[Federal Register: July 1, 1997 (Volume 62, Number 126)]
[Notices]
[Page 35635-35644]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr01jy97-146]
[[Page 35635]]
_______________________________________________________________________
Part VI
Department of Education
_______________________________________________________________________
National Institute on Disability and Rehabilitation Research; Final
Funding Priorities for Fiscal Years 1997-1998 for Rehabilitation
Research and Training Centers and a Knowledge Dissemination and
Utilization Project; and Office of Special Education and Rehabilitative
Services; Inviting Applications for New Awards Under Certain Programs
for Fiscal Year 1997; Notices
[[Page 35636]]
DEPARTMENT OF EDUCATION
National Institute on Disability and Rehabilitation Research;
Notice of Final Funding Priorities for Fiscal Years 1997-1998 for
Rehabilitation Research and Training Centers and a Knowledge
Dissemination and Utilization Project
AGENCY: Department of Education.
SUMMARY: The Secretary announces final funding priorities for the
Rehabilitation Research and Training Center (RRTC) Program and the
Knowledge Dissemination and Utilization (D&U) 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 areas 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: These priorities take effect on July 31, 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 final priorities to
establish RRTCs for research related to persons who are late-deafened
(L-D) or hard-of-hearing (HOH), substance abuse, and rural
rehabilitation. In addition there is a D&U project on parenting.
These final priorities support 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 priorities does not solicit
applications. A notice inviting applications under these
competitions 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
priorities in the Federal Register (62 FR 19432-19439). The Department
of Education received 19 letters commenting on the notice of proposed
priorities by the deadline date. Three additional comments were
received after the deadline date and were not considered in this
response. 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 1: Maintaining the Employment Status and Addressing the
Personal Adjustment Needs of Individuals Who Are Late-Deafened or Hard-
of-Hearing
Comment: Three commenters made a number of different suggestions
about the experience and expertise of the RRTC's key personnel. They
suggested that key personnel: have extensive experience with vocational
rehabilitation policies and procedures at the Federal and State level;
have experience working with children who are HOH or L-D enrolled in
mainstream programs; include individuals who are L-D; and include
individuals who have demonstrated background, interest, and skill
working with individuals who are L-D or HOH.
Discussion: The peer review process evaluates the degree to which
an applicant's key personnel are qualified to accomplish the purposes
of the priority. The selection criteria for RRTCs are used to determine
the degree to which: the staffing plan for the Center provides evidence
that the project director, research director, training director,
principal investigators, and other personnel have appropriate training
and experience in disciplines required to conduct the proposed
activities; the commitment of staff time is adequate to conduct all
proposed activities; and the Center, as part of its nondiscriminatory
employment practices, will ensure that its personnel are selected for
employment without regard to race, color, national origin, gender, age,
or handicapping conditions. These selection criteria address the issues
raised by the commenters, and no further requirements are necessary.
Changes: None.
Comment: Five commenters suggested that the RRTC should address the
needs of adolescents and young adults who are L-D or HOH. The
commenters indicated that recent research suggests that for a
significant number of young people hearing loss may be taking place
earlier than previously expected and may go undiagnosed for extended
periods of time. The commenters indicated that very little research has
been conducted on the personal adjustment needs of adolescents and
young adults who are L-D or HOH.
Discussion: There is a need for research and training on personal
adjustment and, to a lesser extent, employment issues affecting
adolescents and young adults who are L-D or HOH. It is desirable and
feasible to expand the scope of RRTC's work in the area of personal
adjustment and in transition-related employment areas to address the
needs of adolescents and young adults who are L-D or HOH.
Changes: The priority has been changed to require the RRTC, where
appropriate, to address the needs of adolescents and young adults who
are L-D or HOH.
Comment: Three commenters suggested that the priority distinguish
between the personal adjustment needs and mental health needs of
persons who are L-D or HOH.
Discussion: In order to provide applicants with general guidance,
at various points the background statement elaborates on issues related
to personal adjustment. Parts of that guidance refer to issues that are
commonly understood as mental health issues (e.g., feelings of
alienation, alcohol and drug abuse). However, ``personal adjustment''
is not defined, and the term ``mental health'' is not used in the
priority in order to provide applicants with the discretion to propose
the specific parameters of the research and training the RRTC will
conduct in this area. The peer review process will evaluate the merits
of each applicant's view of personal adjustment issues affecting
persons who are L-D or HOH.
Changes: None.
Comment: Three commenters suggested that the RRTC address not only
maintaining employment for persons who are L-D or HOH, but also
underemployment and unemployment.
Discussion: In regard to employment, the focus of the RRTC is
maintenance of employment status because the majority of the target
population are employed when they begin to experience hearing loss and
because research has determined that interventions that effect
maintenance of employment are more effective than restorative
interventions. However, the first activity of the priority refers to
``employment status'' and provides applicants with the authority to
propose research and training on other aspects of employment, so long
as such activities are in addition to those related to maintenance of
employment.
Changes: None.
Comment: Three commenters suggested specific disability
organizations that the RRTC should consult with or include in their
training and technical assistance activities.
Discussion: The fifth activity requires the RRTC to provide
training and technical assistance to organizations representing persons
who are L-D or HOH. There are a large number of
[[Page 35637]]
organizations representing the interests of persons who are L-D and
HOH, and applicants have the discretion to select the organizations
that will participate in their training and technical assistance
activities. The peer review process will determine the merits of their
selections.
As necessary, all RRTCs are expected to consult with a wide range
of entities. NIDRR declines to single out specific organizations for
this purpose.
Changes: None.
Comment: The RRTC should be required to consult with NIDRR grantees
addressing the needs of persons who are deaf including the RRTC for
Persons Who Are Deaf or HOH.
Discussion: The priority includes a requirement, in part, to
coordinate with NIDRR's other research projects that address the needs
of individuals who are L-D or HOH. There are areas of research common
to persons who are L-D, HOH, and deaf, and research projects addressing
the needs of persons who are deaf should be included in this
coordination requirement.
Changes: The priority has been revised to require the RRTC to
coordinate with NIDRR research projects addressing the needs of
individuals who are deaf.
Comment: Two commenters recommended changes to the definitions of
L-D and HOH, and a third commenter suggested that the RRTC generate
definitions of L-D and HOH based on research. The first commenter
recommended that the definition be revised to recognize that the needs
of persons who are L-D or HOH may include issues related to deaf
culture and the need for appropriate accommodations. The second
commenter recommended that the definition of HOH be revised to indicate
that these individuals can understand conversational speech ``through
the ear'' in order to clearly distinguish this population from persons
who are late-deafened and can speechread.
Discussion: The definitions that are included in the background
statement are purposefully broad in order to provide applicants with
the discretion to refine their approach to the RRTC's target
population. Applicants have the discretion to propose research that
incorporates the idea that needs of persons who are L-D or HOH may
include issues related to deaf culture and the need for appropriate
accommodations. In addition, an applicant may propose to distinguish
the needs of persons who are HOH from those who are L-D, in part, by
their ability to understand normal conversation ``through the ear.''
While these two recommendations are reasonable refinements of the
definitions included in the priority, there are many others that could
be proposed, and there is no compelling reason to require all
applicants to utilize the two that were recommended.
In regard to the recommendation for the RRTC to generate a
definition of L-D and HOH based on research, an applicant could propose
to conduct this research as long at it furthered the purposes of the
RRTC as set forth in the priority. The peer review process will
evaluate the merits of such a project.
Changes: None.
Comment: One commenter recommended using a different database to
indicate the number of persons who are L-D or HOH, and a second
commenter indicated that the Bureau of the Census data underestimated
the number of persons who have a functional limitation in hearing
normal conversation because many people may fail to realize they have a
mild hearing loss.
Discussion: The priority cites data from the Bureau of the Census,
the National Center for Health Statistics, and the Association of Late-
Deafened Adults. Neither commenter presented compelling evidence to
indicate that these databases are incorrect.
Changes: None.
Comment: The RRTC should address the needs of various racial and
ethnic groups who are L-D or HOH.
Discussion: By statute, each applicant must demonstrate how it will
address, in whole or in part, the needs of individuals with
disabilities from minority backgrounds. No further requirements are
necessary to address the commenter's concern.
Changes: None.
Comment: Five commenters suggested numerous specific activities for
the RRTC to carry out. These suggestions include, but are not limited
to, specific age group focus, development of educational materials,
incidence studies, model demonstrations, and family dynamics.
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: All of the RRTC's activities and information should be
fully accessible to individuals who are deaf, L-D, or HOH.
Discussion: All of NIDRR's grantees must conduct all activities in
a manner that is accessible to and usable by individuals with
disabilities. No further requirements are necessary.
Changes: None.
Comment: The RRTC should be capable of rigorous scientific research
combined with a strong commitment to consumer involvement with equal
attention given to individuals who are L-D and HOH.
Discussion: Using the relevant selection criteria, the peer review
process will evaluate the quality of the research design that an
applicant proposes. No further requirements are necessary to ensure the
scientific rigor of the RRTC's research activities.
In regard to consumer involvement, the general requirements for all
RRTCs state that the 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 and disseminating the research
findings, and in evaluating the Center.
In regard to providing equal attention to individuals who are L-D
and HOH, each applicant is expected to propose and justify its
allocation of research and training efforts, which must include
attention to both population groups. The peer review process will
evaluate the merits of this allocation.
Changes: None.
Priority 3: Improving Employment and Independent Living Outcomes for
Persons With Disabilities in Rural Areas
Comment: The project should include a scientifically valid,
credible, and outcome-based evaluation program.
Discussion: Applicants have the discretion to propose the RRTC's
plan of evaluation. Plans of evaluation that are scientifically valid,
credible, and outcome-based are consistent with the plan of evaluation
selection criteria for RRTCs. These selection criteria are used to
determine the degree to which the plan for evaluation of the Center
provides for an annual assessment of the outcomes of the research, the
impact of the training and dissemination activities on the target
populations, and the extent to which the overall objectives have been
accomplished.
Changes: None.
Comment: The third, fourth and six activities specifically call for
the development of new strategies and services, while the first,
second, and fifth activities require the project to carry out
identification, analysis, and evaluation activities. May a project
carry
[[Page 35638]]
out additional activities than those included in priority?
Discussion: An applicant must propose to address each of the
specific activities included in the priority, but may propose
additional activities as well.
Changes: None.
Comment: The fifth activity refers to people with ``significant''
disabilities. Is this term synonymous with ``severe'' disabilities, and
is it NIDRR's intent to restrict the fifth activity to services
affecting only persons with significant disabilities?
Discussion: The terms ``severe'' and ``significant'' are used
synonymously. By statute, NIDRR research must have a particular
emphasis on problems of individuals with severe disabilities. This
provision applies equally to all priorities in all Centers. The fifth
activity of the proposed priority unnecessarily restricted the RRTC to
address services provided to persons with significant disabilities.
Changes: The reference to persons with significant disabilities in
the fifth activity has been eliminated.
Comment: One commenter suggested that the collaboration requirement
should be broadened to include other Federal agencies, in addition to
USDA and DHHS, that may be carrying out projects related to persons
with disabilities in rural areas. A second commenter suggested
broadening the collaboration requirement to include RRTCs that address
the needs of underserved and minority populations of consumers with
disabilities.
Discussion: The priority establishes the minimum collaboration
requirements that the project must meet. While an applicant may choose
to propose to undertake additional collaborative activities, including
those suggested by the commenters, additional collaboration is not
specifically required by NIDRR.
Changes: None.
Comment: Is it NIDRR's intent to restrict training and information
services to the entities included in the sixth activity, and to limit
training activities?
Discussion: An applicant must propose to provide training and
information services to the entities identified in the sixth activity,
but may propose to provide training and information services to
additional entities. In regard to the nature of the training
activities, an applicant may propose to undertake a variety of training
activities, and the peer review process will evaluate the merits of the
activities.
Changes: None.
Comment: A seventh activity should be added to the priority,
requiring the RRTC to identify, evaluate, develop, and disseminate
information about appropriate assistive technology that enables persons
with disabilities living in rural areas to live more independently and
improve their employment outcomes.
Discussion: Access to assistive technology is an important issue,
and an applicant could propose to integrate assistive technology into
the fourth and fifth activities of the priority. Adding a seventh
activity to the priority related exclusively to assistive technology
would significantly limit the RRTC's capacity to carry out the six
activities in the priority.
Changes: None.
Comment: While the third activity addresses the participation of
persons with disabilities in local public planning for community
development, it should include service providers such as independent
living centers and vocational rehabilitation agencies.
Discussion: An applicant may propose to include service providers
in the strategies that are developed to increase participation of
persons with disabilities in local planning for community development.
The peer review process will evaluate merits of the proposal. There is
insufficient information regarding the role of service providers in
local public planning for community development to warrant requiring
all applicants to include them.
Changes: None.
Priority 4: Parenting With a Disability Technical Assistance Center
Comment: The priority should specifically include ``research''
among the information that the Center identifies, disseminates, and
synthesizes across various activities in the priority.
Discussion: The background statement clearly indicates that the
Center should utilize research findings in its various information
dissemination activities. It would be redundant to include ``research''
among the specific activities included in the priority.
Changes: None.
Comment: Pre-service training activities should have a relatively
equal weight with the other training activities required by the Center.
Discussion: Each applicant is expected to propose and justify its
allocation of training efforts, which must include attention to
organizations and institutions of higher education that provide pre-
service and in-service training. The peer review process will evaluate
the merits of this allocation.
Changes: None.
Comment: The inter-disciplinary focus of the priority should be
wider and include related health service providers such as occupational
therapists, physical therapists, speech and language pathologists, and
psychologists.
Discussion: The priority refers to a range of ``fields of social
services, law, and medicine.'' The health service providers included in
the comment fall within this range.
Changes: None.
Comment: It is important to emphasize the importance of technical
competence, access to technology resources, and potential for multi-
site national collaboration of the successful applicant.
Discussion: All of the characteristics included in the comment are
within the purview of the application review process.
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
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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 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
meet one of these absolute priorities:
Priority 1: Maintaining the Employment Status and Addressing the
Personal Adjustment Needs of Individuals Who are Late-Deafened or Hard-
of-Hearing
Background
Individuals whose hearing is impaired, but who can understand
conversational speech with, or without, amplification are hard-of-
hearing (HOH). Adults who are late-deafened (L-D) become deaf after
having experienced hearing as well as speech and language development.
Adults who are late-onset HOH and those who are L-D have common and
different employment-related and personal adjustment needs. A third
group of persons who are considered hearing impaired are those persons
who are prelingually deaf. Because the prelingually deaf have been and
continue to be the focus of other NIDRR-funded research, this proposed
priority is for research that addresses the needs of adults who are L-D
or late-onset HOH.
According to data from the Bureau of the Census, the number of
individuals who have a functional limitation in hearing normal
conversation is approximately 10.9 million (McNeil, J., ``Americans
with Disabilities: 1991-1992,'' Household Economic Studies, P70-33,
December, 1993). The National Center for Health Statistics (NCHS)
estimates the number of persons who are HOH ranges from 20 million to
22 million (``National Health Survey,'' Series 10, No. 188, 1994). The
NCHS studies use the ``Gallaudet Hearing Scale'' which is self-
reporting and quantifies the amount of interference with hearing in
ordinary day-to-day situations. According to the Association of Late-
Deafened Adults, the number of persons who are L-D is estimated to be
between 800,000 and 1.5 million. For 1991 and 1992, of all persons 21
to 64 years old who had some functional limitation hearing normal
conversation, 3,335,000 individuals or 63.6 percent were employed,
while 189,000 individuals, or 58.2 percent of those who were totally
unable to hear normal conversation, were employed (McNeil, J., 1993).
Over the years, NIDRR has supported a number of research efforts to
address the problems caused by various hearing impairments. At various
times these efforts have included: developing hearing aids and
telecommunication devices; enhancing the use and teaching of sign
language interpreters; developing interventions for ``low-functioning''
deaf persons with multiple disabilities; developing more effective
interventions and service models for hearing impaired vocational
rehabilitation clients; and studying mental health issues of persons
who are deaf, HOH, or L-D.
As the population ages, as people recover from serious illness with
hearing impairments, and as environmental factors contribute to the
incidence of hearing loss, it has become clear that there is a growing
population of persons who experience disabling hearing loss as adults.
The time of onset is likely to be in older adulthood, but this
population is distinguished by the fact that the hearing loss occurs
after the person has developed spoken language, has completed
substantial formal education, and may have worked, married, had
children, or developed social relationships--as a hearing person with
``normal'' speech.
These individuals face major adjustment problems in all phases of
their lives, and may undergo depression
[[Page 35640]]
and disruption in family or community life, as well as in their ability
to perform their work and maintain their career. Such individuals need
to learn ways to maintain communication skills--both receptive and
expressive--and frequently need interventions to enable them to
maintain speech quality (i.e., volume, modulation, articulation).
Because they socialize and work with colleagues, family, and friends in
a hearing and speaking environment, and because of their age, they are
not likely to make a transition to deaf culture even if they do learn
some sign language. Most will depend on lip-reading, amplification, or
written communication. Multiple personal adjustment and work
performance issues confront these individuals ranging from safety
(e.g., driving and traffic noise, fire alarms, public announcement
warning systems) to following instructions at work, to communicating
with doctors, dentists, and therapists about their health and
medications.
The impact of partial or complete hearing loss may have compound
effects on the work status of individuals who are L-D or HOH. In
addition to the functional impact of the hearing loss on an employee's
performance, the employee may be unfamiliar with his or her civil
rights and concerned about disclosing his or her condition for fear of
dismissal, demotion, or loss of potential career advancement. This fear
of disclosure not only produces additional anxiety, but also may delay
or prevent the employee from obtaining needed assistance. Even if the
employee discloses his or her condition, human resource personnel,
family counselors, and other employment and social service providers
may not be familiar with the sundry impacts that hearing loss and
impairment can have on work performance and personal life. The
inability of human resource personnel, family counselors, and others to
provide effective services can increase the individual's sense of
isolation and anxiety.
Factors such as early identification, family support, and the
provision of reasonable accommodations can play an important role in
enabling the individual to adjust to the hearing impairment and
maintain employment, family, and community status. Providing such
individuals with appropriate assistive technology (e.g., assistive
listening devices, realtime computer assisted captioning) in a timely
manner can make a significant difference in job performance and morale.
The onset of a hearing impairment or the increased loss of hearing
ability also can have a significant impact on the personal life of an
individual who is L-D or HOH. It is not uncommon for those individuals
to experience feelings of disorientation and alienation and to withdraw
from family and friends. That withdrawal reinforces the individual's
isolation and can, in extreme instances, lead to secondary
complications such as alcohol and drug abuse.
Priority 1:
The Secretary will establish an RRTC for the purpose of conducting
research on the maintenance of employment status and personal
adjustment of persons who are L-D or HOH. The RRTC shall:
(1) Identify and analyze the factors that negatively impact the
employment status and the personal life of persons who are L-D or HOH;
(2) Develop and disseminate interventions that address these
employment and personal adjustment problems, including early
identification, reasonable accommodations, counseling, and assistive
technology;
(3) Develop information materials on effective interventions and
disseminate those materials to employers, human resource organizations,
appropriate counseling organizations, and organizations representing
persons who are L-D or HOH;
(4) Identify materials that address the rights of persons who are
L-D or HOH under the Americans with Disabilities Act, and other
disability rights laws, disseminate these materials to organizations
representing those persons, and inform those organizations about
opportunities to receive training and technical assistance from
entities such as the Disability and Business Technical Assistance
Centers (DBTACs); and
(5) Develop training and technical assistance materials and provide
training and technical assistance to employers, human resource
organizations, appropriate counseling organizations, and organizations
representing persons who are L-D or HOH to enable them to address
effectively the employment and personal adjustment problems experienced
by persons who are L-D or HOH.
In carrying out the purposes of the priority, the RRTC shall:
* Identify and address the employment and personal
adjustment issues that are common to both persons who are L-D and those
who are HOH, as well as those issues that are unique to each
population;
* Coordinate with NIDRR's other research projects addressing
individuals who are L-D, HOH, or deaf, the DBTACs, and the Assistive
Technology Projects; and
* Where appropriate, address the needs of adolescents and
young adults who are L-D or HOH.
Priority 2: Improving Vocational Rehabilitation Outcomes for
Individuals Who Are Substance Abusers
Background
In 1993, NIDRR funded the establishment of a three-year RRTC on
Substance Abuse and Disability to address the vocational rehabilitation
needs of two major categories of eligible individuals served by the
State Vocational Rehabilitation (VR) Services program. The two
categories of VR eligible individuals were: (1) Those whose substance
abuse has resulted in a work disability; and (2) those who have some
other disability but whose substance abuse interferes with their
ability to benefit from vocational rehabilitation services.
In addition, the 1993 priority authorizing the RRTC limited the
scope of substance abuse to substances other than alcohol abuse
(although the presence of alcohol abuse in conjunction with other
substance abuse was within the scope of the RRTC). For the purposes of
this priority, substance abuse includes alcohol abuse with or without
the presence of other substance abuse. The RRTC is expected to address
the needs of VR eligible individuals who abuse alcohol, other
substances, or alcohol and other substances.
Individuals with a disability that results in a substantial
impediment to employment and who can benefit from VR services,
including those individuals whose disabling condition is due to
substance abuse, are eligible for services through the State Vocational
Rehabilitation (SVR) Services Program, authorized under Title I of the
Rehabilitation Act. Program data for fiscal year 1995 show that
substance abuse was reported as the primary disabling condition for
51,339 eligible individuals who exited the program in that year. Of the
51,339 individuals with a primary disability of substance abuse, 22,708
persons' primary disabling condition was alcohol abuse and 28,631
persons' primary disabling condition was drug abuse. Of the 40,766
eligible individuals with a primary disabling condition of substance
abuse who received services before exiting the program, 21,718 (53
percent) achieved an employment outcome (Rehabilitation
[[Page 35641]]
Services Administration, Caseload Services data, 1995).
There are also individuals with disabilities served by the SVR
program for whom substance abuse is a co-existing, and sometimes
hidden, condition. In addition to those individuals who exited the SVR
program in 1995 for whom substance abuse was reported as the primary
disabling condition, another 33,808 individuals were reported to have a
secondary disability of substance abuse. Findings from a State-wide
survey of alcohol, tobacco, illicit drugs, and medication among
applicants for vocational rehabilitation services from Michigan
Rehabilitation Services indicate that while alcohol use patterns
approximate the general population, the percent of applicants who
report current tobacco use or lifetime use of illicit drugs appear
considerably higher than the general population (Moore, D. and Li, L.,
``Substance Abuse Among Applicants for Vocational Rehabilitation
Services,'' Journal of Rehabilitation, Vol. 60, No. 4, pgs. 48-53,
1994).
Unrecognized or untreated substance abuse as a co-existing
condition can be a greater barrier to employment than the primary
disability. Chief among those barriers are complications of
psychological and social adjustment to the disability, impaired
learning processes, decreased chances for vocational preparation and
employment, and increased risk of adverse medical effects from the
interaction of abused substances with treatment medications.
One of the primary modes of transmission of HIV is through
injection drug use when an HIV-infected syringe is shared between
individuals. The higher incidence of intravenous drug abuse in socio-
economically depressed communities means that resultant HIV is
concentrated among individuals who lack health care, have low education
and little prior work experience, and lack access to transportation,
assistive technology, and other community supports that facilitate
vocational rehabilitation and job maintenance. Substance abuse also
leads to more high risk sexual behaviors, further increasing the
incidence of HIV infection in this population. The presence of HIV
infection can be a complicating factor in the vocational rehabilitation
of substance abusers. There is a need for research on the specific
vocational rehabilitation needs of substance abusers with HIV.
The need for an expanded understanding of the relationship between
vocational rehabilitation, substance abuse, and disability has been
further underscored by recent changes in legislation, including welfare
reform and discontinuance of Social Security Insurance and Social
Security Disability Insurance benefits for individuals who previously
were eligible based on addictions to alcohol and other drugs. The
removal of substantial numbers of substance abusers from income
supports and medical assistance is likely to cause strains on the SVR
service delivery system by increasing the demand for services,
decreasing the ``comparable benefits'' dollars available for SVR
services, decreasing access to general health care during
rehabilitation, and increasing client financial instability. Changes in
the management and financing of health care in both the public and
private sector, including managed care, may also have an impact on SVR
agencies' financial arrangements with third party payers and access to
comparable benefits for substance abuse treatment.
Although there is an increasing prevalence of substance abuse among
a diverse population of individuals undergoing rehabilitation, many
service providers communicate that they have an inadequate
understanding about substance abuse and co-existing disability and that
this adversely impacts their ability to address the problem effectively
(Heinemann, A. W.,''An Introduction to Substance Abuse and Physical
Disability,'' Substance Abuse and Physical Disability, New York: The
Haworth Press, 1993). Practitioners in a growing number of disciplines
within the rehabilitation field need information about substance abuse
and co-existing disability, including rehabilitation educators,
vocational rehabilitation counselors, health care providers,
independent living specialists, community-based rehabilitation
providers, rehabilitation administrators, chemical dependence
counselors, and directors of State vocational rehabilitation programs.
In order to address this need and because there are other Federal
agencies that focus significant resources on individuals whose sole or
primary disability is substance abuse, this RRTC will focus its
efforts, although not exclusively, on issues affecting individuals with
co-existing disabilities. Particular emphasis would be given to SVR
eligible individuals for whom substance abuse is not their sole or
primary disabling condition, but whose substance abuse interferes with
their ability to benefit from vocational rehabilitation services.
Priority 2: The Secretary will establish an RRTC for the purpose of
improving vocational rehabilitation outcomes for SVR eligible
individuals whose substance abuse has resulted in a work disability, or
who have some other disability that results in a substantial impediment
to employment but whose substance abuse interferes with their ability
to benefit from vocational rehabilitation services. The RRTC shall:
(1) Conduct epidemiological studies to advance the understanding of
the relationship between substance abuse and disability among
individuals who are eligible for the State Vocational Rehabilitation
Services program, including determining the relative prevalence of
substance abuse among persons with more severe disabilities;
(2) Develop, identify, and evaluate information about effective
methods for providing vocational rehabilitation services to individuals
who are substance abusers;
(3) Investigate the impact of recent legislative changes (including
welfare reform and SSA eligibility) and changes in health care
management and financing of substance abuse treatment on the provision
of vocational rehabilitation services to individuals who are substance
abusers; and
(4) Disseminate informational materials and provide technical
assistance and training to SVR eligible individuals whose substance
abuse has resulted in a work disability, or who have some other
disability that results in a substantial impediment to employment but
whose substance abuse interferes with their ability to benefit from
vocational rehabilitation services, vocational rehabilitation
personnel, and related rehabilitation disciplines concerning effective
strategies for providing vocational rehabilitation services.
In carrying out the purposes of the priority, the RRTC shall:
* Give special emphasis to issues affecting the vocational
rehabilitation of individuals with co-existing disabilities,
particularly issues affecting SVR eligible individuals for whom
substance abuse is not their sole or primary disabling condition, but
whose substance abuse interferes with their ability to benefit from
vocational rehabilitation services.
* Address the vocational rehabilitation needs of individuals
with HIV/AIDS who are SVR eligible individuals whose substance abuse
has resulted in a work disability, or who have some other disability
that results in a substantial impediment to employment but whose
substance abuse interferes with their ability to benefit from
vocational rehabilitation services;
* Where appropriate, address the needs of transitioning
special education
[[Page 35642]]
students who may have substance abuse problems, their special education
teachers, and administrators; and
* Coordinate with projects on substance abuse supported by
the Substance Abuse and Mental Health Services Administration and with
NIDRR centers and projects on vocational rehabilitation and emerging
disability populations.
Priority 3: Improving Employment and Independent Living Outcomes for
Persons with Disabilities in Rural Areas
Background
Between 11 and 15 million persons living in rural areas have a
chronic or permanent disability, a higher per capita rate of disability
than exists in cities with populations over 50,000 (Young, C. and
O'Day, B., ``Issues in Rural Independence: Funding,'' Rural Monograph
Series.'' Compared to their counterparts in metropolitan areas, persons
with disabilities in rural areas have higher rates of activity
limitation (16.4% versus 14.6%), work limitation (14.2% versus 10.9%),
and personal care limitation (4.7% versus 3.8%) (LaPlante, M. et al.,
``Disability Statistics Report #7,'' Disability in the United States:
Prevalence and Causes, 1992, Institute for Health and Aging, University
of California, San Francisco, July, 1996). Persons with disabilities in
rural areas face challenges that are quite different from their peers
living in and around metropolitan areas. The quality of life for many
people with disabilities residing in rural America is characterized by:
(1) Limited job opportunities; (2) inadequate health care; (3)
isolation and inadequate transportation; (4) lack of accessible
housing; and (5) underfunded social services.
For many rural areas, social and economic vitality hinges on
overcoming the problems posed by remoteness from urban centers--such as
the lack of easy access to advanced education, medical knowledge, and
enterprise development opportunities. People with disabilities living
in rural communities often live a long distance from vocational
rehabilitation (VR) agencies, independent living centers (ILCs), and
other social service agencies. Although these resources have great
potential for reducing the impact of disability, service delivery
challenges limit their availability in rural areas.
Currently, Federal, State, and local initiatives such as
Empowerment Zones (EZ) or Enterprise Communities (EC) are addressing
community and economic development in rural areas. The Federal
government, working across agency lines and in a new partnership with
State and local government and the private sector, has provided
distressed communities with the tools they need and flexibility they
desire, in the form of block grants, tax breaks and waivers. In return,
EZ/EC communities--residents, community leaders, businesses, State and
local governments and schools--must demonstrate that they are taking
responsibility for their own futures by developing and implementing a
plan to utilize these tools. The U.S. Department of Agriculture (USDA)
is authorized to designate three rural EZs and thirty ECs.
These projects are intended to demonstrate that innovative economic
development and service delivery approaches can make a difference for
people with disabilities living in rural areas. It is important for
individuals with disabilities living in rural communities to
participate in long-range community development planning. Their
involvement is crucial to ensure that the unique needs of people with
disabilities for employment, economic self-sufficiency, transportation,
affordable and accessible housing, and access to generic community
facilities are addressed. Research is needed to study current
approaches, and to develop new models, for increasing their
participation in public and private economic development and services
improvement initiatives.
The health problems experienced by people with disabilities living
in rural areas are complicated by the burden of travelling long
distances and the general shortage of primary health care providers. As
a result, people with disabilities living in rural areas may experience
a high rate of secondary conditions each year such as pressure sores,
physical deconditioning, urinary tract infections, depression and pain
(Seekins, T. et al., ``A Descriptive Study of Secondary Conditions
Reported by a Population of Adults with Physical Disabilities Served by
Three Independent Living Centers in a Rural State,'' Journal of
Rehabilitation, Vol. 60, No. 2, pgs. 47-51, 1994). Proper education,
support delivered by health clinics and independent living centers, and
utilization of telemedicine can dramatically improve the health of
adults with disabilities and reduce medical service utilization.
The USDA's Rural Utilities Service, which funds telecommunications
infrastructure in many rural areas, provides grants to link rural
health clinics with larger hospitals to better serve rural residents.
The U.S. Department of Health and Human Services' (DHHS') Health Care
Financing Administration funds Rural Telemedicine Grants which
demonstrate and collect information on the feasibility, costs,
appropriateness, and acceptability of telemedicine for improving access
to health services for rural residents and reducing the isolation of
rural practitioners. The intended beneficiaries of these grants are
rural health care providers, patients, and rural communities which gain
from this program.
Changes in health care policy, such as managed care, are
significantly affecting the lives of people with disabilities living in
rural areas. For example, managed care emphasizes primary care and
control of access to specialized services. Persons with significant
disabilities in rural areas, however, have difficulty obtaining primary
care and often need extensive services and access to highly specialized
providers to prevent death or further disability (``Medicaid Managed
Care: Serving the Disabled Challenges State Programs,'' U.S. General
Accounting Office (GAO)/Health, Education, and Human Services-96-136).
The use of telecommunications technologies may be a critical
element in efforts to provide social services as well as maintain and
foster economic development. Advanced telecommunications technologies--
the Internet, videoconferencing and high-speed data transmission--offer
rural areas the chance to overcome some of the problems they face as a
result of their geographic isolation. These technologies can link rural
areas with other communities and expertise to improve medical services,
create new jobs, and increase rural residents' access to education
(``Rural Development: Steps Toward Realizing the Potential of
Telecommunications Technologies,'' GAO/Resources, Community, and
Economic Development-96-155).
Interactive technology can link isolated rural settings with
comprehensive services at distant facilities. With these linkages, the
distant facility can review X-rays, CAT scans, and other medical
evidence to diagnose an illness and prescribe treatment without having
the patient make long, and sometimes difficult, trips to the larger
institution. Colleges and schools can offer classes, and even degree
programs, to students in remote locations. Large businesses can
establish or maintain branch offices in rural areas by using
videoconferencing or on-line access to hold meetings and conduct
business. There is a need to design ways to apply these emerging
interactive technologies to the lives of people with
[[Page 35643]]
disabilities living in rural areas, particularly as Federal and other
public and private programs expand their uses of interactive
technology.
Priority 3
The Secretary will establish an RRTC for the purpose of examining
means to improve the employment status and ability of persons with
disabilities to live independently in rural areas. The RRTC shall:
(1) Identify, analyze and evaluate the impact of rural economic
development strategies in improving the employment outcomes and
economic status of people with disabilities living in rural
communities;
(2) Identify and examine issues of access to health care for
persons with disabilities living in rural areas, particularly those
issues contributing to the onset of secondary conditions;
(3) Develop and evaluate strategies to increase the participation
of people with disabilities in local public planning for community
development;
(4) Identify, develop, and evaluate strategies to improve rural
transportation, accessible housing, and access to generic community
facilities services for people with disabilities;
(5) Identify and evaluate strategies to improve the use of
telecommunications technologies for the delivery of health, employment,
education, and social services to people with disabilities living in
rural communities; and
(6) Develop training and informational materials and provide
training and information to persons with disabilities, and providers of
health care, vocational rehabilitation, and independent living
services, on effective strategies for improving the employment, health,
and independent living outcomes of people with disabilities living in
rural areas.
In carrying out the purposes of the priority, the RRTC shall:
* Coordinate with NIDRR-funded research, training and
demonstration activities on delivery of rehabilitation and independent
living services in rural areas, including those sponsored by RSA and
the RRTC on managed care;
* Where appropriate, address the needs of transitioning
special education students and their special education teachers and
administrators;
* Coordinate with rural projects affecting persons with
disabilities funded by USDA and DHHS; and
* Address the needs of persons with disabilities in rural
communities in all parts of the country, including persons from ethnic
and racial minority backgrounds.
Knowledge Dissemination and Utilization Projects
Authority for the D&U program of NIDRR is contained in sections 202
and 204(a) 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. Under the regulations for this
program (see 34 CFR 355.32), the Secretary may establish research
priorities by reserving funds to support particular research
activities.
Priority
Under 34 CFR 75.105(c)(3), the Secretary gives an absolute
preference to applications that meet the following priority. The
Secretary will fund under this competition only applications that meet
this absolute priority:
Priority 4: Parenting With a Disability Technical Assistance Center
Background
Approximately one in eleven families with children at home includes
one or more parents with a disability (LaPlante, M., ``Disability in
the Family,'' presented at the annual meeting of the American Public
Health Association, Atlanta, GA, 1991). This proportion can be expected
to increase as a correlate of the gains that persons with disabilities
have achieved in their efforts to live and work independently in the
community. In the course of becoming parents and rearing children,
persons with disabilities may encounter a variety of attitudinal,
physical, medical, and legal barriers. They may also find
misinformation or an absence of information regarding advances in
fields that address issues related to parenting.
NIDRR has been addressing the physical barriers and reproductive
issues faced by parents with disabilities through a variety of research
and development projects. Since 1993 NIDRR has supported a
Rehabilitation Research and Training Center on Families in which one or
more adult parent or guardian has a disability. The Center has
investigated a wide range of parenting issues, including the assistive
technology needs of parents with disabilities, training obstetricians
to deal with the needs of women with disabilities, and needs of mothers
with visual disabilities. The Center has created and identified a wide
range of valuable information for parents and professionals. In
addition, over the last ten years, NIDRR has supported research
projects on the design and development of new adaptive equipment for
parents with physical disabilities and parenting assessment techniques.
A wide array of parenting equipment has been developed, for example, a
lifting harness and an adapted baby bathing cart. Information is also
available on the social service needs of parents with disabilities. As
a result of these and other research, training, and development
efforts, a substantial body of knowledge now exists related to
parenting with a disability.
Persons with disabilities who want to become, or remain parents,
may need information and technical assistance. A NIDRR-sponsored focus
group on women and disabilities held in 1994 recommended that NIDRR
explore issues related to sexuality, reproductive health, pregnancy and
parenting for women with disabilities, including ``the level of
information that women have about these topics'' (``Focus Group on
Women and Disabilities,'' unpublished ``Report of Proceedings,'' NIDRR,
pg. 8, July, 1994). Parents with disabilities and prospective parents
with disabilities need information about related advances in the field
of assistive technology and medicine, public policy and legal
developments, and parenting resources.
One source of information and valuable experience is persons with
disabilities who are parents. These individuals have a wealth of
knowledge and can not only share their experiences and practical
information, but also serve as uniquely qualified sources of support.
Currently, this ``parent to parent'' networking is primarily informal
and limited in scope.
Persons with disabilities may encounter substantial attitudinal and
legal barriers in their efforts to become pregnant, gain or maintain
custody, or adopt children. Barbara Faye Waxman, an expert on
reproductive rights, notes that laws allowing sterilization of persons
with disabilities remain on the books in some States and that social
service agencies are often too quick to put the non-disabled children
of parents with disabilities up for adoption (Mathews, J., ``The
Disabled Fight to Raise Their Children,'' Washington Post Health
Section, August 18, 1992). Most States treat disability as prima facie
evidence of parental unfitness and a possible detriment to the child
(Conly-Jung, C., ``The Early Parenting Experiences of Mothers with
Visual Impairments and Blindness,'' Dissertation, California School of
Professional Psychology, Alameda, CA, pg. 21, May, 1996). One important
strategy in the effort to overcome these attitudinal and legal barriers
is
[[Page 35644]]
providing social service, legal, and medical professionals with
information that dispels stereotypes and describes advances in the
related fields that enable persons with disabilities to provide a safe
and nurturing environment for their children.
Priority 4
The Secretary will establish a center for the purpose of providing
technical assistance and disseminating parenting information to persons
with disabilities and to social service, medical, and legal service
providers. The technical assistance center shall:
(1) Identify and disseminate technological, legal, and medical
information on parenting, pregnancy, custody, and adoption to parents,
and prospective parents with disabilities, and service providers in
related field of social services, law, and medicine;
(2) Develop training materials on parenting with a disability and
disseminate those materials to organizations and institutions of higher
education that provide pre-service and in-service training to
professionals in related fields of social services, law, and medicine,
as well as to organizations representing persons with disabilities;
(3) Provide technical assistance on parenting with a disability to
persons with disabilities and service providers, including making
referrals and serving as a clearinghouse of technical information; and
(4) Develop and establish a parent-to-parent network that enables
experienced parents with disabilities to voluntarily provide
information and support to persons with disabilities interested in
becoming or remaining parents.
In carrying out the purposes of the priority, the technical
assistance center shall:
* Collect and synthesize information from other NIDRR-funded
projects and centers that could be relevant to parenting with a
disability including, but not limited to, the Assistive Technology
Projects;
* Collaborate with other NIDRR and Office of Special
Education Programs-funded projects and centers that address issues
related to parenting and to disability rights of persons with
disabilities; and
* Establish a national toll-free telephone hotline and
publish a quarterly newsletter.
Applicable Program Regulations
34 CFR Parts 350, 352, and 355.
Program Authority: 29 U.S.C. 760-762.
Dated: June 25, 1997.
(Catalog of Federal Domestic Assistance Numbers: 84.133B,
Rehabilitation Research and Training Center Program, 84.133D,
Knowledge Dissemination and Utilization Program)
Judith E. Heumann,
Assistant Secretary for Special Education and Rehabilitative Services.
[FR Doc. 97-17206 Filed 6-30-97; 8:45 am]
BILLING CODE 4000-01-P