[Federal Register: July 14, 1997 (Volume 62, Number 134)]
[Notices]
[Page 37645-37650]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr14jy97-150]
[[Page 37645]]
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Part II
Department of Education
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National Institute on Disability and Rehabilitation Research; Final
Funding Priority for Fiscal Years 1997-1998 for a Rehabilitation
Research and Training Center and Availability of Applications; Notices
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DEPARTMENT OF EDUCATION
National Institute on Disability and Rehabilitation Research
Final Funding Priority for Fiscal Years 1997-1998 for a
Rehabilitation Research and Training Center
AGENCY: Department of Education.
ACTION: Notice of a Final Funding Priority for Fiscal Years 1997-1998
for a Rehabilitation Research and Training Center.
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SUMMARY: The Secretary announces a final funding priority for the
Rehabilitation Research and Training Center (RRTC) Program under the
National Institute on Disability and Rehabilitation Research (NIDRR)
for fiscal years 1997-1998. The Secretary takes this action to focus
research attention on an area of national need to improve
rehabilitation services and outcomes for individuals with disabilities,
and to assist in the solutions to problems encountered by individuals
with disabilities in their daily activities.
EFFECTIVE DATE: This priority takes effect on August 13, 1997.
FOR FURTHER INFORMATION CONTACT: David Esquith. Telephone: (202) 205-
8801. Individuals who use a telecommunications device for the deaf
(TDD) may call the TDD number at (202) 205-2742. Internet:
David__Esquith@ed.gov
SUPPLEMENTARY INFORMATION: This notice contains a final priority to
establish an RRTC for research related to medical rehabilitation
services and outcomes. This final priority supports the National
Education Goal that calls for all Americans to possess the knowledge
and skills necessary to compete in a global economy and exercise the
rights and responsibilities of citizenship.
Note: This notice of final priority does not solicit
applications. A notice inviting applications under this competition
is published in a separate notice in this issue of the Federal
Register.
Analysis of Comments and Changes
On April 21, 1997, the Secretary published a notice of proposed
priority in the Federal Register (62 FR 19437-19438). The Department of
Education received 22 letters commenting on the notice of proposed
priority by the deadline date. Technical and other minor changes--and
suggested changes the Secretary is not legally authorized to make under
statutory authority--are not addressed.
Rehabilitation Research and Training Centers
Priority: Medical Rehabilitation Services and Outcomes
Comment: Three commenters supported maintaining the priority's
conceptual framework of addressing the topics of medical rehabilitative
service delivery and functional assessment and outcome measurement in
one RRTC. Twelve commenters suggested that NIDRR fund two centers
instead of one. The commenters who supported establishing two centers
indicated that one center would not be able to organize sufficient
expertise to address all the priority's purposes adequately and that
the unique aspects of the two topics require separate research
activities.
Discussion: The subject of the priority is improving medical
rehabilitation services delivery and outcomes. Appropriate use of valid
functional assessment measures is one important element toward
improving services as well as justifying the availability, utilization,
and financing of those services. This is a dynamic field and linking
the assessment of functional outcomes with the medical rehabilitation
services in which they will be used, while presenting many challenges
to the RRTC, reflects the challenges that are occurring in the field of
medical rehabilitation services.
RRTCs conduct coordinated and advanced programs of research
targeted toward the production of new knowledge to improve both
rehabilitation methodology and services. In this priority, improved
measurement of outcomes is a vital area of need for methodological
research. There is a need for improved use of outcome measures to
assess medical rehabilitation services. The RRTC will need to assemble
and coordinate the work of experts from diverse fields. While this is a
demanding undertaking, it is feasible and necessary in order to fulfill
the purposes of the RRTC. NIDRR emphasizes the importance of involving
a range of disciplines and collaborative efforts in centers of
excellence.
In regard to whether the unique aspects of the two topics require
separate RRTCs, applicants have the discretion to propose specific
research and training activities that will define the parameters of the
RRTC. The priority and application evaluation process are designed to
provide applicants with the freedom to address unique aspects of one or
more issues. It is not necessary to establish two RRTCs in order to
fulfill the purposes of the priority.
Changes: None.
Comment: The third purpose should focus on the development and
validation of methods to evaluate the cost effectiveness and impact on
functional performance of specific rehabilitation interventions in
diverse settings and populations. The database elements and standards
tasks that make-up part of the third purpose are independent of the
development of measures.
Discussion: The RRTC is intended to improve rehabilitation services
and service delivery, applying measures of functional outcomes as a key
strategy in this endeavor. Uniform database elements and standards are
prerequisites to implementing any system of functional outcome measures
in service delivery systems.
Changes: None.
Comment: One commenter suggested that methods are needed that will
provide consumer perspectives on functional abilities and outcomes as
well as the effectiveness of interventions. The commenter also
indicated that methods are also needed to support the consumer in
decision making about interventions including choices about appropriate
rehabilitation settings and timing of service delivery, accommodations
in the physical environment, and caregiver assistance options. A second
commenter suggested that the priority should connect measures of
specific disabilities or performances with the person's own values and
perceptions.
Discussion: All RRTCs are required to involve individuals with
disabilities and, if appropriate, their family members, as well as
rehabilitation service providers, in planning and implementing the
research and training programs, in interpreting and disseminating the
research findings, and in evaluating the Center. This requirement is
sufficient to ensure that the RRTC addresses consumer perspectives on
functional abilities and outcomes, the effectiveness of interventions,
decision making about interventions, and the connection between
measures of specific disabilities or performances with the person's own
values and perceptions.
Changes: None.
Comment: The sixth purpose should be deleted from the priority
because it is substantially different than the priority's main
emphasis.
Discussion: The emphasis of the sixth purpose relates to medical
rehabilitation services system applications. The sixth purpose is
necessary because it connects the RRTC's work on functional outcome
measures to applied service settings.
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Changes: None.
Comment: The RRTC should establish a health policy research
fellowship program targeted to people with disabilities seeking to
become proficient in health policy research at either the masters or
doctoral level within the context of a university-based degree-granting
program.
Discussion: The priority does not provide the RRTC with the
authority to establish a research fellowship program on the general
subject of health policy research. An applicant could propose to
establish a research fellowship program related directly to medical
rehabilitation services and outcomes. The peer review process will
evaluate the merit of the proposal.
Changes: None.
Comment: Many commenters suggested numerous specific activities for
the RRTC to carry out. These suggestions include, but are not limited
to, developing a theoretical or conceptual model of the disablement
process, establishing an interdisciplinary panel of experts to review
and author a series of papers summarizing the state of science in their
area of expertise and disseminate the papers, studying and emphasizing
the relationship between treatment process to patient outcomes, and
creating a common metric scale or platform for all functional
disabilities.
Discussion: Applicants have the discretion to propose the specific
activities that the RRTC will undertake in order to fulfill the
purposes of the RRTC as set forth in the priority. Providing this
degree of discretion to applicants is an acknowledgement of the wide
range of approaches that applicants could take. The peer review process
will determine the merits of the suggested activities.
Changes: None.
Comment: The government should insist that any instruments that are
developed through grant funds are placed in the public domain.
Discussion: According to the Education Department General
Administrative Regulations, the Federal government has the right to
obtain, reproduce, publish, or otherwise use data first produced under
an award, and authorize others to receive, reproduce, publish, or
otherwise use these data for Federal purposes. NIDRR is planning to
convene a public meeting to inform its decision making on this
important issue as it relates to this and other grants.
Changes: None.
Comment: The terms ``rehabilitation centers'' and ``community-
based'' appear in the background statement, but are not defined. It
would be helpful if they were defined.
Discussion: These terms, and many others that appear in the
priority, are not defined in order to provide applicants with the
option of proposing their own definitions if they consider it
necessary. The peer review process will determine the merits of any
proposed definition.
Changes: None.
Comment: This Center, and others, should publish their research
findings in refereed journals.
Discussion: The quality of an applicant's proposed dissemination
activities are evaluated in the peer review process using applicable
selection criteria. No further requirements are necessary.
Changes: None.
Comment: The reference to telemedicine and multimedia technology is
overly prescriptive and should be deleted from the first purpose.
Discussion: Community-based rehabilitation settings that use
telemedicine and multimedia technology are increasingly common. If the
RRTC did not include these settings in their research, the
applicability of the research that it carries out under the first
purpose would be significantly restricted.
Changes: None.
Comment: The second purpose should be revised to require the RRTC
to develop and validate measures of social and physical environments,
and evaluate the ways in which social and physical environments limit
or enhance the community participation of medical rehabilitation
service recipients.
Discussion: The essential difference between the commenter's
suggestion and the second purpose as set forth in the priority is that
the commenter's suggestion focuses on the ``community participation''
of medical rehabilitation service recipients. An applicant could
propose to emphasize community participation under the second purpose,
and the peer review process will evaluate the merits of the emphasis.
Changes: None.
Comment: The third purpose should be revised to address evaluation
activities rather than the development of the database elements and the
fourth purpose should be revised to address how accrediting bodies can
serve to enhance routine measurement.
Discussion: Applicants have the discretion to propose to emphasize
sundry aspects of a purpose. An applicant could propose to emphasize
the evaluation components of the third purpose and propose to address
how accrediting bodies can serve to enhance routine measurement under
the fourth purpose. The peer review process will evaluate the merits of
the proposals.
Changes: None.
Comment: Four commenters stated that the required purposes under
the priority did not address sufficiently the problems discussed in the
background statement related to changes in the organization and
delivery of medical rehabilitation services. For example, one commenter
suggested that the RRTC should document trends in the consolidation of
medical rehabilitation services and evaluate the impact of those
trends.
Discussion: NIDRR assumed that these organization and service
delivery issues would be addressed by applicants under existing
requirements in the priority. NIDRR agrees with the commenters that the
priority as written does not ensure that the RRTC will address these
important topics.
Changes: A new purpose has been added to the priority that focuses
on issues of the organization, financing, and delivery of services, the
impact of managed care on the delivery of medical rehabilitation
services, consumer access to services, and the capacity of the field of
medical rehabilitation.
Comment: Two commenters suggested that the priority should identify
the most important gaps in current outcome measurement systems and the
need for better measures or methods of estimation of severity and case
mix.
Discussion: Under the first and second purposes, respectively,
applicants could propose to identify and address the most important
gaps in current outcome measurement systems and develop better measures
or methods of estimation of severity and case mix. The peer review
process will evaluate the merit of the activities.
Changes: None.
Comment: It is not necessary to conduct pilot projects in purpose
four in order to fulfill the purpose's purpose. The RRTC should conduct
research on obstacles to the use of validated functional outcome
measures and identify strategies to overcome these obstacles and
enhance valid use of these measures.
Discussion: The commenter is correct that pilot projects are not
the only means that could be used to identify and evaluate strategies
to evaluate obstacles in the use of validated functional outcome
measures. Applicants should be given the discretion to propose means to
evaluate the strategies developed to identify
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obstacles in the use of validated functional outcome measures.
Changes: The requirement to conduct pilot projects has been
eliminated from the fourth purpose.
Comment: Instead of emphasizing the development of strategies for
determining the long-term results of rehabilitation, the fifth purpose
should identify factors that affect whether the results of medical
rehabilitation are sustained in the community over the long term,
identify linkages between short and long-term outcomes and methods of
improving and sustaining rehabilitation outcomes in the long term.
Discussion: There a large number of social, economic, and physical
factors that could affect whether the results of medical rehabilitation
are sustained in the community over the long term. The resources that
would be necessary to properly carry out the commenter's suggestion are
beyond those that will be provided to the RRTC without significantly
limiting its capacity to carry out the RRTC's other purposes. An
applicant could propose to identify linkages between short and long-
term outcomes and methods of improving and sustaining rehabilitation
outcomes in the long term. The peer review process will evaluate the
merits of the proposal.
Changes: None.
Comment: The RRTC should hold a third conference on the cost-
benefit and cost-effectiveness of medical and vocational
rehabilitation.
Discussion: The priority requires the RRTC to support two national
conferences. An applicant could propose to support additional
conferences, and the peer review process will evaluate the merits of
the proposal.
Changes: None.
Comment: NIDRR should expand the RRTC to address the rehabilitation
needs of individuals who are disabled by land mines.
Discussion: The rehabilitation needs of individuals who are
disabled by land mines is outside the scope of the priority. In
developing future priorities, NIDRR will consider the rehabilitation
needs of individuals who have been disabled by land mines.
Changes: None.
Rehabilitation Research and Training Centers
Authority for the RRTC program of NIDRR is contained in section
204(b)(2) of the Rehabilitation Act of 1973, as amended (29 U.S.C. 760-
762). Under this program the Secretary makes awards to public and
private organizations, including institutions of higher education and
Indian tribes or tribal organizations for coordinated research and
training activities. These entities must be of sufficient size, scope,
and quality to effectively carry out the activities of the Center in an
efficient manner consistent with appropriate State and Federal laws.
They must demonstrate the ability to carry out the training activities
either directly or through another entity that can provide that
training.
The Secretary may make awards for up to 60 months through grants or
cooperative agreements. The purpose of the awards is for planning and
conducting research, training, demonstrations, and related activities
leading to the development of methods, procedures, and devices that
will benefit individuals with disabilities, especially those with the
most severe disabilities.
Under the regulations for this program (see 34 CFR 352.32) the
Secretary may establish research priorities by reserving funds to
support particular research activities.
Description of the Rehabilitation Research and Training Center
Program
RRTCs are operated in collaboration with institutions of higher
education or providers of rehabilitation services or other appropriate
services. RRTCs serve as centers of national excellence and national or
regional resources for providers and individuals with disabilities and
the parents, family members, guardians, advocates or authorized
representatives of the individuals.
RRTCs conduct coordinated and advanced programs of research in
rehabilitation targeted toward the production of new knowledge to
improve rehabilitation methodology and service delivery systems, to
alleviate or stabilize disabling conditions, and to promote maximum
social and economic independence of individuals with disabilities.
RRTCs provide training, including graduate, pre-service, and in-
service training, to assist individuals to more effectively provide
rehabilitation services. They also provide training including graduate,
pre-service, and in-service training, for rehabilitation research
personnel and other rehabilitation personnel.
RRTCs serve as informational and technical assistance resources to
providers, individuals with disabilities, and the parents, family
members, guardians, advocates, or authorized representatives of these
individuals through conferences, workshops, public education programs,
in-service training programs and similar activities.
NIDRR encourages all Centers to involve individuals with
disabilities and minorities as recipients in research training, as well
as clinical training.
Applicants have considerable latitude in proposing the specific
research and related projects they will undertake to achieve the
designated outcomes; however, the regulatory selection criteria for the
program (34 CFR 352.31) state that the Secretary reviews the extent to
which applicants justify their choice of research projects in terms of
the relevance to the priority and to the needs of individuals with
disabilities. The Secretary also reviews the extent to which applicants
present a scientific methodology that includes reasonable hypotheses,
methods of data collection and analysis, and a means to evaluate the
extent to which project objectives have been achieved.
The Department is particularly interested in ensuring that the
expenditure of public funds is justified by the execution of intended
activities and the advancement of knowledge and, thus, has built this
accountability into the selection criteria. Not later than three years
after the establishment of any RRTC, NIDRR will conduct one or more
reviews of the activities and achievements of the Center. In accordance
with the provisions of 34 CFR 75.253(a), continued funding depends at
all times on satisfactory performance and accomplishment.
General: The following requirements will apply to these RRTCs
pursuant to the priorities unless noted otherwise:
Each RRTC must conduct an integrated program of research to develop
solutions to problems confronted by individuals with disabilities.
Each RRTC must conduct a coordinated and advanced program of
training in rehabilitation research, including training in research
methodology and applied research experience, that will contribute to
the number of qualified researchers working in the area of
rehabilitation research.
Each RRTC must disseminate and encourage the use of new
rehabilitation knowledge. They must publish all materials for
dissemination or training in alternate formats to make them accessible
to individuals with a range of disabling conditions.
Each RRTC must involve individuals with disabilities and, if
appropriate, their family members, as well as rehabilitation service
providers, in planning and implementing the research and training
programs, in interpreting
[[Page 37649]]
and disseminating the research findings, and in evaluating the Center.
Priorities: Under 34 CFR 75.105(c)(3), the Secretary gives an
absolute preference to applications that meet one of the following
priorities. The Secretary will fund under these competitions only
applications that meets this absolute priority:
Priority: Medical Rehabilitation Services and Outcomes
Background
Medical rehabilitation services are provided to individuals with
disabilities to restore maximum function and independence.
Traditionally, these services were provided by physicians, nurses, and
allied health professionals in hospitals and rehabilitation centers.
Medical rehabilitation service consumers comprise a wide range of
diagnostic groups including individuals with stroke, orthopedic
conditions, brain injury, spinal injury, and neurologic conditions. The
need for medical rehabilitation services for persons with disabilities
is expected to continue to grow in the coming decades because of
increased chances of survival after trauma, disease, or birth anomaly,
increased prevalence of disability related to the general aging of the
population, and the increased incidence of individuals with
disabilities acquiring secondary disabilities or chronic conditions as
a result of increased longevity. Despite large growth projections, the
impact of the projected increase in need for medical rehabilitation has
not been extensively investigated in relation to long-term costs and
outcomes.
Changes in the organization and delivery of health services issues
are having a significant impact on the delivery and outcomes of
comprehensive medical rehabilitation services. Recent trends, such as
decreased length of stay associated with the high costs of inpatient
care, have contributed to the growth of rehabilitation programs in sub-
acute facilities, such as skilled nursing homes, and increased use of
outpatient and home health care. Many rehabilitation hospitals, as well
as medical rehabilitation programs within hospitals, have been
influenced significantly by program consolidations, changes in
ownership, third-party reimbursement provisions, and related factors
that have decreased the number of beds and the average length of
patient stay. At the same time, demand is increasing for sub-acute
rehabilitation and general outpatient physical medicine (``Adapting to
a Managed Care World: The Challenge for Physical Medicine and
Rehabilitation,'' Lewin-VHI Workforce Study, American Academy of
Physical Medicine and Rehabilitation, 1995).
The effectiveness of the treatments and therapeutic interventions
that are generally used in clinical practice are, for the most part,
not evaluated in terms of their impact on long-term functional outcomes
or their cost. The cost-effectiveness and impact of alternative
rehabilitative strategies should be evaluated rigorously in order to
obtain information that will contribute to cost-effective, rational,
and fair decisions regarding the provision of treatment and services.
Medical rehabilitation services need an enhanced validated outcome
measurement system to inform decisions in management issues facing
health care consumers, providers, and insurers. Increasingly, payers
are seeking to base decisions of whether to provide coverage for
selected services or interventions on the basis of proven efficacy or
cost-effectiveness as determined by rigorous scientific evidence such
as that gained through randomized controlled trials.
Functional Assessments (FAs) can be used to evaluate an
individual's ability to carry out activities of daily living and
instsrumental activities of daily living such as eating, bathing, moving
from place to place, dressing, doing household chores or other
necessary business, and taking care of personal hygiene. Data from FAs
also are used to predict post-rehabilitation functioning, and to
evaluate rehabilitation services. Improving rehabilitation practices
and outcomes requires an ability to assess the status and changes in
function in many areas. Multiple measures of function and activities of
daily living are needed in all rehabilitation settings, including in
the home and community. The increased use of telemedicine and
multimedia technology is rapidly changing the manner in which
functional assessment measures are generated and shared among members
of the rehabilitation team. Functional outcome measures are of
increasing importance in medical economics, benefits planning, managed
care, and program evaluation (Ikegami, N., ``Functional Assessment and
Its Place in Health Care,'' New England Journal of Medicine, Vol. 332,
pgs. 598-599, 1995).
There is a need to collect and analyze data to determine the
organization and delivery of rehabilitative care, including parameters
such as facility and program sizes (i.e., economies of scale) and the
number and mix of health care providers needed to serve various
disability groups. Few data are available to define optimal strategies
for outpatient services, nor are there methods to apply FAs or gather
patient outcome data in non-hospital settings.
Improving rehabilitation medicine and ensuring that disabled
individuals will have access to needed medical rehabilitation in the
future requires: an ability to assess functional status and changes in
status in many functional areas; the ability to evaluate rehabilitation
outcomes for individuals with various diagnoses, characteristics, and
interventions; and the ability to apply these measures in health
services policy research in order to affect policy and funding
decisions in the health care delivery context.
In the past, NIDRR has supported the development and application of
the ``Functional Independence Measure'' (FIM), a criterion-referenced
scale that has been widely accepted in inpatient rehabilitation
settings, and also the development of the ``Craig Handicap Assessment
and Reporting Technique'' (CHART), which contains scales for assessing
the World Health Organization (WHO) dimensions of handicap, and is
currently being refined to measure cognitive components of handicap.
NIDRR currently supports an RRTC on Functional Assessment that has
contributed to the scientific measurement of medical rehabilitation
through applications of the FIM, refinement of the CHART, and
management and analysis of the Uniform Data System (UDS), a collection
of data from the application of FIM measures in many institutions.
Current measurement systems, such as the FIM and the UDS, have made
significant contributions, but need modifications to increase their
utility and applicability in the new environment of rehabilitation
care. For example, many practitioners and theorists have suggested that
the FIM does not make adequate provision for the role of assistive
technology in attaining functional levels. Like the FIM, most
functional assessment measurement systems were designed for use in an
inpatient setting. These systems need to be evaluated and modified to
measure functional status and functional change outside of hospital and
clinical settings, either in community-based facilities or in real-
world environments of daily living. The FIM, for example, needs further
refinement to address the social and environmental dimensions of
disablement. The UDS at present contains data on a limited number of
disabilities, and those measurements again are not community-based.
[[Page 37650]]
NIDRR also has supported a center on medical rehabilitation
services that has looked at factors such as supply and demand for
rehabilitation facilities and practitioners, financing, and evaluation
of the outcomes of rehabilitation medicine. This center has also
addressed the changing context for the delivery of medical
rehabilitation and access to medical rehabilitation by various
population groups. Both of these centers have made contributions to the
maturing of the field of medical rehabilitation and its ability to
evaluate and document its interventions and outcomes.
However, it is now clear that the field needs a larger and more
integrated effort to refine measures of functional ability, changes in
ability over the lifespan or in response to medical rehabilitation
interventions, and to apply the measurement system in the changing
environment in which medical rehabilitation is delivered. NIDRR
therefore is proposing a large-scale effort to involve significant
leaders in the classification and measurement of function, the
evaluation of rehabilitation interventions, and the broader application
of knowledge to the organization and management of medical
rehabilitation services in today's environment.
Priority: The Secretary will establish an RRTC for the purpose of
examining the impact of changes in the field of rehabilitation medicine
and developing improved measures for assessing individual function and
the impact of medical rehabilitation services. The RRTC shall:
(1) Identify and evaluate validated functional outcome measures
that can be used or modified for assessing the impact of medical
rehabilitation services in a wide range of rehabilitation settings,
with particular emphasis on measures that can be adapted for use in
outpatient and community-based settings, including those that use
telemedicine and multimedia technology;
(2) Develop or improve measures to assess the impact of the social
and physical environment in achieving quality rehabilitation outcomes,
including the use of assistive technology in attaining functional
outcomes; (3) Identify or develop uniform database elements and
standards based on validated individual measures at the person level
for determining the cost-effectiveness and functional impact of
specific rehabilitation interventions used by medical rehabilitation
and allied-health disciplines across multiple settings and disability
populations;
(4) Identify obstacles to the use of validated functional outcomes
measures in a wide range of settings in which medical rehabilitation
services are provided, and in decisions to provide and assess the
effectiveness of medical rehabilitation treatments, and develop and
evaluate strategies to overcome those obstacles;
(5) Identify strategies for determining the long-term results of
medical rehabilitation care, including use of assistive technology;
(6) Analyze how models for the organization of medical
rehabilitation services affect outcomes and costs, and how the
demographic, economic, and presenting conditions of consumers affect
their utilization of rehabilitation services and the outcomes that are
achieved;
(7) Analyze the impact of new configurations of medical
rehabilitation service delivery and financing, such as capitated
managed care and risk adjustment strategies, on access to quality
medical rehabilitation services; and
(8) Develop an information dissemination and training program to
enable consumers, providers, researchers, policy makers, and relevant
others in health and rehabilitation settings to assess the quality of
medical rehabilitation services.
In carrying out the purposes of the priority, the RRTC shall:
* Coordinate with rehabilitation medicine research and
demonstration activities sponsored by NIDRR, including the RRTC on
Health Care for Individuals with Disabilities--Issues in Managed Health
Care, the National Center on Medical Rehabilitation Research, Veterans
Administration, and the Health Care Financing Administration; and
* Support two national conferences as follows: (1) a
conference on the use of functional outcome measures to improve medical
rehabilitation practices and interventions, and (2) a conference on
improving validity and reliability in the measurement of rehabilitation
outcomes.
Applicable Program Regulations: 34 CFR Parts 350 and 352.
Program Authority: 29 U.S.C. 760-762.
(Catalog of Federal Domestic Assistance Numbers: 84.133B,
Rehabilitation Research and Training Center Program)
Dated: July 9, 1997.
Judith E. Heumann,
Assistant Secretary for Special Education and Rehabilitative Services.
[FR Doc. 97-18418 Filed 7-11-97; 8:45 am]
BILLING CODE 4000-01-P