dollars by curbing fraud, waste, and
abuse.  These losses occur largely because of inappropriate pricing
and inadequate scrutiny of claims for payment and because abusive or
poorly qualified providers of medical services and supplies are
allowed to participate in the program.  These problems are not unique
to Medicare--they can be found elsewhere in both the public and
private sectors.  However, private payers have been able in many
instances to react quickly through a variety of management
approaches, whereas Medicare's pricing methods and controls over
utilization, which were consistent with health care financing and
delivery when the program started, have not been adapted to today's
environment.  Private-sector payers use modern management techniques,
such as competitive bidding, advanced software programs, and
preferred provider networks.  If Medicare were able to apply
appropriate private-sector techniques, its weaknesses could be
significantly remedied. 

Health Insurance for Children:  Many Remain Uninsured Despite
Medicaid Expansion (Report, 7/19/95, GAO/HEHS-95-175). 

Policy changes to expand Medicaid eligibility for children helped to
increase the number of children enrolled in Medicaid by 4.8 million
between 1989 and 1993.  However, the overall number of children who
are uninsured did not decline because employment-based coverage for
adults and children also declined during the same period.  Because of
expanded Medicaid coverage, children were not as affected by the loss
of employment-based insurance as adults.  Without expanded Medicaid
coverage, many more children would have been uninsured in 1993. 
While the Medicaid expansion allowed many children to be covered who
might otherwise be uninsured, a substantial number of uninsured
children in 1993 were eligible but not enrolled in the program.  At
least one-quarter of currently uninsured children--2.3 million--met
federal Medicaid age and income eligibility standards.  Reasons that
eligible children are not covered may include their parents' lack of
knowledge about their potential eligibility and difficulties in
applying for Medicaid. 

Health Insurance Regulation:  National Portability Standards Would
Facilitate Changing Health Plans (Testimony, 7/18/95,
GAO/T-HEHS-95-205). 

GAO found that federal and state laws reflect steps taken to improve
the portability of health insurance, but the possibility remains that
an individual's coverage would be reduced when changing jobs.  Most
private health plans still require waiting periods before making
people with preexisting conditions fully eligible for coverage.  On
the basis of existing data on the number of people who change jobs
and studies on the effect of health insurance on job mobility, GAO
estimates that roughly up to 21 million Americans a year would
benefit from legislation waiving preexisting condition exclusions for
individuals who have maintained continuous health care coverage.  In
addition, perhaps as many as 4 million Americans who at some time
have been unwilling to leave their employer because of concerns about
losing their health care coverage would benefit from the proposed
legislation.  However, although premium increases are possible, the
insurance industry's response to such reforms remains unclear. 

Ryan White CARE Act:  Access to Services by Minorities, Women, and
Substance Abusers (Testimony, 7/17/95, GAO/T-HEHS-95-212).  Report on
same topic (1/13/95, GAO/HEHS-95-49). 

GAO found that minorities, women, and injection drug users generally
use services at a rate that reflect their representation in the human
immunodeficiency virus (HIV)- infected population in the five
locations visited.  Service providers and advocates of HIV-infected
people in these communities agreed with this assessment of the
patient population receiving Ryan White Comprehensive AIDS Resources
Emergency Act (CARE)-funded services.  Nonetheless, these
HIV-infected groups may have to rely on Ryan White CARE Act-funded
services more so than other subpopulations.  Therefore, there may
still be unmet needs for care.  Providers and advocates described
barriers to care that are particularly difficult to overcome, such as
homelessness, substance abuse, and language and cultural differences. 
Providers mentioned the importance of outreach to help overcome these
barriers. 

Medicare Managed Care:  Enrollment Growth Underscores Need to Revamp
HMO Payment Methods (Testimony, 7/12/95, GAO/T-HEHS-95-207). 

The recent enrollment growth in Medicare HMO has been rapid and
accelerating.  This growth adds to the urgency of correcting
rate-setting flaws that result in unnecessary Medicare spending.  By
not tailoring its HMO capitation payment to how healthy or sick HMO
enrollees are, HCFA cannot realize the savings that private- sector
payers capture from HMOs.  Alternative methods of determining HMO
rates have been suggested, but little experience exists on how well
these methods would work under Medicare.  GAO derived two lessons
from reviewing ways to fix Medicare's HMO capitation payment:  (1)
With respect to rate-setting, one size does not fit all, and (2) with
respect to achieving initiatives for improving the capitation
payment, details matter in determining the difference between success
and failure.  Although HCFA is planning demonstration projects to
study ways to correct its HMO rate- setting method, results are
likely to be at least several years away.  HCFA can mitigate its
capitation rate problem by introducing a better health status risk
adjuster.  HCFA should also proceed promptly to test competitive
bidding and other promising approaches to setting HMO rates that
reduce Medicare costs. 

Medicaid:  State Flexibility in Implementing Managed Care Programs
Requires Appropriate Oversight (Testimony, 7/12/95,
GAO/T-HEHS-95-206). 

Requiring states to obtain waivers to broaden use of managed care may
hamper their efforts to aggressively pursue cost-containment
strategies.  At the same time, because current program restrictions
on managed care were designed to reinforce quality assurance, their
absence requires the substitution of appropriate and adequate
mechanisms to protect both Medicaid beneficiaries and federal
dollars.  Finally, the reinvestment of managed care savings to expand
Medicaid coverage to several million additional individuals suggests
the need for up-front consultation with the Congress because of (1)
the heavier financial burden that such 1115 waivers may place on the
federal government and (2) the issue of whether the U.S.  Treasury
should benefit from those savings. 


      OTHER HEALTH PRODUCTS
-------------------------------------------------------- Chapter 1:1.2

Treatment of Hardcore Cocaine Users (Letter, 7/31/95,
GAO/HEHS-95-179R). 

Impact of Organ Allocation Variances (Letter, 7/31/95,
GAO/HEHS-95-203R). 

Medicaid:  Local Contributions (Letter, 7/28/95, GAO/HEHS-95-215R). 

Hospital-Based Home Health Agencies (Letter, 7/19/95,
GAO/HEHS-95-209R). 

Medicare:  Allegations Against ABC Home Health Care (Testimony,
7/19/95, GAO/T- OSI-95-18).  Report on same topic (7/19/95,
GAO/OSI-95-17). 

Superfund:  Information on Current Health Risks (Report, 7/19/95,
GAO/RCED-95- 205). 

Medicare Providers' Legal Expenses (Letter, 7/18/95,
GAO/HEHS-95-214R). 

Reassignment of Two NIH Employees (Letter, 7/5/95, GAO/OSI-95-14R). 


   EDUCATION
---------------------------------------------------------- Chapter 1:2


      SELECTED SUMMARIES
-------------------------------------------------------- Chapter 1:2.1

Vocational Education:  2-Year Colleges Improve Programs, Maintain
Access for Special Populations (Report, 7/26/95, GAO/HEHS-95-163). 

As 2-year colleges have enhanced their vocational-technical programs,
their efforts have reflected many of the priorities outlined in the
Perkins amendments.  Colleges appear to have moved aggressively to
increase their use of performance measures-- such as placement rates,
program completion rates, and results from state licensing exams--in
program assessments.  In addition, 3 years after the passage of the
Perkins amendments, nearly all colleges in our sample indicated that
they either offer or are developing tech-prep programs.  Other
desired changes, however, have been slower to develop.  The removal
of the set-aside requirement in the Perkins amendments has not
adversely affected enrollments of special-population students. 
Special-population students enrolled in 2-year colleges to the same
extent in fall 1990 and fall 1993, and participation by
special-population students in vocational- technical programs
remained virtually unchanged over this period.  Furthermore, colleges
reported either increasing or maintaining the availability of support
services for special-population students. 

Vocational Education:  Changes at High School Level After Amendments
to Perkins Act (Report, 7/12/95, GAO/HEHS-95-144). 

The 1990 amendments to the Perkins Act removed a requirement that
funds be set aside for students from special populations.  Some
individuals expressed concern that removal of the set-aside
requirement would hurt these student groups.  However, GAO found that
removal of the set-aside requirement for students from
special-population groups did not inhibit their participation, limit
the availability of services, or affect their postgraduation status. 
In addition, Both signs of progress and room for improvement exist as
secondary schools and school districts have acted to modernize and
enhance their vocational education programs.  Schools have moved
aggressively to apply some approaches but have been slower to adopt
other changes.  Teacher training in integrating vocational and
academic instruction also increased, but the majority of schools in
GAO's survey did not employ several practices (team teaching, for
example) that bring integrated learning concepts into the classroom. 
School districts also reported increased use of quality indicators
(such as placement data) in their self-assessment processes, despite
the difficulties many of them encounter in gathering this kind of
information. 

Student Financial Aid:  Data Not Fully Utilized to Identify
Inappropriately Awarded Loans and Grants (Report, 7/11/95,
GAO/HEHS-95-89). 

Although continuing to face billions of dollars in annual payments
for defaulted student loans, the Department of Education has, in
general, ineffectively used available student aid data to enforce
compliance with federal requirements.  Further, the Department has
not effectively used other data that could identify students who
received (1) grants while attending two or more schools concurrently
or (2) additional financial aid despite being ineligible because they
had defaulted on previous loans.  GAO found instances in which
oversight responsibilities were divided and data ineffectively shared
by units in the Office of Postsecondary Education.  In early 1995,
these weaknesses were addressed when the Department made improvements
to its organizational structure.  The Department has initiated a
series of improvements to its student loan and grant systems.  These
include developing new systems, implementing data controls in its
existing systems, and strengthening program reviews at schools. 


   EMPLOYMENT
---------------------------------------------------------- Chapter 1:3


      SELECTED SUMMARIES
-------------------------------------------------------- Chapter 1:3.1

Employment Discrimination:  Most Private-Sector Employers Use
Alternative Dispute Resolution (Report, 7/5/95, GAO/HEHS-95-150). 

To determine the extent of the use of alternative dispute resolution
(ADR) approaches, GAO sent a questionnaire to a stratified, random
sample of 2,000 businesses that had (1) filed equal employment
opportunity (EEO) reports with the Equal Employment Opportunity
Commission (EEOC) in 1992 and (2) reported having more than 100
employees.  GAO estimates, on the basis of the questionnaire results,
that almost all employers with 100 or more employees use one or more
ADR approaches.  Arbitration is one of the least common approaches
reported.  Some employers using arbitration make it mandatory for all
workers.  Employer policies on arbitrating discrimination complaints
vary considerably in form and level of detail.  However, some of
these policies, such as those for employees obtaining information and
empowering the arbitrator to use remedies equal to those under law,
would not meet standards of fairness proposed recently by the
Commission on the Future of Worker- Management Relations, which was
established by the Secretary of Labor and the Secretary of Commerce
at the President's request. 


   SOCIAL SECURITY, DISABILITY,
   AND WELFARE
---------------------------------------------------------- Chapter 1:4


      SELECTED SUMMARIES
-------------------------------------------------------- Chapter 1:4.1

Illegal Aliens:  National Net Cost Estimates Vary Widely (Report,
7/25/95, GAO/HEHS-95-133). 

Three national studies concluded that illegal aliens in the United
States generate more in costs than revenues to federal, state, and
local governments combined.  However, their estimates of the national
net cost varied considerably, ranging from $2 billion to $19 billion. 
Because little data are available on illegal aliens' use of public
services and tax payments, the various indirect approaches used to
estimate costs and revenues were often based on assumptions whose
reasonableness is unknown.  Moreover, the studies varied considerably
in the range of costs and revenues they included and their treatment
of certain items, making them difficult to compare.  GAO found that a
relatively small number of costs and revenues account for much of the
variation in the estimates of the national net cost of illegal
aliens.  Better data on the illegal alien population and clearer
explanations of which costs and revenues are appropriate to include
would help improve the usefulness of estimates of the national net
cost. 

Supplemental Security Income:  Growth and Changes in Recipient
Population Call for Reexamining Program (Report, 7/7/95,
GAO/HEHS-95-137). 

Since the mid-1980s, a variety of changes in the Supplemental
Security Income (SSI) program have made benefits available to a
broader population.  Both congressional actions and court decisions
have allowed a wider range of impairments to qualify as disabilities,
notably for mentally impaired adults and for children.  Also, the
Congress has mandated increased outreach and publicity efforts to
help overcome barriers to getting SSI.  Meanwhile, some disabled
recipients may stay on SSI longer and receive larger benefits than
they would otherwise because the program has devoted little effort to
checking that recipients continue to be disabled and helping them
return to work.  Since these program changes began, the SSI recipient
population has changed dramatically; disabled recipients now account
for nearly 80 percent of federal SSI payments.  Three groups have
accounted for nearly 90 percent of SSI's growth since 1991--adults
with mental impairments, children, and noncitizens.  SSI recipients
now tend to be younger, stay on SSI longer, receive larger benefits,
and depend more on SSI as a primary source of income. 


      OTHER SOCIAL SECURITY,
      DISABILITY, AND WELFARE
      PRODUCTS
-------------------------------------------------------- Chapter 1:4.2

OHA Backlogs (Letter, 7/28/95, GAO/HEHS-95-228R). 

Welfare to Work:  State Programs Have Tested Some of the Proposed
Reforms (Report, 7/14/95, GAO/PEMD-95-26). 


   VETERANS AFFAIRS AND MILITARY
   HEALTH
---------------------------------------------------------- Chapter 1:5


      SELECTED SUMMARIES
-------------------------------------------------------- Chapter 1:5.1

Defense Health Care:  Problems With Medical Care Overseas Are Being
Addressed (Report, 7/12/95, GAO/HEHS-95-156). 

Since the downsizing of the American military presence in Europe
began in 1989, beneficiaries have generally found it more difficult
to obtain health services at military facilities.  Beneficiaries have
access to primary care, but for some, particularly non active-duty
beneficiaries, access to specialty care varies and is often
inconvenient.  Military medical personnel must overcome many
obstacles to provide the care that is offered.  These personnel are
hampered by staff shortages, long waits for laboratory test results,
and equipment failures.  The reduced military health care system has
resulted in the Department of Defense's (DOD) placing a greater
reliance on the German and Italian medical system for providing
treatment to beneficiaries.  Beneficiaries, however, must contend
with language barriers, cultural differences, unfamiliar doctors,
quality of care concerns, and a general lack of information about
obtaining host nation care.  To address these problems and concerns,
DOD has taken or is planning to take a number of actions. 


VA Health Care:  Physician Peer Review Identifies Quality of Care
Problems but Actions to Address Them Are Limited (Report, 7/7/95,
GAO/HEHS-95-121). 

The peer review process at the six Department of Veterans Affairs
(VA) medical centers that GAO visited has enabled the facilities to
identify potential quality of care problems.  However, actions taken
by VA clinical service chiefs to address these problems were often
limited to undocumented discussions with the physicians involved. 
Peer review in both VA and non-VA facilities is a highly subjective
process that relies heavily on professional judgment.  While experts
recognize that some element of professional judgment will always be
present in peer review, the development of practice guidelines and
use of peer review by committee can help to reduce it.  By
establishing restrictive procedures for reporting to the National
Practitioner Data Bank, VA medical centers are not reporting to the
Data Bank many of the malpractice payments made on behalf of
physicians, dentists, and other licensed health care practitioners or
the adverse actions taken against physicians' and other
practitioners' clinical privileges. 


HEALTH
(COMPREHENSIVE
1-YEAR LISTING)
============================================================ Chapter 2


   ACCESS AND INFRASTRUCTURE
---------------------------------------------------------- Chapter 2:1

Ryan White Care Act:  Access to Services by Minorities, Women, and
Substance Abusers (Testimony, 7/17/95, GAO/T-HEHS-95-212).  Report on
same topic (1/13/95, GAO/HEHS-95-49). 

Health Care:  Federal and State Antitrust Actions Concerning the
Health Care Industry (Report, 8/5/94, GAO/HEHS-94-220). 


   EMPLOYEE AND RETIREE HEALTH
   BENEFITS
---------------------------------------------------------- Chapter 2:2

Employer-Based Health Plans:  Issues, Trends, and Challenges Posed by
ERISA (Report, 7/25/95, GAO/HEHS-95-167).  Testimony on same topic
(7/25/95, GAO/T-HEHS- 95-223). 


   FINANCING
---------------------------------------------------------- Chapter 2:3

Health Insurance For Children:  Many Remain Uninsured Despite
Medicaid Expansion (Report, 7/19/95, GAO/HEHS-95-175). 

Health Insurance Regulation:  National Portability Standards Would
Facilitate Changing Health Plans (Testimony, 7/18/95,
GAO/T-HEHS-95-205). 

Health Insurance Regulation:  Variation in Recent State Small
Employer Health Insurance Reforms (Report, 6/12/95,
GAO/HEHS-95-161FS). 

Ryan White Care Act of 1990:  Opportunities Are Available to Improve
Funding Equity (Testimony, 4/5/95, GAO/T-HEHS-95-126).  Testimony on
same topic (2/22/95, GAO/T-HEHS-95-91).  Correspondence on same topic
(2/14/95, GAO/HEHS-95-79R, and 3/31/95, GAO/HEHS-95-119R). 

German Health Reforms:  Changes Result in Lower Health Costs in 1993
(Report, 12/16/94, GAO/HEHS-95-27). 

Biotech R & D, Reform, and Market Change (Letter, 12/15/94,
GAO/HEHS-95-34R). 

Hospital Costs:  Cost Control Efforts at 17 Texas Hospitals (Report,
12/9/94, GAO/AIMD-95-21). 

Health Care:  Employers Urge Hospitals to Battle Costs Using
Performance Data Systems (Report, 10/3/94, GAO/HEHS-95-1). 

Insurance Ratings:  Comparison of Private Agency Ratings for
Life/Health Insurers (Report, 9/29/94, GAO/GGD-94-204BR). 

Hospital Compensation:  Nationally Representative Data on Chief
Executives' Compensation (Report, 8/16/94, GAO/HEHS-94-189). 

Health Insurance For The Elderly:  Owning Duplicate Policies Is
Costly and Unnecessary (Report, 8/3/94, GAO/HEHS-94-185). 


   HEALTH CARE REFORM RELATED
   ISSUES
---------------------------------------------------------- Chapter 2:4

Cost of Health Care Task Force Related Activities (Testimony,
3/14/95, GAO/T- GGD-95-114). 

Health Care Reform:  "Report Cards" Are Useful but Significant Issues
Need to Be Addressed (Report, 9/29/94, GAO/HEHS-94-219). 

Health Care Reform:  Considerations for Risk Adjustment Under
Community Rating (Report, 9/22/94, GAO/HEHS-94-173). 

Small Business:  SBA's Health Care Reform Activities (Report, 9/6/94,
GAO/RCED- 94-240). 


   HHS PUBLIC HEALTH SERVICE
   AGENCIES
---------------------------------------------------------- Chapter 2:5

Practice Guidelines:  Overview of Agency for Health Care Policy and
Research Efforts (Testimony, 7/25/95, GAO/T-HEHS-95-221). 

Reassignment of Two NIH Employees (Letter, 7/5/95, GAO/OSI-95-14R). 

Immunization:  HHS Could Do More to Increase Vaccination Among Older
Adults (Report, 6/8/95, GAO/PEMD-95-14). 

Health and Human Services:  Opportunities to Realize Savings
(Testimony, 1/12/95, GAO/T-HEHS-95-57). 

Food and Drug Administration:  Carrageenan Food Additive From the
Philippines Conforms to Regulations (Report, 8/2/94,
GAO/HEHS-94-141). 


   LONG-TERM CARE AND AGING
---------------------------------------------------------- Chapter 2:6

Immunization:  HHS Could Do More to Increase Vaccination Among Older
Adults (Report, 6/8/95, GAO/PEMD-95-14). 

Long-Term Care:  Current Issues and Future Directions (Report,
4/13/95, GAO/HEHS-95-109). 

Aging Issues:  Related GAO Reports and Activities in Fiscal Year 1994
(Report, 12/29/94, GAO/HEHS-95-44). 

Long-Term Care:  Diverse, Growing Population Includes Millions of
Americans of All Ages (Report, 11/7/94, GAO/HEHS-95-26). 

Long-Term Care Reform:  States' Views on Key Elements of
Well-Designed Programs for the Elderly (Report, 9/6/94,
GAO/HEHS-94-227). 

Long-Term Care:  Other Countries Tighten Budgets While Seeking Better
Access (Report, 8/30/94, GAO/HEHS-94-154). 

Medicaid Long-Term Care:  Successful State Efforts to Expand Home
Services While Limiting Costs (Report, 8/11/94, GAO/HEHS-94-167). 


   MANAGED CARE
---------------------------------------------------------- Chapter 2:7

Medicare Managed Care:  Enrollment Growth Underscores Need to Revamp
HMO Payment Methods (Testimony, 7/12/95, GAO/T-HEHS-95-207). 

Medicare Managed Care:  Program Growth Highlights Need to Fix HMO
Payment Problems (Testimony, 5/24/95, GAO/T-HEHS-95-174). 

Community Health Centers:  Challenges in Transitioning to Prepaid
Managed Care (Report, 5/4/95, GAO/HEHS-95-138).  Testimony on same
topic (5/4/95, GAO/T-HEHS-95- 143). 

Defense Health Care:  DOD's Managed Care Program Continues to Face
Challenges (Testimony, 3/28/95, GAO/T-HEHS-95-117). 


   MEDICARE AND MEDICAID
---------------------------------------------------------- Chapter 2:8

Medicare:  Modern Management Strategies Could Curb Fraud, Waste, and
Abuse (Testimony, 7/31/95, GAO/T-HEHS-95-227). 

Medicaid:  Local Contributions (Letter, 7/28/95, GAO/HEHS-95-215R). 

Medicare:  Enhancing Health Care Quality Assurance (Testimony,
7/27/95, GAO/T- HEHS-95-224). 

Medicaid:  Matching Formula's Performance and Potential Modifications
(Testimony, 7/27/95, GAO/T-HEHS-95-226). 

Medicare:  Adapting Private Sector Techniques Could Curb Losses to
Fraud and Abuse (Testimony, 7/19/95, GAO/T-HEHS-95-211). 

Health Insurance For Children:  Many Remain Uninsured Despite
Medicaid Expansion (Report, 7/19/95, GAO/HEHS-95-175). 

Medicare:  Allegations Against ABC Home Health Care (Testimony,
7/19/95, GAO/T- OSI-95-18).  Report on same topic (7/19/95,
GAO/OSI-95-17). 

Medicare Providers' Legal Expenses (Letter, 7/18/95,
GAO/HEHS-95-214R). 

Medicare Managed Care:  Enrollment Growth Underscores Need to Revamp
HMO Payment Methods (Testimony, 7/12/95, GAO/T-HEHS-95-207). 

Medicaid:  State Flexibility in Implementing Managed Care Programs
Requires Appropriate Oversight (Testimony, 7/12/95,
GAO/T-HEHS-95-206). 

Medicare:  Rapid Spending Growth Calls for More Prudent Purchasing
(Testimony, 6/28/95, GAO/T-HEHS-95-193). 

Medicaid:  Statewide Section 1115 Demonstrations' Impact on
Eligibility, Service Delivery, and Program Cost (Testimony, 6/21/95,
GAO/T-HEHS-95-182). 

Medicare:  Modern Management Strategies Needed to Curb Program
Exploitation (Testimony, 6/15/95, GAO/T-HEHS-95-183). 

Medicare Managed Care:  Program Growth Highlights Need to Fix HMO
Payment Problems (Testimony, 5/24/95, GAO/T-HEHS-95-174). 

Medicare:  Reducing Fraud and Abuse Can Save Billions (Testimony,
5/16/95, GAO/T-HEHS-95-157). 

Medicare Claims:  Commercial Technology Could Save Billions Lost to
Billing Abuse (Report, 5/5/95, GAO/AIMD-95-135). 

Medicaid Managed Care:  More Competition and Oversight Would Improve
California's Expansion Plan (Report, 4/28/95, GAO/HEHS-95-87). 

Medicaid:  Spending Pressures Drive States Toward Program Reinvention
(Report, 4/4/95, GAO/HEHS-95-122).  Testimony on same topic
(GAO/T-HEHS-95-129). 

Medicaid:  Restructuring Approaches Leave Many Questions (Report,
4/4/95, GAO/HEHS-95-103). 

Medicare:  Tighter Rules Needed to Curtail Overcharges for Therapy in
Nursing Homes (Report, 3/30/95, GAO/HEHS-95-23). 

Medicaid:  Experience With State Waivers to Promote Cost Control and
Access to Care (Testimony, 3/23/95, GAO/T-HEHS-95-115). 

Medicare and Medicaid:  Opportunities to Save Program Dollars by
Reducing Fraud and Abuse (Testimony, 3/22/95, GAO/T-HEHS-95-110). 

Medicare Secondary Payer Program (Letter, 3/6/95, GAO/HEHS-95-101R). 

GAO's 1995 High Risk Reports:  Medicare Claims (Report, 2/95,
GAO/HR-95-8). 

Medicare Secondary Payer Program:  Actions Needed to Realize Savings
(Testimony, 2/23/95, GAO/T-HEHS-95-92). 

Uninsured and Children on Medicaid (Letter, 2/14/95,
GAO/HEHS-95-83R). 

Medicare:  Opportunities Are Available to Apply Managed Care
Strategies (Testimony, 2/10/95, GAO/T-HEHS-95-81). 

Medicare:  High Spending Growth Calls for Aggressive Action
(Testimony, 2/6/95, GAO/T-HEHS-95-75). 

Medicare Part B:  Regional Variation in Denial Rates for Medical
Necessity (Report, 12/19/94, GAO/PEMD-95-10).  Testimony on same
topic (12/19/94, GAO/T-PEMD- 95-11). 

Veterans' Health Care:  Use of VA Services by Medicare-Eligible
Veterans (Report, 10/24/94, GAO/HEHS-95-13). 

Medicare:  Referrals to Physician-Owned Imaging Facilities Warrant
HCFA's Scrutiny (Report, 10/20/94, GAO/HEHS-95-2). 

Medicare:  Changes to HMO Rate Setting Method Are Needed to Reduce
Program Costs (Report, 9/2/94, GAO/HEHS-94-119). 

Financial Management:  Oversight of Small Facilities for the Mentally
Retarded and Developmentally Disabled (Report, 8/12/94,
GAO/AIMD-94-152). 

Medicaid Long-Term Care:  Successful State Efforts to Expand Home
Services While Limiting Costs (Report, 8/11/94, GAO/HEHS-94-167). 

Medicaid:  Changes in Best Price for Outpatient Drugs Purchased by
HMOs and Hospitals (Report, 8/5/94, GAO/HEHS-94-194FS). 

Medicare:  HCFA's Contracting Authority for Processing Medicare
Claims (Report, 8/2/94, GAO/HEHS-94-171). 

Medicaid:  States Use Illusory Approaches to Shift Program Costs to
Federal Government (Report, 8/1/94, GAO/HEHS-94-133). 


   PRESCRIPTION DRUGS
---------------------------------------------------------- Chapter 2:9

Prescription Drugs and the Elderly:  Many Still Receive Potentially
Harmful Drugs Despite Recent Improvements (Report, 7/24/95,
GAO/HEHS-95-152). 

Prescription Drug Prices:  Official Index Overstates Producer Price
Inflation (Report, 4/28/95, GAO/HEHS-95-90). 

Family Planning Clinics:  Strain of Norplant's High Up-Front Costs
Has Subsided (Report, 10/7/94, GAO/HEHS-95-7). 

Prescription Drug Prices in France (Letter, 8/12/94,
GAO/HEHS-94-200R). 

Prescription Drugs:  Automated Prospective Review Systems Offer
Significant Potential Benefits for Medicaid (Report, 8/5/94,
GAO/AIMD-94-130). 

Medicaid:  Changes in Best Price for Outpatient Drugs Purchased by
HMOs and Hospitals (Report, 8/5/94, GAO/HEHS-94-194FS). 

Immunosuppressant Drugs (Letter, 8/1/94, GAO/HEHS-94-207R). 


   PROVIDER ISSUES
--------------------------------------------------------- Chapter 2:10

Indian Health Service:  Improvements Needed in Credentialing
Temporary Physicians (Report, 4/21/95, GAO/HEHS-95-46). 

Medical Education:  Curriculum and Financing Strategies Need to
Encourage Primary Care Training (Report, 10/21/94, GAO/HEHS-95-9). 


   PUBLIC HEALTH AND EDUCATION
--------------------------------------------------------- Chapter 2:11

Hospital-Based Home Health Agencies (Letter, 7/19/95,
GAO/HEHS-95-209R). 

Vaccines for Children:  Reexamination of Program Goals and
Implementation Needed to Ensure Vaccination (Report, 6/22/95,
GAO/PEMD-95-22). 

Immunization:  HHS Could Do More to Increase Vaccination Among Older
Adults (Report, 6/8/95, GAO/PEMD-95-14). 

Vaccines for Children:  Barriers to Immunization (Testimony, 5/4/95,
GAO/T- PEMD-95-21). 

Community Health Centers:  Challenges in Transitioning to Prepaid
Managed Care (Report, 5/4/95, GAO/HEHS-95-138).  Testimony on same
topic (5/4/95, GAO/T-HEHS-95- 143). 

Tuberculosis:  Costly and Preventable Cases Continue in Five Cities
(Report, 3/16/95, GAO/HEHS-95-11). 

Health Care:  School-Based Health Centers Can Expand Access for
Children (Report, 12/22/94, GAO/HEHS-95-35). 


   QUALITY AND PRACTICE STANDARDS
--------------------------------------------------------- Chapter 2:12

Impact of Organ Allocation Variances (Letter, 7/31/95,
GAO/HEHS-95-203R). 

Medicare:  Enhancing Health Care Quality Assurance (Testimony,
7/27/95, GAO/T- HEHS-95-224). 

Maine Practice Guidelines (Letter, 4/4/95, GAO/HEHS-95-118R). 

Electromagnetic Interference with Medical Devices (Letter, 3/17/95,
GAO/RCED- 95-96R). 

Cholesterol Measurement:  Variability in Methods and Test Results
(Testimony, 2/13/95, GAO/T-PEMD-95-17).  Report on same topic
(12/30/94, GAO/PEMD-95-8). 

Breast Conservation versus Mastectomy:  Patient Survival in
Day-to-Day Practice and in Randomized Studies (Report, 11/15/94,
GAO/PEMD-95-9). 


   SUBSTANCE ABUSE AND DRUG
   TREATMENT
--------------------------------------------------------- Chapter 2:13

Treatment of Hardcore Cocaine Users (Letter, 7/31/95,
GAO/HEHS-95-179R). 


   OTHER HEALTH ISSUES
--------------------------------------------------------- Chapter 2:14


      ENVIRONMENTAL IMPACT ON
      HEALTH
------------------------------------------------------- Chapter 2:14.1

Superfund:  Information on Current Health Risks (Report, 7/19/95,
GAO/RCED-95- 205). 

Health and Safety:  DOE's Epidemiological Data Base Has Limited Value
for Research (Report, 6/6/95, GAO/RCED-95-126). 

Health and Safety:  Status of Federal Efforts to Disclose Cold War
Radiation Experiments Involving Humans (Testimony, 12/01/94,
GAO/T-RCED-95-40). 

Nuclear Health and Safety:  Further Improvement Needed in the Hanford
Tank Farm Maintenance Program (Report, 11/08/94, GAO/RCED-95-29). 

Health and Safety:  Protecting Workers and the Public Continues to
Challenge DOE (Testimony, 9/22/94, GAO/T-RCED-94-283). 

Nuclear Health and Safety:  Consensus on Acceptable Radiation Risk to
the Public Is Lacking (Report, 9/19/94, GAO/RCED-94-190). 


      MISCELLANEOUS
------------------------------------------------------- Chapter 2:14.2

Financial Audit:  U.S.  Senate Health Promotion Revolving Fund for
the Periods Ended 9/30/93 and 12/31/92 (Report, 5/3/95,
GAO/AIMD-95-105). 


EDUCATION
(COMPREHENSIVE
1-YEAR LISTING)
============================================================ Chapter 3


   DEPARTMENT OF EDUCATION
---------------------------------------------------------- Chapter 3:1

Student Financial Aid:  Data Not Fully Utilized to Identify
Inappropriately Awarded Loans and Grants (Report, 7/11/95,
GAO/HEHS-95-89). 

Federal Family Education Loan Information System:  Weak Computer
Controls Increase Risk of Unauthorized Access to Sensitive Data
(Report, 6/12/95, GAO/AIMD-95-117). 

Department of Education:  Information on Consolidation Opportunities
and Student Aid (Testimony, 4/6/95, GAO/T-HEHS-95-130). 

Department of Education:  Opportunities to Realize Savings
(Testimony, 1/18/95, GAO/T-HEHS-95-56). 

Buyouts at the Department of Education (Letter, 8/17/94,
GAO/GGD-94-197R). 


   EARLY CHILDHOOD DEVELOPMENT
---------------------------------------------------------- Chapter 3:2

Early Childhood Centers:  Services to Prepare Children for School
Often Limited (Report, 3/21/95, GAO/HEHS-95-21). 

Early Childhood Programs:  Promoting the Development of Young
Children in Denmark, France, and Italy (Report, 2/22/95,
GAO/HEHS-95-45BR). 

Early Childhood Programs:  Parent Education and Income Best Predict
Participation (Report, 12/28/94, GAO/HEHS-95-47). 

Early Childhood Programs:  Local Perspectives on Barriers to
Providing Head Start Services (Report, 12/21/94, GAO/HEHS-95-8). 

Early Childhood Programs:  Multiple Programs and Overlapping Target
Groups (Report, 10/31/94, GAO/HEHS-95-4FS). 


   ELEMENTARY AND SECONDARY
   EDUCATION
---------------------------------------------------------- Chapter 3:3

Vocational Education:  Changes at High School Level After Amendments
to Perkins Act (Report, 7/12/95, GAO/HEHS-95-144). 

District of Columbia:  Weaknesses in Personnel Records and Public
Schools' Management Information and Controls (Testimony, 6/14/95,
GAO/T-AIMD-95-170). 

School Safety:  Promising Initiatives for Addressing School Violence
(Report, 4/25/95, GAO/HEHS-95-106). 

School Facilities:  America's Schools Not Designed or Equipped for
21st Century (Report, 4/4/95, GAO/HEHS-95-95).  Testimony on same
topic (4/4/95, GAO/T-HEHS-95- 127). 

School Facilities:  Condition of America's Schools (Report, 2/1/95,
GAO/HEHS- 95-61). 

Multiple Youth Programs (Letter, 1/19/95, GAO/HEHS-95-60R). 

Charter Schools:  New Model for Public Schools Provides Opportunities
and Challenges (Report, 1/18/95, GAO/HEHS-95-42).  Testimony on same
topic (1/19/95, GAO/T-HEHS-95-52). 

Health Care:  School-Based Health Centers Can Expand Access for
Children (Report, 12/22/94, GAO/HEHS-95-35). 

Education Finance:  Extent of Federal Funding in State Education
Agencies (Report, 10/14/94, GAO/HEHS-95-3). 

Precollege Math and Science Education:  Department of Energy's
Precollege Program Managed Ineffectively (Report, 9/13/94,
GAO/HEHS-94-208). 

Education Reform:  School-Based Management Results in Changes in
Instruction and Budgeting (Report, 8/23/94, GAO/HEHS-94-135). 


   HIGHER EDUCATION
---------------------------------------------------------- Chapter 3:4

Vocational Education:  2-Year Colleges Improve Programs, Maintain
Access for Special Populations (Report, 7/26/95, GAO/HEHS-95-163). 

Teacher Training:  Status and Participants' Views of Delta Teachers
Academy (Report, 6/29/95, GAO/RCED-95-208). 

Student Loan Defaults:  Department of Education Limitations in
Sanctioning Problem Schools (Report, 6/19/95, GAO/HEHS-95-99). 

Direct Student Loans:  Selected Characteristics of Participating
Schools (Testimony, 3/30/95, GAO/T-HEHS-95-123). 

Higher Education:  Restructuring Student Aid Could Reduce Low-Income
Student Dropout Rate (Report, 3/23/95, GAO/HEHS-95-48). 

GAO's 1995 High Risk Reports:  Student Financial Aid (Report, 2/95,
GAO/HR-95- 10). 

Guaranteed Student Loans:  Actions to Ensure Continued Student Access
to Subsidized Loans (Report, 2/24/95, GAO/HEHS-95-64). 

Multiple Teacher Training Programs:  Information on Budgets,
Services, and Target Groups (Report, 2/22/95, GAO/HEHS-95-71FS). 

Adult Education Act (Letter, 2/16/95, GAO/HEHS-95-65R). 

GAO Education Reports (Letter, 2/3/95, GAO/HEHS-72R). 

NCAA Student Athlete Pell Grants (Letter, 1/10/95, GAO/OSI-95-13R). 

Women's Educational Equity Act:  A Review of Program Goals and
Strategies Needed (Report, 12/27/94, GAO/PEMD-95-6). 

College Savings Issues (Letter, 11/4/94, GAO/HEHS-95-16R). 

Motor Carrier Academy (Letter, 11/2/94, GAO/RCED-95-43R). 

Pell Grant Costs (Letter, 9/28/94, GAO/HEHS-94-215R). 

Pell Grants for Prison Inmates (Letter, 8/5/94, GAO/HEHS-94-224R). 


   SCHOOL-TO-WORK TRANSITION
---------------------------------------------------------- Chapter 3:5

Youth Training (Letter, 9/6/94, GAO/PEMD-94-32R). 


EMPLOYMENT
(COMPREHENSIVE
1-YEAR LISTING)
============================================================ Chapter 4


   EQUAL EMPLOYMENT OPPORTUNITIES
---------------------------------------------------------- Chapter 4:1

Employment Discrimination:  Most Private-Sector Employers Use
Alternative Dispute Resolution (Report, 7/5/95, GAO/HEHS-95-150). 

Federal Affirmative Employment:  Progress of Women and Minority
Criminal Investigators at Selected Agencies (Report, 4/25/95,
GAO/GGD-95-85). 

Equal Employment Opportunity:  Group Representation in Key Jobs at
the National Institutes of Health (Report, 3/16/95, GAO/GGD-95-83). 

Equal Opportunity:  DOD Studies on Discrimination in the Military
(Report, 3/95, GAO/NSIAD-95-103). 

Discrimination Complaints:  Monetary Awards in Federal EEO Cases
(Report, 1/3/95, GAO/GGD-95-28FS). 

Managing DOE:  Further Review Needed of Suspensions of Security
Clearances for Minority Employees (Report, 12/8/94, GAO/RCED-95-15). 

Equal Employment Opportunity:  Immigration and Naturalization
Service's Equal Employment Opportunity Program (Testimony, 11/17/94,
GAO/T-GGD-95-41). 

Equal Employment Opportunity:  Displacement Rates, Unemployment
Spells, and Reemployment Wages by Race (Report, 9/16/94,
GAO/HEHS-94-229FS). 


   LABOR AND MANAGEMENT RELATIONS
---------------------------------------------------------- Chapter 4:2

U.S.  Postal Service:  The State of Labor-Management Relations
(Testimony, 11/30/94, GAO/T-GGD-95-46). 

U.S.  Postal Service:  Labor-Management Problems Persist on the
Workroom Floor (Volume I) (Report, 9/29/94, GAO/GGD-94-201A). 


   TRAINING AND EMPLOYMENT
   ASSISTANCE
---------------------------------------------------------- Chapter 4:3

Job Corps:  High Costs and Mixed Results Raise Questions About
Program's Effectiveness (Report, 6/30/95, GAO/HEHS-95-180). 

Department of Labor:  Rethinking the Federal Role in Worker
Protection and Workforce Development (Testimony, 4/4/95,
GAO/T-HEHS-95-125). 

Multiple Employment Training Programs:  Information Crosswalk on 163
Employment Training Programs (Report, 2/14/95, GAO/HEHS-95-85FS). 

Multiple Employment Training Programs:  Major Overhaul Needed to
Create a More Efficient, Customer-Driven System (Testimony, 2/6/95). 

Multiple Employment Training Programs:  Major Overhaul Needed to
Reduce Costs, Streamline the Bureaucracy, and Improve Results
(Testimony, 1/10/95, GAO/T-HEHS- 95-53). 

Dislocated Workers:  An Early Look at the NAFTA Transitional
Adjustment Assistance Program (Report, 11/28/94, GAO/HEHS-95-31). 

Multiple Employment Training Programs:  Basic Program Data Often
Missing (Testimony, 9/8/94, GAO/T-HEHS-94-239). 

Multiple Employment Training Programs:  How Legislative Proposals
Address Concerns (Testimony, 8/4/94, GAO/T-HEHS-94-221). 


   WORKPLACE QUALITY
---------------------------------------------------------- Chapter 4:4

Department of Labor:  Rethinking the Federal Role in Worker
Protection and Workforce Development (Testimony, 4/4/95,
GAO/T-HEHS-95-125). 

Garment Industry:  Efforts to Address the Prevalence and Conditions
of Sweatshops (Report, 11/2/94, GAO/HEHS-95-29). 


   OTHER EMPLOYMENT ISSUES
---------------------------------------------------------- Chapter 4:5

Federal Reorganization:  Congressional Proposal to Merge Education,
Labor, and EEOC (Report, 6/7/95, GAO/HEHS-95-140).  Testimony on same
topic (6/29/95, GAO/T- HEHS-95-188). 

Personnel Practices:  Selected Characteristics of Recent Ramspeck Act
Appointments (Testimony, 5/24/95, GAO/T-GGD-95-173). 

Title 6 T&A Data (NASA) (Letter, 5/23/95, GAO/AIMD-95-140R). 

Title 6 T&A Data (NRC) (Letter, 5/23/95, GAO/AIMD-95-139R). 

Administratively Uncontrollable Overtime (Letter, 4/14/95,
GAO/GGD-95-129R). 

Federal Quality Management:  Strategies for Involving Employees
(Report, 4/18/95, GAO/GGD-95-79). 

Federal Downsizing:  The Administration's Management of Workforce
Reductions (Testimony, 3/2/95, GAO/T-GGD-95-108). 

Labor's Regional Structure and Trust Funds (Letter, 2/10/95,
GAO/HEHS-95-82R). 

Block Grants:  Characteristics, Experience, and Lessons Learned
(Report, 2/9/95, GAO/HEHS-95-74).  Testimony on same topic (2/9/95,
GAO/T-HEHS-95-80). 

GAO Labor Products (1990-1995) (Letter, 2/3/95, GAO/HEHS-95-73R). 

Department of Labor:  Opportunities to Realize Savings (Testimony,
1/18/95, GAO/T-HEHS-95-55). 

Federal Personnel:  Federal/Private Sector Pay Comparisons (Report,
12/14/94, GAO/OCE-95-1). 

NPR Recommendations on T&A Data (Letter, 9/28/94, GAO/AIMD-94-193R). 

Federal Employment:  GAO's Observations on H.R.  4719, the Federal
Service Priority Placement Act of 1994 (Testimony, 9/21/94,
GAO/T-GGD-94-213). 

Federal Employment:  How Government Jobs Are Viewed on Some College
Campuses (Report, 9/9/94, GAO/GGD-94-181). 

The Public Service:  Issues Confronting the Federal Civilian
Workforce (Report, 8/25/94, GAO/GGD-94-157). 


SOCIAL SECURITY, DISABILITY, AND
WELFARE
(COMPREHENSIVE
1-YEAR LISTING)
============================================================ Chapter 5


   CHILDREN'S ISSUES
---------------------------------------------------------- Chapter 5:1


      CHILD SUPPORT
-------------------------------------------------------- Chapter 5:1.1

Child Support Enforcement:  Families Could Benefit From Stronger
Enforcement Program (Report, 12/27/94, GAO/HEHS-95-24). 


      OTHER CHILDREN'S ISSUES
-------------------------------------------------------- Chapter 5:1.2

Child Welfare:  Opportunities to Further Enhance Family Preservation
and Support Activities (Report, 6/15/95, GAO/HEHS-95-112). 

Child Support Enforcement:  Opportunity to Reduce Federal and State
Costs (Testimony, 6/13/95, GAO/T-HEHS-95-181). 

Foster Care:  Health Needs of Many Young Children Are Unknown and
Unmet (Report, 5/26/95, GAO/HEHS-95-114). 

Child Care:  Recipients Face Service Gaps and Supply Shortages
(Testimony, 3/1/95, GAO/T-HEHS-95-96). 

Child Care:  Narrow Subsidy Programs Create Problems for Mothers
Trying to Work (Testimony, 1/31/95, GAO/T-HEHS-95-69). 

Low-Income Families:  Comparison of Incomes of AFDC and Working Poor
Families (Testimony, 1/25/95, GAO/T-HEHS-95-63). 

Child Care:  Child Care Subsidies Increase Likelihood That Low-Income
Mothers Will Work (Report, 12/30/94, GAO/HEHS-95-20). 

Child Care:  Promoting Quality in Family Child Care (Report, 12/7/94,
GAO/HEHS- 95-36).  Testimony on same topic (12/9/94,
GAO/T-HEHS-95-43). 

Child Care:  Current System Could Undermine Goals of Welfare Reform
(Testimony, 9/20/94, GAO/T-HEHS-94-238). 

Dependent Exemption (Letter, 8/31/94, GAO/GGD-94-200R). 


   PENSIONS
---------------------------------------------------------- Chapter 5:2


      PENSION BENEFIT GUARANTY
      CORPORATION
-------------------------------------------------------- Chapter 5:2.1

Management Letter:  Pension Benefit Guaranty Corporation's Accounting
Procedures (Report, 8/29/94, AIMD-94-168ML). 


      PUBLIC AND PRIVATE PENSION
      ISSUES
-------------------------------------------------------- Chapter 5:2.2

Federal Retirement System Financing (Testimony, 6/28/95,
GAO/T-GGD-95-197). 

Overview of Federal Retirement Programs (Testimony, 5/22/95,
GAO/T-GGD-95- 172). 

Federal Retirement:  Benefits for Members of Congress, Congressional
Staff, and Other Employees (Report, 5/15/95, GAO/GGD-95-78). 
Testimony on same topic (5/15/95, GAO/T-GGD-95-165). 

CSRS Funding (Letter, 4/3/95, GAO/GGD-95-200R). 

Federal Retirement Issues (Testimony, 3/10/95, GAO/T-GGD-95-111). 

District Pensions:  Federal Options for Sharing Burden to Finance
Unfunded Liability (Report, 12/28/94, GAO/HEHS-95-40). 

Private Pensions:  Funding Rule Change Needed to Reduce PBGC's
Multibillion Dollar Exposure (Report, 10/5/94, GAO/HEHS-95-5). 

DOE Management:  Contract Provisions Do Not Protect DOE From
Unnecessary Pension Costs (Report, 8/26/94, GAO/RCED-94-201). 

Pension Plans:  Stronger Labor ERISA Enforcement Should Better
Protect Plan Participants (Report, 8/8/94, GAO/HEHS-94-157). 


   SOCIAL SECURITY AND DISABILITY
---------------------------------------------------------- Chapter 5:3


      DISABILITY
-------------------------------------------------------- Chapter 5:3.1

Disability Insurance:  Broader Management Focus Needed to Better
Control Caseload (Testimony, 5/23/95, GAO/T-HEHS-95-164). 

D.C.  Disability Retirement Rate (Report, 3/31/95, GAO/GGD-95-133). 

Supplemental Security Income:  Recipient Population Has Changed as
Caseloads Have Burgeoned (Testimony, 3/27/95, GAO/T-HEHS-95-120). 

Social Security:  New Functional Assessments for Children Raise
Eligibility Questions (Report, 3/10/95, GAO/HEHS-95-66). 

Social Security:  Federal Disability Programs Face Major Issues
(Testimony, 3/2/95, GAO/T-HEHS-95-97). 

Supplemental Security Income:  Recent Growth in the Rolls Raises
Fundamental Program Concerns (Testimony, 1/27/95, GAO/T-HEHS-95-67). 

Social Security:  Rapid Rise in Children on SSI Disability Rolls
Follows New Regulations (Report, 9/9/94, GAO/HEHS-94-225). 


      SOCIAL SECURITY
      ADMINISTRATION
-------------------------------------------------------- Chapter 5:3.2

OHA Backlogs (Letter, 7/28/95, GAO/HEHS-95-228R). 

Supplemental Security Income:  Growth and Changes in Recipient
Population Call for Reexamining Program (Report, 7/7/95,
GAO/HEHS-95-137). 

Social Security Administration:  Leadership Challenges Accompany
Transition to an Independent Agency (Report, 2/15/95,
GAO/HEHS-95-59). 

SSA Services to Employers (Letter, 12/6/94, GAO/HEHS-95-38R). 

Accuracy of Form SSA 1099 (Letter, 9/26/94, GAO/HEHS-94-234R). 

Social Security Administration:  Risks Associated With Information
Technology Investment Continue (Report, 9/19/94, GAO/AIMD-94-143). 

Social Security:  Trust Funds Can Be More Accurately Funded (Report,
9/2/94, GAO/HEHS-94-48). 

Social Security:  Most Social Security Death Information Accurate But
Improvements Possible (Report, 8/29/94, GAO/HEHS-94-211). 


      OTHER SOCIAL SECURITY
      PROGRAMS
-------------------------------------------------------- Chapter 5:3.3

Social Security:  GAO's Analysis of the Notch Issue (Testimony,
9/16/94, GAO/T- HEHS-94-236). 

Social Security Retirement Accounts (Letter, 8/12/94,
GAO/HEHS-94-226R). 


   WELFARE
---------------------------------------------------------- Chapter 5:4

Welfare to Work:  State Programs Have Tested Some of the Proposed
Reforms (Report, 7/14/95, GAO/PEMD-95-26). 

Low-Income Families (Letter, 6/28/95, GAO/HEHS-95-162R). 

Welfare Benefits:  Potential to Recover Hundreds of Millions More in
Overpayments (Report, 6/20/95, GAO/HEHS-95-111). 

Welfare Programs:  Opportunities to Consolidate and Increase Program
Efficiencies (Report, 5/31/95, GAO/HEHS-95-139). 

Welfare to Work:  Most AFDC Training Programs Not Emphasizing Job
Placement (Report, 5/19/95, GAO/HEHS-95-113). 

Welfare to Work:  Measuring Outcomes for JOBS Participants (Report,
4/17/95, GAO/HEHS-95-86). 

Means-Tested Programs (Letter, 2/24/95, GAO/HEHS-95-94R). 

Welfare Reform:  Implications of Proposals on Legal Immigrants'
Benefits (Report, 2/2/95, GAO/HEHS-95-58). 

Welfare to Work:  AFDC Training Program Spends Billions, but Not Well
Focused on Employment (Testimony, 1/10/95, GAO/T-HEHS-95-51).  Report
on same topic (12/19/94, GAO/HEHS-95-28). 

Child Care:  Current System Could Undermine Goals of Welfare Reform
(Testimony, 9/20/94, GAO/T-HEHS-94-238). 


   OTHER PRODUCTS RELATED TO
   SOCIAL SECURITY, DISABILITY,
   AND WELFARE
---------------------------------------------------------- Chapter 5:5

Illegal Aliens:  National Net Cost Estimates Vary Widely (Report,
7/25/95, GAO/HEHS-95-133). 

Health and Human Services:  Opportunities to Realize Savings
(Testimony, 1/12/95, GAO/T-HEHS-95-57). 

Illegal Aliens:  Assessing Estimates of Financial Burden on
California (Report, 11/28/94, GAO/HEHS-95-22). 

Financial Audit:  House Child Care Center--Fiscal Years Ended
9-30-93, 9-30-92, and Month Ended 9-30-91 (Report, 10/14/94,
GAO/AIMD-95-2). 


VETERANS AFFAIRS AND MILITARY
HEALTH (COMPREHENSIVE
1-YEAR LISTING)
============================================================ Chapter 6


   MILITARY HEALTH CARE
---------------------------------------------------------- Chapter 6:1

Defense Health Care:  Problems With Medical Care Overseas Are Being
Addressed (Report, 7/12/95, GAO/HEHS-95-156). 

Operation Desert Storm:  Health Concerns of Selected Indiana Persian
Gulf War Veterans (Report, 5/16/95, GAO/HEHS-95-102). 

Wartime Medical Care:  Aligning Sound Requirements with New Combat
Care Approaches Is Key to Restructuring Force (Testimony, 3/30/95,
GAO/T-NSIAD-95-129). 

Defense Health Care:  DOD's Managed Care Program Continues to Face
Challenges (Testimony, 3/28/95, GAO/T-HEHS-95-117). 

Defense Health Care:  Issues and Challenges Confronting Military
Medicine (Report, 3/22/95, GAO/HEHS-95-104). 

VA/DOD Health Care:  More Guidance Needed to Implement CHAMPUS-Funded
Sharing Agreements (Report, 10/28/94, GAO/HEHS-95-15). 

Operation Desert Storm:  Questions Remain on Possible Exposure to
Reproductive Toxicants (Report, 8/5/94, GAO/PEMD-94-30).  Testimony
on same topic (8/5/94, GAO/T-PEMD-94-31). 


   VETERANS' BENEFITS
---------------------------------------------------------- Chapter 6:2

Veterans' Benefits:  VA Can Prevent Millions in Compensation and
Pension Overpayments (Report, 4/28/95, GAO/HEHS-95-88). 

Concurrent Receipt (Letter, 4/27/95, GAO/HEHS-95-136R). 

Veterans Compensation:  Offset of DOD Separation Pay and VA
Disability Compensation (Report, 4/3/95, GAO/NSIAD-95-123). 

Veterans' Benefits:  Basing Survivors' Compensation on Veterans'
Disability Is a Viable Option (Report, 3/6/95, GAO/HEHS-95-30). 

Veterans' Benefits:  Better Assessments Needed to Guide Claims
Processing Improvements (Report, 1/13/95, GAO/HEHS-95-25). 

Fiscal Year 1995 VA Certification (Letter, 11/10/94,
GAO/HEHS-95-32R). 

Veterans' Benefits:  Lack of Timeliness, Poor Communication Cause
Customer Dissatisfaction (Report, 9/20/94, GAO/HEHS-94-179). 


   VETERANS' HEALTH CARE
---------------------------------------------------------- Chapter 6:3

VA Health Care:  Physician Peer Review Identifies Quality of Care
Problems but Actions to Address Them Are Limited (Report, 7/7/95,
GAO/HEHS-95-121). 

Operation Desert Storm:  Health Concerns of Selected Indiana Persian
Gulf War Veterans (Report, 5/16/95, GAO/HEHS-95-102). 

VA Health Care:  Challenges and Options for the Future (Testimony,
5/9/95, GAO/T-HEHS-95-147). 

VA Health Care:  Retargeting Needed to Better Meet Veterans' Changing
Needs (Report, 4/21/95, GAO/HEHS-95-39). 

Barriers to VA Managed Care (Letter, 4/20/95, GAO/HEHS-95-84R). 

VA Health Care:  Albuquerque Medical Center Not Recovering Full Costs
of Lithotripsy Services (Report, 12/28/94, GAO/HEHS-95-19). 

Veterans' Health Care:  Veterans' Perceptions of VA Services and VA's
Role in Health Care Reform (Report, 12/23/94, GAO/HEHS-95-14). 

VA Health Care:  Inadequate Planning in the Chesapeake Network
(Report, 12/22/94, GAO/HEHS-95-6). 

VA Health Care:  Purchases of Safer Devices Should Be Based on Risk
of Injury (Report, 11/17/94, GAO/HEHS-95-12). 

Fiscal Year 1995 VA Certification (Letter, 11/10/94,
GAO/HEHS-95-32R). 

VA/DOD Health Care:  More Guidance Needed to Implement CHAMPUS-Funded
Sharing Agreements (Report, 10/28/94, GAO/HEHS-95-15). 

Veterans' Health Care:  Use of VA Services by Medicare-Eligible
Veterans (Report, 10/24/94, GAO/HEHS-95-13). 

Veterans Health Care:  Implications of Other Countries' Reforms for
the United States (Report, 9/27/94, GAO/HEHS-94-210BR). 

Veterans' Health Care:  A Profile of Married Veterans Using VA
Medical Centers (Report, 8/26/94, GAO/HEHS-94-223FS). 



MAJOR CONTRIBUTORS
============================================================ Chapter 7

Jessie L.  Battle
David W.  Bieritz
Susan Y.  Higgins
James L.  Kirkman
Stephen F.  Palincsar



ORDER FORM
============================================================ Chapter 8



MAILING LIST REQUEST FORM
============================================================ Chapter 9


         ADDRESS INFORMATION
------------------------------------------------------ Chapter 9:0.0.1

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         AREAS OF INTEREST
------------------------------------------------------ Chapter 9:0.0.2

To receive future reports and testimonies, check your area(s) of
interest. 

HEALTH EMPLOYMENT
Access and Infrastructure Equal Employment Opportunities
Employee and Retiree Benefits High Performance Workplaces
Financing Labor and Management Relations
Health Care Reform Training and Employment
HHS Public Health Service Assistance
Long-Term Care and Aging Workplace Quality
Malpractice Other Employment Issues
Managed Care
Medicare and Medicaid SOCIAL SECURITY, DISABILITY,
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Quality and Practice Standards Social Security & Disability
Substance Abuse and Treatment Welfare
Other Health Issues Other Social Security, Disability,
& Welfare Issues
EDUCATION
Department of Education
Early Childhood Development VETERANS AFFAIRS & MILITARY
Armed Forces HEALTH
Elementary and Secondary Military Health
Higher Education Veterans' Benefits
School-to-Work Transition Veterans' Health Care


         MAIL OR FAX TO: 
------------------------------------------------------ Chapter 9:0.0.3

Janet Shikles, Assistant Comptroller General
Health, Education, and Human Services Division, NGB/ACG
U.S.  General Accounting Office
441 G Street, N.W., Washington, D.C., 20548


         (7/95)
------------------------------------------------------ Chapter 9:0.0.4

Fax Number (202) 512-5806. 



CHANGE OF ADDRESS NOTIFICATION
FORM
=========================================================== Chapter 10


         REQUESTING CHANGES
----------------------------------------------------- Chapter 10:0.0.1

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To change name, organization, or address, enter appropriate changes
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         FAX OR MAIL TO: 
----------------------------------------------------- Chapter 10:0.0.2

Janet Shikles, Assistant Comptroller General
U.S.  General Accounting Office
Fax (202) 512-5806


         (8/95)
----------------------------------------------------- Chapter 10:0.0.3

Turn this page over, fold on the dotted lines, and affix stamp. 



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