[Federal Register Volume 64, Number 73 (Friday, April 16, 1999)]
[Notices]
[Pages 18992-18995]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-9617]



[[Page 18991]]

_______________________________________________________________________

Part IV





Department of Education





_______________________________________________________________________



National Institute on Disability and Rehabilitation Research; Notice of 
Final Funding Priorities and Notice Inviting Applications for New 
Awards; Notices

  Federal Register / Vol. 64, No. 73 / Friday, April 16, 1999 / 
Notices  

[[Page 18992]]



DEPARTMENT OF EDUCATION


National Institute on Disability and Rehabilitation Research; 
Notice of Final Funding Priorities for Fiscal Years 1999-2000 for a 
Center and Certain Projects

SUMMARY: The Secretary announces final funding priorities for one 
Rehabilitation Research and Training Center (RRTC) and two Disability 
and Rehabilitation Research Projects (DRRPs) under the National 
Institute on Disability and Rehabilitation Research (NIDRR) for fiscal 
years 1999-2000. The Secretary takes this action to focus research 
attention on areas of national need. These priorities are intended to 
improve rehabilitation services and outcomes for individuals with 
disabilities.

EFFECTIVE DATE: These priorities take effect on May 17, 1999.

FOR FURTHER INFORMATION CONTACT: Donna Nangle. Telephone: (202) 205-
5880. Individuals who use a telecommunications device for the deaf 
(TDD) may call the TDD number at (202) 205-2742. Internet: 
Donna__N[email protected]
    Individuals with disabilities may obtain this document in an 
alternate format (e.g., Braille, large print, audiotape, or computer 
diskette) on request to the contact person listed in the preceding 
paragraph.

SUPPLEMENTARY INFORMATION: This notice contains final priorities under 
the Disability and Rehabilitation Research Projects and Centers Program 
for one RRTC related to health and wellness for persons with long-term 
disabilities, and two DRRPs related to: health care services for 
persons with disabilities; and medical rehabilitation services for 
persons with disabilities. The final priorities refer to NIDRR's 
proposed Long-Range Plan (LRP). The LRP can be accessed on the World 
Wide Web at: http://www.ed.gov/legislation/FedRegister/announcements/
1998-4/102698a.html
    These final priorities support the National Education Goal that 
calls for every adult American to possess the skills necessary to 
compete in a global economy.
    The authority for the Secretary to establish research priorities by 
reserving funds to support particular research activities is contained 
in sections 202(g) and 204 of the Rehabilitation Act of 1973, as 
amended (29 U.S.C. 762(g) and 764).

    Note: This notice of final priorities does not solicit 
applications. A notice inviting applications is published in this 
issue of the Federal Register.

Analysis of Comments and Changes

    On February 1, 1999 the Secretary published a notice of proposed 
priorities in the Federal Register (64 FR 4936). The Department of 
Education received seven letters commenting on the notice of proposed 
priority by the deadline date. Technical and other minor changes--and 
suggested changes the Secretary is not legally authorized to make under 
statutory authority--are not addressed.

Rehabilitation Research and Training Centers

Priority 1: Health and Wellness for Persons With Long-Term Disabilities
    Comment: Two commenters asked if the RRTC is required to address 
each of the disabilities identified in the priority equally.
    Discussion: Applicants must address the disabilities identified in 
the introduction and may propose to address additional disabilities. 
Applicants have the discretion to determine the emphasis that they 
propose to place on the disabilities addressed by the RRTC.
    Changes: The Introduction has been revised to clarify that the RRTC 
may address disabilities in addition to those identified in the 
Introduction.

    Comment: Two commenters indicated that NIDRR should specify the 
alternative therapies that the RRTC should address.
    Discussion: NIDRR prefers to provide applicants with the discretion 
to propose alternative therapies to investigate. The peer review 
process will evaluate the merits of the proposals.
    Changes: None.

    Comment: One commenter indicated that the RRTC should be required 
to carry out ``population-based'' research and utilize emerging 
dissemination methodologies that utilize technology. The same commenter 
and a second commenter indicated that the RRTC should be required to 
explore theories on health behaviors, readiness to change, and barriers 
to change.
    Discussion: NIDRR prefers to provide applicants with the discretion 
to propose specific research approaches, theoretical perspectives, and 
dissemination techniques. The peer review process will evaluate the 
merits of the proposals.
    Changes: None.

    Comment: The RRTC should investigate the economics of promoting 
health and wellness.
    Discussion: An applicant could propose to investigate the economics 
of health and wellness under the second or third required activity. The 
peer review process will evaluate the merits of the proposal. NIDRR has 
no basis to require all applicants to investigate the economics of 
health and wellness.
    Changes: None.

    Comment: Two commenters questioned the extent to which the RRTC was 
expected to address the needs of adults or children, or both?
    Discussion: The RRTC is required to address the needs of persons 
with long-term disabilities, regardless of their age. Adults are more 
likely to experience long-term disabilities. However, the RRTC is 
expected to address the needs of children who meet the definition of 
long-term disabilities included in the priority. Applicants have the 
discretion to propose to emphasize certain age groups.
    Changes: None.

    Comment: The RRTC should be required to develop and test innovative 
health promoting techniques, strategies, or programs.
    Discussion: The priority requires the RRTC to identify and evaluate 
best practices in health promotion activities. Having met the 
requirement to identify and evaluate best practices in health 
promotion, an applicant could propose to develop new health promoting 
techniques, strategies, or programs. The peer review process will 
evaluate the merits of the proposal. NIDRR believes that it is not 
feasible for the RRTC to also develop and test innovative health 
promoting techniques, strategies, or programs.
    Changes: None.

    Comment: The priority appears to limit the scope of the RRTC to 
certain disabilities that are identified in the priority. NIDRR should 
clarify why these disabilities were selected.
    Discussion: The priority requires the RRTC to include selected 
disabilities, but does not limit the RRTC to addressing only those 
disabilities. Applicants have the discretion to propose to address 
other disabilities in addition to those identified in the priority. The 
disabilities identified in the priority were selected because of their 
prevalence and impact on the health and wellness of persons with long-
term disabilities.
    Changes: None.

    Comment: The RRTC should include a special emphasis on women with 
disabilities.
    Discussion: An applicant could propose to emphasize the health 
promotion and wellness needs of women with disabilities, and the peer 
review process will determine the

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merits of the proposal. NIDRR has no basis to require all applicants to 
emphasize the health promotion and wellness needs of women with 
disabilities.
    Changes: None.

    Comment: What is included in the requirement for the project to 
coordinate with the RRTC on Managed Care for Persons With Disabilities?
    Discussion: NIDRR requires coordination activities in order to 
avoid duplication of effort and improve the quality of the research 
that a project carries out. Applicants have the discretion to propose 
how they will coordinate with other entities carrying out related 
research.
    Changes: None.
Priority 2: Health Care Services for Persons With Disabilities
    Comment: The second required activity could be read to authorize a 
very wide range of initiatives. NIDRR should clarify the intent of the 
second required activity.
    Discussion: The second required activity is based on the findings 
of the first required activity to analyze the access of persons with 
disabilities to the continuum of health care services and identify 
successful service delivery strategies and barriers to access to the 
continuum. NIDRR recognizes that the range of activities that an 
applicant could propose to do is very broad. This broad discretion is 
necessary in order to provide applicants with the necessary authority 
to follow-up the findings from the first required activity.
    Changes: None.
Priority 3: Medical Rehabilitation Services for Persons With 
Disabilities
    Comment: The priority should be revised to provide applicants with 
the discretion to propose to address underserved populations instead of 
referring specifically to certain emergent disabilities.
    Discussion: NIDRR believes that the cost and complexity of 
treatment of the emergent disabilities identified in the priority merit 
requiring all applicants to address them. However, applicants are not 
limited to addressing only those disabilities included in the priority, 
and have the discretion to address other populations.
    Changes: None.

Rehabilitation Research and Training Centers

    Authority for the RRTC program of NIDRR is contained in section 
204(b)(2) of the Rehabilitation Act of 1973, as amended (29 U.S.C. 
764(b)(2)). Under this program the Secretary makes awards to public and 
private organizations, including institutions of higher education and 
Indian tribes or tribal organizations for coordinated research and 
training activities. These entities must be of sufficient size, scope, 
and quality to effectively carry out the activities of the Center in an 
efficient manner consistent with appropriate State and Federal laws. 
They must demonstrate the ability to carry out the training activities 
either directly or through another entity that can provide that 
training.
    The Secretary may make awards for up to 60 months through grants or 
cooperative agreements. The purpose of the awards is for planning and 
conducting research, training, demonstrations, and related activities 
leading to the development of methods, procedures, and devices that 
will benefit individuals with disabilities, especially those with the 
most severe disabilities.

Description of Rehabilitation Research and Training Centers

    RRTCs are operated in collaboration with institutions of higher 
education or providers of rehabilitation services or other appropriate 
services. RRTCs serve as centers of national excellence and national or 
regional resources for providers and individuals with disabilities and 
the parents, family members, guardians, advocates or authorized 
representatives of the individuals.
    RRTCs conduct coordinated, integrated, and advanced programs of 
research in rehabilitation targeted toward the production of new 
knowledge to improve rehabilitation methodology and service delivery 
systems, to alleviate or stabilize disabling conditions, and to promote 
maximum social and economic independence of individuals with 
disabilities.
    RRTCs provide training, including graduate, pre-service, and in-
service training, to assist individuals to more effectively provide 
rehabilitation services. They also provide training including graduate, 
pre-service, and in-service training, for rehabilitation research 
personnel and other rehabilitation personnel.
    RRTCs serve as informational and technical assistance resources to 
providers, individuals with disabilities, and the parents, family 
members, guardians, advocates, or authorized representatives of these 
individuals through conferences, workshops, public education programs, 
in-service training programs and similar activities.
    RRTCs disseminate materials in alternate formats to ensure that 
they are accessible to individuals with a range of disabling 
conditions.
    NIDRR encourages all Centers to involve individuals with 
disabilities and individuals from minority backgrounds as recipients of 
research training, as well as clinical training.
    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.

Priorities

    Under 34 CFR 75.105(c)(3) the Secretary gives an absolute 
preference to applications that meet the following priority. The 
Secretary will fund under this competition only applications that meet 
this priority.

Priority 1: Health and Wellness for Persons With Long-Term Disabilities

Introduction
    Chapter Four of NIDRR's proposed LRP (63 FR 57190-57219) focuses on 
maximizing health and function for persons with disabilities. Health 
maintenance for persons with disabilities includes not only access to 
care for routine health problems and appropriate specialty care 
including medical rehabilitation, but also participation in health 
promotion and wellness activities.
    The National Center for Health Statistics defined long-term 
disabilities as ``long-term reduction in activity resulting from 
chronic disease or impairment.'' For the purpose of this priority, 
long-term disabilities include, but are not limited to, cerebral palsy, 
multiple sclerosis, post-polio, amputation, and spinal cord injury. 
This center will assess the health maintenance and promotion practices 
of persons with long-term disabilities. NIDRR expects this research to 
clarify whether specialized assessment and health promotion activities 
are required for persons with long-term disabilities, and how health 
promotion activities affect the incidence of secondary conditions.
    For the purpose of this priority, health promotion strategies 
include alternative

[[Page 18994]]

therapies (e.g., therapeutic massage, acupuncture), stress management 
practices, physical exercise, nutrition, and other activities designed 
to promote healthy lifestyle and social well-being. These strategies 
are vitally important in maintaining health and wellness. NIDRR expects 
the RRTC, through its training and dissemination activities, to 
encourage self-directed health promotion activities.
Priority
    The Secretary will establish an RRTC for the purpose of developing 
strategies for health maintenance and reducing secondary conditions for 
persons with long-term disabilities. The RRTC must:
    (1) Evaluate health assessment definitions, policies and practices, 
and measurement methodologies and instruments, and describe their 
impact on health promotion activities for persons with long-term 
disabilities;
    (2) Evaluate the impact of selected health maintenance strategies 
on the incidence and severity of secondary conditions and other 
outcomes such as function, independence, general health status, and 
quality of life;
    (3) Identify and evaluate best practices in health promotion 
activities for persons with long-term disabilities;
    (4) Provide training on: (i) research methodology and applied 
research experience; and (ii) knowledge gained from the Center's 
research activities to persons with disabilities and their families, 
service providers, and other parties, as appropriate;
    (5) Develop informational materials based on knowledge gained from 
the Center's research activities, and disseminate the materials to 
persons with disabilities, their representatives, service providers, 
and other interested parties;
    (6) Involve individuals with disabilities and, if appropriate, 
their representatives, in planning and implementing its research, 
training, and dissemination activities, and in evaluating the Center;
    (7) Conduct a conference on the findings of the RRTC and publish a 
comprehensive report on the final outcomes of the conference. The 
report must be published in the fourth year of the grant; and
    (8) Coordinate with other entities carrying out related research or 
training activities.
    In carrying out these purposes, the RRTC must coordinate with 
health and wellness research and demonstration activities sponsored by 
the National Center on Medical Rehabilitation Research, the Department 
of Veterans Affairs, and the Centers for Disease Control and 
Prevention.
Disability and Rehabilitation Research Projects
    Authority for Disability and Rehabilitation Research Projects 
(DRRPs) is contained in section 204(a) of the Rehabilitation Act of 
1973, as amended (29 U.S.C. 764(a)). DRRPs carry out one or more of the 
following types of activities, as specified in 34 CFR 350.13-350.19: 
research, development, demonstration, training, dissemination, 
utilization, and technical assistance. Disability and Rehabilitation 
Research Projects develop methods, procedures, and rehabilitation 
technology that maximize the full inclusion and integration into 
society, employment, independent living, family support, and economic 
and social self-sufficiency of individuals with disabilities, 
especially individuals with the most severe disabilities. In addition, 
DRRPs improve the effectiveness of services authorized under the 
Rehabilitation Act of 1973, as amended.

Priorities

    Under 34 CFR 75.105(c)(3) the Secretary gives an absolute 
preference to applications that meet the following priorities. The 
Secretary will fund under this competition only applications that meet 
these priorities.

Research Priorities in Health Care and Medical Rehabilitation Services 
for Persons With Disabilities

Introduction
    Chapter 4 of NIDRR's proposed LRP (63 FR 57202) discusses the 
health care service and medical rehabilitation service needs of persons 
with disabilities. The demand for these services is expected to 
continue to grow in the coming decades because of increased potential 
for survival after trauma and disease, prevalence of disability related 
to the general aging of the population, and the incidence of persons 
with disabilities acquiring secondary disabilities or chronic 
conditions. NIDRR proposes to establish a research agenda that examines 
access to the continuum of health care services, and changes in medical 
rehabilitation service systems, including demands that new populations 
of persons with disabilities are placing on medical rehabilitation 
service systems.
    There has been insufficient research on the access of persons with 
disabilities to the continuum of health care services. Access to this 
continuum, including primary, acute, and long-term health care services 
over the course of a lifetime, bears directly on quality of life 
issues. By developing new knowledge about access to the continuum of 
health care services for persons with disability, NIDRR expects the 
DRRP on health care services to contribute to persons with disabilities 
maintaining their health and decreasing the occurrence of secondary 
conditions.
    Medical rehabilitation service systems are changing in response to 
a number of factors. One major factor is the rise of managed care as 
the dominant form of organization and payment for health care services, 
including medical rehabilitation services. In addition, as discussed in 
the proposed LRP, new populations of persons with disabilities are 
emerging and placing new demands on medical rehabilitation service 
systems. NIDRR expects the DRRP on medical rehabilitation services to 
generate new knowledge about these changes in order to assist service 
providers and consumers to achieve desired rehabilitation outcomes. For 
the purpose of the proposed priority, emergent disabilities include, 
but are not limited to, AIDS, Attention Deficit Hyperactivity Disorder, 
violence-induced neurological damage, repetitive motion syndromes, 
childhood asthma, drug addiction, and environmental illnesses.

Priority 2: Health Care Services for Persons With Disabilities

    The Secretary proposes to fund a DRRP to improve the continuum of 
health care services for persons with disabilities over their lifetime. 
The DRRP must:
    (1) Analyze the access of persons with disabilities to the 
continuum of health care services and identify successful service 
delivery strategies and barriers to access to the continuum; and
    (2) Based on paragraph (1), develop strategies to improve access to 
the continuum of health care services.
    In carrying out the purposes of the priority, the project must:
     Address the health care needs of persons with disabilities 
of all ages; and
     Coordinate with the RRTC on Managed Care for Persons with 
Disabilities.

Priority 3: Medical Rehabilitation Services for Persons With 
Disabilities

    The Secretary proposes to establish a DRRP to improve medical 
rehabilitation services for persons with disabilities, especially those 
with emergent disabilities. The DRRP must:
    (1) Describe the changes taking place in the delivery of medical 
rehabilitation services including, but not limited to, those related to 
the setting where

[[Page 18995]]

services are provided, length of stay, qualifications of personnel, and 
payment systems; and
    (2) Develop a methodology to analyze the impact of these changes on 
outcomes;
    (3) Identify the nature and extent of the need for medical 
rehabilitation services by persons with emergent disabilities;
    (4) Analyze persons with emergent disabilities' access to medical 
rehabilitation services; and
    (5) Identify strategies to improve access by persons with emergent 
disabilities to medical rehabilitation services.

Electronic Access to This Document

    Anyone may view this document, as well as all other Department of 
Education documents published in the Federal Register, in text or 
portable document format (pdf) on the World Wide Web at either of the 
following sites:

http://ocfo.ed.gov/fedred.htm
http://www.ed.gov/news.html

To use the pdf you must have the Adobe Acrobat Reader Program with 
Search, which is available free at either of the preceding sites. If 
you have questions about using the pdf, call the U.S. Government 
Printing Office at (202) 512-1530 or, toll free at 1-888-293-6498.
    Anyone may also view these documents in text copy on an electronic 
bulletin board of the Department. Telephone: (202) 219-1511 or, toll 
free, 1-800-222-4922. The documents are located under Option G--Files/
Announcements, Bulletins and Press Releases.

    Note: The official version of this document is the document 
published in the Federal Register.

APPLICABLE PROGRAM REGULATIONS: 34 CFR Part 350.

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

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

    Dated: March 13, 1999.
Judith E. Heumann,
Assistant Secretary for Special Education and Rehabilitative Services.
[FR Doc. 99-9617 Filed 4-15-99; 8:45 am]
BILLING CODE 4000-01-P