[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]]
_______________________________________________________________________
Part V
Department of Education
_______________________________________________________________________
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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