RECOMMENDATION 20: Foster local capacity-building and demonstration projects

The NDPP should support capacity-building and demonstration programs for state and local organizations to prevent primary disabilities and secondary conditions. The community-based demonstrations (including Health Care Financing Administration demonstrations) should emphasize surveillance, interventions and assessment of their effectiveness, and the special needs of low socioeconomic status populations (e.g., prenatal care, access to and financing of preventive services, and health promotion and disability prevention education).

RECOMMENDATION 21: Continue effective prevention programs

Public health programs with proven efficacy in the prevention of disability should receive continued federal support. Those programs that show promise should be continued and evaluated further. Priorities for additional support and evaluation should include the following few examples:

  • Head Start and comprehensive day care programs;

  • state-based systems to provide family-centered, community-based, multidisciplinary services for children with or at risk of chronic and disabling conditions; and

  • interventions to reduce adverse outcomes associated with alcohol and other drug use in pregnancy.

Access to Vocational Services

Vocational services are crucial to ensure that return-to-work goals are achieved. These services may include counseling and work readiness evaluations, job training, job placement, work-site modification, and postemployment services (e.g., Projects with Industry) to ensure satisfactory adjustment and assistance in sustaining employment.

RECOMMENDATION 22: Provide comprehensive vocational services

Vocational services aimed at reintegrating persons with disabilities into the community and enabling them to return to work should be made financially and geographically accessible.


The prevention of disability requires not only access to care and restructuring of services but also a radically different mind-set among many health and other professionals (e.g., psychologists, sociologists, educational specialists) and the general public. As the committee observes throughout its report, the attitudes and behavior of health professionals and the public

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