Health, Education, Employment, Social Security, Welfare, and Veterans
Reports (Letter Report, 10/01/95, GAO/HEHS-96-15W).

This booklet lists GAO documents on government programs related to
health, education, employment, social security, welfare, and veterans
issues, which are primarily run by the Departments of Health and Human
Services, Labor, Education, and Veterans Affairs. One section identifies
reports and testimony issued during the past month and summarizes key
products. Another section lists all documents published during the past
year, organized chronologically by subject. Order forms are included.

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

 REPORTNUM:  HEHS-96-15W
     TITLE:  Health, Education, Employment, Social Security, Welfare, 
             and Veterans Reports
      DATE:  10/01/95
   SUBJECT:  Managed health care
             Employee medical benefits
             Health insurance
             Fair employment programs
             Employment or training programs
             Social security benefits
             Veterans benefits
             Drug treatment
             Educational programs
             Public assistance programs
IDENTIFIER:  Bibliographies
             Medicare Program
             Medicaid Program
             
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Cover
================================================================ COVER


Health, Education, and Human
Services Division Reports

October 1995

HEALTH
EDUCATION
EMPLOYMENT
SOCIAL SECURITY
WELFARE
VETERANS

GAO/HEHS-96-15W



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

  AEA - Adult Education Act
  AFDC - Aid to Families With Dependent Children
  CDR - continuing disability review
  CHAMPUS - Civilian Health and Medical Program of the Uniformed
     Services
  COLA - Cost of living allowance
  CSRS - Civil Service Retirement System
  DC - District of Columbia
  DMEPOS - durable medical equipment, prostheses, orthoses, and
     supplies
  DOD - Department of Defense
  DODDS - Department of Defense Dependents Schools
  DOE - Department of Energy
  DOL - Department of Labor
  EEO - Equal Employment Opportunity
  EEOC - Equal Employment Opportunity Commission
  ERISA - Employee Retirement Income Security Act of 1974
  FSA - Family Support Act
  GAO - General Accounting Office
  HCFA - Health Care Financing Administration
  HEHS - Health, Education, and Human Services Division, GAO
  HHS - Department of Health and Human Services
  HMO - health maintenance organization
  HPSA - Health Professional Shortage Area
  HRD - Human Resources Division, GAO
  JOBS - Job Opportunities and Basic Skills program
  MCO - managed care organization
  MUA - Medically Underserved Area
  NAFTA - North American Free Trade Agreement
  NASA - National Aeronautics and Space Administration
  NCI - National Cancer Institute, National Institutes of Health
  NIH - National Institutes of Health
  NPR - National Performance Review
  NRC - Nuclear Regulatory Commission
  ODCCP - Office of Federal Contract Compliance Programs, DOL
  OHA - Office of Hearings and Appeals, Social Security
     Administration
  ORI - Office of Research Integrity, HHS
  PBGC - Pension Benefit Guarantee Corporation
  PSDA - Patient Self-Determination Act
  SBA - Small Business Administration
  SSA - Social Security Administration
  SSI - Supplemental Security Income
  T&A - time and attendance
  TRICARE - DOD nationwide managed health care program
  VA - Department of Veterans Affairs

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. 

Please let me know if you would like to get on our mailing list by
either faxing our mailing list request form on page 41 to (202)
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phone in your requests to (202) 512-6000. 

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





Janet L.  Shikles
Assistant Comptroller General


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


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


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

Health Care:  Employers and Individual Consumers Want Additional
Information on Quality (Report, 9/29/95, GAO/HEHS-95-201). 

Many employers and individual consumers GAO interviewed are using
information that measures and compares the quality of health care
furnished by providers and health plans when making their purchasing
decisions.  For example, employers are using report cards to select
and monitor the performance of providers and plans furnishing
services to their employees, negotiate with insurance carriers, and
market managed care plans to employees.  Employers and individual
consumers GAO interviewed wanted performance reporting efforts to
continue.  In fact, they are requesting more data than are publicly
available.  Employers and individual consumers GAO interviewed also
reported that the most useful information would measure health care
outcomes.  They also said that they want standardized and comparable
health care information to assess health care providers' or health
plans' performance equally.  Many of the employers GAO interviewed
are getting some of the data they want through business coalitions,
consultants, and their own data collection efforts.  But these
sources are not available to individual consumers, and few employers
are sharing these data with their employees. 

Health Insurance Portability:  Reform Could Ensure Continued Coverage
for up to 25 Million Americans (Report, 9/19/95, GAO/HEHS- 95-257). 

Although current federal and state laws have generally improved the
portability of health insurance, an individual's health care coverage
could still be reduced when changing jobs.  Between 1990 and 1994, 40
states enacted small group insurance regulations that include
portability standards, but the federal Employee Retirement Income
Security Act of 1974 (ERISA) prevents states from applying these
standards to the health plans of employers who self-fund.  As a
result, some in the Congress have proposed broader national
portability standards.  GAO estimates that up to 21 million Americans
a year would benefit from federal legislation that would waive
preexisting condition exclusions for individuals who have had
continuous health care coverage.  In addition, perhaps as many as 4
million Americans who at some time have been unwilling to leave their
jobs because of concerns about losing their health care coverage
would benefit from national portability standards.  Such a change,
however, could possibly increase premiums, according to insurers. 

Medicare Spending:  Modern Management Strategies Needed to Curb
Billions in Unnecessary Payments (Report, 9/19/95, GAO/HEHS-95- 210). 

Medicare's vulnerability to billions of dollars in unnecessary
payments stems from a combination of factors.  First, Medicare pays
higher than market rates for certain services and supplies.  Second,
Medicare's collection of anti-fraud-and-abuse controls does not
systematically prevent the unquestioned payment of claims for
improbably high charges or manipulated billing codes.  Third,
Medicare's checks on the legitimacy of providers are too superficial
to detect the potential for scams.  These weaknesses are aggravated
by the fact that Medicare's efforts to address them, as well as its
efforts to penalize wrongdoers, are too slow to be effective in
curbing avoidable costs or deterring further fraud and abuse. 
Various health care management strategies help private payers
alleviate these problems, but these strategies 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.  GAO believes that a viable strategy for remedying
the program's weaknesses consists of adapting the health care
management approach of private payers to Medicare's public payer
role. 

Durable Medical Equipment:  Regional Carriers' Coverage Criteria Are
Consistent With Medicare Law (Report, 9/19/95, GAO/HEHS-95-185). 

The final criteria adopted by the regional carriers are consistent in
all material respects with Medicare's national coverage criteria and
Medicare law.  GAO does not believe that the regional carriers'
criteria have impeded disabled beneficiaries' access to customized
durable medical equipment, prostheses, orthoses, and supplies
(DMEPOS).  In 1994, the regional carriers approved DMEPOS claims for
disabled Medicare beneficiaries at a similar rate as for aged
beneficiaries, and there is no apparant difference in the application
of the criteria between disabled and aged Medicare beneficiaries. 
Further, from January 1992 through September 1994, the differences in
approval rates between aged and disabled beneficiaries narrowed. 
Some groups representing disabled persons have stated that the
disabled need items to accommodate a more active lifestyle than aged
beneficiaries.  The Health Care Financing Administration (HCFA) has
taken the position that Medicare law restricts coverage to standard
items unless the beneficiary's physician prescribes and justifies
lightweight materials or customized items on medical grounds.  HCFA's
position is consistent with current law. 

Cancer Drug Research:  Contrary to Allegation, NIH Hydrazine Sulfate
Studies Were Not Flawed (Report, 9/13/95, GAO/HEHS-95-141). 

In three large clinical trials, the National Cancer Institute (NCI)
found that hydrazine sulfate did not prolong survival for cancer
patients.  Nevertheless, controversy and confusion developed, in
part, because some researchers have suggested that hydrazine sulfate
is incompatible with tranquilizers, barbiturates, and alcohol.  In
testing hydrazine sulfate, NCI permitted study patients to use
tranquilizing agents, barbiturates, and alcohol in one NCI-sponsored
clinical trial.  In the other two trials, NCI prohibited the use of
barbiturates and alcohol, but patients were permitted to use
tranquilizing agents as antiemetics to control nausea and vomiting. 
However, subsequent analyses of the use of concurrent medications
found no evidence to invalidate NCI's conclusion that hydrazine
sulfate is ineffective. 

Health Care Shortage Areas:  Designations Not a Useful Tool for
Directing Resources to the Underserved (Report, 9/8/95, GAO/HEHS-
95-200). 

The Department of Health and Human Services (HHS) uses two main
systems for identifying areas where there are barriers to obtaining
primary health care.  One system designates Health Professional
Shortage Areas (HPSAs), and the other designates Medically
Underserved Areas (MUAs).  The HPSA and MUA systems do not
effectively identify areas with primary care shortages or help target
federal resources to benefit those who are underserved.  Data and
methodology problems are widespread, severely limiting the systems'
ability to pinpoint the extent of need in underserved areas.  Even
when the systems accurately identify needy areas, they often do not
provide the information needed to decide which programs are best
suited to the area's particular need.  HHS proposals for combining
and streamlining the systems are unlikely to solve the problems GAO
identified.  Fixing the systems is not the only option--and probably
not the best option.  Instead, all but one of the individual programs
already have criteria and application processes in place that may be
more easily modified to identify where a need exists and whether the
program is an appropriate remedy. 

Medicaid:  Tennessee's Program Broadens Coverage but Faces Uncertain
Future (Report, 9/1/95, GAO/HEHS-95-186). 

In seeking its 5-year waiver approval from the Department of Health
and Human Services (HHS), Tennessee had several objectives.  Two of
these were to expand health care coverage to the state's uninsured
and to control total program and state costs.  In less than 2 months
after receiving approval, Tennessee had contracted with 12 managed
care organizations (MCO) to place its entire Medicaid population in
its new capitated managed health care program, TennCare, and to open
enrollment to uninsured persons in the state.  By the end of the
first year, Tennessee had enrolled approximately 800,000
Medicaid-eligible persons and over 400,000 uninsured persons who were
not determined to be eligible for Medicaid in TennCare, with two of
the MCOs accounting for nearly three-fourths of the over 1.2 million
enrollees.  Despite this increase in the number of persons covered,
federal and state reported expenditures for Tennessee's Medicaid
program increased less than 1 percent in fiscal year 1994,
considerably below the national average.  Although TennCare
essentially met its objectives to provide health care coverage to
many uninsured individuals while controlling costs, concerns remain
about TennCare.  Primary among these concerns are enrollee access to
quality care and MCO financial performance.  TennCare's long-range
success is uncertain. 


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

Cost Factors in CARE Act Formula (Letter, 9/15/95, GAO/HEHS-95-
256R). 

Preventing Abusive Medicare Billing (Letter, 9/5/95, GAO/HEHS-
95-260R). 


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


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

School Finance:  Trends in U.S.  Education Spending (Report, 9/15/95,
GAO/HEHS-95-235). 

Since 1980, total real expenditures (that is, expenditures in
constant dollars) in public elementary and secondary schools have
increased, while the average national per pupil expenditure increased
then stabilized after 1989.  Since 1990, public school enrollments
began to increase after a decade of decline in the 1980s, when public
school enrollment decreased to a low of 39.2 million children in the
school year 1984-85.  This upward trend is expected to continue, with
public school enrollment increasing by 11 percent between school
years 1993- 94 and 2000-01 to about 48.3 million.  The number of poor
children is also increasing at a high rate.  The cost of educating
these and other at-risk children is generally higher than the cost of
educating children not at risk.  GAO found that education's share of
state budgets decreased between fiscal years 1987 and 1994, while
Medicaid and corrections increased their shares.  The ability of
states to raise taxes and revenues on the basis of taxable resources
(fiscal capacity) and each state's willingness to tax these resources
(fiscal effort) vary widely.  State and local governments feel
pressure from different sources, including growing numbers of
students--especially at-risk students--those who want to improve
America's schools through education reform, and state court
challenges to school funding to increase education spending in less
wealthy school districts.  Education is losing its dominance of state
budgets as it competes with other public services, such as Medicaid
and corrections, for public funds. 

DOD Dependents Schools:  Enrollment Categories, Numbers, and
Locations (Report, 9/18/95, GAO/HEHS-95-149). 

The Secretary of Defense is authorized by the Defense Dependents'
Education Act of 1978 to establish eligibility for space-available
enrollment for students and has placed space-available children into
two broad categories:  tuition-paying and tuition-free. 
Tuition-paying students can be either (1) federally connected, such
as dependents of the State Department or other U.S.  government
agency sponsors or (2) nonfederally connected, including dependents
of retired military and foreign national sponsors.  The majority of
tuition-free, space- available students are the dependents of
Department of Defense (DOD) military or civilian sponsors who are not
authorized government transportation and housing overseas for their
dependents.  A Conference Committee report instructed DOD not to
include the cost of educating tuition-free, space-available students
in its budget request, and to include only the cost of educating
space-required and tuition-paying, space-available students.  The
Department of Defense Dependents Schools (DODDS) has not followed
these instructions, even though doing so would not pose a serious
burden on most schools, whose space-available, tuition-free
enrollments are very low. 

Adult Education:  Measuring Program Results Has Been Challenging
(Report, 9/6/95, GAO/HEHS-95-153). 

The goals of the Adult Education Act (AEA), which encompasses the
State Grant Program, are broad to enable people with diverse needs to
receive varying types of instruction.  The most common types of
instruction funded under the State Grant Program are basic education
(for adults functioning below the eighth grade level), secondary
education, and English as a Second Language.  Although the State
Grant Program funds programs that address the educational needs of
millions of adults, it has had difficulty ensuring accountability for
results because of a lack of clearly defined program objectives,
questionable validity of adult student assessments, and poor student
data.  Amendments to the AEA required the Department of Education to
improve accountability by developing model indicators of program
quality that states could adopt and use to evaluate local programs. 
However, experts disagree about whether developing indicators would
help states to define measurable program objectives or evaluate local
programs and collect more accurate data.  Other federal efforts may
help states achieve better accountability systems, but it is too soon
to evaluate their effectiveness. 


      OTHER EDUCATION PRODUCTS
-------------------------------------------------------- Chapter 1:2.2

AmeriCorps*USA Clarifications (Letter, 9/11/95, GAO/HEHS-95- 267R). 

AmeriCorps*USA Benefit-Cost Study (Letter, 9/7/95, GAO/HEHS-95-
255R). 


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


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

Equal Employment Opportunity:  DOL Contract Compliance Reviews Could
Better Target Federal Contractors (Report, 9/28/95, GAO/HEHS-95-
177). 

To fulfill its mission and responsibilities to identify and resolve
instances of discriminatory employment practices by federal
contractors, the Department of Labor's (DOL) Office of Federal
Contract Compliance Programs (OFCCP) uses compliance reviews as its
main enforcement strategy.  In fiscal year 1994, OFCCP devoted about
80 percent of its enforcement hours to compliance reviews, completing
about 4,000 such reviews.  OFCCP's financial and staff resources have
declined over the past several years.  As OFCCP's resources have
decreased, so too has the number of compliance reviews it conducts. 
One of the procedures OFCCP uses to select contractors for review
raises concerns about its ability to effectively target potential
violators.  OFCCP receives data on the sex and individual racial
groups that compose the contractor's workforce, yet OFCCP aggregates
the data on all minority employees in a given company before
completing its initial analysis.  This practice could cause OFCCP to
overlook companies that discriminate against one or more minority
groups. 


      OTHER EMPLOYMENT PRODUCTS
-------------------------------------------------------- Chapter 1:3.2

Equal Employment Opportunity:  Women and Minority Representation at
Interior, Agriculture, Navy, and State (Report, 9/29/95, GAO/GGD-
95-211). 


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


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

Child Welfare:  Complex Needs Strain Capacity to Provide Services
(Report, 9/26/95, GAO/HEHS-95-208). 

Between 1983 and 1993, sharp increases in the number of foster
children combined with unprecedented service needs led to a crisis in
foster care.  Reports of child abuse and neglect nearly doubled, and
foster care caseloads grew by two-thirds.  Demands for child welfare
services grew not only because the number of foster children
increased but also because families and children were more troubled
and had more complex needs.  Meanwhile, resources for child welfare
services failed to keep pace with the needs of troubled children and
their families.  While foster care funding has increased dramatically
at all levels of government, federal funding for child welfare
services has lagged.  States and localities have found it difficult
to meet the demand, although they have more than tripled expenditures
in some cases.  Federal foster care funds generally cannot be
transferred to support child welfare services, and available state
funds are increasingly being spent on child abuse and neglect
investigations.  Faced with increasing demands and limited resources,
states have adopted various measures to meet the needs of troubled
children and their families while maintaining children's safety. 

Welfare to Work:  Child Care Assistance Limited; Welfare Reform May
Expand Needs (Report, 9/21/95, GAO/HEHS-95-220). 

Although 73 percent of the state Job Opportunities and Basic Skills
(JOBS) programs in GAO's nationwide survey reported child care
subsidies or help arranging child care to all or almost all
participants who needed assistance, their ability to do so stemmed
from two key Family Support Act (FSA) provisions that serve to limit
the number of AFDC recipients who participate.  JOBS serves only a
small portion of adult welfare recipients--approximately 13 percent
in any given month--in part because many meet the statutory exemption
provisions.  Regardless of their ability to provide child care
assistance, state and county officials told GAO that a number of
difficulties hinder finding child care for the small number of
recipients who participate in JOBS such as shortages of care for
infants and during non standard work hours.  Once a welfare recipient
secures work, her ability to continue working and become self-
sufficient enough to support a family can be impaired if her child
care subsidy is cut off from aid because of insufficient state
resources.  Providing funding and finding care for additional
children as more mothers are required to work or limit their stay on
AFDC under welfare reform may be difficult. 

Private Pension Plans:  Efforts to Encourage Infrastructure
Investment (Report, 9/8/95, GAO/HEHS-95-173). 

Although pension plans constitute a vast pool of capital, they have
not been invested to any significant degree in domestic public
infrastructure because of the combined effects of federal law.  To
encourage greater investment, the Infrastructure Commission
recommended creating two new federally sponsored financing entities
to assist projects and attract investors, including pension plans. 
In reviewing the Infrastructure Commission's recommendations, GAO
found that although the proposals might encourage pension plans to
invest in infrastructure projects, many analysts and market
participants are skeptical about whether they are the best way to
encourage infrastructure investment or whether they are needed at
all.  The Infrastructure Commissions's proposals would expand federal
subsidies, which under current pension and tax law cost the U.S. 
Treasury more than $60 billion in foregone revenue in fiscal year
1994.  However, the share of pension plan assets that might go to
infrastructure projects would probably be small.  Given existing
federal law on pension plans and municipal bonds, other options, such
as the federal capitalization of state revolving funds, may offer an
alternative way to expand infrastructure investment without relying
on pension plans. 


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

SSA's Rehabilitation Programs (Letter, 9/7/95, GAO/HEHS-95- 253R). 

Children and Families Services Programs (Letter, 9/1/95,
GAO/HEHS-95-191R). 

Block Grants:  Issues in Designing Accountability Provisions (Report,
9/1/95, GAO/AIMD-95-226). 


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


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

Military Physicians:  DOD's Medical School and Scholarship Program
(Report, 9/29/95, GAO/HEHS-95-244). 

Determining the most cost-effective way to educate and retain
military physicians depends on the cost elements included and the
unit of analysis used to measure cost.  By most measures, the
Uniformed Services University of the Health Sciences, the Department
of Defense's (DOD) medical school in Bethesda, Maryland, is a more
costly way to educate and retain military physicians.  GAO's analysis
shows that the University provides a medical education that compares
well with that of other U.S.  medical schools.  Traditional measures
of quality place the University within the midrange of medical
schools nationwide and its graduates at or above other military
physicians.  University graduates begin their military medical
careers with more readiness training than their peers, but the
significance of the additional training is unclear.  GAO's review
suggests that University graduates are likely to provide DOD with a
cadre of experienced physician career officers.  Given the changes in
operational scenarios and DOD's approach for delivering peacetime
health care, new assessments of the military's physician needs and
the means to acquire and retain such physicians are in order. 

Veterans' Benefits:  Effective Interaction Needed Within VA to
Address Appeals Backlog (Report, 9/27/95, GAO/HEHS-95-190). 

VA's appeals process is increasingly bogged down, and the outlook for
the future is not bright.  The Veterans' Judicial Review Act and
Court of Veterans Appeals rulings expanded veterans' rights but also
expanded VA's adjudication responsibilities.  VA is having difficulty
integrating these responsibilities into its already complex and
unwieldy adjudication process.  The current legal and organizational
framework--which involves several autonomous VA organizations in
claims adjudication--makes effective interaction among those
organizations essential to fair and efficient claims processing.  A
common theme of many study recommendations is the need for VA
organizations to work together to identify and resolve problems.  VA
officials have not, however, implemented many of the recommendations,
believing that other formal and informal mechanisms are effective. 
GAO found evidence that in spite of these mechanisms, problems are
not being identified or resolved. 


      OTHER VETERANS AFFAIRS AND
      MILITARY HEALTH PRODUCTS
-------------------------------------------------------- Chapter 1:5.2

VA Clinic Funding (Letter, 9/19/95, GAO/HEHS-95-273R). 

Proposed VA Hospital at Travis Air Force Base (Letter, 9/19/95,
GAO/HEHS-95-268R). 

VA Medical Resources Allocation (Letter, 9/12/95, GAO/HEHS-95- 252R). 

Medical Care Budget Alternatives (Letter, 9/12/95, GAO/HEHS-95-
247R). 


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). 


   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 Portability:  Reform Could Ensure Continued Coverage
for up to 25 Million Americans (Report, 9/19/95, GAO/HEHS- 95-257). 

Cost Factors in CARE Act Formula (Letter, 9/15/95, GAO/HEHS-95-
256R). 

Medigap Insurance:  Insurers' Compliance With Federal Minimum Loss
Ratio Standards, 1988-93 (Report, 8/23/95, GAO/HEHS-95-151). 

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). 


   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

Cancer Drug Research:  Contrary to Allegation, NIH Hydrazine Sulfate
Studies Were Not Flawed (Report, 9/13/95, GAO/HEHS-95-141). 

Health Care Shortage Areas:  Designations Not a Useful Tool for
Directing Resources to the Underserved (Report, 9/8/95, GAO/HEHS-
95-200). 

Health Research Misconduct:  HHS' Handling of Cases is Appropriate,
but Timeliness Remains a Concern (Report, 8/3/95, GAO/HEHS-95-134). 

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). 


   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). 


   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 Spending:  Modern Management Strategies Needed to Curb
Billions in Unnecessary Payments (Report, 9/19/95, GAO/HEHS-95- 210). 

Durable Medical Equipment:  Regional Carriers' Coverage Criteria Are
Consistent With Medicare Law (Report, 9/19/95, GAO/HEHS-95-185). 

Preventing Abusive Medicare Billing (Letter, 9/5/95, GAO/HEHS-
95-260R). 

Medicaid:  Tennessee's Program Broadens Coverage but Faces Uncertain
Future (Report, 9/1/95, GAO/HEHS-95-186). 

Medicare:  Antifraud Technology Offers Significant Opportunity to
Reduce Health Care Fraud (Report, 8/11/95, GAO/AIMD-95-77). 

Medicare Competitive Bidding (Letter, 8/11/95, GAO/HEHS-95- 238R). 

Medicare:  Excessive Payments for Medical Supplies Continue Despite
Improvements (Report, 8/8/95, GAO/HEHS-95-171). 

Medicare:  Increased HMO Oversight Could Improve Quality and Access
to Care (Report, 8/3/95, GAO/HEHS-95-155).  Testimony on same topic
(8/3/95, GAO/T-HEHS-95-229). 

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). 


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

Nonprescription Drugs:  Value of a Pharmacist-Controlled Class Has
Yet to Be Demonstrated (Report, 8/24/95, GAO/PEMD-95-12). 

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). 


   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

Planned Parenthood (Letter, 8/9/95, GAO/HEHS-95-216R). 

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

Health Care:  Employers and Individual Consumers Want Additional
Information on Quality (Report, 9/29/95, GAO/HEHS-95-201). 

Patient Self-Determination Act:  Providers Offer Information on
Advance Directives but Effectiveness Uncertain (Report, 8/28/95,
GAO/HEHS-95-135). 

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). 


      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

Adult Education:  Measuring Program Results Has Been Challenging
(Report, 9/6/95, GAO/HEHS-95-153). 

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). 

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

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


   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

School Finance:  Trends in U.S.  Education Spending (Report, 9/15/95,
GAO/HEHS-95-235). 

DOD Dependents Schools:  Enrollment Categories, Numbers, and
Locations(Report, 9/18/95, GAO/HEHS-95-149). 

D.C.  Public School Enrollment (Letter, 8/28/95, GAO/AIMD-95- 229R). 

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). 


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

AmeriCorps*USA Clarifications (Letter, 9/11/95, GAO/HEHS-95- 267R). 

AmeriCorps*USA Benefit-Cost Study (Letter, 9/7/95, GAO/HEHS-95-
255R). 

National Service Programs AmeriCorps*USA--Early Program Resource and
Benefit Information (Report, 8/29/95, GAO/HEHS-95-222). 

Direct Student Loans (Letter, 8/25/95, GAO/HEHS-95-225R). 

College Savings:  Information on State Tuition Prepayment Programs
(Report, 8/3/95, GAO/HEHS-95-131). 

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). 


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


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

Equal Employment Opportunity:  Women and Minority Representation at
Interior, Agriculture, Navy, and State (Report, 9/29/95, GAO/GGD-
95-211). 

Equal Employment Opportunity:  DOL Contract Compliance Reviews Could
Better Target Federal Contractors (Report, 9/28/95, GAO/HEHS-95-
177). 

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). 


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

Federal Personnel Management:  Views on Selected NPR Human Resource
Recommendations (Report, 9/18/95, GAO/GGD-95-221BR). 

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


   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). 


   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). 


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:  Complex Needs Strain Capacity to Provide Services
(Report, 9/26/95, GAO/HEHS-95-208). 

Children and Families Services Programs (Letter, 9/1/95,
GAO/HEHS-95-191R). 

Federal Reimbursement for Foster Care (Letter, 8/11/95,
GAO/HEHS-95-197R). 

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). 


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


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

PBGC (Letter, 8/24/95, GAO/AIMD-95-225R). 


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

Private Pension Plans:  Efforts to Encourage Infrastructure
Investment (Report, 9/8/95, GAO/HEHS-95-173). 

Penson COLAs (Letter, 8/11/95, GAO/HEHS-95-219R). 

Combined Fund Analysis (Letter, 8/7/95, GAO/HEHS-95-230R). 

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). 


   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
      ADMINISTRATION
-------------------------------------------------------- Chapter 5:3.2

Supplemental Security Income:  Disability Program Vulnerable to
Applicant Fraud When Middlemen Are Used (Report, 8/31/95, GAO/HEHS-
95-116). 

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). 


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

SSA's Rehabilitation Programs (Letter, 9/7/95, GAO/HEHS-95- 253R). 

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


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

Welfare To Work:  Child Care Assistance Limited; Welfare Reform May
Expand Needs (Report, 9/21/95, GAO/HEHS-95-220). 

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). 


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

Block Grants:  Issues in Designing Accountability Provisions (Report,
9/1/95, GAO/AIMD-95-226). 

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

Military Physicians:  DOD's Medical School and Scholarship Program
(Report, 9/29/95, GAO/HEHS-95-244). 

Defense Health Care:  Despite TRICARE Procurement Improvements,
Problems Remain (Report, 8/3/95, GAO/HEHS-95-142). 

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). 


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

Veterans' Benefits:  Effective Interaction Needed Within VA to
Address Appeals Backlog (Report, 9/27/95, GAO/HEHS-95-190). 

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

VA Clinic Funding (Letter, 9/19/95, GAO/HEHS-95-273R). 

Proposed VA Hospital at Travis Air Force Base (Letter, 9/19/95,
GAO/HEHS-95-268R). 

VA Medical Resources Allocation (Letter, 9/12/95, GAO/HEHS-95- 252R). 

Medical Care Budget Alternatives (Letter, 9/12/95, GAO/HEHS-95-
247R). 

VA Health Care:  Need for Brevard Hospital Not Justified (Report,
8/29/95, GAO/HEHS-95-192). 

VA Construction Contract Award Delays (Letter, 8/25/95,
GAO/HEHS-95-240R). 

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). 

VA Savings Options (Letter, 5/18/95, GAO/HEHS-95-165R). 

VA's Florida Network Planning (Letter, 5/16/95, GAO/HEHS-95- 160R). 

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). 


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


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------------------------------------------------------ Chapter 9:0.0.1

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

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

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



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


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