[Federal Register Volume 60, Number 100 (Wednesday, May 24, 1995)]
[Notices]
[Pages 27634-27639]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-12767]




[[Page 27633]]

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Part V





Department of Education





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Grants and Cooperative Agreements; Availability, etc.; Rehabilitation 
Research and Training Centers Program; Notices

  Federal Register / Vol. 60, No. 100 / Wednesday, May 24, 1995 / 
Notices    
[[Page 27634]] 

DEPARTMENT OF EDUCATION


National Institute on Disability and Rehabilitation Research

AGENCY: Department of Education.

ACTION: Notice of Final Funding Priorities for Fiscal Years 1995-1996 
for Rehabilitation Research and Training Centers.

-----------------------------------------------------------------------

SUMMARY: The Secretary announces final funding priorities for certain 
Rehabilitation Research and Training Centers (RRTCs) under the National 
Institute on Disability and Rehabilitation Research (NIDRR) for fiscal 
years 1995-1996. The Secretary takes this action to focus research 
attention on areas of national need. These priorities are intended to 
improve outcomes for individuals with disabilities.

EFFECTIVE DATE: These priorities take effect on June 23, 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) 205-5516.

SUPPLEMENTARY INFORMATION: This notice contains four final priorities 
under the RRTC program: Independent living and disability policy; 
Management and services of Centers for Independent Living (CILs); 
Improved services for low-functioning deaf individuals; and 
Rehabilitation in long-term mental illness. These priorities support 
the National Education Goals that call for all Americans to possess the 
knowledge and skills necessary to compete in a global economy and 
exercise the rights and responsibilities of citizenship.
    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). The Secretary may make awards through grants or cooperative 
agreements. 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.
    On November 15, 1994, the Secretary published a notice of proposed 
priorities in the Federal Register at 59 FR 59030. The Department of 
Education received a number of letters commenting on each of the 
priorities, as well as a large number of letters recommending 
additional priority areas. Modifications were made to the priorities as 
a result of those comments. The comments, and the Secretary's responses 
to them, are discussed in an appendix to this notice.

    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.

    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 Secretary announces that the following requirements will apply 
to all of the RRTCs pursuant to the priorities:
    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 Center must disseminate and encourage the use of new 
rehabilitation knowledge. They must make available 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 this competition only applications that 
meet one of these absolute priorities:

Priorities 1 and 2: Independent Living

Background
    Independent Living (IL) programs operate from a philosophy of 
consumer control, self-help, advocacy, development of peer 
relationships and peer role models, and equal access of individuals 
with significant disabilities to society, programs, and activities. The 
IL philosophy stresses the concept of empowerment of individuals with 
disabilities to control their own lives through participation in 
service planning, management of their own personal assistants, informed 
decisionmaking, and self advocacy. In its 25-year history, 
``Independent Living'' has been a philosophy, a social movement, and a 
service program. These priorities address all of these aspects of 
independent living, and propose investigations into new applications of 
independent living concepts, as well as studies and training related to 
the operations of the publicly-supported IL programs.
    The 1992 Amendments to the Rehabilitation Act: established 
Statewide Independent Living Councils (SILCs) to jointly develop and 
sign the State plan for independent living; created a new definition of 
a CIL as a consumer-controlled, community-based, cross-disability, 
nonresidential, private non-profit agency that is designed and operated 
within a local community by individuals with disabilities and provides 
an array of independent living services; modified the State and Federal 
responsibilities for making grants to CILs; and specifically authorized 
advocacy services.
    NIDRR has funded RRTCs in independent living since 1980. Current 
RRTCs focus on disability policy, IL management, and IL for underserved 
populations. The current Centers on policy and management will receive 
their final funding in fiscal year 1994. In order to determine the 
continued need for RRTCs in IL, and some possible research needs, NIDRR 
convened a two- [[Page 27635]] day focus group of experts in IL 
research and administration in Washington in January, 1994. The 
following priorities are based largely on the work of this focus group 
as well as reports from the current research centers and input from 
other Federal agencies. Focus group participants raised issues for 
further investigation in the following areas of program operations: 
implementation of program standards; outcome measures and 
accountability; improved program services; reaching diverse 
populations; training, recruitment, and retention of staff; and 
effective operations of governing boards and SILCs.
    The focus group also discussed a number of issues concerning new 
roles for CILs in societal developments such as violence, homelessness, 
and information technology, and in the formulation and implementation 
of policy in areas with particular implications for individuals with 
disabilities, such as the Americans with Disabilities Act (ADA) and the 
reform of the health care delivery system.
    The RRTC on CIL management and services will be funded jointly by 
NIDRR and RSA and will be required to work closely with the RSA grantee 
providing training, technical assistance, and transition assistance to 
CILs under Part C of Title VII of the amended Rehabilitation Act.

Priority 1: Independent Living and Disability Policy

    Under this priority, the Secretary supports an RRTC on independent 
living and disability policy that--(1) conducts research on policy 
barriers to achieving independent living in such areas as 
transportation, housing, and health care; (2) examines the role and 
effectiveness of CILs in increasing community options for independent 
living and the capacity of communities to meet the independent living 
needs of individuals with significant disabilities; and (3) identifies 
and provides training and information on effective strategies that CILS 
use to effect change.
    In addition to activities proposed by the applicant to carry out 
these purposes, the center must conduct the following activities:
     Analyze CIL policies regarding activities to promote 
implementation of the ADA, and develop strategies that CILs might 
adopt, including an analysis of the implications and consequences of 
various options;
     Review CIL and vocational rehabilitation agency policies 
related to collaborations, and design strategies for innovative 
partnerships to promote employment outcomes for individuals with 
disabilities;
     Identify strategies for CILs to promote accessible generic 
community services for individuals with significant disabilities, 
including vulnerable individuals such as persons with disabilities who 
are homeless, who are at risk for societal abuse and violence, and 
those who are from minority backgrounds.
     Provide training and information to CILs, policymakers, 
administrators, and advocates on research findings and identified 
strategies.

Priority 2: Independent Living Center Management and Services

    An RRTC on CIL management and services will conduct research and 
training activities and develop model approaches that will enhance the 
capacity of CILs to--(1) plan, manage, and evaluate program services, 
including the measurement of program outcomes and compliance with 
national standards; (2) provide appropriate services to cultural and 
linguistic minorities; (3) recruit, train, and retain appropriate 
staff; (4) develop effective governing boards, including appropriate 
staff relations; and (5) collaborate effectively with State Vocational 
Rehabilitation agencies to promote employment outcomes among 
individuals with disabilities. The RRTC will also conduct research and 
training activities to promote the effective operation of SILCs.
    In addition to activities proposed by the applicant to carry out 
these purposes, the Center must conduct the following activities:
     Identify best practices and develop and test optimal 
programs for CILs in expanding services to youth with disabilities and 
in interfacing with education and transition programs to prepare youth 
for independent living;
     Review CIL funding patterns and analyze the impact on CILs 
of diverse funding sources, and design and test several options for 
generating funding from alternate sources, including those independent 
of public financing;
     Document the initial development, composition, and 
operation of the SILCs; identify effective operational practices, 
develop and provide training to a selected sample of SILCs, and 
evaluate the impact of this effort; and
     Coordinate activities with and provide instruments, 
curricula, and methodologies, as well as research findings, to the RSA 
technical assistance grantee under Part C of Title VII of the 
Rehabilitation Act.
Peer Support in the Rehabilitation of Long-Term Mental Illness
Background
    Findings of the National Institute of Mental Health Epidemiological 
Catchment Area program are that more than 20 percent of all Americans 
have a diagnosable mental disorder in any given year. (Office of 
Technology Assessment, Psychiatric Disabilities, Employment, and the 
Americans with Disabilities Act, 1994). Of the population with mental 
disorders, 4 to 5 million adults are considered ``seriously mentally 
ill'' (Rutman, 1993). This priority focuses on that part of the 
population that has serious and persistent mental disorders that 
interfere with normal activities of daily life; the term ``persons with 
long-term mental illness'' (LTMI) is also commonly used to refer to 
this population.
    A number of community-based programs, many of them operated by 
consumers, have developed in recent years offering vocational 
counseling, educational and training programs, job placement services, 
and ongoing peer support. These programs often are a low-cost 
augmentation of scarce community services. (Parrish, J., Center for 
Mental Health Services, 1994). The programs are, however, very 
difficult to evaluate (Goldklang, D., American Journal of Community 
Psychiatry, October, 1991). Nevertheless, in order to identify those 
elements of community-based programs that are most effective in meeting 
the needs of individuals with LTMI, there is a need to evaluate the 
effectiveness of various models of peer support services in community-
based programs (including those that are consumer-run) in: serving the 
most significantly disabled individuals; providing appropriate services 
for individuals from minority cultures; obtaining diverse funding 
sources; maintaining accountability; training peer service providers; 
providing an appropriate range and quality of services; providing 
crisis response services; and achieving optimal outcomes.
    In addition, peer-support programs may have a significant role in 
crisis response and in minimizing the need for involuntary 
institutionalization or treatment. However, the leadership and the 
staff of organizations that rely on peer support require appropriate 
training and preparation if they are to be effective in crisis 
intervention.
    The mental health field has become increasingly aware of the 
special concerns and unmet needs of women with LTMI. A recent study 
indicated [[Page 27636]] that 40 percent of the children in foster care 
in New York City have mothers with mental illness (New York State 
Office of Mental Health). Peer support is a potential resource to 
assist these women to develop the capacity to parent children and to 
obtain and maintain housing, employment, and social supports in the 
community (Salasin, S., Center for Mental Health Services, 1994).
    There are strong indications that community-based peer support 
programs have not been as prevalent or as effective in minority 
cultures. Approaches to this problem include providing more training in 
cultural awareness and sensitivity (Cook, J. A., 1992) to existing 
community-based programs, and developing programs operated by or 
representing minority individuals and cultures.
    The National Task Force for Rehabilitation and Employment of 
Persons with Psychiatric Disabilities called, in 1993, for improved 
dissemination of useful research findings and best practices to all 
appropriate target audiences. The Task Force also recommended that the 
findings be translated in ways that are useful for policymakers, 
administrators, consumers, and families of diverse cultural 
backgrounds. The mental health field currently does not make full use 
of computerized information systems to access knowledge about long-term 
mental illness, or to link researchers, service providers, trainers, 
educators, and consumers for on-line discussion and information 
sharing. (Nance, R., Illinois Dept. of Mental Health and Developmental 
Disabilities, 1993, letter to CMHS). With effective training and 
technical assistance, community-based programs and consumer 
organizations could use technology to access resources, establish 
electronic bulletin boards, and conduct conferences and training.
    The National Institute on Disability and Rehabilitation Research 
proposes to support an RRTC on LTMI in collaboration with the Center 
for Mental Health Services of the Substance Abuse and Mental Health 
Services Administration. This RRTC on LTMI will focus on the role of 
community-based peer support in improving independence, employment, and 
community integration. Any Center to be funded under this priority must 
involve individuals with long-term mental illness and consumer-run and 
other community-based programs that use peer support in the planning, 
management, and operations of the Center and must consider the 
perspectives of individuals with LTMI in all aspects of its research 
and related programs.

Priority

    An RRTC on peer support approaches to the rehabilitation of 
individuals with LTMI will study the most effective uses of peer 
support in: (1) Crisis management and prevention of hospitalization; 
(2) facilitating employment and return to work; (3) meeting the 
specific needs of women with LTMI; and (4) addressing the needs of 
individuals with LTMI from diverse cultural backgrounds.
    In addition to activities proposed by the applicant to carry out 
these purposes, the center must conduct the following activities:
     Develop an evaluation protocol for community-based peer 
support programs, including those that are consumer-run, with outcome 
measures based on empirical data on factors such as recovery, 
independence, empowerment, employment, community integration, and 
cultural competency;
     Develop, test, and implement model training programs for 
preservice and inservice training of peers as service providers; and
     Develop and disseminate strategies to increase the 
effectiveness of information-sharing among and between consumer and 
provider organizations, researchers, and peer organizations.

Priority 4: Improved Outcomes for Low-Functioning Deaf Individuals

Background
    Approximately one of every 1,000 infants is born with a hearing 
impairment that is severe enough to prevent the spontaneous development 
of spoken language, according to the National Strategic Research Plan 
for Deafness and Hearing Impairment, National Institute on Deafness and 
Other Communication Disorders (NIDCD), 1992. While many of these 
prelingually deaf and severely hearing-impaired individuals complete 
education and attain employment and independence, the report of the 
Commission on the Education of the Deaf (COED) indicates that the 
majority of deaf students do not go into any postsecondary education, 
and that many need further education or training to obtain appropriate 
employment (COED, Toward Equality: Education of the Deaf, 1988). 
Moreover, an estimated 100,000 deaf people are unemployed or seriously 
underemployed due to such problems as deficiencies in language 
performance and related psychological, vocational, and social 
underdevelopment. (COED, 1988, p. 69.)
    These ``low-functioning'' deaf (LFD) individuals often do not have 
comprehensive rehabilitation training and related services accessible 
and available to them. This segment of the deaf population--sometimes 
called ``low functioning'', ``low achieving'', ``multiply disabled 
deaf'', or ``traditionally underserved deaf''--requires long term and 
intensive habilitative and rehabilitative services and is the focus of 
this priority.
    The deaf individuals to be addressed by this Center frequently 
exhibit deficits in vocational skills, independent living skills, 
manual and oral communication skills, social skills, and academic 
skills, and many have significant secondary disabilities. Many are from 
socioeconomically and culturally disadvantaged backgrounds, and many 
are from ethnic or linguistic minorities. Services to this population 
are scarce and fragmented. In addition to understanding the social, 
vocational, and educational implications of the disability, service 
providers must also be able to communicate with the individuals, often 
through less than optimal means, such as rudimentary sign language.
    In 1990, NIDRR funded an RRTC on Traditionally Underserved Persons 
Who Are Deaf, located at the University of Northern Illinois, to study 
the parameters and service needs of this population. Funding for this 
Center ends in fiscal year 1994. Activities of this Center included a 
needs assessment, development of a model service program, outcome 
studies, qualitative and quantitative analyses and surveys, development 
of curriculum and training materials, conduct of training seminars, and 
provision of technical assistance. The new Center will have the benefit 
of the work of the previous Center on Traditionally Underserved Deaf 
Populations. The new Center will be required to coordinate its 
activities with related projects for this population funded by RSA and 
by the Office of Special Education Programs (OSEP), including 
activities supported by these agencies that target the needs of 
children, youth, and adults who are deaf-blind.
    In January 1994, NIDRR convened a focus group of consumers and 
providers of services, researchers, and advocates to consider the issue 
of the need for ongoing research in the area of low-functioning deaf 
individuals and to identify specific questions. The input from the 
panel and other experts from the field has contributed to the decision 
to fund additional research to understand more fully the population of 
low-functioning deaf individuals, [[Page 27637]] especially those with 
secondary disabilities, and to develop improved interventions and 
service systems for those individuals.

Priority

    An RRTC on the special needs of low-functioning deaf individuals 
shall--(1) develop appropriate assessment techniques for this 
population; (2) evaluate the applicability of a variety of strategies 
to enhance the development of language and literacy skills in this 
population; and (3) identify the range of services and service 
resources necessary to meet the rehabilitation and independent living 
needs of this population and develop mechanisms for coordination among 
service agencies and across service systems to foster a comprehensive 
system of services to enhance their integration into the community. In 
addition to activities proposed by the applicant to carry out these 
purposes, the center must conduct the following activities.
     Identify and develop appropriate personnel training that 
will lead to the required competencies and train service providers to 
deliver enhanced services to this population; and
     Develop effective materials and media to enhance the 
dissemination of new knowledge on LFD to appropriate audiences, 
including LFD individuals and their families, independent living 
centers, educators, and health care practitioners.
     Coordinate its activities with related projects for this 
population funded by RSA and by the Office of Special Education 
Programs (OSEP), including activities supported by these agencies that 
target the needs of children, youth, and adults who are deaf-blind.

Applicable Program Regulations

    34 CFR Parts 350 and 352.

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

(Catalog of Federal Domestic Assistance Number 84.133B, 
Rehabilitation Research and Training Centers)

    Dated: May 18, 1995.
Judith E. Heumann,
Assistant Secretary for Special Education and Rehabilitative Services.
Appendix--Analysis of Comments and Changes

    The Secretary received 17 letters of comment about the proposed 
priorities and 138 letters urging the establishment of various 
additional priorities. These comments are discussed in the order of 
the priorities to which they refer.

Independent Living--General

    Comment: One commenter stated that all priorities should contain 
language stating that the SILCs must include equal representation of 
persons with cognitive and physical disabilities.
    Discussion: The SILCs are appointed by the Governors according 
to statute and regulation that are not subject to governance by the 
NIDRR priorities.
    Changes: None.
    Comment: The same commenter recommended including language that 
would make clear that both the RRTC and ``its Independent Living 
programs'' must include both people with physical disabilities as 
well as people with cognitive disabilities.
    Discussion: The CILs are chartered, governed, and staffed 
according to State and Federal statutes and regulations that are not 
subject to governance by NIDRR priorities. The Rehabilitation Act, 
as amended, requires that independent living centers supported by 
funds under the Act be ``cross-disability'' (Sec. 702).
    Changes: None.
    Comment: The same commenter suggested that one of the RRTC's 
activities should be analyzing issues related to independent and 
supported living for persons with mental retardation and 
developmental disabilities.
    Discussion: NIDRR agrees that it is important to make 
independent living services available and relevant to individuals 
with cognitive, emotional, sensory, and physical disabilities. In 
fact, in 1993, NIDRR established a separate RRTC specifically to 
address the research and training aspects of expanding IL programs 
and concepts to those populations not traditionally served in CILs. 
That RRTC is located at the University of Kansas. ``Supported 
living'' is not a required subject of these Independent Living 
priorities. However, any applicant is free to address these issues 
within the general scope of either of these priorities.
    Changes: None.
    Comment: One commenter stated that the priorities related to 
independent living should emphasize improving collaboration between 
CILs and State vocational rehabilitation agencies to enhance 
employment outcomes and other common goals.
    Discussion: The Secretary agrees that improving collaboration 
between CILs and State VC agencies is an important strategy in 
enhancing independent living for individuals with significant 
disabilities.
    Changes: The Secretary has added an activity to each of the 
RRTCs on IL focusing on strategies for collaboration and innovative 
partnerships between CILs and State vocational rehabilitation 
agencies to promote employment outcomes.

Independent Living and Disability Policy

    Comment: One commenter suggested that the name of the Center be 
changed to Independent Living and Public Policy because there are 
generic public policies affecting individuals with disabilities.
    Discussion: The Secretary regards disability policy as any 
public policy that affects the ``inclusion and integration into 
society, employment, independent living, family support, and 
economic and social self-sufficiency of individuals with 
disabilities of all ages.'' (Quotation from the Rehabilitation Act, 
as amended, Sec. 200, stating the purpose of NIDRR's research.) This 
definition includes ``generic'' public policy when the specific 
relevance to the outcomes of integration-independence-employment for 
persons for disabilities is demonstrated. As described in the 
response to the succeeding comment, the genesis of this RRTC was as 
a center to conduct research and training that would enhance 
independent living programs. The Secretary believes there is strong 
support for maintaining this as an RRTC on independent living.
    Changes: None.
    Comment: The same commenter recommended that other organizations 
serving people with disabilities should be included as appropriate 
research subjects and training audiences in this Center, since many 
of these single disability organizations have a superior record of 
serving individuals traditionally underserved by CILs.
    Discussion: Again, the Secretary points to the genesis and 
justification of this as an RRTC on independent living. While the 
priority does not preclude gathering data from or providing training 
to, other disability organizations that may be able to contribute to 
strengthening CILs and independent living programs, the focus of 
this Center is on defining and disseminating the concept of 
independent living programs and on strengthening those programs, 
particularly the CILs, in their ability to promote and apply 
independent living concepts and to measure their effects. The 
priority does not preclude the Center from disseminating its 
products broadly as long as the focus on independent living programs 
is maintained.
    Changes: None.
    Comment: The same commenter also requested that the Department 
modify the third activity in the proposed priority, which requires 
the Center to analyze CIL policies regarding implementation of the 
Americans with Disabilities Act (ADA) and develop potential 
strategies for CILs, to add ``other strategies to promote full 
community inclusion'' after ADA. The commenter goes on to say that 
this entire activity could be a subset of the second activity under 
the priority.
    Discussion: NIDRR has a particular interest, based on 
Congressional directives, in facilitating and analyzing the 
successful implementation of the ADA, and in assisting CILs to 
participate effectively in that process. The ADA reflects a 
statutory civil rights and antidiscrimination approach to achieving 
equal opportunity for individuals with disabilities. As such, it has 
been hailed as a landmark piece of legislation in disability, and is 
certainly different in many important respects from other approaches 
to inclusion. An applicant may propose to examine other inclusion 
strategies consistent with the stated purposes of the priority. 
However, NIDRR is continuing to require that the RRTC analyze CIL 
policies with respect to the ADA.
    Changes: None.
    Comment: The same commenter also suggested that the priority be 
modified to authorize the Center to ``conduct research and provide 
training on a range of policy issues not limited to the content 
outlined above''. The commenter suggests that 
[[Page 27638]] subjects such as health care reform, ADA, housing, or 
employment, (along with presumably as yet unidentified policy issues 
that could emerge) could take center stage and become important 
issues for the Center to examine.
    Discussion: The Secretary reiterates that the focus of this 
priority is on policy barriers to achieving independent living and 
the role of CILs in increasing the capacity of communities to meet 
the IL needs of individuals with disabilities. The priority requires 
that the applicant address the areas that were given priority 
importance by the focus group, namely homelessness, abuse, violence, 
ADA, and diverse populations. However, other than that, the 
applicant may propose to conduct research on those policy barriers 
which the applicant believes are most critical.
    Changes: None.
    Comment: One commenter suggested that the Secretary define 
health care reform to include both medical and non-medical services 
that are funded through the public health care system, because of 
the dependence of persons with developmental disabilities on the 
health care system for non-medical services and supports.
    Discussion: The final priority has been revised to clarify the 
focus of this RRTC. The RRTC must conduct research on policy 
barriers to independent living. While issues of the availability of 
health care may constitute policy barriers, the priority no longer 
specifically requires the RRTC to analyze issues related to health 
care reform.
    Changes: Analysis of health care reform is no longer a 
requirement.

Independent Living Center Management and Services

    Comment: One commenter recommended that the activity related to 
CIL services to linguistic, cultural, and ethnic minorities should 
be centered on CIL management activities related to diverse 
populations. The commenter urged that NIDRR maintain its current 
RRTC on IL programs for underserved populations.
    Discussion: The inclusion of this activity in this RRTC does not 
imply a change in NIDRR's commitment to an RRTC on underserved 
populations. NIDRR would like to point out that a major emphasis in 
the NIDRR priority that established the Center for underserved 
populations was on those disability groups that are not 
traditionally served by CILs and independent living programs--such 
as persons with cognitive, emotional, and sensory disabilities, 
persons with HIV/AIDS, homeless individuals, youth, and elderly 
persons--as well as ethnic and linguistic minorities. Therefore, the 
Secretary believes it is appropriate to increase attention to 
improving the ability of IL programs to serve ethnic and linguistic 
minorities. The priority as proposed suggested that the RRTC do this 
through identification of best practices, and the development and 
testing of models for the delivery of IL services to ethnically 
diverse populations. Applicants for the RRTC may propose to focus on 
``management'' aspects of enhancing the capacity of CILs to provide 
appropriate services, such as staffing, recruitment, staff training, 
evaluation, consumer participation, or training of ethnic minority 
groups in IL management. The suitability of the approach would be 
assessed by the peer reviewers for these applications.
    Changes: None.

Improved Outcomes for Individuals With Long-Term Mental Illness

    Comment: Several commenters were concerned that consumer-run 
organizations should not be excluded from participating in any 
resultant Center, or that, in fact, their participation should be 
encouraged.
    Discussion: The Secretary agrees that consumer-run organizations 
should be involved as applicants, consortium-members, 
subcontractors, advisory board members, trainees, dissemination 
vehicles, or in other appropriate capacities, in any Center 
resulting from this priority.
    Changes: The background statement to the priority has been 
amended to include a provision that any Center to be funded under 
this priority must involve consumers and consumer-run organizations 
in the planning, management, and operations of the Center and must 
consider the perspectives of individuals with LTMI in all aspects of 
its research and related programs.
    Comment: Two commenters commented on the terminology used in the 
priority. The comments focused on the appropriateness of the terms 
``long-term mental illness'', ``LTMI'', and ``consumer''.
    Discussion: Among the few commenters who commented on this 
question of terminology, there were several competing and apparently 
inconsistent nomenclatures. Other commenters did not mention 
nomenclature. This inhibits any conclusion that there is a generally 
accepted terminology. Furthermore, the Rehabilitation Act, under 
which NIDRR is authorized, uses the term ``individuals with mental 
illness''. The Secretary does not believe there is sufficient cause 
to change the terms throughout the priority.
    Changes: None.
    Comment: One commenter suggested that the requirement for model 
training programs for culturally sensitive training for peer service 
providers could be extended to include models that include pre-
service, inservice, and ongoing technical support.
    Discussion: The Secretary believes that culturally sensitive 
training models are needed for all levels of peer support workers. 
However, the priority as written would permit applicants to focus on 
training for all parts of the continuum, or to focus on specific 
segments that they identify as needing more attention. The Secretary 
is reluctant to impose more requirements on the applicants, and 
prefers to allow the applicants to present their proposals for 
evaluation by the peer reviewers.
    Changes: None.
    Comment: Two commenters suggested that emphasis on parenting 
skills should be for men as well as women.
    Discussion: The reference to parenting skills in the priority 
was provided as an example of an area for consideration in 
addressing the specific needs of women with LTMI. The topic of 
parenting skills is not itself a focus of the priority.
    Changes: None.
    Comment: One commenter suggested that the activity on special 
adaptations for minority populations should include focus on the 
role of family support, values, and expectations.
    Discussion: The Secretary believes that applicants should have 
the opportunity to propose how they will study the most effective 
approaches to meeting the needs of individuals with LTMI from 
diverse cultural backgrounds.
    Changes: None.
    Comment: One commenter suggested that the activity on outcome 
evaluations should contain specific reference to operationally 
defining the emerging concepts of ``recovery'' and ``community 
integration''. Two commenters recommended that any outcomes to be 
measured should be defined through the perspectives of individuals 
with psychiatric disabilities, and that the RRTC should be 
encouraged to use the expertise of researchers with long-term mental 
illness in the development of outcome measures.
    Discussion: The Secretary believes that these comments are 
important ones in the discussion of these issues. Operational 
definitions of outcome variables are likely to be essential to any 
evaluation strategy. However, the Secretary does not believe it is 
necessary to direct applicants on how to develop an evaluation 
methodology. The Secretary believes that it is important to include 
the perspectives of individuals with psychiatric disabilities in all 
activities, models, strategies, training programs, research methods, 
and dissemination strategies of the Center.
    Changes: A sentence has been added to the Background statement 
emphasizing the importance of including the perspectives of 
individuals with long-term mental illness in all areas of the RRTC's 
work.
    Comment: One commenter suggested that there needs to be a clear 
definition of ``consumer-operated'' programs.
    Discussion: The Secretary is aware that there may be more than 
one definition or model for ``consumer-operated'' or ``consumer-
run'' programs and acknowledges that the multiple terms used in the 
proposed priority may have caused some confusion. The nomenclature 
used in the final priority has been revised for consistency. 
However, the Secretary prefers to encourage each applicant to 
present the definition, or definitions, of consumer-run program and 
community-based program which it proposes to use, and the peer 
reviewers to evaluate the appropriateness of the definitions to the 
purposes of the priority.
    Changes: The nomenclature in the background section and the 
final priority have been revised for consistency.
    Comment: Several commenters made references to the desirability 
of involving consumer-run organizations as grantees, either by 
mandating that only such organizations could receive the grant or by 
specifying roles for consumer-run organizations in the grantee's 
organizational structure.
    Discussion: Program regulations, which are discussed in the 
preamble to these priorities, and delineated in part in the notice 
soliciting [[Page 27639]] applications for these Centers, describe 
the entities that are eligible to apply for RRTC grants. The 
Secretary does not intend to amend those regulations by further 
restricting eligibility for this Center grant. However, the 
Secretary believes that additional language inserted into the 
Background and the activities of the priority indicate the 
expectation that consumers and consumer organizations will have 
important roles in the RRTC.
    Changes: The final paragraph of the Background statement has 
been amended to add ``Any Center to be funded under this priority 
must involve consumers and consumer-run organizations in the 
planning, management, and operations of the Center and must consider 
the perspectives of individuals with LTMI in all aspects of its 
research and related programs.''
    Comment: Several commenters suggested modifications to the 
information dissemination components of the priority. Some 
questioned the appropriateness of the dissemination activity 
centered around the use of electronic information networks, since 
they believe that consumers, consumer organizations, and many other 
community-based service providers do not have access to the 
necessary electronic technology. One commenter recommended that the 
priority include an activity for developing a consumer information 
exchange.
    Discussion: The Secretary believes that applicants should have 
the flexibility to propose how they will develop and disseminate 
strategies to increase the sharing of information.
    Changes: The final activity in the priority has been amended to 
read ``develop and disseminate strategies to increase the 
effectiveness of information-sharing among and between consumer and 
provider organizations, researchers, and peer organizations.

Improved Outcomes for Low-Functioning Deaf Individuals

    Comment: One commenter stated that the RRTC should be required 
to address the needs of deaf-blind individuals who meet the profile 
of low-functioning.
    Discussion: The Secretary points out that the priority requires 
the new Center to coordinate activities with related projects funded 
by RSA and OSEP, which do serve individuals who are deaf-blind. 
Applicants for a grant under this priority may address needs of 
deaf-blind individuals as the priority now exists. However, the 
Secretary does not require that they do so.
    Changes: None.

Recommendations for Additional Priorities

    Comment: Several commenters recommended that NIDRR establish 
RRTCs addressing the needs of individuals with End-Stage Renal 
Disease (ESRD); one recommended a center on assistive technology for 
inclusion, and a substantial number urged the establishment of an 
RRTC on community integration for individuals with mental 
retardation.
    Discussion: The Secretary is considering these suggestions for 
future priorities. In part as a response to these comments, the 
Secretary published a Notice of Proposed Priority for a 
dissemination and technical assistance center on Facilitating 
Community Integration for Individuals with Mental Retardation in the 
Federal Register of March 31, 1995 (60 FR 16760). The Secretary also 
reminds all commenters that NIDRR sponsors a Field-Initiated 
Research program under which potential applicants may submit 
applications for research related to any area of disability and 
rehabilitation.
    Changes: None.

[FR Doc. 95-12767 Filed 5-23-95; 8:45 am]
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