[Federal Register Volume 60, Number 10 (Tuesday, January 17, 1995)]
[Notices]
[Pages 3494-3499]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-1017]




[[Page 3493]]

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Part VII





Department of Education





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Final Funding Priorities for Fiscal Years 1995 and 1996 for Research 
and Demonstration Projects; Inviting Applications for New Awards Under 
the Research and Demonstration Program for Fiscal Year 1995; Notices

  Federal Register / Vol. 60, No. 10 / Tuesday, January 17, 1995 / 
Notices   
[[Page 3494]] 

DEPARTMENT OF EDUCATION


National Institute on Disability and Rehabilitation Research; 
Notice of Final Funding Priorities for Fiscal Years 1995 and 1996 for 
Research and Demonstration Projects

AGENCY: Department of Education.

SUMMARY: The Secretary announces final funding priorities for Research 
and Demonstration (R&D) projects under the National Institute on 
Disability and Rehabilitation Research (NIDRR) for fiscal years l995-
1996. The Secretary takes this action to focus research attention on 
areas of national need consistent with NIDRR's long-range planning 
process. These priorities are intended to assist in the solutions to 
problems encountered by individuals with disabilities in their daily 
activities.

EFFECTIVE DATE: These priorities take effect on February 16, 1995.

FOR FURTHER INFORMATION CONTACT: David Esquith, U.S. Department of 
Education, 600 Independence Avenue, S.W., Switzer Building, Room 3424, 
Washington, D.C. 20202-2601. Telephone: (202) 205-8801. Individuals who 
use a telecommunications device for the deaf (TDD) may call the TDD 
number at (202) 205-8801.

SUPPLEMENTARY INFORMATION: This notice contains three final priorities 
for the R&D program. These priorities are in the areas of 
accommodations for individuals with disabilities in adult education 
programs, reproductive issues for women with disabilities, and HIV/AIDS 
and disability.
    Authority for the R&D program of NIDRR is contained in section 
204(a) of the Rehabilitation Act of l973, as amended (29 U.S.C. 760-
762).
    Under this program the Secretary makes awards to public agencies 
and private agencies and organizations, including institutions of 
higher education, Indian tribes, and tribal organizations. In part, 
this program is designed to assist in the provision of vocational and 
other rehabilitation services to persons with disabilities, especially 
those individuals with severe disabilities, through planning and 
conducting of research and demonstration projects, and specialized 
research activities. In addition, this program is designed to assist in 
the development of solutions to the problems encountered by individuals 
with disabilities in their daily activities, especially problems 
related to employment (see 34 CFR 351.1). Under the regulations for 
this program (see 34 CFR 351.32), the Secretary may establish research 
priorities by reserving funds to support the research activities listed 
in 34 CFR 351.10.
    These final priorities support the National Education Goals, one of 
which states that every American will be literate and will possess the 
knowledge and skills necessary to compete in a global economy and 
exercise the rights and responsibilities of citizenship.
    On October 7, 1994, the Secretary published a notice of proposed 
priorities in the Federal Register (59 FR 51326).
    The Department of Education received thirty-five letters commenting 
on the proposed priorities. Modifications were made to the priorities 
as a result of those comments. The comments, and the Secretary's 
responses, are discussed in an appendix to this notice.

    Note: This notice of final priorities does not solicit 
applications. A notice inviting applications in the areas of 
accommodations for individuals with disabilities in adult education 
programs and HIV/AIDS and disability is published in a separate 
notice in this issue of the Federal Register. At this time, NIDRR is 
not inviting applications in the area of reproductive issues for 
women with disabilities.

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 this program only applications that meet 
one of these absolute priorities:

Priority 1: Accommodations for Individuals With Disabilities in Adult 
Education Programs

Background
    In program year 1991 Adult Education (AE) programs funded under the 
Adult Education Act (P.L. 88-452, as amended) served over 3.7 million 
people in adult basic, adult secondary, and English-as-a-second-
language programs. Adult Basic Education programs serve persons who are 
educationally disadvantaged, including individuals with all types of 
disabilities. The Office of Vocational and Adult Education estimates 
that at least 30 percent of the persons in AE programs have a 
disability. Adults (aged 16 years or older) with disabilities are 
enrolled in AE programs located in 57 States or territories in local 
educational agencies, community colleges, community-based 
organizations, mental hospitals, rehabilitation and correctional 
facilities, and other facilities serving individuals with disabilities 
(U.S. Department of Education, Adult Learning and Literacy 
Clearinghouse, Fact Sheet 9, February 1994).
    Some individuals with disabilities in AE programs may need 
accommodations to make the educational program accessible. These 
accommodations may involve the modification of policies, practices, or 
procedures, or the provision of auxiliary aids and services (e.g., 
relaxed time requirements for tests, interpreters, assistive 
technology) or both. Published efforts to identify accommodations for 
adults with disabilities in AE programs have focused on administering 
tests and diagnostic assessments (American Council on Education, ``GED 
Test Accommodations,'' Washington, D.C., 1990; American Council on 
Education, ``External Diploma Program Assessment Accommodations and 
Modifications for Adults with Special Learning Needs,'' Washington, 
D.C., 1990).
    In addition to testing and assessment accommodations, individuals 
with disabilities in AE programs may require accommodations related to 
the presentation of instructional materials, alternative formats to 
print materials, notetakers, alternatives to written assignments, 
practicums, scheduling, and a variety of other educational tasks and 
requirements.
    Adult Education administrators and teachers need to understand not 
only their obligations under Section 504 of the Rehabilitation Act, as 
amended, and the Americans with Disabilities Act, but also the 
resources that are available to enable them to provide the 
accommodations. Similarly, students with disabilities in AE programs 
need to understand their rights, articulate their needs, and identify 
the accommodations that will assist them to meet the program's 
requirements.
Priority
    An R&D project on accommodations for individuals with disabilities 
in Adult Education programs shall--
     Survey the nature and extent to which a representative 
sample of AE programs are providing programmatic accommodations to 
students with disabilities and determine the relationship between the 
provision of those accommodations and program outcomes for those 
students (e.g., graduation rates, program completion, career 
advancement, etc.);
     Identify and evaluate effective programmatic 
accommodations for individuals with disabilities in AE programs, and 
develop recommendations for the development of new accommodations, 
including, but not limited to, accommodations related to testing, 
presentation of instructional [[Page 3495]] materials, alternative 
formats to print materials, notetakers, alternatives to written 
assignments, practicums, scheduling, and assistive technology;
     Utilizing existing materials to the maximum extent 
possible, develop guidance for AE staff and students with disabilities 
in AE programs on the rights and duties of covered entities to provide 
appropriate accommodations to individuals with disabilities;
     Utilizing existing material to the maximum extent 
possible, develop information for AE staff and students with 
disabilities on both innovative and common accommodations provided to 
students with disabilities, as well as information on resources that 
will assist AE programs provide accommodations;
     Field-test and ensure that the materials that are 
developed address the needs of individuals with disabilities from 
minority backgrounds who are in AE programs; and
     Coordinate efforts with NIDRR's Disability and Business 
Technical Assistance Centers (DBTACs, the ADA technical assistance 
centers) as well as with the Division of Adult Education and Literacy 
within the U.S. Department of Education Office of Vocational and Adult 
Education.

Priority 2: Reproductive Issues for Women With Physical Disabilities

Background
    Despite the attention given to disability in general and certain 
impairments in particular, one category within the disabled population 
has received little recognition or study--women. (Doggone, Mary J., 
Brooks, Nancy A., Women and Disability: The Double Handicap, l985). 
Over 3,000,000 women of childbearing age in the United States have some 
type of disability. Many women with disabilities have been discouraged 
by their families, friends, and health providers from considering the 
option of parenthood. Until very recently, women with many types of 
physical disabilities have not been encouraged or facilitated in 
exercising that option by health care providers and others. Medical 
professionals have often discouraged pregnancy for women with physical 
disabilities because of the limited understanding of the effect of 
bodily changes during pregnancy, labor, and delivery on existing 
impairments. This priority addresses issues confronted specifically by 
women with physical disabilities.
    Some aspects of women's health maintenance that are an ordinary 
part of life for most women pose significant problems for women with 
physical disabilities. Depending upon the type of disability, fertility 
may be unaffected but pregnancy may be an increased risk and require 
high-risk management; genetic counseling may be suggested; symptoms of 
chronic disease or impairment may or may not be exacerbated; delivery 
may be difficult; and urinary infections, decubitus ulcers and 
autonomic hyperreflexia during labor and delivery may be present. 
(Asrael, W., Huberman, B., NAACOG Update Series, Vol. 5, Lesson 11, 
1986).
    Women with physical disabilities often require specialized 
gynecological attention for a number of possible concerns. The 
interaction of drugs may have a more severe impact on their systems, 
such as the canceling effect of antiseizure medications and oral 
contraceptives, or the multiplying effect of antispasmodics on other 
drugs with depressive side effects. There has been little research on 
the long-term effects of oral contraceptives and other hormonal 
treatments for women who lead sedentary existences and who often have 
compromised circulatory systems. (Nosek, M., Point of View, Primary 
Care Issues for Women With Severe Physical Disabilities, Journal of 
Women's Health, Vol. 1, No. 4, 1992). Concerns revolve around the 
ability to conceive, the presence of special problems and risks during 
pregnancy, the impact on the disability itself and the methods of 
delivery.
    Elaine Carty and Tali Conine, (Rehabilitation Nursing, Vol. 13, No. 
2, 1988), looked at six important areas of stress that pregnant women 
with physical disabilities experience. Three are role related: 
accepting the new role of childbearing and the impending 
responsibilities of parenthood, accepting extra nurturing and assuming 
a more dependent role, and dealing with fatigue and limitations on 
activity in the perinatal period. Psychosocial issues cannot be 
separated from the woman's general well-being.
    Research supports the conclusion that more extensive education of 
health care providers and consumers in the medical and psychosocial 
aspects of disability and in the area of human sexuality and 
communications regarding this aspect of health care could lead to 
improved health services for women with disabilities. Among the 
problems in providing appropriate reproduction-related services to 
women with disabilities is the limited experience of obstetricians-
gynecologists with health issues of various types of disabilities, and 
the limited involvement of physiatrists and other specialists in 
prenatal care. Physicians who may have been involved in the woman's 
previous care include a physiatrist, orthopedist, neurologist and 
urologist. The proposed project is to investigate appropriate roles for 
these specialists in the pregnancy care team.
    If women with disabilities are to have options for reproductive 
care comparable to those available to women without disabilities, then 
the obstetrical profession and ancillary health care personnel must be 
educated on the special pregnancy-related needs of women with physical 
disabilities. Development and dissemination of current information to 
health care practitioners and to women with disabilities will be a key 
element of any project to be funded under this priority.
    Being informed is one of the best ways for a woman to increase her 
confidence and ensure she is given the same pregnancy-related options 
as her nondisabled peers. (Beckmann, Gittler, Barzansky, and Beckmann, 
On the Gynecologic Health Care of Women With Disabilities, Obstetrics 
and Gynecology, Vol. 74, No. 1, July, 1989). A woman with a disability 
who is pregnant should be aware of major risk-benefit ratios, and needs 
a support system that includes an obstetrical team sensitive to the 
specific issues related to her disability. (Freda, Cioschi, Nilson, 
Childbearing Issues for Women with Physical Disabilities, Special 
Interest Section Newsletter, Physical Disabilities, Vol. 12, No. 2, 
June 1989, published quarterly by the American Occupational Therapy 
Association, Inc.)
    Choices concerning pregnancy and motherhood often have different 
implications for women in diverse cultures, depending upon the 
psychosocial expectations of women and the support systems available to 
them. Disabled women from minority backgrounds may be quite different 
from those available to nonminority women. A project to be funded under 
this priority is expected to address the research questions concerning 
disability, pregnancy, and cultural competency. Thus, any project must 
involve not only women with physical disabilities, but also disabled 
women from diverse cultural backgrounds, in the design, conduct, and 
dissemination of the research. A grantee funded under this priority is 
expected to demonstrate familiarity and ability to coordinate with 
other projects and agencies addressing related issues, including the 
Department of Health and Human Services and its grantees.
Priority
    An R&D project on reproductive issues for women with disabilities 
shall-- [[Page 3496]] 
     Study the impact and risks of pregnancy and childbirth, 
and, at the discretion of the applicant, other reproductive health 
issues affecting women with various physical disabilities;
     Identify the current gaps in research and the information 
needed by practitioners and consumers regarding gynecologic and 
reproductive care for women with physical disabilities;
     Identify and evaluate strategies that foster communication 
and collaboration among the various health care practitioners relevant 
to pregnancy and childbirth and to other reproductive health issues of 
women with physical disabilities;
     Identify and evaluate methods to improve education and 
training for health care providers regarding the medical and 
psychosexual aspects of disability and reproductive issues;
     Incorporate issues pertinent to culturally diverse 
populations in addressing issues of pregnancy and childbirth, and, at 
the discretion of the applicant, other reproductive health issues 
identified by women with disabilities from minority backgrounds; and
     Disseminate the research findings to health care providers 
and women with disabilities through the most effective channels, likely 
to result in maximum impact on practice and training.

Priority 3: HIV/AIDS and Disability

Background
    The human immunodeficiency virus (HIV) causes a chronic, 
progressive immunologic deficiency disease with a spectrum of 
manifestations. (Atkins, B. J. and Hancock, A. K., American 
Rehabilitation, 1993). The continuum can be seen as four major stages: 
Acute HIV Disease; Chronic Asymptomatic HIV Disease; Chronic 
Symptomatic HIV Disease; and Advanced Disease (AIDS). It is known that 
HIV affects every cultural, social, economic, sexual, racial, and 
geographic group in this country.
    Former Surgeon General C. Everett Koop stated that HIV is expected 
to impact every household in America in the 1990's.'' The numbers of 
people who have AIDS is significant: the Centers for Disease Control 
and Prevention (CDC), in its HIV/AIDS Surveillance Report, 1994, noted 
that, as of December, 1993, 361,509 cases of AIDS had been reported in 
the United States. Of these, 138,223 individuals were known to be 
living with AIDS. These figures do not include individuals who have 
been diagnosed as HIV seropositive, but have not yet developed full-
blown AIDS; that number is estimated to exceed one million. Racial and 
ethnic minority populations have been disproportionately affected by 
HIV infection and AIDS. In 1992, 47 percent of all reported AIDS cases 
were among African-Americans and Hispanics although these two groups 
represent only 21 percent of the entire population (1992 CDC 
Newsletter). HIV infections are also increasing rapidly among women.
    Although HIV disease is chronic, progressive, and, so far, 
ultimately fatal, the average period of time from onset of infection to 
death continues to increase, due to improved health care interventions, 
and is now estimated to be 11.5 years (Whitman-Walker Clinic). 
Individuals may well begin to live longer at each stage of the disease 
process. Thus, as the natural course of the disease changes, it will be 
important to track the changing needs for rehabilitation and community 
support services. Most ``Persons Living with AIDS'' (PLWA) aspire to 
maintain as normal a life as possible during the period of disease and 
disability and have both the potential and the right to benefit from 
appropriate service programs. It is extremely critical that culturally 
sensitive, community integrated service systems to promote 
rehabilitation, independence, employment, and community integration and 
to reduce barriers be developed and implemented.
    The Americans with Disabilities Act (ADA) and Section 504 of the 
Rehabilitation Act of 1973, as amended, have very similar definitions 
of an individual with a disability, and define such an individual, in 
summary, as one who has a physical or mental impairment that 
substantially limits his or her ability to perform one or more major 
life activities, has a record of an impairment that substantially 
limits a major life activity, or is regarded by an employer or other 
covered entity as having an impairment that substantially limits a 
major life activity. This definition includes people with HIV/AIDS.
    Individuals with HIV/AIDS may be entitled to income transfer 
payments and medical assistance; they also may be eligible, depending 
on specific criteria in the various statutes, for services under a 
number of public service programs, including vocational rehabilitation 
and independent living, mental health and drug abuse services, 
veterans' services, and housing assistance.
    There are many allegations that the traditional social service 
systems, including vocational rehabilitation, are ill-equipped to 
respond to the need for services. For example, the 1991 National Survey 
of Vocational Rehabilitation (VR) and AIDS,'' distributed to State VR 
agencies by the American Rehabilitation Association (ARA), concludes 
that there are numerous barriers to the delivery of rehabilitative 
services to persons living with HIV/AIDS. These barriers include the 
fears and anxieties of vocational rehabilitation staff, public stigma 
associated with HIV/AIDS, confidentiality issues, lack of knowledge 
about the rehabilitation needs of persons with HIV/AIDS, and the need 
for more extensive services than those currently available through the 
vocational rehabilitation system.
    Factors in the natural course of the disease, including remissions, 
exacerbations, compounding, rates of decline, and many other 
characteristics that are not well understood in terms of their relation 
to disability and to support services, may affect the suitability of 
existing service models to meet the needs of PLWA. In addition, there 
is some indication that the patterns of the disease, and the associated 
service needs, are different for minority individuals, who are likely 
to enter the health care service system later in the illness, and for 
women, for whom not only the support needs but also the natural course 
of the disease appear to differ (Campbell, et.al., 1989).
    Many rehabilitation experts hypothesize that the approaches and 
techniques that have been developed to address issues regarding other 
types of disability are relevant to, and will be effective in, 
addressing issues regarding HIV/AIDS. These approaches include 
secondary prevention, vocational rehabilitation, job accommodations, 
barrier removal, peer support, independent living, personal assistance 
services, public education, integrated model service systems, job 
sharing, and advocacy.
    However, the most effective application of disability and 
rehabilitative approaches to HIV/AIDS is dependent upon first 
increasing knowledge about the pattern(s) of disabling consequences 
typically associated with the disease process; the functional 
capacities associated with various stages of the disease process; and 
the duration and intensity of various types of supports needed for this 
population at different stages of the disease process. Any research 
designed to address these issues must ensure that findings can be 
applied cross-gender and to various ethnic and linguistic cultures.
    Any project to be funded under this priority is expected to be 
familiar with, [[Page 3497]] and to coordinate and cooperate with, the 
related AIDS research activities of the Centers for Disease Control and 
the National Institute of Allergy and Infectious Diseases, and with 
other major current or future research initiatives.
Priority
    An R&D project on HIV/AIDS and disability shall--
     Analyze existing data on HIV/AIDS, prepare population 
estimates and statistical profiles of adults with HIV/AIDS, including 
such factors as: age; age at onset or confirmation of HIV infection or 
both and AIDS diagnosis or length of time with the disease; ethnic 
background; gender; educational level; employment experience and 
current employment status; patterns of SSI, SSDI, Medicaid, and 
Medicare enrollment; and standard demographic factors;
     Document the natural course of the disability consequences 
of the disease process, including iatrogenic disabilities, and document 
the functional losses associated with various stages of the disease 
process, taking into consideration such factors as age, gender, ethnic 
background, and concomitant disabilities;
     Identify and assess the major disability-related societal 
barriers confronted by adults with HIV/AIDS, including unemployment, 
discrimination, lack of accommodations, and lack of opportunities to 
maintain independent living, distinguishing patterns by age, gender, 
ethnic background, and urban or rural location;
     Identify best practices in rehabilitation, independent 
living, peer support programs, community mental health, housing, job 
accommodations, and related services that have the most potential to 
assist adults with HIV/AIDS to maximize quality of life;
     Demonstrate and evaluate the effectiveness of selected 
rehabilitative techniques that enable PLWA to maintain maximum 
independence in employment and in the community, involving PLWA, 
individuals with other disabilities, and adults from diverse cultural 
backgrounds in the design of the demonstrations; and
     Disseminate the findings from this project to potential 
adapters in other programs, projects, and service facilities that 
provide services to PLWA and through other resources, including NARIC, 
the Council of State Administrators of Vocational Rehabilitation 
(CSAVR), and the National Council for Independent Living (NCIL), the 
National Association of Protection and Advocacy Systems (NAPAS), and 
HIV/AIDS information networks.
    Applicable Program Regulations: 34 CFR Parts 350 and 351.

    Program Authority: 29 U.S.C. 760-762.

(Catalog of Federal Domestic Assistance Number 84.133A, Research and 
Demonstration Projects)

    Dated: January 10, 1995.
Judith E. Heumann,
Assistant Secretary for Special Education and Rehabilitative Services.

Appendix

Analysis of Comments and Changes

    By the deadline date, the Department received thirty-five comments 
in response to the proposed priorities. Sixteen additional comments 
were received after the deadline date and were not considered in this 
response. The majority of the letters supported the priorities. This 
Appendix contains an analysis of the comments and the changes in the 
priorities since the publication of the notice of proposed priorities. 
Technical and other minor changes--and suggested changes the Secretary 
is not legally authorized to make under applicable statutory 
authority--are not addressed.

Priority 1: Accommodations for Individuals With Disabilities in Adult 
Education Programs

    Comment: Two commenters recommended including assistive technology 
in the examples of accommodations in the Background statement and in 
the priority.
    Discussion: The Secretary believes that assistive technology will 
play an increasingly important role in the provision of accommodations 
for persons with disabilities in adult education programs. The 
Secretary agrees to clarify that applicants may address accommodations 
that utilize assistive technology.
    Changes: Assistive technology has been added to the list of 
examples of accommodations in the Background statement and in the 
priority.
    Comment: Many commenters recommended adding specific emphases and 
activities to the priority.
    Discussion: The Secretary believes that applicants should have the 
discretion to propose any emphasis or activity that is authorized by 
the priority. The application review process will determine the merits 
of the emphasis or activity that an applicant proposes. The Secretary 
believes that the commenters' recommendations listed directly below are 
authorized by the priority and may be proposed by an applicant. 
However, the Secretary declines to require all applicants to address 
them. These recommended emphases and activities are as follows: 
separately, inform students about their right to accommodations and 
teachers about the uses of accommodations, develop a self-advocacy 
curriculum, address alternative teaching techniques, broaden the 
priority's coordination requirements, emphasize in the materials that 
are developed by the project that accommodations need to be provided 
only when a barrier to participation exists, address the needs of 
students with disabilities' for assistance in documenting their 
disabilities, emphasize and identify existing model programs, develop 
statistical information on the impact and need for accommodations in AE 
programs, develop a teacher training model, address the recruitment and 
placement of students with disabilities with average and above average 
intelligence into AE programs, emphasize individuals with traumatic 
brain injuries, emphasize case-by-case assessment to determine 
individual accommodations, study issues involving the deaf community 
and the impact of interpreters, and study the use of personal 
assistants in facilitating access to AE by persons with spastic 
cerebral palsy or quadriplegia.
    Changes: None.
    Comment: One commenter suggested revising the priority to clarify 
that the second activity of the priority is intended to address 
existing AE programs.
    Discussion: The second priority requires the grantee to identify 
and evaluate effective programmatic accommodations for individuals with 
disabilities in AE programs, and develop recommendations for the 
development of new accommodations. The Secretary believes that the 
grantee may identify effective programmatic accommodations for persons 
with disabilities that exist in other programs serving persons with 
disabilities (e.g., special education, vocational education). The 
Secretary does not agree to limit the grantee's activities to 
consideration of existing AE programs.
    Changes: None.
    Comment: One commenter suggested referencing the Americans with 
Disabilities Act (ADA) in addition to Section 504 of the Rehabilitation 
Act.
    Discussion: The Secretary agrees that the AE administrators and 
educators need to understand that they have obligations under the ADA 
as well as Section 504 of the Rehabilitation Act.
    Changes: Title II of the ADA is referenced in the Background 
statement. [[Page 3498]] 

Priority 2: Reproductive Issues for Women With Physical Disabilities

    Comment: One commenter recommended using the term ``reproductive 
health'' instead of ``pregnancy and childbirth'' in the third and fifth 
activities of the priority. The commenter pointed out that there are 
many women with disabilities who have reproductive health needs other 
than those related to pregnancy and childbirth.
    Discussion: The Secretary recognizes that ``pregnancy and 
childbirth'' are a subset of the topics that fall under the heading of 
``reproductive health.'' The Secretary believes that all applicants for 
this project should address issues of childbirth and pregnancy. 
Additionally, the Secretary believes that applicants should be given 
the discretion to propose to address other issues of ``reproductive 
health.'' The application review process will determine the merits of 
the activities that an applicant proposes.
    Changes: The background statement and the priority have been 
revised to provide applicants with the discretion to propose to address 
issues of reproductive health in addition to childbirth and pregnancy.
    Comment: Many commenters recommended adding specific emphases and 
activities to the priority.
    Discussion: The Secretary believes that applicants should have the 
discretion to propose any emphasis or activity that is authorized by 
the priority. The application review process will determine the merits 
of the emphasis or activity that an applicant proposes. The Secretary 
believes that the commenters' recommendations listed directly below are 
authorized by the priority and may be proposed by an applicant. 
However, the Secretary declines to require all applicants to address 
them. These recommended emphases and activities are as follows: study 
impact and risks of hormone treatment, develop demographic data by age 
and disability on childbirth and pregnancy, evaluate risks and efficacy 
of birth control methods, address issues surrounding estrogens as sex 
steroids used in contraception and menopause, identify and evaluate 
methods to improve decision-making about reproductive health care by 
women with disabilities, address issues pertinent to culturally diverse 
populations, identify and evaluate postnatal adaptions to maximize 
parenting skills in women with disabilities, and identify and evaluate 
strategies that address physical and programmatic access issues to 
health care as it pertains to pregnancy.
    Changes: None.
    Comment: One commenter recommend that the project should be funded 
by the National Institutes of Health.
    Discussion: NIDRR has collaborated with various units of the 
National Institutes of Health in planning research on women with 
disabilities, including reproduction research. NIDRR has the authority 
to support research on reproductive care, including research on 
promoting sensitivity to disability concerns, educating consumers and 
providers on treatment approaches, service delivery, and consumer 
empowerment.
    Changes: None.
    Comment: Twelve commenters indicated that the priority was too 
narrow. The commenters recommended that the priority be expanded to 
address a wide range of issues in addition to reproductive issues. The 
commenters recommended that the priority be expanded to address: access 
to basic health care, violence, abuse, employment, housing, education, 
and independent living. Ten of the commenters recommended that NIDRR 
support a Rehabilitation Research and Training Center (RRTC) on women.
    Discussion: NIDRR recently convened a focus group on the topic of 
women with disabilities. The Secretary recognizes that there are many 
issues related to women with disabilities that warrant further 
research. The Secretary plans to consider supporting this research in 
the near future. However, at this time, the Secretary declines to 
expand the priority as recommended by the commenters, in favor of 
retaining a discrete focus for this R&D project.
    Changes: None.
    Comment: One commenter recommended that the title of the priority 
be changed to ``Access to Health Care and Reproductive Issues for Women 
with Disabilities.''
    Discussion: The Secretary believes that the commenter's 
recommendation connotes a different scope of activity than is intended 
for the priority. For example, the proposed priority was not intended 
to study issues of financing of health care (a topic implied by the 
suggested title).
    Changes: None.
    Comment: Three commenters recommended expanding the priority to 
include women with cognitive or psychiatric disabilities.
    Discussion: The Secretary recognizes that there are important 
reproductive health issues confronted by women with cognitive and 
psychiatric disabilities. The Secretary does not believe it is feasible 
to address these research issues in this priority because of the 
limited resources available to the R&D project. The Secretary is 
considering plans to address these research issues in the near future.
    Changes: None.
    Comment: Two commenters recommended that the project include women 
of color.
    Discussion: The Secretary expects this project to include women of 
color. The statute requires that each applicant for a project under 
this competition must demonstrate how its application will address the 
needs of individuals from minority backgrounds who have disabilities. 
In addition, the selection criteria for the program evaluate how the 
applicant will include women and members of racial or ethnic minority 
groups, as well as persons with disabilities and the elderly. The 
Secretary does not believe any further requirements are necessary in 
order to ensure that this project will address the commenters' 
recommendation.
    Changes: None.

Priority 3: HIV/AIDS and Disability

    Comment: One commenter recommended that the National Association of 
Protection and Advocacy Systems (NAPAS) be included in the list of 
groups that will receive the project's findings.
    Discussion: The Secretary believes that providing NAPAS with 
project's findings will enhance its dissemination activities.
    Changes: NAPAS has been added to the list of groups that will 
receive the project's findings.
    Comment: Many commenters recommended adding specific emphases and 
activities to the priority.
    Discussion: The Secretary believes that applicants should have the 
discretion to propose any emphasis or activity that is authorized by 
the priority. The application review process will determine the merits 
of the emphasis or activity that an applicant proposes. The Secretary 
believes that the commenters' recommendations listed directly below are 
authorized by the priority and may be proposed by an applicant. 
However, the Secretary declines to require all applicants to address 
them. These recommended emphases and activities are as follows: study 
physical barriers as well as attitudinal barriers, study housing 
issues, study the relationship between HIV/AIDS and other disabilities, 
study the attitudes of service providers when addressing societal 
barriers, study self-help and consumer-driven approaches in best 
practices, in addition to studying rehabilitation organizations, 
identify [[Page 3499]] best practices of organizations such as AIDS 
service organizations in addressing disability aspects of AIDS, and 
develop a program of orientation, education, and training for groups 
that the HIV/AIDS epidemic has affected.
    Changes: None.
    Comment: One commenter recommended a long-term training component 
for the priority.
    Discussion: The Secretary points out that length of this project is 
36 months. A long-term training component is incompatible with this 
priority. Also, this is an R&D project, which does not encompass 
authority for training.
    Changes: None.
    Comment: One commenter indicated that the priority contains too 
many activities for an R&D project.
    Discussion: The Secretary recognizes the wide array of activities 
that applicants can propose under the priority. The Secretary expects 
that applicants will propose to undertake activities that are feasible 
in light of the size of the award, while addressing all of the required 
activities over a 36-month period.
    Changes: None.

General Comments

    Comment: One commenter recommended the following four additional 
priorities: changing service delivery programs from segregated to 
integrated programs; the use of emerging assistive technology to 
improve the inclusion of children with disabilities in regular 
classrooms and all aspects of community living; accommodations for 
individuals with significant physical and speech disabilities in 
employment; and telecommunications technology for individuals with 
significant communications disabilities in adult education.
    Discussion: The Secretary will consider the commenter's 
recommendations when new priorities are being developed.
    Changes: None.

[FR Doc. 95-1017 Filed 1-13-95; 8:45 am]
BILLING CODE 4000-01-P